Overcoming local anesthesia failure during routine dental treatments in children.

BACKGROUND: Local anesthesia (LA) during routine dental treatment in children fails in 5%-35% of first attempts. No data, however, are available on the success rates of subsequent attempts. AIM: To evaluate the effectiveness of primary, secondary, and tertiary LA attempts (P-LA, S-LA, and T-LA, respectively) for anesthetizing molars during routine dental treatments in children. DESIGN: We retrospectively analyzed dental records of all children (2-18 years) who had been administered LA for the treatment of primary or permanent molars by a single paediatric dentist, between 2011 and 2022. All LAs were delivered using a computer-controlled local anesthetic delivery (CCLAD) system. RESULTS: The failure rate of P-LA in 1312 molars was 13% and correlated with age (p < .001), type of tooth (p < .001), type of treatment (p < .001), and treated arch (p < .001). The effectiveness of S-LA for buccal infiltration, intrasulcular, inferior alveolar nerve block, greater palatine nerve block (GPNB), posterior superior alveolar nerve block (PSANB), or a combination of the last two was 50%, 87.2%, 66.7%, 63.6%, 33.3%, and 100%, respectively, and was not significantly associated with age or the type of tooth, treatment, or P-LA. CONCLUSION: The optimal choice of S-LA for anesthetizing maxillary molars was a combination of PSANB and GPNB, whereas for mandibular molars, it was IS-CCLAD system.

Factors associated with toothbrushing performance among children: An observational cohort study.

BACKGROUND: Effective removal of dental plaque is essential factor for prevention of caries, gingival, and periodontal diseases in children and adults. AIM: To evaluate factors associated with improving toothbrushing performance (TB-P) among children. DESIGN: An observational cohort study analyzed all paediatric patients receiving regular examinations in a single dental clinic between 2009 and 2017 and regularly brushing their teeth with a triple-headed toothbrush (TH-TB). At every periodic follow-up, the TB-P of the child/parent was evaluated using the TB-P Skill Index (TB-PS-I); that is, did the child reach all five teeth segments within each arch and did he/she perform 10 back-and-forth stocks in each segment. When not optimal, they received instructions for improving TB-P and subsequently were asked to re-demonstrate. TB-PS-I was calculated and analyzed for correlation with other explanatory variables. RESULTS: A total of 1737 children with 7399 follow-up appointments were analyzed. Older age, female gender, higher number of follow-up appointments, and compliance with twice-daily toothbrushing significantly improved TB-P. The most typical mistakes in their performance were not reaching the canine segments and not performing enough strokes in each segment. Instructions given after imperfect TB-P significantly improved the TB-P. The magnitude of improvement, however, did not correlate with the performers' age, gender, or the number of follow-up visits. CONCLUSIONS: A significant percentage of children >8 years did not perform optimal toothbrushing even when using TH-TB.

Effect of prolonged hospitalization on the maintenance of oral health: A self-report survey.

OBJECTIVES: This study aims to evaluate the effect of prolonged hospitalization on the maintenance of dental health and to assess the nursing staff's approach to addressing these concerns. METHODS: A survey questionnaire explored changes in the routine dental care of patients hospitalized for over a month. The involvement of nursing staff in addressing dental care was also evaluated. RESULTS: Fifty adult patients aged 18-89 years (mean age 62.4 ± 20.54 years), 27 (54%) males, completed the survey. During hospitalization (mean 58.59 ± 38.63 days) 26% and 18%, increased consumption of sweets and sugary beverages, between meals, respectively; 26% and 20% of the patients reduced the frequency of tooth brushing in the morning and in the evening, respectively, and 42.2% of them, reduced the quality of their toothbrushing during hospitalization. Nevertheless, 95.9% and 93.9% of them were never instructed during hospitalization to limit their consumption of sweets and sugary beverages and 83.3% and 62.5% of them had never been reminded or offered assistance during hospitalization in performing toothbrushing, respectively. The lower frequency of morning toothbrushing was significantly correlated with a lack of nurses' assistance (p = 0.004). In contrast, 62.6% reported they were reminded every day to shower. Patients in the rehabilitation and geriatrics departments reported a greater need for a brush/toothpaste (p < 0.0001) and assistance in toothbrushing (p < 0.0001). CONCLUSIONS: Prolonged hospitalization leads to significant deterioration in inpatients' dental health maintenance. Raising awareness among nurses regarding their inpatient's oral health maintenance is warranted. Providing patients with toothbrushes, toothpaste and educational materials upon hospitalization is recommended.

