Search Results (90)

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

Sensory processing disorder (SPD) involves difficulties in receiving and responding to sensory information from the environment. Their development is influenced by various factors during the perinatal period and early childhood. Children with sensory integration disorders often struggle with everyday situations and stress, typically experiencing either sensory hypersensitivity or hyposensitivity. Their visit to a doctor’s office presents challenges for both the child and the medical practitioner, requiring active cooperation from parents. This review aims to analyze the challenges faced by clinicians in managing pediatric patients with SPD during healthcare visits, with a specific focus on dental settings and to propose effective communication and management strategies. Proper preparation of the child before the visit and the use of appropriate communication techniques during the appointment play a crucial role in ensuring a smooth experience. Strategies such as minimizing visual and auditory stimuli, applying recommended touch techniques, and opting for the least invasive treatment methods can help create a child-friendly environment and improve the overall quality of care. Full article

Molar Incisor Hypomineralization (MIH) is a common dental condition that affects the mineralization of the enamel, primarily affecting the first permanent molars and often the incisors. This condition can lead to a wide range of clinical presentations, from mild opacities to severe post-eruptive breakdown, which can significantly impact a child’s oral health and quality of life. Background/Objectives: The prevalence and complex management of MIH have posed a significant challenge for dental practitioners. Our preceding investigation found that 14.3% of school-aged children have MIH. Based on this finding, we wanted to understand what other Romanian dental professionals think about this condition. Therefore, the aim of the present study was to assess the awareness, perception, and clinical management approaches of Romanian dentists toward MIH in order to inform future educational strategies and contribute to the development of dedicated preventive programs. Methods: To gain a comprehensive understanding of MIH in actual clinical settings, we developed and administered a questionnaire consisting of three distinct sections. Our objective was to capture the collective knowledge and perspectives of dental practitioners. We distributed the survey, which included 14 pertinent questions, to a large professional group of Romanian dentists. Results: This study collected responses from 219 Romanian dental practitioners (median age: 34 years) about their experiences with MIH. The vast majority (86.76%) had encountered MIH cases in their practice, with half reporting moderate prevalence among their patients. The most frequently observed complications were hypersensitivity (41.95%), pulp exposure (33.33%), and failed restorations (24.71%). While adhesive restorations were identified as the overall preferred treatment approach (70.00%), notable differences emerged in both clinical complications encountered and therapeutic approaches implemented across dental specialties. There was near-unanimous agreement on the importance of early MIH diagnosis (99.09%), and almost all participants (98.63%) expressed a desire for more information about this condition, demonstrating high awareness and concern about MIH among Romanian dental professionals. Conclusions: This study highlights that general dentists, endodontists, and pedodontists encounter MIH patients frequently in their practice, emphasizing the critical need to enhance awareness and education about MIH among both dental professionals and the general public. Full article

Background: Gastroesophageal reflux disease (GERD) is a chronic condition that causes an abrupt decrease in salivary pH in the oral cavity, which can lead to demineralization, erosion, hypersensitivity, functional impairment, and possibly fracture of dental elements. The aim of this clinical study is to compare two types of treatment in patients with dental erosion diagnosed with gastroesophageal reflux. Methods: Thirty patients were enrolled in this randomized clinical trial. Each patient underwent clinical evaluation and esophageal pH measurement, in order to diagnose GERD. After an initial examination and assessment by an experienced dentist, the Trial group (15 patients) was assigned to home treatment with a zinc hydroxyapatite-based toothpaste and a hydroxyapatite-based paste, while the Control group (15 patients) was assigned to home treatment with zinc hydroxyapatite-based toothpaste only. The following indices were measured: Basic Erosive Wear Examination Index (BEWE); Schiff Air Index (SAI); Plaque Index (PI); and Bleeding Score (BS). Each index was assessed at T0 during the first visit, one month (T1), three months (T2), six months (T3), nine months (T4), and 12 months (T5). The Kolmogorov–Smirnov test was used to analyze the normality of the data, while Friedman’s test followed by Dunn’s post hoc test were used to compare the two groups (significance threshold: p < 0.05). Results: The results showed no statistically significant change in the BEWE and SAI indexes (p > 0.05). However, an improvement in dentin sensitivity and BS was observed. Plaque control also improved. Conclusions: The results of this study indicate that the additional hydroxyapatite paste did not significantly improve the outcomes of the study in respect to hydroxyapatite toothpaste alone. However, there was an improvement in the oral health of GERD patients using hydroxyapatite-based remineralizing treatment in terms of oral and periodontal indices calculated. Full article

