The influence of the volume of dental treatment on change in self‐reported oral health

Objectives: To find an association between self‐reported change in oral health and dental treatment volume. Methods: Baseline data were obtained from the Tasmanian component of the National Survey of Adult Oral Health 2004‐06 and 12‐month follow‐up data from service use logbooks and mail self‐complete questionnaires. The global oral health transition statement indicated change in oral health. Many putative confounders were analyzed and Poisson regression with robust variance estimation was used to calculate the prevalence ratios and 95 percent confidence intervals for bivariate‐ and multivariate‐adjusted relationships. Results: One‐eighth (12.4 percent) of the participants reported that their oral health had improved. Over half visited a dentist (n = 176, 52.6 percent), of whom 105 received less than six dental services and 71 received six or more dental services. Baseline oral disease (P = 0.01), having a treatment need (P < 0.01), usually visiting a dentist for a problem (P < 0.05), and having a lot of difficulty paying a $100 dental bill (P = 0.01) were significantly associated with the same or worsening oral health. The regression model indicated that having six or more dental services (P < 0.01) was significantly associated with improvement in oral health, indicating a threshold effect. Usually visiting a dentist for a check‐up was significantly associated with improvement in oral health (P < 0.01). Conclusion: Having six or more dental services was significantly associated with a greater self‐reported improvement in oral health than having less than six dental services. The greater prevalence ratios with increasing dental service volume suggested a threshold effect.     

Prenatal and neonatal risk factors for the development of enamel defects in low birth weight children

Oral Diseases (2010) 16 , 257–262 Objective: To analyse the influence of several prenatal and neonatal risk factors in the development of enamel defects in low birth weight children. Subjects and methods: Children between 4 and 5 years of age (n = 102) were classified into: Group 1) 52 low birth weight (<2500 g); Group 2) 50 normal birth weight (≥2500 g). Medical history, prenatal and neonatal variables were collected. Enamel defects were evaluated with the modified Developmental Defects of Enamel Index. Results: The prevalence of hypoplasia and average number of affected teeth were significantly higher in group 1 than in group 2 (59.6%vs 16% and 1.6 vs 0.3 respectively). Low gestational age was linked to a higher prevalence of hypoplastic (P = 0.027) and combined defects (P = 0.001). Children with neonatal risk factors (low Apgar scores, parenteral nutrition, orotracheal intubation, mechanical ventilation and acidosis) developed defects more frequently (P < 0.05). Defects were symmetrically distributed in children who were not intubated; in those who required intubation they concentrated on the left maxillary teeth (P < 0.05). Smoking during pregnancy, young maternal age and multiple birth were significantly associated to developmental defects. Conclusions: The prevalence of enamel defects in primary dentition is significantly influenced by birth weight, gestational age and several systemic factors. Orotracheal intubation probably plays an important role as a result of laryngoscope trauma on the maxilla.     

Oral health in preschool children with cerebral palsy: a case–control community‐based study

International Journal of Paediatric Dentistry 2010; 20: 330–335 Objectives. To assess and compare the oral health status of preschool children with and without cerebral palsy (CP). Methods. Preschool children with CP (72) were recruited from 23 Special Child Care Centers in Hong Kong. An age (±3 months) and gender matched sample of preschool children from mainstream preschools were recruited as the control group. Dental caries status, gingival health status, tooth wear, developmental defect of enamel, malocclusion, dental trauma and oral mucosal health were assessed and compared between the two groups. Results. Significant differences in gingival health status were found between children with and without CP (mean plaque index scores, P = 0.001 and mean gingival index scores, P < 0.05). Tooth wear involving dentine was more prevalent among CP children (P < 0.001), as were evidence of anterior open‐bite (P < 0.001) and oral mucosal lesions (P < 0.05). Children with and without CP had similar caries experiences (P > 0.05), prevalence of enamel defects (P > 0.05) and dental trauma (P > 0.05). Conclusions. Differences of oral health status exist among preschool children with and without CP. Preschool children fare worse in terms of gingival health, tooth wear, oral mucosal health and malocclusion.     

