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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]

Objective: Dental anxiety is widespread among both children and adults. To diagnose dental anxiety, standardized anxiety questionnaires are recommended. Based on the suggestive nature of the questionnaires, the study aimed to find out whether asking respondents about personal coping strategies before dental treatment influences their anxiety. Methods: This prospective, double-blind, randomized controlled clinical trial included a total of 158 patients of a university dental clinic on emergency service. The intervention group (n = 82) received the Coping with Anxiety Questionnaire (CAQ) and the control group (n = 76) the Hierarchical Anxiety Questionnaire (HAF). State anxiety scores were assessed by using the State– Trait Anxiety Inventory (STAI) before and after the completion of each questionnaire. Results: Anxiety decreased in the intervention group (CAQ) (p  < 0.001) and increased in the control group (HAF) (p  < 0.001). Conclusion: Within the limitations of the current study, a diagnostic tool of a standardized questionnaire for the assessment to assess personal coping strategies decreased state anxiety in comparison to a questionnaire assessing anxiety. [ABSTRACT FROM AUTHOR]

Background: In China, most of the citizens experienced SARS-CoV-2 infection since the end of 2022. The Coronavirus disease 2019 (COVID-19) pandemic affected people’s physical health and also had a significant impact on mental well-being. The present study aims to discover if the experience of SARS-CoV-2 infection influences patients’ anxiety toward third molar surgery in the Chinese population. Materials and methods: The present study took the form of a questionnaire survey. From January 1, 2023, to June 30, 2023, patients who went to the Stomatology Center of China-Japan Friendship Hospital (Beijing, China) for the third molar extraction were included according to the inclusion criteria. The information on COVID-19 infection and the Modified Dental Anxiety Scale (MDAS) was collected. The software SPSS 22.0 was used for the statistical analyses. Results: A total of 574 survey results were harvested in the present study. The infection rate of COVID-19 was 86.6% (p >  0.05). The Average MDAS scores between patients who had been infected with COVID-19 and patients who were never infected were not significantly different (11.65  ±  4.41 vs. 11.42  ±  4.41, p >  0.05). The subgroup analysis was conducted according to the length of time after the recovery of COVID-19 (Model 1), and the highest temperature during the infection (Model 2). In Model 1 and Model 2, the one-way ANOVA test did not find statistical significance between the groups (Model 1 p =  0.114; Model 2 p =  0.481). The MDAS scores in female patients were significantly higher than in male patients (12.29  ±  4.53 vs. 9.91  ±  3.80, p <  0.001). Patients who extracted double teeth got significantly higher MDAS scores than those who extracted single teeth before the surgery (12.03  ±  4.74 vs. 11.24  ±  4.18, p =  0.037). Conclusion: The present study did not establish a significant impact of SARSCoV-2 infection on the anxiety levels associated with third molar surgery among Chinese patients. The potential long-term biopsychological effects of the virus warrant further investigation. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the effect of the COVID-19 pandemic on the anxiety levels and career satisfaction of dentistry students. Methods: A total of 220 dentistry students were included in the study. A questionnaire was mailed to dentistry students at Trakya University between June 2021 and January 2022. Beck Anxiety Inventory (BAI) was used to evaluate anxiety levels. Data were analyzed, and p < 0.05 was considered statistically significant. Results: The mean BAI scores of the participants were 14.6 ± 13.6. The anxiety levels of the females were significantly higher than the males (p = 0.004). There was a significant relationship between the level of knowledge about COVID-19 and anxiety (p = 0.032). More than half of dentistry students were anxious about the pandemic conditions and concerned about being infected during treatment. Moreover, most participants were anxious about infecting their patients and families, yet 86.8% do not regret choosing dentistry as a profession. Conclusion: An increase was observed in the anxiety levels caused by the pandemic in dentistry students. The outcomes of the current study revealed that the COVID-19 pandemic affected female dental students more. Although the COVID-19 pandemic negatively affected the psychological health of dental students, most participants were satisfied with their careers. [ABSTRACT FROM AUTHOR]

We all know that the use of marijuana is a potent anti-inflammatory and analgesic and possible mechanisms of action and components that can help reduce the effects of pain in temporomandibular joint (TMJ) disorders. Our study aimed to analyze the anti-inflammatory and analgesic characteristics of cannabis derivatives in patients with temporomandibular pathology. Thirty-six patients were divided into three groups: one was treated with Cannabidiol (CBD) cream, the second was treated with CBD Vaper, and the third was treated with conventional anti-inflammatories such as Ibuprofen 600 mg. All patients underwent a dental computed tomography scan at the beginning and another at the end of treatment 28 days later. In addition to the study treatment of Cannabis and anti-inflammatories, all patients received physiotherapy treatment on day 0, day 14, day 21, and day 28 of the study. The study's results allow us to evaluate that using the CBD cream with physiotherapy results in a favorable pain reduction of 59%, CBD Vaper with physiotherapy has reduced pain by 35%, and the combined use of ibuprofen medication with physiotherapy has reduced pain by 45%. Therefore, using CBD and physiotherapy allows a biological reduction of pain and inflammation at TMJ. The most significant reduction in analgesia and pain occurred with CBD cream, followed by ibuprofen, which had less effect than CBD Vaper. We can control the pain of the TMJ with the use of CBD and treatment with the physiotherapist that allows us to maintain the dose and time of use of CBD both in cream and in Vaper; this improves the quality of life and returns the patient to cognitive relieving stress and anxiety. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between dental fear and dental caries in children aged 6 to 12 years in a systematic review and meta-analysis. Methods: Systematic review search terms were selected according to medical subject headings (MeSH) or non-MeSH. An electronic search of studies published in English assessing the relationship between dental fear (children’s fear survey schedule–dental subscale) and dental caries (DMFT or dmft index) was carried out of the Scopus, Web of Science, PubMed, Embase, Cochrane and Proquest databases up to March 2022. Of 5,759 articles retrieved initially, 16 were eligible for inclusion in the study, and 5 of these were included in the quantitative analysis. The quality of studies was evaluated based on the Newcastle-Ottawa scale. Begg tests were employed to assess the publication bias. Results: According to the meta-analysis, the results revealed no statistically significant difference in mean of DMFT score in low and high fear score groups, with a mean difference of 1.28 (95% confidence interval −0.132 to 2.693) (P = 0.076). A statistically significant difference was found in the mean dmft score for the low and high fear score groups, with a mean difference of 0.227 (95% confidence interval 0.058 to 0.395) (P = 0.008). The mean dmft was significantly higher in the high fear score group. Conclusion: Dental fear has a significant relationship with caries in primary teeth, but not in permanent teeth. [ABSTRACT FROM AUTHOR]

This article, published in the Romanian Journal of Oral Rehabilitation, compares dental anxiety and dental attendance frequency between dental students and students majoring in other fields. The study found that dental students had lower levels of dental anxiety compared to non-dental students. Dental students also attended dental care for periodical control more frequently than non-dental students. The most anxiety-provoking stimuli for both groups were painful or uncomfortable procedures, the cost of dental treatments, needles or injections, and having an unsympathetic dentist. Overall, the study suggests that dental students have lower levels of dental anxiety and higher dental attendance frequency compared to students majoring in other fields. [Extracted from the article]

Background and Objectives: Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. Materials and Methods: A cross-sectional study with 422 respondents from four occupational groups (physicians, teachers, industry workers, and artists) was carried out. A questionnaire on previous dental experience using the Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and Self-Esteem Scale was self-administered electronically. The data analysis involved descriptive statistics and structural equation modeling (SEM). Results: The DFA levels differed significantly across the occupational groups, with the lowest mean scores among physicians (DAS = 9.29 (SE 0.39); DFS-1 = 14.67 (0.63); DFS-2 = 33.94 (1.69)) and the highest mean scores among artists (DAS = 10.74 (0.38); DFS-1 = 17.19 (0.71); DFS-2 = 41.34 (1.92)). A significant impact of self-esteem on DFA was observed among physicians, teachers, and artists, but not among industry workers. Multi-group analysis with SEM revealed differences in the variable association (Chi-squared = 53.75; df = 21; p < 0.001), thus rejecting the hypothesis of the same mechanism underlying DFA across occupational groups. Conclusions: Individuals from various occupations experience DFA at different levels, and there are different mechanisms underlying their DFA. These findings can provide valuable insights for dental practitioners in developing tailored approaches to reduce the feeling of DFA of their patients. [ABSTRACT FROM AUTHOR]

Copyright of Necmettin Erbakan University Dental Journal (NEU Dent J) is the property of Necmettin Erbakan University Dental Journal (NEU Dent J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments. Aim: The aim of this study was to compare 1 μ/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects. Materials and Methods: In this cross‑over trial, 15 children aged 6–8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week. Results: All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post‑treatment. Conclusion: 0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 μ/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/ kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the effectiveness of anxiety reduction protocol using auditory distraction in alleviating dental anxiety among patients undergoing tooth extraction. Materials and Methods: A randomized controlled trial was conducted at the Oral Surgery Department at Islamabad Dental Hospital from July to December 2022, involving 50 patients scheduled for tooth extraction. Participants were randomly divided into two groups: an interventional group, exposed to auditory distraction, and a noninterventional group, without exposure to auditory distraction before the dental extraction. Dental anxiety was measured using the modified dental anxiety scale (MDAS) questionnaire, which scores anxiety levels on a range from 5 (not anxious) to 25 (extremely anxious). Anxiety levels were assessed in the waiting room and just before extraction, and the results were compared across both groups to evaluate the effectiveness of auditory distraction in reducing dental anxiety. Results: The sample size of 50 was randomly and equally allocated to the interventional and noninterventional groups. The study population consisted of 28 (56%) female and 22 (44%) male participants. No significant difference was observed between the anxiety scores of interventional and noninterventional groups at baseline. A significant reduction in anxiety scores was observed in the intervention group during postintervention assessment, while no significant difference was seen in the noninterventional group's anxiety scores. Conclusions: The study supports the efficacy of anxiety reduction protocol using auditory distraction as a practical tool for reducing dental anxiety among patients undergoing tooth extraction. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Clinical & Experimental Hypnosis is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The injection of local anesthetics is the procedure that still causes the most fear and anxiety in a dental session; to minimize this problem, we can use topical anesthesia. The aim of this study is to analyze the tolerability and the clinical efficacy in the control of pain, during the subsequent injection of the local anesthetic, of an experimental anesthetic patch with a new formulation, which was previously tested in gel formula. Methods: A total of 150 children, aged 4 to 9 years, were included in the study. Each patient was treated using three different pre-anesthesia methods (placebo gel, experimental gel, and experimental patch), according to a split-mouth procedure, within a week of each other. The injection pain was analyzed using the WBFPRS and FLACC scales. Patients' caregivers' satisfaction was recorded at the end of the procedures. The data were analyzed using one-way ANOVA-RM, Wilcoxon–Mann–Whitney, Mann–Whitney U, and χ2 tests. Results: In this study, significantly higher pain ratings were observed with the topical placebo gel and lower pain ratings were observed with the experimental patch. Conclusion: The use of the patch proved to be very effective in reducing pain both subjectively and objectively, in the absence of both local and systemic side effects, validating its use in the oral mucosa. [ABSTRACT FROM AUTHOR]

In the area of dental healthcare services, where patients and professionals deal with multiple auditory stimuli, this cross-sectional study reports on the various dynamics of sound preferences, noise obstacles, and the profound impact of music on anxiety reduction within dental office settings. The sample comprises 134 dental patients, primarily females (56.7%), with varying age groups, education levels, and therapy durations in the university clinics of the Department of Dentistry, National and Kapodistrian University of Athens, and four private dental offices at the metropolitan area of Athens, Greece. Notably, 92.5% of the participants reported no hearing loss, and 56.7% exhibited some level of noise sensitivity. This study reveals a moderate to good perceived health status (M = 3.84, SD = 0.95) among participants, with low perceived noise disturbance in university dental clinics. Preferences for instrumental music, foreign pop, and classical music are prominent during waiting times. Potential irritations include impersonal treatment (44%) and staff behavior (41.8%). Correlations and predictors indicate associations between age, gender, educational status, music preferences, and noise disturbances. Findings aim to optimize eco-soundscapes in dental offices, contributing to enhanced patient well-being. The research underscores the potential of music interventions to alleviate dental anxiety and improve the overall dental experience and quality care. [ABSTRACT FROM AUTHOR]

Introduction: Stress and anxiety are emotional states that often accompany patients who have to receive dental treatments, leading them to postpone or avoid treatments with the consequent deterioration of their oral health and, hence, their general condition. Music therapy has been shown to be an alternative to other treatments that are invasive and not without danger, such as anxiolytics or sedation. This systematic review and meta-analysis evaluated the effect of music therapy on anxiety and stress prior to dental treatments. Methods: Studies published in PubMed (through Medline), Web of Science (WOS), Embase, and Cochrane Library databases were consulted up to October 2023. The inclusion criteria were established for intervention studies (randomized controlled trials, RCTs) according to the PICOS (population, intervention, comparison, outcomes, and study) strategy in subjects with dental stress and anxiety (participants) treated with music therapy (intervention) in comparison with patients without music therapy (control) and evaluating the response to treatment (outcomes). Results: A total of 154 results were obtained, with 14 studies finally selected. The risk of bias and the methodological quality were assessed using the Cochrane Risk of Bias Tool and the Jadad scale, respectively. A random-effects metaanalysis was used to quantify the results of the pooled studies, while a fixedeffects meta-analysis was used for studies in the pediatric population. The metaanalysis of pooled studies found statistical significance in the subgroups of anxiety and anxiety--stress (p = 0.03 and p = 0.05, respectively), with an overall effect in favor of the intervention group (p = 0.005). Meta-analysis of the studies in the pediatric population showed considerable statistical significance for the experimental group (p < 0.00001). Conclusion: Music therapy as a treatment for stress and anxiety, prior to dental treatment, proved to be effective in both children and adults although more welldesigned randomized clinical studies are needed to validate its efficacy. [ABSTRACT FROM AUTHOR]

