Knowledge and Perceptions Regarding Coronavirus (COVID-19) among Pediatric Dentists during Lockdown Period.

AIM: To assess the knowledge and perceptions of COVID-19 among pediatric dentists based on their dependent source of information. METHODS: A descriptive-analytical cross-sectional survey using a self-administered questionnaire with 23 questions was sent via Google forms to pediatric dentists. All participants were divided into three groups [postgraduate residents (PGs), private practitioners (PP), and faculty (F)]. The comparison of knowledge and perception scores was made based on occupation, source of information, and descriptive statistics used for the analysis using SPSS 21.0 (IBM, Armonk, NY, USA). RESULTS: A total of 291 pediatric dentists completed the survey, and the majority of them were females (65%). Overall, good mean scores were obtained for knowledge (9.2 ± 1.07) and perceptions (5.6 ± 1.5). The majority of the participants used health authorities (45%) to obtain updates on COVID-19, while social media (35.1%) and both (19.6%) accounted for the next two. A statistically significant difference (p < 0.05) was found among different pediatric dentists groups for relying on the source of information. CONCLUSION: Overall good pediatric dentists showed sufficient knowledge regarding COVID-19. The pediatric dentists' age, occupation, and source of information influenced knowledge regarding COVID-19, whereas perceptions were influenced by age and gender of the participants. Health authorities successfully educated pediatric dentists than the social media.

Role of Dental Discomfort Questionnaire-Based Approach in Recognition of Symptomatic Expressions Due to Dental Pain in Children with Autism Spectrum Disorders.

AIM: The aim of this study is to investigate whether the Dental Discomfort Questionnaire (DDQ) could help to identify toothaches in children with autism spectrum disorder (ASD). MATERIALS AND METHODS: This study involved sixty children between the age groups of 6-16 years, attending the day-care schools diagnosed with ASD. Five different groups of children were identified based on the presence of a toothache and/or carious teeth. The DDQ-8 was completed by parents and evaluated by a single examiner. Data were analyzed using descriptive statistics (SPSS version 17), and a correlation was observed between the total DDQ score and the decayed, missing, and filled teeth (dmft-DMFT) score. RESULTS: Analysis of the data showed that DDQ-8 had a significant correlation with that of DMFT score in a group "with carious teeth but no toothache" (r = 0.497, P = 0.019) and group "with carious teeth and a toothache" (r = 0.682 P = 0.043). A group "without carious teeth where the parents were not sure whether or not the child had a toothache" had higher mean compared to other groups with DDQ-8 scores. CONCLUSION: There was a significant difference in the total mean DDQ scores when they were compared with that of the control group. Children with high DDQ-8 often had a high DMFT/dmft score. A significant correlation was found when the total DDQ-8 scores were compared with that of the DMFT score.

Prevalence of Community-Associated Methicillin-Resistant Staphylococcus aureus in Oral and Nasal Cavities of 4 to 13-year-old Rural School Children: A Cross-sectional Study.

AIM: This study aimed to investigate the oral and nasal prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in 4 to 13-year-old rural schoolchildren. MATERIALS AND METHODS: A total of 100 children aged 4 to 13 years were randomly selected and divided into ten groups based on their age (Group 1 = 4-year-old children to Group 10 = 13-year-old children). From each participating child, sampling was done from the anterior nares and dorsum of the tongue. All samples were inoculated into Baird-Parker agar medium and HiCrome™ MeReSa agar medium for the isolation of SA and MRSA. Both the culture plates were checked for the presence of SA and MRSA and overall SA and MRSA carriage. The distribution of SA and MRSA was evaluated. Descriptive statistics were performed using SPSS software (version 17.0). RESULTS: Overall SA in 4-13 years' age group was 47%, while CA-MRSA was 35%. On the tongue, 16 children had concomitant MRSA and SA, while only 23.8% (n = 20) of the children comprised the presence of SA when MRSA was absent (P < 0.001). In the nasal cavity, 30 children had concomitant MRSA and SA, while only 21.4% (n = 15) of the children had the presence of SA when MRSA was absent (P < 0.001). When tongue and nose were assessed, 11 children encompassed concomitant MRSA and SA, while only 16.9% (n = 13) of the children had the presence of SA when MRSA was absent in both sites (P < 0.001). CONCLUSION: A significant relation was found between nasal SA and CA-MRSA carriage, with oral SA and CA-MRSA carriage. The study concludes that oral cavity is possibly as important as the nasal area as a zone of SA and MRSA. Dentists dealing with pediatric population should take proper precautions to prevent cross contamination of SA and MRSA in the dental clinic.

