Children

Research

18 pages, 2232 KB

Open AccessArticle

Parental Reports of Oral Health Behaviours and Dental Caries in Romanian Children and Adolescents: A Cross-Sectional Study

by Darius Dacian Macavei, Raluca Iurcov, Abel Emanuel Moca, Rebeca Daniela Marton, Gabriela Ciavoi and Ligia Luminița Vaida

Children 2026, 13(9), 1154; https://doi.org/10.3390/children13091154 - 27 Aug 2026

Viewed by 504

Abstract

Background/Objectives: Dental caries remains one of the most prevalent chronic diseases in childhood, influenced by a combination of hygiene, dietary, and access-related behaviours that are largely shaped by parental involvement. This study aimed to evaluate oral hygiene habits, dietary risk factors, access [...] Read more.

Background/Objectives: Dental caries remains one of the most prevalent chronic diseases in childhood, influenced by a combination of hygiene, dietary, and access-related behaviours that are largely shaped by parental involvement. This study aimed to evaluate oral hygiene habits, dietary risk factors, access to dental services, awareness of caries prevention, and the impact of oral health on the child, in relation to parent-reported dental caries in Romanian children and adolescents. Methods: A cross-sectional study was conducted using a structured online questionnaire completed by parents or legal guardians of 508 children and adolescents aged under 18 years. Associations between categorical variables and reported caries were assessed using chi-square tests and Cramér’s V. Ordinal variables were compared using the Mann–Whitney U test. A multivariable logistic regression identified independent predictors of reported caries, with robustness examined through sensitivity analyses. Results: Parent-reported caries was present in 61.2% of children. The strongest associations with caries were the absence of parental supervision during brushing (Cramér’s V = 0.364), the age at which children began brushing unsupervised (V = 0.354), and the reason for the last dental visit (V = 0.426). In the multivariable model, older age, absence of brushing supervision, sweets before bedtime, less frequent dental visits, and rural residence were independent predictors (all p < 0.05; Nagelkerke R² = 0.361). All six assessed dimensions of oral-health impact on the child were significantly associated with caries, with physical discomfort showing the largest effect (V = 0.349). Conclusions: Parent-reported caries risk in this population clustered around a small number of modifiable behaviours rather than any single dominant factor, while reported caries was associated with a substantial burden on children’s daily functioning. These findings point to sustained parental supervision and routine, non-symptomatic dental care as priority targets for future prevention efforts, although intervention studies are needed to confirm their effectiveness. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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11 pages, 368 KB

Open AccessArticle

Reasons for First Dental Visit Among Infants and Toddlers in Bucharest, Romania—A Cross-Sectional Study

by Aneta Munteanu, Sabina Teodorescu-Drăghicescu, Mihaela Tănase, Diana Daciana Zmărăndache, Amiel Stroianu and Ioana Andreea Stanciu

Children 2026, 13(7), 964; https://doi.org/10.3390/children13070964 - 21 Jul 2026

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Abstract

Background: In Romania, data regarding the oral health of infants and toddlers is scarce. This study aimed to analyze the reasons for the first dental visit among children aged 3 or under and to assess their oral health status and the therapeutic methods [...] Read more.

Background: In Romania, data regarding the oral health of infants and toddlers is scarce. This study aimed to analyze the reasons for the first dental visit among children aged 3 or under and to assess their oral health status and the therapeutic methods applied. Methods: A retrospective cross-sectional study was conducted on 602 children (339 boys and 263 girls), aged ≤ 3 years, who were referred for their first dental visit to the Pediatric Dentistry Department, Faculty of Dentistry, Carol Davila University, Bucharest, Romania. Results: The main reasons for referral were routine check-up (28.23%), asymptomatic carious lesions (21.92%), abscess or swelling (18.43%), and dental trauma (14.78%). Caries was diagnosed in 344 children; 23 (6.68%) had only non-cavitated lesions, 157 (45.64%) had uncomplicated cavitated lesions, and 174 (50.58%) already had complicated caries. Mean values of caries experience indices were significantly higher in rural children (dmf-t = 4.33 ± 4.13; dmf-s = 9.16 ± 11.34) than in urban children (dmf-t = 2.67 ± 3.61; dmf-s = 5.62 ± 8.86) (p = 0.000). The most frequent treatments were routine check-up with oral hygiene and dietary instructions (55.31%), pulp treatments (19.91%), and restorative procedures (15.1%). Conclusions: Many infants and toddlers were referred later than the recommended age and required therapeutic rather than preventive care. More than half had carious lesions, and many of those were already complicated. Significant disparities were observed between rural and urban children from this study group. Targeted public health initiatives are needed to improve early access to dental care. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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17 pages, 4333 KB

