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Antibiotic prophylaxis in dentistry has been recommended for different groups of patients, such as patients with impaired immunologic function, patients at risk of developing infective endocarditis or prosthetic joint infection, patients previously exposed to high-dose irradiation of the head and neck regions, and patients receiving intravenous bisphosphonate and antiangiogenic treatment. The guidelines have been changed over the years, and the list of medical conditions requiring antibiotic prophylaxis has been shortened considerably in the context of antibiotic resistance and unnecessary antibiotic prescription. [ABSTRACT FROM AUTHOR]

Antibiotics have various indications for treatment and prophylaxis in dental practice. While only a handful of antibiotics are typically prescribed in dentistry, unlike in medicine, clear indications and appropriate dosing and duration remain controversial among antibiotic-prescribing dentists, which may result in inappropriate or excessive antibiotic prescriptions. This practice can increase the risk of antibiotic resistance and expose patients to unnecessary side effects. Moreover, the concept of antibiotic stewardship in dental practice remains in its early stages. This review was developed by pharmacists (general and infectious disease pharmacists) in collaboration with a periodontist and a maxillofacial surgeon to provide an antibiotic prescription guide for dentists who frequently prescribe antibiotics. It also sheds light on antibiotic stewardship. The review discusses in detail antibiotic indications for treatment and prophylaxis in dental practice and provides tables that can be used by dentists in their everyday practice. It also discusses the concept of antibiotic stewardship and provides recommendations that can be applied to the practice of antibiotic prescribing in dentistry. Antibiotic prescribing in dental practice should be limited to cases with documented infections or when indicated for prophylaxis. Every dentist can act as an antibiotic steward by prescribing antibiotics wisely and only when necessary, using their discernment to identify appropriate cases and exclude those that do not meet infection criteria. Collaboration with pharmacists is encouraged to provide such recommendations and implement antibiotic stewardship interventions, such as developing antibiotic prescription protocols. [ABSTRACT FROM AUTHOR]

Over the past decade, access to National Health Service (NHS) dentistry in England has been problematic. There are increasing media reports of patients being unable to find treatment at a local NHS dentist. However, the extent of this issue varies by location and by the characteristics of the neighbourhood. The study uses official data sources on NHS dental provision and population. Travel accessibility is measured using car journey times. An advanced form of Floating Catchment Area accessibility is used, which accounts for supply competition, varying catchments, and distance decay. Spatial availability and accessibility indices are calculated. Ways in which the method can be used to explore various types of 'what-if' scenarios are outlined. Both availability and accessibility vary by the level of neighbourhood deprivation and the urban/rural nature of the neighbourhood. A case study, based on a real-world situation, shows the impact on the local neighbourhood of the closure of a dental practice. For all neighbourhoods, NHS dental provision is generally less than would be needed to provide basic dental care. The interpretation of outputs needs to take account of edge-effects near to Scotland and Wales. Possible improvements include the inclusion of other modes of travel and the exclusion of the population that does not want to access NHS care. [ABSTRACT FROM AUTHOR]

Background: Local anaesthesia in dental procedures is generally safe, although the occurrence of transient bradycardia (TB) has occasionally been reported. TB is often associated with two reflexes, the trigeminal cardiac reflex (TCR) and the vasovagal reflex (VVR) and is characterised by a rapid decrease in heart rate (HR) and blood pressure (BP). The prevalence of TCR is considered low, and its predictors have not been thoroughly investigated, although an association with the gag reflex has been suggested in recent years. Methods: This prospective study assessed TB occurrence during local anaesthesia and its potential associated factors. A comprehensive questionnaire was used to categorise discomforts during dental treatment, and various anxiety scales were used to measure patients' anxiety levels. We investigated HR variability during local anaesthesia administration under sedation and the association between the incidence of TB and gag reflex. Subsequently, logistic regression analysis was performed to assess factors associated with TB occurrence. Results: The prospective analysis included 188 patients of 234 initial patients. The analysis revealed a high TB incidence rate of 41% during local anaesthesia administration under sedation. No severe hypotensive events occurred, indicating a relatively benign nature of TB during local anaesthesia. TB occurrence was significantly higher in the group of patients with the gag reflex. Further analysis revealed that both gag reflex and trait anxiety were significantly associated with TB occurrence, whereas dental phobia did not directly correlate with TB. Conclusion: This study highlights the prominent occurrence of TB during local anaesthesia in dental treatment, which is primarily attributed to TCR activation. The identification of gag reflex and trait anxiety as independent factors associated with TB development may pave the way for TB prevention measures. Further research is required to clarify the mechanisms of TCR and perform safer dental procedures under sedation. Future studies should also aim to elucidate the precise mechanisms underlying TB during local anaesthesia through direct measurements of neural activity. A better understanding of TB in dentistry is crucial for improving patient safety and optimising dental practice protocols. [ABSTRACT FROM AUTHOR]

Abstract Background Local anaesthesia in dental procedures is generally safe, although the occurrence of transient bradycardia (TB) has occasionally been reported. TB is often associated with two reflexes, the trigeminal cardiac reflex (TCR) and the vasovagal reflex (VVR) and is characterised by a rapid decrease in heart rate (HR) and blood pressure (BP). The prevalence of TCR is considered low, and its predictors have not been thoroughly investigated, although an association with the gag reflex has been suggested in recent years. Methods This prospective study assessed TB occurrence during local anaesthesia and its potential associated factors. A comprehensive questionnaire was used to categorise discomforts during dental treatment, and various anxiety scales were used to measure patients’ anxiety levels. We investigated HR variability during local anaesthesia administration under sedation and the association between the incidence of TB and gag reflex. Subsequently, logistic regression analysis was performed to assess factors associated with TB occurrence. Results The prospective analysis included 188 patients of 234 initial patients. The analysis revealed a high TB incidence rate of 41% during local anaesthesia administration under sedation. No severe hypotensive events occurred, indicating a relatively benign nature of TB during local anaesthesia. TB occurrence was significantly higher in the group of patients with the gag reflex. Further analysis revealed that both gag reflex and trait anxiety were significantly associated with TB occurrence, whereas dental phobia did not directly correlate with TB. Conclusion This study highlights the prominent occurrence of TB during local anaesthesia in dental treatment, which is primarily attributed to TCR activation. The identification of gag reflex and trait anxiety as independent factors associated with TB development may pave the way for TB prevention measures. Further research is required to clarify the mechanisms of TCR and perform safer dental procedures under sedation. Future studies should also aim to elucidate the precise mechanisms underlying TB during local anaesthesia through direct measurements of neural activity. A better understanding of TB in dentistry is crucial for improving patient safety and optimising dental practice protocols.

Background: Unlike other amide local anesthetics (LAs), articaine has better lipid solubility and potency. Very few studies have been done on comparing articaine with other LAs as buccal infiltration among the participants requiring paired extraction of maxillary premolars but limitations of those studies include smaller sample size, lack of washout periods, and diversity in study designs. Aims and Objectives: This study compares the anesthetic efficacy of 4% articaine (1:100,000 epinephrine) with 2% lidocaine (1:100,000 epinephrine) as buccal infiltration. Materials and Methods: This is a randomized double-blinded crossover study conducted at the Department of Oral and Maxillofacial Surgery in collaboration with the Department of Pharmacology, SRIHER, Chennai. This study was done on 59 participants on an outpatient basis. The selected participants received 4% articaine or lignocaine with epinephrine (1:100000) in the mucobuccal fold at the maxillary area during their first visit and the same individual received the other local anesthetic drug on the other side in the same area during the second visit, i.e., 1 week from the date of the first visit. All the statistics were calculated using the software Statistical Package for the Social Sciences 16 version. For all primary and secondary outcomes in the study, the Mann--Whitney U-test was employed to compute the mean and standard deviation. Results: The total mean age of the participants included was 21.69. The volume of drug required was 1.578 ± 0.2760 mL for articaine and 2.2068 ± 0.0984 ml for lignocaine. The onset time was 30-45 s with articaine and 75-90 s with lignocaine. A decrease in pain scores was seen in the articaine group compared to the lignocaine group. Conclusion: This study showed better efficacy of articaine in comparison to lignocaine. Articaine may replace lignocaine in orthodontic corrections with its higher efficacy, faster action, and longer duration. [ABSTRACT FROM AUTHOR]

