Dental age estimation by assessing the pulp volume of five teeth in a peruvian population using cone beam computed tomography images / Estimación de la edad dental evaluando el volumen pulpar de cinco dientes utilizando imágenes de tomografías computarizadas de haz cónico en una población peruana

Abstract Dental age estimation is very important for individual identification in criminal and civil forensic investigations. One of the methods for age estimation is studying age related changes in pulp volume of teeth. The objective of the current study was to estimate dental age from the pulp volume of five different categories of teeth of a Peruvian sample using cone beam computed tomography (CBCT). Retrospective CBCT records of 231 patients (females (134), males (97), age: 12-60 years) were included in the study, categorized into five different age groups (12-19, 20-29, 30-39, 40-49, 50-59, 60 years and older). Dental pulp volume of five categories of teeth(upper canines, left upper central incisors, left upper first molars, lower left first premolars, first molars) were analyzed using Romexis® 5.3.3.5 software for each patient. There was a reduction in the pulp volume of upper right and left canine with age. The Pulp volume was lowest in people aged 60 years and over. Linear regression analysis of the pulp volume and chronological age showed a coefficient of determination of 30%, suggesting a weak correlation. A weak correlation between dental pulp and age is derived. But, a robust large homogenous sample of teeth in future for different age groups may establish a reliable regression equation.

Resumen La estimación de la edad dental en personas vivas y cadáveres es muy importante para la Odontología Forense, sobre todo en casos de identificación en investigaciones legales y sociales. El objetivo del estudio fue estimación de la edad dental mediante la medición del volumen pulpar de imágenes dentales en tomografía computarizada de haz cónico (TCHC) de pacientes peruanos. Fueron analizadas 231 TCHC de pacientes entre 12 a 60 años a más. (Mujeres (134), hombres (97)) se dividieron en seis grupos de edad (12-19, 20-29, 30-39, 40-49, 50-59, 60 años a más). El análisis volumétrico de la pulpa dental se realizó en un total de 1155 dientes (caninos superiores, incisivos centrales superiores izquierdos, primeros molares superiores izquierdos y primeros premolares inferiores izquierdos), mediante el software Romexis® 5.3.3.5. El análisis de regresión lineal mostró un coeficiente de determinación del 30% que sugiere una correlación débil entre la relación del volumen pulpar de los dientes y la edad. El volumen pulpar de los caninos superiores derecho e izquierdo disminuyó a medida que aumentaba la edad y el volumen pulpar en dientes de personas de 60 años a más fue el más bajo. Sin embargo, se pueden proponer estudios futuros para incluir una gran muestra homogénea de dientes en diferentes categorías y grupos de edad para confirmar la correlación y establecer una ecuación de regresión confiable.

A community survey on maternal perception about the initiation of dental home for infants in Lagos, Nigeria.

INTRODUCTION: because efforts directed toward oral health promotion and disease prevention are fundamentally superior to dental rehabilitation after disease development, early preventive dental visits are widely encouraged by dental professional and academic stakeholders. Aim: this study aimed to determine the perceptions and practices of mothers with regards to the establishment of dental home at four local government areas (LGAs) in Lagos, Nigeria. METHODS: was a community-based descriptive household survey conducted amongst mothers in Alimosho, Ikorodu, Surulere and Epe LGAs of Lagos State. Socio-demographic data, information about the importance of primary teeth, knowledge about dental home as well as their child´s age at first dental visit and reasons for attending was obtained with a validated, structured interviewer administered questionnaire. Descriptive statistics, Chi-square and multivariable regression analysis were conducted, and the level of significance was set at P<0.05. RESULTS: the highest proportion of the mothers were aged between 26-30 years (27.4%; mean age: 34.58±7.8 years) and had a tertiary level of education (n=206, 59.9%); most respondents (n=80, 51.4%) did not know the age a child should be taken to the dental clinic for the first time and had not taken their child for any dental visit (n=229, 65.4%). Out of those who had previously taken their child for dental visits, the greater proportion (n=115, 95.0%) took the child when he/she was older than one year of age. Overall, only 126 (36.0%) respondents had a good perception about oral health and the need for a dental home while 224 (64.0%) respondents had poor knowledge. Logistic regression analysis of predictor variables that showed mothers with a tertiary level of education (OR=0.108; CI=0.0023-0.495) and those with 2-3 children (OR=0.482; CI=0.253-0.920) had significant lower odds of poor perception about the importance of a dental home. CONCLUSION: maternal knowledge and practices with regards to dental home were poor and inadequate. It is necessary to create more awareness among parents/caregivers, especially through antenatal and immunization clinics to establish the concept of dental home.

