Journal of South Asian Association of Pediatric Dentistry

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2021 | July-September | Volume 4 | Issue 2

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Gauri Kalra, Vijay P Mathur

COVID-19 Third Wave: A Concern for Pediatric Dentists?

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:2] [Pages No:71 - 72]

Keywords: COVID-19, Pandemic, Pediatric, Third wave, Vaccination

   DOI: 10.5005/jp-journals-10077-3086  |  Open Access |  How to cite  | 



Jayalakshmi Pandranki, Narasimha Rao V Vanga, V Rajasekhar, Chandrabhatla S Kumar

Sequelae of Tethered Oral Tissues in Infants: A Challenging Expertise Conundrum

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:6] [Pages No:73 - 78]

Keywords: Infants, Lip tie, Tethered oral tissues, Tongue tie

   DOI: 10.5005/jp-journals-10077-3069  |  Open Access |  How to cite  | 


Timely prediction of diversified effects of tethered oral tissues in infancy is utmost important for the proper development of the stomatognathic system. Objective: To assess current opinion/knowledge of infant oral care specialists about the repercussions of tethered oral tissues in infants influencing function, growth, and development. Study design: A cross-sectional survey was done among 192 dentists of which 46.35% were oral surgeons and 53.65% were pediatric dentists. The responses obtained were subjected to the statistical analysis using the Chi-square test. Results: Most commonly reported conjectures include speech defects (77.6%), breastfeeding dysfunction (71.8%), midline spacing between teeth (71.4%), atypical swallowing (67.7%), followed by sleep issues (31.8%) and dentoskeletal alterations (43.2%). Least possibly reported conjectures are postural alterations (10.4%), caries susceptibility (13.5%), unexpected and unexplained asphyxia (15.6%), and tearing of gingival tissues (19.3%). Conclusion: Both specialty dentists, i.e., pediatric dentists and oral surgeons, believe that tethered oral tissues cause breastfeeding dysfunction, speech impediments, midline diastema, and permanence of atypical swallowing but limited awareness exists about their consequences such as sleep and breathing disorders, caries initiation, gingival recession, malocclusions, and postural alterations.



Sakshi Joshi, Meera Sandhu, Abhishek Dhindsa, Neetu Jain, Divya Arora

A Study of Variables Affecting Child Fear on Successive Dental Office Visits

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:7] [Pages No:79 - 85]

Keywords: Child–maternal anxiety relationship, Children's fear survey schedule-dental subscale, Dental fear, Modified dental anxiety scale, Parental anxiety

   DOI: 10.5005/jp-journals-10077-3045  |  Open Access |  How to cite  | 


Aim: To study influence of age, gender of the children, and their accompanying person's characteristics in managing fear of children on successive visits to the dental office. Materials and methods: An observational study was conducted in 50 children (5–8 years) and the accompanying persons. Children were divided into two groups according to their age: Group I: 5–6 years old and group II: 7–8 years, who required multiple visits for restorative treatment. The modified dental anxiety scale (MDAS) and children's fear survey schedule-dental subscale (CFSS-DS) questionnaires were used to evaluate accompanying person anxiety and child fear, respectively. Other factors like accompanying person, their education, age and sex of the child, and their relation to child fear level were also evaluated. Results: The child fear level was observed to significantly decrease on successive three visits (p value < 0.001) using the post hoc comparison test. Parental (accompanying person) anxiety (p value = 0.044) and parent education level (p value = 0.048) were observed to be two factors affecting child anxiety significantly. Also, educational level and area of residence were observed to affect parental anxiety significantly (p value = 0.001). Conclusion: Dental fear among children was observed to significantly decrease on successive visits. Age and sex of the child were observed to have no effect on child fear. Parent anxiety and their education level were observed to directly affecting child's behavior in the dental office.



