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Objectives: This randomized clinical trial compared the effectiveness of music and informative videos as distraction tools to reduce the anxiety of patients during root canal treatment and retreatment. Method and materials: A total of 90 patients were enrolled in the study. The patients were randomly allocated to three groups: Group 1 listened to music during the treatment (n = 30), Group 2 watched an informative preoperative video (n = 30), and a control group underwent treatment without a distraction method (n = 30). Prior to treatment, the Corah Dental Anxiety Scale (CDAS) and a visual analog scale for pain were used to assess anxiety and preoperative pain. Systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation were recorded before the intervention (T1), after the local anesthetic (T2), following pulp extirpation or removal of root fillings (T3), and immediately following rubber dam removal (T4). One-way ANOVA, followed by post-hoc Bonferroni tests for multiple comparisons, were used to compare mean values of systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation among the groups. A P value of 5% was considered as significant. Results: Listening to music reduced systolic blood pressure, heart rate (P < .001), and diastolic blood pressure (P = .003) in patients undergoing root canal treatment and retreatment at T4 compared to the baseline (T1). Music (P < .001) and informative video (P = .003) groups had significantly lower postoperative visual analog scale pain scores. Conclusion: Listening to music during root canal treatment and retreatment reduced anxiety levels in patients compared to informative preoperative videos and no distraction technique. [ABSTRACT FROM AUTHOR]

Objectives: Sedation is commonly utilized for individuals otherwise unable to receive dental treatment, such as those with disabilities, medically complex conditions, and dentophobics. The aim was to characterize the profiles of patients receiving various types of sedation and assess the corresponding success rates. Method and materials: This was a 5-year records-based retrospective study. Data regarding the indication for sedation, medical history, sedation type, and treatments performed were recorded. Results: In total, 103 patients underwent 389 treatment sessions under sedation; 42.7% of the patients were disabled. The most commonly administered sedation was moderate sedation, (49.4%), followed by deep (36.8%) and inhaled sedation (13.9%). Successful treatment results were achieved in 96.1% of sessions, with no adverse effects noted during recovery. The high success rates were independent of patient age, sex, and sedation type. There was a positive association between the indication for sedation and the type of sedation. The medically complex patients and the dentophobic patients received mainly moderate sedation (85.3% and 58.2%, respectively), whereas the disabled patients received deep sedation (51.2%). In total, 94% of patients were returning (revisiting) patients. A statistically significant association was found between the type of sedation administered and the success rate during the first and last sessions (P< .001). The success rate at the first session may be predictive of the success in subsequent sessions. Conclusion: A significant positive correlation was found between patient characteristics and the chosen sedation type leading to a high success rate across the various sedation modalities. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the factors that affect treatment delay in early childhood caries (ECC), guided by a modern medical model. This study attempted to analyze the pathways influenced by these factors and provide a theoretical foundation for designing targeted intervention programs. Methods: Data were collected from young children who visited the department of stomatology at a tertiary hospital from January to December 2023. Data were collected via a general information survey questionnaire, the Scale of Oral Health Outcomes for 5-year-old Children (SOHO-5), the Children's Fear Survey Schedule-Dental Subscale-Chinese (CFSS-DS-C), the Parental Caregiver Perceptions Questionnaire-8 (P-CPQ-8), the Family Impact Scale (FIS-8), and the Perceived Barriers to Health Care-Seeking Decision-Chinese (PBHSD-C). The data in this study were analyzed using a variety of statistical tests, including the Kruskal-Wallis and Mann-Whitney tests, correlation analysis, multiple stepwise regression analysis, and structural equation modeling (SEM). Results: The treatment delay score of early childhood caries was 36.77 ± 10.11, indicating that the state of early childhood caries was currently at a moderate level of delay. The SOHO-5 score was 6.41 ± 1.78, the CFSS-DS-C score was 23.60 ± 6.91, the P-CPQ-8 score was 18.43 ± 4.33, and the FIS-8 score was 18.66 ± 4.28. Multi-factor analysis revealed key factors affecting treatment delay, including permanent residence, medical insurance type, oral health habits, reasons for visit, first symptoms, the time of first discovery of oral problems, brushing teeth before bedtime every day, a genetic history of dental caries and the staging of dental caries. A positive correlation existed between oral health, children's dental fear and treatment delay, whereas social support was negatively correlated with treatment delay. The SEM, which is based on the modern medical model, revealed that children's dental fear plays a mediating role in the relationships among social support, oral health, and treatment delay. Conclusion: The present study developed a novel model to study the ECC treatment delay, elucidated the causal links between the identified variables, and proposed potential intervention strategies to enhance oral health awareness, knowledge, and skills among young children and their parents. These strategies can help improve children's dental visiting behavior and reduce treatment delay. [ABSTRACT FROM AUTHOR]

Background: Most children experience distress while visiting a dentist, above which the sound of the airotor and suction machine results in fear and difficulty in performing further procedures. Methods: This was a randomized controlled parallel-group study of 40 children aged 6–13 years who required cavity preparation via the airotor. The children were randomly allocated to either Group 1 (Piano music app; active distraction combined with audio analgesia) or Group 2 (basic behavioural guidance alone). Self-reported dental anxiety was measured via a modified child dental anxiety scale, and behavior was assessed via Venham's and FLACC (Faces Legs Activity Cry and Consolability) scales. The data obtained were subjected to appropriate statistical analysis. Results: Self-reported dental anxiety was significantly lower in group 1 (p < 0.005). No significant difference between the groups was observed for the Venham and FLACC scores. Conclusion: Compared with basic behavioural guidance alone, the use of active distraction with audio analgesia in the form of the piano music app significantly decreased the degree of dental anxiety caused by the use of the airotor. This also resulted in clinically better cooperation by the child during cavity preparation. Trial Registration: Registered in the Clinical Trials Registry India (CTRI/2024/07/070160) dated 08/07/2024. [ABSTRACT FROM AUTHOR]

Background: Understanding the interactions among predictors of dental trust in children is important for designing effective interventions in pediatric dental care. Aim: This study aimed to develop and validate a conceptual model to evaluate factors influencing dental trust in children. Design: This cross-sectional study included 267 parent-child dyads. Data collection tools included a sociodemographic data form, the Turkish Oral Health Literacy Assessment Task (TOHLAT-P), the Dental Trust Scale (DTS), the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and the Early Childhood Oral Health Impact Scale (ECOHIS). The conceptual model explored the factors influencing dental trust in children by incorporating endogenous and exogenous variables. Path analysis was conducted to test model fit. Results: Dental trust was significantly associated with parental oral health literacy (β = −0.20; P < 0.001), dental anxiety (β = −0.18; P < 0.001), and oral health-related quality of life (β = −0.15; P < 0.001). The path analysis confirmed the validity of the proposed model, showing significant pathways between these variables and dental trust in children. Conclusions: This study presents a validated model illustrating the relationships between parental and child-related factors and dental trust in children. These findings underscore the importance of addressing these factors in clinical strategies to enhance dental trust and improve pediatric dental outcomes. [ABSTRACT FROM AUTHOR]

Aim: The objective of this research was to compare two methods of conscious sedation (midazolam vs. sevoflurane) used for performing oral surgical procedures in the older adult population by analyzing dental treatment-related anxiety levels, the quality of sedation, and potential hemodynamic changes during the interventions, as well as post-recovery symptoms and patient satisfaction levels. Methods: A total of 104 patients underwent oral surgery with intravenous (age: 84.00 ± 8.410; 17 men and 36 women) and inhalation conscious sedation (age: 82.73 ± 8.809; 18 men and 33 women). Anxiety levels were recorded using the Modified Corah Dental Anxiety Scale (MDAS) and the Hamilton Anxiety Rating Scale (HARS). During the intervention, the heart rate, systolic/diastolic blood pressure, oxygen saturation, episodes of hypoxia (<90%SpO2), sedation duration, and Sedation–Agitation Scale (SAS) values were monitored. Upon completion of their treatment, all patients completed three questionnaires which evaluated their recall of the intervention, postoperative symptoms, and recommendation of the sedation method used. Results: Anxiety levels were slightly higher in the midazolam group (MDAS score: 9.60 ± 5.849; HARS score: 27.19 ± 6.802) compared to the sevoflurane group (MDAS score: 8.37 ± 5.063; HARS score: 24.92 ± 5.199), with no statistical significance (MDAS, p = 0.453/HARS, p = 0.065). No significant differences in the analyzed hemodynamic parameters were observed between the two groups. However, SAS values were significantly higher in the sevoflurane group (p = 0.006), while the sedation duration was longer in the midazolam group (p = 0.000). Postoperative symptoms, particularly gastrointestinal disturbances and dry mouth, were significantly more prevalent in the midazolam group, while there were no differences in neurological symptoms between the two groups. The majority of patients expressed a preference for either of these sedation methods. Conclusions: Sedation with agents such as midazolam and sevoflurane appears to be quite safe, given the absence of relevant hemodynamic changes. Midazolam has been shown to be effective for a longer duration, as well as to have a lower risk of developing greater digestive problems during the postoperative period. On the contrary, sevoflurane produced a greater sensation of dry mouth. Both sedative agents are perceived by the older adult population as satisfactory, recommending their use. [ABSTRACT FROM AUTHOR]