Associação entre idade na primeira consulta odontológica e tipo de tratamento dentário realizado em pacientes infantis: estudo transversal / Association between age of the first dental visit and type of dental treatment performed in infant patients: a cross-sectional study

Objetivo: Avaliar a associação entre idade na primeira consulta odontológica e o tipo de tratamento dentário realizado em pacientes infantis por meio de um estudo transversal que avaliou registros em prontuários odontológicos. Métodos: A coleta de dados foi realizada por meio de prontuários de pacientes de 0-5 anos atendidos em uma Clínica Escola de Odontologia, de março de 2014 a julho de 2018, com registro de informações referentes às características dos participantes e procedimentos odontológicos realizados. Para a análise dos dados, foram calculadas medidas descritivas e posteriormente os dados foram ajustados em um modelo de regressão logística; o desfecho foi o tipo de procedimento realizado, dicotomizado em tratamentos não-invasivos (fluorterapia e/ou restauração) e invasivos (endodontia e/ou exodontia). Resultados: Foram avaliados prontuários de 210 crianças, com média de idade na primeira consulta de 38 meses (DP=14,5). Fluorterpia e/ou restauração foram realizados em 74,8% das crianças, enquanto tratamentos invasivos foram realizados em 25,2% da amostra. A análise ajustada indicou um incremento (OR = 1,03, p = 0,027) na chance de realização de tratamentos invasivos com o aumento da idade das crianças na primeira consulta odontológica. Conclusão: Quanto maior a idade das crianças na primeira consulta, maior a chance de terem recebido um tratamento invasivo. Ressalta-se a importância da consulta odontológica nos primeiros meses de vida, com a finalidade de prevenção e manutenção da saúde bucal.(AU)

Objective: To evaluate the association between the age of the first dental visit and the type of dental treatment performed in infant patients through a cross-sectional study that examined dental records from the years 2014 to 2018. Methods: Data collection was conducted using medical records of patients aged 0 to 5 years treated at a Dental School Clinic, including information about participants' characteristics and the types of dental procedures performed. For data analysis, descriptive measures were calculated, and the data were subsequently fitted into a logistic regression model. The outcome was categorized into non-invasive treatments (fluoridation therapy and/or restoration) and invasive treatments (endodontics and/or extraction). Results: Medical records of 210 children were evaluated, with a mean age of the first dental visit being 38 months (SD = 14.5). Non-invasive treatments, including fluoride therapy and/or dental restoration, were performed in 74.8% of children, while invasive treatments were performed in 25.2% of the sample. Adjusted analysis indicated an increase (OR = 1.03, p = 0.027) in the odds of undergoing invasive treatments as the children's age at the first dental visit increased. Conclusion: Older age at the first appointment was associated with increased odds of receiving invasive treatment. The significance of early dental consultations within the first months of life is underscored, aiming to prevent and maintain oral health.(AU)

Comportamento da criança durante o atendimento odontológico nas clínicas de uma instituição de ensino pública / Child behavior during dentistry treatment

Objetivo: avaliar o comportamento de crianças de 3 a 7 anos durante o atendimento odontológico nas clínicas de uma instituição de ensino pública e sua relação com características demográficas e relacionadas aos procedimentos realizados. Metodologia: foram avaliados os prontuários odontológicos de crianças entre 3 e 7 anos de idade para coleta de dados demográficos, socioeconômicos, histórico de internação hospitalar e de atendimento odontológico prévio, tipo de procedimento executado e comportamento. Os dados foram tabulados no Microsoft Excel® e analisados por meio de estatística descritiva no Programa Stata versão 12.0. Resultados: foram incluídos no estudo 81 prontuários odontológicos (40,9%). A maioria das crianças pertencia ao sexo masculino (50,6%), raça branca (77,3%), com renda familiar de até 2 salários-mínimos (73%), as mães apresentavam mais de 9 anos de estudo (54,6%) e a criança não tinha histórico de internação hospitalar (61,3%). A maioria apresentou comportamento colaborador nas consultas com procedimentos pouco invasivos e invasivos, percebendo-se, de uma maneira geral, um aumento gradativo da colaboração com o passar da idade, independentemente do tipo de procedimento. Nas consultas com procedimentos muito invasivos constatou-se que a maioria tende a ser colaboradora (66,4%), porém em proporção menor que nos pouco invasivos (83,3%) e invasivos (78,0%). Conclusão: As crianças apresentaram, em sua maioria, comportamento colaborador frente aos procedimentos odontológicos executados por estudantes e empregando técnicas de manejo do comportamento não farmacológicas. A frequência de comportamento colaborador foi maior em crianças de 5 anos ou mais e que realizaram procedimentos pouco invasivos.(AU)

