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Purpose: Investigating the effect of visual distraction using animated video cartoons (AVCs) on anxiety of children during class I class I glass-ionomer cement (GIC) restoration procedures. Patients and Methods: This randomized clinical trial, 42 children between the ages of 5–6 years were enrolled. These participants were divided into two groups: Group 1, consisting of 21 individuals (AVCs), who were exposed to a cartoon as a visual distraction tool, and Group 2, a control group with 21 participants who did not receive any form of distraction during their first visit. Both groups underwent class I GIC restoration procedures that were conducted in a consistent manner. To evaluate the anxiety levels of the children, measurements of their pulse rate (PR) were taken at the beginning and end of the treatment. Additionally, patient behavior was assessed using the Frankl behavior rating scale (FBRS) as well as validated self-reported dental anxiety scale, the Visual Analog Scale – Anxiety (VAS-A) score. Results: In the control group, postoperative PR increased significantly, while the AVC group experienced a decrease compared to their preoperative PR levels. Additionally, audio-visual distraction had a notable impact on FBRS scores compared to the standard approach. Similarly, the VAS-A score displayed a significant reduction when patients received audio-visual distraction compared to the control condition. Subgroup analysis by gender showed that girls tended to be more responsive to AVCs than boys when evaluated by PR and FBRS, but such findings were not observed using VAS-A. Patients with deeper caries had higher VAS-A scores than those with shallower ones. Despite the caries depth, those who received AVC seemed to be calmer, especially to those with deeper lesions, as indicated lower postoperative VAS-A scores compared to their preoperative levels, unlike the control group. Conclusion: Our study suggests that the use of AVCs can be an effective method for reducing anxiety in children undergoing class I GIC restoration procedures. [ABSTRACT FROM AUTHOR]

Purpose: To assess levels of dental fear and anxiety (DFA) in children with and without Molar-Incisor Hypomineralisation (MIH) and dental caries lesions. Methods: In this cross-sectional observational study, 159 children between 8 and 12 years of age were included. For the evaluation of DFA, children responded to the validated version of the Children's Fear Survey Schedule-Dental Subscale. MIH was assessed using the MIH Index. To evaluate the activity of dental caries lesions and dental caries experience, the Nyvad criterion and the dmft/DMFT index were used, respectively. Dental hypersensitivity was evaluated using air stimulation and a Visual Analogue Scale. The association between MIH and dental caries with DFA was assessed using the generalised linear model with Poisson family, identity link function and robust variance estimation. The significance level was set at 5%. Results: The mean DFA score was 28.3 (SD = 13.4) with scores ranging from 15 to 64. Amongst children presenting both MIH and dental caries, the perception of DFA was notably higher compared to those with either MIH or dental caries alone. The activity of caries lesion in patients with MIH also influenced DFA levels (diff: 18.6; 95% CI: 12.0–25.2; p < 0.001). Dental caries experience in the primary dentition also demonstrated statistical significance concerning DFA (95% CI: 0.8–13.3; p value = 0.027). Conclusion: Children with MIH exhibit higher levels of DFA than children without MIH. The experience of dental caries and the activity of caries lesions significantly influence the perception of DFA in children with MIH. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to evaluate the effectiveness of brainwave entrainment on pre-operative fear and anxiety in pediatric dental patients. Methods: The study protocol received approval from the Institutional Ethical Committee under reference number 3010/IEC/2021. Pediatric patients (252) aged from 7 to 12 years, who reported to the dental department were randomized pre-operatively and presented either with brainwave entrainment (experimental), delivered using a "David delight plus device" or a standard behavior management protocol (control). Baseline and post-assessment of anxiety and fear levels were done using the Visual Facial Anxiety Scale and Frankl's behavior rating scale with Wright's modification. Vitals such as blood pressure and pulse rate were also measured. Results: The study sample (n = 252) comprised 118 females and 134 males. The non-significant differences for values of (VFAS1, FRS1, HR1, and BP1) indicated similar baseline characteristics. In the brainwave entrainment group, the p values of the Mann–Whitney U test and Wilcoxon Signed Ranks test (p < 0.01) between the two-timepoints indicated a statistical difference for the values of (VFAS1, FBRS1, HR1, BP1) and (VFAS2, FBRS2, HR2, BP2). Conclusions: Brainwave entrainment effectively reduces pre-operative fear and anxiety in pediatric dental patients. Therefore, they can be a non-pharmacological and non-invasive behavior management aid. Trial Registration: Clinical Trial Registry of India database CTRI/2023/03/051066. [ABSTRACT FROM AUTHOR]

Dental anxiety poses challenges for providing effective oral healthcare. While therapy dogs have shown promise in various medical and mental health contexts, their use for alleviating dental anxiety in adults remains underexplored. This study aimed to investigate the emotional and physiologic effects of therapy dogs on self-reported dental anxiety. Adults with dental anxiety were randomly assigned to an intervention group (DOG: n = 19) or a standard care group (SC; n = 14). Standard self-report measures were used to assess dental anxiety (Index of Dental Anxiety and Fear [IDAF-46+]), depression (Patient Health Questionnaire 9), and generalized anxiety (Generalized Anxiety Disorder 7) prior to the intervention. Participants in the DOG group received a 10-minute therapy dog intervention before dental procedures in sessions 1 and 2, while participants in the SC group rested quietly for 10 minutes before their procedure. The SC participants received the 10-minute therapy dog intervention before dental procedures in the third and final session, while patients in the DOG group received no intervention prior to their third procedure. After the dental procedures, patients completed a questionnaire about their satisfaction with the dog therapy (Therapy Satisfaction Scale) and recorded their anxiety and comfort levels on visual analog scales. Continuous electrocardiographic recording measured heart rate variability during the intervention and dental procedure. Prior to the intervention, most participants (90.9%) met the IDAF-46+ criteria for dental anxiety, with 7 (21.2%) meeting the criteria for dental phobia. The DOG group participants expressed high satisfaction with the therapy dog intervention. No significant differences in heart rate variability were observed between the groups during dental procedures. Therapy dogs can effectively manage dental anxiety in adults with mild to moderate dental anxiety, offering potential benefits for oral healthcare. [ABSTRACT FROM AUTHOR]

