Sigalit Blumer

Local anesthetic injections are an essential tool in dentistry, particularly in pediatric dentistry. The needle penetrating the tissue can cause stress, anxiety, and pain. Studies have shown that using touch may alleviate pain and reduce patient anxiety. Yet, this has not been tested in pediatric dental patients. Therefore, this study examined the effect of hand-holding on children undergoing local anesthetic injections. Its effect on children’s pain perception was tested, with the hypothesis that pain perception would be lower for children whose hand was held by an assistant. Additionally, the study examined whether hand-holding would affect children’s anxiety levels and cooperation. Fifty-five children, who underwent dental treatment within the Department of Pediatric Dentistry at Tel Aviv University, were recruited. The patients were randomly divided into two groups. In the study group, the assistant gently placed her hand on the patient’s hand during the anesthetic injection. In the control group, the same treatment was performed without the hand being placed by the assistant. After the anesthetic injection, the child’s pain and anxiety levels were assessed using visual analog scales (VAS). The patients’ pulse was measured. The level of cooperation was evaluated using the “Frankl” scale. Interestingly, although the trends aligned with this study’s hypotheses, no significant effect of hand-holding on pain, anxiety, or cooperation during anesthetic injections was found.

Purpose: The objectives of this study were to examine the effectiveness of diagnosing occlusal caries in molar teeth in children under the use of loupes and, secondarily, to examine whether there is a difference in the diagnosis between permanent and primary teeth using dental loupes. In addition, to check whether the student’s diagnosis using loupes improves caries diagnosis compared to dentists’ diagnosis in both methods. Methods: The data were collected from 163 patients aged 6–14 who sought treatment in the Pedodontic Department of the Faculty of Dentistry at Tel-Aviv University during 2020–2021. The first and second permanent molars and second primary molars with deep groves were examined. A student and dentists made the diagnosis with and without loupes while using the ICDAS criteria. Results: The student’s examinations without the loupes detected no caries in 60% of the cases compared to 76.9% in the examinations with the loupes and found initial caries without cavitation (ICDAS1) in only 17.6% of teeth without loupes examination compared to 33% using loupes. The dentist correctly diagnosed no caries (ICDAS0) in 82.1% of cases without loupes and initial caries without cavitation (ICDAS1) in 62.5% of cases. The dentist correctly diagnosed distinct caries without cavitation (ICDAS2) in 90.8% of cases. No differences were observed in caries diagnosis between primary and permanent teeth when the examiner was a specialist/intern using loupes; however, there was a statistically significant difference (p = 0.047) when the diagnosis was made by a student using loupes. Clinical significance: The use of dental loupes is an effective method for the correct and early diagnosis of occlusal caries lesions in children’s molar teeth by both dentists and students, and this is in accordance with the principle of minimally invasive dentistry. There is a justification for the use of dental loupes for the diagnosis of initial occlusal caries in primary and permanent molars in children in a precise way. Using loupes especially improves the correct diagnosis of initial caries in primary teeth by students.