Oral health in children and adolescents with myotonic dystrophy

Myotonic dystrophy or dystrophia myotonica (DM) is a hereditary neuromuscular multisystem disease with a varying clinical expressivity and severity. The objective of this study was to assess the oral health in children with myotonic dystrophy and to compare it with a control group. Fifty-six DM patients, aged 2.7-18.0 yr, were compared with age- and gender-matched control patients with respect to caries, plaque, and gingivitis. Oral function and signs of temporomandibular dysfunction (TMD) were assessed, and the ability to co-operate in dental treatment was estimated. Questionnaires concerning eating habits, dental care, traumatic injuries to teeth, and orofacial function were also used. The DM patients had significantly more caries, plaque, and gingivitis than did control patients. They had more TMD problems and lower co-operation ability than the healthy control persons. General sedation was frequently needed to carry through dental treatment. DM patients are at risk of caries, gingivitis and TMD problems, and need intensified prophylactic care. Behavior management problems are common.     

Oral soft tissue lesions in Greek children and adolescents: a retrospective analysis over a 32-year period

Pediatric oral pathology encompasses a wide clinical spectrum of local and systemic diseases. The purpose of this study was to evaluate the clinical characteristics of oral soft tissue lesions in Greek children and adolescents up to 18 years old. Data available through a 32 year old period revealed that among the 1040 cases analyzed, benign lesions, mainly cysts, inflammatory lesions and reactive hyperplasias, were the most common causes for seeking dental advice during childhood.     

Masticatory dysfunction in patients with myotonic dystrophy (type 1): a 5-year follow-up

Eight patients with myotonic dystrophy type 1, DM1 (age range 45–63 years) were followed for a period of 5 years. Two sets of data analyzing masticatory function and activities of daily living (ADL) were obtained at baseline and at 5 years. The results from both time points were compared. The number of food items considered easy to chew, maximum bite force, occlusal contact area, number of teeth, and ADLs were significantly reduced ( p < 0.05) at the second assessment when compared to the first. During the intervening 5 years, six of the eight patients adopted a soft diet. These results suggest deterioration in ADLs and masticatory function of patients with DM1. Continuous evaluation of the feeding ability and the type of diet are necessary for patients with DM1.     

重庆市4~17岁孤儿口腔健康现状调查分析

目的 了解重庆市4~17岁孤儿口腔健康现状及其流行趋势,为制定孤儿口腔保健计划提供依据。方法 根据第三次全国口腔健康流行病学抽样调查方案,抽取重庆市江北区某儿童福利院孤儿为调查对象,对该福利院317名孤儿进行口腔健康检查,记录龋齿、牙龈出血和牙结石情况。采用SPSS 17.0软件对数据进行统计分析。结果 重庆市岁孤儿乳牙和恒牙的患龋率及龋均分别为50.00%、1.94±2.81和39.53%、0.90±1.38,男女之间差异无统计学意义（P>0.05）。恒牙患龋率 12岁及以下年龄组与12岁以上年龄组间有统计学差异（P<0.05）。第一恒磨牙患龋率为35.25%,女性高于男性（P<0.05）。龋齿充填率及第一恒磨牙窝沟封闭率均为0.00%。牙龈出血检出率为78.22%,牙结石检出率为67.66%。结论 重庆市4~17岁孤儿口腔健康现状不佳,牙科服务利用率极低,在今后的工作中,应将这部分人群纳入口腔健康预防保健的重点人群之列。     

Distribution of 10 periodontal bacterial species in children and adolescents over a 7-year period

Objective: There is scant information available regarding the distribution of periodontal bacterial species in children and adolescents over an extended period. The purpose of this study was to compare bacterial profiles in the same individuals over a period of 7 years. Subject and methods: Twenty‐six children and adolescents from whom dental plaque and saliva specimens were obtained during both the first (1999–2000) and second (2006–2007) periods, were analyzed. Bacterial DNA was extracted from each specimen and the presence of 10 periodontal bacterial species was determined using a PCR method, with a focus on the red complex species of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. Results: Subjects with red complex species in saliva specimens obtained during the second collection possessed a significantly higher number of total bacterial species than those without. The detection rate of the red complex species in the second collection period samples was significantly greater in subjects who had two or more species detected in samples taken during the first collection compared with the other subjects. Conclusion: Subjects possessing red complex species may be at possible risk for infection with a high number of periodontal bacterial species during adolescent and younger adult years.     