Objectives: To predict and identify the key demographic and clinical exposure factors associated with dental anxiety among young adults, and to compare if the traditional statistical modelling approach provides similar results to the machine learning (ML) approach in predicting factors for dental anxiety. Methods: A cross-sectional study of Western Illinois University students. Three survey instruments (sociodemographic questionnaire, modified dental anxiety scale (MDAS), and dental concerns assessment tool (DCA)) were distributed via email to the students using survey monkey. The dependent variable was the mean MDAS scores, while the independent variables were the sociodemographic and dental concern assessment variables. Multivariable analysis was done by comparing the classical statistical model and the machine learning model. The classical statistical modelling technique was conducted using the multiple linear regression analysis and the final model was selected based on Akaike information Criteria (AIC) using the backward stepwise technique while the machine learining modelling was performed by comparing two ML models: LASSO regression and extreme gradient boosting machine (XGBOOST) under 5-fold cross-validation using the resampling technique. All statistical analyses were performed using R version 4.1.3. Results: The mean MDAS was 13.73 ± 5.51. After careful consideration of all possible fitted models and their interaction terms the classical statistical approach yielded a parsimonious model with 13 predictor variables with Akaike Information Criteria (AIC) of 2376.4. For the ML approach, the Lasso regression model was the best-performing model with a mean RMSE of 0.617, R2 of 0.615, and MAE of 0.483. Comparing the variable selection of ML versus the classical statistical model, both model types identified 12 similar variables (out of 13) as the most important predictors of dental anxiety in this study population. Conclusion: There is a high burden of dental anxiety within this study population. This study contributes to reducing the knowledge gap about the impact of clinical exposure variables on dental anxiety and the role of machine learningin the prediction of dental anxiety. The predictor variables identified can be used to inform public health interventions that are geared towards eliminating the individual clinical exposure triggers of dental anxiety are recommended. [ABSTRACT FROM AUTHOR]

Background/Aim: To analyse, from the perspective of adults with a history of sexual abuse, the impact of the experience on their general health and well‐being. Material and Methods: The participants comprised 12 strategically selected informants (10 women), aged 19–56; all sexually abused during child‐ and/or adulthood. They were interviewed in‐depth and encouraged to describe the impact of the sexual abuse on their daily lives. The consequences of sexual abuse on oral health have previously been reported. The interviews were recorded digitally, transcribed verbatim and analysed according to qualitative content analysis with an inductive approach. Results: The overall theme illustrating the latent content was Sexual abuse experience—limiting long‐term consequences, always present in body and mind. The first category covering the manifest content was 'A lost foothold', with two subcategories: (i) emotional repercussions and (ii) physical health repercussions. The second category was 'The significance of distance to trauma', with two subcategories (i) keeping a distance and tending to escape and (ii) processing the trauma experience—a struggle towards balance. Conclusions: A history of sexual abuse cannot be understood in isolation: the long‐term repercussions pervade daily life. However, after disclosure of the abuse and processing the trauma, it is possible to ameliorate some of the negative effects. In this context, the dental setting emerges as a potentially important venue for disclosure as almost every person, sooner or later, visits the dentist. [ABSTRACT FROM AUTHOR]

Study Design: Cross-sectional Objective: This study evaluated the various reasons and causes for odontophobia among Saudi parents accompanying pediatric patients at King Khalid University, Saudi Arabia. Methods: A cross-sectional study was carried out on a total number of 300 parents (Male=150; Female=150) who participated in the study with age ranges from 30- to 55-year-old to know the various reasons and causes for odontophobia among Saudi parents accompanying pediatric patients attending dental clinic in college of dentistry, King Khalid University, Abha. The Questionnaire was given to Saudi parents accompanying pediatric patients attending dental clinics and data was collected from them. The data were entered and analyzed using the Statistical Package for the Social Sciences (SPSS 20). A P-value of less than 0.05 was considered to be statistically significant. Results: The majority of participants, 189(63%) were, said that they have experience of dental fear and anxiety in their lifetime period. 255(85%) agreed that they have come across one of their relatives or friends having the fear of dental treatment. Parents experienced various reasons for the cause of their dental fear, one of the major factors for dental fear they told was having the dentist remove their tooth (26%). Parents 155 (52%) stated that they visited dental clinic for treatment very often and 66(22%) visited rarely. Conclusions: Recognizing the level of fear that prevents patients from seeking dental care and understanding the occurrence of dental anxiety hold crucial importance in dental practice. While only a small percentage of subjects reported dental fear or would consider refusing dental consultations, assessing dental fear provides valuable insights for dental practitioners. However, there is a call for further research and efforts to enhance the comprehension of dental anxiety and behaviors during dental visits. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia not only impairs physical growth but also affects behavioral and cognitive abilities. Past studies have proved that increased haemoglobin levels result in improved Central Nervous System (CNS) functions. However, there is a significant lacuna between cognition and anaemia among young adults, especially females. Aim: To assess the cognitive ability of female undergraduate dental students with and without anaemia. Materials and Methods: This cross-sectional study included 100 young female dental students, aged between 18 and 23 years, who presented in the Department of Physiology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India, from February to July 2019. Haemoglobin levels were analysed using the colourimetric cyanmethemoglobin method with Drabkin's solution, and based on this, the students were divided into anaemic and non anaemic groups. Cognitive status was assessed using the Digit Symbol Substitution Test (DSST), letter cancellation test, and Stroop test. The Student's t-test and Pearson's correlation were used to examine the association between haemoglobin levels and cognition. Results: The mean age in the anaemic group and non anaemic group was 19.95±1.80 years and 19.64±1.60 years, and the Body Mass Index (BMI) was 19.54±1.62 kg/m² and 19.32±1.43 kg/m², respectively. Haemoglobin levels were significantly lower in the anaemic subjects at 10.408 gm/dL compared to the non anaemic subjects (p-value<0.001). A statistically significant difference was observed between the two groups on DSST scores (21.10±2.99 versus 32.60±14.69), letter cancellation test (25.80±4.63 versus 35.80±4.56), and Stroop test (132.10±8.15 versus 123.56±10.52). Conclusion: The present study reported a significant association between anaemia and cognitive function. Therefore, early screening and prompt treatment of anaemia are crucial for improving both physical as well as mental health. [ABSTRACT FROM AUTHOR]

Purpose: Fearful dental patients often cite various dental instruments or procedures as triggers for their dental fear. Thus, visual dental stimuli provoke anxiety. This preliminary study aimed to assess the level of aversion to visual stimuli in dental patients and compare it with that in dentists. Patients and Methods: A total of 43 dental patients (25 women, 18 men; average age, 29.9 ± 13.3 years; patient group) and 13 dentists (4 women, 9 men; average age, 28.2 ± 2.0 years; dentist group) were included. All participants had previously undergone dental treatment. The dental fear level was assessed using the self-reported Dental Fear Survey (DFS). Thirty-two images associated with dental treatment were prepared and classified into three categories: dental instruments, dental procedures, and the dental environment. All participants rated their level of disgust toward each image on a visual analog scale with scores ranging from 0 to 100. Results: In the patient group, the disgust ratings for tooth extraction, dental drilling, and local anesthesia were > 60, which were significantly different from those in the dentist group (Mann–Whitney U-test, p< 0.001, p=0.001, and p=0.001, respectively). The ranking order of the disgust ratings for the 32 images showed significant correlation between the patient and dentist groups (Spearman correlation coefficient, r=0.80, p< 0.001). In the patient group, the disgust ratings for dental impressions and the interdental brush, dental light, and dental chair were significantly correlated with DFS scores (r=0.61, p< 0.001; r=0.47, p=0.001; r=0.41, p=0.006; and r=0.40, p=0.008, respectively). Conclusion: This study revealed that patients have more negative feelings toward invasive procedures than dentists. However, a significant correlation was identified between the ranking of aversion-provoking dental stimuli by patients and dentists. Furthermore, the level of aversion to several dental-related items that do not cause pain was correlated with the dental fear level. [ABSTRACT FROM AUTHOR]

