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Dens invaginatus is a developmental variation resulting from an alteration in the normal growth pattern of the dental papilla of a tooth. They predominantly occur on maxillary permanent lateral incisors. Their occurrence in several maxillary incisor teeth in an individual has been frequently reported, and the examination of bilateral teeth for the anomaly is well accepted. However, the present case illustrates the importance of examining both maxillary and mandibular incisors in patients who present with a dens invaginatus, in addition to other members of the family. [ABSTRACT FROM AUTHOR]

Summary. The aim of this study was to evaluate four behavioural scales which have been used to assess anxious children during dental treatment: The Frankl (F), Houpt (H), Visual Analogue (VAS) and Global Rating (GR) scales. The study measured the agreement on three of the scales (F, H and VAS) between two judges expert in the management of anxious children and also between four other dentists. The operating dentists scored each visit using the fourth scale (GR). Twenty-nine anxious children aged 3-16 years who had been referred to a specialist clinic were included in the study, and 64 separate visits were recorded on videotape. The two-judge panel evaluated the children's behaviour on all 64 visits, and the four-judge panel evaluated a 12-visit segment. Comparisons within and between the two-judge and four-judge panels showed close agreement on the Visual Analogue and Houpt scales but not on the Frankl scale. There was significant correlation between the Global Rating scale and the Visual Analogue, Houpt and Frankl scales. Résumé. Evaluation de quatre méthodes de prise en charge comportementale d'enfants pour les soins dentaires Le but de cette étude est d'évaluer les tests de comportement utilisés pour noter les enfants anxieux pendant les traitements dentaires: les tests de Frankl (F), Houpt (H), Analogue Visuel (AV) et Note Globale (NG). L'étude a mesuré la concordance des réponses à trois de ces tests par deux praticiens spécialisés dans la prise en charge des problèmes de comportement d'enfants anxieux et aussi par quatre dentistes différents. Les opérateurs ont noté chaque séance à l'aide du quatrième test (NG). Vingt neuf enfants anxieux âgés de 3 à 16 ans, qui avaient été adressés dans un service spécialisé, ont été inclus dans cette étude et soixante quatre séance ont été enregistrées sur vidéo-cassettes. Le jury des deux praticiens spécialisés a noté les soixante quatre séances et le jury des quatre autres opérateurs a noté un groupe de douze séances. Les comparaisons entre les deux jurys ont montré des réponses proches pour le test Analogue Visuel et Houpt mais pas pour le test de Frankl. Il n'y avait pas de corrélation significative entre test Note Globale et Analogue Visuel, Houpt et Frankl. Zusammenfassung. Ein Vergleich von 4 Methoden zur Beurteilung des Benehmen von ängstlichen pädodontischen Patienten Das Ziel dieser Studie war 4 verschiedene Skalen, welche für das Benehmen von ängstlichen Kindern während einer zahnärztlichen Behandlung angewendet werden, zu beurteilen und vergleichen, das Frankl (F), Houpt (H), Visual Analogue (VAS) Global Rating (GR) Skalen. Die Studie beurteilt die Übereinstimmung von 3 Skalen (F, H; VAS) durch 2 Experten und zwischen 4 anderen Zahnärzten. Die behandelten Zahnärzte benutzen die GR Skala, 29 ängstliche Kinder zwischen 3 und 16 Jahre welche an eine Spezialistenpraxis überwiesen wurden nahmen teil an dieser Studie. 64 einzelne Behandlungstermine wurden per Video aufgezeichnet. Die 3 Experten beurteilten das Benehmen der Kinder an alien 64 Sitzungen. Die 4 anderen Beurteilten Segmente von 12 Sitzungen. Zwischen der 2er und der 4er Gruppe ergab sich ein Einvernehmen bezüglich der VAS und der H Skalen aber nicht bei der F. Skala. Eine signifikante Korrelation ergab sich zwischen GR, VAS, H und F Skalen. Resumen. Evaluación de cuatro métados para evaluar el comportamiento de pacientes niños en odontología El propósito de este estudio fue evaluar diferentes escalas que han sido utilizadas para evaluar el grado de ansiedad de los niños durante el tratamiento dental: las escales de Frankl (F), Houpt (H), Análoga Visual (AV) y Evaluación Global (EG). El estudio midió el grado de acuerdo entre de las escalas (F, H y AV) entre dos jueces expertos en el manjo de niños ansiosos y tambien entre cuatro odontólogos. Los odontólogos evaluaron cada visita con la cuerta escala (EG). Un total de 29 niños ansiosos de 3-16 años que habían sido referidos a la chínica especialista en niños fueron incluídos en el estudio y 64 visitas separadas fueron grabadas en video. El panel de dos jueces evaluaron el compostramiento de los niños para las 64 vistas y el panel de los cuatro jueces odontólogos evaluaron un segmento d 12 visitas. Las comparaciones entre los paneles de dos y cuatro jueces mostró una gran similitud al utilizar la escala Visual Análoga pero no con la escala de Frankl. Hubo una significativa correlación entre las escalas de Evaluación Global, Visual Análoga, Houpt y Frankl. [ABSTRACT FROM AUTHOR]

