Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China.

Background: Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments. Methods: We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific. Results: Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries. Conclusions: The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.

Comparative Evaluation of Compressive Strength of Self-cure, Dual-cure, and Light-cure Glass Ionomer Cements in a Simulated Oral Environment: An In Vitro Study.

Background: In primary dentition, glass ionomer cements (GICs) have unique benefits as a restorative material. Various types of GICs are available in the market. In pediatric dentistry, the choice of GI materials is generally focused on handling convenience with adequate consideration for mechanical qualities, including compressive strength to withstand occlusal stresses in the oral environment. Aim of the study: To evaluate the compressive strength of self-cure, dual-cure, and light-cure GI-based cements using a universal testing machine. Materials and methods: The study population comprised 30 cylindrical restorative blocks for compressive strength assessment. The restorative materials used for the studies were self-cure GIC (ChemFil Rock and GC Fuji IX GP Fast GIC), dual-cure GIC (Equia Forte and Ionolux GIC), and light-cure GIC (GC Fuji II LC and Ketac N 100 GIC). The cylindrical blocks were prepared using prefabricated Teflon mold measuring 4 mm diameter and 6 mm height from respective restorative materials and divided into three major groups and were subdivided into six groups comprising two materials in each group. Using an Instron universal testing machine, compressive strength was assessed. Data obtained were tabulated, and statistical analysis was done using Statistical Package for the Social Sciences (SPSS v22.0) software. Results: On individual comparison of GI-based types of cement, Ketac N100 GIC showed the highest compressive strength, and Fuji IX GP Fast GIC showed the least compressive strength. Conclusion: Light-cure GIC exhibited the highest compressive strength in comparison to dual-cure and self-cure GICs with regard to the nature of curing. How to cite this article: Chandru TP, Chandran S, Peedikayil FC, et al. Comparative Evaluation of Compressive Strength of Self-cure, Dual-cure, and Light-cure Glass Ionomer Cements in a Simulated Oral Environment: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(5):707-710.

Malayalam language translation and validation of oral health-related early childhood quality of life tool (OH-ECQoL).

Objective: The objective of this study was to adapt the Oral Health-related Early Childhood Quality of Life (OH-ECQoL) tool for the Malayalam-speaking community and investigate its validity and reliability. Methodology: Malayalam language version of OH-ECQoL was derived through a forward-backward translation and tested for content validity. A convenient sample (n = 300) was recruited by including children with and without early childhood caries (ECC). Parents of these children completed the derived Malayalam OH-ECQoL measure. The properties of translated OH-ECQoL were evaluated by determining its validity and reliability using concurrent validity, construct validity, discriminant validity, internal consistency, and test-retest reliability. Results: OH-ECQoL scores varied with ECC and caries-free groups (P < 0.001), supporting the ability to distinguish between patient groups. Discriminant validity tests show that children with ECC have greater median scores and interquartile range (21 ± 8) compared to children without ECC (14 ± 2). Concurrent validity was observed to be 0.72 and 0.71, respectively, for child section (P < 0.001). Convergent validity demonstrates a strong positive correlation between child impact and family impact with a Spearman's correlation coefficient significant of 0.73 (P ≤ 0.01). Cronbach's alpha for the child impact section and family impact section showed good internal consistency at 0.92 and 0.83, respectively. Test-retest reliability at 0.87 shows good reliability. Conclusions: The Malayalam version of the OH-ECQoL tool demonstrated acceptable validity and reliability. The study also shows that ECC presents a negative impact on the QoL of preschool children and their parents.

Evaluation of antifungal activity of six children's toothpaste on Candida albicans isolated from early childhood caries patients.

BACKGROUND: Early childhood caries (ECC) is an aggressive, destructive form of dental caries that affects the children younger than 6 years of age. Candida is known to increase the adherence of Streptococcus mutans to the oral biofilm and produce acids that cause tooth demineralization. AIM OF THE STUDY: To evaluate the efficacy of six commercially available children's toothpaste on clinical isolates of Candida albicans obtained from ECC patients. MATERIALS AND METHODS: The study population comprised 60 children aged 3-6 years having ECC. Samples were divided into six groups comprising ten children in each group. Samples were collected using sterile cotton swabs, inoculated on Sabouraud dextrose agar, and incubated at 37°C for 24 h. Species identification was done by germ tube test and growth on corn meal agar. After the confirmed growth of C. albicans, the six commercially available children's toothpaste namely Organic Children's Coconut Oil Toothpaste®, Aloe Dent Children's Toothpaste®, Patanjali Dant Kanti Junior Toothpaste®, Colgate Kids Toothpaste®, Pediflor Kids Toothpaste®, and Crest Pro-Health Stages Kids Toothpaste® and distilled water as control group were subjected for antifungal activity of C. albicans. Agar plates were incubated at 37°C for 48 h, and the diameter of the zones of inhibition was measured and recorded. Data were tabulated and statistical analysis was done using Statistical Package for the Social Science (16.0) version. RESULTS: Pediflor kids toothpaste® showed maximum antifungal activity and Aloe Dent children's toothpaste® showed minimum antifungal activity. CONCLUSION: All brands of children's toothpaste show antifungal activity against Candida albicans.

