Journal of South Asian Association of Pediatric Dentistry

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2020 | July-December | Volume 3 | Issue 2

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Guest Editorial

Virinder Goyal

A Guide to Young Pediatric Dentists in the Globally Changing Era

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:4] [Pages No:45 - 48]

   DOI: 10.5005/jp-journals-10077-3059  |  Open Access |  How to cite  | 


The specialty of pedodontics has a long history in South Asia as it started in Government College Amritsar by Punjab University in 1950. In the south Asian countries, India has 204 dental institutions offering postgraduation in pedodontics and preventive dentistry. A postgraduate degree in pediatric dentistry opens doors to diverse sectors of research or work opportunities at the national and international levels. This article aims at summarizing all the possible options available for a pediatric dentist at the National and International levels.


Original Article

Swati S Samaleti, Ashwin M Jawdekar

Comparison of “Earplug and Temporal Tap Technique” with Standard Distraction Method on Gag Reflex Related to Maxillary Impression Making in 6–12-year-old Children: A Crossover Study

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:5] [Pages No:49 - 53]

   DOI: 10.5005/jp-journals-10077-3051  |  Open Access |  How to cite  | 


Introduction: Exaggerated gag reflex affects dental care. Few studies have reported effectiveness of earplug and temporal tap technique (E-TTT) in children. Aim: To compare “earplug and temporal tap technique” with standard distraction method (control) on gag reflex (GR) related to maxillary impression-making in 6 to 12-year-old children. Materials and methods: A maxillary impression with standard distraction method, followed by another impression with E-TTT after a 10 minute washout, was made in group I (n1 = 15). The order was reversed in group II (n2 = 15). Gag prevention index (GPI) and five-point patient response scales were used to measure the GR. Result: Mean differences in GPI at 2 minutes within groups I and II were 0.333 (p value = 0.399) and 0.267 (p value = 0.579); and between the groups were 0.333 (p value = 0.462) and 0.267 (p value = 0.532). The 95% confidence intervals ranged from −1.131 to 0.465 and −0.706 to 1.239 within groups I and II, whereas they were −1.248 to 0.581 and −0.597 to 1.130 between the groups. As per the 5-point patient-reported scale, 80% children with E-TTT (of group I) when compared to 46.6% with control (of group II) reported same to superior experience (p = 0.046*). Conclusion: E-TTT did not mitigate the GR during impression making but led to a better experience.


Original Article

Devanshi N Mehta, Bhavna Dave

Comparative Assessment of Maximum Voluntary Bite Force and Electromyography of Masseter Muscle Pre- and Post-oral Rehabilitation in Children between 3 and 14 Years of Age: An In Vivo Study

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:6] [Pages No:54 - 59]

   DOI: 10.5005/jp-journals-10077-3052  |  Open Access |  How to cite  | 


Aim: The aim of the study was the assessment of maximum voluntary bite force (MVBF) and electromyography (EMG) of masseter muscle pre- and post-oral rehabilitation in children between 3 years and 14 years of age. Materials and methods: The study population consisted of 60 children aged 3–14 years of age divided into 3 groups of 20 each based on the dentition. The MVBF and the EMG of the masseter muscle were recorded pre- and post-oral rehabilitation. Results: The MVBF in phase I and II for right side was found to be 32.32 and 36.59 kg, respectively, and for the left side was found to be 32.24 and 36.53 kg, respectively, which was highly significant. Electromyography of masseter muscle for both the phases was found to be 283.87 μV in phase I and 329.64 μV in phase II with a high significance. Conclusion: A significant improvement was observed post-oral rehabilitation in the MVBF and the electromyographic activity of the masseter muscle. Maximum voluntary bite force was seen more in males as compared to females with no side predilection. Hence, the effect of dental caries on bite force and masticatory muscle activity was established.



