AIM:This pilot study aimed to describe the implementation of a school-based peer-led oral health education program in primary school children and to explore its feasibility and preliminary educational outcomes. The program was implemented in an international primary school and involved third- and fourth-grade students aged 7-9 years. After parental informed consent was obtained, baseline assessments were performed using questionnaires investigating oral health knowledge, oral hygiene habits, dietary behaviors, and previous dental experiences. Plaque-disclosing tablets were also used as a visual awareness tool. Fourth-grade students received a 3-hour training session delivered by a dental hygienist and subsequently conducted peer-led educational activities for third-grade students through five interactive learning stations. Follow-up assessments were carried out approximately 2 weeks and 5 months after the intervention. All educational materials were independently produced and designed to be easily reproducible in school settings. At the 5-month follow-up, most participants showed an improvement in oral health knowledge compared with baseline. Overall, 87.5% of children improved their knowledge scores, 75% reported improvements in oral hygiene and dietary habits, and 59.4% showed improvement in a derived home oral hygiene score based on questionnaire responses. In addition, the proportion of children reporting no gingival bleeding increased compared with baseline. Although limited by the small sample size, the single-school setting, the lack of a control group, and the reliance on questionnaire-based outcomes, this pilot study suggests that a peer-led school-based oral health program is feasible and may support improvements in children's oral health knowledge and self-reported habits. Larger controlled studies are needed to evaluate effectiveness and long-term sustainability.
AIM:To synthesise evidence from existing systematic reviews on the clinical effectiveness of SDF for the prevention and arrest of dental caries in primary teeth. METHODS:This umbrella review was conducted in accordance with PRISMA 2020 guidelines. Systematic reviews (SRs), with or without meta-analyses, involving paediatric populations treated with SDF were retrieved from five databases (PubMed, EMBASE, Web of Science, CENTRAL, LILCAS) up to January 2025. Methodological quality was assessed using the AMSTAR 2 tool. CONCLUSION:The biannual use of 38% SDF remains the most evidence-supported, non-invasive intervention for arresting caries in primary dentition. Further high-quality randomised trials are required to confirm long-term outcomes and support clinical guideline development.
For decades, the scientific community has produced guidelines, consensus statements, and shared recommendations. The literature on the prevention of early childhood caries is extensive, robust, and consistent. Yet epidemiological data have not improved in proportion to the effort invested. Early childhood caries remains one of the most prevalent chronic diseases worldwide. Evidently, a substantial gap persists between knowledge and practice. The issue does not lie in the quality of the evidence. Rather, it lies in the assumption, too often implicit, that dissemination alone is sufficient to translate evidence into action. We have produced rigorous and well-argued documents, assuming that their intrinsic strength would be enough to modify behaviours. It is not. Between recommendations and everyday practice lies a divide that no consensus statement, in isolation, can bridge. A shift in perspective is therefore required. Not less research, but different research: fewer studies on what is already known to be effective, and greater focus on how to make such interventions genuinely adoptable in vulnerable contexts-among families with limited time and difficult access, within the constraints of brief paediatric consultations, and in healthcare systems operating under pressure and with limited resources. Evidence-based medicine has taught us to ask whether an intervention is effective; today, we must add an equally critical question: how can we ensure its actual implementation? Alongside evidence of efficacy, we therefore need evidence-based implementation, capable of identifying the conditions, organisational frameworks, and engagement strategies that render interventions feasible in routine practice. Implementation science is not a secondary discipline; it is the missing one. Idealism without pragmatism produces literature. Pragmatism guided by ideals produces health. Paediatric prevention requires the latter, and the scientific community, if it is to remain true to its mission, cannot afford to overlook it. Knowledge without change is insufficient; it is merely nostalgia.
METHODS:A narrative review of the literature was performed focusing on the structural, neuromuscular, and neurophysiological components of the orofacial region. Evidence regarding cranial nerve involvement, sensorimotor integration, autonomic regulation, respiratory influences, and functional activities such as breathing, swallowing, mastication, and parafunctional behaviors was analyzed to explore the biological rationale for integrated therapeutic approaches. CONCLUSION:Recognising the bidirectional relationship between structure and function within a neuroplastic framework supports a multidisciplinary therapeutic model involving orthodontists and myofunctional therapists. The integration of mechanical correction with neuromotor re-education may enhance functional rehabilitation, optimise treatment stability, and contribute to overall patient health and systemic well-being.
