Digital Commons Network^™

Threshold Levels Of Patient And Parent Esthetic Concern In The Mixed Dentition, Justin Josell

Theses and Dissertations

Purpose: The mixed dentition is a period of unique dental changes for developing children and their parents. The purpose of this study is to determine threshold levels of concern regarding diastema spacing and angulation of maxillary incisors during the “Ugly Duckling Stage” in pediatric patients and their parents.

Methods: This study is modeled as a cross sectional-survey among pediatric patients and parents. The surveys contain photographs of a sex-neutral, mixed-dentition smile with variations of midline spacing and incisal angulation which randomly differ in quantifiable values. Participants were asked to rate each photograph on a visual analog scale.

Results: The interaction …

Detection And Reporting Of Child Abuse And Neglect: A Survey Amongst Pediatric Dental Care Providers In The United States, Daniel J. Lander

Theses and Dissertations

Purpose: The purpose of this study is to survey pediatric dental care providers in the United States to evaluate their knowledge in the detection and reporting of child abuse and neglect (CAN). Methods: This study has been modeled as a cross sectional- survey based research study. Email invitations were sent to pediatric dentists, orthodontists, and others who work in pediatric dental practices in the United States through email lists of the American Association of Pediatric Dentists (AAPD) and the American Association of Orthodontists (AAO). The survey completion page included sample text and the public survey link for providers to use …

Effect Of Moderate Sedation Regimen (Diazepam, Meperidine, And Hydroxyzine) Dosages On Patient Behavior And Outcome Of Sedation In Pediatric Dentistry: A Retrospective Study, Taibah M A M J Albaker

Theses and Dissertations

Purpose: To determine if behavior at consult visit and sedation medication dosages are associated with the success of sedation visits and patient’s behavior using the diazepam, meperidine, and hydroxyzine (DMH) regimen.

Methods: A retrospective chart review was conducted of 324 VCU Pediatric Dentistry Department patients who underwent 404 moderate conscious sedation visits with DMH regimen from April 2017 to June 2022. Sedation visits were graded as “Successful” or “Unsuccessful” and “Good” or “Poor behavior.” The primary variables of interest included Frankl behavior at consult visit and the sedation medication dosages. Logistic regression models were used to determine if these factors …

The Effect Of Local Anesthesia When Used In Dental Restorative Cases Under General Anesthesia On Control Of Intraoperative Physiologic Parameters And Post-Operative Comfort, Kathryn S. Skarda

Theses and Dissertations

Purpose:

To determine the effect of local anesthesia on post-operative pain and physiologic parameters intraoperatively in patients undergoing dental care under general anesthesia.

Methods:

This study was modeled as a double-blinded randomized control trial. Patients included healthy children under the age of six scheduled for restorative dental treatment under general anesthesia. Patient behavior was evaluated pre and post-operatively using the FLACC score and post-operatively using the Parental Pain Score Measure. Intraoperatively, all participants followed a standardized general anesthesia protocol and were given either local anesthetic infiltration by the dental surgeon performing the surgery or no anesthesia was utilized. Intraoperatively physiologic …

Repeat Full Mouth Dental Rehabilitation Under General Anesthesia For Medicaid Eligible Healthy Children Who Are High Caries Risk, Lajoi E. Wiggins

Theses and Dissertations

Purpose: To evaluate the treatment of healthy children who are high caries risk and of low socioeconomic status and who require repeat full mouth dental rehabilitation (FMDR) under general anesthesia (GA).

Methods: A retrospective chart review was performed on healthy Medicaid eligible patients who were initially between 18 months - 6 years of age who underwent FMDR under GA in the OR more than once at the Virginia Commonwealth University (VCU) School of Dentistry, Department of Pediatric Dentistry from January 2008 to December 2018. Biographical information for each patient was gathered into a REDCap™ Survey. Statistical analysis, chi-squared test with …

Perception Of Patient Cooperation Among Dentist, Guardian, And Child, Cole A. Staines Dds

Theses and Dissertations

Purpose: Evaluate behavior assessment and agreement among dentist, guardian, and child. Evaluate child behavior by appointment type.

Methods: Patients recruited from the pediatric dental department at Virginia Commonwealth University for this convenience sample. Inclusion criteria: patients presenting for clinical exams and/or restorative treatment without the use of advanced behavior guidance between August 29, 2018, and March 7, 2019; ages 4-12-years-old; and scheduled with a single clinician. Appointments were stratified by difficulty. Behavior was assessed by dentist and caregiver using the Frankl Scale. Patient self-assessed cooperation using an age-appropriate modified Frankl Scale, developed for this study. Agreement assessed among the 3 …

Assessment Of Pediatric-Focused Brief Motivational Interviewing Training Of Dental Students And Pediatric Dental Residents, Victoria M. Onesty

Theses and Dissertations

Purpose: To assess dental students and pediatric dental residents’ knowledge and attitudes towards motivational interviewing and evaluate the efficacy of a pediatric-focused brief motivational interviewing training program.

Methods: A total of 66 participants were enrolled; 35% were third year dental students, 46% were fourth year dental students and 18% were pediatric dental residents. Participants completed three questionnaires: the first before the training, the second immediately after the training and the third approximately 3.5 months after the training.

