Ram D

The traditional practice of canine bud removal in the offspring of Ethiopian immigrants

BackgroundThe custom of canine bud removal has detrimental consequences on children’s general health and dental care. The objective of this study was to assess whether the prevalence of missing primary canines and dental defects in offspring of emigrants from Ethiopia is greater than in offspring of native Israeli parents of similar socioeconomic class.Methods477 children of Ethiopian descent and 317 offspring of native Israeli parents, from 21 nursery schools and kindergartens, underwent dental examinations aimed to determine the presence or absence of primary canines and of developmental enamel defects on adjacent teeth to the primary canines. For purposes of analysis, children were classified into two age groups: younger (ages 18–48 months) and older (ages 49–82 months).ResultsCanines were present in more Israeli than Ethiopian younger children, 87.5% vs. 42.3%, p=0.0001; and in more Israeli than Ethiopian older children, 92.6% vs. 40.4%, p=0.0001. More dental defects were detected in Ethiopian than in Israeli younger children, 32% vs. 3.9%, p=0.0001; and in more Ethiopian than Israeli older children, 31.2% vs. 5.8%, p=0.0001.ConclusionsThe prevalence of missing primary canines and dental defects was greater among offspring of parents who had emigrated from Ethiopia 15–20 years earlier than among offspring of native Israeli parents living in the same low socioeconomic neighborhoods.

Child-management techniques. Are there differences in the way female and male pediatric dentists in Israel practice?

The purpose of this study was to assess differences in the management techniques used by Israeli female and male pediatric dentists. All 112 participants of the meeting of the Israeli Society of Dentistry for Children that was held in February 1999 received a questionnaire which sought information regarding age, sex, behavioral and pharmacological methods used to treat children, having a course in nitrous oxide, general anesthesia, and feelings towards pediatric patients. No differences between female and male dentists were found regarding most management techniques. The majority of dentists used tell-show-do, and gave presents at the end of the appointments. Hypnosis was the least used technique. Papoose board was more prevalent among male dentists than among female dentists. Most dentists reported having the parents present during treatment, and more male dentists used their assistance when restraint was needed. General anesthesia was significantly more prevalent among males than among females (p = 0.01). One-third of the dentists reported feeling aggression toward the pediatric patient. Although not statistically significant, more female dentists reported about feeling aggression than male dentists. Most dentists felt authority towards the pediatric patient. Our findings imply that female and male dentists use similar management techniques when treating children.

Compliance of children and youngsters in the use of mouthguards

The purpose of the study was to examine the compliance of children wearing their mouthguards, and to evaluate socio-environmental factors that impact upon the usage of the device. Eighty children attending the student clinic of the Hadassah School of Dental Medicine received mouthguards free of charge. One year later, 69 participants and their parents answered a survey aimed at gaining information regarding compliance and comfort when wearing the mouthguard correlated with gender, ages of parents and child, number of siblings, position of child in the family, socio-economic status, education of parents and past dental injuries of siblings or parents. Twenty-nine percent of the children never wore the mouthguard, 32% wore it sometimes, 15.9% wore it when necessary at the beginning but stopped after one month and 23.2% wore the mouthguard whenever needed. About 68% of the participants still possessed the mouthguard one year after receiving it, 44.9% reported that they did not wear the mouthguard because they forgot and 42% reported that the reason for not wearing the appliance was because it was not comfortable. Seventy-seven percent of the parents were not aware of the existence of this appliance prior to this study. In addition, 47.9% stated that dentists had not offered such treatment to them in the past, 20.8% indicated that their child had never possessed a mouthguard before due to its significant expense and 39.6% stated that they would not invest in this treatment in the future because their child would not wear the appliance. Boys were more comfortable wearing the mouthguard than girls. The younger the child and the later s/he was in the sibling order of the family, the more likely s/he was to lose the mouthguard.

Unsweetened ice popsicles impart a positive feeling and reduce self-mutilation after paediatric dental treatment with local anaesthesia.

