Showing papers in "ASDC journal of dentistry for children in 1999"

Visual pedagogy in dentistry for children with autism.

Abstract: The aim of the present study is to present and evaluate a model based on visual pedagogy for the introduction of dentistry to preschool children with autism. The model is based on the knowledge that it is easier for these children to communicate via pictures than via words. A book has been produced with distinct color-prints describing every step when visiting the dentist. The project has been designed in cooperation with the multi-professional team involved with the children. A total of sixteen children with autism participated in the project. Evaluation was done after 1.5 years. The ability of the children to cooperate is compared with that of sixteen children with autism of the same ages who were not treated with this method. The capacity of the children in the project to cooperate during dental treatment is superior to that of the control-children. Visual pedagogy is a way of introducing dentistry to children with autism.

Assessment of early childhood caries and dietary habits in a population of migrant Hispanic children in Stockton, California.

Abstract: Objective This study estimated the prevalence of early childhood caries (ECC) and related behavioral risk factors in a population of low-income, Mexican-American children in Stockton, California. Methods We collected data for 220 children ages six years or less using a parent-completed questionnaire and clinical dental examinations during the Su Salud Health and Education Fair in July 1995. We employed five case definitions of ECC: buccal or lingual caries on one or two primary maxillary incisors; caries on any surface of one or two primary maxillary incisors; and five decayed, missing (due to caries), or filled primary teeth. Results The prevalence of ECC ranged from 12.3 percent to 30.5 percent, depending upon the case definition. More than 17 percent of children age two years had one primary maxillary incisor affected by caries on the buccal or lingual surface; 13.2 percent had two affected. Mean age at weaning from breast--or bottle-feeding and patterns of bottle use during sleep did not differ significantly between children with ECC and those without. There were no clear patterns of cariogenic food frequency and disease status. Conclusions Our findings question whether feeding patterns with human breast milk, formula, or bovine milk are sufficient etiologic factors for this condition.

The effect of metoclopramide and hydroxyzine in sedation of infants undergoing dental treatment.

Abstract: The purpose of the present study was to determine whether the administration of 5 mg of the anti-emetic drug metoclopramide (MTP) would improve the effectiveness of 3.7 mg/kg of hydroxyzine (HYZ) in dental treatment of young patients. Thirty uncooperative children, with a mean age of twenty-nine months, and needing at least two restorative visits, participated in this study. The patients were assigned randomly to receive either 3.7 mg/kg HYZ or the same drug in conjunction with MTP; alternate regimens were administered at the two appointments. All the children received 50 percent nitrous oxide, and were restrained in a Papoose Board with a head holder. The following parameters were evaluated at baseline (before initiation of treatment), and at five-minute intervals throughout the procedure: degree of alertness, crying and movement. Evaluation of the overall behavior at each session was performed by one investigator, who was blind to the drug regimen the child had received, utilizing a separate rating scale. The results were submitted to statistical analysis. No differences were observed in the behavior of the children receiving both regimens. Successful sedation, as assessed by lack or minimal crying and/or movement was observed in all the treatment visits, with both regimens (mean score 4.4 for HYZ + MTP and 4.6 for HYZ). In the few occasions, however, where the restorative sessions were longer (45 to 60 minutes), more children fell asleep after receiving protocol A (pramin + hydroxyzine), suggesting a possible trend to improve effectiveness in these situations. No adverse effects were observed, and all the treatments were successfully completed. Although no significant differences could be observed in treatments lasting up to a half hour, the addition of MTP could help in sedations lasting longer than a half hour.

Predoctoral education in special care dentistry: paving the way to better access?

Abstract: The number of people with mental retardation and developmental disabilities (MR/DD) living in small community-based group residences is increasing throughout the United States. Dental services to this population, once provided in large institutional settings, must increasingly be sought at the community level. The purpose of this study was to determine whether U.S. and Canadian dental schools are adequately training their students to provide quality dental care to this group with complex psychosocial and medical issues. With a response rate of 78 percent to a mail survey, it was found that 53 percent of the schools provide less than five hours of didactic training in special care dentistry. Clinical training in this area comprised only 0-5 percent of predoctoral students' time in 73 percent of the responding schools.

