Arthur J. Nowak

INFANT ORAL HEALTH AND ORAL HABITS

Many oral diseases and conditions, including dental caries (cavities) and malocclusions, have their origins early in life. Prudent anticipatory guidance by the medical and dental professions can help prevent many of the more common oral health problems. This article provides information on the rationale for early dental examination and instructions for pediatric and family practitioners in scheduling and conducting an early oral intervention appointment. In addition, feeding practices, non-nutritive sucking, mouth breathing, and bruxing are discussed, including their effects on orofacial growth and development.

Arch length changes from 6 weeks to 45 years

The purpose of this study was to evaluate, on a longitudinal basis, changes in maxillary and mandibular arch length over a 45-year period. Subjects were drawn from two pools of normal individuals. Twenty-eight male and 33 female infants were evaluated longitudinally at 6 weeks, 1 year, and 2 years (before the eruption of the deciduous dentition). Fifteen males and 15 females from the Iowa Facial Growth Study were evaluated at 3, 5, 8, 13, 26, and 45 years. Arch length measurements were obtained independently by two investigators. Intra- and interexaminer reliabilities were predetermined at 0.25 and 0.5 mm, respectively. The greatest incremental increases occurred during the first two years of life. Arch length continued to increase until 13 years in the maxillary arch, and until 8 in the mandibular. Then significant and consistent decreases occurred in both arches mesial to the permanent first molars.

An unusual triad: Microdontia, taurodontia, and dens invaginatus

A 12 1/2-year-old white boy was examined and found to have permanent teeth that were smaller than those of the average adult. The microdontia was accompanied by taurodontia of the mandibular molars and several teeth with dens invaginatus. The patient was normal in appearance and had no other illness. The pedigree was compatible with X-linked recessive inheritance.

Appliance for stabilizing orogastric and orotracheal tubes in infants.

The long-term use of orotracheal tubes in infants has been associated with airway damage, palatal groove formation, acquired cleft palate, and defective primary dentition. Nasotracheal intubation is associated with trauma to the nasal septum and deformities of the nares. Because the infant is an obligatory nose-breather, nasogastric feeding tubes obstruct the nares and cause mucosal edema. We have developed an intraoral appliance designed to stabilize orogastric feeding and orotracheal tubes, and prevent obstruction to the nares and trauma to the palate and alveolar ridge.

Oral opening and other selected facial dimensions of children 6 weeks to 36 months of age

Four hundred twenty-two children (Caucasians, Asians, and blacks) aged 6 weeks to 36 months were recruited. Five measurements (incisal edge distance, alveolar crest distance, closed mouth breadth, open mouth breadth, and nose-lip distance) were made by two calibrated examiners and an average was recorded. Because there were no statistically significant differences among races or genders the data were combined. The normative data for seven age groups (6 weeks to 36 months) and five oral-facial parameters are presented.

Practices and Attitudes Concerning Oral Health in Pediatric Cardiology Clinics to Prevent Infective Endocarditis

A survey of 121 pediatric cardiology clinics investigated the current practices and attitudes toward oral health education and oral screenings in pediatric cardiology clinics for patients susceptible to infective endocarditis. Most pediatric cardiology clinics do not provide oral health education and oral screenings, but believe it would be beneficial.