Pediatric Dental Patients Research Articles

Assessment of Pain During Pediatric Dental Treatment Using Different Sedative Agents: A Crossover Trial.

Background Behavioral management techniques are employed for children who are fearful and uncooperative. Pharmacologic sedation and anesthesia are frequently utilized to manage pain and anxiety in pediatric dental patients. Aim To evaluate the intraoperative and postoperative pain levels during dental treatment of children sedated with 1.5 μg/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide. Materials and methods In this crossover study, 24children between the ages of five and seven years were randomly assigned to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhaled nitrous oxide during three different visits. At each visit, a single pulp therapy procedure was conducted after administering the respective sedative agent, and the pain levels were documented. There was a one-week interval between each visit to allow for a washout period. The data were analyzed using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp, Armonk, NY, United States) using the Wilcoxon signed-rank test and Kruskal-Wallis H test (p < 0.05). Results All three sedative agents were equally effective in controlling postoperative and intraoperative pain. Although there was no statistically significant difference among the groups, clinically,midazolam showed lower intraoperative pain levels (mean 1.78 ± 1.42). Conclusion In pediatric dental patients, intranasal midazolam at a dosage of 0.3 mg/kg and intranasal dexmedetomidine at a dosage of 1.5 μg/kg demonstrate comparable effectiveness to nitrous oxide sedation in pain management. These options serve as effective alternatives for anxious children who may not tolerate nitrous oxide sedation.

Upper Labial Frenectomy in Pediatric Dentistry: When to Indicate? – Literature Review

The labial frenulum, or frenum, is one of the components of the oral mucosa that can be found in both the upper and lower mucosa. When it does not develop correctly, it can present anomalies. It is common among parents, caregivers, and even healthcare professionals to have some difficulty in managing improperly inserted labial frenula, as well as in addressing their potential consequences. The most common measure for managing this alteration is frenectomy, which is a surgery that completely removes the labial frenulum with abnormalities. However, there is still much to study to determine the best age or when to indicate frenectomy. The objective of this work is to review literature addressing when to indicate upper labial frenectomy in pediatric dental patients. To do this, the PubMed, Google Scholar, SciELO, and Virtual Health Library (BVS) databases were consulted, using the boolean operator OR for the descriptors: lip, labial frenulum, oral surgery, pediatric dentistry, and child. A period between 2013 and 2022 was also limited for article publication. A total of 2049 articles were found, with 642 from PubMed, 412 from Google Scholar, 469 from SciELO, and 526 from the Virtual Health Library (BVS). However, only 13 were chosen due to their richness of content within the theme. All articles that were duplicated or diverged from the proposed theme, as well as theses, dissertations, and monographs, were excluded from this work. In addition to the chosen articles, two books by renowned authors in dentistry, published in 2016, contributed to this work. Upon analysis of the articles and books, there was a significant discussion among professionals who treat anomalies found in frenulae; some advocate for early frenectomy, while others approach frenectomy with caution. Thus, there is an evident need for more multidisciplinary studies focused on age-related results and when to recommend upper labial frenectomy in children.

Prevalence and risk factors of missed appointment among paediatric patients after minor oral surgical procedures in a tertiary hospital in Southern Nigeria

Missed appointments are common in paediatric dentistry, yet not many studies have explored its prevalence and associated factors. To determine the prevalence of missed appointments and the associated factors. This prospective study design recruited all consecutive paediatric patients that presented for minor oral surgical procedures from 1st July 2020 to 30th June 2021. Data collected was the age of patients, gender, parents’ educational level, distance from the clinic, type of minor oral surgical procedures and missed appointments. Descriptive and inferential statistics were performed. Chi-square test of association was used to determine the association between study participants’ age, sex, parents’ educational level, the distance from the clinic, and the prevalence of missed dental appointments. Binary logistic regression was used to determine the predictors. Data was analysed using the Statistical Package of Social Science (SPSS) version 26 (IBM, Chicago, IL, USA). A p-value of less than 0.05 was considered significant. A total of 182 paediatric dental patients, age ranged from 0.5 to 16 years and with a mean age of 8.55+3.88 participated. Most (60.4%) of the patients were females and 46.2% of them were of school age. Most of the parents had a tertiary level of education and lived within 7 to 12 kilometers from the clinic. The prevalence of missed appointments was 54.9% and the most performed minor oral surgical procedure was primary tooth extraction. The relationship between age group, minor surgical procedures with missed appointments was statistically significant (P&lt;0.05). Binary logistic regression analysis revealed that the type of surgical procedure was the only independent predictor of missed appointments (p&lt;0.05) The prevalence of missed appointments in this study is remarkably high. Although the age of the patients and the type of procedure was associated with the prevalence of missed appointment, it was only the type of surgical procedure that was a significant risk factor for missed appointment.

