Oral Health Status of Kuwaiti Children with a History of Chronic Liver Disease.

OBJECTIVE: To investigate the oral health status and dental manifestations of children with a history of chronic liver disease (CLD) compared to healthy children. SUBJECTS AND METHODS: Twenty children (15 boys and 5 girls) with a history of CLD were compared to 20 healthy controls matched for age and gender. The clinical examination was carried out by the same dentist. Caries prevalence, using the decayed, missing, and filled primary and permanent teeth indices (dmft/DMFT), was recorded. Developmental enamel defects, plaque scores, and gingival overgrowth were also investigated. RESULTS: No statistically significant differences were found in mean dmft scores for children with a history of CLD (4.9 ± 5.4) and for healthy individuals (3.9 ± 4.5). However, the mean DMFT score was significantly higher (p =0.025) in children with CLD (4.2 ± 4.6) compared to controls (1.7 ± 1.6). The mean decayed teeth parameter (DT) was also significantly higher in children with CLD (p =0.004). All patients with CLD exhibited enamel defects compared to only 33% in the control group (p< 0.05). A higher mean plaque index was observed in children with a history of CLD (p< 0.001). Also, a positive correlation for gingival overgrowth was noted in patients with a history of CLD (p< 0.05). Green staining was evident only in the permanent dentition of 1 child with CLD. CONCLUSION: Children with a history of CLD exhibited a high caries prevalence, high plaque scores, and more enamel defects compared to healthy subjects. Gingival overgrowth is less prevalent among pediatric liver transplant patients on tacrolimus therapy.

Dentists' perception, knowledge, and clinical management of molar-incisor-hypomineralisation in Kuwait: a cross-sectional study.

BACKGROUND: Molar-incisor Hypomineralisation (MIH) is considered as a global dental problem. There is little knowledge of general dental practitioners (GDPs) and dental specialists (DSs) about this condition in different parts of the world, particularly in Gulf Cooperation Council (GCC) countries. Hence, this study has been carried out to assess the knowledge of GDPS and DSs in Kuwait about MIH condition, its clinical presentation and management. Findings would help national school oral health program (SOHP) to promote good oral healthcare. METHODS: A structured questionnaire was distributed to 310 attendees of the 18th Kuwait Dental Association Scientific Conference, Kuwait. Data concerning demographic variables, prevalence, diagnosis, severity, training demands and clinical management of MIH were collected. RESULTS: A response rate of 71.3% (221/310) was reported. 94% of respondents noticed MIH in their practice. Yellow/brown demarcation has been observed as a common clinical presentation (> 50%). Almost 10-20% of MIH prevalence has been reported by the participants. Resin composite was the dental material often used in treating MIH teeth (~ 65%), and fewer than half would use it for treating moderately affected molars. Most respondents would use preformed metal crowns for severe MIH (63%). Dental journals were the information source for DSs; whereas, the internet was the information source for GDPs. Child's behaviour was the main reported barrier for treatment of MIH affected children. Many GDPs felt unconfident when diagnosing MIH compared to dental specialists. Respondents supported the need to investigate MIH prevalence and to receive a clinical training. CONCLUSIONS: Molar incisor hypomineralisation is a recognised dental condition by practitioners in Kuwait. Yellow/brown demarcated opacities were the most reported clinical presentation, and the composite resin was the most preferred dental material for restoring MIH teeth. Most GDPs and dental specialists would use preformed metal crowns for severely affected molars. GDPs reported low levels of confidence in MIH diagnosis which necessitates conducting continuing education courses to provide high- quality dental care for children with MIH.

Xylitol Chewing Gums on the Market: Do They Prevent Caries?

PURPOSE: To measure the xylitol content in sugar-free chewing gums available on the market in Gulf Cooperation Council (GCC) countries in the Middle East, in order to identify those products that can provide the recommended daily dose of xylitol for caries prevention (6-7 g). Acid production from chewing gums was also measured in vitro and in vivo. MATERIALS AND METHODS: Twenty-one chewing gums containing xylitol were identified and collected from the GCC market (Kuwait, Bahrain, Qatar, Saudi Arabia, UAE and Oman). Xylitol was extracted and its concentration was analysed using a special enzymatic kit. The pH of extracts was measured during 30-min incubation with Streptococcus mutans. Changes in saliva and plaque pH were noted in four subjects after the consumption of highly concentrated xylitol gums. RESULTS: The xylitol content in grams was clearly mentioned only on one product's label. Twelve products stated the percentage of xylitol (3.5% to 35%). The rest did not specify the amount. The mean measured weight of one piece of gum was 1.67 ± 0.38 g. The mean measured xylitol content/piece was 0.33 ± 0.21 g. Xylitol content was < 0.3 g/ piece in 9 products, 0.3-0.5 g in 7 and > 0.5 g in 5 products. None of the highly concentrated xylitol gums showed a pH drop in vitro or in vivo. One chewing gum, containing xylitol and glucose, resulted in a low pH level (< 5.5) when tested in vitro. CONCLUSION: The majority of xylitol chewing gums sold on the GCC market do not provide the consumers with the recommended daily dose of xylitol for caries prevention. Clear, accurate labeling is recommended.

