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Wu W, Le May S, Hung N, Fortin O, Genest C, Francoeur M, Guingo E, St-Arneault K, Sylfra A, Vu AK, Carmel J, Lessard L, Cara-Slavich S, De Koven K, Paquette J, Hoffman H, Asselin ME. Effects of a Virtual Reality Game on Children's Anxiety During Dental Procedures (VR-TOOTH): Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49956. [PMID: 37948113 PMCID: PMC10674143 DOI: 10.2196/49956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Dental fear and anxiety (DFA) is a condition that affects approximately one-quarter of children and adolescents. It is a significant cause for pediatric patients to avoid dental care later in adulthood. Lack of patient cooperation due to DFA can create an environment of stress, often obligating dentists to end appointments prematurely and consider alternative pharmacological treatment options. Virtual reality (VR) use during dental care, providing an immersive experience through sensory stimuli, is potentially an additional nonpharmacologic tool to better manage DFA in children with special health care needs (SHCN) undergoing dental procedures. OBJECTIVE This pilot study aims to assess the feasibility and acceptability of VR immersion as a tool to reduce DFA in pediatric special needs patients undergoing dental procedures. The study also aims to gain insight on parent and health care provider perspectives on the use of VR during dental appointments. METHODS This pilot randomized controlled trial study will follow a parallel design including 2 groups: a control group (clinic's standard care using a wall TV) and an experimental group (using a VR game). We will randomize 20 participants to either group. Recruitment will be carried out at the dental clinic of the Centre Hospitalier Universitaire Sainte-Justine, a tertiary-quaternary care center that mostly serves pediatric patients with SHCN. The primary outcome will be patient recruitment rates and completion rates of planned procedures. DFA in children will be assessed using both an observation-based proxy assessment with the Venham Anxiety and Behavior Rating Scale and physiological assessments using parameters such as change in heart rate and levels of salivary alpha-amylase as a stress biomarker before and 10 minutes after the procedure. Sociodemographic characteristics, measures of the levels of parent and health care professional satisfaction, occurrence of side effects, and any deviation from normal procedure length will also be collected. Descriptive statistics, nonparametric tests, and effect sizes will be used for demographic and clinical variables and to present parent and health care professional satisfaction levels as well as procedural time. RESULTS This study will be conducted from May 2023 to May 2024, with results expected to be available in December 2024. CONCLUSIONS The pilot study will provide insight on the feasibility and acceptability of VR use in clinical dentistry to reduce DFA for pediatric patients with SHCN. This study will guide future research on VR use in pediatric dentistry and can serve as a framework for a larger randomized clinical trial. TRIAL REGISTRATION ClinicalTrials.gov NCT05898100; https://classic.clinicaltrials.gov/ct2/show/NCT05898100. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49956.
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Affiliation(s)
- Wenjia Wu
- Department of Dental Medicine, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
| | - Sylvie Le May
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Nicole Hung
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Olivier Fortin
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Christine Genest
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Trauma Studies Centre, Le Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
| | - Maxime Francoeur
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Estelle Guingo
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Université du Québec en Abitibi-Témiscamingue, Quebec, QC, Canada
| | - Kate St-Arneault
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Annie Sylfra
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - An Kateri Vu
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Janick Carmel
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Laurence Lessard
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Stephany Cara-Slavich
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Katheryn De Koven
- Department of Anesthesia, Centre Hospitalier Universitaire St-Justine Hospital, Montreal, QC, Canada
| | - Julie Paquette
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | | | - Marie-Eve Asselin
- Department of Dental Medicine, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
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Aldafaai RR, Jafar Z, Al-Rubbaey Y. Impact of dental anxiety on dental caries and salivary alkaline phosphatase in children across different nutritional statuses. J Med Life 2023; 16:1540-1545. [PMID: 38313167 PMCID: PMC10835552 DOI: 10.25122/jml-2023-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/15/2023] [Indexed: 02/06/2024] Open
Abstract
Dental anxiety is a familiar problem among children, which may affect their oral health. This cross-sectional study aimed to evaluate dental anxiety during the first dental examination in relation to dental caries and salivary alkaline phosphatase, taking into account the nutritional status of children. Eighty-two children (45 boys and 37 girls), aged six to eight years old (average 6.96), were recruited from public clinics in Baghdad city. Participants were divided into the anxious and the non-anxious groups according to physiological measures (oxygen saturation and heart rate) before the first dental treatment. The weight and height of each child were measured to determine the nutritional status (normal weight, overweight, and obese). Dental caries (prevalence and severity) in children with different nutritional statuses were recorded using dmf, DMF, and the guidelines outlined by Manjie et al. Saliva was collected to analyze salivary alkaline phosphatase. No statistically significant differences were observed between anxious and non-anxious children in means of dmf and DMF indices (teeth and surfaces) in primary and permanent teeth (p>0.05) in the three nutritional status groups. However, non-anxious children exhibited a higher mean of d1 (initial enamel caries) compared to anxious children, with statistical significance (p<0.05) observed only in normal-weight children. Salivary alkaline phosphatase was not significantly different between the two groups. In conclusion, dental anxiety did not appear to significantly impact caries development in primary teeth or salivary alkaline phosphatase levels in children with varying nutritional statuses. Anxiety reduced the initial enamel caries in normal-weight children.
