Inhibition of Streptococcus mutans, antioxidant property and cytotoxicity of novel nano-zinc oxide varnish.

OBJECTIVE: Zinc is a potent antimicrobial against cariogenic bacteria and effective anti-plaque agent. The present study investigated the efficacy of zinc oxide nanoparticles (ZnO-NP) varnish to inhibit S. mutans growth, biofilm, acid production, and its antioxidant potential and cytotoxicity. DESIGN: Green synthesized ZnO-NP were characterized using ultraviolet-visible spectroscopy, x-ray diffraction spectroscopy, and transmission electron microscopy. Secondary metabolites were assessed using fourier transform infrared spectroscopy. Anti-oxidant potential was ascertained using 2,2-diphenyl-2-picrylhydrazyl hydrate (DDPH) assay and cytotoxicity of synthesized nanoparticles was evaluated on human liver cancer (Hep G2) and human embryonic kidney 293 (HEK-293T) cell lines. RESULTS: Synthesized ZnO-NP showed excellent antimicrobial properties against S. mutans, as the minimum inhibitory and bactericidal concentrations were 0.53 µg/mL, and 1.3 µg/mL respectively. ZnO-NP at 0.1 mg/µl concentration had the greatest zone of inhibition (24 mm), followed by 0.05 mg/µl ZnO-NP (23 mm) and 0.05 mg/µl ampicillin (21 mm). Further, 0.1 mg/µl ZnO-NP varnish inhibited 90 % of S. mutans biofilms and reduced 24 h acid production closest to that of baseline and it also exhibited antioxidant capacity in a dose dependent manner (94 % inhibition-100 µg/mL). Biocompatibility of ZnO-NP varnish was evaluated on Hep G2 and HEK-293T cell lines; and the highest concentration of 0.1 mg/µl ZnO-NP used caused very low cytotoxicity to Hep G2 cells and was non-cytotoxic to HEK-293T cells. CONCLUSIONS: Within the limits of this study, ZnO-NP varnish was effective in inhibiting S. mutans and holds great potential as an effective anticaries agent.

Pediatric dental emergency management and parental treatment preferences during COVID-19 pandemic as compared to 2019.

Pediatric dental emergency management were temporarily suspended during the COVID-19 pandemic, which worsened urgent dental needs. This retrospective study investigated the management of pediatric emergencies during COVID-19 lockdown and the trends in parental preferences from March to July in 2019 and 2020. Pediatric dental emergencies managed during pandemic was collated, procedures were categorized (emergency, restorative, preventive, elective) and trends in parental treatment preference was compared from March-July 2019/2020. Bivariate analysis was performed using fisher-exact test and statistical significance was set at 5%. Total 1081 children were treated during COVID-19 lockdown, and 1509 procedures were performed, of which 20.8% were emergency, 42% restorative, 24.4% preventive, 12.6% elective. In 2019, 7462 children were treated; and except for emergency (10.6%), other procedures were comparable to 2020. Extractions (267) predominated in 2020 followed by sealants (195); but in 2019, pulectomy (1268), scaling (1251) were predominant. None of the residents who performed aerosol procedures got infected with COVID-19 during the lockdown. Emergency dental needs among pediatric patients were very high during the COVID-19 pandemic in South India, and there was not much change in the trend in parental treatment preference in 2019 and 2020. Further, aerosol procedures did not increase the risk of COVID-19 during the pandemic provided proper universal precautions were followed.

Frequency of Oral Impacts on Daily Performances and Dental Pain Among Indigenous Adolescents of Himalayas (Leh, Ladakh): A Cross-Sectional Study.

PURPOSE: Psychosocial impacts on quality of life among adolescents with access to affordable dental care is not well documented. In addition, dental pain is accelerating towards a public health problem that needs immediate attention. The objective was to determine impacts on quality of life using the Oral Impacts on Daily Performances (OIDP) frequency scale and to determine prevalence of dental pain with its impact. METHODS: A total of 288 students (mean age 15.72 ± 1.5) completed the survey instrument (sociodemographic variables, consumption of chocolates/candies, perceived need for dental care, history of dental pain in last 6 months and OIDP frequency scale) designed to measure subjective oral health indicators. Mean OIDP simple count scores were analysed using logistic regression and additive (ADD) scores for dental pain were compared using student's t test. RESULTS: The response rate was 96%. About 44.4% reported impacts affecting daily performances. About 11.4% consumed tobacco and 92.7% consumed forms of refined sugars. About 39% perceived a need for dental care and 32.3% experienced dental pain with problem in eating and cleaning teeth. Those not perceiving a need for dental care were more likely to have an impact (OR: 2.3; CI: 1.2-4.4). Males had higher OIDP ADD scores for dental pain than females (p = 0.015). CONCLUSION: Overall impact was less than 50%. Dental pain was reported among students with access to dental care with impacts on eating and cleaning of teeth. Oral health promotion needs to be reinforced by strengthening school community relationship.

Impact of pain, psychological-distress, SARS-CoV2 fear on adults' OHRQOL during COVID-19 pandemic.

