The purpose of the present study is to clarify how exactly the dentist and the dental hygienist at a public health center or a dental office recognizes the obligation concerning child abuse, and to consider their roles in the early detection and prevention of child abuse.
The questionnaire was sent to dental offices and public hea lth centers in Tokyo. Forty-seven dentists and 69 dental hygienists at dental offices, and 37 dental hygienists at public health centers accepted our request and answered the questionnaire after reading the written explanation about the purpose of this study and the confidentiality obligation.
The following results were obtained from this survey:
1. The ratio of people having concerns about child abuse was 100% in dental hygienists at the public health centers,93.6% in dentists at dental offices, and 69.6% in dental hygienists at the dental offices, showing that dental hygienists at dental offices have less concerns about child abuse compared with others.
2. Dental hygienists at dental offices have predominantly obtained the information about child abuse in class at their vocational schools, while dentists and dental hygienists at public health centers have obtained it at lecture meetings and seminars after graduation.
3. The ratio of persons understanding the obligation to report suspected cases of child abuse was 81.1% in dental hygienists at the public health centers,66% in dentists,44.9% in dental hygienists at the dental offices, suggesting that the awareness of this obligation in dental hygienists at dental offices is lower than others. Regarding the detailed contents of obligation to report, although most of dental hygienists and dentists knew where to report suspected child abuse and that reporting suspected cases does not break confidentiality, less dental professionals knew that they do not have to verify the query.
4. Seventy-three percent of dental hygienists at public health centers,36.2% of dentists and only 4.4% of dental hygienists at dental offices experienced at least 1 case of suspected child abuse.
5. Among the dentists who experienced a suspected case of child abuse,76.5% of them did not repot the case. Over 75% of dental professionals feel some unease about reporting a suspected case, which leads to hesitation in reporting.
6. In dental offices, only 14.9% of dentists and 7.3% of dental hygienists have implemented some program supporting child-rearing for prevention of child abuse. Further assistance for child-raising by dental professionals at dental offices is required to promote the physical and mental health of the community.

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Dental plaque has many varieties and properties. Its properties are deeply involved with dental cavities. The dental plaque, detected from children's mouths is usually white, but we also recognize yellow-brown colored plaque in some cases. In this study, we research the differences between yellow-brown colored plaque and white plaque from the clinical and molecular biological view points.
Plaque samples were collected in 30 children who had dental treatment at Pediatric Dentistry of Hiroshima University from erupted teeth, and those sites in the subjects. Differences of the composition among bacterial types, production power of acidity, caries experiences, and the tolerance power of bacteria, in regard to S. mutans and S. sobrinus, which were separated from yellow-brown and white dental plaque, were investigated. In this study, we examined 15 samples of the yellow-brown colored plaque, and the same 15 samples of the white plaque. The results of this study were as follows:
1. Among children with white plaque and yellow-brown colored plaque, it was observed that the children with yellow-brown colored plaque experienced less dental caries than the children with white plaque, and the rate score was significant.
2. In comparison to the productive power of acidity by using cryostat (CAT21), the yellow-brown colored plaque group showed a tendency of low scores (under 1.5, which showed lower risk) and the average score of CAT was also lower against the white plaque group.
3. PCR assay was conducted to identify the bacterial species which were included in each plaque. In the yellow-brown colored plaque group, the detection rate of cariogenic species (S. mutans, S. sobrinus)was low. Mixed infections of these cariogenic species were not identified. The high detection rate of non-cariogenic species (S. sanguinis, S. mitis) was noted. Whereas, in the white plaque group, the detection rate of cariogenic species was high, and both infections were noted. The rate of noncariogenic species was lower in the white plaque group, compared with the yellow-brown colored plaque group.
4. The survival assay of the two species (S. mutans and S. sobrinus) to examine the acidity tolerance power of those clinical isolates showed that the tolerance score of the white plaque group was slightly higher than that of the yellow-brown colored plaque group.
The above suggests that the yellow-brown plaque has a lower risk than the white plaque, in the light of the cariology, because of the different distribution of the species and inducing power of dental caries.

