Dental Treatment Research Articles

The impact of children’s dental anxiety on dentists

INTRODUCTION. According to statistics, medical workers and, in particular, dentists are exposed to stressful factors in the workplace on a daily basis. Due to the specifics of their daily activities, pediatric dentists experience a great emotional burden, especially when treating children who are not adapted to dental care, which leads to the development of an emotional burnout syndrome among specialists. AIM. To determine the effect of children’s dental anxiety on emotional stability during admission and psychoemotional status after admission by dentists with emotional burnout syndrome.MATERIALS AND METHODS. The study involved 76 pediatric dentists and 68 patients aged 6–7 years. The psychoemotional state of dentists was assessed using the Maslach Burnout Questionnaire and a Visual Analog Scale. The behavior of children at the dental appointment was recorded according to the evaluation scale of the behavioral profile of the Melamed.RESULTS. According to the results of the Maslach questionnaire, burnout syndrome of varying severity was detected in all specialists. Deterioration of the psychoemotional state after receiving a patient who was not adapted to dental treatment was observed in 16%.CONCLUSIONS. The study shows that in order to prevent burnout syndrome in pediatric dentists, it is necessary to reduce professional stress through methods of adapting children to treatment, correcting patient behavior and reducing dental anxiety.

The efficacy of socially assistive robots in improving children’s pain and negative affectivity during needle-based invasive treatment: A systematic review and meta-analysis

BackgroundThe ability of socially assistive robots (SARs) to treat dementia and Alzheimer’s disease has been verified. Currently, to increase the range of their application, there is an increasing amount of interest in using SARs to relieve pain and negative emotions among children in routine medical settings. However, there is little consensus regarding the use of these robots.ObjectiveThis study aimed to evaluate the effect of SARs on pain and negative affectivity among children undergoing invasive needle-based procedures.DesignThis study was a systematic review and meta-analysis of randomized controlled trials that was conducted in accordance with the Cochrane Handbook guidelines.MethodsThe PubMed, CINAHL, Web of Science, Cochrane Library, Embase, CNKI, and WanFang databases were searched from inception to January 2024 to identify relevant randomized controlled trials (RCTs). We used the Cochrane Risk of Bias tool 2.0 (RoB2.0) to assess the risk of bias among the included studies, and we used RevMan 5.4 software to conduct the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used to assess the quality of the evidence.ResultsTen RCTs involving 815 pediatric subjects were selected for this review and reported outcomes related to pain and emotions during IV placement, port needle insertion, flu vaccination, blood sampling, and dental treatment. Children undergoing needle-related procedures with SARs reported less anxiety (SMD= -0.36; 95% CI= -0.64, -0.09) and fewer distressed avoidance behaviors (SMD= -0.67; 95% CI= -1.04, -0.30) than did those receiving typical care. There were nonsignificant differences between these groups in terms of in pain (SMD = -0.02; 95% CI = − 0.81, 0.78) and fear (SMD = 0.38; 95% CI= -0.06, 0.82). The results of exploratory subgroup analyses revealed no statistically significant differences based on the intervention type of robots or anesthetic use.ConclusionsThe use of SARs is a promising intervention method for alleviating anxiety and distress among children undergoing needle-related procedures. However, additional high-quality randomized controlled trials are needed to further validate these conclusions.Trial registrationThe protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023413279).

Management of antithrombotic therapy in patients undergoing dental procedures

A growing number of patients receiving antithrombotic therapy require dental procedures. Dental interventions in these patients can be challenging, as the risk of bleeding from the continuation of antithrombotic therapy needs to be weighed against the thromboembolic risk associated with drug interruption or de-escalation. Most minor dental procedures, including simple dental cleaning and filling, pose minimal bleeding risk, and antiplatelet or anticoagulation therapy can be continued without interruption. Local hemostatic measures, such as tranexamic mouthwash, can be used, as needed, to reduce bleeding events following these interventions. Managing antithrombotic therapy during more invasive dental interventions and oral surgeries with a higher risk of perioperative bleeding necessitates the consideration of specific factors influencing the bleeding risk and thromboembolism. In patients receiving antithrombotic therapy for primary prevention, temporary interruption is reasonable. In others, the decisions may be more complex and more nuanced. In this article, we review the current evidence for managing patients receiving oral antiplatelet or anticoagulant drugs scheduled for various dental procedures and present a practical approach for the periprocedural management of antithrombotic treatments.

