Journal of South Asian Association of Pediatric Dentistry

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2022 | September-December | Volume 5 | Issue 3

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South Asian Association of Pediatric Dentistry becomes the first dental society in the world to get Special Consultative Status by ECOSOC, United Nations

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:1] [Pages No:iv - iv]

   DOI: 10.5005/jsaapd-5-3-iv  |  Open Access | 



Ruchi Singhal, Virendra Singh, Amrish Bhagol, Nancy Goel

Pediatric Dentofacial Trauma during COVID-19 Lockdown Period in North Indian Population: The changed Trends

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:117 - 120]

Keywords: Children, Coronavirus disease 2019, Dentofacial trauma, Lockdown, Pandemic, Pediatric

   DOI: 10.5005/jp-journals-10077-3237  |  Open Access |  How to cite  | 


Background/aims: Coronavirus disease 2019 (COVID-19) pandemic has impacted the life of mankind, including the epidemiology and pattern of dentofacial traumatic (DFT) injuries. The aim of the present study is to quantify and analyze the characteristics of DFT among children during the COVID-19 pandemic lockdown period in 2020 and to compare this to data over the same period in 2019 (prepandemic/prelockdown period). Materials and methods: Data of patients aged 0–12 years who suffered DFT was collected retrospectively from the beginning of the lockdown period, that is, 24th March 2020, till the day lockdown restriction was eased, that is, 31st May 2020. The children aged 0–12 years with similar characteristics who reported during a similar time period in the year 2019 were kept as the comparator group. The outcomes studied were epidemiology, etiology, and pattern of injury. Result: Total number of children who suffered DFT increased during the pandemic lockdown in 2020 as compared to the prepandemic period. The place where the injury occurred was significantly changed to the indoor environment. Fall was still the major cause of trauma. Luxation injuries were more frequent than tooth fractures (p < 0.05). Conservative management was more favored during the lockdown period. Conclusion: Results suggest that the lockdown period had affected the epidemiology, etiology, and diagnosis of traumatic dentofacial injuries in children. We must plan our resources considering the expected wave/school shutdowns in the future and the increased incidence of traumatic dental injuries in children. While trends were evident in the collected data, these must be carefully interpreted as this was a single-center study with a small sample size.



CH Chandana Krishna Shree, HR Pooja, Andrea Natalia Mascarenhas

Magic: A Modern Alleviating Constituent of Anxiety Levels in Children

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:6] [Pages No:121 - 126]

Keywords: Behavior guidance, Distraction tricks, Magic trick, Rubber light and thumb trick, Strong-willed children

   DOI: 10.5005/jp-journals-10077-3241  |  Open Access |  How to cite  | 


Background: Anxiety in the dental setup is a most encountered problem associated with fear and stress, which has overemphasized its impact on the pediatric population. The lack of cooperativeness of children seen in the dental setup is mainly accredited to the behavioral expression of anxiety. There is a requirement for a constructive technique in dealing with children with obstinate attitudes. The magic technique is a new epoch in dentistry that can be used in strong-willed children. The magic technique helps in distracting the child and thus helps the child to relax and the dentist to perform the necessary treatment. Aim: To evaluate the change in behavioral attitude during the first visit in children and adolescents using magic distraction and audio-video distraction aids. Materials and methods: A total of 60 children of the age-group 4–13 years, who are recognized as strong-willed children, were chosen for the study. Children falling under the inclusion criteria were treated with endodontic and surgical procedures requiring local anesthesia administration and were assessed using three distraction aids (audio, audio-video, and magic group). Anxiety was assessed before and after the procedures using the Chotta Bheem and Chutki anxiety scale. Results: Mean anxiety levels were observed to be significantly reduced with the magic group using the thumb and light trick, followed by the audio-video group and then with the audio group. Conclusion: The use of distraction aids significantly reduced anxiety levels in children and adolescents.



