In this study, we conducted a questionnaire survey of hospitals with an NICU/PICU to investigate whether their in-house dentists provide dental care, including oral examination, for pediatric patients with special healthcare needs transitioning to home care; we also examined the details of the dental care provided. The survey aimed to understand the hospital dentistry needs of these patients and the dental interventions they receive at general hospitals, while clarifying the necessity of home-visit dental care after their transition to home care. Of the 192 facilities surveyed, the number of full-time dentists was 3 at 39 facilities (20.3%), 2 at 37 facilities (19.3%), and 4 at 18 facilities (9.4%). The number of full-time dental hygienists was 2 at 36 facilities (18.8%), 3 at 35 facilities (18.3%), and 4 at 28 facilities (14.7%). Of the 105 facilities providing dental care for pediatric patients with special healthcare needs, the most common dental care services provided for pediatric patients with special healthcare needs were: oral health guidance and general dental procedures in outpatient care (77 facilities), oral health guidance in inpatient care (67 facilities), and oral health guidance in home-visit dental care (9 facilities). Ninety-five facilities did not offer home-visit dental care (90.5%). At 45.3% of the facilities, pediatric patients with special healthcare needs were not offered an opportunity to receive dental services before transitioning to home care. Based on our findings, it is clear that there are children with special healthcare needs who transition to home care without ever receiving dental services; home-visit dental care can play a significant role in these cases. Moreover, even those who were provided dental services before starting home care may not receive continuous dental care from hospital dentistry. Therefore, it is desirable that they receive dental care support during the early stage of home care. Furthermore, our findings confirm the need for hospital and clinic dentistry to strengthen dental care collaboration without relying entirely on home-visit dental care.

The purpose of this study was to develop a non-invasive and non-contact measurement method for lip closure. A portable three-dimensional imaging device (VECTRA H1, Canfield, USA) was used for photography. Images were combined into one three-dimensional facial image by software (VECTRA VAM ver.6.5.4, Canfield, USA). Using the imaging device and software, invasive and non-contact images were taken and analyzed. The difference between the at-rest and pursed-lip states of the facial 3D images superimposed on the lip region was defined as the 3D lip morphology during lip-pursing. The volume, surface area, and distance were analyzed based on the at-rest image. The relationship between the three-dimensional lip morphology analysis values and the lip-closing force was examined in 100 schoolchildren when the lips were pursed, using the total multidirectional lip-closing force, which was the sum of the multidirectional lip-closing forces measured in eight directions. As a result, the volume, surface area, and distance of the three-dimensional lip morphology during lip-pursing were significantly positively correlated with each other, and all of them were significantly positively correlated with the total multidirectional lip-closing force (volume : r＝0.63, surface area : r＝0.44, distance : r＝0.62, all p＜0.001). There was no significant difference in the correlation coefficients. From these results, it was found that the three-dimensional lip morphology of schoolchildren when they pursed their lips reflected their multidirectional lip-closing force. It was suggested that lip closure can be inferred from the three-dimensional lip morphology when the lips are pursed.

Molar Incisor Hypomineralization (MIH) is defined as an unexplained enamel hypoplasia that develops locally in the first permanent molars and incisors, and is different from enamel hypoplasia caused by enamel imperfecta and local causes known so far in that it develops locally in these teeth, including the first molar. In Japan, the incidence of MIH is about 1 in 5 to 10 people, and it is thus a disease with a relatively high frequency of expression. Various studies have been conducted on the causes of MIH, but they have not yet been clarified. MIH is found on the enamel surface as cloudy, yellow-brown, or brown discoloration at the beginning of eruption, but it is not uncommon for substantial deficiencies of a wide range of denticles to occur due to contact with the paired teeth after eruption. Therefore, dentists need to perform regular and long-term oral health management to guide the patient's occlusion to a healthy permanent dentition and to take appropriate measures as the teeth grow and develop.

We outline three cases of children with MIH of different severity who received oral management at our hospital.

In pediatric dentistry, treating tongue bites in infants and young children is challenging at times because no proven treatment has been established. In this report, we describe the case of a one-year-three-month-old boy who had been biting his tongue while sleeping since infancy. We recommended his parents provide him with gingival massage (gum rubbing) and tongue-raising training based on the muscle stimulation training method (Vangede method) used to teach feeding abilities.

The patient was referred to our hospital when he was one year and three months old because his parents were concerned about his frequent tongue-biting while asleep after the lower deciduous central incisor had erupted at around nine months. His birth and medical histories were unremarkable, and his family history revealed that both of his parents had an anterior crossbite with dental crowding. His developmental history was as follows : head and neck control at three months, weaning diet introduction at six months, and discontinuation of breastfeeding at 11 months. The child had never sucked his thumb or used a pacifier. The patient had a crossbite, crowding in the mandible, eight erupted maxillary incisors, and an ulceration on the lower lingual apex. Bite reflexes and involuntary jaw movements were observed ; generalized tension was sensed while touching the perioral area. Since the patient was too young to wear a mouth protector, gingival massage and tongue-raising training using the Vangede method were performed at home to support the development of oral functions. With continued treatment, the frequency of tongue bites decreased progressively, the anterior crossbite improved at two years and two months of age, and at two years and eleven months, the crowding of the mandibular anterior teeth also showed improvement and transformed into a normal deciduous dentition bite.

The Vangede method of massaging the gingiva effectively improved the symptoms of tongue bites in this infant with delayed development of oral functions, although the effect was not instantaneous.