Dental Chair Research Articles

Dental team barriers and enablers for the dental management of adults with severe obesity: a qualitative analysis

BackgroundBroad challenges regarding the dental management of people with severe obesity experienced by general dentists have been minimally explored. The perspectives of the dental team regarding these multifaceted issues are currently unknown and they potentially impede the delivery of optimal dental care to this population and contribute to poor oral and general health.AimsOur qualitative study aimed to identify and explore barriers and enablers in the dental management of adults with severe obesity among dental professionals and support staff in Australia.MethodsFocus groups and semi-structured interviews (n = 34 participants) were conducted with dental professionals (n = 23) and support staff (n = 11). Recordings were transcribed verbatim and synthesised using thematic, inductive analysis.ResultsMultiple barriers to adequate provision of dental care for people living with severe obesity in both general and specialist dental settings were identified. Key themes emerged related to the clinical challenges reported by participants in providing dental management for people living with severe obesity, appropriateness of existing bariatric dental service provision and safety of care. Enablers to access were identified, including increased availability of bariatric dental chairs, environmental modifications, education of both patients and the entire dental team and for guideline development.ConclusionThe current study explored multiple barriers to optimal dental management of people living with severe obesity in both general and specialist dental settings. Enablers should be used to inform future practice. The optimisation of existing bariatric dental service provision requires urgent review with solutions guided by systemic change. Study findings suggest a review of current health systems, economics, access barriers, policies and procedures and education and training beyond the individual level are needed. Future directions to improve the dental management of people living with severe obesity are proposed.

Assessment and quantification of the microbial flora in the output water of two types of dental chairs: A comparative study

Objectives: Dental Unit Waterlines (DUWL) have shown to be a perfect host for different pathogenic microorganisms. The purpose of this study was to analyze and compare the level of bacterial contamination in the output water of 2 types of DUWL. Methods: Dental unit water samples from the air/water syringe of the A-dec (A-dec™ Performer 200, Newberg, USA) DUWL type and KaVo (ESTETICA™ E30/E70/E80 Vision, Kavo, Biberach, Germany) type were collected and analyzed for total aerobic flora, Pseudomonas aeruginosa, faecal coliforms, total coliforms, faecal streptococci and sulfite-reducing anaerobic flora. Results: The bacteriological analysis of water samples shows the presence of bacterial contamination at high levels exceeding the standard safety guidelines of 100 CFU/mL set up by the American Dental Association (ADA) and accepted by the Centers for Disease Control and prevention (CDC) on the heterotrophic bacterial load. The data shows no statistically significant differences for all bacteriological parameters studied between the conventional A-dec DUWL type and the KaVo type that has an automated mode of decontamination. Conclusions: Despite all the disinfecting solutions considered to eradicate the bacterial proliferation in DUWL, the problem remains one of the greatest challenges in modern dentistry. Practitioners and medical staff should not underestimate the harmful consequences of this bacterial growth, not only on the health of their patients but also on their own health.

Virtual reality in specialized dentistry: employing virtual reality for the alleviation of pain and anxiety in hereditary angioedema patients.

Following an episode of hereditary angioedema (HAE), dental anxiety commonly arises, and many patients find it challenging to access proper care. While the use of virtual reality (VR) for pain and anxiety management in dentistry is on the rise, its application in individuals with angioedema remains largely unexplored. In a case series conducted at a specialized dental clinic, three patients with a history of acute angioedema attacks and dental anxiety engaged with 360° VR videos while seated in the dental chair, utilizing a virtual reality device. Three patients with hereditary angioedema were treated by subjecting them to virtual immersion using VR glasses. Intraoperative reactions were analyzed using VAS scales in order to report the patients' level of anxiety and pain. The outcomes, evaluated through a standard observation tool, surveys, and interviews, encompass the assessment of patient anxiety and pain, responses to VR, and the evaluation of system usability along with its impact on the dental team's workflow Three individuals underwent examination, from which three reliable questionnaires were obtained, demonstrating a success rate of 99.9%. The group included one male and two females, with their ages spanning from 6 to 58 years. The findings revealed an average anxiety score of 1.80 with a standard deviation of 0.6 points, and an average pain score of 1.98 with a standard deviation of 0.3, thus validating full immersion in distraction. Statistical analysis using independent-sample t-tests and ANOVA indicated no significant differences in anxiety levels among the patients based on gender. Both patients wore the VR device throughout the procedure, expressing that it was comfortable, diverting, and held the potential to alleviate anxiety and pain. The dentist noted a positive influence on patient anxiety levels and procedure completion times, expressing an intention to continue employing VR with other angioedema patients and across diverse clinical populations. Virtual reality can be an excellent distraction tool in patients with hereditary angioedema who present at least one acute attack per year.

