Search Results (103)

Background and Objectives: Speech sound disorders, particularly dislalia (DIS), often stem from multifactorial anatomical, functional, and emotional causes during child development. Early identification of risk factors can improve therapy outcomes and prevent long-term communicative and social impairments. This study aimed to assess the relationship between structural (orofacial anomalies, dental arch morphology, and gonial angle (GA)), emotional, and therapeutic variables as predictors of DIS and its subtypes in children aged 5–12 years. Materials and Methods: A cross-sectional observational study was conducted on 121 pediatric subjects (58 boys; 63 girls; median age 7.5 years) using clinical examination, standardized speech assessments, emotional-behavioral questionnaires, and radiological imaging(GA measurement). Associations between DIS types, TMJ function, anatomical variation, and therapy outcomes were analyzed using chi-square tests (χ²), odds ratios (ORs), and 95% confidence intervals (CIs). Results: Cleft-type (OR = 21.43; p = 0.003), asymmetrical (OR = 14.66; p = 0.004), and crossbite arches (OR = 6.43; p = 0.013) significantly predicted DIS. A GA > 130° and <120° trended toward increased speech and motor dysfunction (OR = 4.67; p = 0.086). Emotional dysregulation (ED) moderately increased the functional temporomandibular joint dysfunction (FTMJD) risk (OR = 2.26; p = 0.060). Early therapy initiation (<7 years) and FTMDJ normalization were consistently associated with superior speech improvement outcomes (OR = 3.10 and 2.40; p < 0.01). Conclusions: DIS is strongly impacted by structural craniofacial anomalies, particularly cleft-type arches and severe jaw angle deviations. Our findings provide evidence that preliminary personalized approaches and emotional regulation may be beneficial for improving treatment outcomes. These exploratory associations support the rationale for interdisciplinary screening in pediatric populations, but confirmation in multicentric and longitudinal studies is needed. Full article

Background: Dental anxiety is a common challenge in paediatric dentistry, often leading to avoidance of treatment and compromised oral health. Non-pharmacological interventions such as music therapy have gained increasing attention as safe and cost-effective alternatives to pharmacological approaches. Although several clinical studies have examined the impact of music on children’s dental anxiety, the evidence has not yet been systematically summarised with quantitative synthesis. Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of music therapy in reducing dental anxiety and fear among paediatric patients. Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library from inception to August 2025. Randomised controlled trials (RCTs) evaluating music therapy for dental anxiety in children were included. Primary outcomes were self-reported dental anxiety/fear scales and physiological measures (heart rate, blood pressure, oxygen saturation). Risk of bias was assessed using the revised Cochrane risk of bias tool (RoB 2, version 2019; Cochrane Collaboration, London, UK) Meta-analyses were performed using a random-effects model with Review Manager (RevMan, version 5.4; Cochrane Collaboration, London, UK). Results: Seven randomized controlled trials (RCTs) involving 476 children aged 4–14 years were included. Music therapy significantly reduced self-re-ported dental anxiety compared with control groups (SMD = −0.48, 95% CI: −0.72 to −0.25, p < 0.001). Heart rate was also significantly reduced (SMD = −0.42, 95% CI: −0.68 to −0.16, p = 0.002), whereas changes in blood pressure and oxygen saturation were not statistically significant. The overall risk of bias was moderate, with most concerns related to blinding. Conclusions: Music therapy is an effective non-pharmacological intervention to reduce dental anxiety in children, particularly improving subjective anxiety and physiological arousal as measured by heart rate. Its integration into paediatric dental practice may enhance cooperation and treatment outcomes, offering a safe, inexpensive, and child-friendly approach. Full article

Background/Objectives: Untreated dental caries, the single most common health condition globally, is strongly associated with behavioural factors. This study examined dental status and oral health habits in child–parent and sibling pairs. Methods: We retrospectively analysed records from a dental practice in northeastern Poland, including 90 child–parent pairs and 27 sibling pairs. Dental status was assessed using the Decayed-Missing-Filled Teeth (DMFT) index, and treatment completion was measured with the Dental Treatment Index (DTI). Oral health behaviours were also evaluated. Results: Significant differences between children and parents were observed only in the mild-to-moderate caries groups (DMFT I: 27 children vs. 12 parents; DMFT II: 15 children vs. 32 parents). No differences were found in the severe caries or caries-free groups. Children had lower treatment completion than parents in the poorest care group (DTI 1: 20 children vs. 7 parents), but similar outcomes in higher DTI categories. Among siblings, differences appeared only in the DMFT I group, with no differences in treatment completion or behaviours. Conclusions: Strong similarities in extreme dental characteristics between children and parents, comparable DTI values in most groups, and consistent sibling outcomes suggest that family environment strongly influences oral health. Full article

