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Dental fear and anxiety (DFA) serves as significant problem in child patient management as it leads to greater prevalence and increased severity of the disease associated with delayed dental visits. Therefore, it is necessary to effectively predict children dental behaviour and identify children at risk of Behaviour Management problems. Study of factors influencing DFA and its association with behaviour in children during first dental visit. The study included 209 children (5-14 years). DFA levels were assessed using 3 standardised questionnaires i.e. Facial Image Scale (FIS), Dental Anxiety Scale (DAS), Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS). The behaviour of the child was then assessed using Frankl’s Behaviour Rating Scale (FBRS). The data were analysed, and a correlation was established between DFA and behaviour using statistical analysis. Presence of DFA according to FIS is 13.4%, according to DAS is 15.2% and according to CFSS-DS is 17.7%. Maximum participants showed positive behaviour (81.8%) according to FBRS. Factors causing maximum Dental anxiety according to DAS was anticipation of treatment (26.30%) and factor which caused maximum dental fear according to CFSS-DS was injections (45.4%). There is association between DFA and behaviour in children during first dental visit. This study will help assess the factors which lead to dental fear and anxiety in children and also find a correlation between dental fear and anxiety and behaviour management problems which can help the Paedodontist to predict various behaviour management problems and to avoid the factors which lead to them before the initiation of the dental treatment. This can lead to a decrease in the fear and anxiety levels of children which will further lead to better treatment and in turn better case management.

Introduction: Snacks and bakery foodstuffs like biscuits are the most preferred food items in the present decade. Thus it is important to know its cariogenicity. Aim: To study the effect of five commercially available biscuits on salivary pH, flow rate and oral clearance rate among children. Materials and methods: The study consisted of five groups of commercially available biscuits: oats, salt, glucose, cream, chocolate biscuits. Samples of saliva were collected, and pH was measured using an electrode, the flow rate directly from the calibrated test tube and the oral clearance time was estimated based on the time taken for the salivary pH to return back to the baseline values. After which, children were given one biscuit each and stimulated saliva samples were collected at different time intervals. Obtained values were subjected to the paired t-test, one-way analysis of variance (ANOVA) and post-hoc Tukey’s test. Results: Salivary pH had decreased compared to baseline for all the five commercially available biscuits with maximum drop seen for glucose, cream and chocolate biscuit group at 5 minutes. Oats group showed a maximum drop in mean salivary pH at 15 minutes and salt biscuits at 10 minutes. Increased salivary flow rate was seen for oats, salt, and cream biscuit group at 15 minutes and chocolate and glucose group had reduced when compared to its baseline value. The pH at 15 minutes had not returned back to the baseline values for all groups. Conclusion: The consumption of commercially available biscuits had an effect on salivary pH, flow rate and oral clearance rate in children.

The maxillary deciduous molar periapical radiograph often presents a diagnostic challenge for the clinician due to the overlapping of their roots with the developing premolar tooth bud. Clear and distortion free images are necessary for decision making while planning the treatment. However, the practical anatomical difficulties discourage the clinician from using the paralleling technique in children. While looking for an alternative technique, it was hypothesized in the literature that the 20 degree paralleling compromise technique suggested by Van Aken (1969), could override the anatomic challenges in children and provide images that are superior compared to those recorded with the bisecting angle technique. To compare the image quality of maxillary deciduous molar IOPAR taken using the “20 degree paralleling compromise technique” with that taken using the “bisecting angle technique”. Parallel double blinded randomized clinical trial. Sixty children who fulfilled the inclusion criteria were randomly split into two groups. In group A, the bisecting angle technique was used and in Group B the 20 degree paralleling compromise technique was used. The radiographs were categorized into three groups according to the quality of the image (1: Foreshortened image of the roots, 2: Elongated Image of the roots, 3: Undistorted well-defined image) by two independent observers who were blinded to the study and then compared. The obtained data was analysed for inter and intra observer agreements using Kappa statistics and analyzed for significance using the Chi square test. The p values obtained for category 1 and 2 were 0.21 and 0.99 for observer 1 and 0.16 and 0.33 for observer 2 respectively. Under the conditions of the study, there was no difference in the image quality of maxillary deciduous molar roots on IOPAR recorded using either the “bisecting angle” or the “20 degree paralleling compromise” techniques.