A cross sectional study to assess the level of awareness of dental surgeons about national oral health program in a city of central India

: In 1999, the Ministry of Health Family Welfare, government of India, launched the first National Oral Health Care Programme on a pilot basis. This cross-sectional study was contemplated in Indore district to assess the awareness of dental surgeons regarding their awareness about the basic tenets of the National Oral Health program. Type of the Study- Cross sectional studyDuration of the Study- 6 months- January-June 2024Site of the Study- Indore districtSample Size- 100Sampling technique- Purposive SamplingStudy method- 1. First of all, the list of dental surgeons operating in Indore district was obtained.2. 100 dental surgeons were randomly identified from this list.3. Their written informed consent was obtained to be a part of the study.4. Pre-designed semi structured questionnaire was prepared and fed in google forms and shared with these identified dental surgeons5. Data collected was entered in MS excel/spreadsheets6. Data was analysed using appropriate statistical software. : 69% dental surgeons were aware of National Oral Health Programme of the Government of India. 47% dental surgeons were aware of National Oral Health Programme of the Government of India- Manpower support [Dentist, Dental Hygienist, Dental Assistant]. 41% dental surgeons were aware of National Oral Health Programme of the Government of India- Equipment including Dental Chair, X-ray units, autoclaves etc. 41% dental surgeons were aware of National Oral Health Programme of the Government of India- Consumables for dental procedures. 37% dental surgeons were aware of National Oral Health Programme of the Government of India- IEC/ BCC activities like Posters, TV, Radio Spots, Training Modules etc. 33% dental surgeons were aware of National Oral Health Programme of the Government of India- national and regional nodal officers training programs. 33% dental surgeons were aware of National Oral Health Programme of the Government of India- Preparing State/District level Trainers by conducting national and regional workshops: The present study clearly indicates that there is need to increase the awareness of National Oral Health Programme not only among dental surgeons but also common men. Government should take active interventions to increase the awareness of NOHP so that more and more people can utilize its facilities.

Do Preventive Programs Reduce the Need for New Sedations for the Treatment of Oral Pathologies in Healthy and Special Health Care Needs Children?

Background: The goal is to analyze the need for reinterventions under deep sedation to treat oral pathologies in a population of children with special health care needs (SHCNs) and healthy children who followed a prevention program and to study the influence of parental motivation and child collaboration on the need for reinterventions under deep sedation. Methods: A retrospective study was carried out in a private clinic in Cartagena (Murcia, Spain), with patients treated under deep sedation from 2006 to 2018, both years included, following the Strobe statement. Results: In this study with 230 children who were treated under deep sedation, 23.92% underwent two or more sedations. The mean time elapsed between the first and the second sedations was 21.64 ± 15.87 months, and the main cause for reinterventions was the occurrence of new pathologies. Significantly more pulp treatments were performed in the first sedation than in the second (p = 0.013) and in the third (p = 0.007). Healthy children required fewer reinterventions under deep sedation than children with special needs (6.42% vs. 39.67%). Similarly, patients who followed the preventive program and required some type of dental treatment were reoperated fewer times than those who did not follow the preventive program (35.8 vs. 50%); than "cooperative" children as opposed to "non-cooperative" (12.12% vs. 60.93%) and than patients with "motivated" parents as opposed to those with "non-motivated" parents (20.83% vs. 46.34%). A total of 50% of the children who participated in the preventive program became "cooperative", and 100% were able to receive some treatment in the dental chair. Conclusions: Prevention programs, including motivational interviewing, are essential to improve children's behavior in the dental chair and reduce the need for reinterventions under general anesthesia or deep sedation. Although patients with special needs do require more sedation during their lifetime due to their inability to cooperate, these programs are necessary for the maintenance of oral health status and for the early diagnosis of caries lesions. Pediatric dentists should implement a quarterly preventive program because it improves patient collaboration. It is essential to achieve the motivation of parents in the oral care of their children.

