Effect of cryoanesthesia and sweet tasting solution in reducing injection pain in pediatric patients aged 7-10 years: a randomized controlled trial.

Background: The delivery of profound local anesthetics helps children receive successful treatment by reducing fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the most anticipated stimuli in dental surgery. Children's perceptions of pain can be altered by applying cryotherapy to precool the oral mucosa or by diverting their minds through taste distractions before administering local anesthetic injections. This study aimed to evaluate the efficacy of cryoanesthesia and xylitol sweet-tasting solution at the injection site in 7-10-year-old children. Methods: A total of 42 participants, aged 7-10 years, who underwent dental treatment requiring local anesthesia, were enrolled in the study. The children were randomly divided into three groups. In group I, sterile water was held in the mouth for 2 minutes before anesthetic administration, similar to group II, and in group III, a xylitol sweet-tasting solution was used for 2 minutes before needle insertion. The analysis of pain perception was carried out based on the Visual Analog Scale (VAS) and the Sound, Eyes, and Motor (SEM) scale. For VAS analysis, a one-way analysis of variance (ANOVA) was performed for intergroup comparison, and a post hoc Tukey test was performed for subgroup analysis. For the categorical SEM scale, the Kruskal-Wallis test followed by the post hoc test was performed for intergroup comparison. Where a P value of <0.05 was considered statistically significant at 95% confidence intervals. Results: Cryoanesthesia significantly reduced pain scores on VAS (4.21 ± 1.42) when compared to those on VAS with xylitol sweet-tasting solution (5.50 ± 1.40) and that with sterile water (6.14 ± 2.47). Intergroup comparison of the VAS scores among the three groups was performed using one-way ANOVA, which demonstrated statistically significant differences (P value <0.026) on the VAS scale. Intergroup comparison of the SEM scale was performed using the Kruskal-Wallis test, followed by post hoc comparison, which exhibited statistically significant differences (P < 0.007) among the three groups for the SEM scale. Conclusion: Cryoanesthesia demonstrated higher efficacy in reducing injection pain than that exhibited by the xylitol sweet-tasting solution.

Assessment of children's emotions before, during, and after the dental treatment procedure: An emoji-based study.

Background: Emojis are used to communicate emotional content as conversational indicators. Emojis of human faces are unrivaled in communication since they can discern between several basic emotions with great precision while also being universal. Aim: Assessment of children's emotions before, during, and after the dental treatment procedure: An emoji-based study. Materials and Methods: A total of 85 children, ranging in age from 6 to 12 years, were separated into four groups. Group 1 required local anesthetic for restoration, while Group 2 required extraction. Pulp treatment was in Group 3 and oral prophylaxis was in Group 4. All groups used an animated emoji scale (AES) to quantify anxiety before, during, and after the dental treatment procedure. Results: There was a statistically significant difference when the mean scores of the four treatment groups were compared before, during, and after the procedure. When Group 2 was compared to Groups 1, 3, and 4 there was a statistically significant difference in the anxiety of the research participant before, during, and after the procedures (P = 0.01). Groups 2, 3, and 4 were statistically significant after the treatment procedure (P = 0.01). Conclusion: The findings of this study suggest that the AES can be a useful tool in tracking a patient's emotions during the dental treatment procedure to initiate appropriate behavior management.

The effect of sterilization and disinfection on the physical-mechanical properties of preformed crowns.

