A new and simple infant assessment table.

Oral examination of an infant forms an important first step toward a lifetime of excellent oral health. Examining an infant during the first visit and the subsequent preventive examination visits may be challenging to dentists and pediatric dentists. There are few concerns regarding the effective oral examination using the traditional “knee-to-knee” position. This paper presents a new, simple infant examination table (INFANTT) to facilitate this examination. This table has many advantages, which includes its stability and simplicity. It is non-threatening and resembles common household furniture. Various modifications of the basic design are also possible to suit the individual dentist’s preferences and dental office needs. Additionally, it is possible to use this INFANTT for performing fluoride varnish applications, taking radiographs of the anterior teeth and extraction of natal, neonatal teeth and traumatized teeth.

Supernumerary teeth: Review of literature and decision support system.

Supernumerary teeth are those which are additional or in excess of the normal number. They can be either single or multiple, unilateral or bilateral and can be present anywhere in the dental arch with predilection for the premaxilla. Supernumerary teeth are mostly classified on position and form. Timing of surgical intervention of supernumerary teeth has been controversial with various authors having different opinions. Hence a new decision support system is put forward which can help in the treatment planning of supernumerary teeth.

Alopecia areata of dental origin in a child.

Alopecia areata (AA) is a chronic inflammatory disease that involves the hair follicle. Current evidence indicates that hair follicle inflammation in AA is caused by a T-cell-mediated autoimmune mechanism occurring in genetically predisposed individuals. AA has a reported incidence of 0.1%-0.2%, with a lifetime risk of 1.7%. It has also been found that AA accounts for roughly 2% of new dermatology outpatient cases in the US and the UK, 3.8% of cases in China and 6.7% of cases in Kuwait. Pediatric AA constitutes approximately 20% of all AA cases. AA affects males and females equally. The most common site to be affected is the scalp (90%). The face, eyebrows, eyelashes, beard, underarm hair, and pubic hair may be affected and, sometimes, even the entire body. AA requires combined therapy, involving topical or intralesional corticosteroids, immune therapy with diphenylcyclopropenone, and even psychotherapy. In some cases, treatment consists of simply eliminating the dental infectious process. This case report describes AA of dental origin in a 9-year-old girl, which resolved after management of the dental problem.

Single-rooted primary first molars.

Knowledge regarding the morphological variations in roots and root canals aids in successful dental treatment. However, literature regarding dysmorphology of roots in primary dentition is sparse. The purpose of this article is to present a case of bilateral primary mandibular first molars with an unusual morphology of single root. Review of literature regarding variations in root number in primary dentition has been discussed in this article. The etiology for occurrence of such variations has also been briefly reviewed.

Children's behavior pattern and behavior management techniques used in a structured postgraduate dental program.

Background : Anxiety and fear remain the primary emotion of a child entering a dental office. Successful pediatric dentistry depends not only on the dentist's technical skills, but also on his ability to acquire and maintain a child's cooperation. Methods: A retrospective study was done using the case records of 247 children, to evaluate their behavior patterns, based on the Wright's modification of Frankl's behavior rating scale. Various behavior management techniques like the tell-show-do, reinforcements, voice control, and hand over mouth exercise used in the postgraduate section of the Department of Pediatric Dentistry, Meenakshi Ammal Dental College, Chennai, India, were also evaluated in this study. Results: Behavior of the children improved on the subsequent visits. Tell-show-do was the most common behavior management technique used and more aversive management techniques were rarely used in managing children in the dental office. Conclusion: Proper assessment of children's behavior helps the dentist to plan appointments and render effective and efficient dental treatment. Appropriate use of management techniques can improve the child's behavior in subsequent dental visits.

Quantitative assessment of IgA levels in the unstimulated whole saliva of caries-free and caries-active children.

Saliva is commonly referred to as the blood stream of the oral cavity. It has many functions, one of the major functions being protection of teeth against dental caries. There are many components in saliva, each one having a specific role in the prevention of dental caries. The composition of saliva varies from individual to individual and in the same individual it varies between the glands. The composition of whole saliva, especially when unstimulated, has gained much interest, because it is this which constantly bathes the teeth. The aim of this study was to determine the IgA levels in the unstimulated whole saliva of caries-free and caries-active children aged 3-6 years and to correlate its role in protection of the tooth against dental caries.

