Evaluation of Salivary Components and Dental Plaque in Relation to Dental Caries Status in Type 1 Diabetes Mellitus.

Purpose: To evaluate the dental caries prevalence in Type 1 Diabetes Mellitus (T1DM) as compared to healthy children and, to assess the salivary components (flow rate, glucose, α-Amylase, Streptococcus mutans) and dental plaque in relation to their dental caries status. Methods: Dental caries were estimated by using the DMFS index and dental plaque by Sillness and Loe plaque index. The following methods were used to assess the salivary components; draining method to determine the flow rate; glucose oxidase peroxidase method for glucose; substrate method for α-Amylase, Mitis Salivarius Bacitracin agar was used to culture Streptococcus mutans. Results: Caries prevalence was significantly lower in T1DM. In the diabetic group, a significant positive correlation was found between DMFS value and plaque, DMFS value and salivary glucose, and also with DMFS value and salivary α-Amylase. A significant negative correlation was found between the DMFS value and the unstimulated salivary flow rate. The multivariate regression analysis demonstrated that decrease in the unstimulated salivary flow rate to be significantly associated with increasing DMFS values. Conclusion: The caries prevalence was found to be low in T1DM when compared to the healthy children, the cause for it being related to the low plaque scores. Low caries prevalence could also be due to the restriction of sucrose in their diet. Clinical significance: As clinicians, along with restoring the smiles of a child patient, we have to retrospectively analyze the factors involved in the causation of dental caries. Educating the parents and the child in regard to this will help prevent the occurrence of any new carious lesion. How to cite this article: Manjushree R, Anandakrishna L, Prasad KS K, et al. Evaluation of Salivary Components and Dental Plaque in Relation to Dental Caries Status in Type 1 Diabetes Mellitus. Int J Clin Pediatr Dent 2022;15(S-2):S121-S125.

Teaching Cariology in Asia and Arabia.

The European Organisation for Caries Research education platform 2020 had the aim to assess the undergraduate curriculum in cariology in Asian and Arabian countries in order to support structured teaching of cariology in these countries with about almost half of the global population. Representatives of 4 Asian and 4 Arabian countries completed a comprehensive questionnaire on structure of dental education in their country in general and the extent, the content, the responsibilities, structure and standardization regarding cariology in particular. In spite of a wide range from very few universities (Lebanon 3) to larger numbers of dental schools (India 313, China 121, Russia 52) there were similar statements on the list of content for cariology teaching. Often the catalogue was close to the Undergraduate Core Curriculum in Cariology (UCCC) covering most of the 5 domains from basic science to dental public health, but a national curriculum for cariology or dentistry was mostly missing. With various departments being involved, a need of coordination is obvious. Most representatives thought it possible and feasible to teach a standardized curriculum in cariology on the basis of the UCCC. In conclusion, many Arabian and Asian countries have implemented modern, evidence-based curricula in their universities, but an obligatory national curriculum in cariology would be advisable to standardize the quality in teaching.

A Comparison of NovaMin™ and Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride on Enamel Remineralization - An In vitro Study Using Scanning Electron Microscope and DIAGNOdent®.

AIM: The aim of this study was to compare the efficacy of NovaMin™ (SHY-NM) and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) (tooth mousse plus™) on enamel remineralization using DIAGNOdent® and scanning electron microscope (SEM). METHODOLOGY: Eighty-six natural permanent maxillary first premolars were selected and randomly divided into two groups of 43 each, Group A (NovaMin™) and Group B (CPP-ACPF). All the samples were assessed using DIAGNOdent® (KaVo) at the baseline, after demineralization, and remineralization after 7 days. Two samples were randomly selected from each group after remineralization to evaluate the surface changes using SEM at × 1000 and × 2000. RESULTS: The mean value of remineralization was highest for Group A NovaMin™ (6.56 ± 0.93) compared to Group B, CPP-ACPF (tooth mousse plus™) (6.02 ± 1.09). The maximum demineralization to remineralization value within the groups showed that the mean values in Group B CPP-ACPF (7.02 ± 3.02) was higher than Group A NovaMin™ (6.42 ± 2.21). The difference in remineralizing potential between the groups and demineralization to remineralization value in within-group comparison was not found to be statistically significant. CONCLUSION: On comparing Group A NovaMin™ and Group B CPP-ACPF, Group B CPP-ACPF showed a higher amount of remineralization than Group A NovaMin™. From the present study, it can be inferred that both the experimental groups have the potential for remineralization.

