Journal of South Asian Association of Pediatric Dentistry

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Volume 7, Number 1, January-April 2024
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Richa Khanna

First Dental Visit of a Child at Age 1: A Policy Proposal

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:2] [Pages No:1 - 2]

   DOI: 10.5005/jp-journals-10077-3301  |  Open Access |  How to cite  | 



Aditi Kapur

Which Toothpaste Should My Child Use? Can We Answer That Yet?

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:2] [Pages No:3 - 4]

   DOI: 10.5005/jp-journals-10077-3300  |  Open Access |  How to cite  | 



Anshula N Deshpande, Aishwarya Jain, Brijesh Tailor, Vidhi Jaiswal, Pooja Bane, Simron Baishya

Morphology of Maxillary Frenum and Correlation to Diastema in Children with Primary, Mixed, and Permanent Dentition

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:6] [Pages No:5 - 10]

Keywords: Diastema, Incisor, Labial frenum

   DOI: 10.5005/jp-journals-10077-3295  |  Open Access |  How to cite  | 


Context: The labial frenum is subject to change with growing age and physical development. It is thought to be a contributing factor to maxillary diastema. Aims: The study aims to check the frenal morphology and midline diastema at different stages of dentition. Materials and methods: Clinical examination of frenum and midline diastema of 515 children with different stages of dentition was carried out. Sewerin's typology and Placek et al.'s classification for attachment level were used. Results: Association was found significant for both spacing (p = 0.001) and midline diastema (p = 0.018). Morphology of frenum, which was prevalent for all three types of dentition, was simple frenum and mucosal type of attachment in primary (47.1%) and permanent (37.6%), whereas it was gingival in mixed dentition (44.3%). The association between dentition and morphology and frenum attachment was found to be significant (p = 0.024 and 0.001, respectively). Crosstabulation for midline diastema with morphology and frenum attachment was found to be highly significant (p = 0.001). Conclusion: As the type of frenal attachment differs depending on the type of dentition, it is crucial to comprehend the relationship between a child's age, the type of frenal attachment, and the morphology in order to prevent misdiagnosis and inconsequential treatment.



Ramanathan Ravi, Tanu Nangia, Law Phui Wai, Beh Tjun Qi, Eunice Soo Liang Yi, Lee Xin Jie, Htoo Htoo Kyaw Soe

Knowledge, Awareness, and Attitude about Basic Life Support and Emergency Medical Services among Dental Students in Manipal University College Malaysia: A Cross-sectional Study

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:5] [Pages No:11 - 15]

Keywords: Attitude, Awareness, Basic life support, Emergency medical services, Knowledge

   DOI: 10.5005/jp-journals-10077-3296  |  Open Access |  How to cite  | 


The incidence of cardiovascular disease (CVD) is on the rise among dental patients, leading to an increased risk of developing emergencies. Life-threatening emergencies may not be common to happen in a dental office, however, the likeliness to occur has increased with increased levels of stress. A dental practice is mired in many risks that lead to life-threatening emergencies. Therefore, all dentists must have sufficient knowledge and be versed with the protocols to manage and handle critical situations and emergencies effectively and efficiently, which is life-saving and imperative in a dental setting. Aim: To assess the knowledge, awareness, and attitude among year 3, 4, and 5 dental students regarding basic life support (BLS). Materials and methods: A cross-sectional study was conducted on a sample of dental students (n = 183) in Manipal University College Malaysia (MUCM). Participants completed the Microsoft (MS) form questionnaire, including questions to obtain students’ demographics and questions to evaluate their knowledge, awareness, and attitude of students toward BLS. These questions were then analyzed using the Chi-squared test and Fisher's exact test. Results: All of them (183) completed the survey with a response rate of (100%). Female participant's awareness was higher than the male counterparts, but it did not differ significantly (p-value > 0.05). Year 3 dental students showed a higher awareness level compared to year 4 and 5 dental students (p-value > 0.05). There was a significant difference in the attitude of students toward BLS among year 3, 4, and 5 dental students (p-value < 0.05). Conclusion: Despite students exhibiting a positive attitude toward BLS training, some of them never underwent any formal BLS training. This gap must be bridged immediately to address this issue. Basic life science programs must not only be imparted in the course curriculum but be updated at constant intervals and time.



