Evidence inconclusive on giving painkillers to children before dental treatment

Child_dentist 3Dental pain is common after dental procedures and can lead to increased fear of dental treatment, avoidance of dental treatment and other associated problems. Reduction of pain is important, particularly in children and adolescents. One way of managing this might be to give painkillers before treatment so that the painkillers can start to work right away. This updated review looked at evidence for using painkillers in children, aged up to 17 years, undergoing treatment without sedation or general anaesthetic, but who may have had a local anaesthetic. The treatments included extracting teeth, restoring teeth and fitting braces. Continue reading

Not enough evidence to recommend chlorhexidine treatment to reduce tooth decay in children

tooth decayTooth decay is a very common disease that over time destroys the tooth surface. It has been estimated to affect up to 80% of people in high-income countries and, despite being preventable through oral hygiene and dietary measures and the use of agents such as fluoride that reduce risk of decay, it is likely to remain a problem, especially in low-income countries. Tooth decay can result in pain and infection, and in young children may require treatment in hospital under a general anaesthetic. As well as causing anxiety and pain, this may mean the child or young person missing time at school and their parents or carers having to take time off work, possibly losing income and incurring extra costs. Prevention of tooth decay is simpler and possibly cheaper than waiting until it occurs and then requires extensive treatment. Tooth decay is largely preventable, and a range of things may assist this: twice-daily toothbrushing with a fluoride toothpaste, and reducing both the amount of and number of times per day sugar is eaten. Tooth decay occurs when certain types of bacteria (germs) in the mouth, such as Streptococcus mutans, produce acids from the sugar we eat, which dissolve the hard enamel coating on our teeth. Some studies have shown that the chemical antiseptic treatment chlorhexidine is highly successful at destroying these bacteria and can be used safely at home in the form of a gel, spray, chewing gum, toothpaste or mouthrinse. Alternatively, chlorhexidine can be applied as a varnish to the surface of teeth by a dentist. But what is the evidence that it works to reduce tooth decay in children? Continue reading

New publications from the Oral Health Group in Issue 5 of the Cochrane Library for 2013

The latest edition of The Cochrane Library is out today, and features 1 new review and 3 new protocols from the Cochrane Oral Health Group. Follow the links to read more!

Children ToothbrushesNew Review:
Primary school-based behavioural interventions for preventing caries
Anna M Cooper, Lucy A O’Malley, Sarah N Elison, Rosemary Armstrong, Girvan Burnside, Pauline Adair, Lindsey Dugdill, Cynthia Pine

This review considers the clinical effects of school based interventions aimed at changing behaviour related to toothbrushing and the frequency of consumption of sugary food and drink. Are programmes aimed at making lasting changes to toothbrushing habits and reducing sugary food and drink consumption in 4-12 year olds effective?

Four clinical trials were included in the review. Three of these showed that there was less dental plaque in the children who had received the programme, and one small study showed there was less tooth decay when children had undergone the educational intervention. However, more high quality research is needed.

New protocol:
Dental cavity liners for Class I and Class II resin-based composite restorations
Andrew B Schenkel, Ivy Peltz, Analia Veitz-Keenan

This review will be undertaken by a team from the College of Dentistry at the University of New York. It will assess the effects of using dental cavity liners in the placement of restorations.

New protocol:
Oral health educational interventions for nursing home staff and residents
Martina Albrecht (nee Bunge), Ramona Kupfer, Daniel Reissmann, Burkhard Haastert, Ingrid Mühlhauser, Sascha Köpke

This new review will assess the effects of educational interventions to improve the oral and dental health of nursing home residents. These interventions could include training programmes for staff or for the residents in oral hygiene, oral care practice, diet and skills training.

New protocol:Triclosan/copolymer containing toothpastes for oral health
Philip Riley, Thomas Lamont

This review will assess the effects (i.e. including both the efficacy and safety) of triclosan/copolymer containing fluoride toothpastes, compared to fluoride toothpastes, for the long-term control of tooth decay, plaque and gingivitis in children and adults.

Other highlights of Issue 5 of the Cochrane Library include: