Comparative cariostatic efficacy of a novel Nano-silver fluoride varnish with 38% silver diamine fluoride varnish a double-blind randomized clinical trial

To evaluate the clinical cariostatic efficacy of a concocted 5% Nano-silver incorporated Sodium fluoride (NSSF) dental varnish with 38% Silver diamine fluoride (SDF) in preventing the progression of dentinal caries of primary molars. A total of 159 active dentinal carious lesions in primary molars (from 50 children) were selected and randomly divided into two groups; NSSF and SDF. Varnish application was performed at the baseline visit and follow-up is carried out at 1, 3, 6 and 12 months. Parameters such as caries activity, depth, size, colour, and presence or absence of pain were noted at baseline and follow-up visits. The intergroup comparison of caries activity status did not reveal significant difference between the number of active and arrested caries lesions in NSSF and SDF groups at any visit (p >0.05) during the 12-month follow-up. There was no difference between overall failure and success rates between the two groups at any follow-up period (p-0.48). Annual application of 5% NSSF is better than or equal to 38% SDF in preventing the progression of dentinal caries of primary molars. NSSF does not cause dark staining of dentinal tissue compared to the SDF and the use of NSSF can be recommended in children

Dentin dysplasia type I with pyogenic granuloma in a 12-year-old girl

This paper presents a case of dentin dysplasia, a rarely reported disorder that is also associated with pyogenic granuloma in a 12-year-old girl. The case presented as excessively mobile teeth that appeared radiographically as rootless teeth and also as a soft tissue lesion in the right maxillary anterior region

Effect of Deep Breathing Exercise using Smartwatch on Behaviour, Anxiety and Pain in Children during Buccal Infiltration Anaesthesia-A Randomised Clinical Trial

Introduction: Despite the newer innovation and recent technological advances in modern dentistry, fear and anxiety constitute an important theme in dentistry. They are a usual reaction to stressful conditions that help children while staying alert in situations of an impending threat. Aim: To evaluate the effect of deep breathing exercise in reducing dental anxiety, behaviour and pain using smartwatch during maxillary buccal infiltration in children aged 7-11 years. Materials and Methods: A prospective interventional and single-blinded randomised clinical trial conducted in the Department of Paediatric and Preventive Dentistry, NDCH, Nellore, Andhra pradesh, India, from November 2019 to October 2020. A total of 70 children of age between 7-11 years. They were randomly allocated into two groups, 35 in each. Children in group I were trained for deep breathing exercise using smartwatch and group II (control group) was traditional tell show do technique. The reaction of children during maxillary buccal infiltration anaesthesia was recorded in terms of behaviour (Frankl behaviour rating scale), anxiety {Facial Image Scale (FIS) and pulse rate}, and pain perception (Wong-Baker FACES pain rating scale and face, leg, activity, cry and consolability scale). Data was tabulated using Kolmogorov-Smirnov test and Kruskal-Wallis for data distribution. Independent Student’s t-test or Mann-Whitney test (Quantitative variables) and Chi-square test or Mann-Whitney test (Qualitative variables) were used to test statistical significance using Statistical Package for Social Sciences (SPSS) version 25.0. Results: The mean age of children in smartwatch group was 8.9±1.4 years and in control group was 8.9±1.6 years with no statistical significant difference. Statistically significant decrease in pulse rate was observed in smartwatch group (p=0.003), subjective anxiety and pain was lowered in intervention group. Objective pain was decreased significantly in smartwatch group (p=0.007). Conclusion: Children performing deep breathing exercise using smartwatch had efficiency to reduce dental anxiety and pain perceived during maxillary buccal infiltration anaesthesia

Parents Attitude Towards Approaching the Paediatric Dentists During COVID-19 Pandemic: A Cross-sectional Study

Introduction: The infection potential of Coronavirus Disease 2019 (COVID-19) is remarkable due to its airborne transmission through droplets and aerosols. Paediatric dental needs were severely compromised during the COVID-19 lockdown period. Aim: To assess parents’ attitudes and concerns towards approaching paediatric dentists during the COVID-19 pandemic. Materials and Methods: This cross-sectional study was conducted in Department of Paediatric and Preventive Dentistry at Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India, from August 2021 to October 2021. The study included 200 parents to assess the attitudes and concerns towards approaching Paediatric dentists during the COVID-19 pandemic. A structured questionnaire was used through Google forms to collect from parents, information regarding precautions, mode of transmission of the virus and type of treatment option. The Chi-square test and Fischer-exact test were used to compare the parameters such as education and occupation with parents' attitude and knowledge. Results: Out of the 200 parents, 37 were males and 163 were females with mean age of the parents was 34.8 years. Out of total 200, 153 (76.5%) of the parents were worried to visit a Paediatric dentist. Only 56 (28%) of the children suffered from toothache during the pandemic. About 28 (14%) of parents believed that the virus is transmitted through the air and 70% of the parents preferred teledentistry. A 152 (76%) of them were willing to pay extra costs and 123 (61.5%) of respondents expected to treat the emergency condition alone. A statistically significant difference was not observed between different occupation in the answers given about transmission paths of a virus (p-value=0.39), extra payment (p-value=0.77), and preference of approach (p-value=0.223). Conclusion: Majority parents were worried to visit a Paediatric dentist and preferred teledentistry. They were ready to pay extra costs for the sanitisation

Atypical presentation of bilateral supplemental maxillary central incisors with unusual talon cusp