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Affiliation(s)
- Raya Rashid Aldafaai
- Department of Clinical Sciences, College of Dentistry, Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq
| | - Zainab Jafar
- Department of Pedodontics and Preventive Dentistry, College of Dentistry, University of Baghdad, Iraq
| | - Yamama Al-Rubbaey
- Department of Clinical Sciences, College of Dentistry, Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq
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3
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Min H, Zhu S, Safi L, Alkourdi M, Nguyen BH, Upadhyay A, Tran SD. Salivary Diagnostics in Pediatrics and the Status of Saliva-Based Biosensors. BIOSENSORS 2023; 13:206. [PMID: 36831972 PMCID: PMC9953390 DOI: 10.3390/bios13020206] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Salivary biomarkers are increasingly being used as an alternative to diagnose and monitor the progression of various diseases due to their ease of use, on site application, non-invasiveness, and most likely improved patient compliance. Here, we highlight the role of salivary biosensors in the general population, followed by the application of saliva as a diagnostic tool in the pediatric population. We searched the literature for pediatric applications of salivary biomarkers, more specifically, in children from 0 to 18 years old. The use of those biomarkers spans autoimmune, developmental disorders, oncology, neuropsychiatry, respiratory illnesses, gastrointestinal disorders, and oral diseases. Four major applications of salivary proteins as biomarkers are: (1) dental health (caries, stress from orthodontic appliances, and gingivitis); (2) gastrointestinal conditions (eosinophilic esophagitis, acid reflux, appendicitis); (3) metabolic conditions (obesity, diabetes); and (4) respiratory conditions (asthma, allergic rhinitis, small airway inflammation, pneumonia). Genomics, metabolomics, microbiomics, proteomics, and transcriptomics, are various other classifications for biosensing based on the type of biomarkers used and reviewed here. Lastly, we describe the recent advances in pediatric biosensing applications using saliva. This work guides scientists in fabricating saliva-based biosensors by comprehensively overviewing the potential markers and techniques that can be employed.
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Affiliation(s)
- Hayeon Min
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Science, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - Sophie Zhu
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Science, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - Lydia Safi
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Science, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - Munzer Alkourdi
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Science, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | | | - Akshaya Upadhyay
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Science, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - Simon D. Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Science, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
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Sriboonlert J, Munkong W, Rintawut S, Paladkhua S, Suwongsa R, Kirisattayakul W. Cananga odorata Aromatherapy Reduces Anxiety in Unexperienced Patients Hospitalized for Interventional Neuroradiology Procedures: A Randomized Control Trial. J Evid Based Integr Med 2023; 28:2515690X221150527. [PMID: 36659818 PMCID: PMC9871980 DOI: 10.1177/2515690x221150527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures.
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Affiliation(s)
- Jetsada Sriboonlert
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Waranon Munkong
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Sunantha Rintawut
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Soodjai Paladkhua
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Ratchalita Suwongsa
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Woranan Kirisattayakul
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand,Woranan Kirisattayakul, Department of
Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002,
Thailand.
