Visit to the Dentist for Oral Health Prevention at "Age One": A proposed policy report from the Indian perspective.

Early childhood caries is a major public health issue in India. The primary reason for poor oral health in children is a lack of awareness about the role of primary teeth and the importance of an early dental visit for infants and toddlers. The primary objectives of an early dental visit are to analyze the child's risk level, provide guidance to parents regarding proper oral hygiene measures, review dietary and eating habits, provide information regarding the infectivity of dental caries, review the risks of traumatic injuries and discuss factors which affect the development of occlusion. Through this paper, we are proposing an "Age One" policy that recognizes dentists, physicians, allied health professionals, community health-care workers, and nongovernmental organizations to work toward a child's overall health as partners to achieve this goal. The expectation is that this policy will provide guidance to childcare centers, pediatric dentists, other health-care professionals, and legislators regarding oral health activities and the promotion of oral health in infants. The purpose of the policy is to lay the foundation for a lifetime of preventive education and dental care, to help ensure optimal oral health beginning in childhood and continuing through the life course.

Comparative Evaluation of Clinical and Radiographic Success of Pulpectomy Done with and without Dental Operating Microscope in Pediatric Patients: An In Vivo Study.

Aim: To assess the clinical and radiographic success of conventional pulpectomy and pulpectomy done under an endodontic microscope over a period of 12 months. Materials and methods: The study was conducted as a single-blinded, parallel-group prospective, randomized, and controlled clinical trial. The enrollment of the study involved the assessment of 258 deciduous molars for eligibility as per the inclusion criteria. A total of 104 teeth were allocated to each group, that is, group I (conventional pulpectomy) and group II (pulpectomy under microscope). However, due to unavoidable circumstances during the coronavirus disease 2019 (COVID-19) pandemic, 98 and 90 teeth were treated in each group, respectively. Pulpectomy in both groups was done using standard protocol except for the use of an endodontic microscope in group II. The clinical and radiographic outcomes were assessed by an independent blinded observer and analyzed using appropriate statistical tests. Results: The clinical success at 6 months is 95.7 and 96.5%, and at 12 months is 96.6 and 97.7% in groups I and II, respectively. The radiographic success at 6 months is 93.5 and 95.4%, and at 12 months is 95.5 and 98.8% in groups I and II, respectively. The overall success rates of both groups with statistically no significant differences. Conclusion: The present study concludes comparable results are achieved using an endodontic microscope to conventional pulpectomy without magnification. How to cite this article: Kumar G, Rehman F. Comparative Evaluation of Clinical and Radiographic Success of Pulpectomy Done with and without Dental Operating Microscope in Pediatric Patients: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(S-2):S155-S160.

Global Scenario of Teledentistry during COVID-19 Pandemic: An Insight.

With the advent of the coronavirus pandemic, dentistry has faced a halt as it involves face-to-face interaction with patients which had to be suspended for quite some time. Teledentistry (TD) can offer an innovative solution to resume dental practice during this pandemic. This paper gives an insight into the practice of TD being used in various countries to aid in the management of dental problems arising during the coronavirus disease 2019 (COVID-19) era. It also reviews the utilization of TD for academic institutions to facilitate educating dental students across the globe. How to cite this article: Kumar G, Rehman F, Al-Muzian L, et al. Global Scenario of Teledentistry during COVID-19 Pandemic: An Insight. Int J Clin Pediatr Dent 2021;14(3):426-429.

Severe Acute Respiratory Syndrome Coronavirus 2 and Dentistry: A Summative Review of Guidelines issued by National Health Authorities.

COVID-19 was first reported in China, in November 2019 and since then the spread of this disease was so rapid that on March 11, 2020, it was declared a pandemic by the World Health Organization. Due to the high transmissibility of the COVID virus and the associated morbidity and mortality, various International and National health authorities released different guidelines for day-to-day living, laying down "new norms" which has impacted our lives enormously. Although these guidelines seem to be convoluted but owing to some differences in the guidelines, it raises an ambiguity in the minds of dentists. Hence, we felt the need of this review to summarize different guidelines issued by various National health authorities for catering emergency and routine dental care. We included guidelines from CDC, ADA, NHS, India, UAE, Egypt, and Tunisia and compared and consolidated to reach a consensus that teledentistry is a good alternative to face-to-face management for nonemergency patients. Triage should be done for all patients coming to the health-care facility. Temperature and other vital parameters should be recorded in our daily practice. Antibacterial mouth rinses before the dental procedure can reduce the microbial load and therefore can alleviate transmission. To reduce indirect transmission through fomites on inanimate objects various waiting area changes must be ensured. Air conditioners can be used in well-serviced conditions with due care given to ventilation of the operatory after each patient. Strict disinfection protocols and personal protective equipment for dentist safety are mandatory.

