Inferior alveolar nerve block anesthesia in children: The effect of ibuprofen and phentolamine mesylate on pain perception.

CONTEXT: For successfully managing pediatric dental patients, local anesthesia is essential to eliminate pain during or after the operative period. An early recovery from soft-tissue anesthesia after an inferior alveolar nerve block (IANB) should benefit a young child patient by avoiding the risk of inadvertently biting the soft tissues. AIMS: Hence, the purpose of the study was to (1) evaluate and compare the efficacy of pre- and postoperative ibuprofen on pain perception in children who undergo IANB anesthesia with or without the use of PM and (2) evaluate the average time required for reversal of anesthesia symptoms using phentolamine mesylate. METHODS: The present study was a randomized, clinical trial performed among 60 children between 6 and 8 years of age using a convenient sampling method. The children were randomly assigned into four equal groups of 15 each using the computer-generated randomization sequence. IANB anesthesia was performed using 2% lignocaine with 1:100,000 epinephrine, and a mandibular primary molar pulpotomy was performed on each group. Group 1: the ibuprofen tablet was taken 1 h before the onset of the procedure. Group 2: ibuprofen tablet 30 min after the pulpotomy procedure. Group 3: the ibuprofen tablet was taken 1 h before the onset of the procedure, and the Phentolamine mesylate (PM) injection was administered. Group 4: immediately after the pulpotomy, the PM injection was administered, and an ibuprofen tablet was taken 30 min after the pulpotomy procedure. All children were assessed for the duration of soft-tissue anesthesia, their behavior scores and pain rating, as well as the incidence of postoperative self-inflicted injuries. STATISTICAL ANALYSIS USED: A one-way ANOVA was used to compare the average time needed for the reversal of anesthetic symptoms between groups. The effects of phentolamine, local anesthetics, and ibuprofen on the child's behavior and pain scores were compared using the Student's t-test. For the study, P < 0.05 was accepted as statistically significant. RESULTS: The time needed for the full reversal of anesthetic symptoms to manifest on the tongue and lip was substantially reduced by the injection of phentolamine (P < 0.001). The use of phentolamine for reversal or the intake of ibuprofen pre- or postoperatively did not exhibit any significant variation in the behavior, pain experience, or incidence of self-inflicted injuries in the child. CONCLUSION: It is evident that although phentolamine injections shorten the duration of anesthesia, the adjunctive use of pre- or postoperative ibuprofen did not significantly alter pain scores.

Association between early childhood caries and feeding practices among 3-5-year-old children of Indore, India.

BACKGROUND: The impact of early childhood caries (ECC) seen in infants and young children to the society is enormous. Most studies on ECC have been focused on specific ethnic and lower socioeconomic communities, however fewer studies are conducted in India as compared to other developed countries. AIMS: The study investigates the association between selected feeding practices and the presence of early ECC among 3-5 year-old children of Indore city. METHODOLOGY: A cross-sectional sample consisted of 640 preschool children of different socioeconomic status (SES). A self-administered questionnaire was used to obtain information about demographic backgrounds and feeding history of the child. The caries experience of children was recorded. STATISTICAL ANALYSIS: The data were evaluated using Chi-square and multivariate logistic regression. RESULTS: The prevalence of ECC was found to be 64%. ECC was found to be significantly associated with age, SES, breastfeeding for more than 1 year, bottle feeding, bottle content used other than water, feeding at night, and cup drinking after 1 year. CONCLUSION: The present study indicates that ECC and feeding habits have a significant relationship. The content of the bottle feed and feeding practices at night are the strongest factors among all feeding habits associated with ECC.

Prevalence of traumatic injuries to the anterior teeth among 3-17-year-old school children of Indore and correlating it with Kuppuswamy SES, occlusal relationship and ascertaining percentage of those seeking the treatment.

