Deciduous dentition and enamel defects

Two hundred eighty children including wellnourished, malnourished and infants with intrauterine growth retardation (IUGR) were examined for dental eruption and enamel hypoplasia. In malnourished and IUGR children eruption of teeth was delayed. The prevalence of enamel hypoplsia in wellnourished children was 20% being significantly higher in females as compared to males in age group 1-2 years. Enamel hypoplasia was seen in 36.6% malnourished subjects. Breast-feeding was protective against enamel hypoplasia.     

The etiology of enamel hypoplasia: a unifying concept

In a study of children with chronic disorders of calcium and phosphate homeostasis, enamel hypoplasia was found in hereditary vitamin D-dependency rickets and in hypoparathyroidism, conditions characterized by hypocalcemia, and was not found in X-linked hypophosphatemic rickets, a condition in which the plasma calcium concentration is normal. The occurrence of enamel hypoplasia bore no relation to the plasma phosphate concentration. Enamel hypoplasia has also been reported in other pediatric disorders in which hypocalcemia is a major sign (for example, vitamin D deficiency, prematurity, and neonatal tetany). The existence of enamel hypoplasia in a hypoparathyroid or rachitic patient, when correlated with the chronology of enamel mineralization, helps to establish the time of onset of hypocalcemia. The observations led us to the hypothesis that a low serum calcium concentration during enamel formation is a specific determinant of enamel hypoplasia. This hypothesis may be relevant to the etiology of linear enamel hypoplasia, an endemic lesion of primary teeth in children of many Third World countries that predisposes the teeth to dental caries. The hypothesis may therefore be relevant also in explaining the prevalence of caries in the primary teeth of children in many underdeveloped countries.     

Long-term effects of chemotherapy on dental status in children treated for nephroblastoma

Dental abnormalities among children treated at a young age for Wilms tumor are reported. The authors retrospectively reviewed the dental records and panoramic radiographs of 27 children treated for nephroblastoma between 1994 and 1998. They evaluated the frequency of apparent microdontia, excessive caries, root stunting, hypodontia, and enamel hypoplasia and compared this group to a control group of 78 children. Seventy percent of the children developed dental abnormalities, comprising root stunting (44%), enamel hypoplasia (22%), microdontia (18%), and hypodontia (7%). Results of control subjects were significantly different regarding dental abnormalities, especially microdontia and taurodontia. These results indicate that chemotherapy in children may lead to troubles affecting teeth growing at the time of treatment. Information and prospective dental care are needed, and further investigations are required.     

LONG-TERM EFFECTS OF CHEMOTHERAPY ON DENTAL STATUS IN CHILDREN TREATED FOR NEPHROBLASTOMA

Dental abnormalities among children treated at a young age for Wilms tumor are reported. The authors retrospectively reviewed the dental records and panoramic radiographs of 27 children treated for nephroblastoma between 1994 and 1998. They evaluated the frequency of apparent microdontia, excessive caries, root stunting, hypodontia, and enamel hypoplasia and compared this group to a control group of 78 children. Seventy percent of the children developed dental abnormalities, comprising root stunting (44%), enamel hypoplasia (22%), microdontia (18%), and hypodontia (7%). Results of control subjects were significantly different regarding dental abnormalities, especially microdontia and taurodontia. These results indicate that chemotherapy in children may lead to troubles affecting teeth growing at the time of treatment. Information and prospective dental care are needed, and further investigations are required.     

Dental Problems in Hypophosphatemic Rickets,a Cross Sectional Study

Objective

Hypophosphatemic rickets is an uncommon metabolic bone disorder which affects all ages and both sexes. It is characterized by low concentration of serum phosphate levels, impairment of mineralization of bone matrix and teeth with variable etiology. Dental problems in this disorder have not been described well in previous studies.

Methods

All hypophosphatemic rickets patients who came to a referral clinic during 2008-2010 enrolled in this study. All patients had low phosphorous and high ALP, normal PTH and 25-hydroxy-vitamin D and normal or low level of serum calcium. After diagnosis all patients were examined by a dentist for enamel hypoplasia, taurodontism, dental abscess, gingivitis, dental caries, and dentition delay.

Findings

Nineteen patients were enrolled in this study. The average age of the patients was 10 (±4.23) years (range 3-17). Seventy-nine percent of patients had regular follow-up after diagnosis of background disease. Dental caries and delay in the dentition were most prevalent (each one 47.7%) followed by enamel hypoplasia in 42.1% of the patients. Other problems were taurodontism in 15.8% patients, dental abscess and gingivitis in 10.9%.

Conclusion

Hypophosphatemic rickets is a disease with different clinical features; one of them is dental problem, dental caries is the most common problem.     

The interface of nutrition and dentition

Conclusion Gross undernutrition in children retards deciduous dental eruption. High fluoride consumption adds to the delay, Exfoliation of teeth is delayed in high fluoride areas. Fluoride has adverse effects on teeth and produces mottling changes and abnormal teeth. Bailey’s formula is not accurate in assessing ages of children in undernourished populations.     

Przyczyny ekstrakcji zębów mlecznych u dzieci – retrospektywne badanie kohortowe

Introduction

The main purpose of this paper was to determine the reasons for dental extractions of deciduous teeth in children, including those made in the period before the physiological replacement of teeth.

Material and methods

In 1,000 patients of the Department of Pediatric Dentistry, Medical University of Warsaw at the age of 1–17 years with at least one deciduous tooth removed, group of extracted tooth, extraction cause and the child's age at the time of performed surgery was rated.

Results

The reason of more than 76% extractions of deciduous teeth was caries and its complications. The other reasons were eruption disorders, orthodontic indications, and mechanical injuries. 1.5% was a supernumerary teeth prematurely erupted, idiopathic resorption, periodontal diseases. 47.5% of extractions were performed in the age between 6 and 9 years, 32.3% before physiological teeth replacement (85.0% due to caries). Extractions of molars (60.5%) and upper incisors (26.8%) were the most frequent.

Conclusions

The caries and its complications are still the most frequent causes of deciduous teeth extractions, especially molars and incisors, often performed before the physiological teeth replacement.     

Coeliac disease, enamel defects and HLA typing

The presence of dental enamel defects in coeliac disease and their relation to hypocalcaemia or a particular HLA class in 82 Italian children with coeliac disease was studied. Demarcated opacities or hypoplasia were detected in 23 subjects (group 1) while minimal or no dental lesions were found in the remaining 59 patients (group 2); in 189 normal controls, enamel lesions were significantly less frequent than in patients with coeliac disease (14.8% versus 28.0%; p < 0.005). No statistically significant differences were found for age at diagnosis and calcium concentrations between groups 1 and 2. Regression analysis showed a correlation between age at diagnosis and number of teeth with enamel defects. In our patients, the presence of HLA DR3 antigen significantly increased the risk of dental lesions, while genotype DR5,7 seemed to protect against enamel defects. A logistic regression analysis of the variables age, serum calcium concentrations, number of affected teeth, type of enamel defect and DR antigens showed that only DR antigens discriminated coeliac disease patients with from those without enamel defects.     

Relationship between gestational age,birth weight and deciduous tooth eruption

BackgroundTeething is a normal part of child growth and development. Growth parameters and feeding pattern may be determinants of the timing of teeth eruption in healthy infant. Primary tooth eruption may be affected by gestational age, postnatal nutrition, degree of prematurity as well as severity of neonatal illness.ObjectivesThe aim of this study was to evaluate the relation between gestational age, weight and neonatal illness to the time of eruption of the first deciduous tooth.Materials and methodsThis study was a follow up prospective study carried out at the Bab El Sharia University hospital from October 2010 to October 2012. The study included 250 newborn from the obstetric department, from the NICU and from the outpatient clinics at the hospital. The babies were stratified according to gestational age to preterm (<37 weeks): 72 cases and full term (>37 weeks): 178 cases. The babies were followed from birth till the eruption of the first deciduous tooth.ResultsThere was a negative linear correlation between the time of the first deciduous tooth eruption and birth weight. The eruption of the first deciduous tooth was delayed in babies admitted to NICU specially if there was major interference such as intubation, mechanical ventilation.ConclusionDelayed tooth eruption was related to lower birth weight and prematurity. The delayed eruption in preterm babies may be related to premature birth and not to a delay in dental development.     

Oral health and related factors in cystic fibrosis and other chronic respiratory disorders.

AIM: To compare the prevalence of dental caries, dental calculus, and enamel defects in children with cystic fibrosis (CF) and children with other chronic respiratory disorders. METHODS: A cross sectional observational survey. One examiner (AN) undertook oral examinations to assess dental caries, periodontal health, and enamel defects in children attending respiratory outpatient clinics. RESULTS: A total of 74 patients with CF (35 male; mean age 10.7 years, range 2.5-16.5) were compared with a control group of 106 patients with other chronic respiratory disorders (52 male; mean age 9.1 years, range 3.0-16.5). There were significantly more defects of enamel in the permanent teeth of CF patients, compared with the teeth of those children with other chronic respiratory disorders. In addition, non-significant trends towards a lower caries prevalence in both dentitions, increased numbers of sextants with calculus deposits, and a reduced number of healthy gingival sextants were observed in the patients with cystic fibrosis. CONCLUSIONS: Enamel defects, particularly enamel opacities, which can be disfiguring, are more common in CF patients. Early, regular dental visits may prevent such defects becoming dentally disabling and would also permit the removal of dental calculus deposits. The use of long term antibiotics and pancreatic enzymes may confer some protection against the development and progression of dental caries in patients with cystic fibrosis. The inclusion of a specialist paediatric dentist, as part of the multiprofessional team managing the care of these children, would be an advantage.     