Application of Bispectral Index System (BIS) Monitor to Ambulatory Pediatric Dental Patients under Intravenous Deep Sedation.

Purpose Intravenous sedation has been well accepted to allow dental restoration in uncooperative children while avoiding aspiration and laryngospasm; however, intravenous anesthetics such as propofol may lead to undesired effects such as respiratory depression and delayed recovery. The use of the bispectral index system (BIS), a monitoring system reflective of the hypnotic state, is con-troversial in the reduction in the risk of respiratory adverse events (RAEs), recovery time, the in-travenous drug dosage, and post-procedural events. The aim of the study is to evaluate whether BIS is advantageous in pediatric dental procedures. Methods A total of 206 cases, aged 2-8 years, receiving dental procedures under deep sedation with propofol using target-controlled infusion (TCI) technique were enrolled in the study. BIS level was not monitored in 93 children whereas it was for 113 children, among which BIS values were maintained between 50-65. Physiological variables and adverse events were recorded. Statistical analysis was conducted using Chi-square, Mann Whitney U, Independent Samples t and Wilcoxon signed tests, with a p value of <0.05 considered to be statistically significant. Results Although no statistical significance in the post-discharge events and total amount of propofol used was observed, a clear significance was identified in periprocedural adverse events (hypoxia, apnea, and recurrent cough, all p value < 0.05) and discharge time (63.4 ± 23.2 vs. 74.5 ± 24.0 min, p value < 0.001) between these two groups. Conclusions The application of BIS in combination with TCI may be beneficial for young children undergoing deep sedation for dental procedures.

Procedural sedation in pediatric dentistry: a narrative review.

Procedural sedation and analgesia are now considered standard care for managing pain and anxiety in pediatric dental patients undergoing diagnostic and therapeutic procedures outside of the operating room. Anxiolysis, which combines both pharmacologic and non-pharmacologic approaches, plays a significant role in procedural sedation. Non-pharmacologic interventions such as Behavior Management Technology can help reduce preprocedural agitation, ease the transition to sedation, reduce the required amount of medication for effective sedation, and decrease the occurrence of adverse events. As the introduction of novel sedative regimen and methods in pediatric dentistry, the potential role of mainstay sedatives administered by new routes, for new indications, and with new delivery techniques, should be considered. The purpose of this paper is to examine and discuss the current state of sedation techniques in pediatric dentistry.

Impact of parent’s knowledge and attitude about pediatric dental treatment during the Covid-19 pandemic in Bhairahawa City, Nepal

A new type of coronavirus that causes pneumonia was first detected in December 2019, in Wuhan. It was first denoted as the 2019 novel coronavirus (2019-nCoV). The International Committee on Taxonomy of Viruses, Wuhan in December 2019, referred to a new coronavirus capable of infecting humans as SARS-CoV-2. At the same time, the World Health Organization declared the official name of the disease caused by this virus as COVID-19.In this cross-sectional questionnaire survey, 180 participants out of 190 participants were included to evaluate the knowledge and attitude about the pediatric dental treatment during covid-19 pandemic among parents, who visited the department of Pedodontics and Preventive Dentistry, of Universal College of Medical Sciences, during covid-19 pandemic for three months (February 2021 to April 2021), in Bhairahawa, Nepal.In this study out of 180 participants, 105(58.33%) were male and 75(41.66%) were female. All parents were concerned and aware of COVID-19. Every child was explained about covid-19 viruses by their parents.Even though the parents were aware of the Covid-19 pandemic and had discussed it with their children, still they do not prefer any kind of dental treatment even in severe pain. As they thought that other places are less infectious than a pediatric dental clinic.Thus, the aim of this study was to evaluate the knowledge and attitude of pediatric dental patients’ parents’ towards COVID-1 9 in Bhairahawa, Nepal.

