Heba Mohamed Elkhodhary

Objective: To evaluate visual attention patterns in anxious versus non-anxious children toward various environmental distractions in a dental clinic using eye-tracking technology and assess the impact of visual distractors on gaze behavior. Materials and methods: This cross-sectional study, including 121 children 6–12 years of age. Anxiety levels were determined using the Children’s Fear Survey Schedule–Dental Subscale. Standardized operatory images, with and without distractors, were presented while eye-tracking metrics were recorded. Heatmaps were generated and group comparisons were performed using non-parametric tests. Results: Nearly one-half (49.6%) of participants were classified as anxious who, in the absence of distractors, exhibited faster entry times and longer dwell times on dental instruments and handpieces than their non-anxious counterparts ( p < 0.001). Introduction of distractors significantly redirected gaze toward child-friendly elements, altered fixation sequences, and reduced revisits to clinical tools. Children in both groups consistently focused on clinicians’ eyes, with decorated masks attracting further attention. Conclusion: Anxious children demonstrated distinct gaze patterns compared with their non-anxious peers, exhibiting faster orienting and altered engagement with dental instruments. Introduction of visual distractors significantly redirected attention toward child-friendly elements and away from anxiety-provoking stimuli, emphasizing the influence of anxiety on visual focus and the effectiveness of environmental modifications in improving the pediatric dental experience. Clinical relevance: This study contributes to the design of anxiety-reducing pediatric dental environments by identifying elements that attract the visual attention of children. The presence of appropriate distractors within the pediatric dental clinic may help redirect children’s gaze away from clinical tools and instruments. These findings can inform the design and layout of pediatric dental clinics to enhance comfort and patient cooperation, ultimately improving the overall quality of pediatric dental care.

Background/Objectives: The study evaluates pain perception in children aged 5–9 during dental extractions, comparing intraligamentary anesthesia (ILA) delivered with a Computer-Controlled Local Anesthetic Delivery System (CCLADS) vs. the traditional inferior alveolar nerve block (IANB). Methods: A randomized clinical trial with 60 healthy, cooperative children measured pain both subjectively using the Wong–Baker Faces Pain Rating Scale (WBFPRS) and objectively using the Sound-Eye-Motor (SEM) scale. Results: Results showed significantly lower mean pain scores with CCLADS during anesthesia administration: WBFPRS was 2.0 ± 2.2 vs. 6.9 ± 2.6 for IANB (p < 0.001). Objective SEM scores during anesthesia delivery were also lower with CCLADS (3.7 ± 0.8) compared with IANB (5.7 ± 1.2) (p < 0.001). During the extraction itself, SEM scores did not differ significantly between groups. Conclusions: The authors conclude that ILA via CCLADS reduces discomfort during anesthesia without compromising anesthetic effectiveness.

Objectives: This study aimed to evaluate the experience and consequences of dental caries and erosion in children aged 1–14 years on long-term liquid medications compared to those not on these medications. Methods: A cross-sectional observational study was conducted using a WHO-adapted questionnaire, medical surveys, and oral examinations. Participants included children with nephrotic syndrome in two groups: those on long-term liquid medications for at least three months (study group) and those not taking liquid medications (control group). The Decayed, Missing, and Filled Surfaces index (dmfs/DMFS) assessed caries, while the Pulpal Involvement, Ulceration, Fistula, and Abscess index (PUFA/pufa) measured caries consequences. The Basic Erosive Wear Examination index (BEWE) assessed erosion. Results: A total of 64 participants were included, with 33 in the study group and 31 in the control group. The study group had a significantly higher mean dmfs/DMFS of 16.9 ± 12.6 versus 5.2 ± 4.0 in the control group (p < 0.001). The PUFA/pufa index was also higher in the study group (0.8) compared to the control group (0.1) (p = 0.009). Erosion showed a non-significant increase with a BEWE score of 0.2 vs. 0.03 in the control group (p = 0.053). Conclusions: Long-term liquid medication use significantly affects dental caries in children after three months.

