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Aim: This study aimed to analyse data from the records of the past five years of Saudi children seen in the dental trauma emergency clinic in College of Dentistry King Khalid University, Abha, Saudi Arabia. Materials and Methods: The current study was a cross-sectional observational analytic study. Our study includes the records of children having age groups of 2 to 12 years who visited the Department of Pediatric Dentistry in the College of Dentistry King Khalid University, from January 2015 to December 2019 as a result of pediatric TDI. Trauma records were obtained based on the Andreasen and Andreasen classification (1). The clinical Information regarding (i) Age, (ii) Sex, (iii) Most affected teeth, (iv) Cause of injury (falls, impact against a hard object or collisions, traffic accident, sport, and game accident, abuse), (v) Monthly distribution of trauma, (vi) Type of trauma (9), (vii) Time elapsed following injury, and (viii) Treatment was recorded. The data were entered and analyzed using the Statistical Package for the Social Sciences (SPSS 20). A P-value of less than 0.05 was considered to be statistically significant. Results: The dental trauma records of patients with an average age of 8 years, including 54 girls (40.9%) and 78 boys (59.1%), were evaluated. The most common cause of trauma was falling (61%). Enamel/ Dentin fracture was the most common type of dental hard tissue fracture around 53 (40.1%). In the category of periodontal tissue injuries, intrusive luxation injury (12.1%) was the most common. Conclusions: Our research disclosed that boys were exposed to more traumatic injuries, and the most crucial factor in traumatic injuries is falling. Therefore, teachers, pediatricians, parents, and children should be cautioned about probable dangers and emergency treatments for all age groups on dental trauma.

Purpose: To evaluate mothers’ knowledge of the use of fissure sealant (FS) and topical fluoride (TF) therapy among children aged between 7 to 12 years in Saudi Arabia. Methods: In this cross-sectional study, participants (n = 350) were selected based on simple random sampling method from the mothers’ of children aged from 7 to 12 years old, attending outpatient pediatric dental clinics in College of Dentistry King Khalid University, Abha, Saudi Arabia. Results: The age group of mothers included are as follows: 31.7 % in 20 - 30 years age group, 53.1 % in 31 - 40 years age range, and 15.1 % in 41 - 50 years. On FS therapy benefits in the prevention of caries in children, 22 % responded that it was beneficial. When participants were asked regarding FS wearing out easily after application on the tooth, 8 % agreed while 13.4 % disagreed. A majority of mothers (40.9 %) agreed that TF therapy prevents caries, while 47.7 % stated that they brush twice daily with fluoride toothpaste. The mothers that disagreed that fluoride gel is recommended only for children, not for adults were 32.9 %. When the mothers were asked about the benefit of fluoride if its cost is taken into consideration, 46.6 % disagreed that fluoride gel was worth its cost, while 22.3 % took the opposite view. Conclusion: Positive knowledge of FS and TF therapy have been observed among mothers. However, mothers demonstrated greater positive knowledge of TF therapy than FS therapy.

Introduction: Dentists earnestly try to practice painless treatment. Conventional inferior alveolar nerve block technique is preferred by most of the dentists despite its various modifications.However its failure rate as per literature is quite high. Inexperienced dentists face difficulty in obtaining effective anesthesia. This may be due to limited access to inferior alveolar nerve,greater density of alveolar bone,bulky soft tissues,damage to nerve or due to risk of intravascular injection. Aim: The aim of this study is to review and clinically assess the factors causing difficulty or failure of inferior alveolar nerve block in predoctoral students and to review the mandibular nervve blocks. Material and methods: Dental interns of riyadh elm university were monitored during administration of inferior alveolar nerve block for difficulty factors influencing inferior alveolar nerve block. Onset of anesthesia, efficacy anesthesia of inferior alveolar nerve, lingual nerve and long buccal nerve were ascertained. Difficulty index was used to assess the “item difficulty” with a score of 0.0 which indicates that none of the dental interns anesthetised correctly to 1.0 suggesting all the dental interns anesthetised correctly. Results: Complete failure of inferior alveolar nerve block was noticed in 2.4% of predoctoral students. The most common cause for inferior alveolar nerve block failure was attributed to the difficulty in palpating the landmarks (77%), 22% of the patients refused multiple needle penetrations,and 19% of inferior alveolar nerve block failure was due to the fear of potential complications by the predoctoral students. Conclusion: Clinical skill of predoctoral students need adequate training in nerve blocks. Revising the current literature on alternative inferior alveolar nerve block techniques or use of evidence based dentistry to update and practice alternative nerve block techniques would aid in improving the clinical skills and treatment outcome which would therefore enable to remove the stumbling blocks in successful anesthesia.

