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Objective: To investigate the association between feeding practices (exclusive breastfeeding, exclusive bottle-feeding, and mixed) with early childhood caries (ECC) and the association between the prevalence of oral Rothia, at the species and genus level, with ECC. Methods: A total of 438 children (178 caries-free, 260 with ECC) were included in this case-control study. A comprehensive questionnaire that included a section on feeding history, was completed by the parent or caregiver of each participant. Based on the feeding history responses, participants were classified as either exclusively breastfed, exclusively bottle-fed, or mixed (both bottle-fed and breastfed). A supragingival plaque sample was collected from each participant and then assessed with 16S rRNA sequencing for Rothia genus and species’ relative abundances. The association between feeding practices and Rothia prevalence with ECC, accounting for confounding variables, was analyzed using multivariable logistic regressions. Results: A low relative abundance of Rothia aeria was significantly associated with ECC (p<0.05), whereas there were no significant associations found between the relative abundance of Rothia dentocariosa or Rothia mucilaginosa with caries status (p>0.05). While the odds of association between a low relative abundance of Rothia (genus) and ECC was 1.63, this relationship failed to reach the threshold of significance (p=0.054). Feeding practices were not significantly associated with ECC after adjusting for confounding variables. However, bedtime bottle use, bedtime snacking, living in a rural/remote area, being an older age, the use of fluoridated toothpaste, and having less-educated guardians were significantly associated with ECC (p<0.05) Conclusions: Findings in this study suggest that low relative abundances of R. aeria and Rothia (genus) are associated with ECC. Feeding practices were not key risk factors for ECC in this sample, as other factors related to the social environme

Introduction: Dental caries is one of the most frequent chronic conditions in childhood. Silver diamine fluoride (SDF) is a recognized caries arresting agent, but its use is relatively new in Canada. SDF has the potential to arrest early childhood caries in young children and delay treatment until children can be seen in outpatient settings. In August 2020 the Non-Insured Health Benefits (NIHB) program of the Department of Indigenous Services Canada approved the following procedure “Topical application to hard tissue lesion(s) of an antimicrobial or remineralization agent (includes silver diamine fluoride)”. The purpose of this study was to investigate the utilization of SDF by Canadian dental providers for First Nations and Inuit Canadians with dental benefits through the NIHB program. Methods: The NIHB program provided data on all claims paid for the procedure “topical antimicrobials or remineralization agent/SDF” for children < 17 years and any other procedure claimed on the same date for the period from August 1, 2020 to July 31, 2022 in all Canadian provinces and territories with the exception of British Columbia, Newfoundland and Labrador, and Prince Edward Island. Claims made by general dentists, pediatric dentists, prosthodontists, and dental hygienists were included. The claims from August 2020 until July 2022 were arranged into eight,3 months, quarters. Rates of SDF application by province or territory were calculated. Data were analyzed using NCSS 2023 Statistical Software. Statistical analyses included descriptive statistics (frequencies, mean ± standard deviations (SD)). Results: There were 4,158 claims for SDF between August 1, 2020 and July 31, 2022 for 3,465 children <17 years of age. The mean age was 7.9 ± 4.0 years and 52.9% of those were female. The majority of claims, both for the initial claim (87.1%) and follow up visit claims, were made by general dentists. Most children had another procedure at the initial and follow up visits, with claims be

Introduction: The Covid-19 pandemic amplified access to care challenges faced by many priority populations, including First Nations and Inuit Peoples. During wave 1 of the pandemic in Canada, dental clinicians were mandated to postpone non-emergency dental services, and in many parts of the country, all dental operations ceased. Concerning this, the Non-Insured Health Benefits (NIHB) program approved “virtual dental consultation services” and decided to temporarily cover fees for consultation services by phone or other virtual methods to help assess clients’ needs and facilitate access to emergency dental care. The purpose of this study was to investigate the utilization of the virtual code by Canadian dentists during the beginning of the Covid-19 pandemic for children 18 years of age or younger. Methods: NIHB provided a secure data transfer portal for dental claims paid for the procedure “consultation with client for the emergency management and triage of client’s acute oral health care needs by phone or other virtual methods” and follow-up treatment with a date of service from April 1, 2020 to August 31, 2021. Data were analyzed using NCSS 2022 Statistical Software. Statistical analyses included frequencies, descriptive statistics, analysis of variance (ANOVA), and Chi-squared test. Results: Overall, 1040 patients 18 years of age or younger had a virtual visit with follow-up treatment between April 2020 and August 2021. The mean age was 10.5 ± 4.9 years and 54.3% were female. Most of the virtual consultations were completed by general practitioners 951 (91.4%) and pediatric dentists 86 (8.3%) and most initial virtual visits were completed in Quebec 358 (34.4%), Saskatchewan 266 (25.6%), Alberta 158 (15.2%), and Manitoba 120 (11.5%). More extractions were completed than any other type of dental treatment during the first visit following the initial consultation with a total of 417 extractions. The time between the initial consultation and the first follow-up visit

