Gingivitis in children with malnutrition.

The purpose of the current study was to compare the prevalence and severity of gingivitis and plaque among 291 well- and malnourished children between the ages of 4 to 7 years. Using the National Center for Health Statistics criteria, the children were identified as normal (well nourished), having a height-of-age > 95% of standard. Selected primary teeth of each child were assessed using the Plaque Index (PlI) and the Modified Gingival Index (MGI). The results demonstrated a 100% prevalence of plaque and gingivitis. Also, there was no significant difference in the PlI and MGI in the well-nourished and malnourished groups, nor between males and females. However, there was a trend in the well-nourished group to less plaque and gingivitis when broken down into different stature-by-age percentiles.

Root surface characteristics of primary teeth from children with prepubertal periodontitis.

This study describes the histologic characteristics of root surfaces of primary teeth from children with prepubertal periodontitis (PP). Fifteen primary teeth from 4 children with PP, and 2 control primary teeth from 2 healthy children were examined. Light microscopy revealed normal root surfaces in the control teeth. In contrast, the PP specimens revealed bacteria inside dentin tubules or covering cementum, a cuticle, or resorbed dentin; normal, wider than normal, or hypoplastic cementum; resorption lacunae with various depths; aplastic root resorption; alternate resorption and repair; and active repair. No cementoclasts were found in the resorption lacunae. Scanning electron microscopy revealed intrabony and suprabony root areas, and a "plaque free zone" (PFZ). Colonies of filaments were evident at the cemento-enamel junction (CEJ). The suprabony root surfaces had resorption lacunae, isolated short rods, calculus, colonies of filaments, or colonies composed by an heterogeneous bacterial population. The coronal boundary of the PFZ was the border of a sheet-like structure, which included isolated rods or filaments. At the PFZ, isolated filaments and rods, and a fibril matrix were evident. The apical boundary of the PFZ consisted of bundles of soft tissue remnants or the insertion of the periodontal fibers. The intrabony surfaces were mostly covered by soft tissue, which included isolated filaments and short rods. Resorption lacunae with or without soft tissue were also evident in this area. Crystals of calcium oxalate dihydrate and erythrocytes in distinct forms were found at various root areas. The present findings are different from those previously reported for hypophosphatasia specimens.

Delayed primary tooth eruption in premature infants: relationship to neonatal factors.

Previous studies suggest that primary tooth eruption (PTE) in preterm infants is related primarily to gestational age, but the impact of other neonatal factors has not been studied. In a prospective longitudinal study, the timing and sequence of PTE were documented by a pictorial PTE record completed by the parents and by frequent oral exams in 14 preterm infants whose first tooth erupted at < or = 10 months chronologic age (normal group) and 21 preterm infants whose first tooth erupted at > 10 months (late group). Initial eruption sequence in both groups was the same as full-term infants, with the two lower central incisors erupting first. PTE occurred significantly later in children with BW < 1000 g (t = 3.4, P < 0.01) or < or = 30 weeks (t = 2.41, P < 0.05). Factors related to nutrition appeared to be important. Age at first tooth correlated significantly with age when full enteral feedings were attained, age when oral vitamin supplementation was started, and with average weight gain per day. Five neonatal factors (duration of oral intubation, birthweight, gestational age, age when full enteral feedings were attained, and apnea of prematurity) explained 44% (R = 0.67, P < 0.05) of the variability in age at which the first tooth erupted. Of that 44%, 77% was explained by a single factor, duration of oral intubation. These results suggest that factors related to severity of neonatal illness and postnatal nutrition as well as degree of prematurity affect timing of primary tooth eruption.

The role of the pediatrician in oral health care.

Many of the dental problems of childhood can be prevented if the physician recognizes and encourages good preventive habits, treats when indicated, and refers appropriately. With sound knowledge of health and disease of the oral and dental structures, the physician can enhance the chances of children growing up under optimal medical and dental conditions.

Managing common dental problems and emergencies.

This article discusses the more common oral and dental emergencies that children and adolescents may present to a physician. Many of these problems represent true emergencies that require immediate treatment or referral, whereas others are more common and less critical problems perceived by the child's parents as needing immediate attention. The problems presented in this article fall into three general areas: gingival and soft-tissue-related problems; problems related to teeth; and traumatic injuries to the teeth, their roots, and supporting structures.

Questioning in preclinical and clinical instruction.

Questioning has long been a basic teaching technique. Dental instructors are encouraged to use questions more frequently in preclinical and clinical courses. The objective of this educational method is to stimulate the independent thinking essential to daily practice and professional growth. This article discusses one category of questions and presents various strategies for questioning in the technique laboratory and clinic.