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Watching cartoons could help children overcome anxiety of dental treatment

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Watching cartoons through video glasses during dental treatment could help lessen children's anxiety and distress as well as reducing disruptive behaviour, according to a randomized controlled trial published in Acta Odontologia Scandinavica.

Anxiety about visiting the dentist and during treatment is common in children. Estimates suggest that as many as 1 in 5 school age children are afraid of dentists. Children with dental phobias end up experiencing more dental pain and are more disruptive during treatment. Although studies have shown that audiovisual distraction (eg, playing video games and watching TV) can be successful in minimizing distress and the perception of pain during short invasive medical procedures, the issue of whether distraction is beneficial during dental procedures is still hotly debated. Research to date has produced conflicting results.

In this study, 56 'uncooperative' children (aged 7 to 9 years) attending a dental clinic at the Royal College of Dentistry, King Saud University in Saudi Arabia were randomly assigned to receive either audiovisual distraction (watching their favourite cartoons using the eyeglass system Merlin i-theatre™) or no distraction (control group). Children underwent three separate (max 30 min) treatment visits involving an oral examination, injection with local anaesthetic, and tooth restoration. The researchers measured the anxiety levels and cooperative behavior of the children during each visit using an anxiety and behavior scale, and monitored each child's vital signs, blood pressure, and pulse (indirect measures of anxiety). Children also rated their own anxiety and pain during each procedure.

During treatment, the children in the distraction group exhibited significantly less anxiety and showed more cooperation than those in the control group, particularly during the local anaesthetic injection. What's more, the average pulse rate of children in the control group was significantly higher during the injection compared with children in the distraction group. However, the children themselves did not report differences in treatment-related pain and anxiety.

The authors conclude that audiovisual distraction seems to be a useful technique to calm children and ensure that they can be given the dental treatment they need. However, they caution that because of the limited number of participants, further larger studies will be needed in general clinical settings to confirm the value of this audiovisual distraction tool.


Cigarette smoking alters the mouth microbiota

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soking significantly changes the mouth's microbiome, with potential implications for tooth decay and the ability to break down toxins, according to results published in the ISME (International Society for Microbial Ecology) Journal.

Cigarette smoking is the number one cause of preventable disease and mortality in the US, leading to 480,000 deaths annually, or 20% of all deaths.

Over 16 million people live with a smoking-related illness in the US, according to figures from the Centers for Disease Control and Prevention (CDC).

In 2014, the CDC estimated that 16.8% of Americans aged 18 years and over were cigarette smokers, or around 40 million adults.

Much recent research has focused on imbalances in the gut microbiota and how they relate to immune disorders such asCrohn's disease and gastrointestinal cancers.

There are around 600 species of bacteria in the human mouth. Over 75% of oral cancers are thought to be linked to smoking, but it remains unclear whether microbial differences in the mouth affect the risk for cancer.

Higher levels of Streptococcus in smokers' mouths

Researchers from New York University Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center have been using precise genetic tests to investigate the impact of smoking on the composition and action of oral microbiota.

The team used mouthwash samples from 1,204 American adults who are registered in a large, ongoing study into cancer risk, funded by the National Institutes of Health (NIH) and the American Cancer Society (ACS).

Participants were all aged 50 years or over. Among them were 112 smokers and 521 individuals with no history of smoking. There were also 571 people who had quit smoking, 17% of them having stopped within the past 10 years.

Using genetic tests and statistical data, the researchers analyzed the thousands of bacteria residing in the mouths of volunteers.

Results suggest that the oral microbiome of smokers is significantly different from that of people who have never smoked or are no longer smoking. In the mouths of smokers, the levels of 150 bacterial species were significantly higher, while levels of 70 other species were distinctly lower.

Proteobacteria made up 4.6% of overall bacteria in the mouths of smokers, compared with 11.7% in nonsmokers. Proteobacteria are thought to play a part in breaking down the toxic chemicals introduced by smoking.

By contrast, 10% more species of Streptococcus were found in the mouths of smokers, compared with nonsmokers.Streptococcus is known to promote tooth decay.

Recovery comes after quitting smoking

On quitting smoking, however, the oral microbiome appears to return to its previous state. In people who had smoked previously, but not in the last 10 years, the microbial balance was the same as in the mouths of nonsmokers.


Cleft Palate Dentistry Pediatrics / Children's Health Genetics Small molecule replacement therapy to rescue craniofacial defects

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At the 45th Annual Meeting & Exhibition of the American Association for Dental Research, researcher Shihai Jia, University of Utah, Salt Lake City, USA, presented a study titled "Small Molecule Replacement Therapy to Rescue Craniofacial Defects." The AADR Annual Meeting was held in conjunction with the 40th Annual Meeting of the Canadian Association for Dental Research.

PAX9 and MSX1 are known to be associated with human cleft palate and tooth agenesis. Mice lacking Pax9 or Msx1 die at birth with cleft palate and tooth developmental arrest at bud stage, and Pax9+/-;Msx1+/- gene in mutant mice have defects in incisor and the third molar development. In this study researchers explored the therapeutic use of small molecules to rescue the craniofacial defects by manipulating signaling pathway involved in craniofacial development. This translational study provides novel candidates for the therapeutic treatment of the patients with craniofacial defects.

To increase Wnt signaling activities, the Dkk1 inhibitor WAY-262611 was injected into the tail vein of pregnant Pax9+/- mice, which had been mated with Pax9+/- or Msx1+/- males for Pax9-/- and Pax9+/-;Msx1+/- embryos, during the embryo developmental stage of palate and tooth formation. To modulate Eda/Edar signaling pathway, anti-Edar antibody was injected into the tail vein of pregnant Pax9+/- mice at embryonic day E9.5. The phenotypes were analyzed at E18.5 via whole mount view and HE stained sections. WAY-262611 treatment partially rescued palatal defects in Pax9-/- embryos, tooth buds advanced to the early cap stage compared with developmental arrest at bud without treatment. However, correction of the craniofacial defects did not prevent postnatal death of Pax9-/- pups. Similarly, Pax9-/- embryos treated by anti-Edar antibody had fused palate shelves with tooth buds advanced to the early cap stage. In addition, both of the treatments could restore the 3rd molar formation in Pax9+/-;Msx1+/- mice. Neither WAY-262611 nor Anti-Edar antibody had negative effects on the mother or control littermates.

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