Global oral health policies and recommendations for children with special health care needs and their applicability and effectiveness during the COVID -19 pandemic: a systematic review.

AIM: This systematic review aims to assess effectiveness of oral health policies, recommendations and guidelines in safeguarding oral health of children with special healthcare needs during COVID-19. BACKGROUND: This systematic review evaluated the adaptation of global oral health policies for children with special healthcare needs (SHCN) during the COVID-19 pandemic, to provide evidence-based insights to inform policymakers and healthcare providers amid the ongoing global health crisis. The study focused on assessing the effectiveness of these adaptations in ensuring equitable access to quality dental care for this vulnerable group. METHODS: A PRISMA guided online search through LILIACS, PubMed, Scopus, COCHRANE and grey literature was conducted. The search strategy incorporated a combination of subject headings (MeSH terms) and free-text terms related to "oral health," "dental health," "policy," "effectiveness," "dental practice guidelines," "oral health policies," and "special care needs children." Eligibility criteria included oral health policies, recommendations and guidelines targeting individuals/children with special care needs. Both qualitative and quantitative studies published in English from 2008 to 2023 were included. RESULTS: Sixteen guidelines, recommendations and policies, from six authorities were identified. These documentations addressed six different areas mentioned broadly as comprehensive care, ethical considerations, preventive and therapeutic measures, equity, patient-centric treatment, and reducing disparities signaling a paradigm shift. International collaborations and standardization of guidelines indicated a unified approach. The review also emphasized on a commitment to continuous improvement through quality measurement, systematic referral management, and needs assessment. With the exception of two documents, the remaining guidelines did not address COVID-19 or provide specific adaptations for it. The lack of emphasis on individual condition was notable, as the guidelines generally took a more generalized approach toward individuals with special healthcare needs. CONCLUSIONS: In conclusion, this review assessed the impact of COVID-19 on oral healthcare for individuals with special needs. It underscores global and local efforts for equitable access, patient-centric care, and preventive measures. The lessons learned advocate for a resilient, inclusive healthcare framework capable of meeting diverse needs. PROSPERO REGISTRATION: CRD 42023452475.

Comparative Evaluation of Indirect Pulp Therapy in Young Permanent Teeth using Biodentine and Theracal: A Randomized Clinical Trial.

OBJECTIVE: In a tooth with deep dentinal caries; judicious removal of infected dentin and isolating affected dentin from oral fluids with suitable biocompatible material is called indirect pulp therapy (IPT). This randomized clinical trial was done to evaluate and compare the efficacy of Biodentine, Theracal LC and. Dycal as an indirect pulp capping agent in young permanent teeth. STUDY DESIGN: IPT was performed in 60 young permanent molars with caries approaching pulp in 55 healthy children using Biodentine, Theracal and Dycal. A 2-3mm layer of GIC was placed over the intervening material followed by restoration of cavity with composite. Clinical and radiographic examinations were conducted at 3 weeks, 3 months, 6 months,12 months, 18 months and 24 months. The data was compared using chi-square test at a significance level of 0.05. RESULTS: By end of 24 months ,54 teeth presented for follow up with overall success rate of 100% in Theracal, 94.44% in Biodentine, and 77.78% in Dycal. Overall success of Theracal was statistically significant in comparison to Biodentine and Dycal at 24 months follow up (p= 0.03) Conclusions: Radiographic and clinical outcomes of Theracal and Biodentine suggest their use as an alternative material for IPT in young permanent molars with higher success.

Evaluation of the Effect of Different Root Canal Preparation Techniques in Primary Teeth Using CBCT.

