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Aims: To evaluate the advice and preventive care provided by General Dental Practitioners (GDPs) to high-caries-risk children in Jordan. Methods: A cross-sectional study using an open-ended questionnaire. GDPs were presented with a high-caries-risk child scenario and asked regarding: (1) oral hygiene and dietary advice they would give; (2) preventive-care they would offer; (3) barriers they face in prevention delivery. Answers were compared to an evidence-based guideline. Data were input into SPSS-20 and analysed using descriptive statistics and frequencies. Chi-square test was used to compare results by age, gender, practice location and type. Results: One-hundred and sixty GDPs were approached and 128 agreed to participate (80%), of whom 87 (69%) were female. The average age was 31 years [range 22–50]. Sixty-nine percent practiced in the capital, Amman. Sixty-five percent gave advice on tooth-brushing frequency, but only 23% suggested brushing at bed-time and 24% recommended parental supervision. None provided advice on toothpaste fluoride content. Seventy-one percent advised reducing sugary-food amounts, but only 21% focused on frequency and 2% suggested using diet diaries. Most knew about fissure-sealants (77%) and fluoride-varnish (80%). Forty-two percent reported barriers to delivering preventive-care, including parental attitudes (36%), child cooperation (30%), financial reward (19%), and training (6%). Participants practicing outside of the capital were less likely to use fluoride-varnish [P= 0.002] and more likely to report barriers [P= 0.001]. Conclusions: Advice delivered by GDPs to high-caries-risk children in Jordan does not meet the standards of an evidence-based guideline. Future initiatives for oral-health-promotion should aim to address the barriers reported, especially outside the capital.

Aim: To evaluate the awareness, knowledge, and beliefs about early childhood caries (ECC) among a sample of expectant mothers and to determine their preferences to help design appropriate interventions. Methods: Expectant mothers attending for antenatal care at a large public hospital were interviewed and asked to complete a questionnaire about ECC. The questionnaire was pre-tested and validated and contained questions about risk factors, presentations, management, and complications of ECC. Participants were also asked about their preferred method for oral health education about ECC. Data were analysed using SPSS for Windows release and descriptive statistics were generated. Results: Four-hundred expectant mothers were approached and 380 (95%) agreed to participate. 59% reported brushing twice or more daily, but only 10% attended the dentist regularly. Only 16% thought that tooth brushing should start as soon as primary teeth erupt. Most (68%) thought that bottle feeding does not need to stop before the age of two. The majority believed that sugar is better consumed between meals (81%) and in portions throughout the day (85%). Only 12% thought that a child should have their first dental visit by the age of one. Educational level influenced knowledge on several aspects of ECC prevention. The participants suggested leaflets (38%) and social media (24%) as methods for oral-health-education delivery. Conclusion: Expectant mothers lack adequate knowledge about ECC prevention. There is a need for interventions that deliver advice on child toothbrushing, dietary practices, and dental attendance as part of wider general-health promotion.

Presents data which help identify changes and trends in the provision of direct restorations, bleaching, endodontics and paediatric dentistry in general dental practice in the UK.New evidence of the dynamic nature of the clinical practice of dentistry in the UK -change is constant.Encouraging trends to minimum intervention approaches in the care of patients.

Objectives To assess the demographic, socioeconomic, behavioural and clinical factors associated with use of dental general anaesthesia (DGA) among British children.Methods This study used data from 3053 children who participated in the 2013 Children's Dental Health Survey in England, Wales and Northern Ireland. Data were collected through parental questionnaires and clinical examinations. The crude and adjusted association of demographic (sex, age, ethnicity and country of residence), socioeconomic (socioeconomic classification and area deprivation), behavioural (age toothbrushing started, age when first went to the dentist, usual reason for dental visit and dental anxiety) and clinical factors (numbers of decayed and filled teeth) with DGA was assessed in logistic regression models.Results The lifetime prevalence of DGA use was 9.1%. Older children and those living in Wales, with higher levels of dental anxiety and more dental fillings, who visited the dentist only when in trouble, and who had parents in routine/manual occupations and parents who never worked have greater odds of reporting having ever used DGA.Conclusion This study shows that family socioeconomic background, usual reason for dental visit and country of residence were associated with DGA use among British children, over and above the effect of child age, dental anxiety and dental status.

Aims To compare the profile of paediatric patients receiving dental treatment under general anaesthesia (GA) or conscious sedation (CS). A second aim was to explore whether there is an overlap between the two patient groups.Design This service evaluation study was based on sociodemographic and clinical data extracted from clinical records of patients attending dental appointments for GA or CS services at King's College Hospital. Sociodemographic and clinical differences between GA and CS groups were explored using logistic regression models.Results Data from 113 children (58 GA and 55 CS) were analysed. There were differences between groups in terms of age and numbers of quadrants and teeth treated, but not in terms of sex, ethnicity or deprivation scores. In the adjusted model, older children and those having more teeth treated were more likely to be in the GA than in the CS group. An overlap between the GA and CS groups was found, with 50% of children aged four to nine years having two to four teeth treated in both groups.Conclusion Age and number of teeth treated were the main characteristics associated with receiving care under GA or CS. Some overlap between children receiving dental treatment under GA or CS existed despite demographic and clinical differences between both groups.