Dental fear and anxiety are highly prevalent among children and have been shown to lead to irregular use of dental services. Previous research has suggested that while touch can alleviate the patient's stress and help in accomplishing dental procedures, it can also be a source of stress or used to restrain the patient. In this study, we explore the emergence and intertwine of controlling and comforting touch in pediatric dental clinic settings in which patients show signs of resistance, distress, or fear. We use microanalysis of video-recorded interactions to unveil how the adults in the room—any combination of the dentist, dental assistant, hygienist, and caregiver(s)—deploy various types of touch on the child patient to perform the dental procedure while simultaneously comforting the child. Our data set covers video-recordings of naturally occurring dental clinic visits of 3- to 12-year-old child patients from four cultural contexts: Finland, China, Iraq, and the United States. Drawing on Merleau-Ponty's writings on intercorporeality and the interaffectivity of bodies, the study proposes that touch in pediatric dentistry unfolds as complex intercorporeal formations where the interaffectivity emerges not only through touch but also via vocal resonance. In contrast to clear boundaries between comforting and controlling touch, our analysis indicates that the line between comforting and controlling touch can be blurred. We suggest that touching a pediatric patient showing resistance toward a dental procedure requires careful affective attention to the patient's subtle and moment-by-moment bodily expressions and reactions to the touch. [ABSTRACT FROM AUTHOR]

This study evaluated the impact of a combined science outreach, oral health education and tooth brushing initiative introduced into a New Zealand Māori immersion primary school. Participants completed questionnaires on dental anxiety, oral health practices and dental knowledge before and after the intervention. Pre- and post-intervention responses were compared to determine if knowledge and outcomes had improved. Semi-structured interviews were conducted with six students 18 -months later to determine long term retention of information and subsequent oral health practices. Improvements in good oral hygiene habits and diet were observed in several areas. Interview participants comments showed that although students may be aware of recommended oral health practices, they will not necessarily implement them. A decline in the number of sugary drinks consumed daily was observed, alongside an increase in participants' understanding of the effect of fluoride on teeth. Not all dental terminology and scientific knowledge was retained long term because of this initiative; however, improvements were observed when reinforcement of messages was delivered regularly throughout the duration of the study. Scientific outreach and dental initiatives need to be ongoing to ensure long term retention of information provided, and to encourage regular oral health practices. [ABSTRACT FROM AUTHOR]

Introduction: Depression and anxiety among youth with Type 1 diabetes (T1D) are associated with poor diabetes management. Further guidance regarding psychosocial screening measures would benefit pediatric integrated care clinics. The purpose of this exploratory study was to examine whether screening for anxiety, assessing caregiver reports, and screening children 12 years old and younger could identify a larger percentage of youth who may benefit from behavioral health support compared to the standard approach of only screening youth 13 and older for depression. Method: Sixty-five youth 8–17 years old with T1D (N = 65; M = 13.2 years; 55.4% females) and their caregivers (75% mothers) completed validated self-report and proxy-report depression and anxiety screeners during routine clinic visits between 2019 and 2021. Twenty-seven youth aged 13–17 also completed a measure of diabetes-related distress. Results: The standard approach of screening youth aged 13–17 for depression via self-report identified 25.6% of participants, whereas screening youth ages 8–17 for depression and anxiety via self- and proxy-reports identified 47.7%. Screening for depression/anxiety identified unique portions of youth independent of diabetes distress. Discussion: Utilizing anxiety and proxy-report measures may identify youth likely to benefit from behavioral health support who are not identified when only a self-report depression measure is used in screening. Research should evaluate whether utilizing multiple measures and screening children under 13 years old improve detection and connection to care for youth experiencing difficulty managing diabetes. Early identification and intervention could subsequently mitigate the negative impacts of social–emotional difficulties on diabetes management. Public Significance Statement: Broadening behavioral health screening among youth with type 1 diabetes identifies a higher portion of youth who may be in need of psychosocial supports than current standard of care. It is vital to consider informant method and factors assessed to meet the needs of all youth with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Background: The current literature lacks scientific research on child and adolescent psychiatrists' (CAPPS) perspectives on dental and oral health. This study aims to investigate the opinions and approaches of child and adolescent psychiatrists and their patients regarding oral and dental health. Methods: A questionnaire-based cross-sectional study was conducted among members of the Professional Association for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany. Results: Out of the association members, 10.9% (n = 109) participated, with 5.2% (n = 52; 38f/14m) completing the questionnaire. Dental and oral health topics were discussed with one-fifth of the patients (19.2%), while 11.5% reported that they were "never" a part of their therapy. Patient-related concerns about dental and oral health were primarily brought into the context of child and adolescent psychiatric work. Dental treatment anxieties were prominent. Only 3.8% of the participants regularly assigned diagnoses related to dental status. The CAPPS employ a bio-psycho-social model for the genesis of oral health-related conditions in Children and Adolescents with Special Needs. Conclusions: CAPPS have a foundation in relationship-based work for assessing oral and dental healthcare and providing recommendations for further dental care. Regional networking and science must be further developed. [ABSTRACT FROM AUTHOR]

Aim: During the major waves of coronavirus disease 2019 (COVID-19) infection, Peru had the highest case fatality rate in the world. This situation may have caused psychological conditions with somatic consequences in students who were susceptible to infection due to exposure to infected patients. The present study was designed to investigate the association between anxiety levels and painful temporomandibular disorders in dental students from two Peruvian provinces during the major waves of COVID-19 infection. Materials and Methods: The study conducted was both longitudinal and analytical. The total population consisted of 558 dental students from Peru, with 314 from Chimbote and 244 from Trujillo. No sample size calculation was necessary as the entire student population was invited to participate. Of the 366 students who initially joined the closed cohort, only 204 remained at the end of the study. During the first and second waves of COVID-19 infections, the Zung anxiety diagnostic test and the diagnostic criteria for painful temporomandibular disorder (DC/TMD) triage questionnaire were used to assess anxiety levels. The study also evaluated variables such as sex, age, marital status, academic year of study, area of residence, housing type, and occupation. The study employed statistical analysis to determine the relative risk (RR) of painful TMD incidence during the first and second waves of COVID-19 infections. A logit model was also used to determine the presence of painful TMD, with odds ratio (OR) as the measure. The statistical significance level was set at P < 0.05. Results: During the initial wave of COVID-19 infections, 50% (95% CI: 43.1-56.9%) of the 204 students experienced anxiety, while 26.5% (95% CI: 20.4-32.6%) reported TMD. Furthermore, those who exhibited anxiety were eight times more likely to develop TMD (OR = 8.88, 95% CI: 3.95 - 19.97). In the second wave, 62.3% (95% CI: 55.6-69.0%) of students reported anxiety, and 86.3% (95% CI: 81.6-91.0%) reported TMD. Additionally, individuals with anxiety were found to have a significantly higher likelihood of developing painful TMD, with a nine-fold increase in risk (OR = 9.87, 95% CI: 5.08-19.19). The cohort of students exposed and not exposed to anxiety during the first and second waves of COVID-19 infection showed a 4.58 times higher risk (95% CI: 2.61-8.03) of developing painful TMD due to anxiety. Conclusion: Between the first and second waves of COVID-19 infection, the prevalence of anxiety and painful temporomandibular disorder (TMD) increased among dental students. This establishes anxiety as a significant predisposing factor for the development of painful TMD over time. [ABSTRACT FROM AUTHOR]

