Watching cartoons could help children overcome anxiety of dental treatment

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.

Article: Effects of audiovisual distraction on children's behaviour during dental treatment: a randomized controlled clinical trial, Amal Al-Khotaniabc, Lanre A'aziz Belloc, Nikolaos Christidisab, Taylor & Francis Online, doi: 10.1080/00016357.2016.1206211, published online 13 July 2016.

Cigarette smoking alters the mouth microbiota

Smoking 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.

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Smokers' mouths have lower levels of the bacteria that break down smoking-related toxins.

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 as Crohn'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.

Fast facts about quitting smoking

  • In the US, there are more former smokers than current smokers, according to the CDC
  • In 2010, 68.8% of American smokers wanted to quit
  • In 2013, 48% of smokers in high school had tried to quit in the past year.

Learn more about quitting smoking

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.

Senior investigator and epidemiologist Jiyoung Ahn, PhD, says:

"Further experiments will be needed, however, to prove that these changes weaken the body's defenses against cancer-causing chemicals in tobacco smoke, or trigger other diseases in the mouth, lungs or gut."

Co-lead investigator Brandilyn Peters, PhD, points out that the results do not reveal how long it takes former smokers' microbiome to find its balance after quitting.

The authors are planning further studies to establish the precise timeline for recovery of the bacterial community in the mouth.

They also hope to understand the biological changes that occur in the oral microbiome as a result of smoking, and how these changes might affect the risk for various cancers of the mouth and elsewhere in the body.

Medical News Today recently reported on research suggesting that the effect of some smoking cessation therapies may be limited.

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