Overhauling dental implications in a child with rare craniofrontonasal syndrome: a case report

Craniofrontonasal syndrome is an extremely rare X-linked dominant genetic disorder characterized by features such as hypertelorism, craniosynostosis, ocular anomalies, a bifid nasal tip, and longitudinal ridging with splitting of the nails. Heterozygous females are more severely affected, presenting frontonasal dysplasia and coronal craniosynostosis (fusion of the coronal sutures), while males typically only exhibit hypertelorism. This case report describes the dental management of a 9-year-old female with craniofrontonasal syndrome who was referred to the department of paediatric and preventive dentistry for pain in the lower right and left back tooth region. The patient exhibited a clinical spectrum including microcephaly, short neck, axillary pterygium, clinodactyly of the toes, longitudinal ridging with split nails, pectus excavatum, and underdeveloped female genitalia. Extraoral examination revealed hypertelorism, flat nasal bridge, low-set ears, strabismus, antimongoloid slant, and an indistinct philtrum. Intraoral examination showed a high palatal vault, crowding of the upper and lower arches during the mixed dentition period, multiple dental caries, and poor oral hygiene. An orthopantomogram confirmed delayed dental development. Dental treatment was carried out on a dental chair system using adequate behaviour management techniques with short appointments, keeping in mind the reduced cooperative ability of the child. The importance of this report stems from the limited dental literature available on the syndrome. Preventive measures along with home care instructions were emphasized to support professional care.

Training Satisfaction of Moroccan Dental Residents at the Center of Dental Consultation and Treatment in Casablanca/ Morocco

Objective: The aim of this study was to evaluate the degree of satisfaction of resident doctors regarding their university hospital training at the Casablanca Dental Consultation and Treatment Center (CDCT) in Casablanca, Morocco, to improve the quality of teaching and educational tools. Method: We conducted a descriptive and transversal study in the University Hospital Center of Dental Consultation and Treatment of Casablanca between November 2021 and June 2022. All residents received an anonymous satisfaction questionnaire (N=40) with 31 questions. The analysis was carried out using Jamovi software. Results: 40 residents responded to the questionnaires, giving an overall response rate of 100%. The proportion of women was 85% (sex ratio M/F was 0.17). The age mean was 27.3± (1.5). The majority of the respondents were 1st-year residents with a percentage of 37.5%. Approximately 80% of residents were satisfied to very satisfied with their training. The supervision during the clinical internship was considered effective by the residents in 82.5% of the cases. The number of teachers was considered sufficient by 87.5% of the participants. The degree of satisfaction with the general atmosphere and the interpersonal relationship was 70%. Among the difficulties encountered, was the availability of dental chairs with a 67.5% satisfaction rate. Conclusion: The majority of the students find the supervision in our center satisfactory. This type of supervision is to be valued in the interest of the teacher and the student and consequently for the benefit of the population.

Effectiveness of respiratory protective equipment in reducing inhalation and contact exposure risks of dental workers during ultrasonic scaling

The high-concentration droplets produced from ultrasonic scaling treatments may carry many pathogens. The close contact between dental workers and patients significantly amplifies their exposure risk to these droplets. Although various types of respiratory protective equipment (RPE) are utilized by dental workers during treatments, their effectiveness in reducing the risks associated with inhalation and contact exposure remains uncertain. In this study, computational fluid dynamics technology was employed to investigate the impact of RPE type, surgery duration, air changes per hour (ACH), and air distribution on the risks related to inhalation and deposition exposure. The results revealed that wearing masks considerably reduced the risk of inhalation exposure for dental workers, with a decrease in inhalation fractions from 25.3 ppm (without RPE) to 1.3–4.5 ppm (with RPE). Combining blue surgical masks and face shields decreased the risk of inhalation fraction by 5% compared to wearing no RPE. Notably, there was over 60% of spray droplets landed on the patient's head; however, only approximately 5%, 6%, 8%, and 3% were deposited on the patient's body, doctor's body, floor, and dental chair, respectively. Increasing ventilation from 3 to 9 ACH decreased dental workers' inhalation fraction by 9.8 ppm. Type III (with the inlet and outlet at opposite walls) decreased the suspension fraction by 4.3% compared with Type II (with the inlet and outlet at the same wall) while achieving a near-zero inhalation fraction of dental workers. These findings offer valuable insights for mitigating cross-infection risks between dental workers and patients in dental clinics.