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5
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Barbosa NB, Rodrigues BR, Madalena IR, de Menezes FCH, Lepri CP, de Oliveira MBCR, Campos MGD, Oliveira MAHDM. Effect of the Case for Carpule as a Visual Passive Distraction Tool on Dental Fear and Anxiety: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1793. [PMID: 36767161 PMCID: PMC9914409 DOI: 10.3390/ijerph20031793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
The present cross-over study aimed to evaluate the effect of a visual passive distraction tool, a case for carpule, in the management of fear and anxiety during invasive dental treatment. Children between the ages of 4 and 8 years that need at least two treatments with inferior alveolar nerve block were selected. All the included children received two treatments at different moments: in one treatment, local anesthesia was performed with a visual passive distraction tool, the crocodile case, for carpule (experimental); in the other treatment, local anesthesia was performed without the device (control). An evaluation of the anxiety levels was performed by measuring the heart rate and salivary cortisol levels. Wilcoxon's nonparametric test was used for a data analysis (p < 0.05). The mean heart rate with the visual passive distraction device fell from 81.8 to 78.1, while the control rose from 91.4 to 100 (p < 0.05). The mean salivary cortisol levels with the visual passive distraction device fell from 2.0 to 1.6, while in the control, they rose from 2.1 to 2.4 (p < 0.05). In conclusion, the crocodile case for carpule as a visual passive distraction device contributed positively to the management of fear and anxiety during inferior alveolar nerve block in children.
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Affiliation(s)
| | | | - Isabela Ribeiro Madalena
- Department of Biomaterials, University of Uberaba-UNIUBE, Uberaba 38010-200, MG, Brazil
- Department of Dentistry, University of Joinville Region-UNIVILLE, Joinville 89219-710, SC, Brazil
- School of Dentistry, Presidente Tancredo de Almeida Neves University Center-UNIPTAN, São João del Rei 36307-251, MG, Brazil
| | | | - César Penazzo Lepri
- Department of Biomaterials, University of Uberaba-UNIUBE, Uberaba 38010-200, MG, Brazil
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6
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Parlak HM, Buber E, Gur AT, Karabulut E, Akalin FA. Statherin and alpha-amylase levels in saliva from patients with gingivitis and periodontitis. Arch Oral Biol 2023; 145:105574. [DOI: 10.1016/j.archoralbio.2022.105574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022]
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7
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Gomes HDS, Anabuki AA, Viana KA, Abreu LG, Batista AC, Hosey MT, Costa LR. Assessment of child's dental anxiety/fear and stress during dental treatment: a systematic review by CEDACORE. Braz Oral Res 2022; 36:e067. [PMID: 36507754 DOI: 10.1590/1807-3107bor-2022.vol36.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 02/18/2022] [Indexed: 12/15/2022] Open
Abstract
There is a lack of evidence on the correlation between salivary biomarkers and subjective measures of dental fear and anxiety in children. This systematic review aimed to retrieve the scientific evidence comparing the results of dental anxiety measured by salivary biomarkers with patient-reported outcomes in pediatric dental setting. The PECOS was as follows: population: pediatric patients aged ≤ 18 years; exposure: patient-reported outcome measures, such as scales and/or questionnaires; comparator: salivary biomarkers; outcome: anxiety, fear, phobia or stress during dental treatment; study design: observational studies or controlled trials. Electronic searches were conducted in PubMed, Scopus, Web of Science, and Ovid databases. Studies that compared scales/questionnaires and salivary biomarkers for the evaluation of dental anxiety, fear, and stress in children/adolescents during dental treatment were included. Certainty of evidence was assessed with GRADE. Risk of bias of the included studies was assessed with the Cochrane tool or the University of Adelaide tool. From the 314 studies identified, eight were included. Participants' age ranged from three to 13 years. The most used salivary biomarkers and instruments were cortisol and the Dental Subscale of the Children's Fear Survey Schedule, respectively. Most studies showed a weak correlation between objective and subjective measures. The main issues regarding bias were on allocation concealment, blinding of assessors, follow up, and exposure assessment. Certainty of evidence was low/very low. Evidence of salivary biomarkers and patient-reported outcome measures to investigate anxiety, fear and stress in children during in the dental environment is limited. There was no correlation between subjective and objective measures in almost all included studies.
