Microcirculation changes in gingival tissue after ultrasonic tooth preparation in beagle dogs.

OBJECTIVE: Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. METHODOLOGY: The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. RESULTS: At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. CONCLUSIONS: Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue.

Microcirculation changes in gingival tissue after ultrasonic tooth preparation in beagle dogs

Abstract Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. Objective The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. Methodology The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. Results At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. Conclusions Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue.

Effect of Magnification on the Precision of Tooth Preparation in Dentistry.

OBJECTIVES: To evaluate the impact of magnification aids on the precision of tooth preparation under simulated clinical conditions. METHODS AND MATERIALS: Two plastic blocks marked with a geometric shape were fixed in a dental phantom head: a circle as the distal surface of tooth 16 (UNS 3) and a y-shaped figure as the occlusal surface of tooth 36 (UNS 19). Sixteen dentists (mean age: 39 years; range: 26-67 years) prepared the geometric shapes from the inside to the boundary line with a cylindrical bur and water-cooling. The boundary line had to be touched but not erased. Chair-side assistance was provided to simulate the clinical situation. Tooth 16 was prepared under indirect vision via a dental mirror. Tooth 36 was prepared under direct vision A) without magnification aids, B) with Galilean loupes, 2.5× and light-emitting diode light, and C) with a microscope, 6.4× and coaxial light. The preparation procedure was performed three times in different sequences of the magnification devices and with a break of at least 1 week between each procedure. The correctly prepared contour and the incorrectly prepared areas were evaluated in relation to the whole circumference of the geometric shapes. RESULTS: For both values the precision was significantly higher when a microscope was used, followed by preparation using loupes; precision was lowest without magnification aids ( p<0.0001). This was true for both indirect and direct vision ( p<0.05). CONCLUSIONS: Magnification devices improved the precision of tooth preparation under simulated clinical conditions.

[Research status of tooth preparation quantitative guide technique].

Tooth preparation is a basic operation in prosthodontics treatment and the quality of preparation influences the effect of treatment directly. How to achieve a precise and quantitative tooth preparation is always one of the main aims of dental prosthodontics. The known types of tooth preparation guide technique can be divided into visual guidance, passive constraint guidance and active constraint guidance (automated tooth preparation), respectively represented by silicon rubber index, tooth preparation guide plate and computerized numerical control cutting system (CNC cutting system). Studies in advanced manufacturing technologies such as robot systems and numerical control ultra-short pulse laser (USPL) have also been reported recently. This review comprehensively introduced tooth preparation quantitative guide techniques and partially summarized the application effects and limitations to provide reference for relative researches and clinical application.

Multivariate evaluation of the cutting performance of rotary instruments with electric and air-turbine handpieces.

STATEMENT OF PROBLEM: Laboratory studies of tooth preparation often involve single values for all variables other than the one being tested. In contrast, in clinical settings, not all variables can be adequately controlled. For example, a new dental rotary cutting instrument may be tested in the laboratory by making a specific cut with a fixed force, but, in clinical practice, the instrument must make different cuts with individual dentists applying different forces. Therefore, the broad applicability of laboratory results to diverse clinical conditions is uncertain and the comparison of effects across studies difficult. PURPOSE: The purpose of this in vitro study was to examine the effects of 9 process variables on the dental cutting of rotary cutting instruments used with an electric handpiece and compare them with those of a previous study that used an air-turbine handpiece. MATERIAL AND METHODS: The effects of 9 key process variables on the efficiency of a simulated dental cutting operation were measured. A fractional factorial experiment was conducted by using an electric handpiece in a computer-controlled, dedicated testing apparatus to simulate dental cutting procedures with Macor blocks as the cutting substrate. Analysis of variance (ANOVA) was used to assess the statistical significance (α=.05). RESULTS: Four variables (targeted applied load, cut length, diamond grit size, and cut type) consistently produced large, statistically significant effects, whereas 5 variables (rotation per minute, number of cooling ports, rotary cutting instrument diameter, disposability, and water flow rate) produced relatively small, statistically insignificant effects. These results are generally similar to those previously found for an air-turbine handpiece. CONCLUSIONS: Regardless of whether an electric or air-turbine handpiece was used, the control exerted by the dentist, simulated in this study by targeting a specific level of applied force, was the single most important factor affecting cutting efficiency. Cutting efficiency was also significantly affected by factors simulating patient/clinical circumstances and hardware choices. These results highlight the greater importance of local clinical conditions (procedure, dentist) in understanding dental cutting as opposed to other hardware-related factors.

