Comparison of two different caries risk assessment tools for infants and toddlers - A cross-sectional study.

CONTEXT: One of the essential components for successful caries management is caries risk assessment (CRA). Among CRA tools (CRATs) published in the literature: Caries management by risk assessment (CAMBRA) 123 and American Academy of Pediatric Dentistry (AAPD) CRATs are specifically designed for infants and toddlers. AIMS: The aim of this study is to compare readily available internationally accepted CRAT for infants and toddlers and check the usability of these tools in assigning caries risk among the Indian population. SETTINGS AND DESIGN: The study was conducted at Baby Oral Health Promotion Clinic, Department of Pediatrics, Tertiary Care Hospital using a cross-sectional study design. SUBJECTS AND METHODS: Data were collected using CAMBRA 123 and AAPD CRATs from 379 children aged 0-6 years. The caries risk of the children was recorded with each CRAT and a comparison was made between the two tools used. STATISTICAL ANALYSIS USED: The percentage of agreement and Cohen's kappa coefficient were used to know the agreement between the CAMBRA 123 and AAPD CRATs using the SPSS statistical tool. The significance level was set at 5% (α = 0.05). RESULTS: For children aged <2 years, the study showed slight agreement between the CAMBRA 123 and AAPD, whereas, for children more than 2 years, there was a fair agreement between the two methods which was statistically significant. This indicates that the agreement between the two methods is still not perfectly established, and AAPD CRA assigns a higher risk category than CAMBRA 123. CONCLUSIONS: CAMBRA 123 is a promising user-friendly quantitative method for CRA in clinical practice. Since there is ambiguity in assessing the caries risk in children <2 years, there is a need to establish a CRAT that can be used exclusively for children below 2 years.

How different attributes are weighted in professionals' decision-making in Pediatric Dentistry-a protocol for guiding discrete choice experiment focused on shortening the evidence-based practice implementation for dental care.

BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .

Current Applications of Artificial Intelligence for Pediatric Dentistry: A Systematic Review and Meta-Analysis.

Purpose: To systematically evaluate artificial intelligence applications for diagnostic and treatment planning possibilities in pediatric dentistry. Methods: PubMed®, EMBASE®, Scopus, Web of Science™, IEEE, medRxiv, arXiv, and Google Scholar were searched using specific search queries. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist was used to assess the risk of bias assessment of the included studies. Results: Based on the initial screening, 33 eligible studies were included (among 3,542). Eleven studies appeared to have low bias risk across all QUADAS-2 domains. Most applications focused on early childhood caries diagnosis and prediction, tooth identification, oral health evaluation, and supernumerary tooth identification. Six studies evaluated AI tools for mesiodens or supernumerary tooth identification on radigraphs, four for primary tooth identification and/or numbering, seven studies to detect caries on radiographs, and 12 to predict early childhood caries. For these four tasks, the reported accuracy of AI varied from 60 percent to 99 percent, sensitivity was from 20 percent to 100 percent, specificity was from 49 percent to 100 percent, F1-score was from 60 percent to 97 percent, and the area-under-the-curve varied from 87 percent to 100 percent. Conclusions: The overall body of evidence regarding artificial intelligence applications in pediatric dentistry does not allow for firm conclusions. For a wide range of applications, AI shows promising accuracy. Future studies should focus on a comparison of AI against the standard of care and employ a set of standardized outcomes and metrics to allow comparison across studies.

Evaluation of pediatric dentists' knowledge and approaches to tooth discoloration.

In recent years, esthetic expectations have come to the fore in pediatric dentistry, as in every field of dentistry. Therefore, to better meet patients' expectations, the steps taken to determine and improve the current level of knowledge of pediatric dentists on tooth discoloration gain importance. This study aims to measure the knowledge levels of pediatric dentists regarding tooth discoloration. A 33-questioned survey created online was emailed to pediatric dentists between March and December 2021. The first part included four multiple-choice and two open-ended questions regarding demographic characteristics. The second part was to measure the participants' knowledge of tooth discoloration. The last part was to evaluate the clinical approaches of the participants. Participants who agreed to answer all of the questions were included in the study (n = 129). The knowledge levels of the participants were scored according to the accuracy of their answers. The data were statistically analyzed using descriptive statistics and chi-square tests. Of the pediatric dentists who participated in this study, 16.3% had high knowledge, 79.8% had medium knowledge, and 3.9% had insufficient understanding of tooth discoloration. There was no correlation between time since dental school graduation and time spent practicing as a pediatric dentist (p > 0.05). The group with the highest average level of knowledge was the group most frequently encountered with tooth discoloration in the clinic (p ≤ 0.05). On average, pediatric dentists had moderate knowledge of tooth discoloration. The group with the highest average expertise in this field was the group that most frequently encountered and treated tooth discoloration. Information on tooth discoloration due to systemic factors was insufficient. To increase the knowledge level of pediatric dentists about the causes and treatments of tooth discoloration, it may be beneficial to establish training programs during and after specialization education.

