Background: Vaping has become one of the most prevalent risk behaviors among adolescents and young adults worldwide. Although electronic cigarettes (ECs) are often perceived as safer than conventional tobacco, concerns regarding their impact on oral health are increasing. This systematic review aimed to critically evaluate and synthesize the available evidence regarding the association between e-cigarette use and oral health outcomes in adolescents and young adults. Methods: A systematic search of PubMed/MEDLINE, EMBASE, Scopus, and EBSCOhost databases was conducted for observational studies published within the last ten years. Studies evaluating oral health outcomes among adolescents and young adults were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool for Analytical Cross-Sectional Studies, and certainty of evidence was graded using the GRADE approach. Results: Eight observational studies met the inclusion criteria and were included in the qualitative synthesis. E-cigarette use was associated with increased caries risk, higher prevalence of gingival inflammation, alterations in salivary flow and pH, changes in oral microbiota—including increased levels of Porphyromonas gingivalis—and elevated frequencies of micronuclei in oral mucosal cells. Four studies were rated as having low risk of bias and four as moderate risk. The overall certainty of evidence was low for all outcomes due to methodological limitations, heterogeneity in outcome assessment, and inadequate control of confounding factors, including dual use of combustible tobacco products. Conclusions: Current evidence may suggest a possible association between e-cigarette use and adverse oral health alterations in adolescents and young adults. However, given the low certainty of evidence, residual confounding, and the predominance of cross-sectional designs, causal relationships cannot be established. Well-designed longitudinal studies that clearly differentiate exclusive e-cigarette users from dual users and adequately adjust for behavioral confounders are required to clarify the independent impact of vaping on oral health in this vulnerable population.

Background: Passive protective stabilization (PPS) remains controversial in pediatric dentistry, particularly in invasive procedures such as pulp therapy. This systematic review and meta-analysis aimed to evaluate current parental acceptance of PPS. Methods: A systematic search of PubMed/MEDLINE, Cochrane Library, Scopus, and Embase was conducted up to 25 November 2025. Cross-sectional studies assessing parental acceptance of PPS in children aged 2–10 years were included. Studies published in English within the last 10 years and including at least 100 participants were eligible. Case reports, reviews, editorials, and studies not aligned with the objectives were excluded. Risk of bias was assessed using the Joanna Briggs Institute checklist. A random-effects meta-analysis with logit transformation was performed. Heterogeneity was quantified using I² statistics. Certainty of evidence was evaluated using GRADE. Results: Five cross-sectional studies, including 1005 parents, were included. The pooled parental acceptance of PPS was 48.9% (95% CI: 29.0–69.2%), with substantial heterogeneity (I² = 97%). Acceptance was consistently higher in emergency situations and among parents of children with special health care needs. Three studies showed low risk of bias and two moderate risk. The overall certainty of evidence was rated as very low due to inconsistency and imprecision. Conclusions: Parental acceptance of PPS is context-dependent and influenced by treatment urgency and patient characteristics. Given the high heterogeneity and low certainty of evidence, results should be interpreted cautiously. Further high-quality research is required.

Objective: To systematically evaluate the effectiveness of virtual reality (VR) distraction systems in reducing pain perception and dental anxiety during pediatric pulp therapy procedures. Methods: A systematic review and meta-analysis was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD42026139774). PubMed/MEDLINE, Scopus, and Embase were searched for randomized clinical trials evaluating immersive VR distraction during pediatric pulp therapy. Risk of bias was assessed using RoB 2, and certainty of evidence was evaluated with GRADE. Random-effects meta-analysis was performed for pain outcomes. Results: Seven randomized clinical trials were included in the qualitative synthesis. Three parallel-group randomized controlled trials were included in the pain meta-analysis. VR distraction significantly reduced self-reported pain (SMD) = −1.28 (95% C.I. = −2.49 to −0.07; p = 0.038) compared with control interventions. Substantial heterogeneity was observed for both outcomes (I² > 93%). Most studies also reported improvements in behavioral cooperation, whereas physiological measures showed inconsistent findings. The certainty of evidence was rated as low for pain and anxiety outcomes. Conclusions: VR distraction may represent a promising non-pharmacological behavioral management strategy for reducing pain perception and dental anxiety during pediatric pulp therapy. However, these findings should be interpreted with caution because they are based on a small number of studies with substantial methodological heterogeneity. Further well-designed randomized clinical trials using standardized intervention protocols and outcome measures are required before firm conclusions or recommendations for routine clinical implementation can be established.

