Harnessing the power of gate control: interventions for procedural pain and anxiety

Medical and dental procedures present a minefield of opportunities for pain and anxiety. Many procedures for diagnosis, treatment, and palliation are performed either without comfort measures at all or with sedation/anesthesia. Yet, there are many ways of decreasing patients’ procedural pain and anxiety and of increasing physical and psychological comfort. Gate control theory explains how we can close the gate on pain transmission (and minimize opening the gate) through non-pharmacological means. An exploration of several bottom-up and top-down interventions will be discussed including breathing, mindfulness, gradual exposure, non-pain stimuli, distraction, touch, and postoperative communications. Interventions will be illustrated with pictures and short videos in the dental setting.

Making safety a priority

Tom Alcraft highlights Covid-19 management in the dental setting

Erratum: Suwattipong et al. Comparison of Point-of-Care Testing and Hospital-Based Methods in Screening for Potential Type 2 Diabetes Mellitus and Abnormal Glucose Regulation in a Dental Setting. Int. J. Environ. Res. Public Health 2021, 18, 6459

In the original article [...]

Evaluation of knowledge and application towards ergonomic principles among undergraduate dental students

This study evaluated the knowledge and application of ergonomic principles as well as manifestation of pain by dental students at the Federal University of Maranhão. Forty-four students answered a questionnaire on ergonomic principles. Photographs of the clinical rounds were performed to evaluate the postures adopted, without the students knowing the moment of photographic registration, avoiding that they modified their posture. The relationship between theoretical knowledge and the applicability of ergonomics in dental setting was evaluated. Data were analyzed using descriptive statistics. The Chi-square test analyzed the distribution of categorical variables among the evaluation instruments (α = 5%). Most of the participants adopted a satisfactory posture and presented knowledge about ergonomic postures, however, one can observe the poor positioning of the eyes and spine. 75% of the patients experienced pain in the body, being the spine (61.4%) and neck (40.9%) the most affected sites. The sample evaluated had good knowledge on ergonomic principles, but these were not adopted entirety, which may have led to the onset of pain.

Post COVID-19 changes in the perception of the parents towards dentistry for their child

The aim of the study is to evaluate the post COVID changes in the perception of the parents towards dentistry for their child/children.A cross-sectional questionnaire based survey was conducted among the parents of children <18 years of age to assess the behavioral changes in the parents after the COVID-19 outbreak towards pediatric dentistry. The survey was carried out with a sample of 5110 respondents.Majority of the parents had correct knowledge regarding the COVID-19 with increase in their anxiety level post COVID-19 outbreak. Almost all the parents were taking the measures regarding the hygiene of their children. Nearly half of the parents were not willing to take their children to the dentist even in the emergency dental condition due to the risk of encountering corona virus at the dental clinic.The majority of respondents lacked confidence towards dentistry, their treatment environments, and the infection control measures taken, and were worried about contracting COVID-19 infection from the dental setting. Parents, however, demanded better infection control measures during the SARS outbreak. From the results of our survey, it is imperative that dentists and dental specialist like pediatric dentists should offer more confidence building measures towards the patients & their parents, involving them in the dental treatment planning as well as decision making and providing them timely appraisal regarding the same.

Hemodynamic Impact of Drug Interactions With Epinephrine and Antipsychotics Under General Anesthesia With Propofol

Objective: Antipsychotic drugs exhibit α-1 adrenergic receptor-blocking activity. When epinephrine and antipsychotic drugs are administered in combination, β-2 adrenergic effects are thought to predominate and induce hypotension. This study aimed to assess hemodynamic parameters in patients regularly taking antipsychotics who were administered epinephrine-containing lidocaine under general anesthesia in a dental setting. Methods: Thirty patients taking typical and/or atypical antipsychotics and scheduled for dental procedures under general anesthesia were enrolled. Five minutes after tracheal intubation, baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and percutaneous oxygen saturation (SpO2) measurements were taken. The SBP, DBP, HR, and SpO2 measurements were repeated 2, 4, 6, 8, and 10 minutes after the injection of 1.8 mL of 2% lidocaine (36 mg) with 1:80,000 epinephrine (22.5 mcg) via buccal infiltration. Results: Differences between the baseline measurements and those of each time point were analyzed using Dunnett test, and no statistically significant changes were observed. Conclusions: Our findings demonstrate that the use of epinephrine at a clinically relevant dose of 22.5 mcg for dental treatment under general anesthesia is unlikely to affect the hemodynamic parameters of patients taking antipsychotic medications.