Silver compounds used in pediatric dentistry for caries arrest: A review of current materials and new technologies.

Silver compounds have been used in medicine and dentistry for centuries. Their use in pediatric dentistry has long been restricted because of some drawbacks, chief among them being the discoloration of teeth with black stains. However, recent advances in technology have resulted in the development of new silver agents that do not have the limitations of previously used ones. This led to the reintroduction of silver compounds in pediatric dentistry. The aim of the present review was to examine the evidence supporting the therapeutic use of silver compounds in pediatric dentistry for caries arrest, as well as the mode of action and biocompatibility, characteristics, advantages, and disadvantages of different silver-containing agents.

Adverse Events in Pediatric Dental Practice: Survey of Pediatric Dentists in the United States.

Purpose: To survey pediatric dentists in the United States regarding adverse events during dental care for children. Methods: A self-administered, anonymous online survey was sent to American Academy of Pediatric Dentistry members (N equals 6,327) using REDCap® software (between October and December 2019). The questionnaire (all items with radio-button numerical categories) included five items surveying pediatric adverse event occurrence and seven demographic items. Annualized occurrences of adverse events in US pediatric dental practices were extrapolated from the data collected. Results: The survey response was 11 percent (n equals 704), with 91 percent of respondents reporting that at least one child experienced an adverse event during dental treatment. The two most prevalent adverse events, each reported by 82 percent of respondents, were self-inflicted trauma to soft tissues after local anesthesia and nausea and vomiting, with annualized estimates of 7,816 and 7,003, respectively. Major adverse events (respiratory depression, cardiovascular depression, neurological damage, death) during pediatric dental treatment were reported by 14 percent of respondents (annualized estimate equals 443). "Wrong" errors (wrong tooth/wrong procedure/wrong patient) were reported by 24 percent of respondents (annualized estimate equals 600). Conclusions: Adverse events during pediatric dental care are of noticeable concern with some (wrong tooth/wrong procedure/wrong patient errors) that can be procedurally mitigated.

O Diamino Fluoreto de Prata é uma opção para o tratamento de lesões de cárie não francamente cavitadas em superfícies oclusais em crianças?: achados sobre sua eficácia e aceitação dos pais em um ensaio clínico randomizado / Is Silver Diamine Fluoride an option for treating non-frankly cavitated caries lesions on occlusal surfaces in toddlers?: findings on its efficacy and parents acceptance from a randomized controlled trial