Purpose: Dental anxiety (DA) is characterized by the expression of tension, stress, apprehension, irritation, anger, and frustration experienced by patients during dental appointment. The objective of this study was to systematically review the literature to assess the effectiveness of the use of informative videos in reducing DA in patients undergoing 3 M surgeries. Methods: Searches were carried out on MEDLINE (via PubMed), the Cochrane Central Registry of Controlled Trials (CENTRAL), the Virtual Health Library (VHL), and the Web of Science. Articles published until November 20, 2021, were included. There were no restrictions on the data or language of publication. Results: A total of 9 randomized clinical trials were included in this review, and five studies were included in the meta-analysis, comprising 529 patients. There was no significant difference in DA between the groups in the baseline when it was evaluated by any of the tools, indicating sample balancing at the beginning of the study. After intervention (video vs. verbal and/or written orientation) in the preoperative period, DA was assessed again; however, there was no difference in DA between the groups when assessed by the MDAS or STAI-S tools. After 3 M removals, the DA was still not significantly different between the groups when measured by the different considered tools. Conclusion: Informative videos addressing 3 M removal surgeries used in the preoperative period did not show an influence on the reduction of pre- and postoperative DA when compared to the verbal and/or written informative presentation. [ABSTRACT FROM AUTHOR]

Objectives: To summarize evidence on the impact of oral health on individual and family economic outcomes, describe trends in the literature, and identify areas for additional research to inform public health research and practice. Methods: Searches were conducted within PubMed, CINAHL, EconLit, Cochrane Library, PsycInfo, and Web of Science databases. Article review, selection, abstraction, and reporting processes were guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews. Results: Of 2758 unduplicated records identified, 52 met inclusion criteria. Study outcomes included indicators of employment/employability (n = 9), earnings/earnings potential (n = 26), parent missed work and family financial impacts of child oral health (n = 19), and financial loss (n = 3). Dental caries‐related variables were the most common predictors of poorer economic outcomes. Other oral health problems, such as poorer dental functioning or poorer self‐reported oral health status, also were associated with adverse economic outcomes. Significant associations with employment were found among studies that assessed interventions designed to improve oral health. Only one study estimated the impact of oral health on earnings. One‐third of studies conducted multivariable analyses, and 14% incorporated race and ethnicity variables. Conclusions: Although existing evidence suggests associations between oral health problems and poorer economic outcomes, there is a substantial need for more rigorous research to better understand the extent of economic impact of oral health problems and which populations are most affected. Additional high‐quality research is needed to inform which interventions are most likely to improve oral health, reduce adverse economic impacts, and promote health and economic equity. [ABSTRACT FROM AUTHOR]

Objectives: U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence‐based cognitive‐behavioral treatments for dental fear (CBT‐DF) exist, they have little impact on the millions who seek dental care annually because they are not disseminable (6 h of in‐chair time, delivered only in person at a few sites). We developed a disseminable CBT‐DF stepped‐care treatment comprising (Step 1) a mobile‐health application and, for those who remain fearful, (Step 2) a 1‐h, one‐on‐one psychological treatment session that allows practice during exposure to the patient's most‐feared stimuli. We hypothesized that the treatment would (a) be rated highly on usability and credibility and (b) result in clinically consequential (i.e., lowering fear into the 0–3 "no/low fear" zone) and statistically significant changes in global dental fear. Method: Racially/ethnically diverse patients (N = 48) with moderate to severe dental fear were recruited; all completed Step 1, and n = 16 completed Step 2. Results: As hypothesized, users found the stepped‐care treatment highly usable, credible, and helpful. Critically, this stepped‐care approach produced reductions in patients' dental fear that were both clinically consequential (with half no longer fearful) and statistically significant (d = 1.11). Conclusions: This usable, credible, stepped‐care approach to dental fear treatment holds promise for liberating evidence‐based CBT‐DF from specialty clinics, allowing broad dissemination. [ABSTRACT FROM AUTHOR]

Background: Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12. Method: A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses. Result: A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell–show–do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell–show–do and other NPBIs in reducing DFA among children. Conclusions: The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA. [ABSTRACT FROM AUTHOR]

Autonomic nervous system (ANS) activity may be associated with dental anxiety; however, no studies exist on the topic. The aim of this study was to assess if ANS activity and dental anxiety are associated. Data were collected as part of a Northern Finland Birth Cohort Study, NFBC1966, at the age of 46 years with eligible data on 1905 participants. Dental anxiety was measured using the Modified Dental Anxiety Scale (MDAS) categorized as follows: 19–25 = high, 10–18 = moderate, 5–9 = no to low dental anxiety. Heart rate variability (HRV) data were collected using an HR monitor and a standard lead-II electrocardiogram (ECG). Baroreflex sensitivity (BRS) was calculated from continuous ECG and blood pressure signals. Participants were categorized into three groups as follows: Low = the lowest 20th percentile, Mid = medium 21–79th percentile, and High = the highest 20th percentile according to their ANS variables. The associations between the MDAS and ANS activity parameters were evaluated using unordered multinomial logit models adjusted for comorbidities, β-blockers, BMI, smoking, and education. High heart rate, reduced HRV, low cardiac vagal modulation, and poor BRS were associated with moderate dental anxiety, and high cardiac vagal modulation and good BRS were associated with no to low dental anxiety. Poorer ANS activity might predispose some to dental anxiety, and better ANS activity might protect from dental anxiety. [ABSTRACT FROM AUTHOR]

We aimed to identify parents' dental anxiety trajectories and the association of the trajectories with the number of parents' and their children's oral healthcare procedures in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale at gestational weeks (gw) 14 and 34, as well as 3 and 24 months (mo) after childbirth. Oral healthcare procedures from gw14 to 24 mo were obtained from the national patient data register and categorized as preventive and treatment. Trajectories were identified with latent growth mixture modelling for 2068 fathers and 3201 mothers. Associations between trajectories and procedures adjusted for education were analyzed using unordered multinomial logit models. Fathers' trajectories were stable low (80.1%), stable high (3.4%), stable moderate (11.0%), moderate increasing (3.9%) and high decreasing (1.6%). Mothers' trajectories were stable low (80.7%), stable high (11.2%), moderate increasing (5.3%) and high decreasing (2.8%). Mothers with decreasing dental anxiety had a higher number of preventive and treatment procedures. Fathers with decreasing dental anxiety had a higher number of preventive and treatment procedures, while fathers with increasing dental anxiety had fewer procedures. Children of mothers with stable low dental anxiety had higher number of preventive procedures. There seems to be a two-way association between dental anxiety trajectories and oral healthcare procedures. [ABSTRACT FROM AUTHOR]

