Preferences and their correlation between children and their parents' attitudes towards non-pharmacological behaviour guidance techniques - A cross-sectional study.

INTRODUCTION: Dental treatment for children requires the use of behaviour guidance techniques (BGTs), which are used in the dental office to make children cope with dental treatment. AIM: Evaluate how children and parents felt towards BGTs used in a dental office, by attitude meter and to correlate them. MATERIALS AND METHOD: Children (200) from 7-17 years and their parents were selected randomly to participate in the study. Each child and parent was asked to watch four video scenes of live BGTs, which include Tell Show Do (TSD), Modeling, Reward system, and Hand holding. A questionnaire collected demographic data, and their expressive attitudes were assessed using Line of favour (LOF) scale and Kruskal-Wallis Test. RESULTS: Most preferred BGTs for Group I was modeling, Group II Reward, Group III Tell Show Do, and Group IV was Modeling, with a mean score of 5.95, 6.04, 5.57, and 5.78, respectively. Gender wise preferences, 32% of boys and 34% of girls preferred modeling in Group I, whereas, in Group II, 20% of boys and 21% of girls preferred reward, respectively. Chi-square test revealed that there is no significant difference between the groups and gender for the preference of BGTs in Group I (P=0.893) and Group II (P=0.592). There was no significant correlation between preferences of children and their parents. CONCLUSION: Modeling was the most preferred BGT for primary school children and parents of High school children. A reward was the most preferred BGT for high school children. TSD was the most preferred BGT for parents of primary school children.

The Effectiveness of Articaine and Lidocaine Single Buccal Infiltration versus Conventional Buccal and Palatal Injection Using Lidocaine during Primary Maxillary Molar Extraction: A Randomized Control Trial.

BACKGROUND: Despite the advent of modern injection techniques, palatal injection continues to be a painful experience for children. AIMS: To compare the pain experienced during extraction of maxillary primary molars with conventional lignocaine anesthesia versus lignocaine and articaine buccal infiltration in children aged 6-14 years. MATERIALS AND METHODS: A prospective randomized triple blinded study was conducted with ninety children (n = 90), randomly allocated to receive lignocaine conventional anesthesia (Group I [control group]), and buccal infiltration using articaine (Group II [articaine group]) or lignocaine (Group III [lignocaine group]). A composite score of self-report (faces pain scale-revised), behavioral measure (face legs activity cry consolability scale), and a physiological response (pulse rate) was measured following maxillary primary molar extraction. STATISTICAL ANALYSIS USED: To test the mean difference between two groups, Students' t-test was used and among the three groups, one-way ANOVA with post hoc test was used. RESULTS: Articaine group had significantly lower pain scores for self-report (P < 000.1) and behavioral measures (P < 000.1) while there was no significant difference (P > 0.05) between articaine and control groups during primary maxillary molar extraction. CONCLUSION: Maxillary primary molar extraction procedure can be successfully accomplished by bypassing the palatal injection. Articaine buccal infiltration can be considered as an alternative to conventional local anesthesia for the extraction of maxillary primary molars.

Preferences of Dentist's Attire by Anxious and Nonanxious Indian Children.

PURPOSE: The purpose of this study was to evaluate preferences of dentist's attire and gender by anxious and nonanxious children in India. METHODS: This cross-sectional study included 1,008 nine- to 14-year-old children. Anxiety levels were measured using the Children's Fear Survey Schedule-Dental Subscale. Children were provided with a series of photographs of dentists in different attires and were asked to choose in which attire they would prefer their dentists to perform treatment. The data obtained was analysed using Pearson's test and chi-square analysis. RESULTS: There were 603 boys (60 percent) and 405 girls, among whom 56 percent were anxious. Anxious children preferred female dentists in formal attire (19 percent). Nonanxious children equally preferred female dentists in formal attire and white coat with glasses (15 percent). CONCLUSION: Irrespective of the anxiety levels, the female dentist was the preferred choice among most of the children. However formal attire might be more appropriate for anxious children.

Apgar index as a probable risk indicator for enamel defects in primary dentition: a cross sectional study.