Management of Ankylotic Root Resorption Following Dental Trauma: A Short Review and Proposal of a Treatment Protocol.

Ankylotic root resorption is a serious complication following traumatic dental injuries. The aetiology of root resorption includes acute injury to the cementum and periodontal ligament, and subsequent biological processes that propagate the harm. The aim of the present paper is to present a structured treatment protocol for teeth that have experienced trauma and are at risk of developing ankylotic root resorption, followed by a decoronation protocol for situations in which ankylotic root resorption developed. This protocol provides a structured road map from the primary dental trauma, through the initial development of ankylosis detected radiographically, to the clinical manifestation that results in significant infra-occlusion. The current protocol integrates the best available evidence from the literature and from published guidelines. Ample contradictory data, which mainly consists of case reports related to the treatment of ankylotic root resorption, is available in the current literature. No accepted protocol or uniform guidelines for treatment in these cases exist, and many clinicians prefer avoiding replantation of an avulsed tooth that seems to have an uncertain longterm prognosis, or performing decoronation when infra-occlusion developed. As a result, young patients lose the benefits associated with replantation and decoronation procedures. The option of re-implantation of the avulsed teeth should be considered irrespective of the negative long-term prognosis. Following ankylosis development, the goal of submerging the tooth root (decoronation) is to maintain the horizontal dimension of the alveolar ridge and also to gain vertical dimension, allowing implant placement in the future.

Evaluation of Orthodontic and Triple-headed Toothbrushes When Used Alone or in Conjunction with Single-tufted Toothbrush in Patients with Fixed Lingual Orthodontic Appliances. A Randomized Clinical Trial.

UNLABELLED: Brushing with a single-tufted toothbrush in conjunction with a manual toothbrush has been widely recommended, although its effectiveness has not been proven. This study investigated the effectiveness of orthodontic and triple-headed toothbrushes when used alone or in conjunction with the single-tufted toothbrush in patients with fixed lingual orthodontic appliances. METHODS: In this randomized, single-blinded, controlled clinical trial, orthodontic patients (N = 26, mean age 27.3 years) with lingual fixed appliances were asked to brush with a triple-headed or an orthodontic toothbrush alone for one month, followed by brushing in conjunction with the single-tufted toothbrush for an additional month. Teeth were professionally cleaned at baseline and one month later. A clinician blinded to group assignments examined the patients and evaluated tooth plaque index, bracket plaque index, modified gingival index and bleeding on probing at baseline at one month and two months. RESULTS: After one month of brushing with the orthodontic toothbrush, the mean plaque index for tooth and bracket, bleeding index and gingival index were higher by 74.4% (0.68 vs. 0.39, p = 0.026), 54.2% (0.37 vs. 0.24), 15.4% (0.15 vs. 0.13) and 30% (0.26 vs. 0.20), respectively, than after brushing with the triple-headed toothbrush. After combined brushing with the single-tufted toothbrush, no additional statistical differences were found between groups. CONCLUSION: When used alone, the triple-headed toothbrush seems to remove plaque more effectively than the orthodontic toothbrush. The addition of the single-tufted toothbrush eliminates differences between groups.

Metal tooth-like surgical templates for tooth autotransplantation in adolescents.

OBJECTIVES: The aim of this study was to suggest a way to fabricate surgical templates to assist the surgeon in preparing the recipient socket when performing premolar autotransplantation. METHODS: Premolars used previously for extractions of periodontal ligament (PDL) fibroblasts were used in this study as archetype of models for tooth transplantation. Eighty-four mandibular and maxillary first and second extracted premolars were reviewed. All teeth were extracted for orthodontic reasons. From these teeth, eight teeth were selected to serve as archetype of models in which all the other teeth were at equal size or smaller in maximum 2 mm in M-D or B-L dimension. These teeth were sent to dental technician to perform identical archetype stainless steel templates. During autotransplantation immediately following donor tooth extraction, the appropriate template is chosen out of the toothlike stainless steel surgical templates and the donor tooth is then immediately replaced in its socket. This enables the surgeon to prepare the recipient site without manipulating the donor tooth and thus preventing damage to the PDL cells of the donor tooth. Only after the recipient site had been prepared to the appropriate size and shape according to the template, the donor tooth is removed from its socket, immediately placed at the recipient site and splinted as recommended. CONCLUSIONS: The advantage of the presented metal tooth-like surgical templates described in this study is that a set of stents has been produced by replicating different common shape adolescent premolars that reflect the biological variation in size and shape of these teeth.

