Blakedalsgaard5644

s support the benefits of early cochlear implantation to maximize the effectiveness of auditory rehabilitation and to avoid cross-modal reorganization.Purpose The purpose of this in vitro study was to assess and compare the microtensile bond strength of three adhesive systems to primary enamel. Methods This laboratory study involved the preparation of 16 primary molars, randomly distributed over three groups, using the following adhesive systems GI-Prime&Bond® XP (PBXP); GII-Clearfil™ SE Protect Bond (CSEPB); and GIII-Clearfil™ S3Bond Plus (CSB). After applying each adhesive system on enamel as recommended, Ceram. X™ Universal composite blocks were built. Samples were then cross-sectioned into quadrangular test specimens and subjected to microtensile tests. Fracture patterns were classified by optical microscopy examination. Statistical analysis was performed using IBM SPSS 24.0 software (five percent significance level). this website Results PBXP showed statistically higher levels of microtensile adhesion than CSEPB and CSB, which, in turn, did not significantly differ from each other. Fracture patterns observed were, for the majority, adhesive fractures across all groups. There was no statistically significant association between group and type of failures. Conclusions Bond strength of the etch-rinse adhesive to primary prepared enamel was statistically higher than for the two self-etch systems tested, which, in turn, did not significantly differ from each other.Purpose To evaluate the association between temperament and caries. Methods A total of 408 primary caregiver-child pairs were followed for 36 months; they completed the Early Childhood Behavior Questionnaire Very Short-Form (ECBQ-VSF) at age four years. Demographic, behavioral, and clinical data were obtained at ages one, two-and-a-half, and four years, with caries experience assessed each time using the International Caries Detection and Assessment System (ICDAS). The ECBQ-VSF (36 items) was used to measure three child temperament domains (1) surgency; (2) negative affect; and (3) effortful control. The associations between cavitated carious lesion experience by age four years (decayed, missing, and filled primary surfaces [dmfs] score greater than zero; d equals ICDAS score greater than or equal to three) and the three ECBQ-VSF temperament domains were analyzed using generalized estimating equation models. Results Temperament domains predicted the number of carious surfaces (dmfs). After adjusting for covariates, every one-point increase in surgency and one-point increase in negative affect were associated with 77 percent and 31 percent increases in dmfs, respectively (P less then 0.05), and every one-point increase in effortful control was associated with a 39 percent decrease in dmfs (P less then 0.05). Conclusions By age four years, children with higher levels of surgency and negative affect have a higher caries experience, whereas children with greater effortful control have a lower caries experience.Purpose This pilot study aimed to evaluate the association between women's depression risk and their children's return for dental treatment. Methods A total of 175 female caregivers of children presenting for an initial dental examination between May and October 2019 at a university clinic answered demographic questions and a validated survey on depression risk. An analysis of caregiver's depression risk relative to children's attendance at the next treatment appointment was made. Results One hundred and eight female caregivers were included in the analysis. Average age was 33 years (standard deviation ± 6.5 years), and 52 percent were Hispanic. The rate of risk for depression was 17.5 percent. Most women at risk lived at least 20 miles away, had an income of less than $29,999, were unemployed or employed part-time, and had no help with childcare. White caregivers were more likely to fail to attend their child's appointment (chi-square [X²] = 7.80, P=0.02) while Hispanic women were more likely to return (X² = 4.10, P=0.04). Caregivers with low depression risk were more likely to return for the child's scheduled appointment (X² = 13.37, P less then 0.001). Thus, there was a positive association between high depression risk and failed appointments (r=0.474, P less then 0.01). Conclusion Children of women at risk for depression are more likely to fail to attend their dental appointment.Purpose A Current Dental Terminology (CDT) code, D1354, for silver diamine fluoride was made effective on January 1, 2016. The purpose of this study was to investigate the utilization of silver diamine fluoride (SDF) by pediatric dentists (PDs) and general dentists (GDs) in the United States. Methods Data were obtained from a commercial dental insurance claims warehouse in the United States. Deidentified data for CDT code D1354 were collected from January 2016 to July 2019. Descriptive statistics and chi-square tests were used. Results A total of 321,726 D1354 claims were found. Data showed that SDF use measured by average monthly claims, unique number of dentists, and percent of paid claims increased each year. Patients zero to nine years old were the most likely to receive SDF treatment. SDF was significantly more likely to be placed on posterior teeth and in children zero to eight years old (P less then 0.001). PDs were more likely than GDs to submit claims for SDF in children (P less then 0.001). Conclusions Silver diamine fluoride use is increasing, especially in patients age zero to nine years. Pediatric dentists are more likely to use SDF in children than general dentists. Posterior teeth receive the majority of SDF treatment.Purpose