Effect of enamel surface coating on staining capability due to iron containing supplements on primary teeth: An in vitro study.

Background: Iron supplements prescribed to anemic children may results in teeth staining. Possible methods for preventing staining of primary teeth following exposure to iron supplements are need of an hour. Aim: This study was conducted with the aim to assess effect of enamel surface coating on staining capability of iron containing supplements in primary teeth. Settings and Design: This is an in vitro Experimental study. Methods: Hundred and forty-four primary incisors with intact crowns were sequentially numbered and randomly divided into four main groups of 36 samples receiving different enamel surface coating such as no surface coating, MI fluoride varnish™, GC G-coat Plus™ and GC-Equia®-forte-coat. Each group was subdivided into two groups, namely A (sound teeth) and B (artificially demineralized teeth). All the samples were immersed in 250 ml artificial saliva containing 10 ml of iron supplement to make the iron concentration 100 mg. The shade of the teeth was measured at baseline and at 90 days, using VITA Easy shade® V digital spectrophotometer. The data was statistically analyzed using the Kruskal-Wallis test and Mann-Whitney U test. Descriptive and inferential statistical analyses was made via SPSS 23. Results: Overall color change was found to be significantly less at the end of 90th day in sound samples when GC-Equia®-forte-coat was used as an enamel surface coating with pvalue of 0.017. In demineralized samples the overall color change was least at the end of 90th day when MI Varnish™ used as an enamel surface coating with P = 0.042. Conclusions: GC-Equia®-forte-coat, MI Varnish™ and GC-G-coat-plus™ can be used as a preventive or a precautionary measure to minimizes the staining of teeth. The amount of color change at the end of 90 days with GC-Equia®-forte-coat was least followed by MI varnish™, GC G coat Plus™ and control group.

Comparison of Plaque Removal Efficacy with Powered and Manual Toothbrushes in 10-14-year-old Visually and Auditory Impaired Children: A Randomized Controlled Study.

AIM AND OBJECTIVE: To compare dental plaque removal efficacy with a manual and powered toothbrush in 10-14 years old visually and auditory impaired children. MATERIAL AND METHODS: The proposed study was a randomized controlled study. The ethical approval was obtained from the institutional ethical board. The written informed consent for the study was taken from the parents. The 60 participants were categorized into group I: visually impaired (30) and group II: speech and hearing impaired (30) which were again divided into I1 (manual toothbrush) and I2 (powered toothbrush); II1 (manual toothbrush) and II2 (powered toothbrush), respectively. The baseline score was recorded using Turesky-Gilmor-Glickman Modification of The Quigley-Hein plaque Index. The oral prophylaxis was performed and then randomization of the toothbrush group was done with concealed allocation method. The plaque-removal efficacy was evaluated at the end of the 15 days in the visually and hearing-impaired children. RESULTS: The mean score of dental plaque at baseline was 1.44 for the manual toothbrush group and 1.65 for the powered toothbrush group in visually impaired children, respectively. In blind children with a manual toothbrush, the mean score difference was 0.14 while the powered toothbrush showed the mean score difference of 0.30 which is significant. The mean score of dental plaque at baseline was 1.74 for the manual toothbrush group and 1.80 for the powered toothbrush group in auditory impaired children. In auditory impaired children with manual toothbrushes, the mean score difference was 0.15 while the powered toothbrush showed the mean score of 0.32 which was significant. CONCLUSION: Dental plaque reduction was significantly better with the powered toothbrush as compared to a manual toothbrush in visually and auditory impaired children. HOW TO CITE THIS ARTICLE: Patel NG, Bargale S, Shah S, et al. Comparison of Plaque Removal Efficacy with Powered and Manual Toothbrushes in 10-14-year-old Visually and Auditory Impaired Children: A Randomized Controlled Study. Int J Clin Pediatr Dent 2021;14(3):364-368.

Comparative evaluation of effect of two relaxation breathing exercises on anxiety during buccal infiltration anesthesia in children aged 6-12 years: A randomized clinical study.