Tanya Agarwal

Effect of Endodontic Irrigating Agents on Microhardness of Radicular Dentin in Primary Teeth: An In Vitro Study

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:4] [Pages No:86 - 89]

Keywords: Citric acid, Ethylene diamine tetraacetic acid, Irrigation, Microhardness, Sodium Hypochlorite, Vickers test

   DOI: 10.5005/jp-journals-10077-3084  |  Open Access |  How to cite  | 


Introduction: Biochemical debridement with an irrigating solution is indispensable to remove microorganisms, debris flushing, and smear layer from a passage of the root canal, thus involving the use of many irrigants. Along with the desirable effects, these agents may have some detrimental effects on dental hard tissues. Aim and objective: To evaluate the effect of different irrigating solutions on the microhardness of radicular dentin of primary teeth. Materials and methods: Thirty buccolingual sections of roots of primary teeth (decoronated using a diamond disk mounted in acrylic) were indiscriminately distributed among three groups of 10 specimens, respectively, in accordance with the irrigants used, i.e., group I [1% sodium hypochlorite with 10% ethylene diamine tetraacetic acid (EDTA)], group II [6% citric acid (CA)], and group III (normal saline). Dentin microhardness was measured before and after irrigation at apical, middle, cervical levels of the roots with a Vickers indenter machine. Data so collected were analyzed using SPSS software version 24. Results: There was a statistically significant difference in the microhardness values of radicular dentin before and after irrigation with the different agents. More reduction was seen with the CA (24.62 ± 6.43) group when compared with 1% sodium hypochlorite with 10% EDTA group (33.09 ± 6.93) (p = 0.001). Conclusion: Citric acid, although an acid belonging to the organic category, acts as a chelating agent like that of EDTA, thus bringing about a significant reduction in microhardness of radicular dentin in primary teeth.



Cheranjeevi Jayam, Amolkumar Lokade, Aradhana Agrawal, Shelja Vashisth, Vinoth K Kalidoss, Rashmi Issar

Survey vis-à-vis “Information Acquirement Systems” Available for Indian Dentists in the Wake of COVID-19 Crisis

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:6] [Pages No:90 - 95]

Keywords: Coronavirus disease-2019, Electronic media, Government regulations for COVID-19, Indian dentist, Information dispensing system, SARS-CoV-2, Social media

   DOI: 10.5005/jp-journals-10077-3083  |  Open Access |  How to cite  | 


A “well-informed dentist” = “best functioning dental care system”. In this context, it is imperative to see how good the information disseminating systems are present for the dentists in times of coronavirus disease-2019 (COVID-19). The following article is in no way related to clinical guidelines for dentists/care of patients/setting up best practices, rather a mirror on how effectively and efficiently dentists are being provided critical information during this confounding time. Materials and methods: A cross-sectional survey utilizing Google forms was conducted to evaluate “Information Acquirement Systems” available for Indian dentists in the wake of the COVID-19 crisis through a structured questionnaire. Six hundred and sixty-four responses obtained just within a week were obtained for which comparison of participants’ response based on qualification, type of practice, and the experience was computed utilizing Pearson Chi-square and Fisher's exact tests. Results: Significant results were obtained on who should dispense the information regarding COVID guidelines for dental practice. Conclusion: Quantity, quality, and authenticity of the information received confused due to the absence of a single source of information dispensation and uncertainty of the hierarchical system. In the current study, it was found that among the options present, dentists depended mostly on DCI for guidelines and proposed that they should continue to dispense the working guideline. Quantity of guidelines obtained, quality of guidelines was satisfactory, and has enabled to take right decisions currently. They have sometimes actively sought further information and lastly, they are confident to start practices after lifting COVID sanctions.



Ishika Garg

Resin Infiltration for Esthetic Improvement of Mild to Moderate Non-pitted Fluorosis Stains in 6–12-year-old Children: A Randomized 6-month Interventional Study

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:8] [Pages No:96 - 103]

Keywords: Esthetic improvement, Non-pitted fluorosis, Resin infiltration

   DOI: 10.5005/jp-journals-10077-3078  |  Open Access |  How to cite  | 


Background: Dental fluorosis is the hypomineralization of tooth enamel due to excessive fluoride, resulting in opaque white areas or discoloration of teeth. The available treatment modalities to improve the esthetics affected due to fluorosis include non-invasive and invasive methods. Nowadays, a newer non-invasive treatment that is resin infiltration (RI) is gaining increasing popularity. The present study evaluated and compared the clinical success in esthetic improvement (EI) and changes in white/brown opacities/stains (SC) of RI on non-pitted fluorosis stains. Materials and methods: A total of 18 patients in the age range of 6–12 years with the unesthetic appearance of upper anterior teeth due to non-pitted fluorosis were randomly selected and subjected to an RI procedure. Evaluation for EI and changes in white/brown opacities/stains (SC) was done on the visual analog scale (VAS). Results: The results were statistically highly significant (p < 0.01) for the mean VAS score values of EI (p = 0.001) and SC (p = 0.001) between the follow-up time intervals with the highest values at time interval 6 months followed by 3 months, 1 month, and least at immediate postoperative. Furthermore, inter-grade comparison of fluorosis showed a highly significant difference (p < 0.01) for the VAS scores for both EI and SC with the highest mean VAS score values in a very mild degree of fluorosis, followed by mild and moderate degrees. Conclusion: Resin infiltration is a promising procedure that demonstrated remarkably successful EI in mild to moderate non-pitted fluorosis with a stable long-term positive outcome.


