Vitamin D deficiency has been associated with significant changes in dental structures. In children, it can induce enamel and dentin defects, which have been identified as risk factors for caries. This study aimed to assess the association between low serum 25-hydroxyvitamin D (25(OH) D) levels (<30 ng/mL) and the prevalence of caries in the permanent teeth and mixed dentition of 7-year-old children. A sample of 335 children from the population-based birth cohort Generation XXI (Porto, Portugal) was included. Data on children’s demographic and social conditions, health status, dental health behaviours, dental examination including erupted permanent first molars, and blood samples available for vitamin D analysis were collected. Dental outcomes included the presence of caries, including non-cavitated lesions (d1–6mft/D1–6MFT > 0), and advanced caries (d3–6mft/D3–6MF > 0). Serum 25(OH) D was measured using a competitive electrochemiluminescence immunoassay protein-binding assay. Bivariate analysis and multivariate logistic regression were used. Advanced caries in permanent teeth was significantly associated with children’s vitamin D levels <30 ng/mL, gastrointestinal disorders, higher daily intake of cariogenic food, and having had a dental appointment at ≤7 years old. Optimal childhood levels of vitamin D may be considered an additional preventive measure for dental caries in the permanent dentition.

No abstract

INTRODUCTION: Performing dental treatments on pediatric patients who present behavioral problems is usually a great clinical challenge. Depending on the patients' emotional maturity and their physical, psychological and mental skills, the usual behavior control techniques may not offer adequate efficacy and safety when dental procedures are being carried out. In these circumstances, alternative and more invasive methods such as conscious sedation and general anesthesia may become necessary. OBJECTIVE: To compare the indications and contraindications of conscious sedation and general anesthesia in pediatric dentistry. METHOD: Literature research undertaken through the MEDLINE/Pubmed, Science Direct and B-on search engines between April and June 2013 using a 5 year time frame and the following keywords: conscious sedation, general anesthesia, pediatric dentistry and guidelines. RESULTS: Conscious sedation is recommended to anxious patients who have dental and needle phobia, to patients that present an increased vomiting reflex and also to patients with special needs but capable of communicating. General anesthesia is indicated for non-cooperating patients under the age of four, in mouth breathers, in children ASA III or higher and in pediatric patients who do not communicate. CONCLUSIONS: Each technique must be selected according to the characteristics showed by patient. Although conscious sedation and general anesthesia introduce benefits to pediatric dentistry, they should not be regarded as priority intervention techniques for behavior control. The pediatric dentist's previous knowledge of these techniques provides a better level of dental care quality as well as more safety and less discomfort for their patients.

Objective Children with cleft lip and palate (CLP) present high incidence of oral health problems, namely those associated with the accumulation of dental plaque. The objective of this systematic review was to verify if there is any solution to improve the hygiene of the cleft area. Materials and methods A structured systematic review was performed based on articles published in several electronic databases: PubMed, Web of Science, Cochrane Library and Scopus in the last 20 years. The MeSH terms used were cleft lip, palate, harelip, oral hygiene and toothbrush. Results From 270 potentially relevant articles, 39 articles were selected, corresponding to a total of 3226 CLP patients and 914 matched controls. The selected studies exhibited great heterogeneity regarding the type of the study, study population (average range 0 ‐49 years old; sampling sizes 15‐400 CLP patients), evaluation periods, reported variables and oral hygiene routines. Consensual outcomes were the presence of high plaque indexes, high prevalence of dental caries and worse oral hygiene patterns in CLP patients. Additionally, poor education in oral health and low motivation to integrate regular hygiene routines in the daily family life were also evident. Conclusion There is a clear need to improve the oral hygiene care of CLP children, but few studies were focused on specific preventive approaches. Development of devices especially designed to the hygiene of the cleft area and implementation of standardized prevention and control programmes targeting education, motivation and compliance would contribute to improve oral health in CLP children.