Khalid H. Al-Samadani

Pain and anxiety management for pediatric dental procedures using various combinations of sedative drugs: A review.

For fearful and uncooperative children behavioral management techniques are used. In order to control the pain and anxiety in pedodontic patients, pharmacologic sedation, anesthesia and analgesia are commonly used. Midazolam is commonly used as an oral sedation agent in children; it has several features such as safety of use, quick onset and certain degree of amnesia that makes it a desirable sedation agent in children. This review paper discusses various aspects of oral midazolam, ketamine and their combinations in conscious sedation including, advantages of oral route of sedation, pharmacokinetics, range of oral doses, and antagonists for clinical dental treatment procedures.

Chitosan Biomaterials for Current and Potential Dental Applications

Chitosan (CHS) is a very versatile natural biomaterial that has been explored for a range of bio-dental applications. CHS has numerous favourable properties such as biocompatibility, hydrophilicity, biodegradability, and a broad antibacterial spectrum (covering gram-negative and gram-positive bacteria as well as fungi). In addition, the molecular structure boasts reactive functional groups that provide numerous reaction sites and opportunities for forging electrochemical relationships at the cellular and molecular levels. The unique properties of CHS have attracted materials scientists around the globe to explore it for bio-dental applications. This review aims to highlight and discuss the hype around the development of novel chitosan biomaterials. Utilizing chitosan as a critical additive for the modification and improvement of existing dental materials has also been discussed.

Prevalence of First Permanent Molar Caries in and Its Relationship to the Dental Knowledge of 9–12-Year Olds from Jeddah, Kingdom of Saudi Arabia

The carious status of the first permanent molar (FPM) was studied in 432 school children (aged 9–12 years) from a randomly selected primary schools from Sharfia area of Jeddah, Kingdom of Saudi Arabia. The sample consisted of 108 children from each age group of 9, 10, 11, and 12 years old. In total, 24.5% had all of their FPMs sound and 6% had all FPMs carious. The prevalence of four sound FPMs varied according to age with the highest (33%) amongst the nine-year olds and the lowest (16.5%) in the oldest children (12 years). Almost one-third (32.5%) of the children, who knew the age of eruption of the FPMs, had all of their molars sound. The children who had received advice regarding oral hygiene from a dentist or parent had more sound FPMs compared to the children who did not receive any advice. The number of carious FPMs increased with age. The prevalence of caries of the FPM was high and increased with increasing age. The level of knowledge had a positive correlation with the caries levels amongst this cohort of scholars.

Comparison of paracetamol, ibuprofen, and diclofenac potassium for pain relief following dental extractions and deep cavity preparations

Objectives: To compare the effectiveness of different oral analgesics for relieving pain and distress in adults following the extraction of teeth and deep cavity preparations under local anesthesia. Methods: This randomized controlled study was conducted between November 2015 and May 2016. One hundred and twenty patients were randomly allocated to 3 groups. Forty patients were in the paracetamol (1 gram) group, 40 in the ibuprofen (400 mg) group and 40 in the diclofenac potassium (50 mg) group. Evaluation of the post extraction and deep cavity preparations pain was made by patients immediately postoperatively, 2, 4 and 6 hours postoperatively on standard 100 mm visual analogue scales (VAS). Furthermore, each patient was observed preoperatively and immediately postoperatively for signs of distress by using a 5 point face scale. Results: There were significant decreases in mean pain VAS scores for diclofenac potassium group compared to paracetamol and ibuprofen groups at 4 hours postoperatively (one-way Analysis of Variance: p=0.0001, p=0.001) and 6 hours postoperatively (p=0.04, p=0.005). Changes in distress scores from the preoperative score to the postoperative score were made using the paired sample t-test. There were significant decreases in distress scores between the preoperative and postoperative scores (p=0.0001). Conclusions: Diclofenac potassium was more effective than paracetamol or ibuprofen for reducing postoperative pain associated with tooth extraction and deep cavity preparation. Patients’ distress levels can be alleviated by using preemptive analgesics.

Articaine and mepivacaine buccal infiltration in securing mandibular first molar pulp anesthesia following mepivacaine inferior alveolar nerve block: A randomized, double-blind crossover study.

