Hubertus van Waes

Tooth Fairy guilty of favouritism

OBJECTIVES To determine the proportion of children visited by the Tooth Fairy, the child-related factors that influence the likelihood of her visit, and the parent-related variables that affect the amount of money the Tooth Fairy leaves. DESIGN Cross-sectional questionnaire study. SETTING Zürich, Switzerland. PARTICIPANTS 3617 parents of children (mean age of children, 6.8 years; 51.9% girls) who had lost at least one deciduous tooth received a self-developed questionnaire; 1274 questionnaires were returned (35.2%). MAIN OUTCOME MEASURES Primary outcome variables were the Tooth Fairys visit after tooth loss and the amount of money given in case of a visit. Child- and parent-related variables were assessed as predictors of the main outcomes. RESULTS Most parents (71.0%) reported that the Tooth Fairy visited their child. She usually exchanged the lost tooth for money (55.8% of visits) or placed money next to the tooth (40.7%); rarely did she take the tooth without pecuniary substitution. The Tooth Fairy left an average of 7.20 Swiss francs (approximately AU

Performance of pit and fissure sealants according to tooth characteristics: A systematic review and meta-analysis

9.45). The Tooth Fairy favoured visiting for the teeth of older children (odds ratio [OR], per year, 1.87; 95% CI, 1.09-3.21), of boys (OR, 2.65; 95% CI, 1.09-6.42), and of children who believed in her (OR, 4.12; 95% CI, 1.77-9.64). The amount of money was influenced by maternal, but not paternal socio-demographic factors, including level of education (OR, per level, 0.78; 95% CI, 0.66-0.92) and country of origin (OR, Western countries v non-Western countries, 2.35; 95% CI, 1.20-4.62). CONCLUSIONS The Tooth Fairy does not visit all children after tooth loss, displaying clear preferences in her choice of business partners. The odds of a visit are dramatically increased if she is believed in, and the value of a deciduous tooth is influenced by socio-demographic factors.

Late reposition of a lateral luxated maxillary incisor with an immature apex

OBJECTIVE Aim of this systematic review was to assess the clinical performance of sealants on various teeth in an evidence-based manner. SOURCES Five databases were searched from inception to February 2017. DATA Randomized clinical studies on humans. METHODS After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, Paule-Mandel random-effects meta-analyses of Relative Risks (RRs) and their 95% confidence intervals (CIs) were calculated. RESULTS A total of 16 randomized clinical trials with 2778 patients (male/female 49.1%/50.9%) and an average age of 8.4 years were included. No significant difference in either caries incidence of sealed teeth or sealant retention could be found according to (i) mouth side (right versus left), (ii) jaw (upper versus lower), (iii) and tooth type (1st permanent molar versus 2nd permanent molar/1st permanent molar versus 2nd deciduous molar/1st deciduous molar versus 2nd deciduous molar), based on evidence of very low to low quality. On the other side, compared to 1st permanent molars, sealed premolars were significantly less likely to develop caries (3 trials; RR=0.12; 95% CI=0.03 to 0.44; P=0.001) and less likely to experience loss of the sealant (5 trials; RR=0.33; 95% CI=0.20 to 0.54; P=0.001), both based on low to moderate quality evidence. CONCLUSIONS The performance of pit and fissure sealants does not seem to be negatively affected by mouth side, jaw, and tooth type, apart from the exception of a favorable retention on premolars. CLINICAL SIGNIFICANCE Based on existing evidence, pit and fissure sealants can be effectively applied on any deciduous or permanent posterior teeth without adverse effects on their clinical performance.

Which Teeth Have to Be Sealed

Here we describe an unusual trauma case. A recently erupted permanent upper-right incisor sustained a lateral luxation when a 5-year-old girl on a playground climbing net dropped off, catching the right upper incisor in the net. The tooth was laterally luxated in vestibular direction, and no other signs of injury occurred. A dental practitioner could not reposition the bony locked tooth. Four days later, the girl came to our clinic, and we performed an incomplete repositioning of the tooth and made a flexible splint. Controls were made at 1, 6, and 12 weeks and at 6, 12, 18, and 24 months later. The 24-month follow-up clinical examination revealed the patient to be asymptomatic and the tooth to be completely functional, and the recall radiograph showed further apical root growth. The implications of a late incomplete reposition of laterally luxated permanent teeth with immature apices are discussed.

Surgical repositioning of a developing maxillary central incisor. A case report

The absolute effectiveness of pit and fissure sealants in preventing the development of new caries lesions or the progress of incipient caries lesions has been proved by randomized clinical trials and systematic reviews thereof. Based on the evidence-based assessment of existing randomized clinical trials performed for this chapter, pit and fissure sealants can be effectively applied on any deciduous or permanent posterior teeth without adverse effects on their clinical performance. However, caries susceptibility varies among different patients and among different teeth within a patient. Therefore, a risk-based assessment on a case-by-case manner by an experienced clinician that takes into account factors like tooth morphology, caries history, fluoride intake, oral hygiene, and patient age needs to be undertaken to maximize the cost-to-benefit value of sealant application.

Maximal mouth opening capacity: percentiles for healthy children 4–17 years of age

BACKGROUND A traumatic injury to the primary dentition can cause damage to the germ of the permanent successor. As a clinical consequence a dilaceration with root deformation, malpositioning and disturbances of eruption can occur. Surgical repositioning of such a dislocated crown of a developing tooth can be a treatment option. CASE REPORT A four year old patient was referred to our clinic because of a mobile upper primary central incisor and a radiographically visible displaced dental crown. Her history revealed a traumatic dental injury one year ago. Radiologic examination confirmed an inflammatory root resorption on tooth 61 and a dislocation of the developing tooth 21. In order to avoid further displacement due to the inflammation, 61 was extracted at the first appointment. A radiographic image 7 months later showed no improvement in the malposition of tooth 21. Therefore tooth 21 was surgically repositioned into its correct position. Follow-up over 3 years confirmed a continued root development and a full eruption of 21 in its correct position. CONCLUSION Early diagnosis and early treatment of a dislocated permanent tooth germ is essential to allow a favorable outcome. Surgical repositioning can be successful in avoiding later malpositioning of the permanent teeth.