Aim and background: Children with special health care needs (CSHCN) are one of the world's underserved dental patient populations. Poor oral hygiene may be caused by an underlying disability, decreased manual dexterity, or an adverse effect of certain drugs. Conducting frequent professional dental visits to promote preventative oral health habits and ensure early detection and therapy of dental abnormalities is one strategy to preserve oral health status. Numerous studies have regularly demonstrated that the CSHCN continues to face significant challenges and barriers in accessing medical and dental treatment. To identify the clinical barriers that general dentists confront when diagnosing and treating CSHCN in Gujarat, India. Materials and methods: A cross-sectional survey was conducted among the Indian Dental Association (IDA) members of Gujarat. A validated electronic questionnaire was sent to the participants through e-mail. The data collected was entered into a computer and analyzed using the Statistical Package for the Social Sciences (SPSS) software. Results: About 93.8% of the participants were aware of the term CSHCN, but only 28.1% of them participated/attended a course on diagnosis and treatment of CSHCN (p < 0.001). Despite being not specially trained 54.4% of practitioners have treated a CSHCN with an untrained nonclinical staff (56.9%). Lack/difficulty in communication (72.5%) with the child was the biggest barrier. Conclusion: This study presented a reliable picture of the barriers to access for CSHCN within the dental practice system. Recommendations for changes to the undergraduate dentistry curriculum should be made in order to better prepare future graduates to work with this group of special children.

Aim: To evaluate the efficacy of cognitive-behavioral play therapy (CBPT) and tell-show-do (TSD) technique in the behavior modification of uncooperative children during local anesthesia prior to dental extraction. Materials and methods: Sixty-two children aged 6–11 years with Frankl's behavior rating of two during their first dental visit and requiring the extraction of retained or mobile primary anterior teeth under local anesthesia were divided into two groups: group I—CBPT, and group II—TSD. Children in group I were introduced to the dental instruments using verbal explanations, actual dental instruments, and a toy demonstration. They were then allowed to role-play as the dentist on a customized toy mouth. Children in group II received an explanation and a demonstration of the procedure before undergoing it. The behavior and anxiety levels of the children were assessed at three different points during the course of the trial. Pulse rate records served as an objective measure of anxiety. Results: Group I showed a statistically significant reduction in pulse rate between the baseline and posttreatment scores (Z = 2.286, p = 0.067 and Z = 3.49, p = 0.002), while no significant change was observed in group II. Both groups showed a significant reduction in behavior and anxiety scores when comparing baseline to postintervention and baseline to posttreatment scores. There was no significant difference in behavior and anxiety scores between groups I and II with the Mann–Whitney U test, with a level of significance at p < 0.05. Conclusion: Cognitive-behavioral play therapy showed greater amelioration in behavior and anxiety levels of children compared to TSD technique. Clinical significance: Cognitive-behavioral play therapy is a safe and noninvasive method to educate children about dental procedures and allow them to role-play, promoting more positive memories and a greater willingness to return. Clinical trial registration: The clinical trial was registered at Clinical Trials Registry—India (CTRI Reg. number: CTRI/2021/05/033675).

Aim: This research aims to assess the reliability of various mixed dentition analyzes among the adolescents of Tamil Nadu and to devise a new regression equation by comparing the current mixed dentition analyzes. Settings and design: About 900 adolescents (13–18 years of age) were selected from the state of Tamil Nadu using stratified multistage sampling. Materials and methods: On the stone casts, the maximum mesiodistal width of permanent lower incisors, canines, premolars, and first permanent molars were measured. The measured values were analyzed and compared with existing mixed dentition analysis methods. Statistical analysis: Descriptive statistics were performed, and Pearson's correlation coefficient analysis was done. The p-value is kept at p < 0.05. Results: The teeth widths show sexual dimorphism and were larger in males than females. Moyer's (21.3 ± 0.6), Legovic's (21.1 ± 0.6), and Bachmann's (20.6 ± 0.6) methods significantly predicted the actual width (21.9 ± 1.3) in maxilla, whereas Moyer's (20.3 ± 0.5), Gross and Hussund's (21.0 ± 0.6), and Tanaka and Johnston's (20.3 ± 0.7) methods significantly predicted the actual width (20.3 ± 1.0) in mandible. Though these methods significantly predicted, they either overestimated or underestimated in the majority of cases. Hence, a regression equation was developed based on the results of the study. Conclusion: The basis of various mixed dentition analysis methods is the mesiodistal width of the teeth which is subjected to variability due to racial and ethnic factors. Therefore, the reliability of these analyzes should be analyzed in different racial groups. The regression equation developed in the study though holds good for a small set of samples, it should be tested on a large-scale for its reliability and accuracy.

