Dental caries and developmental defects of enamel in cerebral palsy: A meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to compare the occurrence of dental caries and developmental defects of enamel (DDE) in individuals with and without cerebral palsy (CP). MATERIALS AND METHODS: We conducted searches across five databases and the grey literature. Data were organized using EndNote 20. Reporting followed the MOOSE checklist. A random-effects model meta-analyses were conducted using RStudio, presenting results as mean difference (MD), odds ratio (OR), and 95% confidence interval (CI). The risk of bias of studies was analyzed using the Newcastle-Ottawa Scale, and the certainty of evidence was assessed using GRADE. RESULTS: Among 1336 identified records, 25 studies involving 59,997 participants (mean age: 11.1 years) were included. Data of 12 were pooled into meta-analyses. No significant differences were found between CP and non-CP individuals across indices: DMFT (k = 7) (MD = 0.31; 95% CI [-0.42-1.05]), dmft (k = 4) (MD = 0.31; 95% CI [-0.50-1.14]), DMFS (k = 2) (MD = -0.61; 95% CI [-20.56-19.33]), dmfs (k = 3) (MD = 0.54; 95% CI [-1.09-2.17]), and DDE (k = 3) (OR = 0.80, 95% CI [0.09-7.31]). The certainty of evidence was very low. CONCLUSION: Individuals with CP do not appear to differ significantly from those without CP in terms of dental caries experience and DDE.

Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management.

OBJECTIVES: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. METHODS: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. RESULTS: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. DISCUSSION: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.

The Impact of COVID-19 on Parental Perception of Oral Health-Related Quality of Life of Children: A Comparison of a Sample from Saudi Arabia and Kuwait.

Materials and Methods: OHRQoL was measured using a a validated Arabic version of the Child Oral Health Impact Profile (COHIP). Parents of children aged between 5 and 9 years were administered questionnaire during the COVID-19 pandemic. The responses were compared across the different domains of the questionnaire between the two countries using the Mann-Whitney U test. Differences were also tested between the parents of males and females separately in each city. The correlation of the COHIP scores with the age of the child was done using the Spearman's rho. Results: No significant differences in overall COHIP scores were found between the parents in Riyadh and Kuwait City (p > 0.05). There were significant gender differences observed across domains in Kuwait (p = 0.030) but not in Riyadh (p = 0.295). There was also a significant negative correlation between the different COHIP domains in Kuwait but not Riyadh. Conclusion: There is a greater gender difference and age correlation of OHRQoL among the population studied in Kuwait City when compared to those in Riyadh.

Intersection of the iADH undergraduate curriculum in special care dentistry and the association of Canadian faculties of dentistry competencies framework.

AIMS: To map the International Association of Disability and Oral Health (iADH) curriculum to the Association of Canadian Faculties of Dentistry (ACFD) competencies framework to develop a strategy for teaching special care dentistry (SCD) using the International Classification of Functioning, Disability, and Health (ICF). To review the literature to identify educational methodologies that support teaching SCD competencies. METHODS: The 20 subdomains of the ACFD competencies framework were mapped to the 18 subdomains of the iADH competency matrix. A literature review of methods, techniques, or innovations used to teach SCD was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and the Sample, Phenomenon of Interest, Design, Evaluation, and Research Type (SPIDER) tool. RESULTS: The iADH curriculum was mapped to the ACFD competencies in the areas of patient care, professionalism, communication and collaboration, practice information management, and health promotion. A total of 176 articles from PubMed and 10 resources from MedEdPortal were identified in the literature search. Eleven articles met the inclusion and exclusion criteria. The overall quantity and quality of studies was low. Experiential learning in either a dental school or hospital-based program seemed to improve knowledge of SCD and to incite greater willingness to treat patients requiring SCD. CONCLUSIONS: Case-based learning, computer-based modules, standardized patients, and clinical practice are educational strategies for teaching SCD competencies. The integration of SCD into the undergraduate dental curriculum seems feasible, as most required competencies are transferable to all dental disciplines. Furthermore, the ICF provides a functional model that is a patient-centered approach and is applicable to dentistry beyond SCD.

