Journal of South Asian Association of Pediatric Dentistry

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2020 | January-June | Volume 3 | Issue 1

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Message from the Secretary

Message from the Secretary

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/jsaapd-3-1-iv  |  Open Access |  How to cite  | 



Mathur VP, Kalra G, Dhillon JK

COVID-19 Impact on Dentistry: Lesser Known Truth

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:2] [Pages No:1 - 2]

   DOI: 10.5005/jp-journals-10077-3044  |  Open Access |  How to cite  | 


Invited Opinion

Francisco Ramos-Gomez

Early Childhood Caries: Policy and Prevention

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:4] [Pages No:3 - 6]

Keywords: Dental caries, Infant care, Oral health, Pediatric dentistry, Perinatal care, Prevention and control, Risk assessment, Socioeconomic factors

   DOI: 10.5005/jp-journals-10077-3040  |  Open Access |  How to cite  | 


Background: Early childhood caries (ECC) is the most common chronic disease in children, aged 2–5 years, and is considered a priority action area by the World Dental Federation (FDI).1,2 The prevalence of ECC in children in India is extremely high and calls for immediate action.3 There is an urgent need for evidence-based oral health care and for the development of policies that support education, prevention, and healthy behaviors, specifically a national policy that recommends every child be seen by a dentist before the age of 1 year. Oral health is a matter of quality of life, overall health, social justice, and human rights. Materials and methods: There is a need to advocate for and promote a mandatory age-one visit to assess a child's risk level for ECC and establish a primary prevention plan. Effective oral health assessments for infants include six steps: caries risk assessment; knee-to-knee positioning of the child; toothbrush prophylaxis; a clinical examination; fluoride varnish treatment; and anticipatory guidance, counseling, and self-management goals. Recommendations: In order to increase oral health literacy and improve the oral health of children, certain recommendations should be prioritized and adhered to. These include the inclusion of risk assessment, anticipatory guidance, and self-management goals, an emphasis on ECC and oral health education, prioritizing primary prevention of ECC through healthy behaviors and the promotion of a mandatory age-one visit policy, interprofessional collaboration, and continued research of ECC inequalities and how to address them.



Ankita S Baheti, Deepak P Bhayya, Shilpi Gupta, Prabhat Kumar, Tarulatha R Shyagali

Assessment of Clinical Success of Three Sealants: Embrace-WetBond, Clinpro, and Helioseal-F in Permanent Molars: An In Vivo Study

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:7] [Pages No:7 - 13]

Keywords: Marginal integrity, Permanent molars, Pit and fissure sealants, Retention rate

   DOI: 10.5005/jp-journals-10077-3035  |  Open Access |  How to cite  | 


Purpose: To evaluate and compare marginal integrity, marginal discoloration, and retention rates of Embrace-WetBond (EW), Helioseal-F (HF), and Clinpro (CL) sealants in permanent molars. Materials and methods: Sealants were applied on 90 permanent mandibular molars in 48 children aged 6–14 years with deep pit and fissures, and evaluation of these sealants was performed using Ryge and Synder's criteria at 0, 2, 4, 6, 8, and 12 months. Results: Embrace-WetBond showed maximum marginal integrity (83.3%) as compared to CL (73.3%) and HF (60%) at the end of 12 months. Lack of marginal discoloration was highest in EW (93.3%) as compared to CL (76.7%) and HF (80%) at the end of 12 months. Embrace-WetBond showed highest retention (96.7%) as compared to CL (80%) and HF (73.3%) at the end of 12 months. The results were, however, statistically insignificant (p > 0.05). Conclusion: Embrace-WetBond sealant is better than CL and HF in terms of retention.



Shivangi Manek, Ashwin M Jawdekar

Assessment of Dietary Behavior Change in Families Participating in a “2-Week Sugar Challenge”: An Observational Study

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:5] [Pages No:14 - 18]