BACKGROUND: Dental procedures, especially local anesthetic administration, are a source of great anxiety to children. Diaphragmatic breathing is defined as an efficient integrative body-mind training for dealing with stress and psychosomatic conditions. Pinwheel exercise is also a highly effective technique of "play therapy." AIM: This study aimed to compare dental anxiety using pinwheel breathing exercise and diaphragmatic breathing exercise during buccal infiltration anesthesia. METHODOLOGY: Sixty children in the age group of 6-12 years with Frankel's behavior rating score of 3 who required buccal infiltration local anesthesia were selected. Subjects were divided randomly into two groups, i.e., Group A: children who performed pinwheel breathing exercise and Group B: children who performed diaphragmatic breathing exercise. The level of anxiety of the patients was recorded using an animated emoji scale. The data were analyzed using IBM SPSS version 20 software with paired t-test and Chi-square test. RESULTS: There was a significant reduction in dental anxiety score from score 1 (before the anesthetic procedure) to score 2 (after the anesthetic procedure) in both the groups. On intergroup analysis, children who performed pinwheel breathing exercise (Group A) showed higher values than children who performed deep breathing exercise without pinwheel (Group B) with a t value of 1.42 but was not statistically significant with a P value of 0.161. CONCLUSION: Pinwheel breathing exercise as well as diaphragmatic breathing exercise proved to be significantly effective in reducing dental anxiety during local anesthesia.

Knowledge, attitude, and practice regarding standardized treatment protocol for pulp therapy in deciduous dentition among general dental practitioners of Vadodara, Gujarat, India.

INTRODUCTION: Dental caries is the most prevailing disease not only affecting permanent dentition, but also involving deciduous dentition. Deciduous teeth are considered a best space maintainer and preserve arch integrity for eruption of succedaneous permanent teeth. General dental practitioners (GDPs) seem to be less interventionist in their investigation and treatment planning and many times, the treatment done remains incomplete either due to the lack of knowledge of the dentist or due to noncooperation of the child and/or parents. PURPOSE: The aim of this study was to assess the knowledge, attitude, and practice among GDPs of Vadodara city regarding standardized treatment protocol (STP) for pulp therapy in deciduous dentition. MATERIALS AND METHODS: This questionnaire-based, cross-sectional study was conducted to assess the knowledge, attitude, and practice regarding standardized treatment options available for pulp therapy in deciduous dentition. The distribution of the self-made questionnaire pro forma was done in person to all the GDPs after obtaining their prior appointments. The GDPs were grouped on the basis of qualification and total clinical experience in years. The questionnaire consisted of 11 questions. The data were collected, and descriptive statistical analysis was performed. The Chi-square test was used to assess the knowledge, attitude, and practice among different groups of GDPs. RESULTS: A statistically significant difference was observed in knowledge regarding STP for pulp therapy in deciduous dentition among both the groups, which is based on the qualification and on the year of clinical experience. CONCLUSION: Qualification and years of clinical practice among GDPs affect the knowledge and treatment regarding pulp therapy in deciduous dentition. Most of the GDPs lack knowledge about the STP for pulp therapy in deciduous dentition.

Evaluation of knowledge regarding emergency management of avulsed traumatic dental injuries in children among general dental practitioners in India.

CONTEXT: Traumatic dental injuries (TDIs) leading to dental avulsion occur very frequently in society. Management of avulsion is critical for the dentist, as it requires appropriate knowledge. AIM: The study was conducted to evaluate the knowledge of the general dental practitioners (GDPs) regarding the emergency management of TDI leading to avulsion in children. SETTING AND DESIGN: Questionnaire-based cross-sectional survey design was utilized to assess the knowledge. SUBJECTS AND METHODS: Data for this cross-sectional survey were collected through questionnaires from July to September 2014. A total of 278 GDP were contacted and requested to fill a pretested questionnaire to assess the knowledge regarding tooth avulsion. The GDPs were grouped on the basis of their educational qualification and years of clinical experience. STATISTICAL ANALYSIS USED: Chi-square test was used for intra- and inter-group comparison. RESULTS: A total of 224 (80.57%) GDPs consented to participate in the survey. Markedly low knowledge levels were noted in the sample irrespective of educational qualification and years of experience with respect to replantation of the avulsed primary tooth, holding the root instead of the crown, choice of appropriate storage medium for transportation of avulsed teeth, use of medications, and splinting type and time. Clinical experience and higher educational qualification of GDPs revealed statistical significant difference in the methods of management for TDI leading to avulsion. CONCLUSION: Higher professional education and added clinical experience were associated with better knowledge in the management of TDI leading to avulsion. The finding warrants the need for informative educational programs to update and boost the knowledge of practicing dentists regarding emergency management of avulsed teeth.

