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Aim: An individual with a blood–injection–injury (BII) phobia often avoids exposure to triggers, such as blood tests and clinic appointments, leading to potentially serious health complications. This population‐based study examined the prevalence, stability and course of BII phobia in children and adolescents. Methods: The data came from the Trondheim Early Secure Study, conducted from 2007 to 2018. All children born in Trondheim, Norway, in 2003 and 2004 were invited to attend. Clinical interviews were conducted by trained personnel to assess BII phobia in 1042 children (51% female) every 2 years from 4 to 14 years of age. Latent growth curves and logistic regression analyses were used in the data analysis. Results: Just under 20% of the cohort experienced a BII phobia at least once, with no significant sex differences. The prevalence of BII phobias increased from 3% at 4 years of age and peaked at about 8% at 10 years of age, before levelling off. The two‐year stability increased as 12–14 years of age approached. Conclusion: The prevalence of BII was affected by age, but not sex. Early BII phobias often recede with time, but children may need treatment if they persist from 8 years of age. [ABSTRACT FROM AUTHOR]

Background: The etiology of dental fear (DF) is multifactorial and involves other contributing factors than dental traumatic experiences. Aim: To study, among adolescents, associations between DF and exposure to child physical abuse (CPA), intimate partner violence (IPV), and bullying. Design: We extracted data from a population‐based survey of 4977 adolescents who were 15–17 years old in 2017. The questionnaire queried socioeconomic background factors, DF, self‐perceived oral health, general health, and exposure to child abuse. To estimate associations between DF and exposure to child abuse, we used multivariate logistic regression analysis. Results: Overall, 8.2% reported DF, girls (10.5%) reported DF significantly more often than boys (5%), and adolescents not identifying themselves as girl or boy reported the highest prevalence of DF (25.5%; p <.001). 15.3% had been exposed to child physical abuse; 11.1%, to IPV; and 11.2%, to bullying. Experiences of IPV and bullying, but not physical abuse, were statistically significantly associated with DF. The odds of developing DF for adolescents exposed to any type of violence was 1.9 times the odds for adolescents with no exposure to child abuse. Conclusion: Exposure to violence is associated with dental fear in adolescents. [ABSTRACT FROM AUTHOR]

Aim: To study the association of parental country of origin—expressed as low‐, medium‐ and high‐Human Development Index (HDI) countries—with caries experience in children of immigrant families in Stockholm. Methods: This registry‐based cohort study included all children born in 2000–2003 who resided in Stockholm County, Sweden, at age 3 years (n = 83,147) with follow‐up at 7 years of age. A logistic regression was performed for the multivariate analysis with adjustments for socio‐demographic factors. Results: After adjustments, logistic regression analyses revealed that, compared with Swedish children of the same age, the risk of caries was highest when the immigrant parents originated in a medium (OR 4.22 (95% CI 3.99:4.47)) or low (OR 2.80 (95% CI 2.56:3.06)) income country background at age 7 years, but was increased also for high‐income country background, OR 1.77 (95% CI 1.52–2.05). Furthermore, the risk of presenting with caries experience at age 7 years increased for all children in the 1st (lowest) household income quintile in the host country Sweden. Conclusion: This study shows that the developmental level of the parental country of birth as well as the family socioeconomic position in Sweden influence the risk for caries development in their children. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorders (TMDs) are multifactorial, and high levels of stress seem to increase symptoms. The association with exposure to violence has not been explored in adolescent populations. Objective: To examine the association of self‐reported symptoms of temporomandibular pain and jaw dysfunction with child physical abuse, intimate partner violence, forced sexual intercourse, and bullying victimisation. Methods: An epidemiological, cross‐sectional, school‐based study was conducted in Olinda, northeast Brazil. The sample comprised 2,431 adolescents aged 14–19 years. TMD‐related symptoms and exposure to violence were assessed with questions from the 3Q/TMD screener and queries on exposure to different forms of violence. Multilevel logistic regressions were conducted to evaluate how 3Q screen‐positive responses are associated with self‐reported exposure to violence. Results: Self‐reported TMD‐related symptoms had a prevalence of 40.5%. Significantly more females than males screened positive to all 3Q/TMD questions (p <.001). Adolescents experiencing intimate partner violence (p =.012) and bullying (p <.001) had significantly higher odds of 3Q positive responses than those who reported no exposure to violence. Significant associations of TMD‐related symptoms with forced sexual intercourse (p =.014) and with bullying (p =.007) were observed. Conclusion: Adolescents with self‐reported symptoms of temporomandibular pain and jaw dysfunction were significantly more often exposed to some type of violence. The number of adolescents reporting TMD‐related symptoms increased in a dose‐response manner with the number of violence forms the individual had experienced. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether treatment with tacrolimus plus sirolimus (Tac/Sir) as a prophylaxis for graft‐versus‐host disease worsens severe oral mucositis and delays healing compared to cyclosporine plus methotrexate (CsA/Mtx) following haematopoietic stem cell transplantation. Subjects and Methods: The study comprised 141 patients: 73 randomized to receive Tac/Sir and 68 to receive CsA/Mtx. The oral mucositis assessment scale and toxicity grading according to WHO were used to assess the severity, peak and duration of oral mucositis from the day −3 to day 24 post‐transplant. Results: Eighty‐seven patients developed oral mucositis in the first 24 days post‐transplant. No significant difference in oral mucositis severity between the Tac/Sir and CsA/Mtx groups was observed. The peak oral mucositis score occurred on day 10 in both groups. Although oral mucositis scores had returned to baseline in the CsA/Mtx group on day 24 post‐transplant, no significant difference compared with the Tac/Sir group was found. Conclusions: The introduction of tacrolimus/sirolimus as a graft‐versus‐host disease prophylaxis in haematopoietic stem cell transplantation increased neither the incidence nor severity of oral mucositis compared with cyclosporine/methotrexate. Furthermore, oral mucositis healing was not prolonged and followed the same time pattern as cyclosporine/methotrexate. [ABSTRACT FROM AUTHOR]

