In recent years, the need for “home and visiting dental care for children” has been recognized; however, the actual number of patients is small and interprofessional collaboration is insufficient. In this study, we investigated the status of pediatric home and visiting dental care by our dental clinic and report its utility and challenges. Fifty-two children receiving home and visiting dental care by our clinic between May 2019 and September 2023 were enrolled. We retrospectively examined the baseline characteristics, treatment, and outcomes of the enrolled children based on medical records. The median age was 2.2 years in the enrolled children (N = 52; male, n = 26; unable to walk, n = 33; technology-dependent children [TDC], n = 40) at consultation (baseline). Most requests for home and visiting dental care came through referrals from home care nurses, and the most common reason for parents to seek treatment was a recommendation from such nurses. The treatments ranged from cleaning and caries prevention to extraction and grinding of deciduous teeth. As for the outcome, a total of 42 patients continued to visit our clinic regularly, of which 31 children “continued to home-visit” and 11 children “shifted to outpatient.”

To promote pediatric home and visiting dental care in the future, it is considered essential to establish an interprofessional collaborative system and share knowledge and skills among dental health care providers.

In pediatric home and visiting dental care, understanding the overall health status with medical care is crucial. Moreover, specific expertise for pediatric procedures is required, such as preventive measures and the replacement of permanent teeth, which accompany growth and development. We believe that pediatric dentists are expected to play a central role in pediatric home and visiting dental care in the community.

It has been reported that the composition of the oral microbiome changes substantially over time, with only a few oral microbiomes becoming established in early childhood. This study was conducted on eight pairs of children and their mothers to examine factors related to the mutual influence of the oral environments of the children and their mothers during childhood. The analysis of oral microbiome by the 16S rDNA-clone library method showed that the highest percentage of streptococcus spp were detected in both children and mothers. The genera Streptococcus, Veillonella, Fusobacterium, and Schalia were detected in all subjects, both children and mothers. A comparison of the prevalence of oral bacteria using the Mann–Whitney's U test showed no significant difference between children and mothers. A single regression analysis was performed using the genus of the detected oral bacteria of the child as the objective variable and the age of the child and mother, sex of the child, mode of delivery, genus of the mother's oral bacteria, DMFT index of the mother, and number of times the child and mother brush their teeth per day as explanatory variables. Among the genera of oral bacteria detected, for the genus Rothia, maternal DMFT index was suggested to be a significant factor influencing the prevalence of Rothia in the child's oral cavity.

This research aimed to clarify the dental arch size and the prevalence of malocclusions in primary dentition. The width and length of the dental arch and the presence of malocclusion were examined using dental models obtained from 1,702 children aged from 3 years and 0 months to 6 years and 6 months registered at nursery schools during the period of 2013 to 2018. The findings were as follows.

1. The width of the primary dental arch in the maxilla and mandible was significantly larger in boys than girls at each age.

2. Regarding the prevalence of malocclusions evaluated based on the criteria for the dental health survey of 3-year-old children by the Japanese Society of Pediatric Dentistry, crowding teeth were seen most frequently and anterior cross-bite ranked second. The prevalence of maxillary protrusion and open bite tended to decrease with age, while deep bite tended to increase with age.

3. Compared to the crowding teeth group, the dental arch widths were significantly larger at multiple measuring points in the normal (without any types of malocclusion) groups of both boys and girls. When the dental arch lengths were compared between the two groups, neither boys nor girls showed differences in the maxilla, while the values in the mandible were significantly larger in the normal group with boys and girls combined.

4. The diameters of the crown of the incisors in both the maxilla and mandible were significantly larger in the crowding teeth group compared to the normal group. Overbites were significantly larger in the crowding teeth group at the ages of 3, 4, and 5.

This study revealed the characteristics of the size of the primary dental arch and the occlusal conditions in children today, and the values at some measuring points were found to be highly relevant to crowding of teeth.

We analyzed the results of a questionnaire survey of parents of young children who visited Kinami Pedodontic & Orthodontic Clinic for the first time, and examined the relationship between the survey results and dental caries. In addition, by comparing the survey results around 2015 (December 2014 to May 2015; the 2015 group) and around 2023 (December 2022 to February 2024; the 2023 group), we aimed to clarify recent trends as well as changes in parents’ awareness of oral health and responses at home over the approximately 8 years before and after the coronavirus pandemic, and obtained the following results.

1. In the 2015 group, there were 28 patients with caries (prevalence rate 26.4%), and in the 2023 group, there were 15 patients with caries (prevalence rate 15%). The caries prevalence rate by age group was the same in both year groups. Although there was a decrease in all age categories in the 2023 group, the decrease was not significant.

2. The number of children attending nursery school nearly doubled, from 24.5% in the 2015 group to 44.0% in the 2023 group. The percentage of children continuing to breastfeed over 1 year and 6 months was 37.0% in the 2015 group, but this had halved to 19.2% in the 2023 group.

