Exploring the Compliance of Resilient High-Caries-Risk Patients Who Reversed Caries Severity

Background: Behavioural factors, such as compliance and regular dental attendance, have been proven to reverse caries severity. However, these factors have not been explored enough. The aim of this study was to explore the behavioural characteristics of compliant patients who had severe dental caries in primary dentition but whose dental conditions were considerably improved in mixed or permanent dentition.Methods: The 'w and W' criteria were designed to classify patients who had a worse or higher caries risk in primary and mixed or permanent dentition. Resilience, or reversal of caries severity, was thus defined as improvement based on these criteria. Interviews were performed with two groups of participants, including eight resilient children (M/F= 5/3) and their ten caregivers (M/F=2/8) in the patient group and ten paediatric dentists (M/F=6/4; clinical experience mean=26.9 years, minimum=16 years) in the dentist group. Thematic analyses were used to identify main themes.Results: Four themes were identified: (1) dental things/teeth are their priority, (2) normalising, (3) tiger parenting/conscientiousness and (4) trust. These ideas were identically described by both the patient and dentist groups.Conclusions: Resilience is the behavioural characteristic of children who outperform expectations, given their caries history and risk. Resilient patients reverse the fate of their teeth by their compliance with treatment protocols following dental guidelines, changing their dental behaviours, and thus, leading to treatment success. Dentists' suggestions are the priority and provide the norms in resilient patients' daily life. These patients find no excuses for not implementing dentists' advice, not only because they trust their dentists but also because they and their caregivers were conscientious about following dentists’ orders.

Botox- the wonder poisonous healer

Botulinum toxin A has a wide variety of medical applications, which are related to the blockade of acetylcholine and often are associated with abnormal muscle contractures. The use of botulinum toxins has also revolutionised the treatment of various dental conditions like bruxism, gummy smiles, Frey’s syndrome spastic disorders, hypersalivation, orthodontic relapse, facial dystonias and temporomandibular disorders. The list of possible new indications is rapidly expanding. Many of these conditions are discussed with regard to their treatment with Botox compared to conventional treatments.

Is antibiotics overuse justified when immediate intervention is not possible? A rapid evidence review

Introduction: This review revisits clinical use of antibiotics for most common acute oro-dental conditions; we aim to provide evidence governing antibiotics use when access to oral healthcare is not available, as during the ongoing outbreak of the severe acute respiratory syndrome coronavirus 2. Materials and methods: In this rapid review, articles were retrieved after conducting a search on PubMed and Google Scholar. Relevant publications were selected and analyzed. Most recent systematic reviews with/without meta-analyses and societal guidelines were selected. Data were extracted, grouped, and synthesized according to the respective subtopic analysis. Results and discussion: There was evidence supporting the use of antibiotics in common oro-dental conditions as temporary measure when immediate care is not accessible, such as in case of localized oral swellings as well as to prevent post-extraction complications. No sufficient evidence could be found in support of antibiotic use for pain resulting from pulpal origin. Conclusion: Antibiotic use may be justified to defer treatment temporarily or reduce risk of complications in case of localized infection and tooth extraction, when no access to immediate dental care is possible. Graphical abstract:

Criteria of Hospital Inpatient Admission of Pediatric Dental Patient

Some dental conditions that are presented to the pediatric emergency department need hospital inpatient admission to facilitate supportive care, provide dental treatment and monitor the physiologic state of the child. The decision to treat the pediatric dental patient as an outpatient or inpatient is very important to control the overuse of hospital resources and at the same time not placing the child at the risk of rapid deterioration. However, no available guidelines or validated measures for the correct decision to treat the patient in either inpatient or outpatient care settings that can be used specifically for pediatric dental patients presented to the emergency department. Up to date, the decision of admitting pediatric patients is usually based on the severity of illness that can be measured by using The Pediatric Risk of Admission (PRISA II) Score. This review gives an overview of indications and clinical criteria of hospital inpatient admission of pediatric patients subsequent to traumatic and non-traumatic dental conditions.

Rehabilitation of an Extremely Atrophied Mandibule with Cortical Plates

A 74-year-old woman presented in our dental practice with severe loss of alveolar bone and soft tissue without any apparent systemic pathology contributing to her dental conditions. She had a complete removable prosthesis supported with a four locaters system. Unfortunately, two of the four supporting implants were failed. The patient wanted a fixed prosthesis. The treatment plan was to use the remaining implant with an additional axial implant and two cortical plates (Victory ®) followed by implant placement. The implants and plates were immediately loaded with a screw-retained prosthesis made with Znatex frame (Victory Implants ®) and resine.

Fear Factor in Seeking Dental Care among Saudis during COVID-19 Pandemic

The recent coronavirus disease of 2019 (COVID-19) pandemic led to major lifestyle changes. The present study sought to assess factors associated with fear to seek dental care during COVID-19 pandemic in Saudi Arabia. This cross-sectional study was conducted during the COVID-19 outbreak in 2020. An online questionnaire was filled by a convenient sample of adult Saudi residents through mobile instant messaging application. The following measures were collected: sociodemographic characteristics, fear of COVID-19 using validated Fears of Illness and Virus Evaluation scale, fear to seek dental care, perceived health status, and COVID-19 experience. There were 826 participants involved in this study (541 females and 285 males, mean age: 38.8 ± 13.29 years). Fear to seek dental care was significantly higher among females, younger age groups, people who perceived poor general and oral health, and people who perceived high risk of contracting the virus in dental clinics. After controlling for confounders, fear to seek dental care was significantly higher among the age group of 35–44 years, those who perceived high and moderate risk of COVID-19 infection in dental clinics, and among participants who reported untreated dental conditions. Fear that Others Get Sick, Fear of the Impact on Social Life, and Behaviors Related to Illness and Virus Fears were significantly associated with high levels of fear to seek dental care. Within the study’s limitations, fear of COVID-19 negatively impacted the study population’s willingness to seek dental treatment. Factors such as age, perceived risk of COVID-19 infection in dental clinics, and untreated dental conditions were associated with fear to seek dental care.