Early dental visit affects dental treatment in Korean preschool children born preterm: a nationwide population-based study

This study investigated the effect of early dental visit on subsequent dental treatments in preterm infants and whether there was a significant difference in dental treatment between children born preterm and full-term (FT). National data from the Health Insurance Review and Assessment Service in Korea were analyzed. Prescription codes related to dental treatments were collected. This study included 3,354,662 patients under age 6 years, who were categorized by gestational age: extremely preterm (EPT), very preterm (VPT), and late preterm (LPT). In the preterm group, the percentage of children with no dental visits was 63.87% although the preterm group visited the dentist earlier than the FT group (EPT = 2.84, VPT = 2.78, LPT = 2.52, FT = 3.9 years old). Glass ionomer and 1-visit pulpectomy were significantly higher in the preterm group than in the FT group (p < 0.001). Preschool children who had their first dental visit after age 2 years received any dental treatment earlier than those who visited the dentist before age 1 year (p < 0.001). Early dental visits in infants may delay the timing of dental treatments and reduce their severity, suggesting the importance of early dental screenings for efficient dental management in preterm infants.

Oral health experience of individuals with eating disorders

BackgroundEvidence on how persons with and in remission from an eating disorder experience their oral health is limited. Dental treatment in Sweden today is often postponed until medical rehabilitation has been completed, but this carries risks. For the patient, the risk is severely impaired oral health and additional suffering, and for both society and the patient, higher costs than might have been necessary.MethodsTen female informants aged 21–51 years (mean age = 36.7, standard deviation 12.7) in remission from an eating disorder with a median duration of 12.5 (range 4–25) years of illness, were questioned in semi-structured interviews about their perceptions of oral health. All participants had been referred to a specialist dental clinic and needed oral rehabilitation. 10% of the patients had been diagnosed with anorexia nervosa and 90% with bulimia nervosa. All had been in remission from the eating disorder for at least one year. Transcripts of the interviews were analyzed with thematic analysis using an inductive approach.ResultsOne overarching theme emerged from the analysis: dental damage persisted as a visible, lingering scar during remission of the eating disorder, reminiscent of the disease and its consequences. The three major themes identified were (1) Physical impact, (2) Psychological impact, and (3) Impact on daily living. The first major theme included erosive tooth wear and impaired oral function and aesthetics. Interviewees described the second as feelings of stigma, guilt, shame, anxiety, and worry, in particular concerning self-inflicted dental damage through self-induced vomiting. The last major theme covered avoidance strategies such as limiting smiling and laughing and minimizing social situations such as eating with others, pursuing a wanted career, and meeting a partner.ConclusionsThe participants in this study expressed a profound negative impact on daily life and a two-fold burden of stigma of having suffered from both an eating disorder and poor oral health.

Acceptability of artificial intelligence in dental radiology among patients in India: are we ready for this revolution?

In recent times, artificial Intelligence (AI) has gained popularity in medical as well as dental radiology. Studies have been conducted among medical and dental students and professionals about the knowledge and understanding towards AI. The aim of this study was to investigate the perceptions and acceptability of AI in dental radiology among a group of Indian patients seeking dental treatment. A cross-sectional research was planned with a validated questionnaire, containing ten close ended questions amongst 1562 patients. Their sociodemographic characters, opinions and attitudes regarding AI and feasibility of acceptance of AI-based dental radiological diagnosis among patients was evaluated. The study sample was divided in various groups on the basis of their age; group-1(16-30years), group-2(31-45years) and group-3(>45years), educational status and urban/rural background. Statistical analysis was done by Chi-square test with significance value set at p< 0.005. The participants possessed impressive knowledge about AI. Patients' awareness, attitudes and acceptability towards AI for dental radiographic diagnosis were substantially influenced by age, education level and residential background. Although many of them, especially the urban and more educated participants believed that AI could be more accurate, they preferred the human judgement. Overall, a negative attitude in terms of acceptability of AI in dental radiology was observed in this study. Participants opined that AI should only be used as an auxiliary tool and valued clinical judgment over AI in ambiguous situations. It is recommended that this promising technological advancement can be used for initial screening in dental radiology.

