Clinical evaluation of feasibility and effectiveness using a virtual reality device during local anesthesia and extractions in pediatric patients.

PURPOSE: Pediatric dentistry requires more than routine dental knowledge and skills in executing quality dental care. The quality of dental treatment is indirectly proportional to a child's anxiety and fear. The recent distraction technique, the use of virtual reality (VR) devices has intrigued many researcher's minds. Therefore, this study was conducted to assess the clinical feasibility and effectiveness of the VR device in reducing pain and anxiety in pediatric patients during mandibular primary molar extraction. METHODS: This research trial had 30 healthy children between the ages of 6 and 12 who required mandibular primary molar extraction. The subjects were divided into two groups using a simple randomization method. In the study group (n = 15), extraction was carried out using a VR device, whereas, in the control group (n = 15), extraction was carried out without the use of a VR device. Pre- and post-extraction anxiety levels were measured by Venham's picture test (VPT) and the heart rate. After the procedure, pain and behavior were evaluated by the Wong-Bakers Faces pain rating scale (WBS) and FLACC Scale respectively. RESULTS: The pre-extraction values of the VPT and heart rate showed no statistically significant difference. This indicates that participants of both groups had a similar level of anxiety at baseline. There was a statistically significant increase (p = 0.028) between pre- and post-heart rates in the control group, with no significant change in the study group. CONCLUSION: The use of a virtual reality device in children can reduce anxiety during primary molar extractions as evaluated by heart rate. Virtual reality devices might be an adjunct to high-quality dental care and to other behavior management methods. Definitive outcomes can be attained by encouraging studies overcoming the present limitations, and considering salivary biochemical indicators for the assessment of these devices.

The effect of different concentrations of water soluble azadirachtin (neem metabolite) on Streptococcus mutans compared with chlorhexidine.

UNLABELLED: Despite advances in the development of anticaries chemotherapy, the newer agents are unable to control the initiation of dental caries. Research and development of natural antibacterial agents that are safe for the host as well as specific for oral pathogens is awaited. Neem tree extracts have been used for thousands of years for maintaining overall well-being. Chewing neem sticks in the morning is the most common indigenous method of cleaning the mouth in rural population. This has generated the interest of the dentists for the use of neem for controlling dental diseases. AIMS: This study aims to evaluate the quantitative and qualitative effect of different concentrations of water soluble azadirachtin (neem metabolite) on Streptococcus mutans (S. mutans) against chlorhexidine. MATERIALS AND METHODS: Plaque was collected from 30 children aged 8-12 years reporting to the Department of Pediatric and Preventive Dentistry, Bharti Vidyapeeth Dental College, Pune and transported to the laboratory. After incubation of the plates the inhibitory zones were noted and the diameter of the zone of inhibition was measured and recorded to check the inhibition of growth of S. mutans. For testing the bacterial survival, the biofilms were prepared and colony forming units (CFU) was enumerated using a digital colony counter. STATISTICAL ANALYSIS USED: Two-way analysis of variance (ANOVA) and Tukey's test. RESULTS: The results show that there was no statistically significant difference in the inhibition of S. mutans between 40% concentration of water soluble azadirachtin and chlorhexidine. CONCLUSIONS: This study concluded that 40% water soluble azadirachtin is as effective as 0.2% chlorhexidine mouthrinse in reducing the S. mutans count in dental plaque. Hence, a water soluble formulation of azadirachtin may provide the maximum benefit to mankind to prevent dental caries.