牙齿脱敏剂对口腔固定正畸治疗中牙釉质脱矿的影响

目的 评价奥敏清牙齿脱敏剂对青少年固定正畸患者牙釉质脱矿的影响.方法 选取2014年9月至2016年12月期间我院就诊的青少年正畸患者179名,随机分成实验组90例(360颗)和对照组89例(356颗),实验组日常刷牙时使用奥敏清牙齿脱敏剂,对照组使用普通牙膏,2组均在三餐后使用,每天至少3次,每次3 min.正畸治疗12个月时观察上颌4个切牙的牙釉质脱矿情况.结果 正畸治疗12个月后,实验组的脱矿率为10.28％,对照组的脱矿率为17.98％,实验组牙釉质脱矿指数低于对照组(P<0.05).结论 正畸治疗中使用奥敏清牙齿脱敏剂牙膏有助于降低牙釉质脱矿的程度.     

Prevalence and risk factors of sleep bruxism and wake-time tooth clenching in a 7- to 17-yr-old population

Carra MC, Huynh N, Morton P, Rompré PH, Papadakis A, Remise C, Lavigne GJ. Prevalence and risk factors of sleep bruxism and wake‐time tooth clenching in a 7‐ to 17‐yr‐old population.
Eur J Oral Sci 2011; 119: 386–394. © 2011 Eur J Oral Sci Sleep‐related bruxism (SB) and wake‐time tooth clenching (TC) have been associated with temporomandibular disorders (TMDs), headache, and sleep and behavioral complaints. This study aimed to assess the prevalence and risk factors of these signs and symptoms in a 7‐ to 17‐yr‐old population (n = 604) seeking orthodontic treatment. Data were collected by questionnaire and by a clinical examination assessing craniofacial morphology and dental status. Sleep‐related bruxism was reported by 15% of the population and TC was reported by 12.4%. The SB group (n = 58) was mainly composed of children (67.3% were ≤12 yr of age) and the TC group (n = 42) was mainly composed of adolescents (78.6% were ≥13 yr of age). The craniofacial morphology of over 60% of SB subjects was dental class II and 28.1% were a brachyfacial type. Compared with controls (n = 220), SB subjects were more at risk of experiencing jaw muscle fatigue [adjusted OR (AOR) = 10.5], headache (AOR = 4.3), and loud breathing during sleep (AOR = 3.1). Compared with controls, TC subjects reported more temporomandibular joint clicking (AOR = 5), jaw muscle fatigue (AOR = 13.5), and several sleep and behavioral complaints. Sleep‐ and wake‐time parafunctions are frequently associated with signs and symptoms suggestive of TMDs, and with sleep and behavioral problems. Their clinical assessment during the planning of orthodontic treatment is recommended.     

Long-term physical inactivity and oral health in Finnish adults with intellectual disability

Physical inactivity is prevalent among patients with intellectual disability. Because little is known about the oral effects of poor mobility, we reviewed the medical and dental charts of institutionalized dentate patients (n = 214;40.2 years &#45 12.1) of the Special Welfare District of Southwestern Finland. The number of decayed, missing, and filled teeth (DMFT), the number of retained teeth, dental treatment visits, and the type of the first treatment visit were recorded. Physical activity was good in 55% and severely reduced or completely absent in 45% of the patients. The degree of intellectual disability was mild or moderate in 40% and severe or profound in 60% of the patients. The walking patients weighed more (64.3 (19.6)versus 44.4 (14.4) kg; P < 0.001), had fewer secondary diagnoses (1.4 (1.3) versus 2.2 (1.4); P < 0.001), fewer daily medications (4.0 (2.1) versus 4.8 (2.4); P < 0.02), higher DMFT scores (18.5 (8.2) versus 14.8 (9.2); P < 0.05), and more dental treatment visits (2.7 (2.4) versus 2.0 (1.3); P < 0.03) than patients with poor physical activity. Periodontal treatment given as the primary type of dental care was more common among subjects with poor mobility than among those with good motor activity (P < 0.002). Poor physical activity was related to better dental health, higher need for periodontal therapy, and fewer dental visits than in patients with good motor activity.     

