Prevalence of pharmacotherapy in the department of paediatric dentistry

Background: Pharmacotherapy plays important role in the management of paediatric dental patients in the department of paediatric dentistry. Many children at their early age suffer from different kinds of dental conditions such as acute and chronic irreversible pulpitis, acute and chronic alveolar abscesses, dentoalveolar and vestibular abscesses, etc along with physiological tooth movement that requires professional help for dental treatment. Treatment of such conditions most frequently requires pharmacotherapy as an either adjunct to dental therapeutic procedure or as a monotherapy. Objective: To assess the prescribing patterns vis-a-vis generic or trade name, generic class, dosage form, route, frequency, duration, number of drugs per patient, cost and indication of drug therapy, patterns of dental treatment and Frankl's behavioral rating. Materials and methods: Prescriptions of 200 paediatric dental patients undergoing dental treatment in the department of paediatric dentistry were analyzed prospectively for a period of six months in a dental teaching hospital. Results: 133 (56.5%) patients were males and 87 (43.5%) females and age group 6-10 years was the most frequent group (70%, P=0.0000000) and all the patients received pharmacotherapy. Total numbers of 357 drugs were prescribed. Out of them, 212 (59.4%, P=0.0000008) were analgesic agents, 133 (37.3%) antimicrobial agents (AMAs) and 12 (3.3%) other drugs. Extended spectrum Penicillins were the most commonly prescribed (90.2%) AMA followed by Metronidazole (9.8%). 247 drugs (69.2%, P=0.0000000) were prescribed by trade names. 60% (P=0.0000002) drugs were prescribed in the form of tablet or capsule followed by syrup 37% and administered entirely through oral route. Percentage of patients receiving three drugs, two drugs and one drug was 13.5%, 56.5% (P=0.0000000) and 30% respectively and one patient received on average 1.78 medicines. 133 patients (56.5%, P=0.0000000) received both AMA and analgesic agent. Minimum to maximum number of days for pharmacotherapy were 2 to 15 and highest frequency was up to four times a day. Cost of medicines was in the range of 10-150 Nepalese Rupees. Chronic irreversible pulpitis was the commonest diagnosis (28%) and extraction (92.5%) was the commonest dental procedure. Frankl's behaviour rating showed that 78.5% (P=0.0000000) patients had positive attitude towards the dental procedures. Conclusion: Findings of the study suggest that pharmacotherapy is the mainstay in therapy to treat the paediatric dental patients along with dental procedures either to control the dental pain or odontogenic infection. Age group 6-10 years, chronic irreversible pulpitis and dental extraction are the commonest age group, diagnosis and dental procedure respectively in the department of paediatric dentistry. Analgesic (non-steroidal anti-inflammatory drugs- Nimesulide, Ibuprofen and Paracetamol) and Amoxicillin are the most frequently prescribed drugs mostly in the solid dosage forms in trade names via oral route. Duration of pharmacotherapy ranges from 2 to 15 days with highest frequency being up to 4 times a day. Majority of the patients are manageable without any behavioural modification technique- physical or pharmacological. Key words: Dentistry; Frankl's behaviour rating; Paediatric; Pharmacotherapy; Prescription DOI: 10.3126/kumj.v8i2.3556 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 190-194

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967. Concordance of Antibiotic Prescribing with the Proposed American Dental Association Acute Oral Infection Guidelines within Veterans Affairs (VA) Dentistry

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.069 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S31-S32

Author(s):

Daniel Carlsen ◽

Katie J Suda ◽

Ursula C Patel ◽

Gretchen Gibson ◽

Marianne M Jurasic ◽

...

