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Visual attention is a significant gateway to a child's mind, and looking is one of the first behaviors young children develop. Untreated caries and the resulting poor dental aesthetics can have adverse emotional and social impacts on children's oral health-related quality of life due to its detrimental effects on self-esteem and self-concept. Therefore, we explored preschool children's eye movement patterns and visual attention to images with and without dental caries via eye movement analysis using hidden Markov models (EMHMM). We calibrated a convenience sample of 157 preschool children to the eye-tracker (Tobii Nano Pro) to ensure standardization. Consequently, each participant viewed the same standardized pictures with and without dental caries while an eye-tracking device tracked their eye movements. Subsequently, based on the sequence of viewed regions of interest (ROIs), a transition matrix was developed where the participants' previously viewed ROI informed their subsequently considered ROI. Hence, an individual's HMM was estimated from their eye movement data using a variational Bayesian approach to determine the optimal number of ROIs automatically. Consequently, this data-driven approach generated the visual task participants' most representative eye movement patterns. Preschool children exhibited two different eye movement patterns, distributed (78%) and selective (21%), which was statistically significant. Children switched between images with more similar probabilities in the distributed pattern while children remained looking at the same ROI than switching to the other ROI in the selective pattern. Nevertheless, all children exhibited an equal starting fixation on the right or left image and noticed teeth. The study findings reveal that most preschool children did not have an attentional bias to images with and without dental caries. Furthermore, only a few children selectively fixated on images with dental caries. Therefore, selective eye-movement patterns may strongly predict preschool children's sustained visual attention to dental caries. Nevertheless, future studies are essential to fully understand the developmental origins of differences in visual attention to common oral health presentations in children. Finally, EMHMM is appropriate for assessing inter-individual differences in children's visual attention., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

Background: Reporting guidelines for different study designs are currently available to report studies with accuracy and transparency. There is a need to develop supplementary guideline items that are specific to areas within Pediatric Dentistry. This study aims to develop Reporting stAndards for research in PedIatric Dentistry (RAPID) guidelines using a pre-defined expert consensus-based Delphi process., Methods: The development of the RAPID guidelines was based on the Guidance for Developers of Health Research Reporting Guidelines. Following a comprehensive search of the literature, the Executive Group identified ten themes in Pediatric Dentistry and compiled a draft checklist of items under each theme. The themes were categorized as: General, Oral Medicine, Pathology and Radiology, Children with Special Health Care Needs, Sedation and Hospital Dentistry, Behavior Guidance, Dental Caries, Preventive and Restorative Dentistry, Pulp Therapy, Traumatology, and Interceptive Orthodontics. A RAPID Delphi Group (RDG) was formed comprising of 69 members from 15 countries across six continents. Items were scored using a 9-point rating Likert scale. Items achieving a score of seven and above, marked by at least 70% of RDG members were accepted into the RAPID checklist items. Weighted mean scores were calculated for each item. Statistical significance was set at p < 0.05 and one-way ANOVA was used to calculate the difference in the weighted mean scores between the themes., Results: The final RAPID checklist comprised of 128 items that were finalized and approved by the RDG members in the online consensus meeting. The percentage for high scores (scores 7 to 9) ranged from 69.57 to 100% for individual items. The overall weighted mean score of the final items ranged from 7.51 to 8.28 (out of 9) and the difference was statistically significant between the themes (p < 0.05)., Conclusions: The RAPID statement provides guidance to researchers, authors, reviewers and editors, to ensure that all elements relevant to particular studies are adequately reported., (© 2021. The Author(s).)

Objectives: To determine different combinations of marginal ridge shape (MRS) and contact extents in nature of the contact between primary molars and its correlation with the presence of carious lesions on radiographic examination of approximal surfaces., Study Design: Retrospective study of 347 clinical records, including photographs and bitewing radiographs, were assessed for intact MRS and caries extent. The carious lesions were scored (0-5, Mejàre scoring system) radiographically and correlated to the intact MRS on clinical photographs, and strength of associations quantified using logistic regression analysis and chi-square tests., Results: Primary molars, 848(contact extent), and 757(MRS) were analyzed. Combination of straight-convex(35.4%) MRS was more common (p<0.001). None of the approximal surfaces were caries-free for straight and straight MRS with 36.4% of both approximal surfaces exhibiting caries in enamel, and 38.2% of one approximal surface exhibiting caries in dentin. Approximately 90% of the primary molars with substantial contacts exhibited carious lesions in the enamel and 80% with light contacts exhibited carious lesions in the dentin (p<0.001)., Conclusion: Six different combinations of intact MRS were identified. Combination of concave-convex shapes exhibited caries extending into dentin. Substantial and/or light contacts between primary molars showed higher caries experience in the approximal surfaces.

