Evaluation of effect of consumption of probiotics on the gingival and periodontal health status in children undergoing chemotherapy.

Background: Probiotics consist of live microbes. They do not have any adverse effects on health. They provide nutritive benefits to individuals when ingested in adequate quantities. The most common oral infections of the oral cavity are those affecting the periodontal and dental tissues. Aims and Objectives: 1) To evaluate the antimicrobial role of oral probiotics against microorganisms involved in infections of periodontal and dental tissues. 2) To evaluate the state of health of gingival and periodontal tissues of children undergoing chemotherapy after the use of oral probiotics. Materials and Methods: 60 children, between the age group of 3 and 15 years, undergoing chemotherapy were randomly distributed under control and probiotics administered test group for 90 days. The gingival, periodontal, and oral hygiene statuses were evaluated along with their caries activity test. The parameters were measured at 0, 15, 30, 45, 60, 75, and 90 days intervals. Statistical analysis was performed using Statistical Package for the Social Sciences version 18.0. Results: The oral probiotics consumption significantly reduced the plaque accumulation between days of observation among those in the treatment group (P < 0.05). There was a significant improvement in the gingival and periodontal status in the tested group (P < 0.05). Snyder test was conducted to assess caries activity. Score 1 was found in 10 children, score 2 in eight children. Score 3 was not found in any child under the study group. Conclusion: The results show that the regular consumption of oral probiotics significantly reduces plaque accumulation, calculus formation, and caries activity among the test group.

Dental Anxiety Assessment through the Drawings of Children and Influence of Art Therapy.

Background: Assessment of dental anxiety in children is difficult because of their immature cognitive and emotional development. Drawings are well well-established emotion assessment tool. These can be used as nonverbal methods of communication for expressing the children's anxiety and emotions. Art therapy utilizes creative therapy interventions to deal with children suffering from emotional problems. Aims and Objectives: The aim of the study is (1) To assess the drawings of children for the presence of dental anxiety. (2) To study the effectiveness of art therapy on dental anxiety in children. Materials and Methods: One hundred and twenty children within the age group of 6-12 years were part of this study. The pretest assessment of dental anxiety was done using Frankl and Five facial anxiety scales. All the participants received local anesthesia during their first treatment session. At the end of the treatment session, all the participants were asked to draw a picture of their experience. The drawn figures were assessed by a psychologist. The children were allotted randomly into the study group (n = 60) and control group (n = 60). Art therapy was given to 60 children in the study group for three consecutive appointments. The posttest assessment of dental anxiety was done using Frankl and Five facial anxiety scales after completion of the entire dental treatment. Results: The pretest scores revealed very high level of dental anxiety in 33 (55%) children in study group and 34 (56.67%) children in control group. The posttest scores of study group, who received the art therapy, revealed that 24 (40%) children had little anxiety and 32 (53.33%) children had some anxiety. Whereas in the control group, the posttest scores showed 20 (33.33%) children had high anxiety and 39 (65%) children had very high anxiety scores. There was a significant correlation between the objective score of dental anxiety and the subjective scores of CD: H. Conclusion: Drawings can be used as an assessment tool for the detection of dental anxiety and art therapy effectively reduces the anxiety in pediatric patients undergoing dental treatment.

Current practices and perceived influences of diet diaries usage in pediatric dental practice.

Introduction: The diet diaries act as an important tool for the assessment of diet. There is a paucity of studies to assess the usage of diet diaries for the management of caries in high-risk patients by pediatric dentists. The study was conducted to explore the perceptions of the pediatric dentists regarding the possible difficulties and their solutions for the usage of diet diaries in their dental office. Materials and Methods: A questionnaire was designed incorporating a diet dairy to understand its perception and utilization by the pediatric dentists while preparing the diet modifications for their patients. A qualitative research methodology was used to understand the factors associated with adherence of the pediatric patients to the issued diet dairies. Observations: Majority of pediatric dentists (78%) collected the information regarding the diet verbally without using diet diaries. Most common reason was constraints were monetary (43%) followed by time (35%). Other reasons were poor compliance of parents and pediatric patients (12%). About 10% of pediatric dentists perceived that they lacked the skills needed for appropriate dietary counselling. The results of the qualitative study showed that adhering to diet diaries was a multi-contextual phenomenon. Conclusions: : In order to use the diet diary as an efficient dietary assessment and monitoring tool multifaceted interventions are needed. A supportive healthcare system, motivation of parents as well as child along with an efficient tool seems to be a need for the success of the utilization of diet diaries.

Perceptions of diet diaries' usage in pediatric dental practice.

Background: Diet diaries are a significant tool for dietary assessment and advice. There is paucity of studies assessing the usage of diet diaries by pediatric dentists during their patient management. Hence, this study was designed and conducted to explore the perceptions of the pediatric dentists regarding the possible difficulties and their solutions for the usage of diet diaries in their dental office. Materials and Methods: A questionnaire was designed to understand the awareness of pediatric dentists regarding the utility of diet diaries while preparing the diet modifications for their patients. The factors related with adherence of pediatric patients to the diet diaries were understood by using qualitative research method. Results: The information regarding the diet was collected verbally by 78% of pediatric dentists. Monetary constraint (43%), time (35%), poor compliance (12%), and lack of skills (10%) were the other reasons. The results of the qualitative study showed that adhering to diet diaries was a multi-contextual phenomenon. Conclusions: Utilization of diet diaries by pediatric dentists and adherence to the diet modifications by the patients are very poor. A supportive health-care system, motivation of parents as well as children, along with an efficient tool seem to be needed for achieving success in utilization of diet diaries.

Shprintzen-Goldberg syndrome with plagiocephaly: A case report.

