A federal agency's extensive report on the well-being of our children at the beginning of the new millennium provides an opportunity to review the many achievements and remaining concerns about the health and social environment of the children in our communities and in many of our dental practices.

The Access to Baby and Child Dentistry (ABCD) program was implemented in Washington State in 1995 to increase utilization of dental services for children enrolled in Medicaid. The program has increased utilization of services; nevertheless, only 54 percent of Medicaid-enrolled children in ABCD who received care were given a topical fluoride treatment. To gain a better understanding of why children may not be receiving topical fluoride treatment, we interviewed parents. Focus group research found strong parental support for preventive services. Parents were willing to take their children to regular dental visits, but lack of knowledge of benefits was common. This lack of knowledge translated into a failure to fully utilize the topical fluoride benefits. We recommend that the program continue to encourage participation of dentists, regularly update information about program benefits for both dentists and parents, and enhance the visibility of the program in the community.

The purpose of the present study was to evaluate the prevalence of early childhood caries among preschool children aged between 12 and 36 months from poor communities in the city of Recife, Brazil. This prevalence was evaluated along with the type and duration of feeding, supplementary diet in terms of cariogenicity and quantity of sugar intake. Of the 468 children studied, 28.46% presented caries and the association between the variable of a cariogenic diet and caries was strongly significant (x2 = 13.36 and p < 0.001). From the results of the present study it is possible to draw the following conclusions: the prevalence of early childhood caries in poor children aged 12-36 months in the city of Recife is in accordance with that found in other Brazilian cities, but is very high compared to that of the world population. Early childhood caries was not found to be related to the type of feeding; however, the number of sugary snacks between meals and a cariogenic diet were strongly related to early childhood caries. The prevalence of early childhood caries increases with age; and the first signs of the carious lesions were only detected after the eruption of the first molars, starting at 18 months.

The rate of child abuse and neglect cases per population may have been decreasing, but there have been increases in the actual number of cases. A review of federal reports serves as an alert for dental practitioners to maintain their vigilance as 1) primary care providers of children, and 2) mandated reporters of child abuse.

The purpose of this study was to compare knowledge regarding preventive measures and reported dental fear, of children treated by certified pediatric dentists (CPDs) to those treated by general practitioners (GPs). A questionnaire was given to 300 children, 150 were treated by GPs and the others by CPDs. Children treated by CPDs provided more correct answers to questions about prevention of oral disease (p < 0.001). However, the percentage of children that showed good knowledge was small (14%-82%), and the differences between the two groups on the various questions was only 7%-20%. Children treated by CPDs reported more frequently that they were not afraid of dental treatments (75.3% vs. 39.3%), loved their dentists (50% vs. 31.5%) and received prizes (85.3% vs. 32.7%). These findings suggest that CPDs invest more effort in communication and education of their patients concerning preventive dentistry. There is a need to improve these skills of GPs and CPDs.

The aim of this study was to examine the prevalence of C. albicans in the oral cavities and root canals of children. Twenty healthy and caries-free children and 13 children with caries, were screened. Imprint samples and sterile paper points were used to obtain the samples from oral cavities and root canals respectively. The production of germ tubes and the development of chlamydospores identified yeast cultures. Sixty-nine percent of children with caries and 5% of caries-free children were found to be Candida carriers. The difference in candidal prevalence between two groups was significant (p < 0.05). Sixty-one point five percent of children were positive for Candida in the root canal. Since, increase in the C. albicans in the oral cavity provides a potential source of the fungus particularly when resistance falls below a certain threshold, attention to strategies for the reduction of this pervasive and persistent pathogen becomes important. Therefore, reduction of caries and or introduction of antifungal agents during root canal treatment of children may be offered.

The purposes of this study were to determine the age at the initial acquisition of mutans streptococci (MS) and to determine the transmission of MS among children at day nursery by describing the occurrence of genotypes prepared by chromosomal DNA fingerprinting of the bacteria using restriction endonuclease EcoRI and HaeIII. The samples were 39 children (23 boys and 16 girls) aged 0-5 years old, 14 pairs of parents and 6 nursery caretakers of a day nursery in Hiroshima city, Japan. The children had no dental caries throughout the experiment. Plaque samples of the children were taken using toothbrushes at 1 month intervals for 30 months. The initial acquisition of MS occurred between the ages of 8 months and 52 months with a mean age of 24.2 months. The cumulative probability of initial acquisition of MS increased rapidly at the age of 12 to 25 months after 10 to 20 primary teeth had erupted. Transmission of MS was found between child and mother (33.3%), child and father (8.3%) and child and others including amongst the children (58.4%), but no evidence of MS transmission from nursery caretakers was found. Two children acquired MS from intra- and extra-familial transmission. This study suggests that the child's environment also plays a role in the initial acquisition and transmission of MS, in addition to the oral condition of the children.

A comprehensive assessment of the dental characteristics of 23 patients with Duchenne muscular dystrophy (DMD) was carried out, based on dental records, oral examinations and dental models. Decreasing muscle function was associated with increased plaque and calculus accumulation, leading to gingival inflammation, but caries experience was low. Disturbances in tooth form, number and eruption of the second premolars were observed in 39% of patients. Anterior and posterior open bites were common, associated with lip incompetence, mouth breathing, macroglossia and tongue thrusting. Maxillary and mandibular arch breadths were significantly larger, on average, in the DMD group than in controls. Rather than a normal parabolic arch form, the dental arches in DMD patients tended to be hyperbolic, with the posterior teeth being displaced buccally, consistent with an imbalance between the lingual and facial musculature.

Dental and radiological findings of a 5-year-old female patient show inverted impaction of the maxillary primary incisors. Family and personal histories of the patient were unremarkable. There were no abnormalities in general growth and development nor was there any history of trauma.

This is a case study of an inflammatory follicular cyst associated with an endodontically treated deciduous molar with radiographic and microscopic diagnosis. This cystic lesion represents a typical follicular cyst that arose in association with periapical inflammation from a non-vital deciduous molar and involved the follicle of the unerupted successor premolar. This paper describes the case and discusses diagnosis, histogenesis, and controversies regarding terminology.

Some authors have noticed a clear decrease of the width of keratinized gingiva when they compared the width over deciduous and newly erupted permanent teeth. The aim of this cross-sectional study was to assess the width of keratinized gingiva over permanent and deciduous teeth present in 6 to 11-year old children in an urban environment. The greatest width of keratinized gingiva was found over deciduous canines and permanent incisors. When comparing the width of keratinized gingiva over deciduous canines and molars and permanent first incisors and first molars, statistically significant differences were found only between 6- and 11-year-old groups. The findings do not seem to support previously published data, but do suggest that periodontal mucogingival surgery is not needed before the patient reaches the adult age, since there is a tendency of an increase of the width of keratinized gingiva.

To determine the positions of teeth and the size and shape of the dental arches, 53 dental casts of children (29 boys and 24 girls) with their early permanent dentition and normal occlusions were examined. The coordinates of cusp tips and line angles of anterior teeth and cusp tips, contact points, and fossa of posterior teeth were digitized. Computer-generated curves were created for both arches using a polynomial model. There were 2 cusp-to-fossa relations and 4 cusp-to-marginal ridge relations for posterior segment intercuspation. Mean values of posterior arch lengths were statistically larger in boys than in girls. Mean curves of boys' dental arch forms were larger than those of girls and the ranges between the largest and smallest curves for both arches in boys were larger than those in girls. The boys' and girls' smallest curves for both arches were almost the same size.