Browsing by Subject "Dental Care"

Now showing 1 - 3 of 3
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    Long-term effects of a toddler-focused caries prevention programme among Northwestern US tribal children: The TOTS-to-Tweens study
    (Wiley, 2021-06) Smith, Nicole Holdaway; Lutz, Tam; Maupomé, Gerardo; Lapidus, Jodi; Jimenez, Candice; Janis, Maxine; Schwarz, Eli; Becker, Thomas; Epidemiology, School of Public Health
    OBJECTIVES: We sought to determine whether American Indian tribe-based interventions that successfully prevented toddler dental caries in a 2005 cohort study (the Toddler Overweight and Tooth Decay Prevention Study, or TOTS) influenced the prevalence of dental caries in children ages 11 to 13 in the same communities ten years later (the TOTS-to-Tweens study). METHODS: We recruited original TOTS participants and conducted school- and community-based dental screenings at tribal communities that received family plus community-wide interventions (F + CW), community interventions only (CW) or were control communities. We also enrolled children who did not participate in TOTS, but were exposed to CW interventions or to the control environment. Trained clinicians examined children's teeth and recorded whether each tooth was decayed, missing or filled (DMFT). We calculated DMFT scores for each child and evaluated differences in DMFT incidence rate ratios (IRR) and components of DMFT by intervention group. RESULTS: We observed lower age- and sex-adjusted DMFT scores among F + CW children (a mean of 2.1 DMFT; 95% confidence interval [CI]: 1.4-2.7) and among CW children (2.2; 95% CI: 1.9-2.6), than control children (3.0; 95% CI: 2.3-3.7). The F + CW group had 32% lower DMFT scores than control children (IRR = 0.68; 95% CI: 0.46-1.01), and CW children had 26% lower DMFT scores than control (IRR = 0.74; 95% CI: 0.55-1.00). The proportion of children with filled teeth was higher in control than intervention communities (37.9% in F + CW, 47.1% in CW, and 67.1% in control, P = .002). CONCLUSIONS: Our findings suggest modest yet significant long-term effects of interventions that prevented toddler dental caries on the DMFT scores of tweens evaluated ten years later. Further study of effective interventions and their sustainability is clearly warranted among tribal children, who remain at high risk for dental caries.
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    Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery
    (The Korean Dental Society of Anesthsiology, 2019-10) Schubart, Jane R.; Schaefer, Eric; Janicki, Piotr; Adhikary, Sanjib D.; Schilling, Amber; Hakim, Alan J.; Bascom, Rebecca; Francomano, Clair A.; Raj, Satish R.; Medical and Molecular Genetics, School of Medicine
    Background: People with the Ehlers-Danlos Syndromes (EDS), a group of heritable disorders of connective tissue, often report experiencing dental procedure pain despite local anesthetic (LA) use. Clinicians have been uncertain how to interpret this apparent LA resistance, as comparison of EDS and non-EDS patient experience is limited to anecdotal evidence and small case series. The primary goal of this hypothesis-generating study was to investigate the recalled adequacy of pain prevention with LA administered during dental procedures in a large cohort of people with and without EDS. A secondary exploratory aim asked people with EDS to recall comparative LA experiences. Methods: We administered an online survey through various social media platforms to people with EDS and their friends without EDS, asking about past dental procedures, LA exposures, and the adequacy of procedure pain prevention. Among EDS respondents who both received LA and recalled the specific LA used, we compared agent-specific pain prevention for lidocaine, procaine, bupivacaine, mepivacaine, and articaine. Results: Among the 980 EDS respondents who had undergone a dental procedure LA, 88% (n = 860) recalled inadequate pain prevention. Among 249 non EDS respondents only 33% (n = 83) recalled inadequate pain prevention (P < 0.001 compared to EDS respondents). The agent with the highest EDS-respondent reported success rate was articaine (30%), followed by bupivacaine (25%), and mepivacaine (22%). Conclusions: EDS survey respondents reported nearly three times the rate of LA non-response compared to non-EDS respondents, suggesting that LAs were less effective in preventing their pain associated with routine office dental procedures.