An automatic tooth preparation technique: A preliminary study.

The aim of this study is to validate the feasibility and accuracy of a new automatic tooth preparation technique in dental healthcare. An automatic tooth preparation robotic device with three-dimensional motion planning software was developed, which controlled an ultra-short pulse laser (USPL) beam (wavelength 1,064 nm, pulse width 15 ps, output power 30 W, and repeat frequency rate 100 kHz) to complete the tooth preparation process. A total of 15 freshly extracted human intact first molars were collected and fixed into a phantom head, and the target preparation shapes of these molars were designed using customised computer-aided design (CAD) software. The accuracy of tooth preparation was evaluated using the Geomagic Studio and Imageware software, and the preparing time of each tooth was recorded. Compared with the target preparation shape, the average shape error of the 15 prepared molars was 0.05-0.17 mm, the preparation depth error of the occlusal surface was approximately 0.097 mm, and the error of the convergence angle was approximately 1.0°. The average preparation time was 17 minutes. These results validated the accuracy and feasibility of the automatic tooth preparation technique.

A comparison of temperature increases produced by "premium" and "standard" diamond burs: An in-vitro study.

OBJECTIVE: Vital tooth preparations may cause irreversible thermal damage to the pulp. The manufacturing techniques of dental burs may decrease heat production and minimize the risk of overheating and trauma to the dental pulp. Strauss (Raanana, Israel) has introduced "premium" diamond burs, claiming superior efficiency and longevity. We sought to determine the safest preparation methods by performing a comparison of intrapulpal temperature increases caused with "standard" and "premium" burs. METHOD AND MATERIALS: Three types of diamond burs (F1R, F21R, and K2) were tested on extracted human teeth (n = 8 teeth per bur type). Premium and standard manufacturing techniques were compared for each bur type (n = 24 teeth per group; total 48 teeth). An intrapulpal thermocouple was used to measure the temperature during the procedure. Comparisons were analyzed with the t test and one-way ANOVA. P ≤ .05 was considered significant. RESULTS: All premium burs demonstrated lower temperature increases compared to the standard burs (P ≤ .001 for F21R and K2, P = .086 for F1R). The temperature increases with premium burs were similar for different bur shapes, but the temperature increases with standard burs depended on the bur shape (P < .001). CONCLUSION: Using premium diamond burs for tooth preparation may reduce the risk of pulp tissue damage, and thus reduce postoperative pulp-associated complications.

Current Assessment of Reciprocation in Endodontic Preparation: A Comprehensive Review-Part I: Historic Perspectives and Current Applications.

INTRODUCTION: During the evolution of mechanical instrumentation in endodontics, an important role has been played by reciprocating stainless steel files using horizontal rotational, vertical translational, or combined movements. These kinds of systems are still in use mainly as an accessory to help in the first phases of the treatment. METHODS: The literature concerning these systems has been analyzed using selected criteria. RESULTS: The latest evolution of horizontal rotational reciprocating movement brought to the development of a different kind of movement in which the angles are asymmetrical and that appears to be ideal in conjunction with modern nickel-titanium (NiTi) files with a greater taper. Initially, this movement was limited to particular handpieces available on the market that was used with existing NiTi files to complete root canal instrumentation. Later on, specific files and proprietary motors were introduced into the market. The differences between reciprocating motion used for NiTi and stainless steel files are described and critically analyzed. CONCLUSIONS: A classification of the different mechanical reciprocating motions used is presented, thus enabling an easier understanding of these systems and anticipated future developments.

