Purpose: Silver diamine fluoride (SDF) is an effective caries control agent. The aim of our study was to investigate the parental acceptance of the utilization of SDF on their child’s primary and permanent teeth and to determine the factors that influence their decision-making. Patients and methods: This descriptive cross-sectional study included parents of healthy children aged 12 years and younger and currently receiving dental treatment. The interview questionnaire was conducted and pre-tested for face and content validity. The trained interviewing dentists showed colored pictures of primary and permanent teeth before and after receiving SDF treatment. The statistical significance was set at P <0.05. Results: A total of 104 parents were included in the study. The mean parental rating of treatment acceptability of the staining associated with SDF was 3.9±1.95. The plurality considered the staining caused by SDF treatment strongly not acceptable 46 (43.4%). Parental acceptance of SDF treatment was significantly affected by the location and type of teeth. Parents showed significantly higher acceptance of SDF treatment on their child’s primary compared to permanent teeth and posterior compared to anterior in both dentitions ( P <0.001). In addition, parents of children with a history of uncooperative behavior during previous dental treatment were significantly more accepting of SDF treatment regardless of the type and location of the teeth. Conclusion: Parental acceptance of SDF increased for primary compared to permanent teeth, on anterior compared to posterior teeth in both dentitions and for uncooperative children.

Background Different distraction techniques have been used in dentistry and have shown great results in managing anxious pediatric patients specially during local anesthesia administration. One of the recently invented techniques is virtual reality. The purpose of the study was to evaluate the effect of virtual reality distraction on anxiety and pain during buccal infiltration anesthesia in pediatric patients. Methods Healthy, cooperative 6- to 12-year-old children requiring buccal infiltration anesthesia were randomly assigned to a test or control group. In the test group, local anesthesia was administered while the subjects were watching a cartoon video using virtual reality goggles. Subjects in the control group watched a cartoon video on a screen during the administration of local anesthesia. To assess anxiety in both groups, heart rate was recorded using a pulse oximeter at five time points: (1) once the subject sets on the dental chair as a baseline; (2) when video is on; (3) at topical anesthesia application; (4) during needle insertion; (5) after the administration of local anesthesia. The face, legs, activity, cry, consolability (FLACC) behavioral pain assessment scale and the Wong–Baker FACES pain rating scale were used to assess pain. Results A total of 50 subjects were included with a mean age of 8.4 ± 1.46 years. Twenty-nine (58.0%) of the subjects were females. The mean heart rate at all time points except baseline was significantly higher among the test group compared to the control group. Multiple regression analysis showed that younger subjects and females had higher mean FLACC behavioral pain assessment scale scores (P = 0.034 and P = 0.004, respectively) regardless of the distraction technique used. Younger subjects and subjects with higher baseline heart rate reported higher mean Wong–Baker FACES pain rating scale score (P = 0.031 and P = 0.010, respectively), controlling for all other variables. Conclusion Female subjects and the younger age group were more likely to report higher pain scores during local anesthesia administration regardless of the type of distraction used. Trial registration The study was retrospectively registered in ClinicalTrials.gov with the identifier: NCT04483336 on 23/07/2020.

Objectives: Child dental fear causes a significant management problem. The Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) is the most widely used measure of dental fear in children. This study was undertaken to develop and test reliability and validity for the Arabic version of the CFSS-DS. Study design: the English CFSS-DS was translated to Arabic language and its reliability and validity were evaluated by distributing it to 6-12 year old Arabic pediatric dental patients (n=220). Of whom 144 children were assigned for test- retest reliability. To test criterion validity; 44 children were subjected to behavior rating during treatment and compared with their CFSS-DS. Fear of returning to the dentist was evaluated for all the children to test construct validity. Results: the Arabic version of the CFSS-DS showed good internal consistency (alpha = 0.86) and test-retest reliability (0.86, P&lt;0.001). Treatment with or without local anesthesia did not affect the children's behavior or fear scores. Significant correlations were found between total fear scores and both Frankl rating scale (r=-0.54, p&lt;0.001) and willingness to return to the dentist (r=0.50, p&lt;0.001). Conclusion: the Arabic version of the CFSS-DS appears to be a reliable and valid method for evaluating child's dental fear in Arabic cultures.

A mucocele is the most common minor salivary gland disease and among the most common biopsied oral lesions in pediatric patients. Clinically, a mucocele appears as a round well-circumscribed painless swelling ranging from deep blue to mucosa alike in color. Mucoceles rarely resolve on their own and surgical removal under local anesthesia is required in most cases. Different treatment options are described in the literature, including cryosurgery, intra-lesion injection of corticosteroid, micro-marsupialization and conventional surgical removal using a scalpel, and laser ablation. Therefore, the goal of this paper was to report three cases of mucocele removal in pediatric patients using a diode laser with a one-month follow-up. Mucoceles were removed by a pediatric dentist using a diode laser with a wavelength of 930 nm in continuous mode and a power setting of 1.8 Watts. In all cases, no bleeding occurred during or after the procedure and there was no need for suturing. On clinical examination during the one-month follow-up, in all three cases there was minimal or no scarring, minimal post-operative discomfort or pain, and no recurrence. Diode lasers provide an effective, rapid, simple, bloodless and well accepted procedure for treating mucocele in pediatric patients. Minimal post-operative discomfort and scarring was reported by all the three patients.

Background Integrating pharmacogenetics (PGx) testing into clinical practice leads to personalized medicine, which improves treatments’ efficacy and safety. Successful implementation of such a service requires sufficient knowledge, perception, and self-confidence among healthcare providers, especially pharmacists. Objectives To evaluate governmental hospital pharmacists’ knowledge, perception, and self-confidence toward PGx testing in Jeddah, Kingdom of Saudi Arabia. Method This cross-sectional study was conducted using previously validated questionnaire. Pharmacists working in five randomly selected general governmental hospitals in Jeddah between August and October 2019 were interviewed. Comparative and descriptive analyses were used to analyze the data, and the significance level was at P -value < 0.05. Results A total of 119 pharmacists with a mean (±SD) age of 31.2 (±5.05) years were included with a response rate of 79.3%. The average total mean (±SD) score for PGx knowledge-based questions was low (2.4 ± 1.09 out of 5). Most of the participants, with a total mean score of (10.1 ± 1.6 out of 12), revealed a positive perception toward PGx testing and its implications. A moderate self-confidence score for utilizing PGx testing (4.3 ± 2.3 out of 8) was observed among the participants. Pharmacists who had completed postgraduate studies had a statistically higher mean knowledge score ( P = 0.006) compared with pharmacists with undergraduate degrees. Conclusion Governmental hospital pharmacists have limited knowledge and understanding about PGx testing; however, the majority expressed a high level of awareness and agreed that PGx testing is a valuable tool for enhancing drug efficacy and safety. The study also highlighted the importance of improving pharmacists’ knowledge about PGx testing, which will help them in implementing such a valuable service into their clinical practice in Saudi hospitals.

No abstract

Background: The aim of the randomized double-blinded clinical trial was to evaluate the effect of tooth brushing with Salvadora persica (miswak) sticks on Streptococcus mutans count and the mean plaque score relative to brushing with fluoridated tooth paste (FTP). Methods: Our sample included 94 healthy, high caries-risk, 8 to 9-year-old students recruited from a government school, in Jeddah, Saudi Arabia between February and April 2016. Subjects were randomly grouped into test (provided with miswak sticks) and control groups (provided with FTP and soft brushes). Both groups were introduced to a preparatory period (PPP) of 3 weeks. Plaque score and saliva sampling were conducted prior to the PPP and in follow-up visits by a single, calibrated and blinded dentist. Results: Both groups showed a statistically significant decrease in the mean plaque score across the study (P = 0.007 and P = 0.001, respectively). In addition, subjects in the test group with abundant S. sanguinis increased from zero to six after 3 months. Conclusions: Salvadora Persica (miswak) and brushing with FTP significantly reduced plaque scores among school children. In addition, Salvadora persica was found to change the proportions of salivary bacteria in favor of species with less risk of inducing caries. Trial registration: ClinicalTrials.gov ID #: NCT04137393.

Parental acceptance of the utilization of silver diamine fluoride on their child's primary and permanent teeth [Corrigendum]