Dental fear and anxiety in children and adolescents: qualitative study using YouTube

A comparative evaluation of peppermint oil and lignocaine spray as topical anesthetic agents prior to local anesthesia in children: a randomized clinical trial

Background

In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years.

Method

Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child.Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores.

Results

Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study.

Conclusion

0.2% peppermint oil was effective in reducing pain perception.

YouTube as an information source for bleeding gums: A quantitative and qualitative analysis

Gum bleeding is a common dental problem, and numerous patients seek health-related information on this topic online. The YouTube website is a popular resource for people searching for medical information. To our knowledge, no recent study has evaluated content related to bleeding gums on YouTube™. Therefore, this study aimed to conduct a quantitative and qualitative analysis of YouTube videos related to bleeding gums. A search was performed on YouTube using the keyword "bleeding gums" from Google Trends. Of the first 200 results, 107 videos met the inclusion criteria. The descriptive statistics for the videos included the time since upload, the video length, and the number of likes, views, comments, subscribers, and viewing rates. The global quality score (GQS), usefulness score, and DISCERN were used to evaluate the video quality. Statistical analysis was performed using the Kruskal-Wallis test, Mann-Whitney test, and Spearman correlation analysis. The majority (n = 69, 64.48%) of the videos observed were uploaded by hospitals/clinics and dentists/specialists. The highest coverage was for symptoms (95.33%). Only 14.02% of the videos were classified as "good". The average video length of the videos rated as "good" was significantly longer than the other groups (p <0.05), and the average viewing rate of the videos rated as "poor" (63,943.68%) was substantially higher than the other groups (p <0.05). YouTube videos on bleeding gums were of moderate quality, but their content was incomplete and unreliable. Incorrect and inadequate content can significantly influence patients' attitudes and medical decisions. Effort needs to be expended by dental professionals, organizations, and the YouTube platform to ensure that YouTube can serve as a reliable source of information on bleeding gums.

Approaches to Research Ethics in Health Research on YouTube: Systematic Review

BACKGROUND

YouTube has become a popular source of health care information, reaching an estimated 81% of adults in 2021; approximately 35% of adults in the United States have used the internet to self-diagnose a condition. Public health researchers are therefore incorporating YouTube data into their research, but guidelines for best practices around research ethics using social media data, such as YouTube, are unclear.

OBJECTIVE

This study aims to describe approaches to research ethics for public health research implemented using YouTube data.

METHODS

We implemented a systematic review of articles found in PubMed, SocINDEX, Web of Science, and PsycINFO following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To be eligible to be included, studies needed to be published in peer-reviewed journals in English between January 1, 2006, and October 31, 2019, and include analyses on publicly available YouTube data on health or public health topics; studies using primary data collection, such as using YouTube for study recruitment, interventions, or dissemination evaluations, were not included. We extracted data on the presence of user identifying information, institutional review board (IRB) review, and informed consent processes, as well as research topic and methodology.

RESULTS

This review includes 119 articles from 88 journals. The most common health and public health topics studied were in the categories of chronic diseases (44/119, 37%), mental health and substance use (26/119, 21.8%), and infectious diseases (20/119, 16.8%). The majority (82/119, 68.9%) of articles made no mention of ethical considerations or stated that the study did not meet the definition of human participant research (16/119, 13.4%). Of those that sought IRB review (15/119, 12.6%), 12 out of 15 (80%) were determined to not meet the definition of human participant research and were therefore exempt from IRB review, and 3 out of 15 (20%) received IRB approval. None of the 3 IRB-approved studies contained identifying information; one was explicitly told not to include identifying information by their ethics committee. Only 1 study sought informed consent from YouTube users. Of 119 articles, 33 (27.7%) contained identifying information about content creators or video commenters, one of which attempted to anonymize direct quotes by not including user information.

CONCLUSIONS

Given the variation in practice, concrete guidelines on research ethics for social media research are needed, especially around anonymizing and seeking consent when using identifying information.

TRIAL REGISTRATION

PROSPERO CRD42020148170; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=148170.

Does use of animal therapy during dental care help to reduce anxiety in children and adolescents? A systematic review

BACKGROUND

Animal-assisted therapy (AAT) is considered a useful technique to reduce anxiety in children and adolescents in medical settings.

AIM

To investigate whether the use of AAT helps to reduce anxiety during dental care in children and adolescents.

DESIGN

Systematic review that included randomized and nonrandomized clinical trials with children up to 18-years of age undergoing dental appointments. The databases Embase, Cochrane, Pubmed/Medline, LILACS, PsycInfo, Scopus, and Web of Science were searched including gray literature. Random-effects meta-analyses using mean difference (MD) and narrative synthesis (vote counting) were implemented. Risk of bias was assessed using RoB2 for randomized clinical trials. The certainty of the evidence was performed using GRADE.

RESULTS

A total of 1103 references were identified, and after a two-phase selection, three studies were included. Anxiety, behavior, and pain were the outcomes. A meta-analysis with 146 participants was performed for anxiety at three time points: before treatment (MD -0.40, CI: -1.06 to 0.26; I²  = 0%; p = .24), during treatment (MD -3.64, CI: -11.18 to 3.91; I²  = 94%; p = .34), and after treatment (MD -5.97, CI: -17.08 to 5.14; I²  = 98% p = .29). There was no difference during dental treatment with or without ATT (dogs), as well as for narrative analysis for any outcome. The risk of bias was high mainly because of the randomization and outcome measurement.

CONCLUSION

There is no evidence to support or refute that the presence of AAT during dental care can help reduce anxiety in children (5-11 years). Studies with larger samples are suggested. Protocol registration (CRD42021293593).

Qualitative Evaluation of YouTube Videos on Dental Fear, Anxiety and Phobia

The aim of this study was to review the health information of dental fear-, dental anxiety-, and dental phobia-related videos on YouTube. The 100 most widely viewed videos for the keywords "dental fear", "dental anxiety", and "dental phobia" were chosen for evaluation. Out of the 300 videos, 145 videos met the inclusion criteria and were analyzed. It was found that most of them were produced by the professions, with a dentist delivering the key messages or with patients giving testimonials. Many etiological factors and symptoms were described. Many pharmacological and non-pharmacological interventions were recommended to the audience, such as sedation and distraction, respectively. However, there was a lack of information on the definition or diagnostic criteria of dental fear, dental anxiety, and dental phobia. Videos with high views had a higher ratio of misleading information. Videos with a dentist being the informant had a similar ratio of misleading information compared to other videos. Without adequate information on how to diagnose, it would be very difficult for the audience to determine if the video content was relevant or useful. The dental profession can work together with psychologists or psychiatrists to produce authoritative videos with accurate content.

Children's Perceptions of Dental Experiences and Ways to Improve Them

This qualitative study explored children's perceptions of their dental experiences and their acceptability of the CARD™ (Comfort, Ask, Relax, Distract) system, adapted for the dental setting as a means to mitigate dental fear and anxiety (DFA). A purposive sample of 12 participants (7 males) aged 8-12 years receiving dental care at the Paediatric Dental Clinic, University of Toronto, was recruited. Virtual one-on-one interviews were augmented with visual aids. Participants were oriented to and asked about their perceptions of various dental procedures. Data were deductively analyzed, according to the Person-Centered Care framework (PCC). Four themes were identified: establishing a therapeutic relationship, shared power and responsibility, getting to know the person and empowering the person. Children emphasized the importance of clinic staff attributes and communication skills. They expressed a desire to engage more actively in their own care and highlighted the positive influence of pre-operative education and preparation. Participants found the CARD™ system to facilitate opportunities for self-advocacy in their dental care.