Background/Objectives: Sugar added to pediatric oral medications may increase the risk of dental caries and erosion. Parental awareness and practices play a crucial role in minimizing the oral health risks associated with such medications. Therefore, the aim was to assess parents’ knowledge, attitudes, and practices regarding the cariogenic potential of pediatric oral medications in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted using an online questionnaire. Parents who had at least one child between 2 and 12 years old were included. Participants were categorized into three groups based on the long-term intake of medications and their child’s health status. Group 1: Parents of children with chronic diseases on long-term medications. Group 2: Parents of healthy children on long-term medications. Group 3: Parents of healthy children not on long-term medications. Results: A total of 2195 responses were collected. The majority of parents were aged 31–40 years. More than half of the mothers and fathers had a diploma or a university degree (59% and 54.3%, respectively). Although a high proportion of the parents (78–83%) were aware that medications often contained sugar, only 46–50% were aware of their cariogenic potential, while 27–38% speculated about their erosive potential. In terms of practices, most parents encouraged their children to drink water (70–71%) or rinse their mouths (14–20%) after medication intake. Conclusions: While most parents were aware that pediatric oral medications may contain sugar, there was a lack of proactive measures to mitigate their negative impact on oral health. Further studies are still needed to evaluate and improve public awareness and practices regarding the oral health risks associated with pediatric medications.

Purpose: The concept of Chemomechanical Caries Removal (CMCR) includes the selective removal of caries-infected tissue while preserving caries-affected tissue. However, studies examining its application to children are scarce. The aim was to assess pain perception and time duration of CMCR agents when removing caries in primary molars in a sample of children compared to the conventional method of caries removal using rotary burs. Methods: A randomized controlled clinical trial with a split-mouth design with a sample of 60 children aged 4–9 years with 120 cavitated occlusal carious primary molars was equally distributed into 2 experiments: BRIX3000^® vs. conventional method (Experiment 1) and Carie-Care™ vs. conventional method (Experiment 2). The time duration of caries removal was recorded. Perception of pain during caries excavation was evaluated using the “Wong-Baker FACES^® Pain Rating Scale.” Results: Caries removal using the conventional method was significantly faster compared to CMCR agents in both experiments (P < 0.001 and P < 0.001). Caries removal using BRIX3000^® was significantly faster than Carie-Care™ (P < 0.001). Caries removal with BRIX3000^® or Carie-Care™ were reported less painful than the conventional method (P = 0.002 and P = 0.011, respectively). Conclusion: The study concluded that although CMCR methods require more time for caries removal, they were reported to be less painful. Trial registration: The study protocol was registered at www.clinicaltrials.gov under the identifier NCT05427591.

Background: The growing demand for esthetic restorative materials highlights the need to evaluate their marginal accuracy and fracture resistance to ensure optimal clinical outcomes for primary molars.Aim: The aim was to assess the vertical marginal gap distance and fracture resistance of esthetic restorative materials after cyclic loading.Design: Forty extracted primary molars were randomly divided into four groups: Group I, stainless steel veneered crowns with tooth‐colored material; Group II, prefabricated monolithic zirconia crowns; Group III, yttria‐partially stabilized zirconia computer‐aided design/computer‐aided manufacturing (CAD/CAM) crowns; and Group IV, hybrid ceramic CAD/CAM crowns. A stereomicroscope was used to measure the vertical marginal gap distance. The fracture resistance was then evaluated by applying cyclic loading.Results: Group I (1710 μm) exhibited the highest total median vertical marginal gap distance, followed by Groups II, III, and IV (418.3, 341.7, and 86.7 μm, respectively; with an overall statistically significant difference, p < 0.001). Regarding fracture resistance, Group III exhibited the best performance (2018.5 ± 236.0 N), followed by Groups II, IV, and I (1185.4 ± 326.1, 782.8 ± 278.5, and 728.3 ± 247.4 N, respectively). The CAD/CAM crowns exhibited better marginal gap distances than the prefabricated crowns. The CAD/CAM hybrid ceramic crowns exhibited better marginal accuracy than the CAD/CAM zirconia crowns.Conclusions: Zirconia crowns showed promising results regarding marginal adaptation, whereas hybrid ceramics showed promising results regarding fracture resistance.

