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Dental Treatment (dental + treatment)
Selected AbstractsDental Caries Status and Need for Dental Treatment of Pennsylvania Public School Children in Grades 1,3, 9, and 11JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2004Robert J. Weyant DMD ABSTRACT Objectives: This cross-sectional study was designed to determine the caries status and provide a general evaluation of the level of dental treatment need of Pennsylvania public school children in grades 1, 3, 9, and 11 on a statewide and regional basis. Methods: Between September 1998 and May 2000, caries status and treatment need were assessed using a school-based dental examination, performed on a representative sample (n=6,040) of public school children in grades 1, 3, 9, and 11 (age range=6 to 21 years). Children's caries status in the primary and permanent dentition was assessed. Need for treatment was scored on a three-level categorical scale,no treatment need identified, routine treatment need, and urgent treatment need,and was based on the presence and severity of caries and other oral conditions. Population estimates of the prevalence of untreated dental caries, DMFT and dft scores, and treatment need were calculated by grade and geographically, using the six Pennsylvania health districts and the cities of Pittsburgh and Philadelphia. The inequality of caries distribution in the population was assessed for both permanent and primary caries using Lorenz curves and Gini coefficients. Results: Dental caries has remained highly prevalent among Pennsylvania's public school children. Caries levels varied considerably by health districts and city. Urgent treatment needs were significant and also varied by health district and city. Conclusions: Dental caries remains the most prevalent disease affecting Pennsylvania's schoolchildren. Caries status varies significantly by region of the state, suggesting that environmental, social, and demographic contextual factors may be important determinants of disease prevalence. [source] Free Movement of Services and Social Security,Quo Vadis?EUROPEAN LAW JOURNAL, Issue 4 2002Maximilian Fuchs Dental treatment (of Aline Kohll) and a pair of spectacles (for Nicolas Decker) recently drew public attention throughout the whole of Europe. It is certainly true that the reactions following the Court of Justice's judgements in both cases were not only to be felt in the profession but in the general public most especially in political circles. Some authors even went as far as to place these judgements on a par with those in the Costa/ENEL and Cassis de Dijon cases. In the meantime these decisions have persistently been upheld by two further judgements (Vanbraekel and Smits/Peerbooms). The essence of the judgements lies in the observation that the Member States must respect an insured person's right to freedom of services despite being entitled to organise their own social security services. The following article is a critical analysis of this approach. The author pleads for a solution to the problems to be found within the ambit of the rules and principles of coordination whose further development he calls for. [source] Periodontal status and IOTN interventions among young hemophiliacsHAEMOPHILIA, Issue 4 2006S. AZHAR Summary., ,Fifty-two young individuals suffering from severe haemophilia A and B volunteered to be compared with school- and college-going students for oral health status description and subsequent management. A total of 244 students (84.42% boys and 15.58% girls) with the age group of 13,23 years were divided into two groups, A and B (controls). The purpose of this study was to increase awareness about evidence-based dental practices by oral examinations followed by comparisons of periodontal health and prevalence of malocclusions among medically compromised students and healthy controls. Results described the oral health in severe haemophilic population to be compromised with combined simplified health index score of 0.50 and Decayed/Modified/Filled Teeth (DMFT) index score of 2.07 when compared with 0.42 and 0.95, respectively, among group B. Although prevalence of malocclusion and orthodontic treatment needs among group A were higher, yet it was not confirmed as a reason for degraded dental and periodontal status. However, spontaneous and/or toothbrush (trauma)-induced gingival bleeding episodes among group A could be explained as factors discouraging oral hygiene maintenance, particularly self-administered measures. Four haemophiliacs presented with symptoms of Temporomandibular Joint Dysfunction Syndrome (TMPDS). Evidence-based oral medicine and clinical practices need to be encouraged and applied to enhance the quality of life among haemophiliacs, particularly in developing world. Dental treatment needs of haemophilic population appear to be greater and maybe incorporated in routine dental practices, at institutional and individual levels. [source] Dental treatment of children referred to general anaesthesia , association with country of origin and medical statusINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2006D. HAUBEK Summary., Background., A small proportion of children and adolescents need dental treatment with general anaesthesia (DGA). The aim of this retrospective cross-sectional study was to analyse how country of origin and medical status were related to age at treatment, waiting times in the system, and dental treatment provided in general anaesthesia. Methods., A total of 786 patients received DGA at the University Hospital of Aarhus, Denmark in the period from 1990 to 2001. Information on the date of referral, the date of examination, the date of treatment, country of origin (Danish or non-Danish), medical status (non-special needs or special needs), and dental treatment performed was collected from patient records. Results., Patients with special needs were older when treated than non-special needs patients, whereas patients with a non-Danish origin were younger than those with a Danish origin when treated. There were no differences between non-special needs and special needs patients in waiting times