Oral health and related factors in cystic fibrosis and other chronic respiratory disorders

Aim: To compare the prevalence of dental caries, dental calculus, and enamel defects in children with cystic fibrosis (CF) and children with other chronic respiratory disorders. Methods: A cross sectional observational survey. One examiner (AN) undertook oral examinations to assess dental caries, periodontal health, and enamel defects in children attending respiratory outpatient clinics. Results: A total of 74 patients with CF (35 male; mean age 10.7 years, range 2.5–16.5) were compared with a control group of 106 patients with other chronic respiratory disorders (52 male; mean age 9.1 years, range 3.0–16.5). There were significantly more defects of enamel in the permanent teeth of CF patients, compared with the teeth of those children with other chronic respiratory disorders. In addition, non-significant trends towards a lower caries prevalence in both dentitions, increased numbers of sextants with calculus deposits, and a reduced number of healthy gingival sextants were observed in the patients with cystic fibrosis. Conclusions: Enamel defects, particularly enamel opacities, which can be disfiguring, are more common in CF patients. Early, regular dental visits may prevent such defects becoming dentally disabling and would also permit the removal of dental calculus deposits. The use of long term antibiotics and pancreatic enzymes may confer some protection against the development and progression of dental caries in patients with cystic fibrosis. The inclusion of a specialist paediatric dentist, as part of the multiprofessional team managing the care of these children, would be an advantage.     

The dental status of children with chronic renal failure

We evaluated the dental status of thirty children with chronic renal failure (CRF): 15 managed conservatively, 9 on dialysis replacement therapy and 6 after kidney transplant. Dental age was delayed, but to a lesser extent than bone age; this delay was most marked where CRF occurred before 7 years of age. Eruption age was only minimally delayed. Eighteen patients (60%) showed enamel defects, mainly hypoplasia, the location of which was related to the age at which major metabolic changes of uremia appeared. In 9 children (30%) there was intrinsic discoloration of the teeth--this was also related to the severity and duration of CRF. Compared to normal Israeli children our patients showed poor oral hygiene and gingival condition, but a significantly lower prevalence of caries. Seven patients (23%) showed mild radiologic changes in the jawbones (mainly loss of lamina dura), the severity of which was related to the severity and duration of CRF. None of the above findings could be related to specific metabolic disturbances.     

III. dental development from birth to 16 years.

Tooth eruption in 212 randomly selected Swedish urban children has been investigated from birth to 16 years as part of a prospective longitudinal study of growth and development. The ages and the order of eruption of the deciduous and permanent teeth were in agreement with those reported in other contemporary studies. The good agreement with another longitudinal study of the tooth eruption of Swedish children born during the same period is an indication that the present sample was representative of contemporary Swedish children. In the deciduous dentition a probable male advancement was found, while girls were consistently the advanced sex as regards the eruption of permanent teeth. Sex differences have also been found in the relation between dental development and other criteria of somatic growth and development. The correlations were low or moderate with, in general, higher values for girls than boys. A positive association with somatic growth was observed both for the deciduous and the permanent dentition but with intriguing sex differences for various body measurements.     

The role of the pediatrician in identifying and treating dental caries

Although dental caries has been reduced greatly in the last two generations, this infectious disease persists. The pediatrician can play a direct and indirect role in preventing dental caries. The pediatrician can provide counseling on feeding practices to prevent baby bottle tooth decay as well as identify children at risk. Dental caries of the grooves of molar teeth now accounts for dental caries in more children than any other form of caries. Dental sealants are recommended to coat the grooves and prevent dental caries. Restoration of decayed teeth is the most direct means of treating dental caries.     

MINERALIZATION DEFECTS IN DECIDUOUS TEETH OF LOW BIRTHWEIGHT INFANTS

ABSTRACT. A group of 91 children with birthweights below 2000 g and 48 healthy full-term children, reference group, were examined for mineralization disturbances of the enamel of deciduous teeth. Perinatal data were collected retrospectively from obstetric and neonatal records. Within the low birthweight group, children with enamel hypoplasia had on the 5% level a significantly lower intake of breast milk during the first week of life than children without disturbances. The only perinatal complication associated with development of mineralization defects was IRDS. Infants with IRDS, however, had a significantly lower intake of breast milk during the first week of life than low birthweight without IRDS. A low frequency of enamel defects was found in the growth-retarded sub-group of the low birthweight infants. These infants had a significantly higher intake of breast milk during the first week compared to the AGA-group. A seasonal variation was found, with the highest prevalence of mineralization disturbances in infants born during winter months. It is concluded that the occurrence of mineralization defects of the deciduous teeth in LBW infants seems to be dependent upon the amount of breast milk given during the early neonatal period and also possibly in which season of the year they are born.     