Fixed Prosthodontic Rehabilitation of a Patient with Cleidocranial Dysplasia: A Case Report

Introduction Cleidocranial Dysplasia (CCD) is a rare congenital disease characterized by skeletal and dental anomalies. Clinical findings of CCD patients include low facial height, pseudoprognathism, unerupted teeth, an excessive deep bite, chewing difficulties, and unsatisfied dentofacial appearance. These patients’ dental treatments present a substantial challenge. Case Representation This case report describes the prosthodontic treatment of a 29-year-old male CCD patient using porcelain-fused-to-metal restorations. The avoidance of a surgical procedure serves to minimize the potential for complications and expedites the attainment of outcomes with greater celerity. Throughout the follow-up period of 1 year, the patient maintained good periodontal health. The restoration of masticatory function and enhancement of facial esthetics were successfully achieved and the patient expressed a high degree of satisfaction with the outcome of the treatment. Conclusion The use of fixed prostheses in CCD patients is a treatment modality that resolves many of the issues caused by the surgical approach.

Soft Tissue Facial Morphology in Growing Patients with Different Occlusal Classes.

The study of facial profiles in the dental field is very important for the diagnosis and the dental and orthodontic treatment plan. The aim of this study is to analyze the three-dimensional morphology of the faces of 269 growing patients with Class I and II occlusions, focusing on children aged between 6 and 9 years old. The analysis was conducted using a non-invasive computerized system, which allowed for the automatic collection of facial landmarks and the subsequent reconstruction of three-dimensional coordinates. The sample comprised 269 children within the specified age range. Each child's facial features were captured using the non-invasive computerized system, which utilized two infrared CCD cameras, real-time hardware for label recognition, and software for three-dimensional landmark reconstruction. Sixteen cutaneous facial landmarks were automatically collected for each participant. From these landmarks, 10 angular and 15 linear measurements, as well as five direct distance rates, were derived. The mean values for each age class were calculated separately for children with bilateral Angle Class I occlusion and compared with those for children with bilateral Class II occlusion. In all children, the left and right occlusal classes were measured as suggested by Katz. The analysis revealed notable differences, primarily in the three-dimensional angular measurements between children with Class I and II occlusions. Specifically, Class II children exhibited more convex faces in the sagittal plane and a less prominent lower jaw compared to Class I children. However, no significant differences were observed in linear measurements, except for the lower facial height rate, which varied inconsistently across age groups between the two occlusion types. the findings of this research highlight distinct three-dimensional facial morphological differences between children with Class I and II occlusions. While Class II children tended to have more convex facial profiles and less prominent lower jaws, linear measurements showed minimal variation between the two occlusion types. These results underscore the importance of three-dimensional analysis in understanding facial morphology in growing patients with different occlusal patterns.

Tea Tree Oil Effect on Dimensional Change and Detail Reproduction of Addition Silicon Impression Material

Objective: Impression materials are thought to be the one of the primary sources of cross infection between patients and dentists. However, it was discovered that disinfection of the impression is not conducted routinely in ordinary dental treatment. Disinfection of addition silicon impression, whether by immersion or spray should not produce dimensional or detail errors. The purpose of this study was to examine the immersion of addition silicon impression material in tea tree oil and its influence on dimensional stability and detail reproduction of the addition silicon imprint material. Materials and Methods: This study employed a total of 120 heavy- and light-body addition silicon impression material specimens. The specimens were randomly sorted and immersed into six groups. These test groups where four concentrations of TTO (0.25%, 0.5%, 0.75%, and 1%), and the other two groups were distilled water (negative control) and 2% glutaraldehyde (positive control). All specimens were immersed for 10 minutes in the testing solutions. Each of the six groups had 20 specimens separated into two subgroups. Results: There were no statistically significant differences in linear dimensional changes and detail reproduction among all test groups. Conclusion: The addition silicon impression material may be safely submerged in TTO for 10 minutes to disinfect it without impairing its dimensional correctness or detail replication of the impression.

