Impact of manual dexterity on toothbrushing efficacy in typically developing children: A cross-sectional study.

BACKGROUND: Manual dexterity includes gross motor skills (GMS) and fine motor skills (FMS). Literature reports manual dexterity as a contributing factor for improved oral hygiene and that the required dexterity for toothbrushing develops above 8 years of age. Research suggests grip force, movement speed, and motor coordination should be assessed to improve knowledge on kinetics of brushing teeth. AIM: To assess the impact of manual dexterity on toothbrushing efficacy in 7 to 12 year old children. DESIGN: The cross-sectional study included 150 typically developing 7-12 year old children. Oral health status was recorded using the Decayed, Missing, and Filled Teeth index. GMS and FMS were evaluated using the MInnesota Manual Dexterity Test (MMDT) and Archimedes spiral test (AST), respectively. Toothbrushing efficacy was determined by Turesky modification of Quigley-Hein Plaque Index- difference in mean scores from before and after toothbrushing. RESULTS: Assessment of GMS, FMS, and toothbrushing efficacy using ANOVA showed a significant increase with age (p value: 0.000); unpaired t-test showed an association of toothbrushing efficacy with GMS and FMS irrespective of age (p value: 0.000). CONCLUSION: Manual dexterity was significantly associated with toothbrushing efficacy in typically developing children. AST, a simple test to determine FMS, may help paediatric dentists to guide parents on the supervision of toothbrushing for their child.

Efficacy of eutectic topical anesthesia in stainless steel crown procedures for primary molars: A randomized controlled trial.

BACKGROUND: Prior literature highlights the importance of local anesthesia (LA) for stainless steel crown (SSC) preparation and placement. Nevertheless, the effectiveness of a eutectic mixture of local anesthesia (EMLA), a topical anesthesia, for this purpose remains unexplored. AIM: The study evaluated the effectiveness of two EMLA application methods during SSC preparation and placement. DESIGN: Eighty-four children between 4 and 8 years of age were randomly allocated to three intervention groups. Group A received EMLA applied supragingivally, Group B received a gingival retraction cord impregnated with EMLA (GRC_EMLA), and Group C (control) received LA. Pain was recorded using Wong-Baker Faces Pain Scale (WBFPS) and Children Hospital Eastern Ontario Pain Scale (CHEOPS) at three time intervals. RESULTS: Control had highest mean pain scores at the first time interval in both maxillary and mandibular arches, followed by Group B and Group A, with statistically significant p-values (p = .00, p < .05). After preparation and placement, all three groups had low mean pain scores, with no statistically significant differences. Group A had minimal pain scores at all three time intervals, although not statistically significant. CONCLUSION: EMLA is a potent topical anesthetic and can be used as an alternative to LA for conventional SSC preparation and placement in primary molars.

Evaluation of the effectiveness of sucrose versus xylitol application in minimizing pain related to dental injection in 5-7-year-old children - A randomized controlled pilot study.

Background: Oral application of sweet-tasting solutions has found to be effective in minimizing pain on dental injection in children. Xylitol has never been tested in this regard. Aim: The aim of this study was to compare the effectiveness of prior application of sucrose versus xylitol solution in minimizing pain on dental injection in 5-7-year-old children. Settings and Design: This study was a randomized controlled clinical trial. Materials and Methods: Informed consent was taken. A total of 30 children who required maxillary buccal infiltration injection were selected. The children were randomly allocated into the sucrose group, xylitol group, or control group by lottery method. In the sucrose and xylitol groups, 30% sucrose or 30% xylitol solution was applied on the lateral surface of the tongue for 2 min. In the control group, distilled water was applied. In all the groups, the topical anesthetic was applied at the site of injection followed by buccal infiltration. A video was taken during injection, and the sound eye-motor (SEM) scale was recorded by a blinded examiner. Patients were asked to self-evaluate using the Wong-Baker Faces Pain Scale (WBFPS). Statistical Analysis: Mann-Whitney test was used to analyze the data. Results: There was a statistically significant difference in the WBFPS and the SEM score between the sucrose and the control group (P < 0.05) and the xylitol and control group (P < 0.05). No statistically significant difference was found between the sucrose and xylitol group. Conclusion: The application of xylitol solution before dental injection was as effective as sucrose solution in minimizing pain during the injection.

