Stainless steel crown aspiration during sedation in pediatric dentistry.

Foreign body aspiration (FBA) causes death in more than 300 children every year in the United States. Morbidity and mortality are increased in children due to narrow airways and immature protective mechanisms. Factors to consider in pediatric dentistry are: (1) the patient's age and behavior; (2) presence and extent of disability; (3) local anesthesia; (4) body positioning; and (5) loose teeth. FBA requires prompt recognition and early treatment to minimize potentially serious and sometimes fatal consequences. The purpose of this case report was to describe the aspiration of a stainless steel crown in a 5-year-old boy during conscious sedation. It also discusses how a prompt and accurate diagnosis, early referral, and immediate treatment helped prevent serious complications.

The incidence of adverse reactions following 4% septocaine (articaine) in children.

PURPOSE: The purpose of this study was to report the incidence of adverse events following the use of 4% Septocaine in children. METHODS: A prospective study was carried out on children attending university-based pediatric dental clinics for restorative core under local anesthesia. Data collection included patient demographics, medical history, amount and site of injection, and treatment complexity. Follow-up telephone interviews were conducted with the parents at 3, 5, 24, and 48 hours regarding prolonged paresthesia, soft tissue injury, and pain. RESULTS: Two hundred sixty-four 2 to 14 year-olds were recruited for the study. Complete interview information was obtained from 204 patients. Prolonged paresthesia at 3 hours postinjection was reported for 40% of the population and at 5 hours for 11%. Soft tissue injury occurred in 14% of the patients at 3 hours and was found to be highest among children younger than 7 years old. The lip was the most commonly affected site for accidental injury and it was not related to injection site. Twenty percent reported postprocedural pain at 3 and 5 hours post-treatment. CONCLUSIONS: Since prolonged numbness appears to be the most frequent adverse event and occurred primarily in children younger than 7 years old, parents need to be informed and reassured accordingly.

Children and informed consent: a study of children's perceptions and involvement in consent to dental treatment.

AIM: The aim of the study was to find out to what extent children are involved in consenting to their dental care. METHODS: It was conducted using a structured interview with 60 8-13-year-old children. In the control group, verbal consent was given by the parent, whilst in the study group written consent was given by the parent and verbal assent by the patient. Interviews were conducted after dental treatment. RESULTS: The findings indicate that children in the study group felt they were more involved in deciding about their dental treatment compared with the control group. CONCLUSION: Children want to be more involved in consenting to their dental treatment.

Oral arginine metabolism may decrease the risk for dental caries in children.

Arginine metabolism by oral bacteria via the arginine deiminase system (ADS) increases the local pH, which can neutralize the effects of acidification from sugar metabolism and reduce the cariogenicity of oral biofilms. To explore the relationship between oral arginine metabolism and dental caries experience in children, we measured ADS activity in oral samples from 100 children and correlated it with their caries status and type of dentition. Supragingival dental plaque was collected from tooth surfaces that were caries-lesion-free (PF) and from dentinal (PD) and enamel (PE) caries lesions. Regardless of children's caries status or type of dentition, PF (378.6) had significantly higher ADS activity compared with PD (208.4; p < .001) and PE (194.8; p = .005). There was no significant difference in the salivary arginolytic activity among children with different caries status. Mixed-model analysis showed that plaque caries status is significantly associated with ADS activity despite children's age, caries status, and dentition (p < .001), with healthy plaque predicting higher ADS activity compared with diseased plaque. Plaque arginine metabolism varies greatly among children and tooth sites, which may affect their susceptibility to caries.