Profile of the oral healthcare team in countries with emerging economies.

Health is a critical dimension of human well-being and flourishing, and oral health is an integral component of health: one is not healthy without oral health. Significant barriers exist to ensuring the world's people receive basic healthcare, including oral healthcare. Amongst these are poverty, ignorance, inadequate financial resources and lack of adequate numbers of educated and trained (oral) healthcare workers. Emerging economies are encouraged to develop a national strategic plan for oral health. International organizations have developed goals for oral health that can be referenced and adapted by emerging economies as they seek to formulate specific objectives for their countries. Demographic data that assess the nature and extent of oral diseases in a country are essential to sound planning and the development of an oral healthcare system that is relevant, effective and economically viable. Prevention should be emphasized and priority consideration be given to oral healthcare for children. The types and numbers of members of the oral healthcare team (workforce) will vary from country to country depending on the system developed. Potential members of the workforce include: generalist dentists, specialist dentists, dental therapists, dental hygienists, denturists, expanded function dental assistants (dental nurses) and community oral health workers/aides. Competences for dentists, and other members of the team, should be developed to ensure quality care and developed economies should cooperate with emerging economies. The development, by more advanced economies, of digital, virtual curricula, which could be used by emerging economies for educating and training members of the oral healthcare team, should be an important initiative. The International Federation of Dental Educators and Associations (IFDEA) should lead in such an effort.

Dental abnormalities of a long-term survivor of a childhood hematological malignancy: literature review and report of a case.

The treatment of haematological malignancy is multimodal and involves chemotherapy, radiotherapy and/or bone marrow transplants. With the advancement in cancer therapy, there is an increase in the survival of many children with childhood haematological malignancy. In addition, the late effect of the oncology treatment to the orofacial and dental development becomes significant in terms of the potential clinical impact that may affect the quality of life of the survivor. The severity of the long-term effects is dependent on the age of the child at initiation of treatment and whether chemotherapy is combined with radiation or not. The dental treatment may become more complex if the patient requires advanced restorative dental care and the roots malformation may complicate orthodontic treatment. Therefore these patients may require a scheduled careful preventive programme, long-term follow up, with prophylactic treatment and intervention at appropriate time to minimize the consequences of the disease and the given therapy.

Traumatic injuries to anterior teeth among schoolchildren in Malaysia.

Evidence of traumatized permanent incisors was recorded as part of a national oral health survey of schoolchildren in Malaysia. A total of 4,085 schoolchildren aged 16 years were examined. The prevalence of injury was 4.1% and it was significantly higher in males than females, with a ratio of 2:1. Almost 75% of the subjects had one tooth affected. Out of a total of 200 fractured teeth, 78.0% involved the maxillary central incisors. A high level of untreated traumatized teeth (89%) was noted. However, of the untreated traumatized teeth, only 9% presented with problems such as discoloration of tooth, sinus or abscess formation.

Dental anomalies in the primary dentition: distribution and correlation with the permanent dentition.

The study consisted of analysis of all cases of anomalies in the primary dentition that were seen or treated by the authors in the Department of Children's Dentistry and Orthodontics. A total of 79 occurrences of anomalies was seen in 65 children. The anomalies detected were double teeth, hypodontia and supernumerary teeth. Radiographic examinations of the affected children showed that over 60% of the cases with anomalies in the primary dentition are associated with anomalies of the succadeneous permanent dentition. All subjects with hypodontia of the primary dentition presented with hypodontia of the permanent dentition. However, anomalies of the permanent dentition were seen in 59% of subjects with primary double tooth and 50% of subjects with primary supernumerary tooth.

Dens invaginatus: complications and treatment of non-vital infected tooth.

A case of non-vital infected dens invaginatus of the maxillary right lateral incisor with open apex, which presented with pain and swelling is presented. Although root growth and apical closure was achieved using calcium hydroxide, the periapical infection persisted and resolution was only achieved after apical curettage and apicectomy.

Erupted compound odontoma.

A case is described in which a compound odontoma erupted into the oral cavity in an 8 1/2-year-old girl. The odontoma was initially discovered as a chance radiographic finding 2 years 8 months previously.

Double teeth--fusion or gemination?

Double teeth or joined teeth have been described under several different terms and the terminology is often confusing. There are several ways in which union of teeth can occur and the terms that are commonly used to describe the condition are fusion and gemination. Although primary double teeth themselves may be regarded as harmless anomalies, its presence can cause some abnormalities to occur in the permanent dentition. Therefore, early diagnosis of the anomaly is of considerable importance.

Supernumerary teeth in the premaxillary region: its effects on the eruption and occlusion of the permanent incisors.

