Watching cartoons could help children overcome anxiety of dental treatment

Watching cartoons through video glasses during dental treatment could help lessen children's anxiety and distress as well as reducing disruptive behaviour, according to a randomized controlled trial published in Acta Odontologia Scandinavica.

Anxiety about visiting the dentist and during treatment is common in children. Estimates suggest that as many as 1 in 5 school age children are afraid of dentists. Children with dental phobias end up experiencing more dental pain and are more disruptive during treatment. Although studies have shown that audiovisual distraction (eg, playing video games and watching TV) can be successful in minimizing distress and the perception of pain during short invasive medical procedures, the issue of whether distraction is beneficial during dental procedures is still hotly debated. Research to date has produced conflicting results.

In this study, 56 'uncooperative' children (aged 7 to 9 years) attending a dental clinic at the Royal College of Dentistry, King Saud University in Saudi Arabia were randomly assigned to receive either audiovisual distraction (watching their favourite cartoons using the eyeglass system Merlin i-theatre™) or no distraction (control group). Children underwent three separate (max 30 min) treatment visits involving an oral examination, injection with local anaesthetic, and tooth restoration. The researchers measured the anxiety levels and cooperative behavior of the children during each visit using an anxiety and behavior scale, and monitored each child's vital signs, blood pressure, and pulse (indirect measures of anxiety). Children also rated their own anxiety and pain during each procedure.

During treatment, the children in the distraction group exhibited significantly less anxiety and showed more cooperation than those in the control group, particularly during the local anaesthetic injection. What's more, the average pulse rate of children in the control group was significantly higher during the injection compared with children in the distraction group. However, the children themselves did not report differences in treatment-related pain and anxiety.

The authors conclude that audiovisual distraction seems to be a useful technique to calm children and ensure that they can be given the dental treatment they need. However, they caution that because of the limited number of participants, further larger studies will be needed in general clinical settings to confirm the value of this audiovisual distraction tool.

Article: Effects of audiovisual distraction on children's behaviour during dental treatment: a randomized controlled clinical trial, Amal Al-Khotaniabc, Lanre A'aziz Belloc, Nikolaos Christidisab, Taylor & Francis Online, doi: 10.1080/00016357.2016.1206211, published online 13 July 2016.

Dentists must know side effects of drugs

 

hamdard_thumb

KARACHI: Associate professor and CPSP supervisor at Hamdard Dental College, Dr. Syed Abrar Ali, recently delivered a lecture on medication relating to inflammation and swelling.

In his lecture on the importance of prescribing medicines in the case of inflammation, he urged the dentists to have complete knowledge of medicines’ side effects before prescribing them and one way of remembering these are CME activities which, he added, must be a part of every dental institute.

The session was followed by a question-answer session. Students, house officers, faculty members and FCPS trainees of Hamdard Dental College attended the session.-PR

 

Add Comment

Current ye@r *

Leave this field empty

Notify me of follow-up comments by email.

Notify me of new posts by email.

Beautify Your Teeth with Ceramic Veneers – A Case Report From the Residency in Cosmetic Dentistry Program Held at University of Toronto

Introduction
In the academic year of 2014 to 2015, a new continuing education program, Residency in Cosmetic Dentistry, was introduced to the dental community. This program was meant to provide opportunity for practicing dentists who are interested in enhancing their knowledge and skill in the subject of esthetic dentistry to join. The program included teaching instructions through lectures, small group seminars as well as hands-on clinical experience. The lectures were provided by a group of carefully selected speakers and covered a wide range of topics. Clinical procedures that were performed by participants ranged from ceramic veneers and crowns, CAD-CAM and implant-supported crowns and direct resin composite restorations. The aim of this paper is to share one interesting case treated by one of the program participants (KM) with readers of Oral Health.

