A Parental Behavior Scale in Pediatric Dentistry: The Development of an Observational Scale.

Children's treatment means a triangular relationship between the child, practitioner, and parent, with specific interactions influencing the procedure. The objective was to create and validate a hetero-rating scale of parental behavior and verify the correlation between child and parental behavior during pediatric dentistry sessions. Treatment sessions were recorded and evaluated, including 60 children representing three age groups. Two raters interpreted the resulting video clips using the modified Venham scale for children and the new hetero-rating scale for parents. They analyzed the videos twice and attributed scores at different time points of the appointment. The correlation between parental behavior upon entrance and the children's behavioral at the dental office in the treatment stage was significantly positive in both raters (Kendall Tau: 0.20-0.30). Furthermore, a panel of 20 dental practitioners scored a randomized selection of five recordings per age group. The level of agreement between the two experts was higher than that between the 20 clinicians. Venham types of scale involving multiple aspects can be used in research, but their application in dental practice requires further development. The link between parental anxiety and child anxiety is confirmed, but further research is required to incorporate specific aspects of treatment and parental behavior.

Behavior of Children during Dental Care with Rubber Dam Isolation: A Randomized Controlled Study.

BACKGROUND: The establishment of the dental dam improves dentist working conditions and patient protection. The purpose of this study was to analyze the behavior of the child during dental care with or without a dam. METHODS: In this interventional randomized study, 51 patients are divided into two groups, one with a rubber dam and the other with cotton roll isolation. Their behavior was observed during the treatment of temporary molars. The duration of the treatment, the patient's feeling with a visual analogue scale (VAS), the behavior (B) of the child measured with a hetero-evaluation scale (modified Venham scale) and the cardiac frequency (CF) were measured. RESULTS: The group treated with a rubber dam has a significant decrease in the various stress parameters that have been identified (B, p value = 0.034; CF, p value = 0.015). Subgroups of patients with and without nitrous oxide sedation were compared and similar results were obtained. CONCLUSIONS: Isolation with a rubber dam reduces child's stress during dental care. Although it is slightly more time-consuming and training is necessary for a quick and effective placement, it allows dentists to perform dental care in the best possible conditions, while reducing dental anxiety in young patients.

Stimuli involved in dental anxiety: What are patients afraid of?: A descriptive study.

BACKGROUND: Dental anxiety is a psychological response inducing aversion following a dental ill-defined stimulus, non-imminent and perceived as potentially dangerous. It is better to intervene during childhood than to resolve in adulthood when dental anxiety is more settled. AIM: The purpose of this study is to determine the nature of dental anxiety-provoking stimuli in young patients. DESIGN: A questionnaire was submitted to 566 children between 3 to 18 years in health institutions and schools in Brussels, Belgium. The items were divided into 3 groups: environment (ENV), local anaesthesia (LA), and intervention (INT) and summarized through averaging per group. Descriptive analysis and non-parametric testing were combined with logistic regression after discretization, above mild, for the group averages. RESULTS: About 7.2% of the respondents expressed high to severe dental anxiety. Several items presented a clear bimodal distribution dividing the population in fearless and fearing patients, for example, sight and feel of the syringe, sight and taste of blood and extraction. Others presented with a gradually lower incidence with increasing fear level. Fear for the environment was generally low. Gender and ethnic origin contribute significantly to the prediction of fear caused by LA. For fear caused by INT, first the place of questioning enters the models, thereafter follow: negative experience, frequency of dental visit, and gender (P < .05). CONCLUSIONS: While the dental environment is in general not causing fear, the invasive part of the anaesthesia and the invasive dental procedures are involved. Fear seems to be related to culture, previous experience, and gender.

The use of beta-tricalcium phosphate, white MTA, white Portland cement and calcium hydroxide for direct pulp capping of primary pig teeth.

AIM: The purpose of this study was to evaluate and compare the response of the pulp of primary pig teeth after capping with beta-tricalcium phosphate (ss-TCP), white mineral trioxide aggregate (WMTA), white Portland cement (WPC) and calcium hydroxide [Ca(OH)(2)]. MATERIAL AND METHODS: Forty teeth of two 3-month old pigs were capped with these materials. Three weeks later, the animals were killed and the specimens were prepared for histological examination and evaluation of inflammatory cell response, tissue disorganization, hard tissue formation and bacteria presence was performed. The data collected from the histological examinations were statistically analyzed using Kruskal-Wallis and Dunn multiple comparison tests. RESULTS: There was no significant difference between ss-TCP, WMTA, WPC and CH in terms of primary pulp response, hard tissue formation and normal pulp tissue preservation. CONCLUSION: Beta-tricalcium phosphate, WMTA and WPC in primary pig teeth are as effective as Ca(OH)(2) in primary pig teeth capping.

