-
Journal of Anxiety Disorders Jun 2024This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental... (Review)
Review
This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.
PubMed: 38945067
DOI: 10.1016/j.janxdis.2024.102891 -
BMC Oral Health Jun 2024Mothers usually have the primary role in raising children and developing health-related behaviors. This study aims to evaluate the relationship between dental anxiety...
BACKGROUND
Mothers usually have the primary role in raising children and developing health-related behaviors. This study aims to evaluate the relationship between dental anxiety and oral hygiene status of mothers and children's dental anxiety and gingival health.
METHODS
The study included 305 children, aged 4-12 years, who came to the dentist for the first time and their mothers. All the demographic and oral hygiene information were collected through a questionnaire. The dental anxiety of the mothers and children was assessed using the Modified Dental Anxiety Scale (MDAS) and Venham Picture Test (VPT), respectively. The oral examination of the mother and children was performed, and their PI, GI, and DMFT scores were recorded.
RESULTS
While the correlation between MDAS and VPT was positive and strong in children aged 8-12, it was positive but weak in the 4-7 age group. A significant relationship was detected between the mother's PI, GI, DMFT, and the child's VPT score. According to the mothers' dental anxiety, there were no statistically significant differences in PI, GI, and dmft values in children aged between 4 to 7. A moderately positive and statistically significant relationship between maternal dental anxiety and children's DMFT was identified in children aged 8-12.
CONCLUSIONS
Children's dental anxiety was significantly influenced by maternal dental anxiety, post-treatment complications experienced by the mother, and the oral health status of the mother.
TRIAL REGISTRATION
Clinical Trials-ID: NCT05563532; Registration Date: 17.09.2022.
Topics: Humans; Dental Anxiety; Child; Child, Preschool; Oral Health; Female; Mothers; Male; DMF Index; Adult; Surveys and Questionnaires; Mother-Child Relations; Periodontal Index
PubMed: 38943136
DOI: 10.1186/s12903-024-04530-0 -
British Dental Journal Jun 2024
Topics: Humans; Dental Anxiety; Communication; Fear; Dentist-Patient Relations
PubMed: 38942869
DOI: 10.1038/s41415-024-7569-3 -
BMC Oral Health Jun 2024In recent years, the demand for orthodontic treatment with aligners has increased, led by patient need, as aligners typically provide them with improved aesthetics and...
A longitudinal pilot study examining the influence of the orthodontic system chosen in adult patients (brackets versus aligners) on oral health-related quality of life and anxiety.
BACKGROUND
In recent years, the demand for orthodontic treatment with aligners has increased, led by patient need, as aligners typically provide them with improved aesthetics and less physical discomfort. In deciding with the patient on an appropriate orthodontic system, it is important to take into account the potential discomfort and the perceptions that patients have in relation to their treatment. The objective of this study was to analyze the influence of brackets or aligners on oral health-related quality of life (OHRQoL) and anxiety levels in a sample of adult patients during the first month of treatment.
METHODS
The pilot study was carried out at the Dental Clinic of the University of Salamanca between November 2023 and February 2024. Eighty adult patients who initiated orthodontic treatment were selected and divided into two groups: the brackets group (Victory®; 3 M Unitek, California, USA) (n = 40) and the aligners group (Invisalign®; Align Technology, California, USA) (n = 40). OHRQoL was analyzed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire, and anxiety was analyzed using the State-Trait Anxiety Inventory (STAI). The follow-up time was one month, with scores recorded at the beginning (T0) and one month after starting treatment (T1).
RESULTS
The mean patient age was 33.70 (± 5.45) years old. The total sample (n = 80) consisted of 66.2% men and 33.8% women. In the brackets group, one month after starting treatment, the dimension with the highest impact was that of physical pain (5.62 ± 1.51). In the aligners group, where the dimension of psychological disability had the highest score (4.22 ± 1.02). In the brackets group the total OHIP score was higher at one month (T1) (33.98 ± 6.81) than at the start of treatment (T0) (21.80 ± 3.34); this greater impact on OHRQoL one month after starting treatment was not observed in the aligners group (T1 = 27.33 ± 6.83; T0 = 27.33 ± 6.22). The orthodontic system used did not influence participants' anxiety (p > 0.05). Age and sex were not influential factors in either OHRQoL or anxiety.
