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Genetic variants of AMELX gene can affect the protein content, organization of enamel prisms, microstructure and microhardness of the enamel, thus altering the caries susceptibility. The present study aims to assess the association between polymorphisms rs17878486, rs5934997, and rs5933871 of AMELX gene and Early Childhood Caries (ECC). This case–control study was conducted on 200 participants, aged 3–6 years, with 100 controls and 100 children with ECC. A questionnaire was used to collect demographic data, birth-weight, type of delivery, oral hygiene practices, feeding history and 24-h diet diary. DNA was isolated from blood and subjected to PCR followed by Sanger sequencing. The CC genotype of rs17878486 showed an OR of 1.93 (0.34–10.81; P = 0.73). In a recessive model, the CC genotype of rs17878486 reported an OR of 2.04 (0.36–11.40; P = 0.68); rs5593871 reported an OR of 1.00 (0.31–3.21). Statistically significant differences (P ≤ 0.05) between genotype and allele frequencies of rs17878486, rs5934997, and rs5933871 were not observed between children with ECC and the controls. Polymorphisms of AMELX gene did not show a significant association with ECC in this population. However, documentation of genetic data in a global context of ECC may be essential for the future.

To investigate both caries prevalence and clinical consequences experienced by deprived children in the West Bank, using a child-centred approach. Children were invited by their social workers to attend free dental screening sessions held across clinics in the north of the West Bank. Data were collected using the dmft/DMFT and pufa/PUFA indices. Dental pain was reported by children using the Wong-Baker FACES® pain scale. Data were analysed using SPSS Version 22.0. Data were collected for 177 children aged 4 to 18 years. Caries prevalence was 95.5% with only eight children presenting clinically caries-free. The sample had a dmft of 3.88, and DMFT of 3.44. The Care Index was calculated at 0.1 (mft/dmft). Clinical consequences of caries were identified in 64% of the sample, with a mean pufa score of 2.12, and a PUFA score of 0.55. Dental pain was experienced by 45% of children. Deprived children living in the West Bank experience high levels of untreated dental caries, with significant clinical consequences and self-reported pain.

Aim: This was to investigate survival rate, median survival time and differences in the progression of different stages of proximal caries in 196 children, aged 6 to 8 years old, with different caries index at baseline examination. Methods: Based on DMFS/dmfs values, children were categorized as low, moderate and high caries index groups. Subjects with DMFS/dmfs smaller or equal to half of a child’s age were classified as low caries index group; children with DMFS/dmfs greater than half and smaller than, or equal to, the child’s age as moderate; those with DMFS/dmfs greater than the child’s age as high. Proximal caries and its progression were diagnosed from bitewing radiographs taken at 1 — year intervals over a period of 4 years. The mesial surface of the first permanent molars, mesial and distal surfaces of the first and second primary molars and distal surfaces of the primary canines were examined. Sound surfaces, caries lesions in the external and internal half of the enamel and external, middle, internal third of the dentine as well as filled, extracted and exfoliated teeth were recorded. Statistics: A life table analysis was performed to estimate survival rate and median survival time of each state of proximal caries and differences between the groups in the progression of the proximal lesions were tested with the Wilcoxon pairwise comparison statistic. Results: There were statistically significant differences in the caries rate of the sound proximal surfaces of the primary teeth between the low and high caries index groups. Also, statistically significant differences between these two groups were found in the progression of the external half of the enamel caries in the first permanent molars and in the primary teeth. Conclusions: A high caries index increases the risk of developing caries in the sound proximal surfaces of posterior primary teeth and causes faster progression of the external half of the enamel lesions in the first permanent molars and posterior primary teeth.

To compare the Tell-Show-Do Technique (TSD-T) with Hiding Dental-Needle Technique (HDN-T) based on children’s anxiety, pain, and behavior during first-time mandibular block anesthesia. A total of 52 children aged 3–5 years who had never received dental anesthesia and had at least one mandibular primary molar requiring extraction or pulpal therapy were included in the study. Children were randomly allocated into two groups: G1: TSD-T (n = 26) and G2: HDN-T (n = 26). This study included two sessions: intervention session (baseline) and control session (7 days after intervention). Facial Image Scale and Wong–Baker Pain Scale were used to evaluate anxiety and pain levels, respectively. Frankl Behavior Scale was used to assess children’s behavior. Anxiety and pain levels were not statistically significant between G1 and G2 groups (p > 0.05). Similar results were observed for children’s behavior rating (p > 0.05). Higher pain level was associated with younger children (rate ratios (RR) = 0.41; p = 0.016) and negative behavior (RR = 1.11; p < 0.001). On the other hand, in within-groups comparisons, there was a statistical difference in anxiety levels between intervention session and control session (p = 0.032) in G2. Even though there are no differences in the efficacy of TSD-T compared to HDN-T during first-time mandibular block anesthesia in preschool children in terms of children’s anxiety, pain, and behavior, children from the HDN-T group can show reduced dental anxiety levels in the control sessions.

