Pediatric Dentistry and Pedodontics Commons^™

The Effect Of Local Anesthesia When Used In Dental Restorative Cases Under General Anesthesia On Control Of Postoperative Comfort, Elizabeth S. Kleefisch Dds

Theses and Dissertations

Purpose:

To determine the effect of local anesthesia on postoperative comfort 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 6 years scheduled for restorative dental treatment under general anesthesia (GA). Patient behavior was evaluated preoperatively and postoperatively using the Faces, Legs, Activity, Cry and Consolability (FLACC) or other pain score and postoperatively using the Parent’s Postoperative Pain Measure (PPPM). Intraoperatively, participants followed a standardized general anesthesia protocol and were given either local anesthetic (LA) infiltration using 2% Lidocaine 1:100,000 Epinephrine by …

Transforming Children's Oral Health: The Impact Of Oral Healthcare Policies On Virginia Medicaid Dental Health Outcomes., Anita M. Kumar

Theses and Dissertations

Abstract: Transforming Children's Oral Health: The Impact of Oral Healthcare Policies on Virginia Medicaid Dental Health Outcomes.

Objectives: This dissertation uses Department of Medical Assistance Services (DMAS) administrative files at the individual and provider level from fiscal years (FY) 2011 to 2021 to systematically study the effect of recently implemented oral health policies (EBD guidelines on sealants, CMS updated quality measures, expansion of Medicaid oral healthcare for qualifying pregnant women) on oral health outcomes of Virginia Medicaid-enrolled children.

Methods: The studies employ a difference in differences regression methods (negative binomial, Poisson, and logistic) to examine the effects of oral health …

Age Of First Dental Visit And Early Childhood Oral Health Quality Of Life, Richard Greene

Theses and Dissertations

Objective: This project aims to examine the association between the age of a child's first dental visit and their Early Childhood Oral Health Impact Scale (ECOHIS) score.

Methods: A 22-item cross-sectional survey was distributed to caregivers of healthy children aged 5 years and younger with an American Society of Anesthesiology (ASA) I and II status who presented for new patient exams.

Results: In total, 117 caregivers participated in the survey. The ECOHIS was assessed on a 5-point Likert scale and scores ranged from 0-52; higher values indicate poor oral health having a greater impact on the child and family. Those …

The Value Of Educating Teachers, Coaches, And Athletic Trainers On The Management Of Dental Trauma., Darlene W. Jean

Theses and Dissertations

Purpose: To investigate the benefit of educating teachers, coaches, and athletic trainers about dental trauma to prevent incidents and improve the management of students/athletes with dental trauma.

Methods: Teachers, coaches, and athletic trainers throughout the greater Richmond metro area were recruited via email. Participants answered a pre-seminar survey to evaluate their baseline knowledge and determine whether they have experienced dental trauma with their students/athletes previously. The participants were given the option to attend an in-person or virtual seminar educating them on the basic management of traumatic dental injuries and how to guide affected students/athletes and their families to obtain optimal …

Clinical Outcomes Of Primary Anterior Esthetic Crowns In Pediatric Dentistry, Jenan Alahmad

Theses and Dissertations

Clinical Outcomes of Primary Anterior Esthetic Crowns in Pediatric Dentistry - A Prospective Cohort Study

By: Jenan Alahmad, BDS

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.

Virginia Commonwealth University, 2024

Thesis Advisor: Parthasarathy Madurantakam, DDS, MDS, PhD

Department of Pediatric Dentistry

BODY

Purpose: This prospective cohort study aimed to compare the effectiveness of restoring maxillary anterior teeth in children (aged 3-6 years) with three different materials: Zirconia Crowns (ZC), Resin Composite Crowns (RC), and Pre-veneered Stainless-Steel Crowns (PVSSC). The study aims to assess the Oral …

A Preliminary Report Of A Randomized Controlled Clinical Trial Comparing Ferric Sulfate With Zin Oxide Eugenol And Non-Eugenol Based Material For Pulpotomy In Primary Molar Teeth, Sarah Balal

Theses and Dissertations

Purpose: This study aimed to evaluate the effect of eugenol and non-eugenol-based Zinc Oxide Eugenol (ZOE) cements on primary tooth pulpotomies where Ferric Sulfate (FS) is used as a medicament.

