Motivational Interviewing to Improve Pediatric Dental Recall Attendance after General Anesthesia.

Purpose: To determine the effect of motivational interviewing (MI) to improve recall attendance after dental treatment under general anesthesia (GA).
Methods: The sample consisted of parents of randomly selected pediatric patients who had oral rehabilitation under GA at a children's hospital. An 18-item questionnaire that included demographics, education, language, country of birth and age was administered prior to the GA appointment. A five-minute MI phone call three months after the procedure and a second MI phone call after the first recall was conducted by a standardized interviewer. The primary outcomes were attendance at the six- and 12-month recall visits. Data were compared to a historical control group of participants who did not receive the MI phone call during the same date range.
Results: Of 100 patients, 72 participated in the first phone call and 51 participated in the second phone call. All children had public insurance. The estimated odds of a six-month recall visit for parents receiving a single motivational interview was 2.52 times (95 percent confidence interval [95% CI]=1.43 to 4.44, P =0.001) higher compared to the control. The estimated odds of a 12-month recall visit for parents receiving two motivational interviews was 2.40 times greater (95% CI=1.27 to 4.54, P =0.006) compared to the historical control.
Conclusion: A brief intervention using MI led to an improvement in attendance at both the six- and 12-month recall visits.

Anesthesia Onset Time and Injection Pain Between Buffered and Unbuffered Lidocaine Used as Local Anesthetic for Dental Care in Children.

Purpose: From a physiological standpoint, increasing the pH of anesthetic solution decreases the injection pain and onset time while increasing the depth of anesthesia. The purpose of this study was to compare injection pain and anesthesia onset time of alkalinized and non-alkalinized local anesthetic solutions in pediatric patients. Methods: A prospective, randomized, single-blind, split-mouth design was utilized. The control agent was nonalkalinized two percent lidocaine 1:100,000 (100k) with epinephrine, and the test agent was two percent lidocaine 1:100k with epinephrine alkalinized. The anesthetic agent (test versus control) was selected randomly. Injection pain was measured using the image result for the Wong-Baker Faces Pain Rating Scale and the Ohio State University Behavior Rating Scale. Time of onset was measured using endodontic ice and a timer after two minutes. Results: Sixty-five seven- to 11-year-olds participated in this study. There were no significant differences between the test and control groups for either onset time or injection pain observed by the clinician or reported by the patient for unbuffered versus buffered lidocaine anesthetic solutions. Conclusions: Administration of buffered anesthetics resulted in no observed differences in pain or anesthesia onset time as compared to unbuffered anesthetics. (Pediatr Dent 2019;41(5):354-7).