Comparative evaluation of three different toothpastes on remineralization potential of initial enamel lesions: A scanning electron microscopic study.

BACKGROUND: The early enamel lesions are reversible as it is a process involving mineral transactions between the teeth and saliva. AIM: To evaluate the efficiency of three different tooth pastes on remineralization potential of initial enamel lesions using Vickers Micro hardness Test and Scanning electron microscopy. MATERIALS AND METHODS: Artificial carious lesions were prepared in human enamel with demineralizing solution. The treatment agents included were Colgate sensitive plus® toothpaste, Regenerate enamel science™ toothpaste, BioRepair® toothpaste and control as Deionized water. All the samples were subjected to treatment solutions as per the pH cycling model for 12 days to simulate the daily oral environment's acid challenge. The remineralization parameters-surface hardness and surface roughness of enamel blocks were evaluated with Vickers indenter and Scanning electron microscope respectively. Statistical Analysis: ANOVA test was used to check mean differences between the groups. Post hoc analysis was done using Tukey's post hoc test. SEM images were graded according to Bonetti et al grading criteria. RESULTS: As per statistical analysis, maximum remineralization of enamel blocks occurred after applying Colgate Sensitive Plus® tooth paste followed by BioRepair® tooth paste and Regenerate enamel Science™ toothpaste. Least remineralization potential was shown by control group. CONCLUSION: Colgate sensitive plus tooth paste with Pro Argin™ formula can be regarded as a potential remineralising agent. It can be concluded as a noninvasive means of managing early enamel carious lesions.

Antimicrobial efficacy of medium chain fatty acids as root canal irrigants: An in vitro study.

BACKGROUND: Enterococcus faecalis and Candida albicans are the microbes that are most resistant to elimination by disinfecting agents and are the causative agents for reinfection of the root canal treated teeth. Medium chain fatty acids (MCFAs), which are the main components of coconut oil, are proven antimicrobial agents. Thus, the aim of this study was to evaluate their antimicrobial efficacy against E. faecalis and C. albicans. METHODOLOGY: Ninety extracted single-rooted mandibular premolar teeth were decoronated, biomechanically prepared, autoclaved, and divided into three groups (n = 30): Group A (inoculated with E. faecalis), Group B (inoculated with C. albicans), and Group C (control group). Each group was again subdivided into three groups (n = 10) and irrigated with lauric acid (LA), decanoic acid (DA), and octanoic acid, respectively, for 5 min. Paper point samples were taken from canal walls and transferred into Brain Heart Infusion broth and potato dextrose broth and placed in an incubator at 37°C. The appearance of tubidity was checked at 24, 48, 72, and 96 h using direct contact test. The data were then statistically analyzed using the analysis of variance and Tukey honestly significant difference post hoc tests. RESULTS: Among the three MCFAs, LA showed the maximum inhibitory against E. faecalis at 24 h and the inhibitory activity decreased considerably at 48, 72, and 96 h. DA was the most effective against C. albicans with a maximum inhibition at 48 h. DA also showed significant substantivity at 72 and 96 h. CONCLUSION: Within the limitations of this study, it can be concluded that MCFAs show promising antimicrobial efficacy against E. faecalis and C. albicans.