Evaluation of dental anxiety in children with Down's syndrome using dog-assisted therapy: A pilot study.

BACKGROUND: Dental anxiety and fear are the major treatment challenges faced by pediatric dentists. Oral hygiene in children with Down's syndrome is highly compromised in comparison to their healthy counterparts. Animal-assisted therapy, through dogs, has been beneficial in alleviating dental fear and anxiety in healthy pediatric population. AIM: The aim of the study was to assess the impact of dog-assisted therapy (DAT) on children with Down's syndrome undergoing dental examination and fluoride varnish application in dental operatory. MATERIALS AND METHODS: Twenty children with Down's syndrome between 5 and 12 years of age were selected. Group A (intervention group): DAT was carried out in the dental operatory. Group B (control group): Dental treatment was performed in the absence of a therapy dog in the dental operatory. Anxiety levels were evaluated by recording the pulse rate and revised modified faces version of the Modified Child Dental Anxiety Scale (MCDAS[f]). STATISTICAL ANALYSIS: The intergroup comparison of pulse rate was done using an unpaired t-test, whereas the variation in intragroup pulse rate was analyzed using the Analysis of Variance test. The anxiety scores were subjected to a paired t-test for intragroup comparison with P < 0.05 considered to be statistically significant. RESULTS: Reduction in dental anxiety was observed in the intervention group (P < 0.001). CONCLUSION: DAT can be used as an effective behavior management technique for children with Down's syndrome undergoing dental examination and simple dental procedures in the dental operatory.

Inflammatory myofibroblastic tumor in the retromolar region of an 8-year-old child: A rare finding.

Inflammatory myofibroblastic tumor (IMT) of the oral cavity is an extremely rare finding. The etiology and pathogenesis of IMT is controversial and unclear. The tumor requires complete surgical excision and continuous monitoring of clinical consequences. The present article describes the clinical, histological, operative and immunohistochemical features of a case of IMT in the mandibular retromolar region of an 8-year-old male. Histologically, the lesion shows myofibroblastic spindle cell proliferations with infiltrative margins in an inflammatory background. Immunohistochemically, the myofibroblastic spindle cells in the present case were positive for α-smooth muscle actin and CD68 due to which the diagnosis of IMT was confirmed.

Correlation between Aerosol Therapy and Other Associated Factors in Early Childhood with Molar Incisor Hypomineralization.

Context: The etiology of molar incisor hypomineralization (MIH) has been extensively explored. Recently, the effect of drugs used in aerosol therapy in childhood has been implicated as a possible factor in the development of MIH. Aim: A case-control study was conducted in children aged 6-13 years to determine the association between aerosol therapy and other factors in the development of MIH. Materials and methods: A total of 200 children were examined for the presence of MIH according to the European Academy of Paediatric Dentistry (EAPD) criteria (2003). Their mothers or primary caregivers were interviewed regarding the preterm history and perinatal, and postnatal history of the child up to 3 years of life. Statistical analysis: The collected data were subjected to statistical analysis using descriptive and inferential analyses. The p-value ≤ 0.05 was considered statistically significant. Results: Statistically significant association was observed between the development of MIH and exposure to aerosol therapy in childhood and the use of antibiotics before 1 year of life. Conclusion: Exposure to aerosol therapy and antibiotics before 1 year of age are risk factors in MIH. Children who had aerosol therapy and antibiotics are 2.01 times and 1.61 times more prone to MIH. How to cite this article: Shinde MR, Winnier JJ. Correlation between Aerosol Therapy and Other Associated Factors in Early Childhood with Molar Incisor Hypomineralization. Int J Clin Pediatr Dent 2022;15(5):554-557.

Assessment of Antiplaque and Anti-Gingivitis Efficacy of Mouthwashes Prepared from Neem and Mango Extracts.

