Aviv Shmueli

Early childhood dental caries is the most prevalent disease in childhood. Paediatricians are considered by parents as the main authority on prevention and treatment of all the health requirements of their infants. Aim: The aim of this study was to evaluate the knowledge and practice of paediatricians in promoting oral and dental health among young patients (under age 36 months) and their parents.Materials and methods: 145 anonymous questionnaires were distributed among paediatricians, 130 of them were 90% or above answered and were suitable for analysis for this study.75% of the questionnaires were distributed during the national convention of the Israeli Association of Clinical Paediatrics, 10% in paediatric ambulatory clinics and 15% in paediatric departments in hospitals. Questionnaires were distributed between 2018 and 2020. The inclusion criteria were physicians specialists in paediatrics or residents in paediatrics, all have Israeli licences to practice in Israel. exclusion criteria were partially filled questionnaires. The questionnaire was validated in a pilot study during the years 2010–2012. In addition to demographic variables that included medical training, post-graduate education and clinical practice the questionnaire included 42 questions. Eleven questions on demographics and amount of dental training during academic and clinical training 31 questions belonged to several sections that referred to the participants’ awareness of the AAP guidelines regarding oral and dental health and knowledge of oral health. In each section paediatricians were asked to answer or give an opinion on a specific issue, their answers were coded to scores on a scale of 0–5 and summed per section. Correlations between different variables were analysed. The t-test and Mann-Whitney U test were performed for comparing two variables. For comparing more than two variables, we used the Kruskal-Wallis one-way analysis of variance test or ANOVA.Results: The response rate was 89% (130 questionnaires out of 145). The survey showed that most paediatricians (80%) recognized their role in maintaining the oral and dental health of their young patients. Nevertheless, most admitted that they do not perform simple procedures on a regular basis, like dental examinations (64.6%), or asking parents about feeding habits (59.2%) or teeth brushing (75.4%). Only 21% of the participants expressed adequate knowledge of dental care for children younger than age 3 years. Fifty-eight percent of the participants never had any dental training during their entire paediatric medicine training, including medical school. Paediatricians in private or baby clinics received higher scores in practicing caries prevention, 24.15 ± 5.17 (SD), than paediatricians in hospitals, 2.79 ± 0.54 (SD) (p = 0.006). Caries prevention practice was not found to correlate with paediatricians’ knowledge or attitudes regarding oral and dental caries prevention.Conclusion: Oral and dental knowledge should be incorporated into the paediatric medicine curriculum. With their heavy workload, paediatricians generally do not implement dental caries risk assessment and counselling.

The long-term effect of Zinc oxide zinc sulfate (Coltosol^®) dressing material on pulpotomy success and tooth survival has not yet been studied. This study compared the success rates of Zinc oxide zinc sulfate and zinc oxide eugenol as coronal dressing materials post radicular pulp amputation in primary teeth pulpotomies. This study included healthy two- to ten-year-old children who had pulpotomies on primary molars between 2012 and 2018 at the Pediatric Dentistry Clinic of the School of Dental Medicine. Data were analyzed at several follow-ups of up to 60 months. Kaplan-Meier survival curves were used to estimate survival probabilities of Zinc oxide zinc sulfate versus zinc oxide eugenol. In the 107 children included in this study, 54 teeth were filled with Zinc oxide zinc sulfate and 53 were filled with zinc oxide eugenol. Follow-up ranged from 12.2 to 73.3 months. Overall survival of Coltosol^® vs. IRM filled teeth was 87.1% and 79.3%, respectively. Overall survival probabilities for Coltosol^®-filled teeth at 15.5, 24 and 45 months were 95%, 89.8% and 79.7%, respectively, while for IRM they were 93.7%, 83% and 67.7%, respectively. Treatment failure rates and type of treated teeth did not differ between boys and girls (p-value = 0.77 and 0.87, respectively). Zinc oxide zinc sulfate and zinc oxide eugenol exhibited comparable high long-term success rates of up to five years (p = 0.16).

Objective: The purpose of this study was to determine if gas tension and acidity levels could serve as biomarkers of pulp inflammatory status in primary dentition. Study design: The present study evaluated acidity level and blood partial pressures of O₂ and CO₂ collected from vital pulp chambers of 84 primary molars with deep carious lesions encroaching the pulp. Teeth were treated with pulpotomy or pulpectomy based on clinical judgement. Pulpectomy was performed when symptoms of spontaneous pain, difficulty in obtaining hemostasis and/or dark purple blood were present. Using a glass capillary, pulp chamber bleeding was collected and within ten minutes a neonate Astrup test was performed to determine blood gas module pH, pCO₂, and pO₂. Results: Eighty-four children with one affected tooth participated in the study (37 girls and 47 boys). Age ranged between 3.5 to 9-years (average: 5.3 years). Seventy-one (84%) were treated with the aid of inhalation analgesia, conscious sedation or general anesthesia. Pulpotomy was performed on 58 teeth (69%). Teeth undergoing pulpectomy revealed significant higher level of CO₂ partial pressure (P= 0.002). Acidity level values (pH) were also lower but none significantly in teeth with pulpectomy (P= 0.137). Conclusions: Higher pCO₂ levels was found in pulps needing pulpectomy.

Aim: The aim of the present review is to describe the current status of early childhood caries (ECC) in Israel in aspects of epidemiology, prevention, and management. Methods: PubMed search was performed using the words caries, children, Israel. Demographic data was collected from the Israeli Central Bureau of Statistics. Results: The decayed, missing, and filled teeth index was 2.72 in 1992 and 2.56 in 2016. The proportion of restored teeth has increased. A number of preventive programs are ongoing but a general preventive program is lacking at the national level. From 2010, every child in Israel is eligible to receive free dental treatment. Conclusion: The gaps in understanding of the epidemiological profile of ECC in Israel is a call for more research conduct on ECC in the country.