Background: Dental fear and uncooperative behavior can hinder dental treatment quality. Pediatric Procedural Sedation and Analgesia (PPSA) is used to facilitate treatment when the coping capacity is exceeded. Out-of-hospital PPSA has been associated with more adverse outcomes compared to when it is used in hospital-based settings. The updated Dutch PPSA guidelines have increased costs and raised concerns about the accessibility of specialized high-quality dental care for children in the Netherlands. This study aimed to investigate the impact of the updated 2017 guidelines on the occurrence rate of adverse events during PPSA in twelve Dutch dental clinics. Methods: The data of 25,872 children who were treated at twelve dental clinics between 1997 and 2019 were analyzed. A logistic two-level mixed-effects model was used to estimate the updated guidelines' impacts on adverse events. Results: The OR of the occurrence rate of an adverse event adjusted for age, weight, and duration of treatment was 0.75 (95% CI 0.64–0.89) after the implementation of the updated guidelines. This outcome was significant with p = 0.001, indicating a protective effect. Conclusions: Our findings demonstrate that there was a significant reduction in adverse events after the implementation of the updated guideline and highlight the importance of adhering to evidence-based practices in out-of-hospital dental clinics. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the concordance of parents' assessments of their child's dental fear. Cross-sectional secondary analysis used data from the multidisciplinary FinnBrain Birth Cohort Study. Child dental fear was assessed at age 5 with the Finnish translation of the modified Children's Fear Survey Schedule Dental Subscale (CFSS-M) by both fathers (n = 588) and mothers (n = 1100). Reply alternatives were from 1 = not afraid to 5 = very afraid and 6 = no experience coded as missing and 1. In total, 514 mother–father pairs were eligible for the analyses. Descriptive statistics, percentage agreement and Cohen's Kappa coefficients were used in the analyses. The concordance of parents' assessments was poor (Kappa range 0.072–0.258). The majority of parents replied "No Experience" to items related to invasive treatment or being unable to breathe. Thus, coding of this reply alternative had a significant impact on the mean values of the child's fear. When assessing the fear of a five-year-old child, it might not be safe to rely only on one parent's assessment, and whether or not the child has experience with the question asked should also be considered. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety is very much common among the patients and could be due to different factors like the behavior of the dentist, past experiences, Needle phobia, or word of mouth from other patients. According to recent studies, a strong association between sound and anxiety has been found, so this observational study has been conducted to find out the link between the activation of anxiety with the sound of a handpiece between experienced patients, who have already gone through the dental treatments and non-experienced patients. Methods: Total of 297 participants were part of this study. These participants were divided into 2 groups according to the experienced and non-experienced dental patients. The researcher first filled out the CORAH Dental Anxiety Scale (DAS) form to mark the anxiety level of the patients, and then noted the readings of the heart rate in 3 intervals which were before during, and after the treatment with the pulse oximeter. Later the data was analysed using the SPSS independent t-test. Results: Results show that patients in group 1 who have gone through the dental treatment before were less anxious and had a lesser effect on their heart rate than the patient who were having the treatment for the first time who were in group 2. Another interesting factor was noticed that in both the groups female were found to be more anxious than male participants. Participants with younger age were found to be more anxious than older age patient in both groups Conclusions: The sound of the handpiece can provoke anxiety in the patient, affecting the heart and increasing the heart rate. Participants who were experienced were found to be less anxious than the participants who were inexperienced. [ABSTRACT FROM AUTHOR]

Background: Latent inhibition occurs when exposure to a stimulus prior its direct associative conditioning impairs learning. Results from naturalistic studies suggest that latent inhibition disrupts the learning of dental fear from aversive associative conditioning and thereby reduces the development of dental phobia. Although theory suggests latent inhibition occurs because pre-exposure changes the expected relevance and attention directed to the pre-exposed stimulus, evidence supporting these mechanisms in humans is limited. The aim of this study is to determine if two variables, pre-exposure session spacing and multiple context pre-exposure, potentiate the hypothesized mechanisms of expected relevance and attention and, in turn, increase latent inhibition of dental fear. Methods: In a virtual reality simulation, child and adult community members (ages 6 to 35) will take part in pre-exposure and conditioning trials, followed by short- and long-term tests of learning. A 100ms puff of 60 psi air to a maxillary anterior tooth will serve as the unconditioned stimulus. Pre-exposure session spacing (no spacing vs. sessions spaced) and multiple context pre-exposure (single context vs. multiple contexts) will be between-subject factors. Stimulus type (pre-exposed to-be conditioned stimulus, a non-pre-exposed conditioned stimulus, and an unpaired control stimulus) and trial will serve as within-subject factors. Baseline pain sensitivity will also be measured as a potential moderator. Discussion: It is hypothesized that spaced pre-exposure and pre-exposure in multiple contexts will increase the engagement of the mechanisms of expected relevance and attention and increase the latent inhibition of dental fear. It is expected that the findings will add to theory on fear learning and provide information to aid the design of future interventions that leverage latent inhibition to reduce dental phobia. [ABSTRACT FROM AUTHOR]

Dental anxiety is a widespread complication occurring in pediatric patients during dental visits and may lead to undesirable complications. Esketamine may be effective in anxiety. The objective of this study was to investigate the effect of premedication with a dexmedetomidine-esketamine combination compared with dexmedetomidine alone on dental anxiety in preschool children undergoing dental treatment under general anesthesia. This is a prospective, double-blinded, randomized controlled trial. A total of 84 patients were scheduled for elective outpatient dental caries treatment under general anesthesia. Patients were randomly premedicated with intranasal dexmedetomidine (group D) or intranasal dexmedetomidine-esketamine (group DS). The primary outcome was the level of dental anxiety assessed by the Modified Child Dental Anxiety Scale (MCDAS) at 2 h after surgery. Secondary outcomes included level of dental anxiety at 1 day and 7 days after surgery, the incidence of dental anxiety at 2 h, 1 day, and 7 days after surgery, sedation onset time, overall success of sedation, acceptance of mask induction, postoperative pain intensity, incidence of emergence agitation in PACU, adverse reactions, HR, and SpO2 before premedication (baseline) and at 10, 20, and 30 min after the end of study drug delivery. The dental anxiety in group DS was lower than that in group D at 2 h, 1 day, and 7 days postoperatively (P = 0.04, 0.004, and 0.006, respectively). The incidences of dental anxiety in group DS were lower than those in group D at 2 h (53 % vs 76 %, P = 0.03), 1 day (47 % vs 71 %, P = 0.04), and 7 days (44 % vs 71 %, P = 0.02) after surgery. Group DS had a higher success rate of sedation (P = 0.03) but showed a lower MAS score (P = 0.005) and smoother hemodynamics (P < 0.01) after drug administration than group D. Group DS showed a significantly lower incidence rate of emergence agitation (P = 0.03) and postoperative pain intensity (P = 0.006) than that in group D during the anesthesia recovery time. The occurrence of adverse reactions was similar in both groups (P > 0.05). We did not analyze and correct for the learning effect caused by repeated applications of the MCDAS and MCDAS scores on the 1 day after surgery were obtained by telephone follow-up. Compared to premedication with dexmedetomidine alone, premedication with intranasal dexmedetomidine combined with esketamine could significantly improve dental anxiety in preschool children undergoing dental treatment under general anesthesia. • Evidence regarding effects of esketamine on dental anxiety has been limited. • Intranasal dexmedetomidine combined with esketamine improves dental anxiety in children undergoing dental surgery. • Premedication with dexmedetomidine and esketamine reduces emergence agitation and postoperative pain in children. [ABSTRACT FROM AUTHOR]