Keyword(s):

Dental Treatment ◽

Apical Periodontitis ◽

Antibiotic Prescribing ◽

Cross Sectional ◽

Oral Infections ◽

American Dental Association ◽

Dental Procedures ◽

Icd 10 ◽

Future Work ◽

Irreversible Pulpitis

Abstract Background US dentists prescribe 10% of outpatient antibiotics. However, assessing the appropriateness of dental antibiotic prescribing has been challenging due to a lack of guidelines for common infections. In 2019, the American Dental Association proposed clinical practice guidelines (CPG) on the management of common acute oral infections for the first time. Our objective was to describe national baseline antibiotic prescribing for the treatment of irreversible pulpitis, apical periodontitis, and acute apical abscess prior to the release of the proposed CPG. Methods We performed a cross-sectional analysis of national VA data from January 1, 2017 to December 31, 2017. We identified cases of irreversible pulpitis, apical periodontitis, and acute apical abscess using ICD-10-CM codes. Patient demographics, facility location, medical conditions, dental procedure codes (“CDTs”), and diagnostic (ICD-10-CM) codes were extracted from the VA Corporate Data Warehouse. Antibiotics prescribed by a dentist within 7 days of a visit were included. Multivariable logistic regression identified variables associated with antibiotic prescribing for each infection. Results Of the 470,039 VA dental visits with oral infections coded, 25% of irreversible pulpitis, 41% of apical periodontitis, and 61% of acute apical abscess visits received antibiotics. Amoxicillin was prescribed most frequently. Although the median days’ supply was 7 days, prolonged use of antibiotics was frequent (9.2% of irreversible pulpitis, 17.8% of apical periodontitis, 28.7% of acute apical abscess received antibiotics for ≥8 days). Of the irreversible pulpitis visits with antibiotics prescribed, 20.0% received ≥2 antibiotics. Patients with high-risk cardiac conditions, prosthetic joints, and certain dental procedures were associated with receipt of antibiotics (table). Conclusion Prior to the release of the ADA guidelines, 75.8% and 59.4% of irreversible pulpitis and apical periodontitis were concordant with proposed recommendations. These data identify opportunities to improve prescribing and serve as a benchmark for future outpatient antimicrobial stewardship efforts. Future work should assess definitive dental treatment and populations without access to oral health care. Disclosures All Authors: No reported Disclosures.

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A New Concept for the Treatment and Rehabilitation of Patients with Pathologic Comorbidities Using Cutting-Edge Digital Technologies in Dental Orthopaedics

European Journal of Dentistry ◽

10.1055/s-0040-1713295 ◽

2020 ◽

Vol 14 (04) ◽

pp. 533-538

Author(s):

Alexey V. Yumashev ◽

Maria V. Mikhailova ◽

Igor V. Fomin ◽

Jiaqi Li ◽

Bowen Yang

Keyword(s):

Statistical Analysis ◽

Dental Treatment ◽

Management Strategies ◽

Digital Technologies ◽

Statistical Probability ◽

Dental Patients ◽

Dental Examination ◽

Dental Procedures ◽

Probability Criterion

Abstract Objectives This article investigates the specific aspects of overactive or exaggerated vomiting reflexes affecting the procedure of dental examination and impression in patients with complete secondary adentia, who need orthopaedic dental treatment. Materials and Methods The prevailing manifestation degree of exaggerated vomiting reflex was diagnosed among patients with complete secondary adentia and exaggerated vomiting reflex. Statistical Analysis Exaggerated vomiting reflexes occur when a patient suffers from dentophobia, the term, which is otherwise known as the fear of dentists. The study was performed using methods of mathematical statistics, including the Pearson χ2 criterion and the statistical probability criterion (p). Results The role of an exaggerated vomiting reflex was revealed in the development of patients’ dentophobic experiences, and the nature of such experiences was established. Variations in dentophobic reactions were distinguished and management strategies were studied for patients with complete secondary adentia and exaggerated vomiting reflex. Conclusions These studies were aimed at preventing the development of vomiting reflex during dental procedures and at identifying an optimal strategy for stopping exaggerated vomiting reflex. The role of the vomiting reflex in the orthopaedic treatment of dental patients was determined.