Microtensile Bond Strength and Micromorphology of Bur-cut Enamel Using Five Adhesive Systems.

PURPOSE: This study compared the microtensile bond strengths (µTBS) of two etch-and-rinse (ER) (OptiBond FL [OBFL]; Prime & Bond NT [PBNT]) and three self-etching (SE) (Clearfil SE Bond [CSEB]; Xeno III [XIII]; Xeno V+ [XV+]) adhesives systems to bur-prepared human enamel considering active (AA) and passive (PA) application of the self-etching systems. MATERIALS AND METHODS: Ninety-six enamel surfaces were prepared with a medium-grit diamond bur and randomly allocated into 8 groups to receive adhesive restorations: G1: OBFL; G2: PBNT; G3: CSEB/PA; G4: CSEB/ AA; G5: XIII/PA; G6: XIII/AA; G7: XV+/PA; G8: XV+/AA. After composite buildup, samples were sectioned to obtain a total of 279 bonded sticks (1 mm2) that were submitted to microtensile testing (µTBS; 0.5 mm/min) after 24-h water storage (37°C). Etching patterns and adhesive interfacial ultramorphology were also evaluated with confocal laser scanning (CLSM) and scanning electron microscopy (SEM). Data was analyzed with one-way ANOVA (α = 0.05). Weibull probabilistic distribution was also determined. RESULTS: Regarding µTBS, both adhesive system and application mode yielded statistically significant differences (p < 0.05) among groups. ER adhesive systems together with CSEB/AA and XIII/PA recorded the highest and statistically similar bond strength results. XV+ presented very low bond strength values, regardless of the application mode. Among self-etching adhesives, CSEB produced significantly higher µTBS values when applied actively. Qualitative evaluation by SEM and CLSM revealed substantial differences between groups both in adhesive interfaces and enamel conditioning patterns. CONCLUSIONS: ER and SE adhesive systems presented distinctive bond strengths to bur-cut enamel. The application mode effect was adhesive dependent. Active application improved etching patterns and resin interfaces micromorphology.

Designed experiment evaluation of key variables affecting the cutting performance of rotary instruments.

STATEMENT OF PROBLEM: Laboratory studies of tooth preparation are often performed under a limited range of conditions involving single values for all variables other than the 1 being tested. In contrast, in clinical settings not all variables can be tightly controlled. For example, a new dental rotary cutting instrument may be tested in the laboratory by making a specific cut with a fixed force, but in clinical practice, the instrument must make different cuts with individual dentists applying a range of different forces. Therefore, the broad applicability of laboratory results to diverse clinical conditions is uncertain and the comparison of effects across studies is difficult. PURPOSE: The purpose of this study was to examine the effect of 9 process variables on dental cutting in a single experiment, allowing each variable to be robustly tested over a range of values for the other 8 and permitting a direct comparison of the relative importance of each on the cutting process. MATERIAL AND METHODS: The effects of 9 key process variables on the efficiency of a simulated dental cutting operation were measured. A fractional factorial experiment was conducted by using a computer-controlled, dedicated testing apparatus to simulate dental cutting procedures and Macor blocks as the cutting substrate. Analysis of Variance (ANOVA) was used to judge the statistical significance (α=.05). RESULTS: Five variables consistently produced large, statistically significant effects (target applied load, cut length, starting rpm, diamond grit size, and cut type), while 4 variables produced relatively small, statistically insignificant effects (number of cooling ports, rotary cutting instrument diameter, disposability, and water flow rate). CONCLUSIONS: The control exerted by the dentist, simulated in this study by targeting a specific level of applied force, was the single most important factor affecting cutting efficiency. Cutting efficiency was also significantly affected by factors simulating patient/clinical circumstances as well as hardware choices. These results highlight the importance of local clinical conditions (procedure, dentist) in understanding dental cutting procedures and in designing adequate experimental methodologies for future studies.

