Effectiveness of Nitrous Oxide Sedation on Child's Anxiety and Parent Perception During Inferior Alveolar Nerve Block: A Randomized Controlled Trial.

Introduction Dental anxiety is a common phenomenon among children and can have significant implications for their overall oral health and well-being. Among the various dental procedures that induce anxiety in pediatric patients, the Inferior Alveolar Nerve Block (IANB) stands out as one of the most feared due to its perceived pain and discomfort. Dental anxiety not only affects the child's cooperation during the procedure but can also lead to long-lasting negative perceptions of dental care, resulting in the avoidance of necessary treatments in the future. Nitrous oxide (N2O) sedation is a well-established sedation technique in dentistry, widely used to manage anxiety and discomfort during dental procedures. However, its efficacy in reducing anxiety during the administration of IANB to pediatric patients remains the subject of ongoing research. The administration of N2O sedation during IANB may not only alleviate the child's anxiety but also influence the parent's perception of the procedure, which can have additional effects on the child's dental experience and future adherence to dental care. The aim of this study was to evaluate the effectiveness of N2O sedation on pain and anxiety in children before and after IANB administration and the parent's perceptions of sedation following the procedure. Methods The current study was a single-centered, double-blinded, randomized controlled trial. The participants were assigned randomly to two groups, with each group consisting of 20 participants. Group 1 (n = 20) was given only oxygen, and Group 2 (n = 20) was given N2O for sedation. Pain perception for local anesthesia was evaluated using the Face, Legs, Activity, Cry, Consolability scale. The anxiety of children was evaluated using the Facial Image scale. Parent satisfaction was analyzed using the Likert scale. Data were extracted before and after the procedure using the Mann-Whitney U test. Results Pain perception evaluated with the FLACC scale showed statistically low pain perception in Group 2 after the procedure with a p-value of 0.001, and anxiety levels assessed with FIS showed a significant difference in Group 2 after the procedure with a p-value of 0.003. Parent satisfaction was analyzed using the Likert scale, and Group 2 showed a statistically significant difference with a p-value of 0.001 after the procedure. Conclusion The administration of the N2O sedation results in a notable reduction in anxiety levels and pain perception, as well as better parental satisfaction. This method allows for a practically pain-free and anxiety-free environment.

Comparative Evaluation on the Effects of Three Pediatric Syrups on Microhardness, Roughness and Staining of the Primary Teeth Enamel: An In-Vitro Study.

​​​​​Introduction One of the most prevalent oral diseases is dental caries. Syrups are commonly used by children who have difficulty swallowing tablets and capsules. Some medications can make dental caries worse and cause the enamel to erode. Most of the time, parents are unaware that a number of foods, drinks, and syrup-formulated pediatric drugs include sugar, which can cause erosion of primary teeth, resulting in plaque accumulation and dental caries. Henceforth, the aim of this study is to assess the effects of pediatric syrups on the microhardness, roughness, and staining ability of primary tooth enamel as a result of daily intake of syrup. Methods Eighty primary teeth, including both anterior and posterior, that required extraction due to pre-shedding mobility were randomly divided into four groups of twenty samples each. Samples were exposed to multivitamin syrup (Rudimin), iron syrup (C Pink), and diuretic syrup (Furosemide). The samples were submerged in 10 mL of the respective medication once daily for five minutes for 21 days. On days 0 and 21, enamel surfaces were assessed for changes in microhardness, roughness, and staining. The microhardness was assessed using a Micro Vickers microhardness tester machine; the roughness was assessed using a Mitutoyo surface roughness tester; and the staining ability was assessed using a spectrophotometer, and data processing was done using the analysis of variance (ANOVA) test and Tukey's post hoc analysis. Results The changes in enamel surface for microhardness, roughness, and staining were assessed twice, at days 0 and 21. Group 4 (Furoped) showed a significant difference in surface microhardness and staining ability of enamel surfaces with a statistically significant p-value (<0.05). When roughness was compared, all three interventions had a significant difference from the control group, whereas there was no statistically significant difference between the intervention groups. Conclusion This study concludes that pediatric syrups can significantly weaken the enamel of primary teeth, resulting in loss of enamel surface microhardness and roughness making them vulnerable to caries. Since frequent consumption of these syrups is correlated with tooth decay, certain precautions like oral hygiene maintenance and rinsing with water after taking the syrup should be done to prevent dental caries, as consumption of medicinal syrups by children cannot be avoided.