CONCLUSIONS
The bracket system significantly influenced patients' OHRQoL. In the sample studied, no influence of the orthodontic system (brackets versus aligners) on anxiety was observed.
Topics: Humans; Quality of Life; Pilot Projects; Female; Male; Adult; Oral Health; Longitudinal Studies; Orthodontic Brackets; Anxiety; Dental Anxiety; Surveys and Questionnaires; Middle Aged
PubMed: 38937720
DOI: 10.1186/s12903-024-04464-7 -
Neuroreport Jun 2024It is commonly accepted that exposure to stress may cause overactivity in the orofacial muscles, leading to consistent muscle pain, which is the main symptom of...
It is commonly accepted that exposure to stress may cause overactivity in the orofacial muscles, leading to consistent muscle pain, which is the main symptom of temporomandibular disorders. The central neural mechanism underlying this process, however, remains unclear. The locus coeruleus is considered to play an important role in stress-related behavioral changes. Therefore, the present study was designed to examine the role of locus coeruleus neurons in masseter overactivity induced by stress. C57BL/6 mice were subjected to chronic restraint stress for 14 days to establish an animal model. The behavioral changes and the electromyography of the masseter muscle in mice were measured. The expression of Fos in locus coeruleus was observed by immunofluorescence staining to assess neuronal activation. A chemogenetic test was used to inhibit locus coeruleus neuronal activity, and the behavioral changes and electromyography of the masseter muscle were observed again. The results exhibited that chronic restraint stress could induce anxiety-like behavior, overactivity of the masseter muscle, and significant activation of locus coeruleus neurons in mice. Furthermore, inhibition of noradrenergic neuron activity within the locus coeruleus could alleviate stress-induced anxiety behavior and masseter muscle overactivity. Activation of noradrenergic neurons in locus coeruleus induced by stress may be one of the central regulatory mechanisms for stress-induced anxiety-like behaviors and overactivity of masseter muscles.
PubMed: 38935079
DOI: 10.1097/WNR.0000000000002058 -
Indian Journal of Dental Research :... Jan 2024Internet Addiction and phubbing are prevalent disruptive behaviours among students. The aim of this study was to assess the relationship between phubbing, smartphone...
BACKGROUND
Internet Addiction and phubbing are prevalent disruptive behaviours among students. The aim of this study was to assess the relationship between phubbing, smartphone addiction and some of the related psychological effects among dental undergraduates.
MATERIALS AND METHODS
A multi-centric cross-sectional pre-validated questionnaire-based study was conducted among undergraduate students of five different dental colleges across India. The questionnaire included the Phubbing Scale, Barratt Impulsiveness Scale (BIS), Smartphone Application-based Addiction Scale (SABAS), and Rosenberg Self-Esteem Scale (RSES). The data were analysed with IBM SPSS version 21, followed by a t-test, analysis of variance (ANOVA), and Spearmen's co-relation to find the association between different psychological variables among study subjects.
RESULTS
The total sample comprise of 1226 with mean age of 22.35. The SABAS showed a higher mean ± standard deviation (SD) score (3.17 ± 0.93). The Phubbing Scale showed a positive correlation with the SABAS (0.658), the results were found to be highly statistically significant (P = 0.01).
CONCLUSION
The present study found a higher prevalence of phubbing and smartphone addiction among dental students. Our results showed that impulsiveness leads to internet addiction and thus phubbing is becoming a way to find solace during communication to escape anxiety and distress.