In 1976, Marbach first described in the literature a clinical entity that he called "the phantom bite," now known as "occlusal dysesthesia" (OD). Most patients suffering from OD are going through an unusually stressful period in their lives and have undergone dental therapy at the same time, resulting in a mental fixation on their teeth. They perceive clinically unremarkable occlusal contacts as bothersome or uncomfortable and TMD is a common comorbidity. Although there is no apparent relationship between the clinical findings and the nature and severity of the reported occlusal complaints, patients search for their "ideal" occlusion or to regain their "lost bite." As a result, they suffer from persistent and severe emotional distress. The co-occurrence of depression, anxiety and/or personality disorders is common. The primary therapeutic goal is to improve oral health-related quality of life. Occlusal adjustments are contraindicated. Instead, professional counseling and education as information therapy, psychological therapy, oral splints as a form of occlusal therapy with the goal of defocusing effects and medication are recommended forms of therapy. Unfortunately, the acceptance of the diagnosis of OD and the therapeutic recommendations is usually low among these patients and a large proportion reject therapeutic efforts out of conviction and continue their journey in search of "healing" invasive therapy. [ABSTRACT FROM AUTHOR]

The number of cardiac transplants carried out each year within the UK is increasing. With this rise in numbers, it is important that dental professionals are aware of both pre- and post-operative considerations for these patients. This paper considers the practical elements of managing these patients, outlining important aspects of history taking, treatment planning, and safe pain and anxiety management options. CPD/Clinical Relevance: The unilateral sagittal split osteotomy may present an alternative method for removing impacted mandibular third molar teeth in certain situations. [ABSTRACT FROM AUTHOR]

Dental anxiety is prevalent and may result in the avoidance of periodontal therapy and maintenance. This study aimed to explore the impact of non-surgical periodontal treatment (NSPT) on dental anxiety among patients with periodontitis. In this study, 122 patients with periodontitis participated. The Chinese version of the Modified Dental Anxiety Scale (MDAS) gauged baseline dental anxiety during the initial appointment. Patients receiving non-surgical periodontal treatment (NSPT) in subsequent appointments formed the NSPT group, while those with a delayed NSPT of at least two months constituted the delayed group. In the NSPT group, the second termination questionnaire was administered one month post the last NSPT visit, just before the periodontal re-evaluation. In the delayed group, the second questionnaire was completed before the delayed NSPT initiation. Baseline MDAS scores were comparable between the delay and NSPT groups. However, the NSPT group exhibited lower total scores and scores for each of the five MDAS items at termination compared with the delay group. At baseline, MDAS total scores were inversely associated with age and were lower in males. A reduction in MDAS total scores between observation points was correlated with NSPT, sex, and age after adjustment. Regarding MDAS item 4 (teeth scaled/polished), score reduction consistently correlated with NSPT and age. Participation in NSPT may alleviate dental anxiety, and consequently enhance the patients' conceptiveness to undergo periodontal maintenance or surgery. [ABSTRACT FROM AUTHOR]

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The article focuses on maximizing dental attendance among older patients, discussing reasons for their discontinuation of recall appointments, systemic health barriers, and strategies for improving communication and access to care, including teledentistry. It also discusses the complex socioeconomic and health-related challenges older adults face in maintaining oral health, highlighting the need for tailored interventions and enhanced health literacy to promote regular dental care.

Background and objectives: Patient education and health literacy are crucial in dentistry, prior to complex procedures like root canal treatment (RCT), that are often associated with anxiety. This mixed-methods pilot study explored the effectiveness of educational material on patients' understanding and experiences of RCT, and dentists' feedback on using a new resource. Methods: Before RCT, patients were provided with an existing New Zealand Dental Association (NZDA) education pamphlet or an enhanced educational resource (EER) in pamphlet or online format, and surveys were conducted to evaluate their helpfulness. Dentists were interviewed to gather insights on the use and value of the resources. Quantitative data and variable relationships were compared using Chi square tests and qualitative data was thematically analysed. Results: The patients valued their dentist as an 'educator' but appreciated the clarity, simple language and visual aids in the resources, which answered questions, enhanced understanding, and reduced anxiety. Those who had received the EER (pamphlet and online) better understood the stages of RCT, reported significantly lower levels of anxiety after RCT (p=.04) and had positive overall experiences. The EER improved and supported dentists in consent processes and enhanced patient-dentist communication. Conclusions: The findings from this study highlight the value of providing patients supplementary educational material to enhance their health literacy and experience of RCT. Dentists have an important role in educating their patients and clear and informative resources are valuable adjuncts. Further validation of these findings in broader clinical settings is warranted. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a profound and enduring impact on various aspects of society, including medical education and the training of dental students. The field of dentistry, given its nature, is particularly susceptible to the challenges posed by a pandemic. Prolonged exposure to the pandemic is believed to have increased stress and burnout among medical and dental students. This study aimed to investigate and analyze the relationship between COVID-19 and stress, burnout, and depression in Korean dental students. A cross-sectional survey was conducted among 162 third and fourth-grade students from the School of Dentistry at Seoul National University. The survey comprised four main sections: general information, the Maslach Burnout Inventory (MBI), the Patient Health Questionnaire-9 (PHQ-9), and the Impact of Event Scale-Revised (IES-R). The results indicated significant differences in age, study time, career satisfaction, and counseling needs between third and fourth-grade students. The fourth-grade students exhibited higher scores in the IES-R survey, PHQ-9 total score, emotional exhaustion, and depersonalization subscale items of the MBI. Furthermore, the group with abnormal responses to COVID-19 demonstrated lower levels of career satisfaction. Fourth-grade dental students experienced higher levels of depression, vulnerability to the effects of COVID-19, and burnout. These findings highlight the need for addressing the mental health challenges faced by dental students during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The article describes a case of partial ceramic restoration treating subgingival caries in a 51-year-old patient. Selective caries removal was performed using caries dye before a bonded full-coverage onlay was prescribed. A modified circumferential wide band was placed and sealed with sterile teflon tape, followed by immediate dentin sealing using G2-BOND Universal and deep margin elevation to move the deep mesial margin coronally with a highly filled injectable composite.