Parental issues and concerns for their children treated under general anaesthesia for early childhood caries: A qualitative research approach.

CONTEXT: Most often, young children with early childhood caries (ECC) may need oral rehabilitation under general anaesthesia (GA) as treatment cannot be done chairside. A procedure under GA can be traumatic and stressful for both the parents and the children. Hence, it becomes necessary to understand the parents' opinions and address their concerns to provide better treatment. Aims: This qualitative study was conducted to explore the parental issues and concerns for their children treated under GA for ECC. Qualitative research approach was used so that it would enable us to address these issues better and prepare parents by counselling them in advance. SETTINGS AND DESIGN: An in-depth interview was conducted with the parents of children who underwent oral rehabilitation under GA for ECC in the M.S. Ramaiah Memorial Hospital, admitted under the Department of Pedodontics and Preventive Dentistry. PARTICIPANTS AND METHODS: Data were audio-recorded and transcribed. STATISTICAL ANALYSIS USED: Data collected were analysed using thematic analysis. Results: The themes derived were 'Concerns and Issues of GA Procedures and Improved Oral-health-related Quality of Life'. CONCLUSIONS: The parents of children who underwent oral rehabilitation under GA initially had a few concerns and were reluctant about the procedure but were happy with the improvement post-operatively.

Development of a Competency-Based Curriculum for undergraduate education in Pediatric Dentistry: A systematic approach.

The changing paradigm of dental education in India has led its way to the development of Competency-Based Curriculum (CBC). This article describes the process of developing CBC in the specialty of Pediatric Dentistry under the initiative of Dental Council of India. Rationale behind CBC development is to bring uniform system of education for improving oral health outcomes of the society in long term. The process of CBC development was a collaborative teamwork, planned meticulously with predefined outline, tasks and timelines. Workflow involved identification of curricular content, defining program goals, outlining competencies, assigning them domains / levels of clinical competence, priority, educational strategies, assessment practices, integration and numbers needed for certification in selected competencies. Early clinical exposure was introduced in CBC. The final content was validated and submitted to the Council. CBC output can be summarized as competencies with fair share of all domains, levels, prioritization and integration. It is characterized by flexibility for choosing educational strategies and assessment practices. It opens up ways for global competition. However, it still has some inherent weaknesses like diverging learning paths, time constraints and number chasing. CBC can further have more academic flexibility and develop toward an outcome-based approach. Faculty preparedness and acceptability shall be the biggest challenges in CBC implementation besides resources' availability, support from leadership and acceptability from our primary stakeholders, our learners. CBC is the beginning of evidence-based delivery of education in dentistry. An effective implementation of CBC in current form would result in increased numbers of competent oral healthcare professionals for the society.

Child Dental Patient's Anxiety and Preference for Dentist's Attire: A Cross-sectional Study.

Aim and objective: Initial perceptions of physicians can affect the level of comfort. Creating a strong rapport on the child's first visit helps to create a comfortable atmosphere. Child-friendly clothing of the dentists might possibly contribute to the dentist's empathy. Different attires may evoke different feelings. Hence, the purpose of the study was to assess the children's preferences for dentist's attire and its relation with anxiety. Materials and methods: Eighty children aged 5-12 years were included in the study. Five photographs of dentists wearing different attires were placed in the same order for every child. The child was asked to look at the photographs and decide which dentist they would prefer to take care of them. A facial image scale was used to evaluate the child's anxiety level. The children were asked to point at which face they felt almost like at that moment. Results: 42.7% of males and 38.5% of females chose child-friendly attire. The least preferred by males was a pink apron (7.5%) compared with females (28.1%). Whereas the blue apron was least preferred by females (5.1%) compared with males (20%). A Chi-square test was done to access the association between dental anxiety and the dental attire the children chose, where statistically significant (0.030) results were found. Anxious children were found to prefer child-friendly attire. Conclusion: Although the view that children are fearful of the white coat was not found, the concept of child-friendly attire might be more appropriate for anxious children and enhance an easy first communication with them. How to cite this article: Sujatha P, Nara A, Avanti A, et al. Child Dental Patient's Anxiety and Preference for Dentist's Attire: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(S-2):S107-S110.

Oral health and glycosylated hemoglobin among type 1 diabetes children in South India.