The presence of supernumerary teeth in the premaxillary region may cause a variety of pathological effects. This study was carried out to determine the various aspects of supernumerary teeth in the premaxillary region, particularly the effects of the supernumerary teeth on the permanent incisors and surrounding tissues. Approximately 20 percent of the patients (n = 49) with supernumerary teeth did not present with any abnormality. A high proportion of patients (37.9 percent) had delayed or failure of eruption of permanent teeth and 24.1 percent had rotation or displacement of permanent teeth. Other effects observed were median diastema and cystic changes around the unerupted supernumerary tooth. The high proportion of pathological effects seen showed that early diagnosis of the anomaly is important to intercept damage to the adjacent normal teeth and surrounding tissues. However, no cases of root resorption of the permanent teeth due to the presence of supernumeraries were observed.

Management of ankylosed temporomandibular joint in a young child.

Various alloplastic and autogenous tissues have been used in attempts to restore facial height and reconstruct temporomandibular articulation. A case is presented where an ectodermal rib graft was used to reconstruct the temporomandibular joint after arthroplasty in a young child.

Hypodontia in the permanent dentition: a study of its prevalence in Malaysian children.

An investigation of the prevalence and distribution of hypodontia was carried out in Malaysian children between the ages of five to fifteen years. Hypodontia occurred in 2.8 per cent of these children. A greater number of females were found to have hypodontia, the ratio of affected females to males is 1.6:1. The teeth most frequently missing were the maxillary lateral incisors followed by the mandibular lateral incisors, then the mandibular second premolars. The aetiology of the condition is discussed. It is noteworthy that studies showing the lower second premolars to be most commonly missing have younger subjects. This suggests delayed development of these teeth in some individuals.

The prevalence and distribution of enamel defects in 11-12 year old Malaysian schoolchildren.

The prevalence and symmetrical distribution of enamel defects were studied in 218 Malaysian school children aged 11-12 years old. The tooth prevalence of enamel defect was 40.3 per cent. The first permanent molars were the most severely affected, whereas the lower incisors were the least severely affected. Overall there was no sex difference. Distribution of symmetry was assessed between the right and left tooth pairs as well as for upper and lower teeth. A higher proportion of symmetry was observed for the right and left tooth pairs and the lingual surfaces showed a greater percentage of bilateral distribution.

Aneurysmal bone cyst of the mandible.

A case report of aneurysmal bone cyst of the mandible in a seven-year-old boy which caused the destruction and loss of the bony crypt around the tooth germ and displacement of the unerupted tooth is presented. This unusual dental findings have not been previously reported in the dental literature.

Bilateral symmetrical fusion of primary and permanent mandibular lateral incisors and canines.

A case is presented where there is bilateral symmetrical fusion of the mandibular lateral incisors and canines involving the primary and permanent dentition. The etiology and treatment of the anomaly are discussed.

An analysis of sugar content of commonly used pediatric liquid medicines--its relevance to dentistry.

The sugar content of twenty-four liquid medicines commonly prescribed for infants and young children were measured and the type of sugars present were also identified in four randomly selected samples. All the liquid medicines tested contained sugar, in the range of 29.4% to 61.2%. Sucrose appeared to be the most commonly used sugar. Whilst it is agreed that sucrose makes the medicine more acceptable to children, its continual use by the pharmaceutical industry should be discontinued due to its harmful effect on the dental health of children, particularly those taking these syrup-based medicines on prolonged basis. Sugar-free alternatives such as sorbitol or saccharin should be used instead.

Double teeth with hypodontia in identical twins.

There is now considerable evidence to support the theory that heredity is the origin of this anomaly. The condition in one of the twins described here was the mirror image of the condition of the other.

A retrospective study of double teeth in the primary dentition.

The study was carried out on 20 subjects with evidence of double teeth, which included gemination and fusion, in the primary dentition. The age of the subjects ranged from 2 1/2 to 9 years. The results of the study indicated that double teeth occurred more frequently in the males and that fusion was much more prevalent than gemination. The frequency of occurrence in the right and left side of the jaws was comparable. About 79 percent of the occurrence was seen in the mandibular arch. A high proportion of fusion was found to involve the lateral incisors and canines. In 50 percent of the occurrence, hypodontia of the permanent dentition was observed, all of which involved the lateral incisors. The clinical significance of the condition was also discussed.

Enamel defects in 11-12 year-old subjects in a fluoridated area.

Enamel defects were studied in a group of 11-12 year-old children in a fluoridated area using the DDE index. The mouth prevalence of this condition was 72.5 per cent with a tooth prevalence of 40.4 per cent. Enamel opacities accounted for 96.5 per cent of the total condition of which the diffuse patchy type predominates. The defects on the affected posterior teeth occurred most commonly on both the buccal and lingual/palatal surfaces, with most defects being located in the incisal one-half, gingival one-half and occlusal simultaneously. In the affected incisors, the highest proportion of defects affected the buccal surface only, with the most frequent location being the incisal one-half and gingival one-half simultaneously. In 20.9 per cent of the affected subjects, there was a 100 per cent tooth involvement.