Longitudinal Follow-up Comparing Future Care of Primary Teeth Treated with Silver Diammine Fluoride: A Private Dental Claims Review.

Purpose: The purpose of this study was to longitudinally evaluate follow-up treatment on primary teeth initially treated with silver diammine fluoride (SDF). Methods: This retrospective cohort evaluated private insurance (not Medicaid) claims data from 2018 to 2019 for children no older than 12 years with at least one primary tooth initially treated with SDF. Additional treatment per tooth was recorded over a follow-up of at least 24 months. Results: The mean and standard deviation (±SD) age of 46,884 patients was 5.7±2.3 and for SDF-treated teeth per patient was 2.6±2.1. Forty percent (95 percent confidence interval [95% CI] equals 39 to 40.7 percent) of teeth initially treated with SDF received additional treatment. The odds of SDF-treated teeth receiving future treatment significantly decreased with patient age by 22 percent per year (odds ratio equals 0.78; 95% CI equals 0.077 to 0.79; P<0.001). Pediatric dentists had only slightly lower odds than general dentists for providing additional treatment (0.91, P<0.001). Posterior teeth and teeth expected to exfoliate in two or more years had significantly higher odds of receiving additional treatment (2.47 and 1.27, respectively, P<0.001). Conclusions: Beginning at age four, patient age at placement of silver diammine fluoride was inversely proportional to future treatment provided. Posterior teeth and teeth expected to exfoliate in two or more years were more likely to receive additional treatment.

Provision of Pediatric Dental Services by Pediatric Dentists Versus General Dentists: Secondary Dental Analysis of Medical Expenditure Panel Surveys.

Purpose: The purpose of the study was to determine whether visiting only a pediatric dentist (as opposed to visiting only a general dentist) was associated with the provision of preventive dental services for a U.S.-based pediatric population (those 18 years and younger). Methods: This study analyzed pooled Medical Expenditure Panel Survey data from 2018 and 2019 to compare the use of certain preventive dental services (i.e., examination, radiographs, prophylaxis, dental sealant, and fluoride treatment) among those who reported visiting a pediatric dentist versus those who visited a general dentist. Survey procedures were used in Stata 14.0 to perform multivariable logistic regression analyses. Results: Controlling for demographic and insurance variables, children who visited only pediatric dentists had statistically significantly greater odds of receiving radiographs (adjusted odds ratio [AOR] equals 1.22; 95 percent confidence interval [95% CI] equals 1.01 to 1.48; P=0.04), fluoride treatment (AOR equals 1.57; 95% CI equals 1.30 to 1.90; P≤0.001), and sealants (AOR equals 1.63; 95% CI equals 1.24 to 2.16; P=0.001) compared to children who visited only general dentists. There was no statistically significant difference in the provision of periodic examinations and prophylaxis services. Conclusion: Based on the nationally representative data evaluated, pediatric dentists are more likely to provide more optimal preventive services than general dentists (i.e., radiographs, fluoride treatments, and sealants) to children in the United States.

Medical-Dental Integration in Ohio: Improving prevention and coordination at the local level.

Access to high-quality, preventive oral health care is fundamental for an individual to achieve positive health outcomes. Recognizing that health is influenced by where a person lives, it is important to consider how systems of care must adapt to meet the changing needs of a community over time. Medical-dental integration is a critical component designed to enhance and broaden the oral health care delivery model. MORE Care® is a framework for communities to leverage their resources and relationships by providing tools and resources to integrate preventive oral health services into primary care settings. This report will show how local stakeholders advocated for an innovative approach to improve oral health gaps for children in Ohio. The MORE Care Ohio pilot is expanding access to preventive oral health services by featuring medical-dental integration to close patient care gaps and build an integrated oral health network. Providing a framework for medical and dental teams to collaborate, seven clinical practices (three medical and four dental) agreed to participate in a 9-month learning collaborative and 16-months of performance monitoring.

Medicaid Managed Care and Pediatric Dental Emergency Department Visits.