Clear aligners are a modern orthodontic solution designed to address dental malocclusions discreetly and effectively. In terms of clinical side effects, the most reported issues among aligner users are mild irritation of the oral mucosa, localized inflammation, and hypersensitivity. The use of advanced polymer materials in clear aligners, such as polyurethane and PET-G, has gained widespread acceptance due to their mechanical properties, biocompatibility, and aesthetic appeal. However, concerns persist regarding their potential to release chemical compounds. Our goal is to understand the impact of clear aligner toxicity on the oral cavity of orthodontic patients. An extensive systematic search was conducted in the electronic databases PubMed, Scopus, and Cochrane to identify articles with relevant data. This systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines (PRISMA) to answer a question formulated according to the Population, Intervention, Comparison, and Outcomes. Four hundred and thirteen articles potentially relevant were identified and after applying PRISMA guidelines and inclusion/exclusion criteria, seven articles were included in this review. Our results suggest that clear aligners are generally safe, but concerns remain regarding the chemical leaching of thermoplastic materials, bacterial accumulation due to reduced saliva flow, and mild inflammatory responses. Our review emphasizes that although most materials are biocompatible, some exhibit moderate cytotoxicity, with the potential to impact these patients’ oral health, underscoring the need for continued research and improvements in material composition. Full article

(1) Background: Tannic acid (TA), a water-soluble polyphenol extensively found in numerous plant species, possesses antimicrobial, anti-inflammatory, antioxidant, and adhesive properties. This scoping review aims to synthesize existing knowledge on TA applications and unveil its potential uses in dentistry. (2) Methods: A comprehensive search across six electronic databases (PubMed, Cochrane, Embase, Scopus, Web of Science, and Opengrey) was conducted in October 2024. Two reviewers performed the screening and risk of bias analysis independently following the PRISMA-ScR guidelines. The findings are presented in a narrative summary. (3) Results: Five hundred and twelve records were identified from the electronic databases. After removing duplicates and applying eligibility criteria, ninety-six studies were ultimately included in this review. Results indicate that TA has been employed in managing dentin hypersensitivity, dental caries, periodontal and mucosal diseases, as well as dentition defects with prostheses. Furthermore, TA displays potential in enhancing the performance of bonding adhesives, root canal irrigants, and root canal filling materials. However, it is noteworthy that the included studies exhibit varied experimental settings, inconsistent outcome measures, a lack of extensive clinical research, and insufficient observation periods. (4) Conclusions: TA is a promising biomaterial with applications to various dental fields, such as endodontics, periodontology, prosthodontics, and dental public health. Its antimicrobial, anti-inflammatory, antioxidant, and adhesive properties warrant future exploration to unleash these potentials and provide robust scientific evidence that guides clinical practice and advances oral healthcare. Full article

Background/Objectives: Excessive occlusal forces manifest in bruxism and have consequences on teeth and jaws. The aim of this study was to determine the association of bruxism with clinical and radiological signs of excessive occlusal forces, such as tooth wear, fatigue dental fissures and fractures, abfraction, masseter muscle hypertrophy, and bone apposition at the mandibular angle. Methods: This cross-sectional clinical study included 181 patients presented for treatment in a general dentistry clinic. For each patient, data were extracted from the dental chart, as follows: demographic data (sex, age, and smoking), clinical data (number of teeth present, Eichner edentulous score, TWI wear score, number of fractured teeth, number of teeth with abfraction, presence of masseter hypertrophy, presence of hypersensitivity), and radiological data (bone apposition at the mandibular angle). The patients were divided into two groups according to the presence or absence of bruxism. A binomial logistic regression model was run to determine the association between bruxism and clinical and radiological signs of excessive occlusal forces. The data were statistically processed in SPSS. Results: In total, 99 women and 82 men with mean age 44.87 ± 12.67 were included in the study. Compared to the group without bruxism, the group of patients with bruxism (39.78%) showed statistically significant higher tooth wear index (TWI) (p < 0.0005), a higher number of fractured teeth (p = 0.037), a higher number of teeth with abfraction lesions (p = 0.001), and a significantly higher bone apposition score (p < 0.0005). The binomial logistic regression model showed a high prediction bruxism score for masseter muscle hypertrophy (15 times, p < 0.0005), for tooth wear index (almost 7 times, p = 0.010), and for bone apposition score (almost 3 times, p = 0.044). Conclusions: Patients with bruxism showed masseter muscle hypertrophy, higher attrition-type tooth wear index, and more teeth with fatigue fractures and abfractions than those without bruxism. Bruxism clinical signs were positively correlated with a higher bone apposition score. Full article