The Impact of COVID-19 on Dental Treatment in Kuwait-A Retrospective Analysis from the Nation's Largest Hospital.

BACKGROUND: The COVID-19 pandemic has changed the way dentistry has been practiced the world over. This study sought to assess the impact of the COVID-19 pandemic on the patterns of attendance for dental treatment in a large hospital in Kuwait through comparisons with data from the year prior to the pandemic. METHODS: A total of 176,690 appointment records from 34,250 patients presenting to the AlJahra specialist hospital in Kuwait for dental treatment from April 2019 to March 2021 were analyzed. The types of procedures and the departments in which they presented were analyzed, and the patterns of attendance before and during the pandemic were compared. RESULTS: While there was a significant reduction in the number of orthodontic, endodontic, and periodontal procedures, there were no impacts on oral surgery, restorative procedures, or pediatric dentistry. CONCLUSIONS: There has been a return in the number of patients obtaining dental treatment; however, there has been a definite shift in the use of certain dental procedures.

COVID-19-Related School Closures and Caries Risk in Canadian Children.

BACKGROUND: Despite increased efforts to improve the health of those with temporomandibular disorder (TMD), the focus remains on medical knowledge rather than patients' opinions and needs regarding quality of treatment and pain management. OBJECTIVES: We aimed to identify what TMD patients want their dentists to know and do. METHODS: Open-ended questions were used to understand the perspectives of 6 TMD patients. Two researchers examined the transcripts using interpretive phenomenological analysis. FINDINGS: TMD participants consistently stressed the need for their dentists to listen and provide them with more advice and information to cope with TMD conditions. They also noted the need for dentists to be skilled in communications, particularly maintaining respectful doctor-patient relations and interpersonal communication. CONCLUSIONS: Health care providers must acquire practical communication skills and expand their knowledge of TMDs to better support their patients. Improving relations between doctors and their TMD patients could result in positive health outcomes. The implications of this study will be to decrease medical crises and expensive interventions, provide better assistance to patients and refer them to other necessary health care professionals, an approach that will lead to lower care costs, more satisfaction and higher quality of life.

Neighborhood-Level Inequalities in Dental Care of Adolescents and Young Adults in Southwestern Ontario.

We examined whether the association of neighborhood-level socioeconomic status (SES) with the cost of dental care and dental care outcomes differs between adolescents and young adults. A total of 2915 patient records were split into two groups: adolescents (15 to 17 years of age) and young adults (18 to 24 years of age). Three dental care outcomes-routine oral evaluation (OEV-CH-A), utilization of preventive services (PRV-CH-A), and dental treatment services (TRT-CH-A)-were determined according to the Dental Quality Alliance (DQA) criteria. Associations of neighborhood SES and other sociodemographic variables with dental care outcomes and the cost of dental care were assessed using binary logistic and univariate linear regression models, respectively. Young adults had significantly lower PRV-CH-A and higher TRT-CH-A scores when compared to adolescents. We observed a significant negative association between TRT-CH-A and median household income in both adolescents and young adults. Utilization of dental treatment services was positively associated with the cost of care in both age groups, whereas utilization of preventive services was inversely associated with the cost of care in young adults, but not in adolescents. Neighborhood-level income was inversely associated with increased TRT-CH-A in both young adults and adolescents. In summary, young adults showed significantly worse preventive and treatment outcomes when compared to adolescents. Moreover, individuals from neighborhoods with a lower household income showed a significantly higher cost of dental care, yet worse treatment outcomes.

Neighborhood Contexts and Oral Health Outcomes in a Pediatric Population: An Exploratory Study.