Prevalence and Distribution of Dental Anomalies in Schoolchildren in Kuwait.

OBJECTIVE: Dental anomalies (DA) can affect paediatric patients' aesthetics, function, and psychological well-being. There is a lack of data about the prevalence of DA in children in Kuwait. This study aimed to investigate the prevalence and distribution of DA amongst schoolchildren aged 8 to 12 years. METHODS: A retrospective study was conducted using panoramic digital radiographs of children who attended a single dental center. All radiographs were evaluated by 2 calibrated and trained examiners. RESULTS: DA were present in 110 (20.1%) out of the 546 panoramic radiographs examined: 53.6% in females and 46.4% in males. The mean age of children with DA (9.83 ± 1.29) was similar to that of children with no anomalies (9.96 ± 1.46). The most prevalent anomaly was dental agenesis (9.3%), followed by taurodontism (6.6%) and ectopic eruption (EE, 2%). DA were more common in the maxilla (58.2%) compared to the mandible (41.8%, P = .042). Congenitally missing teeth were significantly more frequent in the mandible (56.9%) than in the maxilla (43.1%, P = .003). EE was significantly more common in the maxilla (90.9%) than in the mandible (9.1%, P = .024). Microdontia and root dilacerations were only present in males, whilst supernumerary teeth, transposition, and impacted teeth were noted in females only. CONCLUSIONS: The prevalence of DA amongst schoolchildren in Kuwait was considered to be relatively high. Certain DA were associated with gender. The significant prevalence of DA highlights the need for early diagnosis using panoramic radiographs, particularly during the ages of 9 and 10, in order to ensure effective patient management.

Pediatricians' Knowledge of Children's Oral Health: A National Survey.

BACKGROUND: A high percentage of dental caries (∼70%) was reported amongst 4- and 5-year-old Kuwaiti kindergarten children. Parents contact paediatricians several times during the child's early life. Paediatricians can play an important role in improving the oral health of their patients. The objective of the study is to evaluate the knowledge level and awareness of paediatricians and paediatric residents regarding children's oral health in Kuwait. METHODS: A national cross-sectional survey was distributed to paediatricians and paediatric residents practicing in Kuwait. Data concerning demographic variables, knowledge on dental caries preventive measures, current anticipatory guidance, and experience with dental problems and oral care were collected using online and paper-based surveys. RESULTS: A total of 230 participants completed the survey, with a response rate of 50.1%. Most respondents (81%) had frequently noticed dental caries in children in their practice. Two-thirds of respondents felt confident in detecting dental caries. However, more than two-thirds were unfamiliar with preventive dental practices and the management of dental trauma. Only 16.5% of the respondents got a satisfactory knowledge score on the preventive measure questions, and nearly 51% had satisfactory knowledge on the recent anticipatory guidance questions. No significant correlations were found between gender or years of practice and knowledge scores. Respondents' confidence in detecting caries was significantly associated with the knowledge score of the anticipatory guidance (P = .003). Fewer than half of the respondents considered prescribing sugar-free syrup (47.4%) and counselled patients regarding the use of mouthguards during sports for schoolchildren (39%). CONCLUSIONS: The majority of paediatricians have adequate knowledge of the current anticipatory guidance of oral health issues, but they have insufficient knowledge of oral preventative measures and dental trauma. Adequate education and training in oral health are highly recommended.

Oral Health Knowledge and Experience of Pediatricians and Pediatric Residents in Kuwait: A Nationwide Cross-Sectional Survey Study.

Objective: To evaluate the knowledge level and practice of pediatricians and pediatric residents regarding children's oral health in Kuwait. Subjects and Methods. A nationwide cross-sectional survey was distributed to pediatricians and pediatric residents practicing in Kuwait. Data concerning demographic variables, knowledge on dental caries preventive measures, current anticipatory guidance, and experience with dental problems and oral care were collected using online and paper-based surveys. Results: A total of 230 completed the survey with a response rate of 50.1%. Most respondents (81%) had noticed dental caries in children more frequently. Two-thirds of respondents felt confident in detecting dental caries. However, more than two-thirds were unfamiliar with preventive dental practices and the management of dental trauma. Only 16.5% of the respondents got satisfactory knowledge score on the preventive measures questions, and nearly 51% got satisfactory knowledge on the recent anticipatory guidance questions. No significant correlations were found between gender or years of practice and knowledge scores. Respondents' confidence in detecting caries was significantly associated with the knowledge score of the anticipatory guidance (p=0.003). Conclusion: Dental caries is an oral problem commonly encountered by many pediatricians and pediatric residents in Kuwait. The majority has adequate knowledge of the current anticipatory guidance of oral health issues, but they have insufficient knowledge levels on oral preventative measures. Adequate education and training in oral health are highly recommended.

