Treatment Trends in Paediatric Dentistry with Evolving Training and Education of Postgraduate Students in India: A Retrospective Study

ABSTRACT Objective: To assess and analyse the pattern of dental treatment services and their characteristics provided to children by evaluating the clinical use of materials and prevalence in material research in a major postgraduate paediatric tertiary care hospital in India over three years. Material and Methods: Institutionally approved retrospective analysis was conducted by auditing the clinical records of 2644 patients who visited and had treatment in the Outpatient and Inpatient Department of Paedodontics and Preventive Dentistry from January 2017 to December 2019. Clinical logbooks of postgraduate students were analysed by crosschecking with the department's data warehouse. Results: Out of the 2644 children who had treatment, more than two-thirds of them were in the age group of 4-7 years old. Around 5.6% of the patients were specially-abled children. Extraction (33.5%) was the most common treatment, followed by restorative treatment (29.1%). Endodontic treatment had a prevalence of 19.8%, with a reduced prevalence of preventive treatment care (0.5%). Patients who had traumatic tooth management included 2.8% of the study population. The prevalence of preventive care was found to be 2.1%. The teaching curriculum with theoretical and clinical skill practices was under the country's assigned authority. Conclusion: Despite advancements in paediatric dentistry, more children had extraction treatment with less observed utilization of preventive care. The widening of the training prospectus includes comprehensive care and an amplified focus on preventive care in the academic curriculum of paediatric postgraduates, which is the need of the hour.

Management of anxiety using eye movement desensitization and reprocessing therapy in children undergoing extraction: a randomized controlled pilot study.

Background: Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy. Methods: Children in the age range of 8-12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2; receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction. Results: Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student's t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. Conclusion: EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

Evidence-based analysis of multi-pronged approaches for education and behavior management of autistic patients in a dental setting.

BACKGROUND: Autism spectrum disorder is a neurodevelopmental condition which has posed a challenge to carers, pediatricians and dentists through the years. Over the last four decades, the disorder has been better understood and management techniques have evolved. In the field of dentistry, the autistic child presents difficulty in management, even for the simplest dental procedures. A comprehensive understanding of other psychoeducational and behavioral approaches to manage autism is very important. This article aims to introduce various important key techniques such as Applied Behavior Analysis, TEACCH, Sensory Adapted Dental Environment, Picture Exchange Communication System, and Animal Assisted Therapy and analyze their application in dentistry. METHODS: A search of literature was carried out in Clinicaltrials.gov, Medline and Scopus with the search terms "Applied Behavior Analysis," "TEACCH," "Sensory Adapted Dental Environment," "Picture Exchange Communication System," and "Animal Assisted Therapy" along with "autism OR autistic," "dental OR dentistry OR oral health." After the screening for inclusion and exclusion criteria, 10 eligible articles were included, in English, published within the last 10 years. RESULTS: Limited research was available regarding these lesser-known behavioral approaches in dentistry. The few that were available showed encouraging results. The different techniques proved useful in increasing acceptance of dental treatment and reducing behavioral disturbances. The patients experienced reduced dental anxiety, lesser discomfort, improved communication, and knowledge. CONCLUSION: Pediatric and special care dentists are likely to benefit by incorporating the recommended comprehensive behavior management techniques in their practice. There is evidence that these techniques will reduce behavioral disturbances in autistic children thereby making primary dental care possible without the need for sedation or general anesthesia.

Evaluation of hepatoprotective activity of aerial parts of Tephrosia purpurea L. and stem bark of Tecomella undulata.

ETHNOPHARMACOLOGICAL RELEVANCE: The aerial parts of Tephrosia purpurea (L.) pers. (Fabaceae) and stem bark of Tecomella undulata seem. (Bignoniaceae) are used for liver disorders in the traditional system of medicine. AIM OF THE STUDY: To evaluate the hepatoprotective activity of aerial parts of Tephrosia purpurea and stem bark of Tecomella undulata against thioacetamide-induced hepatotoxicity. MATERIALS AND METHODS: Hepatotoxicity was induced in albino rats of either sex by subcutaneous injection of thioacetamide. Aqueous-ethanolic extract of aerial parts of Tephrosia purpurea (100, 300 and 500 mg/kg/day and ethanolic extract of stem bark of Tecomella undulata (200, 500 and 1000 mg/kg/day were evaluated. RESULTS: Oral administration of Tephrosia purpurea at 500 mg/kg and Tecomella undulata at 1000 mg/kg resulted in a significant reduction in serum aspartate aminotransaminase (35% and 31%, respectively), alanine aminotransaminase (50% and 42%, respectively), gamma glutamyl transpeptidase (56% and 49%, respectively), alkaline phosphatase (46% and 37%, respectively), total bilirubin (61% and 48%, respectively) and liver MDA levels (65% and 50%, respectively), and significant improvement in liver glutathione (73% and 68%, respectively) when compared with thioacetamide damaged rats. Histology of the liver sections of the animals treated with the extracts also showed dose-dependent reduction of necrosis. CONCLUSIONS: The present study demonstrates the hepatoprotective activity of the aerial parts of Tephrosia purpurea and stem bark of Tecomella undulata against thioacetamide-induced hepatotoxicity.