Background: Self‐perceived oral health (SPOH) is a summary of multiple determinants related to oral health and has been suggested for use in clinical practice as a health assessment tool. Aim: To analyse determinants of SPOH among adolescents. Design: In 2018, we selected 1742 participants from eight high schools in Olinda/PE, Brazil, using a multistage stratified cluster sample. The main survey item of SPOH was 'How would you rate your oral health'. Determinants of were queried with a questionnaire and a clinical examination: socio‐demographic variables, exposure to family violence, somatic symptoms, and orofacial and general health factors. Pearson's chi‐square test and logistic regressions evaluated associations between determinants and SPOH. Results: Very poor SPOH had a prevalence of 8.7%. Nearly half (43.5%) rated their oral health as 'fair'. Very poor SPOH was associated with poor self‐perceived general health (OR = 2.60), anterior open bite (OR = 2.24), not cohabiting with one or both parents (OR = 2.40), caries experience (OR = 1.93), dental pain (OR = 1.91), and temporomandibular disorders (OR = 1.77). Conclusion: Very poor self‐perceived oral health indicates life stress and associates with poor oral conditions. Assessments should be used to explore individual treatment needs and abilities to comply with recommendations. [ABSTRACT FROM AUTHOR]

Aim: To evaluate oral health outcomes and early oral health promotion of children in a Swedish, parental support programme conducted in a collaboration between Child Health Services and Social Services. Methods: The intervention offered first‐time parents six home visits from a paediatric nurse and a parental advisor with Social Services. On the fourth visit (infant age 6‐8 months), parents received a toothbrush and fluoride toothpaste from non‐dental staff. Twice, at child ages 18 and 36 months, a dentist used the International Caries Detection and Assessment System to record caries and conducted a structured interview with the parents on oral health habits. The intervention group (n = 72) was compared to a reference group (n = 100) from the standard child healthcare programme, which included one home visit. Results: Significantly, caries prevalence was lower and tooth brushing habits more consistent in the intervention group compared to the reference group in the standard child health programme. The difference was most pronounced at 18 months and had decreased at the 36‐month follow‐up. Conclusion: The extended postnatal home visiting programme had a positive impact on oral health. Early oral health promotion delivered by non‐dental professionals could be a beneficial approach to early caries prevention. [ABSTRACT FROM AUTHOR]

Aim: To study trends in prevalence and risk factors of child physical abuse over 10 years in Sweden.Methods: This study analysed responses from school surveys in 2008, 2011, 2014 and 2017 in Södermanland County, Sweden with average 5125 respondents per year, 15 and 17 years old. There were identical questions on exposure to violence and risk factors including parental employment, separated parents, disability or disease, foreign background and lack of adult support. Intimate partner violence was included at three occasions. Data were analysed with bi- and multivariate models, and mean of accumulated risks were compared.Results: Child physical abuse decreased significantly between 2008 and 2017. Repeated abuse decreased to a less degree than abuse once. In bivariate analyses, the share of risk factors declined for those exposed to physical abuse. In multiple analyses, it was found significant associations with exposure. There was and a dose-relationship between numbers of accumulated risk categories and self-reported abuse.Conclusion: Exposure to child physical abuse decreased substantially between 2008 and 2017. However, prevalence of abuse is still unacceptable, and the finding that prevalence of the more severe forms of CPA decreased less during the same time, draws attention to the need of ongoing efforts. [ABSTRACT FROM AUTHOR]

Background: Since birth outcome is associated with maternal and newborn health, it can be a predictor of the future health of the child. Aim: To investigate the association between adverse birth outcomes and dental caries. Design: The present registry‐based cohort study included all children born in 2000‐2003, residing in Stockholm County, Sweden and who received a dental examination at the age of 3 years (n = 74 748). National registries supplied data on socioeconomic conditions, maternal health, maternal health behavior, and birth outcomes. Forward stepwise binary logistic regression was performed to determine predictors of caries experience in the 3‐year‐olds. Results: Of the subjects, 6.0% had caries experience (decayed, extracted, and filled teeth [deft] ≥ 1), 5.6% were born preterm (<37 weeks); 2.2% were born small (SGA) and 3.7% large (LGA) for gestational age. Of the studied adverse birth outcomes, only SGA was significantly associated with caries experience at 3 years of age, and only for mothers who had refrained from smoking during pregnancy. Conclusions: SGA is associated with caries experience in 3‐year‐old children; however, this relationship occurs only in mothers who did not smoke during pregnancy. [ABSTRACT FROM AUTHOR]

Background: No longitudinal study has evaluated the mutual relationship between dental fear and oral health in the same investigation. Aim: To evaluate the reciprocal longitudinal relationship between dental fear and oral health in schoolchildren. Design: This longitudinal study monitored 416 Brazilian children aged 5‐7 years of age at baseline for 2 years. The decayed, filled and missing teeth were clinically assessed for each child. Dental fear was evaluated by Dental Anxiety Question. Multilevel mixed‐effects linear and logistic regressions analysed the reciprocal relationship between dental fear and oral health. Results: Children with caries experience had 1.8 times higher odds of dental fear compared to children who were caries free. The presence of a carious tooth increased the odds of dental fear by 1.2 times. Children with dental fear had 0.46 additional carious tooth; an additional 0.22 tooth indicated for extraction; and a 0.67 higher caries experience score compared to children without dental fear. Conclusions: We observed a reciprocal relationship between dental fear and poor oral health. Both parents and dentists should provide realistic information for the children, discouraging biased negative expectations regarding dental treatment. Ultimately, the child would acquire positive perceptions of the dental environment, reducing their phobia and consequently improving oral health. [ABSTRACT FROM AUTHOR]

