Journal of Public Health Dentistry Volume Issue 2016 (Doi 10.1111/jphd.12159) Azofeifa, Alejandro Yeung, Lorraine F. Alverson, C. J. Beltrà - Dental Caries and Periodontal Disease Among U.S. Preg
Title: Oral Health Characteristics of Preschool Children with Autistic
Syndrome Disorder Author(s): Sarnat, H (Sarnat, Haim); Samuel, E (Samuel, Eli); Ashkenazi- Alfasi, N (Ashkenazi-Alfasi, Naomi); Peretz, B (Peretz, Benjamin) Source: JOURNAL OF CLINICAL PEDIATRIC DENTISTRY Volume: 40 Issue: 1 Pages: 21-25 Published: WIN 2016 Abstract: Objective: to assess the dental status of young children with Autistic Syndrome Disorder (ASD) in order to allow better understanding of the dentist's role in treating these children. Study design: The ASD group consisted of 47 children diagnosed as ASD from three special kindergartens from three towns in Israel. The control group was 44 normally developed children from 4 kindergartens from 2 neighboring towns. Parents were asked to complete a questionnaire requesting the following: socio-demographic information, general medical condition, dental information (previous visit to a dentist, feeding habits, oral hygiene behavior, oral habits and the Vinland Adaptive Behavioral Scales (VABS). Results: While in the control group there was no report of no brushing at all, among the ASD children 25% did not brush at all. Use of pacifier, fussy eating and eating problems were significantly more prevalent among the ASD group. In addition, the ASD children significantly preferred more salty, spicy and sweet foods than the control. There were more caries-free children among the ASD group. In the ASD group, the ability to perform everyday life functions was slightly more than half of what is expected for age. Conclusions: autistic children have a relative age of one half, meaning they function at half the level of normally developed children at their chronological age, more eating problems and more persistent oral habits yet no correlation to dental health could be shown. Caries experience of autistic children was lower than in the control group, maintaining good oral hygiene is difficult for autistic children yet their gingival health was found to be good. Document Type: Article Record 2 of 98 Title: Prenatal exposure to dental amalgam and pregnancy outcome Author(s): Lygre, GB (Lygre, Gunvor Bentung); Haug, K (Haug, Kjell); Skjaerven, R (Skjaerven, Rolv); Bjorkman, L (Bjorkman, Lars) Source: COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY Volume: 44 Issue: 5 Pages: 442-449 DOI: 10.1111/cdoe.12233 Published: OCT 2016 Abstract: ObjectiveQuestions have been raised about potential risks of prenatal exposure to mercury from amalgam fillings during pregnancy. The aim of this study was to assess possible associations between exposure to amalgam fillings in pregnant women participating in a large cohort study and adverse pregnancy outcome. MethodsIn the Norwegian Mother and Child Cohort Study (MoBa), a valid information about the number of teeth with amalgam fillings and dental treatment, including new amalgam fillings placed or removed during pregnancy, was available from 69 474 pregnancies. The information was obtained from two questionnaires sent to the women at 17 and 30 weeks of pregnancy, and the data were linked to the Medical Birth Registry of Norway. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (95% CI) as a measure of association between pregnancy outcome and prenatal exposure to amalgam fillings. ResultsLogistic regression models, including mothers age, education, BMI, parity, smoking during pregnancy, and alcohol consumption during pregnancy revealed no significant associations between the number of teeth with amalgam fillings and early preterm delivery, late preterm delivery, low birthweight, malformation or stillbirth. ConclusionsWe found no evidence for serious perinatal consequences of maternal exposure to amalgam fillings during pregnancy. Document Type: Article Record 3 of 98 Title: Developing and Testing the Short-Form Knowledge, Efficacy, and Practices Instrument for Assessing Cultural Competence Author(s): Garvan, GJ (Garvan, Gerard J.); Garvan, CW (Garvan, Cynthia W.); Behar-Horenstein, LS (Behar-Horenstein, Linda S.) Source: JOURNAL OF DENTAL EDUCATION Volume: 80 Issue: 10 Pages: 1245-1252 Published: OCT 2016 Abstract: The importance of educating dental students in cultural competence has been widely emphasized, but there is a need to assess cultural competence in a consistent and reliable way. The aims of this study were to determine latent constructs for the initial measure of cultural competence for oral health providers, the Knowledge, Efficacy, and Practices Instrument (KEPI), and to determine how well these factors related to previously identified latent constructs. Data were collected in surveys of dental students and from dental hygiene, dental assisting, and dental faculty members in 44 academic dental institutions from 2012 to 2015. There were a total of 1,786 respondents to the surveys; response rates to individual surveys ranged from 35% to 100%. There were 982 (55%) female and 804 (45%) male respondents, 286 (16%) underrepresented minority (URM) and 1,500 (84%) non-URM respondents, and 339 (19%) faculty and 1,447 (81%) student respondents. Three latent constructs were identified. Female respondents scored significantly higher on the culture-centered practice and efficacy of assessment factors, while URM respondents had significantly higher scores on all three of the KEPI factors. Measurements indicated that the long-form KEPI could be shortened by ten questions and still have three meaningful measurements. Continued research in assessing other health care providers' cultural competence is needed to expand the KEPI to measure providers' cultural competence with patients with minority sexual orientation and gender identity issues and those with physical disabilities, mental illness, and autism to advance patient-centric communication. Document Type: Article Record 4 of 98 Title: Perception of dental visit pictures in children with autism spectrum disorder and their caretakers: A qualitative study Author(s): Wibisono, WL (Wibisono, Witriana L.); Suharsini, M (Suharsini, Margaretha); Wiguna, T (Wiguna, Tjhin); Sudiroatmodjo, B (Sudiroatmodjo, Budiharto); Budiardjo, SB (Budiardjo, Sarworini B.); Auerkari, EI (Auerkari, Elza I.) Source: JOURNAL OF INTERNATIONAL SOCIETY OF PREVENTIVE AND COMMUNITY DENTISTRY Volume: 6 Issue: 4 Pages: 359-365 DOI: 10.4103/2231-0762.186791 Published: JUL-AUG 2016 Abstract: Objectives: One of the most common ways to communicate to children with autism spectrum disorder (ASD) is by using pictures. This study was conducted to identify the easiest perception of dental visit by children with ASD when using pictures as printed photographs. Materials and Methods: Purposive sampling was used to recruit participants from a school for children with special needs in south Jakarta. Semi-structured interviews were conducted with 10 autistic children aged 13u17 years, 2 parents, and 2 teachers. Open-ended questions were asked to participants regarding pictures of dental clinic personnel and activity. Conversations were noted, tape recorded, and then categorized to extract a theme. The data were analyzed using Dedoose mixed methods software. Results: Most respondents showed a positive perception of the dental visit pictures. Many of the pictures were easily recognized by children with ASD, but some failed to be understood. Caretakers not only gave their perception but also recommendations for improvement of the pictures. Conclusions: Dental visit pictures could be used as useful communication tools for children with ASD. Based on the results, the pictures related to dental visit were generally easy to understand, however, some needed correction to be comprehensible. Document Type: Article Record 5 of 98 Title: Risk factors for anterior traumatic dental injury in children and adolescents with autism spectrum disorders: a case-control study Author(s): Habibe, RCH (Habibe, R. C. H.); Ortega, AOL (Ortega, A. O. L.); Guare, RO (Guare, R. O.); Diniz, MB (Diniz, M. B.); Santos, MTBR (Santos, M. T. B. R.) Source: EUROPEAN ARCHIVES OF PAEDIATRIC DENTISTRY Volume: 17 Issue: 2 Pages: 75-80 DOI: 10.1007/s40368-015-0207-7 Published: APR 2016 Abstract: Aim This was to assess and compare risk factors for traumatic dental injury (TDI) among children/adolescents with and without autism spectrum disorders (ASD). Methods The study consisted of 122 children and adolescents (98 males, 24 females), 61 with ASD (study group) and 61 without ASD (control group, CG). Dental injuries were determined according to Andreasenss classification. The cause, location and type of activity at the time of trauma were recorded from patient/carer recollection. Results Subjects with ASD presented higher percentages of TDI in routine activities (P = 0.003), falling while walking and episodes of self-harm (P = 0.007) in the individual's own residence (P = 0.036). TDI prevalence in the ASD group was higher (39.3 %) than in the CG (26.2 %) though not significant, (P = 0.123). Girls with ASD presented a significantly higher TDI percentage (50.0 %) compared with girls from the CG (8.3 %) (P = 0.024). Enamel fracture was the most frequent type of TDI for both groups (P = 0.292). The teeth most commonly affected were #11 and #21 for both groups. Conclusions Children and adolescents with ASD exhibit different risk factors for TDI compared with those without ASD, and girls with ASD are more prone than boys. Document Type: Article Record 6 of 98 Title: Fgf20 and Fgf4 may contribute to tooth agenesis in epilepsy-like disorder mice Author(s): Ogawa, N (Ogawa, Nao); Shimizu, K (Shimizu, Kunihiko) Source: PEDIATRIC DENTAL JOURNAL Volume: 26 Issue: 1 Pages: 21-27 DOI: 10.1016/j.pdj.2015.11.001 Published: APR 2016 Abstract: Background/purpose: Tooth agenesis is one of the most clearly recognized dental anomalies in the permanent dentition and can be challenging to manage clinically. Recent genetic studies identified several genes related to syndromic and nonsyndromic human dental agenesis. However, the genetic factors related to agenesis of the third molars (M3s), second premolars, and lateral incisors, which are most commonly involved in hypodontia, are still unknown. Therefore, this study aimed to identify the genetic causes of the lacking M3s in epilepsy-like disorder (EL) mice, which have 100% incidence of M3 agenesis. Methods: M3 tooth germs from EL and C57BL/6 control mice on postnatal day 3 were dissected out and total RNA was extracted. mRNA expressional analysis was carried out using DNA microarray, real-time polymerase chain reaction and in-situ hybridization. Results: DNA microarray analysis revealed significantly decreased expression of Fgf20 and Fgf4 and increased expression of EDA in the M3s of EL mice at the bud stage relative to C57BL/6 control mice, which was supported with both reverse-transcriptase polymerase chain reaction and real-time polymerase chain reaction analyses (p < 0.05). Furthermore, in- situ hybridization revealed low mRNA expression levels of Fgf20 and Fgf4 in the M3s of EL mice, whereas strong signals were observed in control mice. Conclusion: Our results suggest that a decrease of Fgf20 and Fgf4 expression may lead to M3 agenesis in EL mice. Understanding the mechanisms controlling tooth agenesis will facilitate the development of strategies for tooth bioengineering. Copyright (C) 2015 The Japanese Society of Pediatric Dentistry. Published by Elsevier Ltd. All rights reserved. Document Type: Article Record 7 of 98 Title: Visualizing the Comorbidity Burden in Children with Autism Spectrum Disorder Receiving Dental Treatment Under General Anesthesia Author(s): Mathu-Muju, KR (Mathu-Muju, Kavita R.); Li, HF (Li, Hsin-Fang); Nam, LH (Nam, Lisa H.); Bush, HM (Bush, Heather M.) Source: PEDIATRIC DENTISTRY Volume: 38 Issue: 2 Pages: 134-139 Published: MAR-APR 2016 Abstract: Purpose: The purposes of this study were to: (1) describe the comorbidity burden in children with autism spectrum disorder (ASD) receiving dental treatment under general anesthesia (GA); and (2) characterize the complexity of these concurrent comorbidities. Methods: A retrospective chart review was completed of 303 children with ASD who received dental treatment under GA. All comorbidities, in addition to the primary diagnosis of ASD, were categorized using the International Classification of Diseases-10 codes. The interconnectedness of the co- morbidities was graphically displayed using a network plot. Network indices (degree centrality, betweenness centrality, closeness centrality) were used to characterize the comorbidities that exhibited the highest connectedness to ASD. Results: The network plot of medical diagnoses for children with ASD was highly complex, with multiple connected comorbidities. Developmental delay, speech delay, intellectual disability, and seizure disorders exhibited the highest connectedness to ASD. Conclusions: Children with autism spectrum disorder may have a significant comorbidity burden of closely related neurodevelopmental disorders. The medical history review should assess the severity of these concurrent disorders to evaluate a patient's potential ability to cooperate for dental treatment and to determine appropriate behavior guidance techniques to facilitate the delivery of dental core. Document Type: Article Record 8 of 98 Title: Patterns of Intracranial Hemorrhage in Pediatric Patients with Facial Fractures Author(s): Marano, AA (Marano, Andrew A.); Hoppe, IC (Hoppe, Ian C.); Halsey, JN (Halsey, Jordan N.); Kordahi, AM (Kordahi, Anthony M.); Granick, MS (Granick, Mark S.); Lee, ES (Lee, Edward S.) Source: CRANIOMAXILLOFACIAL TRAUMA & RECONSTRUCTION Volume: 9 Issue: 1 Pages: 35-39 DOI: 10.1055/s-0035-1558453 Published: MAR 2016 Abstract: Intracranial hemorrhage (ICH) is a potentially fatal injury accompanying fractures of the cranium and facial skeleton. When occurring at a young age, ICH can lead to developmental delay, cerebral palsy, epilepsy, and death. It is therefore important for clinicians to recognize the presence of ICH early, and understand the factors that affect its prognosis. In this study, we aim to identify diagnostic and prognostic signs for ICH in pediatric facial fracture patients by examining aspects of patient presentation, concomitant injuries, and fracture patterns. Data were collected for all radiologically diagnosed facial fractures between January 2000 and December 2012 at a level I trauma center in Newark, NJ. This was then further refined to include only patients 18 years of age or younger who had a documented ICH. Patient age, Glasgow coma scale (GCS) on presentation, fracture location, type of hemorrhage, and certain aspects of management were collected from these records. Data were then analyzed by either Pearson chi-square test or a t-test to determine significant relationships. A total of 285 pediatric patients were found to have sustained a facial fracture during this time period, 67 of which had concomitant ICH; 46 of these patients were male and 21 were female, with average ages of 14.26 and 9.52 (p<0.01), respectively. Causes of injury included motor vehicle accidents, pedestrians struck, assault, falls, gunshot injuries, and sports-related injuries. All patients who suffered injuries as a result of violent crimes (assault and gunshot injuries) were male. Although nearly all fracture patterns were significantly associated with the presence of ICH, mandibular fractures showed a significant negative association with the presence of ICH. In addition, patients who received surgical intervention were significantly younger than those who did not (7.7 vs. 13.7, p<0.05). The GCS was significantly lower in patients who underwent ICP (intracranial pressure) monitoring or EVD (external ventricular drain) placement, suffered intraventricular hemorrhage, experienced worsening of hemorrhage on repeat imaging, and suffered fatal injuries. Our data also showed a significant association between the need for intubation in the emergency department and fatality. Because the consequence of ICH can be life threatening, proper diagnosis and management are imperative. The purpose of this study is to describe patterns associated with ICH in pediatric facial fracture patients to promote early recognition of the injury and understanding of poor prognostic signs. Document Type: Article Record 9 of 98 Title: Management of patient with acrometageria for routine dental treatment: A case report Author(s): Young, AS (Young, Andrew S.); Cooke, MR (Cooke, Matthew R.); Taiclet, LM (Taiclet, Lynne M.) Source: SPECIAL CARE IN DENTISTRY Volume: 36 Issue: 1 Pages: 32-38 DOI: 10.1111/scd.12127 Published: JAN-FEB 2016 Abstract: The population of special needs patients in dental offices is growing. Therefore, the demand for well-trained, educated practitioners must increase to fit the need. Conditions such as intellectual developmental disorder, Down syndrome, and autism spectrum disorder are more readily encountered in dental settings. However, it is equally appropriate to identify management techniques for patients with less common conditions. A case is reported in which a 38-year-old Caucasian male with a history significant for acrometageria and associated signs of Mallampati Class IV, micrognathia, decreased mouth opening, decreased thyromental distance, and decreased cervical range of motion presented for routine dental treatment under intravenous sedation. Providers should recognize appropriate management techniques to safely and effectively care for a wide patient demographic. Document Type: Article Record 10 of 98 Title: Visual Schedule System in Dental Care for Patients with Autism: A Pilot Study Author(s): Mah, JWT (Mah, Janet W. T.); Tsang, P (Tsang, Phoebe) Source: JOURNAL OF CLINICAL PEDIATRIC DENTISTRY Volume: 40 Issue: 5 Pages: 393-399 Published: 2016 Abstract: Objectives: A pilot study to test whether a visual schedule system using picture communication symbols can help children with autism have successful routine dental cleaning visits. Study Design: 14 boys with autism between three- to eight-years-old presented