Visit to the Dentist for Oral Health Prevention at "Age One": A proposed policy report from the Indian perspective.

Early childhood caries is a major public health issue in India. The primary reason for poor oral health in children is a lack of awareness about the role of primary teeth and the importance of an early dental visit for infants and toddlers. The primary objectives of an early dental visit are to analyze the child's risk level, provide guidance to parents regarding proper oral hygiene measures, review dietary and eating habits, provide information regarding the infectivity of dental caries, review the risks of traumatic injuries and discuss factors which affect the development of occlusion. Through this paper, we are proposing an "Age One" policy that recognizes dentists, physicians, allied health professionals, community health-care workers, and nongovernmental organizations to work toward a child's overall health as partners to achieve this goal. The expectation is that this policy will provide guidance to childcare centers, pediatric dentists, other health-care professionals, and legislators regarding oral health activities and the promotion of oral health in infants. The purpose of the policy is to lay the foundation for a lifetime of preventive education and dental care, to help ensure optimal oral health beginning in childhood and continuing through the life course.

Pediatrician's perception of oral health in children - A qualitative study.

Background It is important to assess pediatrician's perception on children's oral health as they tend to meet children early on a regular basis. Quantitative research has shown that pediatricians in India have inadequate knowledge and limited awareness about oral health care in children. Hence, it is important to assess pediatrician's opinion and perception on children's oral health using qualitative interview method. AIM: The aim of the study is to assess and explore the perception of pediatricians on children's oral health in Western Tamil Nadu, India. METHODS: A grounded theory approach was employed to conduct this qualitative study. Face-to-face interviews with the pediatricians were conducted using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. Collected data were written as codes, from which categories and themes were derived. RESULTS: Four themes arrived: (1) dental health and disease, (2) anticipatory guidance, (3) barriers, and (4) remedial measures. The participants felt that they were underinformed about dental home, emergency care for dental trauma, and the interceptive role of dentists on oral deleterious habits. Insufficient dental information in their curriculum and the absence of common guidelines between pediatricians and pediatric dentists in India were considered the common causes for their lack of knowledge. CONCLUSION: Pediatricians were receptive to acquire knowledge and improvising their skills. They felt that periodic lectures and formal gatherings should be planned between pediatric dentists and pediatricians. Collaborations between pediatrics and pediatric dentistry societies are warranted to provide children with better oral health care.

Survival Function of Clinical and Radiographic Success of Three Obturating Materials in Primary Teeth at 3, 6 and 9 Months Periodic Intervals - A Randomized Controlled Clinical Trial.

The study aims to assess clinically and radiographically the success of zinc oxide eugenol, metapex, and endoflas as root canal obturating materials in primary teeth over 3, 6, and 9 months of time intervals. The randomized controlled trial was performed in 60 primary molars of 36 children aged between 4 and 9 years. Permanent restorations were given and stainless steel crowns were placed for the treated tooth. Comparing the survival proportion between the three groups was done using the Wilcoxon (Gehans) statistical test. The clinical survival variable showed 100% survival proportion for zinc oxide eugenol and endoflas, while for metapex it was 69% at the end of 9 months. The radiographical survival proportion was 100% for zinc oxide eugenol, followed by endoflas at 92% and 58% for metapex group.

Assessment of Personality Traits among Pediatric Dentists in India: A Cross-sectional Study.

Aim: To identify the most common personality traits among pediatric dentists in India. Materials and methods: A cross-sectional study was conducted using the Big Five personality test (BFPT). It included 50 questions based on five personality traits-extroversion, agreeableness, conscientiousness, emotional stability, and openness to experience. The questionnaire was e-mailed and also sent through WhatsApp messages as a Google Form to all the pediatric dentists in India. Scoring for each trait was done based on the specific formula provided. The data were subjected to statistical analysis using Mann-Whitney U test. Results: A total of 390 pediatric dentists responded and filled out the questionnaire. The agreeableness trait was the most commonly exhibited trait, followed by the conscientiousness trait. Emotional stability was the least exhibited trait. Emotional stability was statistically different between male and female pediatric dentists. Conclusion: Agreeableness and emotional stability were the most and least expressed traits, respectively, among the participants. This survey showed that pediatric dentists in India could have a high tolerance and competent behavior. Clinical significance: Dentists may possess unique personality traits that distinguish them from the general population. Within the dental profession, there could be variations in personality traits depending on the specialty they practice. How to cite this article: Asokan S, PR G, Dhanabalan O, et al. Assessment of Personality Traits Among Pediatric Dentists in India: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(3):489-493.

Association between sleep patterns and early childhood caries in 3-4-year-old children: A cross-sectional study.