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Private Practice Pricing in the Birmingham Region

Primary Dental Journal ◽

10.1308/205016819826439547 ◽

2019 ◽

Vol 8 (1) ◽

pp. 34-37

Author(s):

Anant Bakshi ◽

Raeesa Khan ◽

Bilal Ahmed

Keyword(s):

Dental Implants ◽

Average Cost ◽

Dental Treatment ◽

Dental Procedure ◽

Dental Procedures ◽

Dental Intervention ◽

The Mean ◽

The Difference ◽

Mean Cost ◽

Insight Into

This study was carried out to evaluate the difference in prices for dental treatments carried out privately in general dental practice within the Birmingham area. Ten different practices were chosen at random, which were spread across Birmingham, in order to get a better insight into the differences across the districts. Their prices for pre-determined dental procedures were procured off the practices’ respective websites or through telephoning. The findings of this study have shown a wide variation in prices for each dental procedure, with the greatest variation in prices between practices being £850 for dental implants. The procedures with the lowest average cost were fissure sealants at £23.14. The procedure with the highest average cost was dental implants at £2,261.11. This study also showed that as more dental treatment was required, the mean cost for the dental intervention increased, regardless of the tooth being treated.

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Possibility to control anxiety and pain in endodontic dental treatment – review

Progress in Health Sciences ◽

10.5604/01.3001.0012.8341 ◽

2018 ◽

Vol 8 (2) ◽

pp. 161-167

Author(s):

E. Stanulewicz ◽

E. Dąbrowska ◽

K. Olszański ◽

K. Borowski ◽

K. Rosłan

Keyword(s):

Dental Treatment ◽

Endodontic Treatment ◽

Root Canals ◽

Dental Procedures ◽

Treatment Review ◽

Dental Office ◽

Unpleasant Feeling ◽

Anxiety Treatment ◽

Treatment Procedures ◽

Irreversible Pulpitis

Modern dentistry aims to limit the unpleasant feeling of pain, associated with dental procedures during treatment in the dental office. There are many ways to reduce pain during dental procedures. Endodontic treatment, necessary in irreversible pulpitis, should be completed during one visit. Removal of the inflamed pulp from cavity and root canals is often accompanied by pain. The study aimed to introduce, based on literature, methods of relieving anxiety and pain accompanying dental treatment procedures, including endodontic treatment, as well as the description of applied measures. According to the modern literature, this research compares methodology and results of the anesthetic and anxiety treatment in the dental office, especially in endodontic treatment.

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Risk of Fungal Infection to Dental Patients

The Scientific World JOURNAL ◽

10.1155/2017/2982478 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Jaqueline Lopes Damasceno ◽

Rafael Aparecido dos Santos ◽

Amir Horiquini Barbosa ◽

Luciana Assirati Casemiro ◽

Regina Helena Pires ◽

...

Keyword(s):

Dental Treatment ◽

Pathogenic Fungi ◽

Fungal Species ◽

Immunocompromised Patients ◽

Dental Procedure ◽

Average Amount ◽

Dental Patients ◽

Dental Clinics ◽

Dental Equipment ◽

The University

Fungi can cause various diseases, and some pathogenic fungi have been detected in the water of dental equipment. This environment offers suitable conditions for fungal biofilms to emerge, which can facilitate mycological contamination. This study verified whether the water employed in the dental units of two dental clinics at the University of Franca was contaminated with fungi. This study also evaluated the ability of the detected fungi to form biofilms. The high-revving engine contained the largest average amount of fungi, 14.93 ± 18.18 CFU/mL. The main fungal species verified in this equipment belonged to the generaAspergillusspp.,Fusariumspp.,Candidaspp., andRhodotorulaspp. Among the isolated filamentous fungi, only one fungus of the genusFusariumspp. did not form biofilms. As for yeasts, all theCandidaspp. isolates grew as biofilm, but none of theRhodotorulaspp. isolates demonstrated this ability. Given that professionals and patients are often exposed to water and aerosols generated by the dental procedure, the several fungal species detected herein represent a potential risk especially to immunocompromised patients undergoing dental treatment. Therefore, frequent microbiological monitoring of the water employed in dental equipment is crucial to reduce the presence of contaminants.