Clinical and microbial oral health status in children and adolescents with type 1 diabetes mellitus

Objectives: To study the oral health of young individuals with controlled and uncontrolled type 1 diabetes mellitus (T1DM) and compare the results with those for healthy counterparts. Materials and Methods: One-hundred and forty-four youngsters (6–15 years of age) were assigned, according to glycaemic control, to three study groups: (i) diabetic patients with poor glycaemic control [glycated haemoglobin (HbA1c ≥7.5%)] (n = 35); (ii) diabetic patients with good glycaemic control (HbA1c <7.5%) (n = 39); and (iii) healthy individuals (n = 70). Plaque, gingival inflammation, calculus and decayed, missing and filled surfaces (DMFS) indices were recorded. Salivary parameters were determined, and stimulated saliva was collected to allow detection and determination of the levels of oral Candida albicans and Streptococcus mutans by real-time polymerase chain reaction (PCR). Results: Significantly different amounts of plaque were found among the study groups (P = 0.024): youngsters with poor glycaemic control had significantly more plaque than youngsters in the other two groups. The gingival, calculus and DMFS indices were not significantly different among groups (P > 0.05). Candida albicans levels were not statistically significant different among groups, but the group with poor glycemic control showed an elevated frequency of detection. Streptococcus mutans was isolated from the oral cavity of 96 of the 144 individuals. A statistically significant difference in the level of S. mutans was found between the group with poor glycaemic control and the healthy control group (P = 0.032). Conclusions: The results imply that youngsters with T1DM have a lower level of oral hygiene and are potentially at a higher risk of future oral disease, particularly when their metabolic disorder is uncontrolled. However, factors outside the oral cavity may also have a considerable impact on the initiation and progression of oral diseases.Key words: Children, oral health status, Candida albicans, Streptococcus mutans, type 1 diabetes mellitus     

Intra-osseous lesions in Greek children and adolescents. A study based on biopsy material over a 26-year period

OBJECTIVE: The purpose of this retrospective study was to investigate the spectrum of oral intra-osseous lesions in a Greek population, consisting of children and adolescents under 18 years of age. MATERIAL AND METHODS: Data was obtained from the histopathological reports that accompanied biopsy request forms, which were retrieved from the files of the Oral Pathology Department, Faculty of Dentistry, University of Athens, during a 26-year period. A retrospective analysis with respect to patients' age and gender, frequency and location of the lesions was performed. The lesions were classified into cystic (odontogenic and non-odontogenic) and solid lesions (odontogenic and non-odontogenic). The patients were divided into three age groups: a) 0-6 years old, b) 7-12 years old and c) 13-18 years old. RESULTS: 474 intra-osseous lesions were detected and represented 2.38% out of a total of 19933 biopsies. Male/female ratio was 1.25/1. The majority of the lesions was located in the mandible (49.8%) and occurred in the third age group of patients (58.7%). Odontogenic cysts represented the most frequent intraosseous lesion (64.1%) followed by non-odontogenic solid lesions representing 22.5% of the intra-osseous population. The most frequently encountered lesions in descending order were radicular (36.3%) and dentigerous (18%) cysts, keratocysts (9.5%), apical granulomas (7.6%), odontomas (6%) and fibrous dysplasia (5%). Only 6 malignant lesions were reported (1.3%). CONCLUSIONS: This clinicopathologic study revealed that a broad spectrum of mostly benign bony lesions may occur during childhood.     

Attachment loss in rural Chinese children over a 3-year period

OBJECTIVES: The periodontal condition of 84 children (9-14 years old, 38 males and 46 females) in a rural area of China was monitored over a 3-year period in order to determine the clinical parameters that act as risk factors for attachment loss. METHODS: Plaque and calculus accumulation (PSS and CI), modified gingival index (MGI), pocket depth (PD) and attachment level (AL) of two quadrants of each child were examined in 1993 and 1996. Following calculation of the mean of each of these parameters and statistical analysis of the change in each of the clinical parameters over the 3-year period, the relationship between attachment loss and clinical parameters was analyzed using multiple regression analysis. RESULTS: At the beginning of this study, the mean values for males and females were 3.66 and 3.58 for PSS, 1.22 and 1.17 for MGI, 1.07 and 0.90 for CI, 2.21 and 2.22 for PD, and both 0.02 for AL respectively. No significant difference between males and females was observed. After 3 years, all except mean PSS had increased significantly. Multiple regression analysis indicated that AL correlated only to age (P<0.01). In 1993, although the AL was > or =1 mm for at least one site in 21 children, none had an AL> or =3 mm. In 1996, the number of children with an AL> or =1 mm had increased to 63, and nine of these children exhibited 3 mm AL (one to six sites per child). No other significant differences were observed between the clinical data of these nine children and those of the other children. CONCLUSION: Although attachment loss tended to increase with age, no clinical parameters correlated with attachment loss in children.     

