Monteiro J, Ashley P F, Parekh S
Eastman Dental Institute, London, UK.
Eur Arch Paediatr Dent. 2020 Oct;21(5):565-571. doi: 10.1007/s40368-019-00494-w. Epub 2019 Nov 29.
Understand EAPD members' practices of vital bleaching for children with dental anomalies.
An anonymous online survey sent via EAPD in January 2019, consisting of 13 questions with possible multiple answers and free text.
110 responses from 24 countries were obtained. The majority worked in hospitals/universities (n = 69, 63%) or private practices (n = 50, 46%) and were specialists (n = 62, 57%) or senior academics (n = 35, 32%). Most respondents (n = 74 68%) did not provide vital bleaching for children. 88 respondents (80%) belonged to EU: of these, 46 (52%) were not aware of bleaching regulations. For respondents who provided bleaching 26 (72%) undertook home bleaching, using 10% carbamide peroxide (n = 21, 58%), most commonly for 2 weeks (n = 14, 39%), following establishment of the permanent dentition (n = 21, 58%). Deciding factors included: extent (n = 27, 75%) and shade (n = 26, 72%) of discolouration and child being teased by peers (n = 23, 64%). Main reasons for not bleaching included: concerns with side effects (n = 41; 55%) and not agreeing with bleaching (n = 23, 31%). Dentists who did not bleach managed a range of conditions, most frequently molar-incisor hypomineralisation (n = 57; 77%). The majority provided composite restorations with removal of tooth structure (n = 50; 68%) with a number opting for no treatment (n = 27, 37%).
This study shows wide variations in treatment of children's dental anomalies across Europe. Fears of adverse effects and personal beliefs seemed to be the main deterrents to bleaching in children. Clinicians who provided bleaching tended to opt for more conservative techniques and to take children's concerns into consideration.
了解欧洲儿科牙科学会（EAPD）成员对患有牙齿异常儿童进行活髓漂白的情况。
2019年1月通过EAPD进行了一项匿名在线调查，包含13个问题，有多个可能答案及自由文本。
获得了来自24个国家的110份回复。大多数人在医院/大学工作（n = 69，63%）或私人诊所工作（n = 50，46%），且为专科医生（n = 62，57%）或资深学者（n = 35，32%）。大多数受访者（n = 74，68%）未对儿童进行活髓漂白。88名受访者（80%）属于欧盟：其中，46人（52%）不了解漂白规定。对于进行漂白的受访者，26人（72%）采用家庭漂白，使用10%过氧化脲（n = 21，58%），最常见的是持续2周（n = 14，39%），在恒牙列形成后进行（n = 21，58%）。决定因素包括：变色的程度（n = 27，75%）和色度（n = 26，72%）以及孩子被同龄人取笑（n = 23，64%）。不进行漂白的主要原因包括：担心副作用（n = 41；55%）以及不同意漂白（n = 23，31%）。不进行漂白的牙医处理多种情况，最常见的是磨牙 - 切牙矿化不全（n = 57；77%）。大多数人采用去除牙体组织的复合树脂修复（n = 50；68%），一些人选择不治疗（n = 27，37%）。
本研究表明欧洲各地在儿童牙齿异常治疗方面存在很大差异。对不良反应的担忧和个人信念似乎是儿童漂白的主要阻碍因素。进行漂白的临床医生倾向于选择更保守的技术并考虑儿童的担忧。