Aims: A crossover double-blind, randomized study was designed to explore the efficacy of 2% mepivacaine with 1:100,000 adrenaline buccal infiltration and 4% articaine with 1:100,000 adrenaline buccal infiltration following 2% mepivacaine with 1:100,000 adrenaline inferior alveolar nerve block (IANB) for testing pulp anesthesia of mandibular first molar teeth in adult volunteers. Materials and Methods: A total of 23 healthy adult volunteers received two regimens with at least 1-week apart; one with 4% articaine buccal infiltration and 2% mepivacaine IANB (articaine regimen) and another with 2% mepivacaine buccal infiltration supplemented to 2% mepivacaine IANB (mepivacaine regimen). Pulp testing of first molar tooth was electronically measured twice at baseline, then at intervals of 2 min for the first 10 min, then every 5 min until 45 min postinjection. Anesthetic success was considered when two consecutive maximal stimulation on pulp testing readings without sensation were obtained within 10 min and continuously sustained for 45 min postinjection. Results: In total, the number of no sensations to maximum pulp testing for first molar teeth were significantly higher after articaine regimen than mepivacaine during 45 min postinjection (267 vs. 250 episodes, respectively, P < 0.001), however, both articaine and mepivacaine buccal infiltrations are equally effective in securing anesthetic success for first molar pulp anesthesia when supplemented to mepivacaine IANB injections (P > 0.05). Interestingly, volunteers in the articaine regimen provided faster onset and longer duration (means 2.78 min, 42.22 min, respectively) than mepivacaine regimen (means 4.26 min, 40.74 min, respectively) for first molar pulp anesthesia (P < 0.001). Conclusions: Supplementary mepivacaine and articaine buccal infiltrations produced similar successful first molar pulp anesthesia following mepivacaine IANB injections in volunteers. Articaine buccal infiltration produced faster onset and longer duration than mepivacaine buccal infiltration following mepivacaine IANB injections.

Effectiveness of benzocaine in reducing deep cavity restoration and post-extraction stress in dental patients

Objectives: To investigate the effectiveness of topical anesthetic, 20% benzocaine in relieving pain and stress in patients following deep cavity restoration and extraction of teeth under local anesthesia (LA). Methods: A prospective clinical trial was conducted from October 2014 until April 2015 at Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. Forty-five patients were included in the 20% benzocaine group, and 46 in the normal saline group. Evaluation of the dental stress was made pre-operatively and immediately post-operative treatment using the visual analogue scale (VAS). Furthermore, discomfort of the injections were recorded by the patients after each treatment on standard 100 mm VAS, tagged at the endpoints with “no pain” (0 mm) and “unbearable pain” (100 mm). Results: There were statistically significant differences between the mean stress scores for patients in the benzocaine and normal saline groups post-operatively (p=0.002). There were significant differences between the mean pain scores for patients in the post buccal injection (p=0.001), post palatal injection (p=0.01), and the post inferior alveolar nerve block groups (p=0.02). Buccal, palatal, and inferior alveolar nerve block injections were more painful for patients in the normal saline group than the benzocaine group. Conclusion: This investigation has demonstrated that post-operative stress associated with deep cavity restoration and dental extractions under LA can be reduced by the application of topical anesthetic (20% benzocaine) at the operative site for intra-oral injections.

The Impact of Hyposalivation on Quality of Life (QoL) and Oral Health in the Aging Population of Al Madinah Al Munawarrah

Hyposalivation (HS) affects aging individuals by causing pain and discomfort in the oral cavity. The aim here was to determine the impact of hyposalivation and the saliva pH on the quality of life and caries status of geriatrics population. A total of 138 male outpatients attending the Taibah University College of Dentistry (TUCoD) dental clinic were included in the study. The saliva flow, pH, Quality of Life (QoL), and caries status were recorded. The QoL was measured using the Arabic version of the Oral Health Impact Profile-14 (OHIP-14), and the caries status was recorded using the Decayed, Missed, Filled Teeth (DMFT) index. The mean age was 67.5 years and 64% were classified as having hyposalivation. The older respondents tended to have a lower saliva flow and pH compared to their younger counterparts. There was a significant inverse association (p = 0.02) between the caries status and mean saliva flow rate. There was also a significant (p < 0.001) positive correlation between caries and the OHIP-14 scores (Spearman’s ρ = 0.293). The prevalence of hyposalivation was relatively high and there was an inverse relationship between the age, the saliva flow, and pH. Those with more caries reported significantly poor QoL.

