The Experts below are selected from a list of 2055 Experts worldwide ranked by ideXlab platform
Douglas S Ramsay - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of local anesthesia in Pediatric dental practice
Journal of the American Dental Association, 2000Co-Authors: Yukie Nakai, Peter Milgrom, Lloyd Mancl, Susan E Coldwell, P Domoto, Douglas S RamsayAbstract:ABSTRACT Background Pain control in dental treatment for children is very important. The purpose of this study is to describe the characteristics of local anesthetic use by Pediatric Dentists and to examine factors related to its effectiveness in children. Methods The authors observed 361 patients in 17 Pediatric dental practices in Washington state while each child received restorative or surgical dental treatment. The authors recorded data concerning local anesthetic use and effectiveness. The children's mean age was 87 months, and 181 (50.1 percent) of the patients were girls. A Pediatric Dentist observer rated each child's anxiety before the initial injection of local anesthetic and the effectiveness of pain control during restorative treatment. The observing Dentist asked the treating Dentist about the effectiveness of pain control after completion of treatment. Results Forty-two of 361 children (11.6 percent) were observed to experience ineffective pain control. Fourteen of 17 Dentists (82.4 percent) were observed to have at least one patient in whom pain control was ineffective. Lidocaine (2 percent with 1:100,000 epinephrine) was used by 15 of 17 Dentists (88.2 percent) and in 312 of 361 cases (86.4 percent). The average amount of agent was one cartridge (36 milligrams of lidocaine). Children who were anxious, who had symptoms before treatment, and who underwent more invasive operative and endodontic procedures were more likely to experience ineffective pain control. Conclusions The data suggest that painful treatment is relatively frequent even in specialized Pediatric practice. Variability in general practice is likely to be greater. Clinical Implications The incidence of ineffective pain control may be less if clinicians use methods to reduce anxiety and perioperative infection and symptoms.
Abhinandan Anand Katageri - One of the best experts on this subject based on the ideXlab platform.
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Postendodontic restoration of severely decayed primary tooth using modified omega loop as a post.
Journal of Natural Science Biology and Medicine, 2016Co-Authors: Ruchi Arora, Chirag M Raiyani, Vikram Singh, Abhinandan Anand KatageriAbstract:The esthetic concern of severely mutilated primary anterior teeth in the case of early childhood caries has been a challenge to Pediatric Dentist. Early childhood caries is the most common chronic disease of the preschool child. The case report presented here is of a three year old boy with severely decayed maxillary anterior teeth. After root canal treatment, the primary maxillary central incisors were reinforced using modified omega post and followed by using celluloid strip crowns. The technique described here offers a simple and effective method for restoring severely decayed primary anterior teeth that reestablishes shape, function, and esthetics.
Noelle Huntington - One of the best experts on this subject based on the ideXlab platform.
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unmet dental needs and barriers to care for children with significant special health care needs
Pediatric Dentistry, 2011Co-Authors: Linda P Nelson, Anne Getzin, Dionne A Graham, Jing Zhou, Elke Wagle, Jessie Mcquiston, Suzanne Mclaughlin, Akshay Govind, Matthew Sadof, Noelle HuntingtonAbstract:Purpose The purpose of this study was to conduct the first known large scale survey of parents of children with special health care needs (CSHCN) to determine their child's: oral health status; access to dental care; perceived barriers (environmental/system and nonenvironmental/family); and oral health quality of life, accounting for each child's medical diagnosis and severity of diagnosis. Methods A 72-item survey was sent to 3760 families of CSHCN throughout urban and rural Massachusetts. Results The study yielded 1,128 completed surveys. More than 90% of the children had seen a Dentist within the past year; 66% saw a Pediatric Dentist, and 21% needed intense behavioral interventions. Although most families had high education levels, private dental insurance, and above average incomes, 20% of CSHCN had an unmet dental need. Children with craniofacial anomalies had twice as many unmet needs and children with cystic fibrosis had fewer unmet needs. Children with cerebral palsy, autism, developmental delay, and Down syndrome had more aversions to dental treatment, more treatment complications posed by their medical conditions, and more difficulty finding a Dentist willing to provide care. Children with cystic fibrosis, metabolic disorders, or hemophilia encountered fewer barriers to care. Conclusions The data paint a picture of high unmet dental needs with subpopulations of children with special health care needs who are more at risk for system barriers and internal family barriers to care based on their medical diagnoses.