Objective: To investigate the oral health-related quality of life (OHRQoL) of young children in a randomized clinical trial of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) to manage early childhood caries (ECC). Methods: Children < 72 months of age with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth received two applications of 38% SDF and 5% FV as part of a randomized clinical trial testing three different frequency regimes (1, 4 and 6 months apart). The early childhood oral health impact scale (ECOHIS) questionnaire was completed at each study visit. Statistical analyses included descriptive and parametric methods. A p-value ≤ 0.05 was statistically significant. Results: Eighty-two children (58.5% male) were recruited with a mean age of 44.3±14.2 months. Statistically significant improvement in total ECOHIS scores for all children was observed following treatment (baseline mean scores 4.64±4.74 vs. second visit score 3.26±4.36 vs. third visit score 3.25±3.77, p=0.006 and p=0.01, respectively). The following domains showed the most improvement with SDF treatment: parental distress, and family function. No statistically significant difference in ECOHIS scores were observed between the three frequency groups at baseline, second visit, and final visit (p=0.24, p=0.71 and 0.26) Conclusions: Children exhibited improved overall OHRQoL following two applications of 38% SDF and 5% FV, although there were no significant differences observed between the treatment groups. The results from our study demonstrate that SDF is a suitable non-restorative caries management option for children with ECC as it is associated with improved oral health related quality of life.

Introduction: The Covid-19 pandemic amplified access to care challenges faced by many priority populations, including First Nations and Inuit Peoples. During wave 1 of the pandemic in Canada, dental clinicians were mandated to postpone non-emergency dental services, and in many parts of the country, all dental operations ceased. Concerning this, the Non-Insured Health Benefits (NIHB) program approved “virtual dental consultation services” and decided to temporarily cover fees for consultation services by phone or other virtual methods to help assess clients’ needs and facilitate access to emergency dental care. The purpose of this study was to investigate the utilization of the virtual code by Canadian dentists during the beginning of the Covid-19 pandemic for children 18 years of age or younger. Methods: NIHB provided a secure data transfer portal for dental claims paid for the procedure “consultation with client for the emergency management and triage of client’s acute oral health care needs by phone or other virtual methods” and follow-up treatment with a date of service from April 1, 2020 to August 31, 2021. Data were analyzed using NCSS 2022 Statistical Software. Statistical analyses included frequencies, descriptive statistics, analysis of variance (ANOVA), and Chi-squared test. Results: Overall, 1040 patients 18 years of age or younger had a virtual visit with follow-up treatment between April 2020 and August 2021. The mean age was 10.5 ± 4.9 years and 54.3% were female. Most of the virtual consultations were completed by general practitioners 951 (91.4%) and pediatric dentists 86 (8.3%) and most initial virtual visits were completed in Quebec 358 (34.4%), Saskatchewan 266 (25.6%), Alberta 158 (15.2%), and Manitoba 120 (11.5%). More extractions were completed than any other type of dental treatment during the first visit following the initial consultation with a total of 417 extractions. The time between the initial consultation and the first follow-up visit

Objective: To investigate the oral health-related quality of life (OHRQoL) of young children in a randomized clinical trial of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) to manage early childhood caries (ECC). Methods: Children < 72 months of age with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth received two applications of 38% SDF and 5% FV as part of a randomized clinical trial testing three different frequency regimes (1, 4 and 6 months apart). The early childhood oral health impact scale (ECOHIS) questionnaire was completed at each study visit. Statistical analyses included descriptive and parametric methods. A p-value ≤ 0.05 was statistically significant. Results: Eighty-two children (58.5% male) were recruited with a mean age of 44.3±14.2 months. Statistically significant improvement in total ECOHIS scores for all children was observed following treatment (baseline mean scores 4.64±4.74 vs. second visit score 3.26±4.36 vs. third visit score 3.25±3.77, p=0.006 and p=0.01, respectively). The following domains showed the most improvement with SDF treatment: parental distress, and family function. No statistically significant difference in ECOHIS scores were observed between the three frequency groups at baseline, second visit, and final visit (p=0.24, p=0.71 and 0.26) Conclusions: Children exhibited improved overall OHRQoL following two applications of 38% SDF and 5% FV, although there were no significant differences observed between the treatment groups. The results from our study demonstrate that SDF is a suitable non-restorative caries management option for children with ECC as it is associated with improved oral health related quality of life.

Objective: To investigate the effectiveness of silver diamine fluoride (SDF) to arrest early childhood caries (ECC) in very young children randomized to three different application frequency groups (regimens) Methods: Children with active dentinal carious lesions (ICDAS 5 or 6) in primary teeth without any signs of pulpal involvement were randomized into three different application frequency groups; 1, 4, or 6 months apart. Children underwent treatment with 38% SDF at baseline visit and again at a second visit. Treated lesions were assessed at the second and third visits to determine arrest success. Participants were considered completely successful (CS) if all treated lesions were arrested and incompletely successful (IS) if at least one lesion was not arrested. Statistical analyses included descriptive and bivariate analyses. A p value ≤ 0.05 was significant. Results: A total of 84 children with 486 carious lesions were recruited into the study with 28 children in each group. The overall proportion of completely successful treated children at visit 2 and final visit were 40% and 68% respectively. Results of McNemar’s test showed a significant increase in complete success from 40% at second visit to 68% at visit 3 (p-value <0.001) across all groups for 84 study participants. Within each group, significant improvement in complete success at child-level was also noted with p-values of 0.041,0.023 and 0.004 for Regimen 1, 2 and 3 respectively. Participants in one month group showed a change of complete success from 36% at second visit to 71% at third visit (p-value 0.004). No significant differences were noted between the groups at second visit and final visit (p >0.05) Conclusions: Findings in this study suggested that two applications of SDF at different frequencies showed similar frequency of successfully treated cases at the child level. No difference was noted in success rates comparing three groups either at second or third visit. Results from our study

