Purpose: To investigate changes in body mass index (BMI) following surgery to treat severe early childhood caries (S-ECC). Methods: Children no older than 71 months of age undergoing surgery to treat S-ECC were recruited into a prospective cohort study in Manitoba, Canada. Heights and weights were measured at baseline (day of surgery) and follow-up (minimum of 3 months after treatment) to calculate BMI z-scores. Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) classification systems were used to determine BMI health status. Descriptive statistics, bivariate analyses, change tests, and regression models were used. Results: Overall, 150 parti- cipants were recruited (mean age=47.7±14.2 months), and 104 children returned for follow-up. Mean BMI z-scores increased significantly (5.8±2.7 months; P<0.001) following surgery. Based on the WHO classification, 44% of children remained healthy based on BMI following surgery (43% for CDC), while 30% declined from the healthy to unhealthy category based on the WHO classification at follow-up (29% for CDC). Those with a household income of less than $28,000 (CAD) were more likely to be at an unhealthy BMI (P=0.01). Conclusions: Children in this study experienced a significant increase in BMI and a decline in health at follow-up. Early childhood caries and BMI share similar risk factors. Lower family income was associated with worse health after surgery when controlling for other variables. Children undergoing surgery for S-ECC would benefit from dietary, lifestyle, and physical activity interventions to improve both overall and oral health.
Purpose: To compare moderate enteral sedation regulations across the 50 US states and evaluate alignment with the American Academy of Pediatrics/American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) guidelines. Methods: An online review of all state dental sedation laws was conducted from January to June 2025. Extracted variables include permit type, renewal interval, site visit, and education requirements. State regulations were compared with the AAPD Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures and the ADA Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students.Results: Forty-eight states (96%) require a permit to administer moderate enteral sedation. The most common renewal interval is 2 years (58%), and two-thirds of states require 1 to 5 annual continuing education hours. Twenty states (40%) require a pediatric endorsement. Nearly all states (98%) mandate advanced life-support training for pediatric patients. More than half (64%) require an initial site visit, and 50% require regular emergency drills. Educational standards vary, though 60 didactic hours and 20 cases are most common. Most states (86%) require Basic Life Support (BLS) for monitoring personnel, and 56% require at least 2 individuals during procedures. Conclusions: Despite increased alignment with published sedation guidelines in recent decades, significant variability persists among state permit definitions and requirements. These findings highlight the need for standardized, evidence-based state dental practice acts that clearly define sedation depths, routes, and training requirements.
Purpose: To comparatively evaluate the accuracy, readability, and concision (word count) of 7 generative artificial intelligence platforms (GenAIs) that developed multilingual postoperative instructions (POIs) for pediatric dental procedures. Methods: Standard prompts were developed and uploaded to 7 trained or untrained GenAIs to create POIs for 5 pediatric dental procedures in 3 languages: English, Spanish, and Polish. Two masked, calibrated, bilingual, simulated parents assessed the accuracy, clarity, cultural neutrality, and language appropriateness of 70 GenAI-developed POIs using an ordinal scale (AI-instructify) for each language pair (English-Spanish, English-Polish). The readability, understandability, actionability, and concision of GenAIs were calculated using evidence-based indices, and the data were statistically evaluated (a =0.05). Results: Trained GenAIs improved the accuracy and readability of multilingual POIs (P<0.05). POIs in English consistently received higher AI-instructify scores than POIs in Spanish and Polish. However, POIs from untrained GenAIs or in the Polish language were concise (lower word count) as compared to those in English and Spanish languages (P<0.001). Most POIs received a score indicating they were "easily" or "fairly easily" readable, understandable, and actionable at a sixth-grade level (the standard literacy level for the US population). Conclusions: Trained generative artificial intelligence platforms produced accurate, readable postoperative instructions. Despite generic content, GenAIs showed promise in generating multi-lingual instructions suitable for diverse populations with lower health literacy.
Purpose:To compare primary care utilization before and after human papillomavirus vaccination delivered through a medical-dental integration (MDI) program. Methods: This retrospective cohort study included patients aged 9 to 17 years who had at least 1 dental visit and were due for HPV vaccination during a 1-year MDI intervention in which vaccination was offered at dental appointments and administered by nursing staff. WCV utilization was compared for eligible patients in the year before and the year after the intervention. Results: Among 1,694 eligible adolescents, 375 HPV vaccines were administered. WCV attendance did not differ among this cohort before versus after the intervention or between those who received an HPV vaccine and those who declined. Conclusion: Human papillomavirus vaccination coordinated during dental visits was not associated with a decrease in primary care utilization, supporting medical-dental integration as a strategy to improve vaccination access without compromising preventive care.