from referral to examination and from examination to dental treatment. In contrast, patients from a non-Danish origin waited longer from examination to treatment than patients of Danish origin, whereas no difference was found in waiting time from referral to examination. Patients with special needs had fewer teeth treated than non-special needs patients, whereas patients with non-Danish origin had more teeth treated than those of a Danish origin. Conclusion., Age at treatment, waiting times in the system, and dental treatment received under general anaesthesia vary according to medical status and country of origin of the patients in Denmark. These findings should be considered in the organization and the funding of this type of service. [source] Oral versus rectal midazolam as a pre-anaesthetic sedative in children receiving dental treatment under general anaesthesiaACTA PAEDIATRICA, Issue 8 2002B Jensen Dental treatment in children who are too young or too apprehensive to cooperate is often performed under sedation. In Sweden, the tradition has been to administer sedatives rectally in small children, but oral liquid sedation is now increasingly used. Aim: To compare the sedative effects of oral and rectal administration of midazolam in children undergoing dental treatment under general anaesthesia and to assess acceptance of sedative administration, acceptance of application of the facemask, and amnesia. Methods: Fifty children aged 2,7 y were randomly allocated to receive either liquid oral or rectal sedation, with 25 children in each group. Results: The sedative effect of rectal administration was higher, but not statistically significantly, than that of oral administration (p= 0.07). No significant differences in acceptance of sedative administration, acceptance of mask application or amnesia were found between the groups. Conclusion: Both the oral and the rectal routes can in most cases be appropriate. However, the better sedative effect of rectal administration of midazolam makes it a more favourable route in pre-cooperative and non-compliant children. [source] Taste deficits related to dental deafferentation: an electrogustometric study in humansEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2006Yves Boucher Dental treatments, the prevalence of which increases with age, can cause orofacial somatosensory deficits. In order to examine whether they may also affect taste sensitivity, electrogustometric thresholds were measured at 9 loci on the tongue surface in 391 healthy non-smoking, non-medicated subjects. Results showed that the greater the number of deafferented teeth, the higher the thresholds. Irrespective of age, subjects with more than 7 deafferented teeth exhibited significantly higher thresholds than subjects with fewer than 7 deafferented teeth. Conversely, across age groups, no statistical difference was observed among subjects with no, or few, deafferented teeth. Hence, a taste deficit, which was not correlated to aging, was observed. An association was noticed between the location of taste deficits and the location of deafferented teeth. Higher thresholds at anterior sites, with no possible traumatic injury relationship, suggested that neurophysiological convergence between dental somatosensory and taste pathways , possibly in the nucleus tractus solitarius , could be responsible for these relative decreases of taste sensitivity when dental afferences were lacking. Among trigeminal contributions, lingual nerve and inferior alveolar nerve may synergize taste. [source] Prevalence of crown fractures in 8,10 years old schoolchildren in Canoas, BrazilDENTAL TRAUMATOLOGY, Issue 5 2004Maximiano Ferreira Tovo Abstract,,, The objective of this work was to evaluate the prevalence of children with crown fractures in permanent anterior teeth in 206 schoolchildren (104 girls and 102 boys) between the ages of 8 and 10 years, enrolled in three public schools in the city of Canoas, Brazil. The prevalence found was 17% with no significant difference between boys and girls, as well as between the ages. The most affected tooth was the maxillary central incisor, and a majority of the children showed only one affected tooth (88.6%). The types of fracture most commonly found were oblique and horizontal, and the portions of dental structures most affected were ,enamel only' and ,enamel and dentin'. Only seven children (20%) sought out dental treatment. [source] Circulation in normal and inflamed dental pulpENDODONTIC TOPICS, Issue 1 2007ELLEN BERGGREEN In the pulp, arteries branch into a capillary network before they leave the pulp as venules through the apical foramina. The tissue has low compliance, as it is enclosed in dentin, and has a relatively high blood flow and blood volume. The interstitial fluid pressure (IFP) and colloid osmotic pressure are relatively high whereas the net driving blood pressure is low. The high pulsatile IFP is probably the major force for propelling lymph in the dental pulp. Vasodilation in neighboring tissue as well as arteriovenous (AV) shunts in the pulp itself can contribute to a fall in total and coronal pulpal blood flow, respectively. The pulp blood flow is under nervous, humoral, and local control. Inflammatory vascular responses, vasodilation, and increased vessel permeability induce an increase in IFP that can be followed by a temporarily impaired blood flow response. Lipopolysaccharides (LPS) from bacteria may cause endothelial activation in the pulp, leading to vasoconstriction and reduced vascular perfusion. Lymphatic vessels are identified with specific lymphatic markers in the pulp but so far, little is known about their function. Because of the special circulatory conditions in the pulp, there are several clinical implications that need to be considered in dental treatment. Received 13 February 2009; accepted 28 August 2009. [source] Clinical dental examinations of 357 donkeys in the UK.EQUINE VETERINARY JOURNAL, Issue 4 2009Part 1: Prevalence of dental disorders Summary Reasons for performing study: Dental disorders have a high prevalence in older donkeys and horses, but the nature and pathogenesis of many of these disorders have