ASDC journal of dentistry for children

PURPOSE Little information is available on malpractice related to dentistry for children. The purpose of this report was to examine characteristics of malpractice allegations related to dentistry for children from the National Practitioner Databank (NPDB) from February 1, 2004 to November 22, 2006. METHODS The public use file of the NPDB was obtained and transformed into a searchable database and allegations involving children were sorted and characterized by payment size, reason, practitioner type, and location. RESULTS During the roughly 34-month study period, 571,172 total cases were evaluated. 51,691 (9%) of these involved dentists; 367 reports were identified using age-based variable reporting. The majority of cases (275; 75%) involved 10- to 19-year-old children and 92 (25%) of the cases involved 0- to 9-year-old children. One case was an infant younger than one year old. No cases were found with the provider citation of dental resident. The geographic distribution of cases was consistent with relation to practitioner (dentist) density and mean age. CONCLUSION The allegation of malpractice related to dentistry for children is a very small portion of both dental and general health malpractice in the United States.

Sarat Thikkurissy

Paul S Casamassimo

Journal of dentistry for children

Should fear of malpractice dissuade dentists from caring for children

应否因害怕医疗事故而劝阻牙医照顾儿童

PURPOSE This study's purpose was to report on parents' esthetic perceptions of their children's mixed dentition and parental satisfaction changes over time. METHODS A total of 376 parents completed esthetic questionnaires concerning satisfaction with their children's teeth at 9- and 11-years-old. Changes in esthetic perceptions were compared based on fluorosis, nonfluoride opacity status (evaluated at 9-years-old), and other factors. RESULTS A total of 36% had definitive fluorosis on permanent maxillary incisors. Fluorosis (P=.003) and opacity (P=.02) status were significantly related to reduced likelihood of parental satisfaction at 11-years-old. Parents were less satisfied with overall tooth color at 11 vs 9-years-old (P=.045), but revealed no significant change in satisfaction with overall appearance (P=.17). Shape and color concerns increased (both P=.003), while spacing concerns decreased (P=.004). Parental satisfaction increases were associated with higher socioeconomic status (P=.03) and starting orthodontic treatment (P=.002), but changes were not significantly associated with fluorosis (P=.38) or opacities (P=.81). CONCLUSIONS Parents were generally less satisfied with overall tooth color at 11 (vs 9) years old and had greater concerns about tooth shape and color, but fewer concerns with spacing. Improvement in parental satisfaction with overall appearance was related to higher socioeconomic status and having begun orthodontic treatment.

Hyrum M Cannon

Barbara Broffitt

Steven M Levy

John J Warren

Longitudinal changes in parental satisfaction: mixed dentition esthetics.

家长满意度纵向变化：混合牙列美学。

Children who qualify for Medicaid are entitled to comprehensive oral health coverage through the federally mandated Early Periodic Screening, Diagnostic, and Treatment program. According to an analysis by the Kaiser Commission on Medicaid and the Uninsured, 43% of low-income children on Medicaid or Children’s Health Insurance Program (CHIP) have had a dental visit within the past year vs 34% of those uninsured and 40% with insurance.1 Nevertheless, disparities in oral health remain among poor, middle, and higher-income familes2 and dental health among preschoolers is worsening.3 The focus of much effort is now on the youngest children, whose utilization of preventive care is especially low.4

To address the underutilization of Medicaid dental services by the very young, the Washington State Access to Baby and Child Dentistry (ABCD) program was developed in 1995.5 The program has been deemed successful and has expanded to 37 of the 39 counties in Washington State. This program consists of 4 components: (1) outreach to parents and families; (2) training and certification of dentists; (3) enhanced dental benefits; and (4) enhanced dental fees.

Initial evaluation of the Spokane, Wash., ABCD program found that only 54% of children visiting the dentist received a fluoride treatment.6 One reason for underutilization of fluoride treatment for children is attributable to the lack of parental knowledge about this benefit. A focus group study indicated that many caregivers were not aware of their coverage.7 An American Dental Association-sponsored symposium also recently highlighted parent education as important.8 In medicine, lack of parental knowledge about immunization schedules has been found to contribute to mothers not taking their children for immunization.9

In June 1999, Yakima County, Wash., began its own version of the ABCD program, entitled “Mom and Me.” 10 The Yakima version of the program differs from prior versions in that primary responsibility for the outreach component of the program rests with the local dental society rather than with the local health department. An outreach manager accepts referrals from various organizations in the community and visits homes to provide family oral health instruction and acts as a liaison between the family and the dentist. In 2001, 51% of the 4,705 0-to 6-year-olds who were enrolled in the Mom and Me program had had at least 1 dental visit.10 In 2009, Yakima County’s dental Medicaid utilization rate for children 5 years of age and younger was the highest in the state at 58%.11 Even so, 42% of this population was still not receiving any dental care that year.

