Evaluating the Effectiveness of the Nudge Theory in Improving the Oral Self-Care of Schoolchildren with Refugee and Immigrant Backgrounds in Mashhad, Iran.

Nudge theory proposes using subtle interventions to encourage individuals to make better decisions. The aim of this study was to evaluate the effectiveness of the Nudge theory in plaque control and assess caries experience among third-grade primary schoolchildren with refugee and immigrant backgrounds in Mashhad, Iran. Moreover, Afghan and Iranian schoolchildren were compared to assess differences in oral health outcomes. A quasi-experimental field trial was conducted in three public primary schools, comprising 309 participants approximately 9 years old. Interventions were randomly assigned to three schools: School I Messages based on Social Norms (MSN), School II Messages based on Fear of Negative Outcome (MFNO), and School III control group (C). MSN and MFNO received customized motivational video clips at baseline, while C only received Oral hygiene instruction (OHI). All participants received OHI, a brush, and toothpaste. Baseline plaque index (PI) and caries experience in primary and permanent dentition (dmft/DMFT) were recorded. PI was reassessed at two weeks, two months, and six months post-intervention. All data were subjected to statistical analysis. The mean PI decreased significantly in all three groups at the two-week follow-up (p < 0.01). The PI improvements declined over a six-month follow-up period in all groups, and the mean PI difference after six months compared to the pre-intervention was significant only in MSN and MFNO (p < 0.01), while C reverted almost to the pre-study level. Schoolchildren with at least one filled tooth or Iranian nationality showed a greater PI reduction (p < 0.01, p = 0.05). The overall mean ± SD dmft and DMFT were 4.24 ± 2.11 and 1.70 ± 1.24, respectively. Among all the examined participants, 32 (10.40%) individuals were caries-free. The mean dmft was statistically significantly higher in Afghan children than in Iranians (p = 0.01). MSN was more effective on PI reduction in the short term, while MFNO was more long-lasting. Using the Nudge theory via visual aids was more effective in motivating children to perform better oral self-care than solely traditional OHI.

Evaluation and comparison of the effects of a new paste containing 8% L-Arginine and CaCO3 plus KNO3 on dentinal tubules occlusion and dental sensitivity: a randomized, triple blinded clinical trial study.

BACKGROUND: Dentin hypersensitivity, often occurring after dental treatments or from erosive lesions, is a prevalent patient complaint. This study introduces a paste combining 8% L-arginine, calcium carbonate, and potassium nitrate to evaluate its impact on dentinal tubules occlusion, dentin permeability, and tooth sensitivity. METHODS: Dentin surfaces from 24 third molars (thickness: 2 mm) were divided into two groups of 12. One received the experimental paste, while the other received a placebo without desensitizer. Permeability and sealing ability were assessed through scanning electron microscopy (SEM) and dentin permeability measurement. The pastes' effects on hypersensitivity were then examined in a triple-blind, randomized parallel-armed clinical trial with 16 eligible patients. Sensitivity to cold, touch, and spontaneous stimuli was recorded using the VAS scale at various intervals post-treatment. Statistical analysis was conducted using Shapiro-Wilk, Mann-Whitney U, Friedman, and Wilcoxon tests (α = 0.05). RESULTS: The permeability test demonstrated a significant reduction in dentin permeability in the experimental group (P = 0.002) compared to the control (P = 0.178). SEM images revealed most dentinal tubules in the intervention samples to be occluded. Clinically, both groups showed a significant decrease in the three types of evaluated sensitivity throughout the study. However, no significant difference in sensitivities between the two groups was observed, with the exception of cold sensitivity at three months post-treatment (P = 0.054). CONCLUSION: The innovative desensitizing paste featuring 8% L-arginine, calcium carbonate, and potassium nitrate effectively occluded dentinal tubules and reduced dentin permeability. It mitigated immediate and prolonged dentin hypersensitivity to various stimuli, supporting its potential role in managing dentin hypersensitivity. TRIAL REGISTRATION: http://irct.ir : IRCT20220829055822N1, September 9th, 2022.

The effect of sodium hexametaphosphate on sensitivity and whitening effectiveness of an at-home bleaching gel: a randomized, triple-blinded clinical trial.

OBJECTIVE: Bleaching sensitivity (BS) is the most common adverse effect of tooth bleaching treatments. This study evaluated the effect of adding 1% sodium hexametaphosphate (SHMP) on BS and the whitening effectiveness of a bleaching gel. METHOD AND MATERIALS: Two maxillary quadrants from 26 patients were randomly assigned to the experimental and control groups in a split-mouth design. In the control group the at-home bleaching gel containing 3% hydrogen peroxide, and in the experimental quadrant the same gel with 1% SHMP, were applied in individual trays for 6 hours per night for 2 weeks. The patients' sensitivity to cold and touch as well as spontaneous sensitivity were recorded based on a visual analog scale (VAS). Changes in shade guide units (ΔSGU) and ΔE were measured using a spectrophotometer. Data were analyzed using the Kolmogorov-Smirnov, Mann-Whitney U, Wilcoxon signed-rank test, and independent sample t test. RESULTS: Twenty-four patients completed the study. After 2 weeks, the sensitivity to cold and touch was significantly lower in the intervention group compared to the control (P = .015 and P = .039, respectively). The spontaneous sensitivity revealed no significant alteration between these two groups and during the bleaching period in each group (P > .050). Regarding both color measurements, the bleaching effectiveness in both groups was comparable, with no noticeable difference (P > .050). CONCLUSION: The application of 1% SHMP was able to reduce the BS with no detrimental effect on the at-home bleaching effectiveness. (Quintessence Int 2021;52:596-605; doi: 10.3290/j.qi.b1098303).