Feasibility of At-Home Serial Testing Using Over-the-Counter SARS-CoV-2 Tests With a Digital Smartphone App for Assistance: Longitudinal Cohort Study

BACKGROUND

The ongoing SARS-CoV-2 pandemic necessitates the development of accurate, rapid, and affordable diagnostics to help curb disease transmission, morbidity, and mortality. Rapid antigen tests are important tools for scaling up testing for SARS-CoV-2; however, little is known about individuals' use of rapid antigen tests at home and how to facilitate the user experience.

OBJECTIVE

This study aimed to describe the feasibility and acceptability of serial self-testing with rapid antigen tests for SARS-CoV-2, including need for assistance and the reliability of self-interpretation.

METHODS

A total of 206 adults in the United States with smartphones were enrolled in this single-arm feasibility study in February and March 2021. All participants were asked to self-test for COVID-19 at home using rapid antigen tests daily for 14 days and use a smartphone app for testing assistance and to report their results. The main outcomes were adherence to the testing schedule, the acceptability of testing and smartphone app experiences, and the reliability of participants versus study team's interpretation of test results. Descriptive statistics were used to report the acceptability, adherence, overall rating, and experience of using the at-home test and MyDataHelps app. The usability, acceptability, adherence, and quality of at-home testing were analyzed across different sociodemographic, age, and educational attainment groups.

RESULTS

Of the 206 enrolled participants, 189 (91.7%) and 159 (77.2%) completed testing and follow-up surveys, respectively. In total, 51.3% (97/189) of study participants were women, the average age was 40.7 years, 34.4% (65/189) were non-White, and 82% (155/189) had a bachelor's degree or higher. Most (n=133/206, 64.6%) participants showed high testing adherence, meaning they completed over 75% of the assigned tests. Participants' interpretations of test results demonstrated high agreement (2106/2130, 98.9%) with the study verified results, with a κ score of 0.29 (P<.001). Participants reported high satisfaction with self-testing and the smartphone app, with 98.7% (157/159) reporting that they would recommend the self-test and smartphone app to others. These results were consistent across age, race/ethnicity, and gender.

CONCLUSIONS

Participants' high adherence to the recommended testing schedule, significant reliability between participants and study staff's test interpretation, and the acceptability of the smartphone app and self-test indicate that self-tests for SARS-CoV-2 with a smartphone app for assistance and reporting is a highly feasible testing modality among a diverse population of adults in the United States.

Analysis of YouTube videos related to a child's first dental visit

BACKGROUND

As parents increasingly turn to online videos for paediatric dental information, it is important to assess the content of those videos and determine whether parents are receiving accurate information.

AIM

To describe and assess the video characteristics, viewer engagement, and content of the most-viewed YouTube videos about a child's first dental visit.

DESIGN

The 100 most popular YouTube videos related to a child's first dental visit were assessed for consistency with current professional guidelines, which included a first visit by age 1, tooth cleaning or prophylaxis, fluoride application, caries risk assessment, dietary counseling, oral hygiene instruction, frequency of dental visits, and anticipatory guidance. Differences in video characteristics (length, age, and viewer engagement) were assessed using the Kruskal-Wallis test and the post hoc Mann-Whitney U test, and differences in content and characteristics by video upload source (healthcare professionals, parents/caregivers, and independent media outlets) were examined using the chi-square test and the Fisher's exact test.

RESULTS

The predominant upload source was parents/caregivers (40%) followed by independent media outlets (32%) and healthcare professionals (28%). Median video length was 2 min, 24 s (IQR = 2:05-3:49), and median video age was 4 years (IQR = 3-4 years). Most videos were filmed in a paediatric dental office (73%) and focused on motivational vs. educational content (77% vs. 23%, respectively). With regard to viewer engagement, videos uploaded by media outlets generated higher viewing rates than those uploaded by parents/caregivers (mean rank [MR] = 44.7 vs. 24.8, respectively) and healthcare professionals (MR = 34.8 vs. 31.5) and higher interaction rates than those uploaded by parents/caregivers (MR = 50.8 vs. 25.0) and healthcare professionals (MR = 39.1 vs. 20.6). Videos uploaded by healthcare professionals were more likely to provide educational content consistent with professional recommendations, particularly regarding caries risk assessment (32.1%), dietary counseling (21.4%), and frequency of dental visits (10.7%), than videos uploaded by parents/caregivers (5.0%, 5.0%, and 0%, respectively) and media outlets (0%, 3.1%, and 0%, respectively).

CONCLUSIONS

This study found that the most popular videos related to a child' first dental visit, as measured by viewer engagement, were uploaded by parents or caregivers, were longer and newer, and featured motivational rather than educational content. The 100 most-viewed videos rarely presented information that was consistent with professional recommendations for children's oral health, particularly regarding caries risk assessment and anticipatory guidance.

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.

Skills, Knowledge, and Implementation of Techniques for Behavioral Guidance in Adults with a Fear of Dentistry

BACKGROUND

Dental fear and anxiety (DFA) is considered the main reason of dental negligence which can lead to detrimental oral health as well as overall health including psychological well-being and quality of life in an individual.

AIMS

The present trial was aimed to assess the skill and knowledge of dentists in managing DFA in adult subjects, to evaluate the available strategies used in treating such subjects, and to find the need for further education.

MATERIALS AND METHODS

The present study was an original survey and questionnaire trial, which was distributed to the 82 dentists. The collected data were subjected to statistical evaluation and the results were formulated.

RESULTS

Educating and motivating subjects was found to be effective by 62.19% (n = 51) of dentists followed by successive approximation, and muscle relaxation was considered highly ineffective by one responder (1.21%). Music and reduced waiting time in the clinic appeared to be the most effective strategy as responded by 56.09% (n = 46) of dentists. Attempting treatment in various visits than a single seems to be a highly ineffective technique by 4 dentists (4.87%).

CONCLUSION

Within its limitation, the study showed that the application of various behavior modification techniques can be effective in alleviating DFA in adult patients.

Psychometric Testing of the Modified Dental Anxiety Scale among Iranian Adolescents during COVID-19 Pandemic

(1) Background: The present study aimed to examine the psychometric properties of the Persian adaptation of the Modified Dental Anxiety Scale (MDAS) in Iranian adolescents. (2) Methods: Adolescents with a mean age of 15.10 (n = 3197; 47.1% males) were recruited from Qazvin city of Iran using a stratified cluster random sampling technique. All children completed the five-item Persian MDAS and information related to background characteristics. Psychometric testing was conducted using classical test theory (CTT) and Rasch models. For CTT, an item-total correlation of >0.4 was considered satisfactory while for Rasch analysis, infit and outfit mean squares (Mnsq) ranging from 0.5–1.5 were considered satisfactory. Confirmatory Factor Analysis (CFA) was conducted to confirm the unidimensional structure of MDAS using various fit indices. Differential item functioning (DIF) was evaluated based on gender and time since last dental visit. Moreover, latent class analysis (LCA) was used to classify the participants into different levels of dental fear based on their pattern of responses. Both item level reliability using Cronbachs alpha (α) and test-reliability using intraclass correlation coefficients were evaluated. (3) Results: Item-total correlations ranged from 0.69–0.78, infit MnSq ranged from 0.80 to 1.11 and the range of outfit MnSq was 0.84–1.10. The data confirmed a one-factor structure of MDAS with satisfactory fit indices. DIF analysis indicated that the scale was interpreted similarly across the genders and time since dental visit groups. LCA analysis identified three levels, low, moderate and high levels of dental anxiety. The groups with moderate and high levels of dental anxiety had more females (44.6% and 36.7%) than the group with low level of dental anxiety (18.8%; p < 0.001). α of the total scale was 0.89 and item test-retest reliability ranged from 0.72–0.86. (4) Conclusions: The Persian MDAS was unidimensional with satisfactory psychometric properties evaluated using both CTT and Rasch analysis among Iranian adolescents. The scale was stable across the genders and individuals with different dental visiting patterns. The Persian MDAS also demonstrated excellent reliability.