Importance: Millions of economically disadvantaged children depend on Medicaid for dental care, with states differing in whether they deliver these benefits using fee-for-service or capitated managed care payment models. However, there is limited research examining the association between managed care and the accessibility of dental services. Objective: To estimate the association between the adoption of managed care for dental services in Florida's Medicaid program and nontraumatic dental emergency department visits and associated charges. Design, Setting, and Participants: This cohort study used an event-study difference-in-differences design, leveraging Florida Medicaid's staggered adoption of managed care to examine its association with pediatric nontraumatic dental emergency department visits and associated charges. This study included all Florida emergency department visits from 2010 to 2014 in which the patient was 17 years or younger, the patient was a Florida resident, Medicaid paid for the visit, and a primary or secondary International Classification of Diseases, Ninth Revision, code was used to classify a nontraumatic dental condition. Analyses were conducted between May 2023 and April 2024. Exposure: The county of residence transitioning Medicaid dental services from fee-for-service to a fully capitated managed care program managed by a dental plan. Main Outcomes and Measures: The rate of nontraumatic dental emergency department visits per 100 000 pediatric Medicaid enrollees and the associated mean charges per visit. Nontraumatic dental emergency department visits are a well-documented proxy for access to dental care. Data on emergency department visit counts came from the Florida Agency for Health Care Administration. Medicaid population denominators were derived from the American Community Survey's 5-year estimates. Results: Among the 34 414 pediatric nontraumatic dental emergency department visits that met inclusion criteria across Florida's 67 counties, the mean (SD) age of patients was 8.11 (5.28) years, and 50.8% of patients were male. Of these, 10 087 visits occurred in control counties and 24 327 in treatment counties. Control counties generally had lower rates of NTDC ED visits per 100 000 enrollees compared with treatment counties (123.5 vs 132.7). Over the first 2.5 years of implementation, the adoption of managed care was associated with an 11.3% (95% CI, 4.0%-18.4%; P = .002) increase in nontraumatic dental emergency department visits compared with pre-implementation levels. There was no evidence that the average charge per visit changed. Conclusions and Relevance: In this cohort study, Florida Medicaid's adoption of managed care for pediatric dental services was associated with increased emergency department visits for children, which could be associated with decreased access to dental care.

Adverse childhood experiences, dental insurance, and developmental disability: Association with unmet dental needs in Ohio.

OBJECTIVE: This study investigated whether insurance status and/or developmental disability moderated the association between adverse childhood experiences (ACE) and unmet dental needs among children aged 0 to 17 in Ohio. METHODS: We utilized cross-sectional data from the 2021 Ohio Medicaid Assessment Survey to assess the dental needs of children. ACE scores, dental insurance status, and developmental disability status were analyzed using multivariable logistic regression to identify their potential association with parental-reported unmet dental needs. RESULTS: The weighted sample represented 2,752,222 children in Ohio. Over half reported zero ACEs (55.8%) and no dental needs (56.1%). Approximately 1 in 9 lacked dental insurance (11.1%), and 1 in 10 had a developmental disability (9.9%). Children with one to three ACEs had three times the odds of unmet dental needs compared to children with zero ACEs (OR = 3.20; 95%CI [2.10, 4.89]), and children with four or more ACEs had eight times the odds of unmet dental needs (OR = 8.78; 95%CI [5.26, 14.67]). Children lacking dental insurance had over six times higher odds of unmet dental needs compared to children with dental insurance (OR = 6.10; 95%CI [3.92, 9.49]). The presence of developmental disability status did not moderate the presence of unmet dental needs; however, the lack of dental insurance status significantly moderated the association between ACEs and unmet dental needs. CONCLUSION: Insurance status, not developmental disability, moderated the association between ACEs and unmet dental needs among children in Ohio. Efforts to ensure continuous access to dental insurance are warranted.

Global oral health policies and recommendations for children with special health care needs and their applicability and effectiveness during the COVID -19 pandemic: a systematic review.