Open AccessArticle

Pharyngeal Airway Volume Changes and Patient-Reported Breathing and Sleep Comfort Following Class II Functional Orthodontic Treatment, Predominantly the Herbst Therapy, in Growing Children: A Retrospective CBCT Study

by Ersen Bilgili, Burçin Akan and Gökçenur Gökçe

Children 2026, 13(7), 864; https://doi.org/10.3390/children13070864 - 29 Jun 2026

Viewed by 456

Abstract

Objectives: To explore volumetric changes in the nasopharynx, oropharynx, hypopharynx, and total pharyngeal airway after Class II functional orthodontic treatment and to relate these anatomical changes to patient-reported breathing and sleep comfort. Methods: A retrospective observational study of 63 growing patients [...] Read more.

Objectives: To explore volumetric changes in the nasopharynx, oropharynx, hypopharynx, and total pharyngeal airway after Class II functional orthodontic treatment and to relate these anatomical changes to patient-reported breathing and sleep comfort. Methods: A retrospective observational study of 63 growing patients (11–14 years) with Class II mandibular retrusion was conducted. Pre- and post-treatment cone beam computed tomography (CBCT) scans (NewTom 5G) were exported as uncompressed digital imaging and communications in medicine (DICOM) files and analyzed with Dolphin Imaging v11.9. The pharyngeal airway was manually segmented into naso-, oro-, and hypopharyngeal regions; volumes were measured twice by a single examiner to assess reliability. Inter-examiner reliability was assessed in a 15-patient subgroup. Patients completed a 5-point Likert rating of perceived breathing and sleep changes. Statistical tests included Wilcoxon signed-rank, Friedman with Holm post hoc, Mann–Whitney U, and Spearman correlation; p < 0.05 was considered significant. Results: Intra-examiner reliability was excellent (ICC1 mean 0.988), and inter-examiner reliability was good to excellent (ICC2 0.87–0.95). Mean total pharyngeal airway volume during the treatment interval in growing Class II patients treated with functional appliances increased from 18,183.62 mm³ at T0 to 23,524.42 mm³ at T1—an average augmentation of approximately 5340.80 mm³ (~29.4%). Regional gains followed the following pattern: Oropharynx > Nasopharynx > Hypopharynx. Nasopharyngeal and total airway changes were found to be associated with improvements in reported breathing (ρ = 0.79 and 0.69) and sleep comfort (total airway ρ = 0.74). Conclusions: Functional mandibular advancement in growing Class II patients was associated with enlargement of the pharyngeal airway—most notably in the oropharynx—and these volumetric gains were followed by improved patient-reported breathing and sleep comfort within the limitations of retrospective study design. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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13 pages, 456 KB

Open AccessArticle

Prevalence, Severity and Treatment Needs of Molar Incisor Hypomineralization Among a Cohort of Lebanese Children: A Cross-Sectional Study

by Ayah Khodor, Ahmad Tarabaih and Mohammad Alkilzy

Children 2026, 13(5), 708; https://doi.org/10.3390/children13050708 - 21 May 2026

Viewed by 462

Abstract

Objectives: The aim of the study was to assess the prevalence, severity and treatment needs of molar incisor hypomineralization (MIH) among a cohort of children in Lebanon. Methods: A cross-sectional study was performed in Akkar district in northern Lebanon on 1237 school children [...] Read more.