This study evaluated the efficacy of an eye massage device that uses acupressure points combined with natural sounds to reduce anxiety and pain in children receiving dental anesthesia for the first time. A total of 105 children aged between 8 and 10 years whose dental treatment required inferior alveolar nerve block (IANB) injection participated in this randomized controlled clinical trial. The participants were randomly divided into three groups: Group A: eye massage with natural sounds; Group B: eye massage only; and Group C (control group): traditional behavior management techniques. Anxiety and pain were assessed before, during, and after anesthesia using the Children's Fear Scale (CFS), Wong-Baker pain rating scale (WBS), the Face-Legs-Activity-Cry-Consolability (FLACC) observational pain assessment scale, and pulse rate as a physiological scale. Anxiety and pain significantly decreased in groups A and B compared with those in the control group (p < 0.05), with group A showing a greater decrease in pulse rate and objective pain assessed during injection via the FLACC scale than group B (p < 0.05); however, no significant difference was noted between groups A and B regarding the data recorded after anesthesia using the WBS and CFS (p > 0.05). Changes in pulse rate and anxiety levels (CFS) measured before and after the procedure in each group revealed a significant decrease in fear and pulse rate in group A and no significant change in group B, whereas group C showed a significant increase in pulse rate and fear at the end of the procedure. Eye massage with natural sounds can effectively alleviate children's anxiety in the dental setting and reduce pain related to anesthesia, and the combination of these two interventions has the best relaxation effect on children. [ABSTRACT FROM AUTHOR]

Background: This study aimed to establish a model for predicting the difficulty of mandibular third molar extraction based on a Bayesian network to meet following requirements: (1) analyse the interaction of the primary risk factors; (2) output quantitative difficulty-evaluation results based on the patient's personal situation; and (3) identify key surgical points and propose surgical protocols to decrease complications. Methods: Relevant articles were searched to identify risk factors. Clinical knowledge and experience were used to analyse the risk factors to establish the Bayesian network. First, the qualitative mechanism knowledge, including the effect of risk factors on the extraction difficulty and the causal relationships between risk factors, was analysed to establish the framework of the Bayesian network. Then, the quantitative knowledge, including the occurrence probability of the parent nodes and the conditional probability table of the nodes with causal relationships, was given by the surgeon experience and calculated using the Dempster-Shafer evidence theory. According to the framework and likelihoods and relationships of risk factors, the Bayesian network model was established. Results: This Bayesian network model analysed the weight by sensitivity of each risk factor and expressed the interaction relationship among risk factors as well as the effect of risk factors on extraction difficulty quantitatively. This Bayesian network model showed quantitative analysis results for extraction difficulty and key risk factors. The Bayesian network model revealed that the relationship to the inferior alveolar nerve, surgeon experience and patient anxiety were the most important risk factors for extraction difficulty. By integrating these patient-specific risk factors across the entire surgical process, this model could be used during preoperative planning to identify high-risk cases and to optimize resource allocation; during intraoperative management to tailor surgical techniques; and during postoperative follow-up to establish targeted follow-up protocols for high-risk patients. Moreover, this Bayesian network model can flexibly improve inclusion factors and conditional probabilities with the development of relevant research and expert opinions, as well as change states and probabilities of relevant nodes based on actual clinical conditions. Conclusions: A model for predicting the difficulty of mandibular third molar extraction was established based on a Bayesian network. [ABSTRACT FROM AUTHOR]

Introduction: Health services accessibility is a multidimensional concept. An early-life dental visit could improve child dental health. Through birth cohorts, it is possible to identify health conditions and pathways of exposure that occur earlier in life. The aim of this study is to propose a theorical model to explain the use of dental care for children with primary teeth, based on results from birth cohorts. Method: 3 databases were queried: PubMed, Embase and Dentistry & Oral Sciences Source. Eligible articles presented data on children's dental visits, with at least one follow-up visit between birth and the child's 6th birthday and based on birth cohorts. Results: We identified 649 articles in biomedical literature databases. After exclusions, we read 136 abstracts, and finally 36 articles in their full length. A total of 22 articles were included in the analysis, from 15 countries on 5 continents. The mains proximal factors for access to dental care for preschool children are related to caregivers' perception of children's oral health and its impacts on quality of life. These perceptions are influenced by the child's oral health, the child's and mother's use of healthcare, and the healthcare organization. Dental fear seems to be another proximal factor. However, family social background seems to be an enabling moderator for dental visits. Conclusion: The scoping review allowed us to develop a model that explains dental visits for children aged 0–5 years as a multifactorial process influenced by caregivers' perceptions of the child's oral health, the family's quality of life, and the child's dental anxiety. [ABSTRACT FROM AUTHOR]

Background/Objectives: Given that dental anxiety can significantly impact patient cooperation and treatment outcomes, it is crucial to implement effective strategies to alleviate this anxiety. This study aimed to evaluate the effect of VR as a distraction tool on pain and anxiety stages in pediatric patients who are undergoing routine dental treatments. Methods: 60 pediatric patients aged 7 to 10 requiring pediatric dental therapy had been divided into two groups: an experimental group that applied virtual truth (VR) as a distraction device and a control group that obtained traditional care. Data on Anxiety and Pain tiers were collected using the Modified Child Dental Anxiety Scale (MCDAS) and the Wong-Baker Faces Pain Rating Scale earlier than and after the dental techniques. Statistical analyses have been accomplished to examine the effects among the two groups, focusing on differences in anxiety and pain levels. Results: At baseline, Group A's mean anxiety score was 4.12 ± 0.28; it reduced significantly to 1.89 ± 0.58 post-operatively, therefore displaying a 54% reduction. Pain levels were clearly improved as evaluations for the control group (Group B) fell from a baseline of 5.56 ± 0.48 to 1.10 ± 1.28 in Group A. The significantly significant (p < 0.001) differences in anxiety and pain measurements among the groups highlight how well Virtual Reality provides a diversion during dental treatment. Conclusions: The findings of this research show that using virtual reality as a distraction method helps children patients' pain and anxiety levels to be considerably lowered during dental treatments. [ABSTRACT FROM AUTHOR]

Introduction: Local anaesthesia (LA) is the cornerstone for pain management of invasive dental procedures, but the process of delivering it may itself induce anxiety, especially in paediatric patients that can affect the pain perception. Advances such as the computer-controlled LA delivery system have expanded the horizons of LA and can serve as an alternative for painless injections. To examine the pain perception and anxiety reduction along with patient preference between computer-controlled Starpen device and conventional aspirating cartridge in LA administration for inferior alveolar nerve block. Materials and Methods: The patients were randomly allotted into two groups: Starpen and Septodont syringe where the LA injections were given using both the methods in the 1st week. After a washout period of 1 week, the crossover was performed and the other mode of LA administration was performed in the 2nd week. Pain scores were objectively recorded by the observer using the Face, Legs, Activity, Cry and Consolability (FLACC) scale during LA administration and extraction. Patients were asked to record the pain scores using the Visual Analogue Scale at three phases: (a) mucosa perforation, (b) needle insertion and (c) solution injection. The effect of pain perception on the vital parameters and the preference between the two techniques were assessed. Statistical Package for the Social Sciences (SPSS) version 23.0, Armonk, NY, USA: IBM Corp was used for statistical analysis, and Mann–Whitney U -test and unpaired t -test were utilised to compare the mean difference of two groups at significance level of 0.05. Results: Intergroup differences among the Starpen and Septodont syringe groups were found to be statistically significant (P < 0.001) during both LA and extraction when pain was objectively assessed using FLACC. Conclusion: Computerised devices such as Starpen offer controlled release of local anaesthetics, effectively decreasing pain perception in paediatric patients and can form a mainstay for the behaviour management of young patients. [ABSTRACT FROM AUTHOR]