Psychiatric morbidity among patients with oral sub‐mucous fibrosis: a preliminary study

J Oral Pathol Med (2010) 39 : 761–764 Background: Oral submucous fibrosis (OSF) is a chronic oral mucosal condition with pre‐malignant potential. The association between psychiatric morbidity and OSF has been sparsely studied. Methods: This cross‐sectional study included 33 consecutive subjects clinically diagnosed with OSF who attended an academic tertiary care dental centre. General Health Questionnaire‐28 was administered to assess the psychological morbidity. Dependence to areca products was assessed using the ICD‐10 criteria. Patient group was compared with an age and gender matched control group (n = 33) from the same hospital that comprised patients who had dental diseases other than OSF and had no areca/tobacco habit. Results: Total mean scores (SD) of GHQ‐28 for study group and control group respectively were 48.2 (18.1) vs. 24.2 (6.5) (P < 0.001). Among the patient group, the mean total GHQ scores were significantly higher in those with functional stage C (those with worst functional staging) of OSF 63.4 (15.2) when compared with those with stage B 54 (14.2) and stage A 38.7 (17) (d.f. = 2; P = 0.005). 22 (66.7%) of patients met ICD‐10 criteria for dependence to areca products. Conclusions: OSF may be associated with considerable psychological morbidity. This morbidity may be significantly more in patients with worst functional staging. It is difficult to determine whether this is the cause or effect of the disease. Further systematic studies are urgently needed to address this issue.     

Disturbances in oral and dental structures in patients with pediatric lymphoma after chemotherapy: a preliminary report

OBJECTIVE: The purpose of this study was to evaluate the effects of chemotherapy on oral and dental structures and craniofacial growth in 30 survivors of childhood lymphoma. STUDY DESIGN: Eruption status, root malformations, premature apexification, agenesis, crown anomalies, soft tissue abnormalities, gingival and periodontal status, enamel defects and discolorations, and craniofacial growth status of the subjects were documented and compared with findings in 20 healthy children who served as controls. RESULTS: Statistically significant (P < .05) differences between the study and control groups were found for plaque index, enamel hypoplasias, discolorations, and agenesis. CONCLUSIONS: The results of the study suggest that antineoplastic therapy and/or childhood cancer can result in a higher prevalence of various malformations in teeth. Children treated in the early years of their lives displayed the most severe dental defects, suggesting that immature teeth are at a greater risk of developmental disturbances than fully developed teeth.     

Genomic aberrations of MDM2, MDM4, FGFR1 and FGFR3 are associated with poor outcome in patients with salivary gland cancer

Fibroblast growth factor receptor 1 and 3 (FGFR1, FGFR3) impact on tissue homoeostasis, embryonic development and carcinogenesis. Murine double minute protein 4 (MDM4) and mouse double minute 2 homologue (MDM2) are regulators of p53‐protein and may be the origin of an apoptosis overpowering cascade. A collective of 266 carcinomas of salivary glands were investigated for MDM2, MDM4, FGFR1 and FGFR3 aberrations by fluorescence in situ hybridization (FISH). The results were matched with clinicopathological parameters and with expression of PTEN and p53. MDM2 gene amplification (n = 9) and chromosomal aberrations (trisomy, n = 47; high polysomy, n = 7) are linked to high‐grade malignancy (P < 0.001), lymph node metastasis (P = 0.001), advanced tumour size (P = 0.013) and stage (P < 0.001), gender (P = 0.002) and age (P = 0.001). MDM4 gene amplification (n = 19) and chromosomal aberrations (trisomy, n = 34; high polysomy, n = 31) are correlated to high‐grade malignancy (P < 0.001), lymph node metastasis (P = 0.008), advanced tumour size (P = 0.039), stage (P = 0.004) and loss of PTEN (P < 0.001). Only, high‐grade malignancy (P < 0.001), lymph node metastasis (P = 0.036) and advanced tumour stage (P = 0.025) are associated with FGFR3 amplification (n = 1) or chromosomal aberrations (low polysomy, n = 61; high polysomy, n = 55) but not with MDM4 alterations. FGFR1 amplifications (n = 5) and chromosomal aberrations (trisomy, n = 38; high polysomy, n = 30) are associated with high‐grade malignancy (P < 0.001), advanced tumour size (P = 0.026) and stage (P = 0.004), gender (P = 0.016) and age (P = 0.023). Aberrations of MDM2, MDM4, FGFR1 and FGFR3 correlate with aggressive tumour growth and nodal metastasis. MDM2 (P < 0.001), MDM4 (P = 0.005) and FGFR3 (P = 0.006) alterations are associated with worse overall survival of patients with salivary gland cancer.     