to the dental clinic for four weekly consecutive dental appointments. Patients were randomly assigned to either the control group who received the tell- show do method (i.e., standard of care), or the test group who received the tell-show-do method plus the visual schedule system. Results: Patients in the test group completed an average of 1.38 more steps, at 35.52 seconds per step faster, and with 18.7% lower levels of behavioral distress than those in the control group. Conclusion: The use of a visual schedule system, along with repeated weekly visits, showed some promise in helping children with autism successfully complete more steps, progress at a quicker rate, and exhibit lower levels of behavioral distress within a dental appointment, compared to a traditional tell-show-do approach. Document Type: Article Record 11 of 98 Title: Management of oromandibular dystonia on a chorea acanthocytosis: a brief review of the literature and a clinical case Author(s): Ortega, MCP (Ortega, Maria Cecilia Pesce); Skarmeta, NP (Skarmeta, Nicolas Patricio); Diaz, YJ (Diaz, Yaglyn Jarpa) Source: CRANIO-THE JOURNAL OF CRANIOMANDIBULAR PRACTICE Volume: 34 Issue: 5 Pages: 332-337 DOI: 10.1179/2151090315Y.0000000027 Published: 2016 Abstract: Background: Chorea acanthocytosis is an extremely rare neurodegenerative condition characterized by neuropsychiatric disturbances, movement disorders, neuropathy, seizures, and acanthocytosis. In this case report, the authors will present the management of the oromandibular movement disorders associated with this disease.Case Description: This case report describes the focal management of the severe orofacial manifestations associated with this condition. The therapeutic approach adopted to reduce the severe oromandibular movements, dysphagia, and the numerous oral ulcers was selective electromyography (EMG)-guided botulinum toxin application to the inferior head of the lateral pterygoid muscles and masseters. This would be applied to control severe and sudden oromandibular dystonia.Results: Through this procedure, the authors were able to reduce these severe oral manifestations, which had a major impact on the patient's quality of life, and temporarily improve vital functions, such as mastication, deglutition, and speech articulation.Conclusions: Electromyography-guided botulinum toxin application may be a useful tool in the multimodal management of this condition. Document Type: Review Record 12 of 98 Title: Dental Treatment of a Child with Pallister-Killian Syndrome Author(s): Didinen, S (Didinen, Serhan); Atabek, D (Atabek, Didem); Kip, G (Kip, Gulay); Munevveroglu, AP (Munevveroglu, Asli Patir); Tulunoglu, O (Tulunoglu, Ozlem) Source: CASE REPORTS IN DENTISTRY Article Number: 4130961 DOI: 10.1155/2016/4130961 Published: 2016 Abstract: The Pallister-Killian syndrome (PKS) is an extremely rare genetic disorder with an incidence estimated around 1/25000. PKS is a multiple congenital anomaly deficit syndrome caused by mosaic tissue limited tetrasomy for chromosome 12p. The presented report is the first confirmed case with PKS in Turkey. This report focuses on the orofacial clinical manifestations of an 6-year-old boy with PKS who was referred to the Department of Paediatric Dentistry clinic, Gazi University. It has been learned that the PKS was diagnosed 1 year after birth. Due to intellectual disability, it was decided to make the dental treatments under moderate sedation. Although significant tongue thrust and anterior open bite were determined, any oral appliances could not be applied because of the 2 epilepsy seizures in the last 2 years. The aim was to treat decayed teeth and set good oral hygiene in the patient's mouth. Still, there is a probability for epilepsy seizures. If epileptic seizures stop permanently, we can apply an oral appliance to block tongue thrust. The patient is now under control. In cases of systemic and oral findings such as PKS, conducting medical and dental approaches together will increase the life quality of patients. Document Type: Article Record 13 of 98 Title: Dental trauma in Brazilian children and adolescents with cerebral palsy Author(s): Cardoso, AMR (Rodrigues Cardoso, Andreia Medeiros); Silva, CRD (Duarte Silva, Clara Regina); Gomes, LN (Gomes, Lays Nobrega); Gomes, MDNC (Cesarino Gomes, Monalisa da Nobrega); Padilha, WWN (Nascimento Padilha, Wilton Wilney); Cavalcanti, AL (Cavalcanti, Alessandro Leite) Source: DENTAL TRAUMATOLOGY Volume: 31 Issue: 6 Pages: 471-476 DOI: 10.1111/edt.12184 Published: DEC 2015 Abstract: Background: Assessing the frequency and factors associated with dental trauma in pediatric populations with cerebral palsy is important for the planning and implementation of prevention and health promotion programs. The aim of this study was to determine the prevalence and factors associated with dental trauma in children and adolescents with cerebral palsy. Material and methods: Cross-sectional study with a non- probabilistic sample of 80 patients aged 2-18 years was treated in a rehabilitation institution in northeastern Brazil. Caregivers completed a socioeconomic questionnaire, while oral exams were performed by a calibrated investigator (K = 0.75-1.00), with record of the Dental Trauma Index, DMFT and dmft, and Dental Aesthetics and malocclusion indices. Bivariate and multivariate Poisson regression analyses (alpha = 0.05) were performed with the Statistical Package for Social Sciences, version 17. Results: The prevalence of dental trauma was 36.3%, enamel fracture was the most common trauma (89.1%), and the upper central incisors were the most affected dental elements (63.0%). Patients with dental trauma were male, aged 7-18 years, with family income more than one minimum wage, caregiver's education over 4 years, increased overjet, lip hypotonia, quadriplegia, epilepsy, oral breathing, and severe communication skills. The presence of dental trauma was not associated with socioeconomic characteristics (gender, age, family income, and caregiver's educational level), oral health perception, and systemic and oral conditions (dental caries, malocclusion, and lip hypotonia) were evaluated (P > 0.05). Conclusion: The prevalence of dental trauma was high, but not associated with clinical variables and evaluated socioeconomic indicators. Document Type: Article Record 14 of 98 Title: Salivary Cortisol Levels and its Implication on Behavior In Children with Autism during Dental Treatment Author(s): Abdulla, AM (Abdulla, A. M.); Hegde, AM (Hegde, A. M.) Source: JOURNAL OF CLINICAL PEDIATRIC DENTISTRY Volume: 39 Issue: 2 Pages: 128-132 Published: WIN 2015 Abstract: The aim of the study was to estimate the diurnal variations of salivary cortisol in children with autism and healthy children and it's implication on behavior during non-invasive dental procedures. Study design: 50 children with autism and 50 healthy children in the age group between 6 to 12 years of both genders with the need for dental treatment were included in the study Whole unstimulated saliva was collected from them during early hours of the day and during evenings for 2 consecutive days. The collected saliva was then subjected to electrochemiluminescence assay. Minimum invasive dental procedures like hand scaling, pit and fissure sealants and glass ionomer cement restorations were performed for the participants each time after the saliva sample collection and their behavior during the procedures was rated using Frankl's Behavior Rating Scale. Results:Significant correlation was seen between cortisol levels and behavior in children with autism. As cortisol levels increased in children with autism, behavior worsened and as the cortisol levels decreased they showed positive behaviour Conclusion: Cortisol acts as a stress marker and studying the diurnal variations of salivary cortisol can help us in attaining better knowledge about the behavior pattern and thereby assist us in modiffing the behavior modification procedures and treatment planning in this group of special children. Document Type: Article Record 15 of 98 Title: Multidisciplinary Aspects of 104 Patients With Pierre Robin Sequence Author(s): Filip, C (Filip, Charles); Feragen, KB (Feragen, Kristin Billaud); Lemvik, JS (Lemvik, Jorunn Skartveit); Lindberg, N (Lindberg, Nina); Andersson, EM (Andersson, Els-Marie); Rashidi, M (Rashidi, Mitra); Matzen, M (Matzen, Michael); Hogevold, HE (Hogevold, Hans Erik) Source: CLEFT PALATE-CRANIOFACIAL JOURNAL Volume: 52 Issue: 6 Pages: 732-742 DOI: 10.1597/14-161 Published: NOV 2015 Abstract: Objective: To describe Pierre Robin sequence patients with a cleft palate from a multidisciplinary perspective. Patients: A total of 104 individuals with Pierre Robin sequence and cleft palate, born between 1980 and 2010. Method: Data were collected retrospectively and compared with large control groups. Results: Of 104 patients, 19 (18.3%) were treated with a nasopharyngeal or oropharyngeal tube, continuous positive airway pressure, and/or a tracheotomy. The mean weight percentile for newborns with Pierre Robin sequence was 30.9. It decreased to 29.9 at the time of cleft palate repair (mean age, 13.7 months) (P = .78). Of 87 patients, 30 (34.5%) developed normal speech after cleft palate repair. Of 93 nonsyndromic Pierre Robin sequence patients, 31 (33.3%) had or are having surgery for velopharyngeal insufficiency, a rate that is significantly higher when compared with a control group of cleft palate-only patients (19.4%; P = . 004). Of 31 patients, 25 (80.6%) developed normal resonance after surgery for velopharyngeal insufficiency. There was no significant difference in the rate of syndromes between the Pierre Robin sequence patients and a control group of cleft palate patients without Pierre Robin sequence (P = .25). Seven of 39 boys (17.9%) with Pierre Robin sequence had a diagnosis of autism spectrum disorder. Conclusion: Even though the mean weight percentile for newborns with Pierre Robin sequence was low, the patients did not show a growth spurt during the first year of life. The high rate of velopharyngeal insufficiency after cleft palate repair in patients with Pierre Robin sequence needs further investigation. Also, the high rate of autism spectrum disorder among boys with Pierre Robin sequence prompts further investigation. Document Type: Article Record 16 of 98 Title: Speech, eating and saliva control in rare diseases - a database study Author(s): Sjogreen, L (Sjoegreen, L.); Mogren, A (Mogren, A.); Andersson- Norinder, J (Andersson-Norinder, J.); Bratel, J (Bratel, J.) Source: JOURNAL OF ORAL REHABILITATION Volume: 42 Issue: 11 Pages: 819-827 DOI: 10.1111/joor.12317 Published: NOV 2015 Abstract: The aim was to study the background to and the manifestations of affected intelligibility of speech and reported difficulty with eating and saliva control in rare diseases. In Sweden, a disease or disorder is defined as rare when it affects no more than 100 individuals per million population and leads to a marked degree of disability. In 1996-2008, 1703 individuals with 169 rare diseases (3-67years) answered a questionnaire about oral health and oro-facial function and 1614 participated in a clinical examination. A control group of 135 healthy children was included. Oromotor impairment was a frequent finding (43%) and was absent among the controls. Half the children in the youngest age group (3-6years) had moderate/severely affected intelligibility or no speech compared with one- third in the other age groups. The most frequent eating difficulties were related to chewing and were found in approximately 20% of the individuals in the study group. Artificial nutrition was most common in children aged 3-6years (92%), followed by children aged 7-12years (49%), adolescents aged 13-19years (33%) and adults (14%). Impaired saliva control was common (312%) and strongly and significantly correlated with oromotor dysfunction, intellectual disability, open mouth at rest and epilepsy. In conclusion, oromotor impairment and oro-facial dysfunctions, such as affected intelligibility, eating difficulties and impaired saliva control, are frequent in individuals with rare diseases. There is a strong correlation between oromotor impairment and affected intelligibility, eating difficulties and impaired saliva control in individuals with rare diseases. Document Type: Article Record 17 of 98 Title: A case report: retigabine induced oral mucosal dyspigmentation of the hard palate Author(s): Beacher, NG (Beacher, Nicholas G.); Brodie, MJ (Brodie, Martin J.); Goodall, C (Goodall, Christine) Source: BMC ORAL HEALTH Volume: 15 Article Number: 122 DOI: 10.1186/s12903-015-0102-y Published: OCT 9 2015 Abstract: Background: Dyspigmentation of the oral mucosa has a multitude of aetiological causes. Retigabine, a new antiepileptic drug, has the potential side effect of inducing a blue/purple pigmentation of the oral mucosa in addition to the skin, lips, nails and retina of the eyes. This article presents a unique case of dyspigmentation present in the oral mucosa of the hard palate which has previously been unreported in the dental literature. Case presentation: A 70 year old white male presented to a secondary care oral surgery department with an unusual asymptomatic pigmented lesion present in the hard palate of the oral cavity. The pigmentation was remarkable for its distinct blue/purple colouration which was associated with a similar discolouration of the nail beds of the hands. This is believed to be a side effect of the anti-epileptic medication retigabine. Conclusion: The dental profession and wider healthcare community should be made fully aware of the potential side effect of oral dyspigmentation associated with the novel anti-epileptic medication retigabine. Enhanced knowledge of the causative role of retigabine in dyspigementation of the oral mucosa will allow the practitioner to make an appropriate diagnosis. As far the authors are aware this is reaction is unreported in the dental literature and should be disseminated to the wider oral health professional's community. Document Type: Article Record 18 of 98 Title: Translating neuroscience research to oral medicine: oxytocin and human behavior Author(s): Nash, DA (Nash, D. A.) Source: ORAL DISEASES Volume: 21 Issue: 7 Pages: 913-917 DOI: 10.1111/odi.12359 Published: OCT 2015 Document Type: Letter Record 19 of 98 Title: Dental care protocol based on visual supports for children with autism spectrum disorders Author(s): Cagetti, MG (Cagetti, Maria Grazia); Mastroberardino, S (Mastroberardino, Stefano); Campus, G (Campus, Guglielmo); Olivari, B (Olivari, Benedetta); Faggioli, R (Faggioli, Raffaella); Lenti, C (Lenti, Carlo); Strohmenger, L (Strohmenger, Laura) Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL Volume: 20 Issue: 5 Pages: E598-E604 Article Number: 20424 DOI: 10.4317/medoral.20424 Published: SEP 2015 Abstract: Background: Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments. Material and Methods: 83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in order to undergo: an oral examination (stage 1), a professional oral hygiene session (stage 2), sealants (stage 3), and if necessary, a restorative treatment (stage 4). Each stage came after a visual training, performed by a pschologist (stage 1) and by parents at home (stages 2, 3 and 4). Association between acceptance rates at each stage and gender, intellectual level, verbal fluency and cooperation grade was tested with chi-square test if appropriate. Results: Seventy-seven (92.8%) subjects overcame both stage 1 and 2. Six (7.2%) refused stage 3 and among the 44 subjects who need restorative treatments, only three refused it The acceptance rate at each stage was statistically significant associated to the verbal fluency (p=0.02, p=0.04; p=0.01, respectively for stage 1, 3 and 4). In stage 2 all subjects accepted to move to the next stage. The verbal/intellectual/cooperation dummy variable was statistically associated to the acceptance rate (p<0.01). Conclusions: The use of visual supports has shown to be able to facilitate children with ASDs to undergo dental treatments even in non-verbal children with a low intellectual level, underlining that behavioural approach should be used as the first strategy to treat patients with ASDs in dental setting. Document Type: Article Record 20 of 98 Title: Our experience about the use of resorbable plates in the treatment of craniostenosis Author(s): Grassiot, B (Grassiot, B.); Delabar, V (Delabar, V.); Szathmari, A (Szathmari, A.); Beuriat, PA (Beuriat, P. A.); Paulus, C (Paulus, C.); Mottolese, C (Mottolese, C.) Source: REVUE DE STOMATOLOGIE DE CHIRURGIE MAXILLO-FACIALE ET DE CHIRURGIE ORALE Volume: 116 Issue: 4 Pages: 245-249 DOI: 10.1016/j.revsto.2015.06.007 Published: SEP 2015 Abstract: Introduction. The use of resorbable plates increases for craniosynostosis surgery. This material, based on polymere (PLA, PGA) can replace steel wire and non resorbable plates. A few studies present surgical results about the use of this material with a long follow-up. We present our ten years experience of using resorbable material for craniosynostosis treatment in children. Methods. Between 2002 and 2012, we operated 283 craniosynostosis (98 scaphocephalies, 55 trigonocephalies, 79 plagiocephalies et 51 craniofaciostenoses). Among these surgeries, 211 were realized with resorbable material (plates and screws). Different criteria were observed: the esthetic result, the infection rate, the re-intervention, the bone defects and the inflammatory granuloma. Results. Among the 211 craniosynostosis, we found 62 plagiocephalies, 66 scaphocephalies, 50 trigonocephalies, 33 craniofaciostenoses. All the reconstructions were realized with the same resorbable material (Macropore by Medtronic). The rate of complications was low: one scar infection without participation of material for two patients (0.9%), a pseudo-meningocele for two patients (0.9%), epilepsy for four children (1.8%) and bone defect for 15 (7%). We observed no granuloma for these patients. Conclusion. Our experience of ten years using resorbable material is very satisfactory. This material permits to realize solid and esthetic reconstructions with a low rate of