AIM: This was to analyse the tooth types extracted and the reasons for extractions in 3–8 year-old Swedish children. Another aim was to determine what treatments and attendance patterns preceded the caries-related extractions. STUDY DESIGN AND METHODS: A retrospective study of all 5,045 dental records of the 3–8 year-olds at six public dental clinics in a Swedish county was performed to find all extractions performed during one year and the reason for each extraction. The dental records, that included a caries-related extraction of a primary molar, were further analysed to find possible non-attended dental visits and treatments preceding the extraction. STATISTICS: The data were analysed using Pearson correlation test, Mann-Whitney U test, and Chi-2 test. RESULTS: 309 (4 permanent and 305 primary) extractions were performed in 206 (119M, 87F) (4.1%) of the patients. The primary molar was the tooth type most frequently extracted, while the central primary incisor was the tooth most frequently extracted. Reasons for extractions were; caries: 60.5%, orthodontics: 11.3%, trauma: 10.4%, other reasons: 17.8 %. Dental records from 100 children with caries-related extractions of primary molars were analysed. A previous treatment had been performed in 51.0% of the caries-related extractions of primary molars, but only 24.0% had any long term restoration material with glass ionomer cement, composite resin or compomer. Non-attendance frequency prior to caries-related extraction of primary molar was higher (P=0.004) among the non-treated children, but 40.1% of the non-treated children had no missed appointments. Caries-related extractions were more common among boys (p=0.0315). CONCLUSIONS: Every 25th child in the age-group 3–8 years had extractions performed during a one-year period. Only every second primary molar had received any treatment before caries-related extraction, and only 24% had received long-term restorations. A considerable number (40%) of the non-treated children had no missed appointments before the caries related extractions. The routines for dental care and caries treatment in the primary dentition need a revision.

The aim of this study was to investigate attitudes and preferred therapy choice for first permanent molars (FPM) with Molar-Incisor Hypomineralization (MIH). An online questionnaire was sent out to general dentists (n = 559) working in the Public Dental Service in Region Västra Götaland, orthodontists (n = 293), and pediatric dentists (n = 156) (members from each interest association), in Sweden. The questionnaire contained three parts: general questions regarding the respondents, patient cases, and general questions regarding extraction of FPMs with MIH. Statistics were carried out using Chi-squared tests, with a significance level of 5%. A response rate of 36% was obtained. Orthodontists and pediatric dentists were more prone to extract FPMs with both moderate and severe MIH, compared to general dentists. When restoring FPMs with moderate MIH, resin composite was preferred. Compared to the general dentists, the pediatric dentists were more prone to choose glass-ionomer cement in the FPMs with severe MIH. The most common treatment choice for FPMs with mild MIH was fluoride varnish. “When root furcation is under development of the second permanent molar on radiographs” was chosen as the optimal time for extracting FPMs with severe MIH, and the general dentists based their treatment decisions on recommendations from a pediatric dentist. Extraction of FPMs with moderate and severe MIH is considered a therapy of choice among general dentists and specialists, and the preferred time of extraction is before the eruption of the second permanent molar.

Although a large number of mesiodentes are left in situ, only a few are found in radiographs from epidemiological studies of adult populations. This leads to the development of a hypothesis that mesiodentes may be resorbed and disappear over time. The aim of this study was to radiographically investigate the frequency of resorptions and pathologies in relation to mesiodentes left in situ. The study population consisted of 44 individuals, with 49 mesiodentes left in situ at an early age. The individuals were 18–38 years old when re-examined. The inclusion criteria were that the mesiodentes had been diagnosed in childhood and left in situ, and that each individual was over 18 years of age at the time of re-examination. Either digital or analogue intraoral radiographs were used at the re-examination and compared with earlier analogue radiographs. Forty-one per cent of the impacted mesiodentes showed resorptions—from limited to nearly complete resorption. No pathologies in connection to the mesiodentes were found. About half of the mesiodentes examined displayed resorption. No pathologies caused by the mesiodentes were recorded.

AIM: To assess the preferences amongst European postgraduates (PG) in Paediatric Dentistry for the treatment of a child with differing caries severity in a primary molar tooth. STUDY DESIGN: An on-line structured questionnaire. METHODS: All European Paediatric Dentistry PGs were contacted by e-mail and asked to participate in an on-line questionnaire. The survey described four different case scenarios of a 5-year-old child, presenting with a mesio-occlusal cavity in tooth 85 with varying symptoms and signs. Treatment options were listed and participants asked to select the single most preferred treatment for each case. The same scenarios were presented for both non-anxious and dentally-anxious patients. RESULTS: Responses were received from 32/56 (F: 27; M: 5) PGs. A range of treatment options were selected for patients with no indication of pulpal involvement for non-anxious patients whilst the Hall technique was selected by 16/32 students for a dentally-anxious patient. For both a non-anxious and dentally-anxious patient, the preferred option for a tooth which produced pulpal symptoms was extraction selected by 16/32 students in both cases, although the mode of extraction differed. CONCLUSION: There was no consistency of response by PGs in Paediatric Dentistry within Europe. The Hall technique appeared to be a favoured option by half of the students for treatment of an asymptomatic carious primary molar tooth in a dentally-anxious child patient. Dental extraction was an option for a tooth demonstrating pulpal symptoms in both non-anxious and dentally-anxious patients.