AIM: This systematic review aims to assess effectiveness of oral health policies, recommendations and guidelines in safeguarding oral health of children with special healthcare needs during COVID-19. BACKGROUND: This systematic review evaluated the adaptation of global oral health policies for children with special healthcare needs (SHCN) during the COVID-19 pandemic, to provide evidence-based insights to inform policymakers and healthcare providers amid the ongoing global health crisis. The study focused on assessing the effectiveness of these adaptations in ensuring equitable access to quality dental care for this vulnerable group. METHODS: A PRISMA guided online search through LILIACS, PubMed, Scopus, COCHRANE and grey literature was conducted. The search strategy incorporated a combination of subject headings (MeSH terms) and free-text terms related to "oral health," "dental health," "policy," "effectiveness," "dental practice guidelines," "oral health policies," and "special care needs children." Eligibility criteria included oral health policies, recommendations and guidelines targeting individuals/children with special care needs. Both qualitative and quantitative studies published in English from 2008 to 2023 were included. RESULTS: Sixteen guidelines, recommendations and policies, from six authorities were identified. These documentations addressed six different areas mentioned broadly as comprehensive care, ethical considerations, preventive and therapeutic measures, equity, patient-centric treatment, and reducing disparities signaling a paradigm shift. International collaborations and standardization of guidelines indicated a unified approach. The review also emphasized on a commitment to continuous improvement through quality measurement, systematic referral management, and needs assessment. With the exception of two documents, the remaining guidelines did not address COVID-19 or provide specific adaptations for it. The lack of emphasis on individual condition was notable, as the guidelines generally took a more generalized approach toward individuals with special healthcare needs. CONCLUSIONS: In conclusion, this review assessed the impact of COVID-19 on oral healthcare for individuals with special needs. It underscores global and local efforts for equitable access, patient-centric care, and preventive measures. The lessons learned advocate for a resilient, inclusive healthcare framework capable of meeting diverse needs. PROSPERO REGISTRATION: CRD 42023452475.

The age and primary reason for the first dental visit in children with special health care needs.

AIM: To evaluate the average age and primary reason for the first dental visit among patients with special health care needs (SHCN) as well as to examine barriers related to accessing care for children with special health care needs. METHODS: This is a cross-sectional survey that was distributed to caregivers of children with special health care needs (CSHCN).  Study data was collected through REDCap, a secure web-based survey application. RESULTS: A total of 75 caregivers participated in the survey.  Only 13% of caregivers reported that their child was less than 1 by the time of their first dental visit.  Nearly all reported seeing a pediatric dentist for their first visit (89%) and that it was for a routine exam and cleaning (83%).  About one-third of guardians reported an experience where a dentist was unable to care for their child due to their SHCN (36%). DISCUSSION: It appears that caregivers of CSHCN that participated in this survey have established routine care with a pediatric dentist at an early age. It is important to continue to educate caregivers on the importance of routine care as well as support general dentists in their role of caring for patients with SHCN.

Barriers to routine dental care for children with special health care needs.

PURPOSE: The aim of this mixed method study was to identify barriers for children with special health care needs (SHCN) to receiving routine preventive dental care following restorative dental care with general anesthesia (GA). METHODS: Electronic health records were reviewed for inclusion criteria and demographic data. Caregivers of children with SHCN were contacted to participate in qualitative interviews. Interview topics explored child, family, and community level influences to accessing routine dental care. Qualitative analysis identified key themes of barriers and enablers to care. RESULTS: A total of 1708 children received dental care with GA during the 2-year study period, of which 498 (29.16%) had a diagnosis of a SHCN. The most common type of SHCN was neurodevelopmental disorders (28.51%). The mean age at time of GA was 8.6 years. Fifty caregivers completed interviews. Identified barriers to obtaining routine dental care included child stress/anxiety, finding an accepting provider, dismissive providers, and proximity of provider/transportation to dental care. Enablers to obtaining care included effective behavior management, continuity of provider/care, positive provider attitude, and referral to an accepting provider. CONCLUSION: Adequately trained and local providers with an accepting attitude are essential to enabling children with SHCN to obtain equitable access to routine dental care.