infection without dangerous reaction for children in young age. (C) 2015 Elsevier Masson SAS. All rights reserved. Document Type: Article Record 21 of 98 Title: STUDY POINTS TO EASIER DENTAL VISITS FOR CHILDREN WITH AUTISM Author(s): [Anonymous] ([Anonymous]) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 146 Issue: 8 Pages: 570-571 DOI: 10.1007/s10803-015-2450-5 Published: AUG 2015 Document Type: News Item Record 22 of 98 Title: A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder Author(s): Blomqvist, M (Blomqvist, My); Bejerot, S (Bejerot, Susanne); Dahllof, G (Dahllof, Goran) Source: BMC ORAL HEALTH Volume: 15 Article Number: 81 DOI: 10.1186/s12903-015-0065-z Published: JUL 15 2015 Abstract: Background: Autism spectrum disorder (ASD) is characterized by impairments in social interaction and communication, restricted patterns of behaviour, and unusual sensory sensitivities. The hypotheses to be tested were that adult patients with ASD have a higher caries prevalence, have more risk factors for caries development, and utilize dental health care to a lesser extent than people recruited from the normal population. Methods: Forty-seven adults with ASD, (25 men, 22 women, mean age 33 years) and of normal intelligence and 69 age-and sex-matched typical controls completed a dental examination and questionnaires on oral health, dental hygiene, dietary habits and previous contacts with dental care. Results: Except for increased number of buccal gingival recessions, the oral health was comparable in adults with ASD and the control group. The group with ASD had less snacking, but also less frequent brushing of teeth in the mornings. The stimulated saliva secretion was lower in the ASD group, regardless of medication. Frequencies of dental care contacts were equal in both groups. The most common reason for missing a dental appointment was forgetfulness in the ASD group. Conclusions: Adults with ASD exhibited more gingival recessions and considerably lower saliva flow compared to healthy controls. Despite equal caries prevalence, the risk for reduced oral health due to decreased salivary flow should be taken into consideration when planning dental care for patients with ASD. Written reminders of dental appointments and written and verbal report on oral health status and oral hygiene instructions are recommended. Document Type: Article Record 23 of 98 Title: Motor, linguistic, personal and social aspects of children with Down syndrome Author(s): Ferreifta-Vasques, AT (Ferreifta-Vasques, Amanda Tragueta); Lamonica, DAC (Cusin Lamonica, Dionisia Aparecida) Source: JOURNAL OF APPLIED ORAL SCIENCE Volume: 23 Issue: 4 Pages: 424-430 DOI: 10.1590/1678-775720150102 Published: JUL-AUG 2015 Abstract: A global developmental delay is expected from Down syndrome, affecting motor, cognitive, linguistic and personal-social skills. However, not always these delays are proportional; different conditions occur due to several intrinsic and extrinsic variables that must be controlled to form groups of greater homogeneity. Objective: To enhance personal-social, fine motor-adaptive, gross motor and linguistic skills among children with Down syndrome and compare them with typically developing children, matched for gender, socioeconomic status and mental age, while controlling some variables that interfere with the global development. Methods: The ethical aspects were fulfilled (Case No. 040/2009). The following inclusion criteria were considered: participants without a history of prematurity, very low birth weight, congenital hypothyroidism, significant hearing and vision problems, and signs of Autism Spectrum Disorder. After the inclusion criteria were considered, 40 children participated in the study, of which 20 had Down syndrome (experimental group - EG), these being of both genders and with chronological ages ranging from 38 to 63 months, and the other 20 being typically developing children (control group - CG), matching the EG in terms of gender, socioeconomic status and mental age, with this age ranging from 13 to 50 months. The evaluation consisted in applying the Denver Developmental Screening Test II, a test that assesses areas such as personal-social, fine motor-adaptive, linguistic and gross motor development. The results were subjected to statistical analysis using Student's t-test. Results: A statistically significant difference was verified between the groups for the language and fine motor-adaptive areas. Conclusion: Children with Down syndrome showed lower performance in language and fine motor skills when compared with typically developing children. There was no statistically significant difference in gross motor and personal-social areas. It is worth mentioning the importance of controlling the variables to deal with more homogeneous groups. Document Type: Article Record 24 of 98 Title: Vaccine hesitancy and unfalsifiability Author(s): Glick, M (Glick, Michael) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 146 Issue: 7 Pages: 491-493 DOI: 10.1016/j.adaj.2015.05.003 Published: JUL 2015 Document Type: Editorial Material Record 25 of 98 Title: A Systematic Review of Observational Studies Evaluating Implant Placement in the Maxillary Jaws of Medically Compromised Patients Author(s): Kotsakis, GA (Kotsakis, Georgios A.); Ioannou, AL (Ioannou, Andreas L.); Hinrichs, JE (Hinrichs, James E.); Romanos, GE (Romanos, Georgios E.) Source: CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH Volume: 17 Issue: 3 Pages: 598-609 DOI: 10.1111/cid.12240 Published: JUN 2015 Abstract: BackgroundEven though the efficacy of implant treatment and the excellent success rates that modern implant surfaces yield remain unchallenged, there is limited information available on implant success rates in medically compromised patients. PurposeThe aim of this systematic review was to evaluate the survival of implants placed in the maxillary jaws of medically compromised patients. Materials and MethodsTwo reviewers using predefined selection criteria performed an electronic search complemented by a manual search, independently and in duplicate. ResultsAfter the final selection, 11 studies reporting on four distinct medical conditions were included out of 405 potentially eligible titles. In detail, three studies reported on implants placed in diabetic patients, six on implants placed in patients with a history of oral cancer, one on implants in patients with a history of epilepsy, and one on implants in patients with autoimmune rheumatoid arthritis. ConclusionsPlacement of maxillary implants in medically compromised patients seems to yield acceptable survival rates. Implant survival in well- controlled diabetic patients, patients diagnosed with rheumatoid arthritis, and patients treated for severe epilepsy is comparable to that in healthy patients. Implants placed in the maxillae of patients treated for oral cancer may attain osseointegration less predictably than in the mandible. Document Type: Review Record 26 of 98 Title: An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases Author(s): Dogan, MS (Dogan, Mehmet-Sinan); Callea, M (Callea, Michele); Yavuz, I (Yavuz, Izzet); Aksoy, O (Aksoy, Orhan); Clarich, G (Clarich, Gabriella); Gunay, A (Gunay, Ayse); Gunay, A (Gunay, Ahmet); Guven, S (Guven, Sedat); Maglione, M (Maglione, Michele); Akkus, Z (Akkus, Zeki) Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL Volume: 20 Issue: 3 Pages: E340-E346 Article Number: 20303 DOI: 10.4317/medoral.20303 Published: MAY 2015 Abstract: Background: This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clincal examination and examination of the jaw and facial areas radiologically and on cone-beam 3- dimensional dental tomography (CBCT) images. Material and Methods: In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5-45 years, and orthodontic analyses were made on these images. Results: The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Conclusions: Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved. Document Type: Article Record 27 of 98 Title: Oral health in a group of patients with Rett syndrome in the regions of Valencia and Murcia (Spain): A case-control study Author(s): Fuertes-Gonzalez, MC (Fuertes-Gonzalez, Maria-Cristina); Silvestre, FJ (Silvestre, Francisco-Javier) Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL Volume: 19 Issue: 6 Pages: E598-E604 DOI: 10.4317/medoral.19743 Published: NOV 2014 Abstract: Objectives: Rett syndrome (RS) is a rare disease with oral manifestations that have not been described in detail or in a standardized manner in the literature. The present study describes the oral health of the population with RS in two Spanish regions, following the protocol of the World Health Organization for conducting common oral health surveys. Study Design: A prospective, observational case-control study was carried out, involving a group of patients with RS (n(1)=41) and a mean age of 13.37 +/- 3.19 years, and an age-and gender-matched control group without RS (n(0)=82). The data referred to oral health and habits were recorded by means of a questionnaire and oral examination was used to document caries indicators (prevalence of caries, df(t), df(s), DMF(T), DMF(S) and indices referred to dental loss, morbidity, restoration), the Community Periodontal Index (CPI), and the most characteristic oral manifestations. Results: The most frequent oral habit in the patients with RS was diurnal bruxism, followed by stereotyped tongue movements and oral breathing. The caries scores were lower in the RS population than in the control group, but patients with RS showed greater periodontal alterations and a greater prevalence of drooling, dental wear, high-arched palate and anterior open bite. Conclusions: The population with RS exhibits characteristic and early oral habits and alterations, and periodontal problems that are more notorious than caries disease, so that our efforts should focus on the diagnosis and early correction of the parafunctional habits, promoting restorative treatment, and providing instructions on correct oral hygiene. Document Type: Article Record 28 of 98 Title: Nonverbal Patient With Autism Spectrum Disorder and Obstructive Sleep Apnea: Use of Desensitization to Acclimatize to a Dental Appliance Author(s): Fetner, M (Fetner, Maggie); Cascio, CJ (Cascio, Carissa J.); Essick, G (Essick, Gregory) Source: PEDIATRIC DENTISTRY Volume: 36 Issue: 7 Pages: 499-501 Published: NOV-DEC 2014 Abstract: Patients with autism spectrum disorders (ASDs) may have difficulty tolerating conventional dental treatment due to aberrant sensory responsiveness. The purpose of this report was to describe the successful treatment of obstructive sleep apnea (OSA) in a nonverbal 20-year-old male patient with ASD using a dental appliance. A series of appointments prepared the patient for the required treatment procedures and desensitized him for use of the final appliance. The final appliance improved outcomes of a post-treatment sleep study, indicating successful treatment of OSA. Understanding the specific challenges of patients with ASD and the patience and foresight of providers in approaching these challenges, in collaboration with caregivers, can contribute to improved health outcomes for these patients. Document Type: Article Record 29 of 98 Title: Temporomandibular dysfunction post-craniotomy: Evaluation between pre- and post-operative status Author(s): Costa, ALF (Ferreira Costa, Andre Luiz); Yasuda, CL (Yasuda, Clarissa Lin); Franca, M (Franca, Marcondes, Jr.); de Freitas, CF (de Freitas, Claudio Froes); Tedeschi, H (Tedeschi, Helder); de Oliveira, E (de Oliveira, Evandro); Cendes, F (Cendes, Fernando) Source: JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY Volume: 42 Issue: 7 Pages: 1475-1479 DOI: 10.1016/j.jcms.2014.04.016 Published: OCT 2014 Abstract: Objective: To identify risk factors associated with post-operative temporomandibular joint dysfunction after craniotomy. Methods: The study sample included 24 patients, mean age of 37.3 +/- 10 years; eligible for surgery for refractory epilepsy, evaluated according to RDC/TMD before and after surgery. The primary predictor was the time after the surgery. The primary outcome variable was maximal mouth opening. Other outcome variables were: disc displacement, bruxism, TMJ sound, TMJ pain, and pain associated to mandibular movements. Data analyses were performed using bivariate and multiple regression methods. Results: The maximal mouth opening was significantly reduced after surgery in all patients (p = 0.03). In the multiple regression model, time of evaluation and pre-operative bruxism were significantly (p < .05) associated with an increased risk for TMD post-surgery. Conclusion: A significant correlation between surgery follow-up time and maximal opening mouth was found. Pre-operative bruxism was associated with increased risk for temporomandibular joint dysfunction after craniotomy. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved. Document Type: Article Record 30 of 98 Title: Behavioural aspects of patients with Autism Spectrum Disorders (ASD) that affect their dental management Author(s): Limeres-Posse, J (Limeres-Posse, Jacobo); Castano-Novoa, P (Castano-Novoa, Patricia); Abeleira-Pazos, M (Abeleira-Pazos, Maite); Ramos-Barbosa, I (Ramos-Barbosa, Isabel) Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL Volume: 19 Issue: 5 Pages: E467-E472 DOI: 10.4317/medoral.19566 Published: SEP 2014 Abstract: Dental treatment in patients with Autism Spectrum Disorders (ASD) can be complicated due to the presence of behavioral alterations. In this group, there are no specific behavioral profiles that allow dentist to anticipate the attitude that a patient will show during a visit. Thus, behavioral attitudes have been described that vary from total permissiveness and collaboration during even bloody procedures, to the absolute impossibility in conducting a simple oral examination. There is no effective behavioral management technique for all ASD patients. Prior information, such as the type of ASD or the presence of certain concurrent pathologies can help predict the patient's likely behavior. Therefore, gathering all the information in a preliminary interview with the parents/guardians of the patient is recommended. Knowing these factors will allow individualized behavioral management strategies to be designed and facilitates the planning of dental treatment. Document Type: Article Record 31 of 98 Title: Consensus Report of the XI Congress of the Spanish Society of Odontology for the Handicapped and Special Patients Author(s): Machuca-Portillo, G (Machuca-Portillo, Guillermo); Cabrerizo- Merino, C (Cabrerizo-Merino, Carmen); Cutando-Soriano, A (Cutando- Soriano, Antonio); Gimenez-Prats, MJ (Gimenez-Prats, Maria-Jose); Silvestre-Donat, FJ (Silvestre-Donat, Farncisco-Javier); Tomas-Carmona, I (Tomas-Carmona, Inmaculada) Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL Volume: 19 Issue: 5 Pages: E495-E499 DOI: 10.4317/medoral.19569 Published: SEP 2014 Abstract: This article summarizes the findings of consensus of the XI congress of the SEOEME. All of these conclusions are referring to the review articles responsible to the general rapporteurs in order to bringing up to date knowledge with regard to the use of implants in patients medically compromised and with special needs and, in the dental management of autism and cerebral palsy, in the dental treatment of patients with genetic and adquired haematological disorders, the dental implications of cardiovascular disease and hospital dentistry. Document Type: Article Record 32 of 98 Title: Correlation between oral health in disabled children and depressive symptoms in their mothers Author(s): D'Alessandro, G (D'Alessandro, G.); Cremonesi, I (Cremonesi, I.); Alkhamis, N (Alkhamis, N.); Piana, G (Piana, G.) Source: EUROPEAN JOURNAL OF PAEDIATRIC DENTISTRY Volume: 15 Issue: 3 Pages: 303-308 Published: SEP 2014 Abstract: Aim The aim of this study was to evaluate the presence and degree of depressive symptoms in mothers of disabled children and to assess the correlation between maternal major depression risk and son/daughter oral health. Materials and methods A prospective study was conducted in 51 disabled children and their 51 mothers. In children dmft/DMFT values, food and/or sugar-sweetened consumption levels and daily tooth brushing frequency were evaluated. Depressive maternal symptoms were Measured by EDPS questionnaire: the questionnaire scores were converted into positive predictive values (PPV) that represented the risk of falling into major depression. A regression analysis was performed on the variables (statical significance was set at p value <= 0.05). Results Children (8.68 +/- 3.98 years old) average dmft/DMFT was 2.7 Fifty three percent of the mothers (38.37 +/- 6.04 years) were at risk for depression (PPV>60%), while depressive symptoms were already present in 25% of the subjects (PPV=100%). Discussion and conclusion Mothers of disabled Children are more likely to fall into major depression compared to mothers of healthy children. For each mother-child couple the correlation between different variables was evaluated: there was a statistically significant Correlation between children's dmft/ DMFT values and mothers' depression risk. The risk of maternal depression was statistically correlated to prevalence of caries and sugar consumption in children. Document Type: Article Record 33 of 98 Title: Association between anticonvulsant drugs and teeth-grinding in children and adolescents with cerebral palsy Author(s): Ortega, AOL (Ortega, A. O. L.); Dos Santos, MTBR (Dos Santos, M. T. B. R.); Mendes, FM (Mendes, F. M.); Ciamponi, AL (Ciamponi, A. L.) Source: JOURNAL OF ORAL REHABILITATION Volume: 41 Issue: 9 Pages: 653-658 DOI: 10.1111/joor.12185 Published: SEP 2014 Abstract: The relation between teeth-grinding and the use of drugs acting on the central nervous system of cerebral palsy (CP) patients has not yet been described. The aim of this research was to evaluate the presence or absence of teeth-grinding (sleep and/or awake periods) in normal and in CP children and adolescents, as well as the association of teeth-grinding and use of anticonvulsant