Are we reaching very young children with needed dental services

Abstract: Recommendations by the Academy of Pediatric Dentistry urging a dental/oral examination of all infants before one year of age, have had limited impact on the profession and the general public. Significant numbers of pediatric dentistry specialists and general practitioners who provide care for children, disagree with the recommendations. Between the mid 1970s and 1990's, there has been no change in the percent of children less than six years of age who were reported to have visited a dentist in the past year. A review is provided of the dental disease needs and dental service patterns of very young children in the various demographic populations in an attempt to 1) increase practitioner awareness of the continuing needs for services and 2) develop a dialogue between the organizations of the profession and the dentists in practice, regarding directions to be taken in the future.

Oral candidiasis in children with immune suppression: clinical appearance and therapeutic considerations.

Abstract: Children and adolescents with immune compromise and suppression are particularly susceptible to the development of oral candidiasis. In fact, oral candidiasis is the most common oral manifestation in HIV-infected children. Oral candidiasis has been linked to a depressed immune system, more rapid progression to AIDS, more advanced stage of disease in AIDS, and decreased survival. Several different forms of candidiasis may be recognized clinically. These forms are 1) pseudomembraneous candidiasis; 2) erythematous (atrophic) candidiasis; 3) papillary hyperplasia; 4) chronic hyperplastic candidiasis; 5) angular cheilitis; and 6) median rhomboid glossitis. Diagnosis of candidiasis is primarily based upon clinical appearance; in some cases, however, exfoliative cytology and/or biopsy of the lesion may be necessary. It is also possible to culture the lesion to determine the specific subtype of candidia and to evaluate the susceptibility of the fungus to specific antifungal agents. Both topical and systemic treatment by antifungal medications are readily available.

Bilateral fusion of the mandibular primary incisors: report of case.

Abstract: Fusion is a common dental finding. However, bilateral mandibular fusion of the primary incisors is a rare event, occurring with a prevalence of less than 0.02 percent. When all four permanent successors are present, this event becomes rarer still. Once fusion has been diagnosed, careful monitoring is required, since problems with exfoliation can occur, along with caries formation in the groove of the incompletely fused teeth.

Regional odontodysplasia: report of a case involving two separate affected areas.

Abstract: The purpose of this study was to report in a 12-year old white child a rare clinical condition called regional odontodysplasia. The diagnosis was based on clinical and radiographic findings. Due to the patient's concern over appearance, the treatment involved extracting the affected teeth and subsequently placing partial removable prostheses, thus providing the patient better function and appearance. The teeth that were removed were examined histologically, both in routine preparation stained by hematoxyline and eosin, and in ground sections.

The fusion of three primary incisors: report of case.

Abstract: The occurrence of a fusion of three primary incisors is rare. A two-year-old Japanese girl was brought to the pediatric dental outpatient clinic, Tokyo Dental College, to receive a caries-prevention treatment. The fused tooth consisted of the maxillary primary central incisors and right maxillary lateral incisor. Primary left lateral incisor erupted normally and the other primary teeth were erupted. The radicular pulp chambers were fused into one for three fourths of the length from the apex, and only one root. The hair and skin of the patient appeared normal and no systemic abnormality or congenital disease was noted in the medical history of the patient and her family. The occurrence of a three-tooth fusion, and no supernumerary tooth was confirmed.

Assessment of compomer proximal restorations in primary molars: a retrospective study in children.

Abstract: The aim of the present retrospective study was to observe the clinical and radiographic performances of a compomer (Dyract) in proximal restorations of primary molars as compared to amalgam restorations. The study was performed at the principal investigator's office. Children between three to eleven years old, who had at least two primary molars with a small to moderate approximal caries lesion were included in the study. The assessed material consisted of 107 proximal restorations (63 Dyract and 44 amalgam) placed in primary molars during the years 1994 to 1997 in forty-two children who were available for follow-up examinations. All the evaluated restorations were clinically acceptable, with smooth surface appearance, satisfactory color match, neither secondary caries nor fracture. The margins of two Dyract restorations presented minimal stain. Of the 63 Dyract restorations evaluated radiographically, two presented with bubbles, one with an overhang, and nine had pooling at the tooth-restoration interface. Minimal overhangs were disclosed in six amalgam restorations, and neither bubbles nor defects were seen at the tooth-restoration interface. These differences were statistically significant (p < 0.001). Based on the clinical performance of the material and on the radiographic findings, the authors conclude that Dyract can be a suitable alternative for restoring primary teeth that need to be retained up to two years. More extensive follow-up is needed to assess longer-term performance.

