YOLO-V5 based deep learning approach for tooth detection and segmentation on pediatric panoramic radiographs in mixed dentition.

OBJECTIVES: In the interpretation of panoramic radiographs (PRs), the identification and numbering of teeth is an important part of the correct diagnosis. This study evaluates the effectiveness of YOLO-v5 in the automatic detection, segmentation, and numbering of deciduous and permanent teeth in mixed dentition pediatric patients based on PRs. METHODS: A total of 3854 mixed pediatric patients PRs were labelled for deciduous and permanent teeth using the CranioCatch labeling program. The dataset was divided into three subsets: training (n = 3093, 80% of the total), validation (n = 387, 10% of the total) and test (n = 385, 10% of the total). An artificial intelligence (AI) algorithm using YOLO-v5 models were developed. RESULTS: The sensitivity, precision, F-1 score, and mean average precision-0.5 (mAP-0.5) values were 0.99, 0.99, 0.99, and 0.98 respectively, to teeth detection. The sensitivity, precision, F-1 score, and mAP-0.5 values were 0.98, 0.98, 0.98, and 0.98, respectively, to teeth segmentation. CONCLUSIONS: YOLO-v5 based models can have the potential to detect and enable the accurate segmentation of deciduous and permanent teeth using PRs of pediatric patients with mixed dentition.

Assessment of advanced paediatric dentistry education programmes in Egypt: a survey of programme directors.

BACKGROUND: Advanced paediatric dentistry education programmes (APDEPs) should follow specific standards to produce competent specialists. The current study assessed APDEPs in Egypt via an online questionnaire to programme directors. SUBJECTS AND METHODS: An online questionnaire was distributed to the directors of fully operational degree-granting APDEPs in Egypt in June 2023. The survey instrument was based on the Accreditation Standards for Advanced Dental Education Programmes in Paediatric Dentistry developed by the Commission on Dental Accreditation (CODA). RESULTS: Directors of the sixteen fully operational APDEPs answered the questionnaire giving a 100% response rate. APDEPs, in Egypt, varied regarding the adequacy of teaching staff, facilities and resources, didactic instruction, clinical requirements, and research activities. CONCLUSION: The current survey provides information about the strengths and weaknesses of fully operational degree-granting APDEPs in Egypt. This information can help maintain and improve the quality of these programmes.

Global overview on current paediatric dentistry teaching: A survey of National Member Societies of the IAPD.

BACKGROUND: Published information on the teaching and recognition of paediatric dentistry (PD) is limited worldwide. AIM: The aim of this study was to investigate the status of current teaching of undergraduate and postgraduate training in PD and identify differences by country-level economic development. DESIGN: Representatives from 80 national member societies of the International Association of Paediatric Dentistry (IAPD) were invited to complete a questionnaire on undergraduate and postgraduate PD curricula, types of postgraduate education offered, and recognition of the specialty. Country economic development level was classified according to the World Bank criteria. The chi-squared test and the Spearman correlation coefficient were used for data analysis (α = 0.005). RESULTS: Response rate was 63%. Teaching of PD at the undergraduate level was present in all countries, but PD specialization, master's, and Doctor of Philosophy (PhD) coursework were offered in 75%, 64%, and 53% of surveyed countries, respectively. Postgraduate specialization courses were offered in a significantly larger proportion of high-income countries than in upper-middle- or lower-middle-income countries (p < .01). In 20% of participating countries, PD was not an officially recognized specialty with no difference in recognition of the specialty by country's economic development level (p = .62). CONCLUSION: Paediatric dentistry is taught at the undergraduate level universally, but at the postgraduate level, significantly fewer courses are available, especially in lower-income countries.

British Society of Paediatric Dentistry: A policy document on dental neglect in children.