Purna Sai Prasad Kolavali, BV Thimma Reddy, Uday Chowdary Birapu, Raichurkar Hemanth Kumar, Kanamarlapudi Venkata Saikiran, Gunde Veronica

Comparative Evaluation of Antifungal Efficacy of Different Pediatric Toothpastes on Candida albicans in Children with and without Early Childhood Caries

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:5] [Pages No:127 - 131]

Keywords: Candida albicans, Dentifrice, Early childhood caries

   DOI: 10.5005/jp-journals-10077-3239  |  Open Access |  How to cite  | 


Aim: To evaluate the antifungal efficacy of four commercially available pediatric toothpaste on Candida albicans in children with and without early childhood caries (ECC). Materials and methods: A total of 40 children were randomly divided into two groups; group I: ECC and group II: non-ECC, with 20 children in each group. After that, sterile cotton swabs were used to collect plaque samples from the tooth surface, and the samples were inoculated on Sabouraud dextrose agar (SDA) and incubated for 72 hours. After the growth was confirmed, four commercially available dentifrices were divided into four subgroups Kidodent®, Cheerio gel®, Pediflor®, and Colgate kids toothpaste® were titrated to a 1:1 dilution to identify the antifungal activity of C. albicans. Four wells, each of 4 mm in depth and 6 mm in diameter, were punched on the agar surface and filled with 0.02 mL of dentifrice solution using a microtiter pipette. Agar plates were incubated at 37°C for 48 hours, and the mean diameter of the zone of inhibition was measured and recorded. The collected data were tabulated and statistically analyzed using the chi-square and analysis of variance (ANOVA) tests. Results: Kidodent® in the ECC group had a maximum zone of inhibition (35.15 ± 5.75) with a significant difference when compared with Pediflor® and Colgate kids® (p < 0.001). In the non-ECC group, Cheerio gel® (14.95 ± 1.80) showed the maximum zone of inhibition, and no significant difference was seen with the other toothpastes (p > 0.001). Conclusion: Kidodent® toothpaste showed maximum antifungal efficacy for the ECC group and Cheerio gel® toothpaste showed maximum antifungal efficacy for the non-ECC group.



Poornima Parameshwarappa, Yanina Singh, Mebin G Mathew, Mallikarjuna Kenchappa, Nagaveni Nandanhosur Basavanthappa, Roopa Korishettar

Prevalence of Streptococcus mutans and Candida dubliniensis in Plaque of Caries-free and Caries-active 3–6-year-old Children by Using Polymerase Chain Reaction: A Clinical Study

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:132 - 135]

Keywords: Candida dubliniensis, Dental caries, Polymerase chain reaction, Streptococcus mutans

   DOI: 10.5005/jp-journals-10077-3238  |  Open Access |  How to cite  | 


Introduction: Oral cavity harbors numerous types of microbial flora, which change frequently with changes in the environment and which in turn leads to the process of caries. Aims: To evaluate the prevalence of Streptococus mutans (S. mutans) and Candida dubliniensis (C. dubliniensis) in dental plaque of caries-free (CF) and carries-active (CA) children aged 3–6 years using polymerase chain reaction (PCR). Material and methods: A total of 18 CA and CF children in the age group of 3–6 years were randomly selected. Plaque samples were collected using sterile micro brushes from teeth. Specific primers were used to carry out PCR in the plaque samples. Statistical analysis was done using Fisher's exact test. Results: In CA group, S. mutans were seen in 61.1% of children which is statistically significant with a p-value of 0.04 and C. dubliniensis in 27.8% of children whereas, in CF group, S. mutans were present in 27.8% of participants and C. dubliniensis in 5.6%. These results show that both organisms were more predominant in the CA group. Conclusion: Though both S. mutans (61.1%) and C. dubliniensis (27.8%) were present in CA group, S. mutans was strongly associated with dental caries. In the individuals with high scores of def and international caries detection and assessment system II, both species were more prevalent.