Effect of sound masking using child-friendly masker sounds on the perception of the dental drill noise in pediatric dental practice

Background: Dental anxiety is significantly influenced by the fear and annoyance brought on by the sound of a dental drill. As a result, the welcoming atmosphere at pediatric dental offices is likely to entice young children to come in for examination and treatment. Aim: The aim of this study was to compare the masking effect of dental drill noise with the sound maskers on the annoyance rate of pediatric dental patients. Materials and Methods: To evaluate the stimuli in the annoyance experiment, 40 children (20 boys and 20 girls) were enlisted. As masker sounds, dragonfly and whistle sounds were chosen, and the functioning dental drill noise was blended with the original sound level. The participants rated each audio stimulus signal delivered to them in a random order, with the level of annoyance indicated by a color scale corresponding to the intensity of their psychological sense. The mean comparison between the acoustic stimuli was made using the Friedman's test. Based on gender, the mean comparison between acoustic stimuli was made using the Mann–Whitney U-test. Results: The mean annoyance rate of dental drill noise dragonfly sound and whistle sound was 4.83, 1.15, and 3.82, respectively. Gender has a significant effect on masking effect in nonacoustic factor outcomes. Conclusion: The dragonfly sound had the best impact and the most significant reduction in annoyance compared to the sound of the drill. Typically, girls felt more at ease around the dragonfly sound than boys did.

Effect of Cooled Topical Anesthetic Gel on Pain Perception During Administration of Local Anesthesia: A Clinical Trial

Background: It is crucial to manage pain during both invasive and noninvasive dental procedures because discomfort may cause patients to refuse care or put off getting it altogether. As a result, it is imperative to develop techniques that lessen pain during injections in order to keep patients from skipping dental appointments. Pain is associated with both invasive and noninvasive dental operations, although it is more commonly associated with tooth extractions, surgeries, and other invasive procedures. The use of local anaesthetics is used to prevent and manage pain, and they are thought to be the safest and most effective medications available for these purposes. Aim: To evaluate the effect of cooled topical anesthetic gel on pain perception of pediatric dental patients during the administration of local anesthesia. Material and Method: In present split mouth clinical trail, 30 children between the ages of 6 and 10 year were enrolled. Uncooled topical anaesthetic was applied in one treatment session and cooled topical anaesthesia gel in the other session prior to the administration of local anesthesia. Lignocaine 2% gel was cooled and maintained at 40 C. A small sized topical anaesthetic gel was applied on tissue using a cotton pellet for 1 minute. Similarly in next treatment session uncooled anesthetic gel was applied on injection site. The procedure was followed by infiltration injection of 2% lidocaine with 1:80,000 adrenaline (LOX* 2% ADRENALINE) using a short 27-gauge needle (Dispovan). Visual analog scale (VAS) was used to evaluate the participants’ self-reports of injection pain. Children were asked to make a mark on the line that represented their level of perceived pain intensity, and the score was recorded after the treatment. Analysis of the data was carried out using SPSS version 20.0. In all the statistical tests used in this study the significant level was pre -set at P ≤ 0.05. Result: The mean visual analog score for uncooled anesthetic gel group were 63.12 ± 4.63 and statistically significant lower score in cooled anesthetic gel group 38.23 ± 5.53 group (p&lt; 0.001) Conclusion: The results of the present study showed application of cooled topical anesthetic gel on injection site prior to the injection of local anesthetic agent did significantly reduce the pain perceived during administration of local anesthesia for routine dental procedures.

Comparison and evaluation of efficacy of olfactory and taste distraction in managing anxious pediatric patients during radiovisiography

Due to dental anxiety &amp; fear, young children tend to be more anxious even at the times of basic clinical examination and investigative procedures such as taking IOPAs, however, with the advent of RVGs, taking X-rays have become less cumbersome. A study was planned for comparison and evaluation of olfactory distraction utilizing aromatherapy, taste distraction and conventional method (Tell-Show-Do) in managing fearful children aged 4-7 years during radiovisiography (RVG). A total of 45 children (4-7 years old) were included and 3 groups (15 each) were formed and radiographs were taken with the help of RVG (radiovisigraphy) under aromatherapy, with taste distraction and using control- Tell Show Do technique. Pre- and Post- anxiety scores were measured using physiological measures- pulse and respiratory rate, oxygen saturation and Venham’s picture test. Statistical Package for Social Sciences (SPSS) version 21, IBM Inc, was used for statistical analysis.Both the test groups (aromatherapy and taste distraction group) when compared with control group, exhibited noteworthy post-treatment variation in anxiety level scores. No statistical significance was seen amongst taste distraction and aromatherapy group, although aromatherapy exhibited superior results in comparison to taste distraction. Both taste distraction using lollipop/candy and aromatherapy employing lavender essential oil are efficacious in management of anxiety among children, however aromatherapy unveils a better result in comparison. To conclude, a combination or individual use of less invasive techniques may be executed effectively in handling pediatric dental patients.