This article reviews the topic of stannous fluoride as an anti-caries additive in toothpastes. It is based on a literature survey carried out using Science Direct, supplemented by information from PubMed. The keywords used were stannous fluoride, toothpaste, clinical effects, caries, hypersensitivity, gingival health, structure and aqueous solutions. The initial searches covered the period 2015–2024 and identified 57 references. Older references cited in these papers, and also papers already known to the author, were also included. The information thus obtained shows that stannous fluoride has three main effects, namely, reduction in the viability of the oral biofilm, increase in remineralisation of the hydroxyapatite tooth mineral and occlusion of dentinal tubules leading to reduced hypersensitivity. Stannous fluoride was shown to be the most effective of all the fluoride additives used in toothpastes. In much of the dental literature, this is attributed to the effects of Sn²⁺ ions. However, as has been shown extensively in the wider scientific literature, free Sn²⁺ ions do not occur in aqueous systems. Rather, the initial products of the dissolution of SnF₂ is undissociated, hydrated SnF₂ and SnF⁺ ions. These gradually exchange fluoride to form Sn(OH)₂ and Sn(OH)⁺. Their likely mechanism of action based on their toxicity towards oral micro-organisms and their interaction with hydroxyapatite is discussed. Full article

Background/Objectives: Molar–incisor hypomineralization (MIH) is a prevalent dental condition characterized by hypomineralized enamel affecting the first permanent molars and incisors. It leads to visible enamel opacities, with varying severity. Children with MIH often experience dental hypersensitivity, which can result in increased dental fear and anxiety, complicating dental treatment. Salivary cortisol, a well-established biomarker of stress, has been used to assess stress levels in various pediatric conditions but has not been extensively studied in MIH. This study aimed to assess salivary cortisol levels as a stress biomarker in children with MIH and compare them to those in children without MIH. Methods: Sixty children aged 5–9 years were divided into two groups: 31 with MIH and 29 healthy controls. Salivary cortisol levels were measured using ELISA, and statistical analysis was performed using IBM SPSS software, version 23 The Mann–Whitney test was used for group comparison, and the Kruskal–Wallis test evaluated the correlation between MIH severity and cortisol levels. Results: Children with MIH showed significantly higher mean cortisol levels (2.63 ng/mL) compared to controls (0.96 ng/mL), with a p-value of 0.0001. A progressive increase in cortisol levels was observed with the severity of MIH, with the highest levels recorded in grade 3 (4.38 ng/mL), in contrast to grade 0 (0.95 ng/mL), with a p-value of 0.001. Conclusions: Salivary cortisol levels are significantly higher in children with MIH, suggesting that MIH-related stress may contribute to dental anxiety and hypersensitivity. These findings highlight the importance of stress management in pediatric dental care. Full article

