Development and Testing of the Novel Sugar Meter for Informing Sugar Intake Guidelines to Parents of Three- to Six-Year-Old Children: A Cross-Sectional Study.

INTRODUCTION: In recent years, the consumption of refined sugar has increased manifold. Added sugar is implicated in dental caries, cardiovascular risk and obesity amongst other conditions. The 1025 World Health Organization (WHO) Sugar Guidelines recommends sugar intake below 10% of energy, but there is limited awareness about the same in the general population. The aim of this study was to test the Novel Sugar Meter for informing the WHO Sugar Guidelines to the parents of three- to six-year-old children. METHODS: Twenty consenting parents and their three- to six-year-old children from an English-medium school in Navi Mumbai, India, were selected. The parents were asked to record their child's baseline dietary data for three consecutive days including one weekend day. The Novel Sugar Meter, an indigenously developed ready reckoner for identifying the quantity of sugars consumed, was used. The parents were counselled using the Novel Sugar Meter (intervention) and standard instructions on the WHO guidelines (control). The dietary data were recorded again to assess and compare dietary behaviour modifications. RESULTS: Comparison of pre-intervention versus post-intervention sugar consumptions showed a statistically significant reduction in the Novel Sugar Meter group (t(10) = 3.70891; p = .001388) but not in the control group (t(10) = 0.94081, p = 0.35926). Both groups showed a reduction in the frequency of daily sugar exposure, with significantly more reduction in the Novel Sugar Meter group (p = .000049). CONCLUSION: Novel Sugar Meter-based counselling has the potential for application for reducing the quantity and frequency of sugar consumption in children.

ECC Status, CRAFT Categorization and OHRQoL Assessment in 3-6-year-old Children: A Cross-sectional Study.

Introduction: Early Childhood Caries (ECC) can affect the health and quality of life of the children. Assessing a patient's risk of developing caries is an important aspect of caries management; however, can assessing the caries risk predict the impact of ECC on the OHRQoL? Few Indian studies have reported association between caries status, risk, and the impact on OHRQoL. Aim: To assess the association between dental caries status, risk assessment, and OHRQoL in 3-6-year-old children. Methodology: A total of 50 healthy children were recruited in a cross-sectional study. Parents filled the ECOHIS questionnaire. Caries status, risk, and OHRQoL were measured as dmft-pufa, CRAFT (Caries Risk Assessment for Treatment- an indigenous tool) and ECOHIS scores, respectively. Results: Moderate correlation was seen between dmft and ECOHIS scores (r = 0.496, p < 0.01), and pufa and ECOHIS scores (r = 0.408, p < 0.05). More number of subjects with higher scores of ECOHIS were in the high-risk category of CRAFT (p < 0.05). Conclusion: Caries status, risk and OHRQoL were associated in 3-6-year-old children. Thus, caries risk assessment may predict poor OHRQoL. How to cite this article: Iyer CR, Jawdekar AM. ECC Status, CRAFT Categorization and OHRQoL Assessment in 3-6-year-old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):199-204.

The Effect of Motivational Interviewing on Reduction of New Carious Lesions in Children with Early Childhood Caries: A Systematic Review and Meta-analysis.

Background: Preventive therapies rely on effective behavior change. Motivational interviewing (MI), has been the most recent advancement in behavior therapies that have been successful in tobacco cessation. The effectiveness of MI needs to be evaluated in caries prevention. Objectives: To evaluate the effectiveness of MI on the reduction of new carious lesions in children with early childhood caries (ECC). Materials and methods: The two authors independently searched data from Cochrane Library, PubMed, Google Scholar, J gate, and Quintpub. Selection criteria-interventional studies written in the English language with MI as an intervention, a mean follow-up period of atleast 2 years, ECC with decayed, missing, and filled primary teeth/decayed, missing, and filled primary surfaces (dmft/dmfs) as the outcome measures, in the age group of 0-6 years. We excluded cross-sectional studies. Information regarding methods, participants, interventions, outcome measures, and results were extracted. A risk of bias assessment within and across studies was conducted. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were applied to generate quality evidence. Results: Six studies with a total of 2,663 participants were included in the review, and meta-analysis was conducted on 4; 3 studies had a high risk of bias. A mean reduction of 2.16 (-5.06, 0.75) was observed with MI as an intervention. A sensitivity analysis revealed a mean reduction of 3.64 (-5.77, -1.51) in favor of MI. Conclusion: There is some evidence with moderate certainty that MI is beneficial in the reduction of new carious lesions in children with ECC. How to cite this article: Manek S, Jawdekar AM, Katre AN. The Effect of Motivational Interviewing on Reduction of New Carious Lesions in Children with Early Childhood Caries: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(1):112-123.

A Comparison of Innovative App-Based Prescriptions With Conventional Prescriptions for Children by General Dentists: A Mixed Methods Study.

