Dental bleaching: patient perception and satisfaction.

BACKGROUND: Teeth bleaching is a common practice performed by dental hygienists and dentists to correct aesthetic problems due to dental discoloration. Patients' opinions on this procedure may be different according to their personal experiences, expectations and individual sensitivities. The aim of this study is to assess the degree of satisfaction and related sensitivity of patients to professional and home bleaching treatment. METHODS: A questionnaire consisting of 12 multiple-choice questions was submitted to 625 subjects among general population. These were related to: 1) patient's age and whether the patient is a smoker; 2) personal satisfaction; and 3) post-treatment tooth sensitivity. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out by Chi-square test and Fisher's exact test. RESULTS: Of the people surveyed, 66% performed home bleaching, while the remaining performed the treatment in a dental office. Thirty-three percent of patients had previously undergone teeth bleaching and the 95.7% stated that they were satisfied with the treatment. Of these, only 36.4% reported experiencing postoperative hypersensitivity. Most patients (91.3%) received professional scaling before undergoing bleaching treatment. CONCLUSIONS: Patient satisfaction with tooth whitening treatment can vary from patient to patient and represents a strong indicator of treatment efficacy and suitability. A proper communication, careful management and individualized patient assessment are key to maximizing satisfaction and ensuring a positive and fulfilling patient experience.

Perception of the oral health risks of passive smoking from traditional cigarettes, electronic cigarettes, and heated tobacco products: A cross-sectional study.

INTRODUCTION: Tobacco smoke is a major health risk factor for smokers but also for non-smokers due to passive smoking. These risks come from conventional cigarette smoke but also from aerosol produced by electronic cigarettes and heated tobacco products (HTPs). The aim of this study was to investigate population knowledge about the adverse effects of passive smoking from traditional cigarettes, electronic cigarettes, and HTPs. METHODS: Between February and October 2023, 504 subjects among the general population responded to a questionnaire with 8 questions in Italian, via a link to the Google Forms platform. The questions related to the oral health effects of active and passive smoking. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out using the chi-squared test and Fisher's exact test. RESULTS: A large subset of individuals interviewed stated that active smoking is harmful to health and consider active smoking more damaging compared with passive smoking (86.3%). The majority believed that passive smoking of cigarettes is more harmful to oral health than passive smoking of HTPs (79.4%) or electronic cigarettes (e-cigarettes) (84.9%). CONCLUSIONS: Results suggest that most people in this study had good knowledge about the adverse effects of active or passive smoking on health; however, knowledge regarding e-cigarettes and HTPs was poor and confused. These results reveal the complexity of perceptions regarding different types of smoking and the need for further research to fully understand the risks associated with each type of passive smoking.

Marginal and Para-Marginal Technique in Late Germectomy of Lower Third Molars.

INTRODUCTION: Third molar surgery can cause post-operative complications to the patient due to the presence of a wound from the incision. This study aimed to compare marginal flap with para-marginal flap on postoperative complications by the measurements on pre and post-surgical plaque index (PI), bleeding on probing (BoP), maximum opening of the mouth (MOM), pain perception (PP) and post-surgical tumefaction (PT). METHODS: In this double-blind randomized clinical trial, 40 patients were recruited and randomly allocated in two groups. In Group 1, third molar extraction was carried out after a marginal flap design was performed, while in Group 2 a para-marginal flap was performed. Plaque index, bleeding on probing, maximum mouth opening, and distal probing were assessed right before and one week after surgery, while post-operative pain perception and post-operative swelling were accounted one week following surgery. RESULTS: Statistically significant differences were reported between treatment groups, as the para-marginal flap led to better outcomes for all the measured indexes. CONCLUSIONS: The para-marginal flap design may decrease the occurrence of post-operative complications and discomforts after mandibular third molar surgery, compared to marginal flap design.

Survey on Oral Health Education Knowledge of Family Members and Health Workers Dedicated to Patients with Disabilities.