To assess sleep quality among dental students and to identify psychological factors associated with self-reported sleep bruxism (SB). A total of 212 dentistry students from the Usak University Faculty of Dentistry participated in this study. A self-report questionnaire was administered to identify possible SB. The Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was administered to evaluate psychological factors, and the Pittsburgh Sleep Questionnaire Index (PSQI) was used to evaluate sleep quality. Possible SB was more frequently observed in females than in males. The mean DASS-21 score in those with possible SB was significantly higher than in those without SB (p< 0.001). The mean PSQI (total) score was also significantly higher in those with possible SB than in those without SB (5.0 ± 2.4) (p= 0.007). The findings revealed that psychological factors and sleep quality significantly affected the prevalence of self-reported SB among dental students. [ABSTRACT FROM AUTHOR]

To evaluate the possible relationship between bruxism and smartphone overuse and assess the potential role of anxiety and depression in this relationship. The null hypothesis was that there was no significant difference between sleep bruxism (SB) and/or awake bruxism (AB) and non-bruxers in the level of smartphone overuse, anxiety, and depression. In total, 167 dental students were included in this study. They were evaluated using the American Academy of Sleep Medicine (AASM) criteria, Smartphone Addiction Scale (SAS), Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI). T-test and chi-square test were used to compare the means and percentages between groups. A higher percentage of sleep bruxers were high smartphone users (60.3%) compared to non-SBs (44.2%). The frequencies of high smartphone users among participants with high anxiety and depression were higher than those with low anxiety and depression. SB and high smartphone use were positively associated. [ABSTRACT FROM AUTHOR]

Dental anxiety is a prevalent concern among individuals undergoing root canal therapy. This study aims to assess the levels of dental anxiety among Jordanian patients undergoing root canal treatment. A total of eighty-two adult patients who underwent nonsurgical root canal therapy at the School of Dentistry, University of Jordan, participated in this study. Pre- and post-treatment questionnaires were administered to assess anxiety levels, age, and gender. Post-treatment questions solicited participants' ratings of anxiety levels and perceptions of certain aspects of the endodontic treatment experience. Analysis revealed that 43.9% of participants reported a reduction in anxiety levels following root canal therapy. Furthermore, a significant majority (96.3%) expressed willingness to undergo root canal treatment again to preserve their teeth. Technological advancements in materials, instruments, microscopes, and other innovations have contributed to decreased patient anxiety levels during root canal procedures. [ABSTRACT FROM AUTHOR]

There is certainly no shortage of literature surrounding the incidence of dental anxiety, the causes of dental anxiety and management strategies. Similarly, much research has been undertaken to investigate the relationship between socioeconomic position and dental disease rates. Both anxiety and a lower socioeconomic position have been linked with poorer oral health-related quality of life. We know that early childhood dental experiences can set the tone for a patient's attitudes towards, and relationships with, dentists and dental treatments. The aim of this review was to investigate whether children from a lower socioeconomic position are more likely to become dentally anxious. It aims to explore whether the treatment of children from lower socioeconomic backgrounds is different to their more affluent peers and, if so, whether this might impact how these individuals go on to perceive dentists and dental treatment. As dentists we must provide appropriate treatment and aim for the best dental health outcomes, whilst also considering the patient holistically. With children, this should involve fostering positive relationships and dental experiences where possible, to set them up for a positive and healthy dental future which is as anxiety free as possible. [ABSTRACT FROM AUTHOR]

This document is a journal scan that provides a synopsis of articles from the last twelve months. One article discusses the use of oral benzodiazepines for managing dental anxiety in the UK, highlighting a lack of confidence and clear guidance among dentists. Another article explores the sedation of pediatric dental outpatients using oral midazolam versus intranasal dexmedetomidine plus oral midazolam, finding that the combination treatment is more effective. The document also mentions the dangers of the recreational use of nitrous oxide and the need for clearer guidelines on its use. Finally, there is an article on the comparison of oropharyngeal oxygen pooling and suctioning during dental office-based anesthesia. It is important to critically evaluate articles from different countries due to variations in definitions and practices. This document is a collection of reviews on various topics related to dentistry and oral surgery. The first review discusses the perioperative management of oral antithrombotics in dentistry and oral surgery, focusing on factors considered when developing a management plan for patients on these medications. The second review explores the impact of bitewing radiographs on treatment planning for carious primary molars, finding that they play an important role in treatment decisions. The third review examines the feasibility of minimum intervention oral healthcare for individuals with dental phobia, showing positive outcomes for patients receiving this approach. Lastly, a systematic review and meta-analysis evaluates the use of virtual reality as a distraction method for managing dental phobia in children, [Extracted from the article]

Introduction: Dental Cognitive BehaviourTherapy (dental CBT) is a talking therapy for adults and children aimed to reduce a patient's anxiety specifically related to dentistry. The Modified Dental Anxiety Score (MDAS) allows an objective measurement of the patient's level of anxiety pre and post CBT. Aims: The objective was to assess the effectiveness of the CBT service within Birmingham Community Healthcare NHS Foundation Trust (BCHC) Community Dental Services (CDS). The aims were to assess the number of patients with a pre- and post-CBT MDAS recorded, the success of CBT and the anxiety management modalities used to facilitate treatment. Methods: A retrospective analysis of internal CBT referrals between January 2018 to December 2022. Results: 135 referrals were identified. 56% had a pre-MDAS score, of these 85% were between 20 to 25, indicating high anxiety (>19). Post-CBT MDAS scores reduced to between 5 to 14 for 85% of patients (indicating low I moderate anxiety). After having CBT 45% of patients had dental treatment with local anaesthetic (LA) alone and 35% with inhalation sedation (IHS). Conclusions: CBT is effective in the treatment of dental anxiety and therefore allows patients to receive treatment from their general dental practitioners (GDP) and step down from general anaesthetic (GA) / intravenous sedation (IVS). [ABSTRACT FROM AUTHOR]

