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Purpose The aim of this retrospective study is to determine children’s attendance and experience of preventative interventions and operative treatment (restorations and extractions) with their primary care dentist (PCD) in the 12 months before and after their caries management under dental general anaesthetic (DGA). Methods A record of all children who had an elective DGA in 2016 across two hospital sites was retrospectively obtained (n = 1308). A representative sample of 300 was randomly selected encompassing 114 dental practices. An online questionnaire to the children’s PCDs collated quantitative and qualitative data regarding participation in the pre- and post-DGA period. Results Data was collated and analysed for 80 children (mean age: 6 years 10 months [SD = 2.49; range: 2 years 1 month – 14 years 3 months]; equal sex distribution) with 43 responding PCDs. Attendance for examination declined significantly from 85% (n = 68) pre-DGA to 57.5% (n = 46) post-DGA (p ≤ 0.001). Attendance at emergency appointments pre-DGA was high (33.75% [n = 27]); a significant reduction post-DGA was recorded (p ≤ 0.001). Over one third of children (37.5% [n = 30]) did not receive any form of preventative intervention over 24 months. A non-significant reduction in the provision of operative treatment was observed post-DGA (p = 0.06 [fill, primary]; p = 0.78 [fill, permanent]; p = 0.66 [ext, primary]). No statistical difference between age and treatment experience was found. Qualitative analysis revealed challenges in providing care included behavioural difficulties and poor attendance. Conclusion Improvements are required in strategies employed to support high caries risk children pre- and post-DGA to facilitate a higher incidence of attendance and preventative intervention with PCDs.

Introduction Silver diamine fluoride (SDF) is an option for biologic caries management that is not well utilised in the United Kingdom (UK). Caries in the primary dentition is common in the UK, and despite current treatment options many children require invasive treatment and multiple extractions. SDF could provide an alternative and due to their clinical expertise paediatric dentists are well placed to discuss this. Methods Fourteen semi-structured interviews were carried out with paediatric dentists across the UK. This was a heterogeneous sample including working across different settings, with differing levels of experience and both academic and NHS primary employment. Thematic analysis was undertaken with respondent validation. Results Participants felt SDF could be useful where patients have caries in their primary dentition, are asymptomatic and cannot manage other treatment options. The five themes influencing their views were child factors, parental influence, external influences, the clinician’s knowledge, experience and beliefs and the properties of SDF. Conclusion Paediatric dentists interviewed feel that there is a role for SDF in caries management in the UK. They believe case selection and communication with families is important.

Design This was a systematic review of the evidence on the impact of dental caries severity and prevalence on undernutrition (wasting and stunting) in children. Study selectionThe systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with PROSPERO (registration number CRD42018091581). A database search of Medline and Embase was conducted in March 2018 with an updated search in July 2019. Participants were children aged 0-18 years from countries of different income groups. The exposure variable was dental caries reported as prevalence, incidence and/or severity, or changes in those variables. The outcome variable was undernutrition; specifically, wasting (low weight-for-height) and stunting (low height-for-age) in children. Data analysisEvidence was grouped into caries of the permanent dentition, primary dentition, early childhood caries and severe early childhood caries as a risk factor for undernutrition. A best-availableevidence approach was applied to narrative synthesis. Evidence