Objectives: The aim of the study was to assess the prevalence, severity and treatment needs of molar incisor hypomineralization (MIH) among a cohort of children in Lebanon. Methods: A cross-sectional study was performed in Akkar district in northern Lebanon on 1237 school children between 10 and 12 years old (mean age 11.11 ± 0.80 years) who were recruited from eight private schools. Clinical evaluations were performed after teeth cleaning and drying using sterile gauze. Examiners assessed all teeth present in the oral cavity using the MIH index of the EAPD. If MIH was diagnosed, a further grading was made according to the MIH-TNI index. Results: In total, 212 children (17.14% [95% CI:15.0, 19.2]) were diagnosed with MIH. Of these, 200 children with completed documentation were included in the further statistical analysis. Out of the affected cases, mild lesions were the most common at 41% (n = 82). Although males exhibited higher cumulative numbers of affected teeth (52.5%, n = 267), with notably greater proportions in moderate (17.7%) and severe (16.7%) cases, the difference between genders was not statistically significant (p = 0.069). Treatment needs increased with severity, in which mild lesions primarily required preventive care (41.0%), while moderate lesions required restorative treatments (34.0%); in contrast, severe lesions (25.0%) often necessitated extensive interventions, such as crowns, pulp therapies or even extractions. Although descriptive patterns suggested an increase in more complex treatment needs in older age groups, the association was not statistically significant (p = 0.26). Conclusions: The prevalence of MIH observed in this cohort study aligns with internationally reported values. Early detection, preventive management, and timely restorative interventions are essential to minimize the long-term impact of MIH. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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9 pages, 767 KB

Open AccessArticle

Association Between Early Childhood Caries and Systemic Inflammatory Profiles: A Retrospective Analysis of Children Undergoing Dental Treatment Under General Anesthesia

by Banu Çiçek Tez Yaşar, Akif Burak Çakmak, Hacer Eberliköse, Arif Yiğit Güler, Bahar Başak Kızıltan Eliaçık and Hakan Alpay Karasu

Children 2026, 13(5), 691; https://doi.org/10.3390/children13050691 - 19 May 2026

Viewed by 2052

Abstract

Background/Objectives: Early childhood caries (ECC) is a chronic inflammatory condition that may impose a systemic burden in pediatric patients. This study aimed to evaluate the association between dental caries severity, classified by dmft (decayed, missing, and filled teeth for primary dentition) scores, and [...] Read more.

Background/Objectives: Early childhood caries (ECC) is a chronic inflammatory condition that may impose a systemic burden in pediatric patients. This study aimed to evaluate the association between dental caries severity, classified by dmft (decayed, missing, and filled teeth for primary dentition) scores, and preoperative systemic inflammatory markers derived from routine complete blood counts (CBC). Methods: This retrospective study included 159 children aged 36–71 months. Participants were categorized into three groups based on dmft scores: low (0–3), medium (4–8), and high (≥9). Hematological parameters and inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII), were analyzed using one-way ANOVA with post hoc comparisons. Results: Significant differences were observed among dmft groups for neutrophil and lymphocyte percentages (p = 0.026 and p = 0.027) and lymphocyte count (p = 0.020). The medium severity group demonstrated higher neutrophil levels and lower lymphocyte values compared to the high severity group (p < 0.05). Although overall group differences for NLR and SII were not statistically significant (p > 0.05), both markers were significantly higher in the medium group than in the high group (p < 0.05). No significant differences were found in hemoglobin, RDW, or platelet parameters. Conclusions: A non-linear trend was observed, with relatively elevated inflammatory markers in the moderate dmft group. These findings suggest that systemic inflammation in ECC is more closely related to disease characteristics than to caries burden alone. CBC-derived parameters may provide supportive but limited value for assessing systemic inflammatory status in pediatric dental patients. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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12 pages, 1041 KB

Open AccessArticle

Optimizing Pediatric Patient Comfort: A Study of Moisture Isolation Techniques During Dental Treatments

by Maham Masud Khan, Jose Garcia, Marzia Mustamand, Xinbin Gu, Indra Mustapha and LaToya Barham

Children 2026, 13(2), 233; https://doi.org/10.3390/children13020233 - 6 Feb 2026

Viewed by 1367

Abstract

Background: Effective dental isolation is crucial for successful restorative procedures in pediatric patients; however, its potential impact on patient stress remains underexplored. This investigation comprised two independent pilot sub-studies evaluating salivary cortisol responses to dental isolation techniques: one comparing cotton roll isolation (CRI) [...] Read more.

