Purpose: To evaluate the prevalence of teething problems throughout the period of primary tooth eruption. Methods: This birth cohort study was conducted in two phases: Phase one (evaluation of teething symptoms among newly recruited infants) and Phase two (evaluation of teething symptoms among newly recruited infants and follow-up evaluation among infants recruited in Phase one). The study included an evaluation of infants born in a tertiary health care hospital using a hybrid design of telephonic conversation/video calling and clinical examination. The data were collected by one trained and calibrated evaluator and recorded in a self-designed form with validated measures of teething problems. Results: A total of 525 infants and parents participated. Teething problems were most prevalent at nine months of age (67.1 percent), followed by 12 months (50.1 percent) and 15 months (43.6 percent). Finger-sucking was the most common teething problem at six months (14 percent), nine months (81 percent), and 12 months (61.1 percent) of age. Incisor eruption was most associated with teething problems (72.5 percent), followed by canines (39.4 percent), first molars (36.9 percent) and second molars (24.9 percent). A significant correlation was seen between maternal education and maternal occupation and the parent-reported prevalence of teething problems (P<0.05). Conclusions: Almost two-thirds of the parents reported one or more teething problems at nine months coinciding with incisor eruption, whereas half also reported teething problems at 12 months. A significant correlation was seen between maternal education, maternal occupation and the prevalence of teething problems.
Purpose: To assess the fracture resistance of prefabricated esthetic crowns for primary molars. Methods: Seventy-two human mandibular second primary molars were divided into three groups: preveneered stainless steel crowns (VSS), prefabricated zirconia crowns (PZ) and BioFlx crowns (BF). Crowns were cemented with glass ionomer cement; for each group, 12 samples were tested for fracture resistance and 12 samples underwent 5,000 thermocycles before testing. The fracture mode was assessed for all the samples. Differences in the fracture resistance values between the groups were tested using analysis of variance (ANOVA), followed by Tukey's post hoc test, while the distribution of fracture modes was tested using Fisher's exact test. Statistical significance was set at P =0.05 and analyses were conducted using SPSS version 25.0 software. Results: ANOVA tests indicated a significant difference in fracture resistance among the test groups (P <0.001). The groups were ranked as follows: before thermocycling- (1) PZ group (3,327±1497), (2) BF group (1,694±163) and (3) VSS group (536±12); and after thermocycling-(1) PZ group (3,308±162), (2) BF group (1,579±77) and (3) VSS group (413±16). Tukey's post hoc analysis indicated that the PZ group exhibited a significantly higher fracture resistance than the BF and VSS groups (P <0.001). The VSS group showed a predominance of minimal cracks (5.6 percent) and loss of less than half of the crown (11.1 percent). Conclusions: PZ yielded the highest resistance, followed by BF crowns. VSS may require caution in high-stress areas due to their susceptibility to esthetic component failure, although the underlying crown remains functional.
Purpose: To understand mandatory educational requirements for child abuse and neglect (CAN) recognition and mandated reporting for dentists to obtain and renew dental licensure in the United States (US).Methods: Publicly available state websites, dental board documents and the American Academy of Pediatric Dentistry's website outlining requirements for dental licensure in the US were reviewed for specifically designated mandated reporting or CAN educational requirements as prerequisites to obtain either initial or renewal of licensure to practice dentistry within the jurisdiction. For inclusion in the study, CAN education had to be listed as a requirement specific to obtaining and renewing dental licensure, not just a general mandated reporting education suggested or required by the state.Results: Four of 50 states (Illinois, Iowa, New York and Pennsylvania) and the District of Columbia require a mandatory educational course on CAN and reporting to obtain a dental license. Four states (Illinois, Iowa, Maryland and Pennsylvania) and the District of Columbia require a mandatory educational course on CAN to renew a license.Conclusions: This study suggests that more US states should implement a requirement for dental professionals to take a mandatory educational course on CAN recognition and reporting to obtain and renew dental licensure. This education should be specific to dentistry and dental practice settings to best prepare professionals to report suspected abuse and/or neglect.
Purpose: To measure the fluoride release and enamel fluoride uptake from a new dimethicone-based fluoride varnish (Profisil) and Duraphat fluoride varnish, and determine if the varnishes occlude dentin tubules. Methods: The fluoride release of both varnishes was measured from specimens with a constant surface area to volume ratio in a water bath. The fluoride uptake of demineralized enamel cores treated with both varnishes was studied over 24 hours using ion-specific electrodes to determine fluoride content and atomic absorption spectroscopy to determine calcium content. Scanning electron microscopy (SEM) was used to examine the occlusion of dentin tubules and the surface of enamel after treatment with varnish. Results: Duraphat varnish released 68±7.1 ppm of fluoride per gram of varnish after 24 hours. Profisil varnish released 65±6.3 ppm of fluoride per gram of varnish after 24 hours. Duraphat varnish specimens had a fluoride content of 2.5±1.8 mg F/g enamel before application of the varnish, which increased to 285±62 mg F/g enamel after 24 hours. Profisil varnish specimens had a fluoride content of 2.4±2.1 mg F/genamel before application of the varnish, which increased to 272±74 mg F/g enamel after 24 hours. SEM images depicted that both varnishes occluded open dentin tubules and left mineral deposits on the surface of the enamel. Conclusions: Both varnishes released significant amounts of fluoride and significantly increased the fluoride uptake of demineralized enamel. Moreover, the new varnish induced occlusion of the tubules and induced mineral growth on the surface of the enamel.
Purpose: To assess the direct and indirect effects of oral conditions, family income, child's sex, history of toothache and dental visits on oral health-related quality of life (OHRQoL) of children, according to parents. Methods: A cross-sectional study was conducted with 843 pairs of parents and children aged three to five years of age, in Campina Grande, Paraíba, Brazil. Parents answered a questionnaire with sociodemographic and socioeconomic questions, and their children's use of services and experience of toothache, as well as the Brazilian Scale of Impact on Oral Health in Early Childhood. Three researchers examined for the presence of dental caries, dental trauma and malocclusion. Descriptive and confirmatory factor analyses were conducted to validate the measurement models and constructs. The analysis accounted for confounding factors to ensure precise estimates of the relationships among variables. Structural equation modeling was employed to examine both direct and indirect associations between variables. Results: Absence of dental visits (β =-0.332; 95 percent confidence interval [95% CI]:- 0.471 to -0.193; P <0.001) and toothache (β =-0.748; 95% CI:0.588 to 0.883; P <0.001) directly impacted OHRQoL negatively. Family income (β =0.689; 95% CI: 0.518 to 0.859; P <0.001) and anterior open bite (β =-0.339; 95% CI:-0.613 to -0.184; P <0.001) had indirect effects mediated by dental caries (β =0.748; 95% CI: 0.748 to 0.883; P <0.001). Conclusion: Both direct and indirect factors affect the OHRQoL of preschoolers, emphasizing the importance of considering oral health conditions and socioeconomic factors to evaluate and improve their quality of life.
