Exogenous Intake of Fluorides in Caries Prevention: Benefits and Risks

Caries incidence and prevalence have decreased significantly over the last few decades due to widespread use of fluoride. However, an increase in the prevalence of dental fluorosis has been reported in both fluoridated and non-fluoridated communities. Care must be taken to ensure that a balance between the optimal fluoride preventive effect at the individual and community level and minimal risk of dental fluorosis is maintained. This review describes the main sources of fluoride intake that have been identified: fluoridated drinking water, dietary fluoride supplement, and topical forms comprising toothpastes, rinses, gels and varnishes. The cited data were taken from meta-analytic studies and reports from Cochrane database systematic reviews up to December 2019. Efficiency, but safety, of topically applied fluorides in individual home care is dependent on the degree of compliance of individuals/parents and on the level of competence of providers of preventive counselling. The broad spectrum of these resources allows individualization of fluoride prevention based on risk analysis of caries attack and taking into consideration other preventive measures.

Recurrent Aphthous Stomatitis in Children: A Practical Guideline for Paediatric Practitioners

Recurrent aphthous stomatitis (RAS) is the most common chronic oral mucosal lesion affecting up to 25% of the population. The diagnosis is based on well-defined clinical characteristics, but the precise aetiology and pathogenesis remain unclear. The treatment of RAS should be based on the identification and control of possible predisposing factors. A wide range of topical medicaments is available as antiseptics, anti-inflammatory drugs and corticosteroids. The systemic treatment is indicated in patients with continuous and aggressive manifestation, which is extremely rare in children. The present article provides a review of the current concept and knowledge of the aetiology, pathogenesis, and management of RAS in the paediatric population.

Complete removal of dentigerous cysts with preservation of associated teeth as an alternative to marsupialization in children and preadolescents

The aim of this study is to evaluate the results of dentigerous cysts enucleation with preservation of cyst-associated teeth as a single procedure in a group of children and preadolescents. A retrospective case series of seven patients with 15 unerupted developing teeth associated with or adjacent to dentigerous cysts was conducted. Patients were treated using the uniform surgical protocol (cystectomy, preservation of cyst-associated teeth, without use of orthodontic traction, primary wound closure). The metric analysis of the cysts and unerupted teeth on CBCT and an evaluation of the state of involved teeth after the treatment was performed. The mean age of patients was 9.0 ± 2.1 years (range 5-12 years, median = 9 years). All teeth erupted spontaneously. No serious postoperative complications or recurrences of lesions were detected. The mean follow-up was 53.1 ± 15.7 months (range 25-71 months, median = 52 months). The cystectomy of dentigerous cysts with preservation of associated teeth may be considered an alternative to marsupialization in children and preadolescents.

[Oral health status of women with normal and high-risk pregnancies]

OBJECTIVE

The aim of this study was to compare the oral health status of women with normal pregnancies and those with high-risk pregnancies.

METHOD

A total of 142 women in the third trimester of pregnancy were randomly selected for this study. The pregnant women were divided into two groups: a normal pregnancy group (group F, n = 61) and a high-risk pregnancy group (group R, n = 81). The following variables were recorded for each woman: age, general health status, DMF index, CPITN index, PBI index, amounts of Streptococcus mutans in the saliva and dental treatment needs. The data obtained were analysed statistically. The Mann-Whitney test, Kruskal-Wallis test and chi square test were used, and p-values less than 0.05 were considered statistically significant. The two-sided t-test was used to compare the two cohorts.

RESULTS

Women with high-risk pregnancies showed increased values in all measured indices and tests, but there were no statistically significant differences between the two groups in the DMF index, CPITN index and amounts of Streptococcus mutans present in the saliva. Statistically significant differences were detected between the two groups for the PBI index and dental treatment needs. In group F, the maximum PBI index value was 2.9 in group F and 3.8 in group R. Significant differences were found also in mean PBI values. Out of the entire study cohort, 94 women (66.2%) required dental treatment, including 52% (n = 32) of the women with normal pregnancies and 77% (n = 62) of the women with high-risk pregnancies.

CONCLUSIONS

This study found that women with complications during pregnancy had severe gingivitis and needed more frequent dental treatment than women with normal pregnancies.

Congenital epulis

Congenital epulis is a rare, soft-tissue benign condition that presents at birth. It arises from the alveolar mucosa and occurs more frequently in the maxilla, mainly in the frontal region. This condition may interfere with respiration, feeding or lip closure. Surgical excision is the only possible treatment, although spontaneous regression has been reported. This article presents the case of a female infant with a solid ovoid mass protruding from the oral cavity. Treatment of this lesion was surgical, and histopathological examination confirmed the clinical diagnosis of congenital epulis. Postsurgical follow-up was without complications; examination of the infant 5 months later has revealed only mild left frontal alveolar ridge hypoplasia without any sign of recurrence.