Introduction: Pain management in pediatric dentistry is crucial for ensuring positive treatment outcomes and reducing patient suffering. This study aimed to evaluate postoperative discomfort and analgesic usage among pediatric dental patients undergoing various procedures in India. Methodology: A cross-sectional study was conducted at a tertiary care dental hospital in India from June 2023 to December 2023. A total of 150 pediatric patients aged 2–18 years who underwent different dental procedures were included. Data on postoperative discomfort and analgesic usage were collected immediately following the procedure and during follow-up phone calls. Results: Significant differences were found in immediate postoperative discomfort following pulpotomy (P = 0.03). Patients receiving primary stainless steel crowns (SSCs) alone or in combination with pulpotomy were significantly more likely to report discomfort (P < 0.001 and P < 0.05, respectively). No significant associations were observed between discomfort and sealants, preventive resin restorations, 1- or 2-surface restorations, or extractions. Over-the-counter analgesic usage was prevalent, particularly following SSC placement. Conclusion: This study highlights the variability in postoperative discomfort among pediatric dental patients undergoing different procedures in India. Tailored pain management strategies based on specific procedures are essential to minimize discomfort and improve patient outcomes in pediatric dentistry.

Background: Effective management of child behavior during dental procedures is crucial for successful treatment outcomes and promoting oral health. Parental involvement has been recognized as a key factor influencing child compliance in various healthcare settings, but its specific impact on child compliance during dental appointments remains understudied. Methods: A cross-sectional clinical research involving 100 children scheduled for routine dental treatments. Parental involvement was categorized as high, moderate, or low based on the level of parental presence and interaction during the dental appointment. Child compliance was assessed using a validated behavior rating scale, evaluating factors such as cooperation, anxiety, and disruptive behavior during the dental procedure. Statistical analysis, including correlation analysis and ANOVA, was performed to determine the association between parental involvement and child compliance. Results: The results revealed a significant correlation between parental involvement and child compliance (P < 0.05). Children with high levels of parental involvement demonstrated greater compliance during dental procedures compared to those with moderate or low levels of parental involvement. Specifically, children with high parental involvement exhibited lower levels of anxiety, reduced disruptive behavior, and greater cooperation with the dental team. Conclusion: This research provides evidence of the positive impact of parental involvement on child compliance during dental procedures in pediatric patients. Higher levels of parental presence and interaction were associated with improved child behavior and cooperation, highlighting the importance of parental involvement in promoting positive oral health behaviors and facilitating successful dental treatments. These findings underscore the need for tailored interventions targeted at enhancing parental involvement and optimizing child compliance in the dental setting.

Antibiotic prophylaxis in dentistry has been recommended for different groups of patients, such as patients with impaired immunologic function, patients at risk of developing infective endocarditis or prosthetic joint infection, patients previously exposed to high-dose irradiation of the head and neck regions, and patients receiving intravenous bisphosphonate and antiangiogenic treatment. The guidelines have been changed over the years, and the list of medical conditions requiring antibiotic prophylaxis has been shortened considerably in the context of antibiotic resistance and unnecessary antibiotic prescription.

Antibiotics have various indications for treatment and prophylaxis in dental practice. While only a handful of antibiotics are typically prescribed in dentistry, unlike in medicine, clear indications and appropriate dosing and duration remain controversial among antibiotic-prescribing dentists, which may result in inappropriate or excessive antibiotic prescriptions. This practice can increase the risk of antibiotic resistance and expose patients to unnecessary side effects. Moreover, the concept of antibiotic stewardship in dental practice remains in its early stages. This review was developed by pharmacists (general and infectious disease pharmacists) in collaboration with a periodontist and a maxillofacial surgeon to provide an antibiotic prescription guide for dentists who frequently prescribe antibiotics. It also sheds light on antibiotic stewardship. The review discusses in detail antibiotic indications for treatment and prophylaxis in dental practice and provides tables that can be used by dentists in their everyday practice. It also discusses the concept of antibiotic stewardship and provides recommendations that can be applied to the practice of antibiotic prescribing in dentistry. Antibiotic prescribing in dental practice should be limited to cases with documented infections or when indicated for prophylaxis. Every dentist can act as an antibiotic steward by prescribing antibiotics wisely and only when necessary, using their discernment to identify appropriate cases and exclude those that do not meet infection criteria. Collaboration with pharmacists is encouraged to provide such recommendations and implement antibiotic stewardship interventions, such as developing antibiotic prescription protocols.

Background: Precise knowledge of the mandibular foramen's location is essential for clinical and surgical procedures, especially the inferior alveolar nerve block. Variability in its position concerning different bony landmarks can significantly impact clinical outcomes. Materials and Methods: This study examined 30 Adult dry human mandibles to determine the mandibular foramen's positions in relation to specific bony landmarks: the occlusal plane, posterior border of the ramus, and lingula. Measurements were obtained using a calibrated digital caliper, and statistical analysis was performed. Results: The study revealed significant variations in the position of the mandibular foramen. In relation to the occlusal plane, the mandibular foramen was found at an average height of approximately 15.2 mm (±2.1 mm). Regarding the posterior border of the ramus, it was situated at an average distance of about 18.5 mm (±3.4 mm). In relation to the lingula, the average distance was approximately 21.8 mm (±4.0 mm). These results underscore the considerable individual differences and anatomical variations in the mandibular foramen's location among the studied specimens. Conclusion: The observed variations in the position of the mandibular foramen emphasize the need for clinicians and surgeons to be cognizant of these differences when performing procedures involving the inferior alveolar nerve block. Understanding these anatomical variations is crucial for enhancing clinical precision, reducing complications, and ensuring optimal outcomes.

Aim of the study: This review evaluates the necessity and effectiveness of antibiotic prophylaxis in preventing prosthetic joint infections (PJI) following dental procedures in patients with joint implants.Material and methods: An extensive literature review was conducted, focusing on studies evaluating the link between dental care and PJI. Sources included PubMed and other databases, using terms such as dental care, joint prosthesis, and antibiotic prophylaxis. The review spanned papers from 2003 to 2023, with a focus on hip and knee joint replacements and dental procedure-related prophylaxis guidelines.Results: The review found that the prevalence of dental pathology in patients with total hip arthroplasty (THA) or total knee arthroplasty (TKA) varied significantly. Studies indicated no significant benefit of antibiotic prophylaxis in reducing PJI risk post-dental procedures. Furthermore, the incidence of PJI was not significantly different in patients receiving antibiotic prophylaxis compared to those who did not. It was observed that routine activities, such as chewing and brushing, contribute more to bacteremia and potential joint infection than dental procedures themselves.Conclusions: The evidence suggests that antibiotic prophylaxis for dental procedures in patients with joint prostheses is not universally beneficial and should not be routinely recommended. Emphasis on individual risk assessment, maintenance of good oral hygiene, and adherence to evidence-based guidelines is paramount. The study advocates for personalized approaches to PJI prevention, aligning with the goals of antibiotic stewardship and patient safety.