A recent review of parent reminder and patient recall systems showed that reminders increased vaccination rates among children by 1.45 to 2.87 times.12 All types of reminders, including postcards, letters, telephone, and auto dialer, were effective. Moreover, postcards with a health message have been found to be more effective in promoting the use of prevention compared to a neutrally worded postcard reminder.12,13 Patient-directed postcards in conjunction with physician reminders are more effective than physician reminders alone.14

Postcard reminders are often used in dental practices for 6-month recalls, and their positive effect on attendance behavior has been documented.15,16 This study evaluated the effect of postcards with information about the dental society-run program in Yakima on utilization of dental care by young children enrolled in Medicaid.

Asia Dela Cruz

Gregory Mueller

Peter Milgrom

Susan E Coldwell

A community-based randomized trial of postcard mailings to increase dental utilization among low-income children.

基于社区的随机试验：明信片邮寄对低收入儿童牙科利用率的影响。

Purpose
We assessed the efficacy of supervised toothbrushing with xylitol toothpaste to prevent early childhood caries (ECC) and to reduce mutans streptococci (MS).

Donald L. Chi

Ohnmar K. Tut

Cluster-randomized xylitol toothpaste trial for early childhood caries prevention.

集群随机化木糖醇牙膏试验用于预防幼儿龋齿。

Abstract For the last 70 years, the phenomenon of pre-eruptive intracoronal resorption (PIR) has been described in the literature, including a number of case reports illustrating the challenges clinicians face in diagnosing and managing these resorptive defects. Pre-eruptively affected teeth can be difficult to access and posteruptively they are difficult to diagnose because the defects resemble caries. Many times, these defects are not detected until after eruption, when the majority are diagnosed as dental decay and teeth are often subjected to surgical tooth restoration. The purposes of this paper are to report a case of nonprogressive PIR that was detected early, treated with a preventive glass ionomer sealant, and monitored for 44 months, and to propose an alternative approach to management of nonprogressive defects that may help preserve tooth structure.

Gail Czarnecki

Melissa Morrow

Mathilde Peters

Jan Hu

Pre-eruptive intracoronal resorption of a permanent first molar

恒牙第一磨牙爆发前牙内吸收

Purpose: Dental development is delayed in individuals born with oral clefts. The purpose of this study was to determine: (1) the proportion of individuals with severe delays in dental maturation; and (2) if there are different patterns of dental development timing, taking into consideration the chronological age of the individual. Methods: Dental maturation was estimated by the Demirjian method in children aged seven to 12 years with and without clefts. The differences between dental age and chronological age between groups were compared using the Mann-Whitney test, with an alpha of 0.05. A subset of 50 individuals in each group had at least two panoramic radiographs at least two years apart. These were analyzed to determine dental maturation trajectories in comparison with chronological age to identify individuals with different patterns of development. Results: The sample consisted of 201 children with oral clefts and 201 without clefts. Individuals born with clefts had, on average, two months of delay in dental maturation compared to those without a cleft. Five patterns of differences were identified between dental and chronological age. These distributions were statistically significant statistically (P Conclusion: Children born with cleft lip and palate have delayed tooth maturation and a high frequency of greater delays in tooth maturation over time compared to individuals born without clefts.

Divanildo Dantas Júnior

Rosa Helena Wanderley Lacerda

Alexandre Rezende Vieira

Distinct Patterns of Dental Age and Chronological Age: Longitudinal Evaluation of Individuals Born with or without Oral Clefts.