Background/Objectives: Oral health plays a crucial role in the physical, emotional, and social well-being of children. Data from 2019 indicate that oral diseases remain a major concern in the Italian paediatric population, affecting not only children’s health but also caregivers’ well-being. This study aimed to assess the importance attributed by Italian families to their children’s oral health and correlate parents’ perceptions with children’s actual oral health status. Methods: A total of 131 children aged 0–12 years, admitted to the IRCCS Giannina Gaslini Children’s Hospital (Genoa, Italy) for reasons other than dental problems, were enroled between 1 January and 31 December 2024. Parents completed validated questionnaires (ECOHIS or PCPQ + FIS) based on their child’s age, along with supplementary questions on socio-demographic background and dental history. Oral examination was performed to assess dmft/DMFT scores, the Index of Orthodontic Treatment Need (IOTN), and the Modified Gingival Index (MGI). Results: In younger children (0–5 years), oral health was generally good, but the presence of caries negatively impacted the family’s quality of life. Older children (6–12 years) showed higher rates of caries and gingival inflammation, affecting their daily functioning and emotional well-being. Poor oral health was more common among children of non-European backgrounds and those with lower parental education. Early dental visits, within the recommended 24 months of age, were rare. Conclusions: Despite clear international recommendations, early dental visits remain uncommon, and many children experience preventable oral health issues. These findings highlight the urgent need to improve caregiver education and public health strategies to promote early preventive dental care. Full article

X-linked hypophosphatemic rickets (XLH) is a rare genetic disorder with a frequency of 1:20,000, caused by mutations in the PHEX gene, resulting in impaired phosphate metabolism and bone mineralization. There is an association between hypophosphatemia and dental issues, though this link is not definitively established. This study aims to evaluate the dental status, including oral hygiene, caries prevalence, and malocclusions, as well as parental awareness of dental complications, in children with XLH in Bulgaria, particularly those receiving or about to begin burosumab treatment, and to compare their oral health status with that of healthy children. Eleven children with XLH (seven girls, four boys, aged 2.5–17 years), nine receiving burosumab, were assessed and compared with eleven age- and gender-matched healthy children (seven girls, four boys, aged 2.5–17 years) without XLH or systemic conditions affecting dental health. Parental awareness of dental implications was assessed via a questionnaire, revealing no awareness of potential complications. Oral hygiene, measured using the Oral Hygiene Index-Simplified (OHI-s), was poor in 66.67% of children, with an average of 6.45 ± 5.80 carious lesions per child, and was highest in the 11–16 age group. Malocclusions were observed in 63.64% of children, and spontaneous endodontic infections occurred in 18.18%. Compared with healthy children, patients with XLH had significantly worse oral hygiene (p = 0.013) and a higher caries prevalence (p = 0.001). Children with XLH exhibit poor oral hygiene, a high caries burden, and frequent malocclusions, compounded by a lack of parental awareness of dental risks. These findings underscore the need for targeted dental interventions and education in XLH management, including the integration of routine dental assessments and structured parental education programs into existing clinical protocols to improve oral health outcomes. Full article

Background: Prematurely born newborns with low birth weight constitute a group of patients who require special care from the first days of life. Prematurity and low birth weight affect about 13.4 million infants. Risk factors include placental disorders but also factors related to the mother, such as smoking, alcohol drinking, drug use, malnutrition, or certain diseases. It is imperative to educate women of reproductive age (15–49) about the basic factors influencing embryonic development, such as oral health, diet, medicine intake, and harmful habits. Even though most women are aware of the negative impact of harmful habits on the fetus, still too little attention is paid to oral health in pregnant women. Poor oral health may influence the well-being of the future mother, as well as of the child. Therefore, women of reproductive age and those who are pregnant must have adequate knowledge on this subject. The aim of this study was to assess the knowledge of Polish women of reproductive age (15–49) regarding oral health during pregnancy, including the impact of dental treatment, oral hygiene, and maternal oral conditions on pregnancy outcomes and the health of the newborn. Materials and Methods: This was a cross-sectional study of 508 women, in the reproductive age, whose age ranged from 18 to 49 years old. The surveys were conducted from April 2020 to November 2020. The questionnaire was originally developed based on the available literature and consisted of seven sections: basic information, general health and habits, pregnancy status and dental care, knowledge of treatment options during pregnancy, oral health status and its association with the risk of preterm birth, prematurity and the child’s oral health, and breastfeeding and oral development. Results: After excluding incomplete questionnaires, a total of 499 questionnaires were included in the analysis. Women participating in the study had a fairly good understanding of the impact of oral health on the fetus and the role of breastfeeding in the development of the stomatognathic system (from 50% to 70% correct answers). However, even though most respondents had completed higher education (344/68.94%), their knowledge of oral health, preterm birth, and low birth weight was very limited (including the impact of inflammation on the intrauterine development of the child or bacteria and transfer across the placenta). In these sections, the percentage of correct answers ranged from less than 20% to 50%. When analyzing knowledge by age, education, number of births, and place of residence, the highest levels of knowledge were observed among respondents with higher education, particularly those aged 27–32. Conclusions: Respondents had a fairly good understanding of the general impact of oral health during pregnancy and recognition of the importance of breastfeeding for infants. However, their knowledge about the impact of bacteria and inflammation in the mother’s oral cavity on prematurity and low birth weight was limited. Therefore, educating women of reproductive age and pregnant women on this topic is essential, as it may help reduce the adverse consequences of prematurity. Full article