Oral findings of Down syndrome children in Chennai city, India.

PURPOSE: To assess the common oral findings and anomalies of Down syndrome (DS) children in Chennai city, India. MATERIALS AND METHODS: Among the 130 DS children examined, 102 children aged 15 years and below were included in the study. There were 57 male children and 45 female children in the total study sample. A specially prepared case record was used to record the following findings in each child: a brief family and personal history; anomalies of soft tissues, teeth, occlusion, and temporomandibular joint. Age wise and sex wise comparisons of the findings were done. RESULTS: About 97 children (95%) had the habit of regular tooth brushing. Everted lower lip (66%), retained primary teeth (31%), and midface deficiency (76%) were the most commonly seen soft tissue, dental, and occlusion anomalies, respectively. CONCLUSIONS: Midface deficiency was the most common orofacial anomaly seen in these children, followed by everted lower lip and retained primary teeth. Almost all the children had a regular tooth brushing habit. All the children examined were offered free dental treatment in our dental college.

Dental caries prevalence and treatment needs of Down syndrome children in Chennai, India.

PURPOSE: To assess the prevalence of caries and the treatment needs of Down syndrome children in the Indian city of Chennai. MATERIALS AND METHODS: Among the 130 Down syndrome children examined, only the children aged < or =15 years were included in the study ( n = 102). There were 57 male and 45 female children in the total study sample. A specially prepared case record was used to record the findings for each child. The dentition status and the treatment needs required were recorded. Comparisons of the findings were done based on age and gender distribution. RESULTS: Twenty-nine per cent of the total sample of Down syndrome children was found to be caries-free. Extraction (in 38 children) and one-surface filling (in 26 children) were the most needed specific treatments for primary and permanent teeth, respectively. Oral prophylaxis (99%) was the most required treatment in the overall treatment category. CONCLUSIONS: Contrary to the findings of earlier studies, the percentage of caries-free Down syndrome children was found to be lower in our study. However, their basic needs like oral prophylaxis, restorations and extractions remain the same and can be easily fulfilled by an efficient, community-based dental team.

Management of a child with autism and severe bruxism: A case report.

Autism is a developmental disorder characterized by severe deficits in social interaction and communication. A wide spectrum of medical and behavioral symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Bruxism or forceful grinding of teeth is one of the sleep problems commonly observed in children with autism. Our patient, a 4-year-old male child with autism, presented with complaints of pain and sensitivity of the teeth. There was history of excessive grinding and clenching of teeth. Limited oral examination revealed severe attrition of all primary teeth. Treatment was planned under general anesthesia because of his poor cognitive abilities. Full-mouth rehabilitation, including placement of stainless steel crowns for all primary molars, was done. Following treatment there was a significant decrease in the grinding habit over the next 2 months. Although the communication and behavioral problems in children with autism pose challenges for the dentist, treatment with proper planning and a lot of patience can definitely make a difference.

First dental visit of a child.

OBJECTIVES: The aim of the study was to assess the common chief complaints of the Indian children and the average age group at which they report for in their first dental visit. MATERIALS AND METHODS: A retrospective study was carried out using the case records of 716 children who reported to the postgraduate section of Department of Pediatric dentistry, Meenakshi Ammal Dental College, Chennai, in 2007. The age groups of the children were divided into three categories 0-3 years, 3-6 years and 6-12 years. The various chief complaints were categorised as follows, Orientation to prevention, Routine visit, Deposits/Discoloration, Habits, Unerupted/Missing or Extra Tooth, Pain, Dental caries, Malocclusion, Trauma, others. The average age group and most common complaint at the first dental visit was assessed. A prospective study was done in January 2008, were 215 children were screened. The assessment was made as explained above. RESULTS: Retrospective study Maximum number of children who reported for their first dental visit was between 6-12 years (59.08%). Most common chief complaint for the visit was pain (42.04%). Second common complaint being dental caries (28.49%). Prospective study Maximum number of children who reported for their first dental visit was between 6-12 years (69.77%). Most common chief complaint was dental caries (34.88%). Second common complaint being pain (27.91%). CONCLUSION: Children report for the first dental visit most commonly only after 6 years and for complaints like pain and dental caries. Orientation to prevention is not considered and preventive dentistry is yet to reach the common population in India.

