Journal of South Asian Association of Pediatric Dentistry

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Volume 5, Number 2, May-August 2022

INVITED EDITORIAL

Bharathi M Purohit, Harsh Priya

Dental Caries in Children is not only Health Issue but also a Matter of Concern as Social Injustice and Inequality

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:2] [Pages No:57 - 58]

Keywords: Caries burden, Oral health inequality, Socioeconomic position, Underprivileged children

   DOI: 10.5005/jp-journals-10077-3236  |  Open Access |  How to cite  | 

Abstract

Dental caries is a one of the major public health problems globally and at the same time it is also one of the preventable diseases. Research has shown that a lower socioeconomic position (SEP) is related to poorer health and oral health outcomes. Low SEP is directly linked to accessibility and affordability of dental care services. It is important to identify and understand the various components of SEP affecting the oral health, particularly with reference to developing countries, so as to direct the already constrained resources toward high-risk groups.

ORIGINAL RESEARCH

Anshula N Deshpande, Yash S Shah, Aishwarya Jain

Effectiveness of Euphemism with and without Self-designed Pictorial Flashcard in the Form of Dental Pictionary as Behavior Modification Technique in 4–6-year-old Children: A Randomized Controlled Study

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:5] [Pages No:59 - 63]

Keywords: Behavior modification, Dental Pictionary, Euphemism, Facial image scale, Flashcards

   DOI: 10.5005/jp-journals-10077-3233  |  Open Access |  How to cite  | 

Abstract

Background: Various linguistic, innovative, and pharmaceutical therapies have been established to control children's anxious and cooperative behaviors. The use of euphemism in verbal communication is an important part of behavior modification. A dentist's or a staff's choice of words is crucial in order to influence the patient's emotional state. The aim of the study was to evaluate and compare the anxiety level and pulse rate of children with and without using Dental Pictionary in the form of flashcards as a behavior modification technique. Materials and methods: A total of 148 children were included in the study, aged between 4 and 6 years, and divided into two groups. Group A—behavior modification using Dental Pictionary in the form of flashcards and group B—behavior modification without using flashcards. The study was carried out in two visits. Before and after intervention pulse rate, facial image scale (FIS), and Venham scale (VS) were recorded. Results: A statistically significant difference was found between group A and group B regarding pulse rate, FIS, and VS (p = 0.001). Conclusion: Dental Pictionary based on euphemism was found to be a promising behavior modification technique for 4–6-year-old children.

ORIGINAL RESEARCH

Siragam Pavani Lakshmi, Suzan Sahana, Aron Arun Kumar Vasa, Done Vasanthi

Caries Inhibition Potential of Salivarius M18 Probiotic in High-risk Children

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:6] [Pages No:64 - 69]

Keywords: Dental caries, Probiotics, Streptococcus mutans, Streptococcus salivarius M18

   DOI: 10.5005/jp-journals-10077-3227  |  Open Access |  How to cite  | 

Abstract

Background: Preventive interventions that aim to halt or slow caries progression provides a practical solution for minimizing the problems stemming from caries. From the oral health perspective, the probiotic approach has been a popular method for modulating microbial communities. Aims: To evaluate the effect of Streptococcus salivarius M18 (Salivarius M18) probiotic in reducing plaque formation and lowering Streptococcus mutans counts when given as a daily supplement to children with high caries risk. Settings and design: A total of 60 children in the age-group of 6–12 years and those classified as “high risk” for caries on the basis of caries management by risk assessment (CAMBRA) were included. Materials and methods: Among the study participants, 30 were supplemented daily for 90 days with Salivarius M18 probiotic, and the remaining 30 served as untreated controls. All participants were subjected to evaluation of various parameters at baseline and 90 days following intervention. This included the decayed, missing, and filled teeth (DMFT)/dmft index, plaque index (Silness and Loe, 1964), and salivary S. mutans count (CFU/mL). The obtained data were compared with baseline scores; intergroup comparisons were made and subjected to statistical analysis. Statistical analysis: Wilcoxon's signed-rank test and Mann–Whitney U test were used for intra- and intergroup comparisons. Results and conclusion: Intergroup comparison showed statistically highly significant difference with respect to S. mutans counts and plaque scores. The Salivarius M18 probiotic can be recommended as a means of caries preventive intervention for children at high risk.