Background: The aim of the study is to know the prevalence of hypomineralizations in second primary molars (HSPM) in 7to 10-year-old Saudi children. Materials and Methods: A Total of 596 school children of age group 7-10 years was screened for HSPM. Clinical examination was done inside the respective schools. Dental examination was carried out by using scoring criteria to identify for HSPM on we surface under the portable light source. The results were recorded and analyzed for statistical significance using the Chisquare test and t-test with a P-value of

Aim: The present cross-sectional study was conducted among dental students to know the knowledge and awareness regarding plagiarism. Materials and Methods: A cross-sectional study was carried out on the sample size of 246 dental students (Males 179 and Females (67) in College of Dentistry, King Khalid University, Abha, Saudi Arabia, to know the awareness of plagiarism among dental students. The questions were designed such that they assessed the plagiarism among dental students and was circulated among dental students in the dental college. The survey data was collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA), and was statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the chi-square test, and P values less than 0.05 were statistically significant (P

Solitary median maxillary central incisor (SMMCI) is a rare dental anomaly. It is estimated to occur in 1 : 50,000 live births. The SMMCI tooth differs from the normal central incisor in that the crown form is symmetric and it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. The presence of SMMCI with hemifacial microsomia (HFM) is a very rare clinical condition. We report a case of SMMCI in a female of African ethnic origin, who presented with SMMCI in permanent dentition with mild nasal stenosis. An early diagnosis of SMMCI is important, since it may be a sign for other severe congenital or developmental abnormalities. Therefore, systematic follow-up and close monitoring of the growth and development of SMMCI patients are crucial.

Background The tribes of India have poor periodontal health status due to their isolation, awareness and less accessibility to dental resources. They follow traditional methods of oral hygiene practice, which are found to be inadequate and inaccurate to maintain their good oral health. This study aims to assess the oral hygiene practice, oral hygiene and periodontal status of two tribes residing in Bhadrachalam, Telangana, India. Methods Based on accessibility the two tribes Koya and Lambada were included in the study. The total study population consisted of 1000 subjects, with 500 subjects in each group. Using a preformed proforma the oral hygiene practices were recorded for two groups and oral examination was done using Oral Hygiene Index (OHI-S) index and Community Periodontal Index (CPI). Results The OHI-S ranged between 2.5–3.0 in both the groups. The CPI index scores showed that sextants with calculus, shallow pockets, deep pockets and loss of attachment of 4-5 mm were significantly present in both groups. Conclusion To conclude, though practice of poor oral hygiene and compromised periodontal status was seen among both groups. However, it was more prevalent in Koya. Under these circumstances, implementation of a basic awareness of oral health care programme for these tribes should be a high priority.

Background: Awareness of malocclusion and the need to make corrections have increasingly become prevalent among the young population. In the period of adolescence, physical appearance is crucial in the construction of personal identity, including one’s relationship with one’s own body. Orthodontic treatment includes improved oral health and enhanced psychological wellbeing. Early orthodontic treatment for children will be crucial to improving oral health. The present study aims to assess the awareness towards orthodontic treatment among school children’s of Aseer region, Saudi Arabia. Materials and Methods: A total of 835 (450 boys and 385 girls) school children’s, of age group between 10 - 15 years were included in the study. A total of 16 schools in the all Aseer region were surveyed during January to May 2018. A pre-structured self-administered questionnaire consisting of 12 questions with multiple answers were given to the children after the clinical examination to assess their knowledge and attitude towards Orthodontic treatment. Statistical Analysis: The survey data was collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA), and was statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the chi-square test and P values less than 0.05 were considered to be statistically significant (P < 0.05). Result: A total of 292 (65%) of males and 285 (74%) of females have heard of an orthodontist. 234 (52%) of males said that orthodontist would align their teeth. 203 (45%) and 250 (65%) of males and females respectively are aware that few teeth needed to be removed for aligning irregular teeth. Majority of the children are aware of taking braces treatment at an earlier age would improve facial appearance. 320 (83%) and 227 (59%) of female children aware of that irregular teeth can affect chewing ability and speech respectively. 261 (58%) of males knew that orthodontic treatment is longer than other dental procedures. Conclusion: Findings confirmed that there is a positive awareness towards orthodontic treatment among school children’s, but specific misconceptions and barrier exist. There is no statistical difference between males and females in knowledge and behaviour related to orthodontic treatment and malocclusion in school going, children.

