Current treatment modalities of orthodontically induced white spot lesions and their outcome - a literature review.

INTRODUCTION: White spot lesion is a demineralization of the enamel that appears as a white spot on the surfaces of the tooth. The cause of this spot is determined by the activity of the bacterial plaque and it represents the initial stage of a carious lesion. This lesion is a common side effect for patients with fixed orthodontic appliances mainly because of the brackets' position that favors the accumulation of plaque that ultimately leads to the formation of the white spot. METHODS: We conducted a search on a single database, PubMed. "Orthodontic", "white spot lesions", "enamel demineralization treatment" and "remineralization" were the search terms used. We found 324 articles, but we took in consideration only the ones from the last 10 years, which resulted in 223 articles. RESULTS: The first step after research was article selection: first by scrutinizing the title and secondly by reviewing the abstracts or full texts. The exclusion criteria were: meta-analysis, reviews, original articles regarding prevention of white spot lesions and their prevalence or incidence. We included the articles that seemed relevant for the treatment of white spot lesions, made either on extracted teeth either on orthodontic patients. We found 75 articles to be eligible for this research and we eliminated 5 because of the lack of an abstract or full text and a further 22 were rejected because they did not fit the aforementioned criteria. CONCLUSION: Although some traditional methods for the treatment of white spot lesions seem to have undesirable results, nowadays with new technologies and thorough investigations in nanotechnology, the eradication of the lesion appears to be short term.

Dental anxiety and fear among a young population with hearing impairment.

BACKGROUND AND AIM: Dental fear and anxiety is a major barrier for dental care provision. Identifying anxious patients can help dental professionals manage them appropriately. The study aimed at assessing dental fear and anxiety among a deaf population in Cluj-Napoca, Romania and their associated and contributing factors. METHOD: In this cross sectional study 165 deaf participants were invited to complete a questionnaire comprising three sections. The first section contained questions about social and economical status, the second comprised a Romanian version of the Modified Dental Anxiety Scale (MDAS) while part three was the Dental Fear Survey (DFS). Data was introduced and analyzed with the Statistical Package for Social Sciences (SPSS) program, version 20.0 (SPSS Inc., Chicago, Illinois, USA). RESULTS: Thirty four point nine percent (34.9%) of respondents were found to be insignificantly anxious, 59.7% were moderately or extremely anxious with 5.3% being identified with dental phobia based on the MDAS scores. Mean total score for dental anxiety on the MDAS scale was 13.7. Patients suffering from a prior negative experience were found to be more anxious (p<0.05). CONCLUSIONS: Dental fear and anxiety is widespread in the deaf communities. Higher percentages were observed among women and people with a previous traumatic dental experience.

Deleterious oral habits in children with hearing impairment.

BACKGROUND AND AIMS: Deleterious oral habits represent a serious public health issue. The information available about this problem in children with hearing impairment is insufficient. The purpose of this study was to investigate the prevalence of deleterious oral habits among children with hearing impairment and comparing results against children without hearing impairment. METHOD: This epidemiological study was carried out in a sample size of 315 children. We used a random sampling technique that included 150 children with hearing impairment and 165 without hearing impairment. All subjects were submitted to a clinical examination. The parents/legal guardians were asked to complete a questionnaire regarding the deleterious habits of their children. RESULTS: The data collected indicated a higher prevalence of deleterious oral habits among children with hearing impairment: 53.3% as opposed to 40.6% among children without hearing impairment. There was a higher incidence of malocclusion in children with hearing impairment (79.3%) compared to children without hearing impairment (57%). CONCLUSIONS: This study highlighted the need to establish protocols for preventive orthodontic treatment at an early age, in order to reduce the deleterious oral habits and prevent malocclusion. Dental institutions/clinicians need to implement oral care programs including proper oral education aiming to promote oral health.

Waardenburg syndrome type 2: an orthodontic perspective.

Waardenburg syndrome is a rare form of neurocristopathy. It is a disorder in the development of neural crest cells, caused by an altered cellular migration during the embryonic phase. That alteration causes an association of different abnormalities such as pigmentary disturbances of the hair, iris, skin, stria vascularis of the cochlea, dystopia canthorum and sensorineural hearing loss. We report a case of a 14-year-old Romanian male, with a family history of Waardenburg syndrome (mother) and Usher syndrome (father - congenitally sensorineural hearing loss and retinal degeneration). The case particularities are: the correlation between malocclusion and Waardenburg syndrome due to hypoplastic alae nasi and also factors that produced hearing loss, which could be Waardenburg syndrome, Usher syndrome or the presence of the connexin 26 (W24X) gene mutation.