Comparative Evaluation of Electronic Acupuncture Pen and 2% Lignocaine Gel as an Intraoral Topical Anesthetic Agent in Children.

Background The most exasperating aspect for pediatric patients in a dental setup is the fear and anxiety caused by injections, called "blenophobia". There are numerous local anesthetic agents available to reduce the needle prick pain. Taking into consideration the paradigm shift, there is always a possibility for alternate treatment options. This study aimed to evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) application through an electronic acupuncture pen (Meridian Energy Acupuncture Pen W-912 GENERIC) and 2% lignocaine gel as an intraoral topical anesthetic agent in children. Method Patients aged 6 to 12 years were eligible for inclusion. The topical anesthetic agents were administered to the patients in a bilateral split-mouth technique. In Group A, 2% topical anesthetic gel was administered on the first visit on one side of the mandible and topical anesthesia through the electronic acupuncture pen was administered on the next visit, on the opposite side of the mandible. The electronic acupuncture pen was applied on one side of the mandible on the first visit, and on the next appointment, 2% topical anesthetic gel on the other side was administered in Group B. Sound, eye, motor scale (SEM) and faces pain scale-Revised (FPS) were used as tools of evaluation after local anesthesia was administered.  Results  The comparison between electronic acupuncture pen and 2% lignocaine gel using the SEM scale shows a statistically insignificant difference (p-value = 0.082). Similarly, a comparison of FPS values between both groups indicates no significant difference (p-value = 0.582). However, results show a reduced pain perception in both groups. Conclusion Topical anesthetic agents are commonly used to reduce needle prick pain in children. TENS through the electronic acupuncture pen, a revisited aid in scientific research, has proved its efficacy as a topical pain reduction measure during dental treatment. This device overcomes the shortcomings of the anesthetic gels and also nullifies the chances of overdosage, hypersensitivity, and disagreeable taste. Thus, this tool can be used in dental practice for the management of pain in children.

Management of Hypodontia Patient Using a Transitional Implant: A Case Report.

Background: Children with missing anterior teeth have physiological and psychological problems. Out of the many treatment options available, dental implants have advantages in replacing teeth. But, conventional implants in growing individuals are contraindicated due to their osseointegration property. Newer literature suggests transitional implants in growing individuals, which may allow easy removal of requirements in the future. Case description: A 12-year-old female patient visited the department with esthetic concerns. The orthodontic treatment was carried out to correct the malocclusion. An MS transitional implant was used to rehabilitate the missing maxillary left lateral incisor. After 24 months of follow-up, the transitional implant provided optimal esthetic and patient compliance. Conclusion: Transitional implant is a possible mode of rehabilitation in children and adolescents with missing teeth. Systematic planning of treatment can lead to desired esthetic and functional results. How to cite this article: Rathi NV, Baliga S, Thosar NR, et al. Management of Hypodontia Patient Using a Transitional Implant: A Case Report. Int J Clin Pediatr Dent 2023;16(1):186-189.

Comparative Evaluation of Antibacterial Efficacy of Emblica Officinalis Lollipop Against Streptococcus Mutans Counts in Institutionalized Visually Impaired Children.

Background Among the 1.21 billion population of India, 26.8 million individuals have disabilities, and around five million are visually impaired. These children encounter problems related to oral health maintenance, thus further leading to dental problems. Even though Pediatric dentists treat visually impaired children for their oral problems, they emphasize mainly on the prevention of dental caries. Dental caries has a multifactorial etiology, and dentists are unable to find a complete solution for its prevention. However, reducing Streptococcus mutans has been seen to reduce the caries rate in the past. The use of the herbal product Emblica officinalis to reduce Streptococcus mutans levels has been documented. An affordable delivery system is required to use Emblica officinalis for its anticaries action. Thus, a unique delivery system of herbal sugar-free lollipops containing Emblica officinalis extract was made and can effectively deliver antimicrobial action in visually impaired children. Aim To evaluate the antibacterial efficacy of Emblica officinalis lollipop on Streptococcus mutans counts and pH levels in institutionalized visually impaired children. Method A total of 60 institutionalized visually impaired children (age: 4 to 14 years) were selected. The study consisted of two groups (experimental "Emblica officinalis lollipop" and control "placebo lollipop"), and the children were divided equally into both groups. Children from the study and control groups were subjected to the respective lollipops twice daily for seven days. Streptococcus mutans count and pH count were evaluated at baseline and after seven days post-intervention of the respective lollipop. Results The results showed that in both groups, Streptococcus mutans count was reduced post-intervention. However, the efficacy of the study group (Emblica officinalis lollipop) in inhibiting the Streptococcus mutans count was better than the control group (placebo lollipop). An increase in the pH level was seen post-intervention for both the study and control groups. And on the intergroup comparison, no statistical significance was found. Conclusion The use of Emblica officinalis lollipop is effective in inhibiting the Streptococcus mutans count when compared with the placebo lollipop. While marginal pH change was seen in both groups. Thus, the herbal modality most acceptable without any pharmaceutical concerns should be chosen. Emblica officinalis lollipops can be used in institutionalized visually impaired children to reduce the oral Streptococcus mutans count and maintain a healthy oral cavity.

Effectiveness of Two Different Behavior Modification Techniques for Anxiety Reduction in Children.