yet to be established. Objectives: The identification and determination of the prevalence of important dental disorders in different age groups in a large single population of donkeys, to establish a better understanding of the nature and pathogenesis of these disorders. Methods: A prospective cross-sectional study was performed on the donkey population at The Donkey Sanctuary with detailed oral examinations of 357 donkeys within 7 different age groups (age range 2,53 years) recorded. Results: The prevalence of dental disease in all donkeys was 73%, increasing in prevalence from 28% in the youngest to 98% in the oldest age group. There was an increase in prevalence of commonly recognised dental disorders with increasing age, such as: diastemata (3.8% in youngest to 86% in oldest group); missing teeth (0,56%); overgrown teeth (15,86%); worn teeth (8,84%); displaced teeth (0,38%); and periodontal disease (0,28%). Conclusions: There was a significant increase in the prevalence of dental disorders with increasing age with the largest significant increase for most dental disorders occurring in the 15,20 year age group. Potential significance: Most dental disorders significantly increase in prevalence in the 15,20 year age group and, therefore, prophylactic geriatric dental treatment in donkeys should be commenced from age 15 years. [source] Childhood leukaemia: experiences of children and attitudes of parents on dental careEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2008Ç.E. ÇUBUKÇU phd Parental perceptions in the importance of dental care and preferences with regard to its provision while profiling the level of dental health knowledge of parents of leukaemic children were elicited. The setting was the Paediatric Dental Care Unit located in Medical Faculty. Data were collected by means of a structured interview, employing a questionnaire. Level of knowledge on both dental facts and preventive dentistry of the participants was insufficient. Major source of dental care was the resident paediatric dentist both in prior to (78.2%) and following (100%) diagnosis. Tooth extraction (17.6%) was the only treatment provided prior to diagnosis. Following diagnosis, 60 (69%) of these children had received operative dental treatment. The source of preventive advice was inconsistent. Parents appeared to place a high level of importance on their children's dental care and the preference for this to be provided within the hospitals in which the child has been treated. There is clearly a need to establish dental care units in hospitals in which treatment of childhood malignancy is provided. The provision for the future should be the continuous education of dentists, physicians and nurses who work in hospitals and public health services. [source] Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxietyEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2006Ad De Jongh This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent. [source] The Fear of Dental Pain questionnaire: construction and validityEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2003Arjen J. Van Wijk Anxiety, fear and pain play an important role in the context of dental treatment and patients' well-being. The Fear of Pain Questionnaire (FPQ)-III is a recently developed self-report questionnaire measuring pain-related fear of a variety of painful stimuli. The present study was undertaken in order to develop a dental equivalent of the FPQ-III, called the Fear of Dental Pain questionnaire (FDP), to determine standard psychometric characteristics and to assess the instruments' validity. Four experienced dentists generated the initial pool of items and two methodologists constructed the initial questionnaire. Two studies were performed. In the study one, a sample of psychology freshmen (n = 309) was taken in order to analyse response patterns. In study two, a sample (n = 176) of patients, dental students and the general population was examined. Results from both studies were used to determine reliability and validity. High internal consistency (0.93) with satisfactory test,retest reliability (0.75) was obtained. Factor analysis revealed a strong one-dimensional factor underlying almost all items. Finally, the proposed FDP version was related to a measure of dental fear and a general measure of fear of pain. All a priori hypotheses were confirmed, thereby providing evidence for the validity of the FDP. The FPD may prove to be a clinically useful tool in the dental setting, and a potentially important covariate in dental pain perception research. [source] Factors related to missed and cancelled dental appointments among adolescents in NorwayEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2000Erik Skaret The aim of this study was to explore possible explanatory factors related to high frequency of missed/cancelled dental appointments during the age group 12,18 yr. A total of 754 20 yr olds completed a questionnaire including variables measuring demographics, occupation (school/job), attendance pattern, attitudes to dentists, opinion about importance of dental treatment, and the psychometric scales Dental Fear Scale (DFS), Dental Beliefs Survey (DBS) and Geer Fear Scale (GFS). Based on written consents, the following data were recorded from their dental records: the total number of scheduled appointments, the number of missed and cancelled appointments and the individual caries experience of those in the age group 12,18 yr. A total of 124 subjects who had missed/cancelled 20% or more of their dental appointments during this age were defined as a target group. A stepwise regression model indicated that the likelihood of being included in the target group increased by a factor of 6.0 if the subject had forgotten dental appointments during the last 5 yr, by a factor of 3.5 for working or without specified occupation (as opposed to attending school), by a factor of 2.7 for negative beliefs of dentists, and by a factor of 2.1 for high caries experience. [source] Original article: Assessment of changes in oral health-related quality of life among patients with complete denture before and 1 month post-insertion using Geriatric