Aim To assess the development of high dental anxiety and the factors that are associated with it over a 2-year period. Design This longitudinal study focused on 416 Brazilian children aged 5-7 years over 2 years. Interviews were conducted with the children's parents to investigate the children's health-related behaviours. Additionally, the children's dental caries experience was clinically evaluated to obtain information about DMFT/dmft (decayed, filled and missing teeth) indices. Using the Dental Anxiety Question, children whose parents responded 'yes' to the prompt 'Is he/she very afraid of going to the dentist?' were classified as having high dental anxiety. Multilevel mixed-effects logistic regression was used to analyse factors to determine the extent to which they were associated with high dental anxiety longitudinally. Results The prevalence of high dental anxiety in children at baseline was 16.2%, whereas it was 19.8% at follow-up. Additionally, 38% of the children with high dental anxiety at baseline still had the condition after two years, although 62% of them no longer had high dental anxiety. The incidence of high dental anxiety at 2-year follow-up was 15.0%. Children who used medication chronically had a 2.1 times greater likelihood of having high dental anxiety. Furthermore, children whose parents reported high dental anxiety had a 2.6 times greater likelihood of having high dental anxiety themselves. A one-unit increase in a child's dmft score increased the risk of high dental anxiety by 1.1 times at follow-up. Conclusion After two years, the incidence of high dental anxiety was 15.0%. Poor oral health, unstable general health and parents with high dental anxiety were factors that were associated with this type of anxiety in schoolchildren. It is important that dentists are aware of children's high dental anxiety and the associated factors so that they can appropriately intervene. Dentists fulfil an important role and should stimulate and promote good general hygiene habits that may prevent future problems. [ABSTRACT FROM AUTHOR]

Background Dental professionals are required to report suspicions of child maltreatment to the social services. As yet, no studies assess the prevalence of these mandated reports from dental care services or their content. Aim This study investigates the prevalence and characteristics of mandated reports from dental professionals to the social services. Furthermore, it analyses associations between dental professionals reporting suspicions of maltreatment with such reports from other sources. Design The study collected dental mandatory reports from within one municipality of Sweden during 2008-2014. The material consisted of a total of 147 reports by dental professionals regarding 111 children. Results The total prevalence of reports from dental care services to the social services was 1.5 per 1000 children with a significant increase between 2008 and 2011 ( P < 0.001). The primary cause for a report concerned parental deficiencies in care ( n = 93) and secondly, a concern for dental neglect ( n = 52) ( P < 0.001). Among all reports, 86% involved children with prior contacts with the social services. Conclusion Reports to the social services from dental care services on suspicions of child maltreatment concern parental deficiencies (failure to attend appointments) and neglect (dental neglect). Mandated reports from dental care services often co-occur with other mandated reports. [ABSTRACT FROM AUTHOR]

Background There is a high prevalence of dental anxiety in children and adolescents. Cognitive behavioral therapy is emerging as a treatment option. Aim The purpose of this study is to explore how children with dental anxiety and their parents experience cognitive behavioral therapy ( CBT) in dentistry. Design We interviewed 12 children and one of their parents and conducted a thematic analysis of the transcribed interviews. Results Perspective shift emerged as overarching theme in our thematic analysis. This theme consisted of three main themes, which were mastery, safety, and reduced fear. Six subthemes were also identified according to our analyses. Mastery includes two subthemes, gradual exposure and autonomy and control. Subthemes and sources for safety feeling were therapeutic alliance and changed appraisal. The theme reduced fear also consisted of two subthemes; reduced anticipatory anxiety and coping. Conclusions The results show that parents and children had positive experiences of CBT and its outcome and were able to benefit from this psychological treatment when dealing with dental anxiety. [ABSTRACT FROM AUTHOR]

This study examined the factors that lead specialists in pediatric dentistry to suspect child abuse or neglect and the considerations that influence the decision to report these suspicions to social services. Focus group discussions were used to identify new aspects of child maltreatment suspicion and reporting. Such discussions illuminate the diversity of informants' experiences, opinions, and reflections. Focus groups included 19 specialists and postgraduate students in pediatric dentistry. We conducted video-recorded focus group discussions at the informants' dental clinics. All sessions lasted approximately 1.5 h. We transcribed the discussions verbatim and studied the transcripts using thematic analysis, a method well-suited to evaluating the experiences discussed and how the informants understand them. The analysis process elicited key concepts and identified one main theme, which we labeled 'the dilemma of reporting child maltreatment'. We found this dilemma to pervade a variety of situations and divided it into three sub-themes: to support or report; differentiating concern for well-being from maltreatment; and the supportive or unhelpful consultation. Reporting a suspicion about child maltreatment seems to be a clinical and ethical dilemma arising from concerns of having contradicting professional roles, difficulties confirming suspicions of maltreatment, and perceived shortcomings in the child-protection system. [ABSTRACT FROM AUTHOR]

This study investigated the association between self-perceived oral health and self-reported exposure to different types of child abuse. It was hypothesized that self-perceived oral health is compromised in exposed adolescents. All Grade-9 compulsory school and second-year high-school pupils in Södermanland County, Sweden ( n = 7,262) were invited to take part in a population-based survey; 5,940 adolescents responded. Survey items on health and social wellbeing included self-perceived oral health and exposure to abuse. The results showed that poor self-perceived oral health was associated with self-reported experience of physical abuse, intimate partner violence, forced sex, and bullying (adjusted OR = 2.3-14.7). The likelihood of reporting poor oral health increased from an adjusted OR of 2.1 for a single incident of abuse to an adjusted OR of 23.3 for multiple abuses. In conclusion, poor self-perceived oral health and previous exposure to child physical abuse, intimate partner violence, bullying, and forced sex is associated. It is important that dental professionals recognize adolescents with poor subjective oral health and take into consideration child abuse as a possible cause in order to prevent these adolescents from further victimization. These results further strengthen that dental professionals are an important resource in child protection. [ABSTRACT FROM AUTHOR]