This article provides an updated review of guidelines and clinical studies on dental antibiotic prophylaxis in total joint replacement. The review found that there is no significant benefit of antibiotic prophylaxis in reducing the risk of prosthetic joint infections (PJI) following dental procedures. Routine activities like chewing and brushing were found to contribute more to bacteremia and potential joint infection than dental procedures themselves. The study concludes that antibiotic prophylaxis for dental procedures in patients with joint prostheses is not universally beneficial and should not be routinely recommended. Instead, emphasis should be placed on individual risk assessment, good oral hygiene, and adherence to evidence-based guidelines. Another systematic review of multiple studies found no increased risk of PJI following dental procedures in patients with hip or knee replacements. The use of prophylactic antibiotics also did not show a significant association with the incidence of PJI. Maintaining good oral hygiene and regular dental assessments were found to reduce the risk of PJI by at least 30%. The review suggests that current policies on antibiotic prophylaxis for patients with joint replacements undergoing dental treatment should be reconsidered. Several studies were reviewed to assess the evidence supporting the use of prophylactic antibiotics. The studies found no direct evidence to support the use of antibiotics prior to dental procedures in patients with prosthetic joints. The authors recommend against routine antibiotic prophylaxis, as it is not cost-effective and contributes to antibiotic resistance. However, maintaining good oral hygiene is important to prevent a small number of infections associated with oral [Extracted from the article]

Background/purpose: The global coronavirus disease 2019 (COVID-19) pandemic continues to cause a significant impact on patient care due to its considerable transmissibility, morbidity, and mortality. The aim of this study was to investigate whether dental procedures performed at private dental clinics were associated with the occurrence of COVID-19 clusters and measures taken to prevent nosocomial infection of COVID-19. Materials and methods: An online questionnaire-based survey on clinical activities, infection control measures, and confirmed or probable COVID-19 cases among patients and clinical staff during the pandemic (February 2020 to September 2021) was administered to dentists at private dental clinics in Nagano prefecture, Japan. Almost all dentists engaged in dental treatment were actively implementing standard precautions. Results: Twenty-seven dental clinics provided dental care to infected patients (nine confirmed and eighteen probable), but there was no transmission from patients to staff. Ten clinics had staff who were infected, but none exhibited disease transmission from staff to patients. Conclusion: The results of this survey suggest that COVID-19 clusters might not occur in dental settings where appropriate protective measures are implemented.

This report details the case of a 69-year-old male who had presented to the emergency department at the suggestion of his dentist after ingesting a diamond-tipped drill bit during a routine dental procedure. Through the use of radiograph, computed tomography, and colonoscopy, the drill bit was determined to be lodged in the distal vermiform appendix. Throughout his clinical course, the patient remained asymptomatic but was monitored closely for signs of complications of a retained foreign body in the appendix. Gastroenterology and general surgery were consulted on the case but ultimately non-surgical approaches prevailed and the drill bit passed in the stool. This patient's case highlights the success of noninvasive measures for appendiceal foreign body removal. [ABSTRACT FROM AUTHOR]

Background: Precise knowledge of the mandibular foramen's location is essential for clinical and surgical procedures, especially the inferior alveolar nerve block. Variability in its position concerning different bony landmarks can significantly impact clinical outcomes. Materials and Methods: This study examined 30 Adult dry human mandibles to determine the mandibular foramen's positions in relation to specific bony landmarks: the occlusal plane, posterior border of the ramus, and lingula. Measurements were obtained using a calibrated digital caliper, and statistical analysis was performed. Results: The study revealed significant variations in the position of the mandibular foramen. In relation to the occlusal plane, the mandibular foramen was found at an average height of approximately 15.2 mm (±2.1 mm). Regarding the posterior border of the ramus, it was situated at an average distance of about 18.5 mm (±3.4 mm). In relation to the lingula, the average distance was approximately 21.8 mm (±4.0 mm). These results underscore the considerable individual differences and anatomical variations in the mandibular foramen's location among the studied specimens. Conclusion: The observed variations in the position of the mandibular foramen emphasize the need for clinicians and surgeons to be cognizant of these differences when performing procedures involving the inferior alveolar nerve block. Understanding these anatomical variations is crucial for enhancing clinical precision, reducing complications, and ensuring optimal outcomes. [ABSTRACT FROM AUTHOR]

Background: Ocular health is significant as undetected and untreated eye conditions can lead to vision loss and blindness. Usually, dentists, dental assisting staff, and patients undergoing frequent dental corrections are likely affected by eye injuries. Methods: This survey aimed to evaluate eye safety protocols in the dental fraternity. A prevalidated questionnaire was given to practicing graduate and postgraduate dentists to obtain details of the eye safety protocol they adopted. Results: A total of 150 dentists approached; only 125 chose to participate in the survey and answered our questionnaire. Although most dentists used eye protection for themselves, primarily personal eyeglasses and face shields, eye injury was quite common in them. Conclusion: Data from this study revealed that the use of eye safety practices among the respondents could be improved. Clinicians should be aware that they are responsible for providing adequate eye protection for themselves and their assisting staff and patients. [ABSTRACT FROM AUTHOR]

Objective: Medicare beneficiaries in rural areas may face challenges in access to dental care. This study assessed rural–urban differences in the use of dental services and dental procedures by Medicare beneficiaries. Methods: We obtained data from the 2018 Medicare Current Beneficiary Survey cost and use files. Outcome variables examined in this study were (1) dental visits (yes/no), whether the Medicare beneficiary had ≥1 dental visit in the past year, and (2) dental procedures—preventive (yes/no), restorative (yes/no), and surgical procedures (yes/no)—whether the beneficiary had the procedure in a dental visit. The independent variable was the beneficiary's residence (rural vs urban). We used multiple logistic regression to analyze data and accounted for the survey design of the Medicare Current Beneficiary Survey. The analytic sample included 7377 respondents aged ≥65 years. Results: Approximately 57.0% (95% CI, 54.9%-59.0%) and 46.4% (95% CI, 41.6%-51.2%) of Medicare beneficiaries in urban and rural communities in the United States had a dental visit in 2018, respectively. Rural beneficiaries were significantly less likely than their urban counterparts to have preventive procedures (adjusted odds ratio = 0.51; 95% CI, 0.36-0.72) but significantly more likely to have restorative procedures (adjusted odds ratio = 1.30; 95% CI, 1.05-1.62). Conclusion: We found significant disparities in use of dental services by Medicare beneficiaries in rural communities. When Medicare beneficiaries in rural areas used dental care, they were less likely than beneficiaries in urban areas to have preventive procedures but more likely to have restorative procedures, suggesting a greater burden of oral health needs among them. Policy research is needed to identify models that can incentivize prevention and improve access to dental care for Medicare beneficiaries in rural communities. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the impact of COVID-19 pandemic on attendance and treatments performed in a paediatric dental clinic. Materials Methods: A retrospective study was conducted using the records of pediatric patients treated in two periods: before the pandemic (15 March 2019–14 March 2020) and during the pandemic (15 March 2020–14 March 2021). Data regarding patients’ age, sex and administered treatment were collected and analyzed. The treatments applied were categorized under 6 groups: examination, restorative, preventive, prosthetic, emergency and surgical, and periodontal. Rates of each procedure were compared between two periods. Results: During pandemic, 11,700 patients applied to our clinics and 26,995 procedures were performed, resulting a decrease by 63.5% and 84.3% in the outpatients and treatments, respectively, compared to the pre-pandemic period. During the pandemic, the rates of examination and surgical procedures were significantly higher than those before the pandemic, while the rates of other procedures were significantly decreased (p

Objectives: This study aimed to determine the characteristics of antibiotic prophylaxis (AP) utilization and the level of adherence of King Saud University Medical City (KSUMC) staff to the latest American Heart Association (AHA) guidelines for AP for infective endocarditis (IE) in cardiac patients undergoing dental procedures. Methods: The study was conducted as a retrospective cohort study to investigate the relationship between AP in dental procedures and cardiac patients admitted in the surgical wards of KSUMC between 2015 and 2021. All cardiac patients who underwent dental procedures were included in the study. We excluded patients with long-term or concurrent antibiotic use for other indications. Results: Overall, 170 (69.4%) cardiac patients received AP before undergoing a dental procedure. The most common comorbidities were hypertension (39.1%) and diabetes (34.2%). Most of the low-risk (69.4%) and moderate-risk (70.5%) patients received AP, despite the guideline's recommendation to limit AP to high-risk patients only. Moreover, only 53.8% of high-risk patients were prescribed AP. In total, 95.9% of the 170 patients who received AP did so without following the recommendations. Only one patient developed IE during the 1-year follow-up. Tooth extraction was the only significant predictor of AP prescription in our study (P = 0.001; OR: 3.73; 95% CI; 1.678-8.298). Conclusion: There was an exceeding level of inconsistency (95.9%) in AP utilization by cardiac patients in our sample compared with the recommendations of the latest AHA guidelines. [ABSTRACT FROM AUTHOR]