Objectives: This study aimed to determine the minimum inhibitory concentration (MIC) of mouthwashes prepared from neem and mango extracts against Streptococcus mutans (S. mutans) in vitro. Their taste acceptability and effects on plaque index (PI), gingival index (GI) and salivary pH were also evaluated and compared with chlorhexidine (CHX) in children. Materials and Methods: Dry extracts of neem and mango twigs were prepared and their MIC against S. mutans was determined. The effective MIC was used to prepare mouthwashes from the two extracts. Three parallel groups of children (n=30) used either neem, mango or 0.2% CHX mouthwash for 21 days. The PI and GI were recorded at baseline and at 7 and 21 days. The salivary pH and taste acceptability were also assessed. Results: The MIC of both extracts was achieved at 25% concentration. There was a significant difference between the GI score of mango group compared with neem and CHX at the three time points (P<0.001). There was no significant difference between the neem and mango groups in PI (P=0.674). There was no significant difference among the three groups in salivary pH either (P=0.817). Intragroup comparison showed significant reductions in PI, GI and salivary pH in all the three groups after 21 days (P<0.001). Conclusion: Neem and mango mouthwashes can be used as effective alternatives to CHX in children.

Impact of malocclusion on oral health-related quality of life in 10-14-year-old children of Mumbai, India.

AIMS AND OBJECTIVES: The aim and objective of this study was to establish the relationship of oral health-related quality of life (OHRQoL) as assessed by the Child Perception Questionnaire (CPQ 11-14) with the Index of Orthodontic Treatment Need (IOTN) and the child's apprehension with his/her dental appearance and how upset the child would feel if he/she is unable to obtain orthodontic treatment. MATERIALS AND METHODS: An observational cross-sectional study was conducted among 604 children between the age group of 10-14 years to analyze the effect of malocclusion on the quality of life of children on the basis of impact on oral symptoms, functional limitation, emotional well-being, and social well-being. Malocclusion was evaluated using the IOTN, and the CPQ 11-14 was used to study the OHRQoL in children. The collected data were then subjected to statistical analysis. STATISTICAL ANALYSIS: Spearman's correlation coefficient was used to analyze the data statistically. RESULTS: Out of the 604 children examined, boys showed effect on emotional well-being, whereas girls showed a significant correlation on both emotional and social well-being. There was a statistically significant correlation between IOTN and all the four domains of CPQ scores with respect to the two questions that were added to the CPQ questionnaire. CONCLUSION: A questionnaire when developed specifically for determining the effect of malocclusion on OHRQoL focusing more on emotional and psychological impact and less on oral symptoms and functional limitation will provide advantages of having limited questions, being less time-consuming, and providing better understanding of the patients' concern.

The comparative evaluation of the effects of tongue cleaning on existing plaque levels in children.

The present study compared and evaluated the effects of tongue scraping and tongue brushing on existing plaque levels in children. The investigation was a single blind, stratified comparison of three parallel groups of children who performed either tongue scraping or tongue brushing along with tooth brushing or only tooth brushing twice daily under professional supervision for a 21 day period. Dental plaque was recorded using the plaque index described by Silness and Loe at baseline, on day 10 and on day 21. All data was subjected to statistical analysis using Wilcoxon's Signed Ranks Sum Test and Mann-Whitney U-test. The results of the present study show that the tongue scraping and tongue brushing groups showed statistically significant reductions in plaque levels after 10 days and also after 21 days. It was also noted that both tongue scraping and tongue brushing were equally effective in reducing the plaque load in children. How to cite this article: Winnier JJ, Rupesh S, Nayak UA, Reddy V, Rao AP. The Comparative Evaluation of the Effects of Tongue Cleaning on Existing Plaque Levels in Children. Int J Clin Pediatr Dent 2013;6(3):188-192.

The relationship of two orthodontic indices, with perceptions of aesthetics, function, speech and orthodontic treatment need.

PURPOSE: The study was conducted to evaluate the relationship between the Dental Aesthetic Index (DAI) and Index of Orthodontic Treatment Need (IOTN) with subjective perceptions of dental aesthetics, function, speech and orthodontic treatment need. METHODS: This is an observational cross-sectional study. The children were assessed using the DAI and IOTN. A questionnaire pertaining to dental aesthetics and function was recorded. RESULTS AND CONCLUSIONS: The aesthetic components of the indices correlated well with aesthetic perceptions of patients, whereas functional components did not have a significant correlation with functional perceptions. The two indices could be used consistently in the present population.