Comparison of oral midazolam with combination of oral midazolam and nitrous oxide inhalation in relation to safety of dental sedation in young children.

The objective of the study was to compare the safety of 0.6 mg/kg oral midazolam sedation alone with a combination of 0.6 mg/kg oral midazolam and nitrous oxide-oxygen sedation during dental treatment of young children. The study had a crossover design where every patient received two different sedation regimens i.e. oral midazolam 0.6 mg/kg alone and oral midazolam 0.6 mg/kg with nitrous oxide-oxygen inhalation during two dental treatment visits. Thirty children (17 males and 13 females) were selected for the study with mean age of 55.07 (+/- 9.29) months. Safety of the two regimens was evaluated by monitoring hemodynamic parameters (heart rate, blood pressure & oxygen saturation) and through observing the child for 24 hours post-sedation for any side effects such as nausea and vomiting. Very few changes in hemodynamics were noted from baseline during both the visits. However, the mean oxygen saturation level with oral midazolam and nitrous oxide-oxygen was significantly (p < 0.05) higher than oral midazolam alone. Postoperative side effects were very few and mainly remained limited to post-sedation drowsiness. It can be concluded that oral midazolam (0.6 mg/kg) alone and oral midazolam (0.6 mg/kg) plus nitrous oxide (30%-50%) sedation are both safe while providing dental treatment to children with behavior problems.

Bilateral occurrence of dental caries and oral hygiene in preschool children of Riyadh, Saudi Arabia.

The objective of the study was to determine bilateral caries occurrence or caries bilaterality in preschool children of Riyadh. For this purpose, 789 randomly selected preschool children, 379 (48%) boys and 410 (52%) girls, were examined for dental caries utilizing the World Health Organization (WHO) criteria for diagnosis of dental caries. Caries were significantly bilateral (p < .05) in all the teeth. Among the posterior teeth, mandibular second molars showed the highest caries bilaterality (88%) and among the anterior teeth, maxillary central incisors had the highest caries bilaterality (88.9%). Mandibular canines had the lowest caries bilaterality (52.7%). There was more than 50% probability of left side tooth being carious given that right side tooth was carious for all the teeth. Amongst posterior teeth, the conditional probability for bilateral caries occurrence was highest in mandibular second molars (.88) and amongst the anterior teeth, maxillary central incisors had the highest conditional bilaterality (.89). Caries bilaterality was significantly high (p < .05) in children with poor and fair oral hygiene as compared to children with good oral hygiene for all the molars and maxillary central incisors. It can be concluded that bilateral caries occurrence or caries bilaterality is highly prevalent in all the primary teeth; especially in mandibular molars and maxillary incisors.

Caries experience and oral hygiene status of blind, deaf and mentally retarded female children in Riyadh, Saudi Arabia.

OBJECTIVE: To determine the caries experience and oral hygiene status in blind, deaf and mentally retarded female children in Riyadh, Saudi Arabia. METHOD: All (N=218) the 6-7-year-old and 11-12-year-old blind, deaf and mentally retarded female children registered with the Presidency of Girls' Education schools in Riyadh were examined for dental caries and oral hygiene in a dental operatory setting. RESULTS: All (100%) the blind 6-7-year-old had caries with a mean dmft score of 6.58 (SD 2.02). The caries prevalence in blind 11-12-year-olds was 88.2% with a mean DMFT score of 3.89 (SD 2.67). Among 6-7-year-old blind children 8.3 %, and in 11-12-year-old blind children 29.4% had good oral hygiene. The caries prevalence in deaf 6-7-year-olds was 95.7% with a mean dmft score of 7.35 (SD 3.51). The caries prevalence in 11-12-year-old deaf children was 93% with a mean DMFT of 5.12 (SD 3.45). Less than one-fifth (17.4%) of the 6-7-year-old deaf children and only 7.0% of 11-12-year-old deaf children had good oral hygiene. The caries prevalence in mentally retarded 6-7-year-old was 93.9% with a mean dmft of 8.00 (SD 4.1). All the mentally retarded 11-12-year-old had carious teeth with a mean DMFT score of 5.81 (SD 2.95). Only 3.1% of the mentally retarded 6-7-year-old and none of the mentally retarded 11-12-year-olds had good oral hygiene. CONCLUSIONS: Caries prevalence and severity in all the three groups of female special children were very high, and the number of children with good oral hygiene was very low.

Caries prevalence and its relation to water fluoride levels among schoolchildren in Central Province of Saudi Arabia.