Sense of coherence and dental fear/dental anxiety: A systematic review and meta-analysis

AIM

The aim of this systematic review and meta-analysis was to evaluate the association between sense of coherence (SOC) and dental fear/dental anxiety.

METHODS

Computerized searches were performed in six databases. Gray literature and manual searches were also conducted. Study selection, risk of bias assessment, and meta-analyses were performed. The results of meta-analyses were reported in odds ratio (OR), mean difference (MD), and confidence interval (CI).

RESULTS

After removing duplicates, 131 references were retrieved and the full texts of 12 were evaluated. Nine references met the eligibility criteria and were included. The results of meta-analyses demonstrated that individuals with a weaker SOC had a score in the dental anxiety/dental fear scale 6.04 times higher than individuals with a stronger SOC (OR = 6.04, CI = 2.62-13.91). Individuals with no dental anxiety/dental fear had a mean score of the SOC scale higher than individuals with dental anxiety/dental fear (MD = 5.39, CI = 2.21-8.56). Sensitivity analysis demonstrated that the result of a higher mean score of the SOC scale among individuals with no dental anxiety/dental fear remained (MD = 7.38, CI = 3.79-10.98). Risk of bias ranged from low to high. The certainty of evidence was very low.

CONCLUSION

Individuals with stronger SOC have lower levels of dental fear/dental anxiety.

Speaker, tell me a joke: The feasibility of using smart speaker technology for health and well-being in an older adult population (Preprint)

Background

Although smart speaker technology is poised to help improve the health and well-being of older adults by offering services such as music, medication reminders, and connection to others, more research is needed to determine how older adults from lower socioeconomic position (SEP) accept and use this technology.

Objective

This study aimed to investigate the feasibility of using smart speakers to improve the health and well-being of low-SEP older adults.

Methods

A total of 39 adults aged between 65 and 85 years who lived in a subsidized housing community were recruited to participate in a 3-month study. The participants had a smart speaker at their home and were given a brief orientation on its use. Over the course of the study, participants were given weekly check-in calls to help assist with any problems and newsletters with tips on how to use the speaker. Participants received a pretest and posttest to gauge comfort with technology, well-being, and perceptions and use of the speaker. The study staff also maintained detailed process notes of interactions with the participants over the course of the study, including a log of all issues reported.

Results

At the end of the study period, 38% (15/39) of the participants indicated using the speaker daily, and 38% (15/39) of the participants reported using it several times per week. In addition, 72% (28/39) of the participants indicated that they wanted to continue using the speaker after the end of the study. Most participants (24/39, 62%) indicated that the speaker was useful, and approximately half of the participants felt that the speaker gave them another voice to talk to (19/39, 49%) and connected them with the outside world (18/39, 46%). Although common uses were using the speaker for weather, music, and news, fewer participants reported using it for health-related questions. Despite the initial challenges participants experienced with framing questions to the speaker, additional explanations by the study staff addressed these issues in the early weeks of the study.

Conclusions

The results of this study indicate that there is promise for smart speaker technology for low-SEP older adults, particularly to connect them to music, news, and reminders. Future studies will need to provide more upfront training on query formation as well as develop and promote more specific options for older adults, particularly in the area of health and well-being.

Dental Fear and Associated Factors among Children and Adolescents: A School-Based Study in Lithuania

Dental fear is a challenging problem in dentistry and many contributing factors have been identified. Although this problem among children and adolescents has been studied in the literature for a long time, few such studies have been conducted in Lithuania. This study aimed to evaluate the prevalence of dental fear and examine its association with gender, age and several psychological and social factors among children and adolescents in Lithuania. The cross-sectional survey included a randomly selected sample (n = 1590) of children aged 11-14 and adolescents aged 15-18. The data were supplemented by interviewing the parents of these subjects (n = 1399). Dental fear was measured with a single five-score question. The data collection also included questions on oral health, socioeconomic status, oral health-related quality of life and self-esteem. Poisson regression analysis was used to assess the association between perception of dental fear and potential predictor variables. It was found that 32.2% (95% CI: 29.9-34.4%) of children and adolescents reported no fear of dental treatment, 12.5% (10.8-14.2%) of their peers were highly afraid of dental treatment, and other subjects assessed their dental fear gradually. Girls reported greater dental fear scores than boys, but the level of dental fear did not depend on the age. We identified the groups of subjects by gender and age, and a higher level of dental fear was significantly associated with untreated caries experience, a delay in the age of the subject's first visit to the dentist, low self-esteem, low oral health-related quality of life, low overall life satisfaction and low family affluence. The results also suggested that dental fear could originate from previous toothache, dentists' actions, high sensitivity in the child and poor psychological readiness for treatment. It was concluded that dental fear among Lithuanian children and adolescents is a common problem that is associated with gender and several dental, psychological and social factors. The findings indicate that school-based health policies, paediatric dentists and parents should be encouraged to focus on the psychosocial factors associated with dental fear because most of them can be prevented.

Reliability and Quality of YouTube Videos on Ultrasound-Guided Brachial Plexus Block: A Programmatical Review

BACKGROUND

Ultrasound-guided regional anesthesia has gained popularity over the last decade. This study aimed to assess whether YouTube videos sufficiently serve as an adjunctive tool for learning how to perform an ultrasound-guided brachial plexus block (BPB).

METHODS

All YouTube videos were classified, based on their sources, as either academic, manufacturer, educational, or individual videos. The metrics, accuracy, utility, reliability (using the Journal of American Medical Association Score benchmark criteria (JAMAS)), and educational quality (using the Global Quality Score (GQS) and Brachial Plexus Block Specific Quality Score (BSQS)) were validated.

RESULTS

Here, 175 videos were included. Academic (1.19 ± 0.62, mean ± standard deviation), manufacturer (1.17 ± 0.71), and educational videos (1.15 ± 0.76) had better JAMAS accuracy and reliability than individual videos (0.26 ± 0.67) (p < 0.001). Manufacturer (11.22 ± 1.63) and educational videos (10.33 ± 3.34) had a higher BSQS than individual videos (7.32 ± 4.20) (p < 0.001). All sources weakly addressed the equipment preparation and post-procedure questions after BSQS analysis.

CONCLUSIONS

The reliability and quality of ultrasound-guided BPB videos differ depending on their source. As YouTube is a useful educational platform for learners and teachers, global societies of regional anesthesiologists should set a standard for videos.

Dentist-patient communication on dental anxiety using the social media: A randomized controlled trial

The purpose of the present study was to assess the effects of dentist-patient communication via social media on dental anxiety and to determine the appropriate timing of such communications. In this randomized, double-blinded and controlled trial, we used Instagram's quick replies system to answer patients' questions to alleviate dental anxiety for patients undergoing impacted teeth extraction under local anesthesia. Patients were assigned randomly into four groups according to the timing of such communications: only after (group 1, n = 36), only before (group 2, n = 35), before and after the operation (group 3, n = 36), and a control group who received no communication on social media (group 4, n = 36). Dental anxiety was evaluated one week before (pre-op) and after the operation (post-op) using recognized assessment scales -the Spielberger's State-Trait Anxiety Inventory, Modified Dental Anxiety Scale (MDAS), and Visual Analogue Scale (VAS). The results showed that the post-op values of group 4 had higher anxiety scores than the groups 2 and 3 according to VAS (p < 0.05). Within the groups, the anxiety levels showed a decreasing trend after surgery according to MDAS and VAS scores (p < 0.05). The results of this study suggest that communication with patients before the operation is sufficient to reduce their dental anxiety.

