Ulla Schröder

Acceptance of dental care following early extractions under rectal sedation with diazepam in preschool children

The aim of the study was to evaluate the effect of amnesia in preschool children on their later acceptance of dental care. Forty-six 4-6-year-old children, who between 2 and 4 years previously had had primary incisors extracted because of trauma, were reexamined for dental health and acceptance of dental care. The extractions had been performed under rectal sedation with diazepam (0.7 mg/kg body weight). Information about dental treatment and degree of cooperation during the intervening period was obtained from records at the referring clinic. The parents were interviewed about their childs experience of amnesia concerning the extractions, background variables, and experiences of dental care before the follow-up examination. Amnesia concerning the extractions was reported in 85% of the children. Twenty-nine percent had on some occasion exhibited behavior management problems (BMP) during the intervening period. Lack of amnesia was significantly associated with BMP (P< 0.002). Children without amnesia concerning the extractions tended to accept dental care less well at the reexamination. Parents were able to predict their childs acceptance of dental care at the follow-up with a significant degree of success (P= 0.02). In conclusion, amnesia in preschool children concerning extractions seems to be essential to facilitate positive acceptance of future dental care.

Progression of proximal enamel caries in early teens related to caries activity

Posterior bite-wing radiographs were available from 3 annual check-ups of 126 individuals 12-13 years of age at the start of the study. Enamel caries was defined according to Granath et al. (2), the lesions graded and the progression largely scored (score = transition between grades) according to Grondahl et al. (4). About 400 surfaces were observed for 2 years and approximately 950 for 1 year (year 1 or year 2). After subdivision, 2-year observations were included in the 1-year observations. The radiographic interpretation was made simultaneously by 2 examiners. A double determination revealed 86% agreement with the first registration. The individual caries activity during the 1-year period under consideration was expressed as the percentage of surfaces that had become carious during the period out of the number of available surfaces at the end of the period minus those that had been carious and filled at the start. The material was subdivided into 5 activity classes. In the 1-year material, there was a ...

Clinical evaluation of preventive and class-I composite resin restorations

This study was initiated in 1986 in response to increased interest in restorative procedures favoring preservation of tooth substance and in the search for alternatives to dental amalgams. Eighty-seven preventive resin restorations in permanent molars and 35 occlusal composite resin restorations in primary molars (limited size) and 13 in premolars were followed up for 2 years. They were placed by a large number of operators, mainly dental students under supervision, and rated by five calibrated instructors in accordance with an internationally accepted system for the evaluation of the clinical performance of dental materials. One composite resin (Occlusin) was used. A survival model was used to calculate the cumulative theoretical number of successful treatments of children who had dropped out. For none of the 6 clinical variables was the success rate lower than 91%, and only 3 of 26 failures were of a nature requiring remake or correction. The failures occurred, with a few exceptions, during the 1st year of observation. The two types of restoration have thus proved to be efficient treatments fulfilling all reasonable requirements in modern operative dentistry.

Explanatory model for the interaction of factors in the caries process

The interaction of factors in the caries process has recently been discussed in a number of articles. Based on this, a new explanatory model has been constructed, consisting of an equilateral triangle with one of the apices on a horizontal line, along which dietary and oral hygiene habits are scaled. The triangle represents the total area of interaction. A horizontal line of resistance cuts off a lower part corresponding to the area within which caries does not occur. Through planogeometric calculations the remaining part of the triangle can be divided into areas, approximately corresponding to the relative caries values of various combinations of dietary and oral hygiene habits. The model has proved to be a useful instrument for demonstrating and creating an understanding of interactive processes among various groups of dental health personnel. The example presented is based on a pilot study of 55 4-year-old children in Malmö.

Early Natural Subsurface Caries

The surface of natural proximal subsurface caries lesions was studied in a scanning electron microscope (SEM) before and after treatment and remineralization in an in vivo model. The material consisted of proximal subsurface lesions from 9 premolars. In 7 cases, one half of each lesion was studied directly and the other half remineralized in vivo before observation in the SEM. In 2 cases the same surface was studied before and after remineralization. The clinical treatment included effective oral hygiene, daily rinsing with 0.05% NaF solution, use of 0.1 % NaF toothpaste and application of Duraphat® varnish every 10th day for 8–10 weeks. The clinical result showed smooth and lustrous surfaces after 8–10 weeks. In the SEM the remineralized surfaces had a more regular and homogeneous appearance with more densely packed and larger crystallites compared to the untreated caries lesions. There was no difference regarding surface characteristics between parts where the lesions were still clinically visible and parts that were clinically healed. This indicates that clinical healing, in the sense that the area of the lesion is no longer clinically visible, does not depend solely on changes in the surface, but also on changes in deeper parts of the carious enamel.