Role of Intraoral Scanners in Pediatric Dentistry

Intraoral Scanners (IOS) are devices which are used for capturing direct optical impressions in dentistry. They are handheld devices used to directly create digital impression data of the oral cavity. Light source from the scanner is projected onto the scan objects, such as full dental arches, and then a 3D model processed by the scanning software will be displayed in real-time on a touch screen. Pediatric dental patients requiring dental prostheses is considered the most challenging for dental professionals owing to managing the children’s behavioural problems, gagging reflex, foreign body aspiration, and choking (breathing) concerns. The conventional impression-making procedures in young children are regarded as quite cumbersome and difficult due to several clinical factors in dentistry. Pediatric dentistry is evolving to minimise the disadvantages of traditional techniques by introducing advanced digital intraoral scanners in the field of pediatric dentistry. Thus this paper reviews the application of intraoral scanners in pediatric dentistry.

Impact of the COVID-19 lockdown on the oral health status of paediatric dental patients in Greece.

Limited evidence regarding the post-COVID-19 dental status of paediatric patients is available, with most studies assessing only children's oral health habits. To evaluate the effect of the COVID-19 lockdown on the oral health of paediatric dental patients in Greece. This was a retrospective cohort study that included a questionnaire on children's oral health behavior and a clinical examination assessing dental caries and dental treatment needs using the International Caries Detection and Assessment System criteria, dmft/DMFT, and Treatment Need Index. The Wilcoxon signed-rank test was used for a statistical comparison between questionnaire and clinical data before, during, and after the lockdown. A total of 102 children with a median age of 9 years were recruited from the current cohort of patients that had their last dental examination 6months prior to the lockdown. Results from the questionnaire showed decreased brushing frequency with increased eating frequency and sugar consumption during the lockdown period (p < .001). Moreover, 16.5% had to visit the dentist for urgent care during the lockdown, 13.6% experienced dental pain, and 51.5% did not experience any dental emergencies. Clinical examination, after the lockdown, recorded significantly increased mean dmft/DMFT scores by 0.63 units in the primary dentition (p=.01) and 0.52 units in the permanent teeth (p=.002). Significantly higher treatment needs, with more carious lesions requiring extensive treatment after the lockdown, were recorded (p < .001). The COVID-19 lockdown negatively affected children's oral health behavior: caries prevalence increased and more complex dental treatments were required.

Which audio distraction technique is more effective for reduction the pain and anxiety of pediatric dental patients; “music” or “kids-story”? A randomized split-mouth crossover clinical trial

ObjectiveControl of pain, fear, and anxiety of children during dental procedures is a major challenge in pediatrics. This study aimed to compare the effect of audio distraction by music and audio-story on pain and anxiety of children during dental treatment. MethodsThis randomized crossover clinical trial evaluated 60 systemically healthy children between 4 and 8 years, who were candidates for pulpotomy and steel crown of bilateral primary maxillary first or second molars. The patients were randomly divided into two groups of music-story (M first), and story-music (S first) according to the sequence of receipt of the distraction techniques with a split-mouth design. The level of pain and anxiety of patients was measured using physiological scales such as pulse rate (PR), sound-eye-motor (SEM) and faces pain rating (FPR). The pkcross package in Stata software version 14 was used to assess the treatment effect, period effect, sequence effect and carryover effect. ResultsIn each group, 28 cases were included in the analysis. The difference in PR was not significant at the onset and termination of each treatment session between two distraction techniques and also, the mean FPR (P = 0.55) and SEM (P > 0.99) scores were not significantly different between the two groups. ConclusionsThe “audio-story” and “music” distraction techniques were not significantly different for pediatrics relieving during LA administration. Thus, considering the equal efficacy of the two techniques, dental clinicians can use any of the two to distract children. Registration informationThe study registered in the Iranian Registry of Clinical Trials (IRCT20190702044077N1).

