scholarly journals Minimally Invasive Dentistry: Parent/Carer Perspectives on Atraumatic Restorative Treatments and Dental General Anaesthesia to the Management of Early Childhood Caries

2021 ◽  
Vol 2 ◽  
Author(s):  
Peter Arrow ◽  
Helen Forrest ◽  
Susan Piggott
Keyword(s):  
Early Childhood ◽  
Minimally Invasive ◽  
General Anaesthesia ◽  
Early Childhood Caries ◽  
Cost Of Care ◽  
Atraumatic Restorative Treatment ◽  
Treatment Needs ◽  
Minimally Invasive Dentistry ◽  
Dental General Anaesthesia ◽  
Childhood Caries

Introduction: Parents of children treated under dental general anaesthesia (DGA) have reported feelings of concern and anxiety. This study elicited the views of parents/carers (P/C) of children with early childhood caries (ECC) who participated in a randomised trial (core study) which tested the effectiveness of care under DGA or care using alternative minimally invasive Atraumatic Restorative Treatment and the Hall Technique approaches (ART/HT).Methods: P/C of children treated using the ART/HT (test) approach or care under a DGA (control) were interviewed. Focus group semi-structured interviews with P/C were undertaken in community facilities. The transcripts were read and inductively coded into domains to identify emergent themes. The codes were entered into NVivo software to assist data management and were further refined into broad themes.Results: Seven grouped interviews with 14 participants were conducted and one test participant provided a written response. Four groups with eight test participants; two groups with four control participants; and one combined group with one test and one control participant were interviewed. Five broad themes emerged after thematic analysis: (1) Impacts on the child and the family; (2) Child-/family-centred care; (3) Timeliness of care; (4) Affordable care; (5) Accessible care. Impacts were related to that of the effects of the disease, and of the care for the disease. Child-centred/family-centred care (CCC) was a source of appreciation by P/C of both groups when it was experienced. Frustration at the lack of timely care of their child's treatment needs, coupled with the perceived expensiveness of care and difficulties in physically getting to the location for a specialist consultation was expressed by P/Cs in the study.Discussion: The use of the ART/HT enabled the establishment of a relationship between the clinical team and the child and P/C which was central to the delivery of CCC. P/Cs in the DGA arm of the study expressed dissatisfaction more often with the issues of timely care, cost of care and accessibility of care. P/C of both groups were equally satisfied with the treatment, where treatment had been received in a timely, child-centred manner.Conclusion: The findings suggest that minimally invasive approaches which facilitated CCC are acceptable alternative options to the DGA and should be considered for the management of ECC.Australian New Zealand Clinical Trials Registry: ACTRN12616001124426.

scholarly journals Minimally Invasive Dentistry Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries in Rural and Remote Aboriginal Communities: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Peter Arrow ◽  
Rob McPhee ◽  
David Atkinson ◽  
Tamara MacKean ◽  
Sanjeewa Kularatna ◽  
...  
Keyword(s):  
Early Childhood ◽  
Minimally Invasive ◽  
Early Childhood Caries ◽  
Test Group ◽  
Caries Experience ◽  
Control Group ◽  
Atraumatic Restorative Treatment ◽  
Randomized Controlled ◽  
Aboriginal Children ◽  
Childhood Caries

BACKGROUND The caries experience of Aboriginal children in Western Australia (WA) and elsewhere in Australia is more than twice that of non-Aboriginal children. Early childhood caries (caries among children <6 years) has a significant impact on the quality of life of children and their caregivers, and its management is demanding and commonly undertaken under general anesthesia. A randomized controlled trial using a minimally invasive dentistry approach based on Atraumatic Restorative Treatment (ART) in metropolitan Perth, WA, has demonstrated a significant reduction in the rate of referral to a dental specialist for dental care among children with early childhood caries, potentially reducing the need for treatment under general anesthesia. The tested approach was clinically successful and was without adverse effects on child dental anxiety. The model of ART-based primary care requires further testing and development if similar outcomes for Aboriginal children in remote and rural settings are to be achieved. OBJECTIVE The study aims to develop, implement, and evaluate a remote primary care model to deliver effective primary dental services, encompassing treatment and preventive services, to Aboriginal preschool children (based on minimally invasive approaches including ART). METHODS This is a two-arm parallel cluster randomized controlled study in which a test group will be provided with the intervention treatment at the start of the study and a control group will be provided with the intervention treatment 12 months after study commencement (delayed intervention). Participating communities, stratified by size of community (ie, number of children in the sample frame) and baseline caries experience, will be randomly assigned using a computer-generated block randomized list into immediate (test group) or delayed intervention (control group; provided with standard care). Informed consent will be obtained from all participants. Aboriginal research assistants will explain the study to the parents and assist the parents in completing the questionnaires. Participants in the randomized study will be examined at baseline and at 12 months follow-up by a calibrated examiner. Test group participants will subsequently be contacted and appropriate appointments coordinated for treatment. Control group participants will be provided with standard preventive care by the Aboriginal Health Workers and managed for treatment as per standard procedures. RESULTS Community consultations have been undertaken and 26 communities have agreed to participate. Fieldwork is in progress to recruit study participants. CONCLUSIONS The significance of the study lies in its holistic approach to testing the model of care. Clinical evaluations as well as oral health‒related quality of life evaluations will be undertaken. Cost-effectiveness and cost-utility evaluations will assist in the development of policy options for oral health services for rural and remote communities. The elicitation of caregiver perspectives through focus group interviews will supplement the clinical, psychosocial, and cost-utility evaluations and provide a richer evaluation of the intervention. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12616001537448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371735 (Archived by WebCite at http://www.webcitation.org/70UMxndFZ) REGISTERED REPORT IDENTIFIER RR1-10.2196/10322

