Benjamin Peretz

Dental Anxiety among Patients Undergoing Endodontic Treatment

The purpose of this study was to evaluate the dental anxiety expressed among patients undergoing endodontic treatment with respect to some social and dental parameters. The dental records of 98 patients, 42 men and 56 women who were referred for root canal treatment to an endodontist, were examined. Patients completed a Dental Anxiety Scale (DAS). Dental experience, time of last visit to the dentist, and symptoms of tooth were recorded. The mean DAS scores were higher than scores reported in other countries (9.4 +/- 3.3). Women demonstrated higher dental anxiety than men. Patients with higher education demonstrated lower dental anxiety. No difference was found between patients experienced in endodontic treatment and those who were not, patients who suffered previous pain in the treated tooth and patients who did not. Women in their mid-thirties to mid-forties and men in their twenties expressed the highest DAS scores.

A comparison of the sialochemistry, oral pH, and oral health status of Down syndrome children to healthy children.

BACKGROUND The aetiology of low caries incidence in Down syndrome (DS) children is not entirely clear. Aim. To compare sialochemistry and oral mucosal pH between Down syndrome children with caries (DS-Ca) and caries free (DS-CaF), and healthy children with caries (C-Ca) and caries free (C-CaF). DESIGN The study group comprised 70 children with DS (mean age 4.41 +/- 1.9 years); 32 healthy children (mean age 9.22 +/- 2.7 years) served as control. Groups were further subdivided according to caries status: DS-Ca, DS-CaF, C-Ca and C-CaF. Sialochemistry analysis included calcium (Ca), sodium (Na), potassium (K), and chloride (Cl). Mucosal pH, plaque and gingival indices (PI and GI), and caries status were recorded. RESULTS DMFT/dmft were significantly lower in the DS group. Cl and Ca levels were significantly higher in the DS-Ca compared to the C-Ca and the C-CaF children. Na and K were significantly higher in DS-Ca group compared to DS-CaF group. PI and GI were significantly higher in DS-C children compared to DS-CaF children. CONCLUSIONS DS may manifest itself in the salivary glands. Consequently, different electrolyte salivary environment may form, leading to lower caries rates among DS children.

Modified cuspal relationships of mandibular molar teeth in children with Down's syndrome

A total of 50 permanent mandibular 1st molars of 26 children with Downs syndrome (DS) were examined from dental casts and 59 permanent mandibular 1st molars of normal children were examined from 33 individuals. The following measurements were performed on both right and left molars (teeth 46 and 36 respectively): (a) the intercusp distances (mb‐db, mb‐d, mb‐dl, db‐ml, db‐d, db‐dl, db‐ml, d‐dl, d‐ml, dl‐ml); (b) the db‐mb‐ml, mb‐db‐ml, mb‐ml‐db, d‐mb‐dl, mb‐d‐dl, mb‐dl‐d angles; (c) the area of the pentagon formed by connecting the cusp tips. All intercusp distances were significantly smaller in the DS group. Stepwise logistic regression, applied to all the intercusp distances, was used to design a multivariate probability model for DS and normals. A model based on 2 distances only, mb‐dl and mb‐db, proved sufficient to discriminate between the teeth of DS and the normal population. The model for tooth 36 for example was as follows:

Child-management techniques. Are there differences in the way female and male pediatric dentists in Israel practice?

The purpose of this study was to assess differences in the management techniques used by Israeli female and male pediatric dentists. All 112 participants of the meeting of the Israeli Society of Dentistry for Children that was held in February 1999 received a questionnaire which sought information regarding age, sex, behavioral and pharmacological methods used to treat children, having a course in nitrous oxide, general anesthesia, and feelings towards pediatric patients. No differences between female and male dentists were found regarding most management techniques. The majority of dentists used tell-show-do, and gave presents at the end of the appointments. Hypnosis was the least used technique. Papoose board was more prevalent among male dentists than among female dentists. Most dentists reported having the parents present during treatment, and more male dentists used their assistance when restraint was needed. General anesthesia was significantly more prevalent among males than among females (p = 0.01). One-third of the dentists reported feeling aggression toward the pediatric patient. Although not statistically significant, more female dentists reported about feeling aggression than male dentists. Most dentists felt authority towards the pediatric patient. Our findings imply that female and male dentists use similar management techniques when treating children.

Cleaning of the Root Canal Using Nd:YAP Laser and Its Effect on the Mineral Content of the Dentin

OBJECTIVE The aim of this study was to compare the efficacy of root canal cleanliness with and without Nd:YAP laser and to assess the effect of the laser on the mineral content of the dentin. BACKGROUND DATA A high degree of cleanliness of the canal when using the Nd:YAG laser has been shown while the laser is in contact with the canal wall. A new Nd:YAP laser has been studied recently, which is considered to be superior to the Nd:YAG with regard to antibactericidal ability due to its 1.34 micro m wavelength, which is in the infra-red range. This wavelength is absorbed better in water than that of Nd:YAG. MATERIALS AND METHODS Fourteen extracted single rooted premplars were divided into two groups. In group 1, canals were cleaned, instrumented, and shaped with K files. In group 2, initial preparation was done using K files and completed with a Nd:YAP laser. Teeth were then split longitudinally and submitted to scanning electron microscopy. RESULTS The cleanliness of the laser-treated teeth was significantly greater than teeth treated with K files alone (p < 0.05). No difference in Ca and P content was detected when the use of K files was compared to the use of laser. CONCLUSION It appears that the Nd:YAP laser improves the cleanliness of the root canal. However, since the Nd:YAP laser serves as an addition to K files, its clinical value for replacing conventional root canal instrumentation remains to be determined.