Background: Effective dental isolation is crucial for successful restorative procedures in pediatric patients; however, its potential impact on patient stress remains underexplored. This investigation comprised two independent pilot sub-studies evaluating salivary cortisol responses to dental isolation techniques: one comparing cotton roll isolation (CRI) and the Isolite system (IS), and a second comparing cotton roll isolation (CRI) and the DryShield isolation system (DSI). The sub-studies were reported together due to a shared clinical context and outcome measure. Methods: Pediatric patients underwent sealant placement using CRI, IS, or DSI, depending on sub-study assignment. Salivary cortisol samples were collected for each procedure. In the CRI–IS sub-study, pulse rate was recorded at three time points, and participants completed subjective preference surveys. Cortisol analyses were conducted separately within each sub-study, with pulse rate and preference outcomes evaluated only for the CRI–IS cohort. Results: DSI produced a significant increase in salivary cortisol from pre- to post-procedure compared with CRI (p = 0.0001), indicating a higher acute stress response. In contrast, CRI and IS did not differ significantly in cortisol levels, but heart rate did significantly increase from pre- to post-procedure when CRI was used (p = 0.035). Of the 15 participants in the CRI–IS comparison, 9 provided subjective feedback, with most preferring the IS. Gender was not associated with differences in stress markers in either sub-study. Conclusions: These findings suggest that while CRI and IS produce comparable physiological stress responses, DSI may be associated with heightened cortisol reactivity. Although IS was subjectively preferred, biological stress measures showed no definitive difference from CRI. Clinicians may therefore select CRI or IS based on clinical judgment and patient comfort, while considering the potential for increased stress when using DSI in pediatric populations. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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11 pages, 385 KB

Open AccessArticle

Oral Health Status of Children in Strasbourg: An Epidemiological Study (2018–2022)

by Damien Offner, Hayat Heddoub, Sabine Chemouni and Gabriel Fernandez de Grado

Children 2026, 13(1), 4; https://doi.org/10.3390/children13010004 - 19 Dec 2025

Viewed by 921

Abstract

Background/Objectives: Dental caries prevalence remains high in France, but data are scarce. In Strasbourg, a local program aims at improving oral health of all school children, from primary to tertiary prevention. We evaluated the oral health of Strasbourg’s children over five repeated cross-sectional [...] Read more.

Background/Objectives: Dental caries prevalence remains high in France, but data are scarce. In Strasbourg, a local program aims at improving oral health of all school children, from primary to tertiary prevention. We evaluated the oral health of Strasbourg’s children over five repeated cross-sectional screenings. Methods: We analyzed 58 287 screenings of children from 1st to 5th grade from 2018 to 2022. The presence and number of carious lesions was the main variable studied. Results: Untreated dental caries were present among 34% of the children and slightly increased from 33% in 2018 to 35% in 2022 (p = 0.002). The mean number of decayed teeth was 0.85 ± 1.68 and 2.5 ± 2.04 among children with at least one. Dental caries was more prevalent among children in schools from socially disadvantaged neighborhoods (43% vs. 27%, p < 0.001), children from less advanced classes (27% in 5th grade vs. 37% in 1st grade, p < 0.001), and children with inadequate hygiene (72% vs. 28%, p < 0.001). The number of decayed teeth followed the same trend as the prevalence. Conclusion: The prevalence of dental caries diminishes throughout the schooling years. Socioeconomic and behavioral factors remain the major predictors of dental caries. A national study could help confirm if these trends are widespread in France. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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11 pages, 496 KB

Open AccessArticle

Relationship Between the Oral Health-Related Quality of Life (OHRQoL) of Mothers and That of Their Adolescent Children: A Retrospective Pilot Study

by Adrián Curto, Beatriz Egido, Cristina Gómez-Polo, Kelly Valeria Restrepo-Colorado, Daniele Garcovich, Virginia Franco-Varas and Javier Flores-Fraile

Children 2025, 12(12), 1691; https://doi.org/10.3390/children12121691 - 13 Dec 2025

Cited by 1 | Viewed by 1277

Abstract

Background: Oral health-related quality of life (OHRQoL) in children is an issue of growing interest in the scientific literature, with various studies focused on the adolescent population published in recent years. Nevertheless, few studies have evaluated the possible influence of the OHRQoL of [...] Read more.

