OXIS Contacts and Approximal Caries in Preschool Children: A Prospective Cohort Study.

The present prospective cohort study was conducted to evaluate the susceptibility of OXIS contact areas, namely, O (open type), X (point type), I (straight type), and S (curved type) in the development of approximal caries. We conducted this study among 953 school children with 3,812 contacts in Puducherry, India. At baseline, the contacts were assessed in accordance with OXIS criteria. At the end of 12 months, two calibrated dentists measured dental caries following the International Caries Detection and Assessment (ICDAS) criteria. Information about feeding practices, diet, and oral hygiene was collected by means of a structured questionnaire from each child's parent. Data were analyzed by unadjusted and adjusted Poisson regression analysis with a multilevel approach. The two levels of analysis were tooth and child. Of 3,812 contacts observed during the follow-up, 127 (3.3%) were observed as carious. Poisson regression analysis revealed a significant association between type of contact and caries prevalence (p < 0.05). The risk ratios for the development of approximal caries in X contacts were 2.4 (0.3-17.2), p value 0.38; in I contacts 4.9 (1.2-19.9), p value 0.027; and in S contacts 8.2 (1.9-34.2), p value 0.004, when compared with the O contacts. Among the child variables, male gender (relative risk [RR] = 2.1; 95% confidence interval [CI], 1.3, 3.5), parental supervision while toothbrushing (RR = 1.6; 95% CI, 1.1, 2.4), and the use of toothpaste (RR = 1.9; 95% CI, 1.3, 3.1) were found to be associated with approximal caries after adjustment for the other variables. Among the OXIS contacts, the S type was most susceptible to approximal caries due to its complex morphology, followed by I, X, and O.

OXIS Contacts as a Risk Factor for Approximal Caries: A Retrospective Cohort Study.

Purpose: The purpose of the present study was to evaluate the individual susceptibility of four different types of OXIS contact areas (open [O], point [X], straight [I], and curved [S]) to approximal caries in children. Methods: A retrospective cohort study was performed using clinical photographs and cone-beam computed tomography images of children, available from January 1, 2014, to August 31, 2015, showing the presence of at least one caries-free contact area between the primary molars. A single calibrated examiner scored 1,102 selected contacts using OXIS criteria from the occlusal view and subsequently evaluated the same contacts with a minimum follow-up period of one year for the presence of approximal caries. Results: Of the 1,102 contacts, 259 (23.5 percent) were found to be carious or restored due to approximal caries. Multivariate logistic regression analysis showed that only the type of contact played a significant role in caries prevalence (P<0.05). The odds ratios of OXIS contacts for the development of approximal caries were: S contact-147.4 (95 percent confidence interval [95% CI] equals 19.7 to 1101.7); I contact-24.5 (95% CI equals 3.4 to 177.9); X contact-1.1 (95% CI equals 1.0 to 12.5); and O contact-1.00 (reference). Conclusions: Among the OXIS contacts, the S type was most susceptible to approximal caries due to its complex morphology. The broad contact areas, namely, I and S types, are at greater risk for approximal caries in primary molars than O and X contacts.

Incidental Finding of an Odontome Attached with Primary Teeth: A Rare Case Report.

Odontomes are hamartomatous developmental malformation of dental tissues which causes disturbances in the eruption of teeth. In general, odontomes occur frequently in permanent dentition and are seldom associated with primary dentition. This case report presents an odontome attached with primary tooth which was incidentally found during routine radiographic diagnosis and it spotlights the significance of early diagnosis and management of odontome to prevent future complications such as retained deciduous teeth and impaction of permanent teeth, malocclusion, etc. How to cite this article: Kavitha M, Prathima GS, Kayalvizhi G, et al. Incidental Finding of an Odontome Attached with Primary Teeth: A Rare Case Report. Int J Clin Pediatr Dent 2021;14(1):167-169.

Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial.