This case report describes a minimal intervention dentistry approach for a tense-cooperative boy with an enamel hypoplastic defect in an incisor as a result of a traumatic dental injury to its predecessor. The primary mandibular left central incisor (tooth 0) was avulsed when the child was 2.7 years of age. At a follow-up visit 2.5 years later, the permanent mandibular left central incisor (tooth 24) was erupting and presented a change in color along with a reduction in the enamel thickness. A temporary restoration of the hypoplastic defect was performed when the child was 7.7 years of age. This conservative approach was chosen based on the child's behavior and because the lesion boundary was located near the free gingival margin due to the eruption stage of the tooth. The procedure was carried out without local anesthetic, utilizing a resin-modified glass ionomer cement and cotton roll isolation. This patient-friendly approach allowed simplification of the steps involved in the process. The child and his guardian were satisfied with the temporary restoration, and the boy regained his self-reliance regarding dental care. The family and the boy were reminded again of the importance of follow-up visits after a traumatic dental injury. [ABSTRACT FROM AUTHOR]

Fear of dentistry, often due to past painful experiences, is a significant barrier preventing patients from visiting dentists. Achieving effective pain control, especially during root canal treatments, is crucial. However, inferior alveolar nerve blocks (IANBs) have a low success rate, influenced by factors such as anxiety, anatomical variations, and technique limitations, leading to anesthesia failure. Although numerous studies have examined the cold test and electric pulp test (EPT) in assessing the success of local anesthesia, no standardized method has been established. This study evaluated the effectiveness of EPT and cold tests in assessing the depth of anesthesia in patients with symptomatic irreversible pulpitis in the mandibular first molar teeth. A cross-sectional study was conducted on 50 patients with symptomatic irreversible pulpitis who met the inclusion criteria and exhibited lip numbness. Following the administration of the IANBs and confirmation of lip numbness, cold tests and EPT were performed on all patients. Subsequently, the preparation of the access cavity (gold standard test) was initiated, and patients' responses during cavity preparation were recorded as either "presence of pain or discomfort" or "absence of pain or discomfort," indicating IANB failure and success, respectively. Sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios, and accuracy (AC) with 95% confidence intervals were calculated for each test separately as well as for sequential testing. IANB failure was determined in 56% of the patients. A comparative analysis of diagnostic tests (cold test and EPT) showed no significant difference in SN, NPV, and AC; however, the cold test had higher SP, PPV, and positive likelihood ratio. Combining cold test and EPT evaluations improved SN, NPV, PPV, and negative likelihood ratio, but SP and AC were similar to EPT alone. No correlation was found between IANB success and patient age, sex, or initial pain. Despite evidence of lip numbness, a significant number of IANBs failed in cases of painful pulpitis. A positive result from the cold test strongly indicated anesthesia failure. The findings of the current study suggested that when the cold test yielded a negative result, further evaluation with EPT was necessary to confirm anesthetic success and ensure complete pain control. [ABSTRACT FROM AUTHOR]

Background and Objective: This study aimed to examine the prevalence of dental fear among schoolchildren in Bosnia and Herzegovina, analyze the distribution of dental anxiety by gender, age, and place of residence in relation to perceived sources of fear, and evaluate its association with oral health status. Materials and Methods: The sample included 355 schoolchildren between the ages of 12 and 15. Data were gathered using a self-assessment questionnaire, a brief clinical oral examination, and the Children's Fear Survey Schedule–Dental Subscale (CFSS-DS). Results: Clinical examinations showed that 87.61% of the children had dental caries, with a mean DMFT score of 3.75 (SD = 2.93). The prevalence of dental caries was significantly higher in the older group compared to the younger group (p < 0.01). Dental fear was present in 21.7% of the children, with a mean total CFSS-DS score of 27.50 (SD = 13.85). The most feared aspect among the children was "Choking" (73.8%), followed by "Injections" (63.7%) and "The noise of the dentist drilling" (52.1%). Children with dental fear had a significantly greater number of decayed and missing teeth, higher DMFT scores, and poorer gingival health and oral hygiene compared to those without dental fear (p < 0.01), even after adjusting for sociodemographic factors. Conclusions: The study found a moderate level of dental fear among Bosnian schoolchildren, with younger children and those from urban areas showing more fear of injections. It also showed a consistent link between dental anxiety and clinical factors such as caries, gum disease, and oral hygiene, even after adjusting for sociodemographic factors. [ABSTRACT FROM AUTHOR]

Dentist–patient communication is at the core of providing quality dental care. This study aims to review the importance, challenges, strategies, and training of dentist–patient communication. The World Dental Federation (FDI) emphasizes the importance of effective communication between oral healthcare providers and patients as a critical component of high-quality care. Effective dentist–patient communication allows dentists to accurately and effectively pass on essential medical information to patients. It improves the dentist's efficiency, boosts self-confidence, reduces occupational stress, and minimizes the risks of complaint or litigation. Moreover, it alleviates dental anxiety and fear, helps build trust between dentists and patients, addresses patients' needs and preferences, increases patients' adherence to improved treatment outcomes, and ultimately leads to enhanced patient satisfaction. Nonetheless, it has been widely acknowledged that dentists universally encounter the repercussions arising from suboptimal communication strategies. Time constraints, difficulties in establishing rapport, the oral-health illiteracy of the patients, the poor communication skills of the dentists, dentists' perceptions, and language barriers often hinder dentist–patient communication. Dentists should take the patient-centered approach as a premise and acquire verbal and non-verbal communication skills to overcome these communication barriers. The patient-centered approach comprises the understanding of patients' illness, shared decision-making, and intervention with mindfulness of the patient's own pace. Simple, succinct, and jargon-free language should be used in verbal communication. Proper body postures and gestures are fundamental for showing positive attitudes towards patients. Communication training for dental students should involve a structured pedagogical approach that includes didactic instruction, role-playing exercises, patient interviewing, and ongoing assessments. Key components of effective communication skills training in dental education include motivational interviewing, open-ended questioning, affirmations, reflective listening, and summaries to enhance patient engagement and adherence to treatment plans. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety has become a major concern for both dental practitioners and patients and prevents a significant proportion of people from attending dental clinics. The present study aimed to determine dental anxiety and associated factors among adult patients attending a public outpatient dental clinic in a base hospital, in the Eastern Province of Sri Lanka. Methods: A descriptive cross-sectional study was conducted among 400 adults aged 18 to 75 years awaiting dental treatment. A validated and pretested interviewer-administered questionnaire was utilised, and it included demographic information, past dental treatment, and the Modified Dental Anxiety Scale (MDAS) which was used to assess dental anxiety. Anxiety scores ranged from 5 to 25, with scores of 5–9 classified as less anxious, 10–18 as moderately anxious, and scores above 18 as extremely anxious. Statistical analysis was done using SPSS version 28. Descriptive analysis, correlation test, chi-square test and multiple logistic regression were applied for statistical analysis. The significance level was set at p < 0.05. Results: The majority of participants in this sample experienced dental anxiety, with 19% classified as extremely anxious, 70% as moderately anxious, and 11% as less anxious. The mean MDAS score was 14.5 (SD = 4.4). Bivariate analysis revealed that dental anxiety is significantly associated with age group, sex, marital status, employment status, monthly family income, past dental visits, sex of treatment provider and previous dental experiences. Multiple logistic regression analysis indicated that age, sex and postponing dental treatment appointments were significant predictor variables of dental anxiety. Conclusion: The findings reveal that the majority of participants in this study experience moderate to high levels of dental anxiety. Notably, younger individuals (under 35 years), females, and those who tend to postpone dental appointments were identified as significant predictors of heightened dental anxiety. [ABSTRACT FROM AUTHOR]