The British Society of Paediatric Dentistry's (BSPD) first policy document on dental neglect was published online in 2009. It proposed a new original definition of dental neglect, discussed the identification of dental neglect and recommended adopting a tiered response, with three stages of intervention according to level of concern. Furthermore, it detailed how the dental team should both contribute to the child protection process and implement wider measures to safeguard and promote children's welfare. Since 2009, these concepts have been widely adopted in the UK and beyond. Furthermore, there have been significant advances in both research and practice. Policy documents produced by the BSPD represent a majority view, based on the consideration of currently available evidence, and are tailored to a UK working environment. Although this updated document's recommendations remain broadly unchanged, this version reflects the professions' progress in understanding dental neglect and minor updates to terminology and, following a consultation process, has been amended to address the needs of two main audiences-dental professionals and nondental health and social care professionals-in order to enhance interdisciplinary working.

A scoping review of guidelines on caries management for children and young people to inform UK undergraduate core curriculum development.

BACKGROUND: Current evidence in cariology teaching is not consistently reflected in paediatric dentistry in the United Kingdom (UK). Many dental schools are not consistently teaching biological approaches to caries management, with outdated or complex methods being taught outwith the purview of general dental practitioners. This scoping review aimed to map current guidelines on the management of caries in children and young people. This is part of a work package to inform the consensus and development of a UK-wide caries management curriculum for paediatric dentistry. METHODS: A search of electronic databases for peer reviewed literature was performed using Cochrane Library, MEDLINE via PubMed, TRIP Medical Database and Web of Science. Hand searching was undertaken for grey literature (citations of sources of evidence, websites of global organisations and Google Web Search™ (Google LLC, California, USA). Results from databases were screened independently, concurrently by two reviewers. Full texts were obtained, and reviewers met to discuss any disagreement for both database and hand searching. RESULTS: This review identified 16 guidelines suitable for inclusion. After quality appraisal, eight were selected for synthesis and interpretation. Key themes included the shift towards selective caries removal and avoidance of complete caries removal unless in specific circumstances in anterior teeth. For "early lesions" in primary and permanent teeth with and without cavitation, several guidelines recommend biological management including site specific prevention and fissure sealants. CONCLUSIONS: This review mapping current cariology guidelines for children and young people found gaps in the literature including classification of early carious lesions and management of early cavitated lesions. Areas identified for further exploration include integration of biological caries management into treatment planning, selective caries removal and whether pulpotomy is specialist-level treatment, requiring referral. These results will inform consensus recommendations in the UK, using Delphi methods.

How different attributes are weighted in professionals' decision-making in Pediatric Dentistry-a protocol for guiding discrete choice experiment focused on shortening the evidence-based practice implementation for dental care.

BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .

Pediatric dentistry systematic reviews using the GRADE approach: methodological study.

BACKGROUND: To assess the reporting of the certainty of the evidence using the GRADE approach in systematic reviews of interventions in pediatric dentistry. METHODS: The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted. RESULTS: Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%). CONCLUSION: The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision. REGISTRATION: PROSPERO database #CRD42022365443.

Acceptability of dental students and professionals concerning child behaviour management techniques: Systematic review.

INTRODUCTION: During child dental treatment, different behavior management techniques (BMTs) are applied and it is important to understand the possible discomfort in the operator. OBJECTIVE: The present systematic review aimed to evaluate the acceptability of dental students and professionals concerning BMTs applied with paediatric dentistry patients. MATERIALS AND METHODS: A systematic search was conducted, following the PEOS strategy: Population (P) - dental students/professionals (S); Exposure (E) - BMTs preconized by the American Academy of Paediatric Dentistry, Outcome (O) - proportion of BMT acceptance; and Study design (S) - observational studies based on data from PubMed, Scopus, Web of Science, BVS (Lilacs/BBO), Cochrane, and Open Grey databases up to September 2021. The eligible studies were submitted to data extraction and to the evaluation of methodological quality, using the Joanna Briggs Institute Critical Appraisal Tool. The certainty of evidence was evaluated by GRADE. RESULTS: The search retrieved 710 articles; a total of 21 fulfilled the eligibility criteria and were used for qualitative analysis. Among the undergraduate students and dentists, the most accepted techniques were tell-show-do and positive reinforcement, while paediatric dentists preferred the tell-show-do technique and dental professionals with graduate degrees preferred sedation using nitrous oxide and positive reinforcement. The least accepted technique was protective stabilization. Seven students presented a low risk for bias, while 14 presented a high risk. The certainty of evidence was classified as very low. CONCLUSION: Although the basis of available certainty of evidence is scarce and with a considerable risk for bias, it is still possible to conclude that the more accepted techniques were based on communication.