Peter Milgrom - One of the best experts on this subject based on the ideXlab platform.
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trends in death associated with Pediatric dental sedation and general anesthesia
Pediatric Anesthesia, 2013Co-Authors: Peter Milgrom, Helene Starks, Wylie BurkeAbstract:SummaryBackground Inadequate access to oral health care places children at risk of caries. Disease severity and inability to cooperate often result in treatment with general anesthesia (GA). Sedation is increasingly popular and viewed as lower risk than GA in community settings. Currently, few data are available to quantify Pediatric morbidity and mortality related to dental anesthesia. Objective Summarize dental anesthesia-related Pediatric deaths described in media reports. Methods Review of media reports in the Lexis-Nexis Academic database and a private foundation website. Settings: Dental offices, ambulatory surgery centers, and hospitals. Patients :US-based children (≤21 years old) who died subsequently receiving anesthesia for a dental procedure between 1980–2011. Results Most deaths occurred among 2–5 year-olds (n = 21/44), in an office setting (n = 21/44), and with a general/Pediatric Dentist (n = 25/44) as the anesthesia provider. In this latter group, 17 of 25 deaths were linked with a sedation anesthetic. Conclusions This series of media reports likely represent only a fraction of the overall morbidity and mortality related to dental anesthesia. These data may indicate an association between mortality and Pediatric dental procedures under sedation, particularly in office settings. However, these relationships are difficult to test in the absence of a database that could provide an estimate of incidence and prevalence of morbidity and mortality. With growing numbers of children receiving anesthesia for dental procedures from providers with variable training, it is imperative to be able to track anesthesia-related adverse outcomes. Creating a national database of adverse outcomes will enable future research to advance patient safety and quality.
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effectiveness of local anesthesia in Pediatric dental practice
Journal of the American Dental Association, 2000Co-Authors: Yukie Nakai, Peter Milgrom, Lloyd Mancl, Susan E Coldwell, P Domoto, Douglas S RamsayAbstract:ABSTRACT Background Pain control in dental treatment for children is very important. The purpose of this study is to describe the characteristics of local anesthetic use by Pediatric Dentists and to examine factors related to its effectiveness in children. Methods The authors observed 361 patients in 17 Pediatric dental practices in Washington state while each child received restorative or surgical dental treatment. The authors recorded data concerning local anesthetic use and effectiveness. The children's mean age was 87 months, and 181 (50.1 percent) of the patients were girls. A Pediatric Dentist observer rated each child's anxiety before the initial injection of local anesthetic and the effectiveness of pain control during restorative treatment. The observing Dentist asked the treating Dentist about the effectiveness of pain control after completion of treatment. Results Forty-two of 361 children (11.6 percent) were observed to experience ineffective pain control. Fourteen of 17 Dentists (82.4 percent) were observed to have at least one patient in whom pain control was ineffective. Lidocaine (2 percent with 1:100,000 epinephrine) was used by 15 of 17 Dentists (88.2 percent) and in 312 of 361 cases (86.4 percent). The average amount of agent was one cartridge (36 milligrams of lidocaine). Children who were anxious, who had symptoms before treatment, and who underwent more invasive operative and endodontic procedures were more likely to experience ineffective pain control. Conclusions The data suggest that painful treatment is relatively frequent even in specialized Pediatric practice. Variability in general practice is likely to be greater. Clinical Implications The incidence of ineffective pain control may be less if clinicians use methods to reduce anxiety and perioperative infection and symptoms.