In practice, continuous and pulse direct current (DC) methods are embodied in classical dental iontophoresis systems (CDISs) for the treatment of dentin hypersensitivity (DH). Changes in body electrical resistance and polarization occurrence are the main problems in dental iontophoresis applications. Moreover, continuous DC application may cause discomforts such as irritation, burning and itching on the skin. For these reasons, it is preferred to use pulse DC instead of continuous DC. However, in pulse DC applications, the treatment period is prolonged depending on the decrease in the electrical charge flow. On the other hand, the pain threshold of teeth when the electric current is applied varies from person to person. In this study, in order to reduce the problems caused by the use of CDIS methods for the treatment of DH, a microcontroller-based switched-mode dental iontophoresis system (SMDIS) using a dual-return probe (RP) is designed, and its performance is compared with CDIS methods. According to the results, the new SMDIS both reduces the polarization effect as in the classical pulse DC method and shortens the prolonged treatment duration in pulse DC by raising the pain threshold of teeth due to increased ion transfer, which is a great advantage over former methods. Full article

The aim of this randomized clinical trial was to evaluate the efficacy of two different remineralising toothpastes in preventing dental caries and promoting oral health. Patients aged 6–18 years old with healthy and fully erupted first permanent molars (C1 and C2 DIAGNOdent scores) were enrolled and randomized into two groups according to the home-hydroxyapatite-based remineralising treatment used: the Trial group used zinc carbonate hydroxyapatite-based treatment (Biorepair Total Protective Repair), while the Control group used magnesium strontium carbonate hydroxyapatite conjugated with chitosan toothpaste (Curasept Biosmalto Caries Abrasion & Erosion). Dental and periodontal parameters were measured over a six-month period, including the DIAGNOdent Pen Index (primary outcome), BEWE Index, Plaque Index, Bleeding Score, Schiff Air Index, and ICDAS assessed with DIAGNOcam. A total of 40 patients were equally allocated in the two groups and finally analyzed. A significant reduction in the DIAGNOdent Pen score was reported in the Trial group after 1 month of treatment, while in the Control group, no significant change was found. The Trial group also showed a significant reduction in plaque levels after 3 months of treatment, while in the Control group, it occurred after 1 month. However, the Bleeding Score and Schiff Air Index showed no significant differences between the groups, suggesting that additional measures may be required to address gingival inflammation and hypersensitivity. The ICDAS index also showed no statistically significant changes, due to the limited duration of this study. Overall, zinc-hydroxyapatite-based toothpaste was more effective than magnesium strontium carbonate hydroxyapatite toothpaste in enhancing enamel remineralisation in the short-term period. The assigned treatments did not result in significant improvements in the oral indexes assessed in this study. Full article

Dentine hypersensitivity (DH) causes pain from exposed dentine, triggered by external stimuli. Limited evidence exists on its impact on quality of life (QoL), the effectiveness of hypersensitivity toothpaste (HT) and the dental behaviors of DH sufferers. This study therefore aimed to generate evidence to address these evidence gaps and validate the existing science behind the effectiveness of HT. An observational retrospective cross-sectional survey was conducted in Indonesia, which included the Dentine Hypersensitivity Experience Questionnaire-15 (DHEQ-15), items related to the perceived effectiveness of HT and self-reported dental health behaviors. A total of 511 respondents completed the survey. The mean (standard deviation) DHEQ score of participants was 82.44 (14.41), showing the substantial impact of DH on QoL. Nearly all HT users (97.7%) reported relief from DH, with additional benefits like long-lasting fresh breath (96.4%) and cleaner teeth (97.1%), with regular HT users experiencing greater benefits such as improvements in DH (R-HT users [4.65 (0.55)] vs. E-HT users [4.46 (0.65)], p < 0.01). Compared to HT users, mainstream toothpaste (MT) users were significantly less likely to brush their teeth at least three times a day (HT users [41.9%], MT users [18.7%], p < 0.05) and to have had a dental check-up within the past year (HT users [82.5%], MT users [47.3%], p < 0.05). This study found that DH significantly impacts QoL, and that HT effectively relieves DH symptoms, particularly for regular users, who also show better dental health behaviors than users of mainstream toothpaste. The preliminary results indicate that educating users about dental products, like hypersensitivity toothpaste, can improve oral health behaviors and outcomes. Full article