AIM: The aim of the present study was to investigate the association of Apgar index with that of enamel defects and to explore gender predilection as a co-variable in the formation of enamel defects. MATERIALS AND METHODS: A random sample of 108 individuals (46 boys and 62 girls) aged 4-5 years (mean - 4.4 years) were included in the study. A questionnaire containing subject's demographic information, Apgar Index (AI), enamel hypoplasia and hypocalcification was collected. Intraoral examination of the subjects was performed by using the type III diagnostic criteria recommended by WHO for oral health surveys. According to the modified index for developmental enamel defects, visual and tactile examinations of the entire primary dentition were performed.The data obtained was analysed using chi-square test. RESULTS: Of all the examined individuals 18 (16.7%) showed enamel defects, of which 10 (9.3%) were having enamel hypoplasia, 4 (3.7%) were having enamel hypocalcification and 4 (3.7%) were having both. Correlation of the enamel defects such as hypoplasia, hypocalcification and both had no significant relationship with the gender (P = 0.36). CONCLUSION: Subjects with lower Apgar Index exhibited more hypoplastic and hypocalcified teeth both qualitatively and quantitatively. If the Apgar value is less than 6, the vulnerability for the development of enamel defects has considerably increased. Gender of the individuals did not influence the final outcome.

Recurrent mandibular supplemental premolars: a case report with 5 year follow up and review of literature.

A 12-year-old girl reported for a routine dental checkup. Radiographic survey disclosed the presence of two developing structures resembling premolars one on either side of the mandible in premolar region, which were of supplemental type and surgical removal of supernumerary premolars facilitated eruption of the left second premolar. On six months follow-up, there was radiographic evidence of another supernumerary premolar in the left side of mandible that is left in situ, patient is on regular follow-up. This emphasizes the importance of thorough clinical and radiographic examination, early diagnosis and follow-up of the developing dentition in children. The patient has been followed-up from the age of 12 year to 17 year. This paper describes a case of recurrent supplemental supernumerary premolars in the mandible along with review of literature.

Oral health concerns with sweetened medicaments: Pediatricians' acuity.

BACKGROUND: Administration of sweetened medicaments poses many oral health related problems in children due to the lack of awareness among the pediatricians regarding their ill effects. PURPOSE: To assess pediatricians' awareness and attitudes toward the use of liquid pediatric medicines and their relationship with dental caries and erosion. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted among the pediatricians residing in Nellore city. Data were obtained from 55 pediatricians using questionnaires. RESULTS: Among the respondents, 95.6% prescribed liquid medicaments, 51.1% expressed that they may be associated with dental effects, 60% were not aware regarding the sweetness of medicaments, whereas majority of them (77.8%) opined that children complained regarding the taste, 73.3% stated that sugar substitutes were used as sweetening agents, 70.9% believed that they were not acidic, 68.9% did not recommend brushing after intake of medicines, 90% failed to deliver oral health instructions, and 54.5% believed that lack of oral hygiene was a contributing factor for development of dental caries. CONCLUSION: Majority of the respondents prescribed liquid medicaments and were unaware regarding the sweetening agents and acidity, which cause ill effects on the dental hard tissues. Most of them neither recommended nor delivered oral hygiene instructions (OHI) after prescribing sweetened liquid medicaments. Hence, OHI should be delivered to enhance the oral health related quality of life in children.

Appraisal of the remineralizing potential of child formula dentifrices on primary teeth: An in vitro pH cycling model.

AIM: To evaluate the remineralizing potential of child formula dentifrices on primary teeth using an in vitro 7 days pH cycling model. MATERIALS AND METHODS: Twenty-one primary teeth were placed in demineralizing solution for 96 h to produce artificial carious lesions; then cut longitudinally into 100-150 µm thick sections and randomly assigned to three groups. Sections in Group A were treated with dentifrice containing 458 ppm monofluorophosphate (MFP) and sections in Group B with 500 ppm sodium fluoride (NaF). Group C sections were treated with a nonfluoridated dentifrice. RESULTS: Group A (458 ppm MFP) and Group B (500 ppm NaF) showed significant decrease in lesion depth, whereas Group C (non F) showed a significant increase in depth (P ≤ 0.05, paired t-test). CONCLUSION: Though dentifrices containing 458 ppm MFP and 500 ppm NaF demonstrated remineralization of carious lesions, it was not complete. Therefore, it is also important to emphasize on other preventive methods in the prevention and/or reversal of carious lesions.

Osteosarcoma of mandible in a 10-year-old girl.

