Effectiveness of low-level laser therapy in reducing pain perception of children during dental local anesthetic administration using laser acupuncture pen on the LI4 point: a randomized clinical trial.

PURPOSE: Laser acupuncture, a non-invasive variant of acupuncture, has been proven effective in the medical and dental fields. Hence, the present study aims to determine the effect of low-level laser therapy on the LI4 point, using a laser acupuncture pen, in reducing children's pain during local anesthetic (LA) administration. METHODS: Children in the age range of 8-12 years, in need of LA administration, were randomly assigned to two groups: Group I: laser acupuncture, Group II: control. For all the children, baseline simplified Modified Child Dental Anxiety Scale-Faces version (MCDAS(f)) was recorded, followed by laser acupuncture or standard care. Following the conventional protocol, LA was administered. The procedural pain was assessed using the Faces, Legs, Activity, Cry and Consolability scale (FLACC) and Faces Pain Scale-Revised (FPS-R). All the variations in pulse rate were recorded from baseline to the completion of LA administration. After the procedure, simplified MCDAS(f) was recorded one more time. The data were tabulated and analyzed statistically. RESULTS: A significant reduction in anxiety after LA administration, as observed in MCDAS(f) score, was noticed only in the laser acupuncture group. The pain scores, as reported in FPS-R, were low in children randomized to the laser group compared to the control. The FLACC pain scores also showed low values in the experimental group. CONCLUSION: Based on the study findings, within the limitations, low-level laser therapy using a laser acupuncture pen can reduce the pain perception of children undergoing LA administration and alleviate dental anxiety.

Effect of Aromatherapy on Dental Anxiety and Pain in Children Undergoing Local Anesthetic Administrations: A Randomized Clinical Trial.

Introduction: In dentistry, local anesthetic (LA) administration in children is often associated with behavioral problems. Hence, the present study evaluated the efficacy of aromatherapy in reducing the dental anxiety and pain during LA procedure. Methods: This clinical trial was conducted upon 150 children in the age range of 8-12 years. Subjects were randomly divided into five groups; Group 1: Lavender essential oil using nebulizer; Group 2: Lavender essential oil using inhaler; Group 3: Orange essential oil using nebulizer; Group 4: Orange essential oil using inhaler; Group 5: Control (without aromatherapy). For all the children, baseline anxiety was recorded followed by aromatherapy (except for children in the control group). Following the standard protocol, LA was administered. The procedural pain was assessed using Faces, Legs, Activity, Cry and Consolability scale (FLACC) and Faces Pain Scale-Revised (FPS-R). Finally, anxiety was again recorded. Data were analyzed using SPSS version 17.0. Results: A significant difference in ANOVA test was observed among anxiety scores after LA in aromatherapy groups 1, 3, and 4 compared to control. When the FLACC scores were analyzed using Kruskal-Wallis, there were significantly lower values in aromatherapy groups compared to the control group. The pain scores, as reported in FPS-R, were also lower in aroma groups 1, 3, and 4. Conclusion: Aromatherapy with lavender or sweet orange, using either nebulizer or inhaler, decreased the dental anxiety of children, whereas, only sweet orange could reduce the pain as self-reported by children.

Comparative evaluation of a modified endodontic approach using Curcuma longa L. and conventional pulpectomy in primary molars: A randomized clinical trial.

Background: Turmeric (Curcuma longa) is known for its anti-inflammatory and anti-septic properties. Aim: The aim is to compare a modified endodontic approach using turmeric and conventional Metapex® pulpectomy in primary molars. Materials and methods: Thirty children, in the age range of 4-9 years, with at least one primary mandibular molar indicated for pulpectomy, were included. Teeth were randomly assigned to turmeric and Metapex® groups. For those that were assigned to turmeric, after coronal and radicular pulp extirpation, a freshly prepared paste of turmeric powder and methyl cellulose (2:1) with saline was packed in the coronal pulp chamber. In the Metapex® group, a conventional pulpectomy was performed. Clinical and radiographic success was recorded at 3-, 6-, and 12-month follow-up visits. The data was statistically analyzed using the Chi-square test. Results: There were no clinical and radiographic failures at 3- and 6-month visits in both groups. The 12-month evaluation revealed clinical success rates of 92% (12 out of 13) and 100% (14 out of 14) for turmeric and Metapex®, respectively, whereas, the radiographic success rates were 85% (12 out of 13) for turmeric and 93% (13 out of 14) for Metapex®. No statistically significant differences were found between the groups at different follow-ups (P > 0.05). Conclusions: A modified endodontic approach using turmeric and conventional Metapex® pulpectomy did not differ significantly in total success after 12 months.