AIM:The intercuspal position of deciduous dentition was investigated. METHODS:A total of 389 patients aged 4.5 to 5.5 years were evaluated and among them, 30 were selected according to the inclusion criteria with clinically normal dental occlusion. Using clinical and photographic analyses of dental contacts, a tracing of both the inferior and superior arches of the deciduous dental anatomy (occlusogram) and the coincidental occlusal points was achieved. CONCLUSION:Observations also showed that the contact between the second molars exhibits morphofunctional anchorage in the mesiodistal direction.
AIM:To evaluate the survival rate and clinical status of a glass ionomer (GI) sealant in hypomineralised permanent first molars (PFMs), as well as to assess the occurrence of post-eruptive breakdown (PEB) and measure dentin hypersensitivity in the sealed molars over a 12-month follow-up period. METHODS:Fifty-two hypomineralised PFMs, with at least two-thirds of their crown erupted, exhibiting opacities on the occlusal surface, no caries or PEB, were sealed using a GI sealant (GC Fuji Triage®). Clinical evaluation was performed using the United States Public Health Service (USPHS) criteria. PEB was clinically diagnosed. In-office dentin hypersensitivity to thermal stimuli (air spray) was measured using the Wong-Baker Faces Pain Rating Scale (WBFPRS); at-home hypersensitivity to thermal (eating/drinking cold foods/beverages) and mechanical (brushing) stimuli was assessed by interviewing the patients. PFMs were evaluated at baseline, immediately after treatment and at 3-, 6-, and 12-month follow-ups. CONCLUSION:Fully retained GI sealants were effective in preventing secondary caries and reducing dentin hypersensitivity in hypomineralised PFMs; however, they did not prevent PEB.
AIM:The present study describes the therapeutic options for first permanent molars with hypomineralisation among Mexican dentists. METHODS:We used a cross-sectional design in which we surveyed Mexican dentists through an electronic questionnaire. The questionnaire consisted of 20 questions, divided into two sections. The first section collected demographic data. The second section consisted of eight questions and focused on presenting a clinical MIH case documented with photographs and radiograph. CONCLUSION:Despite the high incidence of MIH in Mexico, the surveyed dentists showed deficiencies in terms of the knowledge that should accompany clinical competence for the treatment of molars with MIH.
AIM:The study aims to determine the Early Childhood Caries (ECC) prevalence in the Olomouc region, Czech Republic, and to evaluate the associated risk factors in a group of children aged up to six years. METHODS:A cross-sectional epidemiological study on ECC prevalence and risk factors was conducted in the Olomouc region, Czech Republic, from January to December 2024. The cohort involved 104 children aged up to six years who received a dental examination in their kindergartens, following parental written informed consent and a questionnaire completion. ECC prevalence was assessed, and risk factors were identified after data processing and analysis. CONCLUSION:Despite existing preventive measures, ECC prevalence remains high, indicating the need for more targeted prevention addressing the main risk factors, such as consumption of sweet and sour beverages, and lower family income in families. Conversely, oral hygiene from the eruption of the first tooth, positively related to the prevalence of ECC, should be promoted.
AIM:To identify and analyse the 100 most-cited articles published in paediatric dentistry journals, providing an updated bibliometric overview of the field and comparing findings with previous analysis. METHODS:The Web of Science database was searched up to January 2026 to identify the most-cited papers published in paediatric dentistry journals. The top 100 articles were selected and analysed for citation count, publication year, source journal, geographic distribution, authorship, study design, and thematic area. Co-occurrence network analysis was performed using VOSviewer. CONCLUSION:Compared with the 2019 analysis, citation thresholds have risen substantially, systematic reviews have replaced cross-sectional studies as the dominant design, MIH has emerged as a leading research theme, and geographic disparities in citation accumulation persist and warrant attention.