Objective: To investigate the effectiveness of silver diamine fluoride (SDF) to arrest early childhood caries (ECC) in very young children randomized to three different application frequency groups (regimens) Methods: Children with active dentinal carious lesions (ICDAS 5 or 6) in primary teeth without any signs of pulpal involvement were randomized into three different application frequency groups; 1, 4, or 6 months apart. Children underwent treatment with 38% SDF at baseline visit and again at a second visit. Treated lesions were assessed at the second and third visits to determine arrest success. Participants were considered completely successful (CS) if all treated lesions were arrested and incompletely successful (IS) if at least one lesion was not arrested. Statistical analyses included descriptive and bivariate analyses. A p value ≤ 0.05 was significant. Results: A total of 84 children with 486 carious lesions were recruited into the study with 28 children in each group. The overall proportion of completely successful treated children at visit 2 and final visit were 40% and 68% respectively. Results of McNemar’s test showed a significant increase in complete success from 40% at second visit to 68% at visit 3 (p-value <0.001) across all groups for 84 study participants. Within each group, significant improvement in complete success at child-level was also noted with p-values of 0.041,0.023 and 0.004 for Regimen 1, 2 and 3 respectively. Participants in one month group showed a change of complete success from 36% at second visit to 71% at third visit (p-value 0.004). No significant differences were noted between the groups at second visit and final visit (p >0.05) Conclusions: Findings in this study suggested that two applications of SDF at different frequencies showed similar frequency of successfully treated cases at the child level. No difference was noted in success rates comparing three groups either at second or third visit. Results from our study

Objective: To investigate the effectiveness of silver diamine fluoride (SDF) to arrest early childhood caries (ECC) in very young children randomized to three different application frequency groups (regimens) Methods: Children with active dentinal carious lesions (ICDAS 5 or 6) in primary teeth without any signs of pulpal involvement were randomized into three different application frequency groups; 1, 4, or 6 months apart. Children underwent treatment with 38% SDF at baseline visit and again at a second visit. Treated lesions were assessed at the second and third visits to determine arrest success. Participants were considered completely successful (CS) if all treated lesions were arrested and incompletely successful (IS) if at least one lesion was not arrested. Statistical analyses included descriptive and bivariate analyses. A p value ≤ 0.05 was significant. Results: A total of 84 children with 486 carious lesions were recruited into the study with 28 children in each group. The overall proportion of completely successful treated children at visit 2 and final visit were 40% and 68% respectively. Results of McNemar’s test showed a significant increase in complete success from 40% at second visit to 68% at visit 3 (p-value <0.001) across all groups for 84 study participants. Within each group, significant improvement in complete success at child-level was also noted with p-values of 0.041,0.023 and 0.004 for Regimen 1, 2 and 3 respectively. Participants in one month group showed a change of complete success from 36% at second visit to 71% at third visit (p-value 0.004). No significant differences were noted between the groups at second visit and final visit (p >0.05) Conclusions: Findings in this study suggested that two applications of SDF at different frequencies showed similar frequency of successfully treated cases at the child level. No difference was noted in success rates comparing three groups either at second or third visit. Results from our study

Objective: To investigate the effectiveness of silver diamine fluoride (SDF) to arrest early childhood caries (ECC) in very young children randomized to three different application frequency groups (regimens) Methods: Children with active dentinal carious lesions (ICDAS 5 or 6) in primary teeth without any signs of pulpal involvement were randomized into three different application frequency groups; 1, 4, or 6 months apart. Children underwent treatment with 38% SDF at baseline visit and again at a second visit. Treated lesions were assessed at the second and third visits to determine arrest success. Participants were considered completely successful (CS) if all treated lesions were arrested and incompletely successful (IS) if at least one lesion was not arrested. Statistical analyses included descriptive and bivariate analyses. A p value ≤ 0.05 was significant. Results: A total of 84 children with 486 carious lesions were recruited into the study with 28 children in each group. The overall proportion of completely successful treated children at visit 2 and final visit were 40% and 68% respectively. Results of McNemar’s test showed a significant increase in complete success from 40% at second visit to 68% at visit 3 (p-value <0.001) across all groups for 84 study participants. Within each group, significant improvement in complete success at child-level was also noted with p-values of 0.041,0.023 and 0.004 for Regimen 1, 2 and 3 respectively. Participants in one month group showed a change of complete success from 36% at second visit to 71% at third visit (p-value 0.004). No significant differences were noted between the groups at second visit and final visit (p >0.05) Conclusions: Findings in this study suggested that two applications of SDF at different frequencies showed similar frequency of successfully treated cases at the child level. No difference was noted in success rates comparing three groups either at second or third visit. Results from our study