ABORDAGENS ODONTOLÓGICAS INTEGRADAS NO CUIDADO E INCLUSÃO DE PESSOAS COM TRANSTORNO DO ESPECTRO AUTISTA (TEA)

Autism Spectrum Disorder (ASD) is characterized by difficulties in communication, social interaction, repetitive behaviors, and restricted interests, with these disorders manifesting in early childhood. These patients may also present motor coordination difficulties, poor adherence to oral hygiene, frequent use of medications, and habits such as bruxism. The behavioral development conditions of these patients require targeted approaches for dental care, which poses a challenge for the dentist. According to the literature review, methods such as TEACCH propose visual approaches like panels and schedules that help reduce anxiety and aid in dental treatment. To facilitate communication, the PECS system uses symbols, allowing individuals with autism to express their needs and emotions visually. Knowledge of these dental approaches is crucial for the dentist to gain the patient's trust and better manage the treatment.

The influence of dental bleaching on patient's quality of life: A multistudy analysis of aesthetic and psychosocial outcomes

ObjectivesTo assess the Quality of Life (QoL) of participants treated with dental bleaching using different techniques by administering two questionnaires Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), as well as the bleaching efficacy and tooth sensitivity (TS). Materials and MethodsSecondary results for nine randomized clinical trials were included, involving 489 participants who underwent bleaching procedures. The questionnaires were applied at baseline and 30-day post-bleaching. Bleaching efficacy (ΔSGU/ΔEab) and TS were also evaluated (VAS/NRS). The effect of bleaching on aesthetic self-perception was evaluated using the Paired t-test. The Kruskal-Wallis test assessed variations by technique. Also, the correlations between questionnaires and outcomes was evaluated (α = 0.05). ResultsAfter the bleaching treatment, both questionnaire revealed significant differences compared to the baseline, regardless of the factor evaluated (p < 0.05), except for Physical pain in OHIP-14 (p = 0.53). No correlation was found between OHIP-14 and bleaching efficacy (p < 0.008). A significant correlation was found between bleaching efficacy and dental self-confidence, indicating that dental self-confidence increased as the number of SGU (ΔSGU) increased, while social impact (ΔEab) and aesthetic concern (ΔSGU) decreased. Additionally, a significant correlation was observed between TS and OHIP-14 (Physical pain). For PIDAC, both dental self-confidence and psychological impact were correlated with TS in the VAS. ConclusionSubjects who underwent dental bleaching treatment improved their self-perception and dental self-confidence. Dental bleaching, besides enhancing the patient's smile, also improves their self-esteem. Clinical RelevanceDental bleaching, besides improving the patient's smile, also enhances their self-esteem.

Comfortable sound design based on auditory masking with chord progression and melody generations using automatic composition

Unpleasant noise is a crucial problem, that we often face in daily life. One of such a problem is in the case of dental treatment. A dental instrumental noise that includes peaky components in the high-frequency band makes doctors and patients discomfort. To reduce discomfort, we proposed a method to mask unpleasant noise with a comfortable sound. The proposed method was automatically generating a comfortable cord progression. In previous subjective test results, it shows that degree of discomfort reduces. The remaining problem is that degree of comfort improves. This is due to the fact that the previous method utilizes the musical element of chord, but does not introduce the musical elements of melody and rhythm. Therefore, in this paper, we propose a new method to introduce the melody generation with automatic composition (AI composition) into the previous method based on the automatic generation of the chord progression. The proposed method automatically generates a chord progression to follow the peak frequency of dental treatment sounds and to add a melody following the chord progression with AI composition assistance tool to improve comfort and to design comfortable sound.

Audio–Visual Modeling and its Effect on Behavior of Pediatric Patient: An Observational Study

ABSTRACT Background: The prognosis and patients’ cooperation are interdependent on each other. In case of children, this aspect becomes all the more highlighted because of heightened response to pain and anxiety. Material and Methodology: Hundred (4-to-10 years old) children who were rated as negative on Frankl Behavior Rating Scale were taken for the study. The children were shown a video of a positive child model, and also various procedures of the dental treatment were shown. Results: Sixty-one children out of 100 demonstrated positive behavior and 3 showed definitely positive behavior during preventive treatment procedures. On the other hand, 73 children out of 100 demonstrated positive behavior and 3 showed definitely positive behavior during main treatment procedures. Significant change was observed in behavior of children in before and after the video was shown to them (&lt;0.001). Conclusion: Audio–visual modeling has been proved to be a very efficient method in developing positive behavior of children toward dental treatment.