Background/Objectives: Obesity and dental caries are significant health issues affecting children worldwide. This study aims to investigate the prevalence of obesity and dental caries among kindergarten children in Saudi Arabia during the early implementation years of the Vision 2030 initiative. Specifically, it examines the obesity rates between public and private kindergartens and assesses the correlation between obesity and caries risk. Methods: We conducted a cross-sectional study involving a stratified sample of 347 kindergarten children in Jeddah, Saudi Arabia, from September 2022 to March 2023, as part of a larger project assessing the obesity and dental caries prevalence in school-aged children. Their body mass index (BMI) was computed after their weight and height were measured. Following an oral examination, the decayed, missing, and filled teeth (dmft) scores were noted. The relationships between dmft and BMI, sex, and school type were studied using non-parametric tests, and its predictors were assessed as well. Results: Our findings indicate that 15.3% of the children were classified as obese based on the BMI measurements, while 9.8% were categorized as overweight. The prevalence of obesity did not show significant differences by school type when classified by BMI. The mean dmft score was 2.8 ± 3.6, with those children in public kindergartens demonstrating significantly higher dmft scores compared to their private counterparts (p < 0.001). Notably, there was no observed relationship between obesity and caries activity. Conclusions: Despite the implementation of Saudi Vision 2030, the high prevalence of obesity and dental caries among kindergarten children suggests that the current health initiatives may be insufficient. The lack of a relationship between obesity and caries activity highlights the complexity of these health issues and the need for targeted interventions. To improve the health outcomes, it is recommended to enhance the awareness campaigns regarding oral health and nutrition, increase access to preventive dental care, and integrate nutrition education into kindergarten curricula.

Saudi Vision 2030 was launched in 2016. Obesity and dental caries are both highly prevalent in Saudi adolescents and have been targeted by the Vision’s health initiatives. The aim is to assess their prevalence in adolescents during the first decade since the launch of the Vision. This cross-sectional study was conducted in Jeddah, Saudi Arabia using a stratified sample of 571 high school students, with an average age of 16.7 (0.6). Their height and weight were measured, and their body mass index (BMI) was calculated. The decayed, missed, and filled scores (DMFTs) were recorded after an oral examination. Non-parametric tests were used to assess the associations of DMFT with BMI, sex, and school type; and its predictors were assessed. One-third of males were overweight/obese compared with 22% of females. Males exhibited higher DMFTs than females. DMFTs were higher among public school students than among their private school counterparts. No significant association was observed between DMFT and BMI. Sex and school type were significant predictors of DMFT. The prevalence of obesity has slowly decreased in adolescents, but the prevalence of dental caries has not. There was no significant relationship between these conditions. Saudi Vision 2030’s current preventive/educational initiatives may be more effective in combating obesity than dental caries.

Journal of Clinical Pediatric Dentistry (JOCPD) is an international, peer-reviewed, open access journal, which is currently indexed in SCIE, etc., aming to provide clinically relevant information to enable the practicing dentist to have access to the state of the art in pediatric dentistry.

This study aims to assess whether parents of children who previously received comprehensive dental treatment under general anesthesia (GA) would prefer comprehensive dental treatment under GA over regular dental care if any of their other children required comprehensive dental treatment. In this cross-sectional study, parents of children who met the inclusion criteria were interviewed by a trained pediatric resident about parental-related factors as well as their satisfaction with their previous GA experience. Also, the factors related to the previously treated child were obtained from dental records. Statistical analysis was carried out, and the p value was set to 0.05. A total number of 306 parents were included. Although most parents, 293 (95.8%), showed satisfaction with the previous GA, 170 (58%) of the satisfied parents preferred regular care. Parents of children who were previously treated under GA for medical-related reasons (p = 0.018), fathers working in a governmental sector (p = 0.021), and families with low-average monthly income (p = 0.017) significantly preferred regular care. In conclusion, most parents were satisfied with the previous GA experience. Family income, fathers’ occupation, and medical-related factors can influence parental preference for comprehensive dental treatment under general anesthesia if any of their other children require comprehensive dental treatment.