Summary. A report is presented of a prospective study into the oral manifestations of liver disease in children. Fifty-five children who had received a liver transplant were examined; their ages ranged from 8 months to 16 years 2 months, and 37 of them were under 5 years of age. The following information was noted: the teeth that were erupted, the presence and severity of enamel hypoplasia and of gingival hyperplasia, and the presence of intrinsic discoloration. Results showed that seven of the 17 children under 3 years of age had delayed eruption of teeth. Six children had enamel hypoplasia, three in permanent incisors and three in primary incisors. Intrinsic discoloration was found in the primary dentition of 25 children (23 of whom had biliary atresia prior to receiving the transplant) and in one child's permanent incisors. Thirty-four children had gingival hyperplasia. There was a significant inverse relationship between the length of time since transplantation and the severity of gingival hyperplasia. Analysis of variance failed to show any association between serum cyclosporin levels and the severity of gingival hyperplasia. There was no significant relationship between current nifedipine medication and the presence of gingival hyperplasia. Résumé. Manifestations orales chez des enfants hépatotransplantés Une étude prospective des manifestations orales chez des enfants souffrant de maladie hépatique a été entreprise chez cinquante cinq enfants ayant reçu un transplant hépatique. Leur âge s'étalait de 8 mois à 16 ans 2 mois et 37 d'entre eux avaient moins de trois ans. Les informations suivantes ont été notées: les dents ayant fait leur éruption, la présence et la sévérité des hypoplasies, des hyperplasies gingivales, des décolorations intrinséques. Les résultats ont montré que 7 des 17 enfants âgés de moins de 3 ans avaient des retards d'éruption. Six enfants avaient des hypoplasies de l'émail, trois sur les incisives permanentes et trois sur les incisives temporaires. Des décolorations intrinséques ont été retrouvées dans la dentition temporaire de 25 enfants (23 d'entre-eux avaient eu une atrésie biliaire avant la transplantation), et sur les incisives permanentes d'un enfant. Trente enfants avaient une hyperplasie gingivale. Il y avait une relation significative inversée entre l'ancienneté de la transplantation hépatique et la sévérité de l'hyperplasie. l'analyse de variance n'a montré d'association entre le taux de cyclosporine dans le sang et la sévérité de l'hyperplasie gingivale. Il n'y avait pas de relation significative entre le traitement par nifédipine et la présence d'hyperplasie gingivale. Zusammenfassung. Orale Manifestationen bei Kindern mit Lebertransplantaten 55 Kinder, nach Lebertransplantationen wurden untersucht. Das Alter bewegte sich zwischen 8 Monaten bis 16 Jahre und 2 Monate. 37 davon waren weniger als 3 Jahre alt. Die folgenden Befunde wurden registriert: der Stand des Zahndurchbruches, das Vorhandensein und der Schweregrad von Schmelzhypoplasien, eventuele Verfárbungen und Gingivahyperplaisen. Man fand dass 7 der 37 Kinder unter 3 Jahren einen verzögerten Zahndurchbruch aufwiesen, ebenso hatten sie Hypoplasien, bei 3 Kindern in den bleibenden Frontzähnen und bei 3 in den Milchfrontzähnen. Verfárbungen wurden an den Milchzähnen von 25 Kindern und bei einem Kind an den bleibenden Frontzähnen gefunden. Von den Kindern mit betroffenen Milchzähnen litten 23 vor der Transplantation an einer Gallenatresie. Bel 30 Kindern wurde eine Gingivahyperplasie diagnostiziert. Eine signifikante umgekehrten Relation, wurde festgestellt, zwischen der Zeitspanne seit der Transplantation und dem Schweregrad der Gingivalen Hyperplasie. In einer weiteren Analyse fand man keine Beziehung zwischen dem Zyklosporinspiegel im Serum und dem Schweregrad der Gingivahyperplasie. Es war keine signifikante Beziehung zwischen der laufenden Nifedipine Medikation und der Gingivahyperplasie festzustellen. Resumen. Manifestaciones orales en niños con transplantes del higado Se presenta un reporte de un estudio prospectivo sobre las manifestaciones orales en niños que han recibido transplantes del hígado. Se examinó un total de 55 niños (de 8 meses a 16 años y 2 meses de edad; 37 de elos menores de 3 años de edad) que habían recibido transplante del higado. La siguiente información fue anotado: dientes erupcionados, presencia y severidad de hipoplasia del esmalte y de hiperplasia gingival, y la presencia de pigmentaciones intrínsecas. Los resultados mostraron que 7 de los 17 niños menores de 3 años de edad presentaron erupción dental retardada. Seis de los niños presentaron hipoplasia del esmalte, tres en los incisivos permanentes y tres en los incisivos temporales. Pigmentaciones intrínsecas fueron observadas en la dentición temporal de 25 niños y en los incisivos permanentes de un niño (23 de ellos tenían atresia billar antes de recibir el implante). Treinta niños presenraron hiperplasia gingival. No hubo relación inversamente proporcional entre el tiempo transcurrido despues del transplante y la severidad de la hiperplasia gingival. El análisis de varianza no mostró asociación entre los niveles de ciclosporina sérica y la severidad de la hiperplasia gingival. No hubo relación significativa entre la medicación con nifedipina y la presencia de hiperplasia gingival. [ABSTRACT FROM AUTHOR]