Purpose: The purpose of this pilot study was to determine the sensitivity and specificity of a newly developed Canadian Caries Risk Assessment Tool for children < 6 years to predict caries development in a cohort of individuals followed in community-based dental clinics. Methods: A prospective observational cohort study was conducted to test the Canadian Caries Risk Assessment Tool. Children were recruited over a 12-month period. The child’s parent/caregiver completed a baseline CRA via interview, and dmft/dmfs were recorded. Participants returned for a follow-up examination at which time a second interview and changes in oral health, including new dental caries activity and dmft/dmfs were recorded. Data was analyzed using standard, bivariate statistics (chi square, t test, McNemar). Odds ratios (OR), sensitivity, specificity and positive/negative predictive values were calculated. Data: Overall, 173 preschool children were initially enrolled. The average age was 39.9 ± 17 months. Baseline CRA enrollment and follow up occurred between January 2019 and October 2021 with an average time between assessments of 13 ± 4 months. 122 (70.5%) children were assigned a high CRA rating at their baseline appointment and 106 (61.3%) were found to have active caries or past evidence of dental treatment for caries. Baseline presence of visible caries and/or past evidence of dental treatment was found to be statistically significant (p <0.0001) with new caries noted at their follow up assessment (OR=7.39). Individuals assigned to a high risk CRA rating were found to be significantly associated (p 0.0001) with formation of new caries noted at their follow up assessment (OR= 4.9). Sensitivity and specificity for baseline CRA rating (high and low risk) and new caries noted at clinical follow-up was determined to be 86.1% and 44.2% with a positive predictive value of 59.1% and a negative predictive value of 77.3%. Conclusion: The current assessment of the Canadian Caries Risk Assessment

Purpose: The purpose of this pilot study was to determine the sensitivity and specificity of a newly developed Canadian Caries Risk Assessment Tool for children < 6 years to predict caries development in a cohort of individuals followed in community-based dental clinics. Methods: A prospective observational cohort study was conducted to test the Canadian Caries Risk Assessment Tool. Children were recruited over a 12-month period. The child’s parent/caregiver completed a baseline CRA via interview, and dmft/dmfs were recorded. Participants returned for a follow-up examination at which time a second interview and changes in oral health, including new dental caries activity and dmft/dmfs were recorded. Data was analyzed using standard, bivariate statistics (chi square, t test, McNemar). Odds ratios (OR), sensitivity, specificity and positive/negative predictive values were calculated. Data: Overall, 173 preschool children were initially enrolled. The average age was 39.9 ± 17 months. Baseline CRA enrollment and follow up occurred between January 2019 and October 2021 with an average time between assessments of 13 ± 4 months. 122 (70.5%) children were assigned a high CRA rating at their baseline appointment and 106 (61.3%) were found to have active caries or past evidence of dental treatment for caries. Baseline presence of visible caries and/or past evidence of dental treatment was found to be statistically significant (p <0.0001) with new caries noted at their follow up assessment (OR=7.39). Individuals assigned to a high risk CRA rating were found to be significantly associated (p 0.0001) with formation of new caries noted at their follow up assessment (OR= 4.9). Sensitivity and specificity for baseline CRA rating (high and low risk) and new caries noted at clinical follow-up was determined to be 86.1% and 44.2% with a positive predictive value of 59.1% and a negative predictive value of 77.3%. Conclusion: The current assessment of the Canadian Caries Risk Assessment

Purpose: The purpose of this pilot study was to determine the sensitivity and specificity of a newly developed Canadian Caries Risk Assessment Tool for children < 6 years to predict caries development in a cohort of individuals followed in community-based dental clinics. Methods: A prospective observational cohort study was conducted to test the Canadian Caries Risk Assessment Tool. Children were recruited over a 12-month period. The child’s parent/caregiver completed a baseline CRA via interview, and dmft/dmfs were recorded. Participants returned for a follow-up examination at which time a second interview and changes in oral health, including new dental caries activity and dmft/dmfs were recorded. Data was analyzed using standard, bivariate statistics (chi square, t test, McNemar). Odds ratios (OR), sensitivity, specificity and positive/negative predictive values were calculated. Data: Overall, 173 preschool children were initially enrolled. The average age was 39.9 ± 17 months. Baseline CRA enrollment and follow up occurred between January 2019 and October 2021 with an average time between assessments of 13 ± 4 months. 122 (70.5%) children were assigned a high CRA rating at their baseline appointment and 106 (61.3%) were found to have active caries or past evidence of dental treatment for caries. Baseline presence of visible caries and/or past evidence of dental treatment was found to be statistically significant (p <0.0001) with new caries noted at their follow up assessment (OR=7.39). Individuals assigned to a high risk CRA rating were found to be significantly associated (p 0.0001) with formation of new caries noted at their follow up assessment (OR= 4.9). Sensitivity and specificity for baseline CRA rating (high and low risk) and new caries noted at clinical follow-up was determined to be 86.1% and 44.2% with a positive predictive value of 59.1% and a negative predictive value of 77.3%. Conclusion: The current assessment of the Canadian Caries Risk Assessment

