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Pediatric Dentistry

WHO opens public consultation on draft sugars guideline

The World Health Organization (WHO) is launching a public consultation on its draft guideline on sugars intake. When finalized, the guideline will provide countries with recommendations on limiting the consumption of sugars to reduce public health problems like obesity and dental caries (commonly referred to as tooth decay). Read the draft guideline 

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Quick Fact: What are pre-eruptive caries?

This is a quick fact presented by Dr. Suham Alexander, Oasis Clinical Editor Pre-eruptive caries (also referred to as occult or hidden caries) has an unclear etiology as well as pathogenesis. As the tooth is usually encased in its crypt, it is unlikely that it is exposed to any cariogenic bacteria. Some theories hypothesize that the cariogenic process is initiated by internal resorptive processes that are precipitated by pressure exerted by abutting teeth or ectopic positioning of the tooth itself. The carious lesions are most often located at the DEJ in the occlusal surface of the tooth.

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How would you manage sleep bruxism in special needs patients?

This summary is based on the article published in Research in Developmental Disabilities: Treatment of bruxism in individuals with developmental disabilities: a systematic review (September 2009) Russell Lang, Pamela J. White, Wendy Machalicek, Mandy Rispoli, Soyeon Kang, Jeannie Aquilar, Mark O’Reilly, Jeff Sigafoos, Giulio Lancioni, Robert Didden Context  Individuals with developmental disabilities experience more oral and craniofacial diseases and injuries than the general population. (1)  Bruxism is a serious psycho-physiological disorder and a common clinical issue in dentistry. (2)  Although data are limited, bruxism appears to be more common in individuals with developmental disabilities, specifically, profound/severe mental retardation, autism spectrum disorders, and Down’s syndrome than other ...

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Your Opinion: How would you treat this case?

This case was submitted by Dr. Matt Gilchrist An 11 year-old presented to my office in December 2013 for a routine recall examination. The right bitewing revealed what appeared to be gross decay on the 1-4 occlusal. Upon further review of the bitewing from last year, it was noted that this exact same lesion had been present since the tooth first erupted into the child’s mouth (sorry, no picture, as we were not digital at that time). The tooth has been symptomatic, and a PA was taken which was within normal limits. Clinically there was no evidence of gross decay, ...

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How do you manage double teeth in children and teenagers?

This summary is based on the article published in the International Journal of Pediatric Dentistry: management of double teeth in children and adolescents (November 2012) Purvi Shah, June M. L. Chander, Joseph Noar & Paul F. Ashley Context Abnormally large teeth are often referred to as ‘double teeth’.  Double tooth anomalies pose numerous management challenges for the clinician especially if they involve anterior teeth. Most significantly, they will result in very poor aesthetics, partly because of their appearance but also because they will cause significant anterior crowding. They may also be associated with caries and periodontal problems, if the fissure or union line extends sub-gingivally making cleaning difficult5. Double teeth can ...

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How do you manage a child patient with an acute asthma exacerbation?

This post is based on the Canadian Medical Association guidelines for managing the paediatric patient with an acute asthma exacerbation Source: CMA Infobase: Clinical Practice Guidelines Database (CPGs) Access the resource in PDF Context Children with acute asthma exacerbations frequently present to an emergency department with signs of respiratory distress. The most severe episodes are potentially life-threatening. Effective treatment depends on the accurate and rapid assessment of disease severity at presentation. This statement addresses the assessment, management and disposition of pediatric patients with a known diagnosis of asthma who present with an acute asthma exacerbation, especially preschoolers at high risk for persistent asthma. Guidance includes the assessment of asthma severity, ...

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Bullying and Dentistry: the effects of malocclusion on school-aged children

This summary is based on the artcile published in the British Dental Journal: Bullying in schoolchildren – its relationship to dental appearance and psychosocial implications: an update for GDPs (May 2011) J. Seehra,J. T. Newton, and A. T. DiBiase Context Bullying in school-aged children is a global phenomenon. The effects of bullying can be both short- and long-term,  resulting in both physiological and psychological symptoms. It is likely that dental care professionals will encounter children who are subjected to bullying. Clinicians should be aware that children with a malocclusion could be subjected to persistent peer victimization, resulting in a negative impact on both their ...

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How safe is oral midazolam sedation in pediatric dentistry?

This summary is based on the article published in the International Journal of Pediatric Dentistry: Safety of oral midazolam sedation use in pediatric dentistry: a review (January 2014) Context Young children needing multiple procedures often cannot be managed using local anesthesia alone. General anesthesia (GA) is an alternative, but is associated with significant morbidity and expense.  Sedation is a possible alternative to GA for behaviour management but evidence in support of its use is weak. A recent systematic review noted that oral midazolam is one of the few agents available whose efficacy in dental procedures for children is supported by evidence. Midazolam is potentially an ideal sedative agent for pediatric dentistry because ...

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