Following the discovery of acid etching and bonding to enamel, the porcelain veneer technique was first introduced to the profession in the 1980s by Dr. John Calamia1. Its swift adoption and vast utilization in dentistry made it a standard dental procedure over a short period of time. However, long-term success and longevity of porcelain veneers continues to necessitate careful case selection.2,3 Compared to crowns, veneers offer a conservative preparation design with minimal depth, ranging from .3 to .5 mm, terminating in enamel that is necessary for reliable bonding.2 In a long-term clinical study that evaluated longevity of 580 porcelain veneers over a period of 12 years, when preparations had 20 percent involvement of dentin failures were observed, however, when preparations were completely confined to enamel no veneer failures were observed.4 This finding was confirmed in a review article on the topic that analyzed 24 papers published on the survival of porcelain veneers.5 It stated that “there is reasonable evidence indicating that a veneer preparation into dentin adversely affects survival.” When preparing teeth to receive porcelain veneers dentists must endeavor to maintain preparations minimally invasive with no involvement of dentin where possible.

While original porcelain veneers were made using feldspathic porcelain formulations, new glass-ceramic formulations with superior strength and resistance to chipping have been developed over the years and are now being utilized in place of the original formulations.

According to Nohl et al., “A complete understanding of a patient’s aesthetic problems is the key to treatment planning. Only then can an attempt be made to match expectations with realities and to provide appropriate restorations”.6 In the case presented below a strategic and instrumental approach was adopted throughout in order to ensure that the outcome met the patient’s expectation and at the same time the most conservative and most effective treatment approach was followed.

Case Report
A 44-year-old female with a history of bulimia presented with dark discoloration in her upper anterior teeth (Figs. 1-3). Vital bleaching of the anterior teeth was attempted, however, while there was some improvement in color the outcome remained less than ideal. Therefore, the case was assessed for suitability for restoration with ceramic veneers. A group discussion of the case among residency program participants and instructors ensued and the case was deemed suitable for restoration with glass-ceramic veneers. A diagnostic wax-up was made in the laboratory for assessment of suitability of the veneer restorations and case discussion with the patient. The patient was shown the diagnostic wax-up and the procedure for preparation of the teeth was explained to her in full detail. Alternative treatment modalities with their pros and cons were also discussed with the patient. The final treatment plan that was formulated with the patient’s consent and approval included six glass-ceramic veneers for maxillary anterior teeth, glass-ceramic veneers for maxillary first premolars and one glass-ceramic crown for maxillary second premolar and a glass-ceramic veneer for the other.

FIGURE 1. Preoperative appearance of the maxillary anterior teeth. Several bleaching attempts were made to get rid of the underlying dark discoloration with little response. 
FIGURE 1. Preoperative appearance of the maxillary anterior teeth. Several bleaching attempts were made to get rid of the underlying dark discoloration with little response.

FIGURE 2. Preoperative appearance of the right anterior side.
 FIGURE 2. Preoperative appearance of the right anterior side.

FIGURE 3. Preoperative appearance of the left anterior side.
 FIGURE 3. Preoperative appearance of the left anterior side.

Teeth were prepared for veneers with minimal tooth reduction that terminated in enamel using special diamond burs (#M392-016 and #SF379-023, Axis Dental) (Fig. 4). For premolar veneer preparations a small shelf was made with bur # F856-016 (Axis Dental) on the buccal aspect for better stability during function. The second premolar to receive crown was prepared with a parallel-sided flat-end diamond bur with a 1 mm all-around shoulder finish line and occlusal reduction of 1.5 mm. All line angles were maintained rounded to minimize stress build-up during function (Fig. 4). The diagnostic wax-up was also used to fabricate a reduction guide used to ensure adequate reduction prior to impression taking. A custom made perforated acrylic resin tray was used for impression taking with a polyvinyl siloxane material (Aquasil light- and heavy-body, Dentsply).

FIGURE 4. Appearance of prepared anterior and premolar teeth after removal of provisional restorations. Both 1st and 2nd premolars were prepared with a step on the vestibular aspect to help in stability of the porcelain veneers.
 FIGURE 4. Appearance of prepared anterior and premolar teeth after removal of provisional restorations. Both 1st and 2nd premolars were prepared with a step on the vestibular aspect to help in stability of the porcelain veneers

The diagnostic wax-up was also used to fabricate a matrix for making provisional restorations (Fig. 5). Spot-etching of enamel with phosphoric acid gel for 30 seconds was performed at mid-central locations on facial aspects of canines and premolars. Bonding resin was applied on the etched spots and light-polymerized. The matrix was loaded with provisional veneer material (Luxatemp, DMG America) and secured in place over the prepared teeth. After three minutes the matrix was then lifted off with a sickle scaler and trimming of excess material was carried out with a #7901 tungsten carbide bur. Occlusion was checked and adjusted accordingly. Final polishing with polishing discs and points was then performed to a glaze-like finish (Fig. 6). A provisional crown was made for the second premolar that was prepared for a crown using the same material.

