A comparison of the effect of triamcinolone ointment and mouthwash with or without zinc on the healing process of aphthous stomatitis lesions.

Background. Recurrent aphthous stomatitis (RAS) is one of the most common ulcerative diseases of the oral mucosa. Definitive etiology of RAS has not been conclusively established. There is no certain treatment for aphthous stomatitis but some drugs such as steroids are commonly used for the treatment of RAS. Regarding the effect of zinc on the healing process of epithelial layer and cell division, in this research the effect of triamcinolone (with orabase) in combination with a zinc-containing mouthwash and triamcinolone alone on the healing process of RAS lesions was assessed. Methods. The present study consisted of 20 patients diagnosed with RAS. The patients were instructed to rinse the mouth-wash or placebo three times a day and triamcinolone ointment twice a day for two weeks. The largest dimension of the ulcer was measured by a digital caliper and the severity of pain was assessed by visual analogue scale (VAS). Number, size, duration, ulcer-free period and pain of the lesions were evaluated twice a week for twomonths. Data were analyzed by SPSS 16 using Mann-Whitney U test and t-test. Results . A decrease was seen in the mean pain severity score (P = 0.631) and the size of the lesions but it was not statistically significant (P = 0.739). Also the difference between the number of lesions (P = 0.739), duration and ulcer-free period (P = 0.873) were not statistically significant. Conclusion. Zinc mouthwash seems to be as effective on wound healing process as typical treatment modalities for RAS.

Impact of Self-concept on Preschoolers' Dental Anxiety and Behavior.

Background and aims . Different factors affect children's behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child's anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child's anxiety and child's behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman's correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P < 0.001), and a moderate correlation between the self-concept and child's behavior scores (r = 0.491, P < 0.001). A strong inverse relation was also found between the anxiety and behavior scores (r = -0.91, P < 0.001). Conclusion. Children with higher self-concept had lower anxiety level and better behavioral feedback during dental treatment.

Does Timing of Eruption in First Primary Tooth Correlate with that of First Permanent Tooth? A 9-years Cohort Study.

Background and aims. Predicting the teeth eruption time is a valuable tool in pediatric dentistry since it can affects scheduling dental and orthodontic treatments. This study investigated the relationship between the eruption time of first primary and permanent teeth and the variation in the eruption time considering socioeconomic status (SES) in a 9-year population- based cohort study. Materials and methods . 307 subjects were examined at bimonthly intervals during the first and second years of life and then at six-month intervals until the eruption of first permanent tooth. Eruption times of primary and permanent tooth were recorded for each child. A modified form of Kuppuswamy's scale was used to assess the SES. Results. Among 267 subjects completed all follow-ups, the eruption time for first primary and permanent teeth indicated a direct strong correlation; in that one month delayed or early eruption of firstprimary tooth resulted in 4.21 months delayed or early eruption of first appearing permanent tooth (r = 0.91, n = 267, P <0.001). No significant correlation was observed between the eruption time of first primary and first permanent teeth and SES (P = 0.67, P = 0.75, respectively). Conclusion. The eruption timing for the first primary tooth had a correlation with the first permanent tooth eruption tim-ing, while SES did not have any influence on eruption times.

Fluoride release from three glass ionomers after exposure to sodium fluoride and acidulated phosphate fluoride gels.

BACKGROUND: Glass ionomer (GI) restorations exposed to fluoride have the ability to slowly release fluoride. Therefore, the aim of this study was to investigate fluoride release from three GIs before and after exposure to sodium fluoride (NaF) and acidulated phosphate fluoride (APF). MATERIALS AND METHODS: Fifteen disc-shaped samples (6 mm in diameter and 2 mm in thickness) from three GIs (Fuji II, Fuji IX, Chem Flex) were made and suspended in a polypropylene recipient containing 10 mL distilled water and stored at 37°C. At the 13(th) day, the samples of each GI were randomly divided into 3 groups. Groups 1 and 2 were exposed to NaF and APF gels for 4 min and group 3 served as control in distilled water. The fluoride released was measured at day 1, 4, 10, 13, 14, 17, 20 and 23 by potentiometer. Data were analyzed by one-way ANOVA and Tukey test. P < 0.05 was considered as significant. RESULTS: Fluoride release was highest after 24 h for the tested GIs, but Fuji II demonstrated the least amount. Fuji IX showed the highest fluoride release followed by Chem Flex. Exposure to fluoride gels significantly increased fluoride release for all materials (P < 0.05). The amount of fluoride release for the three GIs was significantly higher in APF groups during the test period. CONCLUSION: Highly viscous conventional GIs (Fuji IX and Chem Flex) released higher quantity of fluoride.