Background: Due to legacies of colonization and inequities in social determinants of health, First Nations children experience high rates of early childhood caries (ECC), and in some of these cases, require full mouth rehabilitation under general anesthesia. This study investigates the dental experiences contributing to ECC in status First Nation children requiring dental rehabilitation under general anesthetic for treatment. Methods: All parent(s)/caregiver(s) presenting to the Children’s Dental Clinic at the Health Sciences Centre in Winnipeg, Manitoba with registered First Nation children requiring dental surgery under general anesthesia for ECC were invited to participate. Participants (n=12) engaged in a semi-structured conversational method. This study followed grounded theory approach and data analysis was performed using Dedoose software. Results: Using grounded theory, three categories emerged from the data: experiencing barriers to dental care; identifying unique experiences and challenges to First Nation communities; and lastly identifying direct contributors to ECC. Conclusion: First Nations children and families present with various obstacles and complications when it comes to oral health and accessing oral health care. This study identifies and discusses some those barriers and hardships in a social context.

Background: Due to legacies of colonization and inequities in social determinants of health, First Nations children experience high rates of early childhood caries (ECC), and in some of these cases, require full mouth rehabilitation under general anesthesia. This study investigates the dental experiences contributing to ECC in status First Nation children requiring dental rehabilitation under general anesthetic for treatment. Methods: All parent(s)/caregiver(s) presenting to the Children’s Dental Clinic at the Health Sciences Centre in Winnipeg, Manitoba with registered First Nation children requiring dental surgery under general anesthesia for ECC were invited to participate. Participants (n=12) engaged in a semi-structured conversational method. This study followed grounded theory approach and data analysis was performed using Dedoose software. Results: Using grounded theory, three categories emerged from the data: experiencing barriers to dental care; identifying unique experiences and challenges to First Nation communities; and lastly identifying direct contributors to ECC. Conclusion: First Nations children and families present with various obstacles and complications when it comes to oral health and accessing oral health care. This study identifies and discusses some those barriers and hardships in a social context.

Purpose: Examine the birth prevalence of cleft lip with or without cleft palate (CLP), Isolated cleft lip (CL) and isolated cleft palate (CP) in Manitoba between January 1 2008 and Dec 31 2019 and to establish the burden of early childhood caries (ECC) among these children. A retrospective chart review was conducted at the Manitoba Cleft Lip and Palate Program at the Health Science Centre in Winnipeg, Manitoba. Children registered between January 1, 2008 and December 31, 2019 with or without an underlying syndrome or significant medical history were included. Data was entered into a REDCap database including the following variables: sex, date of birth, postal code, type of orofacial clefting, whether GA was required to treat ECC, oral hygiene prior to treatment under GA, age at the time of GA, cost of treatment, and the type of treatment rendered. Cumulative scores of decayed, extracted, and filled primary teeth (dmft) were also calculated. The mean birth prevalence in Manitoba from 2008-2019 was 2.46 per 1000 live births for orofacial clefting, 1.33 per 1000 live births for CLP, 0.46 per 1000 per live births for isolated CP, and 0.41 per 1000 live births for isolated CL. The orofacial clefting in Manitoba was almost 1.5 times greater than the Canadian national average. A child with any form CLP, including those who were syndromic or presented with additional medical comorbidities between 12 – 59 months were 15 times more likely to require GA to treat their ECC than a healthy child. A CLP patient who had an associated syndrome was 32 times more likely to require GA to treat ECC than their aged matched healthy counterparts, and 3.5 times more likely to require GA to treat ECC than a CLP patient who is otherwise healthy. While the birth prevalence of CLP in Manitoba was relatively stable from 2008-2019, it has increased from 2 per 1000 live births in the period of 1948-1977 to 2.46 per 1000 live births. While the rates of general anesthetic (GA) to treat ECC is sign

Purpose: Examine the birth prevalence of cleft lip with or without cleft palate (CLP), Isolated cleft lip (CL) and isolated cleft palate (CP) in Manitoba between January 1 2008 and Dec 31 2019 and to establish the burden of early childhood caries (ECC) among these children. A retrospective chart review was conducted at the Manitoba Cleft Lip and Palate Program at the Health Science Centre in Winnipeg, Manitoba. Children registered between January 1, 2008 and December 31, 2019 with or without an underlying syndrome or significant medical history were included. Data was entered into a REDCap database including the following variables: sex, date of birth, postal code, type of orofacial clefting, whether GA was required to treat ECC, oral hygiene prior to treatment under GA, age at the time of GA, cost of treatment, and the type of treatment rendered. Cumulative scores of decayed, extracted, and filled primary teeth (dmft) were also calculated. The mean birth prevalence in Manitoba from 2008-2019 was 2.46 per 1000 live births for orofacial clefting, 1.33 per 1000 live births for CLP, 0.46 per 1000 per live births for isolated CP, and 0.41 per 1000 live births for isolated CL. The orofacial clefting in Manitoba was almost 1.5 times greater than the Canadian national average. A child with any form CLP, including those who were syndromic or presented with additional medical comorbidities between 12 – 59 months were 15 times more likely to require GA to treat their ECC than a healthy child. A CLP patient who had an associated syndrome was 32 times more likely to require GA to treat ECC than their aged matched healthy counterparts, and 3.5 times more likely to require GA to treat ECC than a CLP patient who is otherwise healthy. While the birth prevalence of CLP in Manitoba was relatively stable from 2008-2019, it has increased from 2 per 1000 live births in the period of 1948-1977 to 2.46 per 1000 live births. While the rates of general anesthetic (GA) to treat ECC is sign