Objective: to evaluate the behavior of children aged 3 to 7 years during dental care at the clinics of a public educational institution and its relationship with demographic characteristics and those related to the procedures performed. Methodology: the dental records of children between 3 and 7 years of age were evaluated to collect demographic and socioeconomic data, history of hospitalization and previous dental care, type of procedure performed and behavior. Data were tabulated in Microsoft Excel® and analyzed using descriptive statistics in Stata version 12.0. Results: 81 dental records (40.9%) were included in the study. Most children were male (50.6%), white (77.3%), with family income of up to 2 minimum wages (73%), mothers had more than 9 years of study (54, 6%) and the child had no history of hospitalization (61.3%). Most showed a collaborative behavior in consultations with minimally invasive and invasive procedures, with a general increase in collaboration being observed with age, regardless of the type of procedure. In consultations with very invasive procedures, it was found that the majority tend to be collaborative (66.4%), but in a smaller proportion than in the slightly invasive (83.3%) and invasive (78.0%). Conclusion: Most of the children showed collaborative behavior when faced with dental procedures performed by students and using non-pharmacological behavior management techniques. The frequency of collaborative behavior was higher in children aged 5 years or older who underwent minimally invasive procedures.(AU)

A Resident-Led QI Project to Improve Dental Health at a Primary Care Pediatric Practice.

BACKGROUND: Dental caries are the most common chronic condition of childhood and have significant medical, psychological, and financial consequences. The American Academy of Pediatrics (AAP) recommends primary care physicians apply fluoride varnish (FV) every 3 to 6 months from tooth emergence through age 5. OBJECTIVE: Through a resident-led quality improvement (QI) project, we aimed to provide FV to 50% of patients ages 1 through 5 who did not have a dental visit in the preceding 6 months or receive FV elsewhere in the past month. METHODS: From May 2017 through April 2018, we conducted 7 monthly plan-do-study-act cycles to improve our primary outcome measure (FV application), secondary outcome measure (percentage of patients who had routine dental care), and process measure (percentage of dental referrals). Balancing measures included time taken away from other clinical priorities and reimbursement rates. RESULTS: Fluoride varnish application improved from 3.6% to 44% with a 54% peak. The percentage of patients under 6 who had seen a dentist in the past 6 months increased from 30% to 47%. The percentage of dental referrals increased from 17% to 33%. CONCLUSIONS: Application of FV is a quick, cost-effective way for primary care providers to improve dental health. This resident-led QI project increased rates of FV application, dental referrals, and dental visits while meeting ACGME guidelines for experiential learning in QI. By adapting to state-specific guidelines and workflows of each clinic, this QI project could be nationally reproduced to improve adherence to AAP and United States Preventive Services Task Force guidelines.

Does Preventive Care Reduce Severe Pediatric Dental Caries?

INTRODUCTION: Tertiary oral health services (caries-related surgery, sedation, and emergency department visits) represent high-cost and ineffective ways to improve a child's oral health. We measured the impact of increased Texas Medicaid reimbursements for preventive dental care on use of tertiary oral health services. METHODS: We used difference-in-differences models to compare the effect of a policy change among children (≤9 y) enrolled in Medicaid in Texas and Florida. Linear regression models estimated 4 outcomes: preventive care dental visit, dental sedation, emergency department use, and surgical event. RESULTS: Increased preventive care visits led to increased sedation visits (1.7 percentage points, P < .001) and decreased emergency department visits (0.3 percentage points, P < .001) for children aged 9 years or younger. We saw no significant change in dental surgical rates associated with increased preventive dental care reimbursements. CONCLUSION: Increased access to preventive dentistry was not associated with improved long-term oral health of Medicaid-enrolled children. Policies that aim to improve the oral health of children may increase the effectiveness of preventive dentistry by also targeting other social determinants of oral health.

Actitud del odontopediatra en la clínica dental ante la pandemia del COVID-19 / Paediatric dentist’s approach in the surgery to the covid-19 pandemic

INTRODUCCIÓN: La aparición del nuevo virus del síndrome respiratorio agudo severo Coronavirus 2 (SARS-CoV-2) ha causado una pandemia mundial llamada enfermedad del coronavirus (COVID-19) y se ha convertido en uno de los desafíos más grandes entre los profesionales dedicados a la salud. Dado que el sector sanitario bucodental es una de las poblaciones de riesgo, se debe tener especial cuidado para minimizar dicho riesgo de infección así como evitar el contagio entre profesionales y pacientes. Los síntomas respiratorios de esta enfermedad en los niños parecen ser más leves que los que experimentan los adultos, se conoce que transmiten la enferme-dad, pero los datos emergentes sobre la propagación en niños afectados por CO-VID-19 no es conocida aún en detalle. El propósito de este artículo es analizar a través de una encuesta online si los odontopediatras prevén cambios en la forma habitual de trabajo para evitar el riesgo de contagio por COVID-19 durante el trata-miento dental con pacientes infantiles. MATERIAL Y MÉTODO: se realizó una en-cuesta online dirigida a odontopediatras y odontólogos que trabajaran con niños, con preguntas sobre el conocimiento y actitud frente al COVID-19 en la consulta dental. Se registraron las variables sexo, edad, años de profesión y posesión de título en Odontopediatría. RESULTADOS: se recogieron 93 cuestionarios y se analizaron los resultados estadísticamente para cada ítem del cuestionario, representados en gráficas de porcentajes de respuesta. La mayoría de los encuestados fueron mujeres, edad media de 34,5 años, que utilizan a diario instrumental rotatorio, pero a favor de tratamientos mínimamente invasivos; cumplen con las medidas de protección, pero a veces para el manejo de la conducta infantil no es posible. CONCLUSIONES: en general, el odontopediatra deberá adaptarse a la nueva situación con el niño con respecto a las técnicas de tratamiento, así como todos los miembros del equipo dental, ya que tienen la responsabilidad profe-sional de mantenerse informados y actualizados respecto a los nuevos datos que vayan surgiendo sobre COVID-19, no solo para protegerse de posibles contagios sino tam-bién para evitar la propagación a los pacientes infantiles que acudan a realizarse un tratamiento odontológico