drugs. The sample consisted of 207 children and adolescents, divided into three groups: G1, individuals with CP who did not take anticonvulsant drugs; G2, individuals with CP administered medications on a regular basis; and CG, normal individuals. Logistic regression analyses were performed to evaluate the association of teeth- grinding with some variables. No significant statistical differences were observed regarding the presence or absence of teeth-grinding when G1 and G2 were compared. However, compared with the CG, a statistically significant difference was determined, with the CG showing fewer children presenting teeth-grinding (P < 0.001). Among those children/adolescents prescribed drug therapy, the barbiturate group showed a greater frequency of teeth-grinding. CP children and adolescents show a greater and significant presence of grinding of the teeth compared with normal individuals. Subjects taking barbiturate drugs showed greater presence of teeth-grinding, than those who were taking medications from the other groups of anticonvulsant drugs. Document Type: Article Record 34 of 98 Title: Oral health status and behaviours of children with Autism Spectrum Disorder: a case-control study Author(s): El Khatib, AA (El Khatib, Amira A.); El Tekeya, MM (El Tekeya, Magda M.); El Tantawi, MA (El Tantawi, Maha A.); Omar, T (Omar, Tarek) Source: INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY Volume: 24 Issue: 4 Pages: 314-323 DOI: 10.1111/ipd.12067 Published: JUL 2014 Abstract: Background. Autism Spectrum Disorder (ASD) is a lifelong neuro- developmental disorder characterized by abnormalities in social interactions and communication and by stereotyped, repetitive activities. Purpose. Assess the oral health status and behaviours of children with ASD. Methods. The study included 100 children with ASD and 100 healthy children from Alexandria, Egypt. Data were collected using a questionnaire and clinical examination. Questionnaire assessed socio-demographics, medical history, dental history, oral hygiene, dietary habits, and presence of self-injurious behaviours. Clinical examination assessed behaviour during examination, gingival condition, plaque accumulation, caries, and other oral conditions. Results. Children with ASD had significantly poorer oral hygiene and gingival condition than healthy children (P < 0.001 for both). No significant differences were found in caries prevalence or experience in primary or permanent dentition. More children with ASD behaved 'negatively' or 'definitely negatively' (37% and 11%) than did healthy controls (11% and 2%) (P < 0.0001). Self-injurious behaviour and bruxism were more practised by children with ASD (32% of children with ASD and 2% of healthy children, P < 0.001). More children with ASD had difficulty in accessing dental care (P = 0.002). Conclusions. The oral condition of children with ASD might increase the risk of developing dental diseases. Their behaviour and life factors may complicate provision of services and limit access to dental care. Therefore, individualized oral health education programmes should be implemented for those children. Document Type: Article Record 35 of 98 Title: AUTISM SPECTRUM DISORDERS: AN UPDATE ON ORAL HEALTH MANAGEMENT Author(s): Gandhi, RP (Gandhi, Roopa P.); Klein, U (Klein, Ulrich) Source: JOURNAL OF EVIDENCE-BASED DENTAL PRACTICE Volume: 14 Pages: 115-126 DOI: 10.1016/j.jebdp.2014.03.002 Supplement: S Published: JUN 2014 Abstract: Dental professionals caring for patients with a diagnosis of autism spectrum disorder (ASD) will need to provide oral health care based on a family-centered approach that involves a comprehensive understanding of parental concerns and preferences, as well as the unique medical management, behaviors, and needs of the individual patient. Background With the rising prevalence of autism spectrum disorders (ASD), oral health providers will find themselves increasingly likely to care for these patients in their daily practice. The purpose of this article is to provide a comprehensive update on the medical and oral health management of patients with autism spectrum disorders. Methods The authors conducted a literature review by searching for relevant articles written in English in the PubMed database pertaining to the medical and oral health management of autism, including caries status, preventive, behavioral, trauma, and restorative considerations. Conclusions A detailed family centered approach based on parental preferences and concerns, the patient's challenging behaviors, and related comorbidities can serve to improve the treatment planning and oral health management of dental patients with ASD. Document Type: Article Record 36 of 98 Title: Children with Special Health Care Needs: Exploring the Relationships between Patients' Level of Functioning, Their Oral Health, and Caregivers' Oral Health-related Responses Author(s): Petrova, EG (Petrova, Elena G.); Hyman, M (Hyman, Michael); Estrella, MRP (Estrella, Maria Regina Padilla); Inglehart, MR (Inglehart, Marita R.) Source: PEDIATRIC DENTISTRY Volume: 36 Issue: 3 Pages: 233-239 Published: MAY-JUN 2014 Abstract: Purpose: The purposes of this study were to increase dentists' understanding of how to best engage parents and their children with special health care needs (SHCN) in oral health promotion efforts and explore the relationships between these patients' level of functioning. and oral health and their parents' comfort concerning oral health promotion. Methods: Survey data were collected from 154 caregivers of SHCN children. Children's oral health data were obtained from their clinical charts. Results: The patients' level of functioning ranged from the lowest to the highest regarding their ability to listen/understand, talk, relate to others, care for themselves, play with others, and participate in physical activities. Children's gingival health was correlated with their ability to talk (r=-.12; P<.05). Their oral hygiene score correlated with their ability to talk (r=.18; P<.05) and their skills in social play interactions (r=.21; P<.05). The parents' comfort level concerning oral health promotion correlated positively with their child's level of functioning. Parents' interest in receiving oral health instruction correlated positively with their child's level of functioning. Conclusions: Understanding patient's level of functioning might predict the degree to which parents actually engage in oral health promotion efforts and are interested in oral health-related education. Document Type: Article Record 37 of 98 Title: Dentition Abnormalities in a Timothy Syndrome Patient With a Novel Genetic Mutation: A Case Report Author(s): Papineau, SD (Papineau, Scott D.); Wilson, S (Wilson, Stephen) Source: PEDIATRIC DENTISTRY Volume: 36 Issue: 3 Pages: 245-249 Published: MAY-JUN 2014 Abstract: The purpose of this paper was to present the case of a two-year- old male diagnosed with Timothy syndrome who presented with generalized enamel defects in the primary dentition. Timothy syndrome is an autosomal dominant condition characterized by a de novo missense mutation in the Ca(v)1.2 L-type calcium channel CACNA1C. Timothy syndrome patients present with multiple clinical manifestations, including: cardiac arrhythmias; syndactyly; immune deficiency; intermittent hypoglycemia; and neurologic issues, including seizures, mental retardation, hypotonia, and autism. Craniofacial abnormalities reported include: low-set ears; flat nasal bridge; small upper jaw; thin upper lip; round face; and baldness at birth. Abnormalities in the dentition have been reported, including small, misplaced teeth with poor enamel and severe caries. At present, there is no thorough description of the dental abnormalities seen in a patient with Timothy syndrome. Document Type: Article Record 38 of 98 Title: A new indicator of the oral hygiene habits of disabled persons: relevance of the carer's personal appearance and interest in oral health Author(s): Limeres, J (Limeres, J.); Martinez, F (Martinez, F.); Feijoo, JF (Feijoo, J. F.); Ramos, I (Ramos, I.); Linares, A (Linares, A.); Diz, P (Diz, P.) Source: INTERNATIONAL JOURNAL OF DENTAL HYGIENE Volume: 12 Issue: 2 Pages: 121-126 DOI: 10.1111/idh.12033 Published: MAY 2014 Abstract: Objective To investigate whether there is a relationship between the oral hygiene habits of individuals with severe disability the carer's personal appearance and interest in oral health. Patients and methods The study group was formed of 60 disabled persons and their respective carers who came for the first time to consultation in the Special-Needs Dentistry Unit of the University of Santiago de Compostela, Spain. All the carers answered a standardised questionnaire of 28 questions divided into four sections: disabled individual's demographic data, disabled individual's general medical details, social aspects of the carer (personal appearance of the carer and interest in oral health), and disabled individual's oral hygiene habits. The personal appearance of the carers and their interest in the disabled individual's oral health were evaluated using independent scales designed specifically for the study, with five binary items in each scale. Results The carer's personal appearance and interest in the disabled individual's oral health showed a statistically significant relationship with the individual's oral hygiene habits, particularly with respect to the frequency and duration of toothbrushing, need for physical restraint during toothbrushing, use of a manual toothbrush and use of toothpaste. Conclusions The carer's personal appearance and interest in the disabled individual's oral health are good indicators of the oral hygiene habits of an individual with severe disability. Consideration should be given to the inclusion of these aspects as a complementary element of the dental record. Document Type: Article Record 39 of 98 Title: Specialist management of routine dental procedures in adults with refractory epilepsy Author(s): Ransford, N (Ransford, N.); Soryal, I (Soryal, I.); McCorry, D (McCorry, D.); Sander, JW (Sander, J. W.); Duncan, F (Duncan, F.); Huggins, N (Huggins, N.) Source: BRITISH DENTAL JOURNAL Volume: 216 Issue: 7 Pages: 403-407 DOI: 10.1038/sj.bdj.2014.247 Published: APR 2014 Abstract: Little published information exists about the management of dental treatment procedures for people with epilepsy who, despite their medication, continue to have seizures. This paper draws on relevant literature in neurology and anaesthetics to provide a multi-speciality consensus on methods of assessment and adjunctive treatment options in order to manage the risk of a clinically significant seizure occurring during a procedure. It aims to enhance current guidelines and practice in the provision of specialist care for this diverse group. Document Type: Article Record 40 of 98 Title: Occurrence of oral trauma in young epileptic patients Author(s): Gerreth, K (Gerreth, K.); Gerreth, P (Gerreth, P.) Source: EUROPEAN JOURNAL OF PAEDIATRIC DENTISTRY Volume: 15 Issue: 1 Pages: 13-16 Published: MAR 2014 Abstract: Aim People with reduced efficiency, as well as those who experience seizures, are prone to traumatic injuries within the facial skeleton. This study aimed to evaluate the incidence of traumatic injuries of the oral cavity in epileptic children and youths from special-care schools. Materials and methods The study was carried out in children and youths with intellectual disability attending special-care schools in the city of Poznan (Poland). The study group comprised 63 epileptic students (31 female and 32 male), aged 6-20 years. Information on disease prevalence was obtained from medical records. The control group consisted of 63 students (23 female and 40 male), aged 7-20 years, not suffering from epilepsy, randomly selected from individuals in the same schools. The examination included assessment of dental traumatic injuries (crown fracture or traumatic tooth loss). Statistics: For statistical analysis relating to differences in the occurrence of injuries of teeth between epileptic subjects and control group, the chi-square test was used, but in case of a low number of observations, chi-square with Yates's correction. Results Crown's fracture of permanent teeth was reported in 10 subjects (15.9% of all patients), which involved 13 permanent incisors. Tooth loss as a result of the injury was seen only in one 14-year-old subject. However, in the control group, symptoms of crown's fracture were found in six permanent teeth in 4 patients (6.4% of all subjects). Conclusion It is necessary to provide appropriate dental care to epileptic patients because Of the risk of injuries and the need for a special prosthoclontic rehabilitation. Document Type: Article Record 41 of 98 Title: Caries Experience and Overall Health Status Author(s): Johnston, L (Johnston, Lindsay); Vieira, AR (Vieira, Alexandre R.) Source: ORAL HEALTH & PREVENTIVE DENTISTRY Volume: 12 Issue: 2 Pages: 163-170 DOI: 10.3290/j.ohpd.a31670 Published: 2014 Abstract: Purpose: The aim of this work was to evaluate whether self- reported systemic diseases were associated with caries experience. Materials and Methods: Medical history data and caries experience (DMFT and DMFS; Decayed, Missing due to caries, Filled Teeth/Surface) were obtained from the University of Pittsburgh School of Dental Medicine dental registry and DNA repository. Information on 1,281 subjects was evaluated (839 with primary caries and 492 with secondary caries experience). Regression analysis was used to test for association between caries experience and disease status. Results: Associations were found between caries experience and specific conditions: stroke (R-2 = 0.007, P = 0.001), asthma (R-2 = 0.003, P = 0.025), hepatitis (R-2 = 0.009, P = 0.0001), liver disease (R-2 = 0.009, P = 0.00001), high blood pressure (R-2 = 0.072, P = 0.00001) and diabetes (R2 = 0.03, P = 0.00001). We found primary caries to be associated with hepatitis (DMFT with R-2 = 0.011, P = 0.002 and DMFS with R-2 = 0.008, P = 0.006). We also found an association between secondary caries and asthma (DMFS with R-2 = 0.006, P = 0.04), high blood pressure (DMFT with R-2 = 0.014, P = 0.005 and DMFS with R-2 = 0.043, P = 0.00001) and diabetes (DMFT with R-2 = 0.013, P = 0.007 and DMFS with R-2 = 0.023, P = 0.00001). Conclusion: Hepatitis, asthma, high blood pressure, stroke, liver disease and diabetes are associated with higher caries experience. Document Type: Article Record 42 of 98 Title: A toothbrush impalement injury of the floor of mouth in autism child Author(s): Sasaki, R (Sasaki, Ryo); Uchiyama, H (Uchiyama, Hiroto); Okamoto, T (Okamoto, Toshihiro); Fukada, K (Fukada, Kenji); Ogiuchi, H (Ogiuchi, Hideki); Ando, T (Ando, Tomohiro) Source: DENTAL TRAUMATOLOGY Volume: 29 Issue: 6 Pages: 467-468 DOI: 10.1111/j.1600-9657.2012.01116.x Published: DEC 2013 Abstract: - Penetrating injuries in the oral cavity are common in children. However, penetrating injuries with retained foreign bodies are rare. We report a case of a toothbrush impalement injury of the floor of the mouth in a child with autism. A 5-year-old boy with autism presented with an accidentally impaled toothbrush in the oral cavity. He was taken to the operation room and examined under general anesthesia. The handle of the toothbrush was cut off using rib scissors for mask ventilation, and intra- oral intubation was performed. The toothbrush was located approximately 2.5cm into the floor of the mouth. The toothbrush was removed uneventfully. Intravenous antibiotic therapy was instituted during hospitalization, and discharge from the hospital occurred 4days after the operation. Document Type: Article Record 43 of 98 Title: Management of children with autism spectrum disorder in the dental setting: Concerns, behavioural approaches and recommendations Author(s): Delli, K (Delli, Konstantina); Reichart, PA (Reichart, Peter A.); Bornstein, MM (Bornstein, Michael M.); Livas, C (Livas, Christos) Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL Volume: 18 Issue: 6 Pages: E862-E868 Article Number: 19084 DOI: 10.4317/medoral.19084 Published: NOV 2013 Abstract: Objectives: This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. Material and Methods: The MEDLINE database was searched using the terms 'Autistic Disorder', 'Behaviour Control/methods', 'Child', 'Dental care for disabled', 'Education', 'Oral Health', and 'Pediatric Dentistry' to locate related articles published up to January 2013. Results: Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs. Document Type: Article Record 44 of 98 Title: Antiepileptic drugs (AEDs) during pregnancy and risk of congenital jaw and oral malformation Author(s): Koo, J (Koo, J.); Zavras, A (Zavras, A.) Source: ORAL DISEASES Volume: 19 Issue: 7 Pages: 712-720 DOI: 10.1111/odi.12061 Published: OCT 2013 Abstract: In the United States, an estimate of 1.3million women suffering from epilepsy are in their childbearing age. Potential teratogenicity of antiepileptic drugs (AEDs) is of concern to these women considering pregnancy because discontinuing pharmacotherapy during pregnancy may not be advised due to the risk of seizures that may be dangerous to the mother as well as the fetus. Using a Relational Online Analytical Processing (ROLAP) software licensed by Simultek, we searched for medications reported for congenital jaw and oral cavity malformation on the FDA Adverse Event Reporting System (AERS), a voluntary adverse event reporting program that contains over 55 million adverse event reports of medical products in the United.States. Our results indicate that various forms of valproic acid, and more importantly, newer generation antiepileptic agents including lamotrigine, topiramate, and gabapentin show signals for either congenital jaw or oral malformation. Although teratogenic potential of valproic acid has long been confirmed, information on teratogenicity of the newer generation antiepileptic drugs is relatively scarce and inconclusive. Early safety signals on the teratogenic potential of AEDs detected in this study are crude statistics that do not establish causation nor exclude confounding. The results require validation and further