Child oral health: A plea for interdisciplinarity / La santé orale de l'enfant : un plaidoyer pour l'interdisciplinarité

A child's oral health has major implications both for their general health and for their quality of life. Even before birth, the mother's oral health can affect the development of the baby and pregnancy outcomes. From the very first months of life, feeding habits together with non-nutritive sucking ones, early transmission of pathogenic bacteria, and oral hygiene practices prefigure the child's future health. The aim of this article is to provide a comprehensive overview of our current knowledge regarding the main oral health issues affecting children, namely dental caries, erosive tooth wear, developmental defects of enamel, maxillofacial growth anomalies, and traumatic dental injuries. Additionally, it aims to examine the oral health prevention and promotion programs that have been implemented in France over several decades. These prevention and promotion initiatives are not only part of a national program but are also being organized at a territorial level, although, unfortunately, they often remain limited to regional, departmental, or municipal scopes. It is essential for all those involved with children, whether they are health care professionals or not, to collaborate effectively to enhance both oral health and overall well-being. This requires fostering an interdisciplinary approach that involves various contributors working together in a complementary way.

La santé orale de l'enfant est d'un enjeu majeur, tant pour sa santé en général que pour sa qualité de vie. Avant même sa naissance, la santé orale de la mère impacte le développement du bébé et l'issue de la grossesse. Dès les tout premiers mois de vie, le mode d'alimentation, les habitudes de succion non nutritives, la transmission précoce de bactéries pathogènes et les pratiques d'hygiène orale préfigurent la future santé de l'enfant. L'objectif de cet article est de faire une synthèse des connaissances sur les principales affections bucco-dentaires chez l'enfant que sont la maladie carieuse, l'usure érosive, les défauts de minéralisation, les anomalies de croissance maxillo-faciale et les traumatismes dentaires et de s'interroger sur les programmes de prévention et de promotion de la santé en santé orale en France depuis plusieurs décennies. Des initiatives de prévention et de promotion de la santé orale s'organisent (en complément du programme national), dans une déclinaison territoriale, encore trop souvent seulement régionale, départementale ou municipale. Ainsi, ce sont tous les acteurs autour de l'enfant, professionnels de la santé ou non, qui doivent s'engager, ensemble, pour améliorer sa santé orale et sa santé en général et c'est tout une culture interdisciplinaire qui doit se développer autour d'une pluralité d'acteurs qui pourraient agir et collaborer, en toute complémentarité.

Malocclusions and oral dysfunctions: A comprehensive epidemiological study on 359 schoolchildren in France.

OBJECTIVES: The purpose was to conduct a comprehensive study of malocclusions and oral dysfunctions on 11-year-old children and to study the risk factors associated with malocclusions. MATERIAL AND METHODS: A cross-sectional descriptive epidemiological survey was conducted among 359 children in France. A clinical examination was conducted, and orthodontic and oral functional data were collected. In addition, the need for orthodontic treatment was evaluated using the criteria defined by of the French National Authority for Health (HAS). Finally, a univariate and multivariate analysis was performed to assess the risks associated with malocclusions. RESULTS: Most children (88%) exhibited a malocclusion, regardless of gender (p = .912). The examination of oral functions identified a large number of swallowing (87%) and respiration (42.7%) disorders. The presence of malocclusion was statistically linked to the low position of the tongue at rest (p < .001), abnormal swallowing (p = .03), and improper mouth breathing (p = .001). After a multivariate analysis, the type of respiration (odds ratio [OR] = 3.2 [1.4-7.3]) and the position of tongue at rest (OR = 3.43 [1.7-7.1]) were the two most prominent factors in the prediction of emerging malocclusion. CONCLUSION: This epidemiological survey reveals a high prevalence of dental malocclusions and functional disorders. Oral respiration and the low position of the tongue at rest are the most important factors in the prediction of a malocclusion.

The dental "box of horrors" clinical practice game: A pilot project.