Aim: This study aims at analyze the current status and influencing factors of missing appointments in patients with periodontitis after supragingivgy scaling, and to explore the measures to reduce the rate of missing appointments, so as to provide a reference for the prevention of periodontitis and oral health promotion. Methods: This study adopted convenience sampling method to select 204 patients who made appointments for revisits in Grade III and Grade A stomatological hospitals in Guizhou Province from May 2021 to May 2022 as the study objects, and conducted the investigation by general data questionnaire, patient satisfaction questionnaire and modified Dental Anxiety Scale (MDAS). Results: The rate of missing appointments in patients with periodontitis was 64.48%.Gender, type of medical payments, perceived severity of disease, communication and convenience of medical service are the influencing factors of missing appointments in patients with periodontitis. Conclusion: The situation of missing appointments in patients with periodontitis is not optimistic, and there are many influencing factors. It is suggested that medical staff should increase the popularization of disease knowledge, communication with patients, and improve the convenience of medical services. Relevant departments should improve the medical insurance system. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion Engagement in preventive dental care is a complex health behaviour and is determined by multiple factors. The study aimed to understand the association of psychosocial determinants with poor dental attendance.Survey data from 333 Mexican‐identifying adults in California aged 21–40‐year were analysed. Poor dental attendance was a composite of time since last dental visit and reason for visit. Responses of ‘more than 1 year ago’ for last dental visit, or ‘something was wrong, bothering or hurting/emergency dental problem’ as the reason for last dental visit were categorised as poor dental attendance. Psychosocial determinants including dental anxiety assessed using the Modified Dental Anxiety Scale, participant reported quality of provider interactions, and perceived social support were assessed. Logistic regression analyses examined associations after accounting for covariates.Over half (58%) had poor dental attendance. Among those with poor dental attendance, 22% had high dental anxiety, 41% perceived low quality of dental explanation, and 48% reported provider occasionally/never checked patient understanding. Participants with high anxiety had twice the odds of poor dental attendance (OR = 2.07, 95% CI = 1.01–4.22) than those with low dental anxiety. Additionally, those reporting that providers did not explain oral health status or treatments well had two times higher odds of poor dental attendance than those reporting adequate explanation (OR = 2.06, 95% CI = 1.11–3.83). Checking patient understanding or perceived social support was not significantly associated with dental attendance.Dental anxiety and poor provider interactions affect use of dental services. Interventions targeting dental staff should prioritise enhancing communication skills and checking patient understanding to improve their dental attendance. [ABSTRACT FROM AUTHOR]

ABSTRACT Dental trauma is highly prevalent, involving 25% of school‐age children and about 12.5% of the general population of the world. Due to the young age of the patients that are usually involved in dental trauma, there are tooth‐related complicating factors, such as open apices, thin dentinal walls, and unfavorable crown‐to‐root ratio, as well as patient‐related factors, such as anxiety and cooperation, and other challenges related to the complex diagnosis and treatment. Therefore, it is not surprising that the global status of knowledge for the prevention and emergency management of traumatic dental injuries among dental professionals was often reported as insufficient. Aiming to improve dental trauma education, one should consider that the contemporary educational settings have transitioned to a digital learning ecosystem and that the current students belong to a unique generational cohort. Therefore, this paper examines the challenges educators encounter in contemporary dental school classrooms and the defining characteristics of current generation Y and Z dental student cohorts. Finally, it outlines strategies to optimize dental trauma learning, considering the unique generational characteristics of the current dental students. [ABSTRACT FROM AUTHOR]

Dental anxiety, the fear related to dental services, can be presented in diverse ways, hindering those in need of dental treatment. This anxiety often results in higher levels of untreated dental issues, affecting oral health-related quality of life primarily due to insufficient dental care or dental care avoidance. Identifying its causes is crucial for effective support and preventative care. This study explores dental care perceptions and experiences among patients at free clinics, offering valuable insights to improve dental support and care for uninsured and underserved individuals. Two hundred ninety-three immigrant patients, mainly Spanish speakers, participated from October 2023 to January 2024. Findings reveal that 14% experienced dental phobia, primarily linked to local anesthetic shots. The majority of patients reported unmet dental needs, highlighting dental care disparities. Understanding how dental phobia contributes to dental care needs is vital to understand, in order to improve oral health outcomes. Future research should address additional barriers like language, finances, and awareness of services. Additionally, exploring other anxiety factors beyond pain, noise, discomfort, and aesthetics is essential. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Oral health is greatly impacted by visual impairment, which raises the possibility of dental treatment anxiety. Therefore, the goal of this research is to assess dental anxiety in children who are blind. Aim and Objectives of the Study: The intention of the study was to raise awareness of oral health among visually impaired children and to use the RMS-tactile scale (TS) to measure their anxiety levels. Materials and Methods: In the current study, 50 students with impairment of vision were split into two groups for a randomized control trial. There were 25 children in each group. Group 1 received dental health instruction using Braille, while Group 2 received it via audio tactile performance (ATP) approach. Pre- and post-treatment anxiety levels were recorded using RMS-TS for both groups, and scores for the plaque index (PI) and gingival index (GI) were also computed from baseline and three-month evaluations were conducted. Results: We performed a statistical study using a paired t -test and a one-way ANOVA. In the evaluation of pre-anxiety level on RMS-TS, group 2 (ATP) had high significance, and the values for the GI (P < 0.032) and PI (P < 0.020) decreased statistically. Conclusion: According to the present study, using a combination of audio and tactile models to explain dental procedures to visually impaired children can effectively reduce their anxiety. [ABSTRACT FROM AUTHOR]

ABSTRACT: Pain is a major symptom in dental visits, especially postendodontic procedures. Prevention and treatment are crucial, requiring clinicians to integrate various pain management strategies to promote physical healing, emotional, and psychological well-being, emphasizing the importance of holistic pain management. The purpose of this narrative review was to summarize the importance of holistic pain management strategies after endodontics. A comprehensive literature search was conducted on various databases including PubMed, Science Direct, Scopus and Google Scholar, focusing on the holistic approach to endodontic pain management and postendodontic pain management, following the PRISMA 2020 Statement protocols. Although numerous review publications on endodontic pain management have emerged, only three of them have delved into both pharmacological and nonpharmacological approaches to treating endodontic pain. These studies illustrated the effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs) in lowering the incidence of adverse events and endodontic postoperative pain. Only one study illustrated the effectiveness of behavioral therapies in treating individuals with dental anxiety and phobia. Holistic pain management strategies postendodontic procedures promote physical recovery, emotional wellness, trust, and treatment outcomes, enhancing patient experience and fostering trust in dental settings. [ABSTRACT FROM AUTHOR]

Aim: The pathways to post‐operative pain are complex and encompass factors that extend beyond the treatment protocol employed. This study aimed to identify patient‐related predictors of post‐operative pain following root canal treatment. Methodology: A total of 154 patients received a single‐visit root canal treatment for asymptomatic necrotic mandibular molars. Before treatment, dental anxiety, dental fear and sense of coherence (SOC) were measured as predictors for each patient using validated questionnaires. Other measured predictors included gender, age, previous negative experiences at the dental offices and prior root canal treatment. Post‐operative pain was assessed using the Numeric Rating Scale at multiple time‐points over 30 days. Structural equation analysis was employed to evaluate the direct and indirect effects of patient‐related predictors on a theoretical model of post‐operative pain. The irrigant solution was also included in the model, as it was the only aspect that varied in the treatment protocol (sodium hypochlorite 2.5% and 8.25%). Results: Dental anxiety (coefficient 0.028; p <.01), dental fear (coefficient 0.007; p =.02) and irrigant solution (coefficient 0.004; p =.03) exerted a direct effect on post‐operative pain. SOC exerted an indirect effect on post‐operative (coefficient 0.006; p =.01) through dental anxiety and dental fear. Moreover, previous negative experiences (coefficient 0.048; p =.04) exerted an indirect effect on post‐operative pain through dental anxiety. Conclusions: Dental anxiety, dental fear, previous negative experiences and SOC are patient‐related predictors of post‐operative pain following root canal treatment. These factors should be taken into consideration in clinical practice, as patients with these characteristics may be at an increased risk of experiencing post‐operative pain. [ABSTRACT FROM AUTHOR]

