Clinical Consequences of Untreated Dental Caries among Primary School Children: A Cross-Sectional Study

Abstract Objective: To evaluate the dental caries experience and clinical consequences of untreated dental caries (UDC) among primary school children of Al Jouf region, Saudi Arabia and to determine the correlation between dental caries experience and clinical consequences of UDC. Material and Methods: A 250 primary school children 6-7 years were recruited using systematic random sampling. The prevalence of dental caries in deciduous dentition was assessed by following WHO criteria using the dmft index and the clinical consequence of UDC was assessed with the pufa index. The pufa score was calculated cumulatively following the pufa diagnostic criteria. The Student's t-test was used to equate the mean dmft and pufa scores between boys and girls. The correlation between the dmft and the pufa scores was evaluated using Pearson's correlation coefficient (r), and the p-value was set at 0.05 for statistical significance. Results: Out of which 154 (61.60%) boys and 94 (37.60%) were girls. The mean (SD) values of dmft for boys reported to be 5.37 (± 3.31) and for girls 6.35 (± 3.27), which was statistically significant with gender (p<0.001). Statistically, significant mean values of pufa were 1.20 (± 1.37) in boys and 1.71 (± 1.58) in girls, respectively was observed (p<0.001). The Pearson correlation between dmft and pufa values showed a highly significant positive correlation among dmft and pufa values (r= 0.635, p<0.001). Conclusion: The present study revealed that high caries prevalence and experience of the clinical consequences of UDC in the primary dentition, and there was a strong positive correlation between dmft and pufa score values.

Assessment of Caries Spectrum of First Permanent Molars in 7- to 8-Year-Old School Children in Northern Saudi Arabia: A Cross-Sectional Study

Abstract Objective: To estimate caries spectrum in first permanent molars (FPMs) of 7- to 8-year-old children in Saudi Arabia using Caries Assessment Spectrum and Treatment (CAST) index, and examine the correlation between distributions of CAST codes among contralateral and opposite arches. Material and Methods: A cross-sectional survey was conducted of 7- to 8-year-old Saudi school children in Sakaka, Aljouf, Saudi Arabia. A total of 385 children were examined. CAST codes were determined for FPMs, and their distribution was analyzed using Spearman's rank correlation coefficient. Statistical significance was set as p<0.05. Intra-examiner reliability was determined using the unweighted kappa coefficient. Results: The results indicated most of the FPMs were scored as code 3 (enamel lesions) such as upper contralateral FPM 44.40% for right, 53.50% for left, respectively, and lower contralateral molars were 61.30% for right and 64.90% for left, respectively. It was also observed that upper FPMs had scored code 0 (sound teeth) more than that of lower FPMs. Serious morbidity (codes 6 and 7) and mortality (code 8) showed a low prevalence in FPMs. Strong correlations were observed between upper contralateral FPMs (r=0.586) and lower contralateral FPMs (r=0.567, p<0.001). Conclusion: A high prevalence of enamel caries lesions (code 3) was observed in FPMs; in addition, a strong correlation was present between upper contralateral FPMs and between lower contralateral FPMs.

Frequency and Characteristics of Mesiodens in Indian School Children: A Retrospective Radiographic Study

Abstract Objective: To determine the frequency and characteristics of mesiodens in Indian school children. Material and Methods: 1232 radiographs of patients attending the Department of Oral Medicine and Radiology of the age group of 4-15 years studied for the present retrospective study. The intraoral periapical radiographs and occlusal radiographs of the premaxilla were examined to determine the presence of mesiodens. The data regarding the presence of mesiodens, number, position, location on the arch, shape and associated complications were recorded. Results: Eleven patients had 14 mesiodens, with a frequency of 0.8%. The ratio of boys to girls was 1.2:1. Maximum mesiodens observed in the age group of 7-9 years. Most of the mesiodens were conical in shape and found on the palatal side. Fifty percent of the mesiodens were unerupted. The majority of patients (57.1%) had vertically positioned mesiodens. Midline diastema was the most common complication due to mesiodens (66.7%). Conclusion: Routine check-up during the primary dentition and mixed dentition stages helps for early detection of mesiodens and thus preventing complications. Early identification is useful for planning comprehensive management, initiating proper consultation and referral for evaluation and treatment.

Prevalence of Peg-Shaped Lateral Incisors in Non-Syndromic Subjects: A Multi-Population Study

Abstract Objective: To evaluate the prevalence and gender-wise distribution of peg-shaped maxillary permanent lateral incisors among populations in Saudi Arabia representing different geographical locations (Saudi, Jordan, Egypt, Syria, Philippine, Pakistan, India and Bangladesh). Material and Methods: Panoramic radiographs of 9945 patients attending outpatient university dental clinics of College of Dentistry, Jouf University, Saudi Arabia between February 2014 and January 2018 were collected from the archives randomly. Two calibrated investigators examined the data, which were collected from the dental radiology department archives with prior permission from the authorities. The anomalies of maxillary lateral incisors (right and left) were investigated. Results: Among all geographic locations, the prevalence of peg laterals was more in males in comparison to females except in Pakistani and Philippine populations. Among the Saudi population, peg laterals' prevalence was more in case of right lateral incisor than the left incisor. Conclusion: A higher prevalence of peg laterals was found in Saudi. Conclusion: A higher prevalence of peg laterals was found in Saudi region, followed by Egypt. Among all geographic locations, the prevalence of peg laterals was higher in males than females except for Pakistan and Philippines populations. Among Saudi population prevalence of peg laterals was found to be higher in case of right lateral incisor when compared to the left.