Osteosarcoma (OS) of the jaws is a relatively rare malignant bone tumor. Like, its counterpart in the long bones, OS affecting the head and neck region shows distinct yet diverse clinical, histologic and prognostic characteristics. Here, we report a rare case of OS of fibroblastic variant in a 10-year-old girl, who came with a bony swelling in the left mandibular posterior region, with a radiographic presentation of sunburst appearance, the histopathological examination confirmed the diagnosis. The patient underwent partial mandibulectomy under general anesthesia followed by prosthodontic rehabilitation and is currently undergoing regular follow-up examination.

Behavioural and physiological outcomes of biofeedback therapy on dental anxiety of children undergoing restorations: a randomised controlled trial.

AIM: To explore the efficacy of biofeedback as possible alternative means of psychological behaviour guidance in children receiving dental restorations. STUDY DESIGN: Randomised clinical trial with a cross over design carried out on 40 children (19 boys and 21 girls) to determine the efficacy of biofeedback in reducing the dental anxiety through subjective and objective measures during restorative treatments under cotton roll isolation without administration of local analgesia. METHOD: Highly anxious children with a minimum of five carious lesions were trained to lower their anxiety using biofeedback in five sessions within a 4-week interval, each session lasting for 45 min. After initial training, children were randomly divided into two groups and restorations were placed in four sequential therapeutic sessions with a 1-week interval and a follow-up visit 3 months later. First group received biofeedback in the second and third sessions; whereas the second group received biofeedback in the first and third sessions. RESULTS: Biofeedback therapy in children led to lower levels of anxiety in the initial appointments when assessed objectively, however the subjective methods of evaluation could not depict any statistically significant difference. CONCLUSION: Biofeedback can be used in the initial visits for dentally anxious children and the usage of simpler biofeedback machines for these appointments in dental setup is suggested.

Protostylid: A case series.

Human jaws and teeth display a high degree of morphological individuality as they represent personal, family and population characteristics. A protostylid is a supernumerary or accessory cusp located on the mesial half of the buccal surface on the molars that may seldom pose problems while its presence may not be a cause for alarm in most instances. This case report presents a rare finding of protostylid on the buccal surface of the primary molars in 4 children. From the perspective of forensic dentistry, this morphological feature, though uncommon, may be useful for classification and identification of victims in mass causalities and bite marks on bodies or inanimate objects.

Pre-maxillary hypo-hyperdontia: report of a rare case.

Agenesis of bilateral maxillary canines is very rare and mesiodens is a commonly occurring supernumerary tooth type. Concomitant occurrence of both hypodontia and hyperdontia is extremely rare and it is a condition of mixed numeric variation in the same individual. The reported prevalence of this condition ranges between 0.002% and 3.1%. The purpose of this case report is to describe a rare occurrence of hypo-hyperdontia involving agenesis of both maxillary canines, mesiodens and associated with taurodontism.

Mandibular hypo-hyperdontia: A report of three cases.

Dental anomalies of tooth number in development of the permanent dentition are quite common than the primary dentition, however, the combined occurrence of hypodontia and hyperdontia is a rare phenomenon, especially in the same dental arch. The purpose of this report is to describe a case of concomitant hypo-hyperdontia (CHH) in three patients (one girl and two boys) with missing mandibular central incisor and an erupted mandibular mesiodens. Three rare cases of mandibular CHH were observed during routine examination, where the two anomalies manifested in the anterior region of the mandible. Furthermore, these are the only cases exhibited taurodontism in association with mandibular CHH.

Agenesis of premolar associated with submerged primary molar and a supernumerary premolar: An unusual case report.

The combination of submerged primary molar, agenesis of permanent successor with a supernumerary in the same place is very rare. The purpose of this article is to report a case of submerged mandibular left second primary molar with supernumerary tooth in the same region along with agenesis of second premolar in an 11-year-old girl, its possible etiological factors, and a brief discussion on treatment options.

Impacted mandibular permanent incisors related to supernumerary teeth: a rare condition.

Supernumerary permanent teeth in the mandibular incisor area are rare, and there are very few reported cases of the supernumerary teeth in the mandibular incisor area leading to impaction of incisors. A south Indian boy aged 14 presented with 3 supernumerary teeth in the mandibular right permanent incisor area resulting in impacted permanent central and lateral incisors.