Evaluation of effect of polymerization time on curing depth of various bulk fill composites- An in vitro study

Objectives: From the time composite has been developed, it has been subjected to various changes in composition like addition of filler and initiators to yield better result. One such modification is the new bulk fill composite. However an acceptable polymerization time to maintain adequate curing depth has to be evaluated. So the aim of this in vitro study was to evaluate the effect of polymerization time on curing depth of four bulk fill flowable composites. Methods: Total of 80 cylindrical specimens were prepared, and divided into 4 groups comprising of 20 specimens in each group. These selected groups were again subdivided into 4 groups comprising of 5 specimens in each group, based on their polymerisation time. The four specimens were Group A: SDR flow (DENTSPLY), Group B: Tetric N' Flow (Ivoclar Vivadent), Group C: Filtek bulk fill (3M) and Group D: Venus bulk fill (Heraeus Kulzer).The aluminium mold of 4mm depth and 5mm diameter was filled with composite and top surface was irradiated using Valo LED curing light with polymerisation time of 10, 20, 40, and 60seconds on respective subgroup.The microhardness of top and bottom surfaces were performed using Vickers Hardness tester under the load of 200gram for 15seconds. The depth of cure of each specimen was determined by hardness ratio method using the formula Hardness ratio=VK of bottom surface/VK of top surface.The results were statistically analysed. Results: The study results showed that all the tested bulkfill composites can be cured to an acceptable depth. Tetric N' Flow exhibits maximum curing depth (95.28 ±0.26) at 10sec polymerisation time. Venus bulk fill showed higher depth of cure at 20 and 40sec curing time (96.79±0.39 and 97.56±0.20). SDR flow showed adequate curing depth at 20 and 40sec curing time (92.94±0.49and 93.62±0.22 respectively). Filtek bulk fill has maximum depth of cure at 40sec curing (89.10±0.79). Conclusion: Increasing polymerisation time increases the top as well as bottom micro-hardness of all tested bulk fill composites. Tetric N' Flow maximum curing depth at 10sec curing time. Filtek bulk fill is the material with least depth of cure.

Comparison of Candida species isolated from children with and without early childhood caries: A descriptive cross-sectional study.

BACKGROUND: Early childhood caries (ECC) is characterized by the presence of one or more decayed, missing (due to caries), or filled teeth surfaces in any primary tooth, in a child below 6 years of age. Although ECC is primarily associated with high levels of maternal Streptococcus mutans, there has been an increased interest in finding the relationship between oral fungal flora and dental caries. OBJECTIVE: The aim of the study is to identify and characterize the Candida species and to compare the candidal isolates in children with ECC and without ECC. MATERIALS AND METHODS: The study was conducted on children below 6 years of age, who were categorized into ECC and non-ECC groups of fifty children each. Samples were collected using sterile cotton swabs and were inoculated on Sabouraud's Dextrose Agar and incubated at 37°C for 24 h. Candidal colonies were isolated, species identified and virulence factors tested for both ECC and non-ECC groups. RESULTS: The candidal carriage among the ECC children was found to be 84%, which was significantly higher than the non-ECC group of 24%. Candida albicans and non-albicans Candida (NAC) were isolated in both ECC and non-ECC groups. Phospholipase production was significantly high in ECC group whereas hemolysin production and germ tube formation showed no significant difference between the two groups. CONCLUSION: A significant correlation was found between the presence of Candida and ECC. NAC also plays an important role in the development of ECC. The virulence factors such as phospholipase may be responsible for the pathogenicity of Candida in the development of ECC.

Awareness of Dental Trauma Management among School Teachers of Kannur, Kerala, India.

INTRODUCTION: Dental trauma can overtake dental caries and periodontal disease as the most significant threat to dental health among young people. The prognosis of traumatized teeth depends on prompt and appropriate treatment. The role of school teachers in the prevention of traumatic dental injuries is a topic that has received a great deal of attention in recent years. However, studies conducted in different regions of the world have demonstrated that teachers and other lay people's knowledge about traumatic dental injuries is inadequate and their behavior does not contribute to reduce the sequelae. AIM: The purpose of this study was to evaluate the knowledge of school teachers about dental trauma and its management in Kannur district. MATERIALS AND METHODS: The survey was conducted under the Department of Paedodontics and Preventive Dentistry; Kannur Dental College among 303 school teachers randomly selected from 16 schools. Four schools were selected from 16 schools using stratified cluster sampling technique. A cross sectional study design was used. A stratified cluster sampling method was done to select the study subjects. The nature and purpose of the study was first explained to the teachers in local language. Following this the printed questionnaire was distributed to school teachers. The questionnaire was prepared based on the needs of the study after referring similar questionnaires used in studies conducted in different parts of the world. RESULTS: A statistically significant association was found between the teacher's knowledge regarding trauma and their teaching experience. Out of the total school teachers who participated in the study, 90.1% responded correctly that the teeth most frequently affected by traumatic accidents are the upper front teeth. Nearly 23.4% responded correctly regarding management of traumatic tooth fracture. Almost 46.5% had correct knowledge regarding the reimplantation of avulsed permanent teeth. Only 14.2% responded correctly to the proper storage medium for avulsed teeth. CONCLUSION: It was concluded from the study that among the school teachers surveyed there was significantly very low knowledge of emergency management of dental trauma.

