Search Results (102)

Background and Objectives: Dental treatments of children with previous negative dental experiences are challenging and frequently require sedation or general anesthesia. Therefore, this study aimed to identify treatment pathways and factors associated with dental treatment under general anesthesia, nitrous oxide sedation, and chairside management among pediatric dental patients with adverse dental experiences. Materials and Methods: A retrospective cohort analysis was conducted on all new children aged 2–12 years with negative dental experience and treatment need visiting the Pediatric Department of the Dental Clinic, University of Greifswald, between 1 January and 31 December 2021. Results: Of the 640 newly presenting patients, 78 cases met inclusion criteria and were analyzed (mean age 6.7 ± 2.19 years, baseline dmft 4.5 ± 3.0 and DMFT 0.6 ± 1.2), with 88.5% having caries as chief complaint and 61.5% having a referral from other dentists. Eventually, only 25.6% received general anesthesia (mean age 5.1 ± 1.9 years, mean dt 5.6 ± 2.6), while 56.4% were managed with nitrous oxide sedation (mean age 7.3 ± 1.7 years, mean dt 3.3 ± 2.4), and 18% with chairside treatment (mean age 6.9 ± 2.8 years, mean dt 1.9 ± 2.4). Children of younger age, with higher dmft/dt scores and lower behavior ratings, were more frequently treated under general anesthesia. However, none of these variables could be identified as independent predictors for treatment under general anesthesia. Conclusions: Minimally invasive caries management, combined with appropriate behavior guidance and conscious sedation when indicated, can drastically reduce the need for general anesthesia in children, even among those with dental anxiety or previous negative dental experience. Full article

(1) Background/Objectives: Obstructive Sleep Apnea (OSA) in childhood is a significant health concern with potential adverse effects on daytime function, behavior, education, and overall development. Early intervention is crucial to ease these consequences. Myofunctional therapy (MT) has emerged as a treatment modality, particularly in young children, to address OSA. This highlights the importance of early detection and intervention by pediatric dentists and other healthcare providers who frequently interact with the pediatric oral and facial structures. This study aimed to investigate the knowledge, attitudes, and practices of Lebanese pediatric dentists regarding pediatric OSA and MT. (2) Methods: A cross-sectional survey was distributed to 103 Lebanese Pediatric dentists registered with the Lebanese Society of Pediatric Dentistry (LSPD). The survey assessed familiarity with OSA, diagnostic practices, treatment approaches, and utilization of MT. (3) Results: Out of 103 pediatric dentists, 62 responded (60.2%). Most respondents were familiar with OSA (86.8%). However, the number of diagnostic symptoms used varied. MT was not pediatric dentists’ primary choice in treating OSA. (4) Conclusions: Lebanese pediatric dentists demonstrate a good understanding of OSA, but there is potential for improvement in diagnostic comprehensiveness and exploration of MT as a treatment option. Full article

Background: Timely dental care is essential to prevent complications and preserve natural teeth, yet inefficient referral practices, low reimbursement rates and systemic barriers continue to disproportionately affect Medicaid-enrolled children. This study assessed the appropriateness of root canal therapy (RCT) referrals to a University-based Advanced Education in General Dentistry (AEGD) program and examined diagnostic and treatment characteristics of referred cases. Methods: A retrospective review was conducted of pediatric patients aged 6–17 years who were referred by external dental providers to two AEGD clinics in Nevada, United States, between February and August 2024 for endodontic evaluation of carious permanent teeth. Demographic, tooth-type, pulp-status, and treatment outcome data were analyzed using descriptive statistics, chi-square tests, Kruskal–Wallis comparisons, and multivariable logistic regression models. Results: Among 154 referred patients, 96.8% (n = 149) were Medicaid beneficiaries. A total of 247 teeth were evaluated; 74.1% were molars. Pulp testing showed that 41.3% had healthy pulps and 16.6% had reversible pulpitis, while only 37.2% of teeth required RCT. Age differed significantly across pulp diagnoses (p = 0.0012), and older age independently predicted appropriate referral (adjusted OR = 1.18, 95% CI 1.07–1.31). Gender was not associated with follow-up compliance (p = 0.47). By November 2024, 53.4% of referred teeth had completed treatment, and 9.3% had no follow-up. Conclusions: More than half of the referral teeth did not require RCT, indicating a high rate of potentially avoidable referrals and highlighting gaps in diagnostic confidence and decision-making at the primary care level. Practical Implications: Enhancing diagnostic training and decision support for general dentists, particularly in vital pulp therapy for young permanent teeth, along with improving Medicaid reimbursement and standardizing referral protocols, may reduce inappropriate specialty referrals. In combination with broader policy reforms, these measures can improve system efficiency and expand access to timely, equitable pediatric dental care. Full article