A Review on the Application of Silver Nanoparticles in Oral and Maxillofacial Surgery

Silver nanoparticles (AgNPs) have been taken advantage of in dentistry because of their good antibacterial resistance and self-sustaining potential. However, in oral and maxillofacial surgery and implantology, there is a lesser amount of evidence. The few pieces of evidence need to be accentuated for possible amplification of its use in the dental setting. AgNPs in oral and maxillofacial surgery can be used in wound healing, bone healing, extractions, guided tissue regeneration, apical surgeries, oral cancer, and dental implants. This review aims to feature the utilization and application of AgNPs in oral and maxillofacial surgery and implant dentistry, emphasizing its need for potential future development in clinical settings.

Dentist Related Factors Associated with Implementation of COVID-19 Protective Measures: A National Survey

Little is known about the extent to which dentists have implemented COVID-19 infection control guidelines and the factors influencing this process in daily practice. This national online survey assessed the implementation of enhanced infection control guidelines in daily practice, and explored dentist related factors influencing their application, more specifically dentist infection status and their perceived risk of cross-infection in the dental setting. The survey was validated, pretested and carried out in 2020. A total of 1436 dentists participated, of whom 9.1% presumably had COVID-19 infection experience. At least 75% of dentists complied with the core part of the recommended protective measures protocol. For each patient treated during the pandemic, an additional cost of 10–30 EUR (86.7%) and an extra time of 10–30 min (70.7%) was estimated. A stepwise binary logistic regression analysis revealed that dentists assumed to have experienced COVID-19 reported a higher self-perceived risk of virus acquisition (β = 2.090; p = 0.011), lower concern of getting infected (β = 0.576; p = 0.027), and lower confidence in being able to prevent disease transmission in the dental setting (β = 0.535; p = 0.022). Some parts of the protective measures were more difficult to apply than others; however, there was no indication of increased disease acquisition in the dental setting.

Clinical Dentistry -The Pandemic’s Late Effects

Coronavirus disease 2019 (covid-19) is the most recent HCID (highly contagious infectious diseases) pandemic to hit the world. The respiratory disease (sars-cov-2) has been shown to spread from symptomatic patients through droplets and aerosols. Because of the closed environment and the use of high and low-speed handpieces, ultrasonic scalers, infection spreads even more easily in a dental setting. During these times, our priority should be inward to protect ourselves as well as the patients who need medical attention. Various methods for controlling infection transmission from aerosol-generating dental procedures are recommended to accomplish this. In light of the effect of oral health on the seriousness of the Covid 19 pandemic, and to protect ourselves financially during this pandemic it is critical to explain patients that we dentists are using the most up-to-date approaches to keep them safe by reducing the risk of them contracting the virus from the dental office in order to maximise the number of outpatients. And it is important to treat every patient as a Covid -19 infected person and take the appropriate precautions to ensure our safety while rendering dental treatment.

Possible transmission of Covid-19 & precautions in a dental setting: A review

A severe pneumonia outbreak occurred in Wuhan City in late December 2019.Inhalation of airborne microorganisms that may remain in the air for a long time, direct blood contact, oral fluid or other patient material, connective contact with droplets and nasal or mouth mucosal microorganisms formed or proposed by an infected person transmitting pathogens to the dental environment for a short time.Contacts can also occur in a relatively closed environment where aerosols are exposed to high aerosol levels. Dental practice produces risky dentists and patients with aerosols.Therefore, the research aims to prevent infections in dental practices from hindering transmission routes between clinics and hospitals. Dentists played a significant role in stopping 2019-ncov transmission. In dental clinics and hospitals, infection control is advised to block routes from person to person.