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Affiliation(s)
- Heloisa de Sousa Gomes
- Universidade Federal de Goiás - UFG, School of Dentistry, Postgraduate Program in Dentistry, Goiânia, GO, Brasil
| | - Anna Alice Anabuki
- Universidade Federal de Goiás - UFG, School of Dentistry, Postgraduate Program in Dentistry, Goiânia, GO, Brasil
| | - Karoline Alves Viana
- Universidade Federal de Goiás - UFG, School of Dentistry, Postgraduate Program in Dentistry, Goiânia, GO, Brasil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Child and Adolescent Oral Health, Belo Horizonte, MG, Brasil
| | - Aline Carvalho Batista
- Universidade Federal de Goiás - UFG, School of Dentistry, Postgraduate Program in Dentistry, Goiânia, GO, Brasil
| | - Marie Therese Hosey
- King's College London, Centre for Oral Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial, London, United Kingdom
| | - Luciane Rezende Costa
- Universidade Federal de Goiás - UFG, School of Dentistry, Postgraduate Program in Dentistry, Goiânia, GO, Brasil
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8
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Santos SVMD, Silva LAD, Terra FDS, Souza AVD, Espindola FS, Marziale MHP, Teixeira RR, Robazzi MLDCC. Association of salivary alpha-amylase with anxiety and stress in nursing professionals. Rev Lat Am Enfermagem 2021; 29:e3468. [PMID: 34468625 PMCID: PMC8432589 DOI: 10.1590/1518-8345.4859.3468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 02/09/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: to assess if changes in salivary alpha-amylase activity are associated with anxiety and stress among hospital nursing professionals and whether anxiety and stress are associated with sociodemographic, epidemiological, and occupational factors. Method: cross-sectional, quantitative study, carried out with 210 nursing professionals from a hospital. For data collection, we used a questionnaire to characterize workers, Beck’s Anxiety Inventory, Lipp’s Stress Symptoms Inventory for Adults and samples and saliva samples collected in work shifts. The data were analyzed descriptively and inferentially using the software Statistical Package for the Social Science and GraphPad Prism. Results: most professionals experienced stress and anxiety. The variables age group, number of children, use of medication and workload were associated with anxiety; age group, smoking and medication use were associated with stress. An increase in the salivary alpha-amylase activity was observed in the middle of the work shift. Professionals who had stress and anxiety had significant changes in alpha-amylase in the night shift. Conclusion: changes in salivary alpha-amylase were associated with anxiety and stress among nursing professionals, indicating that this enzyme can be a possible biomarker of anxiety and stress in workers.
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Affiliation(s)
- Sergio Valverde Marques Dos Santos
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Universidade do Estado de Minas Gerais, Campus Passos, Passos, MG, Brazil
| | | | | | | | | | - Maria Helena Palucci Marziale
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | | | - Maria Lucia do Carmo Cruz Robazzi
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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9
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Kumari A, Chandra P, Roy S, Agarwal R, Singh A, Sharan S. Evaluation of Preoperative Salivary Cortisol Level in Patients Undergoing Major Maxillofacial Surgery. J Pharm Bioallied Sci 2021; 13:S120-S123. [PMID: 34447058 PMCID: PMC8375804 DOI: 10.4103/jpbs.jpbs_598_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 11/04/2022] Open
Abstract
Aim The main purpose of the study was to compare the preoperative salivary cortisol levels 3 days before the major surgery under general anesthesia and to compare it with the patients undergoing extraction under local anesthesia. Materials and Methods Forty-two patients were undergoing major surgery and 42 age- and sex-matched patients undergoing dental extraction were included and their salivary cortisol levels were analyzed before and after the dental procedure. Results Results showed that there is a significant increase in the mean salivary cortisol concentration after extraction (23.7 ± 9.2) than before extraction (18.9 ± 23.7) in the study group (P = 0.015) as well as in the control group. The comparison between salivary cortisol in the study group before (18.9 ± 23.7) and after (23.7 ± 9.2) surgery was significantly higher than the control group (15.2 ± 5.5) (P = 0.013 and 0.005), respectively. Conclusion We have concluded from this study that the salivary cortisol level shows a significant increase on the day of surgery.