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Cleft lip, alveolus and/or palate (CLP) is the most frequent congenital craniofacial malformation. It is known that this malformation occurs in a ratio of about one to 500 birth in Japanese. Most of them have absence of teeth, supernumerary teeth, fused teeth, abnormalities of tooth eruption and/or enamel dysplasia. Because of these abnormalities, caries risk in CLP children is higher than that in the normal ones.
The first purpose of this study is to survey the correlation between the types of cleft and malformation of tooth. Especially, we focus on the enamel dysplasia. The second purpose is to survey caries risk of CLP children. We examined the primary dentition of the CLP children who visited the clinic of pediatric dentistry in Kyushu University Hospital.
The following results were obtained.
1. Cleft alveolus children tend to have abnormalities of tooth on the cleft side of maxilla, but some have abnormalities of tooth on the opposite side of maxilla which has no cleft, as well as mandible.
2. Cleft palate children without cleft alveorus do not have abnormalities of tooth in the right side of maxilla.
3. Caries risk of cleft palate children is lower than that of normal ones.
These results indicate that we have to perform three important steps for CLP children as follows. Firstly, to predict the abnormalities of primary teeth of CLP children. Secondly, to give oral hygiene instruction for the parents of CLP children. Thirdly, to perform a periodical examination to prevent new dental caries for CLP children.

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In this study, the role of CPP-ACP (casein phosphopeptide-amorphous calcium phosphate) containing paste (MI paste®, GC, Japan) on caries prevention was determined in a pH cycling experiment of de/remineralization.
To evaluate the effects of CPP-ACP containing paste on promoting remineralization, bovine enamel slabs were immersed in 0.01% sodium fluoride (NaF) solution conditioned in the presence of CPPACP with/without xylitol for 0.5 hour and then each specimen was stored in demineralizing solution (0.1 M lactic acid buffer solution,1 mM CaCl₂,0.6 mM KH₂PO₄: pH 5.3) for 23.5 hours. This process was repeated once a day for 4 days.
The results were as follows:
1. By the action of CPP-ACP, it has kept enamel surface intact in the demineralizing solution, and moreover with the presence of xylitol, this situation was showed to promote remineralization in the mid to bottom of affected enamel area.
2. In the presence of xylitol without CPP-ACP, little effect was observed on the enamel surface whereas remineralization was seen in the mid to bottom area of the demineralized enamel.
3. In the presence of CPP-ACP without xylitol, however the maintenance effect of the enamel surface was seen clearly, the remineralization of enamel inside was seen slightly, and so the mineral loss values were evaluated highly.
These results suggest that MI paste® has the ability to maintain the enamel surface by CPP-ACP and to promote remineralization of the enamel inside by xylitol. The application of MI paste® with fluoride on the enamel surface is considered to play an effectual role in caries prevention.

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The lip closure effects after frenectomy of the upper labial frenum were studied by the high position of the upper labial frenum, the lip closing force, the upper lip pressure, the lower lip pressure and the upper-lower lip pressure ratio in 16 patients' control group (aged 5-7 years) and 14 patients which excised the upper labial frenum (aged 5-11 years). There was the position of the upper labial frenum which was smaller than before a control group, and the following measurements were significantly larger than after a resection of the lip closing force, the lower lip pressure and the upper lip pressure which had no significant difference before a control group and before a resection. And these are significantly larger than after a follow up in a resection group and after a control group. Moreover, the lower lip pressure after a resection and the follow up was significantly larger than the upper-lip pressure before and after a control group, but there was no significant difference before a resection group. The upper-lower lip pressure ratio was significantly larger than before a resection which were not significantly different before and after a resection and after a follow up in a control group. These results suggested that frenectomy of the upper labial frenum improves lip closure in children.