Oral health status among children and adolescents in governmental and private schools of the Palestinian Territories

Background: Political conflicts in the Palestinian Territories (PT) have resulted in systematic deterioration of socio-economic conditions and health. The World Health Organization (WHO) has emphasised the negative impacts of social crisis on children’ oral health and quality of life. Objectives: To assess the prevalence and trends in dental caries and poor gingival health of schoolchildren in the PT through the scholastic years 1998/1999 to 2012/2013. Methods: This is a retrospective study. Prevalence data on dental caries of primary and permanent dentitions among children 6, 12 and 16 years of age were gathered from annual oral health reports of the School Dental Health Programme (SDHP)-Ministry of Health. Caries was recorded according to WHO methods and criteria. Decayed, missing and filled teeth indices for primary (dmft) and permanent (DMFT) teeth were calculated. Gingival health status was examined according to the Community Periodontal Index (scores 1 and 2). Statistical analysis used SPSS. Results: In 2012/2013, dental caries prevalence rates and the index scores among schoolchildren were as follows, respectively: 56.4% and 2.7 dmft at age 6; 42.0% and 1.4 DMFT at age 12; and 38.7% and 1.7 DMFT at age 16. For all age groups, the d/D-component of the caries indices was high. Trends of dental-caries prevalence, caries experience and gingival bleeding were fairly constant over time from 1998/1999. Conclusion: The SDHP was established in order to prevent and control oral diseases among schoolchildren in the PT. The Programme is fairly passive and the survey indicates an urgent need for reorientation of activities towards population-based prevention and health promotion. The application of the WHO Health Promoting Schools concept is highly recommended.Key words: Dental caries, gingival health, schoolchildren     

Oral health of southern Chinese children and adolescents with severe hypodontia

OBJECTIVE: The aim of this study was to assess the oral health condition of southern Chinese children and adolescents with severe hypodontia. METHODS: This was a cross-sectional clinical study in the dental teaching hospital in Hong Kong. Twenty-five children and adolescents with severe hypodontia, and a comparison group of 25 age- and gender-matched controls took part. Verified clinical examination techniques were used to assess the pattern of missing teeth, tooth spacing, dental caries, periodontal condition, enamel defects, and tooth wear. Statistical comparisons were made between groups using independent Student t-tests and chi-square tests. RESULTS: The mean number of congenitally missing permanent teeth in the severe hypodontia group was 9.1 (SD = 5.0), with the maxillary lateral incisor being the most common missing tooth (14.5%). There were significant space discrepancies in both jaws between groups (P < 0.001). Caries prevalence was low with no difference between groups. There was no difference in periodontal condition between groups, with about half of the participants having no gingival inflammation. The severe hypodontia group had more enamel defects (P = 0.043), enamel hypoplasia (P = 0.044) and tooth wear (P = 0.005) than the comparison group. Three of the severe hypodontia group had ectodermal dysplasia. CONCLUSIONS: The oral health condition of southern Chinese children and adolescents with severe hypodontia was good in terms of caries experience and periodontal health. However, the increased prevalence of developmental defects of enamel and tooth wear complicates already complex interim and definitive prosthodontic management, and may increase psychosocial impact.     

Oral alterations in Steinert's myotonic dystrophy: a presentation of two cases

Two patients with Steinert's myotonic dystrophy are presented. The disease was suspected because of alterations in orofacial musculature clinically manifest as difficulties in swallowing, mastication, and speech, and as occlusal anomalies and maxillary bone deformities. The presumed diagnosis was reached as a result of the presence of percussion myotonia of the tongue; confirmation was based on family antecedents, electromyographic alterations, and muscle histopathologic findings.     

Oral health status of children with Treacher Collins syndrome

There is a lack of data on the oral health status of individuals with craniofacial syndromes. A group of 15 children with Treacher Collins syndrome, aged 5 to 15 years old, was examined and evaluated for plaque, caries and gingival problems. The ability of the patients to clean their teeth was also investigated. A high plaque index and poor efficacy of tooth‐brushing was recorded. The caries and gingival indexes were not proportionally as high as the plaque accumulation. There was no association between the gingival index and presence of mouth breathing. There was predominance of the D component in both the dmft and DMFT indexes; this was associated with a need for restorative dental treatment in 60% of the patients, which indicated the need for dental care for these patients. Caretakers should be informed of the importance of oral health and oral hygiene and encouraged to take responsibility for the oral care of the children living at home.