Effect of Preventive Oral Hygiene Measures on the Development of New Carious lesions.

PURPOSE: To evaluate the effect of preventive oral hygiene measures on the development of new carious lesions. MATERIALS AND METHODS: Children regularly and irregularly attending recall appointments in a paediatric dental clinic were interviewed regarding their preventive measures performance. Newly developed carious lesions were also recorded. The files of 651 children were analysed. RESULTS: A significant negative correlation was found between newly developed carious lesions and total number (P < 0.001) and frequency (interval in months to the next dental examination) of recall appointments (P = 0.021), regular toothbrushing twice a day (P < 0.0001), regular brushing in the evening (P < 0.001), high fluoride concentration in toothpaste (P < 0.0001) and drinking water between meals (P = 0.015), but not with regular brushing in the morning or eating more than 6 times a day. Multivariate analysis revealed three of the variables independently correlated with the development of new carious lesions: brushing regularly twice a day, concentration of fluoride in the toothpaste greater than 1100 ppm and frequency of follow-ups. CONCLUSIONS: Regular toothbrushing twice a day is of high importance for caries prevention. Fluoride concentration of > 1100 ppm in toothpaste should be recommended for children (considering the child's age) in order to maximise the fluoride protective effect. The importance of attending periodic recall appointments in order to maintain long term oral health should be emphasised.

Successful conservative treatment of dentigerous cyst following intrusion of lower primary incisors.

This paper reports on the development of a dentigerous cyst associated with a lower permanent incisor following intrusion of two lower primary incisors. The small root remnant of one of the traumatized primary incisors was associated with granulation tissue, while the second incisor was discolored and suspected of being non-vital. The associated permanent incisor and other adjacent incisors were apically and laterally dislocated from their natural site of eruption. The conservative treatment included extraction of the involved primary discolored incisor, as well as the root remnant, followed by removal of the granulation tissue. After 18 months of follow-up, the permanent incisors were erupting in normal position, without pathological signs of the dentigerous cyst. Following severe traumatic injury to a primary tooth, periodic radiographic follow-up, until eruption of the correspondent permanent tooth, is recommended.

Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study.

Purpose: Vital partial pulpotomy (PP) or cervical pulpotomy (CP) in carious pulp-exposed permanent teeth preserves tooth vitality, promotes pulp healing, decreases treatment costs, and shortens treatment duration, which is a significant factor in treating noncooperative children. The aim of this retrospective study was to compare clinical and radiographic outcomes of partial and CP in vital carious-exposed permanent teeth. Materials and methods: All vital permanent teeth with carious pulp exposure, treated by pulpotomy using mineral trioxide aggregate (MTA) during 2017-2019, by two operators in one dental center, were included in the study. Around 118 permanent teeth in 97 children and adolescents (mean age 10.9 years) were evaluated 6-57 months postoperatively. Results: The total success rates of CP and PP were 82.5 and 80.8%, respectively (p = nonsignificant). The only factor that significantly affected the success rate was the presence of preoperative periapical pathology. Teeth without such pathology showed an 87.3% success rate compared to 74.1 and 58.3% in teeth with preoperative enlarged periodontal ligament (PDL) or with periapical radiolucency, respectively (p = 0.0301). Demographic variables, maturation state of the tooth, type of tooth (incisor, premolar, molar), postoperative variables, such as the presence of radiographic dentinal bridge, partial or full obliteration of the pulp during the follow-up period, and the integrity of the final restoration during the recall examinations did not affect the success rate of the treatment. Conclusion: Partial and CP in vital permanent teeth with carious pulp exposure in children and adolescents might be a reliable alternative to full root canal treatment (RCT). How to cite this article: Yoshpe M, Kaufman AY, Lin S, et al. Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study. Int J Clin Pediatr Dent 2023;16(4):555-559.

Factors associated with reduced compliance of children to dental preventive measures.