Background: Children with Autism Spectrum Disorder (ASD) often struggle with dental care due to sensory sensitivities and behavioral issues, increasing their risk for oral health problems. Adaptation strategies such as visual aids, video modeling, and sensory-adapted environments aim to improve their dental experiences. Methods: A systematic review of randomized controlled trials (RCTs) was conducted according to PRISMA 2020 guidelines using the PubMed, Scopus, Embase, and Cochrane databases. Of the 1072 records screened, nine RCTs were included in the analysis. Studies included children with ASD under 18 years and compared dental adaptation techniques with traditional care. The risk of bias and study quality were assessed. The quality of evidence for the results was determined using the GRADE tool. Results: Nine RCTs with sample sizes ranging from 25 to 138 participants showed significant improvements in oral hygiene, reduced anxiety, and increased cooperation. Video modeling and sensory-adapted environments were particularly effective in lowering distress during dental visits. Conclusions: Dental adaptation strategies, especially video modeling and sensory-adapted environments, effectively improve oral health outcomes and reduce anxiety in children with ASD. More research is needed to explore the long-term effects and include children with severe ASD. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to (1) investigate whether dental anxiety (DA) and oral health-related quality of life (OHRQoL) differed between patients diagnosed with periodontitis and individuals with periodontal health, (2) examine associations and correlations between these patient-reported measures, and (3) analyze demographic and clinical parameters. Methods: Ninety-six patients diagnosed with periodontitis and age- and sex-matched periodontally healthy controls were included. Participants' demographic characteristics, smoking status, current dental pain, dental pain during the last month, the Modified Corah's Scale (MDAS), and the Oral Health Impact Profile (OHIP-14) were determined. Results: The mean age of participants was 48.51 years ± 11.41. Patients with periodontitis experienced higher pain in the last month compared to controls (p = 0.003). Patients with periodontitis exhibited significantly higher MDAS total and sub-scores (p < 0.001). Compared to controls, the periodontitis group indicated extreme DA (1.04% vs. 7.79%, p = 0.034). Patients with periodontitis feared having a foreign object in the mouth compared to controls (p = 0.004). The periodontitis group exhibited worse OHIP-14 global and sub-scores (all Ps < 0.001). Positive associations and correlations of MDAS total and sub-scores with OHIP-14 global and domain scores were found for the periodontitis group, but not for controls. Patients with periodontitis who reported "moderate and extreme anxiety" had poorer OHRQoL compared to controls (p = 0.001). The minimal importance difference for this finding indicates a large effect size and a moderate standardized response mean between groups. Conclusions: Patients with periodontitis had higher levels of DA and worse OHRQoL compared to controls. Our study highlights the importance of providing a comprehensive approach, including psychosocial well-being, when diagnosing and treating periodontal disease. [ABSTRACT FROM AUTHOR]

Purpose: Phenomenology is a branch of philosophy that focuses on human lived experience. Illness including dental diseases can affect this living experience. Within the dental literature, there is very little reported on the use of phenomenology compared to other healthcare sciences. Hence, the aim was to review the literature and provide an overview of various applications of phenomenology in dental research. Methods: This study was a narrative review using literature in the last 10 years identified by web-based search on PubMed and Scopus using keywords. A total of 33 articles that were closely related to the field and application in dentistry were included. The methodology, main results, and future research recommendations, if applicable, were extracted and reviewed. Results: The authors in this study had identified several areas such as orofacial pain and pain control research, dental anxiety, dental education, oral healthcare perceptions and access, living with dental diseases and dental treatment experience in which the phenomenological method was used to gain an in-depth understanding of the topic. Conclusions: There are several advantages of using the phenomenological research method, such as the small sample size needed, the diverse and unique perspective that can be obtained and the ability to improve current understanding, especially from the first-person perspective. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the effectiveness of cannabidiol (CBD)-rich Cannabis extract in reducing anxiety and postoperative pain in patients submitted to endodontic treatment. The study was carried out after approval by the Research Ethics Committee (Registration No. 5.075.961). The following groups were tested: CBD and placebo. Pain was measured using a visual analog scale before the start of treatment and 24, 48, and 72 hours and 7 days after the session. Anxiety was assessed using the Modified Dental Anxiety Scale and a visual analog scale, before and immediately after treatment. In addition, salivary cortisol was measured before drug administration and after anesthesia. Data were analyzed descriptively using absolute frequencies and percentages, with a 5% margin of error. The mean anxiety scores were higher in the CBD group than in the placebo group in each assessment (pre: 5.06 vs 3.07, respectively; post: 4.61 vs 2.60). However, there was no significant difference in the reduction of dental anxiety at the beginning of the consultation and throughout the procedure. We did not find statistically significant differences in postoperative pain between the CBD and placebo groups at any of the time points. There was no evidence of an exposure-response relationship between the intervention and control groups. However, more studies are needed to determine clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: To evaluate parental reports of the oral health status and anxiety levels of children who attended a paediatric dental service and their association with children's caries experience. Methods: This questionnaire- and dental record-based study included a total of 70 healthy recall children aged between five and 10 years, who presented for a dental check-up to the specialised paedodontics department at the University of Greifswald, and for whom an application of fluoride varnish was indicated. The accompanying parent (n=70) was asked to evaluate their child's dental anxiety (dichotomously with a single question - yes or no answer) and oral health status (good, satisfying, poor). Caries experience was categorised according to the dmft index based on World Health Organisation (WHO) criteria. Results: An overall frequency of dental anxiety of 40% (n=28) was found in recall children according to parental report. Only 32.1% (n=9) of those were children with low to very low caries experience, whereas 67.9% (n=19) belonged to the moderate to high/very high caries experience group. Thus, dental anxiety in this study was significantly associated with caries experience based on dmft index (p=0.030, chi-square test). Parental assessment of the oral health status of the schoolchildren and their caries experience level also showed a statistically significant association (p=0.020; chi-square test). Conclusion: Dental anxiety in recall children attending a specialised paediatric university dental clinic is high, which is clearly associated with higher caries experience. The majority of children who attended for dental follow-up appointment had moderate to very high caries experience, which was also associated with higher parent-reported dental anxiety and a poorer oral health status report. [ABSTRACT FROM AUTHOR]

Background: With an estimated global prevalence rate of over 30%, dental fear is a ubiquitous public health phenomenon. Dental fear's adverse effects on patient oral health and quality of life are well established; the stresses and financial repercussions it can pose to providers are increasingly recognized. Although dental fear is highly treatable, a disseminable intervention that satisfies the needs of patients and dental care providers has yet to be realized. Objectives: We sought to understand allied dental professionals' experiences treating patients with dental fear and their impressions of, and receptivity to, a stepped-care approach, including perceived barriers and facilitators to its adoption. Methods: Thirteen semi-structured focus groups comprising students in (a) current dental hygiene programs and (b) other dental programs, who had prior experience working as licensed dental hygienists or allied professionals (i.e., dental assistants, dental therapists, dental treatment coordinators; N = 49) were conducted. Focus group discussions were recorded, transcribed, and thematically analyzed. Results: Participant responses supported the need for innovation in managing dental fear in practices, and supported hygienists as likely facilitators of any new behavioral approach. Overall, participants were receptive to the idea of a stepped-care treatment approach but identified several factors (e.g., accessibility, costs, treatment credibility) that would need to be addressed for its adoption by patients and dental professionals. Conclusion: A stepped-care approach to dental fear treatment has promise to meet the needs of patients and dental professionals. Potential barriers and facilitators to adoption provide a roadmap for future intervention refinement and efficacy testing. [ABSTRACT FROM AUTHOR]

In spite of the development in technology and the recent innovations in dentistry, dental anxiety remains a common issue, and accurately assessing it is challenging due to reliance on patients' self-reports, which are often biased. Hence, this study was undertaken to determine whether dental anxiety can be quantified objectively using the EDA parameters. EDA (skin conductance (SC), skin susceptance (SS), and skin potential (SP)) parameters and heart rate (HR) were recorded from 40 participants during two different sessions (baseline and anxiety). In addition, the Modified Dental Anxiety Scale (MDAS) scale was also used to record the level of anxiety. The physiological data from EDA and HR were compared with the subjective self-reports of anxiety provided on the MDAS to show whether higher EDA and HR readings correspond to higher scores on the MDAS. To elicit dental anxiety, participants were exposed to several film clips associated with dental treatment. EDA signals were compared between the two sessions for all clips and all EDA scores. SC and HR significantly (p < 0.05) increased during the anxiety session compared to the baseline session. The number of fluctuations per minute in the SC, SS, and SP notably increased during the anxiety session. The MDAS results revealed that the participants had dental anxiety when they were exposed to video clips of dental procedures. The study results imply that EDA parameters could be used as a useful tool to monitor dental anxiety, in particular in young children and non-verbal patients or those with intellectual disabilities, which may aid the dentist in the successful management of dental anxiety during treatment. The moment-to-moment EDA data on a patient's anxiety levels throughout particular dental operations provides a clearer picture of anxiety variations than pre- or post-appointment surveys alone, in addition to offering unbiased tracking of dental anxiety levels over self-reports. This study seeks to encourage further research into the most effective EDA parameters for improving the management of dental anxiety. [ABSTRACT FROM AUTHOR]

