Parental anxiety associated with children undergoing dental treatment.

AIM: Over the past two decades, improvements in both the safety of anaesthetic agents and the techniques of operative dentistry have resulted in the popularity of "day-case anaesthesia". The aim of this study was to evaluate the stress felt by parents of children undergoing dental treatment. The study also aimed to compare the stress felt by parents of children undergoing chairside treatment to the stress felt by parents of children who received their treatment under general anaesthesia. MATERIALS AND METHODS: Study Design: Stress among parents was assessed subjectively using the Modified Dental Anxiety Stress (MDAS) questionnaire and objectively using a pulse oximeter to record the heart rate. The sample comprised of 60 parents of children aged between 4 and 7 years who were divided into three groups. Group A comprised of 20 sets of parents of children who underwent complete dental treatment without any pharmacological behaviour management. Group B comprised of 20 sets of parents of children who were treated at the dental chair with N2O used as pharmacological behaviour management. Group C comprised of 20 sets of parents of children who underwent dental rehabilitation under general anaesthesia. Objective signs were recorded preoperatively, during the procedure and post-operatively. RESULTS: Dental treatment is a stressful experience for a parent. The introduction of a pharmacological method of behaviour management seems to significantly increase the stress felt by the parent. CONCLUSIONS: A significant increase in heart rate was observed among parents whose children were under treatment.

The relationship between examination-related academic stress, salivary antioxidant capacity and exercise patterns of final-year Saudi dental students.

OBJECTIVE: To study the impact of examination stress on the total antioxidant capacity (TAC) of senior dental students and compare changes in TAC between students who exercise regularly and those who do not. METHODS: A questionnaire designed to evaluate physical activity levels, body mass index (BMI) and academic performance was distributed to 325 senior dental students. Of the 312 who responded, a total of 70 were enrolled in the study, of whom 60 completed the study. The students were composed of a low-activity group (n = 30), who had a Goddard-Sheppard (GS) exercise score of <25, and a high-exercise group (n = 30), who had a GS score >60. Dental Environment Stress (DES) questionnaires and salivary samples were collected at the first week of the semester and at the week of the examinations. Salivary TAC was measured using a commercially available Radical Absorbance Antioxidant Assay measurement kit (Zen-Bio ORAC™, AMS Biotechnology, Abington UK). A total of 60 students completed the study. RESULTS: A significant increase in DES values and a significant reduction in salivary TAC values were observed in the week of the examination compared to baseline scores. Although no differences were observed in the DES scores between the high-exercise and low-exercise groups, the high-exercise group showed a significantly lower reduction in examination week salivary TAC compared to their counterparts in the low-exercise group. Regression models showed a significant association between the TAC, exercise scores and DES scores in the week of the examinations. CONCLUSION: Regular exercise may help protect students against the oxidative stress associated with academic stress.

The role of an occlusal template during the placement of preformed metal crowns in children under general anaesthesia: a randomised control trial.

AIM: This aim was to evaluate preformed metal crowns (PMC) placed under general anaesthesia using an occlusal template in comparison to crowns placed without the use of a template. METHODOLOGY: CONSORT protocols were followed in the design of the study. A total of 60 children between 4-7 years requiring pulpotomy and PMC for all primary molars met the inclusion criteria for this study. The control group comprised patients for whom the PMC were placed without the use of an occlusal template, while in the test group crowns were placed using a polyvinyl siloxane occlusal template. Patients were followed up at 24 h, 7 days, 3 and 6 months. The time taken for the placement of crowns, instances of post-operative discomfort, success or failure of the pulp therapy and loss of any crowns were compared between the groups. RESULTS: The mean time taken for completion of the procedure in the control group was significantly greater than the template group (t = 2.566, p = 0.013). Significantly fewer patients in the template group reported symptoms of discomfort or high points at the 24-h recall; however, these differences were not significant at the 1-week, 3- or 6-month recall. CONCLUSION: The use of an occlusal template for the placement of multiple PMC under general anaesthesia reduces the time taken for their placement and reduces the incidence of immediate post-operative discomfort.

Accuracy of electronic apex locators in primary teeth: a meta-analysis.

AIM: To conduct a meta-analysis on the accuracy of electronic apex locators (EALs) in determining working length in human primary teeth. METHODOLOGY: An electronic literature search was conducted using a combination of the terms 'primary teeth', 'root canal length' and 'electronic apex locators'. Additional eligible articles were identified using a manual search. The full texts of identified articles were screened according to inclusion criteria. RESULTS: Overall, 19 studies met the inclusion criteria and were subjected to further data extraction. Meta-analysis of studies that reported mean lengths and difference in mean lengths between EAL and actual root canal length (ARCL) revealed a significant difference (P = 0.015) between the two readings whilst those studies that evaluated intraclass correlation (ICC) suggested a high correlation (P < 0.0001) between the EAL and ARCL readings. A subgroup analysis revealed that the presence of root resorption did not affect the accuracy of EALs (P = 0.567). CONCLUSION: Electronic apex locators offer an acceptable level of accuracy in the measurement of root canal length in primary teeth.

The impact of dental treatment on the salivary cortisol levels of children with severe early childhood caries.

AIM: To compare salivary cortisol levels of caries-free children with those of children with severe early childhood caries (S-ECC) before and 3 months after comprehensive dental treatment. METHODS: Thirty children with S-ECC were matched with 30 caries-free children from middle income families with college-educated working mothers. Early-morning saliva samples were collected from the children using the passive drool method. Post-treatment saliva samples were collected 3 months after completion of treatment in the S-ECC group. Salivary cortisol levels were analysed using electrochemiluminescence immunoassay. RESULTS: Salivary cortisol levels of caries-free children were significantly lower than both the pre-treatment and post-treatment levels of children with S-ECC (F = 26.221, p < 0.0001). The pre-treatment cortisol levels of children with S-ECC were significantly higher than the post-treatment levels (t = 2.588, p = 0.015). No significant differences in cortisol levels were observed between genders or between children treated over multiple visits under local analgesia and in a single visit under general anaesthesia. CONCLUSION: Dental treatment significantly reduced the salivary cortisol levels of children with S-ECC, however, the post-treatment levels remained significantly higher than those of caries-free children.