O uso do diamino fluoreto de prata (DFP) em lesões não fracamente cavitadas raramente é investigado. Esta dissertação apresenta resultados de um ensaio clínico controlado randomizado (ECR) delineado para avaliar se o DFP seria uma opção eficaz ao verniz fluoretado no tratamento dessas lesões na superfície oclusal de molares decíduos (NCT02789202). Além disso, trouxemos os resultados de uma revisão sistemática com meta-análise (CRD42020186245) sobre a percepção de responsáveis em relação ao uso do DFP e os resultado do ensaio sobre a aceitação deles ao tratamento de lesões de cárie não francamente cavitadas com DFP em crianças. No Capítulo 1, 109 crianças de 1 a 4 anos com pelo menos uma lesão de cárie ativa (ICDAS 1 a 3) em molares decíduos foram randomizadas em DFP e verniz fluoretado e acompanhadas por 24 meses. Análises por intenção de tratar adotando regressão logística multinível e regressão de Cox com fragilidade compartilhada foram realizadas. 309 molares foram incluídos e 239 reavaliados. DFP preveniu mais progressão (91%) do que o verniz (81%). As lesões tratadas com DFP apresentaram, em media, 69% menos chance de progressão quando o modelo foi ajustado pela severidade (lesões iniciais vs microcavitadas). A progressão demorou mais para ocorrer no grupo do DFP. Para o Capítulo 2, foi realizada uma busca nas bases de dados MEDLINE, Scopus, Web of Science, Embase e Open Grey até maio de 2020. Foram incluídos ECR, estudos clínicos não randomizados e estudos observacionais que avaliaram a percepção de responsáveis sobre compostos de prata no tratamento de lesões de cárie. O risco de viés foi avaliado utilizando uma ferramenta específica para estudos de atitutes e práticas. Para a meta-análise, os estudos foram separados considerando se os entrevistados receberam o DFP como tratamento de seus filhos ou não e se foram obtidos quanto a satisfação geral ou quanto, especificamente, a descoloração. Análises de subgrupo e meta-regressão foram realizadas para avaliar a influência de variáveis associadas ao instrumento na percepção e explorar possíveis fontes de heterogeneidade. 19 estudos foram incluídos na revisão sistemática e 12 na metaanálise. A aceitação geral do tratamento foi de moderada a bem aceita (26.9% a 100%) e variou de acordo com a metodologia utilizada. Em geral, responsáveis responderam mais positivamente quando a criança recebeu o tratamento (90%) do que quando a aplicação foi mostrada com uma foto (59%). Por fim, avaliou-se a percepção dos responsáveis sobre a saúde e estética em crianças que tiveram lesões em esmalte tratadas com DFP (Capítulo 3). Crianças incluídas em três ECR que tiveram as lesões em esmalte tratadas com DFP ou não foram consideradas. Um questionário padrão foi utilizado. Primeiramente, avaliamos a percepção geral e, em seguida, focada nos dentes tratados. Análise multiníveis foram realizadas para comparar a percepção de responsáveis de crianças tratadas vs não tratadas com DFP. Os níveis foram definidos conforme o dente e a criança/responsável. O tratamento com DFP não afetou a percepção geral dos responsáveis sobre as condições estética e de saúde bucal relacionadas a criança (85%). No entanto, quando a avaliação foi focada no dente tratado, a percepção naquelas crianças que receberam tratamento com DFP foi pior do que naquelas que não receberam. Concluindo, o DFP é uma opção eficaz no controle de lesões de cárie não francamente cavitadas. Além disso, geralmente, parece ser aceito de maneira adequada pelos cuidadores. No entanto, um padrão diferente de aceitação é observada quando destacamos o dente tratado, mostrando que a educação/informação é uma questão importante na indicação desse tratamento em crianças.

Working at the interface: lessons from a joined-up approach between oral medicine and paediatric dentistry.

Oral mucosal and other head and neck conditions in children have a variety of presentations. The joint oral medicine and paediatric (JOMP) dental clinic is a specialised unit within a London teaching hospital, developed to manage a wide range of oral conditions with an absolute commitment to a child-centred care approach. The authors present eight cases from the JOMP clinic experience at Guy's and St Thomas' NHS Foundation trust, over a nine-year period. Each case is unique in its presentation, diagnosis and bespoke management, tailored to the nuance of each individual patient and their unique position. The eight clinical cases demonstrate the success of the JOMP team in achieving good patient outcomes, in terms of providing accurate diagnoses for their oral conditions and for appropriately tailored management/ treatment. The cases also serve to raise awareness of some of the more unusual oral conditions affecting paediatric patients among our professional colleagues.

Initial bacterial adherence and biofilm formation on novel restorative materials used in paediatric dentistry.