Objectives: About 10% of adults in northern Finland have severe dental fear, but there is a lack of detailed knowledge about dental fear among illicit drug users. The aim of the study was to evaluate the prevalence of dental fear and its association with self‐reported oral health and health behavior as well as background factors of the customers of substance abuse services living in the region of Oulu, Northern Ostrobothnia, Finland. Materials and Methods: One hundred seventeen volunteers, either active or former illicit drug users, were interviewed face‐to‐face about their background factors, health and health behaviors, and use of illicit drugs. The Modified Dental Anxiety Scale (MDAS) was used to assess a situation‐specific level of dental anxiety. For analyses, Pearson's χ2 test, Fisher's exact test, ANOVA, and logistic regression analysis were performed. Results: Three out of four participants had at least moderate dental fear (MDAS ≥ 10) and 24% had severe dental fear (MDAS ≥ 19), with the average MDAS being 14.0 (SD 5.7). Participants in drug rehabilitation reported significantly more dental fear than the rest of the participants. Severe dental fear was associated (adjusted) with previous painful experiences OR 10.8 (2.3–52.0) and poor behavior by dental personnel OR 4.1 (1.2–13.9). Conclusions: Dental fear is common among illicit drug users, and it is, particularly, associated with previous painful experiences and poor behavior by dental personnel. [ABSTRACT FROM AUTHOR]

Objectives: Modified Dental Anxiety Scale (MDAS) is a frequently used psychometric tool to evaluate the dental anxiety level of dental patients or the general population. However, it was largely unclear if MDAS was consistently administered in the original format in the academic literature. This work aimed to survey the literature published in the last 10 years to reveal the current usage of MDAS. Methods: Web of Science and Scopus were queried to identify papers that mentioned the use of MDAS. Results: Among a total of 260 analyzed papers, 101 papers included comprehensive information regarding both the questions posed and the response format employed. Two papers only used an explicitly renamed MDAS with modified contents. Among the 258 papers that used MDAS that were supposed to be standardized, many discrepancies from the original version were discovered. There were only 39 papers that strictly followed the recommended scoring scheme: if a participant had a score of ≥ 19, he or she might be highly dentally anxious. Notable modifications included the use of a cut‐off score different from the original recommendation, the use of multiple cut‐off scores, modifications of the response format or descriptors, and modifications to the question items especially adding extra questions. Conclusions: These modifications would create confusion when researchers and clinicians tried to compare data across studies. Researchers are recommended to administer MDAS in its original format. [ABSTRACT FROM AUTHOR]

Background: Patients with high dental anxiety are found to visit dental offices less frequently and have a higher number of severely diseased teeth so they are at a greater need for intensive oral care and rehabilitation. Objectives: The aim of this study was to assess the prevalence of dental anxiety and its impact on the dental status of Nepali adult patients. Material and Methods: A semi‐structured questionnaire of the Modified Dental Anxiety Scale (MDAS) in the Nepali version was used for data collection. The data analysis was done using Statistical Package for Social Sciences (SPSS IBM, Chicago, IL, USA, version 24). Variables were calculated as frequency and percentage, while the comparisons of different factors were done using the ANOVA and t‐test. A difference with p < 0.05 was considered statistically significant. Results: The study population consisted of 446 subjects, among them 205 were male (45.96%), 241 were female (54.04%), 357 (80.04%) were married, and 222 (49.78%) were employed. The mean age of the patients was 41.24 years (ranging between 18 and 79 years). Only 41 subjects (9.19%) showed high dental anxiety (MDAS ≥ 19). The mean MDAS for the total study population was 10.81. The highest mean MDAS was seen in the age group 30–39 (11.78) and the lowest mean MDAS was seen in the age group 40–49 (9.64). While comparing dental anxiety among genders, dental anxiety was higher in females (mean MDAS = 11.78) compared to males (mean MDAS = 9.67). Patients having high dental anxiety had a significantly higher number of decayed teeth (p‐value = 0.001, t‐test). Conclusion: Oral health and dental status both are negatively affected by dental anxiety. It interferes with dental attendance, service delivery, prevention of dental diseases, and early diagnosis. Thus, dental practitioners have a major role to play in the management of dental anxiety. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated associations between changes in dental anxiety and oral health-related quality of life (OHRQoL) in parents of the FinnBrain Birth Cohort Study. Methods: Two-year dental anxiety trajectories measured with Modified Dental Anxiety Scale from gestational weeks (gw) 14 and 34, and 3 and 24 months after birth were used. OHRQoL was measured with the Oral Health Impact Profile 14-item questionnaire at gw34 and 4 years. Changes in the OHRQoL sum and dimension scores according to dental anxiety trajectories were analyzed with the Jonckheere–Terpstra test separately for mothers (n = 998) and fathers (n = 513). Results: Overall, OHRQoL decreased in all dental anxiety trajectory groups except the High decreasing group in mothers and in fathers. The decline in the overall OHRQoL was greatest in the Stable high trajectory group for both parents. In fathers, OHRQoL increased considerably but not statistically significantly in the High decreasing trajectory group. The changes in OHRQoL dimensions Psychological discomfort and Handicap differed according to dental anxiety trajectories for both of mothers and fathers, and also for the dimension Psychological disability for mothers. Conclusions: These findings highlight the need for targeted interventions in treating high dental anxiety and in preventing the increase in dental anxiety to improve oral health outcomes such as OHRQoL. [ABSTRACT FROM AUTHOR]

Background: The study aimed to assess dental anxiety (self and proxy reported) using a Modified Dental Anxiety Scale (MDAS) and modified short State-Trait Anxiety Inventory scale (Emoji). Methods: 200 children visiting the pediatric dental clinic at the College of Dentistry at Prince Sattam bin Abdulaziz University were recruited to assess their anxiety levels. The anxiety score was measured before and after the treatment using a short STAI scale and MDAS of 200 children using a Modified Dental Anxiety Scale (MDAS) and a modified short STAI (Emoji) Scale. Results: The perception of children with MDAS was found to have the highest mean score of 14.54 ± 3.82 before the dental procedure compared to the mean score of 9.40 ± 2.90 after the dental procedure. This difference was statistically significant (p < 0.001). A statistically significant difference was observed in MDAS after the dental procedure and, in short, STAI before the dental procedure. Conclusion: All children improved their dental anxiety levels before and after the procedure. Therefore, procedural experience may improve the child's response. [ABSTRACT FROM AUTHOR]