Quantitative assessment of the enamel machinability in tooth preparation with dental diamond burs.

Enamel cutting using dental handpieces is a critical process in tooth preparation for dental restorations and treatment but the machinability of enamel is poorly understood. This paper reports on the first quantitative assessment of the enamel machinability using computer-assisted numerical control, high-speed data acquisition, and force sensing systems. The enamel machinability in terms of cutting forces, force ratio, cutting torque, cutting speed and specific cutting energy were characterized in relation to enamel surface orientation, specific material removal rate and diamond bur grit size. The results show that enamel surface orientation, specific material removal rate and diamond bur grit size critically affected the enamel cutting capability. Cutting buccal/lingual surfaces resulted in significantly higher tangential and normal forces, torques and specific energy (p<0.05) but lower cutting speeds than occlusal surfaces (p<0.05). Increasing material removal rate for high cutting efficiencies using coarse burs yielded remarkable rises in cutting forces and torque (p<0.05) but significant reductions in cutting speed and specific cutting energy (p<0.05). In particular, great variations in cutting forces, torques and specific energy were observed at the specific material removal rate of 3mm(3)/min/mm using coarse burs, indicating the cutting limit. This work provides fundamental data and the scientific understanding of the enamel machinability for clinical dental practice.

Effect of different burs on the topography of smear layer formation on the dentinal surface: a scanning electron microscope study.

Whenever a hand or a rotary instrument is used to eliminate tooth tissue, the mineralized matrix shatters rather then being uniformly sheared, producing considerably quantities of cutting debris. Much of the debris made up of very small particles of mineralized collagen matrix over the surface of dentin is known as smear layer. The clinical outcome of dental restorations is dependent upon the surface preparations, smear layer formation and hybrid layer which which provides a stable adhesion. Different surface morphology is produced by use of different burs. The thickness of the smear layer is affected by various factors as type of the bur, use of water spray and speed of rotation. Bonding is enhanced when smear layer is completely removed or modifed. The purpose of this in vitro study is to evaluate the effect of different burs on the topography of the smear layer formation and thickness on dentinal surface.

An automatic robotic system for three-dimensional tooth crown preparation using a picosecond laser.

BACKGROUND: Laser techniques have been introduced into dentistry to overcome the drawbacks of traditional treatment methods. The existing methods in dental clinical operations for tooth crown preparation have several drawbacks which affect the long-term success of the dental treatment. OBJECTIVE: To develop an improved robotic system to manipulate the laser beam to achieve safe and accurate three-dimensional (3D) tooth ablation, and thus to realize automatic tooth crown preparation in clinical operations. METHOD: We present an automatic laser ablation system for tooth crown preparation in dental restorative operations. The system, combining robotics and laser technology, is developed to control the laser focus in three-dimensional motion aiming for high speed and accuracy crown preparation. The system consists of an end-effector, a real-time monitor and a tooth fixture. A layer-by-layer ablation method is developed to control the laser focus during the crown preparation. Experiments are carried out with picosecond laser on wax resin and teeth. RESULTS: The accuracy of the system is satisfying, achieving the average linear errors of 0.06 mm for wax resin and 0.05 mm for dentin. The angle errors are 4.33° for wax resin and 0.5° for dentin. The depth errors for wax resin and dentin are both within 0.1 mm. The ablation time is 1.5 hours for wax resin and 3.5 hours for dentin. CONCLUSIONS: The ablation experimental results show that the movement range and the resolution of the robotic system can meet the requirements of typical dental operations for tooth crown preparation. Also, the errors of tooth shape and preparation angle are able to satisfy the requirements of clinical crown preparation. Although the experimental results illustrate the potential of using picosecond lasers for 3D tooth crown preparation, many research issues still need to be studied before the system can be applied to clinical operations.

[Experimental rationale of hand stabilization devices use by teeth preparation].

