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NIHR Signal Virtual reality can help reduce the pain and anxiety of stressful medical procedures for children
Virtual reality shows promise in helping to distract children from self-reported pain and anxiety during medical procedures. Younger children in particular may benefit from the intervention. This review of seventeen trials looked at virtual reality interventions tested in trials with children receiving treatment for burns, dental and tumour related health needs, and during needle insertion for intravenous access. Results suggested a marked impact on pain and anxiety of children from these immer...
NIHR Signal Honey may help painful mouth inflammation caused by cancer treatments
Compared to usual care, honey was more likely to reduce moderate or severe pain for patients after radiotherapy and/or chemotherapy treatment. This systematic review looked at trials from around the world comparing different types of honey with other treatments such as chamomile, golden syrup or placebo. The main outcome was the onset of moderately severe oral mucositis as measured by a range of standardised assessment scales. The findings suggest that honey might be useful, although whether t...
NIHR Signal Decontamination of the mouth or digestive tract was not linked to reductions in drug-resistant bloodstream infections in the intensive care unit
Decontamination strategies to remove potentially harmful bacteria from the mouth, throat and gut of critically ill patients don’t reduce the risk of intensive care unit-acquired bloodstream infections or deaths from bacteria that were resistant to antibiotics. The study was carried out in 13 intensive care units across Europe, including the UK, with moderate to high levels of antibiotic resistance (extended resistance in more than 5% of all bloodstream infections). This fills an important ...
NIHR Signal Cartoons are promising for reducing dental anxiety in children
Cartoons delivered on laptops, projectors or 3D goggles with sound can help distract anxious children who fear dental procedures. Dental anxiety can prevent children from attending the dentist for care, and this type of distraction could offer a useful tool to help them. This review looked at a range of audiovisual approaches tested in trials of healthy children receiving dental treatment under local anaesthetic. The children were assessed for physiological measures related to emotional state (...
NIHR Signal Redesigning oral surgery with enhanced primary dental care, electronic referral and triage may save overall costs
An electronic referral system including consultant-led triage and an advanced oral surgery service in primary care results in fewer people requiring oral surgery in hospital. It comes at a lower overall cost than the previous arrangement. About two-thirds of patients could be treated safely in enhanced primary settings rather than hospital. This NIHR-funded study implemented several changes, an electronic referral system which standardised and improved the level of information provided in refer...
NIHR Signal Pilocarpine improves dry mouth caused by radiotherapy
Out of several treatments tested, the drug pilocarpine gave the most significant improvement in dry mouth following radiotherapy for head and neck cancer. Less dry mouth and increased salivary flow were twice as likely after taking pilocarpine than after a dummy pill. Dry mouth from radiotherapy impairs quality of life. Although people can try simple measures at home, such as sucking ice cubes, they may wish to discuss pilocarpine treatment with their GP. Side effects from this medication are u...
NIHR Signal Fluoride varnish every six months helps protect children’s permanent teeth from decay
Fluoride varnish and fissure sealant are equally good at preventing tooth decay on children’s first permanent back teeth when applied to six or seven year olds in South Wales. Six applications of fluoride varnish were less expensive, by about £68 per child, for the NHS at 36 months compared to applying the more expensive fissure sealant. Children’s permanent back teeth are particularly vulnerable to decay when they first come through. The pitted biting surface can make these t...
NIHR Signal Chlorhexidine mouthwash is useful short-term for people with mild gum disease
In people with mild gum disease chlorhexidine mouthwash, in addition to tooth brushing, reduces plaque build-up in the first weeks or months of use. However, when used for longer than four weeks chlorhexidine mouthwash can lead to tooth staining and a build-up of chalky deposits on the teeth, called tartar. There is insufficient evidence to assess its effectiveness in people with moderate to severe gum disease. Plaque is a sticky bacteria-filled substance that forms on teeth and can cause gum d...
NIHR Signal Fluoride-based treatments alone are not enough to stop tooth decay in young children
Providing a set of additional fluoride-based treatments at dental appointments for children aged two to three years was no better than health education at preventing tooth decay. A range of public health measures to reduce sugar consumption are also needed. The treatment involved providing fluoride toothpaste and applying a fluoride varnish to the teeth at each six-monthly appointment for three years. This large NIHR-funded trial in Northern Ireland found no difference in the number of childre...
NIHR Signal Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children
A reduction intooth decay of about 27% can be expected from the supervised regular use of fluoride mouthrinsing by school children. Tooth decay has a significant impact on health and wellbeing. It is more common in disadvantaged communities and can be prevented by good oral hygiene and diet with reduced sugar intake. Children and young people are encouraged to brush their teeth regularly with fluoride toothpaste and some schools in the UK have supervised programmes to encourage this. This revi...
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