Examining the accuracy of caregivers' assessments of young children's oral health status

BackgroundCaregivers' perceptions of their young children's oral health status (OHS) are a strong determinant of whether the children visit a dentist. Our aims were to quantify the correlation between caregivers' assessments and their children's clinically determined restorative treatment needs, while investigating factors related to this association.MethodsOne hundred eight caregivers assessed their children's OHS by answering a question on the self-reported National Health and Nutrition Examination Survey III instrument. Children underwent clinical oral examinations at one of two study sites of the Carolina Oral Health Literacy Project: a dental school–based clinic and a community-based health clinic. Examiners recorded the children's clinical treatment needs by using a modification of the caries severity index. The authors quantified concordance between the two measures with use of the Spearman rank correlation (ρ) and Kendall τ rank correlation, whereas they assessed differences in sociodemographic factors and oral health literacy (OHL) levels by using a homogeneity χ² test (P < .2 criterion).ResultsThe concordance between caregivers' assessments and clinically determined OHS was lower for younger children (< 2 years, ρ = 0.29 versus = 2 years, ρ = 0.63 [homogeneity P = .03]), a pattern that was evident in the community clinic but not in the university clinic. Caregivers' age, education and OHL did not influence the accuracy of self-reports.ConclusionsFor children younger than 2 years, caregivers' assessments correlated poorly with clinical needs, which routinely were underestimated.Practice ImplicationsThese findings underscore the importance of preventive dental visits at a young age and the early establishment of a dental home.     

Application of Isolite system during treatment of dental caries identified in submerged mandibular second primary molar

We used the Isolite system for treatment of dental caries identified in a submerged mandibular right primary second molar. A 5-year-6-month-old girl was referred to our clinic for close examination of an impacted mandibular right second primary molar. An intraoral examination showed a slight pit extending inside the gingiva and on the occlusal surface of the tooth. X-ray photographic examination revealed that the affected tooth was severely submerged and had a radiolucent area on the occlusal surface, which extended close to the pulp cavity. Most of the periodontal ligament space could not be clearly identified except for the distal side of the distal root. We considered that the area of the tooth was partially ankylosed and consulted with oral surgeons, who decided to postpone extraction, due to the presence of the permanent successor close to the affected tooth. Thus, we treated the dental caries, which appeared to be technically difficult because of the deep location of the tooth. The Isolite system was utilized in this case, as we considered that adjacent soft tissue and saliva could be excluded with its use. Under infiltration anesthesia, gingival tissue covering the occlusal surface was removed with an electric knife, and the carious lesion was removed, which resulted in pulp exposure. Severe inflammation of the pulp was revealed and pulpectomy was performed. There were no signs and symptoms after the treatment. At 1 year after treatment, the occlusal surface remained exposed and no inflammatory findings were observed in adjacent gingival tissue.     

乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察

目的乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察。方法 2013年7月至2015年12月于本院就医的乳磨牙龋的患儿78例,所有患儿均通过入院前确诊,满足乳磨牙龋诊断标准,然后按照随机数字表法分为观察组与对照组,各组均为39例,其中观察组采用预成冠方法进行修复,而对照组以复合树脂进行修复,两组患儿均为同一位医生完成治疗,统计各组的总体治疗成功率。结果本研究半年内两组患儿随访临床治疗评估(每月1次)显示,观察组患儿在治疗后3个月、6个月的总有效率分别为97.43%、94.87%,均高于对照组的89.74%、84.61%,以上组间差异显著,具有统计学意义(P0.05);对于乳牙功能的行使保存,预成冠成功率要远远高于树脂修复成功率,预成冠保存乳牙继续行使咀嚼功能疗效较树脂修复显著,以上两组的组间数据对比存在明显差异,具有统计学意义(P0.05)。结论对于乳磨牙龋修复而言,运用预成冠修复方法无论在成功率、咀嚼功能疗效均高于树脂修复效果,具有临床推广意义。     

中西部地区儿童口腔疾病综合干预项目预防儿童龋病的2年效果评价

目的:探讨以口腔健康教育和窝沟封闭为主要内容的中西部地区儿童口腔疾病综合干预项目对二年级小学生龋病的预防作用。方法:随机选取襄阳市樊城区5所小学二年级学生共546人,记录(第一次检查)所有学生口腔保健知识知晓分数、是否正确刷牙和第一磨牙的龋坏情况。随机选择2所学校(学生222人)为对照组,对照组学生不作任何干预。另3所学校(学生324人)为干预组,干预组所有学生首先接受口腔健康教育,然后对其中238名学生(窝沟组)进行第一磨牙窝沟封闭,剩余86人(教育组)未进行窝沟封闭。两年后,对选取的546名学生进行第二次检查。结果:第一次检查保健知识知晓分数、正确刷牙率和第一磨牙龋均,对照组、教育组和窝沟组两两比较均无明显统计学差异。第二次检查中,干预组的保健知识知晓分数、正确刷牙率均明显高于对照组(P0.01);教育组和对照组的第一磨牙龋均无明显统计学差异(P0.05);窝沟组的第一磨牙龋均明显低于对照组。结论:中西部地区儿童口腔疾病综合干预项目可显著减少龋病的发生,从而预防儿童龋病。     

Ionic liquid as antibacterial agent for an experimental orthodontic adhesive

ObjectiveThe aim of this study was to formulate and evaluate experimental orthodontic adhesives with different concentrations of 1-n-butyl-3-methylimidazoilium bis(trifluoromethanesulfonyl)imide (BMIM.NTf₂).MethodsThe experimental orthodontic adhesives were formulated with methacrylate monomers, photoinitiators and silica colloidal. The ionic liquid BMIM.NTf₂ was synthesized and characterized. BMIM.NTf₂ was added at 5 (G_5%), 10 (G_10%) and 15 (G_15%) wt.%. One group contained no BMIM.NTf₂ to function as control (G_Ctrl). The adhesives were evaluated for polymerization kinetics, degree of conversion (DC), Knoop hardness and softening in solvent, ultimate tensile strength (UTS), shear bond strength (SBS), thermogravimetric analysis (TGA), antibacterial activity and cytotoxicity.ResultsBMI.NTf₂ showed the characteristic chemical peaks. The polymerization kinetics were different among the groups. G_10% and G_15% showed higher DC (p < 0.05). G_5% and G_Ctrl had no differences for softening in solvent (p > 0.05). There were no differences for UTS (p > 0.05) and SBS (p > 0.05). TGA showed one different peak for G_15%. All groups with BMIM.NTf₂ showed antibacterial activity compared to G_Ctrl (p < 0.05) without cytotoxicity (p > 0.05).SignificanceTo reduce biofilm formation around brackets and to prevent demineralization at susceptible sites, materials have been developed with antibacterial properties. In this study, a new experimental orthodontic adhesive was formulated with an imidazolium ionic liquid (BMIM.NTf₂) as antibacterial agent. The incorporation of 5 wt.% of ionic liquid decreased biofilm formation without affecting the physico-chemical properties and cytotoxicity of an experimental orthodontic resin.