Recent trends in the management of dentoalveolar traumatic injuries to primary and young permanent teeth REVIEW ARTICLE BackgroundOne of the commonly encountered dental emergencies is dentoalveolar traumatic injuries (DTIs). Unfortunately, DTIs result in fractured, displaced, or lost anterior teeth and this could have significant functional, esthetic, speech, and psychological effects on children thus affecting their quality of life (1). Although it is impossible to guarantee permanent retention of a traumatized tooth, patient age, severity of injury, and timely treatment and follow up of the tooth using recommended procedures can maximize the chances for success (2,3). This review examines the recent trends in the management of DTI to primary and young permanent teeth. Electronic search of scientific papers from 1990s to 2009 was accomplished using Pub Med search engine. The inclusion criteria were English language, publication year, experimental studies and review articles, the age of the study group, and the management technique. The search terms used were the following: dental, trauma, injury, primary teeth, permanent teeth, enamel infraction, crown fracture, crown-root fracture, root fracture, luxation, avulsion, and replantation. In addition, some text books and guidelines were used in this review. A proper definition of DTI is an injury that results from an external force, involving the teeth, the alveolar portion of the maxilla or mandible, and the adjacent soft tissues (4, 5). Different frequencies of DTI are reported in the literature, depending on the employed methodology, the type of dentition, and patients' age.The frequency of DTI is inversely proportional to age (6, 7). Several epidemiological studies investigated DTI in schoolchildren by means of clinical examinations and questionnaires, which might increase significantly the number of cases (8, 9). The number of DTI decreases significantly when epidemiologic studies are performed in a hospital environment (6,10). This is attributed to two reasons: minor dental injuries such as concussion and subluxation are not usually reported in hospital settings, and school-based studies usually involved large slice of the community in contrast to the limited hospital reported cases.The greatest occurrence of DTI to the primary dentition is when motor coordination is developing and children are more susceptible to falls (6, 11). Most injuries to permanent teeth occur secondary to falls, followed by traffic accidents, violence, and sports (6,(12)(13)(14). Boys are twice as likely as girls to report DTI and are much more likely to experience such trauma more than once (7). Children with special needs are in more danger of having trauma than others. This occurs more frequently in people who have intellectual disability, sensory impairment, attention-deficit/hypersensitivity disorder, seizures, abnormal protective reflexes, or muscle incoordination (15)(16)(17)(18)(19)(20). Occlusal relationship is another risk factor because the frequency of DTI is significant...

Objectives Behaviour management strategies involving pharmacological or non-pharmacological interventions during dental procedures should be considered to attain safe and successful treatment outcomes. This study compared the frequencies of use and the completeness of treatment with these interventions. Methods A total of 1725 dental records of patients up to 18 years old, who were treated in the King Abdulaziz Medical City in Jeddah City from October 2018 to June 2019, were used in this retrospective, cross-sectional study. Inferential analysis, Chi-square test, Kruskal–Wallis test, and regression model were used in the data analysis. Results About two-thirds of the patients were treated with attendant non-pharmacological interventions, while one-third, with pharmacological interventions. The application of General Anesthesia (GA) was the most frequently used intervention. Restorative procedures and extractions were done in higher frequencies with pharmacological interventions. Treatments with space maintainers and orthodontic appliances were carried out in higher frequencies with non-pharmacological strategies. The choice of intervention was significantly influenced by the systemic conditions of the patients. Patients treated with non-pharmacological intervention comprised the dominant type of patients, because they required treatments with less pain. Those treated with GA needed restorative treatments and extractions, or treatments that involve pain, but these treatments had higher frequencies of being completed. Conclusions The treatments with pharmacological intervention through GA have higher frequencies of being completed, compared to those with non-pharmacological interventions. Factors, such as age, potential to complete the treatment, and the type of dental treatment applied, influence the choice of treatment intervention.

The aim of this study is to compare the effect of dental rehabilitation on oral health-related quality-of-life (OHRQoL) in children with special health care needs (CSHCN) and healthy children. The prospective study's sample consisted of 213 parents of caries-affected children, who were aged 6 years or younger and were scheduled for dental rehabilitation under general anesthesia (DRGA). The parent-child dyads were recruited from three public hospitals in Jeddah between October 2014 and May 2016. They comprised healthy children (n = 133) and CSHCN (n = 80). Parents self-completed the early childhood oral health impact scale (ECOHIS) before and 1 month after DRGA. The parents also rated the overall oral health status of their children by answering a global question before and after DRGA. At baseline, the CSHCN had significantly worse OHRQoL in most of the scale domains at 25.9 [standard deviation (SD) 11.3] and 19.9 (SD 10.3) respectively. The OHRQoL significantly improved in both groups postoperatively (p = 0.005, Wilcoxon rank-sum test). The effect size of the improvement in the CSHCN group (+1.8) was greater than that in the healthy group (+1.5) in all domains, except for the family impact and parental distress sections. The DRGA markedly improves OHRQoL in children aged 6 years or younger, and the improvement is even greater in CSHCN. The substantial improvement in OHRQoL after DRGA highlights the importance of oral health care in young children, which should receive higher priority than it has been done to date. Children with special health care needs, Dental caries, Early childhood oral health impact scale, General anesthesia, Oral health-related quality-of-life.