Retraction Notice

Umapathy Thimmegowda, Joseph Thomas

Comparison of Novel NaviTip Obturating Technique with Lentulospiral and Endodontic Plugger Techniques in Primary Teeth: A Randomized Clinical Trial

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:1] [Pages No:104 - 104]

Keywords: Endodontic plugger, Lentulospiral, NaviTip, Obturation, Primary teeth

   DOI: 10.5005/jp-journals-10077-3080  |  Open Access |  How to cite  | 


This article has been retracted as it has been previously published elsewhere (International Journal of Medical Science and Current Research (IJMSCR), Vol-3, issue-2) without proper attribution to previous sources or disclosure to the editor, permission to republish, or any justification thereof



Puzhikkunnath K Nabeeh, Chandru T Premkumar, Dhanesh Narasimhan

Comparison of Volumetric Changes in Primary Molar Root Canals by Four Different File Systems: A Cone-beam Computed Tomography Study

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:5] [Pages No:112 - 116]

Keywords: Cone-beam computed tomography, Pediatric endodontics, Rotary endodontics

   DOI: 10.5005/jp-journals-10077-3085  |  Open Access |  How to cite  | 


Aim and objective: To evaluate and compare the pre- and post-instrumentation canal volume using hand K-files, ProTaper Gold rotary files, Kedo-S rotary files, and One Shape rotary files in primary molars using cone-beam computed tomography (CBCT). Materials and methods: The study was done on 40 primary molars randomly divided into four groups of 10 teeth. Samples were subjected to CBCT scan and image analysis before instrumentation, following which the teeth were instrumented with respective endo files. Post-instrumentation CBCT scan was done and volume of the canal was measured from CEJ to apex. The obtained values were statistically analyzed to find the level of significance using mean, standard deviation. Statistical analysis was further done using one-way ANOVA and a post hoc test. Results: A statistically significant difference was observed in dentin removal by hand K-files when compared with rotary file groups. One Shape files removed less root dentin followed by Kedo-S rotary files, ProTaper Gold rotary files, and hand K-files, respectively. Conclusion: It can be concluded that rotary files, mainly One Shape and Kedo-S files can be used as an acceptable instrument in roots of primary teeth as it shows the least root dentin removal.



Sanjeev K Singh, Mrinalini Rathore

A Comparative Evaluation of CPP-ACP Cream and Fluoride Varnish in Remineralization of MIH-affected Teeth Using Laser Fluorescence

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:5] [Pages No:117 - 121]

Keywords: CPP-ACP, Fluoride varnish, Laser fluorescence, Molar incisor hypomineralization, Remineralization

   DOI: 10.5005/jp-journals-10077-3081  |  Open Access |  How to cite  | 


Background: Molar incisor hypomineralization (MIH) affected teeth have enamel with altered mineral content like decreased calcium, phosphorous, and increased carbon leading to porous enamel and subsequent post-eruptive breakdown. The treatment is aimed at the prevention of their breakdown. Various remineralization strategies originally employed for initial carious lesions have been extrapolated for use on these defects. Aim and objective: To evaluate the remineralization potential of CPP-ACP-based cream and fluoride varnish for MIH-affected teeth using laser fluorescence (LF). Materials and methods: Thirty children aged 8–14 years who exhibited intact, demarcated opacities on their first permanent molars or permanent incisors, were randomly divided into two groups using simple randomization technique; group I: professional application of fluoride varnish (n = 15); group II: daily single application of CPP-ACP cream (n = 15). The mineral density was assessed before and after 15 days of application with a DIAGNOdent™ pen (KaVo). Results: The mean change in LF values depicting a change in the mineral density scores was 8.933 ± 5.05 for the fluoride varnish group and 7.133 ± 4.17 for the CPP-ACP group. This decrease was statistically significant for both groups. However, no significant difference was found between the two groups in terms of these changes. Conclusion: Both CPP-ACP cream and fluoride varnish are equally effective in achieving remineralization of MIH-affected teeth.



