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Purpose: The purpose of this study was to survey the membership of the American Academy of Pediatric Dentistry (AAPD) and determine the current status of nitrous oxide (N2O) utilization in their dental practices while also comparing the findings to a similar survey completed 20 years ago., Methods: A 55-item questionnaire on the use of N2O was sent to the AAPD membership., Results: The total number of respondents was 1,632 (26 percent). Sixty-two percent are board-certified, 97 percent use N2O in their office, 18 percent indicated greater than 80 percent of their patient pool required N2O versus six percent in 1996. Fifty percent of parents expressed concerns about N2O use., Conclusions: Changes have occurred in the use of nitrous oxide since 1996, including: (1) a greater percentage of practitioners using N2O; (2) perceptions that more pediatric patients need N2O; (3) a shift in use of N2O by duration of practitioner experience; (4) an increased percentage of board-certified respondents; and (5) possible increasing parental concerns about N2O.

Full-coverage restorations are indicated for posterior primary teeth as definitive treatments for high caries-risk children and in patients whose treatment is being performed under general anesthesia. Advances in biomaterials and parental preferences have driven interest in esthetic full coverage treatment options for primary posterior teeth. The prefabricated resin crown offers a 'flex fit' adaptation over the anatomic cervical convexity of the primary clinical crown, similar in functionality to a stainless steel crown. A new commercial product, BioFlx, hopes to address the ductility, color stability and durability concerns that glass fiber-reinforced composite crowns have while maintaining the enticing clinical aspects, namely the flex fit, esthetic appearance and more conservative tooth preparation when compared to pediatric zirconia crowns. The purpose of this case report is to describe an alternative restorative material that can be employed to deliver an esthetic full coverage solution in a child with a potential nickel allergy. [ABSTRACT FROM AUTHOR]

The world is hopeful a vaccine will help mitigate the COVID-19 pandemic. The authors conducted a hospital-based study using a questionnaire to examine parental acceptance of an anticipated COVID-19 vaccination. A 41-item questionnaire using the Health Belief Model was administered to caregivers of children receiving oral health care in a dental clinic in an urban pediatric teaching hospital. Demographic, health-seeking, and health-behavior questions were assessed. A total of 39.2% of caregivers would not allow their child to receive a COVID-19 vaccination. Whereas 27.8% of caregivers agreed that if their physician recommends a COVID-19 vaccination, they will allow their child to receive it, 52.2% said that a health care professional could influence this decision. Dentists, intimately aware of the suggested risks of aerosol-generating procedures, can play a critical role in educating the public about the importance of accepting a COVID-19 vaccine. Dentists are in a unique position to discuss and advocate for vaccine acceptance. If a COVID-19 vaccine is not widely accepted, risks associated with performing aerosol-generating procedures will remain. [ABSTRACT FROM AUTHOR]

Purpose: To assess the diagnostic confidence of intraoral radiographic image quality while reducing the pediatric patient's radiation exposure using a longer position indicating device (PID), additional X-ray beam filtration and rectangular collimation while using modern, lower-power intraoral dental X-ray units. Methods: A randomized prospective study scored bitewing intraoral dental images based on relevant clinical features. Observer studies with pediatric dentists and dental residents were conducted to verify whether diagnostic confidence remained unchanged after dose reduction modifications. The study involved a two-phase investigation to determine: (1) the best thickness of aluminum (Al) 2024-T3 alloy filter and (2) required increased exposure time to maintain intraoral radiographic image quality. A 30 cm PID with a rectangular collimator was used to further manage patient dose. For each phase, images from 125 patients were collected from February 2017 to September 2018 and analyzed. Results: The results from the observer study using a 30 cm PID, 1.02 mm thick Al alloy filter, and a rectangular collimator resulted in a patient dose reduction between 64 percent (exposure time of 400 msec) to 77 percent (250 msec), without any statistically significant effect to the diagnostic confidence of the observers in evaluating the reduced radiation images. Conclusion: Long recognized dose reduction methods, when implemented on a modern, low-power intraoral dental X-ray unit, do not impact confidence in bitewing diagnostic images, but substantially reduce patient dose and should be adopted to increase patient safety, especially for children. [ABSTRACT FROM AUTHOR]

A 13-year-old female presented with traumatized maxillary central incisors that had been endodontically treated. Five years later, at a different dental office, she had the clinical crowns removed, leaving subgingival margins. From the patient's history and our initial assessment, it seemed as if the teeth had been fractured and luxated but not avulsed. Endodontic posts with spot-welded orthodontic brackets were temporarily cemented to enable orthodontic extrusion. Once access to restorable margins was obtained, the temporary posts were removed and conventional fiber posts with interim composite crowns were placed. The restorations were still satisfactory at the one-year follow-up, with a healthy periodontium, intact apical seal, and no signs of external resorption observed. Combined specialty treatment provided an esthetically acceptable outcome in a difficult restorative situation for a growing child. The purpose of this case report is to discuss an interim treatment until the child reaches dentofacial maturity, when definitive restorations can be provided. [ABSTRACT FROM AUTHOR]