OBJECTIVE: To evaluate the initial bacterial adherence and biofilm formation on novel restorative materials in paediatric dentistry and compare the results to stainless steel crown and primary enamel. MATERIALS AND METHODS: Twenty-five samples (Diameter = 4 mm) from five restorative materials (Tetric Power Fill light cured for 3 s or 10 s, Fuji II LC, Equia Forte HT Fil, Cention Forte, Stainless-steel crown) and primary enamel were prepared. Four samples served for recording of surface roughness (Ra) using a contact profilometer, 21 samples were incubated in stimulated human saliva for 2 h (initial bacterial adherence) and 72 h (biofilm formation) and served to determine ion releasing and bacterial growth. After 2 and 72 h, the number of colony-forming units (CFU) per ml was counted and expressed in Log10 CFU/ml. Data were analysed with two-way ANOVA and Tuckey's multiple comparisons test (p < 0.05). RESULTS: All tested materials showed similar initial bacterial adherence (p > 0.1). Stainless steel crown showed statistically significantly less biofilm formation than all other tested materials (p ≤ 0.02), except for Fuji II LC (p = 0.06). In terms of biofilm formation, the differences between all tested materials were not statistically significant (p ≥ 0.9). SIGNIFICANCE: Novel restorative materials in paediatric dentistry show similar initial bacterial adherence and biofilm formation. However, compared to other restorative materials, stainless steel crowns demonstrate the lowest level of biofilm formation. Ion-releasing materials may not necessarily show better antimicrobial properties than conventional materials.

Parental satisfaction and acceptance of silver diamine fluoride treatment for molar incisor hypomineralisation in pediatric dentistry: a cross-sectional study.

The study aimed to investigate parental satisfaction and acceptance of silver diamine fluoride (SDF) treatment for permanent molars affected by molar incisor hypomineralisation (MIH). This study was conducted in the pediatric dental department at Damascus University, Syria. This study was performed at the period from Jan 2023 to April 2023. In this cross-sectional study, a validated questionnaire employing a 5-point Likert scale was used to evaluate esthetics, ease of application, pain perception, and taste acceptability. Participants included 100 parents or guardians of children aged 6-9 years who had received SDF treatment in the past year. The findings of this study revealed high satisfaction levels (77.5%) with the treatment. Parents expressed contentment with the appearance of their child's molars after SDF application (58% agreed or strongly agreed) and found the application process easy and pain-free (100% agreed or strongly agreed). However, taste acceptability posed a challenge, with over half of the parents (53%) finding it unacceptable. Regression analysis underscored the significant impact of esthetics, ease of application, pain perception, and taste on parental satisfaction. Moreover, parents with higher education levels (graduate or postgraduate) exhibited higher acceptance rates compared to those with lower education levels (63.1% vs. 33.6%). Notably, parental gender and age did not significantly influence SDF treatment acceptance. This study provides critical insights into parental satisfaction and acceptance of SDF treatment for MIH-affected permanent molars. Despite concerns about tooth discoloration, the high satisfaction levels suggest that SDF holds promise as an effective treatment option. Parental education significantly influenced acceptance rates. This research highlights the importance of considering parental perspectives and tailoring communication strategies in pediatric dentistry, ultimately contributing to improved care for young patients with MIH.

Humanisation and health needs in children: present or future?

AIM: For a few years, teledentistry has been an emerging innovative strategy with potential in the field of paediatric dentistry. There are still few studies in this regard, so further research is needed to verify and ensure that teledentistry is not only an accessible mode of communication, but above all effective and evidence-based. This study aimed to use a preliminary telematic approach to promote the compliance of patients in the developmental age during the first dental visit. MATERIALS: Two hundred patients were selected according to the eligibility criteria, and distributed in two groups: a study group with the preliminary telematic approach (ATP) before the first visit and a control group with traditional first visit without ATP. Through an ordinal semi-proportional regression model, the degrees of collaboration between the study and control groups were compared, correcting the estimate for age groups, the presence of systemic pathologies, disorders of cognition, attention and learning, degree of anxiety and previous medical-dental experiences. CONCLUSION: The preliminary telematic approach could be useful as a support to the traditional paediatric dental visit, to promote better management and fidelity of the patient, reducing anxiety and increasing collaboration during the first visit.

Assessment of advanced paediatric dentistry education programmes in Egypt: a survey of programme directors.

BACKGROUND: Advanced paediatric dentistry education programmes (APDEPs) should follow specific standards to produce competent specialists. The current study assessed APDEPs in Egypt via an online questionnaire to programme directors. SUBJECTS AND METHODS: An online questionnaire was distributed to the directors of fully operational degree-granting APDEPs in Egypt in June 2023. The survey instrument was based on the Accreditation Standards for Advanced Dental Education Programmes in Paediatric Dentistry developed by the Commission on Dental Accreditation (CODA). RESULTS: Directors of the sixteen fully operational APDEPs answered the questionnaire giving a 100% response rate. APDEPs, in Egypt, varied regarding the adequacy of teaching staff, facilities and resources, didactic instruction, clinical requirements, and research activities. CONCLUSION: The current survey provides information about the strengths and weaknesses of fully operational degree-granting APDEPs in Egypt. This information can help maintain and improve the quality of these programmes.