RESPIRATORY DISEASES IN CHILDREN- ORAL FINDINGS AND DENTAL TREATMENT APPROACHES

Respiratory disease/condition is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in the body. The most common respiratory disease which a pediatric dentist generally seen in practice is bronchial asthma ,cystic fibrosis,tuberculosis etc.Dental work occur close to the airways, and dental environments processes and setup also contribute to respiratory diseases.The management on the dental chair for this patient is different from the normal patient.Asthma affects about 1 in 10 children.The condition is characterized by acute respiratory distress and treated with medications aimed to reduce reaction to stimulants by the airway.Dental management involves attention to the status of the patient and awareness of stimulants of the reactive airway. Cystic fibrosis is an autosomal recessive disorder that effects epithelial cells of the respiratory,gastrointestinal and reproductive tracts leading to abnormal exocrine gland secretion.Management includes treatment of bronchial inflammation and infection. At Dental operatory patient should be treated under regulated temperature and others precaution .In this article ,common oral findings related to respiratory diseases will be discussed and the precautions and treatment approaches of dentist will be mentioned.

Evaluating the Effectiveness of CHRIS'S Birds Assisted Therapy on Dental Anxiety among Pediatric Patients: A Pilot Study.

The heart of childhood nurtures an array of immature emotions. Through this rollercoaster of childhood emotions, from tears to laughter, it is the sole responsibility of a pediatric dentist to help the children navigate through their emotions with their empathetic actions. Whenever a child is anxious or fearful in the dental chair, the child may put forth his emotion through crying or taking up a flight response. Dental caries is a disease that is aggravated when a child refuses to cooperate with dental treatment. The tiny holes in the tooth, when unfilled, may lead to bigger problems, which in turn may lead to tooth loss in future. It is the comprehensive responsibility of the pediatric dentist to support health and emotional development and provide a complete, fulfilling oral rehabilitation to the child patient. The purpose of this study was to determine the anxiety levels of pediatric patients visiting the dental Outpatient Department at a Dental College and Hospital in Kavalkinaru. This study unveils a novel technique wherein birds were used in the form of CHRIS'S Birds Assisted Therapy to reduce anxiety in pediatric dental patients. Results showed that intervention with birds through CHRIS'S Birds Assisted Therapy significantly reduced the anxiety levels in children. Thus, CHRIS'S Birds Assisted Therapy is shown to be a promising method of anxiety control, a key to a successful pediatric dental practice. Joybell C, Kumar K. Evaluating the Effectiveness of CHRIS'S Birds Assisted Therapy on Dental Anxiety among Pediatric Patients: A Pilot Study. Int J Clin Pediatr Dent 2024;17(S-1):S84-S94.

Perception of Caregivers about Oral Health Services for Institutionalized Older Adults: A Mixed Method Study.

In India, the absence of formal training in geriatric dentistry and the lack of recognition of it as a speciality contributes to the deterioration of oral health in the older adults. India lacks specific oral healthcare policies for older adults. Additionally, caregivers' perspective in old age homes regarding oral healthcare services remains underexplored, necessitating further studies in this context. A mixed method study was conducted, and the quantitative component focused on assessing the oral health status of institutionalized older adults and caregivers' perceptions using a questionnaire. The qualitative part evaluates caregivers' perceptions of providing oral healthcare services for older adults through in-depth interviews. Mean DMFT among institutionalized older adults was 15.52±8.23. More than 50% of caregivers perceived that the oral health status of institutionalized older adults was fair. Barriers to oral health services include autonomy, difficulty in traveling, lack of financial support, lack of knowledge and time. Approaches to enhancing oral health services for institutionalized older adults include oral health education for older adults and their caregivers, monthly dental visits to the institution, utilization of portable dental chair services, collaboration with dental colleges/dental clinics, distribution of oral health education materials, and provision of oral hygiene aids. Findings from our study indicate the need to collaborate with dental institutions to provide oral health services in old age homes, to improve the oral health status of older adults and caregivers' knowledge.

Evaluating the tightness of proximal contact between natural tooth and adjacent implant supported prosthesis.

The changes in interproximal contact between implant supported prosthesis (ISP) and adjacent natural tooth is of interest to dentists. Hence, we evaluated the tightness of proximal contact (PCT) between adjacent natural tooth and ISP by applying a digital force gauge spanning over a period of 1.5 year with a regular follow-up of 3, 6, and 12 months.80 patients who received ISP were included in this study. In order to measure the PCT, every patient seated in the identical upright position in the dentist chair. The digital force gauge was used to take measurements for mesial PCT and distal PCT. The mesial as well as distal interproximal contacts was more tight as in case of natural tooth adjacent to other natural tooth as compared to interproximal contacts between ISP and adjacent natural tooth. It was also observed that as the time progressed there was decrease in PCT values in both categories. After 12 month follow up 30.6% cases in category 2 while 21.2% cases in category 1 showed complete loss of interproximal contact. There is significant change in proximal contact tightness in interproximal area between implant supported prosthesis and adjacent natural tooth over a period of time and necessary measures should be taken to prevent or reduce it.