Background/Objectives: Dental anxiety in children is a common issue that can hinder the delivery of effective dental care. Traditional approaches to managing this are often insufficient or involve pharmacological interventions. This study shows the potential of virtual reality (VR) to aid in reducing anxiety in children undergoing simple dental procedures. By immersing children in relaxing VR environments (such as beaches, forests, mountains, or underwater scenes with calm music), the objective is to assess VR’s effectiveness in calming pediatrics patients during these procedures. Methods: Children scheduled for minor dental treatments wore a wearable device that monitored pulse, perspiration, and stress levels. Each child’s baseline data was collected without the VR headset, followed by data collection during VR exposure before and during dental procedures. VR scenarios ranged from soothing nature scenes to animated cartoons, designed to foster relaxation. Results: The data collected showed a reduction in physiological indicators of stress, such as lower heart rate and reduced perspiration, when the VR headset was used. Children appeared more relaxed, with a calmer response during the procedure itself, compared to baseline levels without VR. Conclusions: This study provides preliminary evidence supporting VR as an effective tool for reducing anxiety and stress in pediatric dental patients. By offering an engaging, immersive experience, VR can serve as an alternative or complementary approach to traditional anxiety management strategies in pediatric dentistry, potentially improving patient comfort and cooperation during dental procedures. Further research could determine if VR may serve as an alternative to local anesthesia for non-intrusive pediatric dental procedures. Full article

Background/Aim: Dental treatment is typically performed under general anesthesia for children who have difficulty cooperating, as well as for those with mental or physical disabilities requiring special care. This study aims to categorize and evaluate the systemic disease or syndrome status, age, and gender of children who require dental treatment under general anesthesia. Materials and Methods: In this study, the ages, sexes, disabilities (if any), and systemic diseases of patients requiring dental treatment under general anesthesia (GA) between the ages of 1 and 15 were analyzed. The patients were categorized based on having difficulties cooperating or having mental or physical disabilities that require special care. Results: In this study, data from 1666 patients were examined. A total of 955 patients (57.32%) were male, while 711 (42.67%) were female. Overall, 232 (13.9%) patients with disabilities or systemic diseases visited the clinic, including 49 who had epilepsy (2.9%), the highest number among the systemic disease group. This finding was statistically significant in the 4–6 age group (p < 0.00). Conclusions: Among patients with special needs, epilepsy emerged as a disorder that requires the most dental treatment. We believe that providing dental treatment for children with neurological diseases, such as epilepsy, in a fully equipped operating room will be beneficial in managing complications that may arise during treatment. Full article

Background/Objectives: Hypohidrotic ectodermal dysplasia (HED) is a rare hereditary disorder affecting ectoderm-derived tissues including teeth, hair, and sweat glands. The dental abnormalities associated with HED, such as oligodontia and conical teeth, often result in significant functional, esthetic, and psychosocial challenges, particularly during childhood. Methods: A 10-year-old child presented with psychosocial concerns related to missing and malformed teeth. Clinical examination revealed oligodontia, conical anterior teeth, and a resorbed mandibular ridge. Based on clinical findings and a positive family history, a diagnosis of HED with significant dental involvement was confirmed. Results: A conservative prosthodontic approach was selected. A maxillary overdenture was fabricated over the retained primary teeth to enhance retention and preserve the alveolar bone, and a resin-bonded bridge was placed in the mandible due to poor ridge anatomy. The treatment restored oral function and esthetics and improved the child’s self-esteem. A recall visit after three months confirmed good prosthesis adaptation and a positive response from the patient and parents. Conclusions: This case highlights the importance of early, conservative, and developmentally appropriate prosthetic rehabilitation in pediatric patients with HED. Interim prostheses can significantly improve oral function, appearance, and psychosocial well-being while preserving future treatment options as the child matures. Full article