Introduction Despite overall improvements in oral health, the number of children admitted to hospital for extraction of teeth due to caries under general anaesthesia (GA) has been reported as increasing dramatically in England. The new UK government plans to transform NHS dentistry by improving oral health.Aim To evaluate the dental care received by children who required caries-related extractions under GA and obtain the views of their parents or guardians on their experiences of oral health services and the support they would like to improve their child's oral health, to inform future planning.Method An interview questionnaire was designed and piloted to collect data from a consecutive sample of 100 parents or guardians during their child's pre-operative assessment appointment. This took place at one London dental hospital between November 2009 and February 2010.Results Most children were either white (43%) or black British (41%); the average age was seven years (range 2-15, SD 3.1, SE 0.31) and the female:male ratio was 6:5. Most (84%) had experienced dental pain and 66% were referred by a general dental practitioner (GDP). A large proportion of parents or guardians (47%) reported previous dental treatment under GA in their children or child's sibling/s. Challenges discussed by parents in supporting their child's oral health included parenting skills, child behaviour, peer pressure, insufficient time, the dental system and no plans for continuing care for their child. Three out of four parents (74%) reported that they would like support for their child's oral health. Sixty percent of all parents supported school/nursery programmes and 55% supported an oral health programme during their pre-assessment clinic.Discussion These findings suggest that the oral health support received by high caries risk children is low. Health promotion programmes tailored to this cohort are necessary and our findings suggest that they would be welcomed by parents. [ABSTRACT FROM AUTHOR]

ObjectiveTo determine the type of dental assessment service offered to children prior to exodontia under chair dental general anaesthesia (CDGA) in the community and hospital dental services (CDS, HDS) in Scotland.Design and settingTelephone interviews were conducted with CDS and HDS clinical directors in Scotland using a semi-structured questionnaire, with written follow-up confirmation. Copies of CDGA referral forms were also requested.ResultsAll clinical directors, or their nominated deputies, participated (n = 21). Almost half of interviewees indicated that their area offered a 'dedicated' pre-CDGA assessment service (n = 10). A range of grades was identified amongst assessors; a minority were described as 'specialist paediatric staff'. The availability of CDGA alternatives, including local analgesia and conscious sedation varied. Changes to the referral treatment plan were reported to occur 'sometimes' or 'often' by 11 interviewees regarding the anaesthetic used, and by 16 respondents regarding the number of teeth extracted. The content of CDGA referral forms was diverse.ConclusionsThe method of referral and assessment of children for CDGA in Scotland is diverse, partly reflecting geographic limitations and local need. Guidance on pre-GA assessment, including use of standardised referral forms, may reduce variation and improve the quality of the pathway of care. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness of preventive interventions in children who have undergone caries-related dental extractions., Methods: Rapid review across five databases (CENTRAL, Ovid Medline, Embase, Web of Science and Scopus). Quality was assessed using the Risk of Bias 2 tool., Results: Five studies were included, all randomised controlled trials involving pre-and/or post-extractions activity. Three studies involved oral health education (computer game, motivational interviewing, visual aids), one delivered clinical prevention (fissure sealants), and one an enhanced prevention programme combining additional health education and a clinical intervention (fluoride varnish). Retention was mixed (55%-80% in the intervention groups). Of the three studies measuring caries, all reported less caries development in the test group. However, only a study involving a dental nurse-delivered structured conversation, informed by motivational interviewing, showed an improvement in oral health. Two studies reporting on plaque and gingival bleeding had conflicting results. A study reporting on subsequent dental attendance did not demonstrate a clear improvement., Conclusion: Few published studies have explored prevention-based interventions in high caries-risk children requiring dental extractions. Whilst evidence of clinical benefit of preventive interventions in this population is limited, the potential use of contemporary behaviour change techniques appears promising. There is an urgent need for more high-quality longer-term trials using contemporary methodologies., (Copyright© 2024 Dennis Barber Ltd.)