AIM: The aim of the study was to assess the remineralizing efficacy of fluoride and its combination varnishes on white spot lesion (WSL) in children with early childhood caries (ECC). MATERIALS AND METHODS: Sixty children with active WSL on primary maxillary anterior teeth were randomly selected. At baseline, the WSL activity was evaluated using ICDAS II [lesion activity assessment (LAA)] and its dimensions through photographic method. They were allocated to group I (GI) (5% NaF), group II (GII) [5% NaF with amorphous calcium phosphate (ACP)], and group III (GIII) [5% NaF with casein phosphopeptides - amorphous calcium phosphate (CPP -ACP)]. First, oral hygiene instructions and diet counseling were given followed by application of fluoride varnishes in their respective groups. The same parameters were recorded at follow-up of 2, 4, 12, and 24 weeks intervals. Data were collected and subjected to statistical analysis using Friedman Chi-square and Mann-Whitney tests. RESULTS: Overall, the active WSL changed to inactive over a period of 24 weeks in GI was 90%, GII was 95%, and 100% in GIII. There was a significant reduction in dimension of WSL in GI from 4.119 to 2.525 (p = 0.0001). Likewise, there was a significant reduction in dimension of WSL in GII and GIII from 4.586 to 3.258 and 4.696 to 1.2155, respectively (p = 0.0001, p = 0.0001). Comparatively, group III (MI varnish) showed statistically significant reduction in the dimension of WSL from baseline to 24 weeks (p = 0.002). But the results were statistically insignificant with change of active lesions to its inactivity (p = 0.349). CONCLUSION: Fluoride varnish with CPP-ACP was found to be an effective preventive strategy in reversing WSL in children with ECC. CLINICAL RELEVANCE: These combination varnishes could prove to be a promising preventive measure for pediatric dentists in reversing white spot lesions of ECC. CLINICAL TRIAL REGISTRY: NCT03360266. HOW TO CITE THIS ARTICLE: Radha S, Kayalvizhi G, Adimoulame S, et al. Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13(4):311-317.

Awareness, attitude, and practice of pediatricians regarding early childhood caries and infant oral healthcare of children in Puducherry- A cross-sectional survey.

CONTEXT: Early Childhood Caries (ECC) is the most virulent form of caries, which requires early intervention. Pediatricians are health professionals who first examine the child, and must be able to educate parents about basic preventive dental care, early diagnosis of pathological changes in the oral cavity and appropriate referrals for the children. AIMS: To assess the awareness, attitude, and practice among pediatricians regarding ECC and Infant Oral Healthcare (IOHC) in Puducherry. SETTINGS AND DESIGN: Setting: Study was conducted among pediatricians of Puducherry. Design: Observational Cross-sectional study. METHODS AND MATERIAL: After obtaining consent from Pediatricians, a prevalidated questionnaire was distributed and collected from them regarding their awareness, attitude, and practices toward ECC and IOHC. STATISTICAL ANALYSIS USED: Percentage. RESULTS: Out of 85% Pediatricians who responded, 57% of them were aware of initial white spot lesions, and 39% of them were aware of maternally-derived Streptococcus mutans disease. 100% of them were willing to avail information, training on IOHC. CONCLUSIONS: It is clear from the study that Pediatricians in Puducherry had limited awareness regarding the prevention of oral diseases. It is essential to provide sufficient knowledge to them by incorporating a module on ECC and infant oral health care in their curriculum.

OXIS Classification of Interproximal Contacts of Primary Molars and Its Prevalence in Three- to Four-Year-Olds.

Purpose: The purpose of this study was to investigate the prevalence of different interproximal contact areas of primary molars, as described in the OXIS classification, in a group of three- to four-year-old caries-free children. Methods: This cross-sectional study was carried out with a representative sample of 4,476 contact areas of 1,119 caries-free school children. A single calibrated examiner performed a type III examination to assess the type of contact area between primary molars, as seen from the occlusal view. The contacts were scored as O (open contact), X (point contact), I (straight contact), and S (curved contact) using OXIS classification. The prevalence of the types was expressed in the form of numbers and percentages. The findings were subjected to chi-square and McNemar's tests. Results: The most common contact type was I (75.5 percent), followed by S (15.3 percent), O (5.8 percent), and X (3.3 percent). Significant differences were obtained (P<0.001) when the inter- arch comparison was performed for all except the X type of contact. Further, 401 (35.8 percent) children had more than one type of contact in dif- ferent quadrants. Conclusions: The present study highlights the existence of four different types of interproximal contact areas, O, X, I, and S, in caries-free three- to four-year-olds.

