Introduction Cone beam computed tomography (CBCT) is used across all dental specialties and has a number of advantages compared to 2D images. The SEDENTEXCT guidelines provide a number of indications for the use, however there are currently no specific guidelines for paediatric dentistry. The aim of this study was to assess current practice of CBCT imaging within paediatric dental departments in England, audit compliance of CBCT justifications against the standards set by SEDENTEXCT and assess whether the use of CBCT affected the treatment plan for each individual patient. Methods From the retrospective analysis of CBCT examinations taken over a 4-year period across three dental hospitals in the north of England, the following data were collected: age at the time of exposure, clinical indication, region of interest (ROI) and diagnostic findings. Clinical notes were also used to identify whether the CBCT had an effect on the final treatment plan. Results A total of 335 CBCT examinations were performed, mean age: 11 years. The number of CBCTs increased each year with a twofold increase in the first 2 years. The main clinical indication in 46% of CBCT examinations was the assessment of localised developing dentition, 68% were in the upper anterior sextant and 61% of CBCT exams were in the mixed dentition age group. The investigations were justified in 100% of the cases. Conclusion The quantity of CBCT examination in paediatric dental patients is increasing to assist treatment planning but more often to enable improved surgical planning.
Attendances to emergency departments (EDs) in England in the last 10 years have increased at double the rate of population growth. 1 With an increase in demand for ED services, national initiatives and targets have been set for EDs in England to address waiting times so that 95% of patients should spend less than 4 hours in the ED. In the UK, an emergency dental service exists both in NHS general practice and within NHS community dental settings; however, availability out of hours varies regionally. For paediatric patients, emergency dental treatment may include examination including radiographs,
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.
ObjectiveTo assess paediatric emergency department (PED) health professionals’ confidence, experience and awareness in managing traumatic dental injuries (TDIs).DesignA cross-sectional online survey.SettingPED at Alder Hey Children’s Hospital and Birmingham Children’s Hospital.Results94 ED health professionals responded. One-third of responders (n=26) encounter children with dental trauma daily or weekly. TDI teaching during undergraduate training was received by 13% (n=12) of responders, and 32% (n=30) had never received training. Responders thought they would benefit from online resources and regular teaching on paediatric TDIs, in addition to an easy-to-use decision-making tool to signpost families.ED health professionals’ confidence in giving advice to families following a TDI, and in recognising types of TDIs, was notably low; −79 and −76 Net Promotor Score, respectively.Responders’ awareness of how to recognise and manage TDIs was varied. Majority were aware of the need to attempt to reimplant an avulsed permanent tooth, and the need to refer a child presenting with a complex permanent tooth injury to the oncall dentist. However, very few responders commented on the importance of follow-up. Responders also raised concerns about the lack of dental services to treat TDIs in children.ConclusionsThere is a need to enhance dental trauma teaching for all ED health professionals who encounter TDIs to increase their confidence and enable them to triage and advise patients appropriately. Additionally, increased signposting for families to the appropriate service could in turn improve outcomes and experience for children who experience a TDI.
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