To assess the emotional intelligence and identify the perceived sources of stress among female dental students and interns at King Khalid University College of Dentistry (KKUCOD), to investigate whether specific stressors were related to the year of study and gender, and to evaluate the relationship between emotional intelligence (EI) and perceived stress (PS).Total of 150 female undergraduates from 5120 students agreed to join the study with a response rate of 84%. Mean EI score for the sample was 120 (SD = 11.56), and the mean PS score was 70.37 (SD = 16.19). One-way ANOVA revealed a significant difference between different age groups and the educational, environmental score (P0.05). Correlational analysis showed that the PS scale and its factors correlated positively with each other (P0.01) and directly with the total EI score (P0.01); except for the living accommodation factor, negative correlations with overall EI score were significant.The present study showed that female interns and undergraduate students in clinical years of study at College of Dentistry reported higher EI and PS. The educational environmental score was found to be significantly different among different age groups. In contrary to most published literature, a direct association between EI and PS scores was found, except for the living accommodation factor. This might be attributed to the fact that the study was conducted 1 month prior to final exams. Living accommodation, personal factors, educational environment, academic work and clinical factors were identified as significant predictors of PS.

Objective: To evaluate the prevalence of deleterious oral habits and its effect on occlusion in school going children from 7 to 13 years old, in Aseer region of Saudi Arabia. Material and Methods: A cross-sectional study was conducted by clinical examination for the total sample of 750, who were attending private/ government schools in Aseer region school. Students were selected by stratified cluster random sampling. Clinical findings of each oral habits, including assessment of malocclusion, were examined involving the following parameters, i.e., crowding, spacing, open bite, crossbite and deep bite. Logistic regression analysis was conducted . Results: Boys had 26.2 % of crowded teeth, while 16.3% of girls were found to have crowded teeth; the difference was found to be significant (p=0.002). Spacing was present in 26.4% of boys and 16.7% girls; a significant difference was found between the two (p=0.002). Sleep bruxism was observed more among male subjects than females with a statistically significant difference in detrimental habits (p

Background: The aim of the study is to know the prevalence of molar relationship in primary dentition in Saudi children. Materials & Methods: This cross-sectional study aimed to record the molar relationship in 560, 2-6-year-old randomly selected Saudi children and to observe the differences between the age groups. Intra oral examination was done after consent from the parents. Molar relationship was recorded clinically. Results: 51.26% of the children had a 'flush terminal plane' molar relationship. The proportion of children with distal step molar relationship was significantly lower 35 (6.2%). 42.6% exhibits mesial step molar relation in children. Conclusions: Flush terminal Plane- the molar relationship is a most common molar relationship, and it also increases with age. Deciduous molar relationship changes as age increases. Least prevalence is distal step molar relationship.

Objective: The aim of this study was to compare the mesiodistal tooth sizes and to see the gender dimorphism among three ethnic groups of southern part of Saudi Arabia, that is, Asir, Najran, and Jizan region. Subjects and Methods: The sample composed of 90 individuals (45 of each gender) from 3 different regions of southern Saudi Arabia, having mean age of 26.9 years. The measurements were done directly on the models with the aid of the digital calliper measuring the largest mesiodistal measure of incisors, canines, premolars, and molars in both sides. Results: Almost all the mesiodistal tooth widths were statistically significant between the groups except maxillary and mandibular permanent third molars. Regarding sexual dimorphism, the groups were combined; almost all the mesiodistal tooth widths were not shown statistically significant difference between the males and females except that right first permanent premolars were significantly larger in the females than in the males. Conclusion: The present study has provided norms of the mesiodistal permanent tooth diameters of a Saudi population that are newer and more complete than the previously published norms. There appear to be some secular trends in the mesiodistal diameter of the Saudi permanent teeth toward sexual dimorphism.