Sudheer Kumar Kotha, BV Thimma Reddy, Uday Chowdary Birapu, Hemanth Kumar L Raichurkar, Kumar J Raghavendra

Comparative Evaluation of Triple Organic Paste vs Triple Antibiotic Paste: An In Vitro Study

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:11] [Pages No:136 - 146]

Keywords: Apexification, Crown discoloration, Regenerative endodontic treatment, Triple antibiotic paste, Triple organic paste

   DOI: 10.5005/jp-journals-10077-3244  |  Open Access |  How to cite  | 


Context: The concept of the revascularization technique mainly depends on root canal sterilization, the presence of a template (blood clot), and coronary filling, which prevents marginal leakage. Successful disinfection is carried out by using triple antibiotic paste (TAP) as an intracanal medication due to its excellent antimicrobial activity, but its use is associated with discoloration of the tooth crown, the development of bacterial resistance, and allergic reactions. Aims: To evaluate the antibacterial efficacy of triple organic paste vs TAP against strains of Enterococcus faecalis, Streptococcus mutans, and Candida albicans. Methods and material: Natural products were divided into six groups and further divided into 18 subgroups. Minimum inhibitory concentration (MIC) was determined for each group using the trial and error method, and results were obtained after incubation for 24 hours at 37°C. Antibacterial efficacy was determined by zone of inhibition and compared with TAP (control group) individually against E. faecalis, S. mutans, and C. albicans. The values were recorded and subjected to statistical analysis by one-way analysis of variance (ANOVA) and Tukey's post hoc test. Results: All the subgroups have shown significant zone of inhibition values against E. faecalis, S. mutans, and C. albicans, except for the subgroup IC, where no statistically significant values were found when compared with the control group. Conclusion: Most of the combinations of natural products have shown better antibacterial efficacy when compared with TAP, suggesting its use to overcome the disadvantages of TAP. Further clinical studies are required for evaluating the antibacterial efficacy in vivo.



Vandana Chandran, M Smitha, Umme Azher, Santhosh T Paul

Comparative Evaluation of Antimicrobial Efficacy of Silver Diamine Fluoride and Curodont™ Protect Remineralizing Agents on Streptococcus mutans: An In Vitro Microbiological Study

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:5] [Pages No:147 - 151]

Keywords: Antibacterial efficacy, Dental caries, Remineralizing agents, Silver diamine fluoride, Streptococcus mutans, Zone of inhibition

   DOI: 10.5005/jp-journals-10077-3245  |  Open Access |  How to cite  | 


Background: Dental caries is regarded as a biofilm-induced oral disease, with Streptococcus mutans assaying a pivotal part in the onset and progression of the carious lesion. Hence, controlling the bacterial load of the oral cavity is one of the elementary objectives in the prevention of dental caries. Objectives: To evaluate and compare the antimicrobial efficacy of silver diamine fluoride (SDF) and Curodont™ Protect remineralizing agents on S. mutans. Materials and methods: An in vitro microbiological study was conducted to ascertain the antibacterial efficacy of SDF (group I) and Curodont™ Protect remineralizing agent (group II) against S. mutans. Chlorhexidine gluconate (CHX) gel 2.0% w/w (group III) and distilled water (group IV) formed the positive and negative controls, respectively. The antibacterial efficacy was determined by agar well diffusion method following 24 hours of incubation, and the diameter of zones of inhibition (ZOI) was quantified. The data were statistically analyzed using Statistical Package for Social Sciences (SPSS) version 22.0. One-way analysis of variance (ANOVA) test was used to compare the mean ZOI between groups, and Tukey's post hoc test was used to compare the mean difference in the ZOI among groups (level of significance set at p < 0.05). Results: The mean ZOI was significantly higher for the SDF group (38.33 ± 0.58 mm) as compared to the CHX group (26.67 ± 0.58 mm), with a mean difference of 11.66 [95% confidence interval (CI)] at p < 0.001. Curodont™ Protect and distilled water did not demonstrate any ZOI. Conclusion: SDF tooth remineralizing agent exhibited higher antibacterial efficacy against S. mutans in comparison with Curodont™ Protect remineralizing agent.