AIMS: This study aimed to explore the impacts of neighborhood-level socioeconomic contexts on the therapeutic and preventative dental quality outcome of children under 16 years. MATERIALS AND METHODS: Anonymized billing data of 842 patients reporting to a university children's dental over three years (March 2017-2020) met the inclusion criteria. Their access to care (OEV-CH-A), topical fluoride application (TFL-CH-A) and dental treatment burden (TRT-CH-A) were determined by dental quality alliance (DQA) criteria. The three oral health variables were aggregated at the neighborhood level and analyzed with Canadian census data. Their partial postal code (FSA) was chosen as a neighborhood spatial unit and maps were created to visualize neighborhood-level differences. RESULTS: The individual-level regression models showed significant negative associations between OEV-CH-A (p = 0.027) and TFL-CH-A (p = 0.001) and the cost of dental care. While there was no significant association between neighborhood-level sociodemographic variables and OEV-CH-A, TRT-CH-A showed a significant negative association at the neighborhood level with median household income and significant positive association with percentage of non-official first language (English or French) speakers. CONCLUSION: Initial analysis suggests differences exist in dental outcomes according to neighborhood-level sociodemographic variables, even when access to dental care is similar.

Factors Influencing the Survival of Preformed Zirconia Crowns in Children Treated under General Anesthesia.

AIM: This study aimed to retrospectively evaluate the success of zirconia crowns placed in the anterior teeth of children and evaluate the impact of pulp therapy of the tooth on the rate of failure. MATERIALS AND METHODS: A total of 70 anterior teeth of 20 children aged between 3 and 5 years who had undergone the placement of zirconia crowns under general anesthesia were followed up for 24 months. Kaplan-Meier Survival curves were plotted for the estimation of two-year survival time. The outcomes for teeth that had received pulp therapy were compared to those that had not received pulp therapy. RESULTS: Kaplan-Meier survival analysis of 70 crowns observed over a two-year period showed that mean survival time for the crowns was 38.7 months with a confidence interval ranging from 38.1 months to 39.3 months. When the survival of the crowns was observed based on the presence or absence of symptoms, it was observed that only 4 out of the 70 crowns were symptomatic (with or without crown loss) at the end of two years, giving a success rate of 94.3%. The mean survival time was also increased to 39.5 months (confidence interval 39.15-39.98 months). CONCLUSION: Zirconia crowns provide an acceptable level of success and longevity. Crowns placed on teeth after pulp therapy are more likely to fail than those placed on teeth without pulp therapy.

The efficacy of two different oral hygiene regimens on the incidence and severity of oral mucositis in pediatric patients receiving hematopoietic stem cell transplantation: A prospective interventional study.

AIMS: This prospective interventional study aimed to assess the efficacy of supersaturated calcium phosphate rinse and the use of an extra-soft toothbrush twice a day when added to the existing oral hygiene protocol regimen (0.12% chlorhexidine gluconate + 3% sodium bicarbonate + nystatin 5000 U/mL) in reducing the severity of oral mucositis among pediatric patients receiving chemotherapy for the hematopoietic stem cell transplant. METHODS: Forty-five patients that received chemotherapy for the hematopoietic stem cell transplant were randomly allocated to three groups of 15 patients each. Group A was advised to follow the existing oral hygiene protocol regimen (Control), group B was advised to brush their teeth twice daily using an extra-soft toothbrush and to follow the control regimen, and lastly group C was advised to use supersaturated calcium phosphate rinse and to follow the control regimen. Oral mucositis was recorded according to World Health Organization criteria from the day of admission (day 1) to the day of discharge (day 28). The incidence of oral mucositis between the three groups was compared using the Kruskall-Wallis test while the severity of oral mucositis between the three groups was compared using a one-way ANOVA test. RESULTS: The results of the study showed no significant difference in the incidence of oral mucositis between the three groups; however, there was a lower severity of oral mucositis in the supersaturated calcium phosphate rinse group when compared to the control group or the group who used an extra-soft toothbrush with the control regimen. CONCLUSION: Although marginally fewer cases and lower severity of oral mucositis was observed in the group using supersaturated calcium phosphate rinse, the lack of statistical significance suggests that the evidence for their use is not conclusive. The results of this study also showed that the introduction of an extra-soft toothbrush into the oral hygiene regimen did not significantly reduce the incidence of oral mucositis and may actually be responsible for an increase in the severity of oral mucositis.

Color Stability of Glass Ionomer Cement after Reinforced with Two Different Nanoparticles.