The aim of this study was to record self-reported factors for non-compliance to 'dental home' preventive measures among pediatric patients, and to clarify whether number or frequency of recall appointments increases their long-term compliance to dental home. Children attending recall appointments in a pediatric dental clinic were interviewed regarding their compliance as well as factors for non-compliance with the previously recommended preventive measures. Files of 651 children were analyzed. A significant positive correlation was found between compliance with regular teeth brushing twice a day (p < 0.0001), using correct fluoride concentration toothpaste (p < 0.0001), drinking water between meals (p < 0.0001), using Elmex gel (p < 0.0001), flossing (p < 0.002) and number of recall appointments. The most common factor for non-compliance to 'dental home' was 'I forgot'. Not flossing was commonly justified by performance difficulty while non-compliance to Elmex gel or to mouth rinses was attributed mainly to 'bad taste'. Additional common reasons were 'it was finished', 'my parents did not purchase', 'I did not find it at home', 'I did not know I need to'. Frequency and number of recall appointments might improve compliance with dental preventive measures. Referring to the specific factors of personal non-compliance may increase compliance.

Clinical and radiographic outcomes of pulpotomized primary molars treated with white or gray mineral trioxide aggregate and ferric sulfate--long-term follow-up.

AIM: To compare the long-term clinical and radiographic outcomes of pulpotomies in primary molars performed with white or gray Mineral Trioxide Aggregate (MTA) in combination with ferric sulfate (FS), when one package of MTA is used for multiple treatments. DESIGN: Sixty eight children with 86 vital carious primary molars underwent pulpotomy with FS, and grey or white MTA. One package of MTA was used for 7-8 treatments. Clinical and radiographic evaluation was performed before and 6 to 47 months after treatment. RESULTS: Success rates were similar for pulpotomies performed with white (60-teeth) and grey MTA (16 teeth) (p > 0.05), and for those performed with the addition of FS to white or gray MTA when one package of MTA was used for multiple pulpotomies compared to one package of MTA alone. CONCLUSION: Gray and white MTA in conjunction with FS induce comparable clinical and radiographic success rate. The use of one package of MTA for multiple pulpotomies, combined with FS, is a cost-effective treatment.

The impact of COVID-19 lockdown on maintenance of children's dental health: A questionnaire-based survey.

BACKGROUND: The COVID-19 pandemic has been associated with several changes in maintenance of children's dental health. The aim of this study was to evaluate the extent of these changes. METHODS: Parents were asked to respond anonymously to a questionnaire regarding alterations in their children's oral habits, such as frequency of eating and drinking, toothbrushing, signs of stress, and receiving oral health care during the lockdown period. The participants were reached either during their visit to the clinics or via the social media groups of the authors. RESULTS: There were 308 parents of children aged 1 through 18 years who responded to the questionnaires. The authors found associations between increased frequency of eating and drinking, decreased frequency of toothbrushing, and postponing oral health care. Among the children, 11% experienced more frequent oral signs of stress, such as temporomandibular disorder and aphthous stomatitis, during the lockdown. Although children from all age groups ate and drank more frequently between meals, younger children received a diagnosis of carious lesions more often during the lockdown (P = .015). CONCLUSIONS: During the lockdown, many children changed their eating, drinking, and toothbrushing habits and, thus, increased their risk of developing caries. PRACTICAL IMPLICATIONS: During pandemic-associated re-care visits or recall visits, it is imperative to conduct a detailed interview regarding changes in oral health habits. In children at high risk, dentists recommended more diagnostic and preventive measures to prevent deterioration of their oral health. Moreover, dentists should put more emphasis on motivational interviewing to help children resume healthier routines after the lockdown.

A rubber-covered ceramic weapon reduces the incidence of dental trauma in recruits during combat basic training.

The effect of a rubber-covered ceramic weapon was assessed on the incidence of dental trauma during basic training, since soldiers are more at risk of impact from a personal weapon. Dental files of soldiers (n = 4,542), who completed 8 months of training during 2008, were analyzed for incidence and type of dental trauma from a personal weapon. A rubber-covered ceramic weapon (n = 2,972) or a conventional one (n = 1,570, control) was used. Dental trauma was 0.4% per 8 months (0.6% per year) from the ceramic weapon and 1.5% per 8 months (2.3% per year) from the conventional one (p<0.001). The most prevalent type of injury was a simple/noncomplicated crown fracture (82% in study group, 75% in control group). The ceramic weapon significantly reduced dental trauma by diminishing the impact while in direct contact with the teeth or by absorbing and/or distributing the impact force. In conclusion, when possible a rubber-covered ceramic weapon should be preferred for basic combat training.

