Association of Sleep-Disordered Breathing and Developing Malocclusion in Children: A Cross-Sectional Study.

Background Sleep Disordered Breathing (SDB) in children and its role in health has received renewed interest in the recent past. Malocclusion is one of the most common multifactorial craniofacial disturbances widely prevalent in children. The primary objective of this study was to assess the association of SDB with developing malocclusion in six to 12-year-old children and the effect of modifiers like age, gender, and tonsillar enlargement. Materials and method One hundred and seventy-seven children aged six to 12 years were assessed for developing malocclusion using Angle classification and Index of Orthodontic Treatment Needs (IOTN) comprising of 5 grades. Their parents were administered a pre-validated Pediatric Sleep Questionnaire (PSQ) for assessing SDB, by a single, calibrated examiner. The primary outcomes were SDB score, Angle class of malocclusion, and IOTN grade, assessed as categorical variables. The modifying variables assessed were age, gender, and tonsillar enlargement (Brodsky's criteria). The data were subject to statistical analysis using Fischer's test and the odds ratio (OR) was estimated. The modifiers were assessed using logistic regression. Results The prevalence of SDB was 69%. SDB has significantly associated with angle class II and class III malocclusion (x2 = 9.475, p < 0.05 OR=3.79) and with higher IOTN grades (x2 = 109.799, p < 0.05, OR=53.64). Logistic regression revealed that gender and tonsillar enlargement had a significant modifying effect (p<0.05). Conclusion SDB had a significant association with developing malocclusion, the odds being higher in angle class II and III malocclusions and higher IOTN grades. Clinical relevance Both SDB and developing malocclusion are quite commonly seen in children, though the relation between the two has not been adequately explored. This study shows that they are strongly associated with each other and one could act as a marker for the other.

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.

Comparison of the Efficacy of Homeopathic Drug Arnica and Ibuprofen on Postextraction Pain in Children: A Triple-blind Randomized Controlled Trial.

Aim: To compare the homeopathic drug Arnica with ibuprofen as an analgesic for postextraction pain control in children. Materials and methods: Forty-four healthy children between 8 and 12 years of age requiring two clinical sessions of tooth extraction in two different quadrants of the oral cavity were selected for the study. All the children received both the drugs in this crossover trial with a washout of 10 days. Patient-rated and operator-assessed pain was compared to a 10-point validated Visual Analog Scale at baseline, 24, 48, and 72 hours using the paired t-test. Acceptance to taste and frequency of dosing was recorded at the end of three days using a five-point Likert scale and were compared using the Chi-squared test. Kappa statistics were performed to assess intraoperator variability. Results: Pain reduction by Ibuprofen was significantly more than Arnica only at 48 hours with respect to both patient-reported and operator-assessed pain [(t = 3.567, p < 0.05), (t = 2.834, p < 0.05)]. As the age of the child increased, patient-reported pain significantly decreased. Children preferred the taste of Arnica over that of Ibuprofen (x 2 = 56.76, p < 0.0001). Conclusion: There was no difference between Arnica and Ibuprofen in the postextraction pain management in 8-12-year-old children. Clinical significance: The results of this study suggest that Arnica may be considered as an alternative to ibuprofen in managing postextraction pain in 8-12-year-old children, especially those with asthma, COPD, or known allergy to ibuprofen. How to cite this article: Thakur JH, Katre AN. Comparison of the Efficacy of Homeopathic Drug Arnica and Ibuprofen on Postextraction Pain in Children: A Triple-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(3):332-337.

Efficacy of Probiotic, Chlorhexidine, and Sodium Fluoride Mouthrinses on Mutans Streptococci in 8- to 12-Year-Old Children: A Crossover Randomized Trial.

INTRODUCTION: The oral cavity is home to a diverse and distinct microbiome. While the role of oral bacteria in cariogenic and other dental diseases is irrefutable, their beneficial effects in the form of probiotics (PB) has been less studied, especially pertaining to oral diseases in children. This study compares the efficacy of a PB mouthrinse with 0.12% chlorhexidine (CHX) and 0.05% sodium fluoride (NaF) mouthrinse on the colony counts of mutans streptococci (MS) in children. METHODS: A triple-blind crossover randomized trial between interventional groups was planned. Fifty-one children between 8 to 12 years of age were divided into three groups (I, II, and III) and were exposed to all three mouthrinses (A, B, and C) by randomized allocation for a period of two weeks with an inter-phase washout period of four weeks. Pre- and post-interventional MS counts (CFU/mL) were assessed, and the mean change was analysed using the t test (intragroup) and ANOVA (intergroup and crossover). RESULTS: The mean changes in the colony counts obtained with the use of PB, CHX, and NaF mouthrinses were -1.0223 (-1.2201 to -0.8246), -0.9564 (-1.1503 to -0.7626), and -0.9511 (-1.1554 to -0.7467), respectively, which were statistically significant (p < 0.0001). However, the intergroup comparison for the mean change in colony counts revealed no statistically significant differences (p > 0.05). CONCLUSION: The study concluded that the PB mouthrinse was equally efficacious as compared to CHX and NaF mouthrinses against MS in 8- to 12-year-old children. However, further studies are recommended to strengthen the evidence.