Fracture strength of adhesively restored pulpotomized primary molars.

Abstract: PURPOSE To evaluate the cuspal fracture resistance of primary teeth restored with different adhesive techniques. METHODS Eighty primary molars were selected for pulpotomy preparations. The molars were matched according to molar type (upper or lower, 1st or 2nd), and divided into four groups: Group 1: Pulpotomy cavity restored with IRM, Dispersalloy amalgam (Control); Group 2: IRM, Hydroxyline, Amalgambond Plus and Dispersalloy; Group 3: IRM, Hydroxyline, Prime & Bond 2.1 and Dyract; Group 4: IRM, Hydroxyline, Single Bond and Z100 resin composite. In Groups 2,3 & 4, Hydroxyline was placed over the IRM to avoid direct contact of the adhesives and resin with the IRM. All specimens were thermocycled (1000 cycles, 5-55 degrees C), and mounted in acrylic 2 mm apical to the CEJ. The molars were then tested for cuspal fracture strength using an Instron machine with tapered steel balls made to match the occlusal area of the primary molars tested. Repeated measures ANOVA and paired t-test were used to test the statistical significance of the results. RESULTS Mean fracture loads in Newtons + S.D.) were as follows: G1: 1087 + 284; G2: 1371 + 434; G3: 1336 + 320; G4: 1404 + 312. The three bonded procedures significantly (P < 0.001) increased the resistance of the primary molars to fracture compared to the control group. There was no significant difference between the three bonded procedures. CONCLUSIONS Bonded restorations of pulpotomized primary molars may be an alternative restorative procedure to stainless steel crowns.

The impact of race on tooth formation.

Abstract: The subjects consisted of 650 children (American white 245, Chinese 202, Japanese 203) from five to twelve years old, who came to the Department of Growth & Development, University of California, San Francisco. Mandibular first molar development was determined by inspecting panoramic radiographs and assigning a rating according to Kullman's method, which classifies tooth formation into seven stages according to growth and development. The samples in each age-stage were evaluated by their means values. Tooth formation was significantly more advanced in the American white children than in the Chinese or Japanese at all stages. The significance of the difference between Chinese and Japanese children was not identified. Tooth formation was shown to be highly correlated with chronological age, with a coefficient of more than 0.7 in all racial groups.

Augmentative communication in dental treatment of a nine-year-old boy with Asperger syndrome.

Abstract: Dental treatment of a nine-year old boy with Asperger syndrome is described. A "social story" is used to explain and perform the treatment.

The effect of dental training on the reactions of mentally handicapped children's behavior in the dental office.

Abstract: This study was planned to observe the negative reactions shown by mentally handicapped children during the dental examination and prophylaxis, and to confirm whether there was a difference in these reactions after dental training. Twenty mentally handicapped children (between 6-18 years) were examined by a dentist and their reactions were reported, before dental training was given. Later, a special educator and a dentist trained the children about the dental process. After the training the children were examined and their reactions were reevaluated. The results obtained from the first and the second appointments were compared using McNemar Test. There were significant differences between the first and the second results.

A dirty secret : the abuse of children with disabilities

Abstract: The media and professional and lay literature are replete with the tragic stories of the abuse and neglect of children. Limited references, however, are made to the even more unbelievable reality that children with disabilities are maltreated at a rate that may be as great as four to ten times that of children without disabilities. The characteristics that make children with disabilities more vulnerable to abuse, the nature of the abuse, the variation by gender, the financial costs of abuse and the reality that this abuse may occur in the "best of families" are reviewed in an effort to increase practitioner awareness of the "dirty secret." Language: en

Periodontitis in the child and adolescent.

