The aim of this study was to investigate whether caries removal with air-abrasion/Carisolv™ gel is an acceptable and viable alternative in the treatment of dental patients. Twenty-two patients were treated with conventional methods (local anaesthetic injection/drill) followed by alternative treatment (air-abrasion and Carisolv gel) in a general practice setting, by the same operator. The participants’ pre-operative anxiety levels were measured using the Modified Dental Anxiety Scale. Their postoperative levels of anxiety/dislike for aspects of both conventional and alternative treatments were assessed using a visual analogue scale. Levels of anxiety/dislike for both treatments were compared and statistically analysed. Results showed 100% of subjects were concerned about several aspects of conventional treatment including pain/discomfort on injection, taste of anaesthetic, length of time tissues remained numb, noise of the drill, its sensory vibrations and water coolant. However, 75% of the study population were happy with all aspects of the air-abrasion technique including dust, pain/discomfort and vibrations produced. Overall, the study population found Carisolv gel to be an acceptable alternative method of caries removal in terms of time taken, pain/discomfort and taste. There were statistically significant differences between patients’ perceptions of various aspects of the two treatment methods. All participants found the alternative treatment to be pain-free, quicker and overall more acceptable compared with conventional treatment. The conclusion drawn from the study was that air-abrasion/Carisolv gel treatment was a well-accepted and viable alternative to conventional local anaesthetic injection and drill for dental patients.
To update clinicians on the dental management of patients with inherited bleeding disorders and how to decide the most appropriate setting for the provision of dental care.
Being able to recognize which drugs may cause bleeding problems at an early stage will lead to good patient management, particularly in planning and delivering treatment following invasive procedures such as dental extractions. Whilst most patients can be successfully treated in general dental practice, the clinician may need to make a decision on whether or not to refer a patient to specialist services for all dental treatment, or to share care between primary care and specialist services for selected procedures.
Being able to recognize fear and anxiety in dental patients is an important part of overall patient management. Knowledge of various behaviour management techniques, and the use of less-invasive operative techniques, enable the clinician to treat a large proportion of anxious people and help them to cope with dental treatment in the primary care setting. Those who remain anxious and unable to cope in the dental setting may require pharmacological techniques, such as conscious sedation, to enable them to receive dental treatment. These techniques are not always readily available, require appropriate training, are more time consuming and costly. In extreme cases, general anaesthesia may be a last resort option.
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