Effect of oil pulling on Streptococcus mutans count in plaque and saliva using Dentocult SM Strip mutans test: a randomized, controlled, triple-blind study.

BACKGROUND: Oil pulling has been used extensively for many years, without scientific evidence or proof, as a traditional Indian folk remedy to prevent teeth decay, oral malodor, bleeding gums, dryness of throat and cracked lips, and for strengthening the teeth, gums, and jaws. AIMS: The aim of this study was to evaluate the effect of oil pulling with sesame oil on the count of Streptococcus mutans in plaque and saliva of children, using the Dentocult SM Strip mutans test, and to compare its efficacy with that of chlorhexidine mouthwash. MATERIALS AND METHODS: Twenty age-matched adolescent boys were selected based on information obtained through a questionnaire. They were divided randomly into two groups: the control or chlorhexidine group (group I) and the study or oil pulling group (group II); there were ten subjects in each group. Plaque and saliva samples were collected from all the 20 subjects on the strips from the Dentocult SM kit and, after incubation, the presence of S. mutans was evaluated using the manufacturers' chart. The study group practiced oil pulling with sesame oil and the control group used chlorhexidine mouthwash for 10 min every day in the morning before brushing. Samples were collected from both groups after 24 h, 48 h, 1 week, and 2 weeks and the efficacy of oil pulling was compared with that of chlorhexidine mouthwash. RESULTS: There was a reduction in the S. mutans count in the plaque and saliva samples of both the study and the control groups. The reduction in the S. mutans count in the plaque of the study group was statistically significant after 1 and 2 weeks (P=0.01 and P=0.008, respectively); the control group showed significant reduction at all the four time points (P=0.01, P=0.04, P=0.005, and P=0.005, respectively, at 24 h, 48 h, 1 week, and 2 weeks). In the saliva samples, significant reduction in S. mutans count was seen in the control group at 48 h, 1 week, and 2 weeks (P=0.02, P=0.02, P=0.008, respectively). CONCLUSION: Oil pulling can be used as an effective preventive adjunct in maintaining and improving oral health.

Effect of fluoride varnish on Streptococcus mutans counts in plaque of caries-free children using Dentocult SM strip mutans test: a randomized controlled triple blind study.

Dental caries is one of the most prevalent infectious diseases and although of multifactorial origin, Streptococcus mutans is considered the chief pathogen in its development. Fluoride is one of the most effective agents used for the reduction of dental caries apart from oral hygiene maintenance. AIMS: The aim of this study was to estimate the counts of Streptococcus mutans and to evaluate the effect of Fluor Protector fluoride varnish on these counts in the plaque of caries-free children using Dentocult SM Strip Mutans. MATERIALS AND METHODS: Thirty caries-free subjects were selected for the study based on the information obtained from a questionnaire and were randomly assigned to the control group consisting of ten subjects and the study group consisting of twenty subjects. Plaque samples were collected on the strips from the Dentocult SM kit and after incubation, the presence of Streptococcus mutans was evaluated using the manufacturer's chart. The study group was subjected to a Fluor Protector fluoride varnish application following which the samples were collected again after 24 hours. RESULTS: The average Streptococcus mutans counts in the primary dentition of caries-free children before and after the application of Fluor Protector fluoride varnish were 10(4)-10(5) colony forming units (CFU)/ml and <10(4) CFU/ml respectively. CONCLUSION: The results showed that the study group had a statistically significant reduction in the plaque Streptococcus mutans counts than the control group.

Noonan syndrome: a case report.

Noonan syndrome is a developmental disorder characterized by facial dysmorphia, short stature, cardiac defects and skeletal malformations. It may be sporadic or inherited as an autosomal dominant or recessive trait and occurs, one in 1,000-2,500 children. This is a case report of a 13 year-old girl who was referred by a general dental practitioner to a pediatric dentist for management. Full mouth dental rehabilitation was done and the child was brought to a dental institution for correction of orofacial and occlusal defects. Multidisciplinary treatment is the key to success in managing children with Noonan syndrome and the pediatric dentists play an important position to lead the health team.

