Parents of Children With Versus Without Special Health Care Needs and Oral Health Promotion: Challenges and Best Practices.

Purpose: Oral health care is a leading unmet health care need of children with special health care needs (CSHCNs). The purposes of this study were to: (1) compare the responses of parents (parents, caregivers) of children with versus without special health care needs (SHCNs) concerning their child's functioning, oral health-related knowledge, attitudes, and behavior; and (2) assess which information parents received/wanted to receive from dentists. Methods: A total of 122 parents of CSHCNs and 115 parents of children without SHCNs responded to the surveys. Results: Parents of CSHCNs reported that their children had lower functioning (per a four-point scale, with zero indicating worst functioning; means without SHCNs/CSHCNs equal 1.98/2.70; P<0.001) and nonverbal interactions (2.24/2.77; P<0.001), flossed and used mouth rinse less frequently (per a fivepoint scale, with one indicating never: 2.23/2.70; P=0.002; 1.82/2.27; P=0.004) than parents of children without SHCNs. They reported more oral care-related challenges (43.4 percent versus 21.7 percent; P<0.001), were less comfortable helping with oral care (per a five-point answer scale, with five indicating very comfortable: 3.92/4.48; P<0.001) and less interested in receiving information (3.13/3.71; P<0.001) than parents of children without SHCNs. Conclusions: Parents of children with or without special health care needs do not differ in their knowledge and attitudes. However, parents of CSHCNs are less comfortable in helping with oral care and less interested in receiving information than parents of children without SHCNs. Understanding the obstacles parents of CSHCNs face when providing oral care for their children can help dentists better support their oral health-related efforts.

Prevalence of molar-incisor hypomineralization in Milwaukee, Wisconsin, USA: a pilot study.

Purpose: This pilot study investigated the prevalence of Molar-Incisor Hypomineralization (MIH) in third-grade school children in Milwaukee Wisconsin, USA. Methods: A convenience sample of third-grade school children in the Milwaukee Public School System (MPS) participated in the study. Calibrated examiners trained on the European Academy of Paediatric Dentistry (EAPD) MIH recommendations examined the children between December 1, 2014 and June 30, 2015. Children were examined at their schools using a flashlight and mirror after receiving consent from parents/caregivers and assent from each child. Findings were recorded onto a standardized form by one of five trained examiners. Summary statistics were calculated, and bivariate analysis were done to identify factors associated with MIH. Results: A total of 375 children (average age =8.66 years, range 7-12) were examined, 60% females and 41% Hispanics. Overall, 36 (9.6%) of the children demonstrated findings consistent with the diagnosis of MIH. Among the teeth with MIH defects, severe defects were higher in lower molars. There were no statistically significant differences between those with and without MIH by sex, race/ethnicity, and socioeconomic status in this study. Conclusion: The study revealed that 9.6% of the children examined were affected by MIH. Future studies should focus on statewide and/or nationwide surveys in the United States to ascertain the extent and severity of the condition.

Acceptance and Use of Protective Stabilization Devices by Pediatric Dentistry Diplomates in the United States.

PURPOSE: To assess acceptance and use of protective stabilization devices (PSD) by Pediatric Dentistry Diplomates. METHODS: Surveys were electronically mailed in 2013 to 2922 members of the American Board of Pediatric Dentistry's (ABPD) College of Diplomates. Bivariate (assessing provider personal and practice characteristics) and multivariate analyses were performed on reported acceptance and use of PSD. RESULTS: Response rate was 28 percent. Providers more likely to report acceptance and use of PSD were those in practices with lower SES patient base, where there was the perception that patients' parents were more accepting of PSD, and those with low patient volume. Provider who were more likely to report acceptance and use of PSD were female, not working solely in private practice, and from Southeast or North Central regions of the U.S. Neither PSD use during residency nor ABPD Board cohort (<2009 versus 2009-2013) was associated with current acceptance or PSD use. Upon multivariate assessments of practice and personal characteristics, only perception of parent acceptance was associated with provider acceptance whereas perception of parental acceptance, practitioner sex and practice setting were associated with provider use of PSD. CONCLUSIONS: Practitioner sex, practice setting, region, and perception of parental acceptance are all important factors related to PSD acceptance and use.

Harlequin ichthyosis: a case report.

Harlequin Ichthyosis (HI) is a very rare subtype of a group of hereditary disorders that have in common the accumulation and shedding of significant amounts of hyperkeratotic epidermis. HI has a very specific clinical presentation that includes eclabium, fish mouth appearance, mouth breathing and xerostomia. The addition of a very high caloric demand to the clinical features place these affected individuals at extremely high risk for developing rampant dental decay. This case report discusses a two-year-old boy with HI that presents with severe early childhood caries. The specific accommodations that were made to accomplish required dental work under general anesthesia are presented. A case is made for the inclusion of dentists in the management of these cases once a diagnosis is made.