OBJECTIVES: The purpose of this in vitro study was to compare and evaluate the cleaning and shaping efficiency of the rotary Ni-Ti, sonic and conventional file systems for root canal preparation in primary teeth under CBCT. STUDY DESIGN: Seventy five maxillary and mandibular first and second primary molars were divided into three groups of 25 teeth each, according to the canal preparation technique: Group I Rotary file system, Group II Sonic file system, Group III Conventional K files. Canals were scanned using an i-CAT CBCT scanner before and after preparation to evaluate their shaping efficiency. Root canal transportation and centering ratio were evaluated at coronal, middle and apical thirds. The cleaning efficiency was evaluated by the extent of India ink removal from the canal walls under stereomicroscope. The collected data was subjected to statistical analysis. RESULTS: Nickel-Titanium (Ni-Ti) rotary system caused less canal transportation and had better centering ability. Sonic system showed better shaping at the apex, and wider at coronal end. Conventional K-files removed more dentin at coronal than in middle and apex and efficiently cleaned the root canals. There were no significant difference in cleaning and shaping efficiency between Rotary system, Sonic system & Conventional K file system. CONCLUSION: Rotary instrumentations could be considered as an efficient alternative to conventional hand preparation as it respects the original canal anatomy with no aberrations or resulting failures.

Parental perspectives on oral health-related quality of life in children and adolescents with autism spectrum disorder: A systematic review.

BACKGROUND: Children with autism spectrum disorder (ASD) face unique challenges related to oral health, which can negatively impact their day-to-day lives, significantly compromising their overall quality of life. Primary caregivers of children with ASD have a critical role in delivering and seeking oral health care. Hence, it is vital to study their perspective towards their children's oral health and its impact on their quality of life. AIM: To explore the parental perception of oral health-related quality of life in children with autism. METHODS: A systematic electronic and manual search was conducted in Medline (via PubMed), Embase, Google Scholar, Scopus, and LILACS of articles published from January 2003 to May 2023 using appropriate MeSH terms, keywords, and other terms. A four-phase study selection process was followed according to PRISMA guidelines, and data extraction and synthesis were performed using an extraction form. The selected studies were critically appraised using the QATSDD and Crombie's assessment tool. The inter-reviewer agreement was assessed using the kappa with a linear weighting coefficient. RESULTS: Out of the 885 results, 15 studies were included in the review after the two selection phases, and the study characteristics were summarized in tabular form. Study quality varied considerably, and out of a total possible QATSDD score of 42, scores for the individual studies ranged from 14 to 40. The risk of bias for the seven criteria was found to be low. CONCLUSION: The parental perception of the OHRQoL in children with ASD is poor, and the most significant perceived impact is on the child's functional and social well-being aspects. Parental-Caregiver Perception Questionnaire was the most commonly used. The most frequent symptoms include bad breath, food lodgment, mouth breathing and night grinding. The familial impact and influence on the OHRQoL of siblings were also studied.

Double Mesiodens in the Mixed Dentition of Non-syndromic North-Indian Patients: A Case Series.

The presence of double mesiodens or mesiodentes, i.e., two supernumerary teeth in the maxillary midline, presents unique challenges in mixed dentition. Common clinical manifestations include delayed eruption, midline diastema, and occlusal disturbances, leading to complications such as root resorption, pathological migration of tooth, crowding, cyst formation, and malocclusion. Mesiodens can be associated with several syndromes, like cleidocranial dysplasia, familial adenomatous polyposis, trichorhinophalangeal syndrome, type I, Rubinstein-Taybi syndrome, and Nance-Horan syndrome, among others. It can also be secondary to trauma, hyperactivity of the dental lamina, and a combination of genetic and environmental factors, but its etiology continues to be idiopathic. Double mesiodens are relatively rare, so this clinical observation aimed to highlight five such cases of double mesiodens in mixed dentition in non-syndromic children and adolescents. Additionally, a literature search reporting cases of double mesiodens in the mixed dentition was done, and the results were tabulated. Clinicians should be able to identify indications of supernumerary teeth, specifically deviations in the eruption pattern. Appropriate investigations and timely intervention are essential to reducing complications that may arise in the developing dentition.

Challenges faced by dentists during provision of oral health care in children and adolescents with special health-care needs: A scoping review.