Impacted Primary Mandibular Second Molar Associated with Late-Formed Second Premolar: A Rare Entity of Reverse Dentition.

Impaction of the tooth in primary dentition is very less common than the permanent dentition. Impaction of teeth in primary dentition may create various problems in occlusion and also in developing dentition. Clinical and radiographic evaluation of such cases may benefit the patient as well as the clinician. Among primary tooth impaction cases, second primary molars are not frequently reported along with late formation of its succedaneous tooth. Nevertheless, the purpose of this report was to describe a case of a rare entity of reverse dentition caused by the impaction of the mandibular primary second molar associated with delayed formation of the second premolar.

A Novel Approach to extrude Subgingivally Fractured Tooth using Customized Removable Appliance.

Traumatic dental injuries (TDIs) are common in growing children. Among all the dental injuries, complicated crown root fractures (Andreasen Class VI) of maxillary permanent anterior teeth are relatively widespread. Such fractured teeth are often considered as hopeless and are extracted. However, if the tooth is to be retained, various treatment strategies have been proposed. The aim of the present case report is to suggest a new technique to treat a complicated crown root fracture. The management of this case included endodontic procedure and orthodontic extrusion to move the fracture line above the supragingival level. A customized removable Hawley's appliance with a modified single cantilever spring was fabricated and an anchoring Begg bracket was bonded on the residual crown of the tooth. This method is useful in the mixed dentition when there is insufficient anchorage of adjacent teeth because of preshedding mobility and trauma. How to cite this article: Mohammad Z, Penmetcha S, Bagalkotkar A, Namineni S. A Novel Approach to extrude Subgingivally Fractured Tooth using Customized Removable Appliance. Int J Clin Pediatr Dent 2018;11(1):53-57.

Assessment of hypoxia, sedation level, and adverse events occurring during inhalation sedation using preadjusted mix of 30% nitrous oxide + 70%oxygen.

PURPOSE: To assess the efficacy of nitrous oxide (N2O)-oxygen (O2) inhalation sedation by rapid induction technique using preadjusted mix of 30% N2O and 70% O2 in children. MATERIALS AND METHODS: Sixty children with a treatment plan which included pulp therapy were recruited for the study. Children categorized 3 and 4 of Frankl behavior rating scale and American Society of Anesthesiologists health status I and II were included for the study. Children were distributed into study group (Group-I) and control group (Group-II) by fishbowl randomization. Children in Group-I were induced inhalation sedation using a preadjusted mix of 30% N2O and 70% O2 through rapid induction technique, and children in Group-II were exposed to inhalation sedation by conventional slow induction technique. Parameters such as least oxygen saturation, sedation levels by Richmond Agitation-Sedation Scale, time taken to achieve ideal sedation, maximum N2O concentrations used, and adverse events were recorded and evaluated for each procedure. Data were analyzed using independent sample t-test and Chi-square tests. RESULTS: Analysis of data showed statistically significant difference between both groups in time taken to achieve ideal sedation (P < 0.001). No significant difference was seen in incidence of hypoxia (P < 0.512), maximum N2O concentrations used (P < 0.118), and occurrence of any adverse events. CONCLUSION: None of the children from both groups exhibited hypoxia. Sense of detachment was seen in one child each from both groups. Rapid induction by preadjusted mix resulted in ideal sedation in 57% children of the Group-I; rest had achieved these levels at 40% N2O. There was a significant difference in the time taken to achieve ideal sedation by rapid induction which was almost half the time taken with slow induction.