The knowledge, attitude and practice regarding the pediatric preventive dental care amongst medical practitioners: a cross sectional study

Dental caries is the most common chronic disease affecting the children today. Many dental problems can be effectively prevented in children if they are detected early. Medical practitioners play a major role in the primary care of the child and are well positioned to recognize potential problems, encourage preventive care and refer appropriately. So the present survey was conducted among Medical practitioners in Kannur, Kerala to determine their knowledge, attitude and practice in Pediatric preventive dental care.o assess the attitude and practice of dental professionals towards using of advance Radiographic technique.

Comparison of antibacterial efficacy of coconut oil and chlorhexidine on Streptococcus mutans: An in vivo study.

AIMS: Streptococcus mutans is the most common organism causing dental caries. Various chemotherapeutic agents are available that help in treating the bacteria, with each having their own merits and demerits. Recent research has shown that coconut oil has anti-inflammatory and antimicrobial action. Therefore, the present was conducted to determine the antibacterial efficacy of coconut oil and to compare it with chlorhexidine. MATERIALS AND METHODS: A total of fifty female children aged 8-12 years were included in the study. Twenty five children were randomly distributed to each group, i.e., the study group (coconut oil) and the control group (chlorhexidine). The participants were asked to routinely perform oil swishing with coconut oil and chlorhexidine and rinse every day in the morning after brushing for 2-3 minutes. S. mutans in saliva and plaque were determined using a chairside method, i.e., the Dentocult SM Strip Mutans test. Patients were instructed to continue oil swishing for 30 days. S. mutans. counts in plaque and saliva on day 1, day 15, and day 30 were recorded and the results were compared using Wilcoxon matched pairs signed ranks test. RESULTS: The results showed that there is a statistically significant decrease in S. mutans. count from coconut oil as well as chlorhexidine group from baseline to 30 days. The study also showed that in comparison of coconut oil and chlorhexidine there is no statistically significant change regarding the antibacterial efficacy. CONCLUSION: Coconut oil is as effective as chlorhexidine in the reduction of S. mutans.

A Cross-sectional Study of the Prevalence of Dental Caries among 12- to 15-year-old Overweight Schoolchildren.

INTRODUCTION: Overweight and obesity are growing health-related problems worldwide, and it is currently the most prevalent nutritional disorder among children and adolescents. The objective of this study was to assess the association between overweight and dental caries among 12- to 15-year-old schoolchildren in Mangaluru district, Karnataka, India. MATERIALS AND METHODS: Data were obtained from 2000 school-going children aged 12 to 15 years. The children were categorized as overweight and normal-weight group by assessing the body mass index (BMI). Body mass index was categorized using the classification system given by the International Obesity Task Force (IOTF) and obtained in units of kg/m2. The dental caries was assessed by detection and was performed according to decayed, missing, and filled teeth (DMFT) index. RESULTS: Of the 2000 children examined, the mean BMI recorded was 26.87 ± 2.26 for the overweight children and 20.82 ± 1.48 for the normal-weight children. Even though the DMFT (3.90 ± 2.95) in the overweight children was slightly higher than the control group (3.36 ± 2.73), it was not statistically significant. CONCLUSION: Within the confines of the present study, it can be concluded that there is no significant association between overweight and dental caries among the schoolchildren of Mangaluru district in Karnataka. Longitudinal studies are necessary to substantiate the possible relationships between dental caries and overweight in children. Knowledge of these relationships could lead to preventive health measures designed to reduce the prevalence of both obesity and dental caries.

Comparison of Antimicrobial Activity of Chlorhexidine, Coconut Oil, Probiotics, and Ketoconazole on Candida albicans Isolated in Children with Early Childhood Caries: An In Vitro Study.