INTRODUCTION: Different sizes of crowns may be tried on children since there is no universal crown size because of distinctions in tooth morphology from one child to other. During the process of trial and error, the crown gets contaminated which needs to be sterilized for reuse of crown. This study was carried out to evaluate the physical-mechanical outcome after the sterilization and disinfection of pediatric preformed crowns. MATERIALS AND METHODS: In total, sixty crowns consisted of 20 each, stainless steel crowns (SSCs) (3M ESPE), preveneered stainless steel (Kinder Krowns), and Zirconia crowns (Kinder Krowns) which were divided into four groups. G1 in which crowns did not undergo any sterilization, G2 consisted of fast sterilization, similarly G3 was slow sterilization, and G4 underwent chemical disinfection using Korsolex Plus for 15 min. Following sterilization, all the crown samples were observed under a stereomicroscope at ×200 magnification and assessed for color change, crazing, dimensional stability, and fracturing. Post hoc Tukey test and two-way ANOVA were performed for comparison between types of crowns and sterilization methods, with a significance level was set at P < 0.05. RESULTS: There was no color change or fracturing following sterilization among crowns in any of the groups. Highest crazing was noted in stainless steel and the least in Zirconia crowns. Preveneered stainless steel was the most dimensionally stable and SSCs was the least. CONCLUSION: No color changes and fracture were noted in any type of crowns. Preveneered stainless steel was most dimensionally stable followed by Zirconia and SSCs. Maximum crazing was seen in SSCs and nil in Zirconia.

Knowledge, attitude, and practice regarding standardized treatment protocol for pulp therapy in deciduous dentition among general dental practitioners of Vadodara, Gujarat, India.

INTRODUCTION: Dental caries is the most prevailing disease not only affecting permanent dentition, but also involving deciduous dentition. Deciduous teeth are considered a best space maintainer and preserve arch integrity for eruption of succedaneous permanent teeth. General dental practitioners (GDPs) seem to be less interventionist in their investigation and treatment planning and many times, the treatment done remains incomplete either due to the lack of knowledge of the dentist or due to noncooperation of the child and/or parents. PURPOSE: The aim of this study was to assess the knowledge, attitude, and practice among GDPs of Vadodara city regarding standardized treatment protocol (STP) for pulp therapy in deciduous dentition. MATERIALS AND METHODS: This questionnaire-based, cross-sectional study was conducted to assess the knowledge, attitude, and practice regarding standardized treatment options available for pulp therapy in deciduous dentition. The distribution of the self-made questionnaire pro forma was done in person to all the GDPs after obtaining their prior appointments. The GDPs were grouped on the basis of qualification and total clinical experience in years. The questionnaire consisted of 11 questions. The data were collected, and descriptive statistical analysis was performed. The Chi-square test was used to assess the knowledge, attitude, and practice among different groups of GDPs. RESULTS: A statistically significant difference was observed in knowledge regarding STP for pulp therapy in deciduous dentition among both the groups, which is based on the qualification and on the year of clinical experience. CONCLUSION: Qualification and years of clinical practice among GDPs affect the knowledge and treatment regarding pulp therapy in deciduous dentition. Most of the GDPs lack knowledge about the STP for pulp therapy in deciduous dentition.

Appropriate electrode placement site of electric pulp tester for the premolars: a clinical study.

CONTEXT: Electric pulp testers (EPTs) are widely used as diagnostic aid in dentistry for dental pulp. This delivers enough current to overcome enamel and dentin resistance and to stimulate the myelinated sensory fibers at the junction of pulp and dentin. Such testing requires the electrode to be in contact with the surface of the tooth, with optimal positions identified for anterior teeth, premolars, and molars. AIMS: To determine the best site position of EPT on premolars. The objective of electric pulp testing was to determine the sensibility of each premolar at the lowest sensory response threshold. SETTINGS AND DESIGN: Clinical study Materials and Methods: The premolars of 20 patients between 13 and 15 years accompanied with parents, free of restorations, and caries were selected. Five sites on the crown were tested with EPT for minimum of four times. STATISTICAL ANALYSIS USED: One-way analysis of variance test and the Tukey's honestly significant difference test. RESULTS: The lowest threshold response was noted at the incisal edge of the tooth; the middle third had a higher threshold among all the different placement of electrode. Statistically significant difference was observed for occlusal surface in terms of region of placement of electrode. CONCLUSIONS: This experiment found the best electrode site for pulp testing in premolars. The appropriate EPT site was on the occlusal surface of maxillary and mandibular premolars.