The effect of diabetes mellitus on the shear bond strength of composite resin to dentin and enamel

Diabetes mellitus might be linked to the deterioration of certain physical properties of dentin and enamel. This study aimed to determine the effect of two types of diabetes on the shear bond strength of enamel and dentin, by using the single bond universal bonding system. Sixty specimens [from 15 teeth; 5 from each group—non-diabetic (ND), Diabetic type I (D1), and Diabetic type II (D2)], were prepared with equal amounts of dentin (n?=?5) and enamel (n?=?5). Enamel specimens (E20) were etched with 37% phosphoric acid, for 20 s, and dentin specimens (D15) were etched for 15 s. A standard shear bond strength test was performed on all specimens. Their failure modes were also studied under a scanning electron microscope, and the data were analyzed by using ANOVA and Post Hoc Tukey’s test (a?=?0.050). For the enamel groups, significant differences were only noticed between the ND and D1 (P?<?0.050) groups, and between the ND and D2 (P?<?0.050) groups. In the dentin groups, there was a significant difference only between the ND and D1 (P?<?0.050) groups. The micrographs showed that the ND group had the highest number of specimens with cohesive failure and D1 had the highest number of specimens with adhesive failure. It can be concluded that both types of diabetes reduce the shear bond strength of composite resin on dentin and enamel. However, it seems that the negative effect of diabetes on shear bond strength of dental composite resin is more drastic in individuals with type I diabetes as compared with type II.

     

Craniofacial parameters of Syrian children with β‐thalassemia major

Abstract Aim: To investigate cephalometric craniofacial parameters (skeletal and dental) of β‐thalassemic‐major patients and to compare findings with a group of healthy patients in the same age group. Methods: Fifty‐one Syrian thalassemic‐major patients aged 8–12 years were recruited. Lateral cephalometric radiographs were taken. Linear and angular cephalometric measurements were recorded and compared with Syrian controls (n = 50) in the same age group. Results: Thalassemic patients, when compared with controls, showed significant retrognathia in the mandible (reduced sella [mid‐point of sella turcica]–nasion [most anterior point on the frontonasal suture] B‐point [deepest point on the concavity of the mandibular profile between the alveolar crest and the point of the chin] angle, and decreased sella–nasion–pogonion [most anterior point on the bony chin] angle, P < 0.0001), a significant decrease in ramus height (articulare–gonian = 36.51 ± 3.87 mm, P < 0.0001). They also exhibited a significant class II skeletal pattern (P < 0.0001) and a convex facial profile as the nasion A‐point (deepest point on maxillary profile between the anterior nasal spine and the alveolar crest) pogonion angle and maxillomandibular A‐point–nasion P‐point angle increased. They also showed a highly‐significant decrease in the total posterior facial height (sella gonion [most posterior, inferior point on the angle of the mandible] = 64.24 ± 5.73 mm, P < 0.0001) and significant increase in the total anterior facial height (N–Me = 110.78 ± 6.66 mm, P = 0.009) when compared to controls. Conclusion: Thalassemic patients exhibited a skeletal class II malocclusion, retrognathia of the mandible, a short height of the ramus, an increase in anterior facial height, and a decrease in posterior facial height.     