Knowledge, attitude and practice regarding the use of dental operating microscope in pediatric dentistry in India: An online survey.

BACKGROUND AND AIM: Literature search shows scarcity of information regarding the use of Dental Operating Microscope (DOM) in children. There are various factors that limit the use of this novel technology by Pediatric Dentists in their practice. The aim of this study is to assess the knowledge, attitude and practice of pediatric dentist regarding DOM use in children. METHOD: The present study was a descriptive web based questionnaire study conducted among 363 Pediatric Dentists (PDs) of India. A close-ended questionnaire was prepared to test the KAP regarding microscope use among PDs. Results obtained were analyzed using descriptive analysis in SPSS software and correlation was studied using chi-square test where statistical significance was observed at p â€‹< â€‹0.05. RESULTS: A response rate of 82.1% was observed. Majority (88.9%) of the pediatric dentists were aware of Dental operating Microscope (DOM) usage in their field, however, only 61.4% were aware of its magnification levels. 76.5% participants responded 12oclock position to be the ideal position. Majority (94.0%) agreed that DOM is helpful in locating canals in deciduous teeth. 70.5% think that DOM can increase apprehension of children. 85.2% believed that DOM can aid in behavior management of children through its live visual output. However, 84.2% of the pediatric dentists hadn't used DOM in their practice. CONCLUSION: The knowledge, attitude and practice regarding dental operating microscope among pediatric dentists in India is limited. In the foreseeable future, the use of magnification is likely to become the standard of practice in dentistry.

Safety and Efficacy of IV Dexmedetomidine as an Adjunct to Propofol to Sedate Anxious and Uncooperative Pediatric Dental Patients: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the safety and efficacy of dexmedetomidine (dex) as an adjunct to propofol sedation in pediatric dental patients. STUDY DESIGN: This RCT enrolled 30 anxious ASA-I 2-5 year olds. Allocated into 2 groups either receiving IV propofol (1 mg/kg)(Gp-P) or [IV dex (1ug/kg) with propofol(1 mg/kg)] (Gp-D) after oral midazolam premedication (0.5 mg/kg). Sedation maintained with propofol infusion at 50-75ug/kg/min. Additional bolus/es of propofol (1mg/kg) was/were administered in case of inadequate sedation. Primary outcome was to compare requirement of propofol in two groups. Secondary outcomes were to compare vital signs, depth of sedation, induction, treatment and recovery time, intra & post-operative complications and analgesic requirement post-operatively. RESULTS: Total propofol (in mgs) used and number of additional boluses were significantly higher in group P (p<0.05). Although within normal limits, heart rate was significantly lower in group D. Respiratory rate, oxygen saturation, NIBP were comparable. Depth of sedation achieved was comparable at all steps (p>0.05). Induction time (mins) was significantly lower in Group P (p<0.05), however treatment and recovery time were similar (p>0.05). Desaturation was observed in 3/15(group P) & 0/15(group D). Analgesic requirement post-operatively was significantly higher in group P (p<0.05). CONCLUSION: Dexmedetomidine is a safe and effective adjunct to propofol.

Biomedical waste management in dentistry during COVID-19 pandemic: What the guidelines recommend??

In the current coronavirus disease 2019 pandemic, dentists, auxiliaries as well as patients undergoing dental procedures are at high risk of cross-infection. Many patients who are asymptomatic may be carriers. For this reason, it is suggested that all patients visiting a dental office must be treated with due precautions. Ample amount of data is available which is mainly focusing on infection prevention and asepsis protocol for dental set ups with little emphasis on biomedical waste (BMW) management which is equally important in curbing the spread of the disease to health-care workers and general population. This article highlights the updated guidelines of BMW management to be followed in various dental set ups to prevent this spread to health-care workers dealing with the disposal of waste generated while treating patients in dental care.