Oral Health Assessment IndexGERODONTOLOGY, Issue 3 2010Kamal Shigli doi:10.1111/j.1741-2358.2009.00323.x Assessment of changes in oral health-related quality of life among patients with complete denture before and 1 month post-insertion using Geriatric Oral Health Assessment Index Objective:, Geriatric Oral Health Assessment Index (GOHAI) is a 12-item measure of "patient-reported oral functional problems" intended for use in the assessment of the effectiveness of dental treatment. Design and Setting:, As there is scanty literature available on GOHAI in the Indian population, the present study was undertaken to assess the changes in GOHAI before and 1 month after placement of dentures in completely edentulous patients reporting to a dental hospital at Indore, India. Measurements:, The GOHAI questionnaire was completed by the examiner who interviewed the patients (n = 35) before placement of complete dentures and 1 month later. Mean, median values were calculated and the data were analysed using Wilcoxon signed-rank test. Results:, When overall mean was considered, the GOHAI scores increased from 27.48 to 30.19 (p = 0.002; highly significant). Conclusion:, Patients reported improvement in functional changes after placement of complete dentures. [source] Undergraduate teaching in gerodontology in Leipzig and Zürich , a comparison of different approachesGERODONTOLOGY, Issue 3 2009Ina Nitschke Objective:, To evaluate undergraduate students' attitude towards the clinical components of the Leipzig (LPEG) and Zürich (ZPEG) Programmes of Education in Gerodontology. Background:, Undergraduate student education is the seedbed for conscientious professionals. Extramural clinical education contributes to the formation of positive attitudes. Students in Zürich participate in three clinical activities (in-house gerodontology clinic, extramural acute geriatrics ward, mobile dental service), in Leipzig they visit a long-term care facility on six occasions within 4 years. Methods:, A structured questionnaire with 10 items was administered to students in Leipzig [n = 34, 70.6% female, mean age 25.8 (SD 3.04) years] at the beginning and after completion of gerodontology training and to students in Zürich [n = 33, 48.5% female, mean age 27.0 (SD 3.28) years] on three occasions after clinical training. Students indicated the degree of their agreement with seven statements presented using a 5-point scale. A choice of responses which characterised the course was offered for assessment. Results:, Close collaboration with dental tutors, while self-treating patients in the mobile dental service (mobiDentÔ) attracted the most positive responses. Ratings from students completing their training in Leipzig were less favourable than their initial responses. Conclusion:, The lack of a dental service and Leipzig students' inability to offer treatment in the presence of disease was associated with frustrations. Practical training should go beyond dental examinations at a long-term care facility and include the opportunity for dental treatment. Personnel and equipment required for mobile treatment exceed resources available at most German dental schools. [source] Oral health conditions of community-dwelling cognitively intact elderly persons with disabilitiesGERODONTOLOGY, Issue 2 2007Ralph Saunders Objectives:, To present descriptive information on oral health and health care of community-dwelling elderly persons with disabilities who are living at home. Background:, Most previous studies have focused on specific subpopulations, namely, persons who are essentially healthy and independent, are homebound, or are nursing home residents. Little information appears to be available on community-residing elderly persons with disabilities. Materials and methods:, A total of 641 participants aged 65 years and over in a Medicare Demonstration who were cognitively intact, completed an oral health questionnaire within 1 year of Demonstration entry. Demonstration participants were required to be living in the community, need or receive help with 2+ activities of daily living (ADLs) or 3+ instrumental ADLs (IADLs), and have recently experienced significant health services utilisation. Results:, Subject mean age was 79.1 years, 73.8% were female, and 4% were minority. They were dependent in a mean of 1.8 ADLs and 2.9 IADLs. 43.1% reported that they had no natural teeth, 77.4% had dentures, 58.8% frequently felt their mouth was dry, 5.2% had jaw pain now and 6.1% had at some time experienced burning sensations in their mouth or tongue. 40.4% reported that they were currently in need of dental treatment, although 56.2% indicated they now had a dentist, and 42.1% identified having a dental visit within the past 12 months. 19.7% indicated some dental insurance coverage. Conclusion:, This is one of the first studies to focus on community-dwelling elderly people with disabilities. Substantial oral health morbidity was reported. [source] Cast titanium overlay denture for a geriatric patient with a reduced vertical dimensionGERODONTOLOGY, Issue 4 2005Satyabodh Guttal An older patient reporting to the dental surgery for his/her dental treatment is becoming a common occurrence. Improved oral hygiene has meant that teeth are retained for a longer time, along with the potential problems of attrition, decreased vertical dimension, temporomandibular joint discomfort/strain, and poor aesthetics. The case in question is that of a 65-year-old male patient who had severe attrition in the lower arch, temporomandibular joint pain and reduced vertical dimension. The maxillary arch had previously been restored with a fixed partial prosthesis. For restoration of the lower teeth, a removable cast titanium overlay denture was fabricated incorporating an increased vertical dimension. Porcelain facings were placed to restore the aesthetics of the anterior teeth. The titanium was cast in a semi-automatic electric arc, pressure type casting machine. A titanium overlay denture with porcelain facing on the anterior teeth may provide a means of restoring a patient's concerns regarding aesthetics and function. [source] Pathologic paediatric conditions associated