Purpose: The purposes of this study were to determine the presence of interproximal carious lesions in the primary molars and assess the risk to adjacent and contralateral surfaces when caries is detected in one quadrant. Methods: Clinical records of high caries-risk children, including bitewing radiographs, were assessed for interproximal caries and the extent of marginal ridge breakdown. The carious lesions were scored radiographically by two calibrated examiners with excellent inter- and intraexaminer reliability. Correlations for the presence of adjacent surface caries and caries in another quadrant were determined by employing the strength of the associations, as quantified using chi-square analysis. Results: A total of 1,290 pairs of primary molars (A and B, I and J, K and L, S and T) were included. Only eight percent of interproximal surfaces were caries-free. Approximately 70 percent of the adjacent surfaces (A and B, I and J, K and L, and S and T) exhibited carious lesions in the enamel when there was enamel caries in one quadrant. Furthermore, 90 percent of the adjacent surfaces exhibited caries in the dentin if one adjacent interproximal surface exhibited dentinal caries. Conclusions: In high caries-risk children, only a small proportion of surfaces remain caries-free, and the adjacent surface caries prevalence remains high at 70 percent to 80 percent. The presence of interproximal caries in one quadrant is a good indicator of caries in the other quadrants, as is the marginal ridge breakdown which indicates the proximity to the pulp.

Background: The influence of parental education, choice of child dentifrice, and its impact on their children's dental caries experience remain unclear., Aim: To investigate (a) dentifrice types used by Australian pre-school children, (b) demographic factors that influence parents' dentifrice choice, and (c) whether dentifrice type is related to pre-schooler's caries experience., Design: 155 parent-child dyads were recruited from five random metropolitan childcare centres. Parents completed a questionnaire recording relevant demographics and child dietary preferences, oral hygiene practice, and dental visits. One calibrated operator performed a clinical examination of their pre-schooler for evidence of carious lesions. Data were analysed, and comparisons between variables made using chi-square tests and regression models., Results: 50% of pre-schoolers used <1000 ppm fluoride dentifrice and 29% used non-fluoridated dentifrice. Higher parental education level was associated with the use of non-fluoridated dentifrice (P = .02, χ 2  = 0.034). Children with higher brushing frequency were more likely to use fluoridated dentifrice (P = .03, χ 2  < 0.001)., Conclusion: The proportion of Australian pre-schoolers using non-fluoridated dentifrice was higher than in other world regions. Higher parental education level was strongly associated with choosing non-fluoridated toothpaste, which warrants further qualitative analysis to assess determinants for parents' choice of child dentifrice., (© 2020 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Calcium phosphate and fluoride (F) delivery systems claim to facilitate enamel remineralization., Aim: To evaluate and compare (i) the remineralizing potential of Clinpro ® Tooth Crème(CTC) and Tooth Mousse Plus ® (TMP) on artificial carious lesions, and (ii) the benefit of 1000ppm F dentifrice prior to the application of CTC and TMP., Study Design: Carious lesions, 200-300μm deep were produced by placing molars in demineralizing solution for 96h, sections 100-150μm thick were then randomly assigned to six groups(n=150). Specimens were treated thrice daily with a non-fluoridated(Group A), or fluoridated dentifrice[1000ppm, (Group B)], or CTC(Group C), TMP(Group D), fluoridated dentifrice followed by CTC(Group E), or a fluoridated dentifrice followed by TMP(Group F), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography., Results: Posttreatment maximum mineral content at the surface zone(V max ) was significantly increased in Groups B, C, and D compared to the other groups. The lesion depth(LD) decreased in Group D>Group C>Group E, and the net mineral content gain(ΔZ) in Group C>Group D, which did not reach statistical significance., Conclusions: CTC and TMP exhibited similar efficacy in remineralizing artificial carious lesions. Nevertheless, the net mineral gain or lesion consolidation following CTC use was higher than TMP.

