RESUMEN
Introduction: The Canadian Dental Association (CDA) recommends children visit a dentist within 6 months of the eruption of their first tooth or by 12 months of age. The aim of this study was to investigate Canadian dentists' awareness and views on early childhood caries (ECC) and its prevention and management. Methods: This study analyzed a subset of questions relating to dentists' knowledge of ECC and prevention strategies, from a national survey of general and pediatric dentists, commissioned by the CDA in 2013. Analyses included descriptive, bivariate, and multivariate analyses. A p-value of ≤0.05 was considered significant. Results: Three thousand two hundred thirty-two out of 14,747 dentists responded (response rate of 21.9%), with 95.1% having heard of ECC. Overall, 60.9% of respondents reported that they were comfortable providing treatment to children with ECC. Significant differences were found between the number of years in practice and whether dentists were or were not comfortable providing prevention (19.5 ± 12.6 years vs. 25.4 ± 12.1 years; p < 0.001) or treatment for patients with ECC (19.1 ± 12.7 years vs. 22.5 ± 12.3 years; p < 0.001). Pediatric dentists (OR = 6.92; 95% CI: 2.57, 18.61), female dentists (OR = 1.13; 95% CI: 1.03, 1.24), dentists practicing in smaller urban areas (OR = 1.17; 95% CI: 1.07, 1.28), and dentists who were aware of the CDA's position on ECC (OR = 1.26; 95% CI: 1.13, 1.41) were more likely to be comfortable providing treatment for children with ECC. Conclusions: While the majority of Canadian dentists have sufficient knowledge of ECC, not all are comfortable providing oral health care services to children at a young age. It is encouraging however, that most dentists are wanting additional oral health resources designed for education on ECC prevention for parents of young children.
RESUMEN
Introduction: Early dental visits set children on an upward trajectory, toward a lifetime of optimal oral health. The purpose of this study was to analyze data from a survey of Canadian dentists to determine their knowledge, attitudes, and behaviors regarding first dental visits. Methods: The Canadian Dental Association (CDA) surveyed general and pediatric dentists regarding the timing of the first dental visit. Demographic and practice information was collected. Analyses included descriptive analyses, bivariate analyses, and multiple logistic regression with forward stepwise selection. Significance was set at p ≤ 0.05. Results: Overall, 3,232 dentists participated. The majority were male (58.5%), general dentists (96.6%), in non-metropolitan areas (50.5%), and practiced for 20.6 ± 12.8 years. The mean age recommended for first visits was 20.4 ± 10.8 months. Only 45.4% of dentists recommended a first visit ≤ 12 months. A majority (59.5%) knew that the correct age recommended for first visits was no later than 12 months. Most dentists who had seen a patient ≤ 12 months before did not typically do so (82.3%). General dentists were 61% less likely to recommend first visits by 12 months (OR = 0.39; 95% CI: 0.16, 0.91). Dentists in Central Canada (OR = 1.83; 95% CI: 1.44, 2.32); dentists who typically saw patients ≤ 12 months (OR = 3.41; 95% CI: 2.41, 4.83); those who echoed the importance of visits by 12 months (OR = 19.3; 95% CI: 8.2, 45.71); dentists with staff that encouraged infant/toddler care (OR = 1.76; 95% CI: 1.34, 2.31); and those who knew official North American recommendations for first visits (OR = 5.28; 95% CI: 4.13, 6.76) were all more likely to recommend first visits by 12 months. Conclusions: A majority of Canadian dentists did not recommend first visits by 12 months of age, despite it being the CDA's official position. Provider characteristics can influence the age that is recommended for first visits. Findings from this study may inform educational campaigns on early childhood oral health targeted toward dentists.
RESUMEN
INTRODUCTION: Hypophosphatasia, a genetic disease impeding development of teeth and bones, is associated with premature exfoliation of primary teeth. Hypophosphatasia is caused by mutations in the ALPL gene, which encodes the tissue non-specific form of alkaline phosphatase. Asfotase alfa (Strensiq®) is a human recombinant bone-targeted alkaline phosphatase. OBJECTIVES: To review development and exfoliation patterns of primary/permanent teeth in a cohort of patients with hypophosphatasia enrolled in an open-label clinical trial of enzyme replacement therapy (ERT) with asfotase alfa. METHODS: Data were collected from existing study files of a cohort of patients ≤5 years of age with infantile hypophosphatasia. Children were recruited at the Winnipeg site of a global clinical trial and were treated with ERT. Dental information, including the exfoliation/eruption patterns, were recorded at each visit. RESULTS: Eleven children (7 females, 4 males) participated. Participants enrolled as infants (5 infants; mean age 3.0 ± 2.3 months) prematurely lost significantly fewer teeth to hypophosphatasia than patients recruited as preschoolers (6 preschoolers; mean age 52.5 ± 11.3 months), who started on asfotase alfa at a later age. Conclusion The oral health of children with early onset infantile hypophosphatasia may be improved with early and continued administration of ERT, compared to institution of therapy later in childhood.