Salivary Cortisol Levels and its Implication on Behavior In Children with Autism during Dental Treatment.

UNLABELLED: The aim of the study was to estimate the diurnal variations of salivary cortisol in children with autism and healthy children and it's implication on behavior during non-invasive dental procedures. STUDY DESIGN: 50 children with autism and 50 healthy children in the age group between 6 to 12 years of both genders with the need for dental treatment were included in the study. Whole unstimulated saliva was collected from them during early hours of the day and during evenings for 2 consecutive days . The collected saliva was then subjected to electrochemiluminescence assay . Minimum invasive dental procedures like hand scaling, pit and fissure sealants and glass ionomer cement restorations were performed for the participants each time after the saliva sample collection and their behavior during the procedures was rated using Frankl's Behavior Rating Scale. RESULTS: Significant correlation was seen between cortisol levels and behavior in children with autism. As cortisol levels increased in children with autism, behavior worsened and as the cortisol levels decreased they showed positive behaviour. CONCLUSION: Cortisol acts as a stress marker and studying the diurnal variations of salivary cortisol can help us in attaining better knowledge about the behavior pattern and thereby assist us in modifying the behavior modification procedures and treatment planning in this group of special children.

A spectroscopic and surface microhardness study on enamel exposed to beverages supplemented with lower iron concentrations.

OBJECTIVES: This study aimed to compare the in vitro mineral loss and surface microhardness (SMH) changes in human enamel specimens following supplementation of acidic carbonated beverages with low iron concentrations than when treated without. STUDY DESIGN: 180 enamel blocks each from primary and permanent teeth were prepared and equally subdivided (n=10) for their respective treatments in Group 1 (Coca Cola and Sprite without iron supplementation) and Group 2 (beverages supplemented with 2/5 mmol/L FeSO4.7H2O). Following initial SMH estimation, the blocks were subjected to 3 treatment cycles of 5/20 minute incubation periods, equally interspaced by a 5-min treatment in artificial saliva. The calcium and phosphate released after each cycle were analyzed spectrophotometrically and the final SMH was recorded. The results were tested using student's T test, One-way ANOVA and Kruskal Walli's test (p<0.05). RESULTS: Two and five mmol/L FeSO4.7H2O supplementation produced a highly significant SMH change and calcium and phosphate reduction than when treated without (p<.0005). Both the enamel specimens showed similar patterns of mineral loss and SMH reduction, with pronounced effects in the twenty minute incubation cycles. CONCLUSION: Our results suggest that 2 mmol/L FeSO4.7H2O supplementation to acidic beverages is beneficial in reducing mineral loss and preserving surface microhardness of human enamel.

Knowledge of care providers regarding the oral health care of visually impaired children.

OBJECTIVE: To assess the awareness of care providers of visually impaired children regarding their oral hygiene. METHOD: A simple pre-structured questionnaire was given to the care providers and the awareness regarding their oral health was assessed. RESULTS: There was a general lack of awareness among the care providers of these children regarding dental diseases and its prevention. Furthermore, the importance of oral hygiene was found to be very low. CONCLUSION: The results obtained showed that most of the caretakers were unaware of the difficulties faced by these children in the maintenance of their oral health.

A novel music based tooth brushing system for blind children.

OBJECTIVES: To assess the Oral Health Status (OHS) of visually impaired children in South India, to devise and implement a specially designed Oral Health Education (OHE) program for them and to assess its efficacy in improving their OHS. STUDY DESIGN: OHS of 98 institutionalized visually impaired children aged 6 to 14 years were evaluated at the start of the study (Pre-OHE level) using the Modified Gingival Index (MGI), the Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index (MQHPI) and Streptococcus mutans colony count. Oral Health Education was imparted with the help of specially designed models and tooth-brushing taught with specially formulated music aided instructions in a song format. These parameters were re-evaluated after a period of reinforced (two weeks and one month) and non-reinforced (two months) tooth-brushing. RESULTS: Mean values of MGI and MQHPI showed a statistically very highly significant drop from the Pre-OHE level to the end of both the periods of reinforcement and non-reinforcement. There was a significant decrease in the S. mutans counts from the Pre-OHE levels to the period of non-reinforcement (p < 0.0005). CONCLUSION: The OHE program specially formulated for the visually impaired children was effective in improving their OHS significantly

Evaluation of salivary sialic acid levels in acute lymphoblastic leukemic children and its correlation with dental caries experience.