A feasibility and acceptability study of screening the parents/guardians of pediatric dental patients for the social determinants of health

BackgroundThe social determinants of health (SDOH) are the conditions in which people are born, grow, work, live, and age. Lack of SDOH training of dental providers on SDOH may result in suboptimal care provided to pediatric dental patients and their families. The purpose of this pilot study is to report the feasibility and acceptability of SDOH screening and referral by pediatric dentistry residents and faculty in the dental clinics of Family Health Centers at NYU Langone (FHC), a Federally Qualified Health Center (FQHC) network in Brooklyn, NY, USA.MethodsGuided by the Implementation Outcomes Framework, 15 pediatric dentists and 40 pediatric dental patient–parent/guardian dyads who visited FHC in 2020–2021 for recall or treatment appointments participated in this study. The a priori feasibility and acceptability criteria for these outcomes were that after completing the Parent Adversity Scale (a validated SDOH screening tool), ≥ 80% of the participating parents/guardians would feel comfortable completing SDOH screening and referral at the dental clinic (acceptable), and ≥ 80% of the participating parents/guardians who endorsed SDOH needs would be successfully referred to an assigned counselor at the Family Support Center (feasible).ResultsThe most prevalent SDOH needs endorsed were worried within the past year that food would run out before had money to buy more (45.0%) and would like classes to learn English, read better, or obtain a high school degree (45.0%). Post-intervention, 83.9% of the participating parents/guardians who expressed an SDOH need were successfully referred to an assigned counselor at the Family Support Center for follow-up, and 95.0% of the participating parents/guardians felt comfortable completing the questionnaire at the dental clinic, surpassing the a priori feasibility and acceptability criteria, respectively. Furthermore, while most (80.0%) of the participating dental providers reported being trained in SDOH, only one-third (33.3%) usually or always assess SDOH for their pediatric dental patients, and most (53.8%) felt minimally comfortable discussing challenges faced by pediatric dental patient families and referring patients to resources in the community.ConclusionsThis study provides novel evidence of the feasibility and acceptability of SDOH screening and referral by dentists in the pediatric dental clinics of an FQHC network.

Trends of Dental Treatment under General Anesthesia and Patterns of Repeated General Anesthesia in Children and Adolescents with Severe Disabilities

The aim of this retrospective study was to evaluate the demographic characteristics of pediatric dental patients who underwent dental treatment under general anesthesia (DTGA) at the Seoul National University Dental Hospital from January 2011 through December 2020 and compare the patterns of repeated DTGA between dental patients with severe disabilities (DSD) and non-DSD (healthy or medically compromised patients without DSD). There were 1,857 DTGAs among 1,719 patients (mean age = 5.1 years; males = 59.3%; ASA 2 or above = 52.9%; DSD = 26.8%). Overall, 6.6% of patients underwent repeated DTGA, and the rate of repeated DTGA over a 10-year period was 7.4%. ASA 2 or above (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and DSD (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001) were more likely to undergo repeated DRGA compared to ASA 1 and non-DSD. At both GA1 and GA2, DSD received significantly more restorative treatment on permanent teeth than non-DSD (&lt;i&gt;p&lt;/i&gt; = 0.002, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001, respectively). There has been an increasing demand for DTGA in pediatric dentistry over the last 10 years. Regular check-ups and preventive oral health care are necessary for pediatric dental patients with severe disabilities to reduce the possibility of repeated DTGA.

Effect of white, brown and pink noises on anxious pediatric dental patients

Purpose: To evaluate the effectiveness of various relaxation noises on anxiety levels of children aged between 4-8 years old by analysing through heart rate, FLACC scale and Wong-Baker Faces Pain Rating Scale. Material and methodology: Using simple random sampling 40 children were equally divided into group of four; GROUP 1: Control group ( any cartoon music), GROUP 2: White noise, GROUP 3: Brown noise, Group 4: Pink noise. Patients in each group were treated in a single appointment after using the particular sound distraction technique, Patients who all require extraction under local anaesthesia were included in the study. Patient anxiety level was evaluated by measuring pulse rate, wong baker’s scale, FLACC scale at different time intervals. Results: Among all shades of noises, White noise shown significant results. Conclusion: It was concluded that audiodistraction is the innovative technique for diverting patient’s mind in pediatric dentistry.