OBJECTIVE: Over a billion people in the world live with some form of disability and this figure is destined to grow due to the increase in life expectancy. As consequence, the caregiver is taking on an increasingly important role that gains relevance also in the field of oral-dental prevention, being able to promptly identify needs for medical treatment. In some cases, however, the caregiver can be an obstacle to consider in case of a lack of adequate knowledge and commitment. The aim of this study is to evaluate the caregiver level of oral education comparing family members and health workers dedicated to people with disabilities knowledge. MATERIALS AND METHODS: Anonymous questionnaires were distributed in five disability service centers and filled alternatively by family members of patients with disability and disability service centers health workers. RESULTS: Two-hundred fifty questionnaires were collected, of which 100 were filled in by family members and 150 by health workers. Data were analyzed by applying the chi-squared (X2) independence test and the pairwise method for missing data. CONCLUSION: Family members oral education appears better in terms of brushing frequency, toothbrush replacement, and number of dental visits.

Patient's perception of hygiene in the dental practice after COVID-19.

BACKGROUND: The COVID-19 pandemic has significantly impacted various sectors, including healthcare. The dental profession has faced unprecedented challenges in providing care while minimizing the risk of transmission. The aim of the study is to assess how patient's perception of hygiene in the dental field has changed since COVID-19. In detail, it has been analyzed patient's attention to hygiene and how in his opinion the dental practice changed its procedures after COVID-19. METHODS: A questionnaire consisting of 10 multiple-choice questions was submitted to 509 subjects, patients of several dental practices. These were related to: 1) change in their perception of hygiene after COVID-19; 2) how the office they usually go to has changed and what hygiene standards it has adopted; 3) vaccination against COVID-19. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out by Chi-square test and Fisher's Exact Test. RESULTS: Most patients (75.8%) stated that they had changed their perception of hygiene after the onset of COVID-19. They reported that they had experienced changes in hygiene procedures at their usual dental practice (70.7%), including rinsing with chlorhexidine mouthwash, continuous air and water disinfection and use of personal protective equipment (PPE). Vaccination of practitioners was considered to be important by 73.5% of participants. CONCLUSIONS: In the present study it was analyzed how emergence of the new Coronavirus has considerably changed the perception of patient hygiene within the dental practice. As a result of the awareness implemented to prevent virus transmission, patients are paying more attention to hygiene and preventive procedures to protect their health.

Evaluating high power laser therapy (HPLT) as treatment for chemotherapy-induced oral mucositis in paediatric patients with oncohematological diseases.

BACKGROUND: Oral mucositis (OM) is one of the most debilitating side effects of chemotherapy. Among the current methods used in OM management, the feasibility of high power laser therapy (HPLT) has been proposed but not fully evaluated. AIM: The aim of this study was to evaluate the efficacy of HPLT in the treatment of OM in paediatric patients. DESIGN: Fourteen oncohematological paediatric patients treated with chemotherapy and/or hematopoietic stem cell transplantation and affected by OM at different grades were enrolled in this study. All patients were treated with a class IV laser device in four sessions for four consecutive days, OM was evaluated with the WHO-OTS scale. The perception of pain was assessed by the visual analog scale. Photographs of and information about lesions and patient questionnaires were taken and collected, respectively. Descriptive analyses and the Wilcoxon signed-rank test (nonparametric test) were used, with a statistical significance of α = .05. RESULTS: After a week into the treatment, 57% of patients were completely healed, whereas the whole cohort experienced a drastic decrease in pain, from an average value of 5.8-1.1 (p = .0016). The average number of injuries per patient decreased from 7.4 to 3.1 (p = .008). CONCLUSION: High power laser therapy appears to be a safe and efficacious method for managing OM. It reduces pain and severity of oral cavity injuries. Further studies are needed to determine the optimal parameters useful in OM treatment and to evaluate the relative effectiveness of HPLT to other treatments like LLLT.

Early Childhood Caries and Oral Health-Related Quality of Life: Evaluation of the Effectiveness of Single-Session Therapy Under General Anesthesia.