Background: Interprofessional collaboration is vital for comprehensive, patient-centered care. Despite growing recognition of oral–systemic health links, the integration of dentists into healthcare teams remains limited. This scoping review mapped existing evidence on dental professionals’ roles within interprofessional healthcare, identifying key benefits, barriers, and facilitators. Methods: A systematic search of PubMed, SCOPUS, and Web of Science identified English-language studies (2014 to 2024) focused on collaboration between dental and non-dental providers. Studies addressing oral–systemic health without team-based integration were excluded. Screening and data charting followed the PRISMA-ScR framework using JBI data extraction and critical appraisal tools. Data were synthesized thematically by collaboration model, outcomes, and influencing factors. Results: Nine studies met the inclusion criteria. Integrating dental professionals into healthcare teams improved patient outcomes, quality of life, and satisfaction. Effective models included nurse practitioner–dentist partnerships and medical–dental collaboration in pediatrics and chronic disease care. Barriers included poor communication, lack of interoperable electronic health records, role ambiguity, and limited interprofessional training. Key facilitators were supportive policies, integrated care structures, professional education, and strong team communication. Conclusions: Integrating dentists into interprofessional teams enhances healthcare delivery and patient outcomes. However, significant barriers remain. Addressing communication gaps, implementing shared health records, and expanding interprofessional education are essential steps toward more cohesive care. Future research should evaluate scalable integration frameworks and incorporate patient perspectives to inform team-based care. Full article

Background and Objectives: Early Childhood Caries affect children’s quality of life and overall health. This study aimed to assess the involvement of dentists in implementing early preventive measures, including fluoride use, for children aged 6–33 months. Materials and Methods: a multiple-choice questionnaire was distributed in six German states, consisting of two sections: Section I covered participant demographics and Section II included items on dental preventive measures for children. The questionnaire was adapted from a validated German-language source, reviewed by five experts at Kiel University, and tested in a focus group of 30 dentists. Descriptive statistics (mean ± SD or median [IQR]) and Mann–Whitney U tests were used to assess pediatric dentists (PD) and general dentists (GP) involvement in early dental preventive measures. Results: A total of 511 eligible questionnaires were returned (mean age 47 ± 11 year, 63.8% females, 36.7% PD). Both GP and PD routinely recommended a diagnostic dental visit (1 = never, 5 = always), with PD reporting higher frequency (GP: 4 [3–5], PD: 4.5 [4–5]; p = 0.001). Parental training in oral hygiene was performed significantly more often by PD (p < 0.01). PD also recommended tooth brushing with fluoridated toothpaste after the eruption of the first tooth more frequently than GP (GP: 5 [3–5], PD: 5 [4–5]; p = 0.06). Surprisingly, fluoride-free toothpaste was still recommended by a relevant number of respondents in both groups. Conclusions: PDs showed greater involvement in early caries prevention than GP. While most recommended fluoridated toothpaste, many still advised fluoride-free options, highlighting gaps in guideline adherence. Full article

Background/Objectives: Vascular Malformation—Osteolytic Subtype (VMOS) is an exceptionally rare autosomal recessive disorder caused by homozygous pathogenic variants in the ELMO2 gene, with fewer than ten genetically confirmed pediatric cases reported worldwide. This report presents the longitudinal dental management and clinical course of a child with VMOS, emphasizing the challenges of preventive and restorative care in such cases. Methods: A four-year-old child with a confirmed diagnosis of VMOS and a history of urgent bilateral coil embolization and surgical excision of mandibular aneurysmal bone cysts presented for dental care. The patient was followed for three years (2022–2025). Management focused on staged oral rehabilitation, preventive strategies, and restorative interventions adapted to changes across dentition stages. Results: At initial presentation, the child exhibited mandibular swelling, gingival hypertrophy, and a history of spontaneous intraoral bleeding. The postoperative course had been complicated by cerebral abscesses requiring prolonged intravenous antibiotics. During the primary dentition stage, full oral rehabilitation and strict preventive protocols were implemented to minimize caries and infection risk. In the mixed dentition period, the permanent incisors and molars erupted with enamel hypoplasia and developmental defects, necessitating composite restorations. Ectopic eruption and suboptimal oral hygiene, partly related to parental fear of bleeding, were also managed with reinforced preventive counseling. Conclusions: This case highlights the long-term dental implications of VMOS, underscoring the crucial role of the pediatric dentist in early preventive planning and individualized restorative management. Effective multidisciplinary coordination remains essential to preserve oral health and minimize complications in rare vascular syndromes with craniofacial involvement. Full article