AIM: This study aimed to compare the staining characteristics of a commercially available restorative glass ionomer cement to a formulation reinforced by the addition of carbon nanotubes and another formulation reinforced by the addition of silver nanoparticles to the powder of the same cement. Methodology. Twenty samples each of a control glass ionomer cement (PULPDENT® Glass Fill®, Pulpdent Corp. Watertown, MA, USA), control cement reinforced with 0.0006 gm (0.03% by weight) of carbon nanotubes (Sigma Aldrich, St Louis MO, USA), and control cement reinforced with 0.2 gm (10% by weight) of silver nanoparticles (Nanocyl™, Nanocyl SA, Sambreville, Belgium) were immersed in a staining solution. Color evaluations were carried out after 1 h, 24 h, and 1 week. Color change values were calculated. RESULTS: The results indicated that carbon nanotube reinforced specimens exhibited less color stability when compared to controlled glass ionomer cement specimens; however, both samples had significantly greater color stability than silver nanoparticle reinforced glass ionomer samples. CONCLUSION: It can be concluded within the limitations of this study that carbon nanotube reinforced glass ionomer cements have better color stability than silver nanoparticle reinforced glass ionomer cements.

Reliability of mobile phone teledentistry in dental diagnosis and treatment planning in mixed dentition.

INTRODUCTION: The aim of the study was to test the reliability of mobile phone teledentistry in the diagnosis and treatment planning of dental caries of children in mixed dentition. METHODS: A total of 57 cases, aged 6-12 years, among six examiners were used yielding 342 comparisons. The patients were examined by a dentist who was calibrated in the recording of oral findings in children using the World Health Organization (WHO) oral health assessment form for children (version 2013), which served as the gold standard for diagnosis. Six paediatric dentists calibrated using the same WHO form served as the teledentistry group and made their diagnoses using only the images sent to them without the use of radiographs. The pictures obtained were stored on an online cloud platform (Google Drive). The sharing links for these pictures were forwarded to participating dentists using a social media application (WhatsApp Messenger, Facebook Corp., Mountain View, CA). RESULTS: This study showed greater sensitivity than specificity, and though both sensitivity and specificity were constantly above 80%, it can be stated that the current model has a higher chance of false positive results than false negative results. The reliability of teledentistry in this study is greater in primary teeth than in permanent teeth. DISCUSSION: Although the use of teledentistry without radiographs is not as accurate as clinical examination, mobile phone teledentistry offers acceptable reliability for the initial diagnosis of caries in children.

The Relationship between Salivary Total Antioxidant Capacity and Dental Caries in Children: A Meta-Analysis with Assessment of Moderators.

OBJECTIVE: There has been variation reported in literature examining the relationship between dental caries and total antioxidant capacity (TAC) of saliva in children. This study aimed to systematically review the literature and conduct a meta-analysis of the association between dental caries and TAC in children. METHODOLOGY: A systematic review of literature was done using the PubMed, Medline, and EBSCO libraries. Of the total of 68 records found, 11 studies were qualitatively assessed in the final analysis. These studies yielded a total of 13 comparisons to be included in the meta-analysis. The type of dentition of the child and the test used to measure TAC were assigned as moderators. A meta-analysis was done of the mean TAC levels, while a meta-regression was formulated using the moderators. All analyses were performed using OpenMetaAnalyst™ meta-analysis software (Brown University, RI, USA). RESULTS: The meta-analysis showed significant increase in TAC in children with dental caries when compared to their caries-free counterparts (P < 0.001). The meta-analysis showed high levels of heterogeneity (I 2= 99.48). The meta-regression revealed that, while the type of dentition was a significant moderating factor (P = 0.002), the method used to assess the TAC was not (P = 0.053). CONCLUSION: There is a significant increase in TAC in children with dental caries when compared to their caries-free counterparts.

The Effects of Presurgical Nasoalveolar Molding on the Midface Symmetry of Children with Unilateral Cleft Lip and Palate: A Long-term Follow-up Study.