Oral health knowledge and practice among administrative staff at Taibah University, Madina, KSA

Background: Although the prevalence of dental caries is decreasing in developed countries, it is still increasing in developing countries. No studies have reported on the oral health status of adults in Saudi Arabia; the role models and parents for the younger generation. Materials and Methods: This was a cross-sectional study carried out between January and June 2012 and included 200 randomly chosen Taibah university staff members. Each participant received a self-administered questionnaire and consent form detailing the objectives and rational of the study. Results: The response rate was 74%; mean age was 32.6 years and almost 90% had obtained higher educational qualifications. Nearly, half (48%) cleaned their teeth in the morning and evening, 77% used a tooth stick and toothbrush and almost 90% used tooth paste regularly. Under two-thirds (61%) visited the Dentist only when necessary and 13% had never visited a Dentist. The treatment received included restorations (35%), scaling and polishing (21%) and extractions (18%). Of those who did not visit the Dentist, 40% cited the high cost as the reason. The majority (78%) were aware that sugar is harmful for the teeth. Under half (46%) used tobacco and 36% had medical conditions. Those who visited the Dentist were more likely to brush twice daily ( P =0.04) and of those who brushed regularly, 50% knew the number of permanent teeth present ( P =0.04) and 57% were aware of the benefits of fluoride ( P =0.01). Conclusion: The majority of respondents had a poor level of knowledge regarding oral hygiene. This was reflected in their poor and inconsistent brushing habits and their lack of utilization of dental services.

Oral health knowledge and practice among 9-12-year-old schoolchildren in the region of Madinah, Saudi Arabia, and its impact on the prevalence of dental caries

Background: Dental caries is one of the most common dental disorders affecting from all over the globe. Dental caries affects 60%-90% of schoolchildren in most developed countries, and in several developing countries, the prevalence rates are increasing. Objective: To know oral health knowledge and practice among 9-12-year-old schoolchildren and its relation with dental caries. Methods: This is a questionnaire-based cross-sectional studies conducted from September 20, 2015, to January 27, 2016, selecting four male and four female primary schools. Two calibrated examiners examined the students under the normal light with mirror and probe. Results: A total of 276 (92%) were included in this cross-sectional study. There were 118 (43%) were males and 158 (57%) were females with mean age of 10.61 years and having mean Decayed, Missing, and Filled Tooth/decayed, missing, and filled tooth (DMFT/dmft) 1.47/1.78 in male and 1.69/5.34 in female. Three-quarters of the sample (75%) reported to cleaning their teeth at least once per day, and >95% reported using a toothbrush and toothpaste. The mean DMFT/dmft and D/d scores of female were significantly higher (P < 0.05) than that of the males. The mean dmft and all the components decreased with age, and there was a significant association (P < 0.01) between oral health knowledge and the caries status. Children with a higher DMFT/dmft score tended to have poor oral health knowledge compared to those with low DMFT/dmft scores. Conclusion: Poor oral health knowledge contributes major role in the prevalence of dental caries in both male and female. In female higher DMFT/dmft was observed in spite of having good oral health knowledge.

Comparing male and female dental students' perceptions regarding their learning environment at a dental college in Northwest, Saudi Arabia

Introduction: Male and female students often have different expectations and requirements regarding learning institutions. Taibah Dental College has separate male and female sections, and it is essential to determine the students′ perceptions regarding the dental college. Methods: All male and female dental students who were in the 3 rd , 4 th , and 5 th year of study during the 2014/2015 academic year were asked to participate. The Dundee Ready Educational Environment Measure, which is a self-administered questionnaire, was used to obtain the necessary data. It consists of fifty items categorized into five domains. For each item, students chose one option that best described their perceptions using a Likert-type scale. A higher score indicated higher levels of satisfaction and vice versa. Results: The 4 th year female students reported the lowest scores. Overall the scores were relatively low and indicated that students were generally dissatisfied. Common areas of dissatisfaction included poor learning experiences, poor teaching experiences, and type of learning atmosphere. The 3 rd year females reported significantly higher scores for their teaching experience compared to their male counterparts. There were significant differences for each domain between the years of study with the 4 th year having lowest scores. Conclusion: In general, the student′s perception was low but within the range of other similar studies. The females tended to be much more dissatisfied compared to males and the 4 th year seemed to have the most problems.