Is aromatherapy associated with patient's dental anxiety levels? A systematic review and meta-analysis

The use of aromatherapy for the reduction of anxiety levels during dental treatment procedures has been well established in the literature; however, there is limited evidence regarding its efficacy. The present meta-analysis is an attempt to assess the association between the use of aromatherapy and anxiety levels among dental patients. A comprehensive search was conducted across Medline, Scopus, Web of Science, EBSCO host, Cochrane databases, and Google Scholar for studies evaluating aromatherapy and anxiety level among dental patients. PRISMA guidelines were followed for the meta-analysis. Randomized and cluster-randomized trials comparing aromatherapy with controls were included. The random-effects model was used to assess the mean differences in anxiety levels of patients visiting dental OPD. The significance value was set at P < 0.05. Six studies were identified that met the requirements for inclusion. Aromatherapy was significantly associated with reduction in patient anxiety levels during dental treatment (pooled mean difference: −3.36 [95% CI, −3.77 – −2.95, P = 0.00001). Low heterogeneity was noted between studies (I² = 1%, P = 0.41) analyzed in the meta-analysis. High certainty of the evidence was obtained from the association between the use of aromatherapy and dental anxiety. This meta-analysis suggests that aromatherapy is effective in reducing dental anxiety. When used judiciously, the results of this work should encourage the use of aromatherapy to reduce patient anxiety levels during dental procedures

Emotional effect of the Covid-19 pandemic on oral surgery procedures: a social media analysis

BACKGROUND

This study aimed to analyze Twitter users' emotional tendencies regarding oral surgery procedures before and after the coronavirus disease 2019 (COVID-19) pandemic worldwide.

METHODS

Tweets posted in English before and after the COVID-19 pandemic were included in the study. Popular tweets in 2019 were searched using the keywords "tooth removal", "tooth extraction", "dental pain", "wisdom tooth", "wisdom teeth", "oral surgery", "oral surgeon", and "OMFS". In 2020, another search was conducted by adding the words "COVID" and "corona" to the abovementioned keywords. Emotions underlying the tweets were analyzed using CrystalFeel - Multidimensional Emotion Analysis. In this analysis, we focused on four emotions: fear, anger, sadness, and joy.

RESULTS

A total of 1240 tweets, which were posted before and after the COVID-19 pandemic, were analyzed. There was a statistically significant difference between the emotions' distribution before and after the pandemic (p < 0.001). While the sense of joy decreased after the pandemic, anger and fear increased. There was a statistically significant difference between the emotional valence distributions before and after the pandemic (p < 0.001). While a negative emotion intensity was noted in 52.9% of the messages before the pandemic, it was observed in 74.3% of the messages after the pandemic. A positive emotional intensity was observed in 29.8% of the messages before the pandemic, but was seen in 10.7% of the messages after the pandemic.

CONCLUSION

Infectious diseases, such as COVID-19, may lead to mental, emotional, and behavioral changes in people. Unpredictability, uncertainty, disease severity, misinformation, and social isolation may further increase dental anxiety and fear among people.

The Efficacy of Little Lovely Dentist, Dental Song, and Tell-Show-Do Techniques in Alleviating Dental Anxiety in Paediatric Patients: A Clinical Trial

Introduction

Dental anxiety is a common occurrence in patients undergoing dental treatments, especially in children. The success in paedriatric dental treatments and patient comfort depends on controlling the level of patient's anxiety in clinical settings. This study is aimed at evaluating the efficacy of different techniques applied for the reduction of dental anxiety in paediatric patients. Material and Methods. One hundred and sixty participants were divided into 4 groups; each group having 40 patients as follows: group I: mobile application "little lovely dentist," group II: YouTube® "dental video songs," group III "tell-show-do," and group IV "control." Dental prophylaxis treatments were provided to all the participants. Initial anxiety levels were noted during the patient's education phase by measuring heart rate with pulse oximeter and distress level with facial image scale, at the same time in each group, respectively. The postoperative anxiety was noted later with the same methods, after the application of anxiety reduction techniques. The data obtained were entered in the statistical package for the social sciences software, version 25. One-way ANOVA and paired t-test for matched groups were used to compare mean values of the 4 groups, in this study to determine their effectiveness. A p value of ≤0.05 was considered as statistically significant.

Results

The mean age of patients in group 1 was 6.8 ± 2.1 years, group 2: 8.15 ± 2.27 years, group 3: 7.5 ± 2.3 years, and group 4: 7.27 ± 1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group.

Conclusion

The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, "little lovely dentist," and "dental songs" can alleviate dental anxiety experienced by paediatric patients. The "tell-show-do" technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.

Does Dental Fear in Children Predict Untreated Dental Caries? An Analytical Cross-Sectional Study

Despite free health care services in Saudi Arabia, the prevalence of caries in children is substantially greater in comparison to other high-income countries. Dental fear in children may be an important issue that needs attention. Therefore, the aim was to investigate the role of dental fear in predicting untreated dental caries in schoolchildren. This analytical cross-sectional study included children aged 8–10 years residing in Saudi Arabia. Dental status via oral examinations was surveyed with the WHO standardized chart and the Children Fear Survey Schedule—Dental Subscale was used to score dental fear. Descriptive, binary, and multivariable logistic regression analyses were performed to report the findings at 5% statistical significance. Overall, there were 798 schoolchildren with an average fear score of 36. Nearly 70.4% reported fear of someone examining their mouth. About 76.9% had at least one carious tooth in their oral cavity. Children with dental fear were 1.8 times (OR = 1.80; 95% CI = 1.26, 2.56) more likely to have at least one untreated carious tooth in their oral cavity than those who did not express fear during oral examinations and dental procedures. Thus, the current study concludes that fear of dentists and dental treatment procedures successfully predicts untreated carious teeth in schoolchildren.

Using process drama to explore the causes of dental anxiety in primary-school children

Background

Drama and role play can be unlisted as methods to allow children to view problems from a range of different perspectives that may differ from their own experience. Application of drama technique to assess the cause of dental fear and anxiety in a school setting is novel.

Aim

The aim of this study was to engage primary school children in the core investigation via participatory arts methodologies, namely, process drama to gain understanding of the causes of dental anxiety.

Design

Sixty-three children, aged 7–10 years from three primary schools participated in this study. A 90-min drama workshop was carried in each school. The children were encouraged to identify the causes of dental anxiety using key concepts from process drama. The sessions were audio-recorded and transcribed.

Results

Four key concepts emerged: (1) fear of the unknown; (2) unpleasant sensory experience; (3) society’s perception and portrayal of the dentist; and (4) learnt negative associations with the dentist. Within each four key concepts, two sub-themes were identified.

Conclusions

Role-playing and use of drama are a novel application and can reveal a considerable amount of information from the child’s perspective on the cause of dental fear and anxiety.