Parent's attitude toward use of internet for child's oral health and treatment.

BACKGROUND: Widespread use of internet in the modern era has allowed increased access to seek medical and dental education by self-education. However, limited evidence is reported regarding the use of internet to gather oral health information by patients reporting to dental hospital in a centrally located institute of New Delhi, India. AIM: The aim of the present cross-sectional study was to evaluate the parental attitude toward the use of internet related to child's oral health and treatment. DESIGN: The data was collected from 500 patients from the Outpatient Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi. A self-administered questionnaire with open ended questions assessing parental attitude toward the use of internet for oral health information was designed, and patients willing to participate were included. MATERIALS AND METHODS: The present cross-sectional study was conducted among 500 parents selected randomly from the Out Patient Department. The participants were given the questionnaire which assessed their attitude towards use of internet related to child's oral health and treatment. The data was collected and statistical analysis was performed. RESULTS: 86% reported to have high school education, 7% to have middle school education, 3% to be diploma holders, 2% to be graduates and postgraduates, and only 2% as professionals. 56.1% of the participants use internet to gather information on oral health, whereas only 41.9% reported that they have access to internet but do not use to search information related to oral health and disease. 26.1% of the participants often search information on internet before consulting a doctor, and 29.3% discuss treatment plan after searching from internet with their doctor. CONCLUSION: Since the use of internet by younger adults seeking information on oral health seems to be more prevalent among educated people, less prevalence is reported in this study. Majority of the participants were aware regarding the harmful effects of such information and also reported that treatment or medication searched on internet made their problem worse than before.

Soft Tissue Applications of Er,Cr:YSGG Laser in Pediatric Dentistry.

Soft tissue laser, such as diode and Nd:YAG lasers were initially used in soft tissue lesions because of its increased success rate. It was because of the fact that these lasers were well-absorbed by chromophores, such as hemoglobin and melanin which are found abundant in the oral mucosa. The introduction of erbium family in 1990 comprising the Er:YAG and Er,Cr:YSGG lasers made the hard tissue laser a boon for dentistry. Erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG) was introduced in 1997 for the surgical needs of clinical dentistry in general practice. The erbium belongs to the rare earth which is embedded in a host crystal. The actual lasing process takes place in the Er ion Er3+. Two host crystals consisting of yttrium, aluminum, and garnet (Y3A5O12) and yttrium, scandium, gallium, and garnet (Y3Sc2Ga3O12) are added to the erbium. The interest to use these hard tissue laser in the treatment of soft tissue lesion was because of the properties of these lasers which are well-absorbed by chromophore water apart from hydroxy appetite crystals. Erbium laser energy is absorbed by collagen, hydroxyapatite, and water components. It allows the laser to cut soft tissue, tooth structure, and bone. In the noncontact mode, the incision is scalpel-like, with very little hemostasis. In contact mode, it performs soft tissue sculpting with adequate hemostasis. The Er,Cr:YSGG is the world's most advanced dental laser, which is ideal all-tissue laser because all dental tissues contain water, for the multidisciplinary dentist who performs a broad spectrum of procedures. It delivers the highest level of clinician control, operating efficiency, flexibility in tip, and accessory selection. For optimal clinical results and patient comfort in hard and soft tissue procedures, the erbium lasers have set a new standard of clinical performance. The present case series aims to highlight the various soft tissue applications of Er,Cr:YSGG (Waterlase Biolase®, Biolase, Inc, San Clemente, California, USA) in pediatric patients. HOW TO CITE THIS ARTICLE: Kumar G, Rehman F, Chaturvedy V. Soft Tissue Applications of Er,Cr:YSGG Laser in Pediatric Dentistry. Int J Clin Pediatr Dent 2017;10(2):188-192.

Comparative evaluation of microhardness and morphology of permanent tooth enamel surface after laser irradiation and fluoride treatment - An in vitro study.