Background: Due to legacies of colonization and inequities in social determinants of health, First Nations children experience high rates of early childhood caries (ECC), and in some of these cases, require full mouth rehabilitation under general anesthesia. This study investigates the dental experiences contributing to ECC in status First Nation children requiring dental rehabilitation under general anesthetic for treatment. Methods: All parent(s)/caregiver(s) presenting to the Children’s Dental Clinic at the Health Sciences Centre in Winnipeg, Manitoba with registered First Nation children requiring dental surgery under general anesthesia for ECC were invited to participate. Participants (n=12) engaged in a semi-structured conversational method. This study followed grounded theory approach and data analysis was performed using Dedoose software. Results: Using grounded theory, three categories emerged from the data: experiencing barriers to dental care; identifying unique experiences and challenges to First Nation communities; and lastly identifying direct contributors to ECC. Conclusion: First Nations children and families present with various obstacles and complications when it comes to oral health and accessing oral health care. This study identifies and discusses some those barriers and hardships in a social context.

Background: Due to legacies of colonization and inequities in social determinants of health, First Nations children experience high rates of early childhood caries (ECC), and in some of these cases, require full mouth rehabilitation under general anesthesia. This study investigates the dental experiences contributing to ECC in status First Nation children requiring dental rehabilitation under general anesthetic for treatment. Methods: All parent(s)/caregiver(s) presenting to the Children’s Dental Clinic at the Health Sciences Centre in Winnipeg, Manitoba with registered First Nation children requiring dental surgery under general anesthesia for ECC were invited to participate. Participants (n=12) engaged in a semi-structured conversational method. This study followed grounded theory approach and data analysis was performed using Dedoose software. Results: Using grounded theory, three categories emerged from the data: experiencing barriers to dental care; identifying unique experiences and challenges to First Nation communities; and lastly identifying direct contributors to ECC. Conclusion: First Nations children and families present with various obstacles and complications when it comes to oral health and accessing oral health care. This study identifies and discusses some those barriers and hardships in a social context.

Objective: To investigate the efficacy of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) in treating cavitated caries in young children and to explore the association between SDF treatment and oral health-related quality of life (OHRQoL). Methods: Children with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth underwent treatment with 38% SDF and 5% FV at baseline and 4 months later. Treated lesions were assessed 4 and 8 months after baseline to determine arrest. Participants were deemed Completely Successful (CS) if all treated lesions were arrested and Incompletely Successful (IS) if at least one lesion was not arrested. The early childhood oral health impact scale (ECOHIS) questionnaire was completed at second and third visits. Statistical analyses included descriptive and bivariate methods. A P value ≤ 0.05 was significant. Results: Forty children with 239 caries lesions were enrolled; mean age 40.2 +/- 14.9 months and 45% male. Lesion arrest rates after one and two applications of SDF were 74.1% and 96.2%, respectively. Children who reportedly brushed twice daily were more likely to be in the CS group compared to those who brushed less (p=0.006). Participants in the CS group had a significantly lower mean baseline dmft score than those in the IS group (p= 0.048). No significant difference in OHRQoL was observed between CS and IS groups. Conclusions: SDF with 5% FV is an effective approach to the management of ECC; more than one application is recommended along with regular follow-up of patients and twice daily brushing. OHRQoL was not found to be affected by the level of success of SDF treatment.

Objective: To investigate the efficacy of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) in treating cavitated caries in young children and to explore the association between SDF treatment and oral health-related quality of life (OHRQoL). Methods: Children with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth underwent treatment with 38% SDF and 5% FV at baseline and 4 months later. Treated lesions were assessed 4 and 8 months after baseline to determine arrest. Participants were deemed Completely Successful (CS) if all treated lesions were arrested and Incompletely Successful (IS) if at least one lesion was not arrested. The early childhood oral health impact scale (ECOHIS) questionnaire was completed at second and third visits. Statistical analyses included descriptive and bivariate methods. A P value ≤ 0.05 was significant. Results: Forty children with 239 caries lesions were enrolled; mean age 40.2 +/- 14.9 months and 45% male. Lesion arrest rates after one and two applications of SDF were 74.1% and 96.2%, respectively. Children who reportedly brushed twice daily were more likely to be in the CS group compared to those who brushed less (p=0.006). Participants in the CS group had a significantly lower mean baseline dmft score than those in the IS group (p= 0.048). No significant difference in OHRQoL was observed between CS and IS groups. Conclusions: SDF with 5% FV is an effective approach to the management of ECC; more than one application is recommended along with regular follow-up of patients and twice daily brushing. OHRQoL was not found to be affected by the level of success of SDF treatment.