Dental fear and anxiety (DFA), as well as dental behavior management problems, are common in children and adolescents. Several psychological factors in the child, and parental DFA, have been studied and found to correlate to the child's DFA. The aim of this study was to investigate the relationship between cognitive ability and DFA in a population-based group of children with identified behavior and learning problems. In conjunction with a dental examination at 11 yr of age, 70 children were assessed with regard to DFA using the Children's Fear Survey Schedule Dental Subscale (CFSS-DS), and their cognitive ability was assessed using the Wechsler Intelligence Scale for Children. In addition, parental DFA was measured using the Corah Dental Anxiety Scale. The results revealed that DFA was significantly correlated to verbal intelligence quotient (IQ) but not to any other cognitive index. A significant correlation was found between parental DFA and child DFA. The results indicate that the child's verbal capacity may be one factor of importance in explaining dental fear in children. [ABSTRACT FROM AUTHOR]

For prevention of graft-versus-host disease (GVHD), treatment of 24 haematopoietic stem cell transplantation (HSCT) patients with sirolimus and tacrolimus was compared to treatment of matched controls with cyclosporine-based regimens. The patients mainly had non-malignant disorders. Two-thirds of the donors were unrelated, and bone marrow was the most common source of stem cells. Rejection occurred in four patients in the sirolimus group and three in the control group. Donor chimerism for CD3, CD19 and CD33 was similar in the two groups. The cumulative incidence of grade II acute GVHD was 22% in the sirolimus patients and 17% in the controls ( P = 0.78). No patients developed acute GVHD of grades III-IV. The cumulative incidence of chronic GVHD was 25% and 37% in the two groups, respectively ( P = 0.40). Two patients in the sirolimus group developed Epstein-Barr virus lymphoma, and none in the controls. Side effects and toxicity were similar in the two groups. There was no transplant-related mortality at 5 yr in the sirolimus group, as opposed to 8% in the controls ( P = 0.47). Survival at 5 yr was 95% and 92%. Thus, sirolimus combined with tacrolimus is a promising immunosuppressive regimen in HSCT, also for non-malignancies, and its efficacy should be confirmed in prospective clinical trials. [ABSTRACT FROM AUTHOR]

Background. Childhood cancer survivors may have experienced a high number of invasive medical and dental procedures which are known to be risk factors for dental anxiety. Aim. The aim of this study was to examine the prevalence of dental anxiety among children who have survived cancer. Design. In a cross-sectional study, we examined 51 6- to 14-year-old children who had been treated for cancer at Aalborg Hospital, and 192 children without cancer. All children answered the Dental Subscale of the Children's Fear Survey Schedule. Dental anxiety was defined as a dental anxiety score exceeding the mean dental anxiety score + 1 standard deviation for the children without cancer. Results. Children with cancer did not have an increased prevalence of dental anxiety compared with children without cancer: the prevalence ratio was 0.41 [95% confidence interval (CI): 0.10–1.24]. The mean dental anxiety score was 23.1 (95% CI: 21.2–25.0) among children who had been treated for cancer, and 24.7 (95% CI: 23.4–26.0) among children without cancer (mean difference: 1.6; 95% CI: 1.1–4.3). Conclusion. Cancer and cancer treatment during childhood were not associated with an increased risk of dental anxiety in this population. [ABSTRACT FROM AUTHOR]

Background. Presentation of scientific information at international meetings is important for the dissemination of new scientific research. It is often assumed that the information contained in an abstract will subsequently be published in a scientific journal in full-length form. Objective. The aim of this investigation was to study the publication rate of abstracts presented to the International Association of Paediatric Dentistry (IAPD) congresses in London 1999 and Paris 2001, and factors that predict subsequent publication were also investigated. Materials and methods. Abstracts presented at the IAPD congresses were reviewed. A Medline/PubMed search, encompassing 1999–2006, was performed. Results. At the two IAPD congresses, a total of 771 abstracts were presented, 231 (30%) as oral presentations, 327 (42%) as poster discussion presentations, and 212 (28%) as poster presentations. During the period studied, 204 (27%) of the 771 abstracts were expanded into articles published in Medline/PubMed indexed journals. The publication ratio for orally presented abstracts was 40%, poster discussion presentation 21%, and for poster presentations 19% ( P < 0.0001). The mean time from the congress to publication was 20 months. Conclusion. The results of this study show that 40% of orally presented abstracts at IAPD congresses were followed by a subsequent scientific publication in a peer-reviewed journal. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. This study tested the hypothesis that children with ADHD exhibit a higher caries prevalence and poorer oral health behavior than children in a control group. Twenty-one children with ADHD and a control group of 79 children, all aged 13 yr, underwent a clinical dental examination and completed two questionnaires on dietary habits and dental hygiene habits. Differences between the groups regarding decayed, missed, or filled surfaces, decayed surfaces, initial caries lesions, and gingival inflammation were non-significant. Forty-eight percent in the ADHD group brushed their teeth every evening compared with 82% in the control group. The corresponding frequencies for brushing the teeth every morning were 48% and 75%. Children with ADHD were 1.74 times more likely to eat or drink more than five times a day than children in the control group. In conclusion, at age 13, children with ADHD do not exhibit a statistically significantly higher caries prevalence but do have poorer oral health behavior than children in a control group. The intervals between dental examinations of children with ADHD should be shorter than for other children to prevent a higher caries incidence in adolescence because of their oral health behavior. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. The present study tested the hypotheses that children with ADHD, particularly those exhibiting severe hyperactivity and impulsivity, have a different stress reaction (measured by salivary cortisol) during a dental recall visit and are more dentally anxious than children in a control group. Eighteen children with ADHD and a control group of 71 children, all 13 yr of age, underwent a clinical dental examination and completed the Corah Dental Anxiety Scale (CDAS). Four saliva samples were gathered for analysis of cortisol: one prior to dental examination, one after, and two the following morning. The subgroup ADHD with hyperactivity/impulsivity had statistically significantly lower cortisol levels than the control group 30 min after awakening. When cortisol values were plotted on a timeline, this subgroup always had lower cortisol concentrations than children in the control group. There was a significant correlation between CDAS scores and cortisol concentrations prior to the dental examination in both the ADHD and the control group. Behavioral expressions of anxiety in children with ADHD may be different from those in other children, not only due to the characteristics of their disorder, but also because of lower stress reactivity. [ABSTRACT FROM AUTHOR]