Kalyani Boorela, Aron AK Vasa, Suzan Sahana

Process Drama as a Tool in the Management of Dental Fear and Anxiety

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:5] [Pages No:16 - 20]

Keywords: Dental anxiety, Dramatic framing, Process drama

   DOI: 10.5005/jp-journals-10077-3289  |  Open Access |  How to cite  | 


Background: Fear of a dental visit leads to avoidance or delay in seeking treatment, which adversely affects a child's oral and psychological health. Children who are worried about going to the dentist may benefit from preliminary knowledge and coping mechanisms created through dramatic framing. Objectives: The aim was to identify children's actual causes of dental fear and anxiety (DFA) and to develop anxiety-minimizing strategies outside a dental setting through process drama. Materials and methods: A total of 60 children between the ages of 8 and 11 were chosen to take part in the process drama workshop. A classroom depicting the scenario of a pediatric dental clinic and a child anxiously waiting for her first dental visit was dramatized in sequence. Through roleplay activity, causes of dental anxiety were identified, and strategies for minimizing it were developed by children. The levels of anxiety were measured using three different rating scales at various intervals. Statistical analysis: The data analysis was done using Statistical Package for the Social Sciences (SPSS) v22 software, analysis of variance (ANOVA), repeated ANOVA, and post hoc Tukey's tests were used for comparative analysis of scores. Results: A statistically significant difference was found in the anxiety scores of children, which were higher at the beginning of the workshop compared to levels after the session. Conclusion: Process drama was found to be effective both in identifying the causes as well as developing strategies to minimize DFA; hence, it can be recommended as a tool to sensitize children awaiting dental visits.



Reshma E Rajan, Sowndarya Gunasekaran, Veena Arali, Vijayakumar Mohan, Arya A Vargheese, Yash S Latkar

Assessing Behavior and Anxiety among 3–9-year-old Children during Local Anesthesia Administration Using Conventional and Camouflaged Syringes: A Randomized Split-mouth Design

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:6] [Pages No:21 - 26]

Keywords: Behavior management, Dental anxiety, Distraction technique, Local anesthesia, Pediatric dentistry

   DOI: 10.5005/jp-journals-10077-3299  |  Open Access |  How to cite  | 


Aim and background: Childhood dental fear often stems from painful stimuli and heightened pain perception. Needles, perceived as threatening instrument, triggers anxiety, exacerbating pain memory. Camouflaged syringes, shaped like toy alligators, conceal the instrument alleviating children's anxiety. This study aims to evaluate whether camouflaged syringes compared to conventional syringes have a favorable impact on the behavior and anxiety levels of the children according to variations in pulse rates, Face, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and facial image scale (FIS). Materials and methods: The study included 60 children divided into two age-groups (3–6 years and 6–9 years). It was also registered in Clinical Trials Registry, India (CTRI) as a prospective study with CTRI number CTRI/2023/08/056189. Conventional syringes were used in the first appointment, and camouflaged syringes in the second, employing a split-mouth design. Prior to block administration, a topical anesthetic gel was applied. Pulse rates were noted before and during the block administrations using a pulse oximeter. Behavior was evaluated by the FLACC scale before and during the administration of local anesthesia (LA). After the injection, children were expressed their anxiety during the block administration using FIS. Paired sample t-tests were used for (p ≤ 0.05) assessing significant differences in bivariate samples. Results: In 3–6-year-olds, camouflaged syringes significantly improved FLACC pain scale and reduced anxiety according to FIS during LA, positively impacting children's behavior. Conclusion: Camouflaged syringes have a positive impact on children's behavior, especially in the 3–6-year-old age-group where cognitive abilities are limited. They enhance distraction, effectively reducing anxiety levels.



Iqbal Singh, Rakesh K Gupta, Parveen A Lone, Manisha Koul, Manik Sharma

Prevalence of Dental Caries and Oral Hygiene Status of Children Aged 12–15 Years in Government vs Private Schools in Jammu City

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:4] [Pages No:27 - 30]

Keywords: Caries, Children, Decayed, missing, filled teeth index, Oral health status, Oral hygiene index