Effect of computerized delivery intraligamental injection in primary molars on their corresponding permanent tooth buds.

OBJECTIVE: To evaluate the prevalence of developmental disturbances in permanent teeth in which buds were exposed to intraligamental injection (ILI) delivered by a computer controlled local anaesthetic delivery (C-CLAD). METHODS: The study population consisted of 78 children (age 4.1-12.8 years) who received ILI-C-CLAD to 166 primary molars. A structured form was designed to include information regarding age at treatment, gender, type of treated tooth, tooth location, type of dental treatment, and type of developmental disturbance(s) present in the associated permanent tooth. Teeth, which received regular anaesthesia or were not anaesthetized by local anaesthesia, served as controls. RESULTS: Five children had developmental defects. In C-CLAD-ILI exposed teeth, one child had two hypomaturation defects. The corresponding primary teeth were extracted. No defects were found on the control side. In two children, hypoplastic defects were found only in the control teeth (one in each child). One suffered from a dentoalveolar abscess in the corresponding primary tooth. Diffuse hypomaturation defects were found in two children on both the C-CLAD-ILI exposed and control sides. CONCLUSION: In the primary dentition, C-CLAD-ILI does not increase the danger of developmental disturbances to the underlying permanent dental bud.

Incidence of reported dental trauma among soldiers during basic training.

The objective of this study was to assess the incidence, characterizations and etiologies of traumatic dental injuries among Israeli army soldiers during basic combat training. Dental files of soldiers (n=11,053) from several combat military camps, who completed 8 months of basic training during 2006-2007, were analyzed for frequency, type and etiology of dental trauma. The study included 118 files. The incidence of dental trauma was 1.1% per 8 months (1.6% per year). The most frequently traumatized tooth was the right maxillary central incisor (46%), most prevalent type of injury was a noncomplicated crown fracture (45%), and most frequent etiology was the personal weapon (53%), with no statistical correlation toward a right-sided injury. The incidence of dental traumatic injuries during basic combat training was higher than among army personnel as found in other studies. A weapon impact can be a major risk factor for soldiers during basic training.

Development of odontoma-like malformation in the permanent dentition caused by intrusion of primary incisor--a case report.

A case is presented of a 10-year-old girl, referred for consultation for failure of the maxillary central incisor to erupt. At 18 months, the patient underwent intrusion of the right central primary incisor, which re-erupted several months later. Radiographic examination revealed a complex odontoma-like malformation located next to the floor of the nose, away from the permanent incisors. Clinical examination revealed space loss of the corresponding permanent incisor and severe hypoplasia of the permanent right lateral incisor. Because of its deep location, it was decided not to remove the odontoma, but to recommend yearly radiographic follow up to rule out the development of a dentigerous cyst. This case describes a very rare complication of intrusion of primary incisors and emphasizes the importance of follow up until eruption of the corresponding permanent teeth.

Dental knowledge regarding preventive measures of young adults.

A study was undertaken to evaluate the oral health behavior and knowledge of preventive measures of young adults in Israel. A questionnaire was given to 442 Israeli young adults who were dentally screened immedi-ately after high school. Of these, 44 reported they were treated regularly by certified pediatric dentists, 244 regularly by general practitioners, and the remainder were treated irregularly by general practitioners. Participants who reported treatment by CPDs provided more correct answers to questions about prevention of oral disease. However, the percentage of participants who showed good knowledge was small and differences between the three groups on the various questions were only 1%-30%. Participants who were treated irregularly by GPs reported receiving significantly less instruction and explanations about toothbrushing, mouthrinses, dental flossing and carbohydrate consumption.

Computerized three-dimensional design for accurate orienting and dimensioning artificial dental socket for tooth autotransplantation.