Bibliometrics is not an exercise in academic vanity, but a diagnostic tool: it measures not only how much we produce, but what we choose to study - and what we leave behind. Over the past two decades, scientific output in paediatric dentistry has grown exponentially. More articles, greater visibility, broader internationalisation. Yet a higher volume of publications does not automatically translate into improved clinical decision-making. Bibliometric analyses reveal a polarised discipline: cariology and orofacial development predominate, whilst emerging topics such as molar-incisor hypomineralisation (MIH) are steadily gaining ground. This is a predictable, yet telling distribution: what is common tends to be studied; what is complex tends to be avoided. The critical issue, however, is methodological. Amongst the most highly cited works, reviews - both systematic and narrative - vastly outnumber randomised clinical trials (RCTs), which remain marginal and are frequently methodologically weak. Even when present, RCTs demonstrate notable limitations, with reporting quality that remains insufficient. The outcome is a paradox: increasingly sophisticated syntheses constructed upon limited primary data. Meta-analyses cite meta-analyses; clinical guidelines are based on reviews of reviews. The evidence pyramid thus risks resting on fragile foundations, yielding descriptive rather than decisional evidence. This is not a matter of quantity, but of direction. Without a determined investment in robust primary studies, growth risks becoming self-referential. The literature continues to describe problems far more readily than it tests solutions. A further concern relates to representativeness: research today is concentrated in a limited number of countries, yet it is widely acknowledged that children's oral health is profoundly influenced by local contexts. A truly mature discipline must therefore critically appraise how inclusive its knowledge base is, and whether it adequately represents diverse realities. Bibliometrics thus offers a clear picture: paediatric dentistry is productive, yet still limited in its capacity to generate decisive evidence. The challenge is not to publish more, but to produce better. What is needed is not further reviews of weak data, but sufficiently robust primary data to render fewer reviews necessary. In this context, scientific journals play a pivotal role. Editorial choices shape the direction of research: prioritising methodologically sound studies - even those that may be less readily 'citable' - means directly influencing the future quality of evidence. For editors, reviewers, and authors alike, the responsibility is tangible: to shift the emphasis towards studies capable of genuinely guiding clinical practice. Because the true indicator of a discipline's maturity is not what it publishes, but what it is able to demonstrate - and to change.
This letter to editor would emphasise the position about topic fluoride into a choorte of children between 0-6 years of age after media messages, personal conviction by social media appeared in the last year about adverse fluoride effects in the topical application. After the preview letter to editor about the negative effects of water added with fluoride when had been highlighted that the hypothetical harmful effect of fluoride on intellectual quotient IQ of children is mainly an USA question because in Europe water is not fluoridated except for little areas of european's countries. Topic fluoride is safe and is a most strategy to carious lesion development if used in the correct modalities. No adverse effect of topic fluoride is possible to adress for yuong adult (> 18 yo) and 6 years old children. In that situation is suggest from paediatric scientific academy and ministerial guide lines to use the maximun concentration of fluoride permitted from European law and World Health Organisation WHO indications into toothpaste and mouthrinse (1500 ppm) for at home for oral hygiene. For children of age lower than 6 years old attention must be payed also for topic fluoride because an excess and not precise measurement of plasmatic fluoride may expose the children to dental fluorosis disease. In particullary the age from 0-2 years old is the most critically because during this stage some of the most important permanent teeth such first molars and incisor perform the mineralisation of protein matrix secreted by ameloblast during amelogenisis. Dose (rise o pea size) and toothpaste fluoride concentration (1000 ppm) are suggested from European Accademy of Paediatric Dentistry EAPD into a policy document and is highligted supervison of parents during at home children oral hygiene to avoid accidental ingestion of toothpate [Toumba et al., 2019]. Parents, Dentist and Paediatric must be pay attention about fluoride concentration of human use potable water and water to prepare the children food whilst there's not information about fluoride concentration into the child food. We just know that fish, tea and potatos peel are rich in fluoride. Avoid the final water rinse after toothbrush with fluoride toothpate is favourable as UK's National Health Service suggest to extend the contact time between fluoride and the dental enamel in order to form Fluoroapatite F-Ap more acid resistent than Hydroxiapatite HAp. We are talking about split the excess of foam at the end of toothbrushing and is very unlikely that this procedures could increase the fluoride concentration in the children lower 6 years old and expose those to dental fluorosis risk [Parakaw et al., 2024].
BACKGROUND:Bony inclusion of permanent teeth refers to the failure of a tooth to erupt within the expected timeframe, commonly affecting upper and lower canines. The etiology remains debated, with genetic factors and eruption guidance disturbances being the primary hypotheses. CASE REPORT:This case report describes the management of a 13.6-year-old male patient presenting with impacted upper and lower canines (1.3, 2.3, 3.3) and transmigration of tooth 3.3. The patient exhibited a Class I malocclusion, midline deviations, and significant dento-dental discrepancies, mainly due to conoid lateral incisors. The treatment plan included orthodontic treatment to create adequate space, followed by autotransplantation of teeth 2.3 and 3.3. The autotransplantation procedure involved atraumatic extraction, careful preparation of the recipient site, and minimal extra-alveolar time to preserve periodontal ligament vitality. After 18 months of treatment, the patient achieved a stable Class I occlusion, with optimal positioning of the impacted canines, improved smile aesthetics, and centered midlines. However, root resorption was observed in tooth 3.3, requiring endodontic treatment. Despite this complication, the overall result was functionally and aesthetically successful. CONCLUSION:This case highlights the effectiveness of dental autotransplantation as a viable therapeutic option for impacted canines in growing patients, providing both functional and aesthetic benefits.