Akash Ardeshana, Seema Bargale, Anuradha Karri, Nikhil G Patel, Brijesh Tailor, Shraddha Sura

Evaluation of Caries Excavation Efficacy with Ceramic Bur and Hand Excavation in Primary Teeth: An Experimental Study

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:5] [Pages No:60 - 64]

   DOI: 10.5005/jp-journals-10077-3054  |  Open Access |  How to cite  | 


Purpose: To compare the caries removal efficacy, time span, and evaluate pain experience during the caries excavation with ceramic bur and hand excavator in primary teeth of children aged between 4 years and 9 years. Materials and methods: This study consisted of 26 subjects with bilateral occlusal carious lesions on primary molars. Caries excavations were performed with hand excavation and ceramic bur. The time taken for caries removal for both the techniques was measured with a stopwatch. The patient perception of pain during the treatment was evaluated with verbal pain scale and visual analog scale (VAS). The unpaired t-test was used for statistical analysis. Results: Mean value of time taken for the removal of caries by hand excavation was 6.17 ± 0.99 minutes and for the ceramic bur, it was 4.35 ± 1.32 minutes and it was found to be significant. There was no significant difference found between verbal pain scale and VAS. Mean value of the caries excavation score for hand was 2.00 ± 1.17 and for ceramic bur was 0.69 ± 0.93. Conclusion: The ceramic bur had better caries removal efficacy with less time compared to hand excavation method. The ceramic bur may be considered as a possible alternative technique for caries excavation in children.



Nidhi Taneja, Mark D Litt

Barriers for Dentists in Treating Children with Autism Spectrum Disorders

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:5] [Pages No:65 - 69]

   DOI: 10.5005/jp-journals-10077-3055  |  Open Access |  How to cite  | 


Aim: To investigate barriers in providing dental care for children with autism spectrum disorder (ASD) for the dentists. Materials and methods: A survey outlining various barriers in treating children with ASD was administered to 109 general dentists. Potential barriers assessed in the survey included: Lack of practice guidelines to manage children with ASD, perceived disruptive behavior of ASD children, and lack of self-perceived competency or time in managing these patients. Results: Seventy-four percent of the general dentists reported treating children with ASD. On average, they treated fewer than three children with ASD per month. The mean number of barriers endorsed by the dentists treating children with ASD was marginally more than those not treating ASD children, and not statistically significant (t = −0.28; df = 107; p = 0.78). Lack of practice guidelines for treating children with ASD was the most common barrier endorsed. Conclusion: The most commonly endorsed barriers to provision of care perceived by general dentists were lack of guidelines for care, lack of sufficient reimbursement for management of ASD children, and difficulty in managing the behavior of ASD children. General dentists, who will be assuming more of the treatment for these children, will need to be better trained to manage the behavioral challenges of children with ASD.



Amrish Bhagol, Parul Singhal, Neha Sikka

Prevalence and Characteristics of Mesiodens among 4–12-year-old Children of North Indian Subpopulation

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:5] [Pages No:70 - 74]

   DOI: 10.5005/jp-journals-10077-3057  |  Open Access |  How to cite  | 


Aim: The objective of the study was to determine the prevalence of mesiodens along with other epidemiological characteristics. Materials and methods: A retrospective evaluation of data of patients was done to calculate the prevalence of mesiodens in 60,590 children (33,038 boys and 27,552 girls) in age range from 4 to 12 years. In addition to the prevalence, age, gender, number, morphology, orientation, and complications associated with it was also recorded. Results: The prevalence of mesiodens was estimated to be 1.12% (680 cases) with male–female ratio of 3.22:1. The dentition-wise prevalence was 5.88% in primary dentition stage, 83.53% in mixed dentition stage, and 10.59% were in permanent dentition stage. Out of the 680 patients, 149 (21.91%) had two mesiodens, whereas 531 (78.09%) cases had 1 mesiodens. Conical shape was the most common type (92.76%), followed by supplemental (4.7%), odontome (1.33%), and tuberculate (1.21%). In all, 67.67% mesiodens were in a vertical position, 28.35% were in an inverted position, and 3.98% were in a transverse position, and 689 mesiodens (83.11%) were erupted and the remaining 140 (16.89%) of the cases were unerupted. In all, 46.56% of the mesiodens were palatally positioned, and root formation was complete in 65.86% cases, and 34.14% had incomplete root formation. Complications caused by mesiodens were malalignment of maxillary centrals (53.09%), noneruption of incisors (17.94%), and diastema (28.97%). Conclusion: Mesiodens is the most common form of supernumerary teeth in permanent dentition. Early detection and management of all supernumerary teeth is a necessary part of preventive dentistry.