Background/Objectives: Orthodontic camouflage is a treatment strategy designed to address mild to moderate skeletal discrepancies through dental compensation when growth modification or orthognathic surgery (OGS) is unsuitable or declined by the patient. This report highlights the treatment of a child with a skeletal Class II pattern, Class II division 1 malocclusion, a 10.8 mm overjet, traumatic overbite, and unilateral temporomandibular joint (TMJ) ankylosis on the left side. Methods: The treatment plan focused on correcting the proclination of the maxillary incisors and improving the facial profile. A non-extraction camouflage approach using pre-adjusted edgewise appliances was implemented following a gap arthroplasty procedure on the left TMJ. Results: The patient achieved a satisfactory treatment outcome, with an ideal static and functional occlusion and significant improvement in facial esthetics. The approach effectively managed the severe mandibular retrognathia and TMJ ankylosis without OGS, thereby minimizing the risk of progressive condylar resorption. Conclusions: This case underscores the importance of personalized treatment plans tailored to each patient’s dental, skeletal, and individual needs. It demonstrates that non-surgical camouflage treatments can be a viable alternative for addressing severe mandibular retrognathia with TMJ ankylosis, achieving favorable esthetic and functional outcomes. Full article

Sensory processing disorder (SPD) involves difficulties in receiving and responding to sensory information from the environment. Their development is influenced by various factors during the perinatal period and early childhood. Children with sensory integration disorders often struggle with everyday situations and stress, typically experiencing either sensory hypersensitivity or hyposensitivity. Their visit to a doctor’s office presents challenges for both the child and the medical practitioner, requiring active cooperation from parents. This review aims to analyze the challenges faced by clinicians in managing pediatric patients with SPD during healthcare visits, with a specific focus on dental settings and to propose effective communication and management strategies. Proper preparation of the child before the visit and the use of appropriate communication techniques during the appointment play a crucial role in ensuring a smooth experience. Strategies such as minimizing visual and auditory stimuli, applying recommended touch techniques, and opting for the least invasive treatment methods can help create a child-friendly environment and improve the overall quality of care. Full article

Objectives: Our aim was to study whether the Modified Dental Anxiety Scale (MDAS) is reliable and valid for use in children aged 9 to 12 years. Methods: The study population was a convenient sample of Finnish comprehensive school pupils in the third and sixth grades (N = 57 and N = 69, respectively). Dental fear and anxiety (DFA) were measured with the Finnish validated adult version of MDAS, the modified Child Fear Survey Schedule—Dental Subscale (CFSS-DS-M), and a single question. Reliability was evaluated using Cronbach’s alpha. The criterion validity of MDAS was assessed using Spearman rank correlation coefficients against CFSS-DS-M and the single question. Construct validity was assessed by examining the ability of MDAS to find differences according to gender and treatment procedures using the chi-square test for categorized and the Mann–Whitney and Jonckheere–Terpstra tests for continuous variables. Results: The Cronbach alphas were 0.841, 0.708, and 0.778 for MDAS total, anticipatory, and treatment-related DFA, respectively. Correlations between MDAS and CFSS-DS-M total and subscale scores were moderate to strong (ρ = 0.559–0.794), supporting criterion validity. Girls in third grade had lower mean MDAS anticipatory DFA (3.4, SD = 1.44) than boys (4.5, SD = 2.21, p = 0.051). In sixth graders, girls had higher mean MDAS treatment-related DFA (8.4, SD = 3.17) than boys (6.9, SD = 2.61, p = 0.067). Children reporting orthodontic treatment had lower anticipatory DFA (mean = 3.4, SD = 2.13) than children not reporting (mean = 4.0, SD = 1.83; p = 0.009), supporting construct validity. Conclusions: The Finnish version of the MDAS showed good reliability, good criterion validity, and acceptable construct validity, supporting its use in children aged 9–12 years. Full article

