Saudi Cultural Missions Theses & Dissertations
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Item Restricted THE ASSOCIATION BETWEEN HOUSING CHARACTERISTICS AND DENTAL CARIES AMONG CHILDREN IN THE USA(King's College London, 2024) Alsaeed, Lina; Sabbah, WaelBackground: Despite the strong evidence on the role of the social determinants in dental caries, there is limited research on association between housing characteristics and dental caries among children. Objectives: To examine the association between housing characteristics and caries experience among 2-6 years American children. Methods: Data from the National Health and Nutrition Examination Survey 2017-18 was used. Children aged 2-6 were included. The association between housing characteristics and the sum of decayed and filled primary teeth was assessed adjusting for family income, ethnicity, age, gender, and dental visits. Results: A total of 861 child were included in the analysis. The mean number of decayed and filled primary teeth was 1.28. Compared to those who lived in owned home, Children living in rented homes or homes with other arrangement had higher rate ratios for decayed and filled teeth with rate ratios 1.98 (95% Confidence Interval “CI” 1.25, 3.12) and 2.60 (95%CI:1.14, 5.93), respectively. Higher family income was also associated with lower rates of decayed/filled teeth. Conclusion: The analysis highlighted the importance of housing characteristics as a social determinant of children caries.31 0Item Open Access Non-procedural Pain Management in Paediatric Dental Patients(University College London, 2023-12) Alkattan, Dakila; Ashley, Paul; Parekh, SusanIntroduction: Efforts to improve pain management in children have included approaches to standardize and advance the use of validated pain measurement tools and encourage comprehensive assessment. The discrepancy between improvements in pain assessment practices and pain management outcomes suggests that translation into clinical practice may have failed. Non-procedural pain management approaches are not standardized, or individualized. Even though there are different validated tools to scale and assess pain, these tools are not serving their main purpose, which is giving better outcomes in pain management practices, especially in a time where management of non-procedural pain is paramount. Aims and objectives: The first part of this project consisted of a scoping review on the non-procedural pain management in paediatric patients; to establish how non-procedural pain is managed in paediatric patients, reflect on the research and literature gaps that could be considered as an opportunity for future exploration and studies. Moreover, we aimed to explore how non-procedural pain is managed in different healthcare settings and how these practices can be applied and employed in the paediatric dental setting. The second part of this project involved qualitative interviews to understand the views of paediatric dentists on non-procedural pain assessment and management. Methodology: The eligibility criteria for the scoping review on non-procedural pain management in paediatric patients was based on Participants, Concept, and Context (PCC) between 2015 – 2022. Participants were healthcare workers caring for children under the age of 17 years, and studies included children under the age of 17 with non-procedural pain. The scoping review focused on the assessment and management of pain before delivering any treatment (medical or dental) in children. A qualitative study was conducted in 2023, investigating the views of paediatric dentists on non-procedural pain assessment and management,. The participants included consultants, specialists, registrars, speciality trainees The exclusion criterion were dentists with less than a year of previous experience in delivering dental care to paediatric patients. The 14 participants who were asked questions addressed the following themes: the dentist’s perception of the need and the importance of a baseline pain assessment prior to dental treatment, challenges in obtaining an appropriate non-procedural pain assessment, challenges in decision making of non-procedural pain management practice, and perception on how well parents/carers are managing pain at home. Results: The scoping review resulted in 15 titles eligible for this review. Five studies were conducted in the UK, 4 studies in Italy, 2 in the US, 2 in India, 1 in Germany, and 1 in Canada. Included studies ranged from reviews, retrospective studies, clinical trials, retrospective observational study, exploratory study, cross sectionals, and pilot studies. The qualitative interviews reflected the different layers of the perception and management of the paediatric dentist in practice. They are aware of how important and effective non-procedural pain assessment and management can be with children and their caregivers yet face different challenges in real life practice due to the subjective nature on non-procedural pain. This research aims to improve the care and management of pain in children before they receive actual treatment by emphasising the need for an individualised patient-centred care that will focus on every child’s need and their parents. Discussion and Conclusion: The scoping review highlighted the scarce literature on non-procedural pain management in children. Different approaches were proposed in different domains to manage non-procedural pain, including two pilot studies with unclear results, and a randomised clinical trial with no results provided. Policies and frameworks trialled to lessen visits to emergency departments by better managing non-procedural pain. Pharmacological and non-pharmacological management were also considered effective, with non-pharmacological management being more effective on decreasing the level