Comparative Evaluation of Plaque Removal Effectiveness of Manual and Chewable Toothbrushes in Children: A Randomized Clinical Trial.

OBJECTIVE: In children, manual dexterity poses a problem with the use of manual tooth brushes (MB), resulting in inefficient plaque removal. Recently, novel chewable brushes (CB) have been introduced which could overcome this problem but are less researched in children. The objective of this study is to assess and compare the plaque removal effectiveness of CB with that of MB. MATERIALS AND METHODS: A total of 60 patients aged 8 to 10 years were enrolled in a single-blinded randomized clinical trial. At baseline, disclosing solution was applied and the Turesky modification of the Quigley-Hein index (TQHI) plaque index and Loe and Silness gingival index were recorded. The subjects were randomly divided into two groups as group I (MB) and group II (CB) and they were instructed to use their respective brushes for a period of 1 week. For statistical comparison, the difference (prebrushing minus postbrushing) in average scores was calculated. Data were evaluated by the independent t test and paired t test, with p < 0.05. RESULTS: The overall plaque scores reduced from 1.71 ± 0.4 to 0.79 ± 0.24 when using CB and from 1.64 ± 0.64 to 1.13 ± 0.47 when using MBs. On lingual tooth surfaces, CB showed a plaque reduction of 38.70 ± 11.04 to 12.60 ± 4.79 compared to less reduction from 37.43 ± 14.26 to 28.73 ± 11.37 for MB. The overall gingival scores were also reduced from 0.33 ± 0.51 to 0.09 ± 0.07 when using CB and from 0.30 ± 0.33 to 0.19 ± 0.23 when using MB. Differences in scores between the two brushes were statistically significant (p = 0.0001). CONCLUSION: It was concluded that the experimental CB was able to remove a significant amount of plaque, particularly on the lingual surfaces, and reduced gingival index scores, thereby improving oral hygiene and gingival health status. HOW TO CITE THIS ARTICLE: Kayalvizhi G, Radha S, et al. Comparative Evaluation of Plaque Removal Effectiveness of Manual and Chewable Toothbrushes in Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2019;12(2):107-110.

Evaluation of Streptococcus mutans serotypes e, f, and k in saliva samples of 6-12-year-old school children before and after a short-term daily intake of the probiotic lozenge.

AIM: The aim of this study is to assess the variations in the levels of Streptococcus mutans in saliva before and after short-term daily intake of the probiotic lozenge. To estimate the prevalence of S. mutans serotypes e, f, and k and its variations in salivary levels before and after short-term daily intake of the probiotic lozenge. MATERIALS AND METHODS: This double-blind randomized controlled trial was conducted among 60 children of 6-12 years old, who were given lozenge twice daily containing probiotic bacteria twice daily, one in the morning and another in the evening after brushing for 1 month. The placebo lozenge group also followed the same protocol. A pre- and post-quantitative analysis of S. mutans and serotypes e, f, and k level were done in the saliva of both experiment and control groups. STATISTICAL ANALYSIS: The data thus collected were statistically evaluated using repeated measures of ANOVA, followed by post hoc test and independent t-test. RESULTS AND CONCLUSION: When compared with baseline, a significant reduction of S. mutans was seen after 1 month intervention and 6 months follow-up. The prevalence of serotype e was found to be 5% and serotype k was found to be 12%, whereas none of the samples carried serotype f. Future long-term research with a larger sample size is required to determine the prevalence of S. mutans serotype and longer evaluation period is required to assess the preventive role against caries development.

Evaluating the Efficacy of Xylitol Wipes on Cariogenic Bacteria in 19- to 35-month-old Children: A Double-blind Randomized Controlled Trial.