This paper compares two methods of teeth preparation - with or without mechanical hand stabilization device preventing accidental angular deviations of dental handpiece during preparation. The results of two experiment series showed decreased convergence of side walls of the prepared teeth in cases when mechanical hand stabilizer corresponding to the values recommended in literature. It is concluded that mechanical hand stabilization device is a useful tool for improving the quality of preparations.

Assessment of anxiety related to dental treatments among patients attending dental clinics and hospitals in Ranga Reddy District, Andhra Pradesh, India.

PURPOSE: To assess the levels of dental anxiety among patients anticipating dental treatments in dental clinics/hospitals of Ranga Reddy district. MATERIALS AND METHODS: A cross-sectional study was conducted among a representative sample of 1200 subjects (at least 18 years old) in dental clinics/hospitals which were selected from a list obtained through systematic random sampling. The data were collected using a pre-tested and calibrated questionnaire consisting of the Modified Corah Dental Anxiety Scale (MDAS) to assess anxiety levels. RESULTS: The majority (52.4%) of subjects showed a low level of anxiety. Females (11.44 ± 4.41) were found to have higher mean MDAS scores than males, and the highest mean MDAS scores were found among 18- to 34-year-olds (11.28 ± 4.67) (P < 0.05). Significant differences were found among subjects anticipating different treatments, with higher MDAS scores for extraction (11.25 ± 5.4), followed by examination, root canal treatment, gum surgery, scaling, restoration and others, e.g. orthodontic treatment, restoration with crowns, bridges and dentures (7.79 ± 3.80). The highest mean MDAS scores were found among subjects who were apprehensive due to 'past difficult experience in dental treatments', followed by 'drill' and 'injection', with the lowest scores among subjects indicating 'other reasons' (7.82 ± 3.84). CONCLUSION: The present data show that anxiety levels are higher in patients who have to undergo extractions than those who must be fitted with dentures. Thus, dental health care providers should pay more attention to patients' anxiety levels associated with different types of treatment.

Performance of single-use and multiuse diamond rotary cutting instruments with turbine and electric handpieces.

STATEMENT OF PROBLEM: As single-use rotary cutting instruments and electric handpieces become more available, the performance of these instruments with electric as compared to turbine handpieces requires evaluation. In addition, if rotary cutting instruments marketed as single-use instruments are used for multiple patients, the effects on their performance of cleaning, sterilization, and repeated use are of interest to the clinician. PURPOSE: The purpose of the study was to evaluate how the cleaning, autoclaving, and repeated use of single-use and multiuse rotary cutting instruments, with either a turbine or electric handpiece, affected their performance. MATERIAL AND METHODS: The effects on cutting performance of 2 handpieces (turbine and electric), 2 cleaning and sterilization conditions (cleaned and autoclaved versus noncleaned and nonautoclaved), and 6 different diamond rotary cutting instruments (4 single-use and 2 multiuse) during simulated tooth preparations were evaluated by using a 24-treatment condition full-factorial experimental design. A computer-controlled dedicated testing apparatus was used to simulate the cutting procedures, and machinable glass ceramic blocks were used as the cutting substrate for tangential cuts. In addition, for each treatment condition, 8 consecutive cuts, for a total of 192 cuts, were measured to assess the durability of the rotary cutting instruments. A linear mixed model was used to study the effect of instrument type, handpiece, cleaning, and sterilization, as well as the status and number of cuts on the outcome variables. The Tukey honestly significant difference test was used for the post hoc pairwise comparisons (α=.05). RESULTS: Performance, as measured by the rate of advancement, decreased with the repeated use of rotary cutting instruments (P<.001), while cleaning and sterilization procedures improved the average performance of the 8 cuts (P=.002). The electric handpiece showed a greater load than the turbine (P<.001) and a lower rate/load metric, but no differences in the rate of advancement. Significant differences were also detected among the different rotary cutting instruments tested with the Two Striper, which showed the highest cumulative performance of all groups. CONCLUSIONS: The repeated use of both single-use and multiuse rotary cutting instruments decreased cutting performance. The use of a cleaning and sterilization procedure between cuts improved the average cutting performance. During a tangential cutting process, although the ease of advancement (rate/load) was greater for the turbine, the electric handpiece did not produce a statistically different cutting rate.