ORIGINAL RESEARCH

Priya Subramaniam, Simerleen K Ghai, Megha Gupta

Evaluation of Caries Management by Risk Assessment in 3–6-year-old Children at High Caries Risk

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:5] [Pages No:70 - 74]

Keywords: CAMBRA, Caries risk assessment, CPP-ACP, Fluoride varnish, High caries risk

   DOI: 10.5005/jp-journals-10077-3226  |  Open Access |  How to cite  | 

Abstract

Objective: Caries management by risk assessment (CAMBRA) is an integral component of dental caries management. The aim of this study was to evaluate caries management in 3–6-year-old children with high caries risk. Study design: Forty children aged 3–6 years who were at high risk for dental caries were selected. Dental plaque was assessed using Silness and Loe plaque index. Dental caries were recorded using def index and International caries detection and assessment system II (ICDAS II). Plaque levels of mutans streptococci (MS) and resting salivary pH was assessed. All the children received oral prophylaxis, sealants, restorations, and motivational interviewing (MI). The children were divided into two groups, group I and group II of 20 children each. Only group II received fluoride varnish application and a remineralizing toothpaste. All the children were examined for dental plaque and caries at 3-month intervals. At the end of 1 year, plaque levels of MS and resting salivary pH were assessed. Ten children from each group were randomly evaluated caries progression. Data were statistically analyzed. The level of significance was 5%. Results: Mean deft of group I increased from 4.2 to 4.45, which was significantly higher than 3.35 of group II (p = 0.04). In group I, the number of non-cavitated lesions was higher, and there was a significant difference in the number of cavitated lesions (p = 0.04). Mean dental plaque scores showed a significant reduction in group II (p < 0.05). In both groups, there was a significant increase in salivary pH (p < 0.05) and a significant reduction in plaque MS levels (p < 0.05). Conclusion: The use of fluoride varnish and remineralization using casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) proved to be effective in the caries prevention for high risk children.

ORIGINAL RESEARCH

Andrea Natalia Mascarenhas, Pallavi Urs, CH Chandana Krishna Shree, HR Pooja, Richa Lakhotia, Priya Nagar

Minimizing Odontophobia in Children Using Colored Compomers in Restorative Pediatric Dentistry

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:7] [Pages No:75 - 81]

Keywords: Anxiety, Anxiety rating scale, Behavior modification, Child, Composite resins, Cooperative behavior, Dental, First, Future, Pediatric dentistry, Preventive dentistry, Postgraduate, Research, Restorative care, Visit, Work opportunity

   DOI: 10.5005/jp-journals-10077-3228  |  Open Access |  How to cite  | 

Abstract

Aim: To assess the levels of dental anxiety in children receiving restorations of multicolored compomers compared with those receiving traditional composite. Materials and methods: A total of 30 children belonging to the age group of 5–12 years of age with occlusal caries in the primary or secondary posteriors after fulfilling the inclusion and exclusion criteria were grouped based on their preference of restorative material into three groups of (1) traditional composite, (2) blue compomer, and (3) pink compomer. Frankl behavior rating scale was used to assess the dental behavior of each child participating in the study, while Venham picture test was used to assess the anxiety levels among children pre and postdental procedure. The obtained data were collected and subjected to statistical analysis. Results: Children who preferred multicolored compomers showed an increased reduction in anxiety levels when compared to those who preferred traditional composite. Majority of the female participants preferred pink compomers over blue or white, whereas males majorly preferred blue over pink compomers. The younger age group showed a tendency of choosing the multicolored compomers over traditional composite when compared to the older age group. Overall result showed that children who preferred traditional composite over the multicolored compomers were significantly lesser. Conclusion: Multicolored compomers among child patients can yield a beneficial advantage to instill a positive dental behavior and attitude in the dental operatory. Clinical significance: The authority given to the child by the pediatric dentist, of choosing the color of restorative material of their preference, helps them to actively participate in the treatment procedure, thus exhibiting immense improvement in their behavior pre and postdental procedures.

ORIGINAL RESEARCH

Komali Paruvada, Jayalakshmi Pandranki, Narasimha Rao V Vanga

Diagnostic Accuracy of Absorption Elution Assay to Detect Specific Blood Group Antigens in Saliva of Children

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:6] [Pages No:82 - 87]

Keywords: Absorption elution method, Blood typing, Saliva, Specific blood group antigens