Mandibular molars can have an additional root located lingually (the radix entomolaris). If present, an awareness and understanding of this unusual root and its root canal morphologycan contribute to the successful outcome of root canal treatment. This report discusses endodontic treatment of two mandibular molars with a radix entomolaris, which is rare macrostructures in the Caucasian population. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris are described. Avoiding procedural errors during endodontic therapy demand an adapted clinical approach to diagnosis and root canal treatment.

Background Gingival enlargement due to calcium channel blockers is a common complaint reported by patients. It can be localized or generalized and can range from mild to severe, affecting patients appearance and function. Nifedipine induced gingival enlargement is noticed only in 10 % of patients and very few cases of Nifedipine induced gingival enlargement in an edentulous patient have been documented in the literature. Case presentation Here in, we report a case of gingival enlargement in a 70 year old hypertensive edentulous patient who was on low dose Nifedipine therapy. Patient wanted complete dentures. We planned to excise the overgrowth and followed up for 1 year. Conclusion Nifedipine induced gingival enlargement noticed only in 10 % of patients. Hence, there is a need for physicians and dentist to make a coordinated treatment plan and practice care while prescribing these drugs which are associated with gingival overgrowth.

Background and objective Streptococcus mutans is the primary initiator and most common organism associated with dental caries. Prediction of post-Streptococcus mutans favours in the selection of appropriate caries excavation method which eventually results in meliorate caries-free cavity preparation for restoration. The objective of this study is to predict the post-Streptococcus mutans prior to dental caries excavation based on pre- Streptococcus mutans using iOS App developed on Artificial Neural Network (ANN) model. Methods For the current research work, children with occlusal dentinal caries lesion were chosen, 45 primary molar teeth cases were studied. Caries excavation was done with carbide bur, polymer bur and spoon excavator. The colony forming units for pre and post-Streptococcus mutans were recorded, data emanating from clinical trials was employed to develop the ANN models. ANN models were trained, validated and tested with the registered clinical data using different ANN architectures. Results Feedforward backpropagation ANN model with an architecture of 4-5-1, predicts post-Streptococcus mutans with an efficiency of 0.99033, mean squared error and mean absolute percentage error for testing cases were 0.2341 and 4.967 respectively. Conclusions Caries excavation methods and pre-Streptococcus mutans are feed as inputs, while post-Streptococcus mutans as targets to develop ANN model. Based on the developed ANN model, an ingenious iOS App was developed, the global clinician may utilize the App to meticulously predict post-Streptococcus mutans on iPhone based on pre-Streptococcus mutans, which in turn aids in decision making for the selection of caries excavation method. This study manifests the potential application of iOS App with built-in ANN model in efficiently predicting the post-Streptococcus mutans. Also, the study extends scope for applications of iOS App with built-in ANN models in clinical medicine.

Background: Occlusal characteristics of the primary dentition vary among populations and ethnic groups. Materials and Methods: This cross-sectional study aimed to record various primary dentition parameters in 700 Saudi children, 2-6 year-old, was divided into 4 age groups and was randomly selected to observe the differences between the age groups. Results: 55.6% of the children had a 'flush terminal plane' molar relationship. The proportion of children with distalstep molar relationship was significantly lower 23 (3.2%). The degree of overbite was significantly less in the 5-year-olds than in the 3-year-olds. The majority of the children (80.7%) had spaced dentition. The prevalence of anterior cross bite was 0.7% and of open bite was 0.3%. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12608 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

Dentigerous cysts are the most common developmental odontogenic cysts of the jaw, arising from impacted, embedded or unerupted permanent teeth. They apparently develop by accumulation of fluid between the reduced enamel epithelium and the tooth crown of an unerupted tooth. There is usually no pain or discomfort associated with the cyst unless there is an acute inflammatory exacerbation. Careful evaluation, coupled with meticulous clinical and radiological investigations could help clinicians to arrive at the correct diagnosis as well as address the implicated etiologies, before instituting the most appropriate therapy. Here, we report a case of a dentigerous cyst in the mixed dentition of a 10-year-old female patient and outline its comprehensive management for the benefit of pediatric and general dentists involved in the care of such patients.