Background: No published studies exist on the remineralizing potential of Tooth Mousse Plus ® (TMP) when applied for less than 3 min., Aim: To evaluate (i) the remineralizing potential of TMP on artificial carious lesions, when applied thrice daily for 60 s, and (ii) the benefit of using a fluoridated dentifrice prior to TMP application., Design: Carious lesions, 120-200 μm deep, were produced by placing molars in demineralizing solution for 96 h, and sections 100-150 μm thick were then randomly assigned to four groups. Specimens were treated thrice daily with a non-fluoridated (Group A), or 1000 ppm F dentifrice (Group B), or TMP (Group C), or a 1000 ppm F dentifrice followed by TMP application (Group D), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography., Results: Post-treatment maximum mineral content at the surface zone (V max ) was significantly increased and lesion depth (LD) significantly decreased in Group C, while only the V max increased in Group D. Increase in LD was observed in Group B; however, no significant differences were noted in percentage LD changes between groups B, C, and D (P > 0.05)., Conclusions: TMP applied for 60 s significantly remineralized the artificial carious lesions. No additional benefit was evident when TMP was preceded by treatment with 1000 ppm F dentifrice., (© 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To assess the changes in the oral health-related quality of life (OHRQoL) of 221 preschool children who presented to the emergency department with the consequences of untreated dental caries requiring dental extractions under general anaesthesia (DEGA)., Methods: Two hundred and twenty-one healthy preschool children, who required emergency DEGA, were recruited over a period of 12 months. The same parent or caregiver completed the Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire; both, prior to the DEGA and at the 2-week post-treatment visit. Data were analysed using repeated anova with adjustments for multiple comparisons using the Bonferroni tests with the significance level set at 5%., Results: One hundred and twenty-six participants, with a mean age of 4.02 and a mean dmft score of 8.27 (SD = 4.13), completed the 2-week post-treatment questionnaires. The overall ECOHIS, CIS, and FIS scores decreased significantly (P < 0.001) after emergency DEGA, demonstrating large effect sizes. The biggest decrease in prevalence after emergency DEGA was observed for the items of pain in teeth, trouble sleeping, being irritated or frustrated, difficulty drinking food, and parents being upset., Conclusions: The OHRQoL of preschool children, who presented to the emergency department with the consequences of untreated dental caries, was significantly improved following emergency DEGA., (© 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Pre-school children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring pre-school refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children., Methods: Community based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bi-lingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software., Results: There were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents' previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees' difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed., Conclusions: The main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already assisted in translating the findings and raising awareness in the provision of targeted refugee oral health services.

Objectives: To examine the effect of adjunctive application of chlorhexidine (CHX) and ethanol-wet bonding (EWB) on bond durability and nanoleakage of hydrophobic adhesive to sound (SD) and caries-affected dentine (CAD)., Methods: Dentine surfaces of molars were etched after caries removal and randomly allocated to four groups (n=12). In Groups 1 and 2, dentine surfaces were saturated with either 2 ml of 100% ethanol or 2 ml of ethanol with 2% CHX for 60s. In Groups 3 and 4, dentine surfaces were saturated with either 15 μL of distilled water or 15 μL of distilled water with 2% CHX for 60s. Two coats of primer, followed by neat resin were applied and light-cured for 40s. Resin composite build-ups were placed and bonded specimens were sectioned for bond strength testing after 24 h and 12 months' storage in artificial saliva. Bond strength data were analyzed using 3-way ANOVA and SNK tests. Interfacial nanoleakage was evaluated after 24 h and 12 months using a field-emission scanning electron microscopy and data were analyzed using Kruskal-Wallis test., Results: Significant differences were observed for the three factors: "substrate" (p<0.001), "rewetting agents" (p<0.001) and "time" (p<0.001) on bond strength. Incorporation of 2% CHX to EWB preserved bond strength to SD and CAD and reduced interfacial nanoleakage after 12 months. Incorporation of 2% CHX to WWB also preserved bond strength to SD after ageing., Conclusions: Incorporation of chlorhexidine to ethanol-wet bonding has an interaction effect on preservation of bond durability to sound and caries-affected dentine., Clinical Significance: Incorporation of chlorhexidine to ethanol-wet bonding with hydrophobic adhesive enhances the success rate of aesthetic bonded restorations., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: To date, research on the relationship between dental caries experience and adiposity status is debated., Aim: To determine associations between dental caries experience and adiposity status among a community sample of preschool children in Hong Kong., Design: Among a random sample of 5-year-old children, clinical assessment for dental caries was conducted using WHO criteria. Anthropometric measurements for body weight, body height, waist circumference (WC), hip circumference, and triceps skinfold thickness (TRSKF) were performed to assess general adiposity, central adiposity, and peripheral adiposity. Associations between adiposity status and caries were examined in regression analyses., Results: The response rate was 83.1% (324/390). Regression analyses (adjusted for tooth brushing habits, snacking habits, and socio-demographic factors) identified that weight/height ratio z-score was associated with caries experience: prevalence of dental caries experience (dmft > 0), OR 1.41 (95% CI 1.04, 1.91), and 'very high' caries experience (dmft ≥ SiC(10) Index value), OR 1.62, (95% CI 1.05, 2.50). In addition, WC z-score was associated with 'very high' caries experience (dmft ≥ SiC(10) Index value), OR 1.72, 95% CI 1.06, 2.81., Conclusion: In a Hong Kong community sample of preschool children, dental caries experience was associated with general adiposity (as assessed by weight/height ratio) and central adiposity (as assessed by WC)., (© 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