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Many kinds of examination method of children's psychological conditions in dental treatments have been reported. However, those methods have some difficulties applying to mentally retarded children. Therefore we applied a new color selection method combined with facial figure selection to investigate the psychological conditions of mentally retarded children and examined the validity of the method. The method was carried out with one selection from 7 colors (white, red, pink, yellow, blue, green, black) and the facial figure before and after treatment. The subjects consisted of 17 mentally retarded persons (MR group) (10-41y, mean age: 26 y 4 m, mentally developmental age: 4 y 8 m)and 17 healthy children (Control group) (3-5y, mean age: 3 y 9 m) at the Pediatric and Disabled Patient Clinic of Osaka Dental University Hospital. Nine items were examined; the color and shape classification test, entering attitude to the clinic, selected color before and after treatment, selected facial figure before and after treatment, dental treatment, the attitude during treatment and the colors which they like.
The results were as follows:
1. Between the MR group an d the Control group, significant differences were seen in the items of the color and shape classification test, entering attitude to the clinic, selected color before treatment, dental treatment.
2. The selected colors were changed before and after treatment in 15 out of 17 of MR group and in 12 out of 17 of the control group, and there was a significant difference between the selected color change and the dental treatments (p< 0.01, p< 0.05).
3. Each color didn't always agree with the same facial figures, then it was suggested that the image of the color could not be fixed and it depended on each subject.
4. The color selection method was easy to use for the MR group and it was considered to be possible to use as an examination method of psychological conditions by adding investigations of the color image in each subject.

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The results of dental examinations and the contents of consultation with parents or guardians at the time of examination were compiled for 1,529 1-year-old infants without having any particular motivation who received dental examinations. The results of this study were as follows:
1. The mean number of erupted teeth in infants aged 1 year and 0 months was 7.5.
2. Dental caries affected 3.2% of the infants aged 1 year and 0 to 5 months and 10.5% of the infants aged 1 year and 6 to 11 months.
3. Among the infants afflicted with caries,85.7% had not been weaned.61.8% were generally breast fed before going to bed or during the night, and 29.1% were bottle-fed before going to bed or during the night.
4. When parents with 1-year-old infants were asked if they felt anxious about their children's oral health, the most common response was“aversion to teeth-brushing”, followed by “teeth alignment”and “methods of brushing their children's teeth”.
5. Of the infants who received dental exam inations at age 1,43.0% continued to receive regular pediatric dental care. Among those infants who become regular patients, only 4.4% were afflicted with caries in examinations at age 1. Moreover,44.4% of the parents of infants who came to receive regular care had answered at the dental examination that they had “no particular anxieties”. Thus it was clear that even without caries or a particular motivation, there are many infants who come to receive regular pediatric dental care due to the approach of the dentist.

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The purpose of this study was to evaluate child behavior and training times during dental treatment.
We examined a total number of 742 children (390 males and 352 females) aged between one and fifteen with an average of six years of age, and the following results were obtained.
1. It is difficult to adapt to dental treatment under three years of age. The r ate of adapting child in the three years of age group was 57.7%, so three years old was the turning age for adaptation during dental treatment. The adapting child increased above three years of age.
2. The average times for training in the three years of age group was two. Over three years of age, training times was decreased as the age increased.
3. In patients with nitrous oxide inhalation sedation, the training times had a tendency to be needed more than in patients without nitrous oxide inhalation sedation.

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It is well known that Bruxism causes to not only tooth wear (abrasion), but also has a risk factor for periodontal disease, orofacial pain, and temporomandibular disorders. It was divided into two groups that present time, such as awake bruxism and sleep bruxism (SB). Awake bruxism is still unclear, however SB was seen clearly by the degree of these details in sleep physiological observation. SB was frequently seen after rhythmic masticatory muscle activity such as induced sleep microarousals. On the other hand, details of bruxism in infants and children is still unknown. Very interesting points was these situations and effect of aging.
We encountered a one year and 7 month (19 month) old girl who had severe high mobility of her lower incisors with bone loss and bleeding.
Here, we report that a very rare case of sleep bruxism and its treatment was the reason.

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