Clinical competency development with handmade simulator in highly realistic paediatric dentistry scenarios.

INTRODUCTION: The use of simulation is extremely useful in pregraduate students. However, there is a very small number of simulators adapted to paediatric dentistry. A paediatric simulator was created to use in simulated scenarios for paediatric dentistry using an actress in the role of mother. The objectives of the present study were three. First, to analyse the perception of clinical competencies acquired by the students. Second, to examine the realism perceived by the students. Finally, to analyse the influence on the perception of clinical competencies after the integration of a handmade simulator in the Paediatric Dentistry III course. MATERIALS AND METHODS: Eight clinical scenarios were carried out with a modified Erler Zimmer simulator for children, a professional actress in the role of the mother and two students (in the roles of dentist and assistant) on a paediatric dentistry case of pulpal pathology. The educational intervention was evaluated on 114 students by means of questionnaires with Likert-type answers applied pre- and post-simulation. RESULTS: The perception of clinical competence in the students increased an average of 0.956 points in relation with the initial clinical evaluation, finding a strong correlation between the perception of subsequent competence and all the perceived realism, with significant statistical differences in all cases. The realism of the simulated participant (professional actress) was the best rated by the students, although not significantly. The realism of the mannequin was positively and strongly correlated with the perceived realism of the cabinet. CONCLUSION: Simulation using a handmade mannequin with a professional actress in a simulated dental office increased the perception of clinical competence in 4th year dental students and raised the level of overall realism perceived by the student.

Students' perception of protective stabilization of pediatric dental patients: a qualitative study.

Protective stabilization (PS) has been utilized to safely perform examinations, make diagnoses and/or provide limited treatment of short duration to uncooperative children. The literature supports PS as an alternative technique when behavior management strategies are not sufficient to enable oral care. The use of PS in pediatric dentistry can be traumatic for patients, parents and the medical team and has sometimes been described as being non-compliant with standards of care. Semi-structured qualitative interviews on dental students' perception of PS were conducted in the pediatric department of dentistry at the University Hospital of Toulouse, France. A thematic analysis of the transcript of interviews was provided using the NViVo software. This analysis identified four main themes. The students described their first experience with physical restraint in pediatric dentistry and wondered about the definition of PS. The students' perception of PS showed that this procedure has a psychological impact and is disturbing. There is a lack of information on PS in dental curricula and didactic and clinical education which requires attention. Finally, the students took into consideration the role of PS in future practice. Dental students' perception of PS provides justification for the development and improvement of theoretical and clinical education in behavior guidance techniques for pediatric dental patients, in accordance with national and international guidelines.

Evaluation of pediatric dentists' knowledge and approaches to tooth discoloration.

In recent years, esthetic expectations have come to the fore in pediatric dentistry, as in every field of dentistry. Therefore, to better meet patients' expectations, the steps taken to determine and improve the current level of knowledge of pediatric dentists on tooth discoloration gain importance. This study aims to measure the knowledge levels of pediatric dentists regarding tooth discoloration. A 33-questioned survey created online was emailed to pediatric dentists between March and December 2021. The first part included four multiple-choice and two open-ended questions regarding demographic characteristics. The second part was to measure the participants' knowledge of tooth discoloration. The last part was to evaluate the clinical approaches of the participants. Participants who agreed to answer all of the questions were included in the study (n = 129). The knowledge levels of the participants were scored according to the accuracy of their answers. The data were statistically analyzed using descriptive statistics and chi-square tests. Of the pediatric dentists who participated in this study, 16.3% had high knowledge, 79.8% had medium knowledge, and 3.9% had insufficient understanding of tooth discoloration. There was no correlation between time since dental school graduation and time spent practicing as a pediatric dentist (p > 0.05). The group with the highest average level of knowledge was the group most frequently encountered with tooth discoloration in the clinic (p ≤ 0.05). On average, pediatric dentists had moderate knowledge of tooth discoloration. The group with the highest average expertise in this field was the group that most frequently encountered and treated tooth discoloration. Information on tooth discoloration due to systemic factors was insufficient. To increase the knowledge level of pediatric dentists about the causes and treatments of tooth discoloration, it may be beneficial to establish training programs during and after specialization education.

