Aim . To evaluate the incidence and severity of postendodontic treatment pain (PEP) subsequent to root canal treatment (RCT) in vital and necrotic pulps and after retreatment. Methodology . A prospective study. Participants were all patients ( n = 274) who underwent RCT in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment, by one clinician, during an eight-month period. Exclusion criteria were swelling, purulence, and antibiotic use during initial treatment. A structured questionnaire accessed age, gender, tooth location, and pulpal diagnosis. Within 24 h of treatment, patients were asked to grade their pain at 6 and 18 hours posttreatment, using a 1–5 point scale. Results . RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP (63.8%; 2.46 ± 1.4, resp.) than RCT of teeth with necrotic pulp (38.5%; 1.78 ± 1.2, resp.) or of retreated teeth (48.8%; 1.89 ± 1.1, resp.). No statistical relation was found between type of pain (spontaneous or stimulated) and pulp condition. Conclusion . RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth.

Background The COVID-19 pandemic was associated with several changes in maintenance of children's dental health. The aim of the present study was to evaluate the extent of these changes. Methods Parents were asked to anonymously respond to a questionnaire regarding alterations in their children's oral-habits, such as frequency of eating and drinking, tooth brushing, signs of stress and receiving dental care during the lockdown period. The participants were reached either during their visit to the clinics or by social media groups of the authors. Results 308 parents to children aged 1-18 years responded to the questionnaires. Associations were shown between increased frequency of eating and drinking, decreased frequency of tooth brushing, and postponing dental care. Of the children, 11% suffered from more frequent oral signs of stress, such as temporomandibular disorder and aphthous-stomatitis, during the lockdown. Although children from all age-groups ate and drank more frequently between meals, younger children were diagnosed with more carious lesions during the lockdown (P=0.015). Conclusions During the lockdown many children changed their eating, drinking and tooth-brushing habits, and thus increased their own risk for development of caries.

Purpose. To compare errors in digital panoramic radiographs of permanent and mixed dentitions. Methods. 143 and 146 digital radiographs of mixed and permanent dentitions were examined. Results. Significantly fewer errors presented in the mixed dentition. Positioning too forward significantly prevalent in the mixed dentition; slumped position and nonpositioning of chin properly were significantly prevailed in the permanent dentition. Blurred or shortened upper incisors were significantly more prevalent in the mixed dentition. Diagnostic ability could be improved by manipulating the brightness or contrast in nearly 45% of all radiographs. In the mixed dentition, tilting the chin down and a slumped position made the lower incisors significantly nondiagnostic. In the permanent dentition, tilting the chin down made the lower incisors to be significantly nondiagnostic. Conclusions. More errors were prevalent in panoramic radiographs of permanent dentitions. Properly positioning the patient is the most important factor in preventing a cascade of errors.

AimTo describe a small series of six cases of children who were diagnosed as uncooperative and referred to general anesthesia to complete their dental treatment. These children were actually exhibiting pain-related disruptive behaviors during previous dental treatments; we determined the reasons for ineffective anesthesia.BackgroundOne of the most common reasons for disruptive behaviors in children during operative dental treatment is the experiencing of pain during treatment. Disruptive behavior may lead to treatment under general anesthesia.Case descriptionParents of six uncooperative children referred to general anesthesia for dental treatment, arrived at our clinic, because they wanted a second opinion. The children were found to be nonresponsive to the common anesthetic technique and were treated by several approaches to increase the effectiveness of anesthesia. These included supplementary anesthesia to accessory innervation (in three cases), changing brands of anesthetic (in two cases), injecting the maximal dose at once to prevent tachyphylaxis, and waiting 5 minutes to achieve effectiveness of anesthesia (in one case). After achieving effective anesthesia, all the children fully cooperated during the operative treatment.ConclusionIneffective anesthesia can lead to severe disruptive behavior when continuing the treatment irrespective to the sensation of pain. Several approaches were used to increase the effectiveness of anesthesia resulting in cooperation of the pediatric patients.Clinical significanceBehavioral response to ineffective anesthesia may be diagnosed as uncooperativeness. Effort should be put to differentiate between ineffective anesthesia and uncooperative patient.How to cite this articleMalka A, Maya G. Pain-related Disruptive Behavior during Dental Treatment Interpreted as Uncooperative Behavior—Small Case Series. Int J Clin Pediatr Dent 2019;12(4):347–351.