Dental fear and phobia in childhood represent a significant challenge in pediatric dentistry, with potential long-term negative consequences for both oral health and emotional well-being. Despite considerable advancements in understanding the psychological and behavioral aspects of dental fear, there remains a lack of long-term studies examining the effectiveness of management strategies and the impact of cultural differences on children’s perceptions of dental treatment. Early identification of the severity of dental fear, which can hinder children from seeking timely dental care, is crucial in clinical practice. Recognizing and assessing signs of dental anxiety allows for the adaptation of behavioral interventions and the implementation of tailored management approaches. Parental influence, particularly maternal anxiety and parenting styles, along with biological predispositions and sociocultural factors such as media portrayals, play a significant role in the development of dental fear. Future research should focus on individualized treatment approaches and further exploration of family dynamics affecting dentophobia in children. Developing effective preventive interventions and strategies to reduce dental fear can improve not only children’s oral health outcomes but also their overall emotional and social stability.

Background: X-linked hypophosphatemic rickets (XLH) is a rare hereditary disorder characterized by renal phosphate wasting and impaired bone mineralization. Oral manifestations such as spontaneous periapical lesions and dental abscesses in the absence of caries or trauma may precede systemic features in XLH due to underlying dentin hypomineralization and enamel–dentin junction defects, and could serve as early diagnostic indicators. Case Report: We report on the case of a 4-year-old boy referred to our pediatric dental unit with recurrent intraoral fistulas persisting over the past year. Clinical examinations and an orthopantomogram revealed extensive root resorption and periapical pathology affecting multiple primary molars without evident caries or trauma. Laboratory investigations showed hypophosphatemia, elevated renal phosphate loss, and raised inflammatory markers (CRP (C-reactive protein) and granulocytes). Genetic testing of the child and his mother confirmed a diagnosis of X-linked hypophosphatemic rickets. Management: Due to behavioral challenges, treatment proceeded with difficulty over multiple visits. Endodontic treatment was initiated using a formalin–resorcinol technique; however, several primary molars developed progressive necrosis and required extraction. Orthodontic space maintainers were placed to preserve arch integrity and support future eruption. The patient remains under follow-up and is currently awaiting Burosumab therapy. Despite systemic management, spontaneous necroses of the primary molars persist, highlighting the refractory nature of dental involvement in XLH. Conclusions: This case underscores the pivotal role of pediatric dentists in recognizing systemic diseases through oral findings and demonstrates the challenges of managing XLH-related dental pathology, even under targeted systemic therapy. Early interdisciplinary collaboration is essential to optimize both dental and systemic outcomes in affected children.

Background/Objectives: Vascular Malformation—Osteolytic Subtype (VMOS) is an exceptionally rare autosomal recessive disorder caused by homozygous pathogenic variants in the ELMO2 gene, with fewer than ten genetically confirmed pediatric cases reported worldwide. This report presents the longitudinal dental management and clinical course of a child with VMOS, emphasizing the challenges of preventive and restorative care in such cases. Methods: A four-year-old child with a confirmed diagnosis of VMOS and a history of urgent bilateral coil embolization and surgical excision of mandibular aneurysmal bone cysts presented for dental care. The patient was followed for three years (2022–2025). Management focused on staged oral rehabilitation, preventive strategies, and restorative interventions adapted to changes across dentition stages. Results: At initial presentation, the child exhibited mandibular swelling, gingival hypertrophy, and a history of spontaneous intraoral bleeding. The postoperative course had been complicated by cerebral abscesses requiring prolonged intravenous antibiotics. During the primary dentition stage, full oral rehabilitation and strict preventive protocols were implemented to minimize caries and infection risk. In the mixed dentition period, the permanent incisors and molars erupted with enamel hypoplasia and developmental defects, necessitating composite restorations. Ectopic eruption and suboptimal oral hygiene, partly related to parental fear of bleeding, were also managed with reinforced preventive counseling. Conclusions: This case highlights the long-term dental implications of VMOS, underscoring the crucial role of the pediatric dentist in early preventive planning and individualized restorative management. Effective multidisciplinary coordination remains essential to preserve oral health and minimize complications in rare vascular syndromes with craniofacial involvement.

Tooth wear is usually a physiological prоcess with multifactorial etiology. When it happens rapidly and causes visual or physical changes in the orofacial region, it becomes pathological tooth wear, which can be found in children also. Some of the risk factors that can contribute to the loss of tooth structure are bruxism, specific eating factors, orthodontic anomalies, etc. Aim The aim of the present study is to investigate the incidence and clinical characteristics of tooth wear in school-aged children and its association with orthodontic abnormalities. Material and Methods The object of the study are 262 children in 2 age groups - in elementary school (aged 7-10) and in middle school (aged 11-14). The examined children underwent a clinical examination, during which the following were registered: dental status, type, degree and prevalence of tooth wear and orthodontic malocclusions. After the examination, the parents of the examined children filled a questionnaire about the child’s general health, eating habits, bruxism, harmful habits, etc. The results were statistically processed with SPSS-19. Results Loss of tooth structures was found in 70.6% of the examined children without predominance in any of the sexes. The registered orthodontic anomalies had almost the same frequency – 66.4%, with a statistically significant correlation between the two examined findings. Conclusions Loss of tooth structure is common in the examined children and a statistical dependence was found between it and the presence of orthodontic anomalies.

Oral health education is a fundamental component of preventive dentistry, but children’s engagement across different educational approaches remains an important area of investigation. This study aimed to comparatively evaluate observed behavioural engagement associated with interactive, demonstrational, and game-based educational approaches among school-age children. A pilot, school-based comparative observational study was conducted among 60 second-grade students at a primary school in Sofia, Bulgaria. A standardized 40 min educational session included three approaches: interactive PowerPoint presentations, demonstrations with dental models and visual tools, and game-based activities emphasizing toothbrushing skills and dietary habits. Children’s engagement was assessed using three indicators: active participation and willingness to engage, confidence, and interaction with the educational materials. The game-based approach demonstrated the highest proportion of children classified in the “Very High” engagement category across all indicators. The average proportion of “very high” performance was 63.4% for the game-based approach, compared with 27.8% for the demonstrational approach and 22.8% for the interactive approach. Children participating in game-based activities demonstrated higher observed levels of participation, confidence, and interaction with educational materials. Game-based educational activities were associated with higher observed engagement during oral health education. These findings highlight the potential value of game-based activities for engaging children in oral health education. Further research using randomized designs, validated assessment instruments, and independent observers is needed to determine whether these differences in observed engagement are reproducible.