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ABSTRACTUnderstanding the parent/child dynamic is important in the delivery of person-centered dental care to the child. However, the nature of parenting has changed and understanding of child development has continued to develop, affecting the ability of dentists to influence child behavior. The purpose of this paper is to review generational differences, the impact of parenting on child development and changes in approval of behavior guidance techniques to propose new approaches to child behavior.

ABSTRACTThere are a number of reasons for a child to misbehave in the dental setting. The aim of this study was to compare provider ratings of fear and defiance to standardized assessments of children’s fear and defiance. Results suggest that misbehavior by defiant children in the dental setting is frequently thought to be related to fear. Providers may not be able to accurately distinguish between defiance and fear.

Malocclusion is a worldwide dental problem that influences the affected individuals to varying degrees. Many factors contribute to the anomaly in dentition, including hereditary and environmental aspects. Dental caries, pulpal and periapical lesions, dental trauma, abnormality of development, and oral habits are most common dental diseases in children that strongly relate to malocclusion. Management of oral health in the early childhood stage is carried out in clinic work of pediatric dentistry to minimize the unwanted effect of these diseases on dentition. This article highlights these diseases and their impacts on malocclusion in sequence. Prevention, treatment, and management of these conditions are also illustrated in order to achieve successful oral health for children and adolescents, even for their adult stage. Ensuring oral health in early childhood could prevent the development of jaw misalignment later in life. Xuedong Zhou, of China’s Sichuan University, and colleagues reviewed the latest research on how common dental conditions in children influence malocclusion, where the teeth of the upper and lower jaws do not properly align, causing problems such as overbite, where the lower teeth overlap the upper teeth, or open bite, where a space remains between the upper and lower teeth when the mouth is closed. Tooth decay, prolonged thumb sucking, trauma, and the appearance of additional baby teeth are but a few of the factors that can ultimately lead to malocclusion in adulthood. Early and adequate management of these factors will establish healthy dentition and alleviate or avoid malocclusion, the researchers conclude.

The University of California, Los Angeles (UCLA) School of Dentistry has implemented a Health Resources and Services Administration‐funded program to prepare dentists for the complex and comprehensive needs of pediatric patients within rapidly changing demographics and a paradigm shift in dentistry. Traditional dental education has focused on how to respond to oral disease, whereas UCLA's program shifts the paradigm to emphasize early assessment, risk‐based prevention, and disease management. A holistic approach to dental care that considers social and environmental determinants is used with minimally invasive techniques for restorative care. To support this change, pediatric dental residents receive traditional training combined with new didactics, advocacy opportunities, and applied learning experiences at community‐based organizations. These new elements teach residents to recognize the causal factors of disease and to identify interventions that promote oral health at the individual, family, community, and policy level. Consequently, they are better prepared to treat a diverse group of patients who historically have faced the greatest burden of disease as well as an increased number of barriers to accessing oral health care; these consist of low‐income, minority, and/or pediatric populations including children with special health needs. The program's ultimate goal is for residents to deploy these skills in treating vulnerable populations and to demonstrate greater interest in collaborating with non‐dental health providers and community organizations to increase access to dental services in private or public health practice settings.

ABSTRACTPremature loss of primary teeth can result in a loss of arch length and have a negative effect on occlusion and alignment, often increasing the need for orthodontic treatment. Use of space maintainers can reduce the severity of problems such as crowding, ectopic eruption, tooth impaction and poor molar relationship. This article presents a review of the consequences of premature tooth loss and discusses the appliances commonly used for space maintenance.

There is a continuing shortage of academic dentists due to myriad factors. However, each graduating class of dental students includes a select group who choose to explore academic positions. It is this group of potential academic dentists that a four‐year R25 initiative, funded by the National Institute of Dental and Craniofacial Research, has targeted with the intent of increasing their numbers and mentoring them for success in a future faculty position. The aims of the program at the School of Dentistry, University of California, Los Angeles, are to target and recruit potential clinician‐scientists and to design and implement an Academic Track (AT) that complements existing clinical and research training with the comprehensive skill set of pedagogical, organizational, and personal strategies necessary to be successful in an academic career. Recruitment to the AT targeted candidates from a variety of sources including those enrolled in the dual D.D.S./M.S. and D.D.S./Ph.D. programs, dental residents, Ph.D. candidates in other disciplines, and predental students. Through a variety of professional development activities in the AT, selected students receive teaching, leadership, and mentoring experiences. Outcomes and lessons learned related to specific activities and lessons learned are presented in this article, and a model that recognizes the diverse paths to an academic career in dentistry is recommended.

ABSTRACTBehavior management is significant to delivery of dental care to the child. We must be able to elicit cooperation of the child for dental procedures, and of child and parents, for adherence to a preventive home care regimen. However, society has changed, affecting the ability of dentists to influence children and their parents. The purpose of this paper is to review changes in parenting styles that have impacted the nature of oral care in the child.

Although many theories have attempted to explain the etiopathogenesis of premature cranial suture fusion, which results in craniosynostosis, recent studies have focused on the role of growth factors and receptors. Using a well-established model of cranial suture biology, the authors developed a novel approach to quantitatively analyze the gene expression profiles of candidate cranial suture growth factors and their receptors. We collected suture mesenchyme and adjacent osteogenic fronts from Sprague-Dawley rats at postnatal days 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, and 35. RNA was extracted from posterior frontal (PF) and sagittal (SAG) sutures, and reverse transcription-polymerase chain reaction (RT-PCR) was performed for cranial suture candidate cytokines BMP2, BMP3, BMP4, FGF-2, FGFR1, FGFR2, FGFR4, TGF-βRI, TGF-βRII, and TGF-βRIII. The authors confirmed quantitative RT-PCR results with Southern and dot blot analyses. Suture growth factor and receptor expression levels changed significantly with time. Expression levels decreased toward baseline in the SAG suture by day 35. There was a marked difference in FGFR1, FGF-2, TGF-βRI, and TGF-βRII expression levels when comparing the fusing PF and nonfusing SAG sutures. Although FGF-2 ligand expression was low, FGF receptor 1 (FGFR1) levels were markedly elevated with a bimodal expression pattern in both PF and SAG similar to that of BMP2, BMP3, and BMP4. Although there were statistically significant differences in TGF-βRI and TGF-βRII expression in the PF and SAG sutures, TGF-βRIII levels were unchanged. The authors report a novel approach to cranial suture growth factor/receptor profiling and confirm their results with standard analytic tools. The data confirm, quantify, and extend the results of previously published studies. By quantifying the gene expression profiles of normal cranial suture biology, we may begin to understand the aberrant growth factor cascades of craniosynostosis and devise targeted therapeutic interventions that can alter the course of this malady.

ABSTRACTOne of the difficulties of the practice of dentistry is being responsible for the highest quality of care for patients while often having to propose alternate solutions for a variety of reasons, which include financial concerns. Dental practitioners treating young children have the added responsibility of gaining their patient’s cooperation to render the best treatment. Determinants that influence the development of a behavioral strategy for a young patient include disease status, the child’s physical and mental development, parental characteristics, and provider personality and capabilities. Classic strategies — including a supportive office environment, “tell-show-do,” successive approximation, distraction, behavior shaping, and retraining — must be matched to the characteristics of each child and family situation. Current cultural trends suggest that disciplinary forms of behavior management strategies — such as hand-over-mouth, physical restraint, and even voice control — are losing societal acceptance.