INTRODUCTION/BACKGROUND: Oral health care for children with special health-care needs (CSHCN) is often overlooked despite a substantial global population with disabilities or special needs. This scoping review delves into the challenges dentists face in delivering oral health care to CSHCN. METHODOLOGY: The scoping review was conducted as per the guidelines of PRISMA-ScR with a search strategy based on the population, intervention, comparison, and outcome (PICO) framework of the research question. The databases searched were PUBMED, Google Scholar, and EBSCOhost. Articles published within 20 years and in the English language were included in the study. RESULTS: The review included 20 studies and highlighted several significant barriers encountered by dentists when providing oral health care for CSHCN. They included inadequate training among dentists in managing special needs patients, the time-intensive nature of oral procedures for this population, and the unpredictable behaviors exhibited by CSHCN during dental visits. CONCLUSION: The findings underscore the crucial need to address the challenges dentists face in delivering oral health care to CSHCN.

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.

Effect of 38% Silver Diamine Fluoride on Salivary Matrix Metalloproteinase-9 Levels in Children with Early Childhood Caries: A Clinical Study.

Background: Early childhood caries is a major oral health problem in most industrialized countries, affecting the overall quality of life of children. It is caused by the action of bacterial acids on the enamel surface thereby demineralizing it and progressively destroying the tooth. It presents initially as smooth-surface carious lesions affecting the primary maxillary incisors. With the advancement of the lesion, decay progresses further to involve other primary teeth as well and if not treated early, the caries may involve the pulp leading to irreversible pulpitis. Matrix metalloproteinases (MMPs) are a group of endopeptidases that degrade almost all the proteins of the extracellular matrix (ECM). Among the different types of MMP, MMP-9 (gelatinase B) is one of the chief MMPs responsible for the breakdown of the organic matrix. Traces of MMP-9 can be found in the human carious lesions, saliva, and gingival crevicular fluid. They are activated by the release of acids by cariogenic bacteria and once activated they are able to digest demineralized dentin matrix. Thus, host-derived MMPs, which are activated by bacterial acids have a crucial role in the destruction of dentine by caries. Thus, this study was undertaken to investigate the effect of 38% silver diamine fluoride (SDF) solution on MMP-9 levels. Aim: This clinical trial investigated the MMP-9 levels before and after the application of 38% SDF in children with early childhood caries. Materials and methods: About 15 children were selected and were subjected to clinical and radiographic assessment before the commencement of the procedure. After the collection of saliva, the teeth with carious lesions were isolated and SDF was applied. Saliva samples were again collected after 1, 3, and 6 months postapplication of SDF. The collected saliva samples were then analyzed for their MMP-9 levels using a human salivary enzyme-linked immunosorbent assay (ELISA) kit. Finally, the data obtained were subjected to statistical analysis by repeated measures of analysis of variance (ANOVA). Conclusion: The MMP-9 levels were found to be gradually increasing postapplication of 38% SDF and were significantly higher after 6 months and the highest mean difference in the MMP-9 levels was observed between baseline and 6th-month follow-up. Also, no new carious lesion appeared in the teeth during the experimental time period of 6 months and the decayed, extraction needed, filled teeth (deft) scores remained the same. How to cite this article: Bora P, Saxena A, Goswami M. Effect of 38% Silver Diamine Fluoride on Salivary Matrix Metalloproteinase-9 Levels in Children with Early Childhood Caries: A Clinical Study. Int J Clin Pediatr Dent 2023;16(S-1):S51-S56.

Comparative Evaluation of the Treatment Outcomes of Pulpotomy in Primary Molars Using Mineral Trioxide Aggregate and 3Mixtatin: A Randomized Clinical Trial.

Objective: To evaluate and compare the efficacy of 3Mixtatin and mineral trioxide aggregate (MTA) for pulpotomy in primary teeth by assessment of pre- and postoperative clinical and radiographic data. Materials and methods: In this randomized clinical trial, 50 primary molars from 48 healthy children aged 3-8 years were randomly allocated into two groups. Deep dentinal caries approaching pulp in primary teeth were treated by pulpotomy using MTA and 3Mixtatin. Over the intervening period, restoration was done using glass ionomer cement (GIC) and composite, followed by stainless steel crown. Clinical and radiographic examinations were conducted at 3, 6, and 12 months after treatment. The data were compared using Chi-squared test at a significance level of 0.05. Results: A total of 39 patients were available for follow-up study. By the end of 12 months, the overall success rates were 95.5% in MTA and 91.3% in 3Mixtatin. No statistically significant difference was found among the outcomes of MTA and 3Mixtatin groups (p > 0.05). Conclusion: Radiographic and clinical outcomes in MTA and 3Mixtatin group in this study show 3Mixtatin as a suitable alternative for pulpotomy medicament in primary teeth. How to cite this article: Mushtaq A, Nangia T, Goswami M. Comparative Evaluation of the Treatment Outcomes of Pulpotomy in Primary Molars Using Mineral Trioxide Aggregate and 3Mixtatin: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(6):810-815.