with a compromised airwayINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2010SUHER BAKER International Journal of Paediatric Dentistry 2010; 20: 102,111 Purpose., The purpose was to describe pathologic paediatric conditions associated with airway compromise adversely affecting dental treatment with sedation and general anaesthesia. Methods., A review of available literature was completed, identifying pathologic paediatric conditions predisposing to airway compromise. Results., Airway-related deaths are uncommon, but respiratory complication represents the greatest cause of morbidity and mortality during the administration of general anaesthesia. Differences in anatomy and physiology of the paediatric and adult airway contribute to the child's predisposition to rapid development of airway compromise and respiratory failure; juvenile rheumatoid arthritis, cervical spine injury, morbid obesity, and prematurity represent only a few conditions contributing to potential airway compromise of which the paediatric clinician needs to be aware. In all cases, thorough physical examination prior to treatment is mandated to affect a positive treatment outcome. Conclusions., Successful management of children and adolescents with a compromised airway begins with identification of the problem through a detailed medical history and physical examination. Due to the likely fragile nature of many of these patients, and possibility of concomitant medical conditions affecting airway management, dental treatment needs necessitating pharmacological management are best treated in a controlled setting such as the operating room, where a patent airway can be maintained. [source] Behaviour guidance in dental treatment of patients with autism spectrum disorderINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2009CHEEN Y. LOO Background., Autism spectrum disorder (ASD) is a neurodevelopmental disorder categorized into autism, pervasive developmental disorder , not otherwise specified (PDD-NOS) and Asperger syndrome. Aims., To identify factors associated with the behaviour of patients with ASD in a dental setting, use of general anaesthesia (GA), and protective stabilization. Design., The dental charts of 395 patients with ASD patients and 386 unaffected patients were reviewed. The following data were analysed: ASD diagnosis, age, gender, residence, seizure disorder, additional diagnosis (mental retardation, cerebral palsy, self-injurious behaviour or pica), medications, caries prevalence and severity, dental treatment history, behaviour, and behaviour guidance technique(s) used. Results., Within both groups, younger patients were more uncooperative. ASD patients with autism were more uncooperative than patients with PDD-NOS; patients with an additional diagnosis were also more uncooperative. ASD patients with higher caries severity, who were uncooperative or female, were more likely to require GA. Use of protective stabilization was associated with lower caries severity, presence of seizure disorder, uncooperative behaviour, male gender, or residency in a group home/institution. Conclusions., Autism spectrum disorder patients with autism, younger age and an additional diagnosis were more uncooperative. Factors associated with the use of GA and protective stabilization in patients with ASD were also identified. [source] An evaluation of the PALS after treatment modelling intervention to reduce dental anxiety in child dental patientsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2009KAREN E. HOWARD Aim., The aim of this study was to assess the effectiveness of the passivity to activity through live symbolic (PALS) after treatment modelling intervention to reduce child dental anxiety. Methods., A convenience sample of consecutive 5- to 10-year-old dental patients were randomly assigned to intervention or control groups. Self-reported child dental anxiety was assessed at the start of each visit. At the end of each visit, children in the intervention group were introduced to a glove puppet, which acted as the PALS model. The intervention group children re-enacted the treatment they had just received on the puppet's teeth. At the end of each visit, the control children received motivational rewards only. The change in dental anxiety scores was examined by t -tests and analysis of covariance. Results., The final analysis included 27 intervention children and 26 control children. For the intervention group, there were no statistically significant changes in dental anxiety over a course of treatment, between first and second preventive visits, between first and second invasive treatment visits, or between first attendance and subsequent recall attendance. For the control group, a statistically significant decrease in dental anxiety was observed between the first and second invasive dental treatment visits. Conclusion., The PALS after treatment modelling intervention was ineffective in reducing child dental anxiety. [source] Barriers for dental treatment of primary teeth in East and West GermanyINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2009CHRISTIAN H. SPLIETH Background., In many countries, restorative treatment in primary teeth is suboptimal. Aim., Thus, this study tried to detect barriers for dentists to restore primary teeth in kindergarten children (3,6 years). Design., For a representative survey, 320 dentists (184 West, 136 East Germany) were randomly selected from the dental associations' registers and asked to answer a questionnaire on their profile, their view of the National Health System, and possible barriers for restoring primary teeth. Results., The analysis (response rate 57.7%) showed that the parents were no barrier and the dentists felt the need of restoring primary teeth. In addition to the children's anxiety, the inadequate reimbursement for fillings were perceived as clear barrier. The comparison of West and East German dentists detected statistically significantly higher barriers in West Germany, where , in contrast to the German Democratic Republic , no structured training in paediatric dentistry was compulsory before unification. Only 35% of the East German