FIGURE 5. A clear matrix was made in a vacuum-forming machine on the waxed up model for fabrication of provisional veneers.
FIGURE 5. A clear matrix was made in a vacuum-forming machine on the waxed up model for fabrication of provisional veneers.

One crown and nine glass-ceramic veneers were fabricated at a local dental laboratory (Shaw labs) in lithium disilicate (e.max CAD, Ivoclar-vivadent) (Figs. 6-9). At the next appointment the provisional restorations were carefully removed and teeth surfaces were cleaned with a slurry of medium-grit pumice with a rubber cup in a slow-speed handpiece. Intaglio surfaces of the ten glass-ceramic restorations were first etched with hydrofluorice acid gel then silanated with a silane-coupling agent. All ten restorations were carefully tried-in while the patient remained in a near horizontal position on the dental chair with face up. The patient was shown the restorations in a mirror for approval. Cementation of the nine glass-ceramic veneers followed using a light-polymerized resin cement (Variolink II, Ivoclar-Vivadent). First enamel surfaces of the prepared teeth were etched with phosphoric acid-etching gel for 45 seconds. The two veneers for the centrals were first simultaneously cemented (Fig. 10). After seating the veneers excess cement was carefully removed with an explorer before light-polymerization through the veneer material (Blue-phase Style, LED light-curing unit, Ivoclar-vivadent). This was followed by cementation of the maxillary laterals’ veneers

FIGURE 6. Provisional restorations were made using a clear matrix made to a waxed-up model. Spot bonding at the centers of the vestibular surfaces of the premolars was followed to optimize retention.
FIGURE 6. Provisional restorations were made using a clear matrix made to a waxed-up model. Spot bonding at the centers of the vestibular surfaces of the premolars was followed to optimize retention.

FIGURE 7. Nine porcelain veneers and one porcelain crown were fabricated at a dental laboratory.
FIGURE 7. Nine porcelain veneers and one porcelain crown were fabricated at a dental laboratory.

FIGURE 8. Lingual aspect of the fabricated porcelain restorations.
FIGURE 8. Lingual aspect of the fabricated porcelain restorations.

FIGURE 9. Four porcelain veneers and one crown fabricated for the right side.
FIGURE 9. Four porcelain veneers and one crown fabricated for the right side.

FIGURE 10. Five porcelain veneers fabricated for the left side.
 FIGURE 10. Five porcelain veneers fabricated for the left side.

(Fig. 11), then veneers for maxillary canines and first premolars were cemented one-side at a time (Figs. 12-14). Finally, the last veneer and the glass-ceramic crown were cemented to the maxillary second premolars. Variolink II was used in the dual-cure mode for cementation of the crown. Figure 15 shows a post-operative view of the case after excess cement was removed and interproximal areas thoroughly polished.

FIGURE 11. Porcelain veneers of the maxillary central incisors were first cemented in place with a light-polymerized resin cement.
 FIGURE 11. Porcelain veneers of the maxillary central incisors were first cemented in place with a light-polymerized resin cement.

FIGURE 12. Veneers for the laterals were then cemented.
FIGURE 12. Veneers for the laterals were then cemented.

FIGURE 13. Veneers for canines and first premolars are cemented.
FIGURE 13. Veneers for canines and first premolars are cemented.

FIGURE 14. Right side view showing porcelain veneers on central, lateral, canine and first premolar in place.
 FIGURE 14. Right side view showing porcelain veneers on central, lateral, canine and first premolar in place.

FIGURE 15. Left side view showing porcelain veneers on central, lateral, canine and first premolar in place.
FIGURE 15. Left side view showing porcelain veneers on central, lateral, canine and first premolar in place.