Impact of educational (sign language/video modeling) and therapeutic (Glycyrrhiza glabra--liquorice mouth wash) interventions on oral health pertaining to children with hearing impairment: A randomized clinical trial.

PURPOSE: To compare the effect of educational (sign language and video modeling) and therapeutic intervention (liquorice) on oral hygiene status of children with hearing impairment (CHI). METHODS: Ninety-three CHI, in the age range of 5-15 years, were recruited in to the study. Children were assigned to two educational intervention groups: sign language and video modeling. Each group was again randomly divided into two: with one subgroup receiving therapeutic intervention using liquorice as a mouth wash and the other group receiving no intervention. For all children, baseline oral hygiene, gingival, and plaque index scores were recorded and oral prophylaxis was performed. Based on the subgroup to which the child was assigned, oral hygiene instructions were given on a weekly basis, whereas therapeutic intervention was performed twice daily for 28 days. Reassessment was done after the completion of interventions and after 3 months, followed by statistical analysis. RESULTS: There was a significant mean reduction in oral hygiene, gingival, and plaque scores in all the children. The educational intervention could not influence the scores recorded, but the therapeutic intervention with liquorice led to a reduction in all the oral health parameters during the follow-up periods. CONCLUSION: Therapeutic intervention using liquorice as mouth wash along with educational intervention can be suggested in CHI.

Effectiveness of Acupressure on Dental Anxiety in Children.

PURPOSE: Acupressure is a non-invasive variant of acupuncture and is known to reduce general anxiety. The purpose of this study was to test acupressure's effect on children's dental anxiety. METHODS: Eight- to 12-year-old children undergoing scaling and/or restorative procedures were randomly assigned to one of the following groups: acupressure (Group 1); sham (Group 2); or control (Group 3). Anxiety was recorded for all the children using the Modified Child Dental Anxiety scale (MCDAS). Acupressure beads with a piece of adhesive strip were employed over the selected acupoints for groups one and two. Anxiety was further recorded for all the children prior to and after completion of the treatment using MCDAS. The Frankl scale was used as the objective measure to assess the behavior of all the children. A physiologic parameter (pulse rate) was also recorded. The scores obtained from all the three groups were tabulated, compared, and analyzed statistically. RESULTS: A significant difference was found in MCDAS, pulse rate, and the Frankl behavior ratings among the three groups of children, with acupressure group displaying a lower level of anxiety. CONCLUSION: Acupressure can be a viable alternative to reduce dental anxiety in children undergoing scaling and restorative procedures.

Comparative efficacy of a self-report scale and physiological measures in dental anxiety of children.

AIM: To determine and correlate dental anxiety in children, using psychometric and physiological measures. METHODS: On hundred children (51 boys and 49 girls) were selected and anxiety was assessed using psychometric (Modified Child Dental Anxiety Scale) and physiological measures (pulse rate and oxygen saturation levels), for local anesthetic administration. Statistical analysis was carried out with SPSS software version 11.0. Metric continuous data are presented as mean ± standard deviation. Analysis between groups was carried out by using one way anova. Categorical variables were analyzed with "Fisher's exact test". For statistical significance, the probability value of < 0.05 was considered. The correlation among psychometric and physiological measures was assessed using the Spearman rank correlation. RESULTS: A very weak negative correlation between pulse rate and MCDAS(f) values was observed. The oxygen saturation level did not show significant variations and was not a reliable indicator of anxiety. CONCLUSION: Both psychometric and physiological measures have their own merits and are important clinically. Even behavioral measures, although having observer bias, can be used as an adjuvant along with these measures. It is essential to take two or more measures into consideration rather than just one to assess dental anxiety.