Investigating the scope and costs of dental treatment provided under general anaesthesia among children with congenital heart disease.

AIM: To identify the types of dental treatment provided under general anaesthesia for children diagnosed with congenital heart disease (CHD), quantify the costs within a publicly funded tertiary paediatric hospital setting and identify factors which affect the cost. METHODS: A retrospective analysis of dental records (July 2015 to June 2019) was conducted for children with CHD who had undergone a dental general anaesthetic procedure at The Children's Hospital at Westmead, Australia. Patient and treatment-related information were collected, and a costing analysis was performed on 89 dental general anaesthetic procedures. RESULTS: Mean age at the time of the general anaesthetic was 8.15 years. About 27% of children with CHD had a history of dental infection. Dental extractions and restorations comprised the majority of treatments provided, with extractions performed in 86% of procedures. The mean number of days in hospital was 1.43 and the mean cost was $4395.14. The cost was significantly greater when children presented with a facial swelling compared to any other reason. CONCLUSIONS: Dental extractions are performed in the majority of general anaesthetics. Not only is there an economic burden to the public health system in providing dental treatment under general anaesthesia for children with CHD, the health impacts also appear to be substantial. A considerable proportion required overnight hospitalisation and days in hospital was strongly related to the cost of the dental general anaesthetic. Systematic referral pathways for accessing dental care are an important consideration for children with CHD.

Impact of the COVID-19 pandemic on pediatric Medicaid dental claims in Arizona.

OBJECTIVES: To examine the role COVID-19 had on access to dental services among children in Arizona by comparing paid pediatric dental claims made before and during the pandemic. METHODS: In a retrospective descriptive study, we examined Medicaid paid claims for dental services among pediatric patients from March through December 2019 and during the outbreak in 2020. Using dental claims data obtained from the Centers for Health Information and Research at Arizona State University (ASU), we analyzed Medicaid (Arizona Health Care Cost Containment System [AHCCCS]) reimbursed dental services. RESULTS: During the COVID-19 pandemic, paid preventive dental claims for children aged birth to 21 years decreased in 2020 compared to the same time period in 2019. Pediatric patients in Arizona utilized fewer dental services and had less access to credentialed Medicaid dental providers during the pandemic. Further, rural counties had statistically significant fewer preventive, minor restorative, major restorative, and endodontic claims compared to urban counties. Arizona rural counties also had fewer providers who were paid $10,000 or more per year during 2020 than in 2019. CONCLUSIONS: COVID-19 has had a detrimental impact on pediatric dental service utilization. While dental services were provided during the COVID-19 pandemic, preventive and restorative dental claims dropped for rural Arizona children aged birth to 21 years. This reveals potential negative impacts on oral health. Further research should examine the direct and indirect impact the COVID-19 pandemic has had on dental service utilization and oral health for the general pediatric population.

Deep Sedation for Dental Care Management in Healthy and Special Health Care Needs Children: A Retrospective Study.

BACKGROUND: Very young children, and those with disabilities and extensive oral pathology, who cannot be treated in the dental chair, require deep sedation or general anesthesia for dental treatment. OBJECTIVE: The aim of this study is to describe and compare the oral health status in healthy and SHCN children and the treatments performed under deep sedation on an outpatient basis with a minimal intervention approach, and their impact on quality of life. METHODS: A retrospective study between 2006 and 2018 was made. A total of 230 medical records of healthy and SHCN children were included. The data extracted were age, sex, systemic health status, reason for sedation, oral health status before sedation, treatments administered during sedation, and follow-up. The quality of life after deep sedation of 85 children was studied through parental questionnaires. Descriptive and inferential analyses were made. RESULTS: Of the 230 children, 47.4% were healthy and 52.6% were SHCN. The median age was 7.10 ± 3.40 years (5.04 ± 2.42 in healthy children and 8.95 ± 3.09 in SHCN children). The main reason for sedation was poor handling in the dental chair (99.5%). The most frequent pathologies were caries (90.9%) and pulp pathology (67.8%). Healthy children had more teeth affected by decay and with pulp involvement. Patients aged < 6 years received more pulpectomies and pulpotomies. After treatment, parents stated that children were more rested and less irascible, ate better, increased in weight, and had improved dental aesthetics. CONCLUSIONS: Differences in treatments carried out did not depend on the general health status or the failure rate but on age, with more pulp treatments in healthy children who were younger, and more extractions near to the age of physiological turnover in children with SHCN who were older. Intervention under deep sedation with a minimally invasive treatments approach met the expectations of parents and guardians, as it improved the children's quality of life.