The purpose of this study was to create an early childhood caries (ECC) risk-screening tool that fits into the primary care provider (PCP) well-child workflow. Methods Integrated health records were employed to develop a predictive model for infants/toddlers at ECC risk; 2,009 patients with 12-, 15-, or 18-month well-child visits and at least one dental visit were used to develop a predictive model for ECC risk at the first dental visit. Independent model validation used 880 18- to 48-month-olds at their first dental appointment after at least one well-child visit. Results Age at the first dental visit strongly predicted caries risk (odds ratio for one-year increase in age equals 2.11; 95 percent confidence interval equals 1.80 to 2.47). Three factors predicted high-caries risk breast feeding status, preferred language not English, and no-show rates for pediatric clinic visits greater than 20 percent. All three non-age risk factors in well-child exams prior to 18 months predicted 42 percent probability of having caries if present for the first dental visit at 18 months. If that child was not seen until four years of age for the first dental visit, the probability of high caries risk increased to 83 percent. Model performance for independent validation was very close to expected performance. Conclusions Existing clinical documentation plus a validated predictive model enables an effective caries risk assessment within well-child visits.Purpose This study assessed state Medicaid dentist enrollment processes and identified best practices for state authorities. Methods A 2018 search of state government websites identified entities involved in enrolling and credentialing dentists. States were classified according to their administrative approach. Results Twenty-two states administered their dental programs internally, 24 through contracted Medicaid managed care organizations (MMCOs), and five through a combined approach. Thirteen of 22 (59 percent) internally-administered and eight of 24 (33 percent) MMCO-administered states carved out their dental programs to a dental managed care organization. Twenty-one of 22 (95 percent) state-administered but only nine of 24 (38 percent) MMCO-administered programs provided complete enrollment instructions. To serve the entire pediatric Medicaid population in a given state, dentists needed to enroll and be credentialed by one to eight entities. Providers needed to complete an average of one application and one contract in carved-out and internally administered states, three applications and two contracts in dental MCO carved-out states, and five applications and four contracts in MMCO states. Conclusions Medicaid enrollment complexity varies considerably across states and is highly influenced by managed care. Recommendations to enhance the enrollment process include dentist-specific guidance, online and automated enrollment platforms, streamlined applications, and application consolidation.Purpose This study's purpose was to examine the sociodemographic and clinical correlates of sleep-disordered breathing in children receiving care at health center dental clinics. Methods Data were collected from the Pediatric Sleep Questionnaire and the health records for two- to 18-year-old children at health centers located in seven states. Results Subjects included 1,000 children (46.3 percent female, 53 percent Hispanic, 70.7 percent white), with mean (± standard deviation) age of 6.89±2.51. Of the sample, 11.9 percent had a Pediatric Sleep Questionnaire score of at least eight. On multiple logistic mixed-effect analysis, age, American Society of Anesthesiology status, anterior overjet, attention deficit hyper-activity disorder, and obesity were significant predictors of the presence of a Pediatric Sleep Questionnaire score of at least eight at a significance level of P=0.05. Conclusions With 11.9 percent of the subjects at risk for sleep-disordered breathing conditions, dentists have an opportunity for interprofessional collaboration with primary and specialist physicians. Dentists should routinely screen children with the Pediatric Sleep Questionnaire tool, cross-reference-associated clinical indicators (such as age, American Society of Anesthesiology status, anterior overjet, attention deficit hyperactivity disorder, and obesity), optimize orofacial growth and development, and refer to and coordinate with physicians to manage high-risk children.Purpose The purpose of this study was to investigate the oral care experiences and challenges encountered by children with Down syndrome. Methods Participants were 372 parents of five- to 14-year-olds with Down syndrome. Parents completed a 48-item questionnaire designed by the authors to elicit information about oral care in the home and dental office. Descriptive statistics were used to examine oral care variables. Results Parents reported difficulty across almost all oral care variables, including oral care in the home, oral care at the dentist, and access to oral care. Approximately one-third of parent respondents reported that toothbrushing was difficult and brushing occurred four or fewer days a week. Over half of the respondents reported that it was difficult to have a dental professional clean their child's teeth, uncooperative behaviors and sensory sensitivities increased in the office, and those behaviors and sensitivities made care challenging. Most respondents reported having a dental home for their child, that it was difficult locating their dentist, and that finances limited visits. Conclusions Children with Down syndrome experience difficulties and barriers to care in both the home and dental office settings.