   DOI: 10.5005/jp-journals-10077-3298  |  Open Access |  How to cite  | 


Introduction: The aim of this research was to contrast and assess the levels of oral hygiene and caries experience among children in government and private schools in Jammu region, India. Materials and methods: The study was conducted among 1,564 schoolchildren aged 12–15 years. By combining a stratified random sampling approach with cluster sampling, research participants were selected. Intraoral examination was recorded in the World Health Organization (WHO) Oral Health Assessment Form for Children 2013, and decayed, missing, filled teeth (DMFT) index and oral hygiene index simplified (OHI-S) were used for recording the oral health status. Results: The mean OHI-S for students in government schools was higher, 2.3 ± 2.91, than the mean OHI-S for students in private schools, 1.6 ± 1.79. In contrast to the children from government schools, where 37.1% of school students had good scores in oral hygiene, 66.5% of students from private schools were found to have good oral hygiene. Government school students had higher mean DMFT scores (1.06 ± 1.63) than those attending private schools (0.49 ± 1.46). The mean OHI-S score and the mean number of decayed teeth in the students attending government schools showed a strong positive correlation. Conclusion: Children who attend government schools have significantly poor oral health than children who attend private schools. The oral health interventions need to be planned in such a way that government schoolchildren should be prioritized due to poor oral health status and lack of access to dental care facilities.



Nidhi Yadav, Ajay Parihar, Prashanthi Reddy, Arun D Sharma

Evaluating the Concept of Oral Manifestation of Thalassemia Major and Its Dental Consideration: A Report on Two Cases and a Literature Review

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:7] [Pages No:31 - 37]

Keywords: Case report, Chipmunk facies, Dental consideration, Gingival hypertrophies, Salt and pepper appearance, Thalassemia major

   DOI: 10.5005/jp-journals-10077-3292  |  Open Access |  How to cite  | 


Background: Thalassemia is one of the most prevalent inherited diseases in the world, posing public health and societal challenges in high-risk locations. Thalassemia can be classified into two types—α-thalassemia and β-thalassemia, which are caused by abnormalities in the synthesis of hemoglobin (Hb) α- or β-polypeptide chains. Reduced synthesis of one of the two globin polypeptides leads to diminished Hb production, resulting in hypochromic microcytic anemia with erythrocyte dysplasia and destruction. The case reports presented and evaluated here show distinctive orofacial features, classic radiographic features, and dental considerations in thalassemia major patients. Conclusion: Thalassemia major causes several orofacial and systemic problems, which worsen with age. Early diagnosis and management result in a better prognosis and decreased morbidity. Clinical significance: Dental practitioners, particularly those working in multiracial populations, need to comprehend the disease's complications and therapy.



Hitesh Chander Mittal, Sudhir Bhandari, Ashima Goyal, Aditi Kapur, Krishan Gauba

Customized Prosthetic Oral Rehabilitation of a Child with Hypohidrotic Ectodermal Dysplasia: A Case Report

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:4] [Pages No:38 - 41]

Keywords: Anodontia, Case report, Child, Dentures, Ectodermal dysplasia, Esthetics, Hypohidrotic

   DOI: 10.5005/jp-journals-10077-3294  |  Open Access |  How to cite  | 


The present case report describes interdisciplinary prosthetic oral rehabilitation of a 7-year-old male child presenting classical features of hypohidrotic ectodermal dysplasia (HED) and subtotal anodontia. The treatment, in this case, was simplified and customized to address various challenges viz. behavioral management, limited hope, low education, and socioeconomic status as well as preserving the erupted two molars. The removable denture was designed to utilize erupted molars for retention with the help of thermoplastic material. The simplification of fabrication steps leads to the successful restoration of a young HED child's masticatory function and esthetics, as well as increased hope and cooperation for future definitive treatment.



VR Chandra Babu Pamidi, Padma Praveena Mavuri, Tripura Pavitra Javangula, Siva Ganesh Pampana, Sri Niharika Medisetti, Viritha Manupati

Use of Tongue Flap in Anterior Palatal Fistula Repair: A Case Report

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:4] [Pages No:42 - 45]

Keywords: Case report, Cleft palate repair, Oronasal fistula, Palatal fistula, Tongue flap

   DOI: 10.5005/jp-journals-10077-3293  |  Open Access |  How to cite  | 


Aims and background: Orofacial clefts are one of the most prevalent congenital anomalies worldwide and contribute significantly to the global burden. Cleft of the palate is widespread and negatively impacts health and child development, leading to social isolation, speech problems, malnutrition, and psychological effects. Case description: A 9-year-old child reported to the department with the chief complaint of regurgitation of liquids through the nose. The patient was diagnosed with an anterior palatal fistula. The present case report provides insight into the use of tongue flaps for palatal fistula closure and a brief review of other techniques. Conclusion: Though recurrent palatal fistula closure is a difficult condition, there are several treatments available, and the success of the treatment depends on the size and position of the fistula and clinical expertise. Clinical significance: Utilization of tongue flaps to close palatal abnormalities is associated with a low incidence of complications and a higher rate of success in both children and adults. When treating end-stage palatal anomalies, tongue flap closure is associated with a high success rate and a low rate of complications in both children and adults.