Access to dental care for children with special health care needs: a cross-sectional community survey within Jeddah, Saudi Arabia.

The aim of this study was to investigate the level of dental care access among children with special health care needs (CSHCN) in Jeddah, Saudi Arabia and the barriers hindering this access. Data of this cross-sectional study were obtained from self-administered surveys distributed through seven CSHCN centers. Children with autistic spectrum disorder (ASD), Down syndrome, cerebral palsy, and developmental delay were included. Univariate and bivariate analyses were conducted to describe the data. A total of 602 study participants were included in the analyses. Only 24.9% of the participated caregivers routinely visited the dentist for their CSHCN. Half of CSHCN caregivers found difficulties obtaining dental treatment. This trend was significantly greater in 12-18 years old children (p = 0.013) and in families commuting for more than one hour to dental clinics (p = 0.045). The most common reported barrier was fear of the dentist (61.6%) followed by child uncooperativeness (37.8%) and treatment costs (27.8%). CSHCN lack sufficient dental care for a variety of reasons, primarily fear of dentists, child uncooperativeness, and treatment costs. Dentists require more training and education to facilitate better access to dental care for CSHCN.

The Impact of Preventive Dental Services on Subsequent Dental Treatment for Children in Medicaid.

OBJECTIVE: The goal of this study was to use claims data linked with community-level measures to evaluate the impact of preventive services on the time to subsequent restorative, advanced restorative, and complex dental treatment among children enrolled in the Virginia Medicaid program. METHODS: Four data sources were used (dental claims, eligibility files, American Community Survey, and Area Health Resource Files) for fiscal years 2011 to 2018. The outcomes of interest were time to first treatment services from birth. The treatment outcomes were basic restorative treatment, advanced restorative treatment, or complex treatment. The independent variable was a preventive service prior to a treatment service. Time-to-event curves were estimated and compared using a log-rank test. Propensity score-matched univariate and multivariate Cox proportional hazards frailty models with an inverse probability censoring weighting correction estimated hazard ratios (HRs) for treatment outcomes comparing use of preventive services while controlling for patient demographic, geospatial, and county-level socioeconomic status measures. RESULTS: The analysis included 430,594 children (10,204,182 claims). A log-rank test showed significant differences (P < 0.001) between the times to treatment of those who had a preventive service and those who did not have a preventive service prior to a treatment service. Both Kaplan-Meier curves and the adjusted HR (1.88; 95% confidence interval [CI], 1.46-2.15) indicated that children without preventive services were more likely to have basic restorative treatment at an earlier age along with advanced restorative treatment (HR, 1.52; 95% CI, 1.28-1.80) and complex treatment (HR, 2.13; 95% CI, 1.68-2.61). CONCLUSIONS: In a population of Medicaid-enrolled children, children who did not receive preventive services were significantly more likely to have treatment at an earlier age than those who did receive preventive services. KNOWLEDGE TRANSFER STATEMENT: This study examines the impact of the utilization of preventive dental services since birth and the subsequent dental treatment for children enrolled in a dental Medicaid program. This study also examines the influence of preventive care on dental complexity of treatment for these children. Findings can inform federal and state policy planning of dental Medicaid programs as well as interventions to improve referral systems for the early use of preventive dental services and the establishment of a dental home.

Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials.

AIMS: The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry. BACKGROUND: The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols. REVIEW RESULTS: Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials. CONCLUSION: The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice. CLINICAL SIGNIFICANCE: Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials. How to cite this article: Valentim FB, Moreira KMS, Carneiro VC, et al. Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023;24(12):1016-1025.

Impact of Mobile Dental Clinics on the Quality of Life of Children

ABSTRACT Objective: To evaluate the impact of mobile dental clinics on the oral health-related quality of life (OHRQL) of children. Material and Methods: A longitudinal epidemiological study was conducted with participants from seven mobile dental clinics carried out between May 2019 and January 2020 by the NGO Missão Sorrisos. Parents and children who attended the program had their sociodemographic data collected. Both completed the Scale of Oral Health 5 (SOHO-5) self-reported questionnaire before treatment and again 30 days after treatment. Results: The improvement in the children's oral health after treatment at the mobile clinics is reflected in the pre-and post-treatment medians measured by the SOHO-5 total score from the children's own reports from the parents' reports. The procedures performed were effective in reducing pain and difficulties in eating, drinking, and sleeping. An improvement in the perception of the children's appearance and self-confidence was reported, both from the perspective of the parents/guardians and the children themselves. The chance of improvement in the perception of the children's oral health was greater for parents (OR=5.96; CI95%: 1.32-26.84) and children (OR=5.76; CI95%: 1.28-25.95) from families whose main caregiver was not professionally active at the time of the study. Conclusion: The mobile dental clinics had a positive impact on the OHRQL of children from the perspective of the participants of the study.

Relación entre el perfil epidemiológico y nivel socioeconómico de la población que demanda atención en la Cátedra de Odontología Integral Niños / Relationship between the epidemiological profile and socioeconomic level of the population requiring care at the Children´s Comprehensive Dentistry Chair

Se identificó el perfil epidemiológico y se caracterizó la situación de la población en base al Nivel Socio-Económico (NSE) asociado al estado dentario y se es-tablecieron las zonas geográficas de pacientes que asistieron a la Cátedra Odontología Integral Niños (COIN) de FOUBA durante el año 2019. La muestra total se conformó con 541 niños de 9,2±3,3 años; masculi-nos 51,0%. La segmentación de los estratos sociales dio como resultado que del total de pacientes, el 33,3% perteneció a Clase Baja D2/E, el 39,2% a Clase Baja Superior D1, el 22,4% a Clase Media Baja C3, el 4% a Clase Media Alta C2 y el 1,1% a Clase Alta ABC1. La mayor demanda de atención provino de las dos clases más bajas de la pirámide social, aunque se trata de un servicio arancelado. Los indicadores del estado den-tario ceod, ceos, CPOD y CPOS, indicaron que los niños de menor posición socioeconómica presentaron los índices más altos. La mayor concurrencia provino de la Ciudad Autónoma de Buenos Aires (52%), respecto a los pacientes concurrentes del Gran Buenos Aires (37%), el 80% provino de la zona Oeste y Sur (AU)

The epidemiological profile was identified, and the situation of the population was characterized based on Socio-Economic Status (SES) associated with their dental state. Geographical areas of patients who attended the FOUBA Children's Comprehensive Dentistry Chair during 2019 were established. The total sample consisted of 541 children aged 9.2±3.3 years; males 51.0%. The segmentation of the social strata resulted in 33.3% belonging to Low-Class D2/E, 39.2% to Upper Lower-Class D1, 22.4% to Lower Middle-Class C3, 4% to Upper Middle-Class C2, and 1.1% to Upper-Class ABC1. The largest demand for care came from the two lowest classes of the social pyramid, even though it is a fee-based service. The indicators of dental status dmft, dmfs, DMFT and DMFS, showed that children coming from the lowest socio-economic position presented the highest rate of occurrence. The highest attendance came from the City of Buenos Aires (52%), compared to patients from Buenos Aires suburbs (37%), of which 80% were from the Western and Southern suburbs (AU)