Background: Oral health-related quality of life (OHRQoL) in children is an issue of growing interest in the scientific literature, with various studies focused on the adolescent population published in recent years. Nevertheless, few studies have evaluated the possible influence of the OHRQoL of mothers on that of their adolescent children. The aim of this study was to analyse the correlation between the OHRQoL of mothers and that of their adolescent children at their first oral examination. Methods: This retrospective pilot study was performed at the Dental Clinic of the University of Salamanca (Spain) between 2023 and 2025. The OHRQoL of 130 adolescent patients (from 11 to 14 years old) who visited the dentist for the first time was analysed. The mothers of these children were also interviewed to evaluate their OHRQoL; the adolescent patients completed the Spanish version of the Child Perceptions Questionnaire (CPQ-Esp_11–14) before their first dental consultation, and their mothers completed the Oral Health Impact Profile-14 (OHIP-14). Results: The study population consisted of 130 mothers (mean age: 43.0 ± 2.66 years) and their respective adolescent children (mean age: 12.5 ± 1.3 years) (65 boys and 65 girls). Among the adolescent patients, the highest score was obtained for the social well-being dimension of the CPQ-Esp_11–14 (25.01 ± 4.10), whereas the lowest was obtained for the oral symptoms dimension (10.88 ± 3.78). A higher score on the physical pain dimension of the OHRQoL for the mothers was related (p < 0.01) to higher scores on the emotional and social well-being dimensions of the CPQ-Esp_11–14 for their children. Conclusions: Considering the limitations of this study, it can be concluded that the OHRQoL of mothers has some effect on that of their adolescent children when visiting a dentist for the first time. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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21 pages, 2101 KB

Open AccessArticle

Assessment of Oral Hygiene Practices and Dental Health Conditions in School-Aged Children of 7–10 Years

by Ana-Gabriela Seni, Liana Todor, Andreea Mihaela Kis, Mădălina-Gabriela Cincu, Ramona Amina Popovici, Anca Porumb, Iustin Olariu and Monica Tarcea

Children 2025, 12(10), 1288; https://doi.org/10.3390/children12101288 - 24 Sep 2025

Cited by 5 | Viewed by 3620

Abstract

Background/Objectives: The ongoing prevalence of dental issues within the school-age population continues to present significant public health challenges. This study aims to thoroughly evaluate the oral health conditions of schoolchildren aged 7–10 years, with a particular focus on identifying the prevalence and [...] Read more.

Background/Objectives: The ongoing prevalence of dental issues within the school-age population continues to present significant public health challenges. This study aims to thoroughly evaluate the oral health conditions of schoolchildren aged 7–10 years, with a particular focus on identifying the prevalence and severity of dental caries, as well as their relationship with dental hygiene and dietary habits. Methods: A cross-sectional approach was employed involving 700 children aged from 7 to 10 years, recruited from nine urban and rural educational institutions across two Romanian counties, namely Mureș and Bistrița-Năsăud. Data were collected regarding the sociodemographic characteristics of participants, including parental educational background and occupational status. Furthermore, information on dental hygiene routines was gathered, encompassing tooth brushing habits, flossing usage, frequency of brushing, along with dietary details such as daily meal count, snacking frequency, and sugar intake levels. An oral examination was performed by a trained specialist to assess the condition of the children’s teeth, documenting the number of decayed, missing, and filled teeth. The presence of plaque was evaluated using a plaque index, and the dental caries status was quantified using the Decayed, Missing, and Filled Teeth (DMFT) index. Results: The findings revealed that the average plaque score was marginally higher in boys (mean = 0.69 ± 0.36) compared to girls (mean = 0.65 ± 0.40). Additionally, children from urban environments demonstrated a mean plaque score of 0.61 ± 0.32, whereas their rural counterparts exhibited a higher score of 0.73 ± 0.38. In multivariable models, irregular brushing, higher daily sugar consumption, and ≥3 snacks/day were independently associated with both caries prevalence (DMFT > 0) and greater DMFT counts (p < 0.05). Conclusions: The evidence denotes a concerning association between poor oral hygiene practices and higher rates of tooth decay among children, particularly among those with elevated sugar intake and frequent snacking behaviors. Dental public health professionals are encouraged to incorporate considerations of oral hygiene habits when developing future health promotion strategies aimed at improving the oral health status of children. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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14 pages, 552 KB