OBJECTIVE: To determine dental caries prevalence and severity among primary and intermediate schoolchildren in Riyadh and Qaseem Regions, and to determine any correlation between dental caries and fluoride levels in drinking water. DESIGN: Cross-sectional. METHODS: 1,104 children; 431 (6-7-year-old) primary schoolchildren (249 in Riyadh and 182 in Qaseem) and 673 (12-13-year-old) intermediate schoolchildren (392 in Riyadh and 281 in Qaseem) were examined for dental caries utilising the WHO criteria for diagnosis of dental caries. RESULTS: In primary schoolchildren the prevalence of caries was 91.2% both in Riyadh and Qaseem. The mean dmft scores were similar in Riyadh (6.53, SD 4.30) and Qaseem (6.35, SD 3.83). Among the intermediate schoolchildren the prevalence of dental caries was slightly higher in Riyadh (92.3%) than Qaseem (87.9%). The mean DMFT score was higher in Riyadh (5.06, SD 3.65) as compared with Qaseem (4.53, SD 3.57) with marginal statistical significance (p = 0.057). Among the primary schoolchildren there was statistically significant (p < 0.05) difference in mean dmft scores at various fluoride levels with lowest dmft scores at the optimum water fluoride level (0.61-0.80ppm) and highest at two extremes i.e. 0.0 to 0.3ppm and > 2.5ppm, while in intermediate schoolchildren no significant difference in overall mean DMFT scores of children at various water fluoride levels could be found. CONCLUSION: The caries experience among the primary and intermediate schoolchildren in Riyadh and Qaseem was very high, and that there was no linear correlation between water fluoride level and caries experience in these children.

Feeding and dietary practices of nursing caries children in Riyadh, Saudi Arabia.

The aim of the study was to determine the feeding and dietary practices of Saudi nursing caries children in Riyadh. A sample of nursing caries children attending the dental clinics of three health care facilities in Riyadh was selected for the study. The information about the feeding and dietary practices was obtained through a self-administered questionnaire. A total of 74 nursing caries children, 34 (45.9%) male and 40 (54.1%) female with a mean age of 55.0 (SD 20.0) months participated in the study and, their mothers completed the questionnaire. About two-thirds of the children (65.0%) were breast-fed before sleep and a similar percentage (60.8%) was breast-fed during sleep. More than two-thirds (68.9%) were bottle-fed with liquids such as fresh fruit juices (51.4%), packed juices (43.2%) and soft drinks (81.1%). The mean age of starting to drink in a cup was 25.1 (SD 10.4) months. The most popular (71.6%) drinks in a cup were fruit juices. More than two-thirds (71.6%) of the children were taking soft drinks directly from a container and, about two-thirds (60.0%) of the children started drinking directly from a container at or before the age of 24 months. Almost all the children (93.2%) were taking sweets; about half (45.9%) of them taking sweets twice or more daily. It was concluded that the study children have feeding and dietary characteristics (typical of nursing caries) such as breast-feeding before/during sleep, nocturnal/nap-time bottle-feeding, excessive consumption of fruit juices/soft drinks from a container and a high frequency of sweet intake.

Early childhood caries: nomenclature and case definition.

A fruitless debate so far has continued to find an ideal name for early childhood caries (ECC), one which could encompass all its risk factors and express the possible seriousness and rampant nature of the problem. It should be simultaneously comprehensible to the dental profession, medical personnel and the general public. However, it is hard to find an example of a multifactorial disease where the name alone indicates its etiology, signs, symptoms, and prevention. It is time for us as a dental profession to accept the responsibility to educate ourselves, our medical colleagues and the public about ECC, and stop hoping that a perfect name for ECC will do the job for us. A similar situation exists regarding the case definition of ECC. To find a single definition of ECC based on number of lesions, teeth involved and age of the affected children is an unrealistic goal. Therefore, a classification of ECC and a case definition for each type is proposed.

Caries prevalence in 2 and 3 year old children of Adelaide, Australia.

Information on caries experience in Australian preschool children is scarcely available. The aim of present study was to determine caries prevalence in two and three year old children in Adelaide, Australia. A weighted random sample of 160 two and three old children was examined by one examiner (AHW) for caries experience. Most children (88.1%) had no clinical caries. Mean dmft (decayed, missing and filled teeth) score was 0.49 (+/- 1.7), with dt component of 0.39 (+/- 1.41), mt of 0.03 (+/- 0.39) and ft of 0.06 (+/- 0.6). The most susceptible tooth in children with clinical caries was maxillary central incisor (63.2%), while the least susceptible was mandibular central incisor (0%). The results have indicated that the percentage of two and three year old children with clinical caries was low in Adelaide Statistical District.

Infant and child feeding practices: a preliminary investigation.