The global coronavirus disease 2019 (COVID-19) pandemic continues to cause a significant impact on patient care due to its considerable transmissibility, morbidity, and mortality. The aim of this study was to investigate whether dental procedures performed at private dental clinics were associated with the occurrence of COVID-19 clusters and measures taken to prevent nosocomial infection of COVID-19. An online questionnaire-based survey on clinical activities, infection control measures, and confirmed or probable COVID-19 cases among patients and clinical staff during the pandemic (February 2020 to September 2021) was administered to dentists at private dental clinics in Nagano prefecture, Japan. Almost all dentists engaged in dental treatment were actively implementing standard precautions. Twenty-seven dental clinics provided dental care to infected patients (nine confirmed and eighteen probable), but there was no transmission from patients to staff. Ten clinics had staff who were infected, but none exhibited disease transmission from staff to patients. The results of this survey suggest that COVID-19 clusters might not occur in dental settings where appropriate protective measures are implemented. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the skills and confidence status of house officers in managing dental patients. Study Design: Mixed method (Sequential-explanatory) study. Place and Duration of Study: Altamash Institute of Dental Medicine, Karachi Pakistan, from Mar 2019 to Mar 2020. Methodology: A self-administered questionnaire was developed for the 1st phase of the study. After validation from the content experts, a pilot test was run on 18 house officers before administering the questionnaire. It included 46 dental procedures; participants rated their skills and confidence in performing them using a Likert scale of 1 to 5 points ranging from poor to excellent. In the 2nd phase, sixteen face-to-face interviews were conducted to explain the reasons for acquiring skills and confidence status. Results: The response rate was 100%. Fifty-eight house officers filled out the questionnaire. Participants with multiple rotations reported significantly above average confidence status with multiple rotations of retainer insertion (81%), treatment of malocclusion using removable appliances (82%), fissure sealants (78%), anterior endodontic (80%), posterior amalgam (69%), oral hygiene (69%), and diagnosis of caries (67%), TMJ disorders (69%), rubber dam placement (71%) and properly prescribed recommended medicine (65%) when compared to the single rotation. The most important high-confidence status themes in evaluating skills were practising the procedures and internal motivation. Conclusion: Multiple rotations with repeated practice sessions enhanced house officers' skills and confidence status.Procedures that were least practised scored the lowest in overall mean confidence. Keywords: Confidence status, Curriculum, Dental graduates, Dental procedures, Evaluation, House officers, Skills.

Introduction: Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) is an alternative medical system and has found acceptance globally for its use of rich medical plants, minerals, and other natural commodities in treating different illness. In November 2020, AYUSH changed its curriculum guidelines for its postgraduate students, which allowed them to perform a variety of general surgery, including orthopedic, ophthalmology, Ear Nose Throat (ENT), and dental treatments. Aim: To assess the awareness and perception among the dentists of these new AYUSH guidelines and to record their opinion. Materials and Methods: The cross-sectional study was conducted in Department of Oral Medicine and Radiology at Saveetha Dental College, Chennai, Tamil Nadu, India, from January 2021 to February 2021. A self-constructed questionnaire of 15 questions was circulated via google forms. The response was collected from 123 dentists. Statistical analysis was done on the IBM software 24 version. Chi-square test was used to assess the relationship between dentists' awareness of dental procedures included under the new AYUSH curriculum and their perception of ayurvedic practitioners performing the dental treatment efficiently. Results: Only 58.5% (n=79) of dentists were aware of the term AYUSH and 53 (43%) dentists were aware of the new guidelines added to the postgraduate curriculum in AYUSH. About, 57.7% of dentists reported that the Ayurvedic practitioners cannot handle the complications occurring during dental procedures. Conclusion: Dentists were not in favor of AYUSH practitioners performing dental treatments. The present study also concluded that dental procedures cannot be effectively and efficiently performed by AYUSH practitioners. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) has been identified as a pandemic by the World Health Organization in March 2020, and it affects all aspects of life, including dental care. Objectives: The purpose of this article is to explore the impact of COVID-19 on the daily operations of the stomatology department and provide some guidance for dental health care personnel around the world in continuing to provide exemplary care while limiting the spread of COVID-19. Materials and methods: Retrospective analyses were performed on dental patients’ medical records from the stomatology department of the First People's Hospital of Yichang, China, which were collected in the pre-epidemic, epidemic, and post-epidemic periods. Hospital-wide triage and stomatology department–specific protocols were established in the hospital to prevent cross-infection during the COVID-19 pandemic. Results: The number of patients decreased and proportion of emergency cases increased during the epidemic period. With prevention protocols in place, the number of dental patients returned to the normal range with a slight elevation during the post-epidemic period. Thus far, there has not been a single documented case of COVID-19 related to dental treatment in the hospital. Conclusions: COVID-19 has a major impact on daily life, including dental care services. Effective prevention and control measures including 3 levels of protection—zoning, instrumentation, and environmental disinfection—are needed for dental settings to provide care.

Background: Hepatitis C virus (HCV) infection is considered one of the growing public health problems. Identification of HCV-associated risk factors is pivotal for developing appropriate prevention strategies. Objectives: To determine the epidemiological variables of HCV infection in a tertiary care hospital. Methods: This hospital-based case-control study was conducted in a tertiary care hospital in Punjab on 320 subjects, including 160 cases and controls each. Cases and controls were matched by age (±5 years), gender, and residence. A patient ≥18 years of age fulfilling the biomarker criteria with or without clinical criteria diagnosed in the last 1 month was considered as a case. The information on socio-demographic characteristics and previous exposures to selected risk factors was collected through detailed interviews of the subjects. Analysis was performed using SPSS 20 statistical software. Odds ratio (OR) with 95% confidence interval (CI) was calculated to measure the strength of association between cases and controls for each risk factor. Results: Odds of having HCV infection was significantly higher among those with a history of blood transfusion (OR: 2.30, 95%CI: 1.14–4.63), dental procedure (OR: 4.82, 95%CI: 2.38–9.77) and intravenous injection/infusion from quacks (OR: 3.26, 95%CI: 1.47–7.19), injectable drug use (OR: 26.69, 95%CI: 3.55–200.24), non-injectable drug use (OR: 2.37, 95%CI: 1.44–3.90), tattooing (OR: 7.91, 95%CI: 2.31–27.08), and piercing from street hawkers (OR: 2.25, 95%CI: 1.18–4.29). Multivariate analysis identified history of blood transfusion, dental procedure, intravenous injection/infusion from quacks, injecting drug use, and piercing as independent risk factors for HCV infection. Conclusion: The study identified multiple risk factors for acquiring HCV infection and suggest appropriate interventions targeting high-risk populations.