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Affiliation(s)
- Archana Kumari
- Department of Dentistry, VIMS Pawapuri (Nalanda), Patna, Bihar, India
| | - Praveen Chandra
- Department of Prosthodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Sonali Roy
- Department of Dentistry, Nalanda Medical College and Hospital, Patna, Bihar, India
| | - Ritika Agarwal
- Department of Dentistry, Patna Medical College and Hospital, Bihar, India
| | - Aartika Singh
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Sciences, Sharda University Greater Noida, Uttar Pradesh, India
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Effects of Green Color Exposure on Stress, Anxiety, and Pain during Peripheral Intravenous Cannulation in Dental Patients Requiring Sedation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115939. [PMID: 34205936 PMCID: PMC8199048 DOI: 10.3390/ijerph18115939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 12/26/2022]
Abstract
Intravenous cannulation is an invasive procedure that causes stress, anxiety, and pain for many patients. A recent animal study found that exposure to green light induced antinociceptive and anxiolytic effects. This study examined whether green color exposure reduced stress, anxiety, and pain during peripheral intravenous cannulation (PIC) for sedation in dental patients. In this controlled clinical trial, 24 patients (mean age 40.9 years) were randomized to wear clear glasses or green-colored glasses for 15 min before PIC on two separate days in a cross-over manner. The primary outcome measures were salivary alpha-amylase (sAA) activity and stress-related hemodynamic changes, and the secondary outcome measures were the visual analog scale anxiety (VAS-A) and pain (VAS-P) scores during PIC. The sAA level in the clear group significantly increased during PIC compared with baseline, but did not increase in the green group. Median VAS-P scores during PIC were lower in the green group than in the clear group (VAS-P, 17.0 vs. 50.0). Green color exposure with glasses significantly reduced stress and pain during PIC without any adverse effects. This simple, safe, and effective method may be useful during painful medical procedures.
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11
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The calming effect of roasted coffee aroma in patients undergoing dental procedures. Sci Rep 2021; 11:1384. [PMID: 33446795 PMCID: PMC7809118 DOI: 10.1038/s41598-020-80910-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 12/30/2020] [Indexed: 12/25/2022] Open
Abstract
Coffee beverage consumption is well-known to exert various health benefits; however, the effects of coffee aroma are rarely explored. This study aimed to investigate the calming effect of inhaling coffee aroma while the patients underwent dental procedures (probing and scaling). Salivary α-amylase (sAA) and cortisol (sCort) levels were measured as proxies of sympathetic nervous system and hypothalamic–pituitary–adrenal axis responses to stress respectively. Blood pressures and pulse rates were recorded. The results showed that undergoing dental procedures could increase sAA and sCort levels of the patients inhaling sham aroma while those inhaling coffee aroma had significantly decreased sAA and sCort levels (40% and 25% differences, respectively). The pulse rates of those inhaling coffee aroma were also lower. Subjective assessment using visual analog scale was in line with objective measures as well. The preference for coffee aroma or the frequency of coffee drinking had no effect on the sAA and sCort responses. This is the first study to provide evidence on the effect of coffee aroma on sAA and sCort levels in patients undergoing dental procedures.
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Wazzan M, Estaitia M, Habrawi S, Mansour D, Jalal Z, Ahmed H, Hasan HA, Al Kawas S. The Effect of Music Therapy in Reducing Dental Anxiety and Lowering Physiological Stressors. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021393. [PMID: 35075079 PMCID: PMC8823572 DOI: 10.23750/abm.v92i6.11668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/15/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND AIM The anxiolytic effects of music have been studied during the past twenty years in different medical therapies. The aim of this study is to evaluate the effect of music therapy on patients' dental anxiety, salivary cortisol, heart rate, blood pressure and body temperature during dental treatment. METHODS In this randomized control study, 46 patients were randomly selected from the Urgent Care dental clinic who needed urgent endodontic treatment (endodontic access and pulp extirpation). Participants were divided into two groups: intervention group (N=23) which was exposed to slow rhythm melody music and had no lyrics throughout the entire procedure and a control group (N=23) who undergoes the same dental procedure without being exposed to music. Participants' blood pressure, heart rate, body temperature and salivary cortisol were measured before and after the treatment for both groups. RESULTS Patients in the intervention group showed lower salivary cortisol, blood pressure, heart rate and body temperature compared to those in the control group, however, the differences did not reach to statistical significance. CONCLUSION -Despite the change in the dental anxiety and stress during treatment with music, the findings of this study could not establish evidence of the effect of music in reducing dental anxiety and lowering physiological stressors. Therefore, further studies with larger sample size may be needed. (www.actabiomedica.it).