Phenotypes of CCAAT/enhancer‐binding protein beta deficiency: hyperdontia and elongated coronoid process

Oral Diseases (2012) Objectives: This investigation aimed to conduct a case–control study of mandibular morphology and dental anomalies to propose a relationship between mandibular/dental phenotypes and deficiency of CCAAT/enhancer‐binding protein beta (CEBPB). Materials and methods: Skulls of CEBPB^?/?, CEBPB^+/? and CEBPB^+/+ mice were inspected with micro‐computed tomography. Mandibular morphology was assessed with a method of Euclidean distance matrix analysis. Results: Elongation of the coronoid process was identified in CEBPB^+/? (P ≤ 0.046) and CEBPB^?/? 12‐month‐olds (P ≤ 0.028) but not in 14‐day‐olds (P ≥ 0.217) and 0‐day‐olds (P ≥ 0.189) of either genotype. Formation of supernumerary teeth in CEBPB^?/? adult mice was demonstrated (χ² = 6.00, df = 1, P = 0.014). Conclusions: CEBPB deficiency was related to elongation of the coronoid process and formation of supernumerary teeth. The mandibular and dental phenotypes of CEBPB deficiency were unseen by the 14th day after birth. Future investigations into the influence of CEBPB on mandibular and dental development are needed.     

Xenogenous Collagen Matrix and/or Enamel Matrix Derivative for Treatment of Localized Gingival Recessions: A Randomized Clinical Trial. Part II: Patient‐Reported Outcomes

Background: Gingival recession (GR) might be associated with patient discomfort due to cervical dentin hypersensitivity (CDH) and esthetic dissatisfaction. The aim is to evaluate the effect of root coverage procedure with a xenogenous collagen matrix (CM) and/or enamel matrix derivative (EMD) in combination with a coronally advanced flap (CAF) on CDH, esthetics, and oral health–related quality of life (OHRQoL) of patients with GR. Methods: Sixty‐eight participants with single Miller Class I/II GRs were treated with CAF (n = 17), CAF + CM (n = 17), CAF + EMD (n = 17), and CAF + CM + EMD (n = 17). CDH was assessed by evaporative stimuli using a visual analog scale (VAS) and a Schiff scale. Esthetics outcome was assessed with VAS and the Questionnaire of Oral Esthetic Satisfaction. Oral Health Impact Profile‐14 (OHIP‐14) questionnaire was used to assess OHRQoL. All parameters were evaluated at baseline and after 6 months. Results: Intragroup analysis showed statistically significant reduction in CDH and esthetic dissatisfaction with no intergroup significant differences (P >0.05). The impact of oral health on QoL after 6 months was significant for CAF + CM, CAF + EMD, and CAF + CM + EMD (P <0.05). Total OHIP‐14 score and psychologic discomfort, psychologic disability, social disability, and handicap dimensions showed negative correlation with esthetics. OHIP‐14 physical pain dimension had positive correlation with CDH (P <0.05). OHIP‐14 showed no correlation with percentage of root coverage, keratinized tissue width, or keratinized tissue thickness (P >0.05). Conclusion: Root coverage procedures improve patient OHRQoL by impacting on a wide range of dimensions, perceived after reduction of CDH and esthetic dissatisfaction of patients with GRs treated with CAF + CM, CAF + EMD, and CAF + CM + EMD.     

Expression of cancer stem cell markers ALDH1 and Bmi1 in oral erythroplakia and the risk of oral cancer

J Oral Pathol Med (2013) 42 : 148–153 Background: Oral erythroplakia (OE) is a notoriously aggressive oral pre‐malignant lesion with a high tendency to oral cancer development, but its biological behavior is largely unknown. The objective of this study was to determine the expression of cancer stem cell markers ALDH1 and Bmi1 in OE and their correlation with malignant transformation of OE. Methods: In a retrospective case–control study, expression patterns of ALDH1 and Bmi1 were determined using immunohistochemistry in samples from 34 patients with OE, including patients with untransformed lesions (n = 17) and patients with malignant transformed lesions (n = 17). Results: ALDH1 and Bmi1 expression was observed in 19 (55.9%) and 20 (58.8%) of 34 patients with OE, respectively. Multivariate analysis revealed that ALDH1 expression was significantly associated with increased risk of transformation (P < 0.05), but Bmi1 expression was not a significant marker (P > 0.05). Notably, the coexpression of both ALDH1 and Bmi1 was a strong indicator associated with 8.56‐fold (95% confidence interval [CI], 1.74–42.17; P < 0.01) for malignant transformation. Point prevalence analysis revealed that 78.6% (95% CI, 54.0–100) of the patient with coexpression of both ALDH1 and Bmi1 developed oral cancer. Conclusion: Our data indicated that the expression patterns of ALDH1 and Bmi1 in OE were associated with malignant transformation, suggesting that they may be valuable predictors for evaluating the risk of oral cancer.     