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Use of Antibiotics in the Management of Pediatric Dental Conditions – A Retrospective Study

Journal of Contemporary Dentistry ◽

10.5005/jcd-1-1-11 ◽

2011 ◽

Vol 1 (1) ◽

pp. 11-14

Author(s):

Ashwin Jawdekar ◽

Srirang Sevekar

Keyword(s):

Retrospective Study ◽

Antibiotic Use ◽

Dental Clinic ◽

Multicentric Study ◽

Dental Patients ◽

Dental Procedures ◽

Irreversible Pulpitis ◽

Dental Conditions ◽

Larger Sample ◽

Antibiotic Cover

Abstract Objectives In order to evaluate the need of antibiotic use in children for a variety of dental procedures, a retrospective study was undertaken. Material and Methods Children as dental patients, a study The records of 100 children between age 2-10 years visiting a pediatric dental clinic for various pulpal and periapical conditions were evaluated. A total of 364 procedures (pulp therapies such as pulpotomy and pulpectomy, and extractions) were carried out in the children for different pulpal and periapical pathologies (irreversible pulpitis, pulp necrosis and periradicular abscess). Timing of the antibiotic cover (preop, intraop and post op), duration of the antibiotic, and type of the antibiotic or a combination was recorded. Results Only 19.5% procedures required antibiotic prescriptions. On most occasions, an antibiotic cover given prior to commencement of the treatment was sufficient to prevent the possible advancement of the infection and promote the post-operative healing. Conclusion Antibiotics are often not a necessity for the treatment of dental conditions in children. However, a larger sample size and multicentric study would be necessary to establish this finding.

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Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions

BioMed Research International ◽

10.1155/2016/7289310 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 16

Author(s):

Angela Galeotti ◽

Annelyse Garret Bernardin ◽

Vincenzo D’Antò ◽

Gianmaria Fabrizio Ferrazzano ◽

Tina Gentile ◽

...

Keyword(s):

Nitrous Oxide ◽

Adverse Effects ◽

General Anesthesia ◽

Conscious Sedation ◽

Dental Treatment ◽

Young Patients ◽

Dental Patients ◽

Dental Procedures ◽

Significant Difference ◽

Disabled Patients

Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients.Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score.Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment.Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.

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Evaluation of the Sedative Effect of Midazolam with and Without Ketamine, by Subcutaneous Via in Pediatric Dental Patients

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.v20i1.30760 ◽

2017 ◽

Vol 20 (1) ◽

pp. 89-97

Author(s):

Daniel Trejo-Herbert DDS ◽

Ricardo Martínez-Rider DDS ◽

Javier Lara-Guevara MD ◽

Socorro Ruiz-Rodríguez DDS, MS ◽

Arturo Garrocho-Rangel DDS, PhD ◽

...

Keyword(s):

Behavior Management ◽

Pediatric Patients ◽

Dental Treatment ◽

Sedative Effect ◽

Controlled Trials ◽

Body Movements ◽

Dental Patients ◽

Randomized Controlled ◽

Dental Procedures ◽

Fear And Anxiety

Children's fear and anxiety about dental treatment can lead to difficulties in the behavior management by the practitioner, which can be a barrier to successful dental treatment. Non cooperative children may need dental treatment under sedation, which is indicated when the non-pharmacological behavioral guidance is unsuccessful. There are randomized controlled trials comparing different sedative protocols for dental procedures; however, evidence of superiority from one form over another is weak. The aim of the present study was to evaluate the sedative effect of midazolam subcutaneously, with and without ketamine, on dental procedures performed in non-cooperative pediatric patients. A randomized, crossover clinical trial with single blinding was performed in 13 children (10 males and 3 females) from 19 to 48 months of age, ASA I and Frankl I behavior. The two methods were applied in the same patient, and the order of the same was assigned randomly, for the two treatment appointments. In each session were evaluated the patient's general behavior, body movements and crying through the modified Houpt scale. In addition, heart rate and oxygen saturation were monitored by means of a pulse oximeter.