INTRODUCTION: The coronavirus disease (COVID-19) pandemic has been caused by appearance of a new virus called the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); and has become one of the greatest challenges for health professionals. The oral health sector is one of the populations at risk, so special care must be taken to minimise the risk of infection and prevent contagion between professionals and patients.The respiratory symptoms of this disease in children appear to be milder than those experienced by adults. Children are known to transmit the disease, but emerging data on the spread in children affected by COVID-19 is not yet known in detail.The purpose of this article is to analyse whether paediatric dentists foresee changes in their usual way of working to minimise the risk of COVID-19 infection during treatment of their patients through conducting an online survey. MATERIAL AND METHOD: An online survey was conducted of paediatric dentists and dentists working with children, with questions about their knowledge of and attitude towards COVID-19 in the dental clinic. The variables of sex, age, years of profession and having a paediatric dentistry qualification were recorded. RESULTS: 93 questionnaires were collected, the results for each item on the questionnaire were represented graphically with the percentage response and analysed statistically. Most of the respondents were women, mean age 34.5 years, who used rotary instruments daily, but were in favour of minimally invasive treatments; they usually complied with the protective measures, but sometimes this was not possible when managing child behaviour. CONCLUSIONS: In general, paediatric dentists are adapting to the new situation with children regarding treatment techniques and with other dental team members, as they have the professional responsibility to keep themselves informed and updated regarding new information about COVID-19; not only to protect themselves from possible infection but also to prevent spreading the infection to children undergoing dental treatment

Odontogenic Infection and dental Pain negatively impact Schoolchildren's Quality of Life.

The aim of this study is to assess the prevalence of odontogenic infection in low-income Brazilian schoolchildren and evaluate its association with the subjective variables of oral health-related quality of life and dental pain. In this cross-sectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ8-10) and self-reports of dental pain were collected. Data were statistically analyzed using MannWhitney or Kruskal-Wallis test with a post-test by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional well-being (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among low-income Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's self-perception of quality of life.

O objetivo deste estudo foi avaliar a prevalência de infecção odontogênica em crianças escolares brasileiras de baixa renda e analisar a sua associação com as variáveis subjetivas da autopercepção de qualidade de vida relacionada à saúde bucal e dor dentária. Neste estudo transversal, 230 crianças escolares com 8 a 10 anos de idade realizaram exame clínico bucal no qual os índices CPO-D/ceo-d e PUFA/pufa foram mensurados. Com isso, as crianças responderam individualmente ao Child Perceptions Questionnaire (CPQ8-10) e relatos de dor dentária foram coletados. Os dados foram estatisticamente analisados utilizando-se o teste Mann-Whitney ou Kruskal-Wallis, com posterior teste da correlação de Dunn e Pearson. Dentre as crianças examinadas, 42,6% apresentavam infecção odontogênica e 80% reportou experiência de dor dentária. A idade (p=0,034) e experiência de dor dentária (p<0,002) das crianças foram associadas à infecção odontogênica, bem como o seu bem-estar emocional (p=0,008) e social (p=0,009) e impacto geral na qualidade de vida (p=0,019). Além disso, a intensidade (p<0,001), frequência (p<0,001) e duração (p<0,001) da odontalgia foram correlacionadas com o impacto geral na qualidade de vida da criança. A prevalência de infecção odontogênica permanece elevada em crianças escolares brasileiras. Infecção pediátrica e sua dor relacionada induzem não apenas diversas desordens biológicas, mas também afetam negativamente a auto-percepção de qualidade de vida das crianças.

Knowledge of and attitudes toward COVID-19 among parents of child dental patients during the outbreak.

The aim of this study was to evaluate the knowledge of and attitudes toward coronavirus disease 2019 (COVID-19) among the parents of child dental patients in Shenzhen during the outbreak. A structured questionnaire containing 10 questions was used, and each question had 2 or 3 possible answers. The parents of children (aged 0-14 years) who visited the dental department of our hospital last year were eligible to participate in this study. A total of 148 parents were interviewed by telephone in February 2020 by research staff. A total of 94.59% of the parents said they paid high attention to COVID-19 and explained it to their children; 66.22% thought the dental department environment was more dangerous than other public places; 91.89% believed the dental department had a higher risk of virus infection; and 83.78% said they would take their children to a dental department if the children had a severe toothache. Approximately 81.08% of the parents expressed confidence after we informed them about the preventive measures taken in the dental department to ensure safe treatment for their children. In conclusion, all parents were concerned about COVID-19, and most of them had talked about it with their children often. In addition, a considerable percentage of them would not take their children to the dental department even if they had severe dental pain and thought that the dental environment could be more dangerous than other environments. More information about this topic should be delivered to this population.

