Diagnosis and management of dental injuries in children.

Approximately half of children sustain some type of dental injury. Management of injuries to the anterior teeth of preschool children is directed toward minimizing potential damage to the developing permanent teeth; therefore, heroic measures to save primary teeth are not indicated. Crown fractures in the permanent dentition, even those exposing the dental pulp, can be successfully treated hours after an injury. Prompt referral for dental treatment is advisable. Displacement injuries to permanent teeth constitute genuine dental emergencies in which the prognosis is directly related to the timeliness of treatment. Avulsed permanent teeth should be immediately reimplanted by any capable person. If that is impossible, the teeth should be placed in cold milk and the child referred for immediate treatment by a dentist. Mouthguards prevent dental injuries but are not widely used outside of a few organized sports. Efforts should continue to promote mouthguard use in all contact sports.

Group effect on parental rating of acceptability of behavioral management techniques used in pediatric dentistry.

The rating of acceptability by parents either in groups of five or alone of behavior management techniques (BMT) displayed in videotaped vignettes was studied. Ratings of acceptability of the techniques for use on "a" vs. "their" child also were evaluated. Sixty parents were divided randomly into two groups (A and B). For Group A, six groups of five parents viewed a videotape containing eight BMT. All parents in Group B viewed the same videotape individually. Following the presentation of each BMT, the parents were requested to rate the technique for acceptability using a visual analogue scale (VAS). One half of Groups A and B were told to rate the acceptability of each BMT for use on "a" child. The remaining parents in Groups A and B were told to rate the acceptability for "their" child. The results indicated that there were no significant differences between groups (groupings of five vs. alone) or "their" and "a" child ratings. However, there was a consistent trend for those in groups to rate BMT as less acceptable than those rating alone. The implications of these findings are discussed in reference to findings of previous studies.

Parental attitudes toward behavior management techniques used in pediatric dentistry.

Previous studies evaluating parents' attitudes toward behavior management techniques used in pediatric dentistry suggest that parental attitudes are generally negative. The purpose of this study was to reexamine this issue by comparing the effect of prior explanation on parental acceptance of eight behavior management techniques. Videotaped segments were made of children's dental appointments containing examples of eight behavior management techniques. One group of 40 parents viewed a videotape which provided no explanation for each technique before it was shown. Another group of 40 parents viewed a videotape which provided no explanation of the techniques. The parents then were asked to rate the acceptability of each technique using a visual analogue scale. Results indicated that the informed parents were significantly more accepting of behavior management techniques than the uninformed parents but both groups were generally positive about the techniques studied. Further, parents reporting greater stress were less accepting of the techniques studied.

A study of facially expressed emotions as a function of age, exposure time, and sex in children.

Facial expressions and body language constitute a major component of communication in the human population. There are no studies in the dental literature that have examined children's ability to recognize facial expressions. The purpose of this study was to determine children's accuracy and latency to respond to facial expressions (photographs) as a function of age and sex. Sixty children were recruited randomly and placed into three groups according to their age (3, 6, and 9 years) with 20 children per group. They were shown photographs of three different emotions (happiness, anger, and sadness) expressed by actors at three different exposure times (0.2, 0.5, and 1.0 sec), tachistoscopically. The children's responses (accuracy and latency) were recorded. The results indicated that three year olds were significantly less accurate and took longer to respond than the older children. Factors that may have influenced the results and clinical implications are discussed.

Fluoride prescription practices of Ohio physicians.

In 1985 a fluoride supplement survey was mailed to all members of the Ohio Academy of Family Physicians and the Ohio chapter of the American Academy of Pediatrics. The response rate after two mailings was 60.2 percent. Of the respondents who were identified as either family physicians or pediatricians, 76.6 percent reportedly prescribed fluoride supplements for at least some of their child patients. Pediatricians were more likely to prescribe fluoride supplements than were family physicians. Younger physicians also were more apt to prescribe fluoride supplements than were their older colleagues. Only 6.2 percent of those physicians who prescribed fluoride adhered to a minimum protocol of inquiring about the fluoride content of the child's drinking water, having the water analyzed when the fluoride content was unknown, and continuing fluoride supplements until at least age ten. Medical schools, and especially residency programs, should include a preventive dental segment that uses a state-specific protocol for the prescription of fluoride, including where water may be analyzed. For those already in practice, the preferred method of providing information may be short articles in local journals or newsletters. Public health dentists should assist the medical profession in this educational process.

Association between children's dental behavior and play behavior.

The results of this study showed that clinical distinctions can be made regarding the behavior of children in the dental setting and that these distinctions are reflected in the behavior of these children in an easily-arranged play situation. The existence of such associations of behavior presents the possibility that play behavior may be a reliable predictor of maladaptive dental behavior. If so, the incorporation of a play dental area into a dental office would be an inexpensive and convenient method of intercepting potential problem dental patients. If the results of this study can be replicated, they would support the initiation of a study to predict the behavior of children in the dental setting by means of easily scorable aspects of their play behavior in a simulated dental environment. Special management considerations could then be made to prevent disruptive behavior at subsequent appointments. The results also point up the tendency of problem patients to avoid certain aspects of the play dental experience. This suggests a possible treatment potential for the dental play area, using it as an instrument to desensitize appropriate patients to those aspects of dental treatment which distress them, and thereby reduce their anxieties, prior to actual dental treatment.