Pain control is an important part of dentistry, particularly in pediatric dentistry. Recently, a computer-controlled local anesthetic delivery system (CCLAD) has been developed to reduce pain related to the local anesthetic injection. In conjunction with this technology, a new approach to the anterior and middle superior alveolar nerves (AMSA) has been induced. Studies evaluating the CCLAD in pediatric dentistry showed variable results regarding its use in pediatric dentistry. Further evaluation of this technique is needed to provide sound scientific evidence on the use of the CCLAD at this specific injection site in children. Aim:To assess children's pain reactions and pain perceptions of the AMSA injection using the CCLAD compared to the traditional buccal/palatal injections. Materials and methods: Children's pain reactions and perceptions to both techniques were measured in a group of 40 children who received both anesthetic techniques alternatively on two visits. The pain reactions were scored using the SEM scale, whereas the pain perception was evaluated by the Eland color scale. Statistical analysis was carried out using SPSS version 10.0.Results: The AMSA injection delivered with the CCLAD had significantly lower mean pain reaction scores compared to traditional buccal and palatal injections. The prolonged injection time required for delivering the CCLAD injection had no negative impact on the children. The children's pain perception scores when using the CCLAD were also significantly lower compared to the traditional injection. Conclusion: The AMSA injection delivered with the CCLAD was found to be a promising device, and had significantly lower pain reaction and perception scores compared to the traditional buccal and palatal injections.

Early assessment of the oral health status of children has the potential to reduce or even eliminate oral diseases. Parents rarely take their children to dentist early enough to control dental diseases. However, parents contact pediatricians several times even before the child is born and during the child's early life. Accordingly, pediatricians are considered a perfect and reliable source for oral health control and prevention.Aim: To measure the dental knowledge, attitude and behavior (KAB) of pediatricians in the City of Jeddah regarding oral health status and methods for prevention of dental diseases in children. Materials and method: Questionnaires consisting of 40 demographic and KAB's questions were distributed to all pediatricians in Jeddah city (605 pediatricians). The KABs' questions consisted of general dental knowledge, preventive dental measures, timing for referral, diet counseling, parafunctional habits and handling of traumatized teeth. A score was given for each question. Percentages of total scores of KABs were compared.Results: The response rate of pediatricians in Jeddah city (363) was 60%. Their mean age was 39.57 years. Pediatricians' KABs were found to be unsatisfactory. The most important observation was that the concept of oral health prevention was deficient. Pediatricians' awareness of fissure sealants, fluoride, dietary counseling,time of first dental visits and thumb sucking were quite limited. Pediatricians' knowledge was significantly lower than their attitude and behavior's scores. Conclusion: In general, pediatricians' knowledge,attitudes and behavior regarding oral health were not satisfactory.

Recent trends in the management of dentoalveolar traumatic injuries to primary and young permanent teeth REVIEW ARTICLE BackgroundOne of the commonly encountered dental emergencies is dentoalveolar traumatic injuries (DTIs). Unfortunately, DTIs result in fractured, displaced, or lost anterior teeth and this could have significant functional, esthetic, speech, and psychological effects on children thus affecting their quality of life (1). Although it is impossible to guarantee permanent retention of a traumatized tooth, patient age, severity of injury, and timely treatment and follow up of the tooth using recommended procedures can maximize the chances for success (2,3). This review examines the recent trends in the management of DTI to primary and young permanent teeth. Electronic search of scientific papers from 1990s to 2009 was accomplished using Pub Med search engine. The inclusion criteria were English language, publication year, experimental studies and review articles, the age of the study group, and the management technique. The search terms used were the following: dental, trauma, injury, primary teeth, permanent teeth, enamel infraction, crown fracture, crown-root fracture, root fracture, luxation, avulsion, and replantation. In addition, some text books and guidelines were used in this review. A proper definition of DTI is an injury that results from an external force, involving the teeth, the alveolar portion of the maxilla or mandible, and the adjacent soft tissues (4, 5). Different frequencies of DTI are reported in the literature, depending on the employed methodology, the type of dentition, and patients' age.The frequency of DTI is inversely proportional to age (6, 7). Several epidemiological studies investigated DTI in schoolchildren by means of clinical examinations and questionnaires, which might increase significantly the number of cases (8, 9). The number of DTI decreases significantly when epidemiologic studies are performed in a hospital environment (6,10). This is attributed to two reasons: minor dental injuries such as concussion and subluxation are not usually reported in hospital settings, and school-based studies usually involved large slice of the community in contrast to the limited hospital reported cases.The greatest occurrence of DTI to the primary dentition is when motor coordination is developing and children are more susceptible to falls (6, 11). Most injuries to permanent teeth occur secondary to falls, followed by traffic accidents, violence, and sports (6,(12)(13)(14). Boys are twice as likely as girls to report DTI and are much more likely to experience such trauma more than once (7). Children with special needs are in more danger of having trauma than others. This occurs more frequently in people who have intellectual disability, sensory impairment, attention-deficit/hypersensitivity disorder, seizures, abnormal protective reflexes, or muscle incoordination (15)(16)(17)(18)(19)(20). Occlusal relationship is another risk factor because the frequency of DTI is significant...

The study aims to evaluate the anesthetic effectiveness of the Anterior and Middle Superior Alveolar (AMSA)injection administered through a computer-controlled local anesthetic delivery system (CCLAD), and compare it with the traditional buccal and palatal injections used to anesthetize maxillary primary molars.Materials and methods: the sample included 80 primary maxillary molars, divided into 2 equal groups:Pulpotomy and extraction groups. Each group was divided equally into 4 subgroups: A. First molars anesthetized with the traditional technique, B. first molars anesthetized with the CCLAD, C. second molars anesthetized with the traditional technique, and D. second molars anesthetized with the CCLAD. The evaluation was done single blind using SEM scale. Results: the AMSA injection with the CCLAD was found to be effective in anesthetizing maxillary primary molars in pulpotomy and extraction procedures. There was no significant difference between the two anesthetic techniques except in the step of gingival retraction buccally in, which the traditional injections were more effective than the CCLAD during extractions. No significant difference was found between first and second primary molars in the effectiveness of both techniques. Conclusion:the AMSA injection using CCLAD was found to be effective in children.

Aim:The present study was designed to determine whether maternal xylitol consumption through regular chewing of xylitol gums can affect the salivary mutans streptococci (MS), dental caries, and dental plaque levels of their children. Method: Study sample included 60 mother and child pairs with high salivary mutans streptococcus (MS) levels. Samples were randomly divided into experimental group (30 pairs) and control group (30 pairs). Mothers in the experimental group received xylitol chewing gum treatment three times/ day for three months, whereas the controls received fluoride varnish. Both groups received oral hygiene instructions, dietary counseling and restorative treatment. All children were examined after 6, 12 and 18 months from the initiation of the study to assess caries, plaque and salivary mutans streptococcus (MS) levels. Results showed that at 18 month the percent of children with high streptococcus levels in the control significantly increased when compared to the increase in the experimental group. Throughout the study, dmft scores of experimental children showed marginal non significant increase compared to controls that showed higher scores. Plaque scores revealed statistically non significant decrease among both groups. Conclusions: maternal xylitol consumption provided better preventive outcomes on salivary (MS) levels compared to fluoride varnish treatments.