Search

Background Early childhood caries (ECC) is highly prevalent with significant long-term consequences. Parents are primarily responsible for the oral health practices of their children. Parents' health beliefs, attitudes, and cultural factors influence oral health practices. Aim To explore and understand the perceptions and challenges faced by the parents of the children with ECC in performing routine oral hygiene practices for their children. Design We conducted a qualitative description study with the parents of children with ECC. Data were collected through five focus groups using culturally appropriate, semi-structured, open-ended questions and probes. Focus groups were audiotaped, and field notes were taken, which were transcribed verbatim after each focus group session. Data were analyzed using content analyses. Results A vast majority of the participants were aware of the significance of oral hygiene. However, they faced challenges in implementing proper home hygiene practices at home and lacked knowledge about the type of toothpaste and toothbrush to be used for their children. Conclusion The parents of the children with ECC face a severe knowledge gap, which is interfering with the selection of proper oral hygiene aids for their children. They also face barriers in implementing oral hygiene routines for their children, in spite of awareness that tooth brushing is important.

Objectives: To evaluate the time taken and the mechanism through which the occlusion settles following the placement of a preformed metal crown (PMC) using the Hall technique. The secondary objective was to assess any temporo mandibular joint dysfunction (TMD) resulting from the Hall technique through a questionnaire. Study Design: 44 children fulfilling the inclusion criteria were evaluated for changes in overbite and occlusal vertical dimension (OVD) following the placement of preformed metal crowns (PMCs) using the Hall technique. The overbite and OVD measurements were taken before treatment, immediately post treatment, then at one, two, three and four weeks post treatment. After four weeks, a questionnaire recorded the occurrence of any signs or symptoms of TMD. Results: At the fourth week, the overbite measurement did not show a statistically significant difference (p value= 0.58) compared to baseline values indicating that the occlusion settled by the fourth week. By the third week the OVD values obtained did not show a significant difference compared to the baseline (p value= 0.42) indicating that the OVD had been restored. The questionnaire provided at the end of four weeks showed negative response for signs and symptoms of TMD in all the children. Conclusion: Any changes in occlusion following the placement of a Hall crown settles in four weeks. The OVD settles three weeks post placement implying that extrusion of teeth do not play a role in settling of the occlusion. The children do not develop any signs or symptoms of TMD post a Hall crown.

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.

Abstract: There are many common dental malocclusions seen in the mixed dentition, such as premature loss of, or retained, deciduous teeth, submerged molars, supernumerary teeth, midline diastema, crossbites, increased overjet, open bites, ectopic eruptions and crowding. In properly selected cases, like dental anterior crossbites or unerupted incisors, interceptive orthodontic treatment not only improves function and aesthetics, but also achieves a relatively stable outcome, even after the removal of the appliance. A removable appliance can be a mode of interceptive orthodontic treatment. The success of the interceptive treatment using a removable appliance, however, depends upon patient compliance. In this regard, use of a sectional fixed appliance is gaining in popularity. This paper discusses four case scenarios of malocclusion in the mixed dentition managed using sectional fixed therapy. CPD/Clinical Relevance: The sectional fixed appliance is versatile, easy to use and well tolerated by patients. When used correctly, it gives a more controlled approach to tooth movement in all three dimensions and a more predictable outcome.

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

Supernumerary teeth appear as one of the most common and significant dental anomalies in the permanent dentition and are rare in primary dentition. Supernumerary teeth in primary dentition exhibit less variety in shapes and commonly occur as conical form. Early intervention is required when supernumeraries appear in primary dentition stage to achieve better occlusion form and function. This case report highlights unusual incidental finding and management of two supernumerary (bilateral, premolar like) teeth, present in the pre-maxilla region during the primary dentition stage of a male child.

Aim: To evaluate and compare the efficacy of customized toothbrushes in maintenance of oral hygiene and gingival health with that of conventional toothbrushes in children with cerebral palsy. Methods: Thirty patients with cerebral palsy in the age group of 6 to 18 years were randomly divided into two groups—group I (normal toothbrush) and group II (customized toothbrush). Common oral hygiene instructions were given to both the groups. Before beginning the study, plaque index (PI) and modified gingival index (MGI) were recorded, following which patients were made to practice their routine twice a day brushing with either normal toothbrush or custom-made toothbrush for 3 weeks. At the end of 3 weeks, PI and MGI were rerecorded. The subjects belonging to group II were also made to perform muscle exercises using the modified brush head. Results: Significantly high percentage drop between the pre- and post-PI as well as MGI (31.55% and 30.23%, respectively) was observed in the custom-made toothbrush group, while the percentage drop of only 8.34% (PI) and 14.51% (MGI) was seen in the normal toothbrush group. Conclusions: Custom-made tooth brushes increased the efficiency of maintaining oral hygiene and gingival health of individuals with cerebral palsy.

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.

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.