The estimated prevalence of extreme dental fear and anxiety is 40% among the adult population. Patient expressed fear of the dentist is rarely used in clinical practice to assess patient concerns. The present study was carried out to identify the risk factors associated to fear of the dentist and the frequency of visits to the dental clinic. The study comprised 98 subjects visiting a private dental clinical in Seville (Spain). Dental fear was measured: (How afraid are you of visiting the dentist? a. not at all, b. little c. a lot). Demographic data were collected assessed based on the Hospital Anxiety and Depression Scale (HAD), while dental fear was evaluated using the Dental Fear Questionnaire (CMD). These evaluations were made before dental treatment was carried out. Results revealed that four dimensions of the CMD were considered: A. accidental care, b. attitude of the dentist, c. neglect and d. organization. Only the dimensions of attitude of the dentist (OR = 2.4 (95% CI: 1.1-5.4); p = 0.02) and neglect (OR = 5.3 (95% CI: 2.0-13.1); p = 0.0001), together with the levels of anxiety (OR = 1.3 (95% CI: 1.3-1.7); p = 0.01), were independently associated to the presence of dental fear. None of the variables were associated to the frequency of visits to the dentist. Results further revealed that the dentist dimensions of attitude and anxiety were associated to fear of visiting the dentist.
Introduction Dental trauma is a public health problem, that have a complex aetiology, with a negative impact in the people life [ 1 ]. It has been reported that 25.7% of the children visit a dentist for the first time due to emergency situations. The most frequently reported injury seems to be damage to the enamel or the dental crowns in children [ 2 ]. Approximately 31% of dental injuries are caused by sporting activities, and many of these traumas can be prevented [ 3 , 4 ]. The anterosuperior teeth are, in most cases, the most injured, affecting the patient’s self-esteem. This study aims to present a clinical case of a definitive tooth that suffered a crown fracture with a pulp exposure. Materials and methods A 9-year-old male was referred to paediatric dentistry clinic, with the chief complaint “Treat the tooth that fractured about one hour ago in the school” SIC mother. A detailed medical, dental, and social history was obtained, a clinical analysis was performed, confirming the crown trauma with a pulp exposure, positive pulpal vitality tests in the upper left incisor, without apical lesion in the radiological analysis, after signed informed consent the treatment first stage consisted in vital pulp therapy, that was performed with partial pulpotomy wherein the sealing material was MTA-Angelus ® . In the second stage it was done a direct restoration with rubber dam technique and a silicone index using the Filtek™ Supreme XTE universal dental composite. Results After the treatment and 2 years of follow-up the tooth presented satisfactory aesthetic and functional results and this treatment increased the patient's self-esteem. Discussion and conclusions In the present case the vital pulp therapy was performed once the tooth had complete root formation and had signs and symptoms of a pulp exposure without apical lesion. MTA has been shown to be a great pulpotomy agent its sealing ability, biocompatibility and regeneration of the original tissues when placed in contact with dental pulp tissue [ 5 ]. It is crucial to develop educational programs that emphasise the importance of prevention and the benefits of immediate treatment. Adequate diagnosis, planning and follow-up of treatment are important to get favourable results and to increase in the patient's self-esteem [ 6 ].
View related articlesView Crossmark data before and after the viscosupplementation and again, after 1 month of the occlusal splint use. The same thing was done with the DC/TMD protocol. Results: According to the OHIP-14 questionnaire, before treatment the patient mainly referred the articular pain that she felt during mastication. After the first viscosupplementation session and the new OHIP-14 questionnaire application, the patient referred substantial improvements on the pain during function. However, she expressed her concerns with the expectations of the treatment. After 1 month of occlusal splint use her concerns were gone and pain during function did not come back. Discussion and conclusions: Disc displacements should be carefully evaluated before the prescription of an anterior repositioning splint. However, in cases like this, they are indicated [5]. In this case, viscosupplementation was used in the beginning of treatment to allow the TMJ to recover function without limitations and restoring a dynamic lubrification. Treatment of TMJ disfunctions should be conservative and always multidisciplinary.
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