Delayed eruption of maxillary permanent central incisors in a child poses a distressing esthetic quandary to parents, by virtue of its location in the dental architecture. Well-aligned anterior teeth add confidence to smile and have enhanced self-esteem, which is critical even in early life. Impaction of the maxillary central incisors compared to third molars or the canines is less reported; bilateral supplemental maxillary central incisors related to impacted permanent maxillary central incisors are rare and one of the supplemental central incisors showing unusual talon is still infrequent. A case of impacted maxillary permanent central incisors related to supplemental maxillary central incisors, with one of them showing an unusual talon cusp, is presented

Success and Acceptability of Stainless Steel Crowns placed by using Hall Technique with Modifications: A Randomised Clinical Trial

Introduction: High frequency of caries in primary teeth and its inadequate treatment is major public health problem, that significantly affecting children’s lives. The Hall Technique (HT) is a novel method of caries management for treating primary molars compared to conventional treatment techniques used in primary health care settings. It is one of the methods used for biological sealing in carious primary molars, in which bacteria will be sealed from the oral environment thereby inactivating the carious lesion. This technique also increases the child’s compliance and operator comfort as the local anaesthetic administration is eliminated. Aim: To prospectively evaluate the clinical success and failure rate, and acceptability of Stainless Steel Crowns (SSC) placed using Hall Technique (HT) and with Modified Hall Technique (MHT) in rural school children aged 6-9 years. Materials and Methods: In a school-based setting, a randomised clinical trial was done on a total of 60 children (60 teeth) aged 6-9 years, who were randomly divided into two groups, 30 in each. In Group A (HT)- crowns were placed using the HT and in Group B (MHT)- MHT and follow-up were done at 3, 6, and 12 months. The acceptability of the technique for both the parents and children was evaluated with the questionnaire. The data analysis was carried out using a Statistical Package for Social Sciences (SPSS Version 21). Statistical significance was set at p<0.05. Results: In the HT group, the majority of crowns 26 (86.7%) were successful with 2 (6.6%) minor failures and 2 (6.6%) major failures, whereas the MHT group showed 100% success with no failures. On comparing Group A with Group B no significant differences were observed (p>0.05). Children’s acceptability and preference were more towards the MHT. Conclusion: The MHT was well accepted by children and the parents showed preference towards both the techniques

pH modulation and salivary sugar clearance of different chocolates in children: A randomized clinical trial

Background: Sugars that occur naturally in foods and those added in processed foods may act as the source for fermentable carbohydrates and may initiate caries process. Among all the foods consumed by children, chocolates form an important constituent. A wide variety of chocolates are available in the Indian market and very few studies have compared their acidogenicity and salivary sugar clearance. Objectives: To compare the acidogenicity and salivary sugar clearance of 6 different commercially available chocolates in the Indian market. Materials and Methods: Thirty subjects aged 10-15 years were selected randomly from one of the available public schools in Nellore city. Six commercially available chocolates in the Indian market were divided into three groups, unfilled (dark and milk chocolate), filled (wafer and fruit and nuts chocolate), and candy (hard milk and mango-flavored candy) groups. Plaque pH values and salivary sugar clearance rates are assessed at baseline, 5, 10, 15, 20, and 30 min after consumption. All the data obtained were statistically evaluated using independent sample t-test and one-way ANOVA for multiple group comparisons. Results: Mango-flavored candy had maximum fall in plaque pH and least fall in plaque pH was recorded with milk chocolate. Fruit and nuts chocolate had a maximum clearance of salivary sugar and least fall in the salivary sugar clearance was recorded with dark chocolate. When the plaque pH and salivary sugar clearance of all the chocolates were assessed, it was seen that the values were statistically significant at all the time intervals (P < 0.05). Conclusion: Dark chocolate had a high fall in pH and milk chocolate had low salivary sugar clearance which signifies that unfilled chocolates are more cariogenic than other chocolates. Even though mango-flavored candy had maximum fall in plaque pH, its salivary sugar clearance was high

Parental Knowledge, Attitudes, and Practices towards Self-medication for Various Oral Health-related Problems in Children: A Cross-sectional Study

Introduction: Over the years, there has been an increase in the practice of self-medication (SM) with over-the-counter drugs for dental conditions. Regarding paediatric patients, it is important for parents to have proper knowledge, attitude, and practice (KAP) regarding SM for their children. Aim: To assess the parental KAP towards SM for various oral health-related problems of children below 15 years of age. Materials and Methods: A cross-sectional study was conducted at schools in Nellore, Andhra Pradesh, India, between March 2021 and January 2022. A total of 323 parents of children aged up to 15 years were included in the study. Data were collected from parents through a prevalidated questionnaire to record their demographic details and KAP of SM. Fisher’s exact test was used to compare KAP of SM with the age, gender, education, and socioeconomic status (SES) of parents. Results: The most common medicine and reason for which SM was practiced were pain relievers (85%) and expensive dental treatment (39.8%), respectively. The pharmacist was the most common source of information for SM (46.9%) and drug dosage (46%). There was a significant association (p=<0.001) between children age groups and the presentation form of medicine. Additionally, statistically significant differences were found when comparing parents’ educational level and SES with dosage difference (p=0.01, p=<0.001), route of administration of medicine (p=0.04, p=<0.002), preference for expensive medicine (p=<0.001, p=<0.001), and reasons for not visiting the dentist (p=<0.01, p=<0.001), respectively. Furthermore, when SES was compared with course completion, a statistically significant difference was found (p=<0.05). Conclusion: Knowledge regarding SM practice was lower in the low educational and low SES groups