AIM The purpose of the current study was to assess whether an unsweetened ice-popsicle imparts a positive feeling to children after dental treatment in which local anaesthesia is administered, and whether it reduces the tendency of children to self-mutilate (bite the lip, cheek or tongue) after the administration of local anaesthesia. DESIGN Crossover study of 31 children aged 4-11 years old who needed similar dental treatments on both sides of the mandible or maxilla under local anaesthesia. At the end of each appointment the child received a toy or an ice-popsicle especially made for this study. Patients and parents answered a questionnaire regarding the childrens behaviour and feeling immediately after the treatment, and 10 and 30 min after receiving the ice-popsicle or toy. RESULTS Children who received ice-popsicles after dental treatment under local anaesthesia felt less discomfort and suffered less soft tissue trauma than they did when they received a toy. Reduction in soft tissue trauma was evident 10 min after receiving the ice-popsicles. CONCLUSION Licking of an ice-popsicle after dental treatment with local anaesthesia reduces the feeling of discomfort and the biting of soft tissue and self- mutilation.

Dental Anxiety Among Israeli Postgraduate Pediatric Dental Students and their Instructors

OBJECTIVE To measure the dental anxiety levels of post-graduate pediatric dental students (PGS) and their instructors, and their ranking of the most anxiety provoking situations in the dental situation; to investigate gender differences with regard to dental anxiety. STUDY DESIGN Twenty-four PGS and 31 of their instructors completed a three-section questionnaire on socio demographic information, dental anxiety scale (DAS) and dental fear survey (DFS). RESULTS The overall mean DAS and DFS scores were similar for both groups. The scores of the PGS were significantly higher on the DFS for perspiration when dental work was done (p = 0.032), the smell of the dentists office (p = 0.009), and seeing the dentist enter the treatment room (p = 0.005). The total DAS score was significantly higher among females than among males (8.03 ± 3.08 and 6.63 ± 1.77, p = 0.037), and for item on waiting for the dentist to scrape the teeth, (p = 0.05). The DAS and DFS scores were strongly correlated (r = 0.768, p = 0.000). The highest DAS score was for the item on anticipation of dental treatment before arrival to the clinic and waiting for the drilling. The response pattern for both groups was similar. CONCLUSIONS Overall dental anxiety of PGS and their instructors was similar. Female PGS and instructors had higher dental anxiety levels than males.

Children's Preferences for Pediatric Dentist Attire: A Multicenter Study

BACKGROUND Data are conflicting regarding the effect of professional staff attire on children at pediatric dental clinics. AIM To compare the preferences of children and their parents in three countries, regarding the gender and attire of pediatric dentists. STUDY DESIGN A multi-centered study was conducted in pediatric dental clinics in Israel (N=100), Uruguay (N=270) and Spain (N=200). Children, aged 4-12 years, and their parents were asked to choose the pediatric dentist they preferred from 5 pictures of the same male and 5 pictures of the same female, in different attire. RESULTS In Israeli clinics, where half of the pediatric dentists were male, and they wore white coats or casual attire, these were preferred by children, with no preference regarding the dentists gender. In Spain, where the majority of dentists were females, wearing surgical scrubs, children preferred female dentists with this attire. In Uruguay, where female dentists wore surgical or pediatric scrubs, these were preferred by children. Parents more often selected female than male dentists; they preferred pediatric scrubs for their childrens dentists more often than their children preferred such attire. CONCLUSIONS Childrens preferences for the attire of pediatric dentists reflected the common wearing apparel for dentists at the clinics they attended.

Post-Discharge Events Occurring after Dental Treatment under Deep Sedation in Pediatric Patients

PURPOSE Deep sedation is often required in dentistry for treating children with uncooperative behavior. We assessed immediate post-sedation events during the first 24 hours after dental treatment under deep sedation in children, and examined correlations to a number of variables. STUDY DESIGN Information was collected from medical files for a convenience sample of children between the ages of 1 and 16, who were treated under deep sedation at one clinic (propofol alone or combined with a sedative agent). Parents were interviewed by telephone regarding the first 24 hours following treatment. RESULTS Among 32 children under age 6 years, 26 (81.3%) had at least one post sedation complication, compared to 19/22 (86.4%) aged 6 and older, p>0.05. According to parent report, 13 (59.1%) of the older children had pain, compared to 6 (18.8%) of the younger ones, p=0.002. For no patient in the younger group compared to 18.2% in the older group was dizziness reported as a complication, p=0.023. Among those who received a sedative agent, 93.3% had one or more complications; 26.7% had nausea or vomiting. The respective rates were 79.5% and 5.1% among those treated only with propofol. CONCLUSIONS Though safe, deep sedation poses complications and adverse events.