Keywords: Behavior, Diet, Environment, Families, Obesity, Parents

   DOI: 10.5005/jp-journals-10077-3036  |  Open Access |  How to cite  | 


Background: Dietary behaviors are a result of social and cultural practices; consumption of sugar-rich food and beverages being no exception. The World Health Organization (WHO) sugar guideline 2015 states that adults and children should reduce their daily intake of sugar to less than 10% of their total energy and a further reduction to 5% would provide additional health benefits. In view of this, a dietary behavior change pertaining to free-sugar reduction is needed in families. Aim: To assess the dietary behavior change in families participating in a “2-week sugar challenge” in terms of their willingness to participate and adherence to the challenge and defaults. Settings and design: A 2-week sugar challenge was conducted in a residential complex in Mumbai. Materials and methods: This study consisted of a convenient sample of 30 families with children belonging to 3- to 12-year age-group, who were approached for the study. They were given a list of products to be avoided and that could be consumed. Families and individuals were assessed for willingness to participate and adherence to the challenge. Statistical analysis: Variable means, standard deviations, and percentages were analyzed. Results: Of the contacted families, more than 80% (with children aged 3–12 years) were willing to participate in the study. Of the participating families, 2.70% and 3.22% of adults and children sustained the challenge for 2 weeks, respectively. None of the families as a whole could adhere to the challenge. The mean number of days the challenge was sustained by adults and children was 2.96 (±3.79) and 3.04 (±3.77), respectively. The most common defaulted food item was “milk additives.” Conclusion: Willingness in terms of sugar challenge was high but sustainability was poor.



Bhavna H Dave, Princy S Thomas, Parth B Joshi, Paridhi S Shah

Prevalence of Oral Melanin Pigmentation among Children of 4–14 Years of Age and its Association with Passive Smoking

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:4] [Pages No:19 - 22]

Keywords: Children, Melanin pigmentation, Oral pigmentation, Passive smoking

   DOI: 10.5005/jp-journals-10077-3034  |  Open Access |  How to cite  | 


Background: Smoking is one of the reasons for melanin pigmentation in the oral mucosa. This study was done to determine the prevalence of oral melanin pigmentation in children and its association with passive smoking. Aim: To determine the prevalence of oral melanin pigmentation in children among 4–14 years of age and its association with passive smoking. Materials and methods: This observational study was carried out among 600 children from oral health screening camps conducted in the government schools of Waghodia district, Vadodara, Gujarat. Gingival pigmentation was assessed on the basis of the Dummett oral pigmentation index (DOPI), and evaluation of exposure to environmental tobacco smoke (ETS) was done by taking through history. Results: Gingival pigmentation was seen in 395 children (65.83%). The Chi-square analysis is used to find the significance of study parameters on the categorical scale. The analysis of variance (ANOVA) is used to find the significance of study parameters between the groups (intergroup analysis). About 23.50% showed no pigmentation, 24.80% showed mild clinical pigmentation, 23.50% showed moderate clinical pigmentation, and 26.30% showed heavy clinical pigmentation. Conclusion: According to the result of this study, we could conclude that there is correlation between passive smoking and oral-melanin pigmentation in children.



Megha Pradhan, P Sudha

Evaluation of Clinicoradiological Orofacial Structures in Children with β-thalassemia Major

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:4] [Pages No:23 - 26]

Keywords: Chronological age, Demirjian's method, Dental age, β-Thalassemia major

   DOI: 10.5005/jp-journals-10077-3042  |  Open Access |  How to cite  | 


Background: Thalassemia is one of the most common genetic disorders worldwide. Orofacial manifestations are the result of bony changes occurring due to ineffective erythropoiesis, with the formation of a bone-expanding erythroid mass. The orofacial manifestations such as saddle nose, prominent malar bones, and proclined anteriors lead to characteristic “rodent facies.” Growth impairment is observed in most of the patients even under regular transfusions along with delayed dental development. Aims and objectives: To assess the orofacial manifestations clinically, compare the difference between chronological and dental age of β-thalassemia major subjects with that of normal using the Demirjian's method radiographically, and also to find out any association between the pretransfusion hemoglobin and dental development. Materials and methods: Forty β-thalassemia major-diagnosed subjects aged 3–16 years on regular blood transfusion were examined clinically for assessment of their orofacial features. Demographic data were collected including the pretransfusion hemoglobin level for at least 6 months. The “DMFT” and “dmft” indices were also assessed. Dental development was assessed along with their age- and sex-matched normal controls using the Demirjian's method for age estimation. Results were compiled and subjected to the statistical analysis. Results: Majority of the thalassemic patients in the study were in their first decade. Saddle nose was the commonest orofacial manifestations observed while the characteristic feature “rodent facies” was seen only in 9 (22.5%) subjects. The “DMFT” and “dmft” indices were high in thalassemic subjects than normal. Out of the 40 β-thalassemia major subjects, 37 demonstrated delay in development of their dentition by 7 months than the controls, which was significant statistically. No association could be found between pretransfusion hemoglobin and the delay observed. Conclusion: Decline in the occurrence of the “rodent facies” indicative of severe facial bone deformation could indicate the benefits of early diagnosis and regular transfusion but growth impairment in the form of dental developmental delay seen postulates a multifactorial etiology. Awareness must be given to β-thalassemia major subjects and their parents about oral health to achieve a better quality of life.



