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Abstract Background Dental caries remains a significant problem in England, affecting 11% of 3-year-olds and 23% of 5-year-olds. While current approaches have been extensively investigated, their ability to (1) control pain and infection; (2) prevent hospital admissions, and (3) be implemented within the National Health Service (NHS) contractual arrangements, remains unsatisfactory. Silver diamine fluoride (SDF) is an alternative, non-invasive approach that has proven efficacy in arresting caries progression in primary teeth, principally from studies conducted outside of Europe. Its use in primary dental care in the UK is limited, despite the acknowledged need. The clinical and cost-effectiveness of SDF has not been compared to usual care in the UK. Before a pragmatic randomised controlled trial (RCT) can be conducted to compare SDF to usual care for caries management in young children, there are several uncertainties that require investigation. This study aims to establish whether such an RCT is feasible. Methods This mixed-method parallel design study is a feasibility study with an embedded process evaluation, to compare SDF with usual treatment in primary dental care in the UK. It will be individually randomised, with 13 dentists and therapists, in 8 different dental primary care sites with a sample size of 80 child participants aged 1–8 years old. The aim will be to recruit ten participants per site with equal arm allocation. Follow-up will be for 1 year. The study will inform whether an RCT is feasible by resolving several key uncertainties. The acceptability and implementation of SDF and the research processes will be explored. Patient and Public Involvement and Engagement representatives will be involved throughout recruitment and retention strategies, participant documentation, analysis, engagement and dissemination. Discussion The ability to conduct an RCT will be evaluated. If feasible, this RCT has the potential to evaluate the effectiveness of a non-invasive approach for the management of untreated caries in young children. A feasibility study also offers the opportunity to consider factors associated with the implementation of SDF at an early stage through a process evaluation that will inform the definitive trial and an implementation strategy for SDF by identifying relevant barriers and facilitators. Trial registration ClinicalTrials.gov identifier: NCT06092151. Date: 19/10/2023.

Abstract Urban stormwater management ponds (SWMPs) are widely employed for stormwater control, but knowledge about their contributions to urban ecosystem function and service delivery remains unclear. We organized a workshop that brought together researchers, managers and students to assess and discuss current information on SWMP ecosystem function and services, identify perceived knowledge gaps and prioritize research needs, to advance understanding and management of SWMPs in Ontario, Canada. Workshop participants identified habitat provisioning and regulation of water quality and quantity as key ecosystem functions in SWMPs. They also recognized carbon sequestration, flood prevention, water purification, educational potential, human health promotion and community engagement as important ecosystem services provided by SWMPs. Despite the availability of engineering information and practitioner knowledge, workshop participants suggested that information on the impacts of maintenance operations, biological condition, water quality, costs and benefits and impact on surrounding landscape are important gaps that hinder a modern approach to design and management of SWMPs for multiple co‐benefits. Participants suggested current gaps can be tackled with a combination of continuous water‐quality monitoring, field, laboratory and mesocosm experiments. They also suggested that future SWMP studies take advantage of existing community and governmental databases using meta‐analyses to summarize knowledge and provide future directions. Practical implication: By linking knowledge gaps to management needs, this practice insight provides a road map that can be used to advance management of SWMPs in Ontario and elsewhere.

Human experiences with nature are important for our culture, economy, and health. Anthropogenically-driven climate change is causing widespread shifts in biodiversity and resident urban wildlife are no exception. We modelled over 2,000 animal species to predict how climate change will impact terrestrial wildlife within 60 Canadian and American cities. We found evidence of an impending great urban shift where thousands of species will disappear across the selected cities, being replaced by new species, or not replaced at all. Effects were largely species-specific, with the most negatively impacted taxa being amphibians, canines, and loons. These predicted shifts were consistent across scenarios of greenhouse gas emissions, but our results show that the severity of change will be defined by our action or inaction to mitigate climate change. An impending massive shift in urban wildlife will impact the cultural experiences of human residents, the delivery of ecosystem services, and our relationship with nature.

ObjectivesApproximately 8 million Ukrainians have been displaced by the war in Ukraine and five million children had their education disrupted. Here, we report an evaluation of (1) the feasibility (i.e., recruitment), (2) the acceptability (i.e., attendance, participants' views) and (3) the influence of a pilot community art-based project on the well-being, health behaviour and socialisation of Ukrainian refugee children in London, UK.MethodsTwenty-two refugee children aged 4–14 years from St Mary's Ukrainian school in London took part in five weekly art workshop group sessions led by a team of volunteer independent artists based in a community art studio in West London in collaboration with Children and War UK. Analyses were conducted on measures of the children's psychological well-being, health behaviour, and socialisation; collected from participating children and their parents through the workshops.ResultsThe community art workshops received sufficient interest from parents during recruitment. Child participants and their parents expressed overwhelmingly positive views and high satisfaction towards the workshops and their activities. While the workshops were conducted without a control group, changes in psychological well-being and health behaviour and socialisation were in the expected direction. The workshops were associated with reduced impact of intrusive re-experiencing of traumatic events (p = .021), negative emotion (ps = .006–.043; rated by children and by their parents, respectively), and sleep disturbance (p = .015). Mood and motivational states increase relative to before activities within sessions (ps = .001–.023).ConclusionsThe artist-led workshops are a valuable community project associated with high satisfaction and potentially increased well-being in Ukrainian refugee children. A provision for a larger number of participants should be considered.

Background: Molar incisor hypomineralisation (MIH) is a common developmental dental condition that presents in childhood. Areas of poorly formed enamel affect one or more first permanent molars and can cause opacities on the anterior teeth. MIH presents a variety of challenges for the dental team as well as functional and social impacts for affected children. Objectives: Here, we provide an up-to-date review of the epidemiology, aetiology, diagnosis and clinical management of MIH. Materials and methods: A review of the contemporary basic science and clinical literature, relating to MIH, was undertaken using information obtained (up to 10 April 2020) from the electronic databases PubMed, Scopus, Web of Science and the Cochrane Library. Results: There is a growing body of evidence relating to the aetiology, presentation and clinical management of MIH. Current knowledge appears to be focused on potential genetic aspects, as well as the development and validation of indices for the diagnosis and management of MIH. There has also been increasing recognition of the global and individual burden of this common condition. Conclusions: Dental health professionals should regularly appraise the basic science and clinical MIH literature to ensure that they provide the best possible short- and long-term care for their young patients.

Dental anxiety affects children worldwide and can have negative consequences on oral health. This study aimed to evaluate a novel communication aid ‘message to dentist’ (MTD), as part of a wider cognitive behavioural therapy approach to reduce dental anxiety in young patients. Dentally anxious children, aged 9−16 years, were invited to complete the MTD proforma, before and following their course of treatment. They scored how worried they were and their anticipated pain levels on a scale of 1−10 (10 being the worst outcome). They also wrote down their coping plans and post-treatment reflections. One hundred and five children, from a UK general dental practice and a hospital clinic, were included. They had a mean age of 11.6 years, and 65% were female. There was a significant reduction in self-report worry (from 4.9 to 2.1) and anticipated pain (from 5.1 to 2.0) scores (p < 0.05, paired t-test). Many children (30%) used listening to music/audiobook as a coping strategy. Thematic analysis revealed concerns around pain, uncertainty, errors and specific procedures. The MTD proforma proved an effective means of facilitating communication between anxious children and the dental team, allowing them to identify their worries and make personalised coping plans.