Comparison of the safety and efficacy of dexmedetomidine with midazolam for the management of paediatric dental patients: A systematic review.

BACKGROUND: Pain, fear, and anxiety have long been associated with pediatric dentistry. A child's cooperation with a dental.procedure.usually requires various behavioral management strategies conveyed by the entire dental team. The use of sedatives in dental clinics for providing analgesia and anxiolysis allows the patient to respond appropriately to verbal commands and light tactile stimulation., thus making dental treatment more patient friendly and effective. AIM: The aim of this study was to compare the safety and efficacy of dexmedetomidine versus midazolam for the management of pediatric patients in the dental clinic. MATERIALS AND METHODS: This systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six articles were selected for this systematic review. Of them, only in four articles, homogeneous data were available which were subjected to meta-analysis. RESULTS: When compared with midazolam, premedication with dexmedetomidine resulted in much lower incidence of emergence delirium (odds ratio = 0.07, 95% confidence interval: 0.01-0.54, P = 0.01). No significant difference was observed with respect to satisfactory behavior of the child, successful parental separation, and satisfactory mask acceptance following sedation. CONCLUSION: Both dexmedetomidine and midazolam are equally effective for the management of pediatric patients in the dental clinic. In addition, dexmedetomidine premedication is associated with lower incidence of emergence delirium and has a better margin of safety.

Comparative Evaluation of Changes in Physiological and Psychomotor Effects in Pediatric Patients during Extraction under Different Concentrations of Nitrous Oxide-Oxygen Inhalation Sedation.

INTRODUCTION: Nonpharmacological behavioral management techniques are routinely used to create an environment that facilitates and builds a rapport between the child and the dentist to carry out procedures with minimal disruption. However, the discomfort associated with oral injections produces varying degrees of stress in all patients. Nitrous oxide (N2O)-oxygen (O2) inhalation sedation is one of the most widely used modalities for the management of fear and anxiety in children. OBJECTIVE: The objective was to evaluate changes in physiological and psychomotor effects in pediatric patients during extraction under different concentrations of N2O-O2 inhalation sedation. MATERIALS AND METHODS: A total of 300 healthy patients in the age range of 6-12 years (mean 8.9 years), who needed extraction of primary tooth, were included in the study. Pulse rate, SpO2, blood pressure (BP), and temperature were recorded at baseline, 30% N2O concentration, 50% N2O concentration, and again postoperatively. In addition, anxiety levels and neuromuscular coordination were recorded at the respective intervals. RESULTS: The results revealed a mean decrease in pulse rate and BP from baseline and an increase in temperature and O2 saturation during the sedation procedure. The findings were statistically significant. Significant impairment of coordination and psychomotor ability was seen at each step. Anxiety had significantly reduced after the onset of sedation due to the anxiolytic effect of N2O. CONCLUSION: N2O-O2 inhalation sedation under different concentrations reduces the anxiety of the patient and produces adequate sedation with vital signs within normal limits along with temporary impairment of psychomotor ability and coordination.

Time to restart: A comparative compilation of triage recommendations in dentistry during the Covid -19 pandemic.

BACKGROUND: The novel coronavirus (COVID-19) pandemic has become a enormous challenge for the health care facilitators. It has significantly affected the dental professionals in their clinical practices, hospitals and even dental schools. Due to the risk of cross - infection involved within in the dental setting, the dental professional is even scared to provide emergent treatment for a patient. AIM: The aim of this comparative review is to throw light on the essential knowledge that a clinician must acquire before triaging a patient, understanding the case definition of COVID-19 and preparedness required before planning to re-open the dental practices. METHODOLOGY: The updated database obtained from various governmental and non-governmental official webpages were rapidly analysed up till May 31, 2020. CONCLUSION: This compilation of recommendations and guidance laid by various authorities across the world will function as a foundation for safer dental practice within the future.