Changes in the cutting efficiency of different types of dental diamond rotary instrument with repeated cuts and disinfection.

STATEMENT OF PROBLEM: Cutting efficiency is one of the most important factors to consider when a specific dental diamond rotary instrument is selected. However, the selection of a dental diamond rotary instrument is based on clinical experience rather than any scientific evidence. PURPOSE: The purpose of this study was to identify how the cutting efficiency of different types of dental diamond rotary instrument changed with repeated cuts and disinfection. MATERIAL AND METHODS: Four types of diamond rotary instrument from 2 dental manufacturers (Shofu, Jin Dental) were investigated with a high-speed air-turbine handpiece. The groups were as follows: S cham group (n=10): chamfer design from Shofu; J cham group (n=10): chamfer design from Jin Dental; S thin group (n=10): thin tapered design from Shofu; J thin group (n=10): thin tapered design from Jin Dental. Changes in the cutting efficiency of diamond rotary instruments on glass ceramic blocks were measured after repeated cuts. Changes in cutting efficiency also were measured for 30 diamond rotary instruments, the same type as those used in group J cham after disinfection with ethylene oxide gas, immersion in solution, or autoclaving. One-way ANOVA, 2-way ANOVA, and repeated-measures ANOVA were used to identify differences in cutting efficiency, in total cutting efficiency, and change trend in cutting efficiency (α=.05). The Tukey honestly significant difference method was used for the post hoc tests. The principal metal components of the diamond rotary instruments were detected with x-ray spectrometry. RESULTS: The mean (standard deviation [SD]) total cutting efficiency after 10 cuts in the 4 groups was in the following order: J cham group (0.210 ± 0.064 g/min) > S cham group (0.170 ± 0.064 g/min) > J thin group (0.130 ± 0.042 g/min) > S thin group (0.010 ± 0.040 g/min) (P<.05).The decrease in the cutting efficiency was greatest after the first cut. The cutting efficiency was not influenced by repeated disinfection. CONCLUSION: The cutting efficiencies of diamond rotary instruments with different designs and particle sizes showed a decreasing trend after repeated cuts but did not show any change after various disinfecting procedures.

Validating a measure of the prevalence of dental anxiety as applied to Kuwaiti adolescents.

OBJECTIVES: To assess self-reported dental anxiety (DA) among Kuwaiti adolescents and to test whether different dental anxiety scales are valid for measuring DA in Kuwait. BASIC RESEARCH DESIGN: Cross-sectional, structured, anonymous questionnaire survey in Arabic completed at government schools. PARTICIPANTS: 757 pupils aged 13-15 years from three schools filled the questionnaire. Useable response rate was 93.0%. MAIN MEASURES: DA was assessed by: 1, a single-item dental fear question (DF); 2, the Modified Dental Anxiety Scale (MDAS); and 3, the Modified Child Dental Anxiety Scale: faces (MCDAS(f)). RESULTS: A third of the girls and 6% of boys reported being very much afraid of visiting a dentist. Use of the drill and injection in the gum were the most anxiety arousing MDAS items; tooth extraction and injection of the MCDAS(f) items. Total mean for MDAS was 11.4 (sd 4.6) and for MCDAS(f) 16.6 (sd 6.5). A tenth of the children were highly dentally anxious when measured by MDAS (score ≥ 19). Girls reported statistically significantly higher DA scores with all the measures. There was a high correlation between the total score of the MDAS and the total score of the MCDAS(f) (p = 0.855). Statistically significant relationship (p < 0.001) was found between the single-item DF and the total score of the MDAS and a single item and the total score of the MCDAS(f). CONCLUSIONs: A tenth of children were highly dentally anxious; girls reporting higher scores. A single-item dental fear question, MDAS and MCDAS(f) were valid tools for measuring DA among Kuwaiti adolescents.