International Journal of Paediatric Dentistry 2010; 20: 330-335 Objectives. To assess and compare the oral health status of preschool children with and without cerebral palsy (CP). Methods. Preschool children with CP (72) were recruited from 23 Special Child Care Centers in Hong Kong. An age (+/-3 months) and gender matched sample of preschool children from mainstream preschools were recruited as the control group. Dental caries status, gingival health status, tooth wear, developmental defect of enamel, malocclusion, dental trauma and oral mucosal health were assessed and compared between the two groups. Results. Significant differences in gingival health status were found between children with and without CP (mean plaque index scores, P = 0.001 and mean gingival index scores, P < 0.05). Tooth wear involving dentine was more prevalent among CP children (P < 0.001), as were evidence of anterior open-bite (P < 0.001) and oral mucosal lesions (P < 0.05). Children with and without CP had similar caries experiences (P > 0.05), prevalence of enamel defects (P > 0.05) and dental trauma (P > 0.05). Conclusions. Differences of oral health status exist among preschool children with and without CP. Preschool children fare worse in terms of gingival health, tooth wear, oral mucosal health and malocclusion.

Objectives: The aim of this study was to compare the performance of a generic health-related quality-of-life measure, the Pediatric Quality of Life Inventory Version 4.0 (PedsQL 4.0) and an oral health-specific quality-of-life measure, the Early Childhood Oral Health Impact Scale (ECOHIS) in assessing the impact of severe early childhood caries (S-ECC) on the children's quality of life., Methods: A trained and calibrated examiner conducted a clinical oral assessment of 111 children (mean age: 49 +/- 12 months): 64 of whom were categorized as having S-ECC and 47 as being caries-free. Primary caregivers completed a Chinese version of the PedsQL 4.0 and the ECOHIS. Clinical examinations were conducted blind of the parental assessments., Results: The ECOHIS scores were significantly higher for the S-ECC group than for the caries-free group (P < or = 0.001). No significant difference was found between the PedsQL 4.0 scores in relation to caries status, except for the subscale of physical functioning (P = 0.04). Correlation of caries status with the ECOHIS scores was strong (r = 0.66; P < 0.01). No significant correlation was found between PedsQL 4.0 scores and caries status (r = 0.02; P > 0.05)., Conclusions: The oral health-specific measure, ECOHIS, shows better discriminant property between children with S-ECC and caries-free children than the generic measure, PedsQL 4.0. The ECOHIS appears more sensitive than PedsQL 4.0 in assessing the impact of dental caries on the life quality of preschool children.

