COVID-19 and Personal Protective Equipment-Related Challenges Faced by Pediatric Dentists during patient care: A Qualitative Study

Abstract Objective: To describe the challenges pediatric dentists face while caring for their patients during the pandemic. Material and Methods: A descriptive qualitative study was conducted with purposefully sampled pediatric dentists. Data were collected through in-depth, semi-structured interviews until the content of the collected data reached theoretical saturation. Data were transcribed verbatim, coded, and analyzed using content analyses. Results: Seven participants (four females and three males) between 29 and 50 years participated in the study. Three themes emerged from the analyses: Anxiety and fear; PPE (Personal Protective Equipment) and its impact on care delivery; and 3) Behavior management. Conclusion: Dental care delivery was challenging for pediatric dentists. They experienced high anxiety levels and modified their services according to the recommended guidelines while making accommodations to lessen patients' COVID-19-related anxiety. The additional mandated PPE use affected the communication between the dentists and their patients, affecting their dentist-patient bonding.

Efficacy of Glutathione Biomolecule in Reducing the Tooth Discoloration Associated with Silver Diamine Fluoride: A Split-mouth In vivo Study.

Background: The necessity to modify silver diamine fluoride (SDF) to make it esthetically acceptable without affecting its beneficial properties keeps the research in this field pertinent. Aim: This study aims to comparatively evaluate the efficacy of Glutathione (GSH) in reducing tooth discoloration associated with SDF. Materials and Methods: This split-mouth in vivo study was conducted on 20 children aged 3-8 years having a minimum of 3 active carious primary teeth. The three teeth in each patient were randomly divided into Group I - 38% SDF; Group II - 38% SDF followed by application of potassium iodide; and Group III - 38% SDF mixed with 20% GSH. Standardized photographs were taken immediately after application and after 6 months, which were analyzed using Image J software. The carious lesions were clinically classified as active or arrested after 6 months. Results: When mean gray values of three groups were compared postoperative, the highest value (lighter shade) was observed for group II and least (darker shade) for group I, whereas, during the 6-month follow-up, the highest value was seen for group III and least for group I. The color change from preoperative to 6 months' follow-up was compared, and a statistically significant difference was observed between groups I and II (P = 0.003) and groups I and III (P = 0.001). When caries arresting effectiveness was analyzed, there was no significant difference found between any of the groups (P = 1). Conclusion: Mixing 20% GSH with 38% SDF was an effective measure in reducing the tooth discoloration associated with SDF, without affecting caries arresting the efficiency of the latter.

Comparative Evaluation of the Phytochemical Analysis and Efficacy of Four Plant-derived Extracts against Streptococcus mutans: An In Vitro Study.

Introduction: Oral health is a loyal part of general health. As per the World Health Organization (WHO), dental caries is the most widespread noncommunicable disease and is a significant universal public health concern. The main causative organism associated with this disease is Streptococcus mutans (S. mutans). Various synthetic agents like chlorhexidine and fluorides are commercially available to prevent dental caries. However, these have side effects. Presently, research is engaged in the use of plant extracts to develop an effective and biocompatible material that may be used safely in the oral cavity. Methodology: Four plants were collected-Emblica officinalis, Vitis vinifera seeds, Psidium guajava (P. guajava) Linn leaves, and Acacia nilotica (A. nilotica), and extracts were prepared individually. These extracts were subjected to phytochemical analysis, and bacterial growth and fermentation were assessed. Result: The level of significance was set at p < 0.05. All the plant extracts inhibited S. mutans growth at all serial dilutions except P. guajava Linn and A. nilotica showing 55 CFU/mL and 5 CFU/mL, respectively in 1/1000 dilution only. The phytochemical analysis confirmed that all four plant extracts had alkaloids, carbohydrates, tannins, and flavonoids. Steroids and proteins are present in P. guajava Linn. Proanthocyanidins were present in Vitis vinifera. Saponins and Anthraquinones were present in A. nilotica exclusively. Conclusion: All the extracts were effective against S. mutans. These could be tried as herbal alternatives to conventional adjuncts. However, these results must be additionally evaluated for toxicity in animal models, and effectiveness must be assessed using in vivo studies on human subjects. How to cite this article: Kripalani KB, Thomas NA, Thimmaiah C, et al. Comparative Evaluation of the Phytochemical Analysis and Efficacy of Four Plant-derived Extracts against Streptococcus mutans: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-3):S258-S262.