OBJECTIVE: The aim of this study is to evaluate whether the treatment of ECC, performed in a single-session dental treatment under general anesthesia, can affect the quality of life of pediatric patients. It was assessed whether risks and discomforts involved in SSGA are outweighed by its effectiveness and reliability in improving oral health-related quality of life. MATERIALS AND METHODS: The quality of life that was assessed in this prospective study was oral health-related quality of life (OHRQL). Pediatric patients aged between 3 and 6 years with ECC undergoing dental treatment in SSGA were asked to fill in the Early Childhood Oral Health Impact Scale (ECOHIS) form both before and 1 month after the intervention. The data obtained were then statistically elaborated and analyzed to evaluate the actual significance of the differences found between the values before and after treatment and between the two sexes. RESULTS: Mean ECOHIS score before treatment was 30.58, following a large decrease after treatment, with a mean score of 2.94. Most parameters show a significant improvement between pre- and post-SSGA treatments, mainly those related to oral-dental pain, daytime irritability, and impact on family environment. Average ECOHIS scores for males and females are 31.72 and 29.76 before treatment and 3.55 and 2.52 1 month after treatment, respectively, showing no statistically significant differences. CONCLUSION: The dental treatment of young children under SSGA is associated with considerable improvement in their OHRQL. It can be considered an effective and reliable way of managing cases that cannot be dealt with by alternative methods.

Soft drinks and dental erosion during pediatric age: a clinical investigation.

BACKGROUND: Dental erosion is an irreversible condition of loss of teeth hard tissues caused by intrinsic or extrinsic acids attack, without bacterial involvement. Common soft drinks have an acid pH and they release hydrogen ions and act as chelating agents, dissolving teeth mineral component. The aim of the study was to investigate the correlation between the consumption of soft drinks in children and the degree of dental erosion. METHODS: A questionnaire of 15 multiple choice questions was addressed to the parents of the 231 children needing different dental treatments. Responses were compared with the level of dental erosion of their child, that was clinically investigated using the Basic Erosive Wear Examination (BEWE) index. RESULTS: About 26.8% of subjects fall into a high-risk category of dental erosion while 24.2% in a low risk level. Socioeconomic status and oral hygiene habits are able to affect the degree of dental erosion. Toothpastes containing fluoride have not proved effective in preventing this phenomenon and no significant correlations were found between the type of toothbrush used and its frequency of use. CONCLUSIONS: It is necessary to apply preventive measures such as information on the processes and causes of erosion, instruction about right home oral hygiene maneuvers and the possible use of specific products, to avoid the development of problems related to severe dental wear.

Mothers' Awareness of the Correlation between Their Own and Their Children's Oral Health.

Pregnancy is a critical time for a woman since it involves a series of changes in the body due to hormonal fluctuations and changes that can also influence the oral cavity and can lead to certain pathologies, such as carious lesions. Furthermore, it has been demonstrated over the years that having poor dental health during pregnancy might have a significant impact on the child's oral health. The aim of the study is to analyze the level of knowledge and information of mothers on the importance of oral health care before, during, and after pregnancy as a preventive factor for the future oral health of the child. A questionnaire of 13 multiple choice questions was formulated and delivered from 24 February 2022 to 13 July 2022, aimed at women with at least one child. The Department of Pediatric Dentistry of the Borgo Cavalli Clinic in Treviso and the Maxillofacial Surgery Department of Santa Maria di Ca' Foncello Hospital in Treviso were the data collection centers. Crosstabs with dependency variables were used to statistically analyze the results. The study cohort consists of 411 women, whose responses showed that the majority did not have dental visits before and during pregnancy, which is why 74% of the whole sample did not request or receive information from professionals. Most mothers knew that they had to cleanse their child's mouth and, among them, those who responded more correctly, that is, who started before the eruption of the teeth, had received instructions from professionals. However, the low frequency of mothers performing dental checks during pregnancy did not allow mothers to become aware of the possibility of transmitting the carious lesions to their child, as conscious mothers represent 21%. Education from dentist and dental hygienists, gynecologists, and pediatricians is essential since they have an impact on mothers' habits and behaviors and ensure favorable oral health for both the mother and the child.

