K. Arapostathis

Reliability and validity of the Greek version of the Children's Fear Survey Schedule–Dental Subscale

BACKGROUND The Childrens Fear Survey Schedule-Dental Subscale (CFSS-DS) is a commonly used questionnaire which measures childrens dental fear. OBJECTIVE The aim of this study was to gather data to evaluate the psychometric properties of a Greek version of the CFSS-DS. METHODS A sample of 260 children aged 4-12 completed the Greek version of the CFSS-DS while in the waiting room of a paediatric dentist. The dentist, who was unaware of the childrens scores, rated the childrens behaviour during the dental appointment using the Frankl scale. Children who returned for a second dental appointment during the study period completed the CFSS-DS a second time. RESULTS The mean CFSS-DS score was 24.80 (standard deviation = 9.17). Age and gender were not related to mean scores. Invasiveness of dental treatment was not related to mean scores. Children who were most uncooperative/fearful on the Frankl had the highest mean scores (Kruskal-Wallis chi2 = 9.48; d.f. = 2; P = 0.009). The internal consistency (Cronbachs alpha) was 0.85, and the test-retest reliability (intraclass correlation) was 0.74. CONCLUSIONS The Greek version of the CFSS-DS appears to be reliable and valid. Further samples should include school samples, to include children who may not go to the dentist.

A form of 'parental presence/absence' (PPA) technique for the child patient with dental behaviour management problems.

AIM: This paper reports on the use of early introduction of a specific parental presence/absence (PPA) behavioural technique to manage the initially uncooperative child. METHODS: Using a prospective design, 440 healthy children aged 3 to 10 years visited a paediatric dental practice within 33 months. Children exhibiting initially Frankl ‘negative’ and ‘definitely negative’ behaviour were empathically offered parental presence only if they were cooperative. Otherwise, the parent stepped out until behaviour improvement. Statistics: t-tests and Chi-square tests were used to compare characteristics of initially cooperative and uncooperative children, as well as proportions of parents who were asked to leave the surgery. The technique’s success was assessed by a one sample binomial test. RESULTS: 75 of the children presented as Frankl either ‘negative’ (30) or ‘definitely negative’ (45) at theirfirst visit; 70 (93.3%, p< 0.001) responded to the PPA technique by displaying positive behaviour as their first visit progressed. 38 responded without the need to ask the parent to exit the practice room, while the other 32 responded only after their parent exited. 52 children had additional appointments, and 8 required an application of PPA at a second appointment; all children cooperated in all subsequent appointments. CONCLUSION: Early and empathic application of the PPA technique appears very successful in managing initially uncooperative child patients, suggesting that a randomised controlled trial of the technique is warranted

Comparison of Acceptance, Preference, and Efficacy Between Jet Injection INJEX and Local Infiltration Anesthesia in 6 to 11 Year Old Dental Patients

Needleless devices have been developed to provide anesthesia without injections. Little controlled research has examined the acceptability of needleless devices in pediatric patients. The aims of the study were to compare childrens acceptance and preference for one type of needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Eighty-seven nonfearful children with no previous experience of dental anesthesia were studied using a split-mouth design. The first dental procedure was performed with the classical infiltration anesthesia. The same amount of anesthetic was administered using the INJEX needleless device in a second session 1 week later, during which a second dental procedure was performed. Patients rated their acceptance and preference for the 2 methods, and the dentist recorded data about the need for additional anesthesia. More negative experiences were reported for the INJEX method. Most (73.6%) of the children preferred the traditional method. Among the 87 treatment procedures attempted following the use of INJEX, 80.5% required additional anesthesia, compared with 2.3% of those attempted following traditional infiltration. Traditional infiltration was more effective, acceptable, and preferred, compared with the needleless INJEX.

Psychometric properties of the Greek version of the Toronto Composite Empathy Scale in Greek dental students

INTRODUCTION Empathy levels of health practitioners are related to patient satisfaction and treatment outcomes. The Toronto Composite Empathy Scale (TCES) was recently developed to assess cognitive and emotional empathy levels in both professional and personal spheres, and tested in an English-speaking sample of dental students. The aim of this study was to examine the psychometrics of the Greek version of the TCES. MATERIALS AND METHODS The TCES was translated into Greek and administered to all of the dental students at Aristotle University of Thessaloniki. A random subset of students completed the questionnaire twice for test-retest analysis. RESULTS Nearly all (96.5%) of the students completed the questionnaire. The internal consistencies of each of the four subscales were generally acceptable (Cronbachs alphas: 0.676-0.805), and the scale showed good discriminant and convergent validities (rs for discriminant validity: 0.217 and 0.103; rs for convergent validity: 0.595 and 0.700). Test-retest reliabilities ranged from 0.478 to 0.779. After eliminating items that fell on both cognitive and emotional factors, a rotated factor analysis indicated that the items loaded on two cognitive and three emotional factors. DISCUSSION Our results indicate that the Greek version of the TCES has good psychometric properties. The factor analysis indicates that the emotional and cognitive aspects of empathy are distinct, supporting the need to address both aspects in studies of empathy. CONCLUSIONS The Greek version of the TCES is a reliable and valid tool for the measurement of cognitive and emotional empathy, in both professional and personal life, in Greek dental students.

Laser-Assisted Pediatric Dentistry

The progress of laser application in dentistry is continuous. There are many debates between researchers, clinicians, and scientists who try to carry on research within and with respect to clinical everyday dental practice. The American Academy of Pediatric Dentistry acknowledges using lasers as scientifically documented, alternative, and/or adjunctive treatment provision methods of soft and hard tissue management for infants, children, adolescents, and persons with disabilities. The aim of this chapter is to describe the indications for their use in various therapeutic procedures in pediatric dentistry and to analyze the advantages and disadvantages compared to traditional techniques. Together with the appropriate child’s psychological management, proper presentation and approach with the laser is crucial. The technological evolution of dental lasers offers the possibility of completing several therapeutic procedures, such as removing carious dental tissue in permanent and deciduous teeth, usually with less or no anesthesia, performing laser-assisted pulpotomy and pulpectomy, soft tissue interventions, dental trauma, etc. Depending on the treatment procedure and the targeted chromophores, all laser wavelengths could be used (e.g., KTP, diodes, Nd:YAG, erbium family lasers, CO2).

The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear

BACKGROUND No studies assessing the association between gagging and dental fear are available in pediatric samples. AIM To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. DESIGN A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Childrens Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. RESULTS A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbachs alpha = 0.697). CONCLUSIONS The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment.

Predictors of Dental Patients' Satisfaction in a Greek Sample

Aims: To evaluate patien t factors, provider factors, and factors related to the patient - provider experience which may predict patient satisfaction with dental appointments. Study Design : A cross - sectional design was used. Place and Duration of Study: Data were gathered from denta l students and their patients at Aristotle University of Thessaloniki, Greece between October, 2010 and April, 2011. Methodology: Data from 157 dental students and 484 of their patients were included. Patients completed questionnaires including the Patient Communication Style Scale, the Patient Assessment Questionnaire, and the Dental Visit Satisfaction Scale, and items measuring the patient’s prior experience with his/her student dentist. Dental students completed questionnaires included the Toronto Compos ite Empathy Scale and the Attitudes Toward Patient Education Scale. Participants also provided demographic information, and the type of dental treatment received was recorded. Results: Patient satisfaction was associated with student communication skills ( P <.001) and dyadic congruence about patient participation in treatment - planning ( P <.001). Empathy was