Topics: Humans; Students, Dental; Smartphone; Female; Cross-Sectional Studies; Male; Young Adult; Behavior, Addictive; India; Surveys and Questionnaires; Internet Addiction Disorder; Adult; Self Concept; Prevalence; Adolescent
PubMed: 38934742
DOI: 10.4103/ijdr.ijdr_565_23 -
Frontiers in Neurology 2024For children who are unable to cooperate due to severe dental anxiety (DA), dental treatment of childhood caries under Dental General Anesthesia (DGA) is a safe and...
BACKGROUND
For children who are unable to cooperate due to severe dental anxiety (DA), dental treatment of childhood caries under Dental General Anesthesia (DGA) is a safe and high-quality treatment method. This study aims to evaluate the impact on neurocognitive functions and the growth and development of children 2 years after dental procedure based on previous research, and further establish a causal relationship between general anesthesia (GA) and changes in children's neurocognitive functions by incorporating Mendelian Randomization (MR) analysis.
METHODS
Data were collected and analyzed from 340 cases of S-ECC procedures of preschool children conducted in 2019. This involved comparing the neurocognitive outcomes 2 years post-operation of preschool children receiving dental procedures under general anesthesia or local anesthesia. Physical development indicators such as height, weight, and body mass index (BMI) of children were also compared at baseline, half a year post-operation, and 2 years post-operation. We performed a Mendelian randomization analysis on the causal relationship between children's cognitive development and general anesthesia, drawing on a large-scale meta-analysis of GWAS for anesthesia, including multiple general anesthesia datasets.
RESULTS
Outcome data were obtained for 111 children in the general anesthesia group and 121 children in the local anesthesia group. The mean FSIQ score for the general anesthesia group was 106.77 (SD 6.96), while the mean score for the local anesthesia group was 106.36 (SD 5.88). FSIQ scores were equivalent between the two groups. The incidence of malnutrition in children in the general anesthesia group was 27.93% ( < 0.001) before surgery and decreased to 15.32% ( > 0.05) after 2 years, which was not different from the general population. The IVW method suggested that the causal estimate ( = 0.99 > 0.05, OR = 1.04, 95% CI = 5.98 × 10-1.82 × 10) was not statistically significant for disease prevalence. This indicates no genetic cause-and-effect relationship between anesthesia and childhood intelligence.
CONCLUSION
There were no adverse outcomes in neurocognitive development in 2 years after severe early childhood caries (S-ECC) procedure under total sevoflurane-inhalation in preschool children. The malnutrition condition in children can be improved after S-ECC procedure under general anesthesia. Limited MR evidence does not support a correlation between genetic susceptibility to anesthesia and an increased risk for intelligence in children.
PubMed: 38933327
DOI: 10.3389/fneur.2024.1389203 -
Children (Basel, Switzerland) Jun 2024Misophonia is a neurophysiological disorder with behavioral implications, is complex and multifactorial in origin, and is characterized by an atypical and... (Review)
Review
Misophonia is a neurophysiological disorder with behavioral implications, is complex and multifactorial in origin, and is characterized by an atypical and disproportionate emotional response to specific sounds or associated visual stimuli. Triggers include human-generated sounds, mainly sounds related to feeding and breathing processes, and repetitive mechanical sounds. In response to the triggering stimulus, the patient experiences immediate, high-intensity, disproportionate physical and emotional reactions that affect their quality of life and social functioning. The symptoms of misophonia can occur at any age, but onset in childhood or adolescence is most common. Affected children live in a constant state of anxiety, suffer continuous physical and emotional discomfort, and are thus exposed to significant chronic stress. Chronic stress, especially during childhood, has consequences on the main biological systems through the dysregulation of the hypothalamic-pituitary-adrenal axis, including the gastrointestinal tract. Here, we provide arguments for a positive correlation between misophonic pathology and gastrointestinal symptoms, and this hypothesis may be the starting point for further longitudinal studies that could investigate the correlations between these childhood vulnerabilities caused by misophonia and their effect on the gastrointestinal system. Further research to study this hypothesis is essential to ensure correct and timely diagnosis and optimal psychological and pharmacological support.