Objective: To investigate the efficacy of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) in treating cavitated caries in young children and to explore the association between SDF treatment and oral health-related quality of life (OHRQoL). Methods: Children with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth underwent treatment with 38% SDF and 5% FV at baseline and 4 months later. Treated lesions were assessed 4 and 8 months after baseline to determine arrest. Participants were deemed Completely Successful (CS) if all treated lesions were arrested and Incompletely Successful (IS) if at least one lesion was not arrested. The early childhood oral health impact scale (ECOHIS) questionnaire was completed at second and third visits. Statistical analyses included descriptive and bivariate methods. A P value ≤ 0.05 was significant. Results: Forty children with 239 caries lesions were enrolled; mean age 40.2 +/- 14.9 months and 45% male. Lesion arrest rates after one and two applications of SDF were 74.1% and 96.2%, respectively. Children who reportedly brushed twice daily were more likely to be in the CS group compared to those who brushed less (p=0.006). Participants in the CS group had a significantly lower mean baseline dmft score than those in the IS group (p= 0.048). No significant difference in OHRQoL was observed between CS and IS groups. Conclusions: SDF with 5% FV is an effective approach to the management of ECC; more than one application is recommended along with regular follow-up of patients and twice daily brushing. OHRQoL was not found to be affected by the level of success of SDF treatment.

Objective: To investigate the efficacy of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) in treating cavitated caries in young children and to explore the association between SDF treatment and oral health-related quality of life (OHRQoL). Methods: Children with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth underwent treatment with 38% SDF and 5% FV at baseline and 4 months later. Treated lesions were assessed 4 and 8 months after baseline to determine arrest. Participants were deemed Completely Successful (CS) if all treated lesions were arrested and Incompletely Successful (IS) if at least one lesion was not arrested. The early childhood oral health impact scale (ECOHIS) questionnaire was completed at second and third visits. Statistical analyses included descriptive and bivariate methods. A P value ≤ 0.05 was significant. Results: Forty children with 239 caries lesions were enrolled; mean age 40.2 +/- 14.9 months and 45% male. Lesion arrest rates after one and two applications of SDF were 74.1% and 96.2%, respectively. Children who reportedly brushed twice daily were more likely to be in the CS group compared to those who brushed less (p=0.006). Participants in the CS group had a significantly lower mean baseline dmft score than those in the IS group (p= 0.048). No significant difference in OHRQoL was observed between CS and IS groups. Conclusions: SDF with 5% FV is an effective approach to the management of ECC; more than one application is recommended along with regular follow-up of patients and twice daily brushing. OHRQoL was not found to be affected by the level of success of SDF treatment.

This study examined the oral health knowledge of community health nurses in Manitoba and what oral health advice is given to the caregivers of infants and children. In addition, the differences in oral health knowledge of rural, northern and urban community health nurses was compared. Surveys were emailed using SurveyMonkey to all nurses that identified themselves as community health or public health nurses in Manitoba. 261 responses were received. Nurses had high oral health literacy in regards to diet and feeding practices but need improvement in some areas of knowledge such as timing of the first dental visit and use of fluoride toothpaste. Statistically significant differences between the groups of nurses were found in regards knowledge of timing of the first dental visit, use of fluoride toothpaste in children younger than 3, and transmission of cariogenic bacteria.

This study examined the oral health knowledge of community health nurses in Manitoba and what oral health advice is given to the caregivers of infants and children. In addition, the differences in oral health knowledge of rural, northern and urban community health nurses was compared. Surveys were emailed using SurveyMonkey to all nurses that identified themselves as community health or public health nurses in Manitoba. 261 responses were received. Nurses had high oral health literacy in regards to diet and feeding practices but need improvement in some areas of knowledge such as timing of the first dental visit and use of fluoride toothpaste. Statistically significant differences between the groups of nurses were found in regards knowledge of timing of the first dental visit, use of fluoride toothpaste in children younger than 3, and transmission of cariogenic bacteria.

This study examined the oral health knowledge of community health nurses in Manitoba and what oral health advice is given to the caregivers of infants and children. In addition, the differences in oral health knowledge of rural, northern and urban community health nurses was compared. Surveys were emailed using SurveyMonkey to all nurses that identified themselves as community health or public health nurses in Manitoba. 261 responses were received. Nurses had high oral health literacy in regards to diet and feeding practices but need improvement in some areas of knowledge such as timing of the first dental visit and use of fluoride toothpaste. Statistically significant differences between the groups of nurses were found in regards knowledge of timing of the first dental visit, use of fluoride toothpaste in children younger than 3, and transmission of cariogenic bacteria.

This study examined the oral health knowledge of community health nurses in Manitoba and what oral health advice is given to the caregivers of infants and children. In addition, the differences in oral health knowledge of rural, northern and urban community health nurses was compared. Surveys were emailed using SurveyMonkey to all nurses that identified themselves as community health or public health nurses in Manitoba. 261 responses were received. Nurses had high oral health literacy in regards to diet and feeding practices but need improvement in some areas of knowledge such as timing of the first dental visit and use of fluoride toothpaste. Statistically significant differences between the groups of nurses were found in regards knowledge of timing of the first dental visit, use of fluoride toothpaste in children younger than 3, and transmission of cariogenic bacteria.