Objective To obtain base line data about the availability of cariogenic foods in the primary school canteens in the city of Abha, Saudi Arabia. Materials and methods The present study was performed in 6 to 10-year-old school boys living in Abha city in 2012. Eight public primary schools with canteen facilities were randomly selected and all the children in the schools were included in the study. Data was collected to know the availability of foods which are cariogenic and the students were made to answer a questionnaire that had questions about their source of food intake. Results A total number of 1,807 primary school students participated in the study. 87% of the items available in school canteens were cariogenic and only 13% were noncariogenic. 1505 (83%) school children get food from home, 263 (15%) depend entirely on the canteen, 1320 (73%) eat from both home and canteen and only 158 (8%) of the school children rely entirely on homemade food. Conclusion The canteens should reinforce the classroom programs relating to food, nutrition and health. Standard guidelines have to be implemented throughout Saudi Arabia about eating habits in school and improve the overall nutritional quality of school food. How to cite this article Togoo RA, Meer Z, Kandlaya R, Yaseen SM, Al-Shehri TD, Al-Ghamdi HG. Availability of Cariogenic Foods in Primary School Canteens of Abha City, Saudi Arabia: A Cross-Sectional Study. World J Dent 2012;3(3):239-242.

Amelogenesis imperfecta is an unusual hereditory disorder affecting both primary and permanent dentition. We present a rare case of hypocalcified auto-somal recessive amelogenesis imperfecta occuring in primary dentition in a 7-year-old girl with a family history of consanguineous marriage. Clinical and radiological examination revealed discoloration and hypoplasia of enamel with easy chipping affecting both maxillary and mandibular dentition.

Perforation is a procedural accident that occurs during root canal treatment, creating an artificial communication between the root canal and the supporting periodontal apparatus. Iatrogenic root perforation is a major complication of endodontic and restorative treatments, leading to impairment of tooth prognosis. Successful management of root perforations is dependent on early diagnosis of the defect, location of the perforation, choice of treatment, materials used, host response, and the experience of the practitioner. This case report presents the successful management of an iatrogenic lateral root perforation in a tooth with radiographic evidence of periodontal healing over one year follow-up.

Background: This study aimed to assess the oral health status and dental treatment needs of children with Sickle Cell disease (SCD) in Abha and Khamis Mushait cities of southern Saudi Arabia.Methods: A total of 82 children were included in the study, 41 children with SCD and 41 control group. A total of 82 children having age group of 2 to 13 years from Abha and Khamis Mushait cities of southern Saudi Arabia were examined. The clinical examinations were performed by experienced clinicians in those children who fulfilled the required inclusion criteria. Intraoral examination was done using Decayed-Missing-Filled Teeth Index (DMFT Index) and other dental conditions were examined. Statistical analysis was done with Chi square test and level of significance was set at p

Aim: The aim of this study was to assess the oral health knowledge, behavior, and practices related to use of miswak (chewing stick) in population of Aseer Region, Saudi Arabia. Subjects and Methods: Of the 2023 participants, 1666 (83.3%) were females and 334 (16.7%) were males. The questionnaires having 10 online questions were used to assess the knowledge of oral hygiene methods, including frequency, reason, and methods for miswak use. Statistical Analysis Used: The survey data were collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA) and were statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the Chi-square test, and P < 0.05 was considered to be statistically significant (P < 0.05). Results: Participants responded regarding the primary oral hygiene methods; 46.5% respondents used toothbrushes, 44.5% used both toothbrushing and miswak, and 8% used only miswak as their primary tooth cleaning method. 28.2% respondents cleaned their teeth with tooth brush or miswak at least once a day, 37.6% twice, 28.4% whenever required, and 5.9% infrequently. Majority of the participants, i.e. 70.2% were using miswak with taper and as a brush to clean all tooth surfaces. About 84.7% feel fresh, and teeth are whiter after the use of miswak. Nearly, 84.7% prefer to continue using miswak in combination with other teeth cleaning methods, which may have more benefits. Conclusions: In our study, most common type of oral hygiene method employed is toothbrush and in combination with miswak. Chewing stick use was common among participants with religious advice being the dominant reason for usage.