Odontogenic Infection and dental Pain negatively impact Schoolchildrens Quality of Life / Infecção odontogênica e odontalgia impactam negativamente a qualidade de vida de crianças escolares

ABSTRACT The aim of this study is to assess the prevalence of odontogenic infection in lowincome Brazilian schoolchildren and evaluate its association with the subjective variables of oral healthrelated quality of life and dental pain. In this crosssectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ810) and selfreports of dental pain were collected. Data were statistically analyzed using MannWhitney or KruskalWallis test with a posttest by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional wellbeing (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among lowincome Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's selfperception of quality of life.

RESUMO O objetivo deste estudo foi avaliar a prevalência de infecção odontogênica em crianças escolares brasileiras de baixa renda e analisar a sua associação com as variáveis subjetivas da autopercepção de qualidade de vida relacionada à saúde bucal e dor dentária. Neste estudo transversal, 230 crianças escolares com 8 a 10 anos de idade realizaram exame clínico bucal no qual os índices CPOD/ ceod e PUFA/pufa foram mensurados. Com isso, as crianças responderam individualmente ao Child Perceptions Questionnaire (CPQ810) e relatos de dor dentária foram coletados. Os dados foram estatisticamente analisados utilizandose o teste MannWhitney ou KruskalWallis, com posterior teste da correlação de Dunn e Pearson. Dentre as crianças examinadas, 42,6% apresentavam infecção odontogênica e 80% reportou experiência de dor dentária. A idade (p=0,034) e experiência de dor dentária (p<0,002) das crianças foram associadas à infecção odontogênica, bem como o seu bemestar emocional (p=0,008) e social (p=0,009) e impacto geral na qualidade de vida (p=0,019). Além disso, a intensidade (p<0,001), frequência (p<0,001) e duração (p<0,001) da odontalgia foram correlacionadas com o impacto geral na qualidade de vida da criança. A prevalência de infecção odontogênica permanece elevada em crianças escolares brasileiras. Infecção pediátrica e sua dor relacionada induzem não apenas diversas desordens biológicas, mas também afetam negativamente a autopercepção de qualidade de vida das crianças.

Técnicas en el manejo de la conducta del paciente odontopediátrico / Techniques in the management of the odontopediatric patient's conduct

INTRODUCCIÓN: El objetivo del presente trabajo fue evaluar las técnicas convencionales más utilizadas por el odontólogo para el manejo de la conducta del paciente infantil en la consulta dental. Diversas técnicas pueden ser aplicadas dependiendo del desarrollo físico y emocional del paciente y de la capacidad del profesional. La Academia Americana de Odontopediatría, en su guía sobre técnicas del comportamiento, las divide en: técnicas de comunicación, otras técnicas básicas y técnicas avanzadas, recomendando las pertenecientes al primer grupo. MATERIAL Y MÉTODO: Se realizó un cuestionario en la plataforma de Google, remitido vía email a 190 odonto/estomatólogos que tratasen pacientes infantiles, obteniendo un total de 115 respuestas adecuadas para el análisis de 8 técnicas convencionales de manejo de la conducta. El estudio estadístico se realizó en el programa SPSS aplicando el test de ANOVA para una significación de p= 0,05. RESULTADOS: La técnica más utilizada por los diferentes profesionales fue la técnica decir-mostrar-hacer seguida de refuerzo positivo y control de voz. Técnicas de modificación de la conducta ocuparon un segundo término: desensibilización seguida muy de cerca por imitación. La técnica menos empleada fue la anestesia general. No encontramos diferencias significativas en relación al sexo en ninguna de las técnicas analizadas excepto en el uso de premedicación (p: 0,027), siendo los varones los que más frecuentemente la utilizaban. No se encontraron diferencias significativas en relación a la especialidad ni con la edad de los profesionales. CONCLUSIONES: Las técnicas comunicativas fueron las preferidas por los odontoestomatólogos siendo las técnicas avanzadas las menos utilizadas

