Amjad H. Wyne

Comparison of oral midazolam with a combination of oral midazolam and nitrous oxide-oxygen inhalation in the effectiveness of dental sedation for young children

AIM To compare the effectiveness of 0.6 mg/kg oral midazolam sedation alone and a combination of 0.6 mg/kg oral midazolam plus nitrous oxide-oxygen inhalation sedation, in controlling the behavior of uncooperative children during dental treatment. STUDY DESIGN The study had a crossover design where the same patient received two different sedation regimens, that is, oral midazolam 0.6 mg/kg and oral midazolam 0.6 mg/kg with nitrous oxide-oxygen inhalation during two dental treatment visits. MATERIALS AND METHODS Thirty children (17 males and 13 females) were randomly selected for the study, with a mean age of 55.07 (+/- 9.29) months, ranging from 48 - 72 months. A scoring system suggested by Houpt et al. (1985) was utilized for assessment of the childrens behavior. RESULTS There was no significant (p > 0.05) difference in the overall behavior assessment between the two sedation regimens, that is, oral midazolam alone and oral midazolam plus nitrous oxide-oxygen. However, the combination of midazolam and nitrous oxide-oxygen showed significantly (p < 0.05) superior results as compared to midazolam alone, in terms of controlling movement and crying during local anesthesia administration and restorative procedures. CONCLUSION Compared to oral midazolam alone, a combination of oral midazolam and nitrous oxide inhalation sedation appears to provide more comfort to pediatric dental patients and operators during critical stages of dental treatment.

Oral health comprehension in parents of Saudi cerebral palsy children

Objective To determine oral health comprehension among parents of cerebral palsy (CP) children. Methods A self-administered questionnaire was utilized to obtain the required information. The study was conducted in two main centers for disabled children in Riyadh, Saudi Arabia. Results Parents of all 157 CP children registered in the two centers completed the questionnaire. Mothers mostly (86.6%) completed the questionnaire. Majority (98.7%) of the parents knew the importance of dental health for general health. More than two-third (70%) of the parents thought that teeth should be brushed thrice daily or after each meal. About three in every ten (29.9%) parents were not aware of the beneficial effect of fluoride in preventing dental caries; and very few (9.6%) were aware of water as a source of fluoride. Almost all (98.7%) the parents knew that sugary foods caused dental caries. Three-fourth (75.8%) of the parents were not aware of the possible harmful effects of bottled juices on teeth. There were no significant (p > 0.05) associations between the parental age/gender with any of the dependent variables. Conclusion Parents of CP children generally showed satisfactory oral health comprehension. However, they need further oral health education in several areas.

Dental caries and related risk factors in Saudi cerebral palsy children

Objective: To determine caries experience and related risk factors in cerebral palsy (CP) children. Methods: Random sample of CP children was examined for dental caries and oral hygiene. Questionnaire was utilized for information about caries risk factors. This cross-sectional study was conducted in Riyadh from December 2014 to May 2015. Results: Fifty-two CP children were examined with mean age of 6.3±2.7 years. Only one (1.9%) child out of the 52 had no clinical caries. Combined (dmft plus DMFT) mean caries score among study sample was 9.98±3.99. Older children had significantly higher mean caries scores (11.5±3.34) than younger children (8.86±4.1, p=0.017). The CP children with good oral hygiene had lowest mean caries score (5.8±7.32) as compared to those with fair (9.72±3.3) and poor (11.55±3.05) oral hygiene (p=0.012). Those children whose first dental visit was for routine check-up had significantly (p=0.02) lower mean caries scores (7.33±4.65) than those who made their first visit due to dental problem (11.57±4.15). Similarly, those who had topical fluoride applications by dentist had significantly (p=0.003) lower mean caries scores (8.67±4.14) than those with no topical fluoride application (11.9±2.89). Conclusion: The studied CP children had very high caries experience and poor oral hygiene. There was strong association between the high caries experience and poor oral hygiene.

Oral health knowledge of health care workers in special children's center.

Objective: To determine the oral health knowledge of health care workers in special children’s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to “wait till there is some pain in case of a dental cavity” before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of “gum disease”. Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers’ response in relation to their specific job. Conclusion: The special health care workers in the disabled children’s center generally had satisfactory oral health knowledge and practices.