3. The number of children who regularly consumed snacks increased in the 2023 group compared to the 2015 group, but the intake of sweet snacks was higher in younger children in the 2023 group and increased in all age groups. A similar trend was observed for sweet beverages.

4. The number of children using fluoride was higher in the 2023 group compared with the 2015 group.

5. In both age groups, children who consumed “sweet snacks” and “sweet snacks and sweet beverages” had significantly more dental caries.

The association between childhood dental caries and Candida albicans, transmitted from mothers to children, has been reported both in Japan and abroad. In this study, we classified children according to caries severity, which provides information on the current status of the whole oral cavity, and examined the association of caries severity with C. albicans prevalence in mother–child pairs in the Japanese population and with other maternal (caregiver-related) factors (diet, behaviors, and mother’s caries experience). The subjects were 80 mother–child pairs: 80 children (50 boys and 30 girls, average age 5 years and 1 month), who were in the primary or mixed dentition period, and their mothers. Seventy percent of the C. albicans carriers in the caries group were classified as “severe,” and the higher the severity of caries, the higher the viable counts of C. albicans and Streptococcus mutans observed both in mothers and their children. All children with recurrent caries within 6 months were infected with C. albicans. Children with “severe” caries exhibited either higher counts of C. albicans or maternal DMFT scores. The genotypes of C. albicans showed a similar distribution between mothers and children, with approximately 60% of the cases being type A, followed by approximately 20% being type D.

Thus, C. albicans, along with S. mutans, may play an active role in the development, severity, and recurrence of dental caries in Japanese children, and is associated with maternal microbial profile and caries status. These findings suggest the importance of renewed efforts in health education and oral care for caregivers including mothers, taking C. albicans into account as a microbial risk factor for childhood dental caries.

Hypophosphatasia is an inherited skeletal disease that causes deficient calcification of bone and teeth and the characteristic premature loss of deciduous teeth. Symptoms include those similar to rickets such as bone dysplasia, gait disorder and bone pain. Rickets is also a skeletal disease caused by disorder of calcium and phosphorus metabolism.

In this study, we report a case of a girl with a history of deciduous tooth loss and complaints of inferior limb pain, which led us to suspect hypophosphatasia and to consider differential diagnosis vitamin D deficiency rickets after a thorough medical examination. The girl presented to our dental hospital for the first time with a chief complaint of delayed eruption of the right maxillary lateral incisor. The parents, who were concerned about hypophosphatasia, told us that she had a history of premature deciduous tooth loss around the age of three. Based on this history and inferior limb pain, hypophosphatasia was suspected and thorough examinations were conducted at a medical hospital by a pediatrician.

Based on low 25-hydroxyvitamin D concentration in blood, a marker of vitamin D sufficiency, and findings on plain radiographs of the knee joint and bone pain, a diagnosis of vitamin D deficiency rickets was suspected, and vitamin D replacement therapy was administered. After commencing this therapy, she underwent dental treatment for extraction of the tooth germ of the right maxillary lateral incisor whose growth was stunted. During the dental visit, her inferior limb pain and back pain had decreased.

It is considered that coordination between pediatric dentistry and medicine is important to enable such children with systemic diseases to receive appropriate treatment in the future.

A 3-year 11-month-old girl presented with an unerupted left primary mandibular second molar. X-ray findings at the initial visit showed bone eruption of the mesial part of the left primary mandibular second molar, with round calcified hard tissue located on its occlusal surface. Root formation of the right primary mandibular second molar was complete, while that of the left primary mandibular second molar was not complete. At 4 years 7 months old, the mesial part of the occlusal surface of the left primary mandibular second molar erupted. Thereafter, at 5 years 3 months, round calcified tissue was away from the primary second molar, and had moved to the distal and lingual side. Root formation of the round calcified tissue was seen, and was considered to be tooth-like calcified tissue. The crown of the left primary mandibular second molar erupted and the tooth axis was much better than before. At 5 years 9 months, in order to diagnose the position and morphology of the tooth-like calcified tissue, 3-dimensional CT imaging was performed. The root was curved, and a part of the tooth-like calcified tissue crown was very close to the tooth germ crown of the left mandibular first molar. Also, the apical root of the tooth-like calcified tissue was close to the apical root of the left primary mandibular second molar. Due to concern regarding disrupting the eruption of the mandibular first molar, we tried to extract the tooth-like calcified tissue under local anesthesia, but abandoned it because it could not be done without damaging the neighboring two molars. A subsequent radiographic examination was performed yearly, and eventually congenital missing of the successor permanent second premolar was diagnosed. At 12 years 10 months, tooth-like calcified tissue erupted on the lingual alveolar side, and tooth-like calcified tissue was extracted. The crown shape was round and the crown color was white with transparency. For these reasons, it was clinically diagnosed as a supernumerary tooth. One year later, slight root resorption of the left primary mandibular second molar was seen, but it is functioned instead of the successor permanent premolar.