Optimizing radiation safety in dentistry: Clinical recommendations and regulatory considerations.

BACKGROUND: The value of dental radiographs to oral health care decision making must be balanced with radiation safety to minimize patient exposure and occupational risk of oral health care providers. This review summarizes recommendations and regulatory guidance regarding dental radiography and cone-beam computed tomography. An expert panel presents recommendations on radiation safety, appropriate imaging practices, and reducing radiation exposure. TYPES OF STUDIES REVIEWED: A systematic search run in Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews identified relevant topical systematic reviews, organizational guidelines, and regulatory reviews published in the peer-reviewed literature since 2010. A supplemental search of the gray literature (eg, technical reports, standards, and regulations) identified topical nonindexed publications. Inclusion criteria required relevance to primary oral health care (ie, general or pediatric dentistry). RESULTS: A total of 95 articles, guidance documents, and regulations met the inclusion criteria. Resources were characterized as applicable to all modalities, operator and occupational protection, dose reduction and optimization, and quality assurance and control. PRACTICAL IMPLICATIONS: Understanding factors affecting imaging safety and applying fundamental principles of radiation protection consistent with federal, state, and local requirements are essential for limiting patient ionizing radiation exposure, in conjunction with implementing optimal imaging procedures to support prudent use of dental radiographs and cone-beam computed tomographic imaging. The regulatory guidance and best practice recommendations summarized in this article should be followed by dentists and other oral health care providers.

Diferentes formas de apresentação do cimento de ionômero de vidro podem influenciar a sobrevida de restaurações em molares decíduos? - 24 meses de um ECR / Can different presenting forms of glass ionomer cement presentation influence the survival of restorations in deciduous molars? - 24 months in a RCT

O objetivo deste ensaio clínico randomizado foi comparar a taxa de sobrevida das restaurações oclusais e oclusoproximais em molares decíduos usando duas versões de cimentos de ionômero de vidro: pó-líquido, manipulado manualmente (MAN) e encapsulado (ENC) após 24 meses. Crianças entre 3 e 10 anos de idade que apresentaram lesões de cárie em dentina nas superfícies oclusais e/ou oclusoproximais de molares decíduos foram selecionadas na Faculdade de Odontologia da Universidade de São Paulo, Brasil. Elas foram alocadas aleatoriamente em dois grupos: M/M (Fuji IX®, GC Europa) ou ENC (Equia Fill®, GC Europa). A ocorrência de falha das restaurações foi avaliada por duas examinadoras calibradas e cegas e em relação aos grupos. As análises estatísticas foram realizadas no software Stata 13 (StataCorp, EUA). A análise de Kaplan-Meier foi utilizada para ilustrar a sobrevida e o comportamento das restaurações ao longo dos 24 meses de acompanhamento enquanto a Regressão de Cox com fragilidade compartilhada foi realizada para avaliar a associação entre falha de restauração e variáveis independentes (=5%). Realizamos ainda a análise por intenção de tratar (ITT) considerando os 24 meses de acompanhamento. Um total de 323 restaurações foram realizadas em 145 crianças. A sobrevida para o grupo MAN foi de 58,2% e 60,1% para o grupo ENC, sem diferença estatisticamente significativa (p=0,738). As restaurações oclusoproximais tiveram menor taxa de sobrevida quando comparadas às oclusais (HR=3,83; p<0,001). A taxa de sobrevida nos molares decíduos não é influenciada pelas diferentes formas de apresentação do CIV Registro do ECR: Este ensaio clínico randomizado foi registrado no ClinicalTrials.Gov em 15/10/2014 sob protocolo (NCT 02274142).

