Search Results (275)

Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

High-pitched noise generated by dental air turbine handpieces (ATHs) causes discomfort and anxiety, discouraging dental visits. Understanding the time-dependent noise generation mechanism associated with compressed airflow in ATHs is crucial for effective noise reduction. However, the direct investigation of airflow dynamics within ATHs is challenging. The transient-state modeling of computational fluid dynamics (CFD) simulations remains unexplored owing to the complexities of high rotational speeds and air compressibility. This study develops a novel CFD framework for transient (time-dependent) modeling under high-speed rotational conditions. Simulations were performed using a three-dimensional model reconstructed from a commercial ATH. Simulations were conducted at 320,000 rpm using a novel framework that combines the immersed boundary and building cube methods. A fine 0.025 mm mesh spacing near the ATH, combined with supercomputing resources, enabled the simulation of hundreds of millions of cells. The simulation results were validated using experimental noise measurements. The CFD simulation revealed transient airflow and aeroacoustic behavior inside and around the ATH that closely matched the prominent frequency peaks from the experimental data. This study is the first to simulate the transient airflow of ATHs. The proposed CFD model can accurately predict aeroacoustics, contributing to the future development of quieter and more efficient dental devices. Full article

Background: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. Clinical Case: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. Results: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. Conclusions: The continuity of cost-free dental care effectively addressed the participant’s oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system. Full article

The acoustic environment of dental clinics plays a critical role in shaping patient experience, staff performance, and overall clinical effectiveness. This comprehensive review, supported by systematic search procedures, investigates how soundscapes in dental settings influence psychological, physiological, and operational outcomes. A total of 60 peer-reviewed studies were analyzed across dental, healthcare, architectural, and environmental psychology disciplines. Findings indicate that mechanical noise from dental instruments, ambient reverberation, and inadequate acoustic zoning contribute significantly to patient anxiety and professional fatigue. The review identifies emerging strategies for acoustic optimization, including biophilic and sustainable design principles, sound-masking systems, and adaptive sound environments informed by artificial intelligence. Special attention is given to the integration of lean management and circular economy practices for sustainable dental architecture. A design checklist and practical framework are proposed for use by dental professionals, architects, and healthcare planners. Although limited by the predominance of observational studies and geographic bias in the existing literature, this review offers a comprehensive, interdisciplinary synthesis. It highlights the need for future clinical trials, real-time acoustic assessments, and participatory co-design methods to enhance acoustic quality in dental settings. Overall, the study positions sound design as a foundational element in creating patient-centered, ecologically responsible dental environments. Full article

Background/Objectives: Dental anxiety in children is a common issue that can hinder the delivery of effective dental care. Traditional approaches to managing this are often insufficient or involve pharmacological interventions. This study shows the potential of virtual reality (VR) to aid in reducing anxiety in children undergoing simple dental procedures. By immersing children in relaxing VR environments (such as beaches, forests, mountains, or underwater scenes with calm music), the objective is to assess VR’s effectiveness in calming pediatrics patients during these procedures. Methods: Children scheduled for minor dental treatments wore a wearable device that monitored pulse, perspiration, and stress levels. Each child’s baseline data was collected without the VR headset, followed by data collection during VR exposure before and during dental procedures. VR scenarios ranged from soothing nature scenes to animated cartoons, designed to foster relaxation. Results: The data collected showed a reduction in physiological indicators of stress, such as lower heart rate and reduced perspiration, when the VR headset was used. Children appeared more relaxed, with a calmer response during the procedure itself, compared to baseline levels without VR. Conclusions: This study provides preliminary evidence supporting VR as an effective tool for reducing anxiety and stress in pediatric dental patients. By offering an engaging, immersive experience, VR can serve as an alternative or complementary approach to traditional anxiety management strategies in pediatric dentistry, potentially improving patient comfort and cooperation during dental procedures. Further research could determine if VR may serve as an alternative to local anesthesia for non-intrusive pediatric dental procedures. Full article