Objective: This study aimed to adapt the Early Childhood Oral Health Impact Scale (ECOHIS) for pre-school children in a Chinese speaking community and to investigate its psychometric properties (validity and reliability)., Methods: A Chinese language version of the ECOHIS was derived through a forward-backward translation and tested for face and content validity among a focus group. A convenient sample of pre-school children (n = 111) was recruited (including a sub-sample with early childhood caries and caries-free children). Parents of the children self-completed the derived Chinese-ECOHIS measure. Validity of the measure was assessed by investigating the relationship between dental caries status and Chinese-ECOHIS scores (construct and criterion validity). A sub-sample of the parents repeated the ratings of the measure to enable reliability assessments. Both internal and test-retest reliability were determined., Results: A Chinese version of ECOHIS was derived with minor modification to the original version. Chinese-ECOHIS scores were associated with children's caries experience (dmft) (r = 0.66, P < 0.05) supporting convergent validity. In addition, variations in ECOHIS scores were apparent with respect to caries and caries-free groups (P < 0.001), supporting the ability to distinguish between patient groups. Cronbach's alpha values (internal reliability) for total ECOHIS score were 0.91 and intraclass correlation coefficient value (test-retest reliability) was 0.64., Conclusions: A Chinese version of the ECOHIS was developed and demonstrated acceptable validity and reliability. These findings can enable assessments of pre-school child oral health-related quality of life in Chinese speaking communities.

The aim of this survey was to study the oral health status of Hong Kong Chinese adults with Down syndrome (DS). Sixty-five community-dwelling adults with DS (aged 17 to 42 years, 26.8+/-6.4) and age- and gender-matched controls attending a dental hospital were included in a cross-sectional survey. The subjects with DS had fewer filled (2.4+/-4.6 vs. 2.7+/-3.1, p=0.017) and fewer decayed (1.1 2.5 vs. 1.7+/-2.4, p=0.007) teeth than the control subjects. Significantly more peg-shaped maxillary lateral incisors and retained primary teeth (p<0.001) were observed in subjects with DS, compared to the control subjects. Adults who had DS had a significantly higher percentage of surfaces with detectable plaque (81.5+/-19.1 vs. 61.9+/-16.0, p<0.001) and a higher percentage of sites with bleeding on probing (76.3+/-25.8 vs. 55.6+/-21.4, p<0.001). A higher proportion of subjects with DS showed one or more occurrences where probing pocket depth was > or =6mm than control subjects (49% vs. 24.5%, p<0.021). In conclusion, while having fewer caries, Hong Kong Chinese adults with DS had poorer periodontal health than age- and gender-matched control subjects.

The aim of this study was to review the outcomes of dental treatment under general anesthesia and to analyze the different types of caries management techniques for children in different age groups and time periods. Seven hundred inpatient general anesthetics were administered for 656 children between 1982 and 1999 were included in the analysis. This study concluded that the treatment modality of the caries management techniques varied according to the different age groups. Furthermore, the nature of the treatment changed the relative proportion of restorative procedures increased during the period under investigation.

Purpose: To determine if the in vitro 10-day pH-cycling model used for permanent teeth could be utilized to evaluate de/remineralization effects, on the enamel of primary teeth, of child formula toothpastes., Methods: Sound extracted primary anterior teeth were coated with nail varnish, leaving a 1 mm-wide window prior to being placed in a demineralizing solution to produce artificial carious lesions in enamel. The teeth were subsequently cut longitudinally into 100 microm thick sections. The 72 specimens were randomly assigned to six groups. In Set 1 contained the specimens in Group a, which were treated with a pea-sized (0.32 g) quantity of non-fluoride toothpaste (First Teeth), and Groups b and c which were treated with half and pea-sized (0.16 g) quantities of fluoridated toothpaste (Colgate), and cycled for 10 days. The specimens in Set 2 (Groups A, B and C) were similarly treated but subjected to 7-day pH-cycling., Results: After Day 8 the lesions in Set 1 extended into dentin and so could not be evaluated. Polarized light microscopy and microradiography were used to evaluate the lesions subjected to 7-day pH-cycling. Lesions in Groups A and B increased in depth and area by approximately 50%, while those in Group C increased in depth and area by 20%; however, no statistically significant differences occurred between the groups. If this model pH cycling is to be used for primary teeth, a reduction from 10 to 7 days in length should be considered.

