Comparison of two behavior management techniques used during mandibular block anesthesia among preschool children: a randomized clinical trial.

PURPOSE: To compare the Tell-Show-Do Technique (TSD-T) with Hiding Dental-Needle Technique (HDN-T) based on children's anxiety, pain, and behavior during first-time mandibular block anesthesia. METHODS: A total of 52 children aged 3-5 years who had never received dental anesthesia and had at least one mandibular primary molar requiring extraction or pulpal therapy were included in the study. Children were randomly allocated into two groups: G1: TSD-T (n = 26) and G2: HDN-T (n = 26). This study included two sessions: intervention session (baseline) and control session (7 days after intervention). Facial Image Scale and Wong-Baker Pain Scale were used to evaluate anxiety and pain levels, respectively. Frankl Behavior Scale was used to assess children's behavior. RESULTS: Anxiety and pain levels were not statistically significant between G1 and G2 groups (p > 0.05). Similar results were observed for children's behavior rating (p > 0.05). Higher pain level was associated with younger children (rate ratios (RR) = 0.41; p = 0.016) and negative behavior (RR = 1.11; p < 0.001). On the other hand, in within-groups comparisons, there was a statistical difference in anxiety levels between intervention session and control session (p = 0.032) in G2. CONCLUSIONS: Even though there are no differences in the efficacy of TSD-T compared to HDN-T during first-time mandibular block anesthesia in preschool children in terms of children's anxiety, pain, and behavior, children from the HDN-T group can show reduced dental anxiety levels in the control sessions.

Does previous dental care experience make the child less anxious? An evaluation of anxiety and fear of pain.

PURPOSE: Evidence has shown an inverse correlation between previous dental care experience and anxiety levels in children. This study aimed to determine the prevalence of dental anxiety in Brazilian schoolchildren and to evaluate the association between previous experience with the dentist and anxiety and fear of pain. METHODS: This was a cross-sectional descriptive study carried out in two cities in Brazil with 1191 schoolchildren aged 6-12 years. The data were collected through interviews and clinical examination. The interviews followed the Dental Anxiety Question (DAQ), the Fear of Dental Pain Questionnaire Short Form (S-FDPQ) adapted to children, and some sociodemographic questions. RESULTS: Dental anxiety was more prevalent in the younger group, with a higher prevalence of moderate and severe anxiety. The group with extreme anxiety showed a higher prevalence of extreme fear, whereas the group who did not present anxiety showed a higher prevalence of children with moderate fear of pain. Children who had not visited the dentist showed a higher prevalence of fear and a lot of fear (33.5%) as compared to those who had already experienced dental care (13.9%). The prevalence of severe anxiety and extreme fear of pain was higher in the group of female children aged 6-9 years, and with caries experience (P < 0.001). CONCLUSIONS: The experience with the dentist was associated with less anxiety and fear of pain. The age of the child was a determining factor for changes in their anxiety level. Severe dental anxiety influences fear of pain experienced by the child.

Efficacy of silver diamine fluoride and sodium fluoride in inhibiting enamel erosion: an ex vivo study with primary teeth.

PURPOSE: To assess the efficacy of silver diamine fluoride (SDF) and sodium fluoride (NaF) in inhibiting enamel erosion in primary teeth. METHODS: 80 primary canine teeth were immersed for 24 h in 2% NaF, 10% SDF, or distilled water. Afterward, some of them underwent a 10-min acid challenge using either 1% or 10% citric acid while others did not. Specimens selected for negative controls were immersed in distilled water but not exposed to the acids, whereas those selected for positive controls were not only immersed in distilled water, but also exposed to the acids. Following, 3-mL samples were collected for calcium and phosphorus analysis by an atomic emission spectrometer. RESULTS: 1% acid caused higher phosphorus loss in the positive control group than in the others (no differences between them). Regarding 10% acid, the SDF group showed lower phosphorus loss compared to the positive control and NaF groups. From calcium loss analysis, SDF and NaF groups presented no significant difference when compared to the positive control groups after both acidic challenges. CONCLUSION: Considering phosphorus loss values, 10% SDF seems to be effective in inhibiting enamel erosion after 1% and 10% citric acid challenges, whereas 2% NaF only after 1% citric acid challenge. Regarding calcium loss values, both fluoride agents seem to have no impact on inhibiting enamel erosion after 1% and 10% citric acid challenges.