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Evaluation of Patient’s Knowledge, Attitude, and Practice of Cross-Infection Control in Dentistry during COVID-19 Pandemic

European Journal of Dentistry ◽

10.1055/s-0040-1721295 ◽

2020 ◽

Vol 14 (S 01) ◽

pp. S1-S6

Author(s):

Muhammad Adeel Ahmed ◽

Rizwan Jouhar ◽

Samira Adnan ◽

Naseer Ahmed ◽

Tuba Ghazal ◽

...

Keyword(s):

Infection Control ◽

Dental Treatment ◽

Cross Infection ◽

Control Measures ◽

P Value ◽

Cross Sectional ◽

Dental Patients ◽

Attitude And Practice ◽

Dental Procedures ◽

Knowledge Attitude And Practice

Abstract Objectives The aim of this study was to evaluate the patient’s knowledge, attitude, and practice of cross-infection control in dentistry during coronavirus diseases 2019 (COVID-19). Materials and Methods This cross-sectional observational study was conducted at Altamash Institute of Dental Medicine, Karachi from June 2020 to August 2020. A total of 775 patients participated to fill questionnaire. After scrutiny, 25 questionnaire forms were excluded due to incomplete information. Questionnaire was divided in to four sections. First section obtained patients sociodemographic information, while knowledge of patients regarding cross-infection control during COVID-19 pandemic was evaluated in second section. Similarly, the purpose of third section was to assess attitude and fourth section was designed to evaluate practice. Likert’s 3-point scale was used for registration of participant’s response. The reliability of questionnaire was assessed through Crohnbach’s α (α = 0.74). Statistical analysis was performed after entering data in to SPSS version 25. Independent t-test was used to evaluate the difference in patients’ knowledge, attitude, and practice. A p-value ≤ 0.05 was considered as statistically significant. Results Majority of the participants agreed that COVID-19 is a highly contagious disease (631, 97%) and daily screening of staff, dental assistants, dentists, and patients is necessary (568, 75.7%) along with proper sterilization of instruments and disinfection of dental operatory (650, 86.66%). A large number of participant also agreed that proper disposal of waste is utmost important for cross-infection control (601, 80.24%) and patient's waiting area should also be marked with social distancing sign (620, 82.66%). However, when asked about the common route of COVID-19 transmission in dentistry, 341 (45.5%) participants disagreed that it is not through aerosol (water droplets) generated during dental procedures. Conclusions Dental health professionals should take additional measures to educate dental patients on mechanism of potential spread of COVID-19 through the aerosols and droplets generated during dental procedures. They should also encourage the dental patients to be vigilant and question the cross-infection control measures practiced by the dentist to whom they go for dental treatment, and to decrease their chances of acquiring an infection during their visit to the dental office.

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Dog-Assisted Therapy and Dental Anxiety: A Pilot Study

Animals ◽

10.3390/ani9080512 ◽

2019 ◽

Vol 9 (8) ◽

pp. 512

Author(s):

Cruz-Fierro ◽

Vanegas-Farfano ◽

González-Ramírez

Keyword(s):

Blood Pressure ◽

Pilot Study ◽

Dental Treatment ◽

Dental Anxiety ◽

Dental Procedure ◽

Therapy Dog ◽

Dental Procedures ◽

Before And After ◽

History Of ◽

Three Stages

Animal-assisted therapy aimed at improving individuals’ mental or physical health has been widely reported. However, the data on how a therapy dog could help control anxiety during dental procedures is scarce. The objective of this work was to evaluate the effect of dog-assisted therapy on people with a history of dental anxiety while receiving preventive dental treatment. Twelve adults participated (women: n = 11 (91.7%) and men: n = 1 (8.3%), mean age = 31.25 years, D.E. = 5.78). The Corah Dental Anxiety Scale was applied, the patient’s mood was assessed with a Likert scale before and after receiving the dental treatment, and their blood pressure was recorded for each of the three stages of treatment. A therapy dog accompanied the participants during the dental procedure. The main results indicated that a decrease in discomfort was perceived during the intervention, and there was also an improvement in the patient’s evaluation of the experience. The results are based on the decrease in patients’ blood pressure when taken in the middle of the dental treatment.

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