Objective. Total body irradiation (TBI) and cyclophosphamide (CY) during allogeneic stem cell transplantation (ASCT) cause salivary gland dysfunction in children. The aim of this investigation was to study the scintigraphic functional changes over time of the parotid and submandibular glands in children and young adults one year after treatment with CY and TBI at ASCT. Methods. Salivary gland scintigraphy (SGS) was performed before ASCT, and 3–6 months and 12 months after ASCT. The three male patients who fulfilled the scintigraphic study had a mean age (± SD) of 17.3 ± 9.8 years at ASCT. Results. The parotid secretion capacity (SPar) was 83.5 ± 3.2% before ASCT and 48.5 ± 25.8% during the next 3–6 months ( P < 0.05). The SPar did not increase (48.1 ± 12.4%) during the rest of the first year after ASCT. The submandibular emptying capacity (SSub) was 91.3 ± 12.9% before ASCT and 35.4 ± 2.3% after 3–6 months ( P < 0.05). The SSub was 87.9 ± 17.9% one year after ASCT. Conclusions. The parotid glands were more sensitive to irradiation since they did not recover lost capacity to secrete saliva, while the submandibular glands recovered the secretion capacity at the one-year follow-up. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. The aim of this study was to investigate whether children with ADHD have a higher caries prevalence, a higher degree of dental anxiety, or more dental behavior management problems (BMP) than children of a control group. Twenty-five children with ADHD and a control group of 58 children, all aged 11 yr, were included in the study. The children underwent a clinical dental examination, and bitewing radiographs were taken. The parents completed the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). Dental records from the subjects were obtained, and data regarding notes on behavior management problems (BMP) of the children when between 3 and 10 yr of age were compiled. Compared with controls, children with ADHD had significantly higher decayed, missing or filled surfaces (DMFS) (2.0 ± 3.0 vs. 1.0 ± 1.5) and significantly higher decayed surfaces (DS) (1.7 ± 3.6 vs. 0.5 ± 0.9). Differences between the groups regarding CFSS-DS scores were non-significant. In the ADHD group, the prevalence of BMP increased when the children were between 7 and 9 yr of age. In conclusion, children with ADHD exhibited a higher caries prevalence, did not exhibit a higher degree of dental anxiety, and had more BMP than children of a control group. [ABSTRACT FROM AUTHOR]

Blomqvist M, Augustsson M, Bertlin C, Holmberg K, Fernell E, Dahllöf G, Ek U. How do children with attention deficit hyperactivity disorder interact in a clinical dental examination? A video analysis. Eur J Oral Sci 2005; 113: 203–209.© Eur J Oral Sci, 2005 Attention deficit hyperactivity disorder (ADHD) is currently the most common behavioural disorder in school-age children. The aim of this study was to perform a detailed analysis of behavioural interactions between the dentist and the child patient with ADHD. All children born in 1991 ( n = 555) in one Swedish municipality were screened for attention and learning problems, and assessed for ADHD. Twenty-two children with ADHD, and a control group of 47 children without attention and learning problems, were included in the study. The dental recall visit was recorded on video. The interaction between the dentist and the child was analysed in detail and scored as verbal and non-verbal initiatives and responses. Compared to the children in the control group, the children with ADHD made significantly more initiatives, especially initiatives that did not focus on the examination or the dentist. The children with ADHD had fewer verbal responses and more missing responses. In conclusion, the problems in communication resulted in less two-way communication between the dentist and the children with ADHD than the interaction between the dentist and the children in the control group. The children with ADHD had particular difficulties staying focused on the examination. [ABSTRACT FROM AUTHOR]

Blomqvist M, Holmberg K, Fernell E, Dahllöf G. A retrospective study of dental behavior management problems in children with attention and learning problems. Eur J Oral Sci 2004; 112: 406–411.© Eur J Oral Sci, 2004Attention and learning problems in children are common. The aim of this study was to investigate whether children with attention and learning problems had more dental behavior management problems (BMP), more cancelled and missed appointments, and more traumatic dental injuries compared with a control group. All children born in 1991 attending mainstream schools (n = 555) in one Swedish municipality were screened for behavioral and learning problems. Conners' 10-item questionnaire and a questionnaire focused on executive and learning problems were used. A total of 128 screen-positive patients were index cases and 131 screen-negative patients control cases. The dental records of these children were studied from 1 yr of age until the child reached 10 yr. Behavior management problems on at least one occasion were more common in the index group (54% vs. 37%). The percentage of appointments at which the children exhibited BMP was higher in the index group (13% vs. 7%). No differences were found for cancelled or missed appointments or dental traumatic injuries between the two groups. In conclusion, the results of this study show that children with attention and learning problems had significantly more dental behavior management problems compared with a control group. [ABSTRACT FROM AUTHOR]

In patients with severe congenital neutropenia (SCN), the absolute neutrophil count (ANC) is raised during treatment with granulocyte colony-stimulating factor (G-CSF), resulting in a marked reduction of bacterial infection. Some patients, however, still have recurrent but less severe bacterial infections and severe periodontal infections. As it has been suggested that the biological activity of glycosylated recombinant human G-CSF (rHuG-CSF, i.e. lenograstim) is higher than the non-glycosylated form (i.e. filgrastim), we compared the two given in equimolar doses. Seven SCN patients participated in an open, randomized, double crossover study comprising 60 weeks, with four 12-week periods when the two drugs alternated after a 12-week run-in-period. The mean ANC values, sampled every second week, were 5·1 × 109/l during filgrastim treatment and 4·2 × 109/l during lenograstim treatment (P = 0·042). The ANC levels were also significantly higher during filgrastim treatment, when comparing each complementary pair of ANC measurements (P = 0·011) as well as the mean ANC values during each 12-week treatment period (P = 0·033). There were no differences regarding the frequency of infection, antibiotic treatment, gingival bleeding and the number of hospital admissions between the groups. We conclude that filgrastim and lenograstim displayed equal clinical efficacy, but that ANC levels were higher during filgrastim treatment, when administered in equimolar doses. [ABSTRACT FROM AUTHOR]