Survey on awareness and perceptions of bisphosphonate‐related osteonecrosis of the jaw in dental hygienists in Seoul

We investigated awareness in dental hygienists of bisphosphonate‐related osteonecrosis of the jaw (BRONJ) in patients with osteoporosis and cancer and assessed the situation in systemic history investigations to broaden the scope of the dental hygienists' BRONJ awareness as a basis for contributing to preventing this disease. The study was carried out through a survey; 217 dental hygienists responded to the survey. They worked at 12 university and general hospitals, 10 dental hospitals and 35 dental clinics, for a total of 57 institutions in Seoul. The survey consisted of 37 questions: general characteristics (J Oral Maxillofac Surg 65: 2007; 369), systemic history investigations (Ruggiero et al. J Oral Maxillofac Surg 62: 2004; 527) and awareness of BRONJ (Park et al. J Korean Dent Assoc 49: 2011; 389). Among them, 79.7% were aware of BRONJ. Recognition was highest among those from 25 to 35 years old (P < 0.05). In terms of work experience, those with 5–10 years experience showed the highest awareness (P < 0.05). In terms of institutions type, dental clinics showed lower awareness than general and dental hospitals (P < 0.05). It was found that 55.3% of the dental hygienists had been educated about BRONJ. Those aged 25–35 years were the most educated. In terms of institutions, dental clinic staff were the least educated. The degree of understanding about BRONJ was analysed with the average score of 6.14 points. According to these results, dental hygienists working in university hospitals and general hospitals had more opportunity to receive training than those working in dental clinics. Thus, it is considered that the development of professional training programs about BRONJ for all dental hygienists is necessary.     

Isolated soft tissue cleft lip: epidemiology and associated dental anomalies

Oral Diseases (2011) 17 , 221–231 Objectives: The aim of this investigation was to study the epidemiology of the isolated soft tissue cleft lip (ICL) population and to evaluate the dental anomalies associated with permanent dentition. Methods: The study included 19 children aged 9–13 years presenting ICL selected from 657 cleft lip‐affected patients treated during the last 10 years in two craniofacial centers. Only 17 patients could be included for dental anomaly evaluation: Hyperdontia, Hypodontia, Gemination, Talon tooth, Microdontia, and Macrodontia. These were compared with cleft lip and palate (CLP) and cleft lip and alveolus (CLA)‐affected populations and with normal populations. Results: The prevalence of ICL was 2.8%. All types of tooth abnormalities were found to be higher and mainly significant for the cleft side of ICL compared with the normal population. On the side opposite the cleft, the prevalence of dental anomalies reduced toward the normal individuals and was not significantly different. The significant differences found between CLP, CLA, and ICL‐affected populations were mostly depicted by lateral incisors and second pre‐molar hypodontia. Conclusions: Isolated cleft lip is a rare phenomenon among the spectrum of the cleft‐affected population. The prevalence of the dental anomalies in ICL maintains the proportional trend according to clefting severity.     

The prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area

Oral Diseases (2011) 17 , 210–216 Objectives: To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area. Subjects and Methods: A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents. Results: One hundred eighty‐one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P < 0.05). Conclusions: Distribution characteristics of tongue lesions in Malaysians are important as local reference data in the daily clinical practice.     