scholarly journals Correlation between dental caries and hormonal, biochemical parameters in children with early childhood caries

2020 ◽  
Vol 10 (1) ◽  
pp. 1-5
Author(s):  
Ahmet Aras ◽  
Mehmet Sinan Doğan
Keyword(s):  
Early Childhood ◽  
Uric Acid ◽  
Statistical Analysis ◽  
Dental Caries ◽  
General Anaesthesia ◽  
Biochemical Parameters ◽  
Early Childhood Caries ◽  
Pediatric Patients ◽  
Radiographic Examination ◽  
Childhood Caries

Aim: The aim of this study was to analyze the relationship between dental caries and hormonal, biochemical parameters in pediatric patients with early childhood caries (ECC). Methodology: This study was conducted on fifty pediatric patients who presented with complaints of pain and caries and underwent dental treatment under general anaesthesia. In this study, the hormonal, biochemical parameters (glucose, urea, uric acid, creatinine, AST, ALT, GGT, CRP, Sodium, Potassium, Calcium, Glucose, Iron, TSH, FT3 and FT4) which were routinely taken from patients before general anaesthesia and the number of decayed, extracted and filled teeth (DMFT) obtained as a result of clinical and radiographic examination were evaluated statistically in patients aged 2-6 years.  Statistical analysis was performed using Independent Samples T-Test and Spearman correlation coefficient at a 0.05% significance level. Results: According to the data obtained, DMFT average of fifty children (male: 35; female: 15) included in the study was found to be 8.26. The mean DMFT was 7.93 in females and 8.40 in males. No statistical relationship was found between DMFT and gender in statistical analysis. (p>0.05). Uric acid and GGT values, which are among the hormonal and biochemical parameters, were found to be outside the normal range in 61.22% of the patients. However, statistical analysis revealed that there was no significant relationship between DMFT and hormonal, biochemical parameters. (p>0.05). Conclusions: In this study, it was concluded that dental caries did not cause a significant change in hormonal and biochemical blood parameters in pediatric patients with ECC.   How to cite this article: Aras A, Doğan MS. Correlation between dental caries and hormonal, biochemical parameters in children with early childhood caries. Int Dent Res 2020;10(1):1-5. https://doi.org/10.5577/intdentres.2020.vol10.no1.1   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

scholarly journals Strategic Management of Early Childhood Caries in Thailand: A Critical Overview

2021 ◽  
Vol 9 ◽  
Author(s):  
Thanya Sitthisettapong ◽  
Parinda Tasanarong ◽  
Prathip Phantumvanit
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
Strategic Management ◽  
Early Childhood Caries ◽  
Community Education ◽  
World Health ◽  
Deciduous Teeth ◽  
Atraumatic Restorative Treatment ◽  
Health Coverage ◽  
Childhood Caries

The aim of this report was to advocate early childhood caries (ECC) and share strategic management in Thailand, despite over two decades of free Universal Health Coverage including oral healthcare. The recent Thai national oral health survey in 2017 indicates the very high prevalence of ECC, with an average of three carious teeth affected in 53% of 3-year-old children. This is despite the efforts of the Ministry of Public Health that has launched several interventional programs ranging from an upstream policy that prohibits sugar additions in baby formula milk to downstream remediations such as advocating and encouraging toothbrushing with fluoride toothpastes. Nevertheless, ECC is strongly predicated by other key factors including the family and community commitment and participation, as embodied in the current World Health Organization guidelines. These encompass three different tiers of community-level prevention: primary, secondary, and tertiary. Accordingly, the following strategies for ECC management in Thailand should be based at primary care clusters (PCC) in sub-district health centers, with the assistance of inter-professional health teams. These include community education on the importance of deciduous teeth and effective toothbrushing with fluoride toothpaste (primary prevention), regular examination and detection of ECC lesions and early intervention (secondary prevention), insertion of non-invasive preventive restorations using cost-effective atraumatic restorative treatment (ART) or simplified and modified ART (SMART) (tertiary prevention), and, finally, effective follow-up and monitoring systems. It is anticipated that this triple tier approach to ECC management will improve not only the oral health but also the overall children's health.

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