Customized Modified Haas Palatal Expansion in Mixed Dentition: A Case Report.

The dental arch perimeter and transpalatal width are the most significant arch dimensions in the developing individuals. Its management during the primary, mixed and early permanent dentition are greatly important for the normal development of the dental arches and significantly improve the occlusion in adulthood. Malocclusion is a constant source of threat to the facial appearance. Severe anterior crowding and narrow maxillary arches adversely affect the smile, facial profile and consequently patient becomes handicapped socially as well as psychologically. Maxillary expansion has been used in resolving the problems of crowding, constricted arches and allow for forward growth of the mandible in growing children. This case report describes the use of a customized modified Haas appliance in intercepting the maxillary anterior crowding and gain the transpalatal width and arch perimeter of the maxilla, enhance the smile and facial profile and to allow the forward mandibular growth without any anterior occlusal interferences.

Agenesis of Permanent Mandibular Central Incisors: A Concordant Condition in Siblings.

Concordance is an identical expression of phenotype in two related individuals. Concordance expression of hypodontia is an uncommon condition where associated individuals are affected with exactly similar kind and number of missing teeth. There is very limited documentation of this condition either in twins or in siblings, and literature shows paucity of data with regard to this anomaly. To the best of our knowledge, there is only one such case reported in the literature, which has actually showed similar missing lower central incisors in siblings. This report presents a case of two girl siblings aged 11 and 13 years with congenital bilateral missing of permanent mandibular central incisors, which is an absolute concordant condition. Apart from discussing etiology, clinical implications and management, this article highlights the significance of concordant and discordant condition of hypodontia and expression of this condition in twins and siblings. How to cite this article: Kagitha PK, Namineni S, Tupalli AR, Challa SK. Agenesis of Permanent Mandibular Central Incisors: A Concordant Condition in Siblings. Int J Clin Pediatr Dent 2016;9(1):74-77.

Effectiveness of Various Sensory Input Methods in Dental Health Education Among Blind Children- A Comparative Study.

AIM: The aim of the study is to evaluate effectiveness of various sensory input methods in dental health education among blind children. Oral hygiene status was assessed through visible plaque index and oral hygiene knowledge was assessed through questionnaire before and after oral health education. MATERIALS AND METHODS: The study involved of 200 blind children with the age range of 8 to 14 years of both genders from two blind schools similar in standard of teaching. The total study population (n=200) was randomized and divided into five Groups, comprising of 40 children in each Group. The first four were the experimental Groups who received dental health education through different modes, while the fifth Group served as control. Oral health related knowledge and plaque scores were assessed in all the study Groups before and after dental health education. RESULTS: After intervention, the mean knowledge scores and plaque scores were statistically significant in all the study Groups when compared to the baseline scores. CONCLUSION: The present study proved that blind children can maintain an acceptable level of oral hygiene when taught with special customized methods like multisensory approach with creative use of other senses which was found to be effective than unisensory method.

Effect of Soft Drinks and Fresh Fruit Juice on Surface Roughness of Commonly used Restorative Materials.

In this in vitro study, the effects of a Cola drink, and fresh fruit juice (citrus) on the surface roughness on flowable composite and resin-modified glass ionomer cement (RMGIC) each was evaluated and compared. Using a brass mold 70 pellets each of flowable composite (Filtek™ Flow) and RMGIC tricure restorative material were prepared according to the manufacturer's instructions. Two groups (groups I and II) were formed containing 30 pellets of each material. Remaining 10 pellets of each restorative material did form the control group [water (group III)]. Experimental group pellets were again divided into three subgroups (mild, moderate and severe) containing 10 pellets each and were kept in plastic containers with 30 ml Cola drink (group I) and fresh fruit juice (group II) respectively. Immersion regime was followed according to M aupome G et al. Baseline and final surface roughness (Ra) value for each pellet was evaluated using a profilometer. Statistical analysis was done with Wilcoxon's signed rank test and analysis of variance (ANOVA) followed by Mann-Whitney test. Results showed that the erosive effect of both Cola drink and fresh fruit juice caused significant surface roughness on both flowable composite and RMGIC restorative materials in the mild, moderate and severe immersion regimes. How to cite this article: Maganur P, Satish V, Prabhakar AR, Namineni S. Effect of Soft Drinks and Fresh Fruit Juice on Surface Roughness of Commonly used Restorative Materials. Int J Clin Pediatr Dent 2015;8(1):1-5.