Background and aims: The aim of the study was to evaluate and compare the surface microhardness and surface morphology of permanent tooth enamel after Er,Cr:YSGG laser irradiation and Fluoride application. Materials and methods: One hundred and twenty premolars extracted for orthodontic purpose were used in the study and randomly divided into 6 groups. Group A was not subjected to any treatment. Group B was subjected to Er,Cr:YSGG laser irradiation. Group C was subjected to Er,Cr:YSGG laser irradiation followed by application of 2% NaF gel for 4 minutes. Group D was subjected to laser irradiation and 1.23% APF gel for 4 minutes. Group E was subjected to 2% NaF gel pretreatment technique followed by laser irradiation. Group F was subjected to 1.23% APF gel pretreatment technique followed by laser irradiation. All the test groups were subjected to microhardness testing and scanning electron microscope evaluation at 500 X and 1500 X. Results: All the treated groups showed an increase in microhardness value in comparison to the control group. The highest increase in microhardness was seen in Group F. Increase in microhardness values of Group B and Group D was not statistically significant as compared to Group A. Scanning Electron Micrographs showed few craters and fine porosities for Group A. These craters and porosities increased in size and often showed glass like appearance after laser irradiation. Conclusions: It can be suggested by means of present study that Er,Cr:YSGG laser irradiation alone or in combination with fluoride gel is an effective tool to provide resistance against the caries. Significantly higher resistance (p< 0.05) was seen when APF gel was used prior to Er,Cr:YSGG laser irradiation and this combination can act as an efficient tool for prevention against dental caries.

Comparison of shear bond strength of reattached incisor fragment using Er,Cr:YSGG laser etching and conventional acid etching: An in vitro study.

Aim: The aim of this invitro study is to evaluate the shear bond strength of reattached fractured incisor fragments using Er,Cr:YSGG laser and conventional acid etching without additional tooth preparation. Materials and methods: Forty extracted human teeth were divided in two groups of 20 each (Groups A and B). In Group A, fractured surface was treated by an Er, Cr: YSGG laser system (Waterlase MD, Biolase Technology Inc., San Clemente, CA, USA) operating at a wavelength of 2,780 nm and frequency of 20 Hz. In Group B, fractured surface was etched using 37% phosphoric acid (Scotchbond, 3M). In both the groups, further subdivision with 10 sample each was made based on horizontal and oblique fracture. After laser or acid etching, all the samples were reattached using flowable composite resin and light cured. The samples were tested for shear bond strength. Results: Mean shear bond strength for Group A (94.70±39.158) was lower as compared to Group B (121.25±49.937), although the difference was not statistically significant(p value=0.121). Similarly no statistical significant difference was observed amongst the subgroups. (p>0.05) Conclusion: Er,Cr:YSGG laser etching in reattachment of fractured incisor fragment is a good alternative to conventional acid etching. Er,Cr:YSGG showed comparable efficiency in rebonding of fractured teeth fragment as acid etching.

A comparative evaluation of retention of pit and fissure sealants placed with conventional acid etching and Er,Cr:YSGG laser etching: A randomised controlled trial.

Aim: The aim of this study was to compare the retention rates of sealant placed either with conventional acid etching or Er,Cr:YSGG laser pretreatment of enamel surface. Materials and methods: This is a prospective, single blind randomised controlled clinical trial enrolling 200 permanent first molars in 50 patients, aged 6-12 years for sealant placement. Study followed split mouth design where each side of the arch was randomly allocated to the two treatment group. Group A(Acid etch group): 37 % phosphoric acid (Scotchbond, 3M ESPE, Seefeld, Germany) was applied for 15 seconds, rinsed with water for 20 seconds and then air-dried using air spray. Group L(Laser etch group): Fissures were prepared with an Er,Cr:YSGG laser system (Waterlase, BIOLASE Technology, San Clemente, CA, USA) emitting photons at a wavelength of 2.78 µm. Laser irradiation at 1.5 W (60% air and 40% water), in a noncontact mode, with a repetition rate of 20 Hz for 10seconds was used. Pit and fissure sealant (3M ESPE, Clinpro) was applied and cured for 20 seconds. One blinded, calibrated examiner, who was unaware of which preparation method has been used and who was not involved in the treatment procedures, evaluated the sealant at baseline and at 3, 6, 9 and 12 month follow-up visits. Results: It was observed that overall retention rate in group A was slightly higher as compared to group L at all time periods, however, the difference was statistically non-significant (p-value>0.05). CONCLUSION: Er,Cr:YSGG laser etching is comparable to acid etching in terms of retention and patient acceptability.