Tooth agenesis in patients referred to an Irish tertiary care clinic for the developmental dental disorders.

PURPOSE: This study was carried out to determine the prevalence, severity and pattern of hypodontia in Irish patients referred to a tertiary care clinic for developmental dental disorders. MATERIALS AND METHODS: Details of 168 patients with hypodontia referred during the period 2002-2006 were entered in a database designed as a national record. Tooth charting was completed using clinical and radiographic examinations. The age of patients ranged from 7-50 years, with a median age of 20 years (Mean: 21.79; SD: 8.005). RESULTS: Hypodontia referrals constituted 65.5% of the total referrals. Females were more commonly affected than males with a ratio of 1.3:1. The number of referrals reflected the population density in this area; the majority were referrals from the public dental service. Mandibular second premolars were the most commonly missing teeth, followed by maxillary second premolars and maxillary lateral incisors; maxillary central incisors were the least affected. Symmetry of tooth agenesis between the right and left sides was an evident feature. Slightly more teeth were missing on the left side (n = 725) than on the right side (n = 706) and in the maxillary arch (n = 768) as compared to the mandibular arch (n = 663). Some 54% of patients had severe hypodontia with more than six teeth missing; 32% had moderate hypodontia, with four to six teeth missing. The most common pattern of tooth agenesis was four missing teeth. CONCLUSION: Hypodontia was a common presentation in a population referred to this tertiary care clinic. The pattern and distribution of tooth agenesis in Irish patients appears to follow the patterns reported in the literature.

Pain and anxiety following the placement of dental implants.

PURPOSE: This study investigated pain experience and anxiety following dental implant placement using questionnaires and salivary cortisol measurements. MATERIALS AND METHODS: Patients about to undergo implant placement were instructed to keep recovery diaries to assess pain experience (limitation of activities, postoperative symptoms) and to record average pain, worst pain, and interference with daily activities on a visual analog scale (VAS). To assess anxiety, patients completed the Spielberger self-evaluation questionnaire and collected salivary samples to measure cortisol levels. Saliva was collected 1 week before surgery, the day of surgery, and 3 and 6 days postoperatively. A repeated-measure analysis of variance was used to analyze pain and anxiety data. RESULTS: Eighteen patients (12 women and 6 men) who received 30 implants were recruited for the study. Following implant placement, most patients reported mild to moderate interference with daily activities and postoperative symptoms. No patient reported high levels of any symptom. Average pain experience decreased significantly with time (F = 6.17; P < .001), from a VAS score of 24/100 on day 1 to 12 on day 3 and 9 on day 6. Worst pain (F = 7.84; P < .001) and limitation of daily activities (F= 6.26; P < .001) were also highest on the first postoperative day; they also decreased to about half the maximum level by the second or third day. State anxiety, as evaluated by the Spielberger self-evaluation scale, was highest on the day of surgery. The salivary cortisol level did not validate this, as it did not differ with the time of collection (F = 2.22; P = .075). CONCLUSIONS: Patient self-assessment indicates that implant placement is a mild to moderately painful and anxiety-provoking procedure. Some limitation of daily activities and symptoms are expected to occur, particularly during the first 3 postoperative days.