PubMed: 38929278
DOI: 10.3390/children11060699 -
BMJ Open Jun 2024The prevalence of major depressive disorder (MDD) is on the rise globally, and the use of antidepressant medications for its treatment does not usually result in full... (Randomized Controlled Trial)
Randomized Controlled Trial
Study protocol on the efficacy of exergames-acceptance and commitment therapy program for the treatment of major depressive disorder: comparison with acceptance and commitment therapy alone and treatment-as-usual in a multicentre randomised controlled trial.
BACKGROUND
The prevalence of major depressive disorder (MDD) is on the rise globally, and the use of antidepressant medications for its treatment does not usually result in full remission. However, the combination of physical exercise and psychotherapy for the treatment of MDD increase the rate of full remission among patients. This three-armed, parallel-group, double-blinded randomised controlled trial (RCT) aims to assess and compare the effects between the combination of exergame and acceptance and commitment therapy (e-ACT) programme, ACT only and treatment-as-usual (TAU) control groups on the severity of depression and anxiety symptoms, the degree of experiential avoidance and quality of life (QoL) and the serum levels of depression biomarkers (such as brain-derived neurotrophic factor, C-reactive protein and vascular endothelial growth factor) among patients with MDD across three time points.
METHODS AND ANALYSIS
This RCT will recruit 126 patients with MDD who will be randomised using stratified permuted block randomisation into three groups, which are the combined e-ACT programme, ACT-only and TAU control groups in a 1:1:1 allocation ratio. The participants in the e-ACT and ACT-only intervention groups will undergo once a week intervention sessions for 8 weeks. Assessments will be carried out through three time points, such as the pre-intervention assessment (t), assessment immediately after completion of the intervention at 8 weeks (t) and assessment at 24 weeks after completion of the intervention (t). During each assessment, the primary outcome to be assessed includes the severity of depression symptoms, while the secondary outcomes to be assessed are the severity of anxiety symptoms, experiential avoidance, QoL and depression biomarkers.
ETHICS AND DISSEMINATION
Approval of this study was obtained from the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/PP/23050420). The findings of the study will be published in academic peer-reviewed journals.
TRIAL REGISTRATION NUMBER
NCT05812001 (ClinicalTrials.gov). Registered on 12 April 2023.
Topics: Humans; Depressive Disorder, Major; Quality of Life; Acceptance and Commitment Therapy; Adult; Double-Blind Method; Male; Female; Video Games; Randomized Controlled Trials as Topic; Middle Aged; Treatment Outcome; Multicenter Studies as Topic; Exercise Therapy; Brain-Derived Neurotrophic Factor; Biomarkers
PubMed: 38926142
DOI: 10.1136/bmjopen-2023-080315 -
Natural Product Research Jun 2024Korth (kratom) is a tropical indigenous tree of Southeast Asia. It is commonly consumed by the people due to its various pharmacological properties. The leaves of this... (Review)
Review
Korth (kratom) is a tropical indigenous tree of Southeast Asia. It is commonly consumed by the people due to its various pharmacological properties. The leaves of this plant are traditionally used for the treatment of several diseases including pain, fever, cough, anxiety, depression, obesity, diarrhoea, wound healing, diabetes, hypertension as well as for the prevention of cancer and improvement of sexual performance. Phytochemical investigations have confirmed the presence of more than forty alkaloids along with the presence of other bioactive secondary metabolites. Among the alkaloids isolated, mitragynine and 7-hydroxymitragynine along with their derivatives have been widely evaluated and reported to possess various pharmacological effects. Hence, the aim of this review is to shed light on the traditional uses of kratom and the scientific studies to justify the folkloric claims and active principles responsible for the various medicinal effects associated with the leaves of this plant. This review highlights the potential benefits and toxicities associated with leaves along with the phytochemistry. Moreover, the existing gaps in the field of study have been identified along with the future directions to further avail the benefits of this plant species.
PubMed: 38923960
DOI: 10.1080/14786419.2024.2371564