of anxiety than the intensity of pain. It has been shown that tele-dentistry can be used as a valuable patient management strategy. The qualitative study reflected that paediatric dentists were not interested to use any of the current validated pain assessment tools with children in exception to the Numeric pain Rating Scale (NSR). The overall perception was that pain was subjective and it is challenging for children to express pain accurately. Moreover, pain assessment is a holistic approach of pain history, clinical presentation, clinical and radiographic examination. Paediatric dentists are familiar with the practice of giving patients and their parents non-procedural pain management such as instructions of how to manage pain at home with diet, hygiene, pharmacological management, behaviour management, and/or exercises that will help to ease pain. More studies are needed on the effectiveness of these instructions and how to improve them to better assess the validity of non-procedural pain management.33 0Item Restricted A service evaluation of children and caregivers who are referred to dental specialists at St Thomas and King’s Hospital Paediatric Dental Institution in London.(Saudi Digital Library, 2021-10-01) Almegren, Nora; Hosey, Marie ThereseBackground: Dental caries is the most prevalent disease affecting children worldwide. It does not only affect oral health, but also a child’s health and wellbeing. This service evaluation reports on the preventive care received by children prior to referral at the specialist paediatric dental hospital at St Thomas’ Hospital, London. Method: Data were collected retrospectively from computerized referral records for children referred to specialist paediatric dental service at St Thomas’ Hospital London between December 2019 to July 2020. Data were manually processed into an electronic database. Patient demographics, reason for referral, dental history and prevention advice were recorded. Data was analysed using descriptive statistics. Results: One hundred and twelve referral forms were reviewed. There were 46 girls and 66 boys. Majority of children were healthy, pre-cooperative, with urgent referrals. Fifty-eight children (52%) were referred due to dental caries, of these 34 were between the age of 0-to-7 years. Out of 112, 62 children (55%) were regular attendees and 50 (47%) were occasional attendees or had never attended previously. Eleven families already have had another child undergone extraction for dental caries. All referred children received verbal dental advice (oral hygiene and dietary) from the referrer. Conclusion: The majority of children were referred for dental treatment under specialist in a hospital dental service at St Thomas Hospital were high-caries-risk- children. As ECC can be preventable, prevention measures are essential to ensure families the effectiveness of home care liaising with the local dentist’s preventive care to reduce future incidence of caries as the vast majority were referred due to dental caries. The importance of shared care between practitioners and specialist in hospital providing multidisciplinary care for the child’s quality of life. Further investigation to explore the health care at home and promote local community oral health service at home and nursery schools.11 0Item Restricted Exploring the current practice of dental professionals in discussing diet with parents/carers of children aged up to 2 years old(Saudi Digital Library, 2023-11-23) Alshammari, Faris; Owen, Jenny; Burrows, Kara-Gray; Leggett, HeatherBackground: Early childhood caries (ECC) is a prevalent oral disease affecting young children and is associated with inadequate feeding practices. The early years after birth are crucial for children's oral health due to the significant shift in diet from liquid to solid. Dental professionals are responsible for providing dietary advice to parents/carers during dental appointments to prevent ECC and promote healthy dietary habits for young children. Understanding the current practices of dental professionals in discussing diet with parents of children up to 2 years old is essential for improving oral health outcomes in this vulnerable age group. Aim: To explore the current practices of dental professionals in discussing diet with parents/carers of children aged 0-2, to identify any challenges that could limit dietary advice delivery and assess the solutions that may facilitate the provision of dietary advice. Methods: A cross-sectional study using an online questionnaire was sent through social media platforms. The questionnaire explored demographic characteristics, current participants’ dietary advice practice, challenges experienced and potential solutions. Results: Of the responses of 195 participants, only 63 participants indicated that they usually see children for their first dental appointment before the age of three. Of 63 participants, 60 reported providing dietary advice to parents/carers of children aged 0-2 years as part of a typical dental appointment. The common topic in participants' dietary advice was sugar consumption, breastfeeding, and bottle feeding. Conclusion: Most participants who reported seeing parents/carers of children aged 0-2, discussed the child's diet to prevent early childhood caries (ECC). However, the small number of those participants may impact the findings' generalisability. Research is needed to support these findings and understand dental professionals' dietary advice practices for preventing ECC. The key challenges were clinical time constraints and lack of parents'/carers' awareness and receptivity. The study has identified possible solutions to enable dietary advice delivery, including allocating time slots for dietary advice, increasing awareness, teamwork collaboration, training, and educational courses.40 0