Dental caries and salivary immunoglobulin A in Down syndrome children

OBJECTIVES: This study investigated the relationship between dental caries and the salivary Streptococcus mutans specific antibodies in Down syndrome children. METHODS: Nineteen children with Down syndrome and 41 normal children aged 8-17 years were selected. The oral health status (dental caries experience, pit and fissure depth, dental arch space, and Simplified Oral Hygiene Index) was examined and unstimulated saliva was collected. The total salivary immunoglobulin A (IgA) and S. mutans specific salivary IgA concentrations were measured using ELISA. RESULTS: The decayed and filled surface index of the deciduous teeth, and the decayed, missing, and filled surfaces index of the permanent teeth in Down syndrome children were significantly lower compared to those in normal children. The salivary S. mutans (serotype g and c) specific IgA concentrations were significantly higher in Down syndrome children than in the normal children. There was no significant difference in the tooth characteristics and oral hygiene between the two groups. CONCLUSIONS: The low caries prevalence in Down syndrome children appears to be due to immune protection caused by the elevated salivary S. mutans specific IgA concentrations.     

Dental disease in children with chronic illness.

This article aims to raise awareness among paediatricians and specialist paediatric services that poor oral health, in particular children with chronic illness, is a major cause of morbidity and can be a risk factor for severe, even life threatening complications. Good oral health and dentition is important for efficient mastication, speaking and of course, cosmetically for smiling. If left untreated, dental caries can lead to pain and infection. Chronic infection around one or more teeth can result in damage to localised structures, such as the developing permanent teeth. Children who are medically compromised (such as being immunocompromised from disease and/or therapy) however are at increased risk of developing systemic complications from dental infections, which may prove fatal. We focus on the role of the general paediatrician in promoting the importance of good dental health for all children and in particular those children "at risk". We present preventive measures, evidence based where available, that may improve dental care and promote the role of paediatric dental services in the multidisciplinary management of chronic disease.     

Dental disease in children with chronic illness

This article aims to raise awareness among paediatricians and specialist paediatric services that poor oral health, in particular children with chronic illness, is a major cause of morbidity and can be a risk factor for severe, even life threatening complications. Good oral health and dentition is important for efficient mastication, speaking and of course, cosmetically for smiling. If left untreated, dental caries can lead to pain and infection. Chronic infection around one or more teeth can result in damage to localised structures, such as the developing permanent teeth. Children who are medically compromised (such as being immunocompromised from disease and/or therapy) however are at increased risk of developing systemic complications from dental infections, which may prove fatal. We focus on the role of the general paediatrician in promoting the importance of good dental health for all children and in particular those children "at risk". We present preventive measures, evidence based where available, that may improve dental care and promote the role of paediatric dental services in the multidisciplinary management of chronic disease.     

FLUORINE CONCENTRATIONS IN DECIDUOUS HUMAN TEETH AFTER ORAL ADMINISTRATION OF SODIUM FLUORIDE IN VITAMIN SOLUTION

Abstract. Bervenmark, H. and Hamberg, L. (ACO Läkemedel AB, Solna and the Department of Paediatrics, Karolinska sjukhuset, Stockholm, Sweden). Fluorine concentrations of sodium fluoride in vitamin solution. Acta Paediat Scand, 63: 232, 1974.–In an earlier study, 705 children were given a vitamin A and D solution: of these, 342 received a supplement of sodium fluoride over a period of 7 years. A significant difference in the frequency of caries was found between the children in the fluoride group and those in the control group. To see if this difference was correlated to the concentration of fluorine in enamel and dentine a quantitative analysis of deciduous teeth from both groups was carried out. The results indicate that fluoride administered orally, in the dosage used, significantly increases the fluoride content of the enamel and dentine. The findings might contribute to explain why children who receive this prophylaxis have. increased resistance to caries.     

Teeth for the Future

The main dietary influences on teeth are, with the exception of ingested fluoride, local rather than systemic. The frequent use of carbohydrates which can be rapidly fermented by dental plaque micro-organisms is the major factor in dental decay. Sweetened and/or highly acidic soft drinks or medicines sweetened with sugars may damage the teeth. Similarly infant's comforters also have their dangers if they provide prolonged exposure of the teeth to cariogenic conditions. Although dental caries is primarily a disease of children many adults still develop new lesions and adults who have lost gingival tissue through periodontal disease may develop root surface caries. Pathological conditions of the oral mucosa can arise from nutritional disorders or inappropriate dietary habits. Health education is most effective when it carries a positive message so encouraging patients to eat the right kind of tasty snacks and to round off meals with sugar-free products or a modicum of cheese should in healthier eating without conflicting with general health guidelines.