Paediatric Dentistry

13. Being aware is an important step

The relationship between children’s perception of caries and gingivitis and their oral health behaviours was put under scrutiny in this cross-sectional study. Participants were 434 children (57% males) aged 11-14 years who completed a questionnaire. Half of them perceived caries as a disease and believed in visiting the dentist regularly regardless of dental need. More than 60% were unaware that gum bleeding is a sign of disease and only 60.7% believed that it requires management. Being aware that gum bleeding is a sign of disease and that it requires treatment increased the odds of brushing. Children aware of the importance of dental visits even without dental decay were 2.9 times more likely to visit the dentist regularly and were 77% more likely to never miss a dental appointment. Being aware that bleeding gums require treatment was a determinant of toothbrushing habit. Improved perceived need for a dental check-up regardless of having a dental problem may promote children’s preventive dental attendance.

Eisalhy M et al. Children’s perception of caries and gingivitis as determinants of oral health behaviours: a cross-sectional study. Int J Paediatric Dent 2015 25: 366-374.

Q Which of the following statements is NOT true of children in this survey?

A The majority were unaware that gum bleeding is a sign of disease

B They were 2.9 times more likely to visit a dentist if they were aware of its importance

C Those who were aware of gum disease were more likely to have a toothbrushing habit

D A minority believed that gum bleeding requires management

14. A healthy start in dental life

This study aimed at determining whether: low birth-weight, preterm birth, pre-natal and natal complications were related to: enamel defects, total number of decayed, missing and filled teeth (total DMFT), disturbances in the tooth shape and disturbances in the number of teeth. From a search of over 2,000 medical files of children aged 2-17 years old, 300 met the selection criteria. Information recorded from the files included: age, gender, health status, birth week, birth weight, total DMFT, hypomineralisation, abnormal tooth shape, abnormal number of teeth and hypoplasia. Twenty one children of 300 (7%) were born after a high-risk pregnancy, 25 children (8.3%) after high-risk birth, 20 children (6.7%) preterm - before week 37, and 29 children (9.7%) with a low birth weight (LBW) – 2,500 grams or less. A relationship between a preterm birth and LBW to hypomineralisation was found as was a relationship between a preterm birth and high-risk pregnancy to abnormal number of teeth. No relationship was found between birth (normal/high-risk) and the other parameters inspected. Preterm birth and LBW may predict hypomineralisation in both primary and permanent dentitions.

Prokocimer T et al. Birth-weight, pregnancy term, pre-natal and natal complications related to child's dental anomalies. J Clin Pediatric Dent 2015 39: 371-376.

Q Which one of the following relationships was found in this research?

A High-risk pregnancy and hypomineralisation in the primary dentition

B Preterm birth to abnormal number of teeth

C Normal or high-risk birth and DMFT

D Low birth weight and an abnormal number of teeth

15. Successful pulpotomies exposed

The aim of this study was to evaluate the scientific evidence of pulpotomy in primary teeth comparing mineral troxide aggregate (MTA), calcium hydroxide, ferric sulphate, and electrosurgery with formocresol. A systematic search using key words was conducted using seven databases up to December 10, 2013. Clinical articles in English, Portuguese and Spanish were selected, which were in accordance with the inclusion and exclusion criteria and the research objective. Out of the 12,515 publication initially identified, 30 clinical articles were included in the systematic review. The success rate of MTA (94.6%) was higher than that of formocresol (87.4%), with a statistically significant difference. Formocresol pulpotomy success was not statistically different from ferric sulphate or electrosurgery. MTA was clinically and radiographically superior to formocresol for pulpotomy of primary teeth. The other alternatives to formocresol such as electrosurgery and ferric sulphate can be used instead of formocresol since they showed success similar to formocresol. In addition, there is no evidence to support calcium hydroxide for pulpotomies in primary teeth.

Stringhini Junior E, Vitcel ME, Oliveira LB. Evidence of pulpotomy in primary teeth comparing MTA, calcium hydroxide, ferric sulphate, and electrosurgery with formocresol. European Arch Paediatric Dent 2015 16: 303-312.

Q Which of the following suggests the most successful hierarchy of techniques for pulpotomy in primary teeth?

A Calcium hydroxide>electrosurgery>formocresol

B Electrosurgery>formocresol>ferric sulphate

C Formocreol>MTA>electrosurgery

D MTA>formocresol>calcium hydroxide

16. Anxiety reduction for youngsters

To compare the effectiveness of inhalation sedation with nitrous oxide/oxygen (N2O/O2) and cognitive behavioural therapy (CBT) in reducing dental anxiety in preschool children was the aim here. Conducted on 45 preschoolers with moderate to severe dental anxiety who required pulp treatment of at least one primary mandibular molar this study determined baseline anxiety and cooperation levels using two scales at the first dental visit (dental prophylaxis and fluoride treatment). Before the second dental visit (pulp treatment), the children were randomly assigned to one of three groups: control, N2O/O2 and CBT. Anxiety and cooperation levels were determined at three periods: injection, rubber dam placement and the application of a high-speed handpiece. N2O/O2 and CBT significantly resulted in lower anxiety and higher cooperation in the second visit (at all three periods) compared to the control, although there was no significant difference between these two treatment methods. Considering the adverse effects and necessity of equipment and trained personnel when using N2O/O2 inhalation sedation, cognitive behavioural therapy is preferable because of its better applicability.

Kebriaee F et al. Comparison of the effects of cognitive behavioural therapy and inhalation sedation on child dental anxiety. European Arch Paediatric Dent 2015 16: 173-179.

Q Cognitive behavioural therapy:

A Provides a means of greater applicability than inhalation sedation with N2O/O2

B Is a poor substitute for inhalation sedation with N2O/O2

C Can be achieved in one session

D Is of no practical use in allying anxiety in young children