The purpose of this study was to determine the efficacy of a dental nurse-delivered intervention-the Dental RECUR Brief Negotiated Interview for Oral Health (DR-BNI)-in reducing the recurrence of dental caries in children who have a primary tooth extracted. It was based on a 2-arm multicenter randomized controlled trial with blinded outcome assessment. Participants were 5- to 7-y-old children ( n = 241) scheduled to have primary teeth extracted in 12 UK centers. Test intervention parents ( n = 119) received DR-BNI led by trained dental nurses. DR-BNI is a 30-min structured conversation informed by motivational interviewing with a forward focus to prevent future caries. Preventive goals are agreed, and a review appointment is made with child's general dental practitioner, who is advised to treat the child as being at high caries risk. The control intervention ( n = 122) was a parent-nurse conversation about child's future tooth eruption, with advice given to visit a general dental practitioner as usual. At baseline, the DR-BNI group's mean dmft was 6.8, and the control group's was 6.3. A median of 5 teeth were extracted, mainly under general anesthesia. Final dental assessments were conducted by a single examiner visiting 189 schools 2 y after intervention; 193 (80%) of 241 children were examined. In the control group, 62% developed new caries in teeth that were caries-free or unerupted at baseline, as compared with 44% in the test group, a significant reduction ( P = 0.021). The odds of new caries experience occurring were reduced by 51% in the DR-BNI group as compared with control. There was a 29% decrease in the relative risk of new caries experience in the DR-BNI group as compared with control. This single low-cost, low-intensity intervention was successful in significantly reducing the risk of recurrence of dental caries in children. This trial has implications for changing pediatric dental practice internationally. Training in and implementation of a motivational interviewing-informed brief intervention provides opportunities for dental nurses to facilitate behavior change improving the oral health of children at high caries risk (ISRCTN 24958829).

Objectives: To: 1, Explore opinions of parents of children undergoing caries treatment under general anaesthesia (GA) regarding delivery of oral health advice; 2, Discover current oral health practices and beliefs; 3, Inform further research and action., Methods: Qualitative study using semi-structured interviews and thematic data analysis, sampling parents of children aged 3-10 years undergoing GA tooth extraction due to dental caries., Results: Twenty nine parents were interviewed (mean age 38.9 years, range 28-50, sd 6.4). The mean age of their children was seven years (range 3-10, sd 2.1). All children required deciduous tooth extractions (5.1 teeth on average). Those that also required permanent tooth extractions had on average 2.1 permanent teeth extracted. Many parents knew the importance of oral hygiene and sugar limitation, describing it as 'general knowledge' and 'common sense'. However, few understood that fruit juice is potentially cariogenic. Parenting challenges seemed to restrict their ability to control the child's diet and establish oral hygiene. Many reported not previously receiving oral health advice and reported never having fluoride varnish applied. There were requests for more caries prevention information and advice via the internet, schools or video games., Conclusion: Parental oral health knowledge, parenting skills, and previous advice received seem to all be issues related to the oral health of those children. Providing advice, especially in respect to fruit juice cariogenicity and the benefits of fluoride application through a child-friendly website, including a video game, as well as the use of school programmes might be an acceptable approach.