Conscious sedation using midazolam can be an effective primary care dental treatment modality for patients with both dental anxiety and additional needs. This retrospective service evaluation aims to assess the efficacy of conscious sedation with midazolam in a new special care primary dental service, by identifying whether midazolam provided operating conditions sufficient to allow planned dental treatment to be completed. Individual electronic records of patients treated with conscious sedation with midazolam by the West Dorset Special Care Primary Care Dental Service during the first nine months were examined. Efficacy of midazolam was evaluated using patient sedation scores and operating conditions. Planned treatment was successfully completed in 37 out of the 41 appointments (90%). Four patients were unable to have treatment carried out for reasons including cannulation refusal, suboptimal co-operation and vomiting. This study demonstrates that delivering dentist-led conscious sedation with midazolam in a primary care setting is a highly effective, costefficient alternative to general anaesthesia for a range of patients with anxiety and I or additional needs, and has significant potential to reduce wait times. However, the technique requires appropriately trained staff, careful patient selection together with suitable premises and equipment in line with evidence-based national policy and guidelines. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the impact of coronavirus disease-2019 (COVID-19) pandemic social restrictions on the lives of children and adolescents is of utmost importance to enable timely diagnosis and treatment. Therefore, the aim of this study was to explore the prevalence of anxiety, sleep bruxism, temporomandibular disorders (TMD) and change in dietary and brushing habits and their association with COVID-19 social restrictions. Methods: Parents of fit and healthy Qatari children and adolescents were recruited and interviewed by the research team, whereby validated questioners were used to assess the prevalence of children's/adolescents' anxiety, sleep bruxism and TMD. Furthermore, changes in dietary and brushing habits were also evaluated. Results: A total of 199 parents of children and adolescents (mean age = 9.3 ± 3.2 years old) were included. Overall anxiety symptoms, sleep bruxism and TMD were evident in 29.6%, 5.7% and 23.1%, respectively. An increased consumption of food, sweets and worsening of brushing habits were evident in 51.8%, 62.8% and 31.2%, respectively. Conclusion: Within the limitations of this study, pandemic-related social restrictions could result in elevated levels of anxiety, specifically, social phobia, amongst children and adolescents, which could inevitably lead to unwanted dental consequences. [ABSTRACT FROM AUTHOR]

To determine which factors influence and better differentiate between good and poor oral health-related quality of life (OHRQoL) in patients with myogenous TMD and which cut-off could predict a good/poor OHRQoL. Fifty-eight women with myogenous TMD were included. Factors of interest were collected (i.e., demographic variables, depression symptoms (Symptom Checklist-90 R (RDC/TMD)), pain intensity (Visual Analog Scale), jaw function (Mandibular Functional Limitation Questionnaire), and OHRQoL (Oral Health Impact Profile-14). A multivariable regression model, logistic regression, and receiver operating curve (ROC) analyses were conducted. Depression symptoms (β = 0.139) and jaw function (β = 0.478) were significantly associated with OHRQoL in the multivariable model. The best model to discriminate between good/poor OHRQoL included only jaw function (AUC = 0.90), with the best cut-off of 17 points (sensitivity: 0.93; specificity: 0.79). Depression symptoms and jaw function were significantly associated with OHRQoL. The best model and cut-off to discriminate good/poor OHRQoL included only jaw function. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between sleep quality, depression, anxiety and stress levels, and the frequency of temporomandibular disorders in a sample of Turkish dental students during the COVID-19 pandemic. The current cross-sectional study was conducted with 699 dental university students during the COVID-19 pandemic. Fonseca Anamnestic Index (FAI), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scale-21 (DASS-21) were used in the present study. The incidence of temporomandibular joint disorders in the present study was found to be 77.5%. Female students' FAI scores were found to be statistically significantly higher than males (p < 0.05). Additionally, higher depression and anxiety and stress levels caused increased PSQI and FAI scores. During the COVID-19 pandemic, increased temporomandibular joint disorders were observed with increased impaired sleep quality and higher depression, anxiety and stress levels among dental university students. [ABSTRACT FROM AUTHOR]

This clinical case study describes the smile restoration of a 33-year-old female patient who exhibited severe dental anxiety, multiple cavities, discoloration, and a fractured tooth. The patient's complex dental history and anxiety-driven treatment preferences posed challenges that were met with a minimally invasive strategy. The case involved meticulous diagnosis, leveraging advanced diagnostic wax-ups, and a comprehensive treatment plan. Esthetic zirconia material was utilized to enable the preservation of tooth structure while achieving visually appealing and functional outcomes, and CAD/CAM technology facilitated same-day restorations with superior marginal fit, aided by the precision of a digital intraoral scanner. The patient's dental anxiety strongly influenced the treatment approach, leading to the integration of smile enhancement alongside caries treatment. The use of a single cement and bond product simplified the final cementation process, while the versatility of the zirconia CAD/CAM material allowed for fabrication of various restoration types with minimal tooth reduction. This streamlined workflow expedited treatment, which was especially crucial for the anxious patient undergoing sedation. [ABSTRACT FROM AUTHOR]

This study evaluated patient's perception of recovery following surgical removal of mandibular third molars (SRM3s) including analyze of potential risk factors associated with impaired convalescent. Patient related parameters combined with preoperative questionnaires including Modified Dental Anxiety Scale, Oral Health Impact Profile-14, and Decayed, Missing, Filled Teeth index were correlated with questionnaires assessing pain, swelling, trismus, sick leave, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, impaired sensation of the lip, chin, and tongue, one month following SRM3s. Totally, 412 patients (223 females, 189 males) with mean age of 29.4 years were included. Treatment satisfaction and willingness to undergo similar surgery were reported by 92% and 95%, although 21% reported that the surgery and postoperative period had been worse than expected. Mean days with pain, sick leave, and swelling were 3.6, 2.1, and 3.6, respectively. Preoperative symptoms, dental anxiety level, and prolonged surgical time were associated with increased pain and swelling (P < 0.05). Pell and Gregory classification (I-IIIC) were associated with impaired sensation of the lower lip and chin (P < 0.05). Consequently, results from this study improve the surgeon's ability to predict parameters that predisposed to impaired recovery and neurosensory disturbances following SRM3s. [ABSTRACT FROM AUTHOR]