FIGURE 16. Frontal view showing all nine porcelain veneers cemented in place in addition to the porcelain crown cemented on tooth 15.
FIGURE 16. Frontal view showing all nine porcelain veneers cemented in place in addition to the porcelain crown cemented on tooth 15.

Conclusions
When considering treatment of maxillary teeth with veneers to improve esthetics dentists must consider each and every case according to its own merits. While the tooth preparation procedure is fairly simple great care must be taken to ensure that preparation boundaries terminate in enamel without encroachment into dentin. Cementation of multiple veneers can be a little tedious, however, breaking them down into manageable numbers is recommended. Careful removal of excess cement after setting is important to maintain health of the gingival tissues. When used judiciously in carefully-selected cases ceramic veneers can help patients achieve the most desirable esthetic appearance. OH


 

Dr. Omar El-Mowafy is tenured professor and head of restorative dentistry at the Faculty of Dentistry, University of Toronto. He is a full-member of the School of Graduate Studies of the University of Toronto. Dr. El-Mowafy is also member of Omicron Kappa Upsilon (Honor Dental Society). He published over two hundred research papers, case reports, literature reviews, book reviews in peer-reviewed journals with high scientific impact factor. He is member of Editorial Boards of Operative Dentistry and International Journal of Prosthodontics. He also, acts as reviewer for over 12 international journals. Dr. El-Mowafy spoke at scientific meetings at 29 different cities worldwide in addition to speaking on-board of two cruise ships. He maintains position in private practice in Mississauga since 1989.

Oral Health welcomes this original article.

References
1. Calamia JR. Etched porcelain veneers: the current state of the art. Quintessence Int 1985; 16(1):5–12.

2. El-Mowafy OM. The use of both porcelain veneers and all-porcelain crowns in restoring anterior teeth. J Can Dent Assoc 2006; 72(9):803–6.

3. El-Badrawy WA, El-Mowafy O. Porcelain veneers Vs. crowns when resolving esthetic problems – two case reports. J Can Dent Assoc. 2009;75(10):701-4.

4. Gurel G, Morimoto S, Calamita MA, Coachman C, Sesma N. Clinical performance of porcelain laminate veneers: outcomes of the aesthetic pre-evaluative temporary (APT) technique. Int J Periodontics Restorative Dent. 2012, 32(6):625-35.

5. Burke FJ Survival rates for porcelain laminate veneers with special reference to the effect of preparation in dentin: a literature review. J Esthet Restor Dent. 2012;24(4):257-65.

6. Nohl FSA, Steele JG, Wassell RW. Crowns and other extra-coronal restorations: Aesthetic control British Dental Journal 2002, 192, 443 – 450.

Anterior Post Traumatic Immediate Implant Manuscript

EXTRACT
Fractured teeth are the mist common encountered dental emergency. This manuscript presents an anterior trauma case from initial presentation to final treatment through use of an interdisciplinary approach to diagnosis, planning, and treatment.


Continue reading “Anterior Post Traumatic Immediate Implant Manuscript”

Evidence-practice gap for sealant application: Results from a dental PBRN

At the 45th Annual Meeting & Exhibition of the American Association for Dental Research, researcher Naoki Kakudate, Kyushu Dental University, Kyushu Dental University, Japan, presented a study titled "Evidence-Practice Gap for Sealant Application: Results from a Dental PBRN." The AADR Annual Meeting was held in conjunction with the 40th Annual Meeting of the Canadian Association for Dental Research.

In this study, the researchers aimed to examine dentist practice patterns regarding treatment recommendation of dental sealants and identify characteristics associated with this recommendation. The study was conducted using a cross-sectional questionnaire survey in Japan. Participants were Japanese dentists (N=282) recruited from the Japanese Dental Practice Based Research Network (JDPBRN) who indicated that they do at least some restorative dentistry. Scenarios, images and questionnaire items were the same as those used in a previous U.S. DPBRN study. A series of three clinical photographs of the occlusal surface of a mandibular first molar, together with a description, were presented portraying increasing depths of cavitation. The researchers inquired about the treatment decision for each case, which had a 12-year-old patient with high caries risk. Chi-square tests were performed to assess the association between belief about the effectiveness of caries risk assessment and sealant recommendation. Multiple logistic regression analysis were conducted to evaluate the association between the decision to recommend sealants and dentist, practice and patient characteristics.