Purpose: No data are available on possible risk indicators or the prevalence of caries lesions for preschool children under 4 years of age in Kerala, southern India. Therefore, the aims of this study were: (1) to gather data on caries lesion frequency and distribution; (2) to determine any possible associations with feeding habits and oral health care practices., Methods: A sample of 530 children, aged from 8 to 48 months (mean=2.5+/-0.96 years), who attended 13 day care centers were clinically examined for caries lesions using a disposable mouth mirror, tongue spatula, and a torch light. There were 513 dentate children. The caregiver of each child then completed, by interview, a structured questionnaire., Results: Among the group of 252 girls and 278 boys, the dmft was 1.84+/-2.87 with 56% of the children being caries-lesion free. Fifty-nine (12%) were considered to have early childhood caries (ECC), based on the criteria that smooth surface caries lesions on all 4 maxillary incisor teeth indicated severe ECC. Breast-feeding was practiced by 99% of the mothers, and 5% did so exclusively. Generally, breast-feeding was on demand. Statistically significant correlations were found between caries lesions and the child's dental condition, as perceived by the mother or caregiver (P<.0001), the dental status of the caregiver (P=.0417), consumption of snacks (P=.0177), giving of sweets as a reward (P<.0001), cleaning of the child's mouth (P<.0001), oral hygiene status of the child (P<.0001) and low socioeconomic status, as measured by income (P<.0001)., Conclusion: From the results of this study of preschool children in Kerala, the groups at high risk from dental caries lesions are: (1) those with poor oral hygiene status; (2) those who consume snacks and are given sweets as rewards; (3) those belonging to a lower socioeconomic class.

Objective: To investigate the relationship between the presence of demarcated opacities and hypoplasia on permanent teeth and the caries status of the primary predecessor teeth in a cohort of Chinese children., Methods: The study sample consisted of 250 children living in a non-fluoridated area in Southern China whose caries status of primary teeth at the age of 3-6 years had been recorded annually in a previous study. A follow-up examination of their permanent teeth was conducted when they were about 12 years old. The presence of enamel defects was determined by consensus of 2 dentists according to the modified DDE index., Results: 56.8% of the 250 children examined had demarcated opacities, while 10.8% of them had hypoplasia. Demarcated opacities and hypoplasia were found in 5.8 and 1.3% of the teeth examined, respectively. A higher prevalence of demarcated opacities was found in those permanent teeth of which their primary predecessor teeth had caries than in those without (7.5 vs. 3.8%, p < 0.001). A similar finding was obtained for the prevalence of hypoplasia (1.9 vs. 0.4%, p < 0.001)., Conclusion: There was an association between caries in primary teeth and the presence of demarcated opacities and hypoplasia in their permanent successors., (Copyright 2003 S. Karger AG, Basel)

This study sought to determine the prevalence of early childhood caries and the oral health habits of children ages 0 to 4 years in Macau, China vs. children in Hong Kong. Caregivers of 353 children from 7 nursery centers completed a questionnaire, and dental personnel examined their children with a light and disposable mouth mirror. The children's mean age was 2.8 +/- 0.6 years. Using the diagnostic criterion that cavitation was evidence of dental caries, the caries prevalence was 18%. When the age range was narrowed to 1.8 to 3.5 years, the caries prevalence was 19% in Macau children compared to 17% in Hong Kong children. No statistically significant relationship existed among caries prevalence, feeding habits, or oral hygiene habits, supporting the notion that the etiology of ECC is multifactorial. The similarity of caries prevalence in these 2 populations may result from the effects of cultural norms on the dental habits of the children.

Purpose: Single-step adhesives which etch and prime simultaneously and are not rinsed should not exhibit areas of incomplete infiltration within hybrid layers produced in sound dentin. This study examined the extent of silver uptake using ammoniacal silver nitrate in three two-step, self-etching primers (Imperva Fluoro Bond, Shofu; UniFil Bond, GC, ABF system, Kuraray) and one single-step, self-etching adhesive (AQ Bond, Sun Medical) bonded to dentin and four poly(HEMA) resins used as controls. Materials and Methods: Flat dentin surfaces were bonded with these adhesives and sectioned into 0.8-mm-thick slabs that were then coated with nail varnish except for the bonded interfaces and immersed in AgNO3 for 24 h. Four types of poly(HEMA) resins were made: 100% HEMA; 90% HEMA-10% water; 75% HEMA-10% water, all polymerized with TBBO at 50°C for 6 h; 100% HEMA polymerized at 25°C for 30 min. After developing, undemineralized, unstained, epoxy resin-embedded sections were prepared for TEM. Results: Nanoleakage patterns were observed in all bonded specimens. Fine segregated silver particles and reticular silver-staining patterns were found within the thin hybrid layers created by the three self-etching primers. For the single-step, self-etching adhesive, heavy silver deposits were identified within the hybridized complex formed by this adhesive within the smear layer, the underlying intact dentin, and in the adhesive layer. Increasing amounts of silver uptake were observed in poly(HEMA) specimens containing more water or that were polymerized at 25°C for a short time instead of 50°C for 6 h. Conclusions: Silver uptake in hybrid layers formed by self-etching adhesives in sound dentin is not necessarily caused by disparities between the depths of demineralization and resin infiltration. They represent areas of increased permeability within a polymerized resin matrix in which water is incompletely removed resulting in regions of incomplete polymerization and/or hydrogel formation. [ABSTRACT FROM AUTHOR]