Gideon Holan - One of the best experts on this subject based on the ideXlab platform.
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comparison of oral midazolam with and without hydroxyzine in the sedation of Pediatric dental patients
Pediatric Dentistry, 2004Co-Authors: Joseph Shapira, Ari Kupietzky, Avishag Kadari, Anna B Fuks, Gideon HolanAbstract:Purpose: The purpose of this study was to compare the effectiveness of midazolam (MDZ) alone to a combination of MDZ and hydroxyzine (MDZH) when sedating young children for dental treatment. Methods: This was a prospective, double-blinded, crossover clinical study of young uncooperative children in need of at least 2 restorative visits. Twenty-eight children, ages 21 to 56 months, with a mean age of 36.6 months, participated in this study. The subjects were assigned randomly to receive either 0.5 mg/kg of oral MDZ 20 minutes prior to the beginning of dental treatment or the combination of 0.3 mg/kg oral MDZ with 3.7 mg/kg of hydroxyzine 30 minutes before treatment. The alternative drug regimen was administered at the second appointment. All subjects also received 50% nitrous oxide and were restrained with a papoose board. The child’s behavior (quiet or crying, relaxed or moving) was evaluated every 5 minutes by an experienced Pediatric Dentist who was unaware of the drug given to the child. At the conclusion of treatment, each session was evaluated for overall effectiveness. Results: Regardless of the type of premedication, more patients exhibited quiet behavior at the beginning of treatment, with an increase in crying and movement toward the end of treatment. Regarding movement, a significant difference was observed during the first 20 minutes between the 2 regimens. MDZ showed more children exhibiting movement. During the first 30 minutes of treatment, more children cried in the MDZ group, while MDZH presented more children asleep or quiet. No significant differences were found in behavior as a function of the order the sedative regimens were given. No significant differences between the 2 regimens regarding overall behavior and success (t=0.655 at 27 degrees of freedom; P=.518) were found. Conclusions: The combination of hydroxyzine (3.7 mg/kg) with MDZ (0.3 mg/kg) administered 30 minutes before treatment resulted in safe and effective sedation for the dental treatment of young children. This combination’s use might be more advantageous when compared to MDZ alone, resulting in less crying and movement during the first 30 and 20 minutes, respectively. (Pediatr Dent. 2004;26:492-496)
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success rate of formocresol pulpotomy in primary molars restored with stainless steel crown vs amalga
Pediatric Dentistry, 2002Co-Authors: Gideon Holan, Anna B Fuks, Nirit KetlzAbstract:Purpose: The purpose of this retrospective study was to compare the success rates of formocresol pulpotomy in primary molars restored with stainless steel crowns (SSC) to those restored with amalgam (AM). Methods: Radiographs of pulpotomized primary molars restored with SSC or AM in the principal author’s Pediatric Dentist practice were evaluated and defined as a “failure” when one or more of the following signs were present: internal (IR) or external (ER) root resorption and periapical (PR) or inter-radicular (IRR) radiolucency. Pulp canal obliteration was not regarded as failure. Three hundred and forty-one molars were available for follow-up evaluations ranging from 6 to 103 months. Results: Forty-seven (14%) teeth were defined as “failure,” with a rate of 13% (36/287) for teeth restored with SSC and 20% (11/54) for AM. This difference was not statistically significant (P>0.1). Failure rates of 2 surfaces AM was 23% (7/30), much higher than that of one surface AM (10%, 2/20). Most of the failed teeth presented more than one pathologic finding, with IR being the most frequently observed (36%), followed by ER (31%), IRR (22%) and PR (11%). Pulp canal obliteration was detected in 80% of the teeth, with similar rates in both groups. Failures were observed initially after a mean follow-up of 27 and 29 months in teeth restored with AM and SSC, respectively. Conclusions: Pulpotomized primary molars can be successfully restored with one surface amalgam if their natural exfoliation is expected within not more than two years.(Pediatr Dent 24:212-216, 2002)