BACKGROUND: Orofacial trauma is one of the most prevailing oral health problems among the children. This study aimed to assess the prevalence and distribution of traumatic injuries and to correlate the causes, specific age groups, socio-economic status, occlusal relationship and ascertain the percentage of those seeking the treatment among school children in Indore (Madhya Pradesh, India). MATERIALS AND METHODS: Five thousand school going children aged between 3 and 17 years belonging to different zones of Indore were randomly selected and divided into three age groups, Group I - 3-5 years; Group II - 6-11 years and Group III - 12-17 years. The study was carried out by a single investigator and assisted by a well-trained cooperative alert assistant. An American Dental Association (ADA) type 3 examination was carried out using a mouth mirror and explorer under sufficient natural light. Traumatic injuries to the anterior teeth were recorded according to the Ellis and Davey classification. Details were noted concerning the gender, age and socio-economic status of patient; cause of trauma, number, type and relationship of teeth, lip competence and the level of unmet treatment needs. RESULTS: One thousand and seventeen children had traumatized anterior teeth with a mean prevalence of 20.34%. Prevalence was more in boys than in girls with a ratio of 2:1. Single tooth injury was observed in 81.7%. The prevalence of trauma was highest in the upper socio-economic class (31.4%) and least was seen in lower class (14.8%). The most common cause of trauma was from a fall (36.72%). Maximum prevalence was seen in either class II division 1 malocclusion or distal step terminal plane primary molar relationship. Only 2.95% of the children had undergone treatment for traumatically injured anterior teeth. CONCLUSION: High prevalence of traumatized teeth with the low percentage of children receiving treatment emphasizes the need for education programs about traumatic dental injuries that should be directed towards the children, parents and school teachers.

Calotropis gigantea extract as a potential anticariogenic agents against Streptococcus mutans: An in vivo comparative evaluation.

OBJECTIVE: The current study was intended to evaluate and compare the in vivo efficacy of Calotropis gigantea mouth rinse as anticariogenic agents with 0.2% chlorhexidine and Listerine mouth rinse. MATERIALS AND METHODS: An experimental crossover study was conducted on sixty school children aged 14-15 years. Participants were divided into three Groups A, B, and C. In all children, baseline unstimulated saliva samples were collected and assessed for Streptococcus mutans counts. The study was conducted in three phases; each phase lasted for 8 days separated by a washout period of 15 days in between them. Groups A, B, and C were treated with 0.2% chlorhexidine, Listerine and C. gigantea extract mouth rinses, respectively, in the Phase I and assessed for salivary S. mutans counts. Subsequently, mouth rinses were crossed over as dictated by the Latin square design in Phase II and III. RESULTS AND CONCLUSION: All the three mouth rinses have individually shown a statistically significant reduction in the salivary S. mutans counts.

A comparative evaluation of retention of pit and fissure sealant bonded using sixth-, seventh-, and eighth-generation adhesives: An in vivo study.

INTRODUCTION: Dental caries is one of the most common preventable childhood infections. a number of measures are available to prevent occlusal caries; pit and fissure sealants are one of the various methods currently available to cost effectively reduce dental caries. AIM: To evaluate the retention of pit and fissure sealant bonded using sixth (Adper promt), seventh (Optibond) and eighth (Futurabond Dual Cure) generations of adhesives. SETTINGS AND DESIGN: A total of 37 healthy children who fulfilled the inclusion were randomly selected. A total of 148 teeth (4 in each subject) were used as samples for the study. METHODS AND MATERIAL: The teeth to be sealed were then isolated using rubber dam. The placement of adhesives was done using split mouth design. The first permanent molars were randomly divided into four groups on the basis of sealant placed without and with using 6th, 7th and 8th generation bonding agents as follows: GROUP A (N=37):- Pit and fissure sealant placed without bonding agent. GROUP B (N=37):- Pit and fissure sealant placed following sixth generation bonding agent (ADPER PROMT). GROUP C (N=37):- Pit and fissure sealant placed following seventh generation bonding agent. (OPTIBOND). GROUP D (N=37):- Pit and fissure sealant placed following eighth generation bonding agent. (FUTURA BOND DUAL CURE). The integrity of the sealant placed was assessed immediately after completion of the procedure, 3 months and 6 months after placement. The post-operative evaluation for retention was done using Simonsen criteria. A score of 0 was given for complete retention, 1 for partial retention and 2 for no retention. STATISTICAL ANALYSIS USED: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) software version 21. RESULTS: It was found that there was no statistically significant difference between the groups after 3 and 6 months as the value obtained (0.133) was much greater than the p-value (0.05). CONCLUSIONS: This study concluded that the use of bonding agent prior to application of pit and fissure sealant does not necessarily aid in retention of sealant as compared to pit and fissure sealant placed without bonding agent, Sealants effectiveness is directly related to its retention and it dependent on application procedures. The failure of retention of pit and fissure sealants can attribute to moisture contamination, improper curing methods, inadequate adhesion, improper application procedure or early age placement.