Pattern and Severity of Early Childhood Caries among Preschool Children in Northern Region, Saudi Arabia: A Cross-Sectional Study

Objective: To investigate the pattern and severity of early childhood caries (ECC) by using the decayed and filled surface (dfs) index in preschool children in Al-Jouf, Saudi Arabia. Material and Methods: A convenience sample of 270 preschool children below 5 years of age (144 boys, 126 girls) attending outpatient pediatric dental clinics was selected for the study. World Health Organization criteria were used to diagnose caries through assessment of the dfs index. Information regarding oral hygiene practices, socio-economic status, and educational status of the mother was obtained through a structured questionnaire given to mothers. The data were statistically analyzed with the Chi-square test and Student's t-test. Results: 73% of children were not brushing regularly; 74.4% of them were using fluoridated toothpaste. In the maxillary teeth, boys had a higher mean dfs index (10.25), as well as a higher number of decayed surfaces (ds), than girls. In the mandibular teeth, boys and girls had similar mean dfs indices. Significant differences were observed between boys and girls regarding filled buccal surfaces (p=0.001) and occlusal surfaces (p=0.001) in maxillary teeth. The mandibular first molar was the most commonly affected tooth (93.3%); lower anterior teeth were the least affected teeth (2-4%) among the primary dentition. Conclusion: The ECC pattern in the northern region of Saudi Arabia follows the typical pattern of nursing caries.

Three-Rooted Mandibular First Molars in a Saudi Arabian Population: A CBCT Study

Objective: To know the prevalence three-rooted mandibular first molars in a Saudi Arabian population by using CBCT. Material and Methods: A total of 428 CBCT scans in the database of the College of Dentistry, Jouf University, Kingdom of Saudi Arabia were analyzed. All well-developed permanent mandibular first molars were analyzed for the presence of extra root in three dimensions and the reconstructed volumetric images by two qualified and experienced observers. The total incidence, distribution and comparison regarding gender, bilateral and unilateral appearance, and the side of occurrences of these permanent three-rooted mandibular first molars were analyzed by the Chi-square test. The level of significance was set at 5%. Results: The CBCT scans of 14 subjects had three rooted mandibular first molars with a prevalence of 3.27%. The prevalence in males and females was 2.96% respectively, with no significant differences between genders (p=0.865). The frequency of bilateral three-rooted mandibular first molars was 1.16%, with unilateral frequencies of 1.40% and 0.70% on the right and left sides, respectively. No significant relationship between sides (p=0.981) and the bilateral prevalence of three-rooted mandibular first molars (p=0.668) was observed. Conclusion: Dental practitioners must be aware of the fact that though it is rare, an extra or third root can be present in mandibular first molars and CBCT can aid in accurate diagnosis of the presence of third root.

A Cone Beam Computed Tomography Study of the Prevalence of Pulp Stones in a Saudi Arabian Adolescent Population

Objective: To assess the prevalence of pulp stones using Cone Beam Computed Tomography (CBCT) in a Saudi Arabian adolescent population. Material and Methods: CBCT scans of 237 individuals compromising of 1018 teeth were examined. All teeth were analyzed in three dimensions and the presence of pulp stones were identified as a round or oval shaped dense structures in the pulp space. The location of involved tooth in terms of arch, side involved and the status of the tooth were documented. Statistical analysis was carried out by applying Chi-square test. The level of significance was set at 5%. Results: Pulp stones were observed in 119 out of the 237 participants, and in 118 teeth out of 1018 teeth examined, with the patient prevalence of 50.2% and tooth prevalence 10.6%. Pulp stones were observed in 76 (51.3%) of males and 43 (48.3%) of females, with no significant difference (p>0.05). A nonsignificant difference was also noted when maxillary and mandibular arches and the left and right sides were compared. Pulp stones were observed more frequently observed in molars and in carious (8.8%) and restored teeth (17.1%). Conclusion: The prevalence of pulp stones was high in molars and in carious and restored teeth. No significant difference was noticed between gender, arch and side of tooth involved with pulp stones.

Comparative Study of the Efficacy of Newer Antioxitands Lycopene and Oxitard in the Treatment of Oral Submucous Fibrosis

Objective: To compare the efficacy of oxitard and lycopene in the management of Oral Submucous Fibrosis (OSMF). Material and Methods: 120 subjects with clinicpathologically diagnosed OSMF were included in the study and divided equally in 2 groups, Group A (oxitard) and Group B (lycopene). Group A was administered 2 oxitard capsules twice daily and Group B was given 8 mg lycopene in 2 divided doses of 4 mg for 3 months. Gingival index and plaque index were documented for all patients and compared. Evaluation for different clinical parameters was done at regular intervals and data was analyzed using the Student's paired t test and Chi-square test. P-value <0.001 was considered to be statistically significant. Results: Clinical improvements in mouth opening and tongue protrusion was significant in Group A (p<0.001). Subjective symptoms of pain associated with the lesion (p=0.0001), difficulty in swallowing (p=0.0004) and speech (p=0.0002) significantly improved in the Group A. However, there was no significant improvement in burning sensation (p>0.001) among the 2 groups. Although the mean gingival index and plaque index in group A was reduced but it was found to be not statistically significant. Conclusion: Oxitard capsules can bring about significant clinical improvements in the symptoms like mouth opening, tongue protrusion, difficulty in swallowing and speech and pain associated with the lesion when compared to lycopene, thereby improving the quality of life of the affected individuals.