PERIODONTAL CONDITIONS AND SALIVARY LEVELS of immunoglobulins sIgA, IgM, and IgG subclass distribution and albumin, quantified by enzyme-linked immunosorbent assay, were determined in 20 patients with Down syndrome and 19 healthy controls. Gingival inflammation was more extensive (P < 0.05) among Down syndrome subjects compared to controls as well as the occurrence of periodontal pockets (> 4 mm) (P < 0.05). The immunoglobulin levels of sIgA, IgM, the sum of IgG subclasses, and the concentration of albumin did not differ significantly between the 2 groups. However, the proportion of IgG1 expressed as percentage of the sum of total IgG was significantly higher (P < 0.01) in the Down syndrome group compared to controls. On the contrary, the proportion of IgG2, IgG3, and IgG4 subclasses in saliva did not differ between the 2 groups. The results indicate an altered distribution of IgG subclasses in saliva, with a higher proportion of IgG1 in Down syndrome individuals compared to controls. [ABSTRACT FROM AUTHOR]

The effect of growth hormone (GH) treatment on craniofacial development was studied in five children exhibiting growth retardation following bone marrow transplantation. Linear and angular measurements were made on lateral radiographic cephalograms taken prior to the start of GH treatment and after an average treatment time of 1.2 yr. The results showed that the mean growth increments of mandibular length in the GH treated children, exceeded the corresponding values of the control group by 150% during the period of investigation. It is suggested that this dimensional increase in the patients was due to GH stimulation on the chondral growth process in the mandibular condyles. [ABSTRACT FROM AUTHOR]

Oral mucous membrane lesions were studied in 54 children below 12 yr of age treated with allogeneic bone marrow transplantation on mainly because of hematological malignancies. Sixty-two percent of the children exhibited a wide range of oral side effects during therapy. Lesions observed during the first 2 wk prior to engraftment of the donor marrow were related to the chemo- and radiotherapy given. Oral ulcerations were seen in 34% of the children. Children given methotrexate as graft-vesus-host disease (GVHD) prophylaxis exhibited oral ulcerations significantly (P≤0.05) more often than those given cyclosporin. Oral lesions related to acute GVHD were only observed in two patients. Reactivating herpes simplex virus infection was seen in 35% of the children who were seropositive prior to BMT. An extensive oral candidiasis was observed in 15% of the patients. All six children with a chronic GVHD exhibited changes in the oral mucosa 2-4 yr after transplantation such as erythma of the mucous membranes, tongue atrophy and also lichenoid changes in the buccal mucosa. [ABSTRACT FROM AUTHOR]

The immunohistochemical occurrence of several different neuronal markers has been investigated in human gingiva with phenytoin-induced overgrowth. The material was compared to gingival material taken following surgical orthodontic treatment, Gingiva obtained from the phenytoin-treated groups seemed to have a reduced number of neurofilament (NF) immunoreactive nerve fibers in the propria compared to control material. In both phenytoin as well as control gingiva sparsely distributed, thin, calcitonin gene-related peptide (CGRP) and substance P (SP) immunoreactive fibers were found in the propria. No obvious differences between the two groups could be observed for CGRP and SP. Immunoreactive cells for somatostatin (SOM) with a dendritic cell shape were found in the propria in both groups, sometimes in densely packed clusters. A tendency for increase of SOM-immunoreactive cells in the phenytoin-treated gingiva was observed, A few γ-melanocyte stimulating hormone (γ-MSH)-immunoreactive cells with a round appearance were found in control as well as phenytoin -affected gingiva. In one instance, however, a heavy γ-MSH-immunoreactive cell infiltration was seen in the phenytoin sample. No immunoreactivity in either the phenytoin-treated group or in the control group was seen for proctolin or galanin. The results indicated that gingiva with phenytoin-induced overgrowth has a reduced innervation density revealed with NF immunohistochemistry. [ABSTRACT FROM AUTHOR]

The in vitro synthesis of sulfated glycosaminoglycans (GAGs) was studied in gingival fibroblasts from two patients exhibiting phenytoin(PHT)-induced gingival overgrowth, i.e. pseudopockets, which required surgical excision, front one patient on PHT medication not exhibiting pseudopockets and from two normal controls. The results showed that the newly synthesized GAGs were distributed to the culture medium, to a pericellular - and to the cell fraction. Gingival fibroblasts from the PHT-induced gingival overgrowth showed a significantly increased incorporation of 35SO42- into GAGs compared to the other strains, and this increase was mainly confined to the dermatan sulfite fraction. These results are in accordance with our previous biochemical studies where increased amounts of GAGs were found in gingival biopsies from the GAG-induced lesion. [ABSTRACT FROM AUTHOR]

Out of 374 schoolchildren, aged 13-15 yr, 42 with high counts of salivary lactobacilli (≥ 105) were selected for this study. Lysozyme activity in saliva and L( +)-lactic acid (LA) production after addition of glucose were determined. The mean values of lysozyme activity and LA concentration were 19.4 μg/ml and 1.4 mmol/1 respectively. The levels of LA produced without addition of glucose were < 0.2 mmol/l. The results showed a statistically significant (P< 0.05) negative correlation between lysozyme activity and the levels of LA produced. The findings of this study suggest that lysozyme may be of imponance in limiting acid production in saliva. [ABSTRACT FROM AUTHOR]