Comparison of Antimicrobial Efficacy of (between) 0.2% Chlorhexidine and Herbal Mouthwash on Salivary Streptococcus mutans: A Randomized Controlled Pilot Study.

BACKGROUND: The chemomechanical plaque control measures are helpful in controlling dental plaque and thus caries, especially in pediatric age group. AIM: This study aims to compare effectiveness of herbal mouthrinse containing Terminalia chebula to that of 0.2% chlorhexidine against children's salivary mutans streptococci levels. SETTINGS AND DESIGN: A double-blind, randomized, controlled study design will be framed for conducting this study. METHODS: A total of 45 participants were randomly categorized in Group 1, Group 2, or Group 3 (control group, experimental group, or negative control). Baseline unstimulated saliva was collected. All the participants were instructed regarding the use of mouthrinse for 2 weeks. After 2 weeks, again unstimulated saliva was collected. After collection, saliva samples were sent for microbiological analysis. STATISTICAL ANALYSIS: The mean colony-forming units (CFU/ml) were determined. Paired t-test, ANOVA test, and post hoc test were applied for statistical analysis. RESULTS: Statistically significant difference in CFU count has been observed in 0.2% chlorhexidine and Oratreat groups at 15 days as compared to baseline (P < 0.001). At 15 days, reduction in CFU count has seen more in Oratreat group as compared to 0.2% chlorhexidine group, and the difference is statistically significant (P < 0.001). CONCLUSION: 0.2% chlorhexidine and Oratreat mouthwash reduce the salivary Streptococcus mutans count. Oratreat herbal mouthwash has proved to be better as compared to 0.2% chlorhexidine mouthwash.

Evaluation of Health on the Net seal label and DISCERN as content quality indicators for patients seeking information about thumb sucking habit.

AIMS: The aim of this study was to evaluate the reliability of websites on the thumb sucking habit using DISCERN instrument and Health on the Net (HON) seal code at a single moment in time. SUBJECTS AND METHODS: An Internet search engine (www.google.com) was used to identify websites comprising information on "thumb sucking habit." Of over 204,000 links for thumb sucking habit, the first 100 were analyzed in detail. After excluding discussion groups, news and video feeds, and removing carbon copy sites, only 36 relevant websites remained, which were then assessed using the DISCERN instrument and HON seal code. Using the 16 questions of DISCERN for assessing the reliability and quality of the consumer information which were scored from 1 to 5, an appropriate index of the quality of the information was generated. All the assessed websites were also checked for presence or absence of HON seal code. RESULTS: The maximum score attainable for an outstanding website is 80. Of the 36 websites that were scored the highest score obtained by one of the websites according to the DISCERN tool was 55 of 80, and the lowest score achieved was 16 of 80. The websites achieving the maximum and minimum score were children.webmd.com and thebehaviorsolution.com, respectively. The HON seal was displayed only in three websites, which were medicinenet.com, righthealth.com, and children.webmd.com. CONCLUSIONS: By directing patients to validated websites on the thumb sucking habit, clinicians can ensure patients find appropriate information.

Clinicopathological significance of Melkersson-Rosenthal syndrome.

Melkersson-Rosenthal syndrome (MRS) classically shows a triad of orofacial swelling, fissured tongue and facial palsy, more commonly the oligosymptomatic form. The orofacial swelling is characterised by swollen reddish-brown non-pruritic lips and facial oedema. In one-third to one half of patients, fissured tongue is seen, which also aids in diagnosis. The histological finding of MRS includes non-caseating, sarcoidal granulomas, but their absence does not exclude the diagnosis. All these findings together form a basis for a cautious search for confrontational reasons for the symptom complex of MRS.

Knowledge and attitude in regards to physical child abuse amongst medical and dental residents of central Gujarat: a cross-sectional survey.