Background Dental anxiety has been a major concern for dentists while operating children. For a smooth, uneventful treatment, operators must incorporate various behavior management techniques in their practice. The incorporation of magic tricks as behavior management techniques has been used earlier by physicians and nurses to reduce pre-operative anxiety in hospitals. This study aimed to compare the impacts of magic tricks on reducing dental anxiety in children. Material and methods Patients aged four to 11 years were eligible for inclusion. The study comprised two groups of 15 children each. During the first visit, children weren't subjected to any behavior management. Behavior management aids (magic tricks and audiovisuals) were used during the second visit. Hemodynamic parameters along with an anxiety scale were used to assess anxiety in children before, during, and after treatment procedures. Venham's picture test and modified visual analog scale were also used to assess the anxiety. Results A reduction in anxiety was seen in both groups after behavior management was used. The hemodynamic parameters like blood pressure and pulse rate were seen to decrease during the second visit, while the oxygen saturation was seen to increase. Conclusion The study demonstrates that magic trick along with audiovisual aids was effective in controlling dental anxiety. Thus, magic tricks can be used in dental practice as a behavior management aid for children to facilitate cooperative behavior. Reducing a child's dental anxiety through various different magic trick aids could be a potential behavior management modality that needs further research.

Rehabilitation of Traumatised Maxillary Anterior Teeth in Children Using Endocrown: A Case Series.

Trauma to the anterior teeth has a great impact on the societal and psychosomatic well-being of an individual. Restoring such teeth with a minimally invasive approach is of utmost importance. Endocrown is a monolithic ceramic bonded structure that can be made at dental laboratories for the maintenance of tooth structures. This alternative for endodontically treated teeth turns out to be a viable option in restoring traumatic tooth structures. The steps in its preparation are easy and conservative when compared to conventional crowns with post and core. This article emphasizes two different cases of traumatic anterior teeth in children, successfully dealt with by means of endocrowns fabricated with composite and lithium disilicate prostheses with a 10-month follow-up period.

Surgical enucleation of radicular cyst in endodontically treated primary mandibular molar.

Radicular cysts are most common odontogenic cysts seen in the orofacial region, but not commonly detected in paediatric cases. This case report describes the accidental detection of radicular cyst and its surgical management in an 8-year-old boy in lower left back region of the jaw. The article also gives an insight about radicular cyst from its aetiology to the various other treatment modalities.

Evaluation of antibacterial efficacy of Triphala toothwipes on oral Streptococcus mutans count in intellectually disabled children.

AIM: To evaluate antibacterial efficacy of Triphala toothwipes on oral Streptococcus mutans counts in intellectually disabled (ID) children. METHODS: Twenty-seven children with a mild ID were randomly divided into two groups: A - Triphala and B - placebo group. Toothwipes were given to caregivers of children belonging to the respective groups, and were instructed to use them 1 h after their meals, twice a day for 7 days. Simplified Plaque index was recorded and plaque samples were collected for microbiological examination at baseline, 48 h, and 7 days. The obtained data were tabulated and analyzed. RESULTS: Triphala group showed a statistically significant reduction of S. mutans after 48 h and 7 days. Both Triphala and placebo groups showed a statistically significant reduction in dental plaque after 48 h and 7 days. CONCLUSION: Triphala toothwipes are effective against the oral S. mutans compared with placebo toothwipes, while both the toothwipes are equally effective in reducing dental plaque. Thus, Triphala toothwipes can be used as an adjunct aid along with routine oral hygiene practices in individuals who lack psychomotor skills or are dependent on others to maintain oral hygiene, including infants, preschoolers, geriatric population, and children with special health care needs.

Comparison of impact of oral hygiene instructions given via sign language and validated customized oral health education skit video on oral hygiene status of children with hearing impairment.

INTRODUCTION: Children with special health-care needs have limitations in oral hygiene performance due to their potential motor, sensory, and intellectual disabilities and so are more prone to have compromised oral health. AIM: This study aimed to compare the impact of oral hygiene instructions given via sign language and a validated customized oral health education skit video on oral hygiene status of children with hearing impairment (CHI). SETTINGS AND DESIGN: Ethical clearance was obtained from the institutional ethical committee for research activities. The study was carried out across CHI schools of Wardha district, Maharashtra, India. METHODOLOGY: Sixty-eight CHI, within the age group of 6-13 years, were divided into two educational intervention groups: customized oral health educational video (Group A) and sign language (Group B). A structured questionnaire was designed to gather information about the routine oral hygiene practices via the Indian Sign Language. Baseline Gingival Index (GI)-S and Plaque Index-S indices were recorded. Based on the group assigned, oral hygiene instructions were given on a daily basis. Reassessment was done after 4 weeks. STATISTICAL ANALYSIS: Unpaired t-tests were performed (P < 0.05) to determine if significant differences exist between the two groups. RESULTS: Postintervention plaque scores between Group A and Group B were 0.12 ± 0.22 and 0.07 ± 0.22, respectively, and the difference between the two was statistically insignificant (P = 0.330). For GI, scores in Group A and Group B were 0.03 ± 0.12 and 0.04 ± 0.12, respectively, and the difference was statistically insignificant (P = 0.669). CONCLUSION: Both sign language and the validated customized video modeling have been proved to be positively influencing the oral hygiene status of CHI equivalently.