Assessment of Effectiveness Acceptability Complications and Parental Satisfaction of Pediatric Dental Patients Treated under Nitrous Oxide-oxygen Inhalational Sedation Using Porter Silhouette Mask.

To estimate the concentration of nitrous oxide (N2O) required for effective sedation to render dental treatment for an anxious child and to assess the child's behavior, patient acceptance, parental satisfaction, postoperative complications, and ease of manipulation of Porter Silhouette mask by the dentist during N2O-O2 sedation. A total of 40 children, 6-10-year-old requiring dental treatment, were treated using N2O sedation. The level of N2O required for optimal sedation, patient behavior, level of acceptance of N2O by the patient, clinical recovery score, and postoperative complications were observed throughout the study. At the end of the treatment, a questionnaire was given to the parents to evaluate parental satisfaction. The sedation was very effective, with 25-50% of N2O concentration. About 92.5% of children were fully cooperative, the dentist was able to place the mask with comfort in 92.5% of children, significant improvement was seen in the patient's behavior with minimal complications, and 100% of the parents were satisfied with the treatment under sedation. Inhalational sedation with N2O using Porter Silhouette mask results in effective sedation, with increased patient comfort, and parental acceptance in providing dental treatment. AKR SP, Mungara J, Vijayakumar P, et al. Assessment of Effectiveness Acceptability Complications and Parental Satisfaction of Pediatric Dental Patients Treated under Nitrous Oxide-oxygen Inhalational Sedation Using Porter Silhouette Mask. Int J Clin Pediatr Dent 2022;15(5):493-498.

Effect of Parental Dental Anxiety Level on Acceptance of Non-Pharmacological Behavior Management Strategies used in Pediatric Dentistry

Objective: To determine the effect of parental dental anxiety level on acceptance of non–pharmacological behavior management strategies used in pediatric dentistry Methodology: This cross-sectional study was conducted at the Pediatric department of FUCDH Pakistan over five months. It was carried out through a pre-validated questionnaire. Behavior management techniques with audiovisual aids were explained to the participants. Patients reporting for routine dental check-ups, on follow up of ongoing dental treatment were included in the study whereas patients with dental trauma, unwilling to be a part of this research, undergoing general anesthesia and medically compromised patients were excluded from the study. Patients are grouped based on age to determine parental behavior in different age groups. Results: 302 parents participated in this study including 130 (43.0%) fathers and 172 (57.0%) mothers. The mean age of children was 7.81±1.92 years, with an age range of 4 – 12 years. The majority of the parents, 297 (98.3%) agreed with behavioral management techniques with 293 (97.0%) parents agreed that the dentist should show videos of behavior management techniques for their understanding. 254 (84.1%) parents agreed to consent for use of sedation and anesthesia. Refusal to sedation technique was significantly more common among parents of children of younger age group as compared to children of older age group (p&lt;0.001). Conclusion: Modest anxiety levels were recorded in parents accompanying pediatric dental patients irrespective of age group thus expressing eagerness for non – pharmacological behavior management strategies with prior explanation and demonstration. However, reluctance to sedation and anesthesia modalities were deciphered by parents particularly evident in parents of younger age group patients.

Children's electronic screen time exposure and its relationship to dental anxiety and behavior

ObjectivesThe purpose of this study was to assess the association between electronic screen time and dental anxiety and behaviour among children aged six to twelve years during dental examination, prophylaxis, and topical fluoride application. Material and methodsThis was a cross-sectional study which included 402 paediatric dental patients aged six to twelve years who came to King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. The data was collected from September 2020 to December 2021. Self-constructed questionnaire was used to collect data from the patient and his/her guardian. It was comprised of eight demographic questions as well as 13 multiple-choice questions regarding the patients' screen time. Child dental anxiety was assessed by using Abeer Children Dental Anxiety Scale (ACDAS). Assessment of child's behaviour was done by using Frankl Behavioural Rating Scale. ResultsThis study had a response rate of 100%. Out of the 402 participants, 248 (61.7%) were found to have anxiety while 154 (38.3%) were not. Of all participants 274 (68.2%) were cooperative and 128 (31.8%) were not. A Significant relationship between anxiety and behavioural problems during a dental visit and the participant's total exposure hours to electronic devices was found (p < 0.001). Children exposed to electronics at the age of two years or before displayed more anxiety and uncooperative behaviour (p < 0.001). Conclusionsearly exposure to electronic screens, especially for entertainment purposes and longer exposure can be associated with increased dental anxiety and uncooperative behaviour in children age 6–12 years. RecommendationsParents should be educated about the risks of permitting their children to use electronic devices and encouraged to replace such devices with activities that incorporate physical activity.

