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BMC Oral Health Jun 2024One of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
One of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease injection pain. So, this study aimed to assess the impact of laser photobiomodulation on local anesthesia (LA) injection pain in children and its effect on the efficacy of LA during pulpotomy and SSC procedures.
METHODS
The research was carried out as a randomized controlled clinical trial with two parallel group design. It involved 64 cooperative healthy children, age range from 5 to 7 years, each having at least one maxillary molar indicated for pulpotomy. Children were randomly allocated to one of the two groups based on the pre-anesthetic tissue management technique used: test group received laser photobiomodulation, while control group received topical anesthetic gel. Pain during injection, pulpotomy, and SSC procedures was assessed using physiological measures (Heart Rate (HR)), subjective evaluation (modified Face-Pain-Scale (FPS), and objective analysis (Sound-Eye-Motor scale (SEM)).
RESULTS
A total of 64 children with mean age 6.23 ± 0.78 participated in this research. The mean HR scores were significantly lower in the laser PBM group during buccal and palatal infiltration injections. The SEM mean scores were significantly lower in the laser PBM group during both injections. For the FPS scale, the number of children who recorded satisfaction during injection was significantly higher in laser PBM group. There was no statistically significant difference in mean HR as well as in SEM and FPS scores between the two groups during pulpotomy and SSC procedures. Comparisons between the two study groups were performed using independent samples t- and Mann-Whitney U tests. Significance was set at p value < 0.05.
CONCLUSION
Laser photobiomodulation is a promising non-pharmacological pre-anesthetic tissue management technique in children that offered less painful injection compared to topical anesthetic gel without compromising the effectiveness of LA.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05861154. Registered on 16/5/2023.
Topics: Humans; Child; Low-Level Light Therapy; Female; Child, Preschool; Male; Pain Measurement; Pulpotomy; Anesthetics, Local; Injections; Anesthesia, Dental; Anesthesia, Local; Pain Management; Heart Rate
PubMed: 38909229
DOI: 10.1186/s12903-024-04430-3 -
BMC Oral Health Jun 2024Isaacs' syndrome, also known as neuromyotonia or peripheral nerve hyperexcitability, is a rare disorder that affects the peripheral nervous system. Clinical findings...
BACKGROUND
Isaacs' syndrome, also known as neuromyotonia or peripheral nerve hyperexcitability, is a rare disorder that affects the peripheral nervous system. Clinical findings include cramps, fasciculations, and myokymia; however, there are few reports of dental treatment for trismus.
CASE PRESENTATION
A patient with trismus due to Isaacs' syndrome experienced swelling and pain in the gingiva surrounding his right lower first molar. He was diagnosed with chronic apical periodontitis by a dentist near his home. However, the patient was informed that dental treatment and medication could not be administered because of the presence of Isaacs' syndrome, and he visited the Geriatric Dentistry and Perioperative Oral Care Center at Kyushu University Hospital 2 weeks later. The patient's painless mouth-opening distance (between incisors) was 20 mm at that time, and medication, including amoxicillin capsules and acetaminophen, was administered because the dental extraction forceps or endodontic instruments were difficult to insert into the oral cavity for treatment. Two months after his initial visit, the patient visited us complaining of pain in the same area. However, he had recently undergone plasmapheresis treatment in neurology to alleviate limited mouth opening and systemic myalgia, resulting in a pain-free mouth-opening distance of approximately 35 mm. During this temporary period in which he had no restriction in mouth opening, we performed tooth extraction and bridge restoration on the mandibular right first molar and created an oral appliance for sleep bruxism.
CONCLUSIONS
Plasmapheresis therapy transiently reduced trismus, rendering dental interventions feasible, albeit temporarily. This case report underscores the importance of close collaboration between neurologists and dentists who encounter similar cases while furnishing valuable insights to inform dental treatment planning.
Topics: Humans; Male; Trismus
PubMed: 38909199
DOI: 10.1186/s12903-024-04485-2 -
JMIRx Med Jun 2024Information about the range of Hounsfield values for healthy teeth tissues could become an additional tool in assessing dental health and could be used, among other...
BACKGROUND
Information about the range of Hounsfield values for healthy teeth tissues could become an additional tool in assessing dental health and could be used, among other data, for subsequent machine learning.
OBJECTIVE
The purpose of our study was to determine dental tissue densities in Hounsfield units (HU).
METHODS
The total sample included 36 healthy children (n=21, 58% girls and n=15, 42% boys) aged 10-11 years at the time of the study. The densities of 320 teeth tissues were analyzed. Data were expressed as means and SDs. The significance was determined using the Student (1-tailed) t test. The statistical significance was set at P<.05.
RESULTS
The densities of 320 teeth tissues were analyzed: 72 (22.5%) first permanent molars, 72 (22.5%) permanent central incisors, 27 (8.4%) second primary molars, 40 (12.5%) tooth germs of second premolars, 37 (11.6%) second premolars, 9 (2.8%) second permanent molars, and 63 (19.7%) tooth germs of second permanent molars. The analysis of the data showed that tissues of healthy teeth in children have different density ranges: enamel, from mean 2954.69 (SD 223.77) HU to mean 2071.00 (SD 222.86) HU; dentin, from mean 1899.23 (SD 145.94) HU to mean 1323.10 (SD 201.67) HU; and pulp, from mean 420.29 (SD 196.47) HU to mean 183.63 (SD 97.59) HU. The tissues (enamel and dentin) of permanent central incisors in the mandible and maxilla had the highest mean densities. No gender differences concerning the density of dental tissues were reliably identified.
CONCLUSIONS
The evaluation of Hounsfield values for dental tissues can be used as an objective method for assessing their densities. If the determined densities of the enamel, dentin, and pulp of the tooth do not correspond to the range of values for healthy tooth tissues, then it may indicate a pathology.
PubMed: 38904484
DOI: 10.2196/56759 -
Cureus May 2024Silver diamine fluoride (SDF) has been demonstrated to be effective in arresting caries lesions and, recently, clinical trials have assessed the effectiveness of SDF as... (Review)
Review
Silver diamine fluoride (SDF) has been demonstrated to be effective in arresting caries lesions and, recently, clinical trials have assessed the effectiveness of SDF as a medicament for indirect pulp therapy (IPT) in primary teeth. This review aims to summarize the literature related to the use of SDF and find out if SDF can be used as an effective material for IPT. A literature search was undertaken on electronic databases including PubMed, MEDLINE, ScienceDirect, and Google Scholar, which elicited 50 studies employing different materials in the IPT of primary molars; however, of them, only four clinical trials used SDF as indirect pulp capping (IPC) material. SDF has the potential to be a useful material for IPT in primary teeth. It is a handy choice for pediatric dentists due to its minimum invasiveness, ease of application, and ability to stop the progression of caries. However, more studies are needed to determine whether SDF can be used routinely for IPT and whether it can even replace the currently available materials, as well as to fully realize its potential and establish criteria for its ideal application in IPT procedures.
PubMed: 38903314
DOI: 10.7759/cureus.60780 -
Cureus May 2024This study aimed to investigate the referral rates of oral lichen planus (OLP) and untreated hepatitis virus-infected patients by dentists to hepatologists.
OBJECTIVES
This study aimed to investigate the referral rates of oral lichen planus (OLP) and untreated hepatitis virus-infected patients by dentists to hepatologists.
MATERIALS AND METHODS
The study was conducted at three dental clinics in the Oita prefecture between November 2021 and June 2023. Two distinct groups of patients who visited the dentist for dental treatment were included: those with liver disease and concurrent hepatitis C virus (HCV) or hepatitis B virus (HBV) infection and those diagnosed with OLP. The rate of medical referrals to a hepatologist was investigated. Data on the number of patients, gender, age, diagnosis of liver disease, and referral practices were collected from the records submitted by each dental clinic. Information about the HCV and HBV infection status was collected through interviews with the dentists.
RESULTS
A total of 1,665 patients were included, of which 10 were HCV-infected, five were HBV-infected, and six were diagnosed with OLP. None of the 15 patients with liver disease were referred to a hepatologist by their dentists. Nine out of the 10 HCV-infected patients had achieved sustained virological response (SVR) after antiviral treatment. Of the six patients with OLP, one had a history of HBV infection, one had severe fatty liver, and the remaining four had normal livers; five of the OLP patients were referred to a hepatologist (83.3%).
CONCLUSION
A high referral rate from dentists to hepatologists was observed among the OLP patients. However, the study highlighted the difficulties in identifying hepatitis patients and establishing appropriate medical coordination in dental institutions.
PubMed: 38903276
DOI: 10.7759/cureus.60624 -
Preventive Medicine Jun 2024This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use. (Review)
Review
OBJECTIVE
This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use.
METHODS
We conducted a systematic review of dentists' knowledge, attitudes and perceptions regarding antibiotic use, by searching the MEDLINE, EMBASE and Web of Science for all original paper published from January 1990 to July 2023, in accordance with the Preferred Reporting Items for systematic Reviews and Meta-analyses (PRISMA 2020) guidelines.
RESULTS
The review included 37 papers, (7 qualitative and 30 quantitative studies). Modifiable factors (knowledge, attitudes) were reported as being associated with antibiotic prescribing by dentists which were cited in 30 of the 37. These attitudes most frequently identified by dentists were: complacency (22/29); lack of trust (16/29); the need to postpone the dental procedure (17/29); and fear (8/29). Gaps in knowledge were also identified (15/29). Only one of the included articles quantified the influence between the reported modifiable factors and antibiotic prescribing.
CONCLUSIONS
The review emphasizes that dentists' antibiotic prescribing is predominantly influenced by modifiable factors. This insight informs the potential for targeted interventions to curtail inappropriate antibiotic use, contributing to global efforts in reducing antibiotic resistance. The protocol of this systematic review can be found in PROSPERO under registration no. CRD42021253937.
PubMed: 38901743
DOI: 10.1016/j.ypmed.2024.108043 -
Singapore Medical Journal Jun 2024Cerebral palsy (CP) is one of the most severe childhood neurodevelopmental disabilities resulting from non-progressive insult to the developing brain. We aimed to report...
INTRODUCTION
Cerebral palsy (CP) is one of the most severe childhood neurodevelopmental disabilities resulting from non-progressive insult to the developing brain. We aimed to report our experience regarding dental visit attendance, caries prevalence and factors affecting dental access in children with CP in Singapore.
METHODS
Patients diagnosed with CP who were born in or after 1994 were included in this study. We reviewed the data of all 151 patients recruited under the CP Registry in Singapore (SingCPR) from September 2017 to May 2020. The SingCPR was launched in September 2017 to assist in future planning of services and resources for CP in Singapore.
RESULTS
The mean age of the patients was 7.8 years, with the interquartile range being 3 years and 8 months-10 years and 10 months. Only 41.7% reported a visit to the dentist ever, with 25.4% reporting presence of dental caries. Age was the only statistically significant factor influencing access to dental care. None of the children less than 2 years old ever received any dental care, and 20% of the children with CP aged 2-6 years had received dental care before. Age range with the highest percentage of dental visits was 7-12 years, with up to 44.0% having ever received dental care. We believe the prevalence of dental caries was underreported as many children did not receive any dental care and therefore may have undetected dental caries.
CONCLUSION
Dental care in children with CP should be advocated early for prevention and detection of caries.
PubMed: 38900000
DOI: 10.4103/singaporemedj.SMJ-2022-022 -
Health Expectations : An International... Jun 2024Women and those with younger onset Parkinson's Disease (YOPD) are typically diagnosed later and face unique situations and challenges. This essay aims to raise awareness...
INTRODUCTION
Women and those with younger onset Parkinson's Disease (YOPD) are typically diagnosed later and face unique situations and challenges. This essay aims to raise awareness of the difficulties in diagnosing YOPD and the need for a personalised approach to care for women with YOPD.
METHODS
Two professional women with YOPD (academic physiotherapist and practicing dentist) and a female neurologist (clinician academic) came together to write a narrative essay on their personal experience and perspectives in relation to women and YOPD.
RESULTS
The essay outlines how the experience of diagnosis is likened to a complex puzzle box with many interlocking components that are hidden and difficult to solve. The concerns of the women about their identity, work, family and the future, with most supports targeting those that are older and retired are outlined.
CONCLUSION
It is concluded that YOPD is a complex puzzle to solve, but can be done by understanding all the intricate interlocking components of the puzzle and combined with greater awareness could lead to earlier diagnosis and the delivery of successful person-centred care.
PATIENT OR PUBLIC CONTRIBUTION
People with lived experience were involved in the essay conception and writing.
Topics: Humans; Parkinson Disease; Female; Middle Aged; Age of Onset
PubMed: 38896007
DOI: 10.1111/hex.14116 -
Cureus May 2024Over-the-counter teeth-whitening products have become popular in accordance with the increasing demands of patients. These products can also be recommended to patients...
AIM
Over-the-counter teeth-whitening products have become popular in accordance with the increasing demands of patients. These products can also be recommended to patients by dentists. The aim was to determine the rates of recommendation of over-the-counter teeth whitening products by dentists in Turkey divided into different categories for their patients and to interpret them based on a cause-and-effect relationship.
MATERIAL AND METHODS
After obtaining ethics committee approval, the survey questions were created using Google Forms (Google Inc., Mountainview, CA) and delivered to dentists via social media. Dentists who signed the informed consent form completed the survey. Within the study's scope, statistical analyses were conducted using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY). Values were expressed as frequency (n) and percentage (%). A chi-square test was used to compare participants' teeth-whitening recommendations according to their demographic characteristics. The statistical significance level was accepted as p <0.05 throughout the study.
RESULTS
A total of 57.9% of dentists working in Turkey did not recommend over-the-counter teeth-whitening products to their patients. When the answers to the question "Which whitening products sold on the market do you recommend to your patients?" were compared according to the participants' place of work, there was a statistically significant difference between the place of work and the recommended whitening product (p <0.05). Participants working in the private sector answered "I do not recommend" at a higher rate than participants working in the public sector. Among those who recommended toothpaste, more dentists with five or fewer years of experience recommended toothpaste to their patients than dentists with greater than five years of experience. Additionally, more dentists working in the public sector recommended toothpaste to their patients than dentists working in the private sector, and more specialist dentists recommended toothpaste to their patients than general practitioner dentists.
CONCLUSION
Most dentists in Turkey do not recommend over-the-counter teeth-whitening products to their patients. Among those who recommend such products, toothpaste has been determined to be the first choice. The results of this study may raise awareness among dentists about over-the-counter teeth-whitening products and encourage new studies.
PubMed: 38894768
DOI: 10.7759/cureus.60602 -
Journal of Clinical Medicine May 2024The World Health Organization's (WHO) 2022 update on the classification of odontogenic and maxillofacial bone tumors has revolutionized diagnostic and treatment...
The World Health Organization's (WHO) 2022 update on the classification of odontogenic and maxillofacial bone tumors has revolutionized diagnostic and treatment paradigms by integrating novel molecular insights. Fibro-osseous lesions of the maxillo-facial bones constitute a heterogeneous group encompassing fibrous dysplasia, Psammomatoid Ossifying Fibroma (PSOF), Juvenile Trabecular Ossifying Fibroma (JTOF), and other variants. Despite histological similarities, their distinct clinical manifestations and prognostic implications mandate precise differentiation. The intricacies of diagnosing fibro-osseous lesions pose challenges for pathologists, maxillofacial surgeons, dentists and oral surgeons, underscoring the importance of a systematic approach to ensure optimal patient management. Herein, we present two cases, fibrous dysplasia and Cemento-Ossifying Fibroma, detailing their clinical encounters and management strategies. Both patients provided informed consent for publishing their data and images, adhering to ethical guidelines.
PubMed: 38892944
DOI: 10.3390/jcm13113233