Introduction: Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) is an alternative medical system and has found acceptance globally for its use of rich medical plants, minerals, and other natural commodities in treating different illness. In November 2020, AYUSH changed its curriculum guidelines for its postgraduate students, which allowed them to perform a variety of general surgery, including orthopedic, ophthalmology, Ear Nose Throat (ENT), and dental treatments. Aim: To assess the awareness and perception among the dentists of these new AYUSH guidelines and to record their opinion. Materials and Methods: The cross-sectional study was conducted in Department of Oral Medicine and Radiology at Saveetha Dental College, Chennai, Tamil Nadu, India,from January 2021 to February 2021. A self-constructed questionnaire of 15 questions was circulated via google forms. The response was collected from 123 dentists. Statistical analysis was done on the IBM software 24 version. Chi-square test was used to assess the relationship between dentists’ awareness of dental procedures included under the new AYUSH curriculum and their perception of ayurvedic practitioners performing the dental treatment efficiently. Results: Only 58.5% (n=79) of dentists were aware of the term AYUSH and 53 (43%) dentists were aware of the new guidelines added to the postgraduate curriculum in AYUSH. About, 57.7% of dentists reported that the Ayurvedic practitioners cannot handle the complications occurring during dental procedures. Conclusion: Dentists were not in favor of AYUSH practitioners performing dental treatments. The present study also concluded that dental procedures cannot be effectively and efficiently performed by AYUSH practitioners.

Social media like YouTube are increasingly used by students as a learning tool. The aim of this study was to examine the use of YouTube videos as a means of learning clinical procedures among dental students in Riyadh, Saudi Arabia. A cross-sectional observational study was conducted among dental students from six dental colleges in Riyadh, Saudi Arabia. Among the total of 331 dental students who responded to this survey, 93.9% (n = 308) reported that they had used YouTube for dental learning. A total of 65.30% (n = 201) of the respondents strongly agreed that they find videos of clinical procedures on YouTube helpful as a learning tool. A total of 54.40% (n = 180) agreed that they always refer to YouTube videos to prepare for a clinical procedure that they have never done before. A total of 75.3% (n = 232) reported that they most commonly watched clinical procedures related to restorative dentistry, 67.2% (n = 207) for fixed prosthodontics procedures, 65.3% (n = 201) for endodontic clinical procedures, and 62.3% (n = 192) for removable prosthodontics videos. A total of 50.60% (n = 156) strongly agreed that YouTube videos are helpful in relating theoretical knowledge with clinical knowledge. A total of 50.30% (n = 155) reported that it is important to have faculty guidance regarding useful YouTube videos on dental procedures. A total of 91.90% (n = 283) participants would like their dental school to post tutorials or videos for clinical procedures on YouTube. Even after increased availability of online videos, a majority of dental students felt that YouTube videos suggested by faculty were more valuable than videos identified through normal searching. [ABSTRACT FROM AUTHOR]

As people are paying more and more attention to dental health, various dental treatment procedures have emerged, such as tooth bleaching, dental implants, and dental restorations. However, a large number of free radicals are typically produced during the dental procedures. When the imbalance in distribution of reactive oxygen species (ROS) is induced, oxidative stress coupled with oxidative damage occurs. Oral inflammations such as those in periodontitis and pulpitis are also unavoidable. Therefore, the applications of exogenous antioxidants in oral environment have been proposed. In this article, the origin of ROS during dental procedures, the types of antioxidants, and their working mechanisms are reviewed. Additionally, antioxidants delivery in the complicated dental procedures and their feasibility for clinical applications are also covered. Finally, the importance of safety assessment of these materials and future work to take the challenge in antioxidants development are proposed for perspective. [ABSTRACT FROM AUTHOR]

Background: Antibiotic prophylaxis (AP) before invasive dental procedures (IDPs) is recommended to prevent infective endocarditis (IE) in those at high IE risk, but there are sparse data supporting a link between IDPs and IE or AP efficacy in IE prevention.Objectives: The purpose of this study was to investigate any association between IDPs and IE, and the effectiveness of AP in reducing this.Methods: We performed a case-crossover analysis and cohort study of the association between IDPs and IE, and AP efficacy, in 7,951,972 U.S. subjects with employer-provided Commercial/Medicare-Supplemental coverage.Results: Time course studies showed that IE was most likely to occur within 4 weeks of an IDP. For those at high IE risk, case-crossover analysis demonstrated a significant temporal association between IE and IDPs in the preceding 4 weeks (OR: 2.00; 95% CI: 1.59-2.52; P = 0.002). This relationship was strongest for dental extractions (OR: 11.08; 95% CI: 7.34-16.74; P < 0.0001) and oral-surgical procedures (OR: 50.77; 95% CI: 20.79-123.98; P < 0.0001). AP was associated with a significant reduction in IE incidence following IDP (OR: 0.49; 95% CI: 0.29-0.85; P = 0.01). The cohort study confirmed the associations between IE and extractions or oral surgical procedures in those at high IE risk and the effect of AP in reducing these associations (extractions: OR: 0.13; 95% CI: 0.03-0.34; P < 0.0001; oral surgical procedures: OR: 0.09; 95% CI: 0.01-0.35; P = 0.002).Conclusions: We demonstrated a significant temporal association between IDPs (particularly extractions and oral-surgical procedures) and subsequent IE in high-IE-risk individuals, and a significant association between AP use and reduced IE incidence following these procedures. These data support the American Heart Association, and other, recommendations that those at high IE risk should receive AP before IDP. [ABSTRACT FROM AUTHOR]

Abstract Background Transcatheter edge-to-edge mitral valve repair using the MitraClip device is increasingly used for high surgical risk patients with severe mitral regurgitation (MR). Previous guidelines for infective endocarditis prophylaxis prior to dental procedures focused on high-risk patients, but without explicit recommendation for MitraClip recipients. We believe this could be the first reported case to identify Streptococcus oralis as the causative organism. Case presentation An 87-year-old male with severe MR treated with two MitraClip devices three months prior to index admission, presented with worsening malaise and intermittent chills on a background of multiple comorbid conditions. The patient had dental work a month prior to presentation, including a root canal procedure, without antibiotic prophylaxis. Vitals were significant for fever and hypotension. On physical examination, there was a holosystolic murmur at the apex radiating to the axilla, bilateral pitting edema in the lower extremities, and elevated jugular venous pulsation. A transthoracic echocardiogram showed severe MR with a possible echodensity on the mitral valve, prompting a transesophageal echocardiogram, which demonstrated a pedunculated, mobile mass on the posterior leaflet of the mitral valve. Five blood cultures grew gram positive cocci in pairs and chains, later identified as Streptococcus oralis, with minimum inhibitory concentration to penicillin 0.06 mg/L. Initial empiric antibiotics were switched to ceftriaxone 2 gr daily and subsequent blood cultures remained negative. However, the patient developed pulmonary edema and worsening hemodynamic instability requiring vasopressors. As surgical risk for re-operation was considered prohibitive, the decision was made to continue medical management and comfort-directed care. The patient died a week later. Conclusions Despite low incidence, infective endocarditis should be included in the differential among MitraClip recipients. The explicit inclusion of this growing patient population in the group requiring prophylaxis prior to dental procedures in the 2020 ACC/AHA valvular heart disease guidelines is an important step forward.