Aim: The aim of this study was to assess the sleep practices of children and their association with early childhood caries (ECC) at three different age periods. Methodology: A cross-sectional study was conducted to assess the sleep practices, feeding practices, and oral hygiene practices of children during nighttime from 0 to 2 years of age. A survey among 550 mothers of children aged 3-4 years with ECC (n = 275) and without ECC (n = 275) was conducted using a pretested and validated questionnaire. The three practices (sleep practices, feeding practices, and oral hygiene practices) of children at 0-3 months, 4-11 months, and 1-2 years of age were recorded and analyzed. Results: Risk factors associated with ECC at 0-3 months of age were gender (odds ratio [OR]: 0.59, 0.36-0.98), no previous dental visit (OR: 2.30, 1.15-4.59), bedtime (OR: 3.54, 2.01-6.25), and intentional feeding practice at night (OR: 1.83, 1.0-3.35). At 4-11 months of age, no previous dental visit (OR: 3.28, 1.66-6.49), mother's education (OR: 0.42, 0.23-0.76), frequent night wakes (OR: 5.98, 1.89-19.21), and intentional feeding practice at night (OR: 111.09, 32.25-382.68) and, at 1-2 years of age, no previous dental visit (OR: 2.37, 1.45-3.88), intentional feeding practice at night (OR: 19.12, 9.09-40.21), and breastfeeding for more than 2 years (OR: 14.56, 7.17-29.56) were associated with ECC. Conclusion: Lack of previous dental visit and intentional feeding at night were the common risk factors associated with ECC in children.

Comparison of Remineralizing Agents in the Management of White Spot Lesions In Three- to Five-year-old Children: a Clinical Trial.

PURPOSE: The purpose of this study was to compare the effectiveness of P11-4 self-assembling peptide (CurodontTM Repair [CR]) and fluoride varnish with xylitol-coated calcium phosphate (Embrace TM Varnish [EV]) on enamel permeability and in the management of white spot lesions (WSLs) in primary teeth. METHODS: A clinical trial was conducted among 30 children aged three to five years with WSLs in 60 anterior teeth. They were randomly assigned to receive CR or EV. Preintervention and postintervention evaluation was done by International Caries Detection and Assessment System (ICDAS) and morphometric analysis. The secondary outcome was to assess the enamel permeability using scanning electron microscopy (SEM) of polyvinyl siloxane impressions. RESULTS: A statistically significant reduction in the ICDAS scores (P=0.05) and percentage area of WSLs in morphometric analysis (P=0.008) was seen in the CR group after six months. No statistically significant difference was observed in the EV group after six months. The SEM evaluation did not show a significant reduction in the percentage area of droplets in both the CR and EV groups (P=0.06 and P=0.21, respectively). No significant difference was seen between EV and CR in the three parameters assessed. CONCLUSION: Curodont TM Repair is effective at remineralizing white spot lesions in primary teeth and can be considered as a remineralizing agent.

Piagetian's principles on moral development and its influence on the oral hygiene practices of Indian children: An embedded mixed-method approach.

BACKGROUND: Moral principles in children can influence their oral hygiene practices and can be beneficial in providing better oral health care. AIM: To assess the consistency of Piaget's moral development principles in Indian children aged 7 to 11 years and evaluate its influence on their oral hygiene practices. DESIGN: The first phase of the embedded mixed-method approach included telephone interviews of 50 children on eight situations of moral development as suggested by Jean Piaget. Children were categorised into heteronomous and autonomous moralities based on the content analysis. The second phase of the study included a semi-structured qualitative interview on knowledge and practice behaviour of children on oral hygiene maintenance. RESULTS: There was no significant difference in the overall moral development of children aged 7 to 9 years and 9 to 11 years (p = .57). Only 4.8% of girls had heteronomous morality, and a significant difference was noted between boys and girls (p = .014). There was a significant difference in the oral hygiene practices observed between heteronomous morality and autonomous morality children. CONCLUSION: Children were autonomous in their morality at 7 to 9 years of age. Children with autonomous morality performed better oral hygiene practices than children with heteronomous morality.

Arginine: A New Paradigm in Preventive Oral Care.

Dental caries is ubiquitous and one of the most prevalent oral diseases and the foremost cause of dental pain and poor quality of life (QoL). Fluoride is an effective caries preventive agent; however, despite its use, there remain some gaps in prevention of dental caries. Arginine, an amino acid, helps to maintain a noncariogenic plaque. It shows synergistic effects with fluoride in dental caries and can help nourish the tooth by enhancing the remineralization effect of fluoride. Supplementing fluoride dentifrices with arginine can bridge the gap in caries prevention. Several clinical studies with 1.5% arginine + fluoride provide evidence for its use in prevention of dental caries. This report throws light on the benefits of arginine in dental caries and guides on its use with fluoride. Recommendations given in the report will help in effective prevention of dental caries. How to cite this article: Goyal V, Damle S, Puranik MP, et al. Arginine: A New Paradigm in Preventive Oral Care. Int J Clin Pediatr Dent 2023;16(5):698-706.