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Affiliation(s)
- Mohammad Wazzan
- Department of Oral & Craniofacial Health, College of Dental Medicine
| | - Mohammed Estaitia
- Department of Oral & Craniofacial Health, College of Dental Medicine
| | - Sima Habrawi
- Department of Oral & Craniofacial Health, College of Dental Medicine
| | - Dina Mansour
- Department of Oral & Craniofacial Health, College of Dental Medicine
| | - Zain Jalal
- Department of Oral & Craniofacial Health, College of Dental Medicine
| | - Hadir Ahmed
- Department of Oral & Craniofacial Health, College of Dental Medicine
| | - Hayder A. Hasan
- College of Health Science, Sharjah Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral & Craniofacial Health, College of Dental Medicine, Sharjah Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Adly MS, Adly AS, Alreshidi SF, Alotaibi AM, Alreshidi MF, Adly AS. Can paracetamol lower stress and anxiety by blunting emotions during and after computer guided dental implant surgeries? Findings from a randomized crossover clinical trial. J Dent Sci 2021; 16:137-144. [PMID: 33384790 PMCID: PMC7770301 DOI: 10.1016/j.jds.2020.05.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/17/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/PURPOSE Dental implants insertion can be a major factor in stress and anxiety. The aim was to evaluate the paracetamol ability to lower stress and anxiety when compared with ibuprofen during and after computer guided implant surgery utilizing CAD/CAM surgical template and a computer vision system for assessment. MATERIALS AND METHODS Thirty patients were enrolled in a crossover study design having bilateral missing lower molars. Patients were randomized into 2 equal groups with the first assigned for dental implant insertion in the lower molar area on one side with the administration of paracetamol (with 7-day follow-up) followed by 2-week washout period, then another implant was inserted on the contra-lateral side with ibuprofen. The second group received the same drugs but in reversed order. Salivary cortisol level was used to measure anxiety and a computer vision system was used to measure swelling. Visual-Analogue-Scale pain score from 0-to-100 was also utilized. RESULTS Only 29 patients completed the study. Stress and anxiety was found to be significantly lower in paracetamol group (4.1 ± 1.08 ng/mL and 6.2 ± 0.94 ng/mL for paracetamol/ibuprofen respectively). Pain score was 13.1 ± 1.1 and 12.9 ± 2.3 in paracetamol/ibuprofen groups respectively with no significant differences. Swelling showed significant difference favoring the paracetamol group (0.91 ± 0.41 and 0.61 ± 0.31 for paracetamol/ibuprofen respectively). CONCLUSION Paracetamol is effective in reducing stress by minimizing anxiety and blunting emotions of "fear-from-pain" so that pain is no longer perceived as much. However, paracetamol lacks the ability to control swelling at implant site. Computer guided flapless-implant surgery with immediate loading can be recommended for fearful patients.
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Affiliation(s)
- Mahmoud Sedky Adly
- Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
- Royal College of Surgeons of Edinburgh, Scotland, United Kingdom
| | - Afnan Sedky Adly
- Faculty of Physical Therapy, Cardiovascular-Respiratory Disorders and Geriatrics, Laser Applications in Physical Medicine, Cairo University, Cairo, Egypt
- Faculty of Physical Therapy, Internal Medicine, Beni-Suef University, Beni-Suef, Egypt
| | | | | | | | - Aya Sedky Adly
- Faculty of Computers and Artificial Intelligence, Helwan University, Cairo, Egypt
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Ostalska-Nowicka D, Paszyńska E, Dmitrzak-Węglarz M, Neyman-Bartkowiak A, Rabiega A, Zachwieja J, Nowicki M. Dental caries-related primary hypertension in children and adolescents: Cross-sectional study. Oral Dis 2020; 27:1822-1833. [PMID: 33128414 DOI: 10.1111/odi.13700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/27/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hypertension is a growing clinical problem in pediatric population. Also, the cause of hypertension is usually unknown and it may result from systemic inflammation related to tooth decay. AIM To estimate the potential association in cross-sectional study between tooth decay and hypertension in children and adolescents. PATIENTS AND METHODS Study group-65 children diagnosed with primary arterial hypertension; control subjects-44 normotensive children. Blood pressure, dental examination, measurement of salivary cortisol, alpha-amylase, secretory IgA, and lysozyme concentrations were performed in all of the children. RESULTS Hyper- and normotensive children had similar peripheral blood morphology and serum biochemical parameters, except of uric acid concentration, which was significantly higher in the study group (p = .047). Salivary evening concentrations of cortisol and alpha-amylase were significantly higher in hypertensive children (p = .002 and p = .004, respectively). Although 24-hr systolic blood pressure (SBP), including daytime and nighttime SBP, correlated with "decay," "microalbuminuria," "BMI," and "glomerular filtration rate" (r > .75, r > .7, r < .68, and r < .43, respectively), in multivariate analysis only "decay" was associated with hypertension both in children and in adolescents (p < .0001). CONCLUSION Tooth decay in children/adolescents might be regarded as a potent trigger factor of hypertension in individuals in whom all other causes of secondary arterial hypertension have been excluded.
