Salivary cortisol response to psychological stress in children with early childhood caries.

Aims and Objectives: Early Childhood Caries (ECC) is a multi-factorial disease and has numerous biological, psychological, and behavioral risk factors. In this study, we have attempted to study psychological stress as a risk factor for early childhood caries by investigating and comparing the response of event-related stress on salivary cortisol level in children with ECC and those without ECC and also compared the adaptability to various dental procedures in children with early childhood caries and without early childhood caries. Materials and Methods: One hundred children aged between four and five years were examined in the school and 16 pairs of children with caries and without caries were selected after cross-matching them on various risk factors for Early Childhood Caries. Oral prophylaxis and topical fluoride treatment procedures were used as stressors and salivary samples were collected at the time of arrival for the treatment, after Oral Prophylaxis and Fluoride treatment. The salivary samples were analyzed by radioimmunoassay for an unbound plasma cortisol level. Results: Statistical analysis was performed using a paired t-test, on the collected data, to compare the mean values of the salivary cortisol across the group and within the groups to evaluate the cortisol response to stress. No significant differences were found between the salivary cortisol levels prior to treatment, post oral prophylaxis, or post fluoride treatment at the first and second appointments of both groups. At the first appointment, the fluoride treatment caused a significant increase in the salivary cortisol level over the pretreatment level, in both the groups, but it was not evident in either of the two groups studied at the second appointment. Conclusion: We have concluded that the stress produced by different dental procedures was similar in children from the two groups studied, and the coping ability of the children was also similar in both the groups. Small sample size may be one of the reasons why no significant differences were found between the groups. Similar study needs to be repeated with a larger sample size.

A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients.

Pain is not the sole reason for fear of dentistry. Anxiety or the fear of unknown during dental treatment is a major factor and it has been the major concern for dentists for a long time. Therefore, the main aim of this study was to evaluate and compare the two distraction techniques, viz, audio distraction and audiovisual distraction, in management of anxious pediatric dental patients. Sixty children aged between 4-8 years were divided into three groups. Each child had four dental visits--screening visit, prophylaxis visit, cavity preparation and restoration visit, and extraction visit. Child's anxiety level in each visit was assessed using a combination of four measures: Venham's picture test, Venham's rating of clinical anxiety, pulse rate, and oxygen saturation. The values obtained were tabulated and subjected to statistical analysis. It was concluded that audiovisual distraction technique was more effective in managing anxious pediatric dental patient as compared to audio distraction technique.

A study of behaviour patterns of normal children in a dental situation and its relationship with socioeconomic status, family type and sibling position.

Different psychosocial variables, such as socioeconomic status, family type and sibling position may be considered to be of great significance as it may influence child behaviour pattern in a dental treatment situation. 143 children in the age group of 3-14 years were selected randomly from the out patient department of Pediatric Dentistry, Dental Wing, S. C. B. Medical College, Cuttack with an aim of assessing relationship, if any, between the magnitude of behaviour and the above mentioned psychosocial variables. Behaviour rating was done using Frankl behaviour rating scale. The results of the study reveals no significant relationship between socio economic status, family type and sibling position with child behaviour pattern, but a trend has been observed that children of high socio economic back ground behave more positively, children of a nuclear family exhibit more negative attitude and middle siblings show less negative behaviour than youngest and eldest.

Compliance with supportive periodontal therapy. Part II: Risk of non-compliance in a 10-year period / Cooperação com terapia periodontal de suporte. Parte II: Risco de não-cooperação no período de 10 anos

Supportive periodontal therapy (SPT) is needed for the success of periodontal therapy; however, patient compliance is poor. Part II of this study analyzes compliance during a 10-year period in an attempt to identify the profile of patients with a higher risk of becoming non-compliant. Data from the records of 874 patients from a private periodontal clinic who had completed active periodontal treatment up to 10 years before and had begun supportive periodontal therapy were analyzed for risk of non-compliance and compliance. The factors evaluated were gender (326 males and 548 females), type of therapy (surgical or non-surgical) and age (<30 years, 31 to 40, 41 to 50, and >51 years old) and the association amongst them. In the period studied, compliance with SPT was 45.8 percent. Forty-three percent of males and 47 percent of females discontinued SPT. In the surgical group 43.9 percent were non-compliant and in the non-surgical group 53.2 percent were non-compliant. Fifty-nine percent of the patients <30 years of age were also non-compliant. Female patients <30 years and >51 years of age that underwent non-surgical therapy were found to be of higher risk for non-compliance in the 10-year period studied.