Development and validation of a novel Middle childhood oral health impact scale (MCOHIS).

Purpose: The study was planned to develop and validate a novel middle childhood oral health impact scale (MCOHIS) for 6- to 9-year-old children in India. Methodology: A cross-sectional study design was employed to develop and validate MCOHIS in the sequential phases. A panel of ten pediatric dentists evaluated a pool of 36 items corresponding to the oral health-related quality of life (OHRQoL) of children. MCOHIS with 20 items under five domains was formulated and content validation was done. Cohen's kappa statistics was employed to measure the concordance between the child's self-report and the caregiver's proxy report. Concurrent validation was done among 130 participants from 13 districts of Tamil Nadu state, India. Discriminant validity was checked among another sample of 60 participants. Internal consistency and test-retest reliability of MCOHIS were assessed using Cronbach's alpha and Kappa statistics respectively. Results: MCOHIS had adequate content validation with Scale Level Content Validity Index / Average score of 0.94 for relevance. There was a statistically significant inter-rater reliability observed between the child's self-report and caregivers' proxy report in all items with a moderate to substantial agreement. Concurrent validation showed a statistically significant positive correlation with a Rho value of 0.712. There was a statistically significant difference noted in overall discriminant validity (P < 0.001). Acceptable internal consistency reliability was observed with Cronbach's alpha value of 0.75. Test-retest reliability showed a high stability coefficient of 0.98. Conclusions: MCOHIS was found to be a valid and reliable age-specific tool for assessing the OHRQoL of Indian children aged 6-9 years.

Pre-eruptive intracoronal radiolucencies in permanent dentition of children in Tamil Nadu-A cross-sectional study.

BACKGROUND: Pre-eruptive intracoronal radiolucency (PEIR) poses a challenge to paediatric dentists as it cannot be clinically detected. AIM: To estimate the prevalence and coexisting factors of PEIR in permanent teeth of children and adolescents in western Tamil Nadu, India. DESIGN: This cross-sectional study assessed 5012 digital panoramic radiographs of children and adolescents below 14 years of age obtained from private digital imaging centers, dental clinics, and dental colleges located in five districts of western Tamil Nadu. The prevalence and PEIR and its coexisting factors were assessed by two independent calibrated investigators. Data were analyzed using the chi-square test. RESULTS: The subject prevalence and tooth prevalence of PEIR were estimated to be 3.2% and 0.4%, respectively. Maxillary canines and mandibular premolars were commonly involved. Majority of the lesions were limited to less than one-third of dentin thickness (74%) and distal aspect of the crown (45.1%). Ectopic positioning (9.3%) and dental caries in the preceding primary tooth (9.9%) were the most common coexisting factors. CONCLUSION: Pre-Eruptive Intracoronal Radiolucency defects were commonly seen in maxillary canines, mandibular premolars, and distal aspect of the crown involving less than one-third dentin thickness. Ectopic positioning and caries in primary teeth were commonly seen along with the PEIR defects.

Stress amongst paediatric dental postgraduate students in India: A mixed-method approach.

INTRODUCTION: Dental profession is one of the most stressful healthcare occupations. Paediatric dental postgraduates face multifaceted challenges in their everyday practice. This study aimed to determine the sources of stress amongst paediatric dental postgraduate students in India using a mixed-method approach. MATERIALS AND METHODS: A sequential mixed-methods approach was employed. In the quantitative phase, a cross-sectional web-based questionnaire survey was conducted amongst paediatric dental postgraduates in India using the "Google Forms application" link. Based on the Dental Environment Stress (DES) questionnaire, the stress PACT questionnaire which includes 35 items was framed and validated. This validated questionnaire was used in the survey. In the qualitative phase, one-on-one, semi-structured telephone interviews were conducted amongst 12 postgraduates. RESULTS: A total of 422 participants took part in the quantitative survey. Academic and specialty-related domains were found to be the significant causes of stress amongst the five domains (p < .001). The top three stressful factors were as follows: getting an ideal case for clinical exams (68.2%), financial resources for conferences, dissertation, short studies and publications (53.2%) and fear of unemployment after graduation (52.3%). Based on qualitative interviews, four themes were derived, namely choice of paediatric dentistry, postgraduate life experience, stress management and expected changes in postgraduate life. CONCLUSION: Psychological well-being of the student is an important factor that influences the overall performance of students. Identifying the stress factors and using appropriate coping strategies can help postgraduates achieve personal, academic and professional success.