The communication barrier that deaf people face when seeking dental care can impact their experience and may potentially lead to exacerbated dental fear or anxiety. This study aimed to investigate the current attitudes and levels of knowledge and confidence of Australian oral and dental health students in treating a deaf patient. A 33-item cross-sectional questionnaire was distributed to Australian dental, oral health therapy and dental hygiene students across 13 tertiary institutions. The online questionnaire was distributed to students via their respective course coordinators. 271 viable survey responses were received. While 55.7% of participants reported previous exposure to deaf or hard-of-hearing people, 90.8% had never completed or attempted an Auslan class. These participants who answered 'Yes' to having taken a prior Auslan class were reported to have significantly higher mean knowledge scores and confidence self-efficacy ratings than those who had answered 'No' (p = 0.002). There was no statistically significant association between higher knowledge scores and higher confidence self-efficacy ratings. Most of these participants that answered 'Yes' to having taken a prior Auslan class implied or stated that the party responsible for changing their communication behaviour was the dentist rather than the patient, in contrast to the inconsistent responses from the 'No' group. Inadequate knowledge and cultural competency regarding the Deaf population was reported by Australian dental, oral health therapy and hygiene students. Incorporating more training pertinent to dental curricula is warranted to minimise oral health inequalities. [ABSTRACT FROM AUTHOR]

Intravenous (IV) sedation with midazolam works as an anxiolytic and muscle relaxant agent and has proved successful in providing safe root canal treatment (RCT) for patients with dental anxiety or special care needs. However, before starting RCT under IV sedation with midazolam, clinicians should consider obtaining a thorough medical history and written, informed consent including any significant or unavoidable risks. A responsible adult escort should also accompany the patient to their appointment. The dental team should also ensure labelling the IV sedation drugs and irrigant solutions, and using a well-sealed rubber dam. [ABSTRACT FROM AUTHOR]

The SAAD Digest provides abstracts of speakers at the annual symposium. The topics covered include incorporating remimazolam into dental care, the impact of childhood sexual abuse on dental care, the use of conscious sedation for dental procedures, the effects of illicit drugs on sedation, and the new NHS England Clinical Guide for Dental Anxiety Management. The abstracts provide insights into these topics from various perspectives, including dental professionals, survivors of childhood sexual abuse, and medical experts. The symposium aims to enhance support for patients and increase awareness of their individual needs. [Extracted from the article]

Dental radiology represents the best model for evaluating the effects of low-dose ionizing radiation. Therefore, this study evaluated the awareness on radiation hygiene among dental ancillary personnel through a questionnaire and their absorbed doses by physical and biologic dosimetry. The multicentric study included two groups. Group I (N = 30) consisted of dental staff involved in dental radiology. An equal number of personnel who were not related to radiology formed the control group. Knowledge (K), attitude (A), and practice (P) of participants were assessed using a KAP questionnaire. Radiation exposure was evaluated by physical dosimetry at 3 time periods: at the beginning of the study (T1), after 10 months (T2), and at the end after 20 months (T3). Similarly, biologic dosimetry was also carried out at 3 time points by dicentric chromosome aberration assay. The data were compared using percentage analysis, analysis of variance (one-way analysis of variance), and Student's t- test. The KAP survey demonstrated enhanced understanding of radiation protection measures and its sound practice by the participants. Physical dosimetry showed a significant increase in absorbed dose at 3 time points: T1, T2, and T3. However, no chromosomal aberrations were observed in blood lymphocytes for any of the participants in the optimized 4-day biodosimetry protocol. Good radiation protection protocols—safe distance from the radiation source and wear of lead aprons and thyroid collars—ensured low absorbed doses. The 4-day protocol is an important step toward developing biodosimetry laboratories in the Armed Forces Medical Services for clinical and national radiation countermeasure strategies. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to investigate whether dental hypersensitivity and dental fear were linked to the presence and severity of MIH. Methods: For this cross-sectional study, 1830 students between the ages of 6 and 12 years were recruited from four randomly selected schools. The Children's Fear Survey Schedule-Dental Subscale questionnaire was used to assess dental anxiety and fear. The children's self-reported dental hypersensitivity resulting from MIH was evaluated using the Wong-Baker Facial Scale and the Visual Analog Scale (VAS). Results: MIH was correlated with tooth hypersensitivity, particularly in severe cases. Dental fear was present in 17.4% of the children with MIH, but it was not associated with dental hypersensitivity, gender, or age. Conclusion: No association was found between dental fear and dental hypersensitivity in children with MIH. [ABSTRACT FROM AUTHOR]

Progress in paediatric dentistry over the last half a century has been evident across all areas of the speciality. This article highlights significant changes in the diagnosis, prevention and management of dental caries, traumatic dental injuries, developmental enamel defects, tooth erosion, dental fear and anxiety and safeguarding children. The dedication of clinicians and researchers along with advances in material science and technology have supported this progress. We discuss the importance of working with those both within and outside of the specialty in order to collaborate to improve children's oral health. There have been significant strides in the provision of child-centred holistic care and research. Reviewing the advancements made over this period has set a high precedent for making further progress within paediatric dentistry over the next 50 years. CPD/Clinical Relevance: Knowledge of key advances in the field of paediatric dentistry will facilitate good diagnosis and treatment of younger patients. [ABSTRACT FROM AUTHOR]

The article focuses on the upcoming 2023 Irish Dental Association Annual Conference in Kilkenny, Ireland celebrating the association's centenary. Topics include the conference include practical tips for managing dental anxiety, the minimum intervention approach to caries, and practical pediatric dentistry.

