The alveolar bone height of the primary and first permanent molars in healthy 6- to 9-year-old Jordanian children

A probable case of hypophosphatasia in St Bride's Lower Churchyard (1770-1849, London, UK)

OBJECTIVES

The objective of this study was to analyse an individual whose remains are characterised by early deciduous tooth loss and multi-focal lesions on the post-cranial skeleton.

MATERIALS

Skeletal remains of an immature individual buried between 1770 and 1849 in London.

METHODS

The remains were examined by visual macroscopic inspection, supplemented by radiographic examination of the mandible and maxillae. A differential diagnosis with possible conditions, frequent in this archaeological context, was conducted. A comprehensive examination of dental lesions was performed to investigate the aetiologies of deciduous tooth loss.

RESULTS

The individual exhibited a mosaic of skeletal and dental pathological changes, including premature loss of deciduous dentition, premature eruption of permanent teeth generalised bone loss in both the mandible and maxilla; osteomyelitis of the left radius; osteolytic lesion on the body of the second lumbar vertebra, and marked expansions of the rib shafts due to sub-periosteal new bone formation.

CONCLUSION

A differential diagnosis considered indicates that the pathological changes of the individual were most likely associated with a comorbidity involving hypophosphatasia and tuberculosis.

SIGNIFICANCE

We present in this study several oral signs that could alert paleopathologists and bioarcheologists to systematically consider the potential of a condition that is rarely encountered in archaeological contexts.

LIMITATIONS

Due to poor preservation, this study was confined to the analysis of a partial maxilla and mandible, a left radius shaft and the axial skeleton (rib heads and vertebrae) of the individual.

SUGGESTIONS FOR FURTHER RESEARCH

Further radiographic, histological and genetic analyses would confirm the diagnosis.

Skeletal indicators of pathology in the context of early tooth loss in children: A systematic literature review

OBJECTIVE

To provide an evidence-based resource for paleopathologists to consider multiple skeletal indicators of pathology associated with early tooth loss in children to aid in diagnosis.

MATERIALS

Three databases (Cochrane Library, MedLine, and Scopus) were used for a review.

METHODS

According to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, a systematic review guideline, 85 articles were selected.

RESULTS

A total of 189 children had a syndrome or disease associated with early tooth loss. Our review, based on 25 diseases, lists the bone and dental lesions observable in archeological remains.

CONCLUSIONS

Based on a review of the literature, a synthesis of 25 diseases and syndromes that may be associated with premature loss of permanent or deciduous teeth in children was developed for paleopathologists. It highlights the importance of a thorough dental examination by paleopathologists to further assess past health conditions.

SIGNIFICANCE

This paper provides an extensive resource addressing early tooth loss in childhood to assist researchers with differential diagnosis.

LIMITATIONS

The articles included in this review are case reports based on living populations.

SUGGESTIONS FOR FURTHER RESEARCH

Further studies into diseases and their association with early tooth loss would complement this work, as would utilizing the differential diagnoses on archeological individuals to clarify its value and limitations.

Parental Knowledge and Acceptance of Different Treatment Options for Primary Teeth Provided by Dental Practitioners

Background: Parents have an influence on dental treatment options for young children regarding type of care provided. The aim of this study was to assess parents' knowledge and acceptance of different treatment options for primary teeth provided by dental practitioners for their children.

Materials and Methods: In this descriptive, cross-sectional study, caregiver/child dyads (n = 476) were recruited from patients at Pediatric Dental Clinics, Jordan University of Science and Technology. The data collection questionnaire to parents included: 1-demographic data 2-parental knowledge and practices regarding child's oral hygiene, caries and caries prevention 3-parental knowledge and acceptance of different treatment options for primary teeth including two given clinical scenarios (ICDAS-5 molar requiring intra-coronal restoration, ICDAS-6 molar requiring pulp therapy and stainless steel crown) with pictures before and after treatment. Afterwards, the child underwent a dental examination to record dmft/DMFT, gingival and plaque indices. Data was analyzed using SPSS, significance was set at P ≤ 0.05.

Results: Children's ages were 2–12 years (mean/SD 6.97 ± 2.5); with 255/53.6% males, 221/46.4% females. There were (166) children 2–5 years in primary dentition; (108/166) 65% had ECC, and (n = 62/166) 37.4% had S-ECC, and (310) 6–12 years in mixed dentition; (278/310) 89.7% had caries. Scaling and extraction were the highest known and accepted treatments for primary teeth by parents (35.5 and 30.1%, respectively), while nitrous oxide/oxygen sedation was the least (3.6%). Parental educational level was significant for composite restorations, fluoride gel application and pulp therapy (P = 0.03, 0.02, and 0.03, respectively) and age above 40 for amalgam restorations (P = 0.04). In both scenarios, most parents preferred to leave any care decision in hands of the dentists with no effect of educational level (P > 0.05). There were 81.5% parents who reported that their children's dental status was good, however, 78.4%/42.8% children had an average dmft/DMFT score 5.34/2.32 and mean PI/GI scores 0.88 ± 0.20/0.17 ± 0.23.

Conclusion: Parental knowledge and acceptance about dental treatment options for primary dentition was generally low. Parental education and age had an impact on parental knowledge and practices regarding child's oral hygiene, caries and caries prevention, and some treatment options. There was an overrated parental opinion of their child's teeth status despite the high dmft/DMFT and PI.