investigation via properly controlled epidemiological studies. Document Type: Article Record 45 of 98 Title: Oral Care and Sensory Over-responsivity in Children with Autism Spectrum Disorders Author(s): Stein, LI (Stein, Leah I.); Polido, JC (Polido, Jose C.); Cermak, SA (Cermak, Sharon A.) Source: PEDIATRIC DENTISTRY Volume: 35 Issue: 3 Pages: 230-235 Published: MAY-JUN 2013 Abstract: Purpose: The purpose of this study was to investigate the relationship between sensory sensitivities and oral care difficulties in children with autism spectrum disorders (ASDs) or typical development (TD). Methods: Participants included 396 parents of 2- to 18-year-old children with ASDs or TD who completed a questionnaire about oral care in the home and dental office. Descriptive and bivariate analyses were conducted to examine the association between sensory sensitivities and oral care variables. Results: Both hypotheses were supported: (1) ASDs children vs. TD children were reported to have a significantly greater prevalence of sensory over-responsivity across all sensory domains; and (2) ASDs children characterized as "sensory over-responders" exhibited a significantly greater prevalence of oral care difficulty in the home and dental office vs. ASDs children who responded more typically to sensory stimuli ("sensory not over-responders"). Conclusions: This study provides further evidence for the impact of sensory processing problems on oral care, both in the home and dental office. Methods to best serve children with autism spectrum disorders may include strategies that alter the sensory characteristics of the dental environment as well as interventions to reduce children's sensory sensitivities. Document Type: Article Record 46 of 98 Title: Evaluation of sedation in oral and maxillofacial surgery in ambulatory patients: failure and complications Author(s): Senel, AC (Senel, Ahmet Can); Altintas, NY (Altintas, Nuray Yilmaz); Senel, FC (Senel, Figen Cizmeci); Pampu, A (Pampu, Alper); Tosun, E (Tosun, Emre); Ungor, C (Ungor, Cem); Dayisoylu, EH (Dayisoylu, Ezher Hamza); Tuzuner, T (Tuzuner, Tamer) Source: ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY Volume: 114 Issue: 5 Pages: 592-596 DOI: 10.1016/j.oooo.2012.03.008 Published: NOV 2012 Abstract: Objectives. This study evaluated the failure and complication rates of sedation in ambulatory patients undergoing oral and maxillofacial surgery. Materials and Methods. This retrospective cohort study was carried out among 619 patients who had undergone maxillofacial surgical procedures under intravenous sedation with midazolam and fentanyl. Each patient's age, American Society of Anesthesiologists (ASA) classification, systemic condition, surgical procedure, complications, and failures were recorded for evaluation. Results. A total of 400 patients with ASA I, 199 with ASA II, and 20 with ASA III between the ages of 9 months and 84 years were included in the study. The most common systemic disorders in our patients were mental retardation (35%), hypertension (19%), and epilepsy (15%). Evaluation of the cases revealed 9 complications (1.4%) and 9 sedation failures (1.4%). The complications were bradycardia, postoperative agitation and hallucination, drug reaction, vomiting and nausea, desaturation, and hypotension. Conclusions. Our results in the oral and maxillofacial surgery clinic revealed low complication and failure rates. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:592-596) Document Type: Article Record 47 of 98 Title: Three- to 21-year-old Patients with Autism Spectrum Disorders: Parents' Perceptions of Severity of Symptoms, Oral Health, and Oral Health-related Behavior Author(s): Weil, TN (Weil, Taryn N.); Inglehart, MR (Inglehart, Marita Rohr) Source: PEDIATRIC DENTISTRY Volume: 34 Issue: 7 Pages: 473-479 Published: NOV-DEC 2012 Abstract: Purpose: The purpose was to explore the relationship between the level of functioning (listening/talking/reading/daily self-care/care at home/social skills) of three to 21-year-old patients with autism spectrum disorders (ASDs) and their oral health and oral health-related behavior (brushing, flossing, dental visits). Methods: Survey data were collected from 85 parents of ASD patients. Patients' level of functioning was determined with a short version of the Survey Interview Form of the Vineland Adaptive Behavior Scales (2nd edition). Results: The patients ranged from very low to high levels of functioning. Oral health correlated with the ability to: listen (r=.53; P<.001); talk (r=.40; P<.001); read (r=.30; P<.01); engage in daily self-care (r=.36; P<.001); engage in care at home (r=.44; P<.001); and demonstrate social skills (r=.36; P<.001). The parents' comfort levels concerning brushing and flossing their children's teeth and taking their children to the dentist varied considerably and correlated with children's level of functioning. Frequency of tooth- brushing correlated with listening skills (r=.31; P<.01); the frequency of flossing correlated with the ability to talk (r=.31; P<.01). Conclusions: Understanding the relationships between level of functioning of children with ASDs and their oral health and oral health-related behavior could increase dentists' ability to provide the best possible care for these patients. Document Type: Article Record 48 of 98 Title: Preferences of Parents of Children with Autism Spectrum Disorders Concerning Oral Health and Dental Treatment Author(s): Capozza, LE (Capozza, Lauren E.); Bimstein, E (Bimstein, Enrique) Source: PEDIATRIC DENTISTRY Volume: 34 Issue: 7 Pages: 480-484 Published: NOV-DEC 2012 Abstract: Purpose: The purpose of this study was to describe the preferences of parents of children with or without autism spectrum disorders (ASDs) concerning oral health and dental treatment. Methods: A questionnaire that queried demographics, dental needs, perceptions of dental materials and treatments, and parental concerns regarding relevant ASD issues in medicine and dentistry was distributed in the waiting rooms of a pediatric dental Clinic and an autism clinic to parents or legal guardians of children undergoing treatment. The responses for the children with or without ASDs were compared. Results: Statistically significant differences between the ASDs (N=23 and non-ASDS (N=33) groups existed for: parental age; frequency of dental visits per year; supervision of tooth- brushing; and use of a fluoridated toothpaste. Statistically insignificant differences were found in attitudes toward: amalgam; composite; fluoride products; or behavior guidance techniques. Conclusions: Parents or legal guardians of children with autism spectrum disorders are likely to have special beliefs and preferences regarding dental materials and dental behavior guidance. Document Type: Article Record 49 of 98 Title: Oral Care Experiences and Challenges in Children with Autism Spectrum Disorders Author(s): Stein, LI (Stein, Leah I.); Polido, JC (Polido, Jose C.); Najera, SOL (Najera, Sandy Oliver Lopez); Cermak, SA (Cermak, Sharon A.) Source: PEDIATRIC DENTISTRY Volume: 34 Issue: 5 Pages: 387-391 Published: SEP-OCT 2012 Abstract: Purpose: The purpose of this study was to investigate the differences between children with autism spectrum disorders (ASD) and their typically developing peers in relation to aspects of oral care. Methods: Participants included 396 parents of ASD children or typically developing 2- to 18-year-olds. Parents completed a 37-item questionnaire designed by authors to elicit information about oral core in the home and dental office. Descriptive, bivariate, and multivariate regression analyses were conducted to examine the association between diagnostic group and oral care variables. Results: Significantly more parents of ASD children than parents of typically developing children reported difficulty across almost all oral care variables explored, including oral care in the home, oral core at the dentist, and access to oral care. Following multivariate regression to control for possible confounders including age, gender, Hispanic status, and paternal education level all previously significant variables remained significant. Conclusion: This study indicates that children with autism spectrum disorders experience greater difficulties and barriers to care in both the home and dental office settings than their typically developing peers. Document Type: Article Record 50 of 98 Title: Salivary antioxidants and oral health in children with autism Author(s): Rai, K (Rai, Kavita); Hegde, AM (Hegde, Amitha M.); Jose, N (Jose, Nijo) Source: ARCHIVES OF ORAL BIOLOGY Volume: 57 Issue: 8 Pages: 1116- 1120 DOI: 10.1016/j.archoralbio.2012.03.006 Published: AUG 2012 Abstract: Individuals with autism vary widely in abilities, intelligence, and behaviours. Autistic children have preferences for soft and sweetened food making them susceptible to caries. A wide spectrum of medical and behavioural symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Mental retardation is evident in approximately 70% of individuals with autism and most psychiatric disorders including autism are associated with increased oxidative stress. Objectives: To evaluate the oral health status of children with autism and to determine the salivary pH and total salivary antioxidant concentration (TAC). Materials and methods: 101 subjects with autism between age group of 6 and 12 year were part of the study and 50 normal healthy siblings of same age group were taken as control group. Oral health status was analysed using oral hygiene index-simplified and dentition status index. The salivary total anti-oxidant level was estimated using phosphomolybdic acid using spectrophotometric method and the salivary pH using the pH indicating paper. The results were statistically analyzed using Mann-Whitney U test. Results: A statistically very highly significant difference was seen in the mean oral hygiene index scores (autistic group-1.2 and control group-1, P < 0.001) and the mean salivary total antioxidant concentration (autistic group - 5.71 mu g/ml and control group - 38 mu g/ml, P < 0.001). No statistical significant difference was observed in the dental caries status and the salivary pH of autistic group and the control group. Conclusions: Similar dental caries status was observed in children with autism and their healthy normal siblings. Oral hygiene was poor in children with autism whereas the Salivary TAC was significantly reduced in autistic children. (C) 2012 Elsevier Ltd. All rights reserved. Document Type: Article Record 51 of 98 Title: Gingival overgrowth in partially edentulous ridges in an elderly female patient with epilepsy: a case report Author(s): Dhingra, K (Dhingra, Kunaal); Prakash, S (Prakash, Shobha) Source: GERODONTOLOGY Volume: 29 Issue: 2 Pages: E1201-E1206 DOI: 10.1111/j.1741-2358.2012.00624.x Published: JUN 2012 Abstract: Background: Drug-influenced gingival overgrowth is an unaesthetic overgrowth of gingiva principally associated with intake of drugs like phenytoin, cyclosporin A and nifedipine. Its occurrence in both dentate and edentulous regions of oral cavity is poorly understood. Objectives: This report highlights clinical and histological description, aetiology and management of gingival overgrowth in a partially edentulous (non-denture wearer) 60-year-old female patient with epilepsy on phenytoin and phenobarbital drugs from past 7 years. Materials and methods: Patient's intraoral examination revealed lobulated and fibrotic consistency gingival overgrowth around teeth and on partially edentulous ridges of upper and lower arches along with generalised tooth mobility. Under medical consultation, full mouth extraction, surgical excision of overgrowth followed by complete denture rehabilitation and replacement of combination drugs with sodium valproate were accomplished. Results: Histologically, the lesion showed fibro-epithelial hyperplasia. Clinical results after 6 months demonstrated almost complete resolution of gingival overgrowth. Conclusion: The findings of present case suggest that gingival overgrowth can occur even in partially edentulous ridges (not exposed to denture wear) that could be due to persistence of gingival overgrowth, which may not resolve completely following tooth extraction or occurs because of incorporation of specific subpopulation of gingival fibroblasts in alveolar ridge mucosa. Document Type: Article Record 52 of 98 Title: Oral manifestations in a group of adults with autism spectrum disorder Author(s): Orellana, LM (Orellana, Lorena-Mirtala); Silvestre, FJ (Silvestre, Francisco-Javier); Martinez-Sanchis, S (Martinez-Sanchis, Sonia); Martinez- Mihi, V (Martinez-Mihi, Victoria); Bautista, D (Bautista, Daniel) Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL Volume: 17 Issue: 3 Pages: E415-E419 Article Number: 17573 DOI: 10.4317/medoral.17573 Published: MAY 2012 Abstract: Objective: A number of studies have evaluated the oral health of patients with autism spectrum disorder (ASD), though most have involved children, and no specific oral manifestations have been described. The present study describes the buccodental disorders and hygiene habits in a group of adults with ASD. Study Design: A prospective case-control study was made of a group of patients with ASD (n=30), with a mean age of 27.7 +/- 5.69 years, and of a healthy age-and gender-matched control group (n=30). An evaluation was made of the medical history, medication, oral hygiene habits and oral diseases, with determination of the CAOD, CAOS and OHI-S oral hygiene scores. Results: Most of the patients in the ASD group used two or more drugs and were assisted in brushing 2-3 times a day. The most frequent manifestations were bruxism, self-inflicted oral lesions and certain malocclusions. The CAOD and CAOS scores were significantly lower than in the controls. Conclusions: Adults with ASD and assisted dental hygiene presented fewer caries than the non-disabled population. However, bruxism, ogival palate and anterior open bite were frequent in the patients with ASD. Document Type: Article Record 53 of 98 Title: Suberoylanilide Hydroxamic Acid Enhances Odontoblast Differentiation Author(s): Kwon, A (Kwon, A.); Park, HJ (Park, H. -J.); Baek, K (Baek, K.); Lee, HL (Lee, H. -L.); Park, JC (Park, J. -C.); Woo, KM (Woo, K. M.); Ryoo, HM (Ryoo, H. -M.); Baek, JH (Baek, J. -H.) Source: JOURNAL OF DENTAL RESEARCH Volume: 91 Issue: 5 Pages: 506- 512 DOI: 10.1177/0022034512443367 Published: MAY 2012 Abstract: Previous studies have shown that histone deacetylase (HDAC) inhibitors stimulate osteoblast differentiation in vitro and bone formation in vivo. However, the effects of HDAC inhibitors on odontoblasts have not been elucidated. Therefore, in this study, we examined the effect of suberoylanilide hydroxamic acid (SAHA), an HDAC inhibitor, on odontoblast differentiation using an MDPC23 odontoblast-like cell line. SAHA significantly enhanced matrix mineralization and the expression levels of odontoblast marker genes. SAHA increased the expression levels of nuclear factor I/C (Nfic) and dentin sialophosphoprotein (Dspp). Nfic bound directly to the Dspp promoter and stimulated Dspp transcription. SAHA increased both basal and Nfic-induced Dspp promoter activity. SAHA- induced Dspp promoter activity disappeared when mutations were introduced within the Nfic binding element of the Dspp promoter. Nfic knockdown by siRNA blocked SAHA stimulation of Dspp expression. These results indicate that SAHA enhances odontoblast differentiation and that SAHA increases Dspp expression, at least in part, by increasing the expression level of Nfic. Document Type: Article Record 54 of 98 Title: Phenytoin- and amlodipine-induced gingival overgrowth Author(s): Chang, CW (Chang, Ching-Wen); Yang, CJ (Yang, Chih-Jen); Lai, YL (Lai, Yu-Lin) Source: JOURNAL OF DENTAL SCIENCES Volume: 7 Issue: 1 Pages: 85-88 DOI: 10.1016/j.jds.2012.01.013 Published: MAR 2012 Abstract: Drug-induced gingival overgrowth is an adverse event associated with three types of drugs, i.e., anticonvulsants, immunosuppressants, and calcium-channel blockers. It was shown that the combined use of an immunosuppressant (cyclosporine) and a calcium-channel blocker increases the prevalence and severity of gingival overgrowth. However, few reports discussed the effects of the combination of an anticonvulsant (phenytoin) and a calcium-channel blocker (amlodipine). In this case report, we present an epilepsy patient who was using both phenytoin and amlodipine, which caused extensive gingival overgrowth. After periodontal treatment and a gingivectomy, the gingival overgrowth was significantly reduced. A postoperative drug-substitution regimen and intensive professional care ensured a stable result 1 year after surgery. Copyright (c) 2012, Association for Dental Sciences of the Republic of China. Published by Elsevier Taiwan LLC. All rights reserved. Document Type: Article Record 55 of 98 Title: Vagus nerve stimulation therapy (VNST) in epilepsy - implications for dental practice Author(s): Lisowska, P (Lisowska, P.); Daly, B (Daly, B.) Source: BRITISH DENTAL JOURNAL Volume: 212 Issue: 2 Pages: 69-72 DOI: 10.1038/sj.bdj.2012.47 Published: JAN 2012 Abstract: Epilepsy is a chronic condition which affects about 1% of the population. It is important that the dental team is aware of the management of epileptic seizures and epileptic syndromes including recent advances in seizure management. As people with epilepsy often get a warning aura before seizures begin, the management of the condition has increasingly involved measures to prevent the seizure, once the aura has begun. Vagus nerve stimulation therapy (VNST) in epilepsy involves the use of an implantable electronic device and is being increasingly used in the UK to control severe treatment resistant epilepsy. As a result, more patients will be presented to clinicians in the primary healthcare setting and hospital services with these devices in place. Members of the dental team need to understand the principles of epilepsy control, how VNST is used in the management of intractable epilepsy, how the VNST system operates and the implications of VNST use for dental practice including medical devices, interactions