A prospective non‐randomised study to compare oral trauma from laryngoscope versus laryngeal mask insertion

Abstract – Background: Prospective studies evaluating the incidence of dental injuries in anaesthesia are scarce or absent. The aim of this study was to compare the incidence of oral trauma in patients submitted to laryngoscopy and orotracheal intubation with those anaesthetized with a laryngeal mask. Material and methods: This observational study was performed in the University Hospital, with blind evaluation. We evaluated 121 patients older than 18 years old who were submitted to elective surgery under general anaesthesia. Patients were excluded if they were pregnant, underwent surgery of the mouth or required nasal intubation. Laryngoscopy and orotracheal tube were used in 70 patients and laryngeal mask in 51. Twelve to 24 h before anaesthesia and after surgery, all patients underwent a detailed oral examination performed by an anaesthesiology and a senior dentist, both blind to anaesthetic management details. Injuries of the teeth were diagnosed based on WHO’s classification system modified by Andreasen. Results: Oral injuries were found in 84.1% of the patients after laryngoscopy and 19.6% after laryngeal mask insertion (P < 0.001). Corresponding values for teeth injuries were, respectively, 38.6% and 2.0% (P < 0.001). The great majority were enamel fractures of the maxillary incisors. This means that patients submitted to laryngoscopy had a significantly higher incidence of oral injuries compared with those having laryngeal mask insertion (unadjusted OR 21, 99; CI 0.95: 8.55–56.55). Conclusion: Minor oral trauma is significantly more frequent after endotracheal intubation than after use of the laryngeal mask. This is true for injuries of the teeth, inferior lip and tongue. Further studies are needed to evaluate on a long‐term basis the clinical relevance of the dental injuries we found.     

Prevalence of traumatic dental injuries in preschool children in Kuwait – a screening study

Abstract – Aims: This is the first study in Kuwait to determine the prevalence, etiology, classification of trauma, teeth involved, place of injury and treatment received after dental trauma in preschool children. Material and methods: A total of 500 preschool children presenting at a dental screening day in all governorates of Kuwait were clinically examined for signs of trauma to their primary teeth. The parents were then interviewed and a prevalidated questionnaire was completed with the demographic data of the participant and history of the dental trauma. Results: A total of 243 (48.6%) males and 257 (51.4%) females were screened. The age range was 2–6 years (mean age of 4.31 ± 1.03 years). Fifty‐six children (68 teeth) suffered trauma to their primary teeth making a prevalence of 11.2%. Majority of dental traumas occurred at home (n = 49, 87.5%) followed by at street (n = 4, 7.1%) and at school (n = 3, 5.4%). The most common reason of oral trauma was falls (n = 53, 94.6%).The most commonly affected tooth was the maxillary right primary central incisor (n = 29, 42.6%) followed by the maxillary left primary central incisor (n = 26, 38.2%). There were 20 teeth with enamel fractures (29.4%), 18 teeth had enamel‐ dentin fractures (26.5%) and 10 teeth had complicated crown fractures (14.7%). There were 17 luxated teeth (25%) and only three primary teeth (4.4%) were avulsed. The only statistically significant relation found in this study was between the type of trauma and the type of the treatment provided. Of the traumatized teeth, 23 (33.8%) did not receive any type of dental or medical care. Conclusion: In spite of the low prevalence of dental trauma in Kuwaiti preschool children, it is highly recommended to plan a community wide trauma prevention campaign targeting parents, children and medical/dental care providers.     

Prevalence and distribution of developmental enamel defects in children with cerebral palsy in Beijing,China

International Journal of Paediatric Dentistry 2011; 21: 23–28 Aim. To investigate the prevalence and distribution of developmental enamel defects in children with cerebral palsy (CP) in Beijing, China. Design. A total of 135 children aged 1.5–6 years with moderate or severe congenital CP diagnosed in Beijing Boai Hospital from year 2005 to 2009 were recruited. The children underwent dental examination at the hospital dental clinic. Results. Enamel defects (opacity and/or hypoplasia) were found in 44 (32.6%) out of 135 CP children. Enamel hypoplasia was found in 35 (25.9%) of the CP children, opacity alone was found in 5 (3.7%) of the CP children, and mixed defects (opacity and hypoplasia) was found in 4 (3.0%) of the CP children. Most of the enamel defects were located symmetrically in the primary incisors and first molars. 42.4% of children with enamel defects were born prematurely (<37 weeks) where as only 23.2% of them were born at normal gestational age. No statistically significant difference in the prevalence of enamel defects was found in relation to birth weight (P > 0.05). Conclusions. A high prevalence of developmental enamel defects was found among the children with CP. The prevalence of defects varied with the tooth type and was associated with gestational age of the children.