BACKGROUND: The study was an attempt to evaluate the relationship between oral health status and the level of glycemic control in type 1 diabetes patients. METHODS: The study was carried out in 87 children with type 1 diabetes, aged 8-16 years, attending a diabetes specialty hospital. The oral health of these patients was measured using the WHO 1997 Oral Health Survey criteria for diagnosis of dental caries, gingival index, and plaque index. Samples were then divided into two groups as controlled (≤6.99% glycosylated hemoglobin [HbA1c]) and uncontrolled (≥7% HbA1c) diabetes as per the guidelines for glycemic control in diabetics given by the American Diabetes Association. The oral health between the groups was compared. RESULTS: Data were statistically analyzed using student t-test. Results showed a significant difference in decayed, missing, and filled surface component (P = 0.043) and gingival index scores (P< 0.001) in the permanent dentition between controlled and uncontrolled groups but not in case of the primary dentition. CONCLUSIONS: The data findings suggest that metabolic control had an impact on caries prevalence and gingival health of these patients, in case of permanent dentition. As the glycemic control became poorer, the caries prevalence and gingival inflammation increased. When primary dentition was taken into consideration, the correlation was not significant.

Distalization of Maxillary First Permanent Molar by Pendulum Appliance in Mixed Dentition Period.

INTRODUCTION: Mesial drifting of molar teeth in maxillary arch is corrected by movement of the molars distally. In addition to traditional distal movement techniques, such as extraoral force application and removable appliances, various intra-arch devices have been introduced since 1980s. These intra-arch appliances have nearly eliminated the need for patient cooperation. CASE REPORT: The purpose of this paper is to report a case of 10-year-old male patient with loss of space in maxillary molar teeth treated by intra-arch appliance-pendulum appliance by distalization of maxillary first permanent molar teeth. Distaliza-tion of the permanent molar teeth helped in proper eruption of second premolar teeth without any extensive treatment procedures. CONCLUSION: In the present case report, the treatment of developing malocclusion was corrected by utilizing the concept of interceptive orthodontics. Hence, correction of space loss in mixed dentition period using pendulum appliance can eliminate the fixed orthodontic therapy. HOW TO CITE THIS ARTICLE: Paranna S, Shetty P, Anandakrishna L, Rawat A. Distalization of Maxillary First Permanent Molar by Pendulum Appliance in Mixed Dentition Period. Int J Clin Pediatr Dent 2017;10(3):299-301.

Validation of different diagnostic aids in detection of occlusal caries in primary molars: An in vitro study.

AIM AND OBJECTIVE: To estimate the accuracy and assess the sensitivity and specificity of direct visual examination (DVE), computerized radiograph (VISTA SCAN mini), and DIAGNOdent (DD) for caries diagnosis in primary molars as compared to histological examination of the teeth. MATERIALS AND METHODS: An in vitro comparative study was carried out on 40 freshly extracted primary molars with questionable pit and fissures that yielded 89 examination sites. These samples were mounted on plaster and were subjected to examination methods for caries detection on the occlusal surface by two trained and calibrated examiners. The examination methods used in this study were DVE, computerized radiographic (CR) examination, laser fluorescence examination using DD followed by histological examination which is a gold standard; later, these samples were examined under microscope for caries extent. The scoring criteria given by Nytun et al. were used in this study for scoring the extent of caries. RESULTS: The sensitivity for caries in enamel were 66.10%, 52.86%, and 54.17% for DVE, CR, and DD, respectively, while the specificity for DVE, CR, and DD were found to be 86.67%, 68.42%, and 76.47%, respectively. For dentinal caries, sensitivity for DVE, CR, and DD were 86.67%, 92.86%, and 81.25%, respectively, while the specificity were 66.10%, 56%, and 54.79%, respectively. The accuracy were 73.03%, 61.80%, and 59.55%, respectively, suggesting that the DVE showed highest sensitivity, specificity, and accuracy for enamel caries, whereas for dentinal caries, CR showed highest sensitivity and DVE showed highest specificity and accuracy. CONCLUSION: The DD exhibited better specificity than sensitivity for enamel lesions and better sensitivity than specificity for lesions into dentin. DD may prove useful as a predictive clinical tool and should only be used in addition to other diagnostic methods such as visual inspection and dental radiographs to avoid false-positive diagnoses.

A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study.