The objective of this preliminary investigation was to examine the feeding practices of infants and pre-school children in Adelaide, and thereby contribute to the development of appropriate preventive dental strategies. A stratified random sample of 160 two year old and three year old pre-school children in the Adelaide Statistical District was obtained. Information about feeding practices and use of comforters or 'dummies' was obtained through a self-administered questionnaire completed by parents of the selected children. Information was collected for the age periods of 0-3 months, 4-6 months, 7-12 months, 13-24 months and 25-36 months. Most of the children (81.8 per cent) were breast-fed at some stage. However the percentage of children being breast-fed decreased markedly across age periods, particularly to 13-24 months, when only 15.9 per cent of children were being breast-fed. Over half of the children, had been bottle-fed with infant formula at some stage. The highest percentage of children being bottle-fed with infant formula occurred in the 4-6 months (42.6 per cent) closely followed by the 7-12 months age period (37.4 per cent). Nearly two-thirds of children were bottle-fed with cow's milk at some stage. The highest percentage of children being bottle-fed with cow's milk occurred in the 13-24 months age period (49.6 per cent). A quarter (24.5 per cent) of the children were put to bed at some stage with a bottle containing cariogenic fluids. The majority of children used a 'dummy' at some stage during both day-time and night-time. Parents are in need of advice on appropriate feeding patterns for infants and young children.

Classification of cervical burnout and its distribution in the dentition.

A retrospective analysis of 25 full mouth intra oral radiographs, including bitewing films was carried out from the hospital records of King Saud University College of Dentistry in Riyadh, Saudi Arabia, A new classification of cervical burnout (CB) based on shape was attempted. Analysis of the data revealed greater frequency of CB in maxillary teeth (67.5%) than in the mandibular teeth (32.5%). The highest frequency among maxillary teeth was in incisors (75%), while the least was in the molars (30%). In mandible, the corresponding findings was in the canines (40%) and in the molars (15.3%). Seventy per cent of CB disappeared in bitewing view in maxillary and mandibular premolars while remaining teeth showed this phenomenon in less than 50% cases. It was concluded that the frequency of CB was greater in maxillary teeth than mandibular teeth. Maxillary incisors and mandibular canines are more likely to show CB. In molars and premolars, CB present in periapical radiographs may disappear in a bitewing view.

Use of sweet snacks, soft drinks and fruit juices, tooth brushing and first dental visit in high DMFT 4-6 year olds of Riyadh region.

A total of 68 children, 4-6 years old and equally distributed by gender were selected for the study. Information about use of sweet snacks, soft drinks and fruit juices/drinks, tooth brushing/cleaning, and first dental visit of the children was obtained through a self-administered questionnaire completed by the parents of the selected children. Sixty (88.2%) children were given sweetened snacks. Fifty one (75%) children were using canned soft drinks and packed fruit juices. Twenty eight (41.2%) children were not brushing/cleaning their teeth. The mean age of first dental visit among the study children was 63 (S.D 16.9) months. It may be concluded that the lack of dietary discipline and good oral hygiene habits were most probably responsible for caries in these children.

Internship program in King Saud University College of Dentistry. Attitudes of interns.

The objective of the present survey was to look into the attitudes of the interns towards their training program in King Saud University College of Dentistry. A self administered questionnaire was designed for this purpose. One hundred and twenty four interns participated in the survey. The branch of dentistry in which they liked to work most was restorative dentistry (20.3%) followed by prosthodontics (18.9%) and, oral surgery (16.2%) and endodontics (16.2%). The greatest faculty assistance was required in orthodontics (46.3%) followed by oral surgery (20.9%) and diagnosis (17.9%). 80.5% of the interns were interested in further studies. The most favorite subject for further studies was oral surgery (37.9%) followed by restorative dentistry (18.9%) and prosthetics (17.9%). A considerable majority of the interns had a very positive attitude towards dentistry as a profession.

Caries activity indicators. A review.

Caries activity is the sum total of new carious lesions and the enlargement of existing cavities during a given time. An objective evaluation of caries activity requires clinical examination of quantification of factors associated with the pathogenesis of caries. Caries activity tests have been in use in dental research and clinical dentistry for years. They are useful in establishing categories of risk for caries, and for targeting specific preventive measures to these groups. They are even more useful in situations of limited resource availability. The limited resources can be concentrated on those identified by caries activity indicators as in most need of help. In recent years a number of techniques to diagnose caries have emerged. It is important for the clinical practitioner to utilize cost-effective measures in diagnosing those at risk. The objective of this paper is to review the current types of caries activity indicators and their relative efficacy.

Relationship between caries, water fluoride level and socioeconomic class in 15-year-old Indian school children.

The purpose of this study was to determine the relation between caries experience, water fluoride level and socioeconomic class among the 15-year-old school children of Tamilnadu. The study children were stratified on the basis of water fluoride level and socioeconomic (SE) class. The children were divided into low, medium and high SE classes. There was a highly significant (P < .001) difference in the carious experience of 15-year-old children from low fluoride (LF) areas in relation to the SE class, the low SE class having the highest caries experience. There was almost no difference between the caries experience of low SE class 15-year-old children from the LF area and high fluoride (HF) area (Z < 1.96 and P > 0.05). The difference between caries experience of 15-year-old children from LF and HF areas was not statistically significant (Z < 1.96 and P > 0.05). The present study has indicated towards the need of provision of more vigorous preventive efforts in lower SE class children in both the urban and rural population.