Root development of permanent lateral incisor in cleft lip and palate children: a radiographic study.

OBJECTIVE: The objective of this study was to compare the root development of lateral incisor on the cleft side with the root development of its contralateral tooth in cleft lip and palate children. SETTING: Cleft lip and palate wing, Meenakshi Ammal Dental College and Hospital, Chennai, South India. MATERIALS AND METHODS: A sample of 96 orthopantamograms of patients with unilateral orbilateral cleft lip and/or cleft palate was selected, regardless of sex and race. MAIN OUTCOME MEASURE: Orthopantamograms were analyzed for root development of lateral incisor on the cleft and non cleft side. Associated anomalies like hypodontia, supernumerary teeth, malformed lateral incisors and root development of canine, if present, were recorded. FINDINGS AND CONCLUSIONS: Root development of permanent lateral incisor was delayed on the cleft side compared to the non cleft side. There was a statistically significant relationship between levels of root development of lateral incisors on the cleft side within the different study groups(P < 0.05). Incidence of hypodontia increased in proportion to cleft severity. Frequency of missing second premolars, supernumerary teeth and malformed lateral incisors increased in cleft lip and palate patients. Root development of canine showed a slight delay on the cleft side when compared to the canine on the noncleft side.

Bird-headed dwarf of Seckel.

Seckel syndrome is an extremely rare inherited disorder characterized by growth delays prior to birth resulting in low birth weight. Growth delays continue after birth resulting in short stature (dwarfism). This syndrome is associated with an abnormally small head, varying degrees of mental retardation and unusual "beak like" protrusion of nose. Other facial features may include abnormally large eyes, a narrow face, malformed ears and an unusually small jaw. This syndrome has an autosomal recessive pattern of inheritance. A case of the Seckel syndrome is presented.

Spontaneous closure of midline diastema following frenectomy.

Maxillary midline diastema is a common aesthetic problem in mixed and early permanent dentitions. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenical factors. Many innovative therapies varying from restorative procedures such as composite build-up to surgery (frenectomies) and orthodontics are available. Although literature says every frenectomy procedure should be preceded by orthodontic treatment, we opted for frenectomy technique without any orthodontic intervention. Presented herewith is a case report of a 9-year-old girl with a high frenal attachment that had caused spacing of the maxillary central incisors. A spontaneous closure of the midline diastema was noted within 2 months following frenectomy. The patient was followed up for 4 months after which the space remained closed and there was no necessity for an orthodontic treatment at a later stage.

Accuracy of electronic apex locator in length determination in the presence of different irrigants: An in vitro study.

Determining the root canal length accurately had been a challenge in endodontics. Introduction of apex locators have definitely served as an effective adjuvant to radiographs. This in vitro study had attempted to compare the effectiveness of electronic apex locator in the presence of various canal contents. Comparison of the length determined by apex locators with the radiographic length was also made. The results of the study had shown that the length of root canals can be accurately made irrespective of the canal contents.

Dental arch dimensions in primary dentition of children aged three to five years in Chennai and Hyderabad.

OBJECTIVE: The purpose of this study was to assess the arch dimensions in primary dentition of 3-5 years old children in Chennai and Hyderabad. As no primary to the mixed dentition and determining the existence of sexual dimorphism. METHODS: Children were selected fro various schools of both Chennai and Hyderabad, with complte set of primary dentition. Study casts were made and measurements of arch dimensions were made using digital sliding calipers. The data obtained was subjected to statistical analysis. RESULTS: The mean values and standard deviations of the various arch dimensions are given in the tables. CONCLUSION: Generally boys exhibited a greater arch dimensions than girls in both groups. Some of the dimensions showed a statistically significant mean values.

Aberrant talon cusps: Report of two cases.

Talon cusp is an uncommon anomaly seen both in primary and permanent dentition. In most instances they are associated with other clinical problems such as occlusal interferences, poor esthetics and caries susceptibility. Management of such instances requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. Here, we present two cases of talon cusps.