Implications in dental treatment during the use of antiresorptive drugs - a literature review

Implications in dental treatment during the use of antiresorptive drugs - a literature review

Oral health of Dutch primary school children in relation to social and health aspects.

This research investigated the oral health status of Dutch primary school children aged 10-12 years in Utrecht and its association with demographic characteristics, lifestyle factors, general psychosocial health, and dental treatment, to guide targeted interventions to improve children's oral and overall well-being. A cross-sectional survey was conducted at 49 primary schools in Utrecht in 2017 and 42 schools in 2019. The questionnaire covered background characteristics (7 questions), psychosocial health (14 questions), nutrition and exercise (20 questions), school and leisure time (26 questions), home situation (23 questions), and oral health (4 questions). Associations were analyzed using multivariate logistic regression. Data from 5,426 children were analyzed. Prior to the survey, 11% did not visit a dentist, 23% had a toothache, 22% had a cavity filled, and 8% had a tooth extracted. Independent predictors for increased odds of oral health problems were migration background, poor general health, drinking more than two glasses of soft drinks per day, having ever drunk alcohol, having fear of failure, experiencing problems at home and/or coming from average or low socioeconomic position group. Factors associated with increased odds of dental treatment, such as cavity filled and tooth extracted, were migration background, fear of failure and home problems. These findings emphasize the need for targeted prevention to improve the oral health of children with a migration background, average or low socioeconomic position and/or with poorer general and psychosocial health, unhealthy diets and problems in the home situation, within a community-based and transdisciplinary approach.

Mental Health, Socioeconomic Position, and Oral Health: A Path Analysis.

Mental health conditions and poor oral health outcomes share bidirectional links, and both are linked to factors related to socioeconomic position (SEP). We used nationally representative survey data to describe the complex interplay of SEP, mental health, oral health behaviors, dental treatment seeking, and oral health. We used data from the 2022 State of Oral Health Equity in America survey, which collects data from US adults on prior depression diagnosis and current depressive symptoms via the Patient Health Questionnaire-9 and demographic characteristics (age, sex/gender, race, ethnicity), SEP (education, income, employment, home ownership, dental insurance), oral health behaviors (brushing and flossing frequency), dental treatment seeking (time since last visit, plans for visit in the coming year), and self-rated oral health (feeling self-conscious due to poor oral health, having symptoms of poor oral health). We used structural equation modeling to identify latent variables and fit the path analytic models. In the total sample (N = 5,682), SEP was significantly associated with dental treatment seeking (standardized parameter estimate [SE] = 0.55 [0.05]), oral health behaviors (standardized parameter estimate [SE] = 0.34 [0.04]), and mental health (standardized parameter estimate [SE] = 0.59 [0.05]). These factors, in turn, were significantly associated with self-rated oral health (estimates ranging from 0.20 to 0.54, SEs ranging from 0.04 to 0.05). SEP, which involves several major social determinants of health, is directly associated with mental health and indirectly associated with self-rated oral health status, with mental health modifying the relationship between SEP and self-rated oral health. Findings emphasize the need to integrate medical, dental, and behavioral health with the goal of providing comprehensive person-centered care.

Mechanisms of functional asymmetry of the face formation in patients with dysfunctional condition of temporomandibular joint