Methods: Children aged 3-7 years with dental caries in their primary molars that have clinical and radiographic diagnosis of reversible pulpitis and undergoing dental treatment under Oral Conscious Sedation (OCS) or General Anesthesia (GA) were recruited. Children were randomly assigned to receive either FS and ZOE (IRM) or FS and non-eugenol based (CAVIT). The outcomes were assessed based on failure rates of the materials separately for clinical or radiographic evidence …

Feasibility Of Using Somatosensory Input On Pediatric Patients Receiving Dental Treatment, Liara D. Vinson

Theses and Dissertations

Purpose: The aim of this randomized, cross-over designed feasibility study is to evaluate patient anxiety, patient cooperation, and patient acceptance of a vibrating weighted vest used during the restorative treatment compared to when no device is used.

Methods: Children aged 5 to 15 years, needing at least two appointments for restorative treatment requiring local anesthesia under basic behavior guidance techniques were recruited. Patients were randomly allocated to wearing a vibrating weighted vest at one of the appointments. At both appointments, behavior was evaluated using Frankl scores and anxiety was evaluated at the beginning and at the end of …

Food Deserts And Pediatric Oral Health Status In An Under-Resourced Urban Community, Jessica T. Mcauliffe

Theses and Dissertations

Purpose: The aim of this analysis of survey data was to assess the influence of living within a food desert as a predictor of oral health problems among children of East Henrico County, Virginia.

Methods: Survey participants were recruited and questionnaires applied online. Residing in a food desert, using access to affordable produce as a proxy value, was the independent variable, while self- reported assessment of the child’s oral health status was the primary outcome variable. Analyses controlled for other indirect factors of pediatric oral health. Logistic regression was used to model the association between the self-reported access to healthy …

The Use Of Silver Diamine Fluoride In Dentistry In Virginia, Jessica Eisenberg

Theses and Dissertations

Purpose: The purpose of this research was to determine the use of silver diamine fluoride (SDF) in dentistry in Virginia and the factors that affect the practitioners’ decision. Methods: A survey was sent to the members of the Virginia Dental Association (VDA) by email and posted on the VDA social media accounts. The survey questions measured the practitioner’s demographics, knowledge, and factors that affect their utilization of SDF. Results: Most providers were general dentists (77%). The most common clinical situations for SDF use were to arrest caries in children with behavioral issues (77%), to delay restorative treatment (73%), in medically …

Provider Racial Concordance And Medical Mistrust In Pediatric Dentistry, Chinelo Eke

Theses and Dissertations

Purpose: Studies have drawn varying conclusions on the importance of a racially concordant patient provider relationship. Medical mistrust has continued to garner attention as healthcare enterprises thread equity, diversity and inclusion throughout their organizational policies, practices and systems.

Methods: Parents/caregivers of pediatric patients at VCU Pediatric Dentistry were invited to participate. Surveys included questions about demographics, racial concordance, language preference, and the validated Group-Based Medical Mistrust Scale.

Results: A total of 246 guardians completed the survey. For guardians, 40% reported Black or African American, 31% Hispanic, and 19% Caucasian. Seventy-one percent of guardians reported speaking English, 18% Spanish, and 11% …

Utilization Of Intraoral Scanners For Fabrication Of Obturators For Patients Born With Cleft Lip/ Palate (Clp), Swara Fadnis

Theses and Dissertations

Objective: The goal of this cross-sectional study was to assess the knowledge and attitude of providers regarding incorporating a digital scanner for impression taking in children born with cleft lip and/or palate (CLP). Methods: A survey was sent out to members of the American Association of Pediatric Dentistry (AAPD). The survey included questions regarding the providers’ perception of incorporating digital intraoral scanners for impressions for fabrication of obturators. The survey also included questions about the providers’ reservations in using this technology in practice, what their experience has been with the incorporation of this technology into practice, and what is …

The Effects Of Celiac Disease On Oral Health In Children And Adults, Marissa Balducci, Katarina Jones

Dental Hygiene Student Scholarship

Objectives: Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. To ensure affected patients receive optimal dental care, it is necessary for dental professionals to recognize the oral manifestations of celiac disease in both children and adults. Upon associating oral conditions with celiac disease, the dental provider should be able to present recommendations to the patient, contributing to an improvement in their oral health.

Methods: This review of the literature used PubMed to identify relevant professional research articles with publication after 2017. MesH terms utilized in the search process were …

Hydroxyapatite Toothpaste On Caries Prevention In Children, Samantha Richardson, Kelly Vaughan

Dental Hygiene Student Scholarship

Are Hydroxyapatite Toothpastes The Answer To Fluoride Free Patients?