INTRODUCTION: The objective of this work was to evaluate the conventional techniques most used by the dentist for the management of the behavior of the child patient in the dental office. Various techniques can be applied depending on the physical and emotional development of the patient and the professional's ability. The American Academy of Pediatric Dentistry, in its guide on behavioral techniques, divides them into: communication techniques, other basic techniques and advanced techniques, recommending those belonging to the first group. MATERIAL AND METHOD: A questionnaire was carried out on the Google platform, sent via email to 190 dentists / stomatologists who treated child patients, obtaining a total of 115 appropriate responses for the analysis of 8 conventional behavior management techniques. The statistical study was carried out in the SPSS program by applying the ANOVA test for a significance of p = 0.05. RESULTS: The technique most used by different professionals was the say-show-do technique followed by positive reinforcement and voice control. Behaviour modification techniques occupied a second term: desensitization followed closely by imitation. The least used technique was general anesthesia. We found no significant differences in relation to sex in any of the techniques analyzed, except in the use of premedication (p: 0.027), with men being the most frequently used. No significant differences were found in relation to the specialty or the age of the professionals. CONCLUSIONS: The communication techniques were preferred by the professionals, with the advanced techniques being the least used

Estimation of Caries Treatment Needs in First Permanent Molars of Lithuanian 5-6-Year-Old Children, Based on Caries Lesion Activity Assessment.

Background and Objectives: Early detection of dental caries lesions at active stages of development can facilitate their monitoring and reduce needs for restorative dental care. This study aimed to describe the prevalence and caries treatment needs in first permanent molars of pre-school children, based on a caries lesion activity assessment, and in relation to participants' ages, dental plaque levels and toothbrushing habits. Materials and Methods: Large cross-sectional dental caries survey using multistage cluster sampling was conducted among Lithuanian 4-6-year-old children attending kindergartens. For the present study purpose, all individuals presenting erupted permanent molars were selected. Thus, only 5-6-year-olds (n = 453) took part in this study. They were examined for caries by one calibrated examiner using Nyvad clinical diagnostic criteria that differentiate between active and inactive caries lesions. Dental plaque was assessed by the Silness-Löe index, and parents' reports about toothbrushing frequency were collected. Results: Overall, 41% of permanent molars were affected by caries; 6-year-olds had more caries lesions than 5-year-olds (p <0.05). Mean number of decayed and filled surfaces (DF-S) of all participants was 1.79 (SD 2.93), half of lesions were noncavitated, more than one-third were cavitated and fillings comprised less than one surface per child. Majority of lesions were active; prevalence of inactive lesions (all noncavitated) was 1% and 6% in 5- and 6-year-olds, respectively. Prevalence of active lesions increased with age; it correlated with plaque levels and with toothbrushing frequency (<0.001). Likelihood to detect active lesions was up to nine times higher in teeth with abundant plaque (odds ratio (OR) 8.73; confidence interval (CI) 5.35-14.25), and up to seven times higher in individuals brushing teeth irregularly (OR 6.88; CI 2.21-21.41). Conclusions: The obtained data indicate high treatment needs in the erupted permanent molars of the Lithuanian pre-school population and imply that caries management should primarily focus on improved biofilm removal, accompanied with regular use of fluoridated toothpaste.

Understanding the association between self-reported poor oral health and exposure to adverse childhood experiences: a retrospective study.

BACKGROUND: Adverse childhood experiences, including physical, sexual or emotional abuse, can have detrimental impacts on child and adult health. However, little research has explored the impact that such early life experiences have on oral health. This study examines whether experiencing adverse childhood experiences before the age of 18 years is associated with self-reported poor dental health in later life. METHODS: Using stratified random probability sampling, a household survey (N = 5307; age range 18-69 years) was conducted in the South of England (Hertfordshire, Luton and Northamptonshire). Data were collected at participants' homes using face-to-face interviews. Measures included exposure to nine adverse childhood experiences, and two dental outcomes: tooth loss (> 8 teeth lost due to dental caries or damage) and missing or filled teeth (direct or indirect restorations; > 12 missing or filled teeth). RESULTS: Strong associations were found between exposure to childhood adversity and poor dental health. The prevalence of tooth loss was significantly higher (8.3%) in those with 4+ adverse childhood experiences compared to those who had experienced none (5.0%; p < 0.05). A similar relationship was found for levels of missing or filled teeth (13.4%, 4+ adverse childhood experiences; 8.1%, none; p < 0.001). Exposure to 4+ adverse childhood experiences was associated with a higher level of tooth loss and restorations at any age, compared to individuals who had not experienced adversity. Demographically adjusted means for tooth loss increased with adverse childhood experience count in all age groups, rising from 1.0% (18-29 years) and 13.0% (60-69 years) in those with none, to 3.0% and 26.0%, respectively in those reporting 4+. CONCLUSIONS: Exposure to childhood adversity could be an important predictive factor for poor dental health. As oral health is an important part of a child's overall health status, approaches that seek to improve dental health across the life-course should start with safe and nurturing childhoods free from abuse and neglect. Given the growing role that dental professionals have in identifying violence and abuse, it seems appropriate to raise awareness in the field of dentistry of the potential for individuals to have suffered adverse childhood experiences, and the mechanisms linking childhood adversity to poor dental health.

"Who cares" is key: factors associated with oral health status in children living with HIV in Phnom Penh, Cambodia.