Design and preliminary validation of the verbal skill scale in the dental setting: an anxiety scale for children.

PURPOSE: The purpose of this study was to design and examine the validity of a scale that uses the verbal performance of children as an indicator of dental anxiety. METHODS: A total of 128 healthy 4- to 6-year-olds were included. The first sessions consisted of a dental examination; in the second session, identical dental treatment was provided to all subjects. In each session, a short communication was done for verbal assessment. During treatment, Frankl and clinical anxiety rating scales were utilized to assess the child's anxiety. Construct validity was assessed using Spearman's correlation coefficient; a factor analysis, concurrent validity, and inter-rater reliability were determined by kappa agreement statistics. Chi-square and Fisher's exact tests were used to assess the difference between sexes. RESULTS: The agreement between the raters was high and significant (k=0.71, P<.001). Intraclass correlation coefficient of 50 same children (28 boys and 22 girls) across a 2-week period showed a strong correlation (correlation=0.8, P<.001). Spearman's correlation coefficient revealed a high and significant correlation between the measures (P<.001). The kappa values ranged from 0.58 to 0.67, suggesting moderate to good agreement between measures. CONCLUSIONS: The verbal skill scale is a reliable and valid measure of assessing child dental anxiety in a clinical context.

The Impact of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 4-6 Year-Old Children: a Randomized Controlled Clinical Trial.

BACKGROUND AND AIMS: Dental practitioners have numerous methods to control anxiety and pain in children, and distracting the child appears to be the most common technique used for behavior management during dental procedures. The aim of the present study was to evaluate the influence of using virtual reality eyeglasses on severity of pain and anxiety during dental procedures in pediatric patients. MATERIALS AND METHODS: This study included 120 healthy children aged 4-6 years. Children with no previous anxiety disorder were randomly divided into two groups, each consisting of 60 children. The study consisted of 3 consecutive treatment sessions. During the first visit fluoride therapy was carried out in both groups. In the next sessions, the groups received restorative treatment with and without virtual reality eyeglasses in a randomized single-blind-controlled crossover fashion. Then at the end of each session the subjects' pain severity was assessed using Wong Baker FACES Pain Rating Scale and state anxiety was measured by Faces version of the Modified Child Dental Anxiety Scale [MCDAS (f)]. RESULTS: There was a significant decrease in pain perception (P < 0.001) and state anxiety scores (P < 0.001) with the use of virtual reality eyeglasses during dental treatment. CONCLUSION: Results of this study showed that virtual reality eyeglasses can successfully decrease pain perception and state anxiety during dental treatment. TRIAL REGISTRATION NUMBER: 201103126036N1.

Can birth order affect temperament, anxiety and behavior in 5 to 7-year-old children in the dental setting?

AIM: The aim of this study was to evaluate the relationships between birth order and child's temperament, anxiety and behavior in the dental setting. MATERIALS AND METHODS: A total of 200 healthy children aged 5 to 7 years, were included in this double-blind randomized controlled trial. The study consisted of two sessions. In the initial appointment, parents were provided with instructions and asked to complete children's behavior questionnaire (CBQ). In the second appointment, identical dental treatments were rendered to all subjects. During treatment, Frankl scale for child's behavior, facial Image scale (FIS) for situational anxiety, and clinical anxiety rating scale for clinical anxiety were utilized. Analysis of data was done using U Mann-Whitney and Kruskal-Wallis tests. RESULTS: Only children had higher clinical (p = 0.041) and situational (p < 0.001) anxiety, and more negative behavior (p = 0.013) compared to children with siblings. In children with siblings, first-born child was in increased risk of developing negative behavior (p = 0.008), clinical anxiety (p < 0.001) and situational anxiety (p = 0.006). With an exception (sadness, p < 0.001), no significant differences in temperament scale were observed among children with different birth orders. CONCLUSION: According to the results, only children and laterborns are at higher risk of developing worse outcomes in the dental setting. CLINICAL SIGNIFICANCE: The role of birth order has been ignored as a possible factor of behavior during routine dental treatment and these findings may shed light on our understanding of behavior management strategies in the dental setting. Considering the increasing pattern of family with an only child both in modern and developing countries, this is more likely that the dental team will face children with negative outcome during dental treatment.