Background: Hepatitis C virus (HCV) infection is considered one of the growing public health problems. Identification of HCV-associated risk factors is pivotal for developing appropriate prevention strategies. Objectives: To determine the epidemiological variables of HCV infection in a tertiary care hospital. Methods: This hospital-based case-control study was conducted in a tertiary care hospital in Punjab on 320 subjects, including 160 cases and controls each. Cases and controls were matched by age (±5 years), gender, and residence. A patient ≥18 years of age fulfilling the biomarker criteria with or without clinical criteria diagnosed in the last 1 month was considered as a case. The information on socio-demographic characteristics and previous exposures to selected risk factors was collected through detailed interviews of the subjects. Analysis was performed using SPSS 20 statistical software. Odds ratio (OR) with 95% confidence interval (CI) was calculated to measure the strength of association between cases and controls for each risk factor. Results: Odds of having HCV infection was significantly higher among those with a history of blood transfusion (OR: 2.30, 95%CI: 1.14–4.63), dental procedure (OR: 4.82, 95%CI: 2.38–9.77) and intravenous injection/infusion from quacks (OR: 3.26, 95%CI: 1.47–7.19), injectable drug use (OR: 26.69, 95%CI: 3.55–200.24), non-injectable drug use (OR: 2.37, 95%CI: 1.44–3.90), tattooing (OR: 7.91, 95%CI: 2.31–27.08), and piercing from street hawkers (OR: 2.25, 95%CI: 1.18–4.29). Multivariate analysis identified history of blood transfusion, dental procedure, intravenous injection/infusion from quacks, injecting drug use, and piercing as independent risk factors for HCV infection. Conclusion: The study identified multiple risk factors for acquiring HCV infection and suggest appropriate interventions targeting high-risk populations. [ABSTRACT FROM AUTHOR]

Eisha Imran,1 Zohaib Khurshid,2 Necdet Adanir,3 Heba Ashi,4 Nawaf Almarzouki,5 Hosam Ali Baeshen6 1Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, 44000, Pakistan; 2Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, 31982, Saudi Arabia; 3Department of Restorative Dentistry, College of Dentistry, King Faisal University, Al Ahsa, 31982, Saudi Arabia; 4Department of Dental Public Health, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Ophthalmology, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Zohaib KhurshidDepartment of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, 31982, Saudi ArabiaTel +966-558-420410Email drzohaibkhurshid@gmail.comIntroduction: COVID-19 created a peculiar situation worldwide, thus altering the fundamental dynamics of clinical dentistry. This KAP survey was carried out to evaluate the knowledge, attitude and practices among dental practitioners regarding the use of mouthwashes and emphasize on pre-procedural utilization of mouthwashes.Methodology: A descriptive, cross-sectional study was conducted during 1st to 15th July 2020, among working dental practitioners across the globe. A questionnaire was formed on Kwiksurveys.com, it comprised of demographic details, it further investigated the level of knowledge and new precautionary measures adopted. A total number of 707 dental practitioners from eighteen different countries responded.Results: Data were analyzed using SPSS version 23. A “fisher exact test” was applied to assess the difference between the mouthwashes prescribed by various countries. Knowledge section revealed a requisite understanding regarding the disease and its transmission. Only 38.9% of the participants knew that Povidone-iodine (PVP-I) mouthwashes are more efficient in reducing coronaviruses in contrast to mouthwashes made of chlorhexidine (CHX). Whereas 33.9% knew that 0.23% of PVP-I had substantial virucidal activity against SARS-COV, MERS-CoV, influenza virus and rotavirus while 31.1% recognized that oral rinses of Cetylpyridinium chloride (CPC) remained successful in the oral cavity for up to 180– 300 minutes.Conclusion: There is an immense need to raise awareness among practitioners, regarding the viricidal activity of commercially available mouthwashes as demonstrated by numerous in-vitro studies and urge health workers to carry out more clinical trials and to get a translational step towards clinical practice.Keywords: mouthwash, povidone-iodine, PVP-I, SARS-CoV-2, COVID-19, dental procedures

Background: Wrong side surgery (WSS) has gained national attention now. These errors are as terrifying as these involve patients who have undergone surgery on the wrong body part, undergone wrong procedure, or had a procedure intended for another patient. Materials and Methods: A questionnaire survey dealing with WSS was prepared, and 300 dental professionals were randomly mailed. All responses were gathered in Excel and analyzed using software SPSS version 19. Results: In the present study, the 213 dental professionals working in dental colleges in Ahmednagar gave the feedback, 29 of them had attempted WSS. The study was carried out on in two groups. The first comprised students undergoing bachelors in dentistry and other group was with professionals completed their bachelors in dentistry. The results were highly significant in those undergoing bachelors in dentistry with more incidence of WSS. Conclusion: The Joint Commission on Accreditation of Healthcare Organizations (JCAHOs) found WSSs as the 3rd highest event. The data are definitely more than that recorded in literature but due to fear clutched at the throat people do not disclose their mistakes though it happens.

Featured Application: Anxious dental patients are arduous to treat, need more time, and have behavioral issues which lead to a stressful and unpleasant experience for them and the treatment provider. Dentists must take additional measures to make the overall clinical experience more pleasant for their patients. The application of these unintrusive interventions, i.e., auditory distraction and brief relaxation therapy, before a dental treatment is thus encouraged. Objective: This study compared the effectiveness of auditory distraction and brief relaxation therapy for reducing anxiety in patients undergoing tooth extraction. Methods: A non-blind, three-armed, randomized control trial was carried out. The targeted study population were patients who needed extraction of a non-restorable and non-mobile molar tooth. Eighty-six patients were recruited; the brief relaxation therapy and auditory distraction groups had 32 participants each, while 10 of the 22 participants in the control group were excluded due to missing data. The Hierarchical Anxiety Questionnaire was used to assess the anxiety level. The Mann–Whitney U or Kruskal–Wallis test was performed to compare means between the groups. The before and after comparisons in each group were carried out using the Wilcoxon Signed-Rank test. The alpha value was set at 0.05, and data were analyzed using SPSS version 24. Results: The mean anxiety score after brief relaxation therapy and auditory distraction had significantly decreased (p < 0.001). Although not significant (p = 0.13), there was a slight increase in the anxiety score of the study participants in the control group just before the extraction procedure. Brief relaxation therapy was significantly effective in reducing anxiety scores in comparison to the control group (MD = 5.87, 95% CI = 2.58, 9.17; p = 0.001), but auditory distraction was not (p = 0.14). Conclusion: Both auditory distraction and brief relaxation therapy were effective in reducing patient anxiety before a dental procedure. Furthermore, it would be interesting to learn if these findings remain consistent for more complex dental procedures, such as surgical removal of an impacted third molar. [ABSTRACT FROM AUTHOR]

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Objective: To evaluate the knowledge, attitude, and practices about personal protective equipment (PPE) among dental surgery assistants in a Public Sector Teaching Hospital of Multan. Methods: A cross-sectional survey was carried out among dental surgery assistants in the dental outpatient departments of a public sector hospital of Multan city from Aug to Oct 2019. Pre-structured questionnaire which comprised of socio-demographic data, questions related to knowledge, attitude and practices was used. In the domain of knowledge there were 6 items. Dental assistant who scores ≤4 were considered to have appropriate knowledge for PPE. In the domain of attitude there were 5 items. Dental assistant who scores ≤3 were considered to have positive attitude for PPE. In the domain of practices there were 6 items. Dental assistant who scores ≤4 was considered good practicing of PPE. Results: Of 80 participants, 65 (81.25%) were males and 15 (18.75%) were females. Majority (n=54, 67.5%) of them were between 21-30 years of age. Appropriate knowledge was observed in 77 (96.3%) participants, positive attitude in 53 (66.3%) while, only 8 (10%) participants practiced good PPE. A significant difference was reported in the practices of dental assistants when compared with their knowledge (p-value 0.046) while attitude was found to be insignificant (p-value 0.710). Conclusion: Dental surgery assistants of the renowned public sector teaching hospital of Multan city reported sound and apposite knowledge, moderate attitude while inappropriate practices about PPE.