牙齿年龄与实际年龄的不同模式：对出生时有无口腔裂隙的个体进行纵向评估。

Severe dental trauma can often result in tooth loss at an early age. Orthodontic space closure and reshaping of the teeth are a conservative treatment approach. The purpose of this paper is to present a fast and predictable way to reshape teeth using the composite resin injection technique. A 10-year-old female presented for orthodontic treatment with a Class II malocclusion, lateral open bite and loss of the permanent maxillary left central incisor due to trauma. The treatment plan involved mesialization of the maxillary left teeth and reshaping of the maxillary left canine and lateral incisor to the shape of the lateral and the central incisor, respectively. At the end of the orthodontic treatment, an impression was made and a transparent silicone index was fabricated based on the diagnostic wax-up. Through the index, flow composite resin was injected at the site to form the direct composite resin restorations.

Georgios Maroulakos

Michael P Maroulakos

Efthymia Tsoukala

Matina V Angelopoulou

Dental Reshaping Using the Composite Resin Injection Technique After Dental Trauma and Orthodontic Treatment.

牙外伤及正畸治疗后采用复合树脂注射技术进行牙体成形术。

Aggressive periodontitis is a disease that causes severe destruction of periodontal tissues, showing early development and rapid progression in both primary and permanent dentitions. Due to familial aggregation, children of parents with periodontitis are considered to be at higher risk for disease occurrence, which suggests that they should be evaluated and monitored as early as possible. The purpose of this case report is to describe aspects related to early diagnosis of periodontitis in two children and their relationship with the parent's periodontal condition, exploring the familial component as a crucial factor that can lead to an early diagnosis and better clinical management in their offspring.

Aurelio Amorim Reis

Hélvis Enri de Sousa Paz

Mabelle de Freitas Monteiro

Marcio Zaffalon Casati

Carolina Steiner-Oliveira

Fernanda Miori Pascon

Renato Corrêa Viana Casarin

Early Manifestation of Periodontal Disease in Children and Its Association with Familial Aggregation.

儿童早期牙周病的显现及其与家族聚集性的关联。

Purpose: To evaluate and compare the clinical and radiographic performance of a new type of mineral trioxide aggregate (MTA, NuSmile® NeoMTA®) and ferric sulfate (FS) as pulpotomy medicaments for primary molars over 12 months. Methods: Fifty participants (25 per group) were enrolled, according to specific inclusion criteria. Each participant received a single primary molar pulpotomy either with MTA or FS, depending on random digit table method allocation. Fifteen pediatric dental residents completed all pulpotomies, supervised by specialist faculty. Two calibrated examiners performed outcome assessments according to standardized criteria. Every six months, the study teeth were evaluated clinically and every 12 months radiographically. The inter- and intraexaminer reliability was assessed using Cohen's kappa, and the chi-square test was used for statistical analysis. Results: At six months, 42 participants (21 in each group) returned for evaluation. The FS group showed 95.2 percent clinical success compared to 100 percent for the MTA group. At the 12-month clinical and radiographic evaluation, the return sample consisted of 29 participants (14 in the MTA group, 15 in the FS group). FS had 86.6 percent clinical success and 60 percent radiographic success, while MTA showed 100 percent clinical and radiographic success. At 12 months, MTA showed a statistically significantly higher success rate compared to FS (P = 0.008). Examiner reliability was excellent with a kappa score greater than 0.88. Conclusion: At 12 months, MTA showed superior success as a pulpotomy medicament in primary molars compared to FS.

Samantha Cordell

Evelina Kratunova

Ian Marion

Sahar Alrayyes

Satish B Alapati

A Randomized Controlled Trial Comparing the Success of Mineral Trioxide Aggregate and Ferric Sulfate as Pulpotomy Medicaments for Primary Molars.

一项比较矿物三氧化物聚集体和硫酸铁作为乳牙活髓切断术药物成功率的随机对照试验。

A myofibroma is a relatively rare neoplasm characterized by its spindle cell proliferation. This lesion can present as a unifocal mass (myofibroma) or multifocal growths (myofibromatosis) in the skin, soft tissue, bone, or internal organs. In the oral cavity, the tumor is commonly identified on the tongue, mucosa, lips, and mandible. Myofibroma classically occurs in infants and young children. Its fast-growing nature often mimics a sarcoma; however, it is a benign tumor. The purpose of this article is to report the case of an eight-year-old boy who presented with a localized, painless, nodular mass in the palate and gingiva. Through clinical, radiological, and immunohistochemical evaluation, the diagnosis of an atypical myofibroblastic tumor was made after resection of the mass. With interprofessional team management, the patient's quality of life was improved.

出版信息	出版商: American Society of Dentistry for Children，出版周期: ，期刊类型: journal，开源期刊: 否
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