Responses were obtained from 189 dentists (67 percent). In the hypothetical scenarios, dentists' recommendations of sealants for the 12-year old patient varied from 16 percent to 26 percent. Nineteen percent of dentists recommended sealants in the absence of dark brown pigmentation. Forty-eight percent of dentists (n=91) recommended sealants to more than 25 percent of patients ages 6-18 years. Multiple logistic regression analysis suggested that the dentist's belief in the effectiveness of caries risk assessment was significantly associated with the percentage of patients who would receive sealants. Dentist practice patterns for sealant treatment recommendation vary widely. Recommending a sealant was significantly related to the dentist having a higher belief about the effectiveness of caries risk assessment.

Meeting Review: 2016 Thomas P. Hinman Dental Meeting

 

ATLANTA, Ga., USA: During the 104th Thomas P. Hinman Dental Meeting, Atlanta was abuzz with excitement for the dental professionals who gathered from around the country at the Georgia World Congress Center and Omni Hotel at CNN Center. The theme was “Your Total Health Connection.” New this year was the Total Health Pavilion, featuring lectures on nutrition and health.

 

In addition to a comprehensive continuing education program featuring hundreds of opportunities ranging from hands-on workshops to all-day educational tracks, there was the exhibit hall, where nearly 400 companies presented some of the latest and most innovative products and services available in the dental industry.

The hall gave meeting attendees plenty of opportunity to shop and get product and equipment questions answered by exhibitors in an efficient setting.

 

Also on the show floor, table clinics were available to meeting attendees for additional continuing education credits.

The Hinman Dental Society uses proceeds from the meeting to award scholarships, and this year nearly $450,000 in scholarships and gifts were awarded to dental education schools and programs. Included in these gifts are 89 scholarships, dispersed to students at 39 different dental programs throughout the Southeast. The students selected for scholarships were named “Hinman Scholars” and were recognized during a luncheon.

“Hinman is proud to support student programs in the Southeast for the past 29 years,” said Dr. Jim Roos, general chairman of the 2016 Hinman Dental Meeting, in a press release announcing the awards. “In the last 16 years alone, the Hinman Dental Society has contributed nearly $8 million in scholarships and large gifts in support of dental education.”

“In addition to providing scholarships and endowments, Hinman invites students to attend the meeting to learn the latest in the profession, network with established dentists and prepare for a successful career in dentistry,” Roos said.

For 104 years, dental professionals have considered the Hinman meeting to be one of the premier sources of continuing education.

Among the many educational highlights: “Botox and Dermal Filler Training” and “Botulinum Toxin for Best Therapeutic and Esthetic Outcomes,” presented by Dr. Louis Malcmacher; “Geriatrics Mini-Residency,” presented by Dr. Gretchen Gibson, Dr. Randy Huffines and Dr. Linda Niessen; and “Pediatric Oral Healthcare Mini-Residency,” presented by Dr. Melinda Clark, Dr. Gregory Psaltis, Dr. David Rothman and Dr. J.C. Shirley.

Other highlights: “Lab Tech Day,” presented by Thomas Sing, Arian Deutsch, Jungo Endo and Mike Dominguez; and “S.I.L.V.E.R. (Strategies to Implement that Lead to a Valuable, Enjoyable Retirement),” presented by Dr. Wayne Kerr, Joseph Jordan and Wes Moss.

 

 

TGA Revises Dental Laboratory Product Standards

Summary —

As a result of ADIA's policy advocacy the TGA has revised the regulatory arrangements for dental laboratory products that introduce new mandatory reporting requirements and have confirmed that crowns, bridges, dentures and similar products need to meet the same design and performance standards whether made locally or overseas.