Caries Experience and Oral Health-related Factors of Kuwaiti Preschool Children and their Mothers: A Pilot Study.

AIM: The objective of this study was to investigate the association between the caries experience and oral-health-related behavior of Kuwaiti preschool children and their mothers. MATERIALS AND METHODS: A convenience sample of 84 participants (42 child-mother pairs) was selected. Data regarding children's and mothers' demographics, oral hygiene practices, and dietary habits were obtained by questionnaires. Oral clinical examinations were carried out on the participant children and mothers to determine their caries experience (decayed, missing, and filled teeth index-dmft/DMFT). RESULTS: An estimated 19% of children were caries-free and 66% of mothers have untreated caries. The mean dmft index of the preschool children was 3.90 ± 2.9, and the mean DMFT index of their mothers was 12.38 ± 5.4. Mothers' untreated caries was significantly associated with their children's untreated caries (r = 0.183, p < 0.05). No correlation was found between the brushing frequencies of children and their mothers (p = 0.582). High consumption of sugary snacks and sugary beverages was detected among the children and mothers with a significant association (p < 0.05). The mean dmft of the children was found to be significantly lower among the young mothers, less than 30 years, (2.4 ± 2.1) compared to that among the mothers older than 30 years (4.3 ± 2.9, p < 0.05). CONCLUSION: There was a high prevalence of early childhood caries in the preschool children studied. A positive correlation was found between the dental caries experience and sugar consumption of the Kuwaiti preschool children and those of their mothers. CLINICAL SIGNIFICANCE: The oral health status and dietary habits of mothers are potentially significant risk factors for the development of early childhood caries in their children. Pediatric dentists need to identify the main caries risk factors in their community in order to implement appropriate preventive dental care and educational programs. HOW TO CITE THIS ARTICLE: Husain FAAM, Alanzi AN. Caries Experience and Oral Health-related Factors of Kuwaiti Preschool Children and their Mothers: A Pilot Study. Int J Clin Pediatr Dent 2019;12(4):283-287.

Role of taste perception in white spot lesion formation during orthodontic treatment.

OBJECTIVES: To investigate the role of individual's taste sensitivity using 6-n-propylthiouracil (PROP) in the development of white spot lesions (WSLs) in adolescent orthodontic patients. MATERIALS AND METHODS: 44 healthy adolescents, aged 12 to 16 years old, who were in fixed-appliance orthodontic treatment for at least 6 months, consented to participate in this cross-sectional study. Data regarding participants' demographic information, oral hygiene practices, and dietary habits were obtained by a questionnaire. An oral clinical examination was performed to determine the oral hygiene status, the presence of WSLs and dental caries experience. The taste phenotype of the participants was evaluated through PROP test and they were accordingly divided into PROP nontasters and PROP tasters. RESULTS: The sample consisted of 24 subjects in the WSL group and 20 subjects in the WSL-free group. The WSL group demonstrated higher mean plaque score (48.2), mean decayed, missing, and filled surfaces (2.38), and mean decayed, missing, and filled teeth (1.96) scores compared to the WSL-free group (38.7, 0.85, and 0.55, respectively), but no significant differences were found. Most subjects in the WSL group were PROP nontasters (66.6%) whereas most subjects in the WSL-free group were PROP tasters (75%); a significant difference was observed between the groups (P = .006). CONCLUSIONS: The prevalence of white spot lesions was significantly higher in adolescent orthodontic patients who were PROP nontasters compared to PROP tasters. A PROP taste perception could be a potential risk factor for the formation of WSLs during fixed orthodontic treatment that warrants further attention.

Mothers' taste perceptions and their preschool children's dental caries experiences.

PURPOSE: This study's purpose was to determine the caries experiences of preschool children whose mothers exhibited various genetic taste sensitivities to sweet foods, as reflected by their ability to taste the chemical 6-n-propylthiouracil (PROP). METHODS: A convenience sample of 38 healthy two- to three-year-old preschool children and their mothers was selected. Data regarding maternal demographics and children's oral hygiene practices were obtained by questionnaires. Children received oral clinical examinations. Mothers received a PROP test to determine their taste type. RESULTS: Twenty mothers were PROP supertasters (disliking sweet food), and 18 mothers were PROP nontasters (liking sweet food). Children of nontaster mothers were found to have a greater prevalence of dental caries and a greater number of decayed, missing, and filled surfaces (dmfs) of maxillary anterior teeth than those of supertaster mothers (P<.05). Children of nontaster mothers whose grandparents reportedly lived in the same household had increased dmfs vs. those without grandparents in the household (P<.05). CONCLUSION: The prevalence of dental caries in two- to three-year-old-children was significantly greater in children of mothers who couldn't taste the chemical 6-n-propylthiouracil than those of mothers who could. A mother's PROP type could be an important variable related to the caries experience of preschool children.