Abstract: Early onset periodontitis (EOP) which affects individuals thirty-five and younger is characterized by a rapid rate of bone loss and disease progression with defects in host response and a specific etiological microbial flora. Within this classification, there are three subsets of the disease: prepubertal periodontitis, juvenile periodontitis, and rapidly progressive periodontitis. The characteristics of each disease are described along with illustrative cases that will help clinicians diagnose EOP in their patients. Currently prescribed treatment modalities and guidelines from the literature are also discussed in this paper. EOP may represent a complex set of diseases that are likely to be reclassified as further advances in microbiological and genetic research are made. Clinicians should be aware of such changes in order to diagnose, treat, and refer their patients for comprehensive care.

Prevalence of early childhood caries at Harris County clinics.

Abstract: Nursing caries has been found to be positively associated with children from families of low socioeconomic status. The Harris County Health Department (HCHD) serves a population consisting predominately of low-income, low-educational-level clients who reside in the suburban areas surrounding Houston, Texas. The purpose of this study was to determine the prevalence of early childhood caries and nursing caries among patients of the HCHD dental clinics. The study method was a retrospective chart review of all patients seen at the HCHD dental clinics within the two years before the study. There were 135 children in the sample, with a mean age of fifty-seven months. About half of the children had a quarter (five or more) of their primary teeth filled or decayed. The prevalence of early childhood caries was 76 percent and 44 percent of the children were classified in the group with nursing caries. The prevalence of early childhood caries and nursing caries among patients from low socioeconomic families is still high.

Dental experiences and parenting practices of Native American mothers and caretakers: what we can learn for the prevention of baby bottle tooth decay.

Abstract: This study attempts to gather information concerning the dental experiences, beliefs, and parenting practices of Native Americans. Five Native American women were trained to conduct interviews in their own language. After pilot testing, seventeen questions were asked. Sixty-two interviews were taperecorded and transcribed. Content analysis was performed on the transcriptions. Results indicate maternal and caretaker upset and displeasure with the dental experiences of adults and children. Fear and pain were prominent. Parenting practices indicate children are expected to clean their own teeth at about a year of age and parental awareness of risks associated with sleeping with a bottle. About half of the mothers and caretakers who used a bottle as a pacifier report engaging in one or more protective activities such as removing the bottle when the child falls asleep. Mothers and caretakers with greater parenting experience are likelier to be aware of these protective activities. In conclusion, results of this study highlight the importance of providing positive dental experiences for mothers and caretakers and the need to be aware of actual parenting practices before making recommendations or counseling mothers or caretakers.

The importance of orofacial myofunctional therapy in pediatric dentistry: reports of two cases.

Abstract: It is essential that the practitioner determine the factors that are etiologically operative in oral myofunctional therapy in order to establish effective methods of intervention. Of these methods, cephalometrics and facial analysis are especially valuable in revealing and differentiating open-bite syndrome. We indicated two cases treated with only the theory of myofunctional therapy and evaluated with cephalometric radiographs and intraoral photos. This is the first report to evaluate for treatment change of myofunctional therapy with cephalometric radiographs.

Children with mental retardation: stigma and stereotype images are hard to change.

Abstract: Societal attitudes and perceptions of children with mental retardation have stigmatized and stereotyped generations of youngsters. Deinstitutionalization and mainstreaming most of these children in our schools and general communities require that we recognize and reevaluate many long-held beliefs and how they serve as obstacles to implementing and ensuring needed health and social services. The background and current status of these attitudes are reviewed in an effort to 1) increase practitioner understanding of the population of youngsters with mental retardation that increasingly will be seeking the services of community dentists and 2) encourage legislative efforts and grass-root initiatives (such as the Special Olympics) to change/improve attitudes relative to children with mental retardation.

A case of dental mutilation.

Abstract: A case of ritual mutilation in a fourteen-year-old Ethiopian girl is described. When the girl was three years old she had frequent stomach problems. According to tribal tradition her illness was thought to arise from her mandibular primary canines and these teeth were removed by a medicine man. The extraction damaged the tooth germs of the succedaneous teeth and resulted in deformed permanent canines. This is the first report of a case of dental mutilation from Ethiopia.