Denture contamination by yeasts in the elderly.

OBJECTIVES: The aim of this study was to investigate yeast carriage in healthy denture wearers by swabbing and to evaluate the effect of denture hygiene habits. MATERIALS AND METHODS: Denture wearers (n = 87) without evidence of denture stomatitis or any other oral disease were investigated by separately swabbing the fitting surface of the upper denture and the corresponding palatal mucosa in contact with the appliance. In a group of volunteers, a gel without any active compound was spread on the palatal side of the denture once in every morning for 2 weeks. RESULTS: Screening showed Candida colonisation of upper prosthesis in 75.9% of individuals. The most frequent species isolated were Candida albicans (77.9% of the positive cultures), Candida glabrata (44.1%) and Candida tropicalis (19.1%). Carriage of more than one yeast species was found in 48.5% of the contaminated dentures. There was a statistically significant association between denture contamination and palatal mucosa colonisation (chi-squared test: p < 0.0001). Repeated swabbings after 1 week as well as during a weekly follow-up for 1 month confirmed the denture contamination and its degree of severity. A daily gel application produced a yeast-count decrease to 10% of the initial value after 2 weeks (chi-squared test: p = 0.0134 and p = 0.2841 for prosthesis and palatal mucosa, respectively). CONCLUSION: This study documented the reliability of oral swabbing when investigating yeast carriage in healthy denture wearers. Moreover, just a diagnostic tool, sampling upper dentures for Candida could be the opportunity to verify the patient's compliance to hygiene advice.

The prevalence of traumatic dental injuries: a 24-month survey.

The aim of the present investigation was to assess the prevalence of dental traumatic injuries in children referred to Queen Fabiola Children's Hospital, Free University of Brussels, Belgium. This study was based on the clinical data of 457 traumatized teeth in 214 children. Most injuries involved 2 teeth (51%). Of these, maxillary central incisors were the most affected teeth (89%). The highest frequency of trauma occurred between 2 and 4 years of age. Falls were the most common cause of injury in both girls and boys. The most common type of injury in the primary and permanent teeth was subluxation. Gingival and mucosal laceration was the most common type of soft tissue lesion (61%). Only 42% of children came for dental treatment on the same day that they were injured.

[Pulpotomy of deciduous teeth]. / La pulpotomie de la dent temporaire.

Rather easy to perform, pulpotomy of the deciduous teeth is the most frequent endodontic treatment performed on children, but also the most controversial. Based on the amputation of the pulp chamber and the conservation of the inflammation-free root canals, the clinical results can be good, depending on the materials used. In this, calcium hydroxide (Ca(OH)2) as well as zinc-oxide-eugenol (ZOE) have been proven very inflammatory whereas Formocresol (FC) remains the reference even if its clinical toxicity is still reported in literature on a very controversial way. Nevertheless, this was sufficient to trigger and stimulate a search for alternatives, and led to the proposition to use ferric sulfate and even more recently MTA as new bases for the treatment of the pulp stumps after pulp chamber amputation.

Sealing ability of new generation adhesive systems in primary teeth: an in vitro study.

PURPOSE: This study evaluated the sealing ability of different types of restorative-adhesive combinations on deciduous molars in vitro. METHODS: Facial and lingual Class V cavities were prepared in 120 primary teeth. They were randomly divided into 8 groups of N= 15, in which different adhesives were used (XE=Xeno III; LP=Adper Prompt L Pop; IB=I Bond; SB=Scotch Bond 1; EP=Etch & Prime 3.0; AS=AdheSE; OB=Optibond Solo plus self-etch primer; CS=Clearfil SE Bond). All cavities were restored with composite Z 250. After thermocycling and immersion in 2% methylene blue, the dye penetration was evaluated under a microscope. RESULTS: In enamel and in cementum: the best seals were obtained with XE and LP, followed by CS, AS, IB, OB, SB, and EP (P=.001). No significant differences were recorded in the microleakage degree between the cementum and the enamel margins (P=.40). CONCLUSIONS: In this in vitro model, Xeno III and Adper Prompt L Pop provided the best seals both at the enamel and the cementum margins of Class V cavities in primary molars.