Background: Oral diseases remain a significant public health problem worldwide despite being largely preventable. Oral disorders such as dental caries, periodontal diseases, and oral cancers are highly prevalent chronic conditions that negatively impact quality of life. The oral health practice in Somalia has been evolving over the years, we therefore explored the challenges of oral health practice in a security-constrained poorly regulated environment to guide policy development. Methods: We conducted a descriptive cross-sectional study among 15 oral health practitioners in Somalia. Using in-depth interviews, we gathered data on challenges working in private dental clinics and governmental institutions. Additionally, we gathered data on gender, age, marital status, profession, country of graduation, current location of practice, and years of clinical experience. Because the participants worked in different cities, we conducted interviews over the phone and recorded them. The data were analyzed via thematic analysis. Results: In this study, 9 of the participants were men and the median age was 29 years. Most of the participants (10) were dentists and remaining were dental specialists. The findings on challenges fall under four broad thematic areas: (1) Patient-related challenges; low patient literacy, preference for dental quacks, delay in seeking oral care, and dental phobia. (2) Institutional-related challenges: limited access to basic oral health services, oral health not an integral part of primary health care, and unregulated private dental clinics resulting in unqualified quacks practising as private caregivers. (3) Societal-related challenges, the absence of community-oriented preventive oral health services and low prioritization of oral health. (4) Personal-related challenges: female dentists in this study faced challenges related to the preference of male dentists and the shortage of oral health specialists in the country. Conclusion: This study reveals the need for the establishment and strengthening of regulation of oral services and its inclusion into the basic primary service package provided to the populace. It also calls for community enlightenment and more investment in dental health care in Somalia. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Dental anxiety, a predictor of both dental treatment avoidance and health outcomes, has been linked with early negative dental experiences. The causes of this relationship remain largely unexplored. This study provides a preliminary exploration of within-cultural variations of dental normative beliefs on the perception of negative dental experiences and the subsequent experience of dental anxiety in the U.S. A sample of 190 U.S. adults recruited from Amazon's MTurk completed measures of cultural normative beliefs about oral health care, age and fear at first dental visit, history of negative dental experiences, and dental anxiety. Factor analysis yielded support for a three-factor model (daily maintenance, regular check-up, and dental treatment) of the dental cultural normative beliefs scale. Correlations and structural equation modeling found support for a previously posited theoretical model in which negative dental experiences and fear at first dental visit mediate associations between the cultural normative beliefs and dental anxiety. Most notably, cultural normative beliefs favoring a prevention orientation to dental treatment and daily maintenance of oral health predicted less fear at the first dentist visit, which in turn, related to fewer negative dental experiences and less dental anxiety. This preliminary survey suggests that dental cultural normative beliefs within the U.S. shape fear during initial dental visits. Future research should build on this initial work and explore between-cultural norm variations as well as strategies for changing cultural normative beliefs to improve perceptions of dental experiences and lessen dental anxiety. [ABSTRACT FROM AUTHOR]

Background/Objectives: Dental fear and anxiety are prevalent issues in both children and adult patients, often leading to avoidance of dental care and deterioration in overall health. While virtual reality (VR) has been increasingly studied as a distraction tool in pediatric dentistry, its effectiveness among adults remains under-researched. This study aims to evaluate the impact of VR distraction on reducing anxiety and physiological stress indicators in adult dental patients. Methods: The study was conducted in a private dental office in Dobrodzień, Poland, involving 90 adult dental patients divided into three groups: two experimental (VR1 and VR2) and one control (C), with 30 patients each. Patients in the VR1 group experienced VR distraction during the first visit, and the second visit was conventional; the VR2 group experienced this in reverse; and the control group underwent traditional treatment in both visits. Physiological parameters (heart rate, saturation, and stress) and psychological anxiety levels (MDAS and STAI-X1) were measured at three time points during each visit. Results: Significant reductions in heart rate and stress levels were observed after VR exposure compared to the control group. VR also demonstrated a significant effect in decreasing anxiety levels (based on STAI-X1) during the visit with VR distraction. No significant changes were found in the saturation levels across the groups. Conclusions: The use of VR as a distraction tool during dental procedures effectively reduces physiological stress and anxiety in adult patients, suggesting its potential as a valuable tool in managing dental anxiety. Further research is recommended to explore the long-term benefits and patient satisfaction with VR-based interventions in dental care. [ABSTRACT FROM AUTHOR]

Background/Objectives: Rehabilitation of missing teeth with dental implants is a strong trigger of dental anxiety. The sympathetic response caused by anxiety can lead to cardiovascular and cerebrovascular incidents, especially in patients at systemic risk (ASA Physical Status-II and ASA Physical Status-III). Dental anxiety can affect physical health by activating the sympathetic response, and the patient's physical health status may also affect dental anxiety. The aim of this study was to analyze the factors that may reduce anxiety and pain, considering the patient's physical health status according to American Society of Anesthesiologists (ASA-PS). Methods: A total of 562 implants were placed under local anesthesia in 201 patients with ASA PS-I (healthy) and ASA PS-II and III (comorbid). The effect of patient-, dentist-, and surgery-related variables on dental anxiety and pain perception were evaluated. Modified Corah Dental Anxiety Scale and Numerical Rating Scale for Pain scores were measured and recorded preoperatively (T0) and 1 week postoperatively (T1). The effects of the associated variables were analyzed using binary logistic regression and non-parametric tests (p < 0.05). Results: Age (OR = 1.089), gender (OR = 6.493), ASA-PS (OR = 13.912), and the number of placed implants (OR = 0.807) were significantly associated with reduction in dental anxiety. There were statistically significant differences between the study groups in terms of mDAS score reduction (p = 0.028). Conclusions: ASA-PS, gender and the number of placed implants affected the anxiety of the patients. Age and number of implants seem to be variables with a relative influence that depends on other factors. [ABSTRACT FROM AUTHOR]

Background: Children with hearing impairment (HI) face communication challenges during dental procedures due to hearing loss. Studies suggest that distraction techniques, like virtual reality (VR), can effectively divert their focus from stressful stimuli, resulting in a more comfortable dental experience. The present study aims to assess the effectiveness of distracting children with moderate to severe (HI) with virtual reality glasses that show cartoons in sign language during pulpotomy treatment compared to conventional management techniques. Methods: Forty children aged five to seven participated in a randomized controlled parallel two-arm clinical trial—the type of behavioral management employed determined which two groups children were randomly placed into. Group I (Study group) used virtual reality glasses as a diversion, while Group II (Control group) used the conventional behavior management approach. Local anesthesia was administrated, and a pulpotomy procedure was performed on the selected tooth, followed by stainless steel crown restoration (SSC). There were three methods used to assess dental anxiety before and after the procedure: the physiological method, which used heart rate (HR); the objective measure, which used the Venham Clinical Anxiety Scale (VCAS); and the subjective measure, which used the modified Facial Affective Scale (FAS). An independent t-test was employed for HR analysis of the difference between the groups as a continuous variable. The Pearson Chi-square test assessed differences between groups for categorical variables, such as (VCAS) (FAS). Results: No significant differences were found in mean (HR) or (VCAS) between the two groups throughout the procedures: during local anesthesia (p = 0.659, 0.282), pulpotomy (p = 0.482, 0.451), and stainless steel crown preparation (p = 0.090, 0.284). Anxiety levels by (FAS) remained statistically comparable between the two groups before and after the procedures (p = 0.507, 0.749), respectively. Conclusions: The use of VR glasses revealed no significant advantages in managing children with HI during the dental visit compared to the conventional method of child behavior management. Trial registration: The trial was prospectively enrolled on 11/11/2023 under the identification number NCT06153823 on ClinicalTrials.gov. [ABSTRACT FROM AUTHOR]