Comparative Evaluation of Chlorhexidine and Cetrimide as Irrigants in Necrotic Primary Teeth: An In vivo Study.

Context: Disinfection of the root canal system by biomechanical preparation and profuse irrigation is especially important in primary teeth due to its complex pulp canal anatomy. Appropriate selection of irrigating solution should be done in terms of tissue dissolving capacity, antibacterial efficacy, and palatability when treating pediatric cases. Aim: The aim of the study was to compare the antibacterial efficacy of 2% chlorhexidine (CHX), 0.2% cetrimide (CTR), and 0.2% CHX + 0.2% CTR against anaerobic bacteria and to test the influence of CTR added to CHX on its antibacterial action. Materials and Methods: Seventy-five teeth that were selected for the study were divided into three groups: Group I (2% CHX), Group II (0.2% CTR), and Group III (0. 2% CHX + 0.2% CTR). Samples collected before and after irrigation were immediately processed and microbial growths were quantified. Statistical Analysis: Intergroup comparison was done using one-way analysis of variance and Newman-Keuls multiple post hoc procedures and intragroup comparison was done using paired t-test. Results: When the mean values of Group I were compared with Group II, the data were statistically not significant (P = 0.2341), whereas Group I showed a significant difference when compared with Group III (P = 0.0107). When the mean values of Group II and Group III were compared, the data were found to be statistically not significant (P = 0.0805). Conclusion: The efficacy of 2% CHX was found to be slightly superior when compared with that of 0.2% CTR, but the difference was not statistically significant. However, a significant difference was found between 2% CHX and combination irrigants.

Evaluation of the Effect of Probiotic Yogurt Consumption on Salivary pH, Buffering Capacity and Calcium Level in 6-12-year-old Children: An In Vivo Study.

Introduction: Dental caries is a preventable disease that can be prevented by suppressing any one of the factors of the Keyes triad. Aim and objective: To investigate the effect of probiotic yogurt on salivary pH, calcium level, and buffering capacity. Materials and methods: A total of 60 children were randomly selected and were divided into 2 groups. The test group consumed 200 mL of probiotic yogurt and the control group consumed 200 mL of regular curd everyday for 30 days. A base-line nonstimulated salivary sample (2 mL) was collected. The salivary pH, buffering capacity, and calcium level was assessed at baseline, after 15 and 30 days. The data were statistically analyzed. Result: The mean pH levels of the probiotic group were 7.03 and salivary buffering capacity was found to be 2.000. Salivary calcium levels increased with the use of probiotic yogurt at the end of 30 days (mean of 4.79) compared to the control group. Conclusion: Consumption of probiotic yogurt for a short period of time can prevent dental caries by increasing salivary calcium level. How to cite this article: Malavalli PL, Shetty SB, Thimmaiah C, et al. Evaluation of the Effect of Probiotic Yogurt Consumption on Salivary pH, Buffering Capacity and Calcium Level in 6-12-year-old Children: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(2):194-198.

Comparative analysis of the remineralization potential of CPP-ACP with Fluoride, Tri-Calcium Phosphate and Nano Hydroxyapatite using SEM/EDX - An in vitro study.

BACKGROUND: In recent years, the non-invasive management of non cavitated caries lesions using remineralization systems to repair the enamel have received more attention from the scientific community. Aim: To quantitatively evaluate the remineralization potential of Casein phosphopeptide-amorphous calcium phosphate-fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(nHAP) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX). MATERIAL AND METHODS: 40 enamel specimens were prepared, and immersed in demineralising solution at a pH of 4.4 for 96 hours at 37°C, to induce artificial carious lesions. Remineralization was carried out for a period of 30 days using CPP-ACPF, TCP, nHAP. The specimens were evaluated for calcium and phosphorus content using SEM-EDX. RESULTS: The Ca/P mass % after remineralization was significantly higher with CPP-ACP-F and TCP-F followed by nHAP. CONCLUSIONS: CPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions. These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface. Key words:Remineralization, in vitro; CPP-ACP fluoride, Nano-hydroxyapatite, Tri-calcium phosphate, SEM/ EDX.