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Affiliation(s)
- Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Paszyńska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Dmitrzak-Węglarz
- Department of Genetics in Psychiatry, Psychiatric Genetics Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Neyman-Bartkowiak
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Alina Rabiega
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
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Comparison of Survival Rates of Stainless-Steel Crowns Placed with and without Pulpotomy: A Two-Year Retrospective Study. Int J Dent 2020; 2020:8883189. [PMID: 33144859 PMCID: PMC7599394 DOI: 10.1155/2020/8883189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 01/17/2023] Open
Abstract
Aim. This study aimed to retrospectively compare the survival outcomes over two years between teeth with proximal dental caries that were restored with stainless-steel crowns to those that were pulpotomized and then restored with a stainless-steel crown in patients who were rehabilitated under general anesthesia. Participants and Methods. The records of 131 patients aged between two to six years who had stainless-steel crowns placed under general anesthesia and had two-year follow-up were screened. 340 teeth with moderate proximal caries on the radiograph (D2) were included in the study. Of these, 164 teeth were treated with a pulpotomy and stainless-steel crown, while 176 teeth were crowned without a pulpotomy. The type of each tooth was compared using the Chi-squared test and Kaplan–Meier survival analysis, and curves were plotted based on the two-year outcomes. Results. Treatment: the sample comprised 59 males (mean age 4.73 years, SD ± 1.4 years) and 72 females (mean age 5.2 years, SD ± 2.0 years). The Kaplan–Meier regression model showed no significant difference in survival outcomes between teeth that had been pulpotomized and those that had not (
= 0.283). Conclusion. Within the limitations of the current study, we can conclude that performing a pulpotomy does not influence the survival outcome of mild/moderate proximal caries restored with stainless-steel crowns under general anesthesia.
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Vlad R, Pop AM, Olah P, Monea M. The Evaluation of Dental Anxiety in Primary School Children: A Cross-Sectional Study from Romania. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E158. [PMID: 33023083 PMCID: PMC7599995 DOI: 10.3390/children7100158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 12/13/2022]
Abstract
Current data report that high levels of dental anxiety in children have a negative impact on oral health. The aim of this study was to measure dental anxiety, based on the Abeer Children Dental Anxiety Scale (ACDAS) used as a self-reported measure and to correlate its values with the salivary cortisol levels. The study was conducted in 2019 and included 389 children aged 6-9 years old; evaluation of dental anxiety and saliva sampling were performed. The influence of gender on the presence of dental anxiety was analyzed using Fisher's exact test, the salivary cortisol level was compared between anxious and non-anxious children and was further correlated with the ACDAS score (p < 0.05). Girls had higher odds of experiencing dental anxiety (odds ratio: 1.533, p = 0.041). Salivary cortisol levels were higher in anxious compared to non-anxious children (median 1.251 vs. 1.091 ng/mL, p < 0.001) and showed a positive moderate correlation with the ACDAS score (r = 0.411, p < 0.001). Children aged 6-9 years have a high prevalence of dental anxiety, with girls being more susceptible to this condition. Salivary cortisol levels are higher in anxious children and correlate positively with the ACDAS score, proving that ACDAS can be used for the detection of dental anxiety.
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Affiliation(s)
- Ramona Vlad
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Tirgu Mures, Romania; (R.V.); (M.M.)
| | - Anca Maria Pop
- Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Tirgu Mures, Romania
| | - Peter Olah
- Department of Medical Informatics and Biostatistics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Tirgu Mures, Romania;
| | - Monica Monea
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Tirgu Mures, Romania; (R.V.); (M.M.)
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