Richardson, Samantha 1 and Vaughan, Kelly 2

Dental Hygiene Program, Virginia Commonwealth University

Abstract:

Objectives/Aims: With the rising trend to become more clean with our ingredient lists, we are facing more patients refusing fluoride treatments and fluoridated toothpastes. This trend has been prevalent in our younger generations due to parents only wanting the purest natural ingredients for their children and now declining fluoride application. The goal of this literature is to find a safe alternative toothpaste that will be just as effective as fluoride.

Methods: This review of literature has been …

Removal Of Prefabricated Zirconia Crowns From Primary Anterior Teeth With Er,Cr:Ysgg Laser Compared To A High-Speed Handpiece: An In- Vitro Study, Andrew Crowell

Theses and Dissertations

Purpose: The aim of this study was to compare the time and pulpal temperature changes associated with the removal of prefabricated zirconia crowns from primary anterior teeth using an Er,Cr:YSGG laser compared to a rotary hand-piece.

Methods: This in-vitro study was conducted using extracted primary incisors. Teeth were prepared and restored with prefabricated zirconia crowns (NuSmile^®, Houston, TX, USA) sizes 4 and 5 cemented with resin-modified glass-ionomer cement. Restored teeth were stored in a humidor for at least 48 hours prior to removing crowns from the teeth using either an air-rotary hand-piece (HG, N=17) or erbium, chromium: …

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 …

Use Of Passive Immobilization During Oral Conscious Sedation: Parental Perceptions And Utilization By Pediatric Dentists In The United States, Jennifer N. Levine

Theses and Dissertations

Use of Passive Immobilization During Oral Conscious Sedation: Parental Perceptions and Utilization by Pediatric Dentists in The United States, Levine J, Caudill, C (Virginia Commonwealth University School of Dentistry, Richmond, VA)

Research supported by the Alexander Fellowship

Purpose: To assess change in parental attitudes of passive immobilization after viewing an informational video and evaluate how pediatric dentists are currently using passive immobilization during oral conscious sedations (OCS).

Methods: A survey consisting of six statements on a 5-point Likert scale was completed by parents at their child’s OCS consultation appointment before and after viewing an educational video demonstrating benefits of passive …

The Value Of Educating Teachers, Coaches, And Athletic Trainers On The Management Of Dental Trauma., Laura Satoski

Theses and Dissertations

Purpose: The aim of this study is to investigate the baseline knowledge and assess the benefit of educating teachers, coaches, and athletic trainers about the management of sports-related dental injuries.

Methods: Teachers, coaches, and athletic trainers working in youth sports activities across the city of Richmond and the Greater Richmond Region were recruited via email. Participants answered a pre-seminar survey to evaluate their baseline knowledge and determine whether they experienced dental trauma with their athletes previously. The survey also indicated whether they participated in a public or private sports facility. The participants watched a pre-recorded virtual seminar educating them on …

Parental Attitudes Regarding The Primary Dentition, Dental Decay, And Trauma, Kathryn Dundervill

Theses and Dissertations

Purpose: The purpose of this study is to identify the ability of parents in the VCU Pediatric Dental Clinic to recognize signs of decay and trauma and to determine their knowledge regarding the primary dentition.

Methods: This is a cross-sectional study that determined parental attitude and knowledge toward the function of primary teeth, childhood dental decay and dental trauma. Study data was collected through REDCap, a secure web-based survey application. Parents who brought their child to the VCU Pediatric Dental Clinic for a new patient examination or a recall examination were included in the study. The survey was only formatted …

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 …

Value Of Pediatric Sleep Questionnaire In Referrals For Obstructive Sleep Apnea At Vcu Pediatric Dental Clinic, Elizabeth H. Hering

Theses and Dissertations

Purpose: The purpose of this study is to determine the number of VCU pediatric dental patients screened for obstructive sleep apnea (OSA) relative to the number of referrals made for a pediatric sleep study.