Background and Objectives: This study retrospectively investigated the impact of regenerative endodontic treatments (RET) on the healing of periapical lesions in young permanent molars with open apices. Our objective was to evaluate the relationship between treatment outcomes and changes in the fractal dimension (FD) of the periapical bone before and after RET. The study was conducted at the Department of Pediatric Dentistry, Necmettin Erbakan University between January 2020 and December 2024. Materials and Methods: We examined panoramic radiographs from systematically healthy patients aged 6–16 years who underwent RET in the posterior mandible between January 2020 and December 2024. Changes in periapical bone were assessed using fractal analysis before treatment and after a 6-month follow-up. Additionally, mental index (MI), mandibular cortical width (MCW), mental length (ML), and periapical index (PAI) values were evaluated. Radiographs were taken with a Planmeca ProOne^® device and analyzed using ImageJ v1.54 software. Results: Comparison of FD values between treated and contralateral tooth areas, as well as before and after RET, revealed an average FD value of 1.27 ± 0.05 after regeneration, increasing to 1.29 ± 0.27 at the 6-month follow-up. Significant increases were observed in MCW (p = 0.005/p = 0.049) and ML (p = 0.022/p = 0.001) in the 35–36 and 45–46 regions post-RET, though MI values showed no significant change. Importantly, PAI scores demonstrated significant improvement after RET. Conclusions: The findings suggest that RET is effective in promoting the healing of periapical lesions in young permanent molars. The observed increases in cortical width and improvements in PAI scores support the positive impact of this treatment on bone healing. Furthermore, FD analysis, when combined with radiomorphometric indices, could provide a valuable and objective tool for evaluating RET outcomes. Full article

Background: Early preventive dental visits are critical to reducing oral diseases in children and establishing lifelong oral hygiene behaviors. The American Academy of Pediatric Dentistry (AAPD) recommends that a child’s first dental visit occur by age one. However, in Saudi Arabia, limited evidence exists on parental awareness, attitudes, and barriers toward this recommendation. Objective: This study aimed to evaluate the timing of the first dental visit among Saudi children and to identify parental knowledge, barriers, and sociodemographic factors associated with compliance with AAPD guidelines. Materials and Methods: A cross-sectional survey was conducted between April and July 2025 at the Pediatric Dental Clinic, King Saud University, Riyadh. A validated, self-administered Arabic questionnaire was distributed both online and in-clinic to Saudi parents of children under 12 years. A total of 465 completed responses were analyzed using descriptive statistics, chi-square tests, logistic regression, and Spearman correlation to assess associations between parental awareness, socioeconomic variables, and compliance. Results: Of the 465 respondents, 39.6% were aware of AAPD guidelines, yet only 30.5% reported compliance with the recommendation of a dental visit by age one. The most cited barriers were lack of time (42%), difficulty accessing clinics (22%), shortage of pediatric dentists (20%), and lack of awareness (16%). Higher parental education (p = 0.003) and income (p < 0.001) were significantly associated with compliance. A moderate positive correlation was observed between early dental visits and regular annual check-ups (ρ = 0.319). Conclusions: Compliance with AAPD guidelines among Saudi parents remains low, largely due to limited awareness and access barriers. Strengthening parental education, community-based programs, and affordable pediatric dental services is essential to promote preventive care and improve oral health outcomes in children. Full article