Knowledge of hepatitis B virus infection and its control practices among dental students in an Indian city.

Background Hepatitis B virus infection is a general cause of chronic hepatitis, liver cirrhosis and hepato-cellular carcinoma worldwide. It is highly contagious. It is an important reason for morbidity and mortality in the Indian population. Oral health professionals are at the highest risk. Vaccination for hepatitis B can prevent this deadly disease. Methods The present study was designed to evaluate the degree of awareness, knowledge of hepatitis B infection and status of hepatitis B vaccination among dental students. A cross-sectional study was conducted among 240 students of 3rd year, 4th year and interns of a professional dental course. A pre-tested questionnaire was given to the students of each year. All the data management and analysis were carried out using SPSS software version 16. Results Eighty-six percent of the students had knowledge about hepatitis B infection. The majority of the students had correct knowledge regarding mode of transmission, however, 21% failed to recognize saliva as the mode of hepatitis B transmission. Forty-five percent of the students were vaccinated for hepatitis B. Conclusion The present study concludes that there is reasonable awareness of hepatitis B infection hazards, its transmission and vaccination, among the dental students who will be entering into the profession. However, half of the students were not vaccinated for hepatitis B in our study group, which keeps them at risk to the disease. The Indian Health Ministry should make hepatitis B vaccination mandatory for all health care professionals. A strategy should be executed for health education and compulsory vaccination of all students joining the health care professional colleges. Antibody titers should be routinely checked among those who are vaccinated.

Recent research trends in dentistry.

Research being an investigative process is employed to increase or revise the current knowledge. Scientific research involves the conduct of a methodical study to prove a hypothesis or give an answer to a specific question with the main aim of finding definitive answer. This paper aims to advance knowledge of research and develop interest in the postgraduate students. It also throws light on the existing and emerging research strengths within a "high-performance culture." The trends in dental research worldwide are looked at, in particular, a comparison between the publication status in two countries, namely India and Australia. The current themes in dental research are also discussed to facilitate future projects for the aspiring pediatric dentists. Stress is given to the importance of evidence-based dentistry as the current times call for high-quality and ethical papers which are devoid of plagiarism. The common reasons for failure of a research are explored and the strengthening factors are highlighted. Proper planning of a pertinent research project is beneficial to the researcher as well as the dental community.

Association between Chewing Side Preference and Dental Caries among Deciduous, Mixed and Permanent Dentition.

INTRODUCTION: Chewing Side Preference (CSP) is said to occur when mastication is recognized exclusively/consistently or predominantly on the same side of the jaw. It can be assessed by using the direct method - visual observation and indirect methods by electric programs, such as cinematography, kinetography and computerized electromyography. AIM: The present study was aimed at evaluating the prevalence of CSP in deciduous, mixed and permanent dentitions and relating its association with dental caries. MATERIALS AND METHODS: In a cross-sectional observational study, 240 school going children aged 3 to 18years were randomly allocated to three experimental groups according to the deciduous dentition, mixed dentition and permanent dentition period. The existence of a CSP was determined using a direct method by asking the children to chew on a piece of gum (trident sugarless). The Mann Whitney U-test was used to compare the CSP and also among the boys and girls. The Spearman's Correlation Coefficient was used to correlate CSP and dental caries among the three study groups and also among the groups. RESULTS: CSP was observed in 69%, 83% and 76% of children with primary, mixed and permanent dentition respectively (p>0.05). There was no statistically significant association between the presence of CSP and dental caries among the three study groups. CONCLUSION: There was a weak or no correlation between gender and distribution of CSP and between presence of CSP and dental caries.

Hookah addiction among adolescents of five major cities in Central India.

INTRODUCTION: Hookah use among the Indian adolescents is on the rise without them being aware of its tobacco content. This prevalence study highlights the issues associated with hookah use among high school students of five cities of Central India. METHODS: A study among 3500 students of high schools was undertaken to estimate the prevalence of hookah users and its associated factors including initiation/cessation, patterns, perceptions and behavior. Responses were received from 225 hookah users. RESULTS: The prevalence of hookah users in the present study was found to be 6.4% (225). Most of the subjects first learned about hookah use from friends (64.5%) and smoked hookah in hookah lounges (90.7%). Generally, the adolescents were aware of various lounges in their locality. CONCLUSION: This study suggests that the use of hookahs is attracting adolescents at a very early age and is attributed to the presence of hookah lounges in various cities of Central India. Hence, the legality of hookah lounges in India should be reconsidered.