Assessment of ergonomic risk of work related musculoskeletal disorders among dentist in Kolhapur region.

Work-related disability is caused commonly due to musculoskeletal disorders (MSD) in dentistry. Prolonged static awkward and repetitive postures cause MSD in dentists. The study was executed to confirm the development of MSD in various body regions as they have to work in a small oral cavity to perform crucial dental procedures with precision and concentration. To assess the occurrence of the MSD in several body regions of dentists and to carry out postural study thereby helping them improve posture. Dentists were assessed for their current working postures with various MSD symptoms and its effects. The questionnaire was devised to get musculoskeletal health data from dentists. The postural load was investigated using Rapid Upper Limb Assessment (RULA). Various risk factors contributing to MSD symptoms were identified after data were statistically analysed using IBM SPSS version 27. According to the current study neck, shoulder, lower back, upper back, wrist hand, elbow, hip, thigh, knee, and ankle were the most affected anatomical regions. Average RULA score for the current study was found to be 6.75 which indicated a need of change of posture while performing dental procedures. There is statistical correlation between gender, Body Mass Index (BMI), uncomfortable positions, stretching, use of ergonomic saddle chair, hand dominance and MSD. There is no statistical correlation between years of experience and MSD. Current workstation (Dental Chair) requires immediate improvements as evident from the postural load analysis, thus immediate implementation of intervention program is required.

Portable Dental Chair Innovation in Improving Operator Comfort

Portable Dental Chair Innovation in Improving Operator Comfort

Psychophysiological wellbeing in a class of dental students attending dental school: anxiety, burnout, post work executive performance and a 24 hours physiological investigation during a working day

AimTo the best of our knowledge, dental school students have never been evaluated for stress, anxiety, burnout, physiological indexes during a 24-h working day, and executive function performance post-work and post-work after returning from vacation; therefore, this research has been conducted.MethodsData were acquired at the Dental School of the University of Padua on 16 students in their 4th year, far from the exam session. While performing clinical activity on the dental chair and during a working day, electrodermal activity (EDA), heart rate variability (HRV), and heart rate (HR) were recorded. Participants’ stress was measured with the Perceived Stress Scale (PSS-10 scale) and anxiety with the General Anxiety Disorder Questionnaire (GAD-7) and State–Trait Anxiety Inventory (STAI-Y-2), while burnout with the Maslach Burnout Inventory (MBI-HSS). Executive functions were evaluated using the Tower of London test (TOL-R).ResultsThree students (2F/1M) had a GAD-7 score ≥ 10. Five students (4F/1M) showed trait anxiety. Moderate levels of perceived stress were reported in 85% of participants. MBI-HSS showed that 7 participants scored high on emotional exhaustion and 7 on depersonalization. TOL-R performance (M = 15.85, SD = 4.01) was below the normative value p < 0.00001. A second test, after the holidays, showed normal values. EDA was higher during children’s treatment (p < 0.05), ANOVA showed high HR during working time (p < 0.001), and HRV was higher in males (p < 0.001).ConclusionBased on the sample size evaluated, it is reported that being a dental student has a moderate impact on stress, anxiety, and burnout while a strong impact on executive functions buffered by rest.

Analysis of the Technological Innovation and Application Prospect of Dental Chair Under the Background of Digital Transformation

With the further development of digital transformation, dental chair technology, as a key equipment in the field of oral medicine, is experiencing unprecedented technological innovation. This paper first reviews the traditional development of dental chair technology and analyzes the bottlenecks and shortcomings of existing dental chair technology. Subsequently, the article focuses on the impact of digital transformation on dental chair technology, including intelligent, networked, personalized and other aspects of technological innovation. These innovations not only improve the performance and comfort of dental chairs, but also improve the accuracy and efficiency of oral treatment. Driven by the digital transformation, the dental chair technology has a broad future development prospect and is expected to play a greater role in the field of oral medicine. This paper also discusses the potential applications of dental chair technology in future oral medicine, including telemedicine, personalized treatment, and intelligent assisted diagnosis. Finally, the paper summarizes the significance of technological innovation in the context of digital transformation, and prospects the future development trend.

