USING COMMUNITY CULTURAL WEALTH NARRATIVES OF LOW-INCOME HIGH SCHOOL STUDENTS IN A RURAL NORTHERN CALIFORNIA COMMUNITY

This study examined the experiences of white, low-income high school students completing their senior year in a rural community and earning their diplomas. The purpose of the study was to examine participants’ stories during high school using a community cultural wealth framework and narrative methodological approach. Results showed that students utilized capitals such as social, moral, familial and resistant in their small communities. Multiple capitals interacted and influenced each other as rural youth draw on these for support

A randomized split-mouth clinical trial comparing pain experienced during palatal injections with two different computer-controlled local anesthetic delivery systems

Several methods have been proposed to reduce pain during injection. The main aim to this study was to compare the pain perception in patients receiving palatal injections of local anesthesia using two different computer-controlled local anesthetic delive

Dental students’ ability to locate emergency equipment‐lessons learned from aviation

PurposeThe purpose of this study was to evaluate the dental student’s ability to locate medical emergency equipment/items at the University of Michigan School of Dentistry clinic.MethodsA total of 138 second‐year dental students (traditional group) participated in this study as part of a simulation‐based medical emergencies rotation course held during the winter term of 2014 and 2015. Without prior training, students were tested on their ability to locate nine predetermined items on the clinic floor using a self‐reported checklist. Six months later, a convenience sample of 18 students (novel group) from the same cohort were later trained on their location and retested individually.ResultsOf the 138 students tested, only 10.14% students could locate seven of the nine items when compared to 100% in the novel group. Only 5.07% of students in the traditional group could locate all items initially, compared with 72.22% students in the novel group.ConclusionWhilst our students have lecture‐based knowledge about medical emergencies, the results of our study identified a gap of knowledge of emergency equipment/item location amongst students. Therefore, an intervention performed with a similar group of second‐year dental students supported that proper training may be used to achieve retention of knowledge. Based on our “novel group” results, we have incorporated targeted training in the dental curriculum that leads to students being better prepared in locating emergency equipment/items. This study suggests that other populations, such as faculty or staff, may also benefit from hands‐on training.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142451/1/eje12251.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142451/2/eje12251_am.pd

Effect of magnesium sulphate added to lidocaine on inferior alveolar nerve block success in patients with symptoms of irreversible pulpitis: a prospective, randomized clinical trial

AIM: To investigate the effect of magnesium sulphate used as an adjuvant to lidocaine with epinephrine local anaesthetic on the success of inferior alveolar nerve blocks (IANB) in patients with irreversible pulpitis undergoing root canal treatment. METHODOLOGY: In a double-blind clinical trial, following power calculation, 124 patients with symptoms of irreversible pulpitis in mandibular molar teeth were selected and initial pain data was collected using a Heft-Parker (Heft & Parker 1984) visual analogue scale. The first group (control) received IANB with 1.8 mL of a local anaesthetic solution containing 1.8% lidocaine with 1:88,000 epinephrine whist the second group (test) received IANB with 1.8 mL of an anaesthetic solution containing 1% magnesium sulphate, and 1.8% lidocaine with 1:88,000 epinephrine. Pain data was collected after access cavity and penetration of files in the canals using a Heft-Parker visual analog scale. Two patients were not included in the study as they did not consent and a further 54 patients were excluded as they did not report lip numbness within 15 minutes after IANB administration, thus the data presented in this study is related to 68 patients. The data were analyzed using chi-square and t- test (α=0.05). RESULTS: The success of pulpal anaesthesia with IANB was 82% for the magnesium sulphate group and 53% for the control group. There was a significant difference in the effectiveness of the IANB between the 2 groups (P < 0.001). There was no significant difference between the magnesium sulphate and control groups regarding gender (P =0.598) or age (P = 0.208) or initial pain scores (P = 0.431). CONCLUSIONS: The addition of 1% magnesium sulphate to 1.8% lidocaine with 1:88,000 epinephrine resulted in a positive impact for the success of IANB in patients with a diagnosis of irreversible pulpitis related to mandibular molar teeth undergoing root canal treatment. Thus magnesium sulphate may be used as adjuvant for achieving profound pulpal anaesthesia in challenging cases. However, more studies with larger sample size and different concentration doses must be carried out to establish an appropriate conclusion before its routine clinical use

The Odyssey of Dental Anxiety: From Prehistory to the Present. A Narrative Review

Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness. Basic emotions are related to survival functions in an inseparable psychosomatic unity that enable an immediate response to critical situations rather than generating knowledge, which is why many anxious patients are unaware of the cause of their anxiety. Archeological findings suggest that humans have been surprisingly skillful and knowledgeable since prehistory. Neanderthals used medicinal plants; and relics of dental tools bear witness to a kind of Neolithic proto-dentistry. In the two millennia BC, Egyptian and Greek physicians used both plants (such as papaver somniferum) and incubation (a forerunner of modern hypnosis, e.g., in the sleep temples dedicated to Asclepius) in the attempt to provide some form of therapy and painless surgery, whereas modern scientific medicine strongly understated the role of subjectivity and mind-body approaches until recently. DA has a wide range of causes and its management is far from being a matter of identifying the ideal sedative drug. A patient's proper management must include assessing his/her dental anxiety, ensuring good communications, and providing information (iatrosedation), effective local anesthesia, hypnosis, and/or a wise use of sedative drugs where necessary. Any weak link in this chain can cause avoidable suffering, mistrust, and emergencies, as well as having lifelong psychological consequences. Iatrosedation and hypnosis are no less relevant than drugs and should be considered as primary tools for the management of DA. Unlike pharmacological sedation, they allow to help patients cope with the dental procedure and also overcome their anxiety: achieving the latter may enable them to face future dental care autonomously, whereas pharmacological sedation can only afford a transient respite

Inferior alveolar nerve injury associated with implant surgery

Objectives Inferior alveolar nerve ( IAN ) is the most commonly injured nerve (64.4%) during implant treatment. At present, no standardized protocol exists for clinicians to manage IAN injury related with implant surgery. Therefore, the purposes of the present article were to analyze the reasons for nerve injury and to propose guidelines in managing IAN injury. Material and methods Patients with IAN sensory disturbances after implant treatment were recruited for the study. Sixteen patients, eight men and eight women, with a mean age of 52.2 ± 8.1 years participated in this study. Patient examination, treatment, and IAN sensory function recovery monitoring were performed following six‐step IAN injury during dental implant surgery ( IANIDIS ) protocol. The control group was composed of 25 healthy volunteers who never had IAN sensory disturbances or any trauma in the maxillofacial region. Results The IAN sensory disturbances were scored as following: 5 (31.25%) had hyperalgesia and 11 (68.75%) expressed hypoalgesia. The mean asymmetry index ( AI ) was calculated for each patient and varied from 0.6 to 3.2. Overall, 31.3% of nerve injury patients were classified as mild, 31.3% as moderate, and remaining 37.5% as severe injury. All patients were successfully treated with proposed IANIDIS protocol. Conclusion The most frequent (50%) risk factor for IAN injury was intraoperative bleeding during bone preparation. The most common (56.3%) etiological risk factor of nerve injury was dental implant. A six‐step protocol aimed at managing patients with IAN injury, during dental implant surgery, was a useful tool that could provide successful treatment outcome.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96264/1/clr2314.pd