dentists rated restorative treatment in 3- to 6-year-olds as stressful in contrast to 65% in West Germany, where especially male dentists found no time to treat children. Conclusion., This study reveals that dentists can also be a considerable barrier to restorative treatment in small children, especially without adequate training in dental schools. [source] The clinically related predictors of dental fear in Taiwanese childrenINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2008CHEN-YI LEE Background. Dental fear has been singled out as one of the most troublesome problems facing paediatric dentistry today. Children with dental fear may avoid visiting dentists; therefore, their oral health protection is often compromised. However, the aetiology of dental fear is still not entirely understood. Objective. This study investigated the dental visiting habit, the previous dental experiences, the conditioning pathway, and the clinically related predictors of dental fear in children. Design., The dental history of 247 children (2,10 years old) was obtained when they came to a dental clinic for treatment. The level of dental fear in these children was assessed using the Children's Fear Survey Schedule,Dental Subscale (CFSS-DS). Observers rated the clinically anxious responses and uncooperative behaviour towards dental treatment in these children. Three stepwise regression analyses were performed to determine significant predictors of CFSS-DS score, clinically anxious responses, and uncooperative behaviour of children, respectively. Results. We found that the CFSS-DS score and clinical anxiety have different predictors, but age , 3.99 years old and cooperativeness in the first dental visit were important predictors for both the CFSS-DS score and the clinical anxiety. Furthermore, the other predictors of the CFSS-DS score were maternal dental fear, unbearable pain during the first dental visit, and visiting dentists in a regular dental clinic; the other predictors of clinical anxiety were first-born, regular dentist, and CFSS-DS score. Finally, the only significant predictor for uncooperative behaviour was clinical anxiety. Conclusion. Children's dental fear and their anxious response during dental treatment were dynamic processes that consisted of many different factors. The direct conditioning of subjective experience of pain was more important than the objective pathway of child dental fear, and the indirect conditioning does not seem influential in this study sample. [source] Fear of blood, injury, and injections, and its relationship to dental anxiety and probability of avoiding dental treatment among 18-year-olds in NorwayINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2008MARGRETHE VIKA Background:, More knowledge about the relationship between blood,injury,injection phobia (BIIP) and dental anxiety (DA) may give new clinically relevant information in the assessment and management of children with DA. Objective:, The aims of this study were to explore the relationships between BIIP and DA, and to explore to what extent the two subtypes of BIIP in combination with DA are related to self-reported probability of avoiding dental treatment if a dental injection is needed. Methods:, The subjects were a random sample of 1385 18-year-olds attending high schools in a county of Norway, and the data were collected by use of questionnaires completed in classrooms. The survey instruments applied were Dental Fear Survey, Injection Phobia Scale-Anxiety, and Mutilation Questionnaire. Results:, About 11% of the subjects with DA and subtypes of BIIP, respectively, reported high probability of avoiding dental treatment in a situation where a dental injection was possibly needed. In multiple regression analysis, only DA contributed to self-reports of high probability of avoiding dental treatment. Conclusion:, The results indicate that among adolescents, BIIP is relatively often connected with DA. Clinical implications are discussed. [source] A fearful child attends: a psychoanalytic explanation of children's responses to dental treatmentINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2007RUTH FREEMAN Background., At the mention of dental treatment some children become overwhelmed by anxiety whereas others appear to take the news in their stride. Sometimes when anxious children attend dental treatment, they appear to cope, contain their fears, and passively submit to treatment, whereas others angrily refuse to open their mouths and a third group of children exist who seem to just ,tough it out' no matter how disagreeable or frightening dental treatment becomes. The question remains: why do children react so differently to dental treatment? Aim., This paper aims to provide a psychoanalytic explanation as to why children react and respond differently to dental treatment. Results., This paper proposes a psychoanalytic formulation based on the functionality of the family, parent,child dyads, child psychological development, and the child's emotional and actual life experiences. Conclusions., There is a need to understand the dynamic nature of child dental anxiety and to appreciate the hidden factors and underlying complexities associated with the anxious child who attends for dental treatment. [source] Dental treatment of children referred to general anaesthesia , association with country of origin and medical statusINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2006D. HAUBEK Summary., Background., A small proportion of children and adolescents need dental treatment with general anaesthesia (DGA). The aim of this retrospective cross-sectional study was to analyse how country of origin and medical status were related to age at treatment, waiting times in the system, and dental treatment provided in general anaesthesia. Methods., A total of 786 patients received DGA at the University Hospital of Aarhus, Denmark in the period from 1990 to 2001. Information on the date of referral, the date of examination, the date of treatment, country of origin (Danish or non-Danish), medical status (non-special needs or special needs), and dental treatment performed was collected from patient