Background: Dental anxiety often poses a significant barrier to effective dental care in pediatric patients. This study evaluated the efficacy and safety of oral midazolam at two different doses for sedation and amnesia in preschool children undergoing dental procedures under 30 min, including primary teeth extraction, root canal treatment, dental filling, and stainless-steel crown. Methods: This prospective, double-blind, randomized controlled trial included 80 children aged 3–6 years with dental anxiety (Types 1 and 2 of the Frankl Behavior Rating Scale) at the National Hospital of Odonto-Stomatology, Hanoi. following the CONSORT guidelines. Participants were randomly assigned to receive oral midazolam at 0.3 mg/kg or 0.6 mg/kg. Sedation efficacy, onset time, procedure duration, cooperation level (Houpt Behavior Rating Scale), recovery time, and amnesia at 12 h, 24 h, and 1 week, as well as adverse events, were recorded and analyzed. Results: Both midazolam doses were effective for sedation (0.3 mg/kg: 95% vs. 0.6 mg/kg: 100%, p = 0.49). The higher dose (0.6 mg/kg) provided significantly longer effective procedural time (27.3 ± 4.1 min vs. 20.3 ± 4.0 min, p < 0.001) and better patient cooperation (95% vs. 78.9%, p = 0.045), but slightly prolonged recovery time (34.6 ± 4.6 min vs. 31.8 ± 4.4 min, p = 0.008). Both doses produced similar amnesic effects, with approximately 90% anterograde amnesia at 12 h post-procedure. Adverse events were minimal and mild. Conclusions: Both 0.3 mg/kg and 0.6 mg/kg doses of oral midazolam are safe and effective for sedation and amnesia in preschool children undergoing dental procedures. While the 0.6 mg/kg dose provides better procedural cooperation and prolonged sedation, it also requires a slightly longer recovery time. Full article

Background/Objectives: Alginate dental impressions are often among the most anxiety-inducing procedures for pediatric patients due to discomfort caused by nausea, gagging, and the vomiting reflex. This technique frequently raises anxiety levels in children. In contrast, intraoral scanners are increasingly used in clinical practice and offer a more comfortable alternative. Physiological parameters such as heart rate (HR) and oxygen saturation (SpO₂) are useful, objective indicators of anxiety. This study aimed to evaluate significant changes in HR and SpO₂ during dental impression procedures using two techniques—an analog (alginate) and a digital (intraoral scanner) one—in both dental arches, to determine the method inducing the least anxiety. Methods: A non-interventional clinical study was conducted on a sample of 30 children. A fingertip pulse oximeter was used to measure HR and SpO₂ during impression taking with alginate and with an intraoral scanner. Statistical analysis was performed using SPSS^® (Version 30.0. Amonk, NY, USA: IBM Corp). Descriptive statistics (mean and standard deviation) were calculated, and the Friedman and Wilcoxon tests with Bonferroni correction were applied, using a 5% significance level. The study was approved by the Ethics Committee of the University of Murcia. Results: Alginate impressions produced a statistically significant increase in HR in both the upper [(19 ± 11) bpm] and lower [(18 ± 9) bpm] arches compared to the scanner [(7 ± 5) bpm and (7 ± 4) bpm, respectively] (χ² = 49.30; p < 0.001). SpO₂ levels also dropped more when using alginate for both the upper and lower arches [(−2 ± 2)% and (−2 ± 3)%, respectively] than when using the scanner [(−1 ± 1)% in both arches] (χ² = 21.41; p < 0.001). Conclusions: Alginate impressions triggered a significant anxiety response, as evidenced by significant changes in HR and SpO₂. Intraoral scanners were less invasive, as indicated by the greater proximity of the physiological parameters to the baseline values, making them a promising alternative in pediatric dentistry. Full article

Objective: Successful local anesthesia reduces patient pain and anxiety, facilitates the procedure, and enhances overall comfort; however, in children, it may also increase the risk of parafunctional activities in anesthetized areas. This retrospective study aimed to evaluate the factors influencing the risk of self-inflicted injuries. Methods: A study was conducted from January to December 2023 using the records of 4285 pediatric patients aged 4–12 years who underwent dental treatment under local anesthesia. Among 1161 cases at Poznan University (Poland), 73 (6.3%) of self-inflicted injuries were reported. At Rome University (Italy), 823 cases were reviewed, with 522 involving local anesthesia and 23 cases (4.4%) of trauma. Results: The overall prevalence of trauma following local anesthesia was 5.9%, indicating significant clinical concern. The lips were the most commonly affected (69.9%), followed by the cheeks (15.1%) and tongue (15.1%). The study confirmed a positive correlation between younger age and higher trauma incidence, with no significant differences in sex or ethnicity. Longer anesthesia duration and higher anesthetic doses were associated with increased lesion severity. The type of anesthetic also played a role, with articaine showing a higher risk compared to lidocaine. Furthermore, the type of injection influenced trauma incidence, due to the distribution of numbness and exploratory behaviors. Conclusions: Local anesthesia remains an indispensable tool in pain management in pediatric dentistry. However, the risk of self-inflicted injuries is not limited to the youngest patient. Proper education on post-anesthetic care is essential for minimizing complications and ensuring safe and effective dental treatment. Full article