BACKGROUND: Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of presurgical nasoalveolar molding (PNAM) on midface symmetry in children treated for CUCLP. This study aimed to compare children with CUCLP who underwent PNAM before surgical interventions, children who did not receive PNAM, and age- and sex-matched controls in terms of midface symmetry. METHODS: We evaluated 39 frontal facial photographs of 13 patients with CUCLP who underwent PNAM as part of the treatment (group 1: PNAM), 13 patient with CUCLP who did not undergo PNAM (group 2: no nasoalveolar molding), and 13 age- and sex-matched controls. The children were evaluated in their fifth year of life. Three midline and 3 bilateral orthopometric midface landmarks were programmed using a custom software (OnyxCeph3, Image Instruments GmbH, Germany), and corresponding linear measurements from the midline were obtained and compared between the groups using 1-way analysis of variance and Scheffe's post hoc test. RESULTS: Significant differences were observed between the control and CUCLP groups for the measurements of the proanasale, subnasale, and zygion. However, there were no significant differences between the PNAM and no nasoalveolar molding groups for the 6 midface landmarks. CONCLUSIONS: PNAM does not seem to significantly impact the long-term midface symmetry in children with CUCLP.

Salivary antioxidant capacity of children with severe early childhood caries before and after complete dental rehabilitation.

OBJECTIVE: There is a need to determine whether total antioxidant capacity (TAC) in severe early childhood caries (S-ECC) is an indicator of inflammatory response to the lesion or a marker of the disease. This study compared TAC levels in children with ECC before and after dental treatment and compared the results with those of caries-free children. DESIGN: Prospective study. SETTING: A teaching hospital. PATIENT SELECTION: Salivary samples were obtained from 20 children aged 5 years and diagnosed with S-ECC, and 20 age- and sex-matched controls. INTERVENTION DETAILS: Complete dental rehabilitation under general anesthesia was performed on the children with S-ECC, and follow-up salivary samples were obtained one week and three months postoperatively. TAC was measured using a commercially available Oxygen Radical Absorbance Antioxidant Assay measurement kit (Zen-Bio ORAC™, AMS Biotechnology, Abington, UK). OUTCOME MEASURES: Differences between children with and without dental caries were tested using the Mann-Whitney U test; differences before and after dental treatment were analyzed using Friedman test followed by Wilcoxon sign-rank test with Bonferroni correction to compensate for multiple comparisons. RESULTS: Median TAC (1.54 mcg/L, CI 1.15-1.92) of the control group was significantly lower than that of the treated group prior to treatment (p = 0.003). Treatment of the dental lesions significantly reduced TAC of the treated group, and no significant differences were observed between the test and control groups at either one week (p = 0.076) recall or three-month recall (p = 0.096). TAC in children posttreatment was significantly reduced compared to their pretreatment values (p < 0.001). CONCLUSION: Total antioxidant capacity in the saliva of children with severe early childhood caries undergoes significant reduction following treatment of the carious lesions.

Impact of birth characteristics, breast feeding and vital statistics on the eruption of primary teeth among healthy infants in Saudi Arabia: an observational study.

OBJECTIVES: This study aimed to explore the impact of gender, birth weight, maternal age, type of delivery, gestational age and feeding practices on the eruption of teeth in children with no underlying medical conditions or developmental defects in their first year of life. DESIGN: A cross-sectional observational study design was used. SETTING: A primary healthcare setting in Riyadh, Saudi Arabia. PARTICIPANTS: All children in their first year of life attending a vaccination clinic (n=422) were included in the study. Infants with chronic childhood illnesses, those who were below the 5th percentile in height or weight, infants with congenital birth defects and chronic illnesses, infants who were born preterm and low birth weight infants were excluded from the study. OUTCOME MEASURES: The type of delivery, birth weight, age of mother, height and weight percentile for age (as plotted on the WHO growth chart for infants) and feeding practices were recorded by the examiner, and this was followed by a clinical examination to determine the presence or absence of each tooth. Regression models were developed to determine the effect of the different variables on the presence of primary teeth. RESULTS: There was a significant association between the weight percentile of the child (adjusted for age) and the number of erupted primary teeth, suggesting that heavier children have an earlier eruption of teeth. No association was observed between birth weight, height percentile for age or maternal age at the time of birth and the number of erupted primary teeth. Children who were exclusively breast fed were significantly more likely to have an erupted first primary tooth earlier than non-breastfed group. CONCLUSIONS: Breast feeding and the weight of the child may have an influence on the eruption of primary teeth in the first year of life.