Papel do cirurgião dentista frente aos casos de abuso sexual infantil: uma revisão da literatura / Role of the dental surgeon in cases of child sexual abuse: a literature review

Objetivo:Revisar a literatura a respeito do papel do cirurgião-dentista frente aos casos de abuso sexual infantil, abordando sua importância na identificação e no encaminhamento adequado das vítimas, além de discutir a necessidade de conscientização eimplementação de políticas públicasque abordem o tema.Revisão deliteratura:O ambiente odontológico é um ambiente propício para a identificação de sinais de abusosexual infantil, uma vez que o profissional tem contato direto com a saúde bucal e facial das crianças. Desempenha um papel fundamental ao observar e reportar esses sinais, contribuindo para a identificação precoce e o encaminhamento adequado das vítimas.Discussão:A literatura préviasugere a necessidade de fornecersubsídios teóricos, aprofundados no tema,para contribuir na ampliação do conhecimento nessa área. Sendo importantea conscientização e capacitação do cirurgião-dentista nesse contexto, bem como a criação de políticas públicas que visam umaabordagem multidisciplinarquecontribuaparaa conscientização, prevenção e a promoção de ações voltadas à proteção das crianças e ao combate do abuso sexual infantil.Conclusão:O cirurgião-dentista desempenha um papel fundamental na identificação e no encaminhamento adequado das vítimas de abuso sexual infantil. É essencial que esses profissionais sejam devidamente capacitados e conscientizados sobre a importância desse tema, além de estabelecerem uma rede de colaboração com outros profissionais da saúde e serviços especializados.

Aim:To review the literature regarding the role of the dental surgeon in cases of child sexual abuse, addressing its importance in identifying and properly referring victims, in addition to discussing the need for awareness and implementation of public policies that address the issue. Literature review:The dental environment is a favorable environment for identifying signs of child sexual abuse, since the professional has direct contact with the oral and facial health of children. It plays a key role in observing and reporting these signs, contributing to the early identification and proper referral of victims. Discussion:Previous literature suggests the need to provide theoretical subsidies, in depth on the subject, to contribute to the expansion of knowledge in this area. It is important to raise awareness and training of dentists in this context, as well as the creation of public policies aimed at a multidisciplinary approach that contributes to awareness, prevention and promotion of actions aimed at protecting children and combating child sexual abuse. Conclusion:The dental surgeon plays a key role in identifying and properly referring victims of child sexual abuse. It is essential that these professionals are properly trained and aware of the importance of this topic, in addition to establishing a collaboration network with other health professionals and specialized services.

Students' perception of protective stabilization of pediatric dental patients: a qualitative study.

Protective stabilization (PS) has been utilized to safely perform examinations, make diagnoses and/or provide limited treatment of short duration to uncooperative children. The literature supports PS as an alternative technique when behavior management strategies are not sufficient to enable oral care. The use of PS in pediatric dentistry can be traumatic for patients, parents and the medical team and has sometimes been described as being non-compliant with standards of care. Semi-structured qualitative interviews on dental students' perception of PS were conducted in the pediatric department of dentistry at the University Hospital of Toulouse, France. A thematic analysis of the transcript of interviews was provided using the NViVo software. This analysis identified four main themes. The students described their first experience with physical restraint in pediatric dentistry and wondered about the definition of PS. The students' perception of PS showed that this procedure has a psychological impact and is disturbing. There is a lack of information on PS in dental curricula and didactic and clinical education which requires attention. Finally, the students took into consideration the role of PS in future practice. Dental students' perception of PS provides justification for the development and improvement of theoretical and clinical education in behavior guidance techniques for pediatric dental patients, in accordance with national and international guidelines.

British Society of Paediatric Dentistry: A policy document on dental neglect in children.

The British Society of Paediatric Dentistry's (BSPD) first policy document on dental neglect was published online in 2009. It proposed a new original definition of dental neglect, discussed the identification of dental neglect and recommended adopting a tiered response, with three stages of intervention according to level of concern. Furthermore, it detailed how the dental team should both contribute to the child protection process and implement wider measures to safeguard and promote children's welfare. Since 2009, these concepts have been widely adopted in the UK and beyond. Furthermore, there have been significant advances in both research and practice. Policy documents produced by the BSPD represent a majority view, based on the consideration of currently available evidence, and are tailored to a UK working environment. Although this updated document's recommendations remain broadly unchanged, this version reflects the professions' progress in understanding dental neglect and minor updates to terminology and, following a consultation process, has been amended to address the needs of two main audiences-dental professionals and nondental health and social care professionals-in order to enhance interdisciplinary working.