Siji Elizabeth, Pramodh T John, Vishal Juneja

Preparedness of Dentists and Dental Operatories during and Post COVID-19 Pandemic

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:6] [Pages No:122 - 127]

Keywords: Attitude, Coronavirus disease-2019, Dental clinic, KAP survey, Knowledge, Practice, Questionnaire survey

   DOI: 10.5005/jp-journals-10077-3082  |  Open Access |  How to cite  | 


Context: Among various healthcare workers, dental professionals are at higher risk of getting infected from coronavirus disease-2019 (COVID-19) infections, provided they make changes and take necessary precautions for the safety of both doctors and patients in the dental clinic. Aim and objective: Assessment of the knowledge, attitude, and practices of Indian dentists in the dental clinic during the COVID-19 pandemic. Settings and design: A questionnaire-based online cross-sectional survey was conducted among Indian dentists. Materials and methods: The questionnaire comprised of 18 closed-ended questions distributed in four sections on demographics, knowledge, attitude, and practices. Statistical analysis used: Responses were summarized as frequencies and percentages. Intergroup comparisons were made using the Chi-square test, one-way ANOVA test, and independent Student's t-test. Results: A total of 304 responses from dentists all over India were received. Among MDS, 64.9% of dentists showed sufficient knowledge, while only 42.5% had sufficient knowledge among BDS. The findings were statistically significant (p = 0.001). Sixty-eight percentage of MDS showed a positive attitude, whereas only 46.3% of BDS and 41.4% of MDS came under the category of dentists with high-level practice. Although the findings related to attitude (p = 0.056) and practices (p = 0.360) were not statistically significant. Conclusion: The study concluded that despite having sufficient knowledge and a positive attitude, the level of practice of dentists in their dental setup with this changing scenario needs refinement.



Madhuri Vegesna

An Unusual Foreign Object Encircling Primary Teeth: A Case Report

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:3] [Pages No:128 - 130]

Keywords: Foreign object, Primary teeth, Plastic ring

   DOI: 10.5005/jp-journals-10077-3077  |  Open Access |  How to cite  | 


Fortuitous placement of objects into the mouth and nibbling while playing is common among infants and toddlers. Most of the time, it is unnoticed until the child complains of pain or discomfort. Sometimes, the inadvertent gnawing of these tiny bits and pieces may injure the oral tissues leading to infections if not intervened at an early stage. It is quite challenging to remove such foreign objects and preserve the involved teeth, especially in young children. This case report highlights one such incident in a 15-month-old child which cost him his lower two central incisors.



Sulakshana Pradeep, Sarakanuru Krishnappa Srinath, Padmapriya Surendranath

Cleft Palate Associated with Michelin Tire Baby Syndrome: A Rare Case Report

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:3] [Pages No:131 - 133]

Keywords: Cleft palate, Genodermatosis, Michelin tire baby syndrome

   DOI: 10.5005/jp-journals-10077-3079  |  Open Access |  How to cite  | 


Michelin tire baby syndrome (MTBS) is one of the rare genodermatosis that is characterized by phenotypic abnormalities and multiple symmetric circumferential folding of excess skin. Diagnosis is done mainly through clinical examination. Skin fold gradually diminishes and fades away with age without any clinical intervention. Here, we are reporting a case of MTBS in a newborn.



PA Hewage, Primali Jayasooriya, Chandra K Herath

Dental Management of a Child Patient with Amelogenesis Imperfecta

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:4] [Pages No:134 - 137]

Keywords: Amelogenesis imperfecta, Hypomineralized type, Sporadic inheritance

   DOI: 10.5005/jp-journals-10077-3061  |  Open Access |  How to cite  | 


Amelogenesis imperfecta (AI) is a hereditary disorder of enamel. In AI, the structure and clinical appearance of both primary and permanent dentition are affected in more or less an equal manner. Its enamel characteristically shows hypoplasia or hypomineralization or hypomaturation. Because of the intricacy of the condition, the major challenge that restorative dentists face in rehabilitating patients with AI is restoring esthetics, function, and occlusal stability with minimum intervention. The patient was diagnosed as AI with a hypomineralized type of sporadic inheritance. His appearance and function of the teeth led to diminished social interactions. Provisional treatment was performed to improve dental esthetics, preserve oral function, and improve the patient's self-confidence.