Social Media and Health Care, Part I: Literature Review of Social Media Use by Health Care Providers

BACKGROUND

As the world continues to advance technologically, social media (SM) is becoming an essential part of billions of people's lives worldwide and is affecting almost every industry imaginable. As the world is becoming more digitally oriented, the health care industry is increasingly visualizing SM as an important channel for health care promotion, employment, recruiting new patients, marketing for health care providers (HCPs), building a better brand name, etc. HCPs are bound to ethical principles toward their colleagues, patients, and the public in the digital world as much as in the real world.

OBJECTIVE

This review aims to shed light on SM use worldwide and to discuss how it has been used as an essential tool in the health care industry from the perspective of HCPs.

METHODS

A literature review was conducted between March and April 2020 using MEDLINE, PubMed, Google Scholar, and Web of Science for all English-language medical studies that were published since 2007 and discussed SM use in any form for health care. Studies that were not in English, whose full text was not accessible, or that investigated patients' perspectives were excluded from this part, as were reviews pertaining to ethical and legal considerations in SM use.

RESULTS

The initial search yielded 83 studies. More studies were included from article references, and a total of 158 studies were reviewed. SM uses were best categorized as health promotion, career development or practice promotion, recruitment, professional networking or destressing, medical education, telemedicine, scientific research, influencing health behavior, and public health care issues.

CONCLUSIONS

Multidimensional health care, including the pairing of health care with SM and other forms of communication, has been shown to be very successful. Striking the right balance between digital and traditional health care is important.

Children's Attitudes and Behaviors about Oral Health and Dental Practices

The present study sought to contribute to a better understanding of children's attitudes and behaviors regarding oral health and dental practices. The sample was composed of 101 children (8-10 years), collected from several schools in the Lisbon metropolitan area. Our main goals were to collect a survey of information about the beliefs, attitudes, habits and knowledge of children about oral and dental issues in order to not only have an overview of them but also to serve as a basis and a starting point for the development of intervention programs to increase positive attitudes and behaviors related to oral health and promote greater knowledge about these subjects. In general, children reported positive behaviors regarding dental habits and oral hygiene practices. Children's opinions and beliefs about dentists were also globally positive; however, the results suggested that younger children reported more positive attitudes, emotions and previous experiences. Regarding children's knowledge about these dental issues, the results were quite negative and worrying, ruled by ignorance and incorrect beliefs and behaviors. In sum, all the results and conclusions of this study may contribute to the development of educational programs within the scope of the promotion of oral health and hygiene practices-"An Adventure about Oral Health."

Developmental Assets of Adolescents and Young Adults With Chronic Illness and Comorbid Depression: Qualitative Study Using YouTube

BACKGROUND

Developmental assets provide a framework for optimizing development among adolescents but have not been studied in adolescents with chronic illness and comorbid depression, which is a group at risk for poor health outcomes. YouTube postings provide valuable insights to understand this understudied population.

OBJECTIVE

This study aims to explore asset development from the perspectives of adolescents and young adults (AYAs) with chronic illness and comorbid depression.

METHODS

YouTube was searched using 12 chronic illnesses (eg, diabetes) coupled with "depression" as keywords. Videos were included if they were uploaded by AYAs aged between 11 and 29 years and discussed living with chronic illness and depression during adolescence. Video transcripts were coded deductively for 40 internal and external assets that constitute the Developmental Assets Framework. Categories not captured by deductive coding were identified using conventional content analysis. Categories and their respective assets were labeled as being discussed either negatively or positively.

RESULTS

In total, 31 videos from 16 AYAs met the inclusion criteria. A total of 7 asset categories, support, constructive use of time, boundaries and expectations (external assets), identity, commitment to learning, positive values, and social competence (internal assets), reflecting 25 (13 internal; 12 external) assets, were discussed. Internal assets, particularly relating to identity, were commonly discussed by AYAs either in a negative way or fluctuated between positive and negative perspectives.

CONCLUSIONS

In this sample of AYAs with chronic illness and comorbid depression, internal assets were commonly discussed in a negative way. Future research is needed to better understand how assets develop and if the Developmental Assets Framework adequately represents the experiences of this population.

Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting

BACKGROUND

Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months.

METHODS

Children (5-10 yo) who had a primary molar with a dentinal occluso-proximal, cavitated carious lesion were allocated to the ART (selective removal) or HT arms.

PRIMARY OUTCOME

restoration survival over 36-months (using Kaplan-Meier survival analysis, log rank test, and Cox regression).

SECONDARY OUTCOMES

(1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and (2) child self-reported discomfort; (3) treatment acceptability (immediately following interventions); (4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and (5) a post hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months).

RESULTS

One-hundred and thirty-one children (ART = 65; HT = 66) were included (mean age = 8.1 ± 1.2). At 36 months, 112 (85.5%) children were followed-up.

PRIMARY OUTCOME

restoration survival rates ART = 32.7% (SE = 0.08; 95% CI 0.17-0.47); HT = 93.4% (0.05; 0.72-0.99), p < 0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p = 0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p = 0.007).

CONCLUSIONS

Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child's tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%).

TRIAL REGISTRATION

This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Rest orative+Treatment&draw=2&rank=2.

Knowledge, Attitude, and Practice amongst General Dentists Regarding Dental Pain Perception in Children

Aim

The objective of this study was to evaluate the knowledge, attitude, and practice among general dentists regarding perception of dental pain in children.

Materials and methods

A cross-sectional study was conducted among 208 general dentists in a dental hospital in Chennai. A self-constructed questionnaire was distributed to the dental practitioners, which comprised 23 closed-ended questions. The data were entered and analyzed for frequency and percentages by using Statistical Package for the Social Sciences (SPSS), version 21.

Results

Results showed that most of the dentists (46%) treated less than five children per week and were having less than 2 years of experience (47%). Seventy one percent of the dentists felt that they did not feel prepared to identify a child with dental pain, and 57% of the dentists had less than two years of experience

Conclusion

Most of the dentists did not feel prepared to identify the children with dental pain. Measures should be introduced to train the general dental practitioners in identifying pain perception in children so as to achieve effective behavior management of children.

How to cite this article

Subramanyam D, Gurunathan D. Knowledge, Attitude, and Practice amongst General Dentists Regarding Dental Pain Perception in Children. Int J Clin Pediatr Dent 2020;13(3):207–210.

Stimuli involved in dental anxiety: What are patients afraid of?: A descriptive study

BACKGROUND

Dental anxiety is a psychological response inducing aversion following a dental ill-defined stimulus, non-imminent and perceived as potentially dangerous. It is better to intervene during childhood than to resolve in adulthood when dental anxiety is more settled.

AIM

The purpose of this study is to determine the nature of dental anxiety-provoking stimuli in young patients.

DESIGN

A questionnaire was submitted to 566 children between 3 to 18 years in health institutions and schools in Brussels, Belgium. The items were divided into 3 groups: environment (ENV), local anaesthesia (LA), and intervention (INT) and summarized through averaging per group. Descriptive analysis and non-parametric testing were combined with logistic regression after discretization, above mild, for the group averages.

RESULTS

About 7.2% of the respondents expressed high to severe dental anxiety. Several items presented a clear bimodal distribution dividing the population in fearless and fearing patients, for example, sight and feel of the syringe, sight and taste of blood and extraction. Others presented with a gradually lower incidence with increasing fear level. Fear for the environment was generally low. Gender and ethnic origin contribute significantly to the prediction of fear caused by LA. For fear caused by INT, first the place of questioning enters the models, thereafter follow: negative experience, frequency of dental visit, and gender (P < .05).

CONCLUSIONS

While the dental environment is in general not causing fear, the invasive part of the anaesthesia and the invasive dental procedures are involved. Fear seems to be related to culture, previous experience, and gender.