Prajakta Anadeo, Alka Gupta, Ashish Saxena, Shweta Pandey

Overhauling the Anophthalmos due to Retinoblastoma in Pediatric Patient: A Case Report

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:4] [Pages No:46 - 49]

Keywords: Anophthalmos, Case report, Enucleation, Ocular prosthesis, Retinoblastoma, Self-Esteem

   DOI: 10.5005/jp-journals-10077-3297  |  Open Access |  How to cite  | 


Anophthalmos, which means ”absence of eye,” is not only a physical or physiological but also a psychosocial burden on a growing child. Retinoblastoma has been found to be the most common tumor of ocular origin, management of which often includes enucleation of the affected eye, rendering the patient disabled. This article is intended to emphasize the rehabilitation of the enucleated left eye due to retinoblastoma by presenting a case of a 5-year-old child restored with a noninvasive customized ocular prosthesis fabricated by modifying the stock eye to achieve a comfortable fit, slight motility, and esthetics. The patient was assessed for compliance, level of satisfaction, and the need for replacement of the prosthesis at follow-up periods of 1, 3, and 6 months. This article encourages pediatric dentists to successfully manage minor patients and prosthetically rehabilitate the orofacial defects to facilitate the development of the orbital region and enhance the self-esteem of the child.



Amina Sultan, Simran Uppal, Akanksha Juneja

Axenfeld–Rieger Syndrome: A Case Report and Brief Review

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:5] [Pages No:50 - 54]

Keywords: Axenfeld–Rieger syndrome, Case report, Everted umbilicus, Glaucoma, Hypodontia, Oligodontia

   DOI: 10.5005/jp-journals-10077-3291  |  Open Access |  How to cite  | 


Axenfeld–Rieger Syndrome (ARS) is a rare autosomal dominant genetic disorder with an overall incidence of 1:200,000 that has mainly ocular, periumbilical, and dental abnormalities like oligodontia/hypodontia, microdontia, and delayed eruption of permanent teeth. Its management requires a multidisciplinary approach involving a team of dentists, ophthalmologists, cardiologists, and general physicians, along with regular follow-up. Pediatric dentists play a crucial role in such patients, as a timely diagnosis could prevent ocular complications such as glaucoma in later stages. This paper presents a case report with the classical signs and symptoms of ARS in a 12-year-old female patient demonstrating oligodontia, microdontia, and short roots.



Urvashi Sharma, Namrata C Gill, Anubha Gulati

Shape Dental Anomalies in Children and Their Implications on Permanent Successor Teeth: A Literature Review

[Year:2024] [Month:January-April] [Volume:7] [Number:1] [Pages:12] [Pages No:55 - 66]

Keywords: Children, Dental anomalies, Permanent dentition, Primary dentition

   DOI: 10.5005/jp-journals-10077-3288  |  Open Access |  How to cite  | 


Background: Dental anomalies of shape are developmental and morphological alterations in teeth resulting from genetic and/or environmental factors. Such anomalies may lead to compromised esthetics and function, dental caries, malocclusion, and periodontal problems. Additionally, a close interrelationship has been observed between dental anomalies of primary and permanent successor teeth. Aim: To study the prevalence and presentation of dental anomalies of shape in 2–5-year-old nonsyndromic children and observe its effect, if any, on successor teeth. Methods: The literature was searched independently by three reviewers for primary double teeth (PDT), fusion, gemination, talon cusp, dens invaginatus, taurodontism, and dilaceration, using the “PubMed” database for articles published between the years 2000 and 2018. Results: Of the 591 articles retrieved, 48 articles (41 case reports/case studies and seven observational studies) were selected. The prevalence of shape dental anomalies ranged from 1.8 to 4%. Fusion was the most common anomaly. Around 71% of the involved teeth had associated dental problems, and in 29% of cases, permanent successor teeth were affected. Conclusion: The results confirmed the clinical importance of these anomalies and observed a close association between dental anomalies of primary teeth and permanent successor teeth. Dental anomalies, even in this age-group, must be viewed seriously. A radiographic examination is recommended for early detection and an appropriate treatment plan.


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