Bindu Kadian, Natasha Saini, Parul Singhal, Ishika Garg

Managing Supernumerary Teeth: A Report of Four Cases

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:5] [Pages No:75 - 79]

   DOI: 10.5005/jp-journals-10077-3043  |  Open Access |  How to cite  | 


A supernumerary tooth represents a tooth that is excess or additional to the natural series. They can be found anywhere in dental arches but often located in maxillary anterior region. The presence of these in oral cavity may lead to certain complications like impaction, delayed or ectopic eruption of adjacent teeth, which may further lead to crowding, midline diastema, and eruption into the floor of the nasal cavity. Therefore, proper management is of utmost importance to avoid these consequences. This article emphasizes the role of early orthodontic treatment in managing complications associated with supernumerary.



Pratik B Kariya, Swara Shah, Adrija Buch, Romil B Shah

Bilateral Fusion of Deciduous Teeth in Mandibular Arch with the Absence of Permanent Successor: Concomitant Fusio-agenesia

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:4] [Pages No:80 - 83]

   DOI: 10.5005/jp-journals-10077-3046  |  Open Access |  How to cite  | 


Tooth fusion is a common type of a developmental dental anomaly that can be described as the union of two embryologically developing teeth at varying stages to its development. It is commonly seen in deciduous dentition, more frequently unilaterally, and in the anterior region. Various terms such as connate teeth, double formations, synodontia, or conjoined teeth are often used to describe tooth fusion. The prevalence of fusion in deciduous teeth is reported to be around 0.5–2.5% and only 0.02% for bilateral involvement of deciduous teeth. Early diagnosis of such conditions is important as it may cause various clinical problems, such as malocclusion, esthetic concerns, periodontal conditions, and dental caries. This paper reports a rare case of concomitant occurrence of bilaterally fused deciduous mandibular lateral incisor and canine with congenital agenesis of permanent mandibular lateral incisors bilaterally.



Richa Kumari, Neeraj Kumar, Krishan Gauba

An Aberrant Root Development in Severely Extruded Immature Young Permanent Tooth: A Case Report

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:4] [Pages No:84 - 87]

   DOI: 10.5005/jp-journals-10077-3047  |  Open Access |  How to cite  | 


Trauma to immature teeth at younger age may result in number of developmental anomalies. Aberrant root development is a rare developmental anomaly reported in the literature thus far. A case of extrusive luxation of immature young permanent central incisor is presented which was repositioned and splinted using suture and semi-rigid wire composite splint. The luxated tooth showed almost complete root development till the root apex. Radiographic and clinical evaluation was done at regular intervals. This case report highlights the management of severely extruded immature young permanent tooth and ability of Hertwig's epithelial root sheath (HERS) to withstand the trauma effects and helps in root development.



Deepika Mishra

Laser-assisted Surgical Excision of Fibroepithelial Polyp with Periosteal Lasing: A Case Report

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:4] [Pages No:88 - 91]