   DOI: 10.5005/jp-journals-10077-3235  |  Open Access |  How to cite  | 

Abstract

Context: Invasive blood typing during a research process induces fear and anxiety in children. Specific blood group antigens, being the exclusive domain of the erythrocyte were also reported in bodily secretions like sweat, semen, and even saliva. Aims: To determine the sensitivity, specificity, and diagnostic accuracy of absorption elution assay to identify blood group antigens in the saliva of children and to validate its usage in blood grouping and Rhesus (Rh) typing. Materials and methods: Unstimulated saliva was collected from 60 schoolchildren who have already undergone blood investigations. The samples were subjected to absorption elution assay to screen for the presence of Rh factor and A and B antigens. The data obtained were statistically analyzed using Pearson's Chi-square test. Results: The sensitivity, specificity, and diagnostic accuracy of absorption elution assay to detect Rh factor in saliva were 85.71, 75, and 84.96%, respectively, for screening blood group antigen A were 80, 97.78, and 93.33%, respectively, and for screening blood group antigen B were 80.95, 97.44, and 91.67%, respectively. About 80% of the findings from the absorption elution assay matched with the medical records with a statistically significant difference (p-value < 0.001). Inference: Sensitivity, specificity, and diagnostic accuracy values obtained indicate that absorption elution assay could be a valid diagnostic method to screen blood group antigens in saliva.

CASE REPORT

Anuja Goit, Sonal Gupta, Shilpi Dutta

Bardet-Biedl Syndrome: A Rare Entity

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:4] [Pages No:88 - 91]

Keywords: Bardet-Biedl syndrome, Ciliopathy, Polydactyly

   DOI: 10.5005/jp-journals-10077-3224  |  Open Access |  How to cite  | 

Abstract

Bardet-Biedl syndrome (BBS) is a rare ciliopathy autosomal recessive hereditary disorder due to mutation in 14 genes. It affects multiple organ systems such as renal dysfunction, congenital heart disease, ocular defect, cognitive impairment, and speech disorder and presented clinically as truncal obesity, polydactyly, along with a history of diabetes mellitus, hypertensive, and rod-cone dystrophy. Dental anomalies are also present in the majority of the affected population due to abnormal embryonic orofacial and teeth development. As a dentist, it is difficult to encounter the diagnosis of such a rare disease. Thus, here is a case report emphasizing the oral pathology associated with multiple clinical phenotypic expressions.

CASE REPORT

Amith Adyanthaya, Aparna Sivaraman, CR Sangeetha, Reshma Aloysius, K Risana, Swetha S Nair

Full Mouth Rehabilitation of an Adolescent Patient with Ectodermal Dysplasia: A Case Report

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:4] [Pages No:92 - 95]

Keywords: Fixed prosthesis, Hypohidrotic form, Oligodontia

   DOI: 10.5005/jp-journals-10077-3225  |  Open Access |  How to cite  | 

Abstract

Ectodermal dysplasia comprises genetic disorders of divergent groups that include dystrophies of ectodermally derived structures and their accessory structures, including hair, glands, teeth, skin, and nails. The most frequent dental features in these patients involve complete or partial anodontia and altered morphology of teeth. Oligo-anodontia is considered to be an appalling impairment, and it has an impact on functional, aesthetic, and psychosocial well-being. This case report illustrates the oral rehabilitation of an adolescent patient with hypohidrotic ectodermal dysplasia (HED) by employing a fixed prosthesis. The treatment objectives were to accomplish an oral rehabilitation that was functional, provided aesthetics, and improve the self-esteem of the patient. Oral rehabilitation using a fixed prosthesis in this patient proved to be an acceptable treatment modality.

CASE REPORT

Mallayya C Hiremath, Srinath Krishnappa, Sahana Srinath, Raja Jayadeva Nayak, Aarcha S Kumar

Dental Management of Prader-Willi Syndrome in a 7-year-old Girl: A Rare Case Report

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:5] [Pages No:96 - 100]

Keywords: Dental management, Genetic, Pyogenic granuloma, Syndrome

   DOI: 10.5005/jp-journals-10077-3231  |  Open Access |  How to cite  | 

Abstract

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by a lack of expression of paternal genes located on chromosome 15q11-q13. Prader-Willi syndrome is characterized by hypothalamic dysfunction. This anomaly causes cognitive, neurological, and endocrine abnormalities, among which hyperphagia is the important feature. Prader-Willi syndrome is of interest to the dentist because PWS is associated with atrophy of salivary glands leading to decreased salivary secretion and increased risk for dental caries and gingivitis. The present case report describes a clinical case of a 7-year-old girl with PWS. The case presented with multiple carious teeth, partial ankyloglossia, and pyogenic granuloma of gingiva. Restorations were done for carious teeth and 64, 83 were extracted under local anesthesia, and an excisional biopsy of the gingival lesion was done. Periodic dental visits and early interventions are needed to improve the oral health of children with PWS.