Introduction Writing drug prescriptions for children with accurate drug dosages and clear instructions is a must for general dentists. A digital tool in the form of a software application (app) to write, save and share prescriptions can potentially overcome the possible limitations of handwritten prescriptions such as handwriting illegibility, errors in calculations, and incomplete descriptions. However, it is also important to assess the satisfaction of dentists with making prescriptions using a digital tool such as an android application. A mixed methods study comparing an innovative "app-based" and handwritten prescriptions in dental settings is presented. Methodology An indigenously developed and piloted app "PREscribing children made EASY (PREASY)" was used in this study. Based on the preliminary study, a sample size of 20 was found to be adequate. Twenty-two dentists participated in the study. The conventional handwritten and an Android app PREASY-based prescriptions were compared in terms of the time taken, precision of writing, and satisfaction of the dentists. Qualitative feedback regarding the PREASY app was obtained in Google Forms (Google, Inc., Mountain View, CA, USA). Results A study sample of 20 subjects was calculated based on a pilot study, and 22 dentists were recruited. The mean time taken in seconds for handwritten prescriptions (199.14 (+ 59.18)) was almost four times higher than that for app-based prescriptions (52.05 (+ 23.89)) (t-test, P < 0.00001). The accuracy of handwritten prescriptions versus app-based prescriptions was compared by two examiners independently using analysis of variance (ANOVA) in three domains: dosage accuracy, legible handwriting, and completeness of instructions, the differences (Domain 1 mean + SD: 1.04 + 0.89, Domain 2 mean + SD: 1.38 + 0.40, Domain 3 mean + SD: 0.88 + 0.58) being statistically significant (P < 0.05). The differences in the percentages of the three domains (dosage accuracy: 40.9%, legibility of handwriting: 63.6%, completeness of instructions: 18.1%) were found to be statistically significant (P < 0.05; chi-squared statistic, 9.4017). Of the participants, 59% were very satisfied, 36.3% were satisfied, and 4.5% were neutral (chi-squared test, P < 0.00001). Participants' feedback/comments were categorized under technical suggestions, dosage suggestions, criticism, and positive remarks and were thematically analyzed. Conclusion App-based prescriptions proved to be more instantaneous and detailed than handwritten ones with the majority of dentists satisfied. Valuable feedback pertaining to the limitations of the tool was obtained for improving the app. PREASY-based prescriptions could be recommended for prescribing to pediatric dental patients.

Effect of immunoglobulin Y formulations on oral microorganisms in human subjects - A systematic review and meta-analysis of clinical trials.

Background: Passive immunization using egg yolk-based antibodies has been tested against oral microorganisms. Our study assessed the effect of immunoglobulin Y (IgY) formulations on Streptococcus mutans, Porphyromonas gingivalis, and Candida albicans in human subjects. Highlights: VS and UT independently searched articles using keyword combinations in four search engines; studies in English were selected. Either parallel-arm or split-mouth randomized controlled trials on healthy human subjects were considered. Ten studies remained in the selection; six studies compared the effect of IgY formulations on S. mutans, three on P. gingivalis, and one on C. albicans. Five studies (422 subjects) compared the effect of IgY formulations on S. mutans. When fixed-effect model (FEM) was applied, the risk ratio (RR) (confidence interval [CI]) was found to be 7.81 (6.00, 10.18). Three studies (167 subjects) compared the effect of IgY formulations on P. gingivalis. When FEM was applied, the RR (CI) was found to be 0.06 (-0.03, 0.15) in relation to reduction in probing depth. When FEM was applied, for percentage reduction in bleeding on probing (BOP), the RR (CI) was 1.99 (1.64, 2.41). Only one study (26 subjects) was available of IgY formulation and C. albicans; hence meta-analysis was not performed.The search was extended using Google Scholar, Semantic Scholar, cross-references and by contacting authors and researchers in the field which further yielded five articles. . Conclusions: IgY formulations were effective in the reduction of S. mutans. They were not effective on P. gingivalis in relation to probing depth but were effective in relation to reduction in BOP. No harms were reported. Evidence is of low quality due to high heterogeneity. The ROB was moderate and publication bias was low.

Assessment of oral health-related quality of life (OHRQoL) in children with molar incisor hypomineralization (MIH) - A systematic review and meta-analysis of observational studies.

Background: Molar Incisor Hypomineralization (MIH) affects about 14% of the population. MIH may lead to enamel breakdown, early tooth decay and is known to cause sensitivity, pain, discomfort, etc., Despite several studies reporting impacts of MIH on oral health-related quality of life (OHRQoL) in children; no systematic review has been reported till date. Objectives: Our study aimed at assessing the impact of MIH on OHRQoL. Search Methods: Two researchers, Ashwin Muralidhar Jawdekar and Shamika Ramchandra Kamath, independently searched articles using appropriate keyword combinations in three search engines - PubMed, Cochrane Library, and Google Scholar and conflicts, if any were resolved by Swati Jagannath Kale. Studies either reported in English or complete translations available in English were selected. Selection Criteria: Observational studies on otherwise healthy 6-18-year-old children were considered. Interventional studies were included only to collect the baseline (observational) data. Data Collection and Analysis: From 52 studies, a total of 13 studies could be included in the systematic review and 8 in meta-analysis. Total scores of OHRQoL measures reported in the child perceptions questionnaire (CPQ) 8-10, CPQ 11-14, and parental-caregiver perception questionnaire (P-CPQ) scales were used as variables. Main Results: Five studies (2112 subjects) showed an impact on OHRQoL (CPQ); the pooled risk ratio (RR) confidence interval (CI) were 24.70 (13.93-35.47), showing statistically significant value (P < 0.001). The Three studies (811 participants) showed an impact on OHRQoL (P-CPQ); the pooled RR (CI) was 16.992 (5.119, 28.865) showing statistically significant value (P < 0.001). Heterogeneity (I2) was high (99.6% and 99.2%); hence, random effect model was used. Sensitivity analysis of two studies (310 subjects) showed impact on OHRQoL (P-CPQ); the pooled RR (CI) was 22.124 (20.382, 23.866) showing statistically significant value (P < 0.001); the heterogeneity was low (I2 = 0.0). The risk of bias across studies assessed using the appraisal tool for cross sectional studies tool was found to be moderate. The reporting bias assessed using the dispersion on the funnel plot was found to be minimal. Authors' Conclusions: Children with MIH are about 17-25 times more likely to have impacts on the OHRQoL compared to children with no MIH. Evidence is of low quality due to high heterogeneity. The risk of bias was moderate and publication bias was low.