[Neglect of oral care in children: a matter of integral approach]. / Verwaarlozing van de mondverzorging bij kinderen: een kwestie van integrale aanpak.

Inadequate oral care will eventually result in pain and inflammation. Inadequate oral care in children may be the result of ignorance, inability to deal with an uncooperative child or parental neglect. Poorly cared-for dentition in a child may be a sign of child neglect as defined by the Royal Dutch Medical Association's (KNMG) Reporting Code "Child Abuse and Domestic Violence". Restorative treatment of caries lesions ("filling holes") in a child with neglected teeth masks the lack of oral health care. Non-restorative treatment methods focus on stopping caries activity. These methods require adequate guidance of oral health care. This means motivating parents to re-brush the child's teeth every day. Medical care-providers, including GPs, paediatricians and public health nurses are necessary to provide alerts regarding neglect of dental care. They can investigate whether the oral problems indicate wider problems of neglect in the child. It is recommended that medical care-providers and dental care-providers work together and make use of their respective expertise.

[Non-restorative treatment of cavities in temporary dentition: effective and child-friendly]. / Niet-restauratieve behandeling van cariës in het melkgebit: doelmatig en kindvriendelijk.

Caries is a multifactorial disease manifesting itself as a dynamic process. Fewer than half of all 5-year-olds have all teeth intact. The treatment of cavities in the temporary dentition requires a switch from predominant restoration to responsible non-restoration. The progression of a process within an existing cavity can in fact be inhibited by cleansing the lesion with fluoride toothpaste if it is, or made, approachable. Such non-restorative treatment changes an acute cavity progression into a chronic one. Chronic caries provides more time to mobilize the immune system through the pulp. Non-restorative treatment of cavities is especially indicated in children with active caries or children who are afraid of treatment by a dentist. Non-restorative treatment of cavities is less burdensome for children than restorative treatment.

Long-term survival of indirect pulp treatment performed in primary and permanent teeth with clinically diagnosed deep carious lesions.

INTRODUCTION: This retrospective study examined clinically and radiographically the 3-year survival of teeth treated with indirect pulp treatment (IPT) performed between 2000 and 2004. METHODS: Sixty-six uncooperative children (4-18 years old) with at least one tooth with clinically diagnosed deep caries were included. Radiographically, the lesion depth was greater than two thirds of the dentin thickness. Incomplete excavation was performed leaving infected carious dentin at the center of the cavity. After placement of a layer of resin-modified glass ionomer as liner, the teeth were restored. A 3-year survival analysis (Kaplan-Meier) was performed. Failure was defined as the presence of either a clinical symptom (pain, swelling, or fistula) or radiologic abnormality at recall. In total, 86 of 125 (69%) treated primary molars and 34 of 45 (76%) treated permanent teeth were available for both clinical and radiographic evaluation. RESULTS: The survival rate was 96% for primary molars (mean survival time, 146 weeks) and 93% for permanent teeth (mean survival time, 178 weeks). CONCLUSION: This study shows that IPT performed in primary and permanent teeth of young patients may result in a high 3-year survival rate.