The Shprintzen-Goldberg syndrome (SGS) is an autosomal dominant disorder with multiple congenital abnormalities. It is the result of de novo gene mutations. Recently, mutations in the SKI gene are considered to be related to this syndrome. This gene is responsible for the manufacturing of protein which regulates the transforming growth factor beta (TGF-ß) signaling pathway. There are characteristic craniofacial, skeletal, neurological, and connective tissue abnormalities associated with SGS. This is a case report of a 6-year-old male child who reported to the Department of Pediatric Dentistry at the Government Dental College and Hospital, Aurangabad, India, with decayed teeth. He had craniofacial, skeletal, cardiovascular, and other abnormalities suggestive of SGS. The patient had a tall forehead with plagiocephaly and a high-arched palate with hypoplastic teeth. His ears were apparently low-set with posterior rotation. The child had eyes with proptosis, myopia, hypertelorism, and down-slanting palpebral fissures. The child had moderate mental retardation with craniofacial features typical of this syndrome. The Shprintzen-Goldberg syndrome has many similarities with the Marfan syndrome (MFS) or the Loeys-Dietz syndrome (LDS) due to considerable phenotypic overlapping.

Nonsyndromic Familial Congenital Lower Lip Pits.

Congenital pits on lower lips unassociated with any syndrome are a rare developmental malformation. Vermilion border of the lower lip is the most common site of occurrence. Mostly, these lip pits are inherited as an autosomal dominant trait with variable penetrance. The females are more affected than males. This is a case report of a 7-year-old female child with nonsyndromic congenital lower lip pits, where two of her other family members were also affected.

Evaluation of validity of Tanaka-Johnston analysis in Mumbai school children.

INTRODUCTION: Estimation of the mesiodistal dimensions of the unerupted canines and premolars in the early mixed dentition is a necessary diagnostic aid in space management. Tanaka-Johnston analysis was developed for North American children. Anthropological study reveals that tooth size varies among different ethnicities. The present study was performed to evaluate the validity of Tanaka-Johnston method of mixed dentition arch analysis in Mumbai school children. AIMS: (1) To determine the correlation between the sum of the mesiodistal widths of the permanent mandibular incisors and combined mesiodistal widths of the permanent mandibular and maxillary canines and premolar in Mumbai school children. (2) To examine the applicability of Tanaka-Johnston method of prediction. MATERIALS AND METHODS: Dental casts of maxillary and mandibular arches of 300 children, 147 boys and 153 girls within the age group of 12-15 years, with permanent dentitions were fabricated. The mesiodistal crown dimensions of teeth were measured with a dial caliper. Tanaka-Johnston method of mixed dentition arch analysis was performed for the study population, and statistical analysis was done. STATISTICAL ANALYSIS USED: Descriptive statistics including the mean, standard deviation, range, and standard error were calculated and tabulated. RESULTS: Tanaka-Johnston's equation when applied to the data available for Mumbai school children, it was observed that it slightly overestimates the tooth size. CONCLUSIONS: (1) There was a positive correlation between the width of mandibular incisors and mandibular and maxillary canines and premolars. (2) The Tanaka-Johnston prediction method was not accurate for a sample of Mumbai school children.

Comparing the antiplaque efficacy of 0.5% Camellia sinensis extract, 0.05% sodium fluoride, and 0.2% chlorhexidine gluconate mouthwash in children.

BACKGROUND: Dental caries is a multifactorial disease which requires a susceptible host, a cariogenic microflora, and a suitable substrate that must be present for a sufficient length of time. Tea is prepared by the infusion of dried leaves of the tea plant, Camellia sinensis, which contains bioactive compounds like polyphenols, flavonoids, and catechins that are thought to be responsible for the health benefits that have traditionally been attributed to tea. These compounds have multidimensional effects such as antibacterial action, inhibitory action on the bacterial and salivary amylase, and inhibition of acid production. AIMS: The aim of this study is to compare the antiplaque efficacy of 0.5% C. sinensis extract, 0.05% sodium fluoride, and 0.2% chlorhexidine gluconate mouthwash in children. MATERIALS AND METHODS: A randomized blinded controlled trial with 60 healthy children of age group 9-14 years was carried out. The subjects were randomly assigned to three groups, i.e. group A - 0.2% chlorhexidine gluconate, group B - 0.05% sodium fluoride, and group C - 0.5% C. sinensis extract, with 20 subjects per group. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. Oral hygiene was assessed by simplified oral hygiene index (OHIS). Salivary pH was assessed using indikrom pH strips. Plaque, gingival, and simplified OHI scores as well as salivary pH were recorded at baseline, immediately after first rinse, after 1 week, and in the 2(nd) week. STATISTICAL ANALYSIS USED: The data were analyzed using a computer software program (SPSS version 17). Analysis of variance (ANOVA) tests were used to identify significant differences between the means of the study groups. Finally, paired t-tests were used to assess the significance of changes within each group between time periods. Critical P values of significance were set at 0.05 and the confidence level set at 95%. RESULTS: Mean plaque and gingival scores were reduced over the 2-week trial period in the experimental groups. Antiplaque effectiveness was observed in all groups, the highest being in group C (P < 0.05). Chlorhexidine gluconate and tea showed comparative effectiveness on gingiva better than sodium fluoride (P < 0.05). The salivary pH increase was sustained and significant in groups B and C compared to group A. Oral hygiene improvement was better appreciated in groups A and C. CONCLUSIONS: The effectiveness of 0.5% C. sinensis extract was more compared to 0.05% sodium fluoride and 0.2% chlorhexidine gluconate mouth rinses. It should be explored as a cost-effective and safe long-term adjunct to oral self-care of patients as it has prophylactic benefits with minimum side effects.