The Severity of Tooth Surface Loss in Adult Patients Presenting to a Private Dental Hospital

This study aimed to assess the severity of tooth surface loss (TSL) in adult patients at a private dental hospital for 6 months. This research explored the severity of TSL using the Smith and Knight Tooth wear index (TWI). Study participants underwent intraoral examination in dental chairs with adequate lighting using a mouth mirror. Prior to examination, sterile cotton swab was used to clean and dry the teeth and to eliminate any plaque residue. Each tooth surface (buccal, lingual, cervical and occlusal/incisal) were evaluated using the TWI and documented on the research proforma. Only the most affected teeth and teeth surfaces were noted in a patient. A total of 320 patients were observed between ages (18-40 years), out of which 140 had tooth wear according to TWI. The male patient had a ratio of 40.91% while female were 50.08%. The mandibular anterior teeth had score 2 in 97.1% of the patients and maxillary premolars had score 1 and 2 which were 96.4% and 92.9% respectively. The occlusal surface was involved in 58% of maxillary teeth and 100% in mandibular teeth. Our study indicates that the mandibular anterior occlusal surfaces are particularly susceptible to the impacts of tooth wear. This may lead to aesthetic concerns, exposure of pulp with advanced wear and occlusal imbalance, which will require extensive treatment. Hence, it is imperative to raise awareness among individuals regarding the early indicators and symptoms of tooth wear.

Mechanistic Modeling of Hydraulic Energy Transmission Technology of an Improved Dental Patient Chair Design

This work focused on mechanistic modeling of hydraulic technology of an improved dental chair design. ISO 6385 standard for P(M)95 patient were basis for system parameters, and fathom masses between 60kg-93kg, corresponding to DINED 2003 mass of patients, produced total load on the pantograph. The force exerted by the lower limb of the dentist is an ergonomic stressor that was experimentally studied using Pascal’s law of the hydraulic system. Methodology adopted was mechanistic modeling technique. The results indicated that pedal force of 0.1375kN elevated trimmed chair (dead load) of 0.55kN, while pedal force of 211N to 277N were required to recline between 60kg-93kg masses on the system. It infers that the pump has a mechanical advantage of approximately 5, with displacement volume, 11.7825cm-2, that produced a platform displacement of 3. 75cm during a 15cm hydraulic pedal travel stroke. The experimental results corroborated Pascal’s laws and is has technological significance on carrier-long musculoskeletal disorders (MSDs) of lower limb among dental practitioners.

Comparative Evaluation of New Needleless Local Anesthetic System (INJEX) and Conventional Syringe Needle Technique during Pulpotomy Treatment: A Randomized Clinical Trial.

The dreaded sensation of pain in the dental chair has a significant impact on children's behavior. This study aimed to compare and contrast the perception of pain and patient behavior between the use of INJEX and the conventional syringe needle technique during pulpotomy among children. A randomized clinical trial was designed and conducted among pediatric dentistry patients aged 6-12 years old. Fifty-eight children were divided into two groups, conventional syringe needle and INJEX, using simple randomization method applying the sequentially numbered, opaque, sealed envelope method of allocation concealment. Anesthesia was administered to the groups as local infiltration by a single operator following routine behavior guidance techniques. After 3 min, pulpotomy was performed using the standard protocol. The Face, Legs, Activity, Cry, Consolability (FLACC) scale and Wong-Baker FACES Pain Rating Scale (WBS) were used to assess the intensity of pain, while the Frankl behavior rating scale (FBRS) was used to assess the children's behavior. During anesthesia, most of the participants in the INJEX group (median = 3) had higher FBRS scores compared with the conventional syringe needle group (median = 2), and the difference was very highly significant (p-value < 0.001). Analyzing the FLACC scores during local anesthesia administration revealed a high statistical significance (p-value < 0.01) across the two groups. A very high statistically significant difference (p-values < 0.001) with higher WBS scores for pain intensity was seen in the group using conventional syringe needles. INJEX administration significantly reduced the intensity of pain experienced by the children and helped maintain a positive attitude among them during pulpotomy. It provided a positive and comfortable experience for both the child and the practitioner. Therefore, it can serve as an excellent alternative to conventional needle anesthesia.

Initial waterline contamination by Pseudomonas aeruginosa in newly installed dental chairs.

Dental unit waterlines (DUWLs) of new dental chairs may be contaminated before their first clinical use, so an initial shock disinfection is crucial at the time of their installation. The microbiological analyses are crucial to control the water quality of DUWLs before their first clinical use because their disinfection does not guarantee the elimination of all bacteria.