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Šimunović-Erpušina M, Bakarčić D, Cicvarić O, Šimunović L, Sotošek V, Petrović D, Ivančić Jokić N. Postoperative Morbidity after Dental Treatment under General Anesthesia in Children with and without Disabilities. Medicina (Kaunas) 2024; 60:668. [PMID: 38674314 PMCID: PMC11051803 DOI: 10.3390/medicina60040668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/04/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: General anesthesia induces reversible unconsciousness, eliminating sensation and enabling painless medical procedures. Vital for dental care, it addresses patients with medical conditions, those needing extensive procedures, and those unable to cooperate due to fear. Dental care for patients with disabilities is a significant unmet need, with studies showing increased oral disease prevalence. This research aims to analyze postoperative morbidity both in healthy and disabled children undergoing dental procedures under general anesthesia. Materials and Methods: This study involved 96 children aged 3 to 15 with dental caries. Two groups were formed: the control group (CTL) (52.94%) included healthy patients requiring general anesthesia due to unsatisfactory cooperation, and the other group included children with physical or intellectual disabilities (CD) (47.96%). Postoperative complications were monitored 1 h after the procedure and 1, 3, 7, and 14 days after the procedure by contacting parents/caregivers by phone. The intensity of postoperative pain was assessed using the Wong-Baker faces pain rating scale. General anesthesia was conducted following a standardized protocol for dental procedures. Results: CTL patients complained more often about postoperative pain 1 h after the procedure (p = 0.03). One day after the procedure, oral bleeding (p = 0.04), fever (p = 0.009), and diarrhea (p = 0.037) occurred more often in CD. In the same period, sore throat appeared more often in CTL (p = 0.036). Three days after the dental treatment, there were statistically significant increases in the occurrence of agitation (p = 0.043) and constipation (p = 0.043) in CD. Seven days later, CD demonstrated a higher occurrence of agitation (p = 0.037). According to the Wong-Baker faces pain rating scale, CTL experienced more frequent and intense pain. Conclusions: CD more frequently reported complications like oral bleeding, fever, and diarrhea. In contrast, the CTL group more often reported pain-related symptoms. The conclusion underscores the need for a pain control protocol for CD and emphasizes the importance of frequent monitoring to prevent unwanted consequences during tooth restoration under general anesthesia.
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Affiliation(s)
- Marija Šimunović-Erpušina
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (M.Š.-E.); (O.C.); (D.P.); (N.I.J.)
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia;
| | - Danko Bakarčić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (M.Š.-E.); (O.C.); (D.P.); (N.I.J.)
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia;
| | - Odri Cicvarić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (M.Š.-E.); (O.C.); (D.P.); (N.I.J.)
| | - Luka Šimunović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Vlatka Sotošek
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia;
- Department of Anesthesiology, Reanimatology, Emergency and Intensive Care Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
- Department of Clinical Medical Sciences II, Faculty of Health Studies, University of Rijeka, Rijeka, Viktora Cara Emina 2, 51000 Rijeka, Croatia
| | - Dorotea Petrović
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (M.Š.-E.); (O.C.); (D.P.); (N.I.J.)
| | - Nataša Ivančić Jokić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (M.Š.-E.); (O.C.); (D.P.); (N.I.J.)
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia;
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Petrović D, Cicvarić O, Šimunović-Erpušina M, Ivančić Jokić N, Bakarčić D, Bučević Sojčić P, Jurić H. The Role of Family Factors in the Development of Dental Anxiety in Children. Medicina (Kaunas) 2024; 60:180. [PMID: 38276059 PMCID: PMC10818455 DOI: 10.3390/medicina60010180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Background and Objectives: In the literature, the influence of parents who suffer from dental anxiety and a previous unpleasant experience at the dentist are cited as the two most common causes of dental anxiety in children. The aim of this study is to investigate the relationship between socioeconomic factors and the development of dental anxiety in children aged 9 to 12 years. Materials and Methods: A total of 131 children and their accompanying parents/guardians participated in the cross-sectional study. The children were divided into an experimental group, which visited a specialised office for paediatric and preventive dentistry for the examination, and a control group, which visited a primary care dental office. During the visit, the children completed questionnaires on dental anxiety (CFSS-DS). Parents completed a socioeconomic questionnaire and a dental anxiety questionnaire for adults (CDAS). Results: The results showed a statistically significant positive predictor: parental dental anxiety as measured by the CDAS. In addition, the t-test showed that children who visited a specialised dental office did not show a statistically significant increase in dental anxiety compared to children who visited a primary care dental office. Conclusions: With this study, we confirm the influence of parental dental anxiety on the development of dental anxiety in children. The socioeconomic status of the family and the type of dental office do not play a statistically significant role in the development of dental anxiety in children.