Background/Objectives: The diagnosis of pediatric dental conditions from panoramic radiographs is uniquely challenging due to the dynamic nature of the mixed dentition phase, which can lead to subjective and inconsistent interpretations. This study aims to develop and rigorously validate an advanced deep learning model to enhance diagnostic accuracy and efficiency in pediatric dentistry, providing an objective tool to support clinical decision-making. Methods: An initial comparative study of four state-of-the-art YOLO variants (YOLOv8, v9, v10, and v11) was conducted to identify the optimal architecture for detecting four common findings: Dental Caries, Deciduous Tooth, Root Canal Treatment, and Pulpotomy. A stringent two-tiered validation strategy was employed: a primary public dataset (n = 644 images) was used for training and model selection, while a completely independent external dataset (n = 150 images) was used for final testing. All annotations were validated by a dual-expert team comprising a board-certified pediatric dentist and an experienced oral and maxillofacial radiologist. Results: Based on its leading performance on the internal validation set, YOLOv11x was selected as the optimal model, achieving a mean Average Precision (mAP50) of 0.91. When evaluated on the independent external test set, the model demonstrated robust generalization, achieving an overall F1-Score of 0.81 and a mAP50 of 0.82. It yielded clinically valuable recall rates for therapeutic interventions (Root Canal Treatment: 88%; Pulpotomy: 86%) and other conditions (Deciduous Tooth: 84%; Dental Caries: 79%). Conclusions: Validated through a rigorous dual-dataset and dual-expert process, the YOLOv11x model demonstrates its potential as an accurate and reliable tool for automated detection in pediatric panoramic radiographs. This work suggests that such AI-driven systems can serve as valuable assistive tools for clinicians by supporting diagnostic workflows and contributing to the consistent detection of common dental findings in pediatric patients. Full article

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge gaps related to pediatric migraine, with the goal of identifying barriers to recognition and referral, as well as informing future training to support accurate diagnosis and interdisciplinary care. Methods: A 28-item electronic questionnaire was distributed to all members of the American Academy of Pediatric Dentistry, including pediatric dentists and postgraduate pediatric dental residents, assessing knowledge, beliefs, clinical experience, and interest in further training regarding pediatric headache/migraine management. Respondents with and without previous training were compared in terms of general understanding using t-tests; a linear regression model analyzed predictors of provider awareness regarding links between oral conditions and headache/migraine. Results: Among 315 respondents, the mean self-perceived awareness score was 2.7 ± 1.3 (on a 0–5 scale). The most frequently identified contributing factors were clenching (73.7%), bruxism (72.4%), and temporomandibular disorders (65.7%). Nearly all respondents (95.2%) reported no formal education on headache/migraine prevention, yet 78.1% agreed on the importance of understanding the relationship between oral health and headache/migraine. Respondents with prior training were significantly more aware (p < 0.001) than those without prior training. Educating families (p < 0.001), frequency of patient encounters with headache (p = 0.032), coordination with healthcare providers (p = 0.002), and access to appropriate management resources (p < 0.001) were significant predictors of providers’ awareness. Conclusions: Pediatric dental providers expressed strong interest in enhancing their knowledge of headache/migraine management, highlighting the value of integrating headache/migraine-related education into training programs and promoting greater interdisciplinary collaboration. Full article

This study aimed to evaluate and compare the performance of four advanced artificial intelligence-powered chatbots—ChatGPT-4 Omni (ChatGPT-4o), DeepSeek, Gemini Advanced, and Claude 3.7 Sonnet—in responding to questions related to traumatic dental injuries (TDIs) in the primary dentition. The assessment focused on accuracy, completeness, readability, and response time, aligning with the 2020 International Association of Dental Traumatology guidelines. Twenty-five open-ended TDI questions were submitted to each model in two separate sessions. Responses were anonymized and evaluated by four pediatric dentists. Accuracy and completeness were rated using Likert scales; readability was assessed using five standard indices; and response times were recorded in seconds. ChatGPT-4o demonstrated significantly higher accuracy than Gemini Advanced (p = 0.005), while DeepSeek outperformed Gemini Advanced in completeness (p = 0.010). Response times differed significantly (p < 0.001), with DeepSeek being the slowest and ChatGPT-4o and Gemini Advanced being the fastest. DeepSeek produced the most readable outputs relatively, though none met public readability standards. Claude 3.7 generated the most complex texts (p < 0.001). A strong correlation existed between accuracy and completeness (ρ = 0.701, p < 0.001). These findings emphasize the cautious integration of artificial intelligence chatbots into pediatric dental care due to varied performance. Clinical accuracy, completeness, and readability are critical when offering information aligned with guidelines to support decisions in dental trauma management. Full article

Background: Pericoronitis is defined as inflammation of the soft tissues around the crown of an erupting tooth or a tooth with incomplete eruption, most commonly during eruption of the third molars. Pediatric dentists frequently encounter pericoronitis of the first molar, most of which resolve spontaneously. We describe the case of a 7-year-old girl who was referred to our hospital with intractable swelling in the right buccal region. Case Presentation: Intraoral examination showed an erupting right mandibular first molar and facial examination revealed swelling and an accumulation of pus in the cheek region. Radiographic examination revealed no pathological findings; therefore, it was diagnosed as a cheek abscess, and the region was incised that day. However, the symptoms recurred 3 weeks later, and cone-beam computed tomography detected a bone defect in the right mandibular first molar region, confirming a diagnosis of dentoalveolar abscess caused by pericoronitis of the first molar. The swelling resolved after incision of the abscess, and bone recovery was confirmed by X-ray in the follow-up period. Conclusions: Erupting first molars is at risk of pericoronitis, which may sometimes progress to a dentoalveolar abscess. Dental professionals should be alert to this possibility and should advise pediatric patients and their guardians to maintain good oral hygiene around erupting molars. Full article