AIM: The aim of present study was to evaluate the salivary sialic acid levels in Acute Lymphoblastic Leukemic (ALL) children and to correlate it with dental caries experience. METHOD: A total of 120 children aged 4-10 yrs were divided into 4 groups of 30 each. Dental caries experience was recorded followed by un-stimulated saliva collection. RESULTS: The mean salivary sialic acid levels of the study group were much higher when compared with the control group, which was statistically significant. A linear relationship between salivary sialic acid levels and dental caries in leukemic children was observed. CONCLUSION: The findings of our study conclude that salivary sialic acid levels may have a potent activity in dental caries process and can be used as a useful marker in cancer

Lead exposure and its relation to dental caries in children.

UNLABELLED: Environmental pollution is a significant health hazard and is mainly caused by commercialization. The etiology of dental caries is multifactorial and one such factor is exposure to trace element such as lead. AIM: Hence, the present study was carried out to find out the correlation between the levels of lead in the enamel, saliva and dental caries in children. METHOD: 90 children aged 5 years consisting of both genders from different kindergartens along Coastal Karnataka were included in the study. The selected children were divided into 3 groups as; control group, early childhood caries (ECC) group and severe-ECC (S-ECC) group respectively. Enamel and salivary lead level was assessed by using graphite atomic absorption spectrophotometry. RESULTS: Mean enamel lead levels in the control, ECC and S-ECC group were 47.7, 85.45 and 90.43 ppm respectively and mean salivary lead levels were 0.23, 1.7 and 1.77 ppm respectively which was statistically very highly significant (p < 0.001) with no gender predilection. There was a positive correlation seen between the enamel and the salivary lead levels (p > 0.05). CONCLUSION: The enamel and the saliva of all the children had measurable amounts of lead and its levels increased with increase in severity of dental caries proving the cariogenic potential of lead. A positive correlation was seen between the enamel and the salivary lead levels.

Salivary sialic acid levels and dental health in children with congenital heart disease.

Congenital cardiac disease is one of the most common developmental anomalies in children. Higher caries prevalence and gingivitis compared to healthy children have been shown in children with congenital heart disease which has a significant implication in the medical care of these patients associated with bacteraemia and endocarditis. Sialic acids being terminal sugar components and marker of chronic inflammatory response are found to be present at higher levels in children with poor oral health status. So the present study aimed to evaluate the oral health status and salivary sialic acid levels among the children with congenital heart disease and normal healthy siblings. A total of 71 children with heart diseases aged 6-10 years attending various heart institutes were examined for oral hygiene status, gingival status and dental caries status by using modified WHO oral assessment form. A case-matched control group of 50 children were also examined. Salivary flow rate, pH and sialic acid levels were measured after saliva collection. The results were subjected to Unpaired t test and Pearson's Correlation Coefficient Test. The salivary pH, salivary flow rate, dental caries status, oral hygiene and the gingival status were significantly compromised with a positive correlation with the sialic acid levels in saliva, leading to increased treatment needs in the study group. Therefore the amount of sialic acid in the saliva can be a useful index of the severity of oral disease.

Evaluation of oral hygiene status, salivary characteristics and dental caries experience in acute lymphoblastic leukemic (ALL) children.