CONTEXT: Child abuse is a state of emotional, physical, economic, and sexual maltreatment met out to a person below the age of 18 and is a globally prevalent phenomenon. However, in India, there has been no understanding of the extent, magnitude, and trends of the problem. AIMS: The aim of this study was to determine the level of knowledge and attitudes of medical and dental residents with regards to physical child abuse of central Gujarat. MATERIALS AND METHODS: A cross-sectional survey was conducted among the medical and dental residents of central Gujarat. Data were collected from a self-administered questionnaire for a total of 130 residents, in which 89 medical and 41 dental residents responded. RESULTS: Knowledge regarding the social indicator of child abuse was found to be poor in 27.7% (n = 36), average in 68.5% (n = 89), and good in 3.8% (n = 5); and for physical indicator it was found to be poor in 10.8% (n = 14), average 66.9% (n = 87), and good 22.3% (n = 29). Forty-nine percent (n = 64) of the respondents reported having formal training in recognizing child abuse, and 32% (n = 42) had read literature on the topic. Fifty-five percent (n = 72) stated that education regarding child abuse is extremely important. CONCLUSIONS: Result of the present study found that medical and dental residents are not sufficiently prepared to endure their role in protection of child from abuse. A significant gap existed between recognizing signs of physical child abuse and responding effectively. Improvements in child abuse education and continuing education courses are advised to provide adequate knowledge.

Appropriate electrode placement site of electric pulp tester for the premolars: a clinical study.

CONTEXT: Electric pulp testers (EPTs) are widely used as diagnostic aid in dentistry for dental pulp. This delivers enough current to overcome enamel and dentin resistance and to stimulate the myelinated sensory fibers at the junction of pulp and dentin. Such testing requires the electrode to be in contact with the surface of the tooth, with optimal positions identified for anterior teeth, premolars, and molars. AIMS: To determine the best site position of EPT on premolars. The objective of electric pulp testing was to determine the sensibility of each premolar at the lowest sensory response threshold. SETTINGS AND DESIGN: Clinical study Materials and Methods: The premolars of 20 patients between 13 and 15 years accompanied with parents, free of restorations, and caries were selected. Five sites on the crown were tested with EPT for minimum of four times. STATISTICAL ANALYSIS USED: One-way analysis of variance test and the Tukey's honestly significant difference test. RESULTS: The lowest threshold response was noted at the incisal edge of the tooth; the middle third had a higher threshold among all the different placement of electrode. Statistically significant difference was observed for occlusal surface in terms of region of placement of electrode. CONCLUSIONS: This experiment found the best electrode site for pulp testing in premolars. The appropriate EPT site was on the occlusal surface of maxillary and mandibular premolars.

Osteochondroma of condyle: case discussion and review of treatment modalities.

Temporomandibular joint (TMJ) forms a synovial articulation between the condyle and the cranium. It is a complex joint and shows hinge and gliding movements. Unlike other articulating heads, condyle grows with intramembranous ossification. TMJ is subjected to excessive loads throughout life as it supports essential functions such as mastication, deglutition, speech and respiration. Traumatic, neoplastic or non-neoplastic pathologies sometimes necessitate joint replacement therapy. Osteochondroma is one such benign tumour originating from condyle which requires surgical replacement of condyle with prosthesis. Various replacement methods have been designed in the past. Alloplastic grafts have been successfully used in joint replacement surgeries like hip joint, knee joint, etc. This case discussion supports the use of titanium-made condylar prosthesis for long-term functional stability of TMJ.

Global developmental delay with sodium valproate-induced gingival hyperplasia.

Global developmental delay (GDD) refers to a disturbance in an individual child across one or more developmental domains, which include motor, cognition, daily activities, speech and language. The present case discusses a 5-year-old child with GDD associated with infantile spasms treated with sodium valproate. Delay in the widespread acquisition of skills, epilepsy and poor oral hygiene with gingival enlargement was the main concern to seek medical aid. This case is special as the child was suffering from GDD associated with sodium valproate-induced gingival enlargement.

Bizarre cause for avulsion of permanent maxillary lateral incisor tooth.

A 9-year-old boy presented with a missing upper front tooth after an accident involving kite flying. Diagnosis of avulsion of the upper right lateral incisor (22) was made after examination of his socket as well as by radiological investigations. A removable partial denture was given for the aesthetic purpose. The patient is under follow-up. The present case illustrates the management of avulsion.

Non-syndromic occurrence of true generalized microdontia with mandibular mesiodens - a rare case.

Abnormalities in size of teeth and number of teeth are occasionally recorded in clinical cases. True generalized microdontia is rare case in which all the teeth are smaller than normal. Mesiodens is commonly located in maxilary central incisor region and uncommon in the mandible. In the present case a 12 year-old boy was healthy; normal in appearance and the medical history was noncontributory. The patient was examined and found to have permanent teeth that were smaller than those of the average adult teeth. The true generalized microdontia was accompanied by mandibular mesiodens. This is a unique case report of non-syndromic association of mandibular hyperdontia with true generalized microdontia.