Parental Perception of Oral Health-related Quality of Life of Syrian Refugee Children.

AIMS AND OBJECTIVES: The conflict in Syria has resulted in the displacement of over 5 million people, many of whom intend to return home at the cessation of hostilities. Oral health plays a critical role in early childhood and this study aimed to qualitatively and quantitatively assess the oral health-related quality of life (OHRQoL) of these children. MATERIALS AND METHODS: The quantitative assessment of OHRQoL was done using a validated Arabic version of the short-form Parental-Caregiver Perceptions Questionnaire-8 (P-CPQ-8). The P-CPQ-8 was administered to 22 sets of parents of children in a community center catering to urban refugees. A focus group interview and thematic analysis of nine mothers were used to gain a qualitative insight into the problems that could affect the OHRQoL of their children. RESULTS: The P-CPQ-8 revealed that oral symptoms were the greatest concern of the parents with dental pain being the most commonly reported condition. Although mothers reported higher P-CPQ-8 scores among all domains than fathers, there were no significant differences in the concerns of the fathers and the mothers. The focus group interview raised three major themes - (1) access to dental care, (2) pain felt by the child, and (3) oral hygiene of the child. CONCLUSION: The parents interviewed in this study were aware of the importance of oral hygiene but reported being unable to look after their children's teeth. Children who are refugees from the Syrian conflict face significant OHRQoL challenges.

Comparison of the Effectiveness of a Mobile Phone-based Education Program in Educating Mothers as Oral Health Providers in Two Regions of Saudi Arabia.

AIMS AND OBJECTIVES: The penetration of mobile phone devices is widespread across the Kingdom of Saudi Arabia. Recently, there has been evidence of the success of phone-based applications in the provision of preventive oral health care to children and their parents. The aim of this study was to compare the effectiveness of a mobile phone-based application in educating mothers of children aged below 6 years of age in preventive dental care. MATERIALS AND METHODS: A mobile phone-based application (iTeethey™) was developed for iPhone and Android and made freely available on Google Play and App Store. The application was then distributed to 3879 mothers of children below 6 years of age (1989 in Riyadh Region and 1890 in Najran region). The mothers were subjected to a standardized knowledge attitude and practice of oral hygiene questionnaire before being asked to download the application. A total of 1055 mothers who downloaded the application completed 3-month recall process. RESULTS: Significant improvement in the knowledge of the mothers was reported after the use of the application from both regions. The mothers from Najran showed significantly greater improvement in knowledge when compared to the mothers from Riyadh region. The application was also more effective in mothers with more than one child when compared to first-time mothers. CONCLUSION: Within the limitations of this study, we can state that the mobile phone application used in this study significantly improves the knowledge of mothers toward their child's oral health.

An Evaluation of Bite Pattern in Children with Severe-Early Childhood Caries Before and After Complete Dental Rehabilitation.

PURPOSE: The purpose of this study was to examine the changes in bite characteristics of children before and after the placement of multiple stainless steel crowns (SSCs) under general anesthesia (GA). METHODS: Twenty children scheduled for treatment under general anesthesia who needed SSCs in three or more posterior quadrants were included in this study. The bite was digitally analyzed and recorded preoperatively and at one and four weeks postoperatively. The occlusion time, number of force outliers, and distribution of force at each visit was recorded and compared. RESULTS: The placement of the SSCs in children significantly improved the bite characteristics of the participants. The placement of the SSC did not alter occlusion time, and there were no significant differences in occlusion time. While there was an increase in the number of outliers in the first week after the placement of the crown, there was a reduction in the total number of outliers at the end of one month. All the patients treated with bilateral placement of an SSC showed a posterior balanced occlusion post-operatively, a finding that was retained over the one-month follow-up period. CONCLUSION: Bilateral placement of SSCs under general anesthesia does not significantly alter the occlusion of the child.