Oro-dental lesions in pediatric patients with celiac disease: an observational retrospective clinical study

Background and aim: to investigate the correlation betweenceliac disease and specific oral lesions.Methods: one hundred and fourteen pediatric patients wereenrolled and divided into three groups: celiac patients (CDgroup), patients with malabsorption without celiac disease(non-CD group) and healthy controls. Oral lesions of hardand soft tissues were detected and analyzed by Fisher’s testand odds ratio calculations.Results: a non-random correlation between the threegroups and the rate of enamel defects was detected. TheCD group showed more severe enamel defects compared tothe non-CD group. A non-random association between thethree groups and the number of mucous lesions was notobserved. Furthermore, malabsorption patterns not relatedto the celiac disease involved a relatively modest risk ofspecific enamel defects compared to controls.Conclusions: hypoplastic enamel defects of the permanentteeth could be reliable indicators for celiac disease. The etiology of specific hypoplastic enamel lesions mainly has tobe sought in the autoimmune response triggered by gluten, while the malabsorption would play only a minor role.Lesions of the oral mucous membranes should not be considered as specific risk indicators, however, they representa non-specific marker of malabsorption. (AU)

Depth of Cure, Hardness, Roughness and Filler Dimension of Bulk-Fill Flowable, Conventional Flowable and High-Strength Universal Injectable Composites: An In Vitro Study.

(1) Objective: To evaluate and compare the depth of cure (DOC) of two bulk-fill flowable composites (Filtek Bulk Fill Flowable Restorative and Tetric EvoFlow Bulk Fill), two conventional flowable composites (Filtek Supreme XTE Flowable Restorative and G-ænial Flo X) and one high-strength universal injectable composite (G-ænial Universal Injectable). (2) Methods: specimens were placed in a stainless-steel mold with an orifice of 4 mm in diameter and 10 mm in depth and light-cured for 20 s using a light emitting diode (LED) light-curing unit (LCU) with an irradiance of 1000 mW/cm2; depth of cure was assessed using the ISO 4049 scrape technique, and the absolute length of the specimen of cured composite was measured in millimeters with a digital caliper. The same procedure was repeated with 14 samples for each material under investigation, for a total number of 70 test bodies. Material roughness and hardness results were also investigated using, respectively, a 3D laser confocal microscope (LEXT OLS 4100; Olympus) at ×5 magnification and a Vickers diamond indenter (Vickers microhardness tester, Shimadzu®, Kyoto, Japan) under 10-N load and a 30 s dwell time. SEM images at 3000 and 9000 magnification were collected in order to study the materials' filler content. Statistical analysis were performed by a commercial statistical software package (SPSS) and data were analyzed using multiple comparison Dunnett's test. (3) Results: The average DOC of both bulk-fill composites was more than 4 mm, as a range of 3.91 and 4.53 mm with an average value of 4.24 and 4.12 mm, while that of the conventional flowable composites was much lower, as a range of 2.47 and 2.90 mm with an average value of 2.58 and 2.84 mm; DOC of the high-strength injectable composite was greater than the one of traditional composites, but not to the level of bulk-fill materials, as a range of 2.82 and 3.01 mm with an average value of 3.02 mm. Statistical analysis revealed significant differences (p-values < 0.05) in the depth of cure between bulk fill flowable composites and other composites, while there was no difference (p-values > 0.05) between the materials of the same type. (4) Conclusions: Bulk-fill flowable composites showed significantly higher depth of cure values than both traditional flowable composites and high-strength injectable composites.

Oro-dental lesions in pediatric patients with celiac disease: an observational retrospective clinical study.

BACKGROUND AND AIM OF THE STUDY: To investigate the correlation between celiac disease and specific oral lesions. METHODS: 114 pediatric patients were enrolled and divided into three groups: celiac patients (CD group), patients with malabsorption without celiac disease (non-CD group) and healthy controls. Oral lesions of hard and soft tissues were detected and analyzed by Fisher's test and Odds Ratio calculations. MAJOR RESULTS: A non-random correlation between the three groups and the rate of enamel defects was detected. The CD group showed more severe enamel defects compared to the non-CD group. A non-random association between the three groups and the number of mucous lesions was not observed. Furthermore, malabsorption patterns not related to the celiac disease involved a relatively modest risk of specific enamel defects compared to controls. CONCLUSIONS: Hypoplastic enamel defects of the permanent teeth could be reliable indicators for celiac disease. The etiology of specific hypoplastic enamel lesions mainly has to be sought in the autoimmune response triggered by gluten, while the malabsorption would play only a minor role. Lesions of the oral mucous membranes should not be considered as specific risk indicators, however they represent a non-specific marker of malabsorption.