Dental Practitioner's Perception of the Compliance of Pediatric Patients to Orofacial Myotherapy Treatment Protocols: A Mixed Methods Study.

INTRODUCTION: The success of orofacial myotherapy in children is dependent on patient compliance to treatment protocols recommended by practitioners, such as reporting for regular follow-ups to the clinic, wear of appliances, and practice of orofacial myotherapy exercises at home. Due to the availability of limited literature on the same, this mixed methods study focused on studying the perception of Indian dental practitioners toward pediatric patient compliance to orofacial myotherapy treatment protocols. MATERIALS AND METHODS: A self-administered, digital questionnaire was emailed to members of the Foundation of Orofacial Myotherapy. Participants were asked to rate the pediatric patient compliance in their practice on a 5-point Likert scale ranging from Very Compliant to Not Compliant at all. Parameters assessed included patient attendance for clinical follow-ups, regular appliance wear, and the daily practice of exercises at home. Qualitative data were collected based on the participant's answers to open-ended questions on compliance barriers faced by them in practice. RESULTS: 39.5% of practitioners rated their patients to be compliant toward clinical follow-ups, while 27.9% of practitioners reported patients to be compliant to home schedule. Barriers to patient compliance reported by practitioners were lack of motivation of parent and child, absence of parental supervision, hectic patient schedule, peer pressure, and difficulty in performing exercises and wearing appliances. CONCLUSION: Patient compliance to orofacial myotherapy treatment protocols remains a problem area for dental practitioners. There is a need to conduct future studies to explore behavioral interventions which can help practitioners overcome the barriers to patient compliance reported in this study. CLINICAL SIGNIFICANCE: The results of this study can help practitioners who are already practicing orofacial myotherapy or plan to do so in future, to identify problem areas in their own practice, in the context of pediatric patient compliance toward orofacial myotherapy treatment protocols and the potential measures that can be implemented by them to overcome the same. HOW TO CITE THIS ARTICLE: Gune NS, Katre AN. Dental Practitioner's Perception of the Compliance of Pediatric Patients to Orofacial Myotherapy Treatment Protocols: A Mixed Methods Study. Int J Clin Pediatr Dent 2021;14(2):222-228.

Assessment of the Correlation between Appointment Scheduling and Patient Satisfaction in a Pediatric Dental Setup.

Introduction. The practice of modern pediatric dentistry requires delivery of quality care in combination with adherence to excellent business as well as time management principles. A definite appointment schedule should be presented to the parents on the first or second appointment. More importantly, the prescribed schedule should be followed to the best of the professional abilities of the pediatric dentist. Aims. The aim of the study was to assess the co-relation between appointment scheduling and patient satisfaction in a pediatric dental setup with the objective of understanding the parameters related to appointment scheduling to increase patient satisfaction. Method. A total of 40 patients, who visited the Department of Pediatric and Preventive Dentistry, YMT Dental College & Hospital, for dental treatment were selected on a random basis. A questionnaire with a set of 6 questions with a rating scale of 1-5 to assess the patient satisfaction related to appointment scheduling was prepared. Results. A significant number of the patients were happy with the existing appointment scheduling system barring a few exceptions.

Comparison of mutans streptococcal strains of father, mother, and child in indian families using chromosomal DNA fingerprinting.

INTRODUCTION: It is now understood and accepted that there is a direct transmission of mutans streptococci (MS) from the mother to the child. There is also a direct correlation between the levels of MS in the mother and the caries status of the child. Advanced technologies in molecular biology like chromosomal DNA fngerprinting have established beyond doubt that the mother and the child bear similar strains of MS. AIM: A study was designed with the aim of comparing the MS strains between the father, mother and the child in Indian families. MATERIALS AND METHODS: A group of 20 Indian families comprising of the father, mother and child were selected and divided into caries free and caries active groups. Mixed salivary samples were collected from the individuals and were cultured for the growth of Mutans streptococci. The colonies were counted on a colony counter and a comparison was made between the mutans streptococcal counts of the mother and the caries status of the child. Further, the genotypes of the father, mother and the child were isolated and compared using the technique of chromosomal DNA fngerprinting. Following electrophoresis, the band pattern obtained was compared for similarities or differences. The results of the same were tabulated and evaluated statistically. RESULTS: When the colony counts of the mother (in CFU/ml) were compared with the 'dft' status of the child, a positive correlation was seen in group II. Intergroup comparison using the unpaired T test was statistically signifcant. Electrophoretic analysis of the chromosomal DNA on the agarose gels revealed identical band patterns in 13 mother-child pairs, which was statistically signifcant. Three of the father-child pairs showed identical band patterns, which was statistically signifcant. Intergroup comparison using Chi-square test was not statistically signifcant. CONCLUSION: One may conclude that irrespective of the caries status of the child, majority of the mother child pairs share identical strains of MS and hence the mother is the primary source of infection. However, in children with a high dft, the father may also play an important role in the acquisition and transmission of MS.