CASE REPORT

Anisha Kakran, Ruchi Singhal, Ritu Namdev, Shefali Negi, Himani Kaushik, Saurabh Narang

An Innovative Approach to Treat Discolored Anterior Teeth: A Novel Method

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:4] [Pages No:101 - 104]

Keywords: Discoloration, Esthetic treatment, Etch-bleach-seal, Fluorosis, Microabrasion

   DOI: 10.5005/jp-journals-10077-3232  |  Open Access |  How to cite  | 

Abstract

Introduction: Discoloration of anterior teeth is not uncommon and can be due to a variety of reasons including genetic and environmental factors. Discolored teeth are not well mineralized and are prone to sensitivity and caries. Therefore, their early management is necessary. Case presentation: Three patients were presented to the Department of Pedodontics, PGIDS, Rohtak, with chief complaint of mild to moderate fluorosis. Microabrasion followed by etch bleach and seal was performed to remove the fluorotic stains. Results were found to be satisfactory with the following technique. Discussion: There are many treatment approaches varying from conservative to invasive treatment options like microabrasion, etch-bleach-seal, bleaching, veneering, and crowns. Veneers and crowns should be avoided in young permanent teeth as the tooth structure loss is more in these techniques which can further lead to sensitivity. But nowadays, dentistry has shifted to more conservative sides as preservation of tooth structure has been considered to be of at most importance. Therefore, this article deals with the effects of the combination of two conservative treatment approaches that is microabrasion and etch-bleach-seal, which can be carried out to treat mild to moderate discolorations.

CASE REPORT

Gaurav Gupta, Dinesh Kumar Gupta, Priyanka Gupta, Parth Shah

Customized Digital Restoration: An Innovative Minimally Invasive Approach to Restore Young Permanent Molars: Case Series

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:5] [Pages No:105 - 109]

Keywords: Customized, Digital workflow, Young permanent molars, Zirconia restoration

   DOI: 10.5005/jp-journals-10077-3234  |  Open Access |  How to cite  | 

Abstract

Background: Crowns are provided for teeth that have extensive caries, developmental defects, or decalcified following pulpectomy/root canal treatment (RCT). Until now, prefabricated crowns have been available of varying sizes to match molars which require replacement after adolescence. Materials and methods: This case series illustrates an innovative technique of customized digital restoration (CDR) with the use of computer-aided design and manufacturing (CAD-CAM) for the fabrication of customized tooth-colored zirconium restoration for grossly decayed young permanent molars. Result: Customized digital restoration is made through CAD-CAM which is more precise for young permanent molars. Conclusion: This approach has the advantage of customization and definitive restoration in contrast to the prefabricated, unesthetic, and provisional options.

REVIEW ARTICLE

U Deepika, Louis S Simon, Susmita Murmu, Kanika Chopra, Althwaf Shajahan, Soumit Kumar Hota

Upshot of Fluoride Varnish in Downgrading Hypersensitivity of Molar Incisor Hypomineralized Teeth: A Systematic Review and Clinical Considerations

[Year:2022] [Month:May-August] [Volume:5] [Number:2] [Pages:6] [Pages No:110 - 115]

Keywords: Management of hypersensitivity of MIH, Management of MIH, MIH hypersensitive, MIH management

   DOI: 10.5005/jp-journals-10077-3229  |  Open Access |  How to cite  | 

Abstract

Aim and objective: To critically evaluate and compare the effect of fluoride varnish (FV) with other recent materials used to reduce the hypersensitivity of molar incisor hypomineralization (MIH) affected teeth. Methodology: The search in electronic databases like MEDLINE, Cochrane, Scopus, Google Scholar, ScienceDirect, and Embase from January 2000 to December 2021 was done to identify studies on the management of hypersensitivity in MIH-affected teeth. The keywords used were MIH hypersensitive, MIH management, management of hypersensitivity of MIH, and management of MIH. Initially, the titles and abstracts were screened to rule out duplicate articles and to evaluate the materials, participants, and assessment methodology. The selected articles were completely screened to assess the risk of bias of the articles. Cochrane's risk of bias was at high risk and might be misleading, so a meta-analysis was not performed. Results: Thousand hundred eighteen studies were identified at the first level of search. After a thorough screening, three studies that met the inclusion criteria were selected. Conclusion: Non-fluoridated remineralizing agents had better efficacy in reducing the hypersensitivity in MIH-affected teeth than FV, fluoridated remineralizing agents, and low-level laser therapy (LLLT). At the same time, the effectiveness of the non-fluoridated remineralizing agent improved when it was used along with ozone therapy.

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