Objective: To examine differences in the usages and otherwise preferences of behaviour guidance techniques between Manitoban general and pediatric dentists when considering year of graduation, training locations, and source of training. Methods: Surveys using SurveyMonkey were emailed to a random 25% sample of general dentists and all pediatric dentists in Manitoba. The nonparametric test Wilcoxon Mann-Whitney test was performed on all data. Significance levels were considered at alpha <0.05 and at 95% confidence interval (CI). Results: A total of 87 completed responses were collected (72 general dentists, 15 pediatric dentists). Statistically significant differences were found in voice control, oral sedation, tell-show-do, and general anesthesia. Conclusions: In general, there were few statistically significant differences; however, there were some clinically significant findings. Overall, tell-show-do for both groups, oral sedation for general dentists, and nitrous oxide sedation for both groups were found to be the most favoured in their respective categories while protective stabilization and IV sedation were the least favoured in their respective categories.

The purposes were to evaluate the difference in SBS of bonding and rebonding orthodontic attachments when using a CEP compared to a SEP and to evaluate if re-etching is necessary prior to rebonding with either a CEP or a SEP. Orthodontic metal buttons were bonded to extracted human molars according to 4 protocols: In Group A, teeth were bonded with the CEP for the first and second bondings. In Group B, teeth were bonded with the CEP for the first bonding but re-etching was omitted for the second bonding. In Group C, teeth were bonded with the SEP for both bondings. In Group D, teeth were bonded with the SEP for the first bonding but re-etching was omitted for the second bonding. The SBSs when the SEP was used for the first bonding were significantly lower (P<0.001; 10.65 ± 4.33 MPa) than when the CEP was used (14.04 ± 3.51 MPa). The second bonding omitting re-etching but still using the primer and adhesive generated significantly lower SBSs (P<0.001; 9.07 ± 4.53 MPa) than when re-etching was used (14.66 ± 3.70 MPa), but still above the "clinically acceptable" standard of 6-8 MPa for in vitro SBS testing. The second bonding SBS omitting re-etching and not using any primer or adhesive was very low (2.61 ± 2.34 MPa) and would definitely negatively effect the outcome of orthodontic bonding clinically. When rebonding a bracket, re-etching may be omitted but a primer and adhesive must be applied to obtain a "clinically acceptable" SBS.

Objective: To examine differences in the usages and otherwise preferences of behaviour guidance techniques between Manitoban general and pediatric dentists when considering year of graduation, training locations, and source of training. Methods: Surveys using SurveyMonkey were emailed to a random 25% sample of general dentists and all pediatric dentists in Manitoba. The nonparametric test Wilcoxon Mann-Whitney test was performed on all data. Significance levels were considered at alpha <0.05 and at 95% confidence interval (CI). Results: A total of 87 completed responses were collected (72 general dentists, 15 pediatric dentists). Statistically significant differences were found in voice control, oral sedation, tell-show-do, and general anesthesia. Conclusions: In general, there were few statistically significant differences; however, there were some clinically significant findings. Overall, tell-show-do for both groups, oral sedation for general dentists, and nitrous oxide sedation for both groups were found to be the most favoured in their respective categories while protective stabilization and IV sedation were the least favoured in their respective categories.

Objective: To examine differences in the usages and otherwise preferences of behaviour guidance techniques between Manitoban general and pediatric dentists when considering year of graduation, training locations, and source of training. Methods: Surveys using SurveyMonkey were emailed to a random 25% sample of general dentists and all pediatric dentists in Manitoba. The nonparametric test Wilcoxon Mann-Whitney test was performed on all data. Significance levels were considered at alpha <0.05 and at 95% confidence interval (CI). Results: A total of 87 completed responses were collected (72 general dentists, 15 pediatric dentists). Statistically significant differences were found in voice control, oral sedation, tell-show-do, and general anesthesia. Conclusions: In general, there were few statistically significant differences; however, there were some clinically significant findings. Overall, tell-show-do for both groups, oral sedation for general dentists, and nitrous oxide sedation for both groups were found to be the most favoured in their respective categories while protective stabilization and IV sedation were the least favoured in their respective categories.

Objective: To examine differences in the usages and otherwise preferences of behaviour guidance techniques between Manitoban general and pediatric dentists when considering year of graduation, training locations, and source of training. Methods: Surveys using SurveyMonkey were emailed to a random 25% sample of general dentists and all pediatric dentists in Manitoba. The nonparametric test Wilcoxon Mann-Whitney test was performed on all data. Significance levels were considered at alpha <0.05 and at 95% confidence interval (CI). Results: A total of 87 completed responses were collected (72 general dentists, 15 pediatric dentists). Statistically significant differences were found in voice control, oral sedation, tell-show-do, and general anesthesia. Conclusions: In general, there were few statistically significant differences; however, there were some clinically significant findings. Overall, tell-show-do for both groups, oral sedation for general dentists, and nitrous oxide sedation for both groups were found to be the most favoured in their respective categories while protective stabilization and IV sedation were the least favoured in their respective categories.