Our aim was to compare the comfort of pediatric patients during the first stage of the conventional 2-stage inferior alveolar nerve block (IANB) versus the modified 2-stage IANB. This was a parallel group, single-blinded, randomized controlled trial. Pediatric patients meeting the inclusion criteria were randomly allocated to 1 of the 2 groups receiving IANB, group 1 (31 subjects) utilized a conventional 2-stage technique, and group 2 (33 subjects) utilized a modified 2-stage approach. Patient comfort was assessed indirectly by 2 observers using the Face, Legs, Activity, Cry, Consolability (FLACC) scale during the first stage of the injections. FLACC score data between the 2 groups were analyzed using the chi-square test, and interobserver reliability was measured using kappa statistics. During the first stage of the injections, lower FLACC scores of 0 indicating a relaxed/comfortable patient experience were found in 57.6% of group 2 subjects compared with only 25.8% group 1 subjects, which was a statistically significant difference (p-value .013). Interobserver reliability assessed using kappa coefficients (κ = 0.812) indicated excellent agreement. FLACC scores for the pediatric patients during the first stage of the modified 2-stage IANB technique were significantly lower than during the first stage of the conventional 2-stage IANB technique.

Introduction: The two-stage technique of inferior alveolar nerve block (IANB) administration does not address the pain associated with “needle insertion” and “local anesthetic solution deposition” in the “first stage” of the injection. This study evaluated a “modified two stage technique” to the reaction of children during “needle insertion” and “local anesthetic solution deposition” during the “first stage” and compared it to the “first phase” of the IANB administered with the standard one-stage technique. Materials and Methods: This was a parallel, single-blinded comparative study. A total of 34 children (between 6 and 10 years of age) were randomly divided into two groups to receive an IANB either through the modified two-stage technique (MTST) (Group A; 15 children) or the standard one-stage technique (SOST) (Group B; 19 children). The evaluation was done using the Face Legs Activity Cry Consolability (FLACC; which is an objective scale based on the expressions of the child) scale. The obtained data was analyzed using Fishers Exact test with the P value set at

Background The growing interest on usage of probiotic lactobacilli in maintaining oral health has posed number of questions on its probable side effects. One such consideration could be an increased acid production in dental plaque, in turn leading to dental caries. Thus, the aim of this study was to comparatively evaluate the lactic acid producing ability of L. acidophilus and L. plantarum with and without dental plaque. Material and Methods The study consisted of five groups: 3 control groups (Supragingival plaque, L. acidophilus and L. plantarum) and 2 test groups (Supragingival plaque with L. acidophilus and Supragingival plaque with L. plantarum). 26 samples for each group were collected and their baseline spectrophotometric values were recorded. The acid production was initiated by adding 25?l fructose (10%) and stopped by centrifugation for 2 min. The concentration of the lactic acid produced was determined with the aid of COBAS INTEGRA 400 plus. Results On comparison of Lactic Acid estimation in mg/dl, the mean values of Plaque group was the highest followed by Plaque +L acidophilus, Plaque +L plantarum, L acidophilus and least in L plantarum. The posthoc analysis shows that the comparison of Group 1 (Plaque) and Group 2 (Plaque +L acidophilus) is statistically Significant results between all the groups except between the Plaque +L acidophilus and Plaque +L plantarum group. Conclusions The lactic acid producing ability of pure suspensions of L.acidophilus and L.plantarum and the lactic acid producing efficiency becomes more when they are added to the supragingival plaque. Key words:Probiotic, lactic Acid, plaque.

Dens invaginatus is a developmental dental anomaly which is clinically seen as a furrow on the palatal aspect of the tooth either limiting to the coronal pulp or extending to the radicular apex. It occurs most commonly in females affecting crowns of the maxillary lateral incisors. This case report presents two bilateral cases of Type II radicular dens invaginatus in mandibular first premolars. It was an incidental diagnosis on an intraoral periapical radiograph when a 12-year-old male patient and a 12-year-old female patient reported with their respective chief complaints. Conservative management in the form of strict follow up of the cases was planned.

Cleft lip and palate (CLP) is the most common congenital craniofacial anomaly. Rehabilitation of CLP generally requires a team approach. Alveolar and nasal reconstruction for these patients is a challenge for the reconstructive surgeon. Various procedures have been attempted to reduce the cleft gap, so as to obtain esthetic results postsurgically. The presurgical nasoalveolar molding (PNAM) technique, developed by Grayson, is a new approach to presurgical infant orthopedics. PNAM reduces the severity of the initial cleft alveolar and nasal deformity. Thus, it enables the surgeon and the patient to enjoy the benefits associated with repair of a cleft deformity that is minimal in severity. This article presents a brief insight into PNAM with a case series of three different cases (one unilateral and two bilateral) which underwent PNAM treatment and gave an excellent surgical prognosis.