Objective. To give a detailed description of clinical manifestations, diagnosis and treatment of functional asymmetry of the face in patients with dysfunctional condition of temporomandibular joint (TMJ). Materials and methods. A complete examination of 34 (25 %) patients with symptomatic facial asymmetry of the 3rd type according to H.S. Hwang classification was carried out. The group consisted of 5 males (14,71 %) and 29 females (85,29 %). Screening protocol included standard dental care, cone beam computer tomography of both jaws and TMJ, MRI of TMJ with functional load. Results. 24 patients (70.59 %) completed complex dental treatment; 10 (29.41 %) people stopped treatment for various reasons and were excluded from further study. Complete restoration of facial symmetry was achieved in 21 people (87.5 %), partial restoration in 3 (12.5 %) patients. The height of the lower facial part and the synchrony of occlusal contacts were restored in all patients. Noise in the joint area persisted in 3 (8.8 %) cases, which is associated with arthrosis in the articular heads. In patients with unreducible dislocations, the intensity of the clicks decreased, and there was no pain at the end of treatment. It should be noted that all patients of this group refused subsequent surgical treatment. Conclusion. Functional asymmetry of the face results from multifactorial impact on the human organism and is multimorbid by nature. This condition is accompanied by complicated dental pathology, such as increased hard tooth tissues attrition, functional overload with traumatic nodes formation, disturbance of muscles and TMJ functions. It requires following diagnostic and treatment algorithm under the supervision of internal medicine specialists to correct sleep, postural stability, impaired psychoneurological status.

Rebuilding the Strength of Hypomineralized Enamel – An In-Depth Systematic Literature Review

Molar Incisor Hypomineralization (MIH) is a prevalent developmental enamel defect characterized by qualitative changes in the enamel of one or more first permanent molars, often accompanied by similar defects in the incisors. This condition leads to significant dental challenges, including soft, porous enamel, which is more susceptible to damage and caries than non-MIH teeth. The affected teeth exhibit lower mineral concentration, higher porosity, and altered mechanical properties, contributing to their increased vulnerability to decay and restoration failures. Research indicates that MIH-affected teeth often require more extensive dental treatments due to compromised structural integrity. The enamel defects associated with MIH manifest as well-demarcated opacities, which can lead to hypersensitivity and aesthetic concerns for patients, particularly children. However, there is hope in the form of various remineralization strategies that have been explored to address MIH's challenges. These strategies, including recent clinical trials, have demonstrated the efficacy of remineralization agents in restoring some of the lost enamel properties, which is crucial for managing MIH effectively. This potential for restoration through remineralization strategies offers a hopeful outlook for improving patient outcomes with MIH.

Validation of the Polish version of an Ageism Scale for Dental Students (ASDS-PL).

Ageism is one of the common forms of discrimination and prejudice. It has also been shown to be present in health professionals, including doctors, nurses, and medical students. The aim of this study was to translate the Ageism Scale For Dental Students (ASDS) into Polish, perform a culture adaptation, and conduct a preliminary validation analysis. The survey was administered to 202 third-, fourth-, and fifth-year students at the Jagiellonian University (No. 1072.6120.283.2020). Data were analyzed using principal components analysis (PCA) with an oblique, Promax rotation, and confirmatory factor analysis (CFA). Cronbach's alpha (α) was calculated to check the internal consistency reliability. Discriminant validity was analyzed using the Mann-Whitney and Kruskal-Wallis test. PCA produced a 10-item scale distributed into three factors, which explains 59.52% of the total variance. Factor 1 ("preconceived notions about dental treatment") contained four items (α=0.703), Factor 2 ("cost-benefit of providing care for older patients")-four items (α=0.660) and Factor 3 ("dentist-older patient interaction")-two items (α=0.662). CFA confirmed that the model is a good fit (RMSE=0.058, 90% CI from 0.014 to 0.092, CFI=0.950, and TLI=0.926). The discriminant validity showed statistically significant differences in factors or individual items related to the year of the study, gender, and having a history of living with an older person(s) or an older patient(s) treated. The validation of the ASDS conducted in Poland identified 10 items with sufficient validity and reliability.

Research progress in the clinical application of inhaled anesthetic sevoflurane.

Sevoflurane has been widely used in clinical anesthesia as an inhalation anesthetic. With the development of medicine, there have been several new applications in recent years, such as daytime surgery, labor analgesia, and combined nerve block for some surgeries. Moreover, as research progresses, it has been found that it not only has potential organ protection effects but can also be used to treat severe asthma and relieve the tracheal spasm state. In addition, local administration can effectively treat vascular ulcers. We briefly review the organ protective effect of sevoflurane, its application in dental treatment, asthma treatment, vascular ulcer treatment and some new progress in clinical application.