Outcomes of luxation injuries to primary teeth-a systematic review.

OBJECTIVE: Luxation injuries are one of the most prevalent type traumatic dental injuries in primary dentition. The impact of these injuries may not only be limited to the primary teeth but may also have adverse effects on the developing succedaneous tooth bud resulting in various unfavorable consequences. This systematic review aims at compiling the evidence of available literature regarding luxation injuries to primary teeth, etiology, treatment modalities, outcomes and sequelae on permanent teeth. METHODOLOGY: Search of PubMed, Google Scholar, Cochrane Database of Systematic Reviews, SCOPUS and LILACS virtual health library was conducted for the literature published from January 1, 2007 to December 31, 2017. Two authors separately reviewed the literature and extracted the data from the included studies. RESULTS: After screening 224 articles, 13 articles fulfilled the inclusion criteria. Most common etiological factor for injury (up to 44.8%) is fall while walking or running. The unfavorable outcomes which are mostly associated with luxation injuries are pulp canal obliteration ranging from 8.6% to 43.3% and pulp necrosis 8.6% -78.9%. Sequelae on succedaneous teeth vary with a high incidence of white or yellow brown discoloration of enamel (78%) and enamel hypoplasia (7.8%-28.3%). CONCLUSION: Fall is the most common cause and regular monitoring is recommended for most of the luxated teeth. Pulp canal obliteration, pulp necrosis and tooth loss due to trauma are prevalent complications observed following luxation. White or yellow brown discoloration of enamel and enamel hypoplasia are the most common undesirable sequelae to permanent teeth.

Comparative Evaluation of the Efficacy of Chlorhexidine, Sodium Hypochlorite, the Diode Laser and Saline in Reducing the Microbial Count in Primary Teeth Root Canals - An In Vivo Study.

Introduction: One of the primary goals of pulpectomy is to decrease the sum total of microorganisms and disinfect the tooth root canal system. To achieve this, mechanical preparation, irrigation, disinfection and obturation of the root canal is necessary. The present study was set out to evaluate the difference in the antibacterial efficacy of primary teeth root canals either irrigated with chlorhexidine, saline, and sodium hypochlorite or irradiated with a soft tissue diode laser (980 nm, Photon Plus, Zolar Tech & Mfg Co. Inc, Ontario, Canada). Methods: Sixty primary teeth of children requiring pulpectomy were divided into 4 groups of 15 each, group 1 (2% chlorhexidine), group 2 (1% sodium hypochlorite), group 3 (laser irradiation) and group 4 (saline). Pulp tissue was extirpated from the canals and the samples were collected using sterile absorbent paper points. After cleaning and shaping, the root canals of the teeth in each group were irrigated using sodium hypochlorite, chlorhexidine, and saline or were irradiated with the laser. The samples were obtained again and sent for microbiological examination. Results: The colony-forming unit (CFU) counts from pre-disinfection sample served as a baseline for comparisons throughout the study. The mean bacterial colony counts of all the isolated bacteria reduced after irrigation or irradiation. Intergroup comparisons showed no significant difference when groups 1, 2, and 3 were compared to each other (P > 0.05). However, a significant difference was seen when groups 1, 2, 3 were compared to group 4 (P < 0.05). Conclusion: Two percent chlorhexidine, 1% sodium hypochlorite and laser irradiation succeeded in reducing the root canal infection. Hence, diode laser irradiation may be a possible supplement to existing protocols for disinfecting the root canal system.

Comparative evaluation of anesthetic efficacy of warm, buffered and conventional 2% lignocaine for the success of inferior alveolar nerve block (IANB) in mandibular primary molars: A randomized controlled clinical trial.

