A Proposed Model for Infant and Child Oral Health Promotion in India

Dental caries is an increasing burden in the developing countries. A proper budgetary allocation for treating dental diseases in an enormous population such as India is impractical, where resources are inadequate for major health challenges such as malnutrition and gastrointestinal and respiratory infections in children. An integrated, directed population approach targeting children is much needed. The existing machinery of successful public health campaigns such as the “Pulse Polio” and the “Mid-Day-Meals Scheme” of the Government of India can be used for oral health promotion for children. India has about 300 dental colleges and countrywide branches of the Indian Dental Association that can provide manpower for the program. An innovative, large-scale “Fit for School” program in Philippines is a model for an integrated approach for children’s health and has proved to be cost-effective and viable. A model for oral health promotion in infants and children of India, combining age-specific initiatives for health education, nutrition, hygiene, and fluoride use, is proposed. The model could be implemented to evaluate the oral health status of children, knowledge and knowledge gain of the community health workers, and acceptability and sustainability of the preventive programs (fluoride varnish and preschool and school tooth brushing) pragmatically

Conservative management of molar incisor hypomineralization using biomimetic material in a 9-year-old boy

Comprehensive management of severe molar incisor hypomineralization with dental caries in a 9-year-old boy is reported. After the consultation, diagnosis and treatment planning; upon obtaining the consent from parents, and behavior modification of the child over a preparatory visit, three of the four permanent first molars (PFMs) were treated: two with indirect pulp therapy and one with direct pulp capping using tricalcium silicate cement. After observation of 1 month for each tooth, preformed stainless steel crowns (SSCs) were placed on all three PFMs in a diagonal manner for minimizing occlusal discomfort. The remaining PFM (36), restored earlier by another dentist, developed a dentoalveolar abscess during the course; the same was treated endodontically and a coronal seal was established with an SSC. A quadrant approach was adopted to complete extractions of all carious primary teeth along with the treatments of PFMs during the same appointments to minimize the number of visits. Local anesthesia with 4% articaine with adrenaline infiltrations was used for all quadrants except for the third where an inferior alveolar nerve block with 2% lignocaine with adrenaline was given. Follow-up of all PFMs, over a period of over 9 months, was uneventful. The endodontically treated PFM, too, showed satisfactory recovery, posttreatment

Comparative evaluation of the efficacy of aloe vera juice, amla juice, and milk as storage media in maintaining the periodontal ligament cell viability: An in-vitro study

Background: Tooth avulsion implies total displacement of the tooth out of its socket. Many storage media such as milk, saliva, Hank’s Balanced Salt Solution (HBSS), propolis, Viaspan, have been studied as storage medias for preserving PDL cell viability. Amongst these, HBSS has been proposed as the storage medium of choice for treatment of avulsed teeth by the American Associations of Endodontists. However, the major disadvantage is that it is not easily available at places where these traumatic injuries occur. Aim: To evaluate and compare the efficacy of aloe vera juice, amla juice, milk and water in maintaining the periodontal ligament cell viability of avulsed teeth. Study Design: Forty premolars extracted for orthodontic therapeutic purposes were randomly and equally divided into four groups based on storage media used [Group I: aloe vera juice; Group II: amla juice; Group III: milk; Group IV: water. Following extractions, the teeth were dried for 30 mins and were placed in one of the four different storage media for 45 minutes, following which the scrapings of the PDL from these teeth were collected in Falcon tubes containing collagenase enzyme in 2.5 mL of phosphate buffered saline

Assessment of oral health-related quality of life (OHRQoL) in children with molar incisor hypomineralization (MIH) – A systematic review and meta-analysis of observational studies

Background: Molar Incisor Hypomineralization (MIH) affects about 14% of the population. MIH may lead to enamel breakdown, early tooth decay and is known to cause sensitivity, pain, discomfort, etc., Despite several studies reporting impacts of MIH on oral health-related quality of life (OHRQoL) in children; no systematic review has been reported till date. Objectives: Our study aimed at assessing the impact of MIH on OHRQoL. Search Methods: Two researchers, Ashwin Muralidhar Jawdekar and Shamika Ramchandra Kamath, independently searched articles using appropriate keyword combinations in three search engines – PubMed, Cochrane Library, and Google Scholar and conflicts, if any were resolved by Swati Jagannath Kale. Studies either reported in English or complete translations available in English were selected. Selection Criteria: Observational studies on otherwise healthy 6–18-year-old children were considered. Interventional studies were included only to collect the baseline (observational) data. Data Collection and Analysis: From 52 studies, a total of 13 studies could be included in the systematic review and 8 in meta-analysis. Total scores of OHRQoL measures reported in the child perceptions questionnaire (CPQ) 8–10, CPQ 11–14, and parental-caregiver perception questionnaire (P-CPQ) scales were used as variables. Main Results: Five studies (2112 subjects) showed an impact on OHRQoL (CPQ); the pooled risk ratio (RR) confidence interval (CI) were 24.70 (13.93–35.47), showing statistically significant value (P < 0.001). The Three studies (811 participants) showed an impact on OHRQoL (P-CPQ); the pooled RR (CI) was 16.992 (5.119, 28.865) showing statistically significant value (P < 0.001). Heterogeneity (I2) was high (99.6% and 99.2%); hence, random effect model was used. Sensitivity analysis of two studies (310 subjects) showed impact on OHRQoL (P-CPQ); the pooled RR (CI) was 22.124 (20.382, 23.866) showing statistically significant value (P < 0.001); the heterogeneity was low (I2 = 0.0). The risk of bias across studies assessed using the appraisal tool for cross sectional studies tool was found to be moderate. The reporting bias assessed using the dispersion on the funnel plot was found to be minimal. Authors' Conclusions: Children with MIH are about 17–25 times more likely to have impacts on the OHRQoL compared to children with no MIH. Evidence is of low quality due to high heterogeneity. The risk of bias was moderate and publication bias was low