The Role of Information in Dental Traumatology in Patients during Developmental Age: A Cognitive Investigation.

OBJECTIVES: The gestation period involves a series of changes in all maternal organs and systems, due to hormonal fluctuations that also affect the oral cavity, leading to possible development of diseases such as gingivitis, oral pregnancy tumor, or periodontitis. Over the years, the positive correlation between poor oral health and adverse outcomes in pregnancy, such as fetal changes, low birth weight, preterm birth, or preeclampsia, has also been highlighted. The aim of this study is to analyze and understand the levels of knowledge and information of pregnant women about the possible repercussions that they may have on the oral cavity, caused by hormonal alterations. MATERIALS AND METHODS: A questionnaire of 17 multiple choice questions was formulated and published online from 01/02/2020 to 31/08/2020, aimed at pregnant women and new mothers. The Google Forms platform was used to collect the data that were then statistically analyzed by creating crosstabs with multiple dependency variables. RESULTS: The study cohort was represented by 1,191 women, whose responses first showed that about half were unaware of the predisposition to develop infections and periodontal problems during the gestation period. The same noticed bleeding and gum swelling during brushing and despite this, only 21% visited their dentist to resolve the situation. Furthermore, 88.2% of all women did not know that problems in the oral cavity can lead to adverse pregnancy outcomes. CONCLUSION: Primary prevention is essential and must be implemented with the collaboration of the various professional figures who follow the woman during gestation.

Relationship between Breastfeeding Difficulties, Ankyloglossia, and Frenotomy: A Literature Review.

OBJECTIVE: Breastfeeding plays a key role in the development of the baby, in addition to the benefits to the mother and this dyad. Among the possible difficulties in this process, we have ankyloglossia. Some professionals opt for the frenotomy, although the literature is controversial. This paper aims to present how the literature provides subsidies for health professionals' decision and action in the intersection of the themes: breastfeeding, ankyloglossia, and frenotomy. MATERIALS AND METHODS: The research on the platforms SciELO and PubMed used the terms: "ankyloglossia," "frenotomy," and "lingual frenulum" and the same ones associated with "breastfeeding." A specific inclusion and exclusion criteria were applied and validated by the American Speech-Language-Hearing Association to reduce any bias in the analysis. In the end, 16 papers were included and, by thematic equivalence, divided into two domains: association between lingual frenulum alteration and breastfeeding and between frenotomy and breastfeeding. RESULTS: The literature does not assure that the frenotomy is the "standard conduct" to be adopted in cases of difficulty in breastfeeding and ankyloglossia. CONCLUSION: Further studies are needed on the different types of ankyloglossia and their direct influence on the sucking function and lactation difficulties.

Can periodontal disease affect conception? A literature review.

Today periodontal health is considered as an integral part of systemic health itself and no longer as a single factor. The literature recognizes that the presence of periodontal disease can represent a risk factor for numerous systemic conditions such as heart disease and diabetes. In recent years, we have witnessed a progressive interest regarding the influence exerted by this condition on reproduction, as well as the possible repercussions on conception possibilities. Upon analyzing a limited number of studies available for the correlation between periodontal disease and female infertility, it could be inferred that this condition can be equated to the presence of a real outbreak of infection and therefore exert its influence, not only through bacterial translocation in the bloodstream, causing the systemic dissemination of pathogens, but also through the production of cytokines and immunoglobulins by inflammatory mediators. This situation limits bacterial growth, but it could cause damage to the fetus, to the reproductive system, and could hinder conception attempts. Although further research is needed to better clarify the mechanism underlying the possible correlation between periodontal disease and female infertility, the present article aims to review all the available literature on this topic. LAY SUMMARY: In recent years, interest regarding the influence of gum disease on conception has increased. Since serious gum disease (periodontitis) can be compared to an outbreak of infection, studies suggest that the bacteria that mediate inflammation do not remain confined only to the gum tissue, but can enter the bloodstream and spread, thus spreading the infection and having a whole-body effect. This situation could cause damage to the developing baby, to the reproductive system and could hinder conception attempts. Constant maintenance of oral health is definitely necessary. It is important for the professionals involved (gynecologists, obstetricians, dentists, etc.) to communicate and collaborate on these issues. Dentists could advise on the correct hygienic maintenance not only to pregnant women, but also to those who are planning a pregnancy in order to avoid the occurrence of unfavorable conditions.

