Assessment of Dental Anxiety and Hemodynamic Changes during Different Dental Procedures: A Report from Eastern Saudi Arabia

Objectives This study aimed to investigate hemodynamic changes in healthy adult patients during different dental procedures and evaluate whether these changes were associated with patients' dental anxiety. Materials and Methods A convenience sample of 119 patients of both genders undergoing routine dental care participated in the study. Participants responded to the Arabic version of the modified dental anxiety scale (MDAS) and a self-structured questionnaire. Each patient had their blood pressure, heart rate, and oxygen saturation measured at three points: before, during, and after the dental procedure using an electronic sphygmomanometer. MDAS scores were categorized into no anxiety, mild, moderate or severe anxiety, while readings of heart rate and blood pressure were categorized into no change, increased or decreased and either “no change” or “increased” for oxygen saturation. Chi-square test was used to investigate the association between the study variables and a p value of < 0.05 was considered statistically significant. SPSS version 20 was used in the analysis. Results Mean ( ± standard deviation [SD]) of MDAS was 11.12 ( ± 3.9) an indicative of moderate dental anxiety. No changes in blood pressure, heart rate, or in oxygen saturation were observed on 39.5%, 54.6% and 97.5% among the study participants, respectively. Half of the participants avoided dental care, with dental anxiety being the main reason for that (26.1%). Pattern of dental visits was significantly associated with MDAS scores (p = 0.042). There were significant changes in blood pressure (p = 0.0003), heart rate (p = 0.01) but not in oxygen saturation (p = 0.33). Changes in blood pressure, heart rate, and oxygen saturation were not associated with dental anxiety p = 0.15, 0.10, and 0.99, respectively. Conclusion The results of this study indicate that the type of dental procedure may cause dental anxiety and cause hemodynamic changes. Therefore, close monitoring of patients with dental anxiety during the treatment is advised.

Pneumomediastinum following a dental procedure

Background: Subcutaneous emphysema is a common presentation to the emergency department. The presence of emphysema in the head and neck region due to dental procedure is not common, and the presence of pneumomediastinum is exceedingly rare. Case Report: A young lady, presented to the emergency department with chest pain, found to have pneumomediastinum following a dental procedure including a wisdom tooth extraction. Conclusion: Complications following dental procedures are not uncommon, hence there should be a high index of suspicion for the emergency physicians for such patients, especially those where air turbine dental tools have been used.

Dental Psychological Stress or Phobia among Orthodontic Patients of Mardan

Objective: To assess the psychological stress or phobia due to dental procedure among patients. Study Design: Descriptive cross-sectional study Place and Duration of Study: Department of Orthodontic, Bacha Khan College of Dentistry/Medical Teaching Institute, Mardan from 1st January 2020 to 31st August 2021. Methodology: One hundred and twenty patients coming for orthodontal treatment with age between 12-31 years were enrolled. The demographic and psychological stress information was recorded. Results: There were more females (65%) than males (35%). The mean age was 15.5±3.2 years. About 82.5% patients reported high level of psychological stress or phobias towards dental treatments while 19.1% were those who had moderate psychological stress or phobias. Majority of the patient’s fear of pain was between 12-17 years. Patients having highest anxiety also belonged to the same group Conclusion: Dental phobias and fears are widespread among patients seeking dental treatments. Orthodontists should recognize the dental phobias and fears so they efficiently interconnect with the patients. Key words: Orthodontic treatment, Pain, Dental phobia

December 2021 Medical Image of the Month: Aspirated Dental Implant

No abstract available. Article truncated after first 150 words. A 76-year-old woman with a past medical history significant for left-sided breast cancer status post lumpectomy recently underwent an extensive dental procedure about 1 month prior to presentation. The dental procedure was prolonged, and the patient reported falling asleep during the procedure several times. She presented with fatigue, right pleuritic chest pain, low-grade fevers, and drenching sweats. She underwent chest radiography at an outside institution which disclosed pneumonia, for which she was treated with cefdinir and doxycycline without improvement. Thoracostomy tube drainage of the pleural effusion was performed and showed empyema. Imaging showed an airway foreign body which was retrieved bronchoscopically. The patient made an uneventful recovery. Aspiration during dental procedures is rare but reported (1). Dental items have been reported as the second most commonly ingested/aspirated foreign objects in adults. If the airway is not compromised, assessment for any lost or missing instrument and its component should be done …

Amnesia after Midazolam and Ketamine Sedation in Children: A Secondary Analysis of a Randomized Controlled Trial

The incidence of peri-procedural amnesia following procedural sedation in children is unclear and difficult to determine. This study aimed to apply quantitative and qualitative approaches to better understand amnesia following dental sedation of children. After Institutional Review Board Approval, children scheduled for sedation for dental procedures with oral midazolam (OM), oral midazolam and ketamine (OMK), or intranasal midazolam and ketamine (IMK) were recruited for examination of peri-procedural amnesia. Amnesia during the dental session was assessed using a three-stage method, using identification of pictures and an animal toy. On the day following the sedation, primary caregivers answered two questions about their children’s memory. One week later, the children received a semi-structured interview. Behavior and level of sedation during the dental session were recorded. Quantitative data were analyzed using descriptive statistics and comparison tests. Qualitative data were analyzed using content analysis. Triangulation was used. Thirty-five children (age: 36 to 76 months) participated in the quantitative analysis. Most children showed amnesia for the dental procedure (82.9%, n = 29/35) and remembered receiving the sedation (82.1%, n = 23/28 for oral administration; 59.3%, n = 16/27 for intranasal administration). The occurrence of amnesia for the dental procedure was slightly higher in the oral midazolam group compared with the other groups (44.8%, n = 13/29 for OM, 13.8%, n = 4/29 for OMK, and 41.4%, n = 12/29 for IMK). Twenty-eight children participated in the qualitative approach. The major theme identified was that some children could remember their procedures in detail. We conclude that peri-procedural amnesia of the dental procedure was common following sedation.

Kajian Pustaka: Potensi Hypnosis untuk Mengurangi Nyeri pada Pasien yang Mendapatkan Perawatan Gigi dan Mulut

The purpose of this literature review is to find out whether hypnosis can be used to reduce pain in patients receiving dental and oral care. Hypnosis has been used to treat acute and chronic pain, anxiety, and other positive benefits before, during and after surgery. However, in the field, the use of hypnosis is still little used and even many who doubt its effectiveness. We reviewed articles in English using keywords: hypnosis, pain, anesthesia, dental, procedure with a time span from 1846 to 2019, with 20 selected articles on google scholars, pubmed, science direct, and the national library portal of the republic of Indonesia (PNRI). , Mesmerism hypnosis and Ericsonian hypnosis have been used for anesthesia for a long time before chemical anesthesia was discovered, the use of chemical anesthesia makes hypnosis no longer used as the main anesthetic in surgery, but in certain cases such as patients with multiple chemical sensitivity or patients with contraindications for general anesthesia, hypnosis still used as the primary anesthetic in surgery, currently hypnosis is widely used in perioperative surgery. The use of hypnosis with chemical anesthetics can increase the benefits and there are no reported side effects. Conclusion: hypnosis can be used as primary anesthesia, especially in certain cases, it needs well-designed research such as randomized control trials on the use of hypnosis with chemical anesthetics, both perioperatively and intraoperatively to obtain clearer and consistent scientific information about hypnosis and chemical anesthetics.