Leukemia constitutes approximately 30% of all childhood cancers and Acute Lymphoblastic Leukemia (ALL) is the most common type of malignancy. Oral dryness, ulceration, increased dental decay seen is due to altered salivary flow rate and buffering capacity in these children. Oxidative stress may play an important role in the malignancies resulting in onset of inflammatory oral pathologies. Saliva constitutes first line of defense against free radical-mediated oxidative stress. The present study attempted to relate the oral health status, salivary flow rate, salivary pH, gingival health status, dental caries experience and total salivary antioxidant levels in ALL children. A total of 120 children aged 4-10 years (90 leukemic children, study group and 30 normal healthy siblings, control group) were divided into 4 groups of 30 each. Oral health status, gingival status and dental caries experience was recorded followed by un-stimulated saliva collection. Total antioxidant capacity of un-stimulated saliva was evaluated. The results depicted deterioration in oral health status, gingival status and increased dental caries experience in leukemic children. Salivary flow rate, salivary pH and total salivary antioxidant levels were lowered in leukemic children when compared with control group.

Eating disorders and their implications on oral health--role of dentists.

Eating disorders (EDs) are primary psychological conditions, often associated with severing medical complications. EDs are characterized by perturbed eating behavior patterns. Their increasing incidence and prevalence is causing concerns to healthcare professionals. Because eating disorders are a complex issue, a multidisciplinary approach to treatment is required and this team includes Psychiatrists, Psychologists and Nutritionists. The purpose of this paper is to review the role of the dentists especially the pediatric dentist and orthodontist in identifying oral manifestations of EDs, which may be utilized for oral diagnosis, referral and management of underlying psychiatric condition and also secondary oral conditions.

Dental caries and salivary alterations in Type I Diabetes.

UNLABELLED: Insulin dependent diabetes mellitus is a severe disease that raises blood glucose levels because of hyperglycemia and insulinopenia. Fluctuations in water and electrolyte levels may result in xerostomia and other changes in the salivary composition. Since diabetes has an influence on oral health, it is important for the dentist to be aware of newer advances in the field of diabetes and to recognize specific oral problems related to diabetes. Thus, the dentist becomes an important part of the health care team for the patients with diabetes. AIM: The present study correlated salivary flow rate, salivary pH and total salivary antioxidant levels and dental caries in type I diabetic patients. METHOD: A total of 200 children that included 100 known diabetic children (study group) and 100 healthy children (controls) of both the sexes and from similar socioeconomic backgrounds formed the part of this study. Dental caries was assessed using DMFT index. The salivary total anti-oxidant level was estimated using phospho molybdic acid using spectrophotometric method. The salivary flow rate was recorded using the Zunt method and the salivary pH using the pH indicating paper. The results were statistically analyzed using t-test. CONCLUSIONS: The analyzed parameters showed increase in salivary anti-oxidant levels, reduced salivary flow rate, increase incidence of dental caries, salivary pH was decreased when compared to the control group.

Dermatoglyphic peculiarities in children with oral clefts.

In humans, the development of the primary palate and the lip is completed by the 7th week of intra uterine life and that of secondary palate by 12th week. The dermal ridges develop in relation to the volar pads, which are formed by the 6th week of gestation and reach maximum size between 12th and 13th weeks. This means that the genetic message contained in the genome--normal or abnormal is deciphered during this period and is also reflected by dermatoglyphics. Hence this study was done in order to observe the differences in dermatoglyphic patterns between the children with oral clefts and normal children and to determine the usefulness of dermatoglyphics in studying the genetic etiology of oral clefts. Dermatoglyphic data from 50 oral cleft children and 50 normal children were collected using the ink method and comparison was done between them. In the present study, we found an increase in the ulnar loop patterns on the distal phalanges of the ten fingers, an increase in the atd angle and an increase in the fluctuating asymmetry of the atd angle in the oral cleft children which indicates the degree of developmental instability of the oral cleft individual.

Caries prevalence amongst handicapped children of South Canara district, Karnataka.

This epidemiological investigation was carried out among 524 handicapped children in the age group of 3-30 years, attending 8 different non-residential special schools in South Canara district, Karnataka. The examination procedure and criteria were those recommended by W.H.O. in 1997. The total caries prevalence was found to be 71.56%. The mean deft in the primary dentition was found to be 3.06 +/- 3.14. The mean deft and DMFT in the mixed dentition were 3.32 +/- 2.82 and 1.14 +/- 1.08 respectively. The mean DMFT in the permanent dentition was 4.51 +/- 3.17. The prevalence of dental caries was higher in the mentally subnormal and handicapped children. The decayed component constituted the majority of the dental caries index. Lack of conservative approach to the treatment had been confirmed in the study.