Introduction: Endodontic treatments are considered by the patients to be one of the most painful and anxiety-generating procedures and this feeling may be linked to both environmental and individual aspects. This study aimed to evaluate the degree of anxiety of patients immediately before the endodontic treatment. Methods: The study design was a cross-sectional quantitative analysis where patient sampling was performed on those who met the inclusion criteria and needed endodontic treatment. The interview instruments for the investigation were a questionnaire with semi-structured questions, the Corah Dental Anxiety Scale, and a digital device for measurement of blood pressure and heart rate. The variables investigated were gender, age, whether the patient liked to visit the dentist, depression, whether the patient used medication for depression, systolic and diastolic pressure, and heart rate. Data statistical were analysed using descriptive statistics and to evaluate the association between variables Pearson's chi-square tests were used with a significance level of 5%. Results: 175 patients were included in the study and categorized as little anxious (33.7%), mildly anxious (45.1%), moderately anxious (15.4%), and extremely anxious (5.7%). There was a strong association between higher degrees of anxiety and whether the patient declared not liking to visit the dentist; no other significant correlation was found. Conclusion: Endodontic patients who claim not to like to visit the dentist are more anxious. Healthcare professionals can pursue strategies to treat these patients with anxiety reduction techniques avoiding the postponement or evasion of endodontic treatments. [ABSTRACT FROM AUTHOR]

Epigenetic alterations are regarded as a potential mechanism mediating the effects of environmental risk factors on vulnerability for a range of mental health problems. Recent studies have addressed the question whether DNA methylation patterns predict the outcome of psychological interventions and whether treatment effects might be associated with changes of DNA methylation. We assessed phobic fear symptoms, treatment-relevant traits and treatment response in 308 adults free of psychotropic medication - highly fearful of either spiders, blood-injury-injections, dental-treatments or heights - all subjected to highly standardized exposure-based one-session fear treatment. DNA methylation level of the promotor region of the serotonin transporter gene (SLC6A4) was assessed in either saliva samples (spider and dental treatment fear cohorts) or oral mucosa (BII, heights) to check whether possible effects are independent of the surrogate tissue examined. Moreover, in order to examine possible DNA methylation by genotype effects, patients were assessed for genetic variation of the serotonin transporter-linked polymorphic region (5-HTTLPR). DNA methylation levels were neither associated with pre-treatment fear levels, treatment relevant traits or treatment outcome data even when allelic variation of the 5HTTLPR was considered. Overall DNA methylation levels were higher in saliva samples compared to buccal samples. In saliva samples there was a small pre- to post-treatment increase in DNA methylation, which, however, was also not associated with the investigated phenotypes. We conclude that DNA methylation of SLC6A4 is no suitable biomarker for response efficacy to highly standardized one-session exposure-based fear treatments. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has had a significant psychological impact on people's lives, including healthcare providers. This impact has manifested in the form of anxiety and fear. Since COVID-19 is a respiratory disease spread through the mouth and nose, dental practitioners have experienced anxiety due to their close proximity to the oro-nasal tissues. Aim: To assess the mental health condition, specifically fear and anxiety, of a group of dental students in Saudi Arabia during the COVID-19 pandemic and to explore students' perceptions about dentistry as a career choice following the pandemic. Materials and Methods: A cross-sectional questionnairebased study was conducted, which included demographic data, the Coronavirus Anxiety Scale (CAS), the Fear of COVID-19 Scale (FCV-19S), as well as a few questions to assess why students chose dentistry as a career and their perceptions about dentistry as a career following the pandemic. A digital link to the questionnaires was distributed through social media outlets such as Twitter, WhatsApp, etc., with the aim of reaching dental students across all dental schools in Saudi Arabia. Dental students and those undergoing internships from both public and private Dental Colleges across Saudi Arabia were approached. The study included a total of 633 students from 21 dental schools across Saudi Arabia. Data were analysed using the Statistical Package for Social Sciences, including Analysis of Variance(ANOVA), independent t-tests, and Chi-square tests. Results: Fear and anxiety levels were found to be the highest among interns and fourth-year dental students, respectively. A total of 346 (54.66%) of the respondents reported that they chose dentistry as a career due to personal desire. Approximately, 239 (37.8%) of the respondents reported being either 'Not Sure' or would not choose dentistry as a career if they had the choice, considering the uncertainty created by the COVID-19 pandemic. Conclusion: Fear and anxiety were reported to be higher among dental students exposed to clinical practice. The majority of dental students reported that they would still choose dentistry as a career option despite the uncertainty caused by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effect of child-friendly dentist attire and camouflage syringes on reducing dental anxiety in children. Methods: A cross-sectional study was conducted with 120 pediatric patients aged 6 to 12 years. Participants were assigned to one of three groups: group A (child-friendly dentist attire), group B (camouflage syringe), or group C (control group). Child preference for dentist attire was assessed using a visual analog scale, while dental anxiety was measured using the Modified Child Dental Anxiety Scale and the Facial Image Scale. Results: The results showed a significant decrease in dental anxiety scores in both group 2 and group 3 compared to group 1 (P < 0.001). Children in group A exhibited a higher preference for child-friendly dentist attire [mean score: 8.7, standard deviation (SD): 1.2] compared to group 1 (mean score: 3.2, SD: 1.5) (P < 0.001). Similarly, children in group 2 showed a higher preference for a camouflage syringe (mean score: 8.5, SD: 1.3) compared to group 1 (mean score: 3.4, SD: 1.6) (P < 0.001). Conclusion: Child-friendly dentist attire and camouflage syringes were found to be effective in reducing dental anxiety among pediatric patients. These interventions were well received by children and their parents, highlighting the importance of considering child preferences in dental settings. [ABSTRACT FROM AUTHOR]

Aim: The aim of this randomized clinical trial was to compare the impact of two management options for primary molars with pulp necrosis (pulpectomy or extraction) on children's oral health‐related quality of life (OHRQoL). Design: A total of 100 children aged 3–5 years with at least one necrotic primary molar were selected and randomized into the study groups. The Brazilian version of early childhood oral health impact scale (B‐ECOHIS) was completed by the parent proxy reports at baseline and after 4, 8 and 12 months. Differences between the trial groups were assessed through bootstrap linear regression for B‐ECOHIS scores, logistic regression for dental pain self‐reports and anxiety scores (α = 5%). Results: The mean (SD) B‐ECOHIS scores at baseline and after 12 months were 17.7 (6.5) and 3.0 (4.0) in the pulpectomy group and 18.8 (7.7) and 7.9 (7.7) in the extraction group. Both treatments significantly improved OHRQoL, but tooth extraction group showed higher scores in total B‐ECOHIS (p <.001) and most domains, indicating lower OHRQoL. Furthermore, higher anxiety levels were reported for dental extraction compared to pulpectomy (OR = 2.52; p =.008). Conclusion: Pulpectomy resulted in an improved OHRQoL scores after 12 months when compared to tooth extraction and should be considered as the treatment of choice for necrotic primary molars. [ABSTRACT FROM AUTHOR]