Background: Maintaining primary teeth in the oral cavity is of prime importance, and grossly carious teeth may require pulp therapy for the same. Pain on injection and incomplete anesthesia causes failure of the procedure and result in fear and anxiety. Various methods have evolved to overcome this; such as distraction, topical anesthesia, etc. A few techniques regaining popularity in dentistry in recent times is the warming or buffering of the solution prior to administration. This study thus aimed to compare and evaluate the anesthetic efficacy and the patient's pain reaction to pre-warmed, buffered and conventional 2% lignocaine for the success of Inferior Alveolar Nerve Block in mandibular primary molars undergoing pulp therapy. Methods: The study is a randomized, split-mouth trial. Sixty children between six -12 years, requiring pulp therapy bilaterally on mandibular primary molars, were administered conventional, buffered or pre-warmed 2% lignocaine on two separate appointments. Various parameters were assessed using objective and subjective scales. Results: Pre-warmed and buffered anesthetics had lesser pain on injection (p<0.001, p<0.001) and pulp therapy (p=0.001, p=0.014), faster onset of action (p=0.004, p=0.001), lower SEM Sound (p=0.035, p=0.028), Eye (p< 0.001, p=0.013) and Motor (p=0.008, p=0.021) scores and shorter duration of action (p< 0.001, p=0.015). No significant difference was found between the two modified solutions. Thus pre-warmed and buffered anesthetic solutions fared better than the conventional solution for all parameters but had no advantage over each other. Conclusion: Buffering or pre-warming the anesthetic solution reduces pain on administration and during procedures in children. TRIAL REGISTRATION NUMBER: CTRI/2017/02/007922.

Prevalence of Principles of Piaget's Theory Among 4-7-year-old Children and their Correlation with IQ.

INTRODUCTION: Cognitive development is a major area of human development and was extensively studied by Jean Piaget. He proposed that the development of intellectual abilities occurs in a series of relatively distinct stages and that a child's way of thinking and viewing the world is different at different stages. AIM: To assess Piaget's principles of the intuitive stage of preoperational period among 4-7-year-old children relative to their Intelligence quotient (IQ). MATERIALS AND METHODS: Various characteristics as described by Jean Piaget specific for the age group of 4-7 years along with those of the previous (preconceptual stage of preoperational period) and successive periods (concrete operations) were analysed using various experiments in 300 children. These characteristics included the concepts of perceptual and cognitive egocentrism, centration and reversibility. IQ of the children was measured using Seguin form board test. Inferential statistics were performed using Chi-square test and Kruskal Wallis test. The level of statistical significance was set at 0.05. RESULTS: The prevalence of perceptual and cognitive egocentrism was 10.7% and 31.7% based on the experiments and 33% based on the interview question. Centration was present in 96.3% of the children. About 99% children lacked the concept of reversibility according to the clay experiment while 97.7% possessed this concept according to the interview question. The mean IQ score of children who possessed perceptual egocentrism, cognitive egocentrism and egocentrism in dental setting was significantly higher than those who lacked these characteristics. CONCLUSION: Perceptual egocentrism had almost disappeared and prevalence of cognitive egocentrism decreased with increase in age. Centration and lack of reversibility were appreciated in most of the children. There was a gradual reduction in the prevalence of these characters with increasing age. Mean IQ score of children who possessed perceptual egocentrism, cognitive egocentrism and egocentrism in dental setting was higher.

Noise levels and sound pollution associated with various operative procedures and equipments in a pediatric dental environment-A clinical study.

AIM: To analyse sound levels and sound pollution in a Pediatric Dental Clinic and to analyse whether the levels are significant to the extent of being a health hazard. METHODS: Noise levels were measured in a Pediatric dental clinic in an institutional setting with a precision noise level meter ((HTC 1350). Recordings were taken at different times of the day, at the centre, chair-side, reception, play area and four corners of the department keeping the microphone at a distance of 6 in. from the operator's ear. The noise levels of various equipments i.e. suction, micromotor, airotor were measured with the equipments turned on and during cutting operations with the microphone placed at a distance of 6 in. from the sound source. The sound levels for the laboratory equipments were taken at a distance of 6 in. and 2 m. RESULTS: The highest mean sound levels were recorded at the reception, play area and chair-side area with least mean sound levels recorded at 9:00am which increased at 11:30am & 2:00pm and reduced again at 3:30pm The maximum sounds were produced by the lathe trimmer, airotor and scaler. CONCLUSION: Noise levels in a pediatric clinic approach the level of risk of hearing loss [85 db(A)]. This would have a serious effect on both providers and patients and a concerted effort would be required to control the noise levels and thus avoid the potential health hazards that it poses.