Background: Dental anxiety and generalized anxiety are common psychological conditions and can lead to poor oral health and avoidance behavior. This research aims to study the complex interplay between dental anxiety, generalized anxiety, dental neglect, and oral health-related quality of life (OHRQoL) in the general public. Methods: This is an online survey study that was conducted between August to September 2024 in Saudi Arabia and Jordan. Four previously validated instruments were used in this study. This study made use of the Modified Dental Anxiety Scale, the General Anxiety Disorder-7, dental neglect scale, and the Oral Health Impact Profile-14. Mediation analysis was conducted using the PROCESS macro (Model 4) to explore whether dental anxiety and dental neglect mediates the relationship between generalized anxiety and OHRQoL. Results: This study had 2704 participants in total. Higher anxiety levels were associated with slightly lower dental neglect and significantly poorer OHRQoL. Generalized anxiety significantly predicted dental anxiety, with a coefficient of b = 0.275 (p < 0.001). Both generalized anxiety and dental anxiety were significant predictors of OHRQoL, with generalized anxiety showing stronger effect. Dental anxiety partially mediates the impact of generalized anxiety on oral health-related quality of life, while a strong direct effect remains. Conclusions: Dental neglect served as a minor mediator, and the primary relationship between anxiety and oral health-related quality of life is direct. Moreover, dental anxiety partially mediates the impact of generalized anxiety on oral health-related quality of life, while a strong direct effect remains. Full article

Background: Intranasal sedation is commonly used in pediatric dentistry to manage dental anxiety and improve patient compliance. This systematic review and meta-analysis aimed to evaluate the recovery time, patient satisfaction, and adverse effects of the intranasal sedatives midazolam, dexmedetomidine, and ketamine in pediatric dental procedures. Methods: A systematic search of PubMed, Scopus, the Web of Science, the Cochrane Library, Embase, and Google Scholar was conducted following the PRISMA 2020 guidelines. Only randomized controlled trials (RCTs) involving intranasal sedation in pediatric patients (≤18 years) were included. The revised Cochrane risk of bias tool (RoB 2) was employed to assess study quality. A meta-analysis using a random-effects model was performed to evaluate the recovery time. Results: Twenty-one RCTs were included in this review. A meta-analysis of seven studies revealed that dexmedetomidine was associated with significantly longer recovery times compared to midazolam and ketamine. Specifically, midazolam demonstrated the shortest recovery time (mean difference: −19.1 min, p < 0.05), followed by ketamine (mean difference: −15.6 min, p < 0.05). A qualitative analysis of adverse effects showed mild to moderate complications, including nasal irritation (midazolam), prolonged sedation (dexmedetomidine), and hypersalivation (ketamine). Patient satisfaction was found to be highest with dexmedetomidine, although midazolam was preferred for its faster onset of sedation. Conclusions: Intranasal sedation in pediatric dentistry is a safe and effective approach, with each agent exhibiting distinct recovery profiles and safety considerations. The findings emphasize the importance of standardized sedation protocols and the need for further research into the long-term outcomes of these sedatives in pediatric populations. Full article

Objectives: To determine the aspects of religion and spirituality among those who belong to an organization for Christian healthcare providers that may contribute to personal and professional well-being and protect against burnout. Participants: Members and affiliates of the Christian Medical and Dental Association (n = 450). Study Method: A cross-sectional study based on survey results of validated instruments and original questions that measured aspects of faith, professional fulfillment, personal fulfillment, and mental health. Findings: This sample of Christian healthcare providers experienced lower rates of burnout than the general population of healthcare providers. Personal aspects of religion and spirituality were negatively associated with anxiety and depression and positively associated with personal flourishing. Conclusions: Calling, virtues, and belonging are possible attributes of Christian faith that are associated with well-being and may be protective against burnout and mental health conditions. Future research can explore these findings among providers of other faith traditions. Full article

Objectives: Our aim was to study whether the Modified Dental Anxiety Scale (MDAS) is reliable and valid for use in children aged 9 to 12 years. Methods: The study population was a convenient sample of Finnish comprehensive school pupils in the third and sixth grades (N = 57 and N = 69, respectively). Dental fear and anxiety (DFA) were measured with the Finnish validated adult version of MDAS, the modified Child Fear Survey Schedule—Dental Subscale (CFSS-DS-M), and a single question. Reliability was evaluated using Cronbach’s alpha. The criterion validity of MDAS was assessed using Spearman rank correlation coefficients against CFSS-DS-M and the single question. Construct validity was assessed by examining the ability of MDAS to find differences according to gender and treatment procedures using the chi-square test for categorized and the Mann–Whitney and Jonckheere–Terpstra tests for continuous variables. Results: The Cronbach alphas were 0.841, 0.708, and 0.778 for MDAS total, anticipatory, and treatment-related DFA, respectively. Correlations between MDAS and CFSS-DS-M total and subscale scores were moderate to strong (ρ = 0.559–0.794), supporting criterion validity. Girls in third grade had lower mean MDAS anticipatory DFA (3.4, SD = 1.44) than boys (4.5, SD = 2.21, p = 0.051). In sixth graders, girls had higher mean MDAS treatment-related DFA (8.4, SD = 3.17) than boys (6.9, SD = 2.61, p = 0.067). Children reporting orthodontic treatment had lower anticipatory DFA (mean = 3.4, SD = 2.13) than children not reporting (mean = 4.0, SD = 1.83; p = 0.009), supporting construct validity. Conclusions: The Finnish version of the MDAS showed good reliability, good criterion validity, and acceptable construct validity, supporting its use in children aged 9–12 years. Full article

