Examining Parental Treatment Decisions Within a Contemporary Pediatric Dentistry Private Practice

A randomized controlled trial to assess parental satisfaction with computerized intraosseous anesthesia versus inferior alveolar nerve block in children

This study aimed to compare parental satisfaction between two pediatric dental anesthesia techniques, computerized intraosseous anesthesia (CIA) and inferior alveolar nerve block (IANB). This study was designed as a split-mouth randomized controlled clinical trial. A total of 52 parents of children undergoing dental treatment were enrolled in the study. Each participant received both CIA and IANB anesthesia, with the order of administration randomized. Parental satisfaction was evaluated using the parental satisfaction of dental local anesthetic techniques scale (PSLAS). Statistical analysis revealed that parental satisfaction regarding CIA was higher than that for IANB with a significant difference (P ˂ 0.05). However, there was no difference regarding the age, gender or the education level of the parents. (P > 0.05). This study provides insights into parental satisfaction with pediatric dental anesthesia techniques and highlights the influence of socioeconomic factors on anesthesia decision-making. Within the limitations of this trial, it was concluded that CIA was significantly superior to IANB in overall parental satisfaction. However, parental satisfaction values were lower in CIA group regarding costs and concern from complications. In addition, it was concluded that there was no difference in satisfaction levels regarding the gender, age and education level of the parents.

Parental satisfaction and acceptance of silver diamine fluoride treatment for molar incisor hypomineralisation in pediatric dentistry: a cross-sectional study

The study aimed to investigate parental satisfaction and acceptance of silver diamine fluoride (SDF) treatment for permanent molars affected by molar incisor hypomineralisation (MIH). This study was conducted in the pediatric dental department at Damascus University, Syria. This study was performed at the period from Jan 2023 to April 2023. In this cross-sectional study, a validated questionnaire employing a 5-point Likert scale was used to evaluate esthetics, ease of application, pain perception, and taste acceptability. Participants included 100 parents or guardians of children aged 6-9 years who had received SDF treatment in the past year. The findings of this study revealed high satisfaction levels (77.5%) with the treatment. Parents expressed contentment with the appearance of their child's molars after SDF application (58% agreed or strongly agreed) and found the application process easy and pain-free (100% agreed or strongly agreed). However, taste acceptability posed a challenge, with over half of the parents (53%) finding it unacceptable. Regression analysis underscored the significant impact of esthetics, ease of application, pain perception, and taste on parental satisfaction. Moreover, parents with higher education levels (graduate or postgraduate) exhibited higher acceptance rates compared to those with lower education levels (63.1% vs. 33.6%). Notably, parental gender and age did not significantly influence SDF treatment acceptance. This study provides critical insights into parental satisfaction and acceptance of SDF treatment for MIH-affected permanent molars. Despite concerns about tooth discoloration, the high satisfaction levels suggest that SDF holds promise as an effective treatment option. Parental education significantly influenced acceptance rates. This research highlights the importance of considering parental perspectives and tailoring communication strategies in pediatric dentistry, ultimately contributing to improved care for young patients with MIH.

Factors for choosing a pediatric dentist in Saudi Arabia

The choice of a pediatric dentist is a crucial decision for parents, influenced by a variety of factors. This study aimed to investigate the key determinants that guide parents in the Kingdom of Saudi Arabia in their selection of a pediatric dentist. A cross-sectional survey was administered to a diverse participant pool. The survey captured demographic information, history of dental visits, parents' level of concern about dental treatment for their children, and the importance of specific factors in the choice of a pediatric dentist. The survey was completed by a balanced representation of different age groups and genders. Most participants from Riyadh and other regions had a history of dental visits. Parents' concern about dental treatment varied based on the number of children they had. The most significant factors influencing the choice of a pediatric dentist were the quality of the dental unit's disinfection process, the dentist's ability to communicate with the child and manage uncooperative behaviour, and the dentist's experience. The least influential factors were the proximity of the dental office to the child's school, the dentist's gender, and the number of pediatric dentists in the practice. This study provided valuable insights into the factors that influence parents' decision in choosing a pediatric dentist in The Kingdom of Saudi Arabia. Data helps dental professionals understand parents' priorities and improve their services accordingly to meet patient needs and expectations.

Comparison of Oral Health-Related Quality of Life scores in children treated for early childhood caries under general and local anesthesia: a quasi-experimental study

PURPOSE

The purpose of this study was to compare the changes in oral health-related quality of life (OHRQoL) scores in children treated for Early Childhood Caries (ECC) under general (GA) and local anesthesia (LA).

METHODS

A quasi-experimental study was carried out on 73 children, with 37 in the GA group and 36 in the LA group. The early childhood oral health impact scale (ECOHIS) was used to measure OHRQoL, with the type of anesthesia (LA or GA) serving as the explanatory variable. A Friedman test was used to assess the difference between the LA and GA groups at baseline, one-week, and one-month follow-up points.