An in vitro evaluation of the demineralization inhibitory effect of F(-) varnish and casein phosphopeptide-amorphous calcium phosphate on enamel in young permanent teeth.

AIMS AND OBJECTIVES: To determine the demineralization inhibitory potential of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and to compare and evaluate the additive effect of fluoride varnish + CPP-ACP. MATERIALS AND METHODS: Ten healthy premolar teeth that were extracted for orthodontic purposes were collected, and each tooth was longitudinally sectioned buccolingually and mesiodistally into four sections. The teeth were then assigned to four different treatment groups namely fluoride varnish, CPP-ACP, F(-) varnish followed by CPP-ACP and control. The prepared enamel samples were suspended in an artificial caries challenge for 10 days. The demineralizing inhibitory effects of the groups were recorded using polarized light microscopy. STATISTICAL ANALYSIS USED: Statistical analysis was carried out using analysis of variance and Duncan's multiple range tests. RESULTS: The mean lesion depths of all the groups were Group 1 (fluoride varnish): 104.71, Group 2 (CPP-ACP): 127.09, Group 3: (F(-) varnish + CPP-ACP): 82.34, Group 4 (control): 146.93. CONCLUSION: Demineralization inhibitory potential on the additive use of F(-) varnish and casein phosphopeptide was superior to fluoride varnish or CPP-ACP applied alone on the enamel of young permanent teeth.

Evaluation of sealing ability two self-etching adhesive systems and a glass ionomer lining LC under composite restoration in primary tooth: An in vitro study.

AIMS AND OBJECTIVES: To evaluate the sealing ability of two self-etching adhesive systems and glass ionomer cement (GIC) lining Light cure (LC) under composite restorations in primary teeth. MATERIALS AND METHODS: Class V cavities are prepared on the cervical third of the facial and lingual surfaces of primary molars. The specimens are then assigned into four experimental groups. The restored primary molars are stored in distilled water and subjected to thermocycling. Each section was examined using a stereomicroscope to assess dye penetration at the margin of the restoration and evaluated via pictures. STATISTICAL ANALYSIS USED: The degree of microleakage was analyzed using Kruskal-Wallis test and the intergroup significance by multiple comparison analysis. RESULTS: The mean rank of the groups are Group I (Adper Prompt™ + Z-100) 19.44, Group II (UniFil BOND + Solare) 5.38, Group III (GIC lining LC + Z-100) 20.06, and Group IV (GIC lining LC + Solare) 21.13 with the P < 0.001. CONCLUSION: Composite resin restorations bonded with two-step self-etching adhesive system (UniFil Bond) exhibited lesser microleakage than one-step self-etching adhesive system (Adperprompt™) in primary teeth.

The effect of xylitol on dental caries and oral flora.

Dental caries, the most chronic disease affecting mankind, has been in the limelight with regard to its prevention and treatment. Professional clinical management of caries has been very successful in cases of different severities of disease manifestations. However, tertiary management of this disease has been gaining attention, with numerous methods and agents emerging on a daily basis. Higher intake of nutritive sweeteners can result in higher energy intake and lower diet quality and thereby predispose an individual to conditions like obesity, cardiovascular disorders, and type 2 diabetes mellitus. Non-nutritive sweeteners have gained popularity as they are sweeter and are required in substantially lesser quantities. Xylitol, a five-carbon sugar polyol, has been found to be promising in reducing dental caries disease and also reversing the process of early caries. This paper throws light on the role and effects of various forms of xylitol on dental caries and oral hygiene status of an individual.

Maturogenesis by revascularization in an infected immature permanent tooth.

Root canal treatment in teeth with incomplete root formation is a challenge. A case of maturogenesis in an immature infected tooth along with probable factors needed for success is discussed. Although clinical and radiographic evidence points to healing and root development, the long-term prognosis and the behavior of tissue occupying the canal space needs further investigation before the procedure can be adopted into routine clinical practice.

Repositioning a laterally luxated maxillary central incisor with a vacuum-formed splint: a case report.