Open AccessArticle

Oro-Dental Characteristics Associated with Pediatric Dental Neglect: A Retrospective Study

by Anamaria Violeta Țuțuianu, Abel Emanuel Moca, Teodora Ștefănescu, Dan Alexandru Slăvescu, Lucian Roman Șipoș, Horia Câlniceanu and Anca Ionel

Children 2025, 12(9), 1266; https://doi.org/10.3390/children12091266 - 21 Sep 2025

Cited by 1 | Viewed by 1688

Abstract

Background/Objectives: Dental neglect represents a preventable form of child maltreatment that may lead to significant oral and systemic health complications. This study primarily aimed to investigate the main oral manifestations and determinants of dental neglect in a pediatric population from Bihor County, Romania. [...] Read more.

Background/Objectives: Dental neglect represents a preventable form of child maltreatment that may lead to significant oral and systemic health complications. This study primarily aimed to investigate the main oral manifestations and determinants of dental neglect in a pediatric population from Bihor County, Romania. Additionally, it assessed the association between systemic factors, such as nutritional status and psychological conditions, and the severity of oro-dental lesions, with the goal of informing future preventive strategies and public health interventions. Methods: A retrospective analysis was conducted on 333 pediatric patients diagnosed with dental neglect. Clinical data were collected from two centers between 2020 and 2024. Oral health status, socio-demographic characteristics, and psychological conditions were evaluated. Statistical analyses included Fisher’s Exact Test, Mann–Whitney U Test, and Bonferroni-adjusted Z-tests, with significance set at p ≤ 0.05. Results: Among the 333 participants, 52.9% were male, with a mean age of 8.75 ± 3.29 years. Most children (81.7%) resided in rural areas, and 55.6% were first-born. Carious lesions were identified in 100% of cases, with 54.7% showing complications such as endodontic pathology. Poor oral hygiene was reported in 99.1% of children, while 58.6% presented signs of periodontal disease and 37.2% reported spontaneous gingival bleeding. Acute pain was experienced by 40.2% of participants. Nutritional issues were prevalent, with 24.3% classified as obese and 21.6% as malnourished. Significant associations were found between lesion severity and both psychological disorders (p < 0.001) and malnutrition (p < 0.001). Conclusions: This study identifies untreated carious lesions, poor oral hygiene, acute dental pain, and oro-dental trauma as key clinical indicators of pediatric dental neglect, with rural residency and limited education as significant socio-demographic risk factors. The findings highlight the urgent need for integrated, community-based strategies, including school-based screenings, parental education, and referral pathways, to improve early detection and prevention in Romania. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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Review

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15 pages, 456 KB

Open AccessReview

Parental Perspectives on Oral Health and Access to Care in Children with Down Syndrome: A Narrative Review

by Petra Saitos, Raluca Iurcov, Abel Emanuel Moca, Teofana Bota, Rebeca Daniela Marton and Mihai Juncar

Children 2025, 12(5), 655; https://doi.org/10.3390/children12050655 - 20 May 2025

Cited by 1 | Viewed by 3314

Abstract

Background/Objectives: Children with Down syndrome are predisposed to various oro-dental conditions, which can impact their oral-health-related quality of life (OHRQoL) and overall well-being. Given their critical role, parents’ and caregivers’ perceptions are essential for understanding the challenges in oral care access and [...] Read more.