Molar Incisor Hypomineralization (MIH) is a common dental condition that affects the mineralization of the enamel, primarily affecting the first permanent molars and often the incisors. This condition can lead to a wide range of clinical presentations, from mild opacities to severe post-eruptive breakdown, which can significantly impact a child’s oral health and quality of life. Background/Objectives: The prevalence and complex management of MIH have posed a significant challenge for dental practitioners. Our preceding investigation found that 14.3% of school-aged children have MIH. Based on this finding, we wanted to understand what other Romanian dental professionals think about this condition. Therefore, the aim of the present study was to assess the awareness, perception, and clinical management approaches of Romanian dentists toward MIH in order to inform future educational strategies and contribute to the development of dedicated preventive programs. Methods: To gain a comprehensive understanding of MIH in actual clinical settings, we developed and administered a questionnaire consisting of three distinct sections. Our objective was to capture the collective knowledge and perspectives of dental practitioners. We distributed the survey, which included 14 pertinent questions, to a large professional group of Romanian dentists. Results: This study collected responses from 219 Romanian dental practitioners (median age: 34 years) about their experiences with MIH. The vast majority (86.76%) had encountered MIH cases in their practice, with half reporting moderate prevalence among their patients. The most frequently observed complications were hypersensitivity (41.95%), pulp exposure (33.33%), and failed restorations (24.71%). While adhesive restorations were identified as the overall preferred treatment approach (70.00%), notable differences emerged in both clinical complications encountered and therapeutic approaches implemented across dental specialties. There was near-unanimous agreement on the importance of early MIH diagnosis (99.09%), and almost all participants (98.63%) expressed a desire for more information about this condition, demonstrating high awareness and concern about MIH among Romanian dental professionals. Conclusions: This study highlights that general dentists, endodontists, and pedodontists encounter MIH patients frequently in their practice, emphasizing the critical need to enhance awareness and education about MIH among both dental professionals and the general public. Full article

Background/Objectives: For dental providers, it can be difficult to distinguish dental neglect from legitimate barriers to care, preventing the completion of dental treatment for pediatric patients. The aim of this study was to utilize caretakers’ self-reported reasons for missing their child’s appointments to identify barriers to treatment completion versus dental neglect. Methods: The treatment setting was oral rehabilitation under deep or intravenous sedation (IV) or general anesthesia (GA). After the responses were examined, patients were categorized into one of four groups: Low-Risk, Treatment Completed; Low-Risk, Treatment Not Completed; High-Risk, Treatment Completed; High-Risk, Treatment Not Completed. Low- or high-risk classifications were determined based on whether the reported rationale was a temporary hindrance that could be overcome through additional effort or assistance, or whether it was because the parent or guardian did not follow through with the recommended instructions and treatment. A chi-square test was completed. Results: A total of 602 IV charts and 1, 296 GA charts were reviewed for this study. For both IV and GA settings, the proposed low- and high-risk factors for dental neglect were statistically significant (IV: p = 0.000442; GA: p < 0.00001). Conclusions: The patients whose appointments were not completed for reasons deemed high risk for dental neglect had a higher risk of having uncompleted treatment. These patients should be closely followed due to a higher risk of dental neglect. Full article

Background/Objectives: Parents/caregivers’ reports are valuable because they frequently play a crucial role in making decisions concerning a child’s health, and their perspectives can significantly impact treatment choices. Furthermore, negative effects of oral health issues extend beyond just the adolescent patient, having an impact on family life. The aim of this study is to explore the perception of parents/caregivers regarding their children’s oral-health-related quality of life (OHRQoL) and how the OHRQoL of adolescents impacts their family life. Methods: The Parental-Caregiver Perception Questionnaire-16 (P-CPQ-16) and the Family Impact Scale-8 (FIS-8) were administered to 160 parents/caregivers of adolescents aged 10–18 years old at the Dental Clinic of the University of Naples Federico II (Italy). Adolescents’ oral health status was recorded using the Decayed Missing and Filled Teeth (DMFT/dmft) index and Dental Aesthetic Index (DAI). Results: FIS-8 and P-CPQ-16 scores showed no significant differences across DAI and DMFT/dmft subgroups. However, regression analysis found a significant association between social well-being and total P-CPQ-16 scores with the DAI and DMFT index. Spearman’s correlation showed statistical significance only for the social well-being domain of P-CPQ-16 with respect to DAI scores. Conclusions: Parents/caregivers perceived a difference in their children’s OHRQoL according to different severities of malocclusion and dental caries; however, they did not report any impact on the family’s quality of life. Since adolescents often visit dentists due to parental influence, involving parents who perceive a lower quality of life in children with severe malocclusions or compromised oral health is crucial for effective care. Full article