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Affiliation(s)
- Dorotea Petrović
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
| | - Odri Cicvarić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
| | - Marija Šimunović-Erpušina
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
- Dental Clinic, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Nataša Ivančić Jokić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
- Dental Clinic, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Danko Bakarčić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
- Dental Clinic, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Petra Bučević Sojčić
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Hrvoje Jurić
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- University Dental Clinic, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
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Fetai A, Debeljak V, Kovačević Pavičić D, Ivančić Jokić N, Negovetić Vranić D, Kovač Z, Komar D, Verzak Ž. Self-Massage and Low-Level Laser in Treatment of Masseter Myalgia: Short-Term Effect. Psychiatr Danub 2021; 33:63-70. [PMID: 34672274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The aim of this study was to explore the efficiency of massage in the treatment of masseter myalgia compared with biostimulatory laser. MATERIALS AND METHODS The instrument Diagnostic Criteria for Temporomandibular Disorders was used to select subjects and monitor treatment outcome. 54 subjects with masseter myalgia of more than 3 months in duration were invited to participated and 42 cases were available at the end and analyzed. Age range was 16-67 years (median 33, interquartile range 25-53), 36% subjects was ≥40 years and there were 62% females in both groups. Both treatment groups (self-massage and laser) had 21 participants and were monitored one months after the start of treatment. Age, gender, distress, somatization, catastrophizing, hypervigilance, health competence and oral parafunctions were also assessed as factors that could influence effectiveness of treatment. RESULTS Laser and massage are effective in reducing symptoms of chronic myalgia of the masseter in self-reported limitation of jaw function and reducing pain intensities (p<0.001). Increase of mouth opening was present in both groups, but mainly significant in laser group. The differences in the amount of change between groups were not significant. Psychological characteristics and parafunctions, present before the treatment, age and gender did not have major affect the effectiveness of treatment. CONCLUSION Both treatment modalities are effective in treatment of chronic myalgia in short-term.
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Farkaš M, Ivančić Jokić N, Mavrinac M, Tambić Andrašević A. Antibiotic Prescribing Habits and Antimicrobial Resistance Awareness of Dental Practitioners in Primorsko-Goranska County, Croatia. Microb Drug Resist 2021; 27:1482-1488. [PMID: 33913770 DOI: 10.1089/mdr.2020.0478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The goal of this study was to investigate the differences in dentists' knowledge, attitudes, and practice regarding antibiotic use and resistance among two areas of Primorsko-Goranska County (P-GC), Croatia. Materials and Methods: A cross-sectional study based on a structured questionnaire that was given to 230 dental practitioners in outpatient settings of P-GC in 2018. Results: The overall response rate was 68.3% (157/230) and 72.2% (83/115) in the city of Rijeka and 64.3% (74/115) in the rest of P-GC. Dentists from two areas of P-GC held similar knowledge about prescribing antibiotics and attitudes regarding antibiotic use (p > 0.05). Most of the dental practitioners chose penicillins (65.0% amoxicillin with clavulanic acid and 33.1% amoxicillin) as the first-choice antibiotic in patients with no medical allergies. The trend of prescribing amoxicillin decreases with the age of the dentists (p = 0.046). Clindamycin (86.6%) was the first choice for patients allergic to penicillin. Postgraduate education changed the attitude toward taking more time to consider whether or not an antibiotic is needed. Croatian dentists had a high awareness of antimicrobial resistance (99.4%). The most common situations for which dentists would prescribe antibiotics were periapical abscess (84.7%), periodontal abscess (72.6%), and implant placement (59.9%). Patient request or expectation (43.4%) and treatment uncertainty (41.5%) were found to be the main factors for prescribing antibiotics with more frequency. Conclusions: Although there is a high level of antimicrobial resistance awareness among dental practitioners, there is still too much overuse of antibiotics and personal responsibility for prudent antibiotic use should be increased. The results of this study indicate that antibiotics are frequently prescribed for indications where surgical treatment should be the first option and the broad spectrum antibiotic is the preferred treatment option.
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Affiliation(s)
- Maja Farkaš
- Department of Microbiology, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia
| | - Nataša Ivančić Jokić
- Department of Paediatric Dentistry, University of Rijeka Faculty of Dental Medicine, Rijeka, Croatia.,Department of Paediatric Dentistry, Clinical Hospital Centre, Rijeka, Croatia
| | - Martina Mavrinac
- Department of Medical Informatics, University of Rijeka Faculty of Medicine, Rijeka, Croatia
| | - Arjana Tambić Andrašević
- Department of Clinical Microbiology, University Hospital for Infectious Diseases, "Dr. Fran Mihaljević," Zagreb, Croatia.,Department of Microbiology, University of Zagreb School of Dental Medicine, Zagreb, Croatia
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Bakarčić D, Lajnert V, Jokić NI, Gržić R. Masticatory efficiency in children with cerebral palsy. Eur Arch Paediatr Dent 2021; 22:77-82. [PMID: 32346832 DOI: 10.1007/s40368-020-00529-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/15/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose of this investigation was to compare quality of chewing in children with CP to the healthy controls, and determine whether the functional capacity of chewing units and overall dental health affect the quality of chewing. METHODS A total of 86 were included in the investigation: 43 children with CP and 43 controls (13 girls aged 7-16 years and 30 boys aged 9-16 years) residents of the institutions for the children with special needs. Control group included the same number of children matched by age and gender for every child from the test group according to the pairing principle. The number of functional masticatory units was expressed through the number of healthy teeth and teeth with cavities which the patients could use for chewing. Masticatory efficiency assessment was determined by the method of chewed almond transparency after ten chewing cycles. The particles were passed through 12 sieves with diameter range from 0.6 to 7.2 mm. The masticatory efficiency was expressed with the number of sieves needed to pass 50% of the total almond mass. RESULTS Healthy children had significantly more teeth in occlusal contact, while the DMF index did not differ significantly. Both groups had the same number of functional masticatory units. Children with CP had significantly poorer quality of chewing. CONCLUSION Children with CP had significantly poorer quality of chewing which is not affected by tooth functionality, but rather the primary condition.