Context: The survival of atraumatic restorative treatment (ART) restorations would probably increase if near total elimination of cariogenic microorganisms could be done in the process of cavity cleaning before going ahead with the restoration. Thus, use of naturally occurring disinfecting agents for achieving this goal could herald a new beginning in the field of contemporary minimum intervention dentistry. Aims: To evaluate the efficacy of hand instruments in excavating dental caries and comparatively evaluate the roles of Aloe vera and propolis as potential cavity disinfecting agents after minimally invasive hand excavation of dental caries. Settings and Designs: Experimental, in vivo intergroup split mouth, randomized clinical trial. Subjects and Methods: The study included Group I (Control), Group II (A. vera) and Group III (propolis). Ten patients with three teeth each have occlusal/occlusoproximal lesions suitable for ART were selected. Dentinal samples were collected three times from each tooth viz., preexcavation, postexcavation and postdisinfection of the cavities. These dentinal samples were subjected to microbiological analyses for total viable count. Statistical Analysis Used: Repeated measures of analysis of variance (ANOVA) with Bonferroni post-hoc test and one-way ANOVA with Tukey post-hoc test. Results: In all the three groups, significant amount of bacteria were left behind after hand excavation. Group II and Group III, in which cavities were treated with A. vera and propolis extracts respectively, showed a significant reduction in the bacterial counts when compared to control the group. Conclusions: Hand excavation alone does not completely eliminate bacteria, which may predispose treated teeth to secondary caries. Both propolis and A. vera extracts can be used as potential natural disinfecting agents, thereby embracing the concept of phytotherapy in minimum intervention dentistry.

Context: Assessing dental anxiety as a predictor of the likely behavior of the child in the dental operatory is of paramount importance for a clinician to render quality care. Aim: This study aims to correlate the dental anxiety of preschool children as shown during the doll placement test with that of their behavioral patterns during the first dental visit. Settings and Design: This cross-sectional study was conducted between the ages of 3–7 years. Materials and Methods: During their first dental visit, the background variables were elicited from parent/guardian at the reception desk. Later at the play area, the child was given a set of dolls representing dentist, child, and mother to place them in a model dental office having a dental chair. The child was then taken for the initial oral examination, during which the behavior of the child was rated using Frankl's Behavior Rating Scale. The data collected were analyzed using Chi-square test and binary regression analysis. Results: The observed association between the doll placement pattern and the behavior of the patient during dental treatment was statistically significant (P < 0.001). The binary regression analysis showed that the child's unpleasant previous medical and parent's unpleasant dental experiences had higher odds favoring uncooperative behavior (46.63 and 41.93, respectively). Conclusions: The child's behavior on the dental chair is associated with the doll placement pattern, which is also influenced by experiences of the child during his/her encounter with the medical doctor and previous dental experiences of their parents.

Introduction: With increased trend among people to choose a healthy diet, there is an increased consumption of health drinks by children. Thus, it is important to know their cariogenicity. Aim: To evaluate the effect of consumption of health drinks viz., Horlicks, Boost and Complan on plaque pH in children. Materials and Methods: The study consisted of four groups: Group I (control)- 10% sucrose solution, Group II- Horlicks, Group III- Boost, Group IV- Complan. Samples of plaque from representative teeth were collected and pH was measured using an electrode outside the mouth. After baseline pH was recorded, children were given their respective drinks and were asked to consume slowly over a period of three to five minutes following swish with 20 ml of the test drink for one minute. The pH was then recorded after 10, 20, 30, 40 and 60 minutes of the post consumption period. Obtained values were subjected to one-way ANOVA test for multiple group comparison followed by Post-Hoc Tukey’s test for group wise comparison. Results: Twenty minutes after consumption of Complan and Boost, pH was decreased, but not to the critical pH value as in case of sucrose. The pH was found to be slightly increased, 20 minutes post Horlicks consumption. Post 60 minutes consumption of all the drinks including sucrose solution, the pH was increased in comparison to post 20 minutes. However, 60 minutes post consumption of Boost and Horlicks, pH increased above the baseline. Conclusion: Consumption of health drinks viz., Complan and Boost did not lower the plaque pH to the level of critical pH. Consumption of Horlicks increased the plaque pH.