Parental attitudes regarding pediatric dentists' counseling on tobacco use: a survey of five private practices.

PURPOSE: To evaluate parental acceptance of provision of tobacco cessation and prevention education to children and parents by private practice pediatric dentists. METHODS: Receptionists gave confidential questionnaires to parents of child dental patients in five private pediatric dentistry practices. Demographic information and questions about dentist interventions were asked, with the most intrusive questions concerning parental tobacco use. RESULTS: Ninety-four percent (234) of parents responded. Over 90 percent of parents favored dentists speaking to 1) the child on the dangers of tobacco use and the benefits of avoiding tobacco, 2) parents about the effects of tobacco use on their children, and 3) parents about cessation. Among tobacco-using parents, 76 percent favored interventions directed at child tobacco use and warnings about adult smoking and children, dropping to 59 percent favoring dentist provisions of cessation education to parents. Users were less approving than nonusers on both parental interventions (P=.001). CONCLUSIONS: Parents showed high acceptance of various levels of tobacco interventions by pediatric dentists in private practice. Tobacco users, however, were less accepting than nonusers. Pediatric dentists may be more willing to provide such messages with this information, but they may also need training to prepare themselves to handle negative reactions.

A giant cell fibroma and focal fibrous hyperplasia in a young child: a case report.

A case of two fibrotic lesions of the oral mucosa in a 17-month-old African-American female is reported. Both lesions occurred on the anterior maxilla, one lesion pedunculated on the buccal attached gingiva and the other lesion sessile on the palate. Histological examination characterized the buccal lesion as focal fibrous hyperplasia (FFH) and the palatal lesion as a giant cell fibroma (GCF). A case is made for continuing the consideration of GCF as a histologically distinct entity from FFH but that no difference in clinical impact between the two lesions exists.

The relationship of dental visits to parental knowledge of management of dental trauma.

PURPOSE: The purposes of this study were to: (1) determine the level of parental knowledge regarding initial trauma management; and (2) assess which factors could influence that level of knowledge. METHODS: A self-administered questionnaire was given to parents of patients that attended 1 of 2 dental clinics. The questionnaire consisted of 3 parts and assessed patient and parental demographics and knowledge of dental trauma management. RESULTS: Four hundred sixty-seven questionnaires were completed. Most patients had Medicaid insurance (79%). Most parents would seek care from a dentist (71% broken tooth; 62% avulsed tooth). Only 31% knew that avulsed permanent teeth could be placed back into the socket, and only 25% of parents chose milk as a transport medium for avulsed teeth. A mere 3% of parents answered all 5 trauma management questions correctly, and 10% had no correct responses. The number of correct responses was not affected by clinic location, history of previous trauma, sex, education, or insurance status. Parents of recalled patients had more correct responses (P<.05). CONCLUSION: Knowledge of dental trauma management was poor. The fact that parents of recalled patients were somewhat more knowledgeable suggests that the dental visit can be an effective vehicle for education. The management of dental trauma should be part of the dental health education provided at dental visits.

Public school educator's knowledge of initial management of dental trauma.

OBJECTIVES: To compare the level of knowledge of physical education teachers/athletic coaches (PETs) and academic teachers (ATs) regarding dental trauma management. METHODS: Surveys were sent to all high schools (17) and all middle schools (23) in the Milwaukee public school system. All PETs and approximately 20 ATs at each school were invited to participate. The survey evaluated knowledge of dental trauma management via two case scenarios. RESULTS: Survey was completed by 140 ATs and 119 PETs. For the urgency of treatment for tooth fractures 81% of ATs and 53% of PETs responded correctly, a significant difference (P < .0001). With regards to avulsions, 56% of ATs and 46% of PETs responded that immediate professional assistance was needed. Only 7% of PETs would replant an avulsed tooth compared with 12% of ATs, a difference that was significant (P = .0062). Milk was chosen as a transportation medium for an avulsed tooth by 25% of ATs and 23% of PETs. CONCLUSIONS: Knowledge regarding the initial management of dental trauma was low for both groups. Educational campaigns regarding dental trauma should be targeted at all teachers.

Pulp polyp associated with a natal tooth: case report.

Natal teeth are an infrequent occurrence at birth. Often these teeth are extracted because they are very mobile and pose a risk of aspiration. This is a rare case in which a natal tooth was extracted by the pediatrician with his fingers. A root fragment remained and out of this developed a large pulp polyp. This relationship has not been previously reported.