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Affiliation(s)
- D Bakarčić
- Department of Paediatric Dentistry, Faculty of Dental medicine, University of Rijeka, Kresimirova 40, 51000, Rijeka, Croatia
| | - V Lajnert
- Department of Prostodontics, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
| | - N I Jokić
- Department of Paediatric Dentistry, Faculty of Dental medicine, University of Rijeka, Kresimirova 40, 51000, Rijeka, Croatia.
| | - R Gržić
- Department of Prostodontics, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
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Verzak Ž, Jokić NI, Modrić VE, Bakarčić D, Karlović Z, Ulovec Z, Vranić DN. Psychosocial and Economic Status of the Parents with Children with and without Tooth Trauma. Psychiatr Danub 2016; 28:428-433. [PMID: 27855436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The main goal of this research is to try and understand influence of psychological and social factors in children with tendencies to repeat tooth trauma. SUBJECTS AND METHODS Research included 147 patients, children of preschool and school age (88 boys and 59 girls). In the research patients were divided in two age groups: 5-8 and 9-12 years. In both groups there were 49 patients with no experience of dental trauma and 69 patients with experience of one dental trauma and 29 patients with repeated dental trauma. All patients that were involved in the study had previous experience with dental and medical treatment. Study included evaluation of dental anxiety and also factors that caused dental phobia previous their visit to the office in the children with no dental trauma compared to repeat dental trauma patients. On the whole study group differences considering sex, age and psychosocial status in the level of dental anxiety and dental fear were also measured. RESULTS Categories of children without trauma and with one or multiple trauma showed that it is a similar sex division in the categories. In the no trauma group participation of the boys is lower (46.9%) while in the group with repeated trauma their participation is significantly higher (79.3%). Based on that the risk of repeated dental trauma is characteristic of boys. CONCLUSIONS Results of this study show that tested psychosocial variables do not differentiate participants according to the tested groups or in other words there is no difference between tested groups in their psychosocial standing.
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Affiliation(s)
- Željko Verzak
- Department of Paediatric Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia,
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Negovetić Vranić D, Ivančić Jokić N, Bakarčić D, Carek A, Rotim Ž, Verzak Ž. Dental Fear in Children with Repeated Tooth Injuries. Acta Clin Croat 2016; 55:259-64. [PMID: 28394113 DOI: 10.20471/acc.2016.55.02.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Tooth injuries are serious clinical conditions. Some children experience dental trauma only once, while others are more prone to repeated tooth injuries. Repeated dental trauma occurs in 19.4% to 30% of patients. Pain and dental trauma are the most common reasons for fear and anxiety. The main objective of this study was to investigate how dental trauma, as well as repeated dental trauma affects the occurrence and development of dental fear in children. The study was conducted on a random sample of 147 subjects (88 boys and 59 girls) aged 5-8 and 9-12 years. Subjects in both age groups were divided into subroups without dental trauma, with one dental trauma and with repeated dental trauma. The validated Children’s Fear Survey Schedule – Dental Subscale was used on fear assessment. Results showed that only 12.2% of children without trauma, 33.3% with one trauma and 51.7% with repeated trauma were not afraid of injection. Older children had a significantly lower fear of injections, touch of an unknown person, choking, going to the hospital and people in white uniforms. Dentist was not the cause of fear in 65.5% of patients with repeated trauma. With each repeated injury of teeth, the degree of their fear of dental treatment was lower.
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Affiliation(s)
| | - Nataša Ivančić Jokić
- Department of Pediatric Dentistry, School of Medicine, University of Rijeka, Rijeka University Hospital Center, Rijeka, Croatia
| | - Danko Bakarčić
- Department of Pediatric Dentistry, School of Medicine, University of Rijeka, Rijeka University Hospital Center, Rijeka, Croatia
| | - Andreja Carek
- Department of Fixed Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Željko Verzak
- Department of Pediatric Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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