Abstracts of randomized controlled trials in pediatric dentistry: reporting quality and spin.

BACKGROUND: Abstracts provide readers a concise and readily accessible information of the trials. However, poor reporting quality and spin (misrepresentation of research findings) can lead to an overestimation in trial validity. This methodological study aimed to assess the reporting quality and spin among randomized controlled trial (RCT) abstracts in pediatric dentistry. METHODS: We hand-searched RCTs in five leading pediatric dental journals between 2015 and 2021. Reporting quality in each abstract was assessed using the original 16-item CONSORT for abstracts checklist. Linear regression analyses were performed to identify factors associated with reporting quality. We evaluated the presence and characteristics of spin only in abstracts of parallel-group RCTs with nonsignificant primary outcomes according to pre-determined spin strategies. RESULTS: One hundred eighty-two abstracts were included in reporting quality evaluation. The mean overall quality score was 4.57 (SD, 0.103; 95% CI, 4.36-4.77; score range, 1-10). Only interventions, objective, and conclusions were adequately reported. Use of flow diagram (P < 0.001) was the only significant factor of higher reporting quality. Of the 51 RCT abstracts included for spin analysis, spin was identified in 40 abstracts (78.4%), among which 23 abstracts (45.1%) had spin in the Results section and 39 in the Conclusions Sect. (76.5%). CONCLUSIONS: The reporting quality of RCT abstracts in pediatric dentistry is suboptimal and the prevalence of spin is high. Joint efforts are needed to improve reporting quality and minimize spin.

Effect of low-level laser stimulation of acupuncture points in pediatric dentistry: a systematic review.

The biomodulatory potential of low-level laser therapy (LLLT) has prompted investigations of different outcomes in health. One line of research is the stimulation of acupuncture points for the relief of different signs and symptoms related to the stomatognathic system. In dentistry, some studies in pediatric dentistry have demonstrated the benefit of LLLT therapies in the management of dental anxiety in children. This systematic review aimed to analyze previous clinical studies on the application of LLLT at acupoints among pediatric dental patients. This systematic review was conducted according to the Cochrane Collaboration guidelines and the population, intervention, comparison, and outcome strategy. A broad literature search up to June 17, 2022, was performed using four electronic databases (PubMed, Scopus, Embase, and Google Scholar). The risk of bias in randomized clinical trials was assessed using the RoB 2 tool. A total of four studies using LLLT for photobiomodulation were included (n = 4). The most common wavelengths used were in the infrared range (variation between 716 nm and 980 nm). There were little variations in the application time (14 s to 1 min) and exposure dose (1 to 5 joules). LLLT acted positively on different acupuncture points. LLLT provided various benefits and optimized dental practice by reducing the gag reflex during radiography and impression taking, preanesthetic pain, and symptoms of sleep bruxism in the pediatric dental population. Only one of the evaluated studies had a high risk of bias. The LLLT at acupuncture points is associated with positive results on sleep bruxism, preanesthetic pain, and gag reflex in pediatric dentistry. Future research studies should prioritize standardization of the study design and the methods of analysis.

Three-dimensional (3D) printing in dental practice: Applications, areas of interest, and level of evidence.