INTRODUCTION: Dental caries is an infectious disease with Streptococcus mutans as the main cariogenic bacteria. Children with early S. mutans colonization have a higher risk of developing dental caries than those with later colonization. Therefore, prevention or delay of S. mutans colonization may be advantageous for the prevention of early childhood caries (ECC). AIM: To evaluate and compare the effectiveness of xylitol and placebo wipes on S. mutans count in 19- to 35-month-old children. MATERIALS AND METHODS: Forty-four children were randomly selected from a daycare center and divided into two groups. Allocation concealment was done and both (placebo and xylitol) wipes were distributed to their parents. Instructions were given regarding their use, to be used twice daily for 2 weeks and the S. mutans levels in the saliva were enumerated before and after wipes usage. The collected data were tabulated and statistically analyzed using paired and unpaired t-tests. RESULTS: A clinically significant decrease in the S. mutans count was observed in the xylitol wipes group than the placebo wipes group. Intergroup comparison results were found to be statistically insignificant. CONCLUSION: Xylitol wipes usage could serve as a useful adjunct in reducing the cariogenic bacteria, especially S. mutans, and thus can be considered as an adjunct oral hygiene tool for caries prevention in young childrenHow to cite this article: Kayalvizhi G, Nivedha D, Sajeev R, Prathima GS, Suganya M, Ramesh V. Evaluating the Efficacy of Xylitol Wipes on Cariogenic Bacteria in 19- to 35-month-old Children: A Double-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2018;11(1):13-17.

Colour Preference to Emotions in Relation to the Anxiety Level among School Children in Puducherry - A Cross-Sectional Study.

INTRODUCTION: Dental setting plays an important role in child's behavior and cooperation to the planned dental treatment. Adding attractive colours to the dental environment and by incorporating colourful equipments can make the child feel good and be at ease. This study tries to convey the relationship between colours and dental anxiety among children. AIM: To evaluate the colour preference to emotions in relation to children's age, gender and anxiety level. MATERIALS AND METHODS: A total of 382 children aged 6-12 years were randomly selected from schools in and around Puducherry. Modified dental anxiety scale was recorded by a calibrated examiner. Each question was scored from one (not anxious) to five (extremely anxious); such that the total score ranges from 5 to 25, wherein a score of 15 or more was considered to be anxious. Based on this, children were divided into anxious and non-anxious groups. All the children were provided with eight different coloured crayon pencils and were asked to shade two cartoon emoticons indicating happiness and sadness with their preferred colour. Values were tabulated and statistically analyzed to evaluate the association between the variables using Z test, Chi-square, Chi-square goodness of fit and odds ratio. (p≤0.05 was considered statistically significant). RESULTS: Among 382 children, 77% (294) were graded as anxious and 23% (88) as non- anxious. For positive emotion (happiness), 31.2% (119) children preferred blue followed by pink 29.3% (112). For negative emotion (sadness), 52.1% (199) of children preferred black and 46.9% (179) preferred red. Association between colour and emotion was highly significant (p= 0.005). CONCLUSION: From the colours preferred by the children in our study, it can be concluded that colours like blue and pink in the dental set-up could enhance a positive attitude while black and red could develop a negative outlook in their mind.

Clinical manifestations of oculodentodigital dysplasia.

Oculodentodigital dysplasia (ODDD) is a multisystem congenital disorder characterized by abnormal facial development, deformed limbs and dentition. This report describes a rare incidence of ODDD-linked dermatological, cardiac, dental, and neurologic manifestations noted in an Indian child patient.

Topical application of antibiotics in primary teeth: an overview.

Root canal infections are polymicrobial in nature, consisting of both aerobic and anaerobic species. The successful treatment of both primary and secondary endodontic infections involves effective eradication of the causative microorganisms during root canal treatment procedures. Reduction and elimination of microorganisms from the infected root canal provides optimal opportunity for treatment success. Local application of antibiotics has been considered an effective way to deliver antibiotics. A combination of antibiotic drugs have been tried under the concept of lesion sterilization and tissue repair therapy to eliminate the target bacteria, which are possible sources of endodontic lesions. The purpose of this article is to discuss the lesion sterilization and tissue repair therapy technique in primary teeth.

Christ-Siemens-Touraine Syndrome with Self-mutilation Habit: An Unusual Presentation.

Ectodermal dysplasia exhibits a classic triad of hypohidrosis, hypotrichosis, and hypodontia. Self- mutilation could be due to organic or functional causes. The occurrence of selfmutilation with functional cause represents a diagnostic challenge to practitioners. In most of the instances dentists are the first to recognize patient with ectodermal dysplasia as they report primarily with a complaint of missing teeth. The most common type is hypohidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome). A thorough knowledge of this disease with multidisciplinary approach aids in successful outcome of the treatment. This is an unusual case report of Christ-Siemens-Touraine syndrome with selfmutilation.