AIM:To investigate emotion recognition abilities in paediatric patients affected by obstructive sleep apnea syndrome (OSAS) and explore related neurocognitive alterations. METHODS:Fifty children aged 6-11 years diagnosed with OSAS and 50 matched controls underwent polysomnography, emotion recognition testing (TEC), and physical activity monitoring. Neurocognitive assessments included analysis of brain morphology, EEG activity, and metabolic markers from previous literature. CONCLUSION:OSAS in children negatively impacts emotion recognition and neurocognitive functions due to brain structural and functional alterations. These findings support the need for early diagnosis and treatment to mitigate cognitive and emotional deficits associated with paediatric OSAS.
AIM:This study aimed to analyse the three-dimensional craniofacial and pharyngeal airway morphology in paediatric patients with 22q11.2 deletion syndrome (22q11.2DS) using cone-beam computed tomography (CBCT) and to evaluate its correlations with velopharyngeal dysfunction (VPD). METHODS:Twenty-eight Spanish children aged 6-17 years were included: 14 with genetically confirmed 22q11.2DS and 14 non-syndromic controls. CBCT was used to obtain linear, angular, and volumetric measurements of the airway. VPD was assessed through oral and nasal examination, flexible nasopharyngoscopy, and perceptual speech evaluation. CONCLUSION:VPD was associated with airway narrowing and cranial base angulation. These findings highlight the utility of CBCT for 3D craniofacial and airway assessment in paediatric patients with 22q11.2DS.
AIM:To evaluate the clinical efficacy of 38% Silver Diamine Fluoride (SDF) in arresting dental caries in paediatric patients in comparison to Atraumatic Restorative Treatment (ART) or placebo. MATERIALS:This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (ID: 596949). A thorough search of PubMed, Scopus, and Cochrane databases was conducted, retrieving 1366 studies. Duplicates were removed, yielding 892 unique records. Screening by title and abstract reduced this number to 96 studies, and after full-text review, 6 RCTS met the inclusion criteria. Data extraction and risk of bias assessment were performed using the Cochrane Risk of Bias Tool. Meta-analysis was conducted using Review Manager (RevMan) software 8.7.0, applying a random-effects model to account for variability across studies, and a sensitivity analysis was performed. CONCLUSION:38% SDF is an effective intervention for halting dental caries in paediatric patients, slightly outperforming ART. Both interventions may be considered for paediatric patients. Further standardised research with extended follow-up is needed.
AIM:To evaluate the effect of preoperative ibuprofen on intraoperative pain and stress responses during vital pulp therapy (VPT), a minimally invasive treatment aimed at preserving pulp vitality, in children with reversible pulpitis. METHODS:Forty-four children aged 7-13 years with reversible pulpitis in mandibular first permanent molars were randomly assigned to either the intervention group (10 mg/kg ibuprofen 40 minutes before treatment, n = 22) or the control group (no premedication, n = 22). Pain was assessed intraoperatively using the Visual Analogue Scale (VAS) and pulse rate monitoring. Postoperative VAS scores were recorded on days 1, 3, and 7. Ethical approval was obtained (Approval No: 2024-KAEK-08; 25.12.2024), and the study was registered at ClinicalTrials.gov (NCT07114198). CONCLUSION:Preoperative administration of ibuprofen significantly reduces intraoperative pain and stress responses during VPT in children, improving comfort and cooperation, and may serve as a simple and clinically applicable adjunct in routine paediatric dental practice.
Aim X-linked hypophosphatemia (XLH) is a rare genetic disorder that causes skeletal deformities, growth retardation and oral complications, being dental abscesses the most frequent reported problem. Patient management is often poor due to a lack of care pathways, particularly in pediatric settings, and this highlights the need for updated clinical protocols. This study emphasises the importance of the role of pediatric dentists in the early recognition of XLH and in the multidisciplinary management of these patients, including early diagnosis, personalised therapies, and prevention to improve oral health and overall well-being. Methods A comprehensive search was conducted to identify studies focused on dental aspects in XLH pediatric patients published from 2020 and 2024. Databases such as the Cochrane Library and MEDLINE via PubMed databases were searched using terms and MeSH terms including X-linked hypophosphatemia, X-linked hypophosphatemic rickets, XLH, teeth, dental, child, oral health, and oral health-related quality of life. Only English-language articles were included. Results A total of 135 articles were initially retrieved. After reviewing the titles and abstracts, sixty-four articles were selected for full-text evaluation to understand the issues related to dental involvement, the occurrence of abscesses, alterations in dental hard tissues, and the potential oral effects of systemic therapies. Ten articles involving studies on mice were excluded, as well as forty-two articles focusing on the systemic aspects of the condition without mentioning dental involvement. Additionally, eight articles on adult patients and eleven articles related to other forms of rickets were also excluded. Conclusions In the end the complexity and rarity of XLH often results in diagnostic delays, compromising either dental or general treatment. For these reasons, the need for early diagnosis and integrated care is evident; development of specific guidelines to improve outcomes and oral health-related quality of life in growing patients is strongly required.and nutritional disorders. The study emphasises the importance of including a dental evaluation in the follow-up of premature infants from the first months of life.
