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The Journal of Clinical Pediatric... May 2024This study evaluated the behavioural changes pertaining to children's oral health before and after the dental general anaesthesia (DGA), with particular focus on the...
This study evaluated the behavioural changes pertaining to children's oral health before and after the dental general anaesthesia (DGA), with particular focus on the factors associated with these changes. The records were collected for the children who received DGA from July 2015 to November 2016, and relevant questionnaires were obtained from their parents/guardians for the information prior to and after the DGA. The questionnaire included Early Childhood Oral Health Impact Scale (ECOHIS) and Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) to investigate the changes in Oral Health-related Quality of Life (OHRQoL) and dental fear. The DGA impact on children's oral hygiene habits and oral health-related behaviours was assessed by analysing the data. The chi-square test and Mann-Whitney test were employed to evaluate the differences. Total of 141 patients (89 before DGA and 77 after DGA, 25 being common) participated in this study. There were 60 children below 5 years and 29 over 5 years before DGA, while 41 children below 5 years and 36 over 5 years after DGA. Most parents/guardians were educated above undergraduate level (59.6% before DGA, 55.8% after DGA). More children lived with grandparents (61.8% before DGA, 54.5% after DGA) than only with parents (20.2% before DGA, 26.0% after DGA). In total, 73.0% (65/89) children before DGA brushed teeth more than twice a day. This proportion increased to 90.9% after DGA (70/77, = 0.03). The eating difficulty decreased after DGA according to ECOHIS ( = 0.01). CFSS-DS score also decreased after DGA ( < 0.05). After DGA, children's oral hygiene habits and oral health-related quality of life (OHRQoL) improved, children fear for dental treatment decreased, and parents became more attentive towards children oral health.
Topics: Humans; Anesthesia, General; Oral Health; Female; Child, Preschool; Male; Anesthesia, Dental; Child; Quality of Life; Dental Care for Children; Oral Hygiene; Health Behavior; Child Behavior; Dental Anxiety; Surveys and Questionnaires
PubMed: 38755987
DOI: 10.22514/jocpd.2024.063 -
Italian Journal of Pediatrics May 2024Type 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades...
BACKGROUND
Type 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades the literature, however, there is less discussion of the psychological consequences. Mental health difficulties, alexithymia and uncertainty are present in this population, and known to be harmful for the onset, maintenance and worsening of T1DM. This study aimed to evaluate the presence of these phenomena in people with T1DM.
METHODS
105 participants aged between 11 and 17 years old (M: 13.88; SD: 2.16) affected by T1DM were included in the sample. To assess the presence of mental health difficulties, SAFA scales (Depression, Anxiety and Somatic symptoms) were included in the protocol together with TAS-20 and IUS-12, which evaluate the presence and role of alexithymia and intolerance to uncertainty in the sample, respectively.
RESULTS
A concerning presence of anxiety, depression and somatic symptoms was found in the sample. Mental health difficulties appeared to be consistently present in the sample, often overcoming pathological thesholds. Alexithymia and uncertainty were also common, highlighting their role in T1DM.
CONCLUSIONS
Active mental health difficulties together with high rates of alexithymia and intolerance to uncertainty were prevalent in the sample of adolescents with diabetes.
Topics: Humans; Adolescent; Diabetes Mellitus, Type 1; Male; Female; Affective Symptoms; Child; Uncertainty; Anxiety; Depression; Mental Health; Prevalence
PubMed: 38755698
DOI: 10.1186/s13052-024-01647-4 -
BMC Oral Health May 2024Dental anxiety is a prevalent issue in society, characterized by an uneasy sensation and anticipation of negative experiences in dental settings. In essence, dental...
BACKGROUND AND AIM
Dental anxiety is a prevalent issue in society, characterized by an uneasy sensation and anticipation of negative experiences in dental settings. In essence, dental anxiety, oral health literacy, and quality of life may have a relationship with each other, however, there is a shortage of evidence examining the interplay between these factors. Therefore, this study aimed to assess the relationship between dental anxiety and oral health literacy (OHL) with oral health-related quality of life (OHRQOL).
METHODS
This is an analytical cross-sectional study conducted on 155 patients referred to the Department of Oromaxillofacial Diseases. Three questionnaires consisting of dental anxiety scale, oral health impact profile- 14, and oral health literacy adult questionnaire were used to measure anxiety, health literacy, and the quality of life-related to oral health. Scores were recorded and analyzed by IBM SPSS 24 software using independent samples T-test and ANOVA. Besides, the confirmatory modeling through the goodness of fit index of the model was applied.
RESULTS
This study involved 155 participants, with a mean age of 38.44 ± 14 years. The majority were females, comprising 99 individuals (63.9%). In this study, 89 patients (57.4%) had dental anxiety. The mean OHL score in the examined participants was 9.88 ± 3.97. Both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on the OHRQOL. There was no significant difference in the mean OHRQOL among the three categories of OHL (p = 0.085). The confirmatory modeling showed that only the fourth (p = 0.065) and fifth (p = 0.146) questions of the OHL questionnaire had no significant effect on the total score of OHL. Besides, both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on OHRQOL. With an increase of one unit in anxiety, the OHRQOL score increases by 0.31 and for a one-unit increase in the OHL score, the OHRQOL score decreases by 0.66 units.
CONCLUSION
In conclusion, it seems that considering various dimensions of oral and dental health can help patients to have reduced psychological anxiety. Notably, further multicenter studies assessing diverse variables related to dental anxiety, OHL, and OHRQOL, and considering more comprehensive study designs with longitudinal follow-up could help provide insights into how changes in dental anxiety and OHL over time affect OHRQOL.
Topics: Humans; Quality of Life; Dental Anxiety; Female; Male; Oral Health; Cross-Sectional Studies; Adult; Health Literacy; Surveys and Questionnaires; Middle Aged
PubMed: 38745147
DOI: 10.1186/s12903-024-04359-7 -
European Journal of Dentistry May 2024The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and...
OBJECTIVE
The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and passive distraction methods using VR during the delivery of inferior alveolar nerve blocks (IANBs) in dental procedures in children.
MATERIAL AND METHODS
The study comprised 45 preschool patients, aged between 4 and 6 years, with no prior dental anesthetic experience. The participants were randomly assigned to three groups based on the sort of management style: Group A used the tell-show-do technique, Group B engaged in passive distraction by watching cartoons using a VR headset, and Group C participated in active distraction by playing games using a controller with the VR headset. Pain and anxiety were evaluated using physiological measurements, namely by analyzing the variations in blood pressure, heart rate, and oxygen saturation before and after the administration of IANB. Psychological assessments were conducted using the Wong-Baker faces scale, Modified Dental Anxiety scale questionnaires, and Revised Face, Legs, Activity, Cry and Consolability scale after administering IANB.
RESULTS
The physiological outcomes revealed no statistically significant differences in blood pressure and oxygen saturation. However, there was a statistically significant increase in the heart rate in group A compared with groups B and C. In terms of psychological measurements, groups B and C exhibited a significant improvement in pain experience and a decrease in anxiety.
CONCLUSION
This study concluded that VR reduced pain and anxiety levels in its passive and active forms.
PubMed: 38744327
DOI: 10.1055/s-0044-1782193 -
Cureus May 2024Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown...
Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown promise in adult studies for reducing procedural anxiety and pain perception, but its effectiveness in pediatric dental settings remains underexplored. Objective This study aims to evaluate the effectiveness of preoperative alpha wave entrainment in alleviating anxiety in gender-specific participants to the interventions. Methods We conducted a randomized controlled trial involving 252 pediatric patients (aged 7-12) with cooperative dispositions. Participants were randomly assigned to either an experimental group receiving alpha wave entrainment or a control group receiving conventional behavior management techniques. The experimental intervention involved 10-minute sessions of binaural beats with visual stimulation designed to induce alpha-wave synchronization. Anxiety levels were assessed using physiological measures (heart rate and blood pressure), both pre- and post-interventions. Results The intervention group demonstrated a significant reduction in heart rate and systolic blood pressure post-intervention compared to the control group. These changes indicate a decrease in anxiety levels, with no significant gender differences in the response to the intervention. Conclusion Alpha wave entrainment effectively reduces dental anxiety in pediatric patients, with similar efficacy observed across genders. This study supports the incorporation of alpha wave entrainment into pediatric dental practices as a viable alternative to traditional anxiety management techniques.
PubMed: 38736759
DOI: 10.7759/cureus.60154 -
Journal of Clinical and Experimental... Apr 2024The objective was to investigate the influence of the material and dimensions of the orthodontic archwire on the pain and anxiety in adult patients in orthodontic...
A pilot study analyzing the influence of the material and the size of the orthodontic archwire on the level of pain and anxiety in adult patients in treatment with brackets: A prospective triple-blind randomized clinical trial.
BACKGROUND
The objective was to investigate the influence of the material and dimensions of the orthodontic archwire on the pain and anxiety in adult patients in orthodontic treatment with brackets.
MATERIAL AND METHODS
A randomized prospective triple-blind clinical pilot study was conducted at the Dental Clinic of the University of Salamanca. The study sample comprised 30 adult patients who started orthodontic treatment with brackets. This sample was divided into two groups: the NiTi group (n=15) and Cu-NiTi group (n=15). Pain was analyzed with a visual analogue scale (VAS) and anxiety with the State-Trait Anxiety Inventory (STAI). Anxiety was assessed at the start of treatment (T0) and after one month (T1). Pain was analyzed at the start of treatment (T0), at different time points at the start (T01), and after 4 (T02), 24 (T03), and 48 hours (T04); these measurements were also recorded one month after starting orthodontic treatment (T11, T12, T13, and T14).
RESULTS
The mean age of patients was 31.3 (± 6.05) years old. The highest level of pain, at the beginning of treatment, was observed after 48 hours (5.57 ± 1.72) and at one month after starting treatment at 24 hours (5.13 ± 1.89), with no significant differences between the two groups. When analyzing anxiety, no differences were observed between groups; the anxiety levels were higher one month after starting treatment compared to the start. Regarding the correlation between pain and anxiety, the NiTi group showed a greater direct relationship (<0.05) between these two variables at the start of treatment in the anxiety trait in relation to pain at T02 and T03 and after a month in T12, T13, and T14.
CONCLUSIONS
In the sample studied, there was no significant influence of the size or material of the orthodontic archwire on pain and anxiety levels. Orthodontics, Brackets, Archwire, Pain, Anxiety, NiTi, Cu-NiTi.
PubMed: 38725824
DOI: 10.4317/jced.61428 -
JMIR Research Protocols May 2024Within hospital systems, diverse subsets of patients are subject to minimally invasive procedures that provide therapeutic relief and necessary health data that are...
BACKGROUND
Within hospital systems, diverse subsets of patients are subject to minimally invasive procedures that provide therapeutic relief and necessary health data that are often perceived as anxiogenic or painful. These feelings are particularly relevant to patients experiencing procedures where they are conscious and not sedated or placed under general anesthesia that renders them incapacitated. Pharmacologic pain management and topical anesthetic creams are used to manage these feelings; however, distraction-based methods can provide nonpharmacologic means to modify the painful experience and discomfort often associated with these procedures. Recent studies support distraction as a useful method for reducing anxiety and pain and as a result, improving patient experience. Virtual reality (VR) is an emerging technology that provides an immersive user experience and can operate through a distraction-based method to reduce the negative or painful experience often related to procedures where the patient is conscious. Given the possible short-term and long-term outcomes of poorly managed pain and enduring among patients, health care professionals are challenged to improve patient well-being during medically essential procedures.
OBJECTIVE
The purpose of this pilot project is to assess the efficacy of using VR as a distraction-based intervention for anxiety or pain management compared to other nonpharmacologic interventions in a variety of hospital settings, specifically in patients undergoing lumbar puncture procedures and bone marrow biopsies at the oncology ward, patients receiving nerve block for a broken bone at an anesthesia or surgical center, patients undergoing a cleaning at a dental clinic, patients conscious during an ablation procedure at a cardiology clinic, and patients awake during a kidney biopsy at a nephrology clinic. This will provide the framework for additional studies in other health care settings.
METHODS
In a single visit, patients eligible for the study will complete brief preprocedural and postprocedural questionnaires about their perceived fear, anxiety, and pain levels. During the procedure, research assistants will place a VR headset on the patient and the patient will undergo a VR experience to distract from any pain felt from the procedure. Participants' vitals, including blood pressure, heart rate, and rate of respiration, will also be recorded before, during, and after the procedure.
RESULTS
The study is already underway, and results support a decrease in perceived pain by 1.00 and a decrease in perceived anxiety by 0.3 compared to the control group (on a 10-point Likert scale). Among the VR intervention group, the average rating for comfort was 4.35 out of 5.
CONCLUSIONS
This study will provide greater insight into how patients' perception of anxiety and pain could potentially be altered. Furthermore, metrics related to the operational efficiency of providing a VR intervention compared to a control will provide insight into the feasibility and integration of such technologies in routine practice.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/52649.
Topics: Humans; Anxiety; Virtual Reality; Pain Management; Pilot Projects; Female; Male; Adult
PubMed: 38722681
DOI: 10.2196/52649 -
SAGE Open Medical Case Reports 2024Dental anxiety is common post-stroke, with many patients unable to receive standard anesthetics. Virtual reality has been increasingly used to manage pain and anxiety in...
Dental anxiety is common post-stroke, with many patients unable to receive standard anesthetics. Virtual reality has been increasingly used to manage pain and anxiety in dentistry, though its use in individuals with stroke is largely unexplored. A case series of two patients with a history of stroke and dental anxiety was conducted at a specialized dental clinic. Patients watched 360°-virtual reality videos in a dental chair using a head-mounted display. Outcomes (patient: dental anxiety and pain, reactions to virtual reality; dental team: system usability, impact on workflow) were assessed using a standard observation tool, questionnaires, and interviews. Both patients wore virtual reality throughout the procedure and reported that the device was comfortable, provided a distraction, and had potential to reduce anxiety/pain. The dentist reported a positive impact on patient anxiety and time to complete procedures, and intends to continue using virtual reality with other stroke patients and clinical populations.
PubMed: 38694905
DOI: 10.1177/2050313X241249910 -
Evaluation of salivary stress markers and inflammatory cytokine levels in peri-implantitis patients.Clinical Oral Investigations May 2024Psychological stress has been identified in some observational studies as a potential factor that may modify and affect periodontal diseases, but there are no similar...
BACKGROUND AND OBJECTIVE
Psychological stress has been identified in some observational studies as a potential factor that may modify and affect periodontal diseases, but there are no similar data for peri-implantitis. The aim of this study was to determine the relationship between interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)α inflammatory cytokines and the psychological stress-related markers, glucocorticoid receptor-α (GRα), and salivary α-amylase (sAA) gene expression levels in saliva samples obtained from healthy implants and peri-implantitis patients.
MATERIALS AND METHODS
The study included a total of 50 systemically healthy subjects. Peri-implant clinical parameters were recorded and psychological stress level was evaluated with the hospital anxiety and depression scale (HAD) and state-trait anxiety inventory (STAI) questionnaire forms. Following the evaluations, the patients were divided into 4 groups according their stress and clinical status (Ia, Ib, IIa, IIb). IL-1β, IL-6, IL-10, IFNα, GRα, sAA gene expression levels in the saliva samples were quantified by quantitative polymerase chain reaction (qPCR).
RESULTS
In the group of peri-implantitis who had a high score in stress level assessment scales, significantly higher IL-1β, IL-6, sAA expression levels were observed (p < 0.001). The IL-10 gene expression levels were lower in the groups with a high score in the stress level assessment scales (p < 0.001). GRα gene was expressed at lower levels in the group of peri-implantitis who had a high score in stress level assessment scales but the difference was not statistically significant (p = 0.065).
CONCLUSION
The study findings suggest that psychological stress may increase the inflammation associated with peri-implantitis by affecting cytokine expression levels.
CLINICAL RELEVANCE
To prevent peri-implantitis or reduce its prevalence, it could be beneficial to evaluate stress levels and identify individuals experiencing stress.
Topics: Humans; Peri-Implantitis; Saliva; Male; Female; Cytokines; Biomarkers; Stress, Psychological; Middle Aged; Adult; Surveys and Questionnaires
PubMed: 38691206
DOI: 10.1007/s00784-024-05692-5