Background/Objectives: Children with Down syndrome are predisposed to various oro-dental conditions, which can impact their oral-health-related quality of life (OHRQoL) and overall well-being. Given their critical role, parents’ and caregivers’ perceptions are essential for understanding the challenges in oral care access and quality. This narrative review aimed to synthesise the available evidence on parental and caregiver perceptions regarding oral health, OHRQoL, and dental care access for children with Down syndrome. Methods: A literature search was conducted in PubMed, Web of Science, and Scopus, covering studies published between January 2015 and January 2025. The search included the keywords “Down syndrome”, “oral health”, “oral health-related quality of life”, “caregivers”, “parents”, “dental care access”, and “special needs children”. Thirteen studies were included after applying eligibility criteria, which selected original research focusing on the target population and themes. Results: The findings highlighted that oral health significantly affects the quality of life of children with Down syndrome, influencing their functional, emotional, and social well-being. Caregivers often reported a gap between perceived and clinically observed oral health. Barriers to dental care access included insufficient training of dental professionals, financial constraints, systemic limitations, and perceived biases. Variations across different countries also revealed the influence of cultural and healthcare system factors. Conclusions: Oral health plays a critical role in the lives of children with Down syndrome and their families. Strengthening caregiver education, improving communication, validating adapted OHRQoL instruments, and enhancing dental professionals’ training in special needs care are crucial steps to ensure equitable and family-centred oral healthcare. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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Other

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12 pages, 1179 KB

Open AccessCase Report

Nonsurgical Endodontic Management of an Odontogenic Cutaneous Sinus Tract in a Child: A Case Report

by Ralitsa Bogovska-Gigova and Maria Kirilova

Children 2026, 13(7), 882; https://doi.org/10.3390/children13070882 - 30 Jun 2026

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Abstract

Odontogenic cutaneous sinus tracts represent an uncommon clinical manifestation of chronic dental infection and are frequently misdiagnosed due to the absence of dental symptoms and their resemblance to dermatologic lesions. This case report describes the nonsurgical endodontic management of a cutaneous sinus tract [...] Read more.

Odontogenic cutaneous sinus tracts represent an uncommon clinical manifestation of chronic dental infection and are frequently misdiagnosed due to the absence of dental symptoms and their resemblance to dermatologic lesions. This case report describes the nonsurgical endodontic management of a cutaneous sinus tract of dental origin in a 13-year-old patient. The patient presented with a persistent extraoral lesion in the mandibular region, initially evaluated by non-dental specialists. Clinical and radiographic examination revealed a necrotic mandibular first molar associated with a periapical radiolucency and intraoral sinus tract. Nonsurgical root canal treatment was performed using chemomechanical debridement with sodium hypochlorite irrigation and calcium hydroxide as an intracanal medicament. Complete obturation was achieved following resolution of intracanal exudation. No surgical intervention of the cutaneous lesion was undertaken. Progressive healing of the periapical lesion and spontaneous resolution of the extraoral sinus tract were observed over a 6-month follow-up period. This case is noteworthy because it combines a prolonged diagnostic delay, an atypical extraoral manifestation in a child, and successful resolution by nonsurgical endodontic therapy alone without surgical excision of the cutaneous lesion. The 6-month follow-up confirms sustained clinical and radiographic healing, underscoring the importance of early recognition and conservative management in pediatric patients. Early identification and elimination of the dental source can prevent unnecessary surgical procedures and minimize the risk of permanent scarring. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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10 pages, 1994 KB

Open AccessCase Report

The Management of a Post-Extraction Gingival Lesion in a Paediatric Patient: A Case Report

by Erika Cirillo, Massimiliano Ciribè, Alessandra Putrino, Sonia Vanacore, Francesco Pio Litta and Angela Galeotti

Children 2025, 12(10), 1331; https://doi.org/10.3390/children12101331 - 3 Oct 2025

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Abstract

Introduction: In clinical practice, the presence of abnormal physiological root resorption frequently results in the retention of deciduous teeth. Also, unilateral mastication may contribute to the altered physiological process of root resorption. This delayed exfoliation and retention of deciduous teeth may compromise the [...] Read more.

Introduction: In clinical practice, the presence of abnormal physiological root resorption frequently results in the retention of deciduous teeth. Also, unilateral mastication may contribute to the altered physiological process of root resorption. This delayed exfoliation and retention of deciduous teeth may compromise the integrity of adjacent soft tissue. In recent years, ozone therapy can be considered a promising strategy in accelerating healing and reducing pain in both traumatic and autoimmune ulcers. Case Presentation: This case report describes a 12 year-old male patient with localized damaged gingival tissue resulting from chronic trauma due to the retention of a deciduous tooth. Following the application of gaseous ozone therapy, complete mucosal healing was achieved. Conclusions: This case supports the potential of ozone therapy in paediatric soft tissue management. Full article

(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)

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