Pandemic COVID-19 increases public anxiety and fear of infection, causing limited access and delays to the dentist. This was affecting the spread of dental and oral health diseases, particularly caries. This study aimed to describes the spread of dental caries at Dental Hospital Padjadjaran University before and during pandemic COVID-19. A descriptive cross-sectional study using 74 patient samples obtained by purposive sampling. The DMF-T index was evaluated using secondary data from medical records, and lifestyle and caries indicators questionnaires provide primary data. Before pandemic COVID-19, the DMF-T index was 3.64, increasing to 6.08 during pandemic. Based on the questionnaire, 63,5% of respondents went to the dentist during pandemic COVID-19, the majority went to the dentist when there was pain (56,7%), and respondents had difficulty accessing treatment to the dentist (72,9%). During pandemic, there was an increase in respondents reporting caries (94,6%) and sweets consumption (59,5%). The spread of dental caries of patients before was medium criteria and became high criteria during pandemic COVID-19. The difficulty of accessing treatment to the dentists, the assumption to go to the dentist when there was pain, and increased consumption sweet consumption, could contribute the spread of caries during pandemic COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the association between children's pain/distress levels and patient characteristics (age, sex, history of dental pain), sedation type (level of sedation, sedative regimen), nociception and pain intensity reported by the parents in sedated children undergoing minimally invasive dental treatment. Methods: This clinical study evaluated secondary outcomes of an RCT that evaluated the efficacy of dexmedetomidine sedation with or without ketamine. Only children who had nociception levels recorded using the Analgesia Nociception Index (ANI) were included (0–100; 0 = highest nociception). FLACC scale (Face, Legs, Activity, Cry and Consolability) was used to assess children's pain/distress (0–10; 0 = no pain/distress). Parental proxy report of the child's pain intensity during the treatment was performed using the Visual Analogue Scale (VAS; 0–100; 0 = no pain). The association between ANI, children's age and sex, dental pain history, sedation level, sedative regimen, and VAS with the FLACC was verified using the generalised estimation equation analysis (alpha 0.05). Results: Participants were 31 children (51.6% boys) and their parents (90.3% mothers). Median FLACC was 3.3 (25th–75th percentiles 1.7–8.2), ANI 80.9 (74.7–85.8), and VAS 10 (1–23). FLACC associated with ANI (OR 0.96; 95% CI 0.93–0.99; p = 0.02), moderate sedation (0.13; 0.03–0.50; p = 0.003), and VAS (1.05; 1.01–1.10; p = 0.01). Conclusion: Pain/distress was generally low and more prominent with minimal (versus moderate) sedation and higher nociception. [ABSTRACT FROM AUTHOR]

Purpose: Evaluate the impact of gingivitis on oral health-related quality of life (OHRQoL) amongst 12-year-old schoolchildren from Quito, Ecuador. Methods: We evaluated 998 school children using the Community Periodontal Index for gingival bleeding and calculus. OHRQoL was assessed with the Child Perceptions Questionnaire 11–14 (CPQ11–14) questionnaire. Results: Of the 998 schoolchildren, 93% had gingival bleeding and 73% had dental calculus. Schoolchildren with more than one sextant with gingival bleeding had 1.18 times higher mean CPQ11–14 (RR 1.18, 95% CI 1.11–1.27) than those with none or just one affected sextant. Male schoolchildren presented a 15% lower mean Child Perceptions Questionnaire (CPQ) (RT 0.85; 95% CI 0.76–0.96). Children whose parents had incomplete secondary education had a 15% lower mean CPQ (RT 0.85; 95% CI 0.77–0.94). Bleeding in more than one sextant was significantly associated with worse quality of life in the emotional well-being (RT 1.40, 95% CI 1.03–1.90) and social well-being domains (RT 1.76, 95% CI 1.32–2.34). Conclusion: Gingival bleeding negatively impacted the OHRQoL of 12-year-old Ecuadorian schoolchildren living in Quito. [ABSTRACT FROM AUTHOR]

Purpose: The current study sought to determine the associations between maternal mental health and oral habits, dental anxiety, and dental service utilization of 6- to 12-year-old children in Ile-Ife, Nigeria. Methods: Data were obtained from a household survey involving 1411 mothers and their 6- to 12-year-old children. Data collected were the confounding (maternal age, child's age at last birthday, sex at birth and socioeconomic status), independent (maternal psychological distress, and depression status) and dependent (child's non-nutritive oral habits, dental anxiety level, and most recent dental visit) variables. Bivariate analyses were conducted to test the associations between the dependent and independent variables. After controlling for confounding variables, the associations between the dependent and independent variables were determined using multivariable linear and logistic regression analyses. Results: Overall, 479 (33.9%) reported one oral habit, 189 (13.4%) reported two and 99 (7.0%) children reported three or more oral habits. Only 25 (1.7%) children reported a dental visit in the year preceding the study. Higher maternal psychological distress was associated with higher dental anxiety in children (AOR: 0.094; 95% CI − 0.080 to − 0.293; p < 0.001). There was no significant association between maternal psychological distress, child's non-nutritive oral habits, and the child's most recent dental visit. There was also no association between maternal depression and the child's non-nutritive oral habits, dental anxiety level, and most recent dental visit. Conclusion: Maternal psychological distress was a significant risk indicator for dental anxiety, but not for dental service utilization or non-nutritive oral habits among children in Ile-Ife, Nigeria. Maternal educational status was also associated with dental anxiety. Further research is needed to elucidate the study's findings. [ABSTRACT FROM AUTHOR]

Negative emotions of medical students during a gross anatomy laboratory are documented in the field of medical education, but those of dental students are relatively less reported in the literature. The purpose of the present study was to explore negative emotions of dental students during the gross anatomy laboratory and possible influential factors. Basic demographic variables, gross anatomy learning attitudes, and/or life attitudes were collected at five time points among year 2 dental students (n = 49) at a medical university in northern Taiwan. Multi-hierarchical regression analyses were executed to explore possible factors that led to negative emotions. Students who were older, had more-positive attitudes towards life, and had more-positive attitudes towards the anatomy laboratory tended to have weaker negative emotions when they first faced the cadavers. Having a tendency to care about and help people and having a grateful attitude also significantly predicted weaker negative emotions at the middle and end of the semester, respectively. Negative emotions of younger dental students who first encounter a cadaver should be of concern. Striving to improve students' positive attitudes toward life, positive attitudes toward the gross anatomy laboratory, willingness to care about and help people, and an overall grateful attitude may help reduce negative emotions during the gross anatomy laboratory. At an institutional level, integrating educational activities that reduce negative emotions toward cadavers by dental students is highly recommended. [ABSTRACT FROM AUTHOR]