Clinical evaluation of Carisolv in the chemico-mechanical removal of carious dentin.

The Chemo-mechanical caries removal technique involves the application of chemical agents, to cause a selective softening of the carious dentine and facilitate removal by gentle excavation. Carisolv is one such new chemical agent used in this minimal invasive technique of carious dentine removal. The present study was, therefore, undertaken to evaluate the efficacy of Carisolv in the chemo-mechanical removal of carious dentine, the time taken for caries removal, the perception of the treatment by the patient, and to evaluate the restorations, radiographically. Accordingly, fifty primary and permanent molars with dentinal carious lesions were excavated using this technique of caries removal. The chemo-mechanical caries removal technique using Carisolv proved to be an effective atraumatic treatment modality with potential interest for use in clinical pediatric dentistry.

Use of EMLA: is it an injection free alternative?

This study was conducted to evaluate the use of Eutectic Mixture of Local Anesthetics (EMLA) for various clinical procedures such as extraction of the mobile primary teeth, root stumps as well as pulpal therapy procedures in the primary teeth. Thirty children in need of routine dental procedures were selected and procedures were done under a single anesthesia of EMLA. Pain perception and the effectiveness of anesthesia were evaluated with the Eland's color scale and Lickert's scale respectively. Results showed that use of EMLA could to some extent eliminate the use of the needle in the procedures performed especially in pediatric dentistry.

Clinical evaluation of electronic dental anesthesia for various procedures in pediatric dentistry.

Electronic dental anesthesia (EDA) is a newer technique for achieving regional anesthesia by the application of transcutaneous electrical nerve stimulation (TENS). The present study intended to be an initial investigation of the attitudes of dentists and patients towards a relatively newly introduced EDA system. The purpose of the study was to evaluate the effectiveness of EDA system, a unit of TENS, in the management of pain during treatment procedures such as minor extractions, restorations (tooth preparations), and pulp therapy, in children. Overall, forty children between the age groups of 5 to 12 years were selected for three different clinical procedures. The response of the patients as well as the opinion of both, the clinician and the patient regarding perception of pain and comfort on administration I effectiveness of electronic anesthesia were recorded and analyzed. Significantly favorable results to the use of EDA were obtained, which indicate that EDA, besides offering safety and psychological advantages, may also be a promising alternative to the conventional methods of local anesthesia.

Ultrasonographic and electromyographic evaluation of the labial musculature in children with repaired cleft lips.

Muscle thickness and activity of the labial musculature in twenty seven children aged 4 to 12 years, with repaired cleft lips were measured using ultrasonographic and electromyographic techniques respectively. The results demonstrated that the muscle thickness and muscle activity were more at the repaired area when compared to that at the normal areas, adjacent to the repaired area, on either side. No significant positive correlation was noted between the muscle thickness and muscle activity.

Gallium alloy versus high copper amalgam: a comparative evaluation of corrosion resistance and microleakage in the primary teeth.

In vivo corrosion and in vitro microleakage of a gallium based and a high copper amalgam alloys were evaluated. Twenty-five primary molars each were restored with Galloy and DPI alloy respectively and evaluated, over a period of three months, for various aspects of corrosion in the oral cavity. Additionally ten primary molars were utilized for evaluation of microleakage by dye penetration after having them restored with the two materials. Gallium alloy restorations showed better marginal adaptation, clinically when compared to amalgam restorations. No significant difference was observed for the degree of microleakage around gallium alloy and amalgam restorations.

Relationship between the existing caries status, plaque S. mutans and Cariostat caries activity test in children.

An attempt was made in this study to find out the sensitivity and specificity of a caries activity test, CARIOSTAT and its relationship to the existing caries status and the plaque S. mutans level. The test proved to be highly sensitive and specific with significant relationship to the S.mutans count in the dental plaque. There also was a significant relationship between both the cultured microorganisms on MSB agar and the plaque in the Cariostat medium.