Key Issues For The Dental Industry —

The regulatory standards for laboratory work (referred to as custom-made medical devices for regulatory purposes) are enforced by the Therapeutic Goods Administration (TGA) pursuant to the provisions of the Therapeutic Goods Act (Cth) 1989. This legislation provides a framework for a risk management approach that allows the Australian community to have timely access to therapeutic goods which are consistently safe, effective and of high quality.

For more than a decade the Australian Dental Industry Association (ADIA) has been working with the TGA to ensure that dental laboratory products meet the same regulatory standards irrespective of source.

After advocacy at a parliamentary and departmental level, ADIA has been able to secure some important reforms that confirm the regulatory standards for dental laboratory products and revise the mandatory reporting arrangements. The outcome is a regulatory framework that:

  Defines the required design and performance standards; and
  Requires a local laboratory or importer to notify the TGA or their operations.

a
Importantly, these obligations are common to all suppliers of dental laboratory products in Australia, whether they be supplied by a local laboratory, an importing wholesaler or a dentist importing the product from overseas.

ADIA has welcomed the leadership shown by the TGA and its senior staff in working with the dental industry to deliver these important reforms that support the sector.

The reporting requirements are the result of a recent regulatory amendment secured by ADIA. Within two months of commencing local manufacturing or importing the product, there is now a requirement that the TGA be notified of the activity and, in so doing, a further requirement to provide information about the manufacturer to the TGA. Further information can be found online at:

Additional online information —

 TGA Regulatory requirements for dental laboratory products

The enclosed brochure sets out these requirements in more detail. Consistent with ADIA’s agenda of keeping red-tape to a minimum, there is only a requirement to notify the TGA when supply commences (i.e. in the first instance) and not every time a dental laboratory or importer supplies a product. ADIA’s work in this area was possible as a result of the support and guidance that we receive from members and I encourage you to consider becoming involved in ADIA’s policy advocacy activities

Member Engagement —

ADIA provides leadership, strategy, advocacy and support. Our members set our agenda, fund our activities and directly benefit from the results. On matters associated with regulation of dental laboratory products ADIA staff receive advice and guidance from members that belong to the ADIA-LIG Laboratory Interest Group and who serve on the ADIA-DRC Dental Regulation Committee.

Currency of Information —

This update was issued on 15 March 2016 and please note that changes in circumstances after the publication of material or information may impact upon its accuracy and also change regulatory compliance obligations.

Disclaimer —

The statements, regulatory and technical information contained herein are believed to be accurate and are provided for information purposes only. Readers are responsible for assessing its relevance and verifying the accuracy of the content. To the fullest extent permitted by law, ADIA will not be liable for any loss, damage, cost or expense incurred in relation to or arising as a result of relying on the information presented here. 

This publication is available for your use under a Creative Commons Attribution 3.0 Australia licence, with the exception of the ADIA logo, other images and where otherwise stated. 

Tags: DentistsSuppliersLaboratories

Dental Industry News

  • TGA Revises Dental Laboratory Product Standards

    17th Mar 16

    As a result of ADIA's policy advocacy the TGA has revised the regulatory arrangements for dental laboratory products that introduce new mandatory reporting requirements for crowns, bridges, dentures and similar products. More

  • ADX16 Sydney To Break Attendance Records

    16th Mar 16

    A record number of dentists and allied oral healthcare professionals have registered to attend Australia's premier dental event, the ADX16 Sydney dental exhibition to be held over 18-20 March 2016. More

GKAS Institute ambassador success stories span the U.S.

By Michelle Manchir

Photo of Dr. Jonathan Zsambeky, Lori Pinion and Adilene at Give Kids A Smile event in North Carolina
Give kids a thumbs up: Dr. Jonathan Zsambeky, right, Lori Pinion, dental hygienist, and Adilene, center, smile following a treatment during the Give Kids A Smile event in Cabarrus County, N.C. on March 4.

When Tracy Ginder walks into dental offices across Cabarrus County in central North Carolina, she’s often greeted with a wave of hellos and familiar smiles.

That’s because Ms. Ginder, for the last 10 years, has coordinated the Give Kids A Smile event there. Under her watch, thousands of youngsters here have accessed dental care and education they may not have received otherwise.

