OBJECTIVE: The purpose of this study was to describe agenesis of permanent teeth in children with respect to prevalence and intra-oral distribution according to gender. METHODS AND SUBJECTS: The study was population based and included all children in one district of the municipality of Aarhus, Denmark, in 1974-1979 (1657 girls and 1668 boys) and 1992-2002 (2409 girls and 2404 boys). The children underwent systematical clinical and radiographic examination. RESULTS: The period prevalence rates were almost identical for the two time periods (1972-1979: 7.8%; 1992-2002: 7.1%). Girls were affected more frequently than boys, and affected girls had more congenitally missing teeth than affected boys. Unilateral agenesis of the second premolars was more frequent than bilateral agenesis. In children with only one congenitally missing tooth, agenesis of the upper lateral incisors was asymmetrical in girls, but not in boys, whereas the opposite was true for the lower second premolars in boys. CONCLUSION: The prevalence of agenesis of permanent teeth in Danish schoolchildren seems to be constant over time, and similar to that found in other large, population-based studies. Intra-oral distributions of congenitally missing teeth indicate gender-specific patterns.
BACKGROUND: Childhood cancer survivors may have experienced a high number of invasive medical and dental procedures which are known to be risk factors for dental anxiety. AIM: The aim of this study was to examine the prevalence of dental anxiety among children who have survived cancer. DESIGN: In a cross-sectional study, we examined 51 6- to 14-year-old children who had been treated for cancer at Aalborg Hospital, and 192 children without cancer. All children answered the Dental Subscale of the Children's Fear Survey Schedule. Dental anxiety was defined as a dental anxiety score exceeding the mean dental anxiety score + 1 standard deviation for the children without cancer. RESULTS: Children with cancer did not have an increased prevalence of dental anxiety compared with children without cancer: the prevalence ratio was 0.41 [95% confidence interval (CI): 0.10-1.24]. The mean dental anxiety score was 23.1 (95% CI: 21.2-25.0) among children who had been treated for cancer, and 24.7 (95% CI: 23.4-26.0) among children without cancer (mean difference: 1.6; 95% CI: 1.1-4.3). CONCLUSION: Cancer and cancer treatment during childhood were not associated with an increased risk of dental anxiety in this population.
OBJECTIVE: The aim of this study was to describe the introduction and the first six years use of midazolam for conscious sedation in a municipal dental service in Denmark. METHODS: In 1998, all dentists were introduced to midazolam conscious sedation. A sedation chart was filled in for each session, and parents' assessment was obtained. In 2004, all clinical materials were collected. RESULTS: Six hundred and eighty sessions were performed; 63.7% of the children were between 2 and 6 years of age; 88.5% belonged to American Society of Anesthesiologists grade 1; 74.8% of the sedations performed used the oral route of administration. Restorations were performed during 60.3% of the sessions, and extractions during 38.4%. Complications during the sessions were rare, the most frequent being double vision (6.1%), hiccups (2.7%), and paradoxical reaction (2.0%). Using Wilton's sedation scale, 42.9% were calm and 27.7% were agitated during treatment, whereas after treatment 61.7% were calm; 80.4% of the parents were very positive towards this sedation method. CONCLUSION: Sedation with midazolam for dental treatment of children with dental fear and anxiety is a feasible and an efficient method with a low rate of complications. It can probably reduce the need for dental treatment under general anaesthesia.
Department of Community Oral Health and Pediatric Dentistry, School of Dentistry, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark. pia.wogelius@rn.dk
BACKGROUND: The few published studies on caries among childhood cancer survivors are small and their results are conflicting. The study aim was to examine the risk of dental caries among children who have survived cancer. PROCEDURE: We included 299,426 7-year-old, 313,461 12-year-old, and 301,930 15-year-old children born between 1984 and 1988 in a nationwide population-based study linking records from Danish Cancer Registry with records from the national database on oral health. Children whose dental examinations had been preceded by a cancer diagnosis (288 7-year-old, 459 12-year-old, and 526 15-year-old) were compared with children without cancer according to presence of caries: caries-free children; children with any caries experience; and children with severe caries experience (i.e., caries in one or more smooth tooth surface). RESULTS: Children diagnosed with cancer before the age of 5 years did not have increased caries prevalence in permanent teeth at ages 12; and 15. Children diagnosed with cancer between 5 and 6 years of age had an increased prevalence of severe caries at age 12 years (prevalence ratio (PR) = 1.59 (95% CI: 1.09-2.31; P = 0.02)), but this difference disappeared by age 15. For children diagnosed with cancer at 5 or 6 years of age and who received radiation therapy the PR of severe caries was 1.52 (95% CI: 0.97-2.37; P = 0.07), 2.13 (95% CI: 0.89-5.10; P = 0.09), and 0.31 (95% CI: 0.07-1.45; P = 0.13) at ages seven, 12 and 15 years respectively. CONCLUSION: Cancer and cancer treatment during childhood are risk factors for caries.
Department of Community Oral Health and Pediatric Dentistry, School of Dentistry, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark. pia.wogelius@rn.dk
OBJECTIVE: To estimate the prevalence and describe the distribution of demarcated opacities and possible consequences of this condition in permanent 1st molars and incisors in Danish children. MATERIAL AND METHODS: Among all 6 to 8-year-old children in two municipalities, 745 (83.6%) were clinically examined for the occurrence of creamy-white or yellowish-brown demarcated opacities, posteruptive breakdown of tooth substance in relation to the opacities, atypical restorations, and extractions, i.e. restorations or extractions as a result of the occurrence of demarcated opacities. RESULTS: In 647 children with four fully erupted permanent 1st molars, the prevalence of demarcated opacities and of lesions with loss of tooth substance due to demarcated opacities in any 1st molar was 37.3% (95% confidence interval (95% CI) 33.6-41.0%) and 6.3% (95% CI 4.7-8.5%), respectively. Permanent incisors were 2.5 times more frequently affected among children with one or more affected permanent 1st molar than among children with no such teeth. Demarcated creamy-white opacities were the type of lesion found most frequently, and the most frequently affected tooth types were the upper central incisors followed by 1st molars. CONCLUSIONS: Nearly half of the examined 6 to 8-year-old children had permanent 1st molars or incisors with demarcated opacities. More than 6% of the children had macroscopic loss of tooth substance due to demarcated opacities.
Clinical data on caries incidence rates based on a long follow-up period are scarce in the dental literature. The purpose of the present study was to describe caries incidence rates in first and second permanent molars in Danish children. The study was based on data reported to a central national registry maintained by the Danish National Board of Health. From this registry, records from more than 50,000 children born in 1980 and followed for 12 to 15 yr were used. Data on first and second molars were analyzed at both tooth and surface level using non-parametric methods for interval-censored data. Caries incidence rates rose slightly as a function of age for both first and second molars during the entire follow-up period. The observation made earlier by others, of a peak in caries incidence rates 2 to 4 yr after emergence, was not confirmed by the present study.