and safety features. Document Type: Article Record 56 of 98 Title: The Effects of Antiepileptic Drugs on Oral Health Author(s): Cornacchio, ALP (Cornacchio, Angelica Lee Petrina); Burneo, JG (Burneo, Jorge G.); Aragon, CE (Aragon, Cecilia E.) Source: JOURNAL OF THE CANADIAN DENTAL ASSOCIATION Volume: 77 Pages: 1-8 Article Number: b140 Published: DEC 2 2011 Abstract: Objective: Long-term use of phenytoin (PHT) causes gingival hyperplasia; however, little is known about the oral side effects of other antiepileptic drugs (AEDs). Through a systematic review of the literature, we explored the effects of AEDs on the oral health of patients with epilepsy. Methods: We searched PubMed, EMBASE and the Cochrane library between January 1963 and August 2010. The search strategy retrieved 170 abstracts. We included studies that involved original research and had >= 10 patients in our review. We also checked the reference lists of reviews, letters and other manuscripts to find studies that met our selection criteria. Results: Only 15 articles were included in the final analysis. Gingival hyperplasia was very common in patients taking PHT (16%-94% of patients). Alveolar bone loss occurred in patients taking carbamazepine or PHT. Patients taking valproate, carbamazepine or phenobarbital also had gingival hyperplasia. We found no published studies of newer-generation AEDs. Conclusion: Although several studies examined the effects of PHT on oral health, none have studied those of the newer generation of AEDs. Studies exploring oral side effects of AEDs are needed. Document Type: Article Record 57 of 98 Title: Oral Health Status of Autistic Children in India Author(s): Subramaniam, P (Subramaniam, P.); Gupta, M (Gupta, M.) Source: JOURNAL OF CLINICAL PEDIATRIC DENTISTRY Volume: 36 Issue: 1 Pages: 43-47 Published: FAL 2011 Abstract: Autism is one of the most severe childhood neuropsychiatric disorders. Autistic individuals are characterized by impairment in social interaction with a restricted range of interests and often, stereotyped repetitive behaviors. Studies on oral health conditions in children with autism are sparse. The complicated disability itself makes clinical research difficult. Aim: The need for baseline information regarding the oral health status of children with autism is essential. Method: The present study assessed the oral health status of 106 autistic children aged 4 to 15 years in Bangalore city, India. The dental caries was recorded according to the WHO criteria; oral hygiene was assessed using the Oral Hygiene Index- Simplified (OHI-S) and its modification for deciduous dentition. The behavior of children towards dental treatment was also assessed using the Frankel's behavior rating scale. Data obtained was subjected to statistical analysis. Results showed that caries experience among autistic children was lower; however they were found to have more debris and calculus deposits. Conclusions: Negative behavior towards dental treatment was seen in autistic children. Document Type: Article Record 58 of 98 Title: CHILDREN WITH AUTISM Author(s): Limeres, JR (Referen Limeres, Jacobo); Feijoo, JF (Feijoo, Javier F.); Diz, P (Diz, Pedro) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 142 Issue: 7 Pages: 793-794 Published: JUL 2011 Document Type: Letter Record 59 of 98 Title: CHILDREN WITH AUTISM Response Author(s): Hernandez, P (Hernandez, Purnima); Ikkanda, Z (Ikkanda, Zachary) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 142 Issue: 7 Pages: 794-795 Published: JUL 2011 Document Type: Letter Record 60 of 98 Title: A dental look at the autistic patient through orofacial pain Author(s): Zeidan-Chulia, F (Zeidan-Chulia, Fares); Gursoy, UK (Gursoy, Ulvi K.); Kononen, E (Kononen, Eija); Gottfried, C (Gottfried, Carmem) Source: ACTA ODONTOLOGICA SCANDINAVICA Volume: 69 Issue: 4 Pages: 193-200 DOI: 10.3109/00016357.2010.549505 Published: JUL 2011 Abstract: Autism is a neurodevelopmental disorder characterized by impaired social interaction and restricted interests, compromised communication skills, and repetitive patterns of behavior. Both social and behavioral problems, which may include hyperactivity and quick frustration, may hinder the detection of other important pathologies such as orofacial pain. This is aggravated by the invasive nature of oral exploration, which may trigger violent and self-injurious responses, such as temper tantrums and/or head banging, which make the work of professionals extremely difficult during diagnoses, follow-up examinations, and dental treatments. In addition, mercury-containing amalgams used to treat dental caries (the most common form of acute orofacial pain) have been associated with higher rates of severe autism in children. The purpose of this review is to describe the current state of the art regarding the co-occurrence of orofacial pain and autism spectrum disorder, and how these conditions may interrelate clinically and neurobiologically. Document Type: Review Record 61 of 98 Title: RESTORATION FRAGMENTS Author(s): Ghafoor, M (Ghafoor, M.); Halsnad, M (Halsnad, M.); Grew, N (Grew, N.); Asokan, S (Asokan, S.); Ajit, P (Ajit, P.) Source: BRITISH DENTAL JOURNAL Volume: 210 Issue: 12 Pages: 558-559 DOI: 10.1038/sj.bdj.2011.491 Published: JUN 2011 Document Type: Letter Record 62 of 98 Title: Dental caries experience, oral health status and treatment needs of dental patients with autism Author(s): Jaber, MA (Jaber, Mohamed Abdullah) Source: JOURNAL OF APPLIED ORAL SCIENCE Volume: 19 Issue: 3 Pages: 212-217 Published: MAY-JUN 2011 Abstract: Objectives: Autism is a lifelong neurodevelopmental disorder. The aims of this study were to investigate whether children with autism have higher caries prevalence, higher periodontal problems, or more treatment needs than children of a control group of non-autistic patients, and to provide baseline data to enable comparison and future planning of dental services to autistic children. Material and Methods: 61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai and Sharjah Autism Centers were selected for the study. The control group consisted of 61 non-autistic patients chosen from relatives or friends of autistic patients in an attempt to have matched age, sex and socioeconomic status. Each patient received a complete oral and periodontal examination, assessment of caries prevalence, and caries severity. Other conditions assessed were dental plaque, gingivitis, restorations and treatment needs. Chi-square and Fisher's exact test of significance were used to compare groups. Results: The autism group had a male-to-female ratio of 2.8:1. Compared to controls, children with autism had significantly higher decayed, missing or filled teeth than unaffected patients and significantly needed more restorative dental treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic children were 0.02 and 0.3, respectively. The majority of the autistic children either having poor 59.0% (36/61) or fair 37.8% (23/61) oral hygiene compared with healthy control subjects. Likewise, 97.0% (59/61) of the autistic children had gingivitis. Conclusions: Children with autism exhibited a higher caries prevalence, poor oral hygiene and extensive unmet needs for dental treatment than non-autistic healthy control group. Thus oral health program that emphasizes prevention should be considered of particular importance for children and young people with autism. Document Type: Article Record 63 of 98 Title: Prosthodontic treatment in a partially edentulous patient with a complex medical history of epilepsy and deep vein thrombosis: A case report Author(s): Kosyfaki, P (Kosyfaki, Panagiota); Woerner, W (Woerner, Wolf); Att, W (Att, Wael) Source: QUINTESSENCE INTERNATIONAL Volume: 42 Issue: 5 Pages: 365- 372 Published: MAY 2011 Abstract: This report describes the prosthodontic rehabilitation of a partially edentulous patient by means of a maxillary implant-supported removable dental prosthesis and mandibular telescopic crown prosthesis. Due to the patient's contributory medical history for epilepsy and deep vein thrombosis, clinical management considerations are outlined along with an evidence-based, medically oriented treatment sequence concerning the surgical and prosthodontic stages of the case. (Quintessence Int 2011;42:365-373) Document Type: Article Record 64 of 98 Title: Applied behavior analysis: Behavior management of children with autism spectrum disorders in dental environments Author(s): Hernandez, P (Hernandez, Purnima); Ikkanda, Z (Ikkanda, Zachary) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 142 Issue: 3 Pages: 281-287 Published: MAR 2011 Abstract: Background. There are a limited number of studies addressing behavior management techniques and procedural modifications that dentists can use to treat people with an autism spectrum disorder (ASD). Methods. The authors conducted a search of the dental and behavioral analytic literature to identify management techniques that address problem behaviors exhibited by children with ASDs in dental and other health-related environments. Results. Applied behavior analysis (ABA) is a science in which procedures are based on the principles of behavior through systematic experimentation. Clinicians have used ABA procedures successfully to modify socially significant behaviors of people with ASD. Basic behavior management techniques currently used in dentistry may not encourage people with cognitive and behavioral disabilities, such as ASD, to tolerate simple in-office dental procedures consistently. Instead, dental care providers often are required to use advanced behavior management techniques to complete simple in-office procedures such as prophylaxis, sealant placement and obtaining radiographs. ABA procedures can be integrated in the dental environment to manage problem behaviors often exhibited by children with an ASD. Conclusions. The authors found no evidence-based procedural modifications that address the behavioral characteristics and problematic behaviors of children with an ASD in a dental environment. Further research in this area should be conducted. Clinical Implications. Knowledge and in-depth understanding of behavioral principles is essential when a dentist is concerned with modifying behaviors. Using ABA procedures can help dentists manage problem behaviors effectively and systematically when performing routine dental treatment. Being knowledgeable about each patient's behavioral characteristics and the parents' level of involvement is important in the successful integration of the procedures and reduction of in-office time. Document Type: Article Record 65 of 98 Title: A Rare Case of Gingival Fibromatosis Associated with Hypertrichosis and a Dysmorphic Face Author(s): Kulkarni, P (Kulkarni, Parimala); Agrawal, N (Agrawal, Neeraj); Tyagi, S (Tyagi, Sanjeev); Kambalimath, H (Kambalimath, Halaswamy) Source: JOURNAL OF CLINICAL PEDIATRIC DENTISTRY Volume: 35 Issue: 3 Pages: 305-308 Published: SPR 2011 Abstract: Several forms of hypertrichosis have been described with and without gingival hyperplasia; some of them are recognized as genetic disorder and associated with syndromes. In all reported cases the most striking differences from other are the craniofacial features. We present a case of a 6-year-old boy with hypertrichosis associated with gingival hyperplasia and a characteristic, coarse face and we consider this case to be a distinctive entity. Document Type: Article Record 66 of 98 Title: DENTISTRY AND AUTISM Author(s): Barnes, VM (Barnes, Virginia Monsul) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 142 Issue: 2 Pages: 126-126 Published: FEB 2011 Document Type: Letter Record 67 of 98 Title: DENTISTRY AND AUTISM response Author(s): Rada, RE (Rada, Robert E.) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 142 Issue: 2 Pages: 126-127 Published: FEB 2011 Document Type: Letter Record 68 of 98 Title: Unmet Dental Needs and Barriers to Care for Children with Significant Special Health Care Needs Author(s): Nelson, LP (Nelson, Linda P.); Getzin, A (Getzin, Anne); Graham, D (Graham, Dionne); Zhou, J (Zhou, Jing); Wagle, EM (Wagle, Elke M.); McQuiston, J (McQuiston, Jessie); McLaughlin, S (McLaughlin, Suzanne); Govind, A (Govind, Akshay); Sadof, M (Sadof, Matthew); Huntington, NL (Huntington, Noelle L.) Source: PEDIATRIC DENTISTRY Volume: 33 Issue: 1 Pages: 29-36 Published: JAN-FEB 2011 Abstract: Purpose: The purpose of this study was to conduct the first known large scale survey of parents of children with special health care needs (CSHCN) to determine their child's: oral health status; access to dental care; perceived barriers (environmental/system and nonenvironmental/family); and oral health quality of life, accounting for each child's medical diagnosis and severity of diagnosis. Methods: A 72- item survey was sent to 3760 families of CSHCN throughout urban and rural Massachusetts. Results: The study yielded 1,128 completed surveys. More than 90% of the children had seen a dentist within the past year; 66% sow a pediatric dentist, and 21% needed intense behavioral interventions. Although most families had high education levels, private dental insurance, and above average incomes, 20% of CSHCN had an unmet dental need. Children with craniofacial anomalies had twice as many unmet needs and children with cystic fibrosis had fewer unmet needs. Children with cerebral palsy, autism, developmental delay, and Down syndrome had more aversions to dental treatment, more treatment complications posed by their medical conditions, and more difficulty finding a dentist willing to provide care. Children with cystic fibrosis, metabolic disorders, or hemophilia encountered fewer barriers to care. Conclusions: The data paint a picture of high unmet dental needs with subpopulations of children with special health care needs who are more at risk for system barriers and internal family barriers to care based on their medical diagnoses. (Pediatr Dent 2011;33:29-36) Received August 7 2009 I Lost Revision November 18, 2009 I Accepted November 27, 2009 Document Type: Article Record 69 of 98 Title: Five-year follow-up of oral health and seizure condition of patients with epilepsy: a prospective observational study Author(s): Karolyhazy, K (Karolyhazy, K.); Kivovics, P (Kivovics, P.); Hermann, P (Hermann, P.); Fejerdy, P (Fejerdy, P.); Aranyi, Z (Aranyi, Z.) Source: COMMUNITY DENTAL HEALTH Volume: 27 Issue: 4 Pages: 233- 237 DOI: 10.1922/CDH_2466Aranyi05 Published: DEC 2010 Abstract: Objective: A five-year follow up of patients with epilepsy to examine the change in their oral health and seizure condition. Basic research design: A prospective observational controlled epidemiologic study under natural treatment settings. Participants: The epilepsy group consisted wholly of patients participating in an epidemiologic survey performed five years previously. The gender-and age-matched control (non-epilepsy) group consisted partly of subjects recovered from the previous study, and partly of new subjects. Interventions: Data pertaining to the disease were collected and a thorough dental examination was performed. Main outcome measures: Indices quantifying oral hygiene, the number and condition of the remaining teeth and periodontium, and the degree of prosthetic treatment were measured. Statistical comparison was performed between the patient and the control group of the present study, and pair wise between the previous and the present survey. Results: The epileptic condition of the patients showed significant improvement upon follow-up, in contrast to a significant deterioration in their oral health as compared to the control group. Concerning oral health, dental indices describing oral hygiene and periodontal condition showed the most pronounced decline. Conclusions: The improvement in the epileptic condition of patients is attributed to changes in treatment strategies. As the epileptic condition and oral health of patients changed in opposite directions, socioeconomic and educational factors appear to play a more important role in the poor oral health of these patients than disease- specific factors (e. g. oral cavity injuries, increased exertion on the teeth, antiepileptic drug effects). Furthermore, the periodontal condition seems to be main factor responsible for the unfavourable dental status. Document Type: Article Record 70 of 98 Title: Special care dentistry: Midazolam conscious sedation for patients with neurological diseases Author(s): Capp, PL (Capp, P. L.); de Faria, MEJ (de Faria, M. E. J.); Siqueira, SRDT (Siqueira, S. R. D. T.); Cillo, MTP (Cillo, M. T. P.); Prado, EGB (Prado, E. G. B.); de Siqueira, JTT (de Siqueira, J. T. T.) Source: EUROPEAN JOURNAL OF PAEDIATRIC DENTISTRY Volume: 11 Issue: 4 Pages: 162-164 Published: DEC 2010 Abstract: Aim Midazolam is used very often to control the anxiety of patients for dental treatment especially in patients with special needs. The objective of this study was to evaluate the efficiency of Midazolam in patients with neurological diseases referred for dental treatment. Study design Descriptive study Methods Forty consecutive patients with neurological disorders (encephalopathy, autism, and epilepsy) were referred to dental treatment, and 45 sedations were performed; all were sedated with Midazolam (intramuscular 0.2-0.3 mg/kg or intravenous 0.1mg/kg) and all were anesthetised with lidocaine 2% (0.5-2 mL). During the dental procedure, their behavior was analysed and classified into 3 categories: A (indifferent), 8 (reacted but allowed treatment), and C (did not allow treatment). Data were tabbed and statistically analysed. Results The final patients' classification was: A 22 (49%), 8 18 (40%) and C 5 (11%); the patients with encephalopathy had the best results of sedation according to the proposed classification (p<0.05). Conclusion Midazolam demonstrated to be effective in 89% of this sample for dental procedures in patients with neurological and behavioral disturbances, but it was less effective for patients with autism (p<0.05). Document Type: Article Record 71 of 98 Title: Dental Education and Dentists' Attitudes and Behavior Concerning Patients with Autism Author(s): Weil, TN (Weil, Taryn N.); Inglehart, MR (Inglehart, Marita R.) Source: JOURNAL OF DENTAL EDUCATION Volume: 74 Issue: 12 Pages: 1294-1307 Published: DEC 2010 Abstract: The number of patients diagnosed with autism spectrum disorders (ASD) in the United States has increased significantly The objectives of this study were to explore general and pediatric dentists' professional attitudes and behavior towards patients with ASD, these dentists' perceptions of their dental education about these issues, and the relationships among their educational experiences, attitudes, and behaviors concerning patients with ASD Survey data were collected from 162 general dentists in Michigan and 212 pediatric dentists across the United States The results showed that 89 percent of pediatric dentists and 32 percent of general dentists treat patients with ASD The respondents disagreed with statements indicating that their predoctoral dental education had prepared them well to treat patients with ASD However, the better they felt prepared, the more likely they were to provide care for these patients The frequency with which pediatric dentists said they use appropriate behavior management strategies when treating patients with ASD correlated with the quality of their educational experiences In conclusion, given the growing number of patients with ASD, it is Important to revisit dental education efforts targeted towards preparing future dental care providers for the treatment of patients with ASD and special needs Document Type: Article Record 72 of 98 Title: Dental Education About Patients with Special Needs: A Survey of U.S. and Canadian Dental Schools Author(s): Krause, M (Krause, Meggan); Vainio, L (Vainio, Lauren); Zwetchkenbaum, S (Zwetchkenbaum, Samuel); Inglehart, MR (Inglehart, Marita R.) Source: JOURNAL OF DENTAL EDUCATION Volume: 74 Issue: 11 Pages: 1179-1189 Published: NOV 2010 Abstract: The objectives of this study were to explore how US and Canadian dental schools educate students about special needs patients and which challenges and intentions for curricular changes they perceive Data were collected from twenty-two dental schools in the United States and Canada with a web-based survey While 91 percent of the programs covered this topic in their clinical education, only 64 percent offered a separate course about special needs patients The clinical education varied widely Thirty-seven percent of the responding schools had a special clinical area in their school for treating these patients These areas had between three and twenty-two chairs and were funded and staffed quite differently Most programs covered the treatment of patients with more prevalent impairments such as Down syndrome (91 percent), autism spectrum disorders (91 percent), and motion impairments (86 percent) Written exams were the most common outcome assessments (91 percent), while objective structured clinical examinations (18 percent) and standardized patient experiences (9 percent) were used less frequently The most commonly reported challenge was curriculum overload (55 percent) The majority (77 percent) planned educational changes over the next three years, with 36 percent of schools planning to increase clinical and 27 percent extramural experiences The findings showed that the responding US and Canadian dental schools had a wide range of approaches to educating predoctoral students about treating special needs patients In order to eliminate oral health disparities and access to care issues for these patients, future research should focus on developing best practices for educational efforts in this context Document Type: Article Record 73 of 98 Title: Management of the Uncooperative Child Author(s): Blitz, M (Blitz, Meredith); Britton, KC (Britton, Kate Cerino) Source: ORAL AND MAXILLOFACIAL SURGERY CLINICS OF NORTH AMERICA Volume: 22 Issue: 4 Pages: 461-+ DOI: 10.1016/j.coms.2010.08.002 Published: NOV 2010 Abstract: The management of a child who requires a medical procedure is a challenging issue for the oral and maxillofacial surgeon (OMS) and practitioners in the dental specialties. The office of the OMS is traditionally one in which short outpatient procedures are performed within brief appointment times often using only local anesthesia. For typical children, this brief procedure may be difficult, and for children with behavioral challenges, it may be impossible without the use of behavioral management techniques or pharmacologic modalities. Practitioners must be aware of current trends in pediatric mental health and should develop treatment protocols to avoid complications. Document Type: Article Record 74 of 98 Title: Role of parental risk factors in the aetiology of isolated non- syndromic metopic craniosynostosis Author(s): Singh, RP (Singh, Rabindra Pratap); Dhariwal, D (Dhariwal, Daljit); Bhujel, N (Bhujel, Nabina); Shaikh, Z (Shaikh, Zarina); Davies, P (Davies, Paul); Nishikawa, H (Nishikawa, Hiroshi); Solanki, G (Solanki, Guirish); Dover, MS (Dover, M. S.) Source: BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY Volume: 48 Issue: 6 Pages: 438-442 DOI: 10.1016/j.bjoms.2009.06.233 Published: SEP 2010 Abstract: To try and identify potential parental risk factors for isolated non- syndromic metopic craniosynostosis, we did a telephone survey of parents of children who attended the craniofacial centre at Birmingham Children's Hospital (BCH), UK, from 1995 to 2004. We calculated the prevalence of a number of potential risk factors and compared them with those of the general population. A total of 103 children with syndromic or non-syndromic isolated metopic craniosynostosis were seen, of which 81 (79%) had non-syndromic, isolated metopic craniosynostosis (M:F ratio 3:1). The response rate to the telephone survey was 72%. The prevalences of maternal epilepsy and the use of valproate, antenatal maternal complications (hypertension or pre- eclampsia, haemorrhage, and urinary tract infection), and fertility treatment in our sample were significantly higher than among the general population (p=0.01 or less in all cases). The likely roles of maternal epilepsy and taking valproate in the aetiology of isolated non-syndromic metopic craniosynostosis are further consolidated by our study. The finding that antenatal complications are possible risk factors for craniosynostosis has not to our knowledge been published previously. (C) 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Document Type: Article Record 75 of 98 Title: Postcraniotomy Temporalis Muscle Atrophy: A Clinical, Magnetic Resonance Imaging Volumetry and Electromyographic Investigation Author(s): Yasuda, CL (Yasuda, Clarissa Lin); Costa, ALF (Ferreira Costa, Andre Luiz); Franca, M (Franca Junior, Marcondes); Pereira, FRS (Silvestre Pereira, Fabricio Ramos); Tedeschi, H (Tedeschi, Helder); de Oliveira, E (de Oliveira, Evandro); Nucci, A (Nucci, Anamarli); Cendes, F (Cendes, Fernando) Source: JOURNAL OF OROFACIAL PAIN Volume: 24 Issue: 4 Pages: 391- 397 Published: FAL 2010 Abstract: Aims: To evaluate both cosmetic and functional effects of temporalis muscle atrophy, by means of clinical examination, magnetic resonance imaging (MRI), and electromyographic (EMG) activity in patients who underwent craniotomy in order to treat refractory mesial temporal lobe epilepsy (MTLE). Methods: A total of 18 controls and 18 patients who underwent surgery for MTLE were investigated. The ternporalis muscle volume of the patients was assessed by a 3D reconstruction. The image analysis software (ITK-SNAP) was used for the 3D reconstruction. In addition, the amplitude of the EMG signal during a maximum voluntary clench was recorded from both temporalis muscles by surface electrodes. The presence of temporomandibular disorder (TMD) signs was assessed by clinical examination that was performed only after surgery. Data were analyzed statistically by means of the Mann-Whitney U test, paired t-test, Pearson chi(2) and linear regression. Results: The volume of the ternporalis muscle of the operated side was significantly reduced (P = .004). The EMG results confirmed the presence of muscle atrophy, the amplitude of the EMG signal being significantly decreased on the operated side (P < .05). Also the patients' maximum mouth opening after surgery was significantly reduced compared to that of the controls (P < .0001). Patients presented facial asymmetry, signs of TMD (pain, disc displacement, and joint sounds), and masticatory abnormalities. Conclusion: These preliminary results showed that, despite the good control of seizures, some patients may experience cosmetic and functional abnormalities of temporalis muscle secondary to atrophy and fibrosis. J OROFAC PAIN 2010;24:391-397 Document Type: Article Record 76 of 98 Title: Controversial issues in treating the dental patient with autism Author(s): Rada, RE (Rada, Robert E.) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 141 Issue: 8 Pages: 947-953 Published: AUG 2010 Abstract: Background. The author conducted a literature review to investigate concerns that parents of a child with an autism spectrum disorder may have when oral health care is provided to the child. Types of Studies Reviewed. The author conducted a search of PubMed using the terms "mercury," "fluoride," "nitrous oxide," "antibiotics," "gluten," "casein," "acetaminophen" and "dentistry" each with the term "autism." He identified controlled studies and literature reviews in both medical and alternative medical literature that were related to areas of importance to oral health care workers. The use of mercury, fluoride, nitrous oxide, antibiotic agents and acetaminophen all are sources of controversy between dentistry and the parents of children who have autism. Results. The author found that patients who have autism frequently also have allergies, immune system problems, gastrointestinal disturbances and seizures. Dental health care workers must be aware of these comorbid conditions so they can provide optimal care to the children with autism spectrum disorders. The author found two distinct theories as to what causes autism: one that focuses on genetic causes, and one that focuses on the impact of the environment. He found that the interpretation of these theories might affect parents' concerns about various dental treatments. Clinical Implications. Dentists treating patients who have autism may need to provide more than standard patient care, as the use of time-tested dental treatment and prevention modalities may be questioned or refused by parents. Document Type: Article Record 77 of 98 Title: Dental Injuries in Autistic Patients Author(s): Altun, C (Altun, Ceyhan); Guven, G (Guven, Gunseli); Yorbik, O (Yorbik, Ozgur); Acikel, C (Acikel, Cengizhan) Source: PEDIATRIC DENTISTRY Volume: 32 Issue: 4 Pages: 343-346 Published: JUL-AUG 2010 Abstract: Purpose: The purpose of this study was to assess the incidence of traumatic dental injury among Turkish children and young adults with autism and compare this to the general population of Turkish children and young adults without autism. Methods: This study was comprised of 786 children and young adults (138 moles and 48 females), 93 with autism (autistic group, or AG) and 93 without autism (control group, or CG). Dental injuries were classified according to drawings and texts based on the WHO classification system, as modified by Andreasen and Andreasen. Results: The rote of injury was higher among the AG (23%) than the CG (15%). The difference between the 2 groups, however, was not statistically significant (P<.19). The most common type of dental injury was enamel fracture. The rote of enamel fracture was higher in the CG (59%) than in the AG (33%), and the distribution of types of traumatic injury differed significantly between the AG and CG (P>.01). Conclusions: There were no significant differences in the rates of traumatic dental injuries among children and young adults with and without autistic disorder. The most frequently injured teeth were the permanent maxillary central incisors, and the frequency of injury to these teeth differed significantly (P>.01) between AG (56%) and CG (91%). The most common type of dental injury, enamel fracture, was more common in CG (59%) than AG (33%). The distribution of types of traumatic dental injuries differed significantly between the 2 groups (P>.07). (Pediatr Dent 2010;32:343-6) Received October 3, 2008 vertical bar Lost Revision April 30, 2009 vertical bar Revision Accepted May 1, 2009 Document Type: Article Record 78 of 98 Title: Caries-risk Assessment and Caries Status of Children with Autism Author(s): Marshall, J (Marshall, Jennifer); Sheller, B (Sheller, Barbara); Mancl, L (Mancl, Lloyd) Source: PEDIATRIC DENTISTRY Volume: 32 Issue: 1 Pages: 69-75 Published: JAN-FEB 2010 Abstract: Purpose: This paper's purpose was to describe the caries status of children with autism and explore associations with the Caries-risk Assessment Tool promoted by the American Academy of Pediatric Dentistry Methods: Data was collected from children with autism, their parents, and dentists using interviews, surveys, and treatment records. Descriptive statistics and bivariate analysis explored the association of new caries activity and caries experience with oral health measures. Results: Subjects were 75 males and 24 females with a mean age (+/- SD) of 9.7 years (+/- 3.7), (range=2.7 to 19 years). Children <= 7 years old had more new caries (60%) than older children (34%; P=.05). Although not statistically significant, all children who brushed less than once per day had new caries and a mean t-DMF-T (def + DMF) of 7.3. Children with poor oral hygiene had more new caries (59%) than those with good/excellent hygiene (28%; P=.06). Caries status was not associated with gender, socioeconomic status, medical history, appointment type, dental home, food rewards, restricted diets, and some hygiene habits. Conclusions: This study confirms the validity of considering autism as an indicator of high caries risk. Oral hygiene may be the most influential risk indicator associated with new caries in children with autism. (Pediatr Dent 2010;32:69-75) Received August 10, 2008 I Lost Revision November 8, 2008 I Revision Accepted December 6, 2008 Document Type: Article Record 79 of 98 Title: Behaviour guidance in dental treatment of patients with autism spectrum disorder Author(s): Loo, CY (Loo, Cheen Y.); Graham, RM (Graham, Richard M.); Hughes, CV (Hughes, Christopher V.) Source: INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY Volume: 19 Issue: 6 Pages: 390-398 DOI: 10.1111/j.1365-263X.2009.01011.x Published: NOV 2009 Abstract: Background. Autism spectrum disorder (ASD) is a neurodevelopmental disorder categorized into autism, pervasive developmental disorder - not otherwise specified (PDD-NOS) and Asperger syndrome. Aims. To identify factors associated with the behaviour of patients with ASD in a dental setting, use of general anaesthesia (GA), and protective stabilization. Design. The dental charts of 395 patients with ASD patients and 386 unaffected patients were reviewed. The following data were analysed: ASD diagnosis, age, gender, residence, seizure disorder, additional diagnosis (mental retardation, cerebral palsy, self-injurious behaviour or pica), medications, caries prevalence and severity, dental treatment history, behaviour, and behaviour guidance technique(s) used. Results. Within both groups, younger patients were more uncooperative. ASD patients with autism were more uncooperative than patients with PDD-NOS; patients with an additional diagnosis were also more uncooperative. ASD patients with higher caries severity, who were uncooperative or female, were more likely to require GA. Use of protective stabilization was associated with lower caries severity, presence of seizure disorder, uncooperative behaviour, male gender, or residency in a group home/institution. Conclusions. Autism spectrum disorder patients with autism, younger age and an additional diagnosis were more uncooperative. Factors associated with the use of GA and protective stabilization in patients with ASD were also identified. Document Type: Article Record 80 of 98 Title: Knowledge and Attitudes about Epilepsy: A Survey of Dentists in London, Ontario Author(s): Aragon, CE (Aragon, Cecilia E.); Hess, T (Hess, Tiiu); Burneo, JG (Burneo, Jorge G.) Source: JOURNAL OF THE CANADIAN DENTAL ASSOCIATION Volume: 75 Issue: 6 Pages: 450-U24 Published: JUL-AUG 2009 Abstract: Background: The controversial relation between societal knowledge and attitudes about epilepsy may affect the access of people with epilepsy to dental care. Materials and Methods: A questionnaire that evaluated knowledge about epilepsy, attitudes toward epilepsy and willingness to provide dental care to people with epilepsy was administered to all 288 dentists in the city of London, Ontario, Canada. Results: Of the 197 respondents, 75.6% were general dentists. Knowledge was patchy about the epidemiology, causes, treatment and recognition of epilepsy. Six percent of dentists did not think that they could safely treat a patient with epilepsy in their offices. Conclusion: Dental care providers' negative attitudes to and lack of knowledge about epilepsy may directly affect the access to dental care for people living with this problem. Document Type: Article Record 81 of 98 Title: Dental Implants in Persons with Severe Epilepsy and Multiple Disabilities: A Long-Term Retrospective Study Author(s): Cune, MS (Cune, Marco S.); Strooker, H (Strooker, Hans); van der Reijden, WA (van der Reijden, Willy A.); de Putter, C (de Putter, Cornelis); Laine, ML (Laine, Marja L.); Verhoeven, JW (Verhoeven, Jan Willem) Source: INTERNATIONAL JOURNAL OF ORAL & MAXILLOFACIAL IMPLANTS Volume: 24 Issue: 3 Pages: 534-540 Published: MAY-JUN 2009 Abstract: Purpose: A retrospective study on the performance of endosseous implants in a population of patients with severe epilepsy and additional motor and/or intellectual impairments was performed. Materials and Methods: All residents of an inpatient center for persons affected by severe, refractory epilepsy and multiple disabilities who received endosseous implants between 1991 and April 2007 were included in the study. Implant survival was analyzed using the Kaplan-Meier method. A subset of patients who were treated between 1991 and 2004 was invited to participate in a clinical and radiographic evaluation in 2004 and 2005. Results: A total of 61 patients were treated between 1991 and April 2007 (n = 134 implants). Three of these implants in three different patients failed during the observation period, demonstrating an estimated probability of functional implant survival of 97.6% (SE 1.4%) after 16 years. In patients who were seen during the clinical evaluation in 2004 (n = 76 implants), only mild inflammation of the peri-implant mucosa was generally observed (Gingival-Bleeding Index = 1), despite the fact that the level of oral hygiene was considered inadequate around 55 of 76 implants (72%). Obvious signs of drug-induced gingival hyperplasia in relation to the implants were not observed. Probing depths averaged approximately 2 mm. Stable marginal bone levels were observed on the radiographs. Conclusions: Dental implant treatment in a population of patients with severe epilepsy and additional disabilities seems to be a viable treatment option. Implant loss is rare. Although adequate plaque control was not feasible in all patients, marginal bone levels remained stable. INT J ORAL MAXILLOFAC IMPLANTS 2009;24:534-540 Document Type: Article Record 82 of 98 Title: The caries experience and behavior of dental patients with autism spectrum disorder Author(s): Loo, CY (Loo, Cheen Y.); Graham, RM (Graham, Richard M.); Hughes, CV (Hughes, Christopher V.) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 139 Issue: 11 Pages: 1518-1524 Published: NOV 2008 Abstract: Background. Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder. The authors conducted a study to evaluate the demographics, caries experience and behavior of patients with ASD and compare these characteristics with those of patients without ASD (unaffected patients). Methods. The authors reviewed patients' charts and identified a group of 395 patients with ASD and a group of 386 unaffected patients. They obtained the following patient data for analysis: primary diagnosis, age, sex, residence (home versus institution or group home), presence of seizure disorder, additional diagnosis (mental retardation, cerebral palsy, self-injurious behavior or pica), medications, caries prevalence, caries severity and behavior. Results. The ASD group had a male:female ratio of 4:1, and patients had a diagnosis of autism, pervasive developmental disorder-not otherwise specified or Asperger syndrome. Sex distribution was equal in the unaffected group, which was younger and had a higher decayed, missing and filled teeth (DMFT) score than did the ASD group. When the authors controlled for age and sex, they noted a statistically significant association between ASD and dental caries prevalence. A significantly higher percentage of patients with ASD than unaffected patients were uncooperative and required dental treatment to take place under general anesthesia. Caries prevalence and severity in patients with ASD were not associated with institutionalization, presence of seizure disorder or additional diagnosis. Conclusions. People with ASD were more likely to be caries-free and had lower DMFT scores than did their unaffected peers. Significantly more patients with ASD than unaffected patients were uncooperative and required general anesthesia to undergo dental treatment. Document Type: Article Record 83 of 98 Title: Parental Attitudes Regarding Behavior Guidance of Dental Patients with Autism Author(s): Marshall, J (Marshall, Jennifer); Sheller, B (Sheller, Barbara); Mancl, L (Mancl, Lloyd); Williams, BJ (Williams, Bryan J.) Source: PEDIATRIC DENTISTRY Volume: 30 Issue: 5 Pages: 400-407 Published: SEP-OCT 2008 Abstract: Purposes: The purposes of this study were to evaluate: (1) parents' ability to predict dental treatment cooperation by their autistic child; (2) behavior guidance techniques (BGTs) used during treatment; and (3) parental attitudes regarding basic and advanced BGTs. Methods: Data were collected from 85 parent/autistic child pairs and their dentists using surveys and treatment records. Results: Parents most accurately predicted If their child would permit an examination in the dental choir (>= 88%) and would cooperate for radiographs (>= 84%). BGTs utilized most often (>50%) were positive verbal reinforcement (PVR), tell-show-do (TSD), mouthprops, and rewards. In general, basic BGTs were more acceptable (>81%) than advanced BGTs (>54%). The most acceptable techniques (>90%) in order were: PVR, TSD, distraction, rewards, general anesthesia, hand-holding by parent, and mouthprops. When parents evaluated only BGTs used for their child, all BGTs, including a stabilization device, were highly acceptable (>91%), except for staff restraint (74%). Conclusions: Parents were accurate in predicting cooperation for some procedures. The most acceptable and efficacious BGTs in order were: PVR, TSD, distraction, rewords, and hand-holding by parent. Parental perceptions of BGTs were influenced by whether or not they had been used for their child. (Pediatr Dent 2008;30:400-7) Received June 22, 2007 / Last Revision October 10, 2007 / Revision Accepted October 15, 2007 Document Type: Article Record 84 of 98 Title: Cooperation predictors for dental patients with autism (vol 29, pg 369, 2007) Author(s): Marshall, J (Marshall, Jennifer); Sheller, B (Sheller, Barbara); Williams, BJ (Williams, Bryan J.) Source: PEDIATRIC DENTISTRY Volume: 30 Issue: 2 Pages: 97-97 Published: MAR-APR 2008 Document Type: Correction Record 85 of 98 Title: Cooperation predictors for dental patients with autism Author(s): Marshall, J (Marshall, Jennifer); Sheller, B (Sheller, Barbara); Williams, BJ (Williams, Bryan J.); Mand, L (Mand, Lloyd); Cowan, C (Cowan, Charles) Source: PEDIATRIC DENTISTRY Volume: 29 Issue: 5 Pages: 369-376 Published: SEP-OCT 2007 Abstract: Purpose: This study evaluated potential predictors of cooperation during dental appointments for children with autism. Methods. Data were collected from 108 parent/child pairs and their dentists, Questions included: (7) medical/dental history; (2)function(71 language; (3) personal hygiene skills; (4) academic setting, and (5) achievements. Behavior was scored using the Frankl scale. Results. Subjects were 80 males and 28 females 2.7 to 19 years old with a mean age of 9.8 years. Frankl scores were 65% uncooperative (definitely negative or negative) and 35% cooperative (positive or definitely positive). Multiple factors predicted uncooperative behavior; (7) appointment type (P=.03); (2) concurrent medical diagnoses (P=.04); (3) nonverbal/minimal or echolalic language (P=.005); (4) inability to understand language appropriate for age (P=.02); (5) inability to follow multistep instructions (P=.04); (6) parents providing most/all tooth-brushing (P=.004); (7) partially or not toilet trained at 4+ years (P=.02); (8) inability to sit for a haircut (P=.01); (9) attending special education (P <.007); and (10) inability to read at 6+ years (P <.001). Conclusions. Five questions readily answered by a caregiver may indicate a child's cooperative potential. Preappointment inquiry about toilet training, toothbrushing, haircuts, academic achievement and language can give the dentist insight into the child's ability to respond positively to behavior guidance techniques based on communication. Document Type: Article Record 86 of 98 Title: Autism Author(s): Tesini, D (Tesini, David); Friedman, C (Friedman, Clive); Connors, SL (Connors, Susan L.); Zimmerman, AW (Zimmerman, Andrew W.) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 138 Issue: 3 Pages: 286-288 Published: MAR 2007 Document Type: Letter Record 87 of 98 Title: More about autism - Response Author(s): Friedlander, AH (Friedlander, Arthur H.) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 138 Issue: 3 Pages: 288-+ Published: MAR 2007 Document Type: Letter Record 88 of 98 Title: More about autism Author(s): Wickenhauser, AJ (Wickenhauser, Alan J.) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 138 Issue: 3 Pages: 288-288 Published: MAR 2007 Document Type: Letter Record 89 of 98 Title: Understanding the patient with epilepsy and seizures in the dental practice Author(s): Aragon, CE (Aragon, Cecilia E.); Burneo, JG (Burneo, Jorge G.) Source: JOURNAL OF THE CANADIAN DENTAL ASSOCIATION Volume: 73 Issue: 1 Pages: 71-76 Published: FEB 2007 Abstract: Epilepsy, which is characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 200,000 Canadians at any one time. Dentists with a thorough knowledge of seizure disorders and the medications used to treat them can provide necessary dental and oral health care to these patients. In this review, we summarize current knowledge of epilepsy, seizures and antiepileptic drugs and provide information on dental-related issues, as well as guidelines for the management of an acute seizure in the dental office. Document Type: Article Record 90 of 98 Title: The neuropathology, medical management and dental implications of autism Author(s): Friedlander, AH (Friedlander, Arthur H.); Vagiela, JA (Vagiela, John A.); Paterno, VI (Paterno, Victoria I.); Mahler, ME (Mahler, Michael E.) Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION Volume: 137 Issue: 11 Pages: 1517-1527 Published: NOV 2006 Abstract: Background. A paucity of information exists in the dental literature about autism and its dental implications. Types of Studies Reviewed. The authors conducted a MEDLINE search for the period 2000 through 2006, using the term "autism," with the aim of defining the condition's clinical manifestations, dental and medical treatment and dental implications. Results. Autism is a severe developmental. brain disorder that appears in infancy, persists throughout life, and is characterized by impaired social interaction, abnormalities in communication (both verbal and nonverbal and restricted interests. Often accompanying the disorder are behavioral disturbances-such as self-mutilation, aggression, psychiatric symptoms and seizures-that necessitate the administration of multiple medications to help the affected person participate effectively in the educational and rehabilitative process. Clinical Implications. Dentists caring for people with autism must be familiar with the manifestations of the, disease and its associated features so that they can garner the maximum level of patient cooperation. They also must be familiar with the medications used to treat the associated features of the disorder because many of them cause untoward orofacial and systemic reactions and may precipitate adverse interactions with dental therapeutic agents. Document Type: Review Record 91 of 98 Title: Epilepsy in the oral and maxillofacial patient: Current therapy Author(s): Turner, MD (Turner, MD); Glickman, RS (Glickman, RS) Source: JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY Volume: 63 Issue: 7 Pages: 996-1005 DOI: 10.1016/j.joms.2004.04.038 Published: JUL 2005 Document Type: Article Record 92 of 98 Title: Prosthodontic status and recommended care of patients with epilepsy Author(s): Karolyhazy, K (Karolyhazy, K); Kivovics, P (Kivovics, P); Fejerdy, P (Fejerdy, P); Aranyi, Z (Aranyi, Z) Source: JOURNAL OF PROSTHETIC DENTISTRY Volume: 93 Issue: 2 Pages: 177-182 DOI: 10.1016/j.prosdent.2004.11.008 Published: FEB 2005 Abstract: Statement of problem. Epilepsy is a chronic disease that can affect oral health and prosthodontic status in different ways. However, epilepsy is a condition of various etiologies and seizure types, and different patients may have differing needs in prosthodontic care. Purpose. The purpose of this study was to examine the prosthodontic status of patients with epilepsy to determine if the disease has any effect on prosthodontic treatment and to obtain information regarding the level of prosthodontic care. This information was used to provide recommendations for the prosthodontic treatment of patients with epilepsy. Material and methods. One hundred one epileptic patients were examined, interviewed, and compared with 101 age-matched control (nonepileptic) subjects of the general population. Epileptic patients were recruited at an epilepsy outpatient clinic. The only exclusion criterion was a mental handicap severe enough to exclude cooperation of the patient during a dental examination. Control subjects were recruited at a community radiographic chest-screening clinic. Epileptic patients were first grouped according to dental risk factors and dental manageability. Dental classification of patients with epilepsy considered the frequency and type of seizures, as seizures may damage the teeth and dental prostheses. The number of missing teeth, the ratio of missing and replaced teeth, and the number of fixed and removable partial dentures and complete dentures, and the characteristics (material, degree of abrasion, and age) of the dentures was determined by dental examination. Finally, the state of oral mucosa and the number of seizure-related injuries was noted. Statistical comparison of the patient and the control group was performed, using the 2-tailed t-test for continuous variables and the chi-squared test or Fisher's exact test for categorical variables (alpha=.05). Results. The number of missing teeth was significantly higher in the epilepsy group than in the control group (P=.021). The ratio of replaced and missing teeth was lower in the epileptic group (P<.01), indicating inadequate prosthodontic care. There was also a significant difference in the age of the fixed prostheses (P=.0016), being lower in the epilepsy group, and in the material of fixed prostheses (P=.033), metal-ceramic being more common in the control group. More epileptic patients were edentulous than control subjects (8 versus 3) and the average age at the time of examination was younger (48 versus 57 years). Seizure-related injuries were reported by 11% of patients, all belonging to the subgroup of patients with frequent generalized tonic-clonic seizures. Conclusion. Patients with epilepsy have an increased risk for loosing teeth and, furthermore, the prosthodontic status of epilepsy patients was not as optimal as compared with the control group. Seizure-related injuries to prostheses arc also an issue, but only in those suffering from frequent generalized tonic-clonic seizures. Therefore, the large majority of patients can and should receive prosthodontic treatment without restrictions. For a smaller group of patients, however, certain restrictions apply, to prevent potentially dangerous seizure-related complications. Document Type: Article Record 93 of 98 Title: Autism caused by dental amalgam? Author(s): Osborne, JW (Osborne, JW); Summitt, J (Summitt, J) Source: OPERATIVE DENTISTRY Volume: 28 Issue: 6 Pages: 665-666 Published: NOV-DEC 2003 Document Type: Editorial Material Record 94 of 98 Title: Dental status and oral health in epilepsy patients. Author(s): Karolyhazy, K (Karolyhazy, K.); Faluhelyi, P (Faluhelyi, P.); Kivovics, P (Kivovics, P.); Aranyi, Z (Aranyi, Z.); Fejerdy, P (Fejerdy, P.) Source: JOURNAL OF DENTAL RESEARCH Meeting Abstract: 0972 Volume: 82 Special Issue: B Pages: B134-B134 Published: JUN 2003 Document Type: Meeting Abstract Record 95 of 98 Title: Temporomandibular joint (TMJ) disorders following anterior temporal lobectomy in patients with medically intractable temporal lobe epilepsy: A retrospective study. Author(s): Markarian, TZ (Markarian, T. Z.); Jasinevicius, TR (Jasinevicius, T. R.); Nelson, S (Nelson, S.); Bingaman, W (Bingaman, W.); Palmer, J (Palmer, J.); Morris, H (Morris, H.); Najm, I (Najm, I.) Source: JOURNAL OF DENTAL RESEARCH Meeting Abstract: 0780 Volume: 82 Special Issue: B Pages: B110-B110 Published: JUN 2003 Document Type: Meeting Abstract Record 96 of 98 Title: Tooth by tooth survival analysis of dental health in epilepsy girls. Author(s): Rajavaara, P (Rajavaara, P); Vainionpaa, L (Vainionpaa, L); Ratty, J (Ratty, J); Knip, M (Knip, M); Pakarinen, A (Pakarinen, A); Isojarvi, J (Isojarvi, J); Larmas, M (Larmas, M) Source: JOURNAL OF DENTAL RESEARCH Meeting Abstract: 0571 Volume: 81 Special Issue: SI Pages: A95-A95 Published: MAR 2002 Document Type: Meeting Abstract Record 97 of 98 Title: Children with mental retardation and epilepsy: Demographics and general concerns Author(s): Waldman, HB (Waldman, HB); Swerdloff, M (Swerdloff, M); Perlman, SP (Perlman, SP) Source: JOURNAL OF DENTISTRY FOR CHILDREN Volume: 67 Issue: 4 Pages: 268-+ Published: JUL-AUG 2000 Abstract: Epilepsy is the most frequent additional handicap in children with mental retardation, with a reported prevalence between 5 and 50 percent. Demographics, issues of control of epilepsy and general attitudes to the care of these youngsters are considered in an effort to increase the availability of needed dental services. Document Type: Article Record 98 of 98 Title: Visual pedagogy in dentistry for children with autism Author(s): Backman, B (Backman, B); Pilebro, C (Pilebro, C) Source: JOURNAL OF DENTISTRY FOR CHILDREN Volume: 66 Issue: 5 Pages: 325-+ Published: SEP-OCT 1999 Abstract: The aim of the present study is to present and evaluate a model based on visual pedagogy for the introduction of dentistry to preschool children with autism. The model is based on the knowledge that it is easier for these children to communicate via pictures than via words. A book has been produced with distinct color-prints describing every step when visiting the dentist. The project has been designed in cooperation with the multi-professional team involved with the children. A total of sixteen children with autism participated in the project. Evaluation was done after 1.5 years. The ability of the children to cooperate is compared with that of sixteen children with autism of the same ages who were not treated with this method. The capacity of the children in the project to cooperate during dental treatment is superior to that of the control-children. Visual pedagogy is a way of introducing dentistry to children with autism. Document Type: Article
Journal of Public Health Dentistry Volume Issue 2016 (Doi 10.1111/jphd.12159) Azofeifa, Alejandro Yeung, Lorraine F. Alverson, C. J. Beltrà - Dental Caries and Periodontal Disease Among U.S. Preg