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ABSTRACT: This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.
Anesthesia Progress 01/2012; 59(1):3-11.
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ABSTRACT: Demand is increasing for esthetic restorations in pediatric dentistry. When full coverage is indicated, one option is to use esthetic stainless steel crowns (SSCs). However, this type of crown is prone to fracture. The purpose of this study was to evaluate the fracture resistance of 3 types of esthetic SSCs.
Esthetic SSCs for first primary mandibular molars were cemented to idealized epoxy dies with glass ionomer cement. The die-crown units were fractured on a universal testing machine. The force was delivered by a stainless steel ball fixture, set in a uniaxial lever to replicate a cusp contact, with a crosshead speed of 1 mm/min. The differences among the 3 types of crown, in terms of force required to fracture, were compared statistically by 1-way analysis of variance. Pairwise comparisons were performed with Fisher's protected least significant difference test, at an overall significance level of 5%.
The force required to fracture, expressed as average ± standard error, did not differ significantly among the 3 brands of esthetic SSCs: 1730 N ± 50 N, 1826 N ± 62 N and 1671 N ± 68 N, respectively (p = 0.19), well below the maximum bite force of pediatric patients determined in a previous study.
Esthetic SSCs should be able to resist occlusal forces over short clinical periods. However, long-term occlusal loading and fatigue failures should be taken into account when evaluating the success of this type of crown.
Journal (Canadian Dental Association) 01/2011; 77:b90. · 1.00 Impact Factor
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ABSTRACT: To evaluate Indiana pediatricians' current practices related to oral health, knowledge of oral health prevention, and opinions on anticipatory guidance integration into their practices.
The American Academy of Pediatrics (AAP) May 2003 policy statement on oral health risk assessment timing and establishment of a dental home has provided pediatricians with guidelines to assess patients' oral health and caries risk status.
A survey of 31 questions was distributed via mail to all active Indiana pediatricians (300) registered in the Indiana State Medical Association to evaluate current practices relating to oral health prevention and guidance.
Of the 300 distributed surveys, 138 were returned (46%). The authors found that 15% of pediatricians recognize the AAP-recommended age for a dental home as 12 months and practice this recommendation. Among the respondents, 7% believe application of fluoride should be part of a well-child visit. The majority (89%) of respondents reported interest in obtaining further knowledge on oral health.
Clinical Pediatrics 10/2009; 49(1):12-9. · 1.15 Impact Factor
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ABSTRACT: The purpose of this study was to determine if there were differences in the amount of time it took to exhibit positive behavior following dental treatment under general anesthesia (GA) vs conscious sedation (CS).
This retrospective study examined charts of a pediatric dental office between 1999 to 2003. Patients presenting before 36 months old for an initial exam who were diagnosed with early childhood caries were included in the study. Following the initial exam, the patients were treated under GA or CS. These patients were followed to determine their behavior at the 6-, 12-, and 18-month recoil appointments.
Thirty-nine patients who received treatment under GA were identified and 41 were treated under CS. The former were 3.9 times (P < .01) (P = .0057) more likely to exhibit positive behavior at the 6-month recall appointment. Although not statistically significant, a trend toward positive behavior was exhibited at the 12- and 18-month appointments.
Clinicians should consider future behavior, in addition to caries, when determining treatment modalities for children presenting to their office with dental caries.
Pediatric dentistry 31(7):492-7. · 1.02 Impact Factor