   DOI: 10.5005/jp-journals-10077-3048  |  Open Access |  How to cite  | 


Introduction: Reactive lesions of gingiva have been shown to exhibit varied features even with similar etiologic irritants. A fibroepithelial polyp is characterized by pink, red, or white knob-like growth with sessile or pedunculated base with a prevalence of 1–2% and a higher female predilection. Case description: A 13-year-old female patient reported with chief complaint of an enlarging, painless soft mass in lower front region of the jaw since last the 6 months. Intraoral examination revealed firm, nontender, pinkish–white sessile lesion of 1.5 × 1.5 × 0.5 cm on interdental papilla and attached gingiva on both labial and lingual sides in relation to tooth 32 and 33. A 940 nm diode laser-assisted surgical excision and lasing of periosteum were performed under local anesthesia. There was no recurrence after 18 months with complete restoration of normal form and esthetics. Histopathology was suggestive of fibroepithelial polyp. Conclusion: The clinicians need to be aware of the clinical, histopathological features, and management of reactive mucosal lesions. Diode laser is an important aid in performing surgical excision of these lesions with minimal patient discomfort, increased operator control, and good postoperative results.



Shivani Mathur, Tushar Pruthi, Vinod Sachdev, Rahul Chopra, Sakshi Jain

Epistaxis during Inhalation Sedation Using Nitrous Oxide: A Rare Case Report

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:3] [Pages No:92 - 94]

   DOI: 10.5005/jp-journals-10077-3060  |  Open Access |  How to cite  | 


Nitrous oxide is widely being used as a behavior management technique to reduce the anxiety of the patient by pediatric dentists worldwide. Nitrous oxide inhalational sedation (NOIS) exhibits a remarkable safety profile with rarely reported cases of complications associated with it. This case report highlights the complication of NOIS of an 8-year-old boy. On administration of nitrous oxide, nasal bleeding occurred. Nasal bleeding was controlled immediately and planned treatment was aborted. This case report explored various possibilities that can lead to epistaxis in a young child. But the question remains whether nitrous oxide triggered nasal bleed or did it happen due to any other local or systemic cause?



Urvashi Sharma, Anubha Gulati, Namrata C Gill

Anomalies of Tooth Number in the Age Range of 2–5 Years in Nonsyndromic Children: A Literature Review

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:15] [Pages No:95 - 109]

   DOI: 10.5005/jp-journals-10077-3050  |  Open Access |  How to cite  | 


Aim and objective: Dental anomalies of number predispose the teeth to malocclusion, caries, periodontal problems, and often compromise aesthetics and function. We present a literature review to assess the distribution of these anomalies and observe associated anomalies of the underlying permanent successor teeth in the age range of 2–5 years in nonsyndromic children. Review: A literature search was conducted using the “PubMed” database with a manual search of cross-references, published in the years 2000–2018. The following key words were used: “dental anomalies, primary teeth” “hypodontia,” “oligodontia,” and “hyperdontia.” Of the 1,232 records accessed, 41 articles were included in the final review—34 articles (42 clinical cases) and 7 cross-sectional studies. Results: The overall prevalence of dental anomalies of number ranged from 1.8 to 4.0%. Among all the clinical cases, a predilection for boys (26/42) was observed. Hyperdontia was the most common primary tooth number anomaly; 23.8% cases (10/42) had additional coexisting primary tooth anomalies. In 35.7% cases (15/42), anomalies of the permanent successor teeth were present of which permanent tooth agenesis was most commonly seen in 75% cases of hypodontia (3/4) and 85.7% cases of oligodontia (6/7). Conclusion: Among all the anomalies, hyperdontia was most common. The anomalies of tooth number were more prevalent in boys and in the maxilla. Apart from dental anomalies of number, those of shape and size also concurrently occurred in the primary dentition and in the permanent successor teeth, stressing upon early diagnosis, radiographic examination, and long-term follow-up visits.



Kunal Gupta

Safety of Nitrous Oxide/Oxygen Inhalation: Are We Still in Doubt?

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:2] [Pages No:110 - 111]

   DOI: 10.5005/jp-journals-10077-3058  |  Open Access |  How to cite  | 


Book Review

Dr. Ikramul Ahmed, Dr. Annapurny Venkiteswaran

Book Review

[Year:2020] [Month:July-December] [Volume:3] [Number:2] [Pages:1] [Pages No:112 - 112]

   DOI: 10.5005/jp-journals-10077-112A  |  Open Access |  How to cite  | 


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