Introduction: Hypoglossal nerve stimulation (HNS) “Inspire_© therapy” has garnered popularity among obstructive sleep apnea (OSA) patients seeking an alternative to continuous positive airway pressure (CPAP) therapy. The growth in HNS has been particularly high in older adults living with OSA. Consistent and proper use of HNS in the geriatric population faces unique age-associated barriers: a high rate of multiple chronic conditions (MCC) and polypharmacy (being on five or more drugs). Early recognition and patient-centered management of these barriers will allow older patients to obtain maximum benefits from HNS. HNS has distinct advantages in the geriatric population because it overcomes many concerns related to CPAP therapy adherence, such as mechanical limitations due to manual dexterity, maxillofacial anatomy, dental issues such as usage of dentures, allergy/otolaryngology-related disorders, and pre-existing post-traumatic stress disorder-related claustrophobia. This paper describes how we worked with older patients with OSA and their care partners to overcome these barriers so patients can continue to derive cardiovascular, neurologic, and quality of life benefits resulting from optimal OSA management. These benefits are especially important in the older population because of higher rates of comorbidities (dementia, coronary artery disease, and atrial fibrillation) exacerbated by sub-optimally treated OSA. In this article, we describe our clinical experience with elderly patients on Inspire_© therapy, with a focus on the everyday difficulties faced by these patients and the measures implemented to address and mitigate these barriers. Methods: A retrospective chart review was conducted to identify patients aged 65 and above who underwent hypoglossal nerve stimulator insertion. Experiences of older patients during and after the insertion procedure were documented and compared to a younger population of patients on HNS therapy. We specifically collected information on difficulties encountered during activation or follow-up visits and compared them between the different age groups. Using this information, we identified areas to improve treatment adherence from the patients’ perspectives. Results: We identified 43 geriatric (65 to 86 years old) patients who received the Inspire implant at a tertiary academic medical center and compared them to a younger population of 23 patients. Most common challenges noted—with a potential to impact adherence—included orofacial and lingual neuropraxia (ischemic or demyelination-induced neuropathy) at activation, cognitive dysfunction (memory problems), preexisting anxiety, and insomnia. Other difficulties that are less commonly reported but equally important to consistent and proper use of HNS included headaches, concerns of device malfunction, change in comfort levels after cardiac procedures, and general intolerance of the device. The older patient population had a statistically significant higher incidence of cognitive difficulties (30.2% vs. 4.4%) and a smaller social support system (62.8% vs. 91.3%) affecting device usage compared to the younger population. There were no statistically significant differences in the rates of other more commonly reported adverse effects such as headaches, dry mouth, and anxiety between the two age groups. Conclusion: Despite several challenges faced by geriatric patients, Inspire_© hypoglossal nerve stimulation remains a viable, alternative treatment option for OSA with improved tolerance and adherence compared to CPAP. After identifying less commonly reported barriers such as cognitive decline, sensory deficits, and decreased social support systems, minor adjustments and appropriate education on use allows older patients to correctly use and benefit from Inspire_© device therapy, with subsequent improvement in sleep and overall quality of life. Full article

Stomatognathic dysfunctions, particularly bruxism, orofacial pain, and temporomandibular joint (TMJ) disorders, are frequently associated with anxiety and depression. However, the reverse hypothesis that these dysfunctions may act as peripheral stressors contributing to neuropsychological imbalance by activating the hypothalamic–pituitary–adrenal (HPA) axis remains underexplored. Objective: To assess the relationship between the severity of stomatognathic symptoms and both physiological and psychological stress markers to determine whether such dysfunctions may influence or exacerbate anxiety and depressive disorders. Methods: A cross-sectional observational study was conducted on 120 adult patients. Clinical assessment was included evaluation of TMJ function, bruxism, and orofacial pain. Psychological screening was performed using validated questionnaires (GAD-7 for anxiety and PHQ-9 for depression). Electromyographic (EMG) analysis of the masseter and temporalis muscles was conducted, along with the quantification of salivary cortisol using an enzyme-linked immunosorbent assay (ELISA). Multiple regression models were applied to identify statistically significant correlations (p < 0.05). Results: A positive correlation was found between the severity of stomatognathic dysfunction and scores on anxiety and depression measures, along with elevated salivary cortisol levels and increased masticatory muscle activity. Conclusions: These findings suggest a bidirectional relationship between stomatognathic dysfunctions and neuropsychological status, underscoring the potential value of integrated therapeutic approaches that combine dental care with psychological support. Full article