Treatment of ectopic mandibular second permanent molar with elastic separators.

Ectopic eruption is a developmental disturbance in which the tooth fails to follow its normal eruption pathway. Ectopic eruption of the second molar is relatively rare. This paper presents the case of thirteen-year-old male with an ectopic mandibular second permanent molar. The condition was corrected with surgical exposure and placement of elastic separators. This case report lays emphasis on the practice of basic methods to obtain acceptable results rather than extensive surgical or orthodontic corrections. It is advised that ectopic teeth should not be neglected especially when it concerns developing caries and malocclusion.

Guest editorial.

At the start of this New Year, I would like to draw attention of pediatric dental fraternity at large toward Raven Maria Blanco Foundation, United States. This is a foundation established by parents of a young girl called Maria, who lost her life in pediatric dental Office, which was not prepared to handle an emergency arising from a procedural sedation for dental treatment. This is very heartening for any parent. It was so heart rending that Grammy award singer Michael Crawford popularly known as 'Magnedo7' penned a song called Raven's Song in her memory. This brings the focus on two important issues: sedation and emergency preparedness in our practices.(1.)

Pediatric obstructive sleep apnea syndrome: time to wake up.

UNLABELLED: Pediatric patients with well-controlled OSA present few difficulties for routine dental treatment. However, patients with untreated or undiagnosed OSA can present the dental practitioner with multiple issues and challenges. Dental professionals have a unique doctor-patient relationship that affords them a role in recognizing sleep disorders by exploring the history of patients who are sleepy. AIM: This paper is aimed at providing comprehensive review of pediatric obstructive sleep apnea. How to cite this article: Arali V, Namineni S, Sampath Ch, Pediatric Obstructive Sleep Apnea Syndrome: Time to Wake Up. Int J Clin Pediatr Dent 2012;5(1):54-60.

Evaluation of Microleakage of RMGIC and Flowable Composite Immersed in Soft Drink and Fresh Fruit Juice: An in vitro Study.

Aim : The objective of the study was to evaluate and compare the effect of a soft drink and a fresh fruit juice on the microleakage of flowable composite and resin modified glass lonomer cement (RMGIC). Methods and materials : 70 non-carious human premolars were collected and stored in saline until further use. Class-V cavities were prepared and restored with RMGIC on the buccal surface and flowable composite on the lingual surface for evaluating microleakage. The experimental groups (Group I and II ) comprised of 60 teeth, while the remaining 10 formed the control group (Group III-Water). The experimental groups were further divided into 2 groups (Group I-Cola drink and Group II-Fresh orange fruit juice) of 30 teeth each. Each group was then further divided into 3 subgroups (Short, Medium and Long-immersion) containing 10 teeth as shown in flow chart. Immersion regime was followed according to Maupome G et al and microleakage was evaluated by using Rhodamine B dye and examined under stereomicroscope. Results : Microleakage data obtained was statistically analyzed by Chi-square test. The teeth showed statistically significant microleakage as the immersion regime increased. Interpretation and Conclusion : Low pH soft drink caused highly significant microleakage at the tooth and restorative material interface in medium and high immersion regimes signifying that the leakage pattern was directly proportional to the number of immersions. Thus, the study conclusively proves that the 'sipping habit' associated with commonly available low pH beverages is detrimental to the longevity of restorations.