AIMS: The purpose of this study was to evaluate the accuracy of a new-generation electronic apex locator (iPex) to determine working length in primary teeth with or without root resorption as compared with the conventional radiographic method. MATERIALS AND METHODS: A sample of 30 primary posterior teeth which are indicated for pulpectomy were selected for the study. After obtaining the informed consent from the parents, local anesthesia was administered. Access cavity was prepared with no.10 round bur. Initial exploration of the canals was done with no.10 K-file. Pulp was extirpated with a barbed broach followed by thorough irrigation of the canals with 0.9% saline. Initially, working length was obtained with iPex (new-generation by Nakanishi International) apex locator using no.10 K-file, which was then compared with conventional radiographic method (Ingle's method). RESULTS: A total of 65 canals were available for the measurement. The data were analyzed using Statistical Analysis system and t-tests were carried out. There was no statistically significant difference found when using iPex apex locator for working length determination as compared with that of conventional radiographic method (p = 0.511). CONCLUSION: Working length determined by iPex apex locator is comparable with that of conventional radiographic method, hence, can be used as an alternative in determining the working length of primary teeth. HOW TO CITE THIS ARTICLE: Bhat KV, Shetty P, Anandakrishna L. A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(1):34-36.

Coconut milk and probiotic milk as storage media to maintain periodontal ligament cell viability: an in vitro study.

BACKGROUND/AIM: The viability of periodontal ligament (PDL) cells is a significant determinant of the long-term prognosis of replanted avulsed teeth. A storage medium is often required to maintain the viability of these cells during the extra-alveolar period. Many studies have been carried out to search for the most suitable storage medium for avulsed teeth, but an ideal solution has not yet been found. The purpose of the study was to compare and analyze the ability of coconut milk and probiotic milk to maintain PDL cell viability. METHODOLOGY: In an in vitro setting, 69 caries free human premolars with normal periodontium that had been extracted for orthodontic purposes were randomly divided into two experimental groups on the basis of storage media used (i.e., coconut milk or probiotic milk) and a Hanks' balanced salt solution (HBSS) control group (23 samples per group). Immediately after extraction, the teeth were stored dry for 20 min and then immersed for 30 min in one of the storage media. The teeth were then subjected to collagenase-dispase assay and labeled with 0.5% trypan blue staining solution for determination of cell viability. The number of viable cells was counted under a light microscope and statistically analyzed using anova and post hoc Tukey test (P ≤ 0.05). RESULTS: Statistical analysis demonstrated there was a significant difference (P < 0.001) between coconut milk and probiotic milk as well as HBSS in maintaining cell viability. However, there was no significant difference between probiotic milk and HBSS in ability to maintain PDL cell viability (P > 0.05). CONCLUSION: Coconut milk may not be suitable as an interim transport media due to poor maintenance of cell viability. However, probiotic milk was able to maintain PDL cell viability as well as HBSS.

Problematic eating and its association with early childhood caries among 46-71-month-old children using Children's Eating Behavior Questionnaire (CEBQ): a cross sectional study.

CONTEXT: Problematic eating behavior in children presents a wide spectrum from anorexia, selective eating, and fussy eating to neophobia. Pouching of food and slow eating represents eating behavioral problems that may be relevant to pediatric dentist as far as early childhood caries (ECC) is concerned. AIM: The aim of this study was to determine the prevalence of problematic eating and its association with ECC among 46-71-month-old children in Bengaluru city, India. SETTINGS AND DESIGN: A cross-sectional study was carried out in 250 children aged 46-71 months old in various schools of Bengaluru city. SUBJECTS AND METHODS: All the selected children were clinically examined for dental caries using decayed, missing, filled surfaces index. Children's eating behavior was assessed using Children's Eating Behavior Questionnaire (CEBQ) which was filled by the parents. STATISTICAL ANALYSIS USED: Both descriptive statistics as well as Chi-square test was used with SPSS 16.00. RESULTS: The prevalence of dental caries was found to be 34%. It was observed that 81.6% of the children did not have a tendency to keep food in their mouth all the time and ECC was found to be significantly less. Furthermore, approximately 90% of the children did not have a tendency to eat too much and in those, 68% of them were caries free which was statistically significant. Prevalence of ECC was highest (52.6%) in children who ate more when they had nothing else to do. CONCLUSION: Problematic eating behavior is prevalent in the preschooler group and needs to be considered by the pediatric dentist.

Leukocyte adhesion deficiency: a case report and review.