Introduction Few studies have assessed the preventive needs of children treated under conscious sedation or their parents'/guardians' views regarding oral health education.Aim To report on the profile of children who required treatment under conscious sedation. Also to obtain the views of the parents or guardians of these children on their experiences of oral health preventive services and the support they would like in order to improve their child's oral health.Method A researcher-administered questionnaire was used to collect quantitative and qualitative responses from a consecutive sample of 123 parents/guardians during their child's sedation appointment at King's College Hospital.Results Caries was the main reason for the child's sedation treatment and 77.2% of them were high caries risk. Parents reported that their general dentist had given advice about sugar (80%) and tooth-brushing (74%), but few had prescribed fluoride varnish (15%), fissure sealants (12%) or a fluoride rinse (36%). Parents felt challenged by the ready availability of sugar, and others suggested difficulty in maintaining healthy oral habits in complex families. Overall, the majority of parents thought leaflets, health professionals' advice, and Internet websites could be informative, and they requested school- and hospital-based prevention programmes.Discussion The majority of children had high caries risk. They had received advice but not professional preventive treatment such as fluoride varnish and fissure sealants. Their parents requested preventive education using new technologies and media and better access through school-based and hospital prevention programmes.

Aim: This was twofold: (1) to report on the type of paediatric patient referred to the sedation assessment clinic at Glasgow Dental Hospital and School, and (2) to report on the evel of anxiety. Method: This was a two-part study. The first part was a retrospective review of case notes to evaluate referral pathways to and from the sedation assessment clinic with regard to a range of variables. The second part was a prospective clinical report of dental anxiety. Results: It was noted that 31 (67.4%) of patients were initially referred by their general dental practitioner, 7 (15.2%) by community dental surgeons and 8 (17.4%) by hospital dental surgeons. At the initial referral, 4 children (9%) showed symptoms of pain. The majority of patients were from lower social economic areas, as determined by DEPCAT score, and exhibiting moderate to high anxiety levels. The children who were referred for general anaesthesia had the highest anxiety scores. Out of a total of 46 patients, five failed to complete treatment within the modality laid out for them at the assessment clinic. Conclusions: (1) The patients attending the newly established sedation assessment clinic were mainly high caries risk, socially deprived patients and (2) that the majority of patients were dentally anxious, the most anxious appearing to have been referred for treatment under general anaesthesia.

Objective To investigate the relative importance of a range of explanatory variables concerning why child patients in Scotland enter path ways for tooth extractions under either Dental General Anaesthesia (DGA) or local anaesthesia (LA). Basic Research Design A cross-sectional study was carried out involving DGA centres across Scotland. Data collected related to demographic characteristics of child DGA patients, reported anxiety and dental attendance levels of patients and parents, reasons given by referring practitioners for requesting DGA, number and type of teeth extracted and parental beliefs and attitudes to DGA. Similar data were collected relating to children having teeth extracted in primary care under LA. Multivariate analysis was performed to determine which factors were the best predictors of anaesthetic choice Results 425 and 121 children having dental extractions under DGA and LA respectively participated. Ninety-six percent of DGA cases and 48% of LA patients had extinctions for caries. For DGA cases, the mean age was 6.7 years, an average of 5.3 teeth were extracted and dental anxiety levels were higher than population norms. Multivariate analysis found the number of teeth extracted was the major predictor of anaesthetic type. On removing this variable, age became the most important factor, with 99% of children under 55 years receiving a DGA. Among DGA patients, 25% were reported to have had a previous DGA for tooth extraction. Conclusions Future reductions in DGA numbers will be dependent on decreasing the number of young children presenting with advanced caries in multiple teeth. Consequently, guidelines are required concerning the prevention and appropriate management of caries in the primary dentition. [ABSTRACT FROM AUTHOR]

Objective To characterize the soft tissue features of infants with unilateral cleft lip (UCL) and unilateral complete cleft lip and palate (UCLP) prior to primary surgery and compare with noncleft controls.Design Prospective controlled capture of the facial morphology of infants using a noninvasive three-dimensional stereophotogrammetry method.Participants 23 children with presurgical cleft: 11 UCL (M = 6, F = 5); 12 UCLP (M = 9, F = 3), and 21 noncleft controls (M = 7, F = 14) were imaged at approximately 3 months of age (range 10 to 16 weeks).Main Outcome Measure Accurate, repeatable quantification of facial soft tissues in infants with clefts prior to surgery.Results Significant differences (p < .05) were found between the UCLP group and UCL and control groups in anatomical and soft nose width, cleft-side alar wing length, and nasal tip horizontal displacement. Both cleft groups were significantly different from controls and from each other in cleft-side nostril dimensions, alar wing angulation, columella angle, and alar base to corner of mouth dimension; alar base width; and soft tissue defect in nose and the lip and philtrum length bordering the cleft. Significant differences between clefts and controls were identified in the nostril and philtrum on the noncleft side.Conclusions The use of children with UCL as controls for UCLP studies is inappropriate. This technique overcame the limitations of direct measurement of infant faces to aid the surgeon in the planning and subsequent re-evaluation of surgical rationale.