Common Errors in Digital Panoramic Radiographs of Patients with Mixed Dentition and Patients with Permanent Dentition

Purpose. To compare errors in digital panoramic radiographs of permanent and mixed dentitions. Methods. 143 and 146 digital radiographs of mixed and permanent dentitions were examined. Results. Significantly fewer errors presented in the mixed dentition. Positioning too forward significantly prevalent in the mixed dentition; slumped position and nonpositioning of chin properly were significantly prevailed in the permanent dentition. Blurred or shortened upper incisors were significantly more prevalent in the mixed dentition. Diagnostic ability could be improved by manipulating the brightness or contrast in nearly 45% of all radiographs. In the mixed dentition, tilting the chin down and a slumped position made the lower incisors significantly nondiagnostic. In the permanent dentition, tilting the chin down made the lower incisors to be significantly nondiagnostic. Conclusions. More errors were prevalent in panoramic radiographs of permanent dentitions. Properly positioning the patient is the most important factor in preventing a cascade of errors.

Dental treatment of patients with systemic diseases compared to patients with developmental disabilities under general anesthesia

The medical and dental records were examined for 46 patients with systemic diseases (SD) and 75 patients with developmental disabilities (DD) aged 2-20 years, who had received dental treatment under general anesthesia (GA). Age, gender, decayed missing and filled teeth (dmft/DMFT), dental procedures, duration of GA, and posttreatment hospitalization were recorded. Before treatment, dental disease in the primary teeth was significantly higher among the group with SD (p= 0.04). In the permanent teeth, dental disease was higher among the group with DD, though not significantly. More teeth were restored, (p= 0.015) and total dmft (p= 0.043) was significantly higher among subjects with SD. In the permanent teeth, more extracted and more restored teeth and higher DMFT were noted among subjects with DD, though not significantly. Only pulpectomies were significantly more prevalent among those with DD (p= 0.038). Six subjects needed hospitalization due to their diseases after GA.

Oral Health Characteristics of Preschool Children with Autistic Syndrome Disorder.

OBJECTIVE to assess the dental status of young children with Autistic Syndrome Disorder (ASD) in order to allow better understanding of the dentists role in treating these children. STUDY DESIGN The ASD group consisted of 47 children diagnosed as ASD from three special kindergartens from three towns in Israel. The control group was 44 normally developed children from 4 kindergartens from 2 neighboring towns. Parents were asked to complete a questionnaire requesting the following: socio-demographic information, general medical condition, dental information (previous visit to a dentist, feeding habits, oral hygiene behavior, oral habits and the Vinland Adaptive Behavioral Scales (VABS). RESULTS While in the control group there was no report of no brushing at all, among the ASD children 25% did not brush at all. Use of pacifier, fussy eating and eating problems were significantly more prevalent among the ASD group. In addition, the ASD children significantly preferred more salty, spicy and sweet foods than the control. There were more cariesfree children among the ASD group. In the ASD group, the ability to perform everyday life functions was slightly more than half of what is expected for age. CONCLUSIONS autistic children have a relative age of one half, meaning they function at half the level of normally developed children at their chronological age, more eating problems and more persistent oral habits yet no correlation to dental health could be shown. Caries experience of autistic children was lower than in the control group, maintaining good oral hygiene is difficult for autistic children yet their gingival health was found to be good.

Relations between dental and somatic pain in children.

PURPOSE To study relations between somatic and dental pain complaints among children who attend a university pediatric dental clinic. METHODS Forty-seven boys, 32 girls aged 4-13 years (mean age 8.41 +/- 2.29 years) participated in the study. Demographic information was obtained from the parents. Children were asked if they had experienced any dental pain during the previous week, the time of day the dental pain had appeared, and their actions when pain had been felt. Then, children were asked to complete a Pain Rating Scale for subjective evaluation of pain regarding various potentially painful organs. RESULTS The majority of the children suffered headaches, stomachaches, and leg pains, regularly. The younger children, aged 4-7 years, significantly reported more ear and stomach pains than the older group, aged 8-13. Significantly, more children who suffered from dental pain also reported more stomachaches. Firstborn and second children had significantly less current dental pain, compared with third children or more. CONCLUSIONS The results of our study suggest that children with dental pain suffer more often of stomachaches than children without dental pain. This may occur because these children are possibly more anxious about a potential treatment.

Effect of Gutta-percha Solvents on Surface Microhardness of IRM Fillings

Eighty identical samples of IRM were prepared and embedded in acrylic resin. The samples were polished, rinsed, and divided into experimental groups and controls, 10 specimens each. Each experimental group was treated for 1 or 5 min with one of the following gutta-percha solvents: chloroform, xylene, or halothane. Sterile saline was used as a control. Treatment consisted of pipetting each solvent onto the external IRM surface. The specimens were then sealed in plastic assay tubes for the corresponding exposure periods. At each time period, surface microhardness of the samples was measured using a mini-load hardness tester with a 500 g load for 20 s. It was found that xylene and halothane caused significant reduction in surface microhardness of IRM after 5 min (p < 0.01). Chloroform caused significant reduction in surface microhardness of IRM after 1 min of treatment (p < 0.01). Chloroform caused total dissolution after 5 min of treatment. Saline caused only minor and nonsignificant changes in surface microhardness of IRM.