records. Results., Patients with special needs were older when treated than non-special needs patients, whereas patients with a non-Danish origin were younger than those with a Danish origin when treated. There were no differences between non-special needs and special needs patients in waiting times from referral to examination and from examination to dental treatment. In contrast, patients from a non-Danish origin waited longer from examination to treatment than patients of Danish origin, whereas no difference was found in waiting time from referral to examination. Patients with special needs had fewer teeth treated than non-special needs patients, whereas patients with non-Danish origin had more teeth treated than those of a Danish origin. Conclusion., Age at treatment, waiting times in the system, and dental treatment received under general anaesthesia vary according to medical status and country of origin of the patients in Denmark. These findings should be considered in the organization and the funding of this type of service. [source] A sociodental approach to assessing dental needs of children: concept and modelsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2006S. GHERUNPONG Summary. Objectives., Traditional normative methods of assessing dental needs do not correspond to current concepts of ,health' and ,need'. Although there is dental research on quality of life, evidence-based practice, and oral behaviours, those concepts are rarely applied to dental needs estimation. Dental needs are usually calculated mainly from clinical data and are likely to be inaccurate. A structured comprehensive method for assessing dental needs is required. The objectives of this study are to develop and test a new sociodental system of needs assessment for overall dental needs of primary schoolchildren. Furthermore, normative and sociodental estimates of need are compared. Design., The study developed a theoretical framework and pathway algorithms of sociodental needs assessment and applied them to assessing overall dental needs. Normative dental needs were assessed using standard normative criteria. The child oral impacts on daily performances (Child-OIDP) was used to assess oral impacts, and a self-administered questionnaire was used to obtain information on demographic variables and oral behaviours. Data were analysed according to the developed algorithms. Setting., A cross-sectional survey in Suphanburi Province, Thailand. Participants., All 1126 children aged 11,12 years in a town. Main results., The sociodental approach was acceptable and not costly. In all, 54·4% had normative need under the dental needs model for life-threatening and progressive conditions, but only 16·6% had high propensity-related need; the remaining 37·8% would require dental health education or oral health promotion (DHE/OHP) or both and appropriately adjusted clinical interventions. Under the basic model of dental needs, 45·1% had normative need. Two-thirds of them (30·9%) had impact-related need and the remaining 14·2% did not have oral impacts and therefore should only receive dental health education. Only one-third of those with impact-related need had high propensity and were suitable for evidence-based conventional treatments; the remaining two-thirds should receive DHE/OHP and alternative clinical interventions. Conclusions., A sociodental system of dental needs assessment was developed and tested on school children. It decreased the estimates of conventionally assessed dental treatment needs and introduced a broader approach to care. [source] A survey of specialist paediatric dental services in Sweden: results from 2003, and trends since 1983INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2006G. KLINGBERG Summary. The child population in Sweden has changed dramatically during the last 20 years. Changes have also occurred within the Public Dental Service (PDS), regarding the provision of dental care to children and adolescents. All these changes may affect the referral pattern and provision of specialist dental care for children and adolescents. Objectives., The primary aim of this study was to survey the services provided by specialists in paediatric dentistry in Sweden during 2003. A secondary aim was to compare the results with previous surveys. Methods., A Web-based survey was sent to all 34 specialist paediatric dentistry clinics and was answered by all clinics. Data were compared with results from the surveys performed in 1983, 1989, and 1996. Results., The number of paediatric dentists had been relatively constant over the last 20 years, whereas the number of children referred to paediatric dentists had increased by 28% since 1983. It was estimated that 1·3% of all children in Sweden are treated at a specialist paediatric dental clinic in 2003. Dental treatment need in combination with behaviour management problems (BMP) was the main reason for referral and occurred in 37% of all referrals. The proportion of medically compromised children/children with disabilities had increased from 6% in 1983 to 22% in 2003. The number of patients treated using sedation and general anaesthesia had increased since 1983, and particularly since 1996. Conclusions., Despite improvements in dental health among children and adolescents in Sweden during the last 20 years, an increasing number of children are referred for specialist paediatric dental treatment. There is an urgent need to increase the number of specialist paediatric dentists in Sweden in order to ensure the continuation of high quality of dental care for children and adolescents. [source] An investigation of language used by children to describe discomfort expected and experienced during dental treatmentINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2005K. HARMAN Summary., Objectives. A study of dental pulp testing has shown that children's linguistic comprehension and chronological age independently influence their descriptions of pain. The present study sought first to demonstrate this for expectations and experience of routine dental treatment, and secondly, to determine whether the effect of age was the result of previous dental and medical