Exploring the Effect of Ethnicity on Chronic Orofacial Pain: A Comparative Study of Jewish and Arab Israeli Patients.

The relationship between ethnicity and chronic pain has been studied worldwide. The population of Israel includes two main ethnic groups, 75% Jews and 21% Arabs. The purpose of this study was to compare orofacial chronic pain characteristics and treatment outcomes between Jewish and Arab Israeli citizens. Two hundred patients admitted to the Orofacial Pain Clinic at Hebrew University-Hadassah School of Dental Medicine between 2017 and 2022 were selected randomly for this historical cohort study. Our cohort included 159 (79.5%) Jews and 41 (20.5%) Arabs. Twenty-six pain-related variables were compared of which only two differed significantly between the two groups, awakening due to pain and mean muscle sensitivity; both indicators were higher in the Arab group (p < 0.05). No differences were found in any of the other variables such as diagnosis, pain severity, onset, and treatment outcome. This minimal difference may be explained by the equal accessibility to medical services for all citizens, and the diversity of our staff that includes Jew as well as Arab service providers. These factors minimize or even eliminate racial bias, language, and cultural barriers, and is reflected in the minor differences in orofacial pain characteristics found between the two main ethnic groups in Israel.

The effect of Ekman-Westborg and Julin trait (generalized megadontia) and localized megadontia on tooth components size and ion content.

AIMS: The objective of this study is to compare size, enamel thickness and ion relative concentration in generalized megadontia (Ekman- Westborg and Julin trait) and a localized megadont upper third molar to normal teeth. MATERIALS AND METHODS: The MD dimensions of permanent teeth were compared to controls. Tooth components of molars were measured from X-rays and compared to controls. The enamel and dentin relative amounts of elements of mandibular first permanent molar and deciduous canines of E-WJ trait girl, and megadont upper third molar were determined using ESD program of SEM and compared to match-paired normal teeth. RESULTS: The teeth of the girl diagnosed with E-WJ trait were true megadont (larger than mean ± 2SD). The ratio of enamel thickness to M-D dimension of molars of E-WJ trait and localized megadontia molars is reduced in comparison with normal similar teeth. In the enamel, carbon and silica concentrations were different in E-WJ trait teeth. CONCLUSIONS: The enamel thickness was reduced in the E-WJ trait and megadont molars, but the relative amount of elements in enamel and dentin was similar to normal. The megadontia is due to a very large tooth germ, as determined by the DEJ, while the ratio of enamel apposition from the total M-D dimension is reduced. CLINICAL RELEVANCE: Generalized megadontia, as observed in E-WJ trait, is due to large tooth germ, but the enamel thickness is similar to normal. Extractions of permanent teeth are necessary in order to allow normal eruption of teeth.

Maxillary deformity following CPAP treatment in myasthenia gravis.

OBJECTIVE: Patients with Myasthenia gravis (MG) are characterized by muscle weakness that may cause obstructive sleep apnea (OSA). The use of a continuous positive airway pressure (CPAP) device is often needed in order to maintain free breathing during the night and sometimes even during the day. CLINICAL PRESENTATION: A 29-year-old MG patient is presented who used a CPAP continuously since the age of 12. Tight fitting of a nasal mask applied enough force to cause severe maxillary deformity. CLINICAL RELEVANCE: Masks with additional forehead and chin support or a regular full face mask are recommended for patients with muscle weakness, in order to spread forces more evenly.

Pediatric sleep-disordered breathing: Role of the dentist.

OBJECTIVE: In this review article, the role of the dentist in the evaluation and treatment of snoring and Obstructive Sleep Apnea Syndrome (OSAS) in children is described. Snoring and OSAS in children is receiving increased awareness, with reported rates approximating 10% of children who regularly snore, and up to 4% who suffer from OSAS. OSAS in children may have serious developmental and behavioral consequences. Apnea Hypopnea Index (AHI) is the main outcome of the polysomnography test, but its diagnostic values differ from children to adults, as do treatment approaches. DATA SOURCES AND STUDY SELECTION: A comprehensive literature search of publications from 1973 to 2017 in the PubMed Direct databases was performed to collect information about snoring and OSAS in children. The search was limited to peer-reviewed articles written in English with a few exceptions in other languages. CONCLUSION: Dentists play a significant role in early detection of OSAS, helping in reducing and preventing its serious consequences. A multidisciplinary treatment team, which manages and treats OSAS, should include the dentist in addition to the sleep specialist and the ENT physician.