Background/purpose: Early diagnosis of vertical root fracture (VRF) has been a great challenge. Since there is no single specific etiology identified, prevention of VRFs in endodontically treated teeth is quite difficult. The study aimed to evaluate the clinical associated factors of VRFs. Materials and methods: A retrospective observational study of medical charts was conducted in the Department of Endodontics of Taipei Medical University Hospital in Taiwan from January 2012 to July 2018. Logistic regression model was performed to determine the association between VRF and its clinical associated factors, inclusive of the tooth characteristics (age, gender and tooth type) and iatrogenic risk factors (history of root canal treatment, restoration and post). Results: A total of 359 teeth were included in the study. The prevalence of VRF on a tooth basis was 18.7%. The result showed that age of more than 50 years (adjusted OR = 3.20, 95% CI: 1.81–5.64, p

Abstract Background Infective endocarditis is an uncommon but serious infection, where evidence for giving antibiotic prophylaxis before invasive dental procedures is inconclusive. In England, antibiotic prophylaxis was offered routinely to patients at risk of infective endocarditis until March 2008, when new guidelines aimed at reducing unnecessary antibiotic use were issued. We investigated whether changes in infective endocarditis incidence could be detected using electronic health records, assessing the impact of inclusion criteria/statistical model choice on inferences about the timing/type of any change. Methods Using national data from Hospital Episode Statistics covering 1998–2017, we modelled trends in infective endocarditis incidence using three different sets of inclusion criteria plus a range of regression models, identifying the most likely date for a change in trends if evidence for one existed. We also modelled trends in the proportions of different organism groups identified during infection episodes, using secondary diagnosis codes and data from national laboratory records. Lastly, we applied non-parametric local smoothing to visually inspect any changes in trend around the guideline change date. Results Infective endocarditis incidence increased markedly over the study (22.2–41.3 per million population in 1998 to 42.0–67.7 in 2017 depending on inclusion criteria). The most likely dates for a change in incidence trends ranged from September 2001 (uncertainty interval August 2000–May 2003) to May 2015 (March 1999–January 2016), depending on inclusion criteria and statistical model used. For the proportion of infective endocarditis cases associated with streptococci, the most likely change points ranged from October 2008 (March 2006–April 2010) to August 2015 (September 2013–November 2015), with those associated with oral streptococci decreasing in proportion after the change point. Smoothed trends showed no notable changes in trend around the guideline date. Conclusions Infective endocarditis incidence has increased rapidly in England, though we did not detect any change in trends directly following the updated guidelines for antibiotic prophylaxis, either overall or in cases associated with oral streptococci. Estimates of when changes occurred were sensitive to inclusion criteria and statistical model choice, demonstrating the need for caution in interpreting single models when using large datasets. More research is needed to explore the factors behind this increase.

Space dentistry addresses the unique challenges of providing dental care in space, where zero gravity, limited resources, and the vast distance from Earth complicate the maintenance of oral health. Ensuring astronauts' dental health is crucial, as dental issues can adversely affect their overall health and mission performance. Microgravity exacerbates risks for dental problems such as periodontitis, dental caries, bone loss, and potentially, neoplasms. Traditional dental care methods become less effective in microgravity, leading to increased plaque accumulation and worsening of dental diseases. As space missions venture further and last longer, maintaining oral hygiene presents unique challenges that necessitate innovative solutions. These include specialized tools like ergonomic toothbrushes and 3D-printed dental prostheses designed to function effectively in a zero-gravity environment. Preventive measures, such as comprehensive astronaut training programs focusing on oral health, are vital. These programs educate astronauts on maintaining oral hygiene and managing potential dental issues using available resources. Collaborative efforts among dental professionals, engineers, and space agencies are essential to developing comprehensive strategies for space dentistry. Such interdisciplinary collaboration leads to the advancement of dental care technologies and methodologies that can address the unique needs of astronauts. Despite the formidable challenges, these innovative solutions and collaborative efforts offer promising avenues for ensuring the dental health of astronauts during long-duration missions. This review aims to examine the detrimental effects of microgravity on the oral cavity and explore potential solutions to these issues, ensuring that humanity can continue to push the boundaries of space exploration while safeguarding the well-being of those who venture into the cosmos., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Hasin Abdul Samathu et al.)

The repercussions of the early loss of primary teeth, be it from trauma or caries, encompass compromised chewing efficiency, diminished aesthetics, potential development of abnormal oral habits, and difficulty in articulation of labiodental sounds, significantly influencing the child's psychological well-being and behavior. Moreover, the untimely loss of posterior teeth results in the loss of space, potentially leading to malocclusion and functional disruptions. Hence, addressing dental rehabilitation in these cases is both a challenge and a necessity. A toddler aged two and a half was brought to our department with a primary concern of multiple caries. Severe decay with 54, 61, 62, and 64 and missing 51 and 52 were seen. The child experienced pain from decayed back teeth, and the parents were distressed about compromised aesthetics caused by decayed front teeth. Given the child's young age and the sufficient time for permanent teeth to emerge, their concerns were heightened. To address these issues, a modified Groper's appliance was crafted to restore aesthetics and functionality. A supplementary crib-like wire component was incorporated into the appliance to facilitate a simpler and aesthetically pleasing composite crown buildup. Satisfaction with the treatment was evident from both the parents and the child. Subsequent follow-up sessions revealed no adverse effects attributable to the appliance, thus concluding that the additional wire component seamlessly integrated into the appliance offers several advantages, including enhanced aesthetics through composite shade matching for a simplified crown buildup. Particularly in remote areas, where obtaining a set of deciduous acrylic teeth can be challenging, this feature proves to be advantageous. It eliminates the necessity to trim permanent acrylic teeth to achieve a deciduous appearance. Additionally, the time and cost associated with the laboratory fabrication of heat-cure acrylic crowns can be circumvented. This distinctive case report underscores the creation of a modified Groper's appliance for the aesthetic and functional rehabilitation of a child grappling with early childhood caries (ECC). The appliance was well received, and no adverse outcomes were observed., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Saini et al.)

Background: Effective management of child behavior during dental procedures is crucial for successful treatment outcomes and promoting oral health. Parental involvement has been recognized as a key factor influencing child compliance in various healthcare settings, but its specific impact on child compliance during dental appointments remains understudied., Methods: A cross-sectional clinical research involving 100 children scheduled for routine dental treatments. Parental involvement was categorized as high, moderate, or low based on the level of parental presence and interaction during the dental appointment. Child compliance was assessed using a validated behavior rating scale, evaluating factors such as cooperation, anxiety, and disruptive behavior during the dental procedure. Statistical analysis, including correlation analysis and ANOVA, was performed to determine the association between parental involvement and child compliance., Results: The results revealed a significant correlation between parental involvement and child compliance ( P < 0.05). Children with high levels of parental involvement demonstrated greater compliance during dental procedures compared to those with moderate or low levels of parental involvement. Specifically, children with high parental involvement exhibited lower levels of anxiety, reduced disruptive behavior, and greater cooperation with the dental team., Conclusion: This research provides evidence of the positive impact of parental involvement on child compliance during dental procedures in pediatric patients. Higher levels of parental presence and interaction were associated with improved child behavior and cooperation, highlighting the importance of parental involvement in promoting positive oral health behaviors and facilitating successful dental treatments. These findings underscore the need for tailored interventions targeted at enhancing parental involvement and optimizing child compliance in the dental setting., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Introduction: Pain management in pediatric dentistry is crucial for ensuring positive treatment outcomes and reducing patient suffering. This study aimed to evaluate postoperative discomfort and analgesic usage among pediatric dental patients undergoing various procedures in India., Methodology: A cross-sectional study was conducted at a tertiary care dental hospital in India from June 2023 to December 2023. A total of 150 pediatric patients aged 2-18 years who underwent different dental procedures were included. Data on postoperative discomfort and analgesic usage were collected immediately following the procedure and during follow-up phone calls., Results: Significant differences were found in immediate postoperative discomfort following pulpotomy ( P = 0.03). Patients receiving primary stainless steel crowns (SSCs) alone or in combination with pulpotomy were significantly more likely to report discomfort ( P < 0.001 and P < 0.05, respectively). No significant associations were observed between discomfort and sealants, preventive resin restorations, 1- or 2-surface restorations, or extractions. Over-the-counter analgesic usage was prevalent, particularly following SSC placement., Conclusion: This study highlights the variability in postoperative discomfort among pediatric dental patients undergoing different procedures in India. Tailored pain management strategies based on specific procedures are essential to minimize discomfort and improve patient outcomes in pediatric dentistry., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Sodium glucose co‐transporter‐2 inhibitors (SGLT‐2i) are a relatively new class of oral glucose lowering agents that improve glycaemic control and also provide significant cardiac and renal benefits. However, SGLT‐2i use is associated with a small but significant increased risk of diabetic ketoacidosis (DKA) especially during periods of reduced oral intake such as following dental procedures, bowel preparation for colonoscopy, surgery and concurrent illness. In contrast with typical DKA, in many cases of SGLT2i‐associated DKA, the blood glucose is normal or only slightly elevated, giving rise to the term euglycaemic DKA (euDKA). Patients with euDKA often present with non‐specific symptoms. Moreover, their normal or only mildly elevated blood glucose levels might lead to delayed diagnosis and treatment and hence potentially life‐threatening complications. Not only should patients taking an SGLT‐2i be informed about the risk of euDKA, and be provided with SGLT‐2i sick day management education, but clinicians should also be alert to this diagnosis. [ABSTRACT FROM AUTHOR]

