Effectiveness of low-level laser therapy in reducing pain perception of children during dental local anesthetic administration using laser acupuncture pen on the LI4 point: a randomized clinical trial.

PURPOSE: Laser acupuncture, a non-invasive variant of acupuncture, has been proven effective in the medical and dental fields. Hence, the present study aims to determine the effect of low-level laser therapy on the LI4 point, using a laser acupuncture pen, in reducing children's pain during local anesthetic (LA) administration. METHODS: Children in the age range of 8-12 years, in need of LA administration, were randomly assigned to two groups: Group I: laser acupuncture, Group II: control. For all the children, baseline simplified Modified Child Dental Anxiety Scale-Faces version (MCDAS(f)) was recorded, followed by laser acupuncture or standard care. Following the conventional protocol, LA was administered. The procedural pain was assessed using the Faces, Legs, Activity, Cry and Consolability scale (FLACC) and Faces Pain Scale-Revised (FPS-R). All the variations in pulse rate were recorded from baseline to the completion of LA administration. After the procedure, simplified MCDAS(f) was recorded one more time. The data were tabulated and analyzed statistically. RESULTS: A significant reduction in anxiety after LA administration, as observed in MCDAS(f) score, was noticed only in the laser acupuncture group. The pain scores, as reported in FPS-R, were low in children randomized to the laser group compared to the control. The FLACC pain scores also showed low values in the experimental group. CONCLUSION: Based on the study findings, within the limitations, low-level laser therapy using a laser acupuncture pen can reduce the pain perception of children undergoing LA administration and alleviate dental anxiety.

Adverse Effects of Implants in Children and Adolescents: A Systematic Review.

OBJECTIVE: To determine the evidence on the adverse effects of placing dental implants in healthy growing children. STUDY DESIGN: A systematic search was conducted in five electronic databases: PubMed, Ovid, Cochrane, EBSCO host, ProQuest. Studies on implants placed in children below the age of 19 years, with loss of tooth either due to trauma or caries were included, whereas, studies on mini implants and implants placed due to congenital absence of teeth were excluded. The articles that fulfilled the inclusion criteria were analyzed based on the predetermined criteria of success. RESULTS: A total of 8 publications fulfilled the inclusion criteria. All the included articles were case reports/series, involving a total of 16 implants (15 maxillary, one mandibular) in 11 adolescents (7 boys and 4 girls). The age of implant placement ranged between ten to 17 years with a mean age of 13.4 years and the follow up period, 4.5 months to 13 years. Pain, paresthesia, mobility or peri-implant radiolucency was not reported in any case report, indicating good integration. Radiographic crestal bone loss, probing depth and implant esthetics were not mentioned. The infraocclusion was not reported in 5 cases (age: 11-17 years, follow up: 4.5 months-two years), however, it was an adverse effect in 6 cases (age: ten-17 years, follow up: three-13 years). CONCLUSION: There is insufficient evidence to contradict the placement of dental implants in healthy growing children; the only reported adverse event is infraocclusion, the management of which too is discussed. However, as all the data is from case reports, the result should be interpreted with caution. Therefore, well-designed randomized controlled trials are needed to address this gap in the literature.

Effectiveness of Acupressure on Dental Anxiety in Children.

PURPOSE: Acupressure is a non-invasive variant of acupuncture and is known to reduce general anxiety. The purpose of this study was to test acupressure's effect on children's dental anxiety. METHODS: Eight- to 12-year-old children undergoing scaling and/or restorative procedures were randomly assigned to one of the following groups: acupressure (Group 1); sham (Group 2); or control (Group 3). Anxiety was recorded for all the children using the Modified Child Dental Anxiety scale (MCDAS). Acupressure beads with a piece of adhesive strip were employed over the selected acupoints for groups one and two. Anxiety was further recorded for all the children prior to and after completion of the treatment using MCDAS. The Frankl scale was used as the objective measure to assess the behavior of all the children. A physiologic parameter (pulse rate) was also recorded. The scores obtained from all the three groups were tabulated, compared, and analyzed statistically. RESULTS: A significant difference was found in MCDAS, pulse rate, and the Frankl behavior ratings among the three groups of children, with acupressure group displaying a lower level of anxiety. CONCLUSION: Acupressure can be a viable alternative to reduce dental anxiety in children undergoing scaling and restorative procedures.