Comparative evaluation of a novel herbal anesthetic gel and 2% lignocaine gel as an intraoral topical anesthetic agent in children: Bilateral split-mouth, single-blind, crossover in vivo study

BACKGROUND

Topical anesthetics have an intrinsic part to reduce pricking pain sensation due to needle stick before injection in children.

AIM

The present study aimed to determine the effectiveness of a novel herbal anesthetic gel used as a topical anesthetic before an inferior alveolar nerve block.

SETTINGSANDDESIGN

This was a bilateral split-mouth, single blind, crossoverin vivo study.

METHODS

Atotal number of 30 children were selected for this study design. After the application of the topical anesthesia, a 26-gauge needle was inserted in the mucobuccal fold and local anesthetic solution was deposited. Assessment of pain perception was done before the procedure and at the time of needle penetration using hemodynamic parameters such as blood pressure and heart rate. The objective and subjective pain assessment was recoded through sound eye motor scale and Faces Pain Scale-Revised (FPS-R).

STATISTICALANALYSIS

As the data followed a normal distribution, parametric tests were used to analyze these data. The independent sample t-test and paired sample t-test were used to check the mean differences.

RESULTS

The data showed no statistically significant differences in the objective and subjective pain assessment values of the novel herbal anesthetic gel compared to the 2% lignocaine gel. However, the intragroup comparisons of the before and during treatment results showed statistically significant results (P < 0.05).

CONCLUSION

The novel herbal anesthetic gel was effective and safe in reducing the pain from needle insertion. Thus, setting up scientific evidence for the therapeutic usage of herbal products can, therefore, assist to develop a more efficient and alternative topical anesthetic.

Why UK dental education should take a greater interest in the behavioural and social sciences

Recent moves by public health academics and social scientists for increased recognition of the behavioural and social sciences (BeSS) in medical education in the UK have put the role and place of the BeSS in dental education back on the curricular agenda. Behavioural and social sciences have been a component of the UK dental curriculum since 1990 but, to our knowledge, have only been reviewed once, in 1999. The aim of this article is to reignite a discussion about the role and place of BeSS in dental education in the UK. It reiterates the benefits of BeSS to dental education and dentistry in general, while remaining cognisant of the implicit and explicit barriers that can conspire to side-line their contribution to dental education. This paper concludes by making renewed calls for more integration of BeSS into the dental undergraduate curriculum as well as sectoral recognition for its contribution to the advancement of dental education and the professional development of dentists.

Dental Care-Seeking and Information Acquisition During Pregnancy: A Qualitative Study

Background: Pregnant women are at risk of oral health problems. This qualitative study aims to understand dental care-seeking behaviours of pregnant women and their oral health-related information acquisition, to identify barriers to and motivators for, dental visits, and further explore their expectations and possible strategies to improve oral health care during pregnancy. Methods: Semi-structured interviews were conducted with 30 pregnant women (after 32 gestational weeks) enrolled in the antenatal care programme in a public hospital in Hong Kong. Two main areas of interest were probed: Dental care-seeking behaviour and oral health information acquisition. Their expectations and suggestions on oral health care service for pregnant women were also explored. An inductive thematic approach was adopted to analyse the data. Results: Pregnant women’s dental care-seeking behaviour was deterred by some internal factors, such as misunderstandings on oral health, and priority on other issues over oral health. External factors such as inconvenient access to dental service during pregnancy also affected their care-seeking behaviours. Oral health information was passively absorbed by pregnant women through mass media and the social environment, which sometimes led to confusion. Oral health information acquisition from antenatal institutions and care providers was rare. Greater attention was paid to dental visit when they obtained proper information from previous dental visit experience or family members. A potential strategy to improve oral health care suggested by the interviewees is to develop a health care system strengthened by inter-professional (antenatal-dental) collaboration. Efficient oral health information delivery, convenient access to dental service, and improved ‘quality’ of dental care targeting the needs of pregnant women were identified as possible approaches to improve dental care for this population. Conclusion: Dental care-seeking behaviour during pregnancy was altered by various internal and external factors. A lack of, or conflict between, information sources result in confusion that can restrict utilisation of dental service. Integrating dental care into antenatal service would be a viable way to improve dental service utilisation.

The psychometric properties of the CFSS-DS for schoolchildren in Saudi Arabia: A confirmatory factor analytic approach

AIM

To test the psychometric properties of an Arabic version of the Child Fear Survey Schedule-Dental Subscale (CFSS-DS) a using confirmatory factor analysis.

METHODS

Two convenience samples were obtained: Sample [1]: 600 boys (33%) and girls attending 4 public schools in Onizah and Sample [2] 800 girls attending 8 public schools in Buridah. The questionnaire asked the participant's age, gender, and completion of the CFSS-DS. The data were subjected to exploratory factor analysis (EFA), parallel factor analysis, Cronbach's alpha, confirmatory factor analysis (CFA), and goodness of fit statistics.

RESULTS

A total of 513 children in Sample [1] and 503 children in Sample [2] participated giving a valid response rate of 86% and 67%, respectively. From the EFA, 3 factors were identified and confirmed statistically using parallel factor analysis. The internal consistency of the 3 factors, Dental Fear Subscale (0.86), Hospital Fear Subscale (0.77), and Stranger Fear Subscale (0.71), was good. The CFA showed that the current EFA model was an equivalent fit to the El Housseiny et al (BMC Oral Health 2016;16:49). model; however, the solution using El Housseiny et al's structure was distorted.

CONCLUSIONS

A 3-factor structure with acceptable reliability exists for this Arabic version of the CFSS-DS, confirmed by a CFA using an additional data set.

Differences in Emotional and Pain-Related Language in Tweets About Dentists and Medical Doctors: Text Analysis of Twitter Content

Background

Social media provides people with easy ways to communicate their attitudes and feelings to a wide audience. Many people, unfortunately, have negative associations and feelings about dental treatment due to former painful experiences. Previous research indicates that there might be a pervasive and negative occupational stereotype related to dentists and that this stereotype is expressed in many different venues, including movies and literature.

Objective

This study investigates the language used in relation to dentists and medical doctors on the social media platform Twitter. The purpose is to compare the professions in terms of the use of emotional and pain-related words, which might underlie and reflect the pervasive negative stereotype identified in relation to dentists. We hypothesized that (A) tweets about dentists will have more negative emotion-related words than those about medical doctors and (B) pain-related words occur more frequently in tweets about dentists than in those about medical doctors.

Methods

Twitter content (“tweets”) about dentists and medical doctors was collected using the Twitter application program interface 140Dev over a 4-week period in 2015, scanning the search terms “dentist” and “doctor”. Word content of the selected tweets was analyzed using Linguistic Inquiry and Word Count software. The research hypotheses were investigated using nonparametric Wilcoxon-Mann-Whitney tests.

Results

Over 2.3 million tweets were collected in total, of which about one-third contained the word “dentist” and about two-thirds contained the word “doctor.” Hypothesis A was supported since a higher proportion of negative words was used in tweets about dentists than in those about medical doctors (z=−10.47; P<.001). Similarly, tests showed a difference in the proportions of anger words (z=−12.54; P<.001), anxiety words (z=−6.96; P<.001), and sadness words (z=−9.58; P<.001), with higher proportions of these words in tweets about dentists than in those about doctors. Also, Hypothesis B was supported since a higher proportion of pain-related words was used in tweets about dentists than in those about doctors (z=−8.02; P<.001).

Conclusions

The results from this study suggest that stereotypes regarding dentists and dental treatment are spread through social media such as Twitter and that social media also might represent an avenue for improving messaging and disseminating more positive attitudes toward dentists and dental treatment.