Objectives: Dental erosion has evolved into a common condition with growing concern in the dental community. The aim of this study was to explore the protective effects of two highly fluoridated products, silver fluoride solution (silver diamine fluoride-potassium iodide solution, SDF-KI) and fluoride varnish, on dental erosion in mouse. Methods: Two groups of ten young CD-1 mouse were given a cola drink ad libitum over a 6-week period. A prophylactic treatment with a silver fluoride solution (38% SDF 48,000 ppm F with a silver concentration of 253,900 ppm) and a fluoride varnish (NaF, 22,600 ppm F) were applied on the mandibular molars, performed under sedation twice a week during the whole experiment. Furthermore, two control groups of ten mice were included, a positive (cola drink) and a negative (distilled water) control. A terminal procedure was followed by dissection of mandibular molars and analysis of them using scanning electron microscopy (SEM). The first molars were transversely ground, further analyzed by SEM, and measured for tooth height and tooth tissue loss. Results: Analyses of mandibular molars treated with a fluoride varnish indicated a 5% decreased tooth tissue loss, compared to the molars which served as a positive control. The best effect was achieved with the application of silver fluoride solution, displaying a 35% decreased tooth tissue loss compared to the positive control group. Conclusions: Preventive treatment with a solution of silver fluoride solution exhibits greater protection against dental erosion compared to a traditional fluoride varnish. This study indicates that silver fluoride solution is an effective fluoride compound and is highly beneficial in a clinical setting with the aim of preventing dental erosion. Full article

The development of laser technology has revolutionized dentistry, offering complementary and alternative approaches to traditional techniques. Lasers have been successfully integrated into various dental procedures, enhancing treatment outcomes and patient care. Several types of lasers can increase the acid resistance of enamel, thus preventing caries. Laser fluorescence has been utilized for the pre-operative diagnosis of dental caries, enabling early detection and effective treatment planning. The therapeutic application of lasers in caries treatment aligns with the contemporary philosophy of minimally invasive procedures. Clinicians can use laser Doppler flowmetry as a supplementary tool for pulp vitality testing by detecting pulpal blood flow. Lasers are also employed in various pulp-related interventions, such as managing dentine hypersensitivity and performing root canal therapy. These procedures benefit from the precision and reduced invasiveness provided by laser technology. Furthermore, laser fluorescence serves as an additional tool for subgingival calculus detection. High-power and low-power lasers are used in both nonsurgical and surgical therapies to treat periodontal and peri-implant diseases, oral mucosa conditions, and even cancer based on their specific properties. Lasers are also utilized to accelerate bone regeneration, promote adhesive strength, and remove ceramic brackets. In summary, laser technology has significantly impacted contemporary dentistry by facilitating early diagnosis, minimally invasive treatments, and precise operative procedures, ultimately improving patient outcomes and expanding the scope of dental practice. Full article

Background/Objectives: The use of silver diamine fluoride (SDF) has increased in recent years for the management of caries lesions in children and adults. The aim of this study is to determine the level of knowledge and the attitude of Spanish dentists (GDPs) and final-year dental students (DSs) regarding the use of SDF. Methods: A cross-sectional survey (questionnaire) was carried out aimed at final-year dental students (DSs) (n = 43) and registered dentists (GDPs) (n = 1050) in the autonomous community of the region of Murcia (Spain). Results: the response rates were GDPs 7.7% (n = 81) and DSs 84.5% (n = 38). Only 20.98% of GDP respondents reported having been trained on SDF versus 100% of DSs. Significant differences were observed between the groups (p < 0.05). While 94.7% of the students were aware of the indications for the use of SDF, only 56.8% of the general dentists reported it. Similarly, for hypersensitivity treatment, 71.1% of the students were informed versus 40.7% of the general dentists, and indications for paediatric patients, 100% for the DS group and 59.3% in GDPs. In adult patients, indications vary from GDPs’ (50%) to DSs’ (25.9%) responses. About 94.7% of DSs know the advantages of use and only 50.6% of GDPs. Both groups showed reluctance to use SDF in esthetic zones, with greater acceptance in non-esthetic areas (p < 0.05). In practice, fewer GDPs (27.16%) and DSs (23.68%) had applied SDF, reflecting a gap between knowledge and implementation. Conclusions: Dental students had a significantly higher level of knowledge, a situation that evidences the high level of education and training in the curricular guides of the universities. Full article