This cross-sectional study aimed to identify social, clinical, and behavioral factors associated with the oral health status of children living with HIV in Phnom Penh, focusing particularly on the effect of primary caregiver type. Data were collected through separate interviews with children and caregivers. The decayed, missing, filled permanent teeth (DMFT) index and debris index scores were assessed for each child. Associations between oral health status and caregiver type as well as with other factors were examined using multiple linear regression. Of 142 total dyads (mean child and caregiver age, 12.3 (SD 1.8) and 44.8 (SD 10.6) years, respectively) 48.6% and 29.6% of caregivers were biological parents and institutional staff, respectively. Children with institutional staff as a primary caregiver had a lower DMFT score (2.81 vs. 5.50), higher rate of ever visiting a dentist (90.5% vs. 50.7%), and better oral health status than those cared for by biological parents. Higher DMFT score was negatively associated with institutional staff as primary caregiver (ß: -1.642, 95% CI: -2.925, -0.360) and positively associated with longer antiretroviral therapy period (ß: 0.223, 95% CI: 0.056, 0.390). Targeted oral health care programs are needed for children living with HIV whose biological parents are their primary caregivers.

Knowledge of and attitudes toward COVID-19 among parents of child dental patients during the outbreak

Abstract: The aim of this study was to evaluate the knowledge of and attitudes toward coronavirus disease 2019 (COVID-19) among the parents of child dental patients in Shenzhen during the outbreak. A structured questionnaire containing 10 questions was used, and each question had 2 or 3 possible answers. The parents of children (aged 0-14 years) who visited the dental department of our hospital last year were eligible to participate in this study. A total of 148 parents were interviewed by telephone in February 2020 by research staff. A total of 94.59% of the parents said they paid high attention to COVID-19 and explained it to their children; 66.22% thought the dental department environment was more dangerous than other public places; 91.89% believed the dental department had a higher risk of virus infection; and 83.78% said they would take their children to a dental department if the children had a severe toothache. Approximately 81.08% of the parents expressed confidence after we informed them about the preventive measures taken in the dental department to ensure safe treatment for their children. In conclusion, all parents were concerned about COVID-19, and most of them had talked about it with their children often. In addition, a considerable percentage of them would not take their children to the dental department even if they had severe dental pain and thought that the dental environment could be more dangerous than other environments. More information about this topic should be delivered to this population.

Food Insecurity and Health Care Use.

BACKGROUND AND OBJECTIVES: Fifteen percent of US children live in households with inadequate food. Children who are food insecure often experience worse physical, emotional, and developmental health outcomes. Authors of previous studies have not examined the quality and cost implications of food insecurity in children. METHODS: This is a retrospective study of 7959 nationally representative US children (aged 1-17 years) in the 2016 Medical Expenditure Panel Survey. Households with food insecurity were identified by ≥3 positive responses to the 30-day, 10-item US Food Security Survey. Main outcomes were annual health expenditures and quality of care indicators: emergency department (ED) and inpatient use, primary care and specialist visits, routine medical and dental care, patient experience measures, and school absenteeism. Logistic and 2-part regression models were constructed to estimate outcomes conditional on sociodemographic and medical covariates. RESULTS: Children in households with food insecurity were more often publicly insured and had special needs compared with all other children. In multivariable logistic regression, household food insecurity was associated with significantly higher adjusted odds of an ED (adjusted odds ratio [aOR] = 1.37) or primary care treatment visit (aOR = 1.24) during the year. Household food insecurity was associated with significantly higher school absenteeism (aOR = 1.74) and lower access to care for routine (aOR = 0.55) or illness (aOR = 0.57) care. There were no differences in annual health expenditures, hospitalizations, or receipt of routine medical or dental care. CONCLUSIONS: Household food insecurity is associated with higher ED use and school absenteeism and lower access to care; however, it was not associated with higher annual health expenditures in children.

Age and reasons for first dental visit among children in Lagos, Nigeria.

BACKGROUND: An early first dental clinic appointment offers the prospect of prompt preventative care and parental education regarding the oral health of the child. The evidence-based recommendation by dental professionals all over the world is that a child should visit a dentist before or by 1 year of age. AIM: This study aimed to determine the chronological age at and the purpose for a first dental clinic visit amongst children aged 16 years and below attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital (LUTH). MATERIALS AND METHODS: This was a retrospective study conducted amongst children who attended the Paediatric Dental Clinic at the LUTH between January 2017 and December 2018. Data on age at first dental visit, reasons for attending and other information relevant to the study were collected. Descriptive statistics and Chi-square analysis were conducted, and the level of significance was set at P < 0.05. RESULTS: A total of 1157 children were studied, comprising 580 (50.5%) males and 577 (49.9%) females. Their mean age on their first dental visit was 7.9 ± 3.7 years. Most of the children (31.4%) had their first dental visits at 7 and 9 years, and 0.8% of the children had their first dental visit below the age of 1 year. The most common reason for visiting the dental clinic was dental pain (33.1%). A higher proportion of the children (911 [79.0%]) had their first dental visit for therapeutic purposes, whereas 246 (21.0%) children visited the dental clinic for preventive care. Sex and age at first dental visit were statistically significantly associated with the reason for attendance (P < 0.001). CONCLUSION: Most children had their first dental visit between the ages of 7 and 9 years, mainly because of pain. It is necessary to create more awareness among parents/caregivers and to establish the concept of dental home.