Methods: This was a retrospective chart review of children between the ages of 1-18 years seen at the VCU Pediatric Dental Clinic between 2016-2020. Patients with a completed sleep apnea screening questionnaire in the health history form or sleep apnea form/referral were identified. The data was used to determine how many referrals were made for a pediatric sleep study in patients screening positive for sleep apnea. …

The Value Of Postoperative Appointments Following Full Mouth Dental Rehabilitation Under General Anesthesia, Priyanka Patel

Theses and Dissertations

Purpose: Follow-up appointments after full mouth dental rehabilitation under general anesthesia (GA) have been suggested as a method for preventing future caries and need for repeat treatment under GA. The purpose of this study is to determine current practitioner and parental perceived value of the postoperative GA appointment.

Methods: Three separate surveys were administered for this study. The pre-appointment survey asked about the guardian’s desire to have a follow-up appointment. At the follow-up appointment, the post-appointment survey ascertained the level of patient satisfaction with their follow-up appointment and postoperative experience. American Academy of Pediatric Dentistry (AAPD) members were e-mailed a …

Knowledge, Perception, And Clinical Management Strategies Of Us Pediatric Dentists On Molar Incisor Hypomineralization, Courtney T. Brashier

Theses and Dissertations

Purpose: The purpose of this cross-sectional, survey-based study is to determine current US pediatric dentists’ knowledge, perceptions, and clinical management strategies for patients with molar incisor hypomineralization (MIH).

Methods: Following appropriate protocol and authorizations, all active pediatric dentists, general dentists, and post-doctoral student members identified by the 2020 American Academy of Pediatric Dentistry’s membership list were invited to partake in an anonymous email survey. Data regarding participants sociodemographic, education, and clinical backgrounds were collected in addition to information obtained from MIH-focused questions. Descriptive statistics and chi-square tests were used to compare and analyze data. A significance level was set at …

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 …

Non-Invasive Retrieval Of Prefabricated Zirconia Crowns With Er,Cr:Ysgg Laser From Primary And Permanent Teeth, Connor W. Mccall Dds

Theses and Dissertations

Purpose: Compromised tooth structure on permanent and deciduous teeth in the pediatric population is increasingly being restored with tooth-colored prefabricated zirconia crowns. These restorations may need to be removed or replaced with permanent crowns. The purpose of this in vitro study was to explore the use of an Er,Cr:YSGG laser for removal of prefabricated zirconia crowns cemented with RMGI as a non-invasive alternative to rotary instruments.

Methods: Thirteen permanent and 12 primary molars were prepared to dentin and prefabricated zirconia crowns were passively fitted and cemented with two resin modified glass ionomer cements. The irradiation parameters for ErCR:YSGG were 4.5 …

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 …

A Comparison In Pediatric Dental Website Design From A Guardian And Pediatric Dentists’ Perspective., David M. Voth

Theses and Dissertations

Purpose: This project aims to determine which aspects of pediatric dental practice websites are preferable to the guardians of pediatric dental patients and which of these aspects are currently available to guardians on the websites of pediatric dental practices across the United States. The comparison will reveal if practice websites are meeting the needs of the guardians of pediatric dental patients. Our hope is to provide meaningful guidance to pediatric dentists designing new practice websites and to provide the guardians of pediatric dental patients with an appealing online experience during their use of the aforementioned websites. Methods: A survey 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 …

Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon

Theses and Dissertations

USE OF EMOJI IN PAIN LEVEL ASSESSMENT IN PEDIATRIC DENTAL PATIENTS

Purpose: The purpose of this study is to determine the efficacy of a pain scale with Emoji images in comparison to the commonly used Wong-Baker FACES® pain scale. Methods: Healthy, English-speaking patients aged 4-17 presenting to the VCU Pediatric Dental clinic and the operating room and presenting to the MCV Pediatric Emergency Room were asked to rate their pain using the Wong-Baker FACES® and Emoji scales. These patients were then asked to select which pain scale they preferred. Results: A total of 151 children were enrolled in the study. …

Comparison Of Triple Combination Oral Sedation Regimens For Pediatric Dental Treatment, Brett H. Henderson

Theses and Dissertations

Purpose: Compare the efficacy of two benzodiazepines (diazepam or midazolam) in combination with meperidine and hydroxyzine for pediatric dental sedation. Methods: A randomized, double blind observation study of behaviors and outcomes related to two sedation groups. Frankl and Houpt behavior scores were recorded at three time points: injection time, initiation of treatment and at the end of treatment. Postoperative phone call surveys were conducted within eight hours of discharge to assess sleep, activity, and behavior. Results: A total of 40 sedation subjects were included in the study, of which 20 were treated with diazepam triple Combination (Di+M+H) and 20 with …