BACKGROUND: The dental department of the University Hospital of Nice has set the "box of horrors," an innovative concept inspired by the "room of horrors," created in 2006 in Canada, and utilized since 2011 in France. PURPOSE: The aim was to assess the impact and perceived value of this clinical practice game utilized by fourth-year dental students. METHODS: This pilot study following a cross-sectional pre- and posttest research design was used to assess students' change in performance. The experimental group was divided into 12 students teams (n = 50). A questionnaire was completed before they entered the box; they had then to find out 10 errors hidden in the box in a set time. A debriefing was held immediately after. The control group answered the same questions but did not follow the course inside the box. The percentages of correct answers were compared between the two groups with a Mann-Whitney test, and the scores per student were analyzed with a mixed effects ordinal multiple logistic regression. Finally, a satisfaction questionnaire was proposed. RESULTS: After the course, the students from the experimental group performed 94% correct answers, while those from the control group showed 78% (significant difference). The outcome of the mixed effect multiple regression showed a significant group effect (p = 0.0001) and gender effect (p = 0.001). CONCLUSION: Clinical games, although complex to implement, are interesting and rewarding tools. The adaptation of the tool to the dental sector appeared to be feasible.

Analysis the Link between Periodontal Diseases and Alzheimer's Disease: A Systematic Review.

The hypothesis of an infectious connection from the oro-pharyngeal sphere to the brain underlines the interest in analyzing the link between periodontal disease and Alzheimer's disease. The aim of this systematic review was to examine the link between Alzheimer's disease and periodontal disease in patients aged 65 and over. Databases (PubMed (MEDLINE), the Cochrane Library, and Embase) were analyzed for relevant references up to 21 June 2021. The authors independently selected the studies and extracted the data. The quality of included studies was checked using the National Institutes of Health's quality assessment tools. Five studies were included. The selected studies described in their results an increase in F. nucleatum in Alzheimer's disease patients (adjusted p = 0.02), and its incidence was linked to C. rectus and P. gingivalis (adjusted HR = 1.22 (1.04-1.43), p = 0.012) as well as A. naeslundii (crude HR = 2.0 (1.1-3.8)). The presence of periodontitis at baseline was associated with a six-fold increase in the rate of cognitive decline over a 6-month follow-up period (ADAS-Cog mean change = 2.9 ± 6.6). The current review suggests an association between periodontal disease and Alzheimer's disease. The treatment of periodontal disease could be a way to explore Alzheimer's disease prevention.

Prioritization of predisposing factors of gingival hyperplasia during orthodontic treatment: the role of amount of biofilm.

BACKGROUND: The mechanism of gingival growth that may occur during fixed orthodontic treatment is not yet fully understood and the amount of dental plaque is often incriminated. The objective of this study was to evaluate the prevalence of gingival growth during multi-attachment orthodontic treatment and to prioritize its predicting factors, especially the quantity of biofilm. METHODS: This comprehensive cross-sectional descriptive study was conducted on orthodontic patients aged 9 to 30 years, in good health, treated by a fixed appliance. Periodontal clinical parameters such as plaque index, gingival index, probing pocket depth, periodontal phenotype and gingival enhancement index were recorded. Likewise, the brushing habits and the date of the last scaling were noted. The orthodontic parameters studied were the duration of the treatment, the type of bracket, the alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, and variables presenting p value < 0.25 were included in a multivariate analysis to calculate the Odds Ratio (OR) of gingival enlargement". RESULTS: A total of 193 patients were included (16.38 ± 4.89 years). Gingival growth occurred for 49.7% of patients included. The predisposing factors for this pathology during fixed orthodontic treatment were conventional metal brackets (p = 0.021), mouth breathing (p = 0.040), male gender (p = 0.035), thick periodontal phenotype (p = 0.043), elastomeric ligations (p = 0.007), duration of treatment (p = 0.022) and presence of plaque (p = 0.004). After achievement of the logistic regression, only two factors remained related to gingival enlargement: metallic brackets (OR: 3.5, 95% CI: 1.1-10.55) and duration of treatment (OR: 2.03, 95% CI: 1.01-4.08). The amount of plaque would not be directly related to the development of gingival increase during orthodontic treatment. CONCLUSIONS: Among the predisposing factors that underlie gingival growth during multi-attachment therapy, the amount of plaque is not found. The qualitative assessment of the plaque and its evolution during treatment could clarify the role of the biofilm in the occurrence of gingival overgrowth.