Introduction Preoperative pain of endodontic origin, has its effect on the patient's attitude towards the endodontic treatment. Dental anxiety associated with the above may cause ineffective anaesthesia of the tissues of interest. To assess the efficacy of preoperative oral single-dose administration of three nonsteroidal anti-inflammatory drugs namely, Diclofenac sodium 50 mg, Ibuprofen 200 mg and Etoricoxib 60 mg and on the effectiveness of infiltration anaesthesia in patients with irreversible pulpitis of maxillary first molars. Material and Methods Sixty (n=60) patients with a chief complaint of moderate to severe pain of endodontic origin participated in the study. Patients were asked to indicate their pain scores on a visual analog scale (VAS) and then they were divided into three groups of n=20. Then according to their groups, the patients received a single dose of Diclofenac sodium 50 mg, Ibuprofen 200 mg and Etoricoxib 60 mg one hour before administration of the infiltration anaesthesia with 2% lignocaine containing 1:80,000 epinephrine. The patients indicated their pain score on VAS after one hour of drug administration and again after completion of the access opening. Differences in the pain scores at these three intervals were noted. Data was collected and analyzed using SPSS v.20 software and subjected to descriptive statistics, one-sample t-test and one-way ANOVA test with the acceptance level of significance set at p<0.05. Results Diclofenac sodium 50 mg, Ibuprofen 200 mg and Etoricoxib 60 mg had shown a gradual decrease in mean pain scores after the completion of access opening, which was statistically significant (p<0.05). Etoricoxib 60 mg (p=0.01) showed lower mean pain scores compared to Diclofenac sodium 50 mg and Ibuprofen 200 mg. Conclusion Within the limitations of the present study, Etoricoxib significantly lower mean pain scores when compared with the other two groups. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of dental avoidance due to dental fear and economic burden and its distribution by utilization of dental care and socio‐behavioural characteristics. Method: A sample of 9052 Norwegian adults aged 25–35 years was invited to participate, and 2551 completed electronic questionnaires regarding lifetime prevalence of dental avoidance due to fear and last year prevalence of dental avoidance due to economic burden. Results: Cancelled‐ and avoided ordering appointments due to fear amounted to 14.7% and 30.5%, respectively. Avoidance of dental visits due to cost was 37.7%. Frequency of cancelled appointments due to fear was 30% and 16.6% among participants attending dental care several times annually and seldom, respectively. Multiple logistic regression revealed that avoiding dental visits due to cost was less likely among participants with higher household income (OR 0.4, 95% CI 0.3–0.5) and more likely among participants with dental care need (OR 1.8, 95% CI 1.2–2.7). Cancelled and avoided appointments due to fear was most likely among those with need for dental care and lower education. Early unpleasant experience with dental care remained a covariate of avoidance behaviour due to fear. Conclusion: 14.7%, 30.5%, and 37.7% confirmed cancelled appointments due to fear, avoided ordering appointments due to fear, and avoided visiting the dentist due to cost. Avoiding dental care due to fear and economic burden was more and less common among participants with respectively, frequent and seldom use of dental care. Dental avoidance behaviours were highest among socially disadvantaged groups, indicating a hole in the welfare state model that needs political consideration. [ABSTRACT FROM AUTHOR]

It is known that both procrastination and self-compassion are associated with health behaviours in the sense that the former reduces them and the latter increases them. It is also known that regular visits to the doctor and especially to the dentist are part of a healthy lifestyle. The aim of this study was to investigate the influence of procrastination and self-compassion on dental attendance. For this purpose, a new questionnaire was designed and confirmed by means of an explorative factor analysis. The results show that procrastination has an influence on dental attendance, even when the influence of dental anxiety is excluded. No conclusion can be drawn about the influence of self-compassion on dental attendance.These results open up a new area in which procrastination plays an important role and which has been neglected until now. The study emphasises the importance of further research into procrastination behaviour in the health area, in order to be able to minimise it in the long term. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to develop the Iranian version of the Children's Experiences of Dental Anxiety Measure (CEDAM) and evaluate its validity and reliability in assessing dental anxiety in children aged 9‒16. Methods: The CEDAM was translated into Persian following the guidelines of the IQOLA project. A ‎sample of children completed the measure in a clinical setting, with a subgroup completing it ‎again to assess test–retest reliability. Concurrent criterion validity was evaluated by having all ‎participants complete the Modified Child Dental Anxiety Scale (MCDAS) alongside the ‎CEDAM. Construct validity was examined using exploratory and confirmatory factor ‎analyses.‎ Results: The study included 275 children between the ages of 9 and 16. The Iranian version of CEDAM ‎exhibited excellent internal consistency with a Cronbach's ⍺ coefficient of 0.83. Test–retest ‎reliability was also high, with an intraclass correlation coefficient value of 0.96. Furthermore, there was a significant and ‎positive correlation between CEDAM and MCDAS scores (ρ = 0.72, p <.01). Exploratory ‎factor analysis identified two factors, and confirmatory factor analysis confirmed that the ‎instrument aligned well with the factor structure obtained from the exploratory analysis.‎ Conclusion: This study provides evidence supporting the validity and reliability of the Iranian version of ‎CEDAM as a valuable tool for evaluating dental anxiety in Persian‐speaking children between ‎the ages of 9 and 16.‎ [ABSTRACT FROM AUTHOR]

Molar incisor hypomineralisation (MIH) is a qualitative developmental enamel defect with a prevalence of 13% worldwide. This review aims to outline the current evidence regarding the impact of MIH on children's oral health and, more broadly, their day-to-day activities. MIH is associated with negative sequelae, including hypersensitivity, post-eruptive breakdown, the rapid development of carious lesions and poor aesthetics. Other concerns pertain to the clinical management of MIH and include difficulty in achieving local anaesthesia, increased dental fear and anxiety (DFA) and increased behaviour management problems. Oral health-related quality of life (OHRQoL) is the most standardised measure of patient impact; however, no instruments have been validated for use in MIH populations. The few existing observational studies investigating the impact of MIH on OHRQoL in children have produced conflicting results. Interventions to alleviate hypersensitivity and improve aesthetics had a positive impact on the OHRQoL of MIH-affected children. Multiple methodological issues make it difficult to measure the impact of MIH, including heterogeneity in the MIH severity classification, an overlap in the indices used to diagnose dental caries and MIH as well as the subjectivity of outcome measures for hypersensitivity and DFA. [ABSTRACT FROM AUTHOR]

This study presents a measure to assess dental anxiety in children. To gain a better understanding of children's fear and anxiety in the dental setting, instruments to gather data with high quality are necessary and missing, especially in the German language. Based upon the facet approach, the Questionnaire to Assess Dental Anxiety in Children (QADA-C) includes items concerning anxiety reactions in thinking, behavior, and feelings in the form of short statements. The item formulation was adapted for children of the target age (9–11 years), and items were presented with pictures of dental situations. Item and reliability analyses in a sample of 1019 children showed the good quality of the instrument (Cronbach's alpha = 0.89), and the validity indicators revealed its ability to differentiate high-anxiety, low-anxiety, and non-anxious children with an overall sum score. This score was proven to correlate with oral health criteria (decayed/missing/filled teeth, oral health behavior, oral health knowledge). Its easy administration and appropriateness for children make the questionnaire applicable in the dental office for clinical purposes as well as in research contexts. [ABSTRACT FROM AUTHOR]

Aim: Examining how pre‑cooling affects children’s experience of pain during local anesthetic administration is the primary goal of this study. Material and Methods: This study was conducted in vivo and involved 60 child patients who required local anesthetic in order to undergo dental procedures. Patients were divided into two groups based on a random chance: Group I was the control group, which did not receive any pre‑cooling. Group II was the pre‑cooling group, which allowed the injection site to be chilled with an ice pack for one minute prior to the administration of anesthesia. The Wong‑Baker FACES Pain Rating Scale was used to evaluate the participants’ level of pain perception immediately following the administration of the anesthetic injection. Results: The group that received pre‑cooling showed a reduction in pain levels that was statistically significant when compared to the group that received control (P < 0.05). Conclusion: Pediatric dental patients may decrease local anesthesia pain by pre‑cooling the injection site. This technique can be simply used in dental practices to improve patient experience, especially for children with dental anxiety or needle phobia. [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.