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Emergency Department (ED) visits result from urgent conditions and instances caused by disease, disaster, accidents, or injury and require immediate medical attention. Today, emergency dental services are becoming an integral and crucial facet of properly functioning healthcare systems. Dental emergency visits are a risky undertaking when the COVID-19 epidemic is decimating global health systems. Emergencies in dental care are possibly life-threatening occurrences and demand instant attention to curb infection, severe pain, and tissue bleeding. Examples of these conditions include trauma affecting different facial bones, bacterial infection on soft tissues or cellulitis, and uncontrolled bleeding. Today, given the implications of the COVID-19 pandemic, all providers need to use their professional judgment to determine the need for emergency or urgent care for a patient. Consequently, this systematic review of literature reviews the implications of the COVID-19 epidemic on the use of dental services in different care facilities across the nation.

Background: Dental aesthectics is now a necessary area in the field of dentistry, and new graduates' perceptions should be investigated. Hence the present cross-sectional study aimed to assess the perception about dental aesthetics among clinical interns, dentistry interns, and pre-clinical interns in dental colleges on Saudi Arabia. Materials and Methods: The study subjects comprises of all above three (clinical interns, dentistry interns, and pre-clinical interns) groups volunteered from different colleges. Perception about dental aesthetics was measured using a 14 item questionnaire. Chi-square test was performed on SPSS to determine the statistically significant differences (p

Introduction: Dental anxiety among dental students is an important issue that needs to be examined more thoroughly by the research community. Dental anxiety among dental students could have implications for their future practice, as it may adversely affect their ability to render quality dental care. Materials and Methods: This was a cross sectional study conducted among the dental students in Riyadh using an online survey. Dental universities in Riyadh were contacted and participants were requested to fill up the survey. 500 students from all six years of dentistry were utilized in this study. Results: overall 21.6% of clinical students reported that dental education did not reduce their dental phobia at all, whereas 40.4% reported definitely yes. Among various dental procedures that may cause anxiety among patients, root canal treatment (RCT) was accounted for the greatest number of responses (28.6%) in ‘high anxiety’. Conclusion: There is a need to intervene and use certain measures to reduce the dental phobia or anxiety among pre-clinical dental students and not wait until they reach clinical levels.

Introduction: Children with ASD face various obstacles to professional dental care that are prominent causes to stop seeking dental care. The main barriers are behavioral problems and trouble finding a dentist who treats ASD children. Materials and Methods: This is a cross sectional study conducted among the dental practitioners of Saudi Arabia using an online survey. Online questionnaire was constructed consisting of questions related to personal, professional, and demographic data followed by questions including knowledge, experience and confidence in managing patients with ASD. Results: Only 18% had previously treated an autistic child, 14% had treated autistic adults and 16% having treated both with 52% with no past exposure. Maximum score of 3.86 was attained when inquired about knowing where to find further information and guidance for treating autistic patients. Conclusion: Overall knowledge and confidence level of participants is low regarding autistic patients.

The association of gustatory dysfunction (GD) with quality of life (QOL) and cognition in older adults is understudied. Our objective was to study the prevalence of GD in the community and explore impacts and associated factors.A prospective, multi-institutional, pre-COVID cohort of adults aged 50 and older had smell and taste testing using "Sniffin' Sticks" (TDI) and "Taste Strips". The impact of GD on mood, QOL, and social interaction was assessed through visual analog scales. Subjects completed the Questionnaire of Olfactory Disorders, Patient Health Questionnaire 9, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment, and the DeJong scale of loneliness.48 patients, average age of 54.7 years, were enrolled. 32% experienced GD on taste strips, and 62% experienced olfactory dysfunction (OD) on TDI. 29.5% had both GD and OD. GD and OD correlated with worsened cognitive function on MMSE (r = 0.392; 0.05, p = 0.018; 0.003). Subjects with both GD and OD had worse MMSE than either alone (p = 0.003). Dry mouth and difficult chewing correlated with GD (r = -0.37 and -0.31, p = 0.10 and 0.37). Self-reported GD and OD were correlated (r = 0.46, p = 0.001), as were psychophysical GD and OD (r = 0.394, p = 0.008). GD did not correlate with other metrics.32% of subjects experienced GD on psychophysical testing, yet most are unaware without impacts on daily life. However, GD correlates with worsened cognitive function. Taste testing may play a role in screening of neurocognitive decline, and multi-sensory dysfunction may indicate of worsened cognitive states. This article is protected by copyright. All rights reserved.

Background: Orthodontics treatment aimed to make patient satisfied about treatment result starting from appearance to the function. Orthodontic retention is consider as important stage to stabilize the result of orthodontic treatment and avoid relapse that caused by normal age changes. Methods: A cross-sectional study performed through patient questionnaires. A total of 450 patients were included in the study. The questionnaire included 19 questions. The questionnaire consisted of question about socio-demographic status of the respondents such as age, gender, also included question about the type of retainer fixed or removable retainers that were used, duration of wearing retainer and Retention protocol. Result: In our study majority of the participants were females (87.3%), and 55.3% belonged to the 20-25 years age group. The fixed orthodontic related history showed 59.8% had undergone the treatment for 1 to 3 years and 31.6% of the participants reported that they had removed the fixed braces for more than five years. Among these participants, 89.5% (n=34) reported that the fascia (space) closed between the upper frontal teeth after Frenectomy, and 65.8% (n=25) agreed that spaced between the two upper front teeth still closed after removing the retainer. Conclusion: The study findings showed that the majority of the participants were aware of the frequency and duration of wearing retainers but didn't completely adhere to the instructions given by the orthodontists and/or dentists. The major reason for not using retainers was difficulty in speaking or uncomfortableness.