AIM:This study aims to compare the effectiveness of a chlorhexidine (2%) and xylitol (5%) varnish (VCX) versus a silver diamine fluoride (SDF) solution (30%) in controlling initial dental caries lesions in young children. METHODS:A randomised clinical trial was conducted with children aged 5 and 6 from public schools in Jequié, Bahia. Participants were randomly assigned to three groups: one treated with VCX, another with SDF, and a control group that received no intervention. Carious lesions were classified using ICDAS-II criteria, and interventions were applied following standardised clinical protocols. Blinding was applied to participants, though not to researchers due to physical differences in treatment materials. CONCLUSION:Both VCX and SDF were effective in reducing initial dental caries lesions, with SDF showing superior efficacy. However, VCX may serve as a viable alternative for patients concerned with aesthetics, though further studies are required to confirm its long-term effectiveness and optimise treatment protocols.
BACKGROUND:Tooth size-arch length deficiencies (TSALD) malocclusions can be treated either with or without extractions in growing patients. The extraction treatments are usually recommended in severe crowding and involve the serial extractions (SEs) or the enucleation (EE) therapies. The aim of the present retrospective study was to compare the skeletal and dental effects of serial extraction and enucleation treatments in subjects with severe crowding in mixed dentition phase. METHODS:Lateral cephalograms from patients who underwent orthodontic treatment involving serial extractions (SE group) or enucleations (EE group) were analysed. The matched control group (CG group) consisted of untreated subjects derived from the American Association of Orthodontists foundation (AAOF) Craniofacial Growth Legacy Collection Project. The initial lateral cephalograms were taken before the eruption of all the second molars (T0) and the second lateral cephalograms were taken after the completion of the extractions (T1). The primary outcome was the change of the vertical skeletal dimension evaluated using the SN to mandibular plane angle (SN-GoGn) angle from T0 to T1. CONCLUSION:Based on this longitudinal cephalometric analysis, significant reduction of SN-GoGn (about 2.3°), MMPA, and gonial angle were detected only in patients who underwent serial extractions, whereas no significant variations were detected in enucleation and control groups. IMPA, L1-Apo, and UIMx measurements did not significantly change at follow-up in all three groups, thus a lingual tipping of the incisor was not detected in both serial extraction and enucleation groups.
BACKGROUND:Rickets is a medical condition caused by vitamin D deficiency, typically caused by inadequate dietary intake, limited sun exposure, or, less commonly, genetic disorders. While skeletal abnormalities are the hallmark of rickets in children, oral manifestations, such as recurrent dental abscesses occurring in the absence of carious lesions, can also be observed. This report describes the case of a child presenting with oral features suggestive of hereditary rickets, despite the lack of skeletal abnormalities and without a confirmed genetic aetiology. Histological and microstructural analyses of dental tissues played a key role in guiding the diagnosis, ultimately leading to referral to a paediatrician and confirmation of vitamin D deficiency. CASE REPORT:A 4-year-old male presented to the Emergency Dental Department of a paediatric clinic with a history of spontaneous dental abscesses. Three affected primary teeth, extracted for clinical reasons, were comprehensively analysed using micro-computed tomography, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and optical microscopy. Investigations revealed an enlarged pulp chamber, pulpal calcifications, extensive interglobular dentine, and porous, hypomineralised enamel. Additionally, an irregular and poorly defined dentino-enamel junction was observed, along with abrupt spatial variations in mineral composition. The findings are consistent with defective biomineralisation. Subsequent biochemical testing confirmed vitamin D deficiency in the absence of a detectable genetic cause. The patient was supplemented with vitamin D and calcium, resulting in clinical improvement. CONCLUSION:Vitamin D deficiency profoundly impairs the development and mineralisation of dental hard tissues, including both enamel and dentine. These alterations compromise the structural integrity of teeth and may increase the risk of spontaneous dental abscesses. Early identification of such oral manifestations is critical for prompt diagnosis and appropriate management.