Background: Inappropriate antibiotic prescribing in dentistry contributes to antimicrobial resistance, a major global health concern. In pediatric dentistry, antibiotics are frequently prescribed despite guidelines discouraging their use in localized conditions such as apical periodontitis (AP). This systematic review aimed to evaluate patterns, indications, and adherence to clinical guidelines in antibiotic prescribing for AP and acute periapical abscess (APA) in children and adolescents. Methods: A systematic review was conducted in accordance with the PRISMA 2020 statement and registered in PROSPERO (CRD420261342269). The review question was structured using the CoCoPop framework. A comprehensive search was performed in PubMed/MEDLINE, Scopus, and Embase up to March 2026. Observational studies assessing antibiotic prescribing practices among pediatric dentists were included. Risk of bias was assessed using the Joanna Briggs Institute checklist, and certainty of evidence was evaluated using the GRADE approach. Results: Six cross-sectional studies were included. Adherence to prescribing guidelines ranged from 38.4% to 68.2%. Antibiotic prescribing rates ranged from 22.9% to 71.0% for AP and from 41.1% to 78.0% for APA. Pooled prevalence estimates increased from 36.0% (95% CI: 18.0–58.9%) for AP to 60.7% (95% CI: 46.1–73.5%) for APA. Amoxicillin was the most commonly prescribed antibiotic, followed by amoxicillin–clavulanic acid, and treatment duration was typically 5–7 days. Substantial variability in prescribing practices was observed. Conclusions: Antibiotic prescribing in pediatric dentistry remains inconsistent, with inappropriate use persisting in conditions where antibiotics are not indicated. Strengthening antimicrobial stewardship and improving adherence to evidence-based guidelines are essential to optimize antibiotic use.

Background/Objectives: Historical concerns regarding permanent dental staining have restricted the use of tetracycline antibiotics in children younger than 8 years. However, newer-generation tetracycline derivatives, particularly doxycycline, differ pharmacologically from first-generation tetracyclines and may present a lower risk of discoloration. This systematic review and meta-analysis evaluated the risk of dental staining associated with newer-generation tetracycline derivatives. Methods: It was conducted according to the PRISMA 2020 statement and registered in PROSPERO. PubMed/MEDLINE, Scopus, and Embase were searched. Methodological quality was assessed, and the certainty of evidence using the GRADE approach. A random-effects meta-analysis of comparative studies was performed using the risk difference (RD) as the summary effect measure. Results: Six observational studies fulfilled the eligibility criteria. Three studies reported no cases of dental staining following doxycycline exposure, whereas one study identified parent-reported discoloration in 2 of 18 evaluated children (11.1%). Dental staining was reported in 2 of 41 children (4.9%) treated with minocycline and in 2 of 12 children (16.7%) with tigecycline. Meta-analysis of the three comparative studies demonstrated no significant increase in the risk of dental staining among exposed children compared with controls (RD = 0.007; 95% CI −0.015 to 0.028; I² = 0%). Methodological quality ranged from moderate to high. According to GRADE, the certainty of evidence was low for doxycycline/minocycline and very low for tigecycline. Conclusions: Current evidence, although limited, suggests that short-course doxycycline is associated with little or no clinically relevant risk of permanent dental staining in children younger than 8 years. In contrast, the available evidence for minocycline and tigecycline remains insufficient to establish their dental safety.

Background: Pulpitis is a common cause of dental pain in children and is primarily an inflammatory condition that can be effectively managed with local operative treatment. Although antibiotics are indicated only in cases of systemic involvement or infection spread, they are frequently overprescribed in dental practice. This misuse contributes to antimicrobial resistance and adverse health outcomes. This systematic review aimed to evaluate antibiotic prescribing practices for pulpitis in pediatric patients and to assess adherence to current clinical guidelines. Methods: A systematic review was conducted in accordance with the PRISMA 2020 statement and registered in PROSPERO (CRD420261342269). A comprehensive search was performed in PubMed/MEDLINE, Scopus, and Embase up to March 2026. Observational studies assessing antibiotic prescribing practices among pediatric dentists were included. A meta-analysis of proportions was conducted using a random-effects model. Risk of bias was assessed using the Joanna Briggs Institute Checklist, and certainty of evidence was evaluated using the GRADE approach. Results: Five cross-sectional studies were included. Antibiotic prescribing rates for pulpitis ranged from 0.6% to 50.0%. The pooled prevalence of antibiotic prescribing was 14.0% (95% CI: 5.0–33.5%), with high heterogeneity across studies (I² = 95%). Amoxicillin and amoxicillin–clavulanic acid were the most commonly prescribed first-line antibiotics, while clindamycin was the most frequently reported alternative in patients with penicillin allergy. Treatment duration was generally consistent, ranging from 5 to 7 days. Conclusions: Although pediatric dentists tend to prescribe antibiotics more conservatively than general practitioners, inappropriate use remains prevalent, particularly in conditions such as pulpitis where antibiotic therapy is not indicated. These findings highlight a persistent gap between evidence-based recommendations and clinical practice and underscore the need for targeted antimicrobial stewardship strategies to optimize antibiotic use in pediatric dentistry.