Background and Purpose: Periodontitis is the leading cause of tooth loss in adults worldwide. The functional loss, nutritional deficiencies, and psychological barriers it causes, as well as its impact on overall health and quality of life, are all significant. The prevalence of periodontal disease is high in China. Our study aimed to determine the intricate relationship between periodontal disease status, dental anxiety, self-rated oral health (SROH), self-efficacy for oral care, perceived social support, socioeconomic status (SES), and the oral health-related quality of life (OHRQoL) among periodontitis patients. Methods: This cross-sectional study used purposive sampling to identify 247 patients with periodontitis who entered the First Affiliated Hospital of Bengbu Medical University between October 2022 and October 2023. 247 participants underwent a periodontal clinical examination combined with imaging, adhering to the " 2018 world new classification of periodontal and peri⁃implant diseases and conditions". Participants also completed a detailed questionnaire in paper format, which included OHRQoL, sociodemographic details, dental anxiety, SROH, self-efficacy in oral care, perceived social support, and subjective SES. Results: Dental anxiety, self-efficacy for oral care, and SROH all had a direct and significant effect on OHRQoL. OHRQoL was indirectly related to SROH mediated by dental anxiety and subjective SES, perceived social support and self-efficacy for oral care, respectively. SROH was directly related to subjective SES, and at the same time, they had a direct effect on dental anxiety. Furthermore, patient's age, gender, annual household income, and education level were significantly associated with the degree of periodontal disease. Conclusion: OHRQoL and periodontal status was influenced by socio-demographics characteristics, dental anxiety, SROH, self-efficacy for oral care, perceived social support, subjective SES in periodontitis patients. These insights underscore the importance of adopting a holistic approach in the management and treatment of periodontal diseases. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety and odontophobia are common issues, leading to challenges with oral hygiene and dental health. Music distraction offers an effective and side effect-free solution to alleviate pain and increase the acceptability of dental treatments. Our meta-analysis aimed to assess the efficacy of music distraction in reducing patient anxiety during invasive dental procedures in children and adults. Methods: The PubMed, Web of Science, and Embase databases were searched for clinically controlled trials, using the keywords "music" and "dental anxiety". The main outcome measured was the anxiety score. A meta-analysis was conducted using a random-effects model to estimate the standardized mean differences (SMDs). The subgroup analyses were conducted based on age groups, music preferences, and music styles. The research protocol has been registered with PROSPERO (Registration ID: CRD42022357961). Results: A total of 24 controlled clinical trials involving 1830 participants met the inclusion criteria for the meta-analysis. Music distraction significantly reduced dental anxiety during invasive procedures under local anesthesia (SMD, −0.50; 95% CI, −0.80 to −0.21; p = 0.0009; I2 = 83%). Our subgroup analysis revealed that music distraction was more effective in adults (SMD, −0.51; p = 0.0007) than in children (SMD, −0.47; p = 0.13) in reducing dental anxiety. Regarding music selection, music chosen by the participant (SMD, −1.01; p = 0.008) demonstrated more anxiolytic effects than by the author (SMD, −0.24; p = 0.02). Regarding music styles, classical music (SMD, −0.69; p = 0.009) was associated with better anxiolytic effects in adults. Conclusions: Our meta-analysis supports the use of music to alleviate dental anxiety during invasive procedures. Listening to classical or customized music can serve as an effective adjunct to outpatient surgical care in dental clinics. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of single-visit dentist-led cognitive behavioral therapy (CBT) in reducing dental fear and anxiety (DFA) and improving cooperation in children aged six to eight years undergoing dental treatment with and without local anesthesia (LA). Methods: Seventy-six children (six to eight years) with a Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS) score of 38 or higher, needing dental treatment, either with LA (n equals 38) or without LA (n equals 38), were randomly divided into two groups: Group I received conventional behavior guidance techniques (control), and Group II received CBT. Dental procedures were video recorded. Anxiety and cooperation were assessed using Venham’s clinical anxiety scale (VCAS) and Venham’s clinical cooperation scale (VCCS), respectively. Pre-operative and post-operative pulse rate and CFSS-DS scores were recorded. Results: CBT significantly reduced CFSS-DS scores in children undergoing dental treatment with LA (P<0.001) and without LA (P=0.003). Post-operative VCAS and VCCS scores were comparatively lower in children who received CBT, irrespective of the treatment. Additionally, CBT significantly lowered VCCS scores in children undergoing treatment with LA (P=0.046). Conclusion: Cognitive behavioral therapy effectively reduced dental fear and anxiety in children undergoing dental treatment with and without local anesthesia and is a feasible behavior management strategy. [ABSTRACT FROM AUTHOR]

Background: Managing anxiety and behavior during pediatric dental procedures is challenging. This study examines the effects of combining ibuprofen with midazolam sedation using both behavioral management and clinical hypnosis to improve patient cooperation and reduce post-treatment pain. Methods: A retrospective cohort study of 311 children (mean age 74.2 months, standard deviation (SD) = 24.7) was conducted. Patients received either midazolam with ibuprofen (n = 156) or midazolam only (n = 155). Behavior was assessed using the Venham Behavior Rating Scale and anxiety with the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) and the Inventory of Stressful Situations (ISS) questionnaires. Statistical analyses included Mann–Whitney U tests and correlation analyses. Results: Ibuprofen did not significantly improve behavior during procedures (drinking phase 0.61, SD 1.31, p = 0.13; before treatment 0.25, SD 0.93, p = 0.53, anesthesia 1.21, SD 1.55, p = 0.29; after treatment 0.51, SD 1.22, p = 0.68), indicating that pharmacological pain management alone is insufficient to address behavioral challenges. Ibuprofen significantly reduced post-treatment pain, with 7.2% of cases reporting pain in the non-ibuprofen group compared to none in the ibuprofen group (p < 0.05). Conclusions: Ibuprofen had no effect on intraoperative behavior and only a limited effect on post-procedural pain, mainly for more invasive procedures. This study highlights the integration of sedation with behavioral strategies, such as clinical hypnosis, to manage anxiety and improve patient cooperation, aiming to enhance treatment outcomes using this integrative approach to pediatric dentistry. Further research is needed to optimize these strategies and verify them in a prospective setting. [ABSTRACT FROM AUTHOR]

Paediatric dental anxiety is a common challenge that many children face when visiting the dentist, often resulting in heightened levels of stress and fear. This anxiety can stem from various sources, including previous negative experiences, fear of the unknown, or even parental attitudes toward dental care. Dentists play a critical role in addressing these fears by creating a welcoming and supportive environment that promotes comfort and trust. Strategies such as using simple, child-friendly language, demonstrating equipment, and involving parents can significantly reduce anxiety levels. Understanding the child's perspective and actively engaging them in the process can also foster a sense of control and security, making dental visits less intimidating. In addition to building rapport with young patients, dentists can utilize various behavioural management techniques to further alleviate paediatric dental anxiety. Distraction techniques, such as providing engaging toys, visual aids, or virtual reality experiences, can help shift the child's focus away from the dental procedures. Positive reinforcement, including praise and rewards for bravery, can encourage children to approach their visits with a more optimistic mind-set. Furthermore, dentists should be trained to recognize signs of anxiety and adapt their approach accordingly, whether that's increasing the time spent on explanations, offering breaks, or using relaxation techniques. By implementing these strategies, dental professionals can create a more pleasant experience for children, ultimately leading to better oral health outcomes and promoting a lifetime of positive dental habits. [ABSTRACT FROM AUTHOR]

Objectives: To study changes in oral health with focus on reported dental fear prevalence and interrelationships between dental fear and prevalence of dental caries and performed restorative dental treatment in preschool child populations attending regular public dental health care between 1983 and 2013. Methods: Every 10 years, random samples of about 100 children aged 3 and 5 years, respectively, took part in cross‐sectional studies based on oral examination and a questionnaire. One question, put to the child and answered by the parent, mirrored dental fear: "What do you feel at the prospect of an appointment with a dentist?". Agreement to at least one of three alternatives, ill at ease, frightened and sick, indicated dental fear. Frightened and/or sick mirrored severe dental fear. 79%–94% of the samples answered the question and constituted the study group. Prevalence of caries and number of filled tooth surfaces were recorded. Dental parameters were presented in mean values. Results: During the 30 years, dental fear prevalence was fairly constant. 21% of 3‐year‐olds and 15% of 5‐year‐olds reported dental fear in 2013. Positive relationships between dental fear prevalence and caries prevalence and number of filled tooth surfaces were found. Dental caries was reduced during the study time, but to a lesser degree in children with dental fear compared to children without dental fear. Conclusions: Although children were offered public dental health care, the prevalence of dental fear remained high. Children with dental fear are caries risk individuals. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of explaining treatment procedures using virtual reality glass (VRG) in a pretreatment waiting room on pretreatment anxiety and behaviors during the treatment process in pediatric patients who will undergo dental treatment for the first time. This randomized controlled clinical trial (RCT) randomly assigned 60 children who underwent dental filling treatment to the intervention group (VRG) (n = 30) or the control group (n = 30). Children's anxiety levels were assessed using the Modified Child Dental Anxiety Scale: Faces Version (MCDASf), and child's behavior during treatment was assessed using the Frankl Behavior Rating Scale (FBRS). Analysis of covariance (ANCOVA) was used to assess the effect of VRG intervention on dental anxiety in children aged 7 and 12. ANCOVA analysis showed that VRG intervention had a significant effect on MCDASf post-test, and FBRS post-test between groups (p values <.05). In addition, post-tests did not differ significantly between groups (p values >.05). This study confirms that providing information via VRG is an effective way to decrease dental anxiety and enhance compliance during treatment in children aged 7 to 12. The results of this study show that procedures aimed at providing information using virtual reality glass before dental treatment is an effective way for reducing child's dental anxiety. Hence, it may facilitate children's compliance with treatment and dentists' realization of treatment. [ABSTRACT FROM AUTHOR]

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