The Analysis of Dental Treatment under General Anaesthesia in Medically Compromised and Healthy Children.

Dental care under general anaesthesia (GA) is an option when normal treatment cannot be accomplished due to un-cooperation and systemic or cognitive/intellectual disabilities. The purpose of this retrospective cohort study was to analyse the dental treatment under GA in medically compromised and healthy children. The data were collected from the medical records of children who received their dental treatment under GA. The data regarding patient age, sex, general health, and type of treatment were analysed. This clinical trial included 229 study subjects (138 males, 91 females) with an average age of 8.34 (SD 3.78). Counts and relative counts were used for description of qualitative data. The association between the variables was analysed using contingency tables. The significance of the findings was tested by the chi-square test. Most of the children were older pre-school 63 (27.51%) and young school children 102 (44.54%). Medical disability (systemic or intellectual) was diagnosed in 142 children (62.01%); the remaining 87 (37.99%) were healthy children. Dental treatment of primary teeth was more commonly performed in healthy children (65.52%) compared to medically compromised children (58.45%) (p = 0.287). The total number of medically compromised children and the total number of healthy children were both considered to be 100% for the purpose of the following calculations. In terms of permanent dentition, medically compromised children required more extractions and fillings (38.03%, 57.04%) compared to healthy children (14.94%, 17.24%, respectively). The results of this study revealed that dental treatment under GA was more commonly performed in medically compromised children in permanent teeth only in comparison to healthy children. Based on these findings, both health professionals and state authorities should focus more on preventive care in medically compromised children in order to improve their oral health.

Psychometric properties of the Child Oral-care Performance Assessment Scale.

OBJECTIVES: This study aimed to assess the psychometric properties of Child Oral-care Performance Assessment Scale (COPAS). METHODS: Items for the instrument were developed and pilot tested. This questionnaire was implemented in the Australian National Child Oral Health Study 2012-2014, whose aims included the assessment of oral care performance. This nationally representative sample of 23 538 respondents with complete data was divided into five groups: a main validation group and four cross-validation groups, using blocked randomization. Two scales were constructed, full scale with 37 items (COPAS) and a partial scale with a subset of 31 items (COPAS-Partial). Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed using correlation coefficients, and structural validity was ascertained in the main validation group and confirmed in the cross-validation groups using structural equation models. RESULTS: Cronbach's alpha for COPAS was 0.95, and for COPAS-Partial was 0.94. The convergent validity of global satisfaction with oral care and the subscales was r = 0.29-0.51, and that with the overall scales was r = 0.59 for COPAS and r = 0.59 for COPAS-Partial. COPAS (Root mean squared error of approximation (RMSEA) = 0.06, Comparative fit index (CFI) = 0.90, Tucker-Lewis index (TLI) = 0.89, and Coefficient of determination(COD) = 0.99) and COPAS-Partial (RMSEA = 0.07, CFI = 0.91, TLI = 0.90, COD = 0.97) had adequate fit. Structural invariance was present (P-value = 0.97). CONCLUSION: There was acceptable structural validity, construct validity and internal consistency in the models tested for COPAS and COPAS-Partial. COPAS has potential use in the evaluation of the delivery of dental services to children.

Recall intervals in children are individualized and extended.

Objective: The aim of this study was to follow attendance patterns longitudinally by exploring length of intervals between routine dental examinations in children at the ages of 5 and 12 years, and study associations between length of recall intervals and caries prevalence, controlled for gender, parent's background and parent's education. Materials and methods: The study included 2960 children in one Norwegian county monitored from 5 to 12 years of age. Data were collected at clinical examinations, from dental records and by parental questionnaires. Length of recall intervals was dichotomized into short (shorter than 18 months) and long (18 months and longer). Data were analysed and tested using Chi-square statistics, correlation coefficient and multivariate regression. The study was ethically approved. Results: Recall intervals were individualized and varied from 4 to 30 months. The most frequent used recall intervals were 12, 18, 20 and 24 months. A majority of children at both ages were given long recall intervals. Multivariate logistic regression showed that the probability of having short interval was higher in children having caries experience than in caries-free children at both 5 years (OR 12.6 CI 9.9-16.0) and 12 years (OR 2.7 CI 2.3-3.1). At 5 years of age, length of recall intervals was associated with parents' background (OR 1.8 CI 1.4-2.4) and parents' education (OR 1.3 CI 1.0-1.5). Conclusions: The results showed that routine intervals were individualized and extended, indicating that more resources were spent on children with the highest need of dental care, aiming at reducing health inequalities.