Current evidence and understanding of bone science recognize the pivotal role of growth factors in all the aspects of bone grafting and regeneration. Platelet-rich-plasma (PRP) is one of the richest sources of growth factors to enhance bone regeneration. The present article aims to highlight the basic mechanisms involved in the successful use of PRP and its clinical applications in Pediatric dentistry based on our case-reports citing its use for bone grafting in young children. With pertinence to its current advantages and recent applications, PRP could soon prove to be an invaluable tool for pediatric dental surgeons worldwide.

Mesiodens is a midline supernumerary tooth commonly seen in the maxillary arch, and incidence of molariform mesiodens in the maxillary midline is rare in permanent dentition and extremely uncommon in primary dentition. A midline supernumerary tooth in the primary dentition can cause ectopic or delayed eruption of permanent central incisors which will further alter occlusion and may compromise esthetics and formation of dentigerous cysts. This paper reports a rare case of the presence of a molariform mesiodens in the primary dentition. On clinical and radiographic examination, flaring of the primary central incisors was seen, with a molariform mesiodens consisting of multiple lobes or tubercles on the occlusal surface with the well-formed root. The treatment plan consisted of the extraction of the supernumerary tooth and regular observation of permanent central incisors for proper eruption and alignment.

Background: It has been observed that the general dentists and pedodontists differ in their treatment recommendations for pulp therapy in deciduous teeth. Aim: To determine the knowledge and practice of pulp therapy in deciduous teeth by general dental practitioners (GDP) in two cities of southern Saudi Arabia. Subjects and Methods: Fifty GDP selected at random from government and private dental clinics were questioned about pulp therapy in deciduous teeth in Abha and Najran cities using a 10.item questionnaire. The data were analyzed using IBM SPSS software version 11.0 and descriptive statistics were obtained. Results: All 50 participants responded to the survey. Pulpotomy was suggested as the first line of treatment for pulp.exposed primary tooth by 32 respondents with 44 using Buckleyfs formocresol and 32 applying it on the pulp for 5 minutes. 43 respondents squeeze dried the cotton pellet before application on the pulp. In pulpectomy procedure 44 respondents preferred zinc oxide eugenol as obturation material with 22 using handheld reamers and 15 using slow.speed lentilospirals for obturation. 12 respondents used obturation techniques which had no scientific relevance. In order of preference Glass ionomer cement (GIC), silver amalgam, and stainless steel crowns were the materials of choice for final restoration of endodontically treated deciduous teeth. All 50 answered in the affirmative when asked if they would like to have additional information about pulp therapy in deciduous teeth. Conclusion: The study concluded that general dentists were regularly performing pulp therapy in decidous teeth and therefore need to be frequently updated about these procedures. Keywords: Saudi Arabia deciduous, General dentists, Pulp therapy

The purpose of this in vivo study was to evaluate and compare the reduction in bacterial count in dentin after caries excavation with a spoon excavator, carbide bur, and polymer bur.Forty-five primary molar teeth from 36 children with occlusal dentinal carious lesions without pulpal involvement were chosen and divided into 3 groups: (1) caries was excavated using a brand new round bur with a slow-speed handpiece at 800 rpm from the occlusal aspect; (2) new polymer burs were used with slow-speed handpiece at 800 rpm, according to the lesion's size; (3) caries was excavated using a sterile spoon excavator.The mean difference in colony forming units of Streptococcus mutans and lactobacilli before and after caries excavation was found to be significant (P.01) in all 3 groups. Further intergroup comparison of percentage reduction in bacterial counts between different groups was statistically significant, except when the percentage reduction in S mutans of group 2 was compared to that of group 3 (P=.26). Reduction in S mutans count was highly significant (P.001) for group 1 vs group 3.Caries removal with a carbide bur, polymer bur, and spoon excavator produced significant reduction in viable count of both Streptococcus mutans and lactobacilli. Carbide burs, however, produced greater reduction in the viable count of bacteria followed by polymer bur and spoon excavator.