Oral health was studied in a group of asthmatic children (n = 61). The children were divided in two groups, 5-10 and 11-18 yr of age. The individuals with asthma were flanker subgroups with respect to the disease severity. Severe asthma was defined as more than 10 asthmatic attacks per year. This patient group had daily medication compared to children with moderate asthma (<10 asthmatic attacks/yr) who medicated temporarily. 55 age matched children from the same area made up the control group. All children were examined clinically and two bitewing radiographs were taken. The result showed no statistically significant differences concerning caries prevalence and gingival condition in asthmatic children compared to a healthy control group. The study shows that neither the asthma per se nor the disease severity affected the caries prevalence and gingival condition in asthmatic children. [ABSTRACT FROM AUTHOR]

The effect of phenytoin and its major metabolite p-HPPH on concanavalin A (ConA) induced DNA-synthesis of human lymphocytes was studied in vitro. In lymphocyte cultures depleted of phagocytizing cells by iron treatment PHT and p-HPPH, in pharmacologic concentrations, caused a depression of the mitogen response measured as uptake of ³H-thymidine. In contrast, the presence of phagocytizing mononuclear cells during ConA-stimulation in the presence of PHT and p-HPPH caused a potentiation of ConA induced DNA-synthesis. These effects of phenytoin on immunocompetent cells may be of significance in the pathogenesis of the PHT-induced gingival overgrowth, since earlier we have reported the presence of large infiltrates of lymphocytes, mainly T-lymphocytes in gingival biopsies from clinically non-inflamed PHT- induced gingival overgrowth. [ABSTRACT FROM AUTHOR]

The presence of mononuclear cells was studied in gingival biopsies from seven children exhibiting phenytoin(PHT)-induced gingival overgrowth, three children with gingivitis and a control group consisting of three children without clinical signs of inflammation. The mononuclear cells were detected using monoclonal antibodies defining functional T-lymphocyte subpopulations, B-lymphocytes and monocytes. Gingival biopsies from the individuals in the PHT-group showed a substantial number of mononuclear cells. The distribution of mononuclear cells in separate individuals were as follows: 69-95% OKT3 +/Leu4+ cells (T-lymphocytes), 50-64% OKT4+ /Leu3 + cells (T-helper phenotype) and 29-46% OKT8 + cells (T-suppressor/cytotoxic phenotype). None of the biopsies in the PHT-group contained more than a few scattered plasma cells. The vast majority of all mononuclear cells present in the biopsies reacted with OKIal, a monoclonal antibody defining the HLA-DR framework. In contrast, biopsies from the control group and the gingivitis group contained few mononuclear cells, the majority of which were cells. This suggests that immunologic reactions mediated by T-cells may play a role in the pathogenesis of the PHT-induced lesion. [ABSTRACT FROM AUTHOR]

Gingival overgrowth was assessed in renal transplant children, 19 boys and 13 girls, aged 2.5- 18 yr. who had been on a cyclosporin-A (CsA)-based immunosuppressive regimen for at least 12 months Data collected included number of posttransplant months, total CsA dose administered during the first 6 post- transplant months, oral dose and blood trough level of CsA on the day of examination, plaque accumulation (VPI%), gingival inflammation (GBI%), loss of attachment, and gingival overgrowth Thirteen percent of the children exhibited gingival overgrowth characterized by one or more units with increased sulcus probing depth (&ges;4 mm), i e pseudopockets The total amount of CsA administered during the first 6 posttransplant months was significantly higher in the children with gingival overgrowth than in those without. The study indicates that the development of CsA-induced gingival overgrowth is positively related to the total dose of the drug administered to the children during the first 6 posttransplant months. [ABSTRACT FROM AUTHOR]

The periodontal condition and caries experience was studied in noninstitutionalized epileptic children (n = 55) who had not been subjected to any additional preventive measures. The children were distributed in a phenytoin (PHT) group with a mean age of 13.2 yr and a control group (mean age 11.8 yr) consisting of children treated with other anticonvulsants. The PHT group had a DF-s mean value of 5.4 in comparison to 7.2 in the control group. Determinations of gingival overgrowth based on the presence of gingival units with increased probing depth (> 4 mm) as well as the thickness of the marginal gingiva in buccolingual dimension measured on stone casts were performed. Although the plaque level and degree of gingival inflammation were similar in the two groups, 43% of the children in the PHT group showed one or more gingival units with increased probing depth (> 4 mm), but none in the control group. The thickness of the marginal gingiva was significantly (P< 0.001) higher in the phenytoin-treated children compared to children who had never had phenytoin medication. In the PHT-group gingival overgrowth based on gingival units with increased probing depth was statistically significantly and positively associated with the variables gingivitis (P< 0.05), visible plaque index (P<0.01), age (P<0.01) and years on PHT therapy (P<0.05). [ABSTRACT FROM AUTHOR]

Colonization with mutans streptococci was studied in 1095 1-year-old children living in suburban Stockholm. During a scheduled vaccination appointment at a child health centre, a bacterial sample was obtained from the child's tongue and a structured questionnaire was completed by the accompanying parent. Six percent of the subjects were colonized with mutans streptococci. The variables most strongly correlated with presence of mutans streptococci were: non-Swedish back- ground, consumption of sugar-containing beverages at night and total consumption of sugar-containing beverages. The results indicate that, by the age of 1 year, maternally influenced behavior patterns such as dietary habits that may predispose to early colonization of mutans streptococci are already established. Such early colonization with mutans streptococci may predict high caries risk in the primary dentition. [ABSTRACT FROM AUTHOR]