OBJECTIVES: The aim of this review to overview three-dimensional (3D) printing technologies available for different dental disciplines, considering the applicability of such technologies and materials development. MATERIALS AND METHODS: Source Arksey and O'Malley's five stages framework using PubMed, EMBASE, and Scopus (Elsevier) databases managed this review. Papers focusing on 3D printing in dentistry and written in English were screened. Scientific productivity by the number of publications, areas of interest, and the focus of the investigations in each dental discipline were extracted. RESULTS: Nine hundred thirty-four studies using 3D printing in dentistry were assessed. Limited clinical trials were observed, especially in Restorative, endodontics, and pediatric dentistry. Laboratory or animal studies are not reliable for clinical success, suggesting that clinical trials are a good approach to validate the new methods' outcomes and ensure that the benefits outweigh the risk. The most common application for 3D printing technologies is to facilitate conventional dental procedures. CONCLUSIONS: The constantly improving quality of 3D printing applications has contributed to increasing the popularity of these technologies in dentistry; however, long-term clinical studies are necessary to assist in defining standards and endorsing the safe application of 3D printing in dental practice. CLINICAL RELEVANCE: The recent progress in 3D materials has improved dental practice capabilities over the last decade. Understanding the current status of 3D printing in dentistry is essential to facilitate translating its applications from laboratory to the clinical setting.

Undergraduate dental students' perception of paediatric dental teaching in an urban and rural Australian dental school.

BACKGROUND: Confidence in performing paediatric dental treatment is important as it ensures better oral health outcomes in the patient's adulthood. AIM: To investigate the confidence and attitudes of final year dentistry students, attending an urban and rural dental programme, towards their paediatric dentistry training. DESIGN: A questionnaire was distributed to final year dentistry students at the urban-based university, The University of Queensland, and at the rural-based university, La Trobe University. The questionnaire collected information using 5-point Likert scale and short-answer questions, which explored the theoretical, observational, preclinical and clinical aspects of students' paediatric dentistry training. Jamovi and GraphPad Prism were used for data analysis and the creation of graphs. RESULTS: The questionnaire was completed by 32 rural students and 47 urban students, with a response rate of 79%. Rural students were found to be less confident with the theory on restorative procedures than urban students. Observations of a dentist performing treatment on child were completed by a significantly larger proportion of urban students (70.2%) than rural students (46.9%). Students from both universities reported to have developed the least confidence in the preclinical training of pulp therapies and expressed the need for additional preclinical sessions for more training. At both universities, students indicated they were the least confident in the clinical practice of pulp therapies and management of traumatic dental injuries. Urban students were found to be more confident than their rural counterparts in the clinical practice of examination, treatment planning and preventative procedures, as well as in restorative procedures. CONCLUSIONS: Both urban and rural students were found to have the least confidence in preclinical and clinical skills related to pulp therapies. Restorative dentistry was an area in which urban students were significantly more confident than rural students in both the theoretical and the clinical aspects.

Selective outcome reporting in paediatric dentistry restorative treatment randomised clinical trials-A meta-research.

BACKGROUND: Selective outcome reporting (SOR) is a bias that occurs when the primary outcome of a randomised clinical trial (RCT) is omitted or changed. AIM: To evaluate the prevalence of SOR in RCTs on restorative treatment in primary teeth. DESIGN: We conducted an electronic search on ClinicalTrials.gov and the World Health Organization platform (International Clinical Trials Registry Platform) on 1st of April 2021, with no registry time or language restrictions. We included RCT protocols that evaluated restorative treatments in primary teeth and excluded trials that did not have a complete publication in a scientific journal. The chi-squared test was used to identify the association between SOR and variables as a discrepancy in the follow-up period, the timing of registration, the type of sponsorship and the type of study design (α = 5%). RESULTS: Of the 294 identified protocols, 30 were included in the study. 83.3% of trials were registered retrospectively. SOR was observed in 53.3% (n = 16) of the published trials and was significantly associated with a discrepancy in the follow-up period (p = .017). CONCLUSIONS: The high prevalence of SOR in RCTs on restorative treatment proves that this is a prominent threat. A proper preregistered protocol, declaration of any protocol deviation and allowance of stakeholders to compare the protocol with that of the submitted papers will achieve transparency.