Dental anxiety is a complex psychological problem in which patients associate negative feelings with the dental experience and is determined clinically through physiological and behavioral presentations. Self-reporting along with questionnaires and patient interviews can indicate the level of a patient’s dental anxiety and guide the dentist in determining the appropriate management. Nonpharmacological methods of managing dental anxiety should be exhausted before pharmacological sedative techniques are considered. Nitrous oxide with oxygen is frequently used in the dental setting because of its relative safety, ease of use, and effectiveness for patients with mild to moderate dental anxiety. Oral sedation may be used for moderate to severely anxious patients and most typically consists of the administration of a single benzodiazepine drug prior to the dental appointment. Combination therapy of nitrous oxide with oxygen and oral sedation may be an option to increase the efficacy of both routes of sedation. Conscious intravenous sedation is a viable alternative for practitioners to use if they are adequately trained and certified to do so. Special considerations may apply for sedation of pediatric, elderly, and medically compromised patients and those with cognitive, physical, and/or behavioral disabilities. Sedation guidelines vary regionally, and dental professionals providing sedation must do so only with adequate training and certification as set by their local medical and dental regulatory governing bodies. This article provides a general review of the pharmacological management of dentally anxious patients as seen by a general dentist. [ABSTRACT FROM AUTHOR]

To evaluate whether delaying treatment with a twin block appliance affects treatment outcomes, in terms of skeletal and dental change and psychological disadvantage. Multicentre, two-arm parallel randomised controlled trial. Three UK hospital orthodontic units. A total of 75 participants were randomly allocated into an Immediate Treatment Group (ITG) (n= 41) and an 18-month delayed Later Treatment Group (LTG) (n=34). Dentofacial changes were recorded from lateral cephalograms and study models, psychological impact was measured using a child perception questionnaire (CPQ11–14) and an Oral Aesthetic Subjective Impact Score (OASIS) at registration (DC1), 18 months (DC2) and 3 years (DC3). The ITG initial effect was a mean ANB reduction was 1.6° (P<0.001) (95% confidence interval [CI] = 0.89–2.29), and an overjet reduction of 5.06 mm (P<0.001) (95% CI = 3.96–6.16) (boys: aged 12 years 8 months; girls: aged 11 years 8 months). There were no statistically significant differences between the ITG and LTG for twin block treatment outcomes, but the ITG active treatment time was longer (P=0.004) (ITG: 13.1 months; LTG: 9.8 months). There was insufficient evidence to state that patients were psychologically disadvantaged by waiting 18 months for active twin block treatment (P>0.05). Participants achieved similar clinical and psychological outcomes irrespective of whether they started their twin block at the age of referral (ITG) or 18 months later (LTG). This suggests that boys aged 12 years 8 months and girls aged 11 years 8 months, on average, are not disadvantaged by waiting 18 months for active twin block treatment. [ABSTRACT FROM AUTHOR]

Root canal treatment (RCT) employed for painful endodontic conditions like apical periodontitis and irreversible pulpitis is associated with a high incidence of postoperative pain. Pharmacological management for this purpose is effective, but not entirely free from side effects and in some cases may fail to provide adequate relief. Furthermore, concerns have been raised regarding the transmission of coronavirus disease-2019 (COVID-19) as a result of the aerosols generated and prolonged chair side time required for RCT. Acupuncture is a traditional Chinese therapy commonly employed as an alternative for the treatment of pain. And what's more, the use of acupuncture has been recently reported as treatment for the management of endodontic pain as well as on the anesthetic success in patients with irreversible pulpitis. This review aims to evaluate the current evidence for acupuncture in endodontics and its potential role in emergency pain relief and management for patients. To combat this, a thorough search for literature within the field was performed in five electronic databases. Retrieved studies were screened according to the pre-defined eligibility criteria. After both an electronic and manual search, five studies were selected for review. These studies reported the beneficial effects of acupuncture in reducing the failure of nerve block in patients with irreversible pulpitis and in controlling both intraoperative and postoperative pain following RCT. In addition, it was also reported to reduce anxiety surrounding the dental procedure and minimized the intake of analgesics after the endodontic procedure, which can result in some unwanted side effects. However, more in depth clinical research is required before any recommendation regarding the application of acupuncture in endodontic patients can be made. [ABSTRACT FROM AUTHOR]

Maternal mental health affects their children's oral health. This study assessed the associations between maternal mental health and dental anxiety level, dental caries experience, oral hygiene, and gingival status among 6- to 12-year-old children in Nigeria. This was a cross-sectional study that recruited mother-child dyad participants through a household survey conducted in Ile-Ife, Nigeria. Data collected included the independent (maternal mental health risk, depressive symptoms, and child's dental anxiety), and dependent (caries experience, oral hygiene status, and gingival health status) variables. Multivariate logistic regression analysis was conducted to determine the associations between dependent and independent variables after adjusting for confounders (mothers' age, child's age, sex, and socioeconomic status). Statistical significance was set at p < 0.05. Of the 1411 mothers recruited, 1248 (88.4%) had low mental health risk, and 896 (63.5%) had mild depressive symptoms. As for the children, 53 (3.8%) had caries, 745 (52.8%) had moderate to high dental anxiety, 953 (63.0%) had gingivitis and 36 (2.6%) had poor oral hygiene. The maternal mental health risk was not significantly associated with the child's caries experience (AOR: 1.012; 95%CI: 0.860-1.190; p = 0.886), poor oral hygiene (AOR:1.037; 95%CI: 0.975-1.104; p=0.250), and moderate/severe gingivitis (AOR:0.887; 95%CI: 0.764-1.030; p = 0.115). Maternal depression status was not significantly associated with the child's caries experience (AOR: 0.910; 95%CI: 0.802-1.033; p = 0.145), poor oral hygiene (AOR: 1 .016; 9 5%CI: 0 .976-1.057; p = 0 .439), a nd m oderate/severe gingivitis (AOR: 0.963; 95%CI: 0.861-1.077; p = 0.509). Maternal mental health risk and depression do not seem to be risk factors for schoolchildren's oral health in Nigeria. Further studies are needed to understand these findings. [ABSTRACT FROM AUTHOR]