Immunohistochemical methods have been used to study the occurrence of neuronal markers in human gingiva from periodontitis-affected sites. In periodontitis-affected buccal gingiva densely distributed neurofilament (NF)-immunoreactive (IR) fiber bundles were observed in the deeper parts of the propria, while NF-IR single finbers occurred in the superficial propria and occasionally in the buccal epithelium. Periodontitis-affected gingiva obtained from interproximal sites showed only sparsely distributed NF-IR fibers. Single nerve fibers immunoreactive to the peptides substance P and calcitonin gene-related peptide occurred close to or within the epithelium in both buccal and interproximal gingiva. Around blood vessels neuropeptide Y-, peptide histidine-isoleucine amide- and vasoactive intestinal polypeptide-IR fibers were occasionally observed, while clusters of γ-melanocyte-stimulating hormone-IR cells were found in the propria, in addition to γ-melanocyte-stimulating hormone IR nerve fibers. Somatostatin-IR dendritic cells were seen in epithelium and propria of buccal and interproximal gingiva, although a high variability in the number of SOM-IR cells was observed. All neuronal markers studied showed a similar distribution in material obtained from young patients with clinically healthy gingivae, although the number of NF-IR fibers in the propria in these subjects was lower. The results demonstrate that in gingiva obtained from periodontitis-affected sites several different biologically active peptides occur in both nerve fibers and cells. At least some of these substances could possible play a role in the inflammatory process. However, since clinically normal gingiva was shown to contain nerve fibers and cells expressing immunoreactivity to the substances studied, no unique periodontitis-induced expression of the neuronal markers studied was found. Thus, any alteration of these substances during the periodontitis process remains to be elucidated. [ABSTRACT FROM AUTHOR]

The aim of this investigation was to study dental maturity in healthy prepubertal children of short stature (height < -2 SD), with or without growth hormone (GH) deficiency, compared to healthy controls. The GH-deficient group (GH level <10.0 μg/l) included 29 children (11 female, 18 male) with a mean age of 10.2± 2.2 years. The GH non-deficient group consisted of 17 children (5 female. 12 male) with a mean age of 8.5 ± 2.1 years. All the children were evaluated for serum concentrations of IGF-1, alkaline phosphatase (ALP), triiodthyronin (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and fasting plasma insulin: height and bone age were also recorded. Dental maturity was determined from panoramic radiographs. The mean difference between the denial and chronological ages was -0.67 ± 0.89 years in the GH-deficient group compared to 0.23 ± 1.07 years in their controls: in the GH non-deficient group the difference was -0.95 ± 0.82 years compared to controls 0.16 ± 1.06 years in their controls. Compared to chronological age, both bone and denial age were lower in the GH-deficient and GH non-deficient groups. It is concluded that children of short stature, both GH-deficient and GH non-deficient, exhibit a delayed dental age compared to their chronological age- and sex-matched controls. A multiple stepwise regression analysis showed that the sitting height and GH level were the only significant factors associated with dental maturity. [ABSTRACT FROM AUTHOR]

International Journal of Paediatric Dentistry 2011; 21: 465-467 Background. Childhood cancer survivors may have experienced a high number of invasive medical and dental procedures, which may affect their oral health-related quality of life (OHRQoL). Aim. To compare children who have survived cancer and children without cancer with respect to OHRQoL. Design. In a cross-sectional study, we compared the OHRQoL of children treated for cancer at Aalborg Hospital with the OHRQoL of classmates without cancer. All children answered The Danish version of the Child Perceptions Questionnaire (CPQ). Children aged 8-10 ( n = 95) answered CPQ8-10, with 27 questions, and children aged 11-14 ( n = 138) answered the CPQ11-14, with 39 questions. Results. Children with cancer rated their OHRQoL better or equal to those without cancer. The mean overall CPQ8-10 score was 5.6 (95% CI: 2.5-8.6) among 18 children who have survived cancer and 8.8 (95% CI: 7.3-10.3) among those without cancer ( n = 77); the mean difference was −3.3 (95% CI: −6.5 to 0.1). The overall mean CPQ11-14 score was 12.5 (95% CI: 6.8-18.2) among 24 children who have survived cancer and 11.8 (95% CI: 10.3-13.3) among those without cancer ( n = 114); the mean difference was −0.7 (95% CI: −4.9 to 6.3). Conclusion. Cancer and cancer treatment during childhood was not associated with a decreased OHRQoL. [ABSTRACT FROM AUTHOR]

The article reflects on the distribution of manuscripts to the "International Journal of Paediatric Dentistry" during 2009. It is said that the journal received 392 new submissions in comparison to 307 submissions during 2008. It is said that in 2009, an increasing number of manuscripts have come from India, China, Israel and Greece.

The article presents a report on the distribution of manuscripts to the "International Journal of Paediatric Dentistry" during 2008 by country of corresponding author. In 2008, there were 307 new submissions, which is the same level as during 2007. According to the article, the journal experienced a slight reduction in the number of case reports submitted due to the change in format.

The article discusses various reports published within the issue, including one by Svante Twetman and Christina Stecksén-Blicks on probiotics and oral health and another by Esber Caglar on the effect of short-term daily ingestion of lactobacilli-derived probiotics.

The article discusses various reports published within the issue, including one about the temperamental characteristics of children referred to specialist pediatric dentistry clinics and another about the memory of a dental treatment episode to reduce fear of future treatment.

Presents a letter to the editor in response to the comment from Osman Sabuncuoglu of the Department of Child Psychiatry at Marmara University Hospital in Istanbul, Turkey about the article "A retrospective study of dental behavior management problems in children with attention and learning problems," by the authors which was previously published in vol.112, 2004 issue of the"Journal of Oral Sciences" publication.

Human mononuclear cells purified by Lymphoprep flotation were incubated with phenytoin (PHT) (20 μg/ml) or its metabolite p-HPPH (2 μg/ml) in the presence of Concanavalin A (10 μg/ml) in vitro. The results indicate that phenytoin and its metabolite p-HPPH induce the release of a mononuclear cell factor(s) that activates quiescent human gingival fibroblast to synthesize DNA. [ABSTRACT FROM AUTHOR]

The article focuses on the submission of manuscripts for the "International Journal of Paediatric Dentistry." The journal will receive its first Institute for Scientific Information impact factor in 2009 and the papers published in 2006 will form the first basis for this calculation. All manuscripts are being submitted electronically. The journal is now in a good position to attract important and innovative research in the field of pediatric dentistry.