Paras Angrish, Ashish Kamboj, Malay Mitra, Rahul Kaul, Dempsy MM Chengappa, Aarti Sharma

Efficacy of Papain Gel—A Smart Alternative to Conventional Methods of Carious Dentin Removal: An In Vitro Study

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:5] [Pages No:152 - 156]

Keywords: Chemomechanical, Conventional caries removal, Papacarie, Papain gel

   DOI: 10.5005/jp-journals-10077-3247  |  Open Access |  How to cite  | 


Aim: The study was aimed at finding out the efficacy of the caries removal ability of a chemomechanical agent (papain gel) and comparing it with that of conventional slow-speed rotary carbide burs and mechanical hand excavators in deciduous extracted molars. Materials and methods: A total of 30 extracted teeth that were used for the present study were distributed equally among two major categories (15 each) by simple random sampling technique. The teeth were sectioned into two halves mesiodistally in a longitudinal plane through the center of the caries. In each category, the corresponding halves were sectioned off randomly but in equal numbers further into two groups as follows: Category 1: Group I hand excavators and group II carbide burs. Category 2: Group III hand excavator group and group IV Papacarie group. Parameters recorded included total time taken for caries removal and residual caries remaining using caries detection dye in each group and category, which were estimated and observed under a stereomicroscope (magnification 12.5×). The data was computed and statistically analyzed to find out and compare the efficacy of caries removal of three different methods used. Results: As per the critical difference (CD), the results of the study showed the caries removal mean time for group IV (Papacarie group) when compared to other groups was significantly higher (p < 0.01). Group II had a significantly lower mean time than the other groups (p < 0.01). Results also showed group II had a significantly lower mean area of residual caries than the other groups (p < 0.01). A significantly lower mean of residual caries was found in group IV than that in group I and group III (p < 0.05). Conclusion: From the results of this study, it was found that papain gel can be used as an effective alternative method compared to conventional methods for caries removal, especially in pediatric patients, owing to its lesser time commitment and better outcome.



Swapnaja V Gadekar, Amey M Panse, Prasad Jathar, Pradyumna S Khairnar, Abhijeet V Gadekar, Apurva Pawar

A Comparative Evaluation of Shear Bond Strength of Type IX GIC to Demineralized Dentin in Primary Teeth with and without Application of SDF: An In Vitro Study

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:7] [Pages No:157 - 163]

Keywords: Primary teeth, Shear strength, Silver diamine fluoride, Type IX GIC

   DOI: 10.5005/jp-journals-10077-3248  |  Open Access |  How to cite  | 


Background: Both deciduous and permanent teeth with single surface cavities have been demonstrated to respond well to the atraumatic restorative technique (ART) combined with glass ionomer cement (GIC). However, ART is not widely accepted due to the prevalence of secondary caries. The silver-modified ART (SMART) technique was proposed to address the drawback of ART. Materials and methods: The ultrasonic scaler was used to clean and debride 65 healthy, noncarious primary molars. The enamel was removed initially from each sample, exposing the dentin. The samples were placed in a 40 mL solution containing 2.2 mM each of potassium dihydrogen phosphate (KH2PO4) and calcium chloride (Cacl2) (pH 4.5) for 3 days to demineralize the dentin. The specimens were then randomly and equally divided into five groups (n = 13) as follows: group I has no application of silver diamine fluoride (SDF) + GIC; group II has SDF air-dried + GIC right away; group III has SDF light-cured + GIC right away; group IV has SDF air-dried + GIC after 24 hours, and group V has SDF light-cured + GIC right away. Result: Except for SDF air-dried + immediate GIC vs SDF air-dried + GIC after 24 hours, where there was an insignificant difference noticed, there was a remarkable difference noted for the values between the groups (p-value, 0.01, 0.05). Conclusion: This study looked at all four treatment groups and found enhanced shear bond strength, which suggests that SDF does improve the durability of the restorations.



