Context:Anxiety and fear of pain are the two major deterrents for which patients avoid dental treatment. Local anesthetic, which forms the foundation for the delivery of pain-free endodontic treatment, does not serve the purpose in anxious patients and requires augmentation with other pharmacological agents.Aims:The aim of this study is to observe the effectiveness of nitrous oxide in alleviating patient anxiety and pain during endodontic treatment of a vital tooth.Settings and Design:The present in vivo study was conducted on sixty healthy patients from the Outpatient Department of Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India.Subjects and Methods:Sixty anxious patients having irreversible pulpitis in their lower molar were selected and divided into two groups, namely control group and intervention group, with thirty patients placed in each group. In control group, access opening and pulp extirpation was done under local anesthesia only, whereas in intervention group, access opening and pulp extirpation was done under local anesthesia and nitrous oxide sedation. The anxiety levels of patients, before and after the treatment, were measured using the Modified Dental Anxiety Scale. Pain felt by the patients during administration of local anesthesia and during access opening was measured using the Visual Analog Scale.Statistical Analysis Used:The data were analyzed using ANOVA and paired t-test, and graphical analysis of the data was done.Results:Significant reduction in anxiety and pain levels of patients during endodontic access opening including significant reduction in pain during administration of local anesthesia was observed under nitrous oxide sedation.Conclusions:Conscious sedation with nitrous oxide is a useful technique to add to the armamentarium used in the treatment of teeth with symptomatic irreversible pulpitis.
Aims and Objectives: This study was intended to assess the prevalence of dental caries and treatment needs, severity of dental caries and to record the periodontal health status in school going children in rural and urban areas of Ferozepur district and to compare the data between rural and urban areas and among 6, 9 and 12 years (±11 months). Methodology: The PUFA/pufa index was used to determine the severity of dental caries as it records the presence of severely decayed teeth. Plaque index (Silness and Loe) and gingival index (Loe and Silness) were used to assess the gingival status of the children. The data recorded from rural and urban area was statistically analyzed using Chi-square test and paired t-test. Results: The prevalence of caries was found to be more in urban area (71.8%) than the rural area (65.2%). Overall, treatment need was found more in rural (68.16%) than urban (61.6%), but the difference was non-significant. PUFA/pufa score was found more in urban area than rural area. Conclusion: Plaque and gingival indexes were found more in rural than urban population. The lack of dental health awareness, poor oral hygiene measures, socioeconomic status, gender variations, improper dietary habits, and less utilization of dental health-care services is the main reason for the high prevalence of dental caries.
Context:Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia.Aim:The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA) during lengthy periodontal surgical procedures.Settings and Design:This was a randomized, split-mouth, cross-over study.Materials and Methods:A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS) was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures.Statistical Analysis Used:Paired t-test and repeated measure ANOVA.Results:The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation.Conclusion:Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.
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