Stomatognathic function in juvenile rheumatoid arthritis and in developmental open-bite subjects.

Abstract: Patients affected with juvenile rheumatoid arthritis present clear radiological alterations of the condyles of the temporomandibular joint (TMJ) due to the inflammatory process, with a prevalence ranging from 17 percent to 63 percent. This work is a comparison between a group of subjects with juvenile rheumatoid arthritis presenting signs and symptoms of TMT dysfunction and a group of the same age not suffering from any rheumatic morbidity, but presenting an open bite > 3 mm. The aim is to verify whether the open bite can induce an alteration in mandibular function comparable to that observed in juvenile rheumatoid arthritis. Statistically significant difference is found in the juvenile rheumatoid arthritis group only regarding spontaneous and provoked muscle pain and the lateral opening deviations of the mouth, but mostly the two groups seem alike and present the same stomatognathic pattern.

Behavior and toothbrushing of young israeli adolescents

Abstract: The purpose of the present study was to assess the toothbrushing behavior of Israeli adolescents attending a pediatric dental clinic, with regard to the maxillary anterior region. One hundred twenty-three adolescents (57 boys, 66 girls, mean age 12.45 +/- 1.76), participated in this study. The amount of plaque extending from the gingival line incisally was measured. Brushing characteristics and daily habits were recorded. In 87 patients, 4 mm or more of plaque were measured on the labial surfaces of the maxillary central incisors, while thirty-six patients demonstrated less than 4 mm plaque. Patients who brushed the maxillary and mandibular incisors separately showed significantly less plaque than patients who brushed them simultaneously. Brushing the maxillary and the mandibular incisors separately was significantly more prevalent in the thirteen-to-seventeen-year-olds, and among girls. Also, significantly more girls brushed twice per day, and for more than three seconds on each incisor.

Children with mental retardation grow older.

Abstract: In an effort to encourage dental practitioners to provide needed services for children with mental retardation as they grow older, a review is provided of the ongoing difficulties faced by families and their children--including attitudes, residence, sibling and older parent dilemmas, cost of care and the realities of sexuality.

Incontinentia pigmenti (Bloch-Sulzberger syndrome): report of case.

Abstract: Incontinentia Pigmenti is an inherited disorder with predominantly ectodermal abnormalities. The dental effects, delayed eruption, hypodontia, and microdontia, are very similar to anhidrotic ectodermal dysplasia. It is important that children with incontinentia pigmenti gain access to specialist dental care including pediatric dentistry, orthodontics, prosthodontics and oral surgery.

The Innsbruck Sensorimotor Activator and Regulator (ISMAR): construction of an intraoral appliance to facilitate ingestive functions.

Abstract: Oral sensorimotor therapy is practiced widely with children who have neuromotor impairments, such as cerebral palsy and eating problems. Although improvement in ingestive skills can be achieved in the short term (5 months), long-term effects (over 12 months) remain to be examined. Interventions with intraoral appliances are used in children with moderate impairments of the oral-motor system and offer an opportunity for long-term treatment. Instead of the daily oral sensorimotor exercises, which must be provided by a qualified therapist, the intraoral appliance is worn during the night, so that the "therapy" is initiated and controlled by the child. The purpose of this paper is to describe the appliance: its prescription, fabrication and therapeutic use. A case study illustrates that improvement in ingestive skills, efficiency of eating, and marked weight gain can be achieved.

Orthodontic management of mandibular lateral incisor-canine transpositions: reports of cases

Abstract: This article presents different treatment aspects in three mandibular lateral incisor-canine transposition cases The early identification of transposed teeth simplifies orthodontic correction Incomplete transposition cases can be managed successfully by interceptive orthodontic treatment If complete transposition occurs, two treatment alternatives may be possible: Extraction of the transposed tooth or keep the teeth in their transposed positions

Children with disabilities: more than just numbers.

Abstract: Listing of the numbers of children with disabilities provide little to no insight in the difficulties faced by children with disabilities and their families. A review is provided of the emotional and psychological hurdles that need to be considered as pediatric dentists continue to provide the necessary services.