Tanya Kakkar, Bhavna G Saraf, Gauri Kalra, Neha Sheoran, Anam K Khan, Pallavi Lakhanpal

Prevalence of Dental Fear and Anxiety and its Association with Behavior Using Three Fear and Anxiety Measurement Scales among Children in Faridabad

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:6] [Pages No:164 - 169]

Keywords: Behavior management of children, Children's fear survey schedule-dental subscale, Dental fear and anxiety, Modified child dental anxiety scale

   DOI: 10.5005/jp-journals-10077-3249  |  Open Access |  How to cite  | 


Introduction: Dental fear and anxiety (DFA) start mostly at the beginning of childhood and persist through adolescence, and it can have a major influence toward the provision of dental services. For effective dental treatment, a good rapport between the pedodontist and the patient is the key, which helps in identifying anxious children. Aim: The aim of the study was to assess the prevalence of DFA and its association with behavior, using three fear and anxiety measurement scales among children in Faridabad. Materials and methods: A cross-sectional study was conducted on 400 children (3–14 years) who visited the Department of Pedodontics and Preventive Dentistry. The children were divided into three groups according to age, and DFA levels were assessed by three sets of questionnaires, namely: Modified Child Dental Anxiety Scale (MCDAS) faces version, Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Dental Fear Survey (DFS). The operator assessed the behavior of the children according to modified Frankl's behavior rating scale (MFBRS). Results: The prevalence of high dental fear in children aged 3–14 years was 63.8% according to MCDAS, 50.8% according to DFS, and 54% according to CFSS-DS. In the assessment of the impact of age on dental fear levels, it was found that the level of DFA decreases with an increase in age. Conclusion: Assessment of DFA, along with behavior management, is the most vital tool in the hands of pediatric dentists, as it helps them to execute the required treatment plan in the most effective manner.



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

An Interim Replacement for Missing Teeth in Children with Temporary Anchorage Device: A Lesser Showcased Aspect

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:6] [Pages No:170 - 175]

Keywords: Avulsion, Interim replacement, Prosthetic rehabilitation, Temporary anchorage device

   DOI: 10.5005/jp-journals-10077-3240  |  Open Access |  How to cite  | 


In this modern age, where the appearance and outlook of an individual play such an important role, missing anterior teeth can be very traumatic to the younger generation, both physically and psychologically. Now with the introduction of a temporary anchorage device (TAD), an interim replacement for these teeth without hampering the adjacent teeth or giving the young patient an unpleasant feeling of wearing fake teeth is possible until the growth is completed. Not much data is available in the literature regarding its use; hence, the aim of this case series is to report the cases where orthodontic TADs were successfully used for interim prosthetic rehabilitation in children suffering from partial edentulism due to the avulsion of young permanent teeth. The results obtained showed great success with healthy gingiva, as well as bone around the miniscrew, and there was no loosening or breakage of the miniscrew or the crown during the period of 1-year follow-up.



Sumita Upadhyay, Rasna Shrestha, Parayash Dallakoti, Sanju S Poudel, Diwas Dhungana

Oral Health Considerations for the Management of Patients with Junctional Epidermolysis Bullosa

[Year:2022] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:176 - 179]

Keywords: Blisters, Bullae, Fragile skin, Junctional epidermolysis bullosa

   DOI: 10.5005/jp-journals-10077-3246  |  Open Access |  How to cite  | 


Epidermolysis bullosa (EB) is a group of hereditary disorders characterized by the mechanical fragility of skin and the appearance of blisters, bullae, and ulcers. This case report presents a 10-year-old boy with junctional EB (JEB) diagnosed at 2 months of age, with skin and oral presentation. There were scar marks of the healed lesion on the forehead, ear, neck, body, palms, and feet. There were no nails in any of the fingers of hands and feet. Ulcers were seen on the lateral border of the tongue, and caries involving pulp were found in three permanent molars. Preventive procedures were performed and root stumps were extracted. Limited mouth opening posed a problem for root canal treatment of permanent molars. Management of EB is challenging and requires a multidisciplinary team approach.


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