Qualitative study on parental behavior as the source of dental fear development as reported by preschool students in Bandung

OBJECTIVE

This study aimed to analyze the contribution of parental behavior in DF development in preschoolchildren and seek its correlation with the level of DF.

MATERIALS AND METHODS

This study was addressed to preschoolchildren (3-6 years) in Bandung area using qualitative method through interviews with children. Data analysis was done using Spearman's rank correlation to find the correlation of parental behavior and level of DF.

RESULTS

Results revealed eight acquisition themes based on the parental behavior; two themes related to negative information, three themes related to direct conditioning, and three themes related to vicarious learning. Statistical analysis showed a significant Spearman rank correlation rs 0.42% or 17.38% (P < 0.01).

CONCLUSION

Parental behavior contributes to the development of DF in children at preschool ages through negative information, direct conditioning, and vicarious learning, as evidenced by the correlation of these parental behaviors with the level of DF in children.

Connecting With Your Dentist on Facebook: Patients' and Dentists' Attitudes Towards Social Media Usage in Dentistry

BACKGROUND

Social media has begun to proliferate across medical areas and transformed how medical professionals serve and interact with their patients. It offers a new communication avenue that has the potential to engage patients and, hence, may be used to create value for both medical professionals and patients. In dentistry, even though patients and dentists frequently use social media in their personal lives, little is known about their attitudes and expectations toward using social media for professional interactions.

OBJECTIVE

In this paper, we focus on the role of social media in dentistry. Specifically, we explore patients' and dentists' attitudes toward social media usage and their current online behaviors in this context. Furthermore, we examine potential challenges and opportunities regarding dentists' adoption of social media practices.

METHODS

This research employed a large-scale online survey of 588 patients and 532 dental professionals. We assessed the attitudes, expectations, and social media behaviors from both patients' and dentists' perspectives.

RESULTS

We found that more than 55% (290/532) of dentists in our sample have accounts for their dental practice on various social media platforms. Interestingly, while 73% (374/511) of patients did not expect their dental practice to have a social media presence, and 44% (207/468) thought that establishing a friendship with their dentists is not appropriate, the findings show that 36% (164/460) of patients had searched for their dentists, and 44% (207/470) of them were happy to establish contacts with dentists on social media. Furthermore, the findings highlight that patients were interested in exploring additional information such as online reviews and the qualifications of their dentists on Facebook pages. For dentists, more than half (375/432, 83%) of them in our sample thought that social media marketing is more efficient compared to traditional marketing.

CONCLUSIONS

Our findings revealed some key challenges and opportunities to utilize social media in dentistry. For both patients and dentists, the role of social media in dental services remains vague, and both parties still share concerns about connecting with each other on social media platforms. However, there also exists a sizeable number of patients who are already comfortable to connect with their dentists on social media sites such as Facebook. The current findings show that there is an opportunity for dental practices to trade upon a more active social media presence for enhanced patient interaction and engagement.

Satisfaction level among patients visiting a rural dental institution toward rendered dental treatment in Haryana, North India

BACKGROUND

To provide quality care to the patient's perspective and patient satisfaction are two major multidimensional concepts. In India, patient satisfaction with dental services has received only minor attention as the importance of the teeth is always neglected.

OBJECTIVE

To assess the satisfaction level among patients toward dental treatment rendered at an academic institution.

MATERIALS AND METHODS

A cross-sectional study was conducted among 474 voluntary camp patients visiting Department of Public Health Dentistry, Swami Devi Dyal Hospital and Dental College, Barwala, using a 14-item closed ended questionnaire which included demographic details, attitude, and practices of the participants and their satisfaction level to the treatment rendered to them was graded as highly satisfied, satisfied, and not satisfied. The data were analyzed using SPSS version 18 which covered both descriptive and inferential statistics.

RESULTS

Curative and preventive treatment was mostly required in younger age groups whereas extraction and prosthetic rehabilitation were found to be present in older age groups. Lack of education and awareness was the most common reason behind not seeking treatment. Majority of the participants were satisfied with the treatment rendered and were found to be statistically significant with visiting and referrals (P < 0.01).

CONCLUSION

Imparting proper and appropriate information regarding the dental treatment will definitely change the attitude of the patients, thus help in raising the satisfaction levels.

Children's dental fear and anxiety: exploring family related factors

BACKGROUND

Dental fear and anxiety (DFA) is a major issue affecting children's oral health and clinical management. This study investigates the association between children's DFA and family related factors, including parents' DFA, parenting styles, family structure (nuclear or single-parent family), and presence of siblings.

METHODS

A total of 405 children (9-13 years old) and their parents were recruited from 3 elementary schools in Hong Kong. Child's demographic and family-related information was collected through a questionnaire. Parents' and child's DFA were measured by using the Corah Dental Anxiety Scale (CDAS) and Children Fear Survey Schedule-Dental Subscale (CFSS-DS), respectively. Parenting styles were gauged by using the Parent Authority Questionnaire (PAQ).

RESULTS

DFA was reported by 33.1% of children. The mean (SD) CFSS-DS score was 29.1 (11.0). Children with siblings tended to report DFA (37.0% vs. 24.1%; p = 0.034) and had a higher CFSS-DS score (29.9 vs. 27.4; p = 0.025) as compared with their counterpart. Children from single-parent families had lower CFSS-DS score as compared with children from nuclear families (β = - 9.177; p = 0.029). Subgroup analysis showed a higher CFSS-DS score among boys with siblings (β = 7.130; p = 0.010) as compared with their counterpart; girls' from single-parent families had a lower CFSS-DS score (β = - 13.933; p = 0.015) as compared with girls from nuclear families. Children's DFA was not associated with parents' DFA or parenting styles (p > 0.05).

CONCLUSIONS

Family structure (nuclear or single-parent family) and presence of siblings are significant determinants for children's DFA. Parental DFA and parenting style do not affect children's DFA significantly.

Effectiveness of Intellectual Distraction on Gagging and Anxiety Management in Children: A Prospective Clinical Study

Objectives:

The aim of the present prospective study is to determine the effect of an intellectual colored game (ICG) on the severity of gag reflex (GR) and anxiety in children during dental alginate impression.

Materials and Methods:

Forty-one children, aging between 5 and 11 years, having a GR varying from normal to moderate had upper alginate impressions. The children's anxiety was evaluated with a facial image scale (FIS) before (T0) and after first failed impression (T1), then, after playing an intellectual colored game (ICG) at T2, while taking an upper alginate impression.

Results:

42.9 % of the children had a gag reflex of stage 2 and 31.0 % a facial scale of 3. Initial GR was not significantly associated with the final success of the impression (P =0.260) whereas final impression success was strongly associated with FIS (P <0.001). There was a statistically significant reduction in median GR score from T0 to T2 (P < 0.001) and FIS dropped significantly at T2 with ICG (P < 0.001).

Conclusion:

This study highlights the clinical performance of the intellectual distraction approach in GR management

Lingual orthodontic treatment: A YouTube™ video analysis

OBJECTIVES

The aim of this study was to examine the quality of information offered for patients seeking information on lingual orthodontic treatment.

MATERIALS AND METHODS

YouTube™ was searched for videos about lingual orthodontic treatment using the key word "lingual braces" from the Google Trends application. One hundred and four videos were selected to be analyzed from the first 120 results. The video content was evaluated using a 10-point score, which was used for classifying low- and high-content video groups. The video information and quality index (VIQI) was applied to determine the quality of the videos. The Mann-Whitney U-test, Chi-square test, and logistic regression analysis were used, and the Pearson correlation coefficient was calculated for statistical evaluations.