Splinting is the standard care for stabilizing replanted or repositioned permanent teeth following trauma. Traditionally, semirigid splints are used to stabilize a repositioned tooth, with support provided by adjacent teeth. However, in cases when the adjacent teeth are wide and/or can only provide minimal anchorage and support, it is difficult to fix the luxated tooth to its original position. This case report describes how a clear vacuum-formed splint was used to reposition and stabilize an avulsed maxillary left central incisor. Due to the avulsion, an unerupted canine, and partially erupted premolars, it was difficult to fabricate a traditional splint, hence the creation of the vacuum-formed splint.

Oral lichen planus in a young Indian child.

Lichen planus (LP) is one of the most distinct mucocutaneous diseases. It is common with the middle aged and elderly population but has rarely been described in children. Incidences of oral LP in children is most commonly reported amongst Asians. We present a 10-year-old Indian girl with the documented clinical aspects and histopathological studies.

A comparative evaluation of Oratest with the microbiological method of assessing caries activity in children.

AIMS: The aim of this study is to find out whether Oratest can be used as a diagnostic tool in assessing the caries activity by evaluating its relationship to the existing caries status and the salivary streptococcus mutans level. MATERIALS AND METHODS: The study sample consists of 90 students divided into two groups. Group I (test group) and Group II (control group) consisting of 30 children for control group and 60 children for test group. The sampling of unstimulated saliva for the estimation of streptococcus mutans was done as per the method suggested by Kohler and Bratthall. The plates were then incubated. Rough surface colonies were identified as streptococcus mutans on a pre-determined area of the tip (approximately 1.5 cm(2)) were counted for each side of spatula pressed against mitis salivarius bacitracin agar using digital colony counter. The results were expressed in colony forming units (CFU). Oratest was carried out in the same patients after the collection of salivary sample for the microbiological method to evaluate the relationship between the two tests. STATISTICAL ANALYSIS USED: The tests used were ANOVA, Pearson Chi-square test, Pearson's correlation analysis, Mann-Whitney U test and Student's independent t-test. RESULTS: In the control group and test group, when the streptococcus mutans count (CFU) and Oratest time (minutes) were correlated using Pearson's correlation analysis, the streptococcus mutans counts was found to be in a statistically significant negative linear relationship with the Oratest time. When the caries status of the children, participated in the test group were correlated with mutans count (CFU) and Oratest time, caries status were found to be in a statistically significant positive linear relationship with streptococcus mutans count and in a significant negative linear relationship with Oratest time. CONCLUSIONS: The test proved to be a simple, inexpensive and rapid technique for assessing caries activity since a significant relationship exists clinically with caries status and microbiologically with the streptococcus mutans count of the individual.

Fixed functional space maintainer: novel aesthetic approach for missing maxillary primary anterior teeth.

The first-line treatment of non-restorable traumatically injured or carious deciduous teeth is extraction which may be a curse for the future dentition as well as social activity of a child. Various therapeutic modalities from removable partial dentures to fixed space maintainer can be used for replacement of such lost teeth. Two types of fixed aesthetic space maintainers for replacing premature loss of maxillary deciduous incisors in 4-year-old children are discussed.

Management of an infant having natal teeth.

Eruption of teeth at or immediately after birth is a relatively rare phenomenon. These teeth are known as 'natal' teeth if present at birth and 'neonatal' teeth if they erupt during the first 30 days of life. Natal teeth might resemble normal primary dentition in size and shape; however, the teeth are often smaller, conical and yellowish and have hypoplastic enamel and dentin with poor or absent root formation. Complications include difficulty and discomfort during suckling, sublingual ulceration, laceration of the mother's breasts and aspiration of the teeth. These situations would warrant extraction. If the tooth does not interfere with breast feeding and is otherwise asymptomatic, no treatment is necessary. Negative cultural attitudes towards natal teeth demand good parental counselling and vigilant management in relation to child protection. Both general practice dentists and paediatric dental specialists may be involved in the supervision or treatment of patients with natal and neonatal teeth.

Accessory tragus: a dentist's perspective.

Accessory tragus (AT) also referred as preauricular tag is a rudimentary tag of ear tissue This paper presents two specific cases: one hereditary and another sporadic case of AT. A general clinical description of AT, its associated syndromes, embryology aetiopathogenesis and management is discussed. A dentist can play an important role in spotting the AT during their head and neck examination. The presence of this defect can be correlated to other congenital defects of first branchial arch. On recognising its occurrence, the dentist can refer to a specialist for thorough investigation management. A dentist can play a vital role in encouraging and counselling the parents for the correction of such defects as it improves the aesthetics of the face. Usually, children with these defects are often targets of teasing by peers.