Comparative evaluation of shear bond strength and nanoleakage of conventional and self-adhering flowable composites to primary teeth dentin.

BACKGROUND: The latest advancement in adhesive dentistry is the development of self adhering flowable composite resin which incorporates the self-etch adhesion technology to eliminate the steps of etching, rinsing, priming and bonding. Few studies have addressed resin bonding to primary teeth. AIM: The aim of this study was to compare the shear bond strength and nanoleakage of conventional and self adhering flowable composites to primary teeth dentin. SETTINGS AND DESIGN: This study was conducted in the Department of Pedodontics and Preventive Dentistry, I.T.S Dental College, Hospital and Research Centre, Greater Noida; in association with the Department of Mechanical Engineering, I.T.S Engineering College, Greater Noida; and the Advanced Instrumentation Research Facility (AIRF), Jawaharlal Nehru University, New Delhi. MATERIALS AND METHODS: Sixty of the ninety primary teeth were evaluated for shear bond strength and thirty for nanoleakage. The samples were divided into three groups; Group I - Dyad Flow (Kerr), Group II - Fusio Liquid Dentin (Pentron Clinical Technologies) and Group III - G-aenial Universal Flo (GC). Shear bond strength was determined using a universal testing machine. Nanoleakage pattern was observed under scanning electron microscope. RESULTS: The shear bond strength of conventional flowable composite was significantly greater than self adhering flowable composite (p<0.05). Nanoleakage scores of both conventional and self adhering flowable composites were comparable. CONCLUSIONS: Self adhering flowable composites combine properties of composites and self etch adhesives, eliminating the need for separate bond application that simplifies direct restorative procedure. The evolution of self adhering materials could open new horizons for pediatric dentistry.

Correlation of Streptococcus mutans count in Mother-child Pair of Working and Nonworking Mothers: A Cross-sectional Study.

PURPOSE: To determine the prevalence of Streptococcus mutans (MS) in mother-child pairs and to evaluate the correlation in the levels of salivary MS of working and nonworking mothers with that of their children and their associations with other related factors. MATERIALS AND METHODS: A cross-sectional study was carried out among 100 mother-child pairs residing in New Multan Nagar Colony, New Delhi, India. A total of 50 children with their mothers were included in the working group and another 50 were included in the nonworking group. A questionnaire regarding the feeding habits, oral hygiene habits, daily intake of sugars of the children along with their weaning time was carried out. All mothers and children were clinically examined for recording decayed, extracted, and filled teeth (deft)/decayed, missing, and filled teeth (DMFT), and whole unstimulated saliva was collected and cultured for MS in the laboratory. The data were collected and subjected to statistical analysis using chi-square, Spearman's correlation, and logistic regression analysis. RESULTS: The prevalence of salivary MS in the children was 69%. A statistically significant correlation was found between the oral levels of MS in nonworking and working mother-child pairs. Regression analysis showed that those children who feed by bottle for more than 12 months, have daily sweet intake, have sugars in feeding bottle and have higher defts were more likely to have mutans score of 1 or 2. CONCLUSION: The mother, working or nonworking, being the primary care provider is the major source of transmission of MS to their child irrespective of the amount of time spent with them. HOW TO CITE THIS ARTICLE: Sharma P, Goswami M, Singh D, Massod SS, Nganba K. Correlation of Streptococcus mutans count in Mother-child Pair of Working and Nonworking Mothers: A Cross-sectional Study. Int J Clin Pediatr Dent 2016;9(4):342-348.

Sturge-Weber syndrome - A case report.

Sturge-Weber syndrome (SWS), also called as encephalotrigeminal angiomatosis is an uncommon congenital neurological disorder & frequent among the neurocutaneous syndromes specifically with vascular predominance. This disorder is characterized by facial capillary malformation & other neurological condition. The oral manifestations are gingival hemangiomatosis restricting to either side in upper and lower jaw, sometimes bilateral. We report a case of SWS with oral, ocular and neurological features.