This year, Ms. Ginder had some newly acquired expertise when it came to coordinating the event. That’s because she was one of 10 GKAS Ambassadors who in October participated in the ADA Foundation Give Kids A Smile Community Leadership Development Institute in St. Louis.

Ambassadors are chosen from state and local dental societies and community-based organizations to learn best practices for initiating, expanding and enhancing a Give Kids A Smile program, in part by attending and helping facilitate one of the country’s largest GKAS events in St. Louis. The ADA Foundation will post the application for the 2016 GKAS Institute April 4 on ADAFoundation.org. The application deadline is May 13.

Here are three of the 2015 ambassadors’ stories.

Tracy Ginder — Cabarrus County, North Carolina

This year, 12 dental offices across Cabarrus County, North Carolina participated in a March 4 Give Kids A Smile event, treating more than 200 underserved kids. Patients received education, cleanings, treatment and in most cases, an invitation to return for future cleanings and treatment when necessary.

Thanks to Ms. Ginder’s GKAS Institute experience, the Cabarrus County program expanded this year to include “Tiny Smiles” — inviting children ages 0 to 5 to see a dentist for the first time. She estimates 40 children in this age group saw dentists this year.

Ms. Ginder also organized a pilot program in which the Cabarrus Health Alliance donated books so children in some of the offices would receive a book on their way out the door — in addition to a goody bag that included toothpaste and a toothbrush.
 

Photo of Erica Pankey with Juan at Give Kids A Smile event in North Carolina
No waiting for a smile: Erica Pankey, above, a dental assistant with the Cabarrus Health Alliance, sits with Juan, 6, as he awaits treatment at the March 4 Give Kids A Smile event in North Carolina.

Ms. Ginder, a marketing coordinator at the Cabarrus County Health Alliance, said she took the reins of the GKAS program when the county’s dental task force was eliminated a few years ago. If she hadn’t stepped up, she worried the program would cease in the county.

“I couldn’t let that happen,” Ms. Ginder said. “As a parent I know what it’s like when your child needs something. I hear the relief in parents’ voices when they call us and make a dental appointment. It’s one more concern they can check off their list.”

Ms. Ginder said she gleaned new information and ideas – and made new friends and contacts – thanks to attending the Institute.

“If I had a problem, someone else there had a solution,” she said.

In Cabarrus County, the Cabarrus Health Alliance that employs Ms. Ginder set up a phone bank with bilingual operators so the county’s growing Spanish-speaking population could make appointments. A local nonprofit, Cabarrus Partnership for Children, pitched in for support – thanks in part to Ms. Ginder’s networking.

“We are fortunate in this county to have a lot of willing collaborators,” she said.

Dr. Tim Kinnard — Oklahoma City

Dr. Tim Kinnard attributes the Oklahoma City Indian Clinic’s record GKAS year to his participation in the GKAS Institute. The clinic, which serves Native American patients, provided more than 50 children with screenings, sealants, radiographs, fluoride treatments and restorations during its Feb. 5 event.

Meeting dentists and others at the Institute in October who had experience streamlining their GKAS programs helped Dr. Kinnard and his team make their event more efficient, he said.

“The Institute helped us find ideas on how to be efficient in evaluating a patient to provide for them a range of treatment – from getting their teeth cleaned to following up right away with any other needs,” he said.

Dr. Kinnard and his team also recruited volunteers from other parts of the clinic to pitch in during the GKAS event, including staff from maintenance and reception who volunteered to offer face painting.

“The positive effects of having a wealth of volunteers is something else that I gathered from the ambassador program,” Dr. Kinnard said.

Dr. Kinnard and his group treated many children who “might not be able to get this type of dental treatment and education anywhere else.”

The Indian Health Service has established that oral health disparities exist among American Indian and Alaskan Native preschool children, and that significant oral health disparities exist among Indian Health Service areas.

Dr. Kinnard said the clinic has always worked to make itself culturally relevant and comfortable place for its target patients so that they are motivated to return for follow-up care.

“A lot of these kids are at risk and there is misinformation about dentistry out there,” Dr. Kinnard said. “Getting kids coming in regularly is so important.”