experience. Sample. Forty-six children between 6 and 17 years of age attending two paediatric dental clinics for routine invasive procedures comprised the study sample. Methods. To describe their expectations of forthcoming treatment, each child selected words from a published list, and gave ratings on scales describing the degree of severity as ,sore' or ,tingly'. They also completed the Child Dental Anxiety Scale and the Spielberger State-Trait Anxiety Scale for Children. After treatment, they described the treatment with the same list and scales, then completed the British Picture Vocabulary Scale and a dental,medical history questionnaire. Results. The children, especially the most anxious ones, chose more words from the list for their expectations than for their experience of treatment, suggesting, as in previous studies, that they expected more discomfort than they experienced. Ratings of ,sore' and ,tingly' did not show this discrepancy. For both expectations and experience of treatment, the children with the largest vocabularies chose the fewest words, thus being more discriminating in their choices. However, vocabulary had no effect on ratings of ,sore' and ,tingly'. There were no significant relationships among age, estimates of discomfort and medical,dental histories. Conclusions. The results suggest that a list of adjectives provides the most discriminating measure of discomfort. They also show that it is necessary to take into account children's linguistic development to evaluate their estimates of pain so as not to entertain the belief of many clinicians that children exaggerate such reports. [source] Danish dentists' knowledge, attitudes and management of procedural dental pain in children: association with demographic characteristics, structural factors, perceived stress during the administration of local analgesia and their tolerance towards painINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2005J. K. RASMUSSEN Summary., Objective., The aim of the present study was to describe Danish dentists' knowledge of, attitudes towards and management of procedural pain during paediatric dental care, and to assess the importance of demographic characteristics, structural factors, perceived stress during administration of local analgesia and the dentists' own tolerance towards procedural dental pain. Design., A cross-sectional questionnaire study was conducted in Denmark in May 2001. Subjects and methods., The subjects were a random sample of 30% of Danish dentists treating children. Usable information was obtained from 327 (80·3%) of the dentists in the sample. Results., One-quarter of the respondents answered that a 3,5-year-old child could report pain only with uncertainty. More than 80% of the dentists stated that they never compromised on painlessness. Very few agreed to the statement that children forget pain faster than adults. One-third agreed to, or were neutral to, the statement that all restorative care in primary teeth could be performed painlessly using N2O-O2 sedation alone. The majority of the respondents reported using three or more methods to assess the effect of their pain control methods. Almost 90% reported using local analgesia for restorative work ,always' or ,often'. A similar proportion reported using topical analgesia before injection ,always' or ,often'. Administering a mandibular block to preschool children was the procedure perceived as the most stressful (33·6%) pain control method. Demographic factors (gender), structural factors (always working alone and treating 3,5-year-old children daily), perceived stress during the administration of a mandibular block in preschool children and the dentists' own willingness to accept potentially painful dental treatment without local analgesia were associated with knowledge of, attitudes towards and management of procedural dental pain in children. Conclusions., Danish dentists treating children demonstrate concern about procedural dental pain in children. Factors amenable to change via training and reorganization into larger clinical units seem to determine their knowledge of, attitudes towards and management of procedural dental pain in children. [source] A study to assess the validity of clinical judgement in determining paediatric dental anxiety and related outcomes of managementINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2005R. D. HOLMES Summary. Objective. The aim of the present study was to determine the validity of subjective anxiety assessment and the outcomes of management of children receiving operative dental treatment. Setting., The study was conducted at the Departments of Sedation and Child Dental Health, Newcastle Dental Hospital, Newcastle upon Tyne, UK. Subjects and methods., One hundred children and adolescents aged between 8 and 15 years participated in the study. Clinicians subjectively allocated 50 children for treatment with local analgesia alone (low anxiety), and identified 50 children who had the potential to benefit from nitrous oxide and oxygen sedation (high anxiety). Participants then completed the State-Trait Anxiety Inventory for Children (STAIC), the Venham Picture Test (VPT) and the Child Fear Survey Schedule , Dental Subscale (CFSS-DS). A global rating scale classified behaviour during dental treatment. Results., State anxiety and dental fear prior to treatment were significantly higher in children allocated to receive inhalation sedation (P = 0·004 and P = 0·005, respectively). There was no significant difference in trait anxiety or post-treatment state anxiety between the two groups (P = 0·69 and P = 0·06, respectively). Only 11% displayed ,negative' behaviour during treatment: 82% of this group represented those allocated to receive sedation. Conclusion., Children receiving inhalation sedation were significantly more anxious prior to treatment than children receiving treatment with local analgesia alone. The findings support the subjective assessment of anxiety in children; however, objective anxiety measures may assist clinicians in identifying specific fears, which may ultimately aid patient management. [source] | ||||||||||||||||||||||||||||||||||