Leukocyte adhesion deficiency (LAD) is a rare inherited primary immunodeficiency disorder characterized by the presence of a defect of phagocytic function resulting from a lack of leukocyte cell surface expression of ß2 integrin molecules (CD11 and CD18) that are essential for leukocyte adhesion to endothelial cells and chemotaxis. A small number of patients with LAD-1 have a milder defect, with residual expression of CD18. These patients tend to survive beyond infancy; they manifest progressive severe periodontitis, leading to partial or total premature loss of the primary and permanent dentitions. Close cooperation with pediatricians and immunologists is often the key to successful management of pediatric patients with LAD. The purpose of this report was to present the case of a 5-year-old boy with moderate leukocyte adhesion deficiency-1 and severe periodontitis, cellulitis and illustrate the need for periodic oral checkups to avoid the progression of oral diseases and prevent premature tooth loss.

Is there an Association between Oral Health Status and School Performance? A Preliminary Study.

The present cross-sectional study was carried out to assess the impact of poor oral health status on school performance of 600 primary and nursery school children of Bengaluru city, India. The data were collected using the methods and standards recommended by the WHO for oral health surveys. Oral health status was assessed using the df-t index (number of decayed and filled teeth). Academic performance was assessed based on the marks obtained. The children were divided into three groups: Excellent, average, below average (as given by the school teachers). Comparison between categorical variables was performed using one-way ANOVA using the SPSS software package (version 12.0). The mean df-t of the excellent group was 1.56 ± 2.5, for average group it was 2.05 ± 2.8 and for the below average group it was 4.47 ± 2.7. The below average group showed high caries index compared to other groups. The relation between school performance and mean df-t was found to be statistically significant (p < 0.001). The findings of this study demonstrate the impact that poor oral health has, on lowering school performance in children. It can be safely concluded that improvement of children's oral health may be a vehicle to improve their educational experience. How to cite this article: Garg N, Anandakrishna L, Chandra P. Is there an Association between Oral Health Status and School Performance? A Preliminary Study. Int J Clin Pediatr Dent 2012; 5(2):132-135.

Comparative Evaluation of Antimicrobial Efficacy of MTAD, 3% NaOCI and Propolis Against E Faecalis.

AIM: The present study sought to compare the antimicrobial efficacy of 3% NaOCl, Biopure MTAD (Tulsa Dentsply, Tulsa, OK) and Brazilian ethanolic extract of propolis (EEP) against Enterococcus faecalis (E. faecalis). METHODOLOGY: The study utilized 55 extracted human permanent teeth with single root canal. The samples were decoronated, instrumented and sterilized. The teeth were infected with E faecalis for 48 hours. The teeth were divided randomly into 3 groups according to the irrigants used and kept in contact with the respective irrigant for 5 minutes. All the samples were incubated in brain heart infusion (BHI) broth for 96 hours. Disinfection of the samples was determined based on presence or absence of turbidity in the BHI broth 96 hours later. Statistical analysis was done using Chi-square test. RESULTS: All the samples treated with MTAD showed complete absence of turbidity, while all the 15 teeth treated with propolis showed presence of turbidity, 8 out of 15 teeth treated with NaOCl showed presence of turbidity. Statistical analysis of the data using chi-square test showed significant difference between the groups (P < 0.05). CONCLUSION: The study concluded that MTAD was more effective than 3% NaOCl and propolis against E. faecalis.

Caries experience and oral hygiene status of children suffering from attention deficit hyperactivity disorder.

OBJECTIVE: The study was conducted to determine the caries experience and oral hygiene status of children suffering from attention deficit hyperactivity disorder (ADHD) and was compared with that of non-ADHD children. STUDY DESIGN: A total of 80 children, including 40 ADHD and 40 non-ADHD children were included in the study. A visual dental examination for dental caries was performed and oral hygiene status of these children was determined. The parent/guardian completed a questionnaire concerning the child's behavior followed by questionnaire to the child regarding oral hygiene practices and food habits. RESULTS: Student-t test and chi-square test showed that children with ADHD had significantly higher defs score, mean plaque score in compared to that of non-ADHD children. Statistical significant differences were also found out in relation with frequency of tooth brushing and consumption of sugary food among the children suffering from ADHD. CONCLUSION: Caries prevalence in the primary dentition is increased in the children suffering from ADHD due to poor oral hygiene and increased consumption of sugary foods.