A Comparison of Innovative App-Based Prescriptions With Conventional Prescriptions for Children by General Dentists: A Mixed Methods Study.

Introduction Writing drug prescriptions for children with accurate drug dosages and clear instructions is a must for general dentists. A digital tool in the form of a software application (app) to write, save and share prescriptions can potentially overcome the possible limitations of handwritten prescriptionssuch as handwriting illegibility, errors in calculations, and incomplete descriptions. However, it is also important to assess the satisfaction of dentists with making prescriptions using a digital tool such as an android application. A mixed methods study comparing an innovative "app-based" and handwritten prescriptions in dental settings is presented. Methodology An indigenously developed and piloted app "PREscribing children made EASY (PREASY)" was used in this study. Based on the preliminary study, a sample size of 20 was found to be adequate. Twenty-two dentists participated in the study. The conventional handwritten and an Android app PREASY-based prescriptions were compared in terms of the time taken, precision of writing, and satisfaction of the dentists. Qualitative feedback regarding the PREASY app was obtained in Google Forms (Google, Inc., Mountain View, CA, USA). Results A study sample of 20 subjects was calculated based on a pilot study, and 22 dentists were recruited. The mean time taken in seconds for handwritten prescriptions (199.14 (+ 59.18)) was almost four times higher than that for app-based prescriptions (52.05 (+ 23.89)) (t-test, P < 0.00001). The accuracy of handwritten prescriptions versus app-based prescriptions was compared by two examiners independently using analysis of variance (ANOVA) in three domains: dosage accuracy, legible handwriting, and completeness of instructions, the differences (Domain 1mean + SD: 1.04+ 0.89, Domain 2 mean + SD: 1.38 + 0.40, Domain 3 mean + SD: 0.88 + 0.58) being statistically significant (P <0.05). The differences in the percentages of the three domains (dosage accuracy: 40.9%, legibility of handwriting: 63.6%, completeness of instructions: 18.1%) were found to be statistically significant (P < 0.05; chi-squared statistic, 9.4017). Of the participants,59% were very satisfied, 36.3% were satisfied, and 4.5% were neutral (chi-squared test, P < 0.00001). Participants' feedback/comments were categorized under technical suggestions, dosage suggestions, criticism, and positive remarks and were thematically analyzed. Conclusion App-based prescriptions proved to be more instantaneous and detailed than handwritten ones with the majority of dentists satisfied. Valuable feedback pertaining to the limitations of the tool was obtained for improving the app. PREASY-based prescriptions could be recommended for prescribing to pediatric dental patients.

THE EFFECT OF DIFFERENT ADHESIVE MATERIALS ON WORKING TIME OF DENTAL TRAUMA SPLINT PLACEMENT AND REMOVAL: IN-VITRO STUDY

Introduction: The placement and removal of dental trauma splints can be challenging in paediatric dental patients especially in emergency cases. An ideal adhesive material which offer simplified and time-saving dental splint procedures is preferred. Objective: This in-vitro study aimed to evaluate the effect of different adhesive materials on working time during the placement and removal of dental trauma splints. Method: Eight types of adhesive materials (packable composite resin with self-etch and etch-and-rinse, flowable composite resin with self-etch and etch-and-rinse, self-cure and light-cure RMGIC, and temporary and semi-permanent GIC) were investigated. The working time during the placement and removal of dental trauma splints was recorded in seconds(s) by using a stopwatch. Results: Data were analyzed with One-way ANOVA and showed that there were significant differences in working time during placement (p &lt;0.001) and removal (p = 0.007) of dental trauma splints between different types of adhesive materials. The shortest working time for placement of dental trauma splint can be observed with flowable composite resin self-etch and light cure RMGIC groups. Meanwhile, the shortest working time during the removal of dental trauma splint can be observed with temporary GIC and light cure RMGIC groups. Conclusion: Light cure RMGIC may offer as an ideal adhesive material for dental trauma splint especially in paediatric dental patient as it showed an advantage on time of placement and removal of the splint.