Results: A significant increase in correct responses was found for 4 of the 5 questions assessing participants’ knowledge. Participants were satisfied with the …

A Comparison Of Treatment Planning Modalities For The Pediatric Dental Patient, Martha M. Holland

Theses and Dissertations

Purpose: To assess the treatment modalities of pediatric dentists for restoring Class II lesions in primary molars.

Methods: A survey of eight cases was emailed to AAPD members, who were asked to choose a stainless steel crown (SSC) or composite resin. Treatment choice was associated with provider type, years in practice, behavior management, lesion detection, and patient age.

Results: Clinically detectable caries restored under general anesthesia were treated more often with a SSC. Faculty and residents chose a SSC at a greater rate. Providers with 10 or more years experience chose a SSC more often.

Conclusions: The scope of treatment …

A Comparison Of Moderate Oral Sedation Drug Regimens For Pediatric Dental Treatment: A Pilot Study, Ojas A. Parikh

Theses and Dissertations

Purpose: Compare moderate oral sedation of pediatric patients using Hydroxyzine and Meperidine with either Diazepam or Midazolam in management of pediatric dental patients.

Methods: Randomized, double-blind, crossover pilot study of patients 3 to 7 years of age requiring two sedation visits. Frankl and Houpt behavior scores recorded at injection time, initiation of treatment and 100% oxygen at end of treatment. Postoperative phone call surveys conducted within eight hours and within 24 hours of discharge. Wilcoxon Signed-Rank tests, Fisher’s Exact Chi-squared test and 0.10 significance level.

Results: 25 subjects completed 35 sedations. Eight participants completed both treatments and demonstrated significantly higher …

General Dentists' Role In Providing Care To Very Young Children:Pediatric Dentists' Perspective, Shinjni Razdan

Theses and Dissertations

To examine the pediatric dentists’ perspective on level of care to children 0-3 years old by general dentists, an electronic survey was sent out to 5185 AAPD members and 769 responded (response rate: 14.8%). Forty-six percent agreed with a general dentist providing a dental home to children 0-3 years old. Only 24% agreed that general dentists could perform complex restorative and behavior management procedures for 0-3 years old. Younger respondents, pediatric dentists who practice in rural areas or teaching pediatric dentistry, and those who perceived adequate exposure during dental school were more likely to agree on general dentists proving a …

The Impact Of Medicaid Reform On Dental Practice Setting, Barrett W. R. Peters

Theses and Dissertations

Purpose: To assess the impact of dental Medicaid reform in Virginia on dental practice settings (private practice, corporate practice and safety net clinics). Methods: This retrospective cohort study of 16.2 million dental claims is from the Virginia Department of Medical Assistance Services, which included claims for providers participating in Virginia’s Medicaid program during a 10-year period (2002-2012). The dividing date for the reform was July 1, 2005. The outcome measure was mean claims per participating provider. A Poisson regression model was used to predict the mean number of claims per provider with the following predictors: reform period, practice setting, provider …

Service-Learning Programs Impact On Dental Students' Confidence In Treating Pediatric Population, Bushra Bhatti

Theses and Dissertations

Purpose: In 2011, Clinical Service-Learning (DENS 762) became a formal university-designated course required to all senior dental students at VCU School of Dentistry. The interest of this study was to measure students' experience in treating pediatric patients and to determine the effect the course had on students' self-perceived confidence in treating the pediatric population. Methods: This was an observational study of the VCU class of 2012 who were enrolled in the clinical service-learning class. Following their service-learning rotations, fourth-year dental students were surveyed about their experiences on their service-learning rotation. Out of 105 students, 76 completed the survey. Results: The …

A Survey On The Usage Of Articaine Among General And Pediatric Dentists, Robert Louis Hollowell Iii

Theses and Dissertations

Purpose: The purpose of this study is to determine the impact that the introduction of articaine has had on local anesthetic selection by general and pediatric dentists for use in three different age groups of children.Methods: Using a cross sectional survey design, a questionnaire regarding the use of local anesthetics in children was mailed to a random sample of 500 general dentists from North Carolina, 500 general dentists from Virginia, and all 230 pediatric dentists from North Carolina and Virginia. The 16-item questionnaire included questions regarding the preferred local anesthetic to use in three different age groups, 2-3 years of …

A Rural Vs. Urban Analysis Of Procedures Provided To Medicaid Recipients By Pediatric, General, And Public Health Dentists In The Commonwealth Of Virginia: Fiscal Years 1994-1995, Frank Carmen Pettinato

Theses and Dissertations

Purpose: The purpose of this study was to report the distribution of procedures provided to Virginia Medicaid children by three types of dental providers in rural and urban areas. Methods: Medicaid claims filed for dental patients younger than 21 were obtained and analyzed for fiscal years 1994 and 1995. Dental providers were categorized according to their practice type: general practice (GP), pediatric (PD) and public health (PH) dentists. Each type of practice was categorized as practicing in a Metropolitan, Urban, Rural or Completely Rural location and evaluated for percentages of preventive, diagnostic, and corrective services provided.Results: The number of procedures …