Sumit Munjal, Seema Munjal

A Novel Presentation of Submerged Supernumeraries as Bilateral Dens Evaginatus Using Cone-beam Computed Tomography

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:4] [Pages No:138 - 141]

Keywords: Cone-beam computed tomography, Dens evaginatus, Multilobed, Supernumerary

   DOI: 10.5005/jp-journals-10077-3064  |  Open Access |  How to cite  | 


Dental anomalies affecting the teeth are relatively common. Simultaneous occurrence of multiple dental abnormalities in a set of teeth is uncommon and relatively rare. This paper aims to report the novel case of dens evaginatus as a covert expression of incisor supernumerary. Also, the use of cone-beam computed tomography (CBCT) for topographic inference is emphasized for routine use for it justifies the sufficient cost-to-benefit ratio.



Mallayya C Hiremath, Srinath Krishnappa, Divya D Putalikar, Bineesh Balan, Nihal Kothari

Early Orthopedic Management of Class III Malocclusion with Rapid Maxillary Expansion and Facemask Therapy: Two Case Reports

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:6] [Pages No:142 - 147]

Keywords: Anterior crossbite, Class III, Expansion appliance, Malocclusion

   DOI: 10.5005/jp-journals-10077-3067  |  Open Access |  How to cite  | 


Orthopedic correction of skeletal class III malocclusion in a child patient is crucial because it can avoid future surgical procedures. Early correction of class III malocclusion helps in avoiding the negative effects produced by the facial disfigurement. In this article, we present two case reports relating to early orthopedic management of class III malocclusion with rapid maxillary expansion (RME) and facemask. An 8-year-old boy and a 9-year-old girl presented with class III malocclusion characterized by mid-face deficiency and anterior crossbite. Both the cases were managed with a combination of RME and facemask therapy. Satisfactory correction of class III malocclusion occurred by a combination of skeletal and dental improvements.



Sainath R Elicherla, Varada Sahithi, Kanamarlapudi V Saikiran, Mahesh Nunna, Ramasubba R Challa, Sivakumar Nuvvula

Local Anesthesia in Pediatric Dentistry: A Literature Review on Current Alternative Techniques and Approaches

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:7] [Pages No:148 - 154]

Keywords: Children, Dental anxiety, Local anesthesia, Recent trends

   DOI: 10.5005/jp-journals-10077-3076  |  Open Access |  How to cite  | 


Prevalence of pain and dental anxiety plays a crucial part in pediatric dentistry. These factors cause a delay in pursuing dental treatment, which in turn increases early childhood caries. Anxiety and fear that arise before and during local anesthesia administration persist as barriers for children experiencing dental treatment. Although local anesthesia plays a significant role in managing pain for children, researchers continue to search for various comfortable methods to alleviate the pain during local anesthetic administration. Thus, the present overview aims to educate pediatric dentists concerning newer local anesthetic delivery devices and several approaches in alleviating dental anxiety and pain in children.



Sumidha Bansal, Urvashi Sharma, Antervir Kaur

Herbal and Chemical Mouthwashes in Pediatric Population: A Scoping Review

[Year:2021] [Month:July-September] [Volume:4] [Number:2] [Pages:7] [Pages No:155 - 161]

Keywords: Chlorhexidine, Fluoride mouthwash, Herbal

   DOI: 10.5005/jp-journals-10077-3075  |  Open Access |  How to cite  | 


The pediatric population is one of the groups having age-specific oral hygiene requirements. Due to lack of manual dexterity, inability to spit till a certain age, and dependence on the caregiver for the performance of oral hygiene due to various other reasons present challenges in achieving a good oral hygiene score. This, therefore, warrants the use of adjunctive oral hygiene aids such as mouthwashes with therapeutic ingredients in children. Safety concerns over the use of chemical mouthwashes in children call for the need for mouthwashes with a high safety profile. This scoping review is an attempt to review the present literature regarding the interventions involving herbal and chemical mouthwashes and their effect on plaque, gingivitis, and cariogenic microflora in children.


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