Zirconia vs. stainless steel pediatric crowns: a literature review.

The aim of this review was to assess efficacy and acceptance of aesthetic zirconia crowns (ZCs) compared to the traditionally employed stainless steel crowns (SSCs) for primary teeth restoration. A comprehensive literature search was completed for the relevant keywords in Scopus and Medline databases. Resulting article abstracts and full texts were screened to determine final inclusion. Eighteen articles were included from the initial search. There is still little evidence to support the use of one type of crowns over another for primary teeth, in particularly for ZCs, lately introduced in pediatric restoration. The gold standard for restoring decayed primary teeth is still represented by SSCs, despite the growing importance of the aesthetic issue related to their use. Aesthetic ZCs resulted in having adequate properties to be employed for the treatment of decayed primary teeth, such as mechanical resistance, limited plaque adhesion, wear behavior and natural appearance. There is still a paucity of literature clinically evaluating the efficacy of ZCs for primary teeth restoration, but they can be considered a promising alternative to SSCs. This field of research has to be more deeply explored to improve dental care in children affected by early childhood caries.

Dental water jet efficacy in the plaque control of orthodontic patients wearing fixed appliance: A randomized controlled trial.

BACKGROUND: Different studies assess the role of fixed orthodontic appliances in supragingival plaque accumulation. In patients wearing fixed orthodontic appliances a good management of oral hygiene is required in order to prevent complication like as decay, enamel demineralization, gingivitis, gingival hyperplasia and periodontitis. The aim of this Randomized Controlled Trial (RCT) is to evaluate the efficacy of the use of a DWJ in patients under orthodontic treatment with fixed multibracket appliance. MATERIAL AND METHODS: The study design was single-blinded RCT with a split mouth protocol. Each patient followed a personal cleaning protocol using a DWJ in addition to traditional brushing only on one side while just brushing on the control side. The side on which was decided to use the DWJ was chosen randomly and the dental hygienist who took the measurements was blind. Plaque and gingival indexes were evaluated at baseline and at one, three and six-months follow-up. RESULTS: It did not emerge any difference in the plaque and gingival indexes trend between the two groups. Patients initially reported an worsening of the indexes at one month evaluation, then they set at baseline levels at three and six months. CONCLUSIONS: The dental water jet does not improve significantly the efficacy of home oral hygiene in orthodontic patients wearing a multi-bracket fixed appliance. Patients did not show the traditional worsening during the whole orthodontic therapy. Key words:Dental water jet, fixed orthodontics, plaque index, gingival index.

Prevalence of Hypodontia in Unilateral and Bilateral Cleft Lip and Palate Patients Inside and Outside Cleft Area: A Case-Control Study.

OBJECTIVES: The aim of this study is to evaluate the prevalence and distribution of hypodontia, inside and outside the cleft area, in an Italian population with a non-syndromic unilateral (UCLP) and bilateral (BCLP) cleft lip and palate on panoramic radiographs and comparing it with a control sample. STUDY DESIGN: Case group was ethnically uniform and consisted in 233 patients. The control group was composed of 1000 subjects. Patients included were between seven and fifteen years old. Descriptive analysis, using absolute and relative frequencies, was performed to check out the prevalence of gender distribution, hypodontia and cleft formation. Statistical analysis was conducted with Chi-squared test, Yate's correction and the Fisher's exact test. The power was set higher than 0.8 for each test. RESULTS: 160 cleft patients (68.68%) presented at least one missing tooth, while 88 patients in the control groups presented agenesis (8.80%). A statistically significant difference was found in case and control groups for upper lateral incisors (37.34% and 48.07% in the case group against 2.50% and 2.60% in the control group), upper and lower second premolars (8.58%, 6.44%, 5.58% and 6.01% in the cleft group and 0.60%, 0.60%, 2.50% and 2.70% in the control group). CONCLUSION: Higher prevalence of dental agenesis in the maxillary dental arch is explained by the cleft defect. Higher prevalence of mandibular second premolars agenesis cannot be explained by the anatomical defect and suggests a multifactorial aetiology, including environmental and genetic factors, of the cleft condition.