Background: The health and well‐being of children are intimately linked to their parents' physical, emotional, and social health and social circumstances. Aim: To conduct a meta‐analysis of studies that have used the Early Childhood Oral Health Impact Scale (ECOHIS) and Child Oral Health‐Related Quality of Life (COHRQoL) instruments, to evaluate the family impact scale (FIS) changes following their children's dental treatment under general anaesthesia (DGA). Methodology: A systematic search was undertaken using the PRISMA guidelines. The inclusion criteria consisted of patients below 16 years of age, DGA, pre‐ and post‐operative assessments, and the use of ECOHIS and COHRQoL. FIS changes were the primary outcome measure, where the mean difference (MD) was calculated. Results: After initial search of 105 studies in the database, twenty‐one articles were included in the analysis. A positive outcome in the FIS changes was identified in all studies. The combined MD for FIS using ECOHIS and COHRQoL was 1.52 [95% CI: 1.15‐1.89; P < 0.00001; I2=87%] and 1.10 [95% CI: 0.68‐1.52; P < 0.00001; I2=79%], respectively. Conclusions: Dental treatment with general anaesthesia for children had a significant positive impact on parental emotions, activity, and conflict. Following DGA, there was significant improvement in the FIS, with large MD. [ABSTRACT FROM AUTHOR]

Objectives. Milk is a universal dietary component and it is now recognized as an effective medium for the delivery of fluoride (F). This study sought (i) to evaluate fluoridated milk (2.5 ppm, 5 ppm, 10 ppm) for remineralizing carious lesions and (ii) to determine the optimum frequency for treating carious lesions with fluoridated milk. Materials and methods. Artificial carious lesions, 90-180 μm deep, were created on extracted third molar teeth that were sectioned to produce specimens of 100-120 μm thickness. Specimens were randomly divided into 13 groups ( n = 20) for treatment with deionized water, plain milk or fluoridated milk (2.5 ppm, 5 ppm, 10 ppm); once daily, twice daily or on alternate days as part of a 20-day pH cycling model. Lesion depth (LD) and mineral content were evaluated before and after pH cycling. Paired t-test, ANOVA and Student-Newman-Keuls tests were employed to make comparisons within and between the different groups. Results. Fluoridated milk significantly reduced LD and increased the mineral content of the lesions compared to plain milk and deionized water ( p < 0.05). The greatest reduction in LD was with 2.5 ppm F milk used twice daily ( p < 0.05). Conclusions. Milk with 2.5 ppm F used twice daily demonstrated the greatest remineralization of artificial enamel carious lesions in vitro. [ABSTRACT FROM AUTHOR]

This study sought to determine the prevalence of early childhood caries and the oral health habits of children ages 0 to 4 years in Macau, China vs. children in Hong Kong. Caregivers of 353 children from 7 nursery centers completed a questionnaire, and dental personnel examined their children with a light and disposable mouth mirror. The children's mean age was 2.8±0.6 years. Using the diagnostic criterion that cavitation was evidence of dental caries, the caries prevalence was 18%. When the age range was narrowed to 1.8 to 3.5 years, the caries prevalence was 19% in Macau children compared to 17% in Hong Kong children. No statistically significant relationship existed among caries prevalence, feeding habits, or oral hygiene habits, supporting the notion that the etiology of ECC is multifactorial. The similarity of caries prevalence in these 2 populations may result from the effects of cultural norms on the dental habits of the children. [ABSTRACT FROM AUTHOR]