RESULTS

The results showed a significant difference in the overall mean ECOHIS scores between the LA and GA groups at 1-week (LAmean ± SD = 6.12 ± 1.11, GAmean ± SD = 5.50 ± 0.88; P = 0.01) and 1-month (LAmean ± SD = 5.87 ± 1.12, GAmean ± SD = 4.96 ± 0.99; P < 0.001) follow-up points. Irrespective of the administered anesthesia, a significant (P < 0.001) reduction in the mean score for dental pain was observed at both 1-week (mean ± SD = 1.30 ± 1.16) and 1-month (mean ± SD = 0.81 ± 0.89) timepoints after the treatment, as compared to the baseline assessment (mean ± SD = 2.02 ± 1.02).

CONCLUSION

Early treatment for ECC reduces pain, restore normal activities, and improves the quality of life of affected children. Specifically, GA was found to be more beneficial for both children and parents. However, further studies using more robust study designs and carefully considering related factors are necessary to confirm these findings.

Does the Modality of Dental Treatment Affect the Treatment Prognosis and the Necessity of Re-Treatments?

BACKGROUND

The utilization of evidence-based approaches is crucial to achieving long-term positive outcomes for treatment performed chairside or under general anesthesia. The study aimed to evaluate if treatment modality (at the chairside or under general anesthesia) affects prognosis and the need for re-treatment.

METHODS

Oral-hygiene, gingival, and plaque indexes were recorded during the control appointment. The success of all treatments was evaluated according to the scoring of particular evaluation criteria.

RESULTS

A total of 1066 dental procedures were performed on 92 children. Plaque index scores were higher for patients treated under general anesthesia. The success rate of restorative procedures was 82.5% under general anesthesia and 80.6% at the chairside. There was no statistically significant difference between the mean number of restorative treatments and the need for re-treatment between general anesthesia or chairside (p = 0.649, p = 0.311). The mean number of unsuccessful endodontic treatments performed under general anesthesia was higher than performed chairside. Only two out of thirty stainless-steel crowns were decemented, all performed under general anesthesia.

CONCLUSIONS

The high volume of restoration failure due to secondary caries has highlighted the need for alternative approaches to caries management, especially given the risks associated with repeat general anesthetic.

Factors Influencing Parents' Decision in Choosing a Pediatric Dentist

Introduction Pediatric dentists support children's dental health while also providing parents with health education and information. Parents are guardians of their children's oral health, as their knowledge, beliefs, also attitude about oral health can influence early childhood oral health directly or indirectly. Recognizing parenting practices on early childhood oral health is essential for developing effective prevention and treatment strategies for the child, because parents' health attitudes, behavior, and their children's dental health are usually influenced directly or indirectly by their practice. Objectives of this study were to find out what factors parents prefer while choosing a pediatric dentist for their kids, to assess parent attitudes towards management of a symptomatic primary tooth, to analyze parental understanding of the importance of deciduous teeth, and to assess parent knowledge and perception regarding their child. Methodology A cross-sectional study conducted at Sharad Pawar Dental College and Hospital was done, where 20 questions were posed to the parents who came with their children for dental treatment. Questions were divided into two parts, knowledge-based assessment scale and perception-based assessment scale. The questions were formulated to assess the knowledge of parents regarding dental care, their perception, and their attitude toward the decision-making while selecting a pediatric dentist for their kids. The questions also included information about the child's habits and associated problems with it. Three hundred parents of children under 14 years of age were chosen randomly where all parents were adequately informed beforehand, and their written consent was taken before proceeding with the questions. All the questions were formulated in the native language that they could easily understand. A convenient method was applied as per the respondent from an offline questionnaire survey.  Results By evaluating the parental knowledge as well as perception towards children's oral health and dental treatment we are able to determine which aspects parents prefer while selecting a pediatric dentist for their child. The study found that parents had limited knowledge about the causes, treatment, prevention, and consequences of oral health problems in children. Many parents neglect oral health problems and lack correct knowledge. Conclusion  Hence this study assesses the parental knowledge as well as perception towards children's oral health. This study concludes that it is crucial to raise awareness about oral health among parents and inform them about available treatments, consequences of negligence and future problems to aid them in decision-making.

Silver diamine fluoride-associated delays in procedural sedation in young children: A retrospective cohort study

BACKGROUND

This analysis evaluated the time to first sedation or general anesthesia (GA) encounter for children treated with and without silver diamine fluoride (SDF).

METHODS

This retrospective cohort study used dental claims of privately insured children from birth through age 71 months with a sedation or GA claim from 2016 through 2020. The exposure was SDF use (yes, no). The outcome was time to first sedation or GA. Descriptive and multivariable negative binomial analysis was performed. The analysis tested the hypothesis that among children who received sedation or GA for their caries treatment, those who received SDF would show a longer time to first sedation or GA than children who did not.

RESULTS

Among 175,824 children included, SDF use increased the time to first sedation or GA encounter by 63 days when treated by different dentists (405 days vs 342 days; P < .001) and by 91 days when treated by the same dentist (337 days vs 246 days; P < .001), after controlling for the effects of age at first encounter, sex, and region of the country.

CONCLUSION

Children treated with SDF had a longer time to first sedation or GA, which was magnified when treatment was performed by the same dentist.

PRACTICAL IMPLICATIONS

Within an individualized caries management plan, SDF could provide benefits for patients, dental offices, and health systems.

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model

Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.