Introduction: Throughout the advancement of subsurface caries lesions, mineral is disbanded out of the enamel, causing enhanced penetrability that look like clinically as incipient or white spot lesions. Nowadays, these lesions are regularly treated by increasing remineralization, e.g., by enhancing the patient’s oral hygiene or fluoridation. Nevertheless, in uncooperative patients with cavitated proximal lesions, this approach has significant drawbacks. Methodology: A total of 508 dentists filled the online survey, which was distributed using social media and emails. Online questionnaire was constructed consisting of questions related to demographic data followed by questions linked to their knowledge and perception of Resin Infiltration use among their patients. Results: Overall knowledge reported by the participants regarding Resin Infiltration was 25.2% poor, 72.9% moderate and only 1.9% excellent. 64% of the dental professionals knew that RI is a micro-invasive procedure. Conclusion: It can be concluded from the findings that the knowledge of Riyadh based dental professionals regarding the use, indication and technique of Resin Infiltration is not satisfactory.

Background Hollywood smile refers to the aesthetic development of dental appearance inspired by the beauty displayed by the movie actors. Therefore, the present study was conducted to determine the extent of social media effect on the decision making of university students towards selecting Hollywood smile as the choice of their aesthetic treatment. Materials and methods This cross-sectional study was conducted by utilizing a self-designed closed-ended questionnaire among under-graduate students from the various public as well as private universities of Riyadh city. The questionnaire was constructed online using Google forms and began with questions related to demographics; questions like Do you notice celebrity's smile on social media? Have you visited a dentist solely after getting inspired by a celebrity's smile? etc., Responses were on a 5-point likert scale ranging from highly dissatisfied or strongly disagree to highly satisfied or strongly agree whenever applicable. Chi-square test was used to compare the differences among the groups with the value of significance kept under 0.05 by using SPSS version 19. Results The majority of the female participants reported noticing the celebrity's smile on social media. Influence by the celebrity smiles on social media was found more in the older age group participants. However, the term "Hollywood smile" was slightly more known among the younger aged participants. Conclusion The overall effect of social media in decision making of opting for Hollywood smile was found to be moderate. More studies should be conducted to investigate how much social medial is effecting the perceptions of youngsters.

Background and PurposeG-protein biased μ-opioid agonists against β-arrestin-2 activation are being investigated to reduce adverse effects. While opioid tolerance is strongly linked to the development of dependence, there is a dissociation between the two phenomena in the gut as tolerance does not develop to opioid-induced constipation, but diarrhea still manifests upon withdrawal. Here, we investigated the mechanism by which morphine tolerance in the small intestine develops.Experimental ApproachMechanism of morphine tolerance in the small intestine was evaluated in vivo and at the neuronal level. Whole-cell patch clamp electrophysiology was used to investigate tolerance in individual ileum myenteric neurons. Rate of morphine tolerance development in the small intestine was assessed against peripheral antinociception and whole gut transit.Key ResultsTolerance develops to inhibition of small intestinal motility after one day of morphine exposure, and is more rapid compared to peripheral antinociception and constipation in chronic morphine-treated mice. Morphine tolerance was reversed by the PKC inhibitor, Tamoxifen, but not by β-arrestin-2 deletion. Similarly, β-arrestin-2 deletion did not prevent morphine tolerance to inhibition of neuronal excitability in ileum myenteric neurons. However, neuronal tolerance was attenuated by inhibiting PKC.Conclusions and ImplicationsUnlike antinociceptive tolerance, rapid morphine tolerance in the small intestine is independent of β-arrestin-2 but is PKC-mediated. These findings reveal a potential mechanism for differences in the rates of tolerances to opioids, implicate myenteric neurons of the ileum as the primary cause for opioid-induced withdrawal effects and suggest that undesired gastrointestinal effects will persist with biased opioid agonist use.SummaryWhat is already known:Tolerance does not develop to chronic-opioid-induced constipation but diarrhea is produced upon withdrawalNovel G-protein biased agonists that preclude β-arrestin-2 activation at the μ-opioid receptor are in developmentWhat this study adds:Morphine tolerance in the ileum develops systemically and in individual myenteric neurons independent of β-arrestin-2Morphine tolerance in the small intestine develops before antinociception and is reversed by PKC inhibitionClinical significance:Clinical use of G-protein biased opioid agonists will not prevent tolerance development in the ileumTolerance in ileum myenteric neurons might be the basis of opioid-induced withdrawal in the gut

Background: The parental awareness and perceptions help in early recognition of problems in deciduous dentition, which will help us plan better preventive measures. Hence, the present study was conducted to evaluate the perceptions of Saudi parents residing in Riyadh towards the problems related to primary dentition of their children. Materials and Methods: A cross-sectional study was conducted on the patients attending private dental institution in Riyadh city. Information about demographic details, questions related to maintenance of primary teeth, and future implications of poor primary dentition health were collected. Descriptive statistics and Chi-square test were used for the analysis. The level of significance was set at P < 0.05. Results: A total of 1773 male and females filled up the survey form, which comprised of 28% males and 72% females, and maximum parents (68%) were university graduates. Overall better responses were in females and parents having more children. Conclusion: Over all mothers had a higher level of knowledge and positive attitude towards their children's oral health as compared to fathers. Developing and strengthening optimistic outlook among parents towards oral health especially primary dentition is utmost important.