Safety protocols at the American Board of Pediatric Dentistry Oral Clinical Examination during COVID-19.

BACKGROUND: There are continued concerns about holding large group gatherings with the ongoing COVID-19 pandemic. The American Board of Pediatric Dentistry (ABPD) made the decision to cancel the Oral Clinical Examination (OCE) in 2020 with a goal to host the exam in 2021. This cancellation postponed the board certification of over 400 pediatric dentists. There is limited published data on safety protocols for in-person examinations. AIM: To determine if safety protocols utilized in the administration of the 2021 ABPD Oral Clinical Examination (OCE) were reassuring to candidates and examiners, and effective at addressing prevention of COVID-19 infection. DESIGN: An electronic survey was emailed to candidates and examiners following completion of the board examination process. The candidate survey had 784 and the examiner survey had 108 eligible participants. Eight questions overlapped between the two surveys. Descriptive statistics were utilized. p-values < 0.05 were considered significant. RESULTS: Three hundred ninety-four candidates (response rate = 50.3%) and 97 examiners (response rate = 89.8%) completed their respective surveys. The majority of candidates (86.8%) and examiners (94.8%) felt safe participating the OCE, and found COVID-19 protocols reassuring, 69.3% and 89.7%. CONCLUSIONS: Participants agreed that safety protocols enacted by the ABPD kept everyone safe and led to a successful and safely conducted high-stakes oral clinical examination during the COVID-19 pandemic.

Evaluating Options and Ethics in Pediatric Dentistry due to Declining Access to Hospital Operating Rooms.

AbstractPediatric dentists rely on access to hospital operating rooms for safe, effective, and humane delivery of dental care. The children who benefit most from dental treatment in a hospital operating room are those who are very young, have dental anxieties or phobias, are precommunicative or noncommunicative, need extensive or invasive dental treatments, or have special healthcare needs. Diminishing access to hospital operating rooms for pediatric dental treatment has become an escalating problem in contemporary times. Financial barriers, hospital costs, reimbursement rates, health insurance policies and deductibles, out-of-network hospitals, socioeconomic factors, and the COVID-19 pandemic are prominent contributing factors. This problem in access to care has resulted in long waiting times for hospital operating rooms, deferral of medically necessary dental care, and pain and infection among this vulnerable patient population. Pediatric dentists have responded to the problem by utilizing alternative methods of care delivery, such as in-office deep sedation or in-office general anesthesia, and by implementing aggressive medical management of dental caries. However, the youngest of pediatric patients and children with special healthcare needs still remain at a disadvantage in receiving definitive dental treatment. This article aims to highlight the ethical challenges faced by pediatric dentists in contemporary practice in the face of limitations in hospital operating room access through four case scenarios.

Disasters in pediatric dentistry: a systematic review.

BACKGROUND: Disasters can harm many people, especially children, in unpredictable and public ways. One of the neglected aspects of children's health in disasters is oral and dental hygiene, which can affect their physical and mental well-being. This systematic review explores how dentistry can help children in disasters, focusing on two aspects: providing oral health care and identifying disaster victims. METHODS: A thorough search of databases, such as PubMed, Cochrane Library, Scopus, Embase, ProQuest, and Web of Science, was done to find English-language publications from 1930 to August 31, 2023. The screening, data collection, and quality assessment followed the PRISMA guidelines. RESULTS: Out of 37,795 articles found in the databases, seven research articles were chosen. Five articles were retrospective, and two articles were prospective. The results showed that dentistry for children is very important in disasters by giving information about the oral and dental problems and identifying the victims. The results also showed some of the challenges and difficulties in giving dental care for children in disaster situations, such as changing control, referral systems, and parental fear of infection. CONCLUSION: Dentistry for children can improve the health and well-being of children affected by disasters.

Virtual reality and behaviour management in paediatric dentistry: a systematic review.

BACKGROUND: Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. METHODS: A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed. RESULTS: A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction. CONCLUSIONS: VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.