OBJECTIVE: To present an improved, accurate, and efficient method for planning and preparing an artificial socket for autotransplantation, by using a three-dimensional (3D) surgical guide and a replica of the transplanted donor tooth. The guide and the tooth replica were fabricated using a computerized 3D simulation. A case treated with this approach is presented. METHOD AND MATERIALS: Cone beam computed tomography (CBCT) and computerized 3D simulations (Simplant plus registration as stereolithography) were used for planning the optimal artificial socket position and dimensions, within the limitations of the alveolar bone borders and the adjacent teeth roots, and for producing a metal replica of the transplanted tooth. The replica was used to assure the correct socket preparation and orientation before extraction and replantation of the donor premolar. RESULTS: The entire procedure time for autotransplantation of a permanent second premolar to the incisor site without the buccal plate was about 45 minutes. At 15 months' follow up, clinical examination of the transplanted tooth demonstrated both normal mobility and no sensitivity to cold stimulation. A radiographic examination revealed continuous root development and pulp obliteration. The adjacent teeth maintained their vitality with no pathologic signs. CONCLUSION: We present an improved technique for autotransplantation based on computerized 3D simulations and guidance for accurate dimensioning and optimal locating of the artificial socket relative to the alveolar bone borders and the adjacent teeth roots. This technique may significantly simplify the autotransplantation procedure and will probably also increase its success rate and use in young patients, even in cases with absence of a buccal plate.

Postoperative prognosis of unerupted teeth after removal of supernumerary teeth or odontomas.

INTRODUCTION: Impacted teeth do not always erupt spontaneously after removal of supernumerary teeth or odontomas. The purpose of this study was to examine the effect of several variables on eruption of impacted teeth in children with supernumeraries or odontomas. METHODS: The sample consisted of 53 patients with 69 impacted teeth; the supernumeraries or odontomas were removed without other interventions. The patients were identified retrospectively and followed until the impacted teeth erupted to their correct positions or until orthodontic traction was started. RESULTS: Loss of space, a second surgical procedure, a third surgical procedure, and orthodontic treatment were recorded in 77.6%, 53.8%, 9.4%, and 85% of the patients, respectively. Spontaneous eruption occurred in 83%, 75%, 46%, 19%, and 32% of the impacted teeth with normal and small size superlative, conical, tuberculated, and odontoma forms, respectively. In the univariate analysis, spontaneous eruption correlated with apex distance of the impacted tooth relative to its estimated position (P <.001), extent of vertical impaction (P <.001), obstacle form (P <.019), stage of root development of supernumerary tooth (P = .006), angle of impaction relative to the midline (P = .015), and time of surgery (P = .05). In the multivariate logistic regression analysis, higher distraction of the apex of the impacted tooth relative to its estimated correct position and the obstacle form (tuberculated and odontomas) were independently associated with impediment of spontaneous eruption (P = .03 and P = .04, respectively). CONCLUSIONS: Spontaneous eruption of impacted teeth correlated mostly with lower distraction of the impacted tooth apex and obstacle form (conical and superlative). Immediate orthodontic traction is recommended concomitantly with the first surgery to remove supernumerary teeth.

Self-reported compliance with preventive measures among regularly attending pediatric patients.

This study evaluated the compliance with preventive measures of regularly attending pediatric patients. Children attending at least four consecutive recall appointments in a pediatric dental clinic were interviewed regarding their compliance with the previously recommended preventive measures. During each recall appointment, participants and/or their parents received oral and written instructions regarding the preventive measures. Caries experience index was calculated as sum of decayed, missing, and filled surfaces of participants' primary and permanent dentition. Files of 496 children were analyzed. Mean age was 9.0 +/-4.5 years. Mean caries experience index was 7.0 +/-9.0. Participants reported eating more than six times a day (22.8 percent) and consuming in between meals water only (54.4 percent), noncarbonated beverages (23.2 percent), carbonated beverages (13.1 percent), and a combination of both beverages (9.3 percent). Children reported brushing their teeth at least once a day (94.4 percent), rinsing their teeth once a day (11.9 percent), flossing once a day (5.6 percent), and brushing once a week regularly with highly concentrated fluoride gel (12.6 percent). No statistical differences were found in compliance measures within two consecutive dental recalls. Caries experience was correlated with regular meals (p=0.01), drinks between meals (p<0.001), and toothbrushing frequency (p=0.01). In conclusion, compliance with preventive measures is low among regularly attending pediatric patients. In high caries risk patients, a frequent preventive intervention might be warranted by dental practitioners.