Background. Early childhood caries (ECC) is associated with early colonisation and high levels of cariogenic microorganisms. With C. albicans being one of those, there is a need to determine the effectiveness of various chemotherapeutic agents against it. The study is aimed at isolating Candida species in children with ECC and at studying the antifungal effect of coconut oil, probiotics, Lactobacillus, and 0.2% chlorhexidine on C. albicans in comparison with ketoconazole. Materials and Methods. Samples were collected using sterile cotton swabs, swabbed on the tooth surfaces from children with ECC of 3 to 6 yrs and streaked on Sabouraud dextrose agar (HI Media) plates and incubated in a 5% CO2 enriched atmosphere at 37°C for 24 hours. Candida was isolated and its susceptibility to probiotics, chlorhexidine, ketoconazole, and coconut oil was determined using Disc Diffusion method. Results. The mean zone of inhibition for chlorhexidine was 21.8 mm, whereas for coconut oil it was 16.8 mm, for probiotics it was 13.5 mm, and for ketoconazole it was 22.3 mm. The difference between the groups was not statistically significant (Chi-square value 7.42, P value 0.06). Conclusion. Chlorhexidine and coconut oil have shown significant antifungal activity which is comparable with ketoconazole.

Effect of coconut oil in plaque related gingivitis - A preliminary report.

BACKGROUND: Oil pulling or oil swishing therapy is a traditional procedure in which the practitioners rinse or swish oil in their mouth. It is supposed to cure oral and systemic diseases but the evidence is minimal. Oil pulling with sesame oil and sunflower oil was found to reduce plaque related gingivitis. Coconut oil is an easily available edible oil. It is unique because it contains predominantly medium chain fatty acids of which 45-50 percent is lauric acid. Lauric acid has proven anti inflammatory and antimicrobial effects. No studies have been done on the benefits of oil pulling using coconut oil to date. So a pilot study was planned to assess the effect of coconut oil pulling on plaque induced gingivitis. MATERIALS AND METHODS: The aim of the study was to evaluate the effect of coconut oil pulling/oil swishing on plaque formation and plaque induced gingivitis. A prospective interventional study was carried out. 60 age matched adolescent boys and girls in the age-group of 16-18 years with plaque induced gingivitis were included in the study and oil pulling was included in their oral hygiene routine. The study period was 30 days. Plaque and gingival indices of the subjects were assessed at baseline days 1,7,15 and 30. The data was analyzed using paired t test. RESULTS: A statistically significant decrease in the plaque and gingival indices was noticed from day 7 and the scores continued to decrease during the period of study. CONCLUSION: Oil pulling using coconut oil could be an effective adjuvant procedure in decreasing plaque formation and plaque induced gingivitis.

Non surgical management of large periapical lesion using mta: report of 2 cases

In the past, cases with open apices were often treated over several appointments, using calcium hydroxide, with the hope of creating a ''calcific'' barrier against which gutta percha could eventually be placed. The treatment could be as long and the prognosis is questionable. These roots were often thinner and, therefore, more brittle; extending treatment over a long period of time without providing a permanent restoration increased the chances of losing these teeth due to fracture. With the favorable histologic response of MTA, this material is the best current choice for this procedure. Completion of these cases in an effective and efficient way allows for permanent restorations to be done in a timelier manner, prolonging the longevity of these teeth. The following case report demonstrates the use of MTA as an obturating material to promote periapical healing with an open apex.

Endodontic Treatment of a Mandibular Second Premolar with Type IV Wiene's Root Canal: A Case Report.

This case report describes an endodontic treatment of a mandibular second premolar with type IV root canal. A 26-year-old male patient reported pain in right mandibular second premolar. Clinical examination showed a large carious lesion with pulp exposure. Radiographs showed minimal periapical changes and slight widening of periodontal ligament space. Mandibular second premolars usually have one canal. The mandibular second premolar may present large number of anatomic variations. The clinician should be aware of the configuration of the pulp system. This case presents the diagnosis and clinical management of a mandibular second premolar with two distinct canals in the apical third of root (Type IV Wiene's canal configuration), drawing particular attention to tactile examination of all the canal walls and obturating it with calamus 3D obturation system.

Trismus pseudocamptodactyly syndrome: a sporadic cause of trismus.

Trismus pseudocamptodactyly syndrome is a very rare autosomal dominant inherited disorder characterized by the inability to completely open the mouth (trismus) and the presence of abnormally short tendon units causing the fingers to curve (camptodactyly). Early diagnosis and management of this condition is important to prevent facial deformities in the patient. Reporting such a case is important as case reports are one of the sources of data for calculating the prevalence of rare diseases. Here, we report a case of trismus pseudocamptodactyly syndrome in an eight-year-old boy with a brief review of the literature.

An update on local anesthesia for pediatric dental patients.

Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients.