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Boyd DH, Foster Page LA, Moffat SM, Thomson WM. Time to complain about pain: Children's self-reported procedural pain in a randomised control trial of Hall and conventional stainless steel crown techniques. Int J Paediatr Dent 2023; 33:382-393. [PMID: 36841968 DOI: 10.1111/ipd.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/21/2022] [Accepted: 02/18/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Children's pain in dentistry has undesirable short- and long-term consequences; therefore, less invasive treatments merit consideration. AIM To investigate procedural pain scores for two treatments for carious primary molars in New Zealand primary care. DESIGN This study was a split-mouth randomised control trial, with secondary outcome analysis. Children (4-8 years) with proximal carious lesions on matched primary molars had one tooth treated with the Hall technique (HT) and one treated with a conventional stainless steel crown (CT); treatment type and order of treatment were randomly allocated (allocation concealment). The Wong-Baker self-report pain scale measured pretreatment dental pain, procedural pain at each treatment and post-operative pain. RESULTS Data were analysed for 103 children: 49 children had the HT first and 54 children had the CT first. Procedural pain scores did not differ by treatment type, with 71.8% and 76.7% of children reporting low pain for the HT and the CT, respectively. Fewer children reported low procedural pain for the second treatment than the first (p = .047). Most children reported low procedural pain for both treatments (58.3%), although 41.7% experienced moderate-high procedural pain with at least one treatment. CONCLUSIONS The HT caused pain for as many children as the CT. There is an opportunity for better dental pain management in this setting.
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Affiliation(s)
- Dorothy H Boyd
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lyndie A Foster Page
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Susan M Moffat
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Berlin H, Hallberg U, Ridell K, Toft D, Klingberg G. A grounded theory study on Swedish 10 to 16-year-olds' perceptions of pain in conjunction with orthodontically indicated tooth extraction. Acta Odontol Scand 2023; 81:235-240. [PMID: 36070618 DOI: 10.1080/00016357.2022.2119163] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Children frequently experience pain and/or discomfort during dental treatment. Still, pain research in dentistry has mainly been performed on adults using quantitative methods while research on the child's perspective is scarce. This study aims to explore and describe children's experiences and/or thoughts regarding pain in conjunction with tooth extraction. MATERIAL AND METHODS Interviews were carried out with twelve Swedish 10-16-year-olds who had recently undergone tooth extractions due to orthodontic reasons. Interviews were transcribed verbatim and analysed according to grounded theory. RESULTS A core category was identified and named 'handling the unavoidable unknown'. The informants recalled experiences of pain and discomfort during extractions. However, instead of focussing on pain, they described an urge for more information about the procedure and what to expect in terms of pain and/or discomfort, during and/or after treatment. They stated that the levels of pain/discomfort were manageable, while the lack of information negatively affected their coping abilities, causing feelings of unease. CONCLUSIONS To improve patients' ability to deal with pain in conjunction with dental extraction, the dental team should ensure better and individually tailored information about the treatment. Thus, the use of psychological techniques is a cornerstone in pain management and must be reflected in clinical guidelines.
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Affiliation(s)
- Henrik Berlin
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ulrika Hallberg
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Karin Ridell
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Gunilla Klingberg
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
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Comparison of the effectiveness of intraligamentary anesthesia and inferior alveolar nerve block on mandibular molar teeth in pediatric patients: a randomized controlled clinical study. Clin Oral Investig 2023:10.1007/s00784-023-04911-9. [PMID: 36773129 DOI: 10.1007/s00784-023-04911-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES The study aimed to compare the two local anesthetic techniques: inferior alveolar nerve block (IANB) and intraligamentary anesthesia (ILA) during the restorative treatment of mandibular first permanent molars in pediatric patients. MATERIALS AND METHODS In this randomized, controlled, cross-over, single-blind, split-mouth study, participants were divided into two groups: group 1, ILA in the first session and IANB in the second session, and group 2, IANB in the first session and ILA in the second session. The pain perception was analyzed using the visual analog scale (VAS) and Wong-Baker FACES pain rating scale (WBFPRS). Heart rate, arterial oxygen saturation (SpO2), and postoperative complications were recorded. The data were analyzed with the Brunner-Langer model, Spearman correlation analysis, Fisher's exact t-test, chi-square, and McNemar tests. RESULTS Seventy-eight patients aged between 6 and 12 years were included. The session effect was not statistically significant in ILA (p = 0.762 and p = 0.411) for pain scores while it was significant in IANB (p < 0.001 for each score). There was no significant difference in the VAS, WBFPRS, heart rate, and SpO2 between the anesthesia techniques (p = 0.454, p = 0.436, p = 0.406, p = 0.285, respectively). Postoperative complications increased in the IANB technique in the first session. CONCLUSIONS Intraligamentary anesthesia may be an alternative technique to IANB for the restorative treatment of mandibular first permanent molars in pediatric patients. In the first session, clinicians may choose the ILA instead of IANB. CLINICAL RELEVANCE In clinical procedures, administering anesthesia, which is effective, is less painful, and poses relatively low complication risk, has significant importance in sustaining children's cooperation with dental treatment.
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Rienhoff S, Splieth CH, Veerkamp JSJ, Rienhoff J, Krikken JB, Campus G, Wolf TG. Hypnosis and Sedation for Anxious Children Undergoing Dental Treatment: A Retrospective Practice-Based Longitudinal Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050611. [PMID: 35626788 PMCID: PMC9139918 DOI: 10.3390/children9050611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/05/2022] [Accepted: 04/21/2022] [Indexed: 12/11/2022]
Abstract
To assess whether the treatment of children with oral midazolam and pediatric hypnosis techniques can improve the compliance in consecutive sessions, a retrospective longitudinal practice-based observational study was designed and carried out. A total of 311 children between 3 and 12 years of age were treated under hypnosis and sedation with midazolam (0.40 mg/kg body weight). Treatments were performed in one to a maximum of three sessions. A total of 183 children received one, 103 received two and 25 children received three treatment sessions. The behavior of the children during the sessions was examined by means of the Venham score. The self-evaluation of the children was based on the Wong−Baker Scale. Child behavior using midazolam and hypnosis techniques showed little difference and good compliance between the sessions. Venham scores did not increase significantly regarding total treatment from the first (0.99 ± 1.41) to the second (1.17 ± 1.39) and to the third session (1.27 ± 1.20) (p > 0.05). However, considering the highest Venham scores that occurred in each case, the behavior of the children worsened significantly (p < 0.01) during the three treatment sessions, from 1.37 ± 1.31 (first) to 1.87 ± 1.74 (second) to 2.32 ± 1.33 (third). In 6.11% of the children, treatment was discontinued in the first session (n = 19), 0.96% in the second (n = 3) and 0% in the third. Treatment with low-dose midazolam, combined with hypnosis techniques, showed to be an effective option for dental treatment in children. Within the limitations of the current study, and with consideration of highest possible compliance, no more than two treatment sessions for pediatric dental treatment should be performed.
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Affiliation(s)
- Sabine Rienhoff
- Pediatric Dental Practice, D-30177 Hannover, Germany; (S.R.); (J.R.)
| | - Christian H. Splieth
- Department of Preventive and Pediatric Dentistry, Center for Oral Health, Ernst Moritz Arndt University Greifswald, D-17475 Greifswald, Germany;
| | | | - Jan Rienhoff
- Pediatric Dental Practice, D-30177 Hannover, Germany; (S.R.); (J.R.)
| | - Janneke B. Krikken
- Snoet Kindermondzorgcentrum, Pediatric Dental Practice, NL-1061 Amsterdam, The Netherlands;
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, I-07100 Sassari, Italy
- Correspondence: ; Tel.: +41-31-632-2580
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, D-55131 Mainz, Germany
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Teles LR, Perazzo MF, Paiva SM, Shetty R, Huebner R, Martins-Júnior PA, Serra-Negra JM. Validation of the Brazilian Version of the RMS Tactile Scale (B-RMS-TS). Braz Dent J 2021; 32:84-91. [PMID: 34755793 DOI: 10.1590/0103-6440202104173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/08/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to validate the Brazilian version of the RMS Tactile Scale (B-RMS-TS) in children and adolescents with visual impairment. Ten visually impaired children and adolescents between 10 and 17 years old of an Educational Center for Visually Impaired People answered the verbalized Dental Anxiety Scale (DAS), and the DAS in Braille to evaluate their dental anxiety levels. B-RMS-TS construct validity was assessed by convergent and discriminant validity. Convergent validity was tested in two ways: Pearson's correlation between the B-RMS-TS and the overall anxiety question; Pearson's correlation between B-RMS-TS and verbalized DAS and DAS in Braille. B-RMS-TS reliability was measured by internal consistency (Cronbach's alfa and McDonald's omega) and test-retest reliability (ICC). B-RMS-TS was moderately correlated to the overall anxiety question (r=0.493;p=0.147). B-RMS-TS showed excellent correlation with verbalized DAS (r=0.971;p<0.001) and DAS in Braille (r=0.934;p<0.011). B-RMS-TS was able to discriminate dental anxiety levels between male and female (p=0.008). The B-RMS-TS demonstrated excellent reliability (Cronbach's alpha=0.661, McDonald's omega=0.700 and ICC=0.987; 95%CI=0.817-0.999). B-RMS-TS is valid and reliable to measure dental anxiety levels in Brazilian children and adolescents with visual impairment.
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Affiliation(s)
- Lucas Rodrigues Teles
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Matheus França Perazzo
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Saul Martins Paiva
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Raghavendra Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates.,Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Rudolf Huebner
- Department of Mechanical Engineering, Laboratory of Bioengineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Júnia Maria Serra-Negra
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Monteiro J, Tanday A, Ashley PF, Parekh S, Alamri H. Interventions for increasing acceptance of local anaesthetic in children and adolescents having dental treatment. Cochrane Database Syst Rev 2020; 2:CD011024. [PMID: 32104910 PMCID: PMC7045283 DOI: 10.1002/14651858.cd011024.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Delivery of pain-free dentistry is crucial for reducing fear and anxiety, completion of treatment, and increasing acceptance of future dental treatment in children. Local anaesthetic (LA) facilitates this pain-free approach but it remains challenging. A number of interventions to help children cope with delivery of LA have been described, with no consensus on the best method to increase its acceptance. OBJECTIVES To evaluate the effects of methods for acceptance of LA in children and adolescents during dental treatment. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the Cochrane Oral Health's Trials Register (to 24 May 2019); the Cochrane Central Register of Controlled Trials (CENTRAL; 2019 Issue 4) in the Cochrane Library (searched 24 May 2019); MEDLINE Ovid (1946 to 24 of May 2019); Embase Ovid (1980 to 24 May 2019); and Web of Science (1900 to 24 May 2019). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and World Health Organization International Clinical Trials Registry Platform were also searched to 24 May 2019. There were no restrictions on language or date of publications. SELECTION CRITERIA Parallel randomised controlled trials (RCTs) of interventions used to increase acceptance of dental LA in children and adolescents under the age of 18 years. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. We performed data extraction and assessment of risk of bias independently and in duplicate. We contacted authors for missing information. We assessed the certainty of the body of evidence using GRADE. MAIN RESULTS We included 26 trials with 2435 randomised participants aged between 2 and 16 years. Studies were carried out between 2002 and 2019 in dental clinics in the UK, USA, the Netherlands, Iran, India, France, Egypt, Saudi Arabia, Syria, Mexico, and Korea. Studies included equipment interventions (using several LA delivery devices for injection or audiovisual aids used immediately prior to or during LA delivery or both) and dentist interventions (psychological behaviour interventions delivered in advance of LA (video modelling), or immediately prior to or during delivery of LA or both (hypnosis, counter-stimulation). We judged one study to be at low risk and the rest at high risk of bias. Clinical heterogeneity of the included studies rendered it impossible to pool data into meta-analyses. None of the studies reported on our primary outcome of acceptance of LA. No studies reported on the following secondary outcomes: completion of dental treatment, successful LA/painless treatment, patient satisfaction, parent satisfaction, and adverse events. Audiovisual distraction compared to conventional treatment: the evidence was uncertain for the outcome pain-related behaviour during delivery of LA with a reduction in negative behaviour when 3D video glasses where used in the audiovisual distraction group (risk ratio (RR) 0.13, 95% confidence interval (CI) 0.03 to 0.50; 1 trial, 60 participants; very low-certainty evidence). The wand versus conventional treatment: the evidence was uncertain regarding the effect of the wand on pain-related behaviour during delivery of LA. Four studies reported a benefit in using the wand while the remaining studies results suggested no difference between the two methods of delivering LA (six trials, 704 participants; very low-certainty evidence). Counter-stimulation/distraction versus conventional treatment: the evidence was uncertain for the outcome pain experience during delivery of LA with children experiencing less pain when counter-stimulation was used (RR 0.12, 95% CI 0.04 to 0.34; 1 trial, 134 participants; very low-certainty evidence). Hypnosis versus conventional treatment: the evidence was uncertain for the outcome pain experience during delivery of LA with participants in the hypnosis group experiencing less pain (mean difference (MD) -1.79, 95% CI -3.01 to -0.57; 1 trial, 29 participants; very low-certainty evidence). Other comparisons considered included pre-cooling of the injection site, the wand versus Sleeper One, the use of a camouflage syringe, use of an electrical counter-stimulation device, and video modelling acclimatisation, and had a single study each. The findings from these other comparisons were insufficient to draw any affirmative conclusions about their effectiveness, and were considered to be very low-certainty evidence. AUTHORS' CONCLUSIONS We did not find sufficient evidence to draw firm conclusions as to the best interventions to increase acceptance of LA in children due to variation in methodology and nature/timing of outcome measures. We recommend further parallel RCTs, reported in line with the CONSORT Statement. Care should be taken when choosing outcome measures.
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Affiliation(s)
- Joana Monteiro
- UCL Eastman Dental InstituteUnit of Paediatric Dentistry, Department of Craniofacial Growth and Development256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Ajit Tanday
- UCL Eastman Dental InstituteUnit of Paediatric Dentistry, Department of Craniofacial Growth and Development256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Paul F Ashley
- UCL Eastman Dental InstituteUnit of Paediatric Dentistry, Department of Craniofacial Growth and Development256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Susan Parekh
- UCL Eastman Dental InstituteUnit of Paediatric Dentistry, Department of Craniofacial Growth and Development256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Hamdan Alamri
- The University of ManchesterPhD student at School of Medical Sciences, Division of DentistryManchesterUK
- College of Dentistry, Majmaah UniversityDepartment of Preventive DentistryAl Majma'ahSaudi Arabia
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Cademartori MG, Costa VPP, Corrêa MB, Goettems ML. The influence of clinical and psychosocial characteristics on children behaviour during sequential dental visits: a longitudinal prospective assessment. Eur Arch Paediatr Dent 2019; 21:43-52. [PMID: 31066016 DOI: 10.1007/s40368-019-00444-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 04/25/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE This is the first study to adopt a multilevel approach to assess the impact of the order of dental visits on child's behaviour. The aim was to investigate which factors directly interfere with child's behaviour regardless of the order of sequential dental visits. METHODS In this prospective longitudinal study, children aged 7-12 years were invited to participate. Child behaviour was assessed using the Frankl Scale during four sequential dental visits. Chi-square test was used to analyse the effect of dental fear on children's non-cooperative behaviour according to the presence of dental fear. Multilevel mixed logistic regression model was used to assess the association between predictor variables and the outcome (child behaviour) during the sequential dental visits. RESULTS Overall, 111 children participated in this study. Maternal dental anxiety, dental pain and complexity of the treatment were associated with the non-cooperative behaviour in children aged 7-12 years. When stratified by dental fear, the complexity of the treatment remained associated with non-cooperative behaviour. CONCLUSIONS The results provide evidence that, even with the familiarization of child with the dental environment, maternal dental anxiety, dental pain in the last month, and the complexity of dental treatment negatively affect the children's behaviour aged 7-12 years.
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Affiliation(s)
- M G Cademartori
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves Street, Pelotas, RS, Brasil.
- School of Dentistry (UFPel), 457, Gonçalves Chaves Street, Pelotas, RS, Brasil.
| | - V P P Costa
- Department of Social and Preventive Dentistry and Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves Street, Pelotas, RS, Brasil
- School of Dentistry (UFPel), 457, Gonçalves Chaves Street, Pelotas, RS, Brasil
| | - M B Corrêa
- Department of Dentistry and Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves Street, Pelotas, RS, Brasil
- School of Dentistry (UFPel), 457, Gonçalves Chaves Street, Pelotas, RS, Brasil
| | - M L Goettems
- Department of Social and Preventive Dentistry and Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves Street, Pelotas, RS, Brasil
- School of Dentistry (UFPel), 457, Gonçalves Chaves Street, Pelotas, RS, Brasil
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Merdad L, El-Housseiny AA. Do children's previous dental experience and fear affect their perceived oral health-related quality of life (OHRQoL)? BMC Oral Health 2017; 17:47. [PMID: 28093086 PMCID: PMC5240375 DOI: 10.1186/s12903-017-0338-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 01/06/2017] [Indexed: 11/30/2022] Open
Abstract
Background Oral health-related quality of life (OHRQoL) has been used to describe the consequences of oral health conditions and treatments in children. A better understanding of OHRQoL and its relationship with dental fear and previous dental experience is necessary to improve children’s oral health status. The aim of this study was to investigate the association of dental history and experience with dental fear and the OHRQoL of children aged 11 to 14 years. Methods A cross-sectional study was conducted using a multi-stage stratified sample of 1,312 middle school children. Information regarding OHRQoL was collected from the children using the Child Perceptions Questionnaire (CPQ11–14), and information regarding dental fear was collected using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS). Information on past dental experiences and sociodemographic data were collected from the parents using self-administered questionnaires. Dental examinations were performed to assess caries experience. Results The multivariable model indicated that dental fear was the strongest predictor of OHRQoL as the fearful children had on average CPQ11–14 scores that were 10 units higher than those of the non-fearful children. Regarding past dental experience, pain as the reason for the most recent dental visit was associated with poor OHRQoL, while receiving a filling during the previous dental visits was significantly associated with better OHRQoL. In addition, a larger number of siblings, a lower family income, a lower paternal education level, health problems and prior hospitalization were significantly associated with poor OHRQoL. Conclusion This study identified that dental fear and some factors related to previous dental experience are associated with OHRQoL. In dental practice, children with dental fear should be identified, guided and treated early to avoid deterioration of their OHRQoL. Electronic supplementary material The online version of this article (doi:10.1186/s12903-017-0338-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Leena Merdad
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, 21589, Jeddah, Saudi Arabia.
| | - Azza A El-Housseiny
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Pediatric Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Thoppe-Dhamodhara YK, Asokan S, John BJ, Pollachi-Ramakrishnan G, Ramachandran P, Vilvanathan P. Cartridge syringe vs computer controlled local anesthetic delivery system: Pain related behaviour over two sequential visits - a randomized controlled trial. J Clin Exp Dent 2015; 7:e513-8. [PMID: 26535099 PMCID: PMC4628807 DOI: 10.4317/jced.52542] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 07/18/2015] [Indexed: 11/05/2022] Open
Abstract
Background Local anesthetic injection is one of the most anxiety provoking procedure in dentistry. Knowledge about change in pain related behaviour during consecutive visits helps in and scheduling of treatment procedures and management of children in dental clinic. Aim To compare the pain perception, behavioural response and the associated change in physiological parameters while receiving local anesthesia injection with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD) over two consecutive visits. Material and Methods In this randomized controlled cross over trial, 120 children aged 7 – 11 years were randomly divided into group A: receiving injections with CCLAD during first visit; group B: receiving injections with cartridge syringe during first visit. The physiological parameters (heart rate and blood pressure) were recorded before and during injection procedure. Objective evaluation of disruptive behaviour and subjective evaluation of pain perceived were done using Face Legs Activity Cry Consolability (FLACC) scale and modified facial image scale (FIS) respectively. Results No statistical difference in pain response (p= 0.164) and disruptive behaviour (p = 0.120) between cartridge syringe and CCLAD injections were seen during the first visit although the latter showed lesser scores. However, during the second visit there were significant increase in pain response (p = 0.004) and disruptive behaviour (p = 0.006) in cartridge syringe group with an associated increase in heart rate. Conclusions Injections with CCLAD produced lesser pain ratings and disruptive behaviour than cartridge syringe in children irrespective of order of visit. Key words:Behaviour, cartridge syringe, CCLAD, local anesthesia.
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Affiliation(s)
- Yogesh-Kumar Thoppe-Dhamodhara
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, TamilNadu, India
| | - Sharath Asokan
- Professor, Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, TamilNadu, India
| | - Baby-John John
- Professor and Head of Department, Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, TamilNadu, India
| | - GeethaPriya Pollachi-Ramakrishnan
- Reader, Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, TamilNadu, India
| | - Punithavathy Ramachandran
- Reader, Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, TamilNadu, India
| | - Praburajan Vilvanathan
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, TamilNadu, India
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Comparative efficacy of active and passive distraction during restorative treatment in children using an iPad versus audiovisual eyeglasses: a randomised controlled trial. Eur Arch Paediatr Dent 2014; 16:1-8. [PMID: 25416522 DOI: 10.1007/s40368-014-0136-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 06/16/2014] [Indexed: 10/24/2022]
Abstract
AIM This study aimed to compare the effects of two types of distraction techniques: passive, using audiovisual glasses (AV glasses), versus active, using an iPad, as an adjunct to local analgesia during vital pulp therapy in children. METHODS Pain behaviour, and heart rates from an exposure group (treatment with the aid of an iPad) and control group (treatment with the aid of AV glasses) were compared in a randomised, split-mouth design using the Wilcoxon signed rank test (pain and behaviour) and paired t test for heart rate scores at p 0.05. RESULTS Children (39) (mean age 6.27 years) received the two treatment sessions. Generally, AV glasses had higher pain and behaviour scores than iPad. Pain results demonstrated marginal significant differences between the two distraction techniques during local analgesia administration (p 0.076) and caries removal (p 0.071). A significant difference between the two techniques during local analgesia administration only (p 0.017), in favour of an iPad. Average heart rates over the treatment intervals were lower among iPad group than those using AV glasses group. Patients preferred an iPad more than AV glasses (24 versus 15). Treatment sessions were significantly shorter for iPad. CONCLUSIONS Active distraction using an iPad demonstrated better performance than passive distraction using AV glasses.
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Monteiro J, Tanday A, Ashley PF, Parekh S, Petrie A. Interventions for increasing acceptance of local anaesthetic in children having dental treatment. Hippokratia 2014. [DOI: 10.1002/14651858.cd011024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Joana Monteiro
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Ajit Tanday
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Paul F Ashley
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Susan Parekh
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Aviva Petrie
- UCL Eastman Dental Institute; Biostatistics Unit; 256 Gray's Inn Road London UK WC1X 8LD
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