As people are paying more and more attention to dental health, various dental treatment procedures have emerged, such as tooth bleaching, dental implants, and dental restorations. However, a large number of free radicals are typically produced during the dental procedures. When the imbalance in distribution of reactive oxygen species (ROS) is induced, oxidative stress coupled with oxidative damage occurs. Oral inflammations such as those in periodontitis and pulpitis are also unavoidable. Therefore, the applications of exogenous antioxidants in oral environment have been proposed. In this article, the origin of ROS during dental procedures, the types of antioxidants, and their working mechanisms are reviewed. Additionally, antioxidants delivery in the complicated dental procedures and their feasibility for clinical applications are also covered. Finally, the importance of safety assessment of these materials and future work to take the challenge in antioxidants development are proposed for perspective.

Social media like YouTube are increasingly used by students as a learning tool. The aim of this study was to examine the use of YouTube videos as a means of learning clinical procedures among dental students in Riyadh, Saudi Arabia. A cross-sectional observational study was conducted among dental students from six dental colleges in Riyadh, Saudi Arabia. Among the total of 331 dental students who responded to this survey, 93.9% (n = 308) reported that they had used YouTube for dental learning. A total of 65.30% (n = 201) of the respondents strongly agreed that they find videos of clinical procedures on YouTube helpful as a learning tool. A total of 54.40% (n = 180) agreed that they always refer to YouTube videos to prepare for a clinical procedure that they have never done before. A total of 75.3% (n = 232) reported that they most commonly watched clinical procedures related to restorative dentistry, 67.2% (n = 207) for fixed prosthodontics procedures, 65.3% (n = 201) for endodontic clinical procedures, and 62.3% (n = 192) for removable prosthodontics videos. A total of 50.60% (n = 156) strongly agreed that YouTube videos are helpful in relating theoretical knowledge with clinical knowledge. A total of 50.30% (n = 155) reported that it is important to have faculty guidance regarding useful YouTube videos on dental procedures. A total of 91.90% (n = 283) participants would like their dental school to post tutorials or videos for clinical procedures on YouTube. Even after increased availability of online videos, a majority of dental students felt that YouTube videos suggested by faculty were more valuable than videos identified through normal searching.

The COVID-19 pandemic pushed dental health officials around the world to reassess and adjust their existing healthcare practices. As studies on controlled COVID-19 transmission remain challenging, this review focuses on particles that can carry the virus and relevant approaches to mitigate the risk of pathogen transmission in dental offices. This review gives an overview of particles generated in clinical settings and how size influences their distribution, concentration, and generation route. A wide array of pertinent particle characterization and counting methods are reviewed, along with their working range, reliability, and limitations. This is followed by a focus on the effectiveness of personal protective equipment (PPE) and face shields in protecting patients and dentists from aerosols. Direct studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are still limited, but the literature supports the use of masks as an important and effective non-pharmaceutical preventive measure that could reduce the risk of contracting a respiratory infection by up to 20%. In addition to discussing about PPE used by most dental care professionals, this review describes other ways by which dental offices can protect patients and dental office personnel, which includes modification of the existing room design, dental equipment, and heating, ventilation, and air conditioning (HVAC) system. More affordable modifications include positioning a high-efficiency particulate air (HEPA) unit within proximity of the patient's chair or using ultraviolet germicidal irradiation in conjunction with ventilation. Additionally, portable fans could be used to direct airflow in one direction, first through the staff working areas and then through the patient treatment areas, which could decrease the number of airborne particles in dental offices. This review concludes that there is a need for greater awareness amongst dental practitioners about the relationship between particle dynamics and clinical dentistry, and additional research is needed to fill the broad gaps of knowledge in this field.

Background: Transcatheter edge-to-edge mitral valve repair using the MitraClip device is increasingly used for high surgical risk patients with severe mitral regurgitation (MR). Previous guidelines for infective endocarditis prophylaxis prior to dental procedures focused on high-risk patients, but without explicit recommendation for MitraClip recipients. We believe this could be the first reported case to identify Streptococcus oralis as the causative organism.Case Presentation: An 87-year-old male with severe MR treated with two MitraClip devices three months prior to index admission, presented with worsening malaise and intermittent chills on a background of multiple comorbid conditions. The patient had dental work a month prior to presentation, including a root canal procedure, without antibiotic prophylaxis. Vitals were significant for fever and hypotension. On physical examination, there was a holosystolic murmur at the apex radiating to the axilla, bilateral pitting edema in the lower extremities, and elevated jugular venous pulsation. A transthoracic echocardiogram showed severe MR with a possible echodensity on the mitral valve, prompting a transesophageal echocardiogram, which demonstrated a pedunculated, mobile mass on the posterior leaflet of the mitral valve. Five blood cultures grew gram positive cocci in pairs and chains, later identified as Streptococcus oralis, with minimum inhibitory concentration to penicillin 0.06 mg/L. Initial empiric antibiotics were switched to ceftriaxone 2 gr daily and subsequent blood cultures remained negative. However, the patient developed pulmonary edema and worsening hemodynamic instability requiring vasopressors. As surgical risk for re-operation was considered prohibitive, the decision was made to continue medical management and comfort-directed care. The patient died a week later.Conclusions: Despite low incidence, infective endocarditis should be included in the differential among MitraClip recipients. The explicit inclusion of this growing patient population in the group requiring prophylaxis prior to dental procedures in the 2020 ACC/AHA valvular heart disease guidelines is an important step forward. [ABSTRACT FROM AUTHOR]

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Background: Infective Endocarditis is relatively a rare disease and is believed to be caused by the vegetative growth on the previously damaged or congenitally malformed cardiac valves or endocardium. Several factors determines that the dentist practicing prophylaxis measures, the foremost important one is the knowledge which is taught to them during dental school, which is the main reason to conduct this study to test the awareness among the dental students of Kantipur Dental College and Hospital, Kathmandu regarding the prophylaxis guideline awareness. Methods: BDS Third, Fourth, Fifth year students and Dental Interns of Kantipur Dental College and Hospital were asked to fill the self-answered questionnaires. The questions were divided into two parts each part containing ten questions each. The first part was to access the knowledge of participants regarding the cardiac conditions that require antibiotics prophylaxis, the second part was to access the knowledge of participants regarding the dental procedures that requires antibiotics prophylaxis. Results: Thirty two percentage of our participants responded that forceps extraction does not require antibiotics prophylaxis which is not true as per AHA guideline, so the participants should be taught regarding the risk of forceps extraction leading to infective endocarditis if the prophylaxis is not administered. We postulated that majority of the Dental Students and Interns have heard about AHA 2007 guideline and will follow it when necessary. Conclusions: The participants who are the Dental Students and Dental Interns in a Dental School at Kathmandu, Nepal will be practicing Dentistry in near future, the knowledge they acquire during their learning period will help them to prevent the Infective endocarditis among the risk population whom they will be treating in near future. Measures should be taken to prevent the incidence of Infective Endocarditis with dental origin.

Introduction: Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures. Case Report: The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI. Discussion: Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.