Corona virus disease (COVID-19) has crippled life, families and oral health care delivery. Hence, we assessed the impact of dental pain, fear of COVID-19 and psychological distress during lockdown on the oral health related quality of life of individuals visiting a tertiary dental care center during COVID-19 pandemic. Cross sectional study conducted among patients between 18 and 60 years. Demographics, access to pain killers, dental care (yes/no), duration ( 15 days) and intensity of pain were self reported. Fear of COVID-19 was assessed using fear of corona virus scale (FCV-19S); psychological distress in the last 30 days and oral health related quality of life was evaluated. Oral examination was performed and dental caries status (DMFT) was assessed using the world health organization method. Univariate and multivariate regression analysis was conducted to evaluate significant predictors and 5% was set as level of significance. 2966 patients visited our dental emergency due to painful decayed tooth between March-June 2020. Mean age was 42.7 years, 53.97% were males and most common cause of painful teeth was upper right third molar (7.7%). 73.4% reported lack of pain medication; 95% reported closure of dental clinics close to home. Almost 79% suffered from dental pain for >15 days. Higher self reported pain (OR 2.1; 95% CI 1.36-14.71), >15 days of suffering from pain (OR 6.8; 95% CI 2.18-23.14), greater fear of COVID-19 (OR 4.14; 95% CI 1.98-16.07) and psychological distress (OR 4.41; 95% CI 1.09-16.76) were associated with poorer OHRQOL of adults during COVID-19 pandemic. Our findings strongly suggest that COVID-19 pandemic negatively impacts the mental and oral health of individuals affecting their overall health.

School Interventions-based Prevention of Early-Childhood Caries among 3-5-year-old children from very low socioeconomic status: Two-year randomized trial.

OBJECTIVES: To assess the effectiveness of school-based interventions to prevent early childhood caries (ECC) among preschool children from very low socioeconomic background over a period of 2 years. MATERIALS AND METHODS: Four hundred and twenty preschool children between the ages of 3-5 years participated in this double blind, three parallel arm clinical trial. School only interventions such as prohibition of sugary snack consumption in school, teacher supervised daily brushing using fluoridated toothpaste, and oral health education were implemented with regular follow-up at 6 months, 1, and 2 years. The study group had all three interventions, in active control-tooth brushing and oral health education, and in negative control, only oral health education. Decay at d1/d2 using World Health Organization criteria, visible plaque and gingival inflammation were assessed at all follow-ups. The value of P < 0.05 was considered significant. RESULTS: Absolute caries risk reduction in the study group was 20 percent and 12 percent when compared to active, negative controls after 2 years. Mean caries increment in the study group was 0.4 for d1/d2, for the active control group was 0.9 and negative control 0.8. The effect of interventions to prevent ECC in each group was calculated using the Çohen's d, and the study group had a score of 0.6 when compared with active controls and 0.9 in comparison to the negative control group. CONCLUSIONS: Prohibition of sugary snacking in school and daily supervised tooth brushing, with or without oral health education is effective in preventing ECC among preschool children with health neglect in very low-resource settings.

Transgender HIV status, self-perceived dental care barriers, and residents' stigma, willingness to treat them in a community dental outreach program: Cross-sectional study.

AIM: Assess the association between high risk transgender (TG) HIV status, self-perceived barriers toward oral care, and the residents' stigma and willingness to treat during community dental outreach. METHODS: Demographics, tobacco habits, HIV status, willingness for rapid HIV testing, and self- perceived oral health, barriers toward oral care were assessed in a cross-sectional study among 212 transgender in South India. Further, the residents' stigma across three subscales and residents' willingness to treat the transgender was evaluated. RESULTS: Overall, 88% had begging as the sole income, and 93% lived in slums and used some form of tobacco. Oral health was perceived to be poor by more than half, and the mean probing pocket depth (PPD) and decayed, missing, or filled teeth (DMFT) was 4.2 mm and 3.67, respectively. The residents reported significantly low regard and willingness to treat TG irrespective of high/low stigma and when the transgender HIV status was positive/do not know. Residents with greater fear of exposure expressed least regard and willingness to treat TG (P < 0.05). CONCLUSION: The self-perceived oral health of transgender' was poor corresponding to the clinical examination findings. Moreover, the stigmatizing attitude and low regard to provide oral care is rampant among the dental residents, which further frustrates dental care.

Effectiveness of Pomegranate Mouthrinse in Reducing Bacterial Plaque, Gingival Inflammation and Total Salivary Proteins over a Period of 90 Days: A Double-Blind Randomized Trial.

