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Objective: Despite the common clinical impression that patients with a history of drug use are challenging to anesthetize with local anesthesia, literature on this clinical phenomenon is sparse. The objective of this pilot study was to assess if differences in local anesthetic efficacy for dental treatment exist between marijuana users and nonusers., Methods: Subjects were healthy adult males and females who qualified as either chronic marijuana users or nonusers. All subjects had an asymptomatic, vital maxillary lateral incisor that responded to an electric pulp test (EPT). A standard maxillary infiltration injection technique was employed using 1.7 mL 2% lidocaine with 1:100,000 epinephrine over the test tooth, and the tooth was tested with an EPT at 3-minute intervals., Results: A total of 88% of nonusers (15/17) and 61% of users (11/18) were successfully anesthetized, defined as anesthesia onset within 10 minutes and lasting at least 15 minutes. The difference in the proportion of anesthetized subjects was not statistically significant (P = .073). For subjects with successful anesthesia, there was no significant difference between nonusers and users in the onset or duration of anesthesia., Conclusion: No significant differences in local anesthetic efficacy with respect to local anesthetic success, onset, or duration of action were found between chronic marijuana users and nonusers. However, larger studies are likely needed to provide more definitive evidence., (© 2022 by the American Dental Society of Anesthesiology.)

Background: This study compared prevalence, incidence, mortality rates, treatment costs, and risk factors for oral and oropharyngeal cancer (OC/OPC) between two large United States adult cohorts in 2012-2019., Methods: Medicaid and commercial claims data came from the IBM Watson Health MarketScan Database. Logistic regression analyses estimated incidence and risk factors for OC/OPC. Mortality was calculated by merging deceased individuals' files with those of the existing cancer cohort. Summing costs of outpatient and inpatient services determined costs., Results: Prevalence of OC/OPC in Medicaid enrollees decreased each year (129.8 cases per 100,000 enrollees in 2012 to 88.5 in 2019); commercial enrollees showed a lower, more stable prevalence (64.7 per 100,000 in 2012 and 2019). Incidence trended downward in both cohorts, with higher incidence in the Medicaid (51.4-37.6 cases per 100,000) than the commercial cohort (31.9-31.0 per 100,000). Mortality rates decreased for Medicaid enrollees during 2012-2014 but increased in the commercial cohort. OC/OPC treatment costs were higher for commercial enrollees by $8.6 million during 2016-2019. OC/OPC incidence was higher among adults who were older, male, and white; used tobacco or alcohol; or had prior human immunodeficiency virus/acquired immune deficiency syndrome diagnosis and lower among those who had seen a dentist the prior year., Conclusions: Medicaid enrollees experienced higher OC/OPC incidence, prevalence, and mortality compared with commercially insured adults. Having seen a dentist within the prior year was associated with a lower risk of OC/OPC diagnosis., Impact: Expanding Medicaid dental benefits may allow OC/OPC to be diagnosed at earlier stages through regular dental visits., (©2022 The Authors; Published by the American Association for Cancer Research.)

Objective: To determine whether, in Class I borderline cases, experienced orthodontists choose nonextraction treatment more frequently than do orthodontists with less experience. A secondary aim was to evaluate whether clinicians' gender and place of education play a role in extraction decision making., Materials and Methods: An online survey was developed using three Class I borderline patient cases. The survey included questions about clinicians' demographics as well as questions about the selected cases. The survey was distributed to approximately 2000 clinicians through the American Association of Orthodontics., Results: Of the 253 responses collected, a trend was observed wherein clinicians with more than 15 years of experience preferred an extraction treatment option more frequently than did clinicians with less than 5 years of experience. There was no association between gender and place of education and the decision to extract in the selected borderline cases. Crowding, patient's profile, and mandibular incisor inclination were among the top three reasons chosen by clinicians for both the extraction and nonextraction treatment decisions., Conclusions: A trend was observed in which clinicians with more experience chose an extraction treatment option more frequently in borderline cases than did those with less experience. Clinicians' gender did not play a role in extraction decision making.

Background: It would be useful to have psychometrically-sound measures of dental fear for Hispanics, who comprise the largest ethnic minority in the United States. We report on the psychometric properties of Spanish-language versions of two common adult measures of dental fear (Modified Dental Anxiety Scale, MDAS; Dental Fear Survey, DFS), as well as a measure of fear of dental injections (Needle Survey, NS)., Methods: Spanish versions of the measures were administered to 213 adults attending Hispanic cultural festivals, 31 students (who took the questionnaire twice, for test-retest reliability), and 100 patients at a dental clinic. We also administered the questionnaire to 136 English-speaking adults at the Hispanic festivals and 58 English-speaking students at the same college where we recruited the Spanish-speaking students, to compare the performance of the English and Spanish measures in the same populations., Results: The internal reliabilities of the Spanish MDAS ranged from 0.80 to 0.85. Values for the DFS ranged from 0.92 to 0.96, and values for the NS ranged from 0.92 to 0.94. The test-retest reliabilities (intra-class correlations) for the three measures were 0.69, 0.86, and 0.94 for the MDAS, DFS, and NS, respectively. The three measures showed moderate correlations with one another in all three samples, providing evidence for construct validity. Patients with higher scores on the measures were rated as being more anxious during dental procedures. Similar internal reliabilities and correlations were found in the English-version analyses. The test-retest values were also similar in the English students for the DFS and NS; however, the English test-retest value for the MDAS was better than that found in the Spanish students., Conclusion: We found evidence for the internal reliability, construct validity, and criterion validity for the Spanish versions of the three measures, and evidence for the test-retest reliability of the Spanish versions of the DFS and NS.

As increasing attention is paid to disparities in oral health care, cross-cultural means for assessing dental fear, a significant barrier to dental care, are in high demand. There is, however, a surprising shortage of Spanish-language dental fear measures in the literature, despite evidence of dental fear and avoidance in Spanish-speaking populations. The goals of the current series of studies were to develop and validate a Spanish-language version of the Interval Scale of Anxiety Response (ISAR). Magnitude estimation, a technique in which participants are asked to assign a number to indicate the perceived intensity of a stimulus or phrase, was used to compare the Spanish ISAR to the original English ISAR during the development studies. As a result of the 4 initial development studies, modifications were made to both the Spanish and English scales. Once 2 seemingly equivalent scales were established, validation studies were completed with native Spanish- and English-speaking dental patients. The results suggest that both the Spanish and modified English ISAR scales are valid measures of state anxiety associated with dental treatment. Additionally, the results of these studies highlight the importance of thoroughly testing translated measures to ensure they are accurately assessing that which they purport to measure.