Dr. Stephen Gasparovich — Biloxi, Mississippi

The days when the dental team at the 81st Dental Squadron at Keesler Air Force Base scrambled to fill 40 open appointment spots during its Give Kids A Smile Event are over.

That’s in part because Dr. Stephen Gasparovich, Lieutenant Colonel and a Support Flight Commander, attended the October Give Kids A Smile Institute.

“At the Institute, I learned skills to form partnerships with medical specialties and key civilian groups on the base,” he said, which helped get more patients scheduled for treatment.
 

Photo of Give Kids a Smile near Biloxi, Miss.
Tiny Smiles: a child of Biloxi, Miss. Give Kids A Smile event on Feb. 10 engages in dental hygiene education with a toy. 

During the event Feb. 10, the group doubled the number of participating children from last year, providing treatment that ranged from well-baby exams to extractions for 120 children. Also different this year was “100 percent staff participation” on the behalf of the dental squadron, Dr. Gasporavich said.

“The Institute helped me present a clear vision of GKAS event objectives to leadership.  That support allowed us to expand the event and increase the outreach to more children,” he said.

Many of the children treated at Keesler were also rescheduled for follow-up care in the dental clinic. Dr. Gasparovich’s team also implemented a Tiny Smiles component to the event this year – allocating a specific location for these young children separate from the older kids.

Dr. Gasparovich said he foresees the GKAS event at the air force base continuing to grow and build momentum.

“In the past, I took on most of the responsibilities myself.  Delegating the tasks allowed more individuals to participate in the planning process.  Hopefully this will translate into a broader perspective and understanding of the event by fellow committee members, and they will feel more comfortable with future GKAS leadership roles,” he said.

Household catastrophic health expenditure and impoverishment

Household catastrophic health expenditure and impoverishment due to payments for dental care in low and middle income countries.

At the 45th Annual Meeting & Exhibition of the American Association for Dental Research, researcher Eduardo Bernabé, King's College London Dental Institute, England, UK, will present a study titled "Household Catastrophic Health Expenditure and Impoverishment Due to Payments for Dental Care in Low and Middle Income Countries." The AADR Annual Meeting is being held in conjunction with the 40th Annual Meeting of the Canadian Association for Dental Research.

In this study, researchers explored whether dental care spending was associated with household catastrophic health expenditure and impoverishment in 40 low- and middle-income countries. Data from 174,257 respondents age 18 years and over (62,961 in 17 low income countries, 58,388 in 15 lower middle income countries and 52,908 in 8 upper middle income countries) who participated in the World Health Organization's World Health Surveys were analyzed.

Respondents were asked to provide information on total household expenditure over the last four weeks, and then details of item-by-item expenditure (including dental care) over the same period. Health expenditure was defined as catastrophic (CHE) if it was equal to or higher than 40 percent of the household capacity to pay. A household was considered impoverished when household expenditure was equal to or higher than subsistence spending but lower than subsistence spending net of health expenditure. The association between expenditure on dental care, CHE and impoverishment was assessed in multilevel logistic regression, with individuals nested within countries and adjusting for a number of individual and country-level factors.

The proportion of households with dental care spending in the last four weeks was 7.8%, whereas the proportions of households incurring CHE and becoming impoverished were 11.2 percent and 4.3 percent, respectively. The odds of CHE (1.88, 95 percent CI: 1.78-1.99) and impoverishment (1.65, 95percent CI: 1.52-1.80) were significantly greater among adults living in households that spent on dental care in the last four weeks, after adjustment for gender, age, marital status, education, household wealth and size, having children less than five years old and adults over 60 years old in the household, health insurance status and urban/rural status, gross domestic product, Gini coefficient and national out-of-pocket health expenditure. This study shows that payments for dental care can pose a considerable burden on households, to the extent of preventing expenditure on basic necessities and pushing families into poverty.

Teens often ignore dental health

The teen years are hard on teeth, and Dr. Justin Rader often sees the evidence when adolescent patients open their mouths. Frequent snacking, sugary lattes and energy drinks take their toll on the enamel of young teeth, whose owners may not be diligent about brushing and flossing. In a free dental screening Thursday afternoon at Lakes Middle School, Rader gave a dental hygiene … (continue reading)