Mucormycosis associated with juvenile diabetes.

Mucormycosis is one of the most rapidly progressing and lethal form of fungal infections in humans which usually begins in the nose and paranasal sinuses. The fungus assaults the arteries, leading to thrombosis that subsequently causes necrosis of hard and soft tissues. The purpose of this article is to describe a rare case of maxillary necrosis due to mucormycosis in a 12-year-old diabetic patient and emphasizes on early diagnosis and timely management of this potentially fatal fungal infection.

A comparative study of pH modulation and trace elements of various fruit juices on enamel erosion: an in vitro study.

Fruit juices are popular worldwide with children of all ages as they are sweet and perceived to be healthful. This in vitro study was sought to measure pH of 10 different fruit juices, to find out possible erosive effects on human dental enamel of 40 extracted sound premolars and also to measure fluoride and trace elements of these juices. The estimation of pH of fruit juices was done by using Systronic upH 362 pH meter. The erosive effects of fruit juices were tested by using polarized light microscope. Orion electrode was used to measure fluoride. The trace elements were estimated by using Atomic Absorption Spectrophotometer No. 6501F. The pH values in different juices were observed at different levels, and pH values of these juices were more acidic than baseline after 24 hours. As the time increased, the erosion effect became more in pineapple; grape and sugarcane juices, and they had more cariogenic trace elements like selenium, iron and manganese. So, these juices were found to be cariogenic. To conclude, orange, mousambi, mango, pomegranate, apple, chikku and watermelon juices had no erosive effect on the human enamel, with the presence of highest amount of trace elements like fluoride and phosphorous which are considered as strongly cariostatic.

Atypical presentation of bilateral supplemental maxillary central incisors with unusual talon cusp.

Delayed eruption of maxillary permanent central incisors in a child poses a distressing esthetic quandary to parents, by virtue of its location in the dental architecture. Well-aligned anterior teeth add confidence to smile and have enhanced self-esteem, which is critical even in early life. Impaction of the maxillary central incisors compared to third molars or the canines is less reported; bilateral supplemental maxillary central incisors related to impacted permanent maxillary central incisors are rare and one of the supplemental central incisors showing unusual talon is still infrequent. A case of impacted maxillary permanent central incisors related to supplemental maxillary central incisors, with one of them showing an unusual talon cusp, is presented.

Unusual occurrence of accessory central cusp in the maxillary second primary molar.

Accessory cusp present on the occlusal surface may seldom pose problems. While its presence may not be a cause for alarm in most instances, it can sometimes lead to serious consequences if it is damaged. This case presents a rare finding of unilateral central accessory cusp seen on the occlusal surface of the maxillary left second primary molar and discusses the need for continuous dental surveillance and preventive measures.

Efficacy of various disinfectants on microbially contaminated toothbrushes due to brushing.

AIMS: To evaluate the effectiveness of different disinfectant agents in decontaminating the toothbrushes, and to educate the children, parents and the community on the decontamination of toothbrushes. MATERIALS AND METHODS: Fifty healthy male children in the age range of 8-11 years were enrolled. They were divided into five groups of 10 each and provided with toothbrushes and disinfectants. Instructions were given to the children and the toothbrushes were collected after brushing and cultured for the growth of microorganisms. The efficacy of Hexidine(®), 3.0% hydrogen peroxide and Listerine(®) and Dettol(®) were evaluated. Chi-square test was used for statistical analysis. RESULTS: Hexidine, 3.0% hydrogen peroxide and Listerine showed 100% efficacy, whereas Dettol showed 40% effectiveness in decontaminating the toothbrushes. Water as a control showed the least effectiveness in cleaning the toothbrushes. CONCLUSIONS: The study concluded that 3.0% hydrogen peroxide is the most economical and effective disinfectant when compared with the other disinfectants.

Hypohyperdontia: Agenesis of three third molars and mandibular centrals associated with midline supernumerary tooth in mandible.

Agenesis of teeth in a patient who also presents with a supernumerary tooth is one of the rare numerical anomalies in human dentition. Agenesis of third molars was shown to be associated with other missing permanent teeth. A review of literature on hypodontia including third molar agenesis, hyperdontia and a concomitant presence of these two conditions which is termed as hypohyperdontia is presented along with a case showing agenesis of three third molars, both mandibular central incisors and a midline supernumerary tooth.