Background/Objectives: Early childhood caries (ECC) is a significant global public health issue with economic and psychosocial consequences, impacting families and pediatric dentists. It affects children’s quality of life, causing pain and infection. Despite increasing research on ECC cross-sectional studies worldwide, inconsistencies and gaps remain in terms of geographical disparities. This study aimed to conduct a bibliometric analysis of cross-sectional surveys on ECC by examining the co-authorship, citation analysis, co-citation networks, and keyword co-occurrence. Methods: An advanced search was performed using relevant terms in the Dimensions database from 2005 to 2024. Bibliometric parameters were retrieved through the database’s analytical view tool and VOSviewer software. Results: A total of 571 documents were identified, with the highest output between 2019 and 2023 (355 records). Saul Martins Paiva authored the most articles (10), with 294 citations and a total link strength of 19. Brazil and the U.S. had the highest numbers of publications (56 and 52) and total link strengths, i.e., a measure of collaborative ties (21 and 50). The Universidade Federal de Minas Gerais in Brazil had the most published documents (15). BMC Oral Health led in terms of citations (44 articles, 899 citations, average 20.43%). The frequently co-occurring terms included ECC (1147 occurrences), oral health (417), and preschool child (301). Conclusions: This bibliometric analysis highlights the global interest in cross-sectional ECC studies beyond pediatric dentistry, helping researchers understand the field’s scope and progress. Full article

Dental anxiety is an intense and irrational fear of visiting the dentist or of undergoing dental procedures. Background/Objectives: The aim of this study was to investigate the prevalence of dental anxiety in children aged 6–11 years and to identify the importance of communication in reducing anxiety in pediatric patients. Methods: The research was conducted through a questionnaire administered to 101 students (55.4% girls and 44.6% boys), aged 6–11 years, from the North-West Region of Romania. The data collected included the age and gender of the subjects, their previous experiences with the dentist, the identification of factors that trigger anxiety, and the way in which patients perceive future dental visits. Results: This study found that for the majority of participants, a visit to the dentist does not represent a source of fear. Moreover, most children are eager to visit the dentist again. Gender and age did not have a significant effect on the prevalence of anxiety. Elements such as sitting in the dental chair, observing dental instruments, having the teeth examined with a mirror, and hearing the sounds produced by the instruments were identified as factors that may cause anxiety in pediatric patients. Conclusions: It was found that pediatric patients who have good communication with the practitioner display lower anxiety levels compared to those of others. Full article

Background/Objectives: The objective of this study was to evaluate practice patterns among pediatric dentists for the management of permanent teeth needing endodontic treatment. Methods: An electronic nationwide survey was sent to all members of the American Academy of Pediatric Dentistry (AAPD). The survey assessed provider training on and confidence (0–100, with 100 = “most confident”) in treating pediatric patients needing endodontic treatment on permanent teeth, referral patterns, and preferred educational resources. A logistic regression identified significant predictors of confidence levels. Results: The final sample included 259 respondents, with 71% having over 10 years of experience in practice. A total of 47% of respondents reported performing endodontic treatments on permanent teeth in pediatric patients, with direct pulp capping (70%) and partial or full pulpotomy (62%) being the most common procedures. Although the respondents moderately agreed (53 ± 32) that they received sufficient training during their residency to perform endodontic treatment on permanent teeth, their reported comfort levels with performing these procedures were low (0.001 ± 33). The adequacy of the training received during their residency was identified as a significant predictor of a higher level of confidence (p < 0.001, 95% CI 0.437, 0.667). The respondents highlighted additional continuing education courses and training, dedicated lectures at the AAPD Annual Session, and annual joint symposia or meetings between the AAPD and the American Association of Endodontists as the most valuable educational resources for the endodontic management of permanent teeth in pediatric patients. Conclusions: The findings suggest that enhancing residency training and expanding access to targeted continuing education opportunities are critical for improving pediatric dentists’ confidence and competence in the endodontic management of permanent teeth in pediatric patients. Full article