This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and dental behavior management problems (DBMPs) than those without MIH (Prospero CDR42020203851). Unrestricted searches were performed in PubMed, Scopus, Web of Science, Lilacs, BBO, Embase, Cochrane Library, APA PsycINFO, Open Grey, and Google Scholar. Observational studies evaluating DFA and/or DBMPs in patients with and without MIH were eligible. Reviews, case reports, interventional studies, and those based on questionnaires to dentists were excluded. The methodological quality assessment was based on the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to synthesize data on DFA. The certainty of evidence was performed according to GRADE. Seven studies that evaluated a total of 3,805 patients were included. All of them presented methodological issues, mainly in the comparability domain. Most studies observed no significant difference in DFA between children with and without MIH. The meta-analysis did not show a significant effect of MIH on the standardized units for the DFA scores (SMD = 0.03; 95%CI: -0.06-0.12; p = 0.53; I2 = 0%). Synthesis including only the results for severe cases of MIH also did not show a significant effect of the condition on DFA scores (MD = 8.68; 95%CI: -8.64-26.00; p = 0.33; I2 = 93%). Two articles found DBMPs were significantly more frequent in patients with MIH. The overall certainty of evidence was very low for both outcomes assessed. The current evidence suggests no difference in DFA between children with and without MIH; DBMPs are more common in patients with MIH. This information should be viewed with caution because of the very low quality evidence obtained. [ABSTRACT FROM AUTHOR]

This study investigated the prevalence of possible bruxism and its association with social capital among undergraduates during the coronavirus disease (COVID-19) pandemic. This cross-sectional study was conducted at a private university in Southern Brazil. Data were collected through a self-administered electronic questionnaire (Google Forms). Possible bruxism was measured using the following question: "Do you grind your teeth or clench your jaws?". Social capital was evaluated using individual social networks. Data on self-perceived oral health, anxiety, sociodemographics, and information related to university graduates were also collected. Adjusted logistic regression models with a hierarchical approach were used to evaluate associations. The results are presented as odds ratios (ORs) and 95% confidence intervals (95%CIs). Altogether, 345 undergraduates participated in the study, with a mean age of 21.8 years (standard deviation = 5.21). The prevalence of bruxism in the sample was 57.1%. Undergraduates with low social capital had 2.06 times greater odds of bruxism than their counterparts (OR 2.06; 95%CI 1.11-3.83). Female undergraduates (OR 2.40, 95%CI 1.39-4.12), those who were in the final year of university (OR 1.13, 95%CI 1.04-1.21), and those who perceived they needed dental treatment (OR 1.91; CI: 1.21-3.02) also had greater odds of possible bruxism. In conclusion, the prevalence of possible bruxism was high among undergraduate students during the COVID-19 pandemic and associated with lower social capital levels. Knowledge of these factors is important to identify risk groups and plan strategies to control bruxism in this population. [ABSTRACT FROM AUTHOR]

Pain is common in orthodontic treatment, is subject to individual variation, and is associated with anxiety and stress, which can potentially become catastrophizing. The aim of the present study was to determine the variability of pain response after the insertion of orthodontic separators and to assess the association of pain levels with dental anxiety, catastrophizing, tooth sensitivity, and genetic expression of cytokines. To this end, 70 patients of both genders were divided into two equal groups according to the elastomeric separator used: G1 (Dentaurum) and G2 (Orthometric). Two separators were inserted in the mesial and distal sides of the lower right first molar. Participants were instructed to rate the level of pain at T0 (before insertion), T1 (just after insertion), and T2 (24 hours after insertion) on a visual analog scale. The gingival crevicular fluid was collected at T0 and T2. The levels of anxiety, catastrophizing, tooth sensitivity, and cytokine expression were also assessed. Statistical analysis was performed with the Fisher-Freeman-Halton, chi-squared, Spearman's correlation, and dependent and independent t tests (α=5%). Pain intensity was higher at T2 than at T1, in both groups (P<.05). An association was established (P<.05) between pain intensity at T1 and catastrophizing, and at T2 with anxiety and catastrophizing. Within-group differences in cytokine expression were found between T0 and T2. There was no correlation between cytokine expression and pain levels, anxiety, catastrophizing, and sensitivity at T2. Tooth separation produced variable pain levels, which were influenced by anxiety and catastrophizing, however, pain level was not correlated with increased cytokine expression. [ABSTRACT FROM AUTHOR]

Considering the unfavorable implications of health falsehoods and the lack of dental research into information disorder, this study aimed to identify and characterize online oral health misinformation. A total of 410 websites published in English were retrieved using Google Advanced Search and screened by two independent investigators to compile falsehoods through thematic content analysis. Afterward, 318 pieces of misinformation were consensually divided into four groups concerning their informational interest (G1), financial, psychological, and social interests produced/disseminated by non-dental professionals (G2) or by dental professionals (G3), and political interests (G4). Social media (Facebook and Instagram) and fact-checking tool (Snopes) were also screened to determine the spread of falsehoods by identifying corresponding posts and warnings. As a result, misinformation was mainly associated with gum diseases (12.0%), root canal treatment (11.6%), toothache (10.4%), fluoride (10.4%), and dental caries (9.8%), with a special highlight on recommendations for the usage of natural products, toxicity concerns, and anti-fluoridation propaganda. Additionally, most misinformation was allocated in G3 (41.9%), which presented a statistically higher frequency of financial interests than G4. Finally, falsehoods were considerably identified on Facebook (62.9%) and Instagram (49.4%), especially G3 and G4. Nevertheless, Snopes has debunked only 5.9% of these content items. Therefore, misinformation was predominantly produced or disseminated by dental professionals mainly motivated by financial interests and usually linked to alternative/natural treatments. Although these items were shared on social media, fact-checking agencies seemed to have limited knowledge about their dissemination. [ABSTRACT FROM AUTHOR]