Clinical examinations of 276 5-year-old children were carried out twice yearly for 2½ years, and a further 1104 11-12-year-old children were examined annually for 3 years. Fifty per cent of permanent first molar teeth had erupted by 6.4 years; the mean age of eruption for permanent second molar teeth was 12.2 years. One year after these mean eruption dates over 10% of first molars and 45% of second permanent molars were already carious. Although development of caries was initially slower in permanent first molars, between the ages of 7.5 and 8.5 years the caries increment rose to 18.8%. By the age of 15 years the DMF was 92% for first and 68% for second molar teeth. The missing and filled proportion of the total DMF rose consistently. This represents the amount of treated caries and exceeded the amount of untreated caries in permanent first molars at all age levels. The rate of caries initiation in the present investigation emphasizes that restorative programmes and preventive regimens for children must be based on frequent recall examinations of not more than 6-monthly intervals. [ABSTRACT FROM AUTHOR]

A system of diagnosing occlusal caries from bitewing radiographs was developed in an attempt to overcome the problems of clinical diagnosis found in other studies. Standardized bitewing radiographs for 1172 Berkshire schoolchildren aged 11-13 years who were participating in a toothpaste trial, were assessed for occlusal caries under uniform magnification and illumination. The radiographic scores were then compared with the clinical records for these subjects. The radiographic technique proved to be acceptably reproducible at 82.6 %. However, only 33.2 % of the lesions present were detected on the radiographs. It is concluded that bitewing radiographs for the detection of occlusal caries are of little value in epidemiological studies. [ABSTRACT FROM AUTHOR]

Abstract: The aetiology of impacted maxillary canines remains obscure. Numerous researchers have focused on identifying specific and non-specific aetiological factors responsible for canine displacement. Currently, the two most popular hypotheses that have gained consensus worldwide are the guidance theory and the genetic theory. However, no single hypotheses, can completely explain the aetiology of impaction of maxillary canines. This retrospective study was used to develop and postulate the aetiology of both buccally and palatally impacted maxillary canines. The study was conducted on a sample of 533 patients for whom the pattern and distribution of the impacted maxillary canines, sex differences, the dental age of the patients, dental anomalies and various geometric measurements which were made on the panoramic radiographs were recorded. Based on these findings, the sequential hypothesis of impaction of the maxillary canine was postulated. The hypothesis states that both buccally and palatally impacted canines have similar aetiological factors leading to their impaction. It is suggested that genetic mechanisms strongly influence the potential of the maxillary canine to be impacted and the guidance from the lateral incisor and the stage of development plays a vital role in determining the ultimate position of the impacted canine. [Copyright &y& Elsevier]

Objectives: To examine the effect of adjunctive application of chlorhexidine (CHX) and ethanol-wet bonding (EWB) on bond durability and nanoleakage of hydrophobic adhesive to sound (SD) and caries-affected dentine (CAD). Methods: Dentine surfaces of molars were etched after caries removal and randomly allocated to four groups (n = 12). In Groups 1 and 2, dentine surfaces were saturated with either 2 ml of 100% ethanol or 2 ml of ethanol with 2% CHX for 60 s. In Groups 3 and 4, dentine surfaces were saturated with either 15 μL of distilled water or 15 μL of distilled water with 2% CHX for 60 s. Two coats of primer, followed by neat resin were applied and lightcured for 40 s. Resin composite build-ups were placed and bonded specimens were sectioned for bond strength testing after 24 h and 12 months' storage in artificial saliva. Bond strength data were analyzed using 3-way ANOVA and SNK tests. Interfacial nanoleakage was evaluated after 24 h and 12 months using a field-emission scanning electron microscopy and data were analyzed using Kruskal-Wallis test. Results: Significant differences were observed for the three factors: ''substrate'' ( p < 0.001), ''rewetting agents'' ( p < 0.001) and ''time'' ( p < 0.001) on bond strength. Incorporation of 2% CHX to EWB preserved bond strength to SD and CAD and reduced interfacial nanoleakage after 12 months. Incorporation of 2% CHX to WWB also preserved bond strength to SD after ageing. Conclusions: Incorporation of chlorhexidine to ethanol-wet bonding has an interaction effect on preservation of bond durability to sound and caries-affected dentine. Clinical significance: Incorporation of chlorhexidine to ethanol-wet bonding with hydropho- bic adhesive enhances the success rate of aesthetic bonded restorations. [ABSTRACT FROM AUTHOR]