OBJECTIVE: Pomegranate is proven to possess effective antibacterial and anti-infl ammatory properties. Hence, we evaluated the effi cacy of pomegranate mouthrinse on plaque accumulation, gingivitis and total salivary proteins among adolescents aged 15 to 19 years over a period of three months. MATERIALS AND METHODS: A double-blind, single-center, controlled clinical trial was conducted among 40 adolescents. The participants were randomly allocated into two groups, pomegranate and placebo, and were requested to use the mouthrinse twice daily. Plaque and gingival indexes were recorded at baseline, 30, 60 and 90 days; total salivary proteins were measured at baseline and after 9 months. Repeated measure ANOVA and post-hoc tests were used for within group comparisons; independent t-tests were used for between group comparisons. RESULTS: Pomegranate mouthrinse reduced the mean plaque and gingival index scores significantly at 3, 6 and 9 months follow-up compared to placebo, and it significantly reduced total salivary proteins from baseline until 90 days compared to placebo. CONCLUSIONS: Pomegranate extract mouthrinse was effective in reducing plaque accumulation, gingival inflammation and total salivary protein count at 30, 60 and 90 days of follow-up and can be considered an effective alternative to chemotherapeutics in treating gingivitis without any side effects.

Antiplaque, Antifungal Effectiveness of Aloevera Among Intellectually Disabled Adolescents: Pilot Study.

PURPOSE: Various candida species have been associated with poor oral hygiene and active carious lesions. The purpose of this study was to evaluate the effectiveness of aloe vera compared to triclosan toothpaste against total candida, C. albicans, C. tropicalis, Candida krusei, and plaque/gingivitis among intellectually disabled adolescents over 30 days. METHODS: A double-blind prospective randomized trial was conducted among 40 intellectually disabled adolescents randomly allocated into aloe vera/triclosan groups. The gingival (Löe and Silness index), plaque (Silness and Löe index), and candidal carriage counts were assessed at baseline and follow-up. Caregivers brushed the participant's teeth twice a day using a modified bass method and refrained from any other oral hygiene practices for at least two hours prior to assessment. RESULTS: Aloe vera-contaiing toothpaste caused significant reductions in gingival inflammation and plaque index scores compared to the triclosan group at the end of 30 days. Also, total candidal counts and C. albicans counts were significantly lower in the aloe vera group compared to triclosan at the end of the 30-day follow-up (P<0.05). CONCLUSION: Aloe vera-containing toothpaste was effective in reducing plaque, gingivitis, and overall candidal counts compared to triclosan. Moreover, individuals treated with aloe vera experienced improved oral health status without any negative side effects.

Retention of Moisture-tolerant and Conventional Resin-based Sealant in Six- to Nine-year-old Children.

PURPOSE: The purpose of this study was to evaluate and compare the retention rates and development of caries in permanent molars in children sealed with moisture-tolerant, resin-based (Embrace WetBond), and conventional resin-based (Helioseal) sealant over a period of one year. METHODS: This was a double blind, split-mouth, randomized controlled trial among six- to nine-year-olds. Sixty-eight permanent mandibular first molars in 34 children were randomly assigned to be sealed with Embrace WetBond or Helioseal sealant. RESULTS: The final sample was 32 children with 64 teeth. At 12 months, 23 of 32 (72 percent) sealants were completely retained in Embrace WetBond, whereas only 16 of 32 (50 percent) were retained in the Helioseal group. There was a statistically significant difference in retention rates of Embrace WetBond and Helioseal sealants at 12 months (P<.05). At 12 months follow-up, only two teeth developed caries in Embrace WetBond; in the Helioseal group, five teeth developed caries (two initial and three enamel caries). CONCLUSIONS: Embrace WetBond was superior to Helioseal sealant, as Embrace exhibited higher retention and lower caries scores. Embrace WetBond can be preferred over conventional resin-based sealants for community and outreach sealant programs where use of rubber dam for moisture control is difficult to practice.

Clinical Evaluation of self and professionally applied desensitizing agents in relieving dentin hypersensitivity after a single topical application: A Randomized Controlled Trial.

OBJECTIVES: The objective of this study is to evaluate the efficacy of self and professionally applied desensitizing agents in relieving dentinal hypersensitivity after single direct topical application. STUDY DESIGN: This was a randomized controlled trial conducted among 57 patients. 8% Arginine paste was self-applied by the subject and Gluma desensitizer was applied by investigator. Numeric rating scale was used to measure hypersensitivity after tactile stimulus, Schiff scale was used for cold and air blast stimuli respectively. Scores were recorded at baseline, immediately, 15 and 30 days after the application. Friedman, Wilcoxon test as post hoc was used to analyze within group differences, between group differences analyzed using Mann Whitney U test (P<0.05 considered significant). RESULTS: 8% Arginine paste elicited significantly higher reductions in sensitivity (P<0.05) than that of Gluma group at all follow ups. There was a significant decrease in hypersensitivity for both the groups from baseline till final follow-up (P<0.05) for all three stimuli. 8% Arginine paste was found to be more effective than Gluma desensitizer in providing immediate relief from dentine hypersensitivity and also sustained the effect significantly for a period of 30 days. CONCLUSIONS: Self applied 8% Arginine paste is effective than professionally applied Gluma desensitizer in relieving dentinal hypersensitivity immediately and over a period of one month. Key words:Dentine hypersensitivity, arginine, gluma, desensitizing agents.