Is this really trigeminal neuralgia? Diagnostic re-evaluation of patients referred for neurosurgery

Objectives Patients with facial pain are sometimes referred for neurosurgical treatment with a poorly documented diagnosis of trigeminal neuralgia. In such cases, neurosurgery will usually not be helpful. We conducted a re-evaluation of the diagnosis in patients referred for neurosurgical treatment of presumed trigeminal neuralgia. Our objective was to find out why and how often misdiagnosis occurred. Methods A retrospective study was done in consecutive first-time patients referred for trigeminal neuralgia to our outpatient clinic in 2019. We used five ICHD-3-based clinical criteria to verify or exclude the diagnosis. In patients where trigeminal neuralgia was excluded, we established a diagnosis for their facial pain based upon medical history and a physical examination by a neurosurgeon – often supplemented with examination by an oral surgeon. Results Thirty-eight patients were referred for presumed trigeminal neuralgia. Only 17 of them fulfilled the five criteria and were diagnosed with trigeminal neuralgia. In 20 of the remaining 21 patients trigeminal neuralgia could be clearly excluded, while one of the patients had a periodontitis closely mimicking trigeminal neuralgia. In 14 of the 21 patients we diagnosed temporomandibular dysfunction or dental conditions. MRI scans had detected low-grade neurovascular contacts in 13 of the 21 patients, a finding that was clearly overestimated by the referring neurologists in seven patients. Conclusions Overdiagnosis of trigeminal neuralgia was common in patients referred for neurosurgery, mostly due to insufficient clinical evaluation combined with an overestimation of MRI-detected NVCs. The clinical diagnosis should be critically re-evaluated before recommending neurosurgery to patients referred for presumed trigeminal neuralgia.

A Web-Based Rendering Application for Communicating Dental Conditions

The importance of visual aids in communicating clinical examination findings or proposed treatments in dentistry cannot be overstated. Similarly, communicating dental research results with tooth surface-level precision is impractical without visual representations. Here, we present the development, deployment, and two real-life applications of a web-based data visualization informatics pipeline that converts tooth surface-level information to colorized, three-dimensional renderings. The core of the informatics pipeline focuses on texture (UV) mapping of a pre-existing model of the human primary dentition. The 88 individually segmented tooth surfaces receive independent inputs that are represented in colors and textures according to customizable user specifications. The web implementation SculptorHD, deployed on the Google Cloud Platform, can accommodate manually entered or spreadsheet-formatted tooth surface data and allows the customization of color palettes and thresholds, as well as surface textures (e.g., condition-free, caries lesions, stainless steel, or ceramic crowns). Its current implementation enabled the visualization and interpretation of clinical early childhood caries (ECC) subtypes using latent class analysis-derived caries experience summary data. As a demonstration of its potential clinical utility, the tool was also used to simulate the restorative treatment presentation of a severe ECC case, including the use of stainless steel and ceramic crowns. We expect that this publicly available web-based tool can aid clinicians and investigators deliver precise, visual presentations of dental conditions and proposed treatments. The creation of rapidly adjustable lifelike dental models, integrated to existing electronic health records and responsive to new clinical findings or planned for future work, is likely to boost two-way communication between clinicians and their patients.

Clinical changes in the severity of dental fluorosis: a longitudinal evaluation

Background Dental fluorosis (DF) has been one of the most prevalent pediatric dental conditions associated with aesthetic concern and treatment needs. This study aimed to identify the longitudinal clinical change in the severity of DF in 8–12-year-old children and its association with gender, age, severity, and tooth type. Methods This observational study assessed the dental aspects of the 92 Colombian children in 2015 (mean age at beginning 9.71 years ± 1.23) and 2018 (mean age 13.69 years ± 1.41), from an area with high DF prevalence. DF was recorded in all permanent teeth by two calibrated examiners using the Thylstrup and Fejerskov Index (TFI). DF severity change (maximum-TFI-score) was analyzed with descriptive analysis at the tooth level. Associated factors were evaluated with the generalized linear model, binomial family, and logarithmic link function. Results TFI scores ranged between 1 (very mild) to 6 (severe), being score 2 (41.7%) the most prevalent. After three years, 29.6% of the teeth presented score reduction, 24.1%, increased and 46.3% did not change; the significant association was related to increasing of the basal TFI = 1 score (44.2%) (RR = 9.7; 95% CI 1.7–56.5; p = 0.01) and with canines, premolars and second-permanent-molars teeth group (RR = 3.3; 95% CI 1.9–5.6; p = 0.005). Conclusion The present study based on clinical features about DF confirms the dynamic post-eruptive nature of this condition. After three years of follow-up, a considerable proportion of the teeth changed to a higher score. Furthermore, the canines, premolars, and second-permanent-molars showed a higher incidence of an increase in severity of TFI score.

Soft tissue rejuvination by botox in dentistry: A review

In this era, the passion to look beautiful has evolved various new technologies to enhance and improve the physical appearance of people. There are many medical and dental conditions, which do not have complete treatment modalities in conventional ways. Botox is emerging as one such popular treatment to improve the facial appearance. Botox can enhance aesthetics and is used therapeutically in other medical conditions. The Botox is a minimally invasive technique and may prove out to be an attractive alternative to surgery in some cases