Cárie na primeira infância: um problema de saúde pública global e suas consequências à saúde da criança / Caries in early childhood: a global public health problem and its consequences to children's health

Esse estudo tem como objetivo realizar uma revisão de literatura para apresentar os efeitos da doença cárie em crianças e ressaltar a importância do acompanhamento familiar. Foram selecionados artigos de 2011-2021, publicados nas bases de dados PubMed e SciELO utilizando os descritores: Doença cárie, Prevenção, Odontopediatria, foram incluídos artigos que estavam disponíveis na íntegra em português e inglês. A cárie dental continua a ser um problema de saúde pública, com maior prevalência em crianças e caracterizada por ser uma doença de etiologia multifatorial, biofilme-açúcar dependente não transmissível. A cárie de primeira infância (CPI) é capaz de afetar negativamente a qualidade de vida, por se apresentar como rápido desgaste da estrutura dental e presença de sintomatologia dolorosa. Isso pode resultar em um quadro de perda precoce, má oclusão, prejudicando a mastigação, dentição permanente, sono, rendimento escolar, favorecendo a desnutrição e afetando desenvolvimento. A Declaração de Bangkok recomenda aumento de conscientização sobre essa doença através da educação dos pais, limitação na ingestão de açúcar até os 2 anos de idade e escovação dos dentes de pelo menos 2x/ dia com dentifrício fluoretado. Diante do exposto, se torna essencial o acompanhamento da saúde odontológica da criança desde a erupção do primeiro dente na cavidade bucal, visando reduzir a CPI e contribuir para uma melhor qualidade de vida.

This study aims to carry out a literature review to present the effects of caries disease in children and emphasize the importance of family monitoring. Articles from 2011-2021 were selected, published in the PubMed and SciELO databases using the descriptors: Caries Disease, Prevention, Pediatric Dentistry, articles that were available in full in Portuguese and English were included. Dental caries continues to be a public health problem, with greater prevalence in children and characterized by being a disease of multifactorial etiology, non-transmissible biofilm-sugar dependent. Early childhood caries (CPI) is capable of negatively affecting the quality of life, as it presents itself as a rapid wear of the tooth structure and the presence of painful symptoms. This can result in early loss, malocclusion, impairing chewing, permanent dentition, sleep, school performance, favoring malnutrition and affecting development. The Bangkok Declaration recommends raising awareness of this disease through parent education, limiting sugar intake until age 2, and brushing teeth at least twice a day with fluoride toothpaste. Given the above, it is essential to monitor the child's dental health from the eruption of the first tooth in the oral cavity, in order to reduce CPI and contribute to a better quality of life.

Race and payor type for child visits with public health dental hygienist practitioners.

PURPOSE: To examine whether growth in visits to public health dental hygiene practitioners (PHDHPs) providing preventative dental services at a pediatric hospital clinic was predominantly among children receiving public insurance and children of minority background from 2013 to 2017. METHODS: Longitudinal descriptive data analysis from electronic health records for 6856 children under age 18 years who visited PHDHPs co-located at a hospital clinic in Pittsburgh, PA, from 2013 to 2017. We compared visits between white versus non-white children and between children with public, private, and no or missing insurance by year. RESULTS: Visit volume doubled from 2013 (n = 811) to 2017 (n = 1868). The proportion of PHDHP visits with non-white children increased from 77% (n = 625) in 2013 to 87% (n = 1472) in 2017 (p < 0.001). The proportion of PHDHP visits with children with public insurance increased from 72% (n = 585) in 2013 to 82% (n = 1377) in 2017 (p < 0.001). CONCLUSIONS: PHDHPs co-located at a pediatric hospital clinic saw a high proportion of visits from children of non-white race and with public insurance. Visits from children of minority race and with public insurance increased disproportionately as visit volume grew from 2013 to 2017, depicting a vehicle through which historically underserved children increasingly accessed preventive dental services.