Bindu Kadian, Natasha Saini

Unilateral Mandibular Space Regaining with Modified Lingual Arch and Ni–Ti Open-coil Spring: A Case Report

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:3] [Pages No:27 - 29]

Keywords: Modified lingual arch, Ni–Ti open-coil spring, Space gain

   DOI: 10.5005/jp-journals-10077-3037  |  Open Access |  How to cite  | 


Premature extraction or exfoliation of deciduous tooth results in space loss which causes malocclusion. Interception of space loss by using space regainer aids in prevention of malocclusion. This article highlights the use of modified lingual arch and nickel–titanium (Ni–Ti) open-coil spring in unilateral space regaining of mandibular arch. The Ni–Ti open-coil spring along with cross-arch stabilization is the mechanics used in this study for space gaining.



Sneha S Kothare, Shikha Choubey, Aumiyo Das

Fragment Reattachment of an Uncomplicated Crown–Root Fracture: A Case Report

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:4] [Pages No:30 - 33]

Keywords: Fragment reattachment, Fragment rehydration, Periodontal health, Root fracture, Uncomplicated crown

   DOI: 10.5005/jp-journals-10077-3038  |  Open Access |  How to cite  | 


Traumatic dental injuries are very common in children and adolescents, with the line of treatment depending on the time elapsed, age of the child, and tooth maturity. Management of crown–root fractures is a multidimensional process involving management of the traumatized tooth as well as the adjacent soft tissues. The present case report is of a 10-year-old boy with an uncomplicated crown fracture of permanent maxillary right central incisor and a palatal uncomplicated crown–root fracture of his permanent maxillary left central incisor. Both the teeth were endodontically treated in a two-visit process, and gingivectomy was performed palatally with the left central incisor. The fractured fragment was reattached using nano-filled dual-cure composite resin and tooth restored with composite resin. The fragment showed opaque discoloration that reduced over time but still persisted after 1 year. During the follow-up period, no unfavorable radiographic changes were seen. The prognosis of the teeth was favorable with good esthetic results.



Management of Endodontic Instrument Separation in Primary Teeth

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:5] [Pages No:34 - 38]

Keywords: Endodontic instrumentation, Instrument fracture, Management, Primary teeth

   DOI: 10.5005/jp-journals-10077-3039  |  Open Access |  How to cite  | 


Background: Endodontic instrumentation is challenging in primary teeth due to narrow and curved roots that are under the influence of the physiological resorption process. Instrument separation in primary tooth root canal can have an adverse effect on erupting succedaneous teeth due to the persistence of infection and the risk of getting embedded into bone following root resorption. Case description: This paper comprised of a series of four cases with endodontic instrument separation at coronal third, middle third, apical third, and beyond apex in the root canal of primary teeth. All the cases were managed successfully using different strategies that include instrument retrieval, obturation and close periodic follow-ups, and the extraction of the involved tooth. Conclusion: Several factors determine the fate of the primary tooth with a separated instrument. Different management strategies can be tried considering the benefit vs risk in preserving the tooth.



Shagun Agarwal, Saumya Navit, Suleman A Khan, Seema Jabeen, Nishi Grover

Oral Rehabilitation of a Severe Early Childhood Caries Case with Prosthetic Intervention: A 12-Month Follow-up

[Year:2020] [Month:January-June] [Volume:3] [Number:1] [Pages:5] [Pages No:39 - 43]

Keywords: Dental caries, Diet, Prevention, Prosthetic rehabilitation, Severe early childhood caries

   DOI: 10.5005/jp-journals-10077-3041  |  Open Access |  How to cite  | 


Early childhood caries (ECC) is a rapid form of dental caries. It is the most common chronic childhood disease that can compromise a child's self-esteem, nutritional intake, oral development, and quality of life subsequently leading to malocclusion and psychological problems. Presence of poor oral hygiene, frequent use of sweetened beverages, and presence of high levels of Streptococcus mutans are some of the causative factors for this multifactorial disease. Management of these severely un-restorable primary teeth in children still remains a challenge to pediatric dentists all over the world. This case report presents the rehabilitation of 5½-year-old boy with severe early childhood caries (S-ECC) with 12 months follow-up for the same.


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