RESULTS

We classified 32 videos as high-content and 72 as low-content. Most videos were uploaded by laypeople (58.7%, n = 61). Definition of lingual braces and psychological impact were the most commonly discussed topics (51.0%), followed by speech performance (47.1%), pain (44.2%), tongue soreness (37.5%), and biomechanics (14.4%). Compared to the low-content group, the high-content video group had a significantly higher mean number of views (19,867.41 vs 6720.08, P = .002) and more "likes" (135.88 vs 13.01, P < .001), "dislikes" (4.34 vs 0.81, P < .001), and "comments" (26.28 vs 5.31, P = .002). There was no difference in the total VIQI score between the groups ( P = .009).

CONCLUSIONS

The content of YouTube™ videos for lingual orthodontics was generally incomplete. Most videos mentioned psychological effects, but few videos discussed the biomechanics or procedure. Orthodontists should be aware of the information available on YouTube™.

YouTube as a source of information for patients considering surgery for ulcerative colitis

BACKGROUND

With the range of health information online, assessing the resources that patients access may improve the content of preoperative information. Our aim was to assess the content of the most viewed videos on YouTube related to surgery for ulcerative colitis (UC).

METHODS

YouTube was searched for videos containing information on surgery for UC. The 50 most viewed videos were identified and user interaction analyzed. Upload source was classified as patient, individual health care professional (HCP), or hospital/professional association. Video content was categorized using an inductive thematic analysis on a purposive sample list of videos. The overarching theme of each video was classified once data saturation was achieved.

RESULTS

Thirty videos were uploaded by patients, 15 by hospitals and 5 by HCPs. Seventeen videos (34%) discussed life after surgery. Sixteen of these were uploaded by patients who had previously undergone surgery for UC. No videos of this theme were uploaded by HCPs. Ten videos (20%) described a number of different operations. Other themes identified were alternative health therapies (12%), colonoscopy (12%), life with UC (8%), miscellaneous (8%), and education for HCPs (6%). Patient uploaded videos had significantly more comments (P = 0.0079), with 28% of comments on patient videos being users requesting further information.

CONCLUSIONS

Understanding the sequelae of surgery is most important to preoperative patients. There are a lack of professional videos addressing this topic on YouTube. HCPs must participate in the production of videos and adapt preoperative consultations to address common preoperative concerns.

Children's experiences of dental anxiety

BACKGROUND

Dental anxiety is common among children. Although there is a wealth of research investigating childhood dental anxiety, little consideration has been given to the child's perspective.

AIM

This qualitative study sought to explore with children their own experiences of dental anxiety using a cognitive behavioural therapy assessment model.

DESIGN

Face-to-face, semi-structured interviews were conducted with dentally anxious children aged 11-16 years. The Five Areas model was used to inform the topic guide and analysis. Data were analysed using a framework approach.

RESULTS

In total, 13 children were interviewed. Participants described their experiences of dental anxiety across multiple dimensions (situational factors and altered thoughts, feelings, physical symptoms, and behaviours). Participants placed considerable value on communication by dental professionals, with poor communication having a negative influence on dental anxiety and the dentist-patient relationship.

CONCLUSIONS

This study confirms the Five Areas model as an applicable theoretical model for the assessment of childhood dental anxiety. Children provided insights about their own dental anxiety experiences that have not previously been described.

Using YouTube to Disseminate Effective Vaccination Pain Treatment for Babies

BACKGROUND

Infant vaccinations are necessary for public health, but are painful, causing distress to the infant and caregivers. Breastfeeding and sucrose effectively reduce infants' pain during vaccinations, and these strategies are recommended in health care provider (HCP)-targeted education and vaccination pain guidelines. However studies show these strategies are infrequently used. YouTube is a popular medium to publicly share and watch videos, and many consumer posted YouTube videos show distressed infants being vaccinated with no pain treatment. The aims of this study were to evaluate the reach and impact of a consumer-targeted YouTube video demonstrating use of effective pain reduction strategies during infant vaccinations.

METHODS

A brief consumer-targeted video showing two infants being vaccinated was posted onto YouTube on October 2013. One infant was breastfed and another infant received sucrose by mouth before and during the injection. A link to a viewer survey was visible on a banner near the end of the video. An intensive strategically planned knowledge dissemination strategy using the media, social media and messages to professional organizations took place to promote the video. Data analysis of the viewer survey, YouTube analytics of the reach of the video in terms of number of views, country of viewers, and comments relating to the video took place 12 months after the video was posted.

RESULTS

Twelve months after posting, the video had 65,478views, 68 comments, 245 likes, 17 dislikes, and 90 shares. Average duration of viewer time was 65% of the video. The viewer survey was completed by 156 (0.24%) viewers; 90 (58%) answered as HCPs and 66 (42%) as parents. Survey results showed that the video was persuasive; intent to use or support breastfeeding or sucrose was high in both parents and HCPs after viewing the video. Comments posted were often emotional in nature, and were related to anti-vaccination (n = 26, 38%); effectiveness or positive personal experiences (n = 21, 32%); research team comments or promotion (n = 12, 18%); pro-vaccination (n = 6, 8%) and barriers to using breastfeeding or sucrose during vaccinations (n = 3, 4%).

CONCLUSION

The video posted onto YouTube demonstrating effective pain treatment during infant vaccinations was viewed by large numbers of people around the world, however the response rate to the linked survey was extremely low. Using YouTube videos for knowledge dissemination has an extensive reach, however it is difficult to evaluate impact on behaviours and practices.

Potential and Challenges in Collecting Social and Behavioral Data on Adolescent Alcohol Norms: Comparing Respondent-Driven Sampling and Web-Based Respondent-Driven Sampling

Background

Respondent-driven sampling (RDS) is a method successfully used to research hard-to-access populations. Few studies have explored the use of the Internet and social media with RDS, known as Web-based RDS (WebRDS). This study explored the use of combining both “traditional” RDS and WebRDS to examine the influences on adolescent alcohol use.

Objective

This paper reports on the recruitment processes and the challenges and enablers of both RDS and WebRDS. It details comparative recruitment data and provides a summary of the utility of both methods for recruiting adolescents to participate in an online survey investigating youth alcohol norms.

Methods

Process evaluation data collected from research staff throughout the study were used to assess the challenges and solutions of RDS and WebRDS. Pearson chi-square test (Fisher’s exact test if applicable) was used to compare the differences in sociodemographics and drinking behavior between data collected by RDS and WebRDS.

Results

Of the total sample (N=1012), 232 adolescents were recruited by RDS and 780 by WebRDS. A significantly larger proportion of Aboriginal or Torres Strait Islander (P<.001) participants who spoke English as their main language at home (P=.03), and of middle and lower socioeconomic status (P<.001) was found in the RDS sample. The RDS sample was also found to have a higher occurrence of past 7-day drinking (P<.001) and past 7-day risky drinking (P=.004). No significant differences in gender, age, past month alcohol use, and lifetime alcohol use were observed between the RDS and WebRDS samples. This study revealed RDS and WebRDS used similar lengths of chains for recruiting participants; however, WebRDS conducted a faster rate of recruitment at a lower average cost per participant compared to RDS.

Conclusions

Using WebRDS resulted in significant improvements in the recruitment rate and was a more effective and efficient use of resources than the traditional RDS method. However, WebRDS resulted in partially different sample characteristics to traditional RDS. This potential effect should be considered when selecting the most appropriate data collection method.