Introduction: Maintenance of good oral hygiene helps in preventing dental diseases. One of the primary etiologies for the development of dental diseases is plaque. The development of a complex flora known as mature dental plaque on the surface of the tooth begins with a small number of pioneer microbial species. Microorganisms like Streptococcus mutans and Candida albicans are predominantly found in dental plaque and are associated with caries lesions. It is an established fact that S. mutans plays a vital role in initiating dental caries and C. albicans has been shown to enhance the adherence of S. mutans to the tooth surface. Dentifrices play a pivotal role in the removal of dental plaque. The market is flooded with various types of herbal and nonherbal toothpaste. Aim and objective: To evaluate the antimicrobial efficacy of commercially available toothpastes on C. albicans and S. mutans isolated from the saliva of patients with early childhood caries (ECC). Materials and methods: This ex vivo study was conducted on 40 children with ECC (aged 3–6 years). Saliva samples were collected and sent for microbial analysis. Positive samples of C. albicans and S. mutans were divided into two groups of 20 each. Five toothpastes and distilled water as the control group were used to test the microorganisms. The agar well diffusion method was used to check the effectiveness of the toothpastes. Results: Dabur Meswak showed the maximum zone of inhibition against S. mutans and C. albicans. Conclusion: The regular use of herbal toothpaste is an alternative to traditional toothpaste because of its effectiveness and chemical-free nature.

Background: As the importance of preserving natural teeth becomes evident, the notion of minimal intervention dentistry (MID) is becoming more acceptable. Two such feasible techniques for caries removal are chemomechanical agents (Carie-Care) and polymer burs (SmartPrep bur). Aim: To compare the clinical efficacy (effectiveness) and efficiency (time taken) of selective removal of carious dentin using Carie-Care and SmartPrep burs in primary teeth. Materials and methods: A comparative split-mouth study was carried out on 4–9-year-old children. Around 70 primary second molars in 35 children were allocated to group C (Carie-Care) and group S (SmartPrep burs). Efficacy and efficiency of caries removal, behavioral change, and pain perceived were evaluated in both groups. Results: The efficacy of caries removal was better with Carie-Care than SmartPrep burs when assessed using visual, tactile, and caries-detector dye methods, though not statistically significant. However, significantly more time was taken for caries removal with Carie-Care than SmartPrep burs (p < 0.001). There was also a statistically significant positive change in behavior in group C and group S when assessed using the Frankl scale (p < 0.001 and p = 0.004) and the Venham scale (p < 0.001 and p = 0.002), respectively. Additionally, 91.4% in group C and 77.1% in group S demonstrated comfort during caries removal, which was statistically nonsignificant (p = 0.101). Conclusion: Carie-Care and SmartPrep burs were both equally effective and comfortable and brought about a positive behavior change, though Carie-Care was found to be more time-consuming. Clinical significance: Minimal intervention techniques for caries removal maximize the preservation of healthy dental tissues while reducing dental fear and anxiety (DFA) in children.

Background: The tobacco-free educational institution (ToFEI) guidelines by the Government of India (GOI) can be used by schools as a self-evaluation scorecard to assess the implementation status of these guidelines. Aim: This observational study assessed the school's adherence to the ToEFI guidelines in the district of Saharanpur, Uttar Pradesh, India. Materials and methods: Around 102 schools (62 government and 40 private) were conveniently selected in a block. None of the schools fulfilled the criteria of mandatory scores. The government schools (32.87 ± 20.97) scored significantly more than private schools (20.45 ± 13.31) for overall ToFEI scores (p = 0.001). The mean mandatory ToFEI scores observed in the government and private schools were 18.71 ± 14.87 and 9.0 ± 7.08, respectively (p = 0.001). None of the schools have marked a 100-yard area from the outer limit of the boundary wall/fence of the educational institute. Conclusion: The mean ToFEI scores were very low among the schools included (28.0 ± 19.27). The alarming situation calls for integrating the ToFEI agenda into regular school-based programs and assisting schools in attaining a tobacco-free status.

Background: Toothbrushing is the most widespread method of oral hygiene maintenance at a personal level. With the variety of toothbrushes available on the market and increasing awareness about making sustainable choices, bamboo toothbrushes are gaining popularity. Since worn-out toothbrushes lose their effectiveness, this study aims to compare the wear between nylon-bristled toothbrushes and bamboo toothbrushes with plant-based bio-bristles. Materials and methods: Toothbrush bristle wear was checked between bamboo toothbrushes with plant-based bio-bristles and nylon-bristled toothbrushes after 7 days of use by 20 participants aged 8–11 years, using the wear index (WI) and acceptable percentage of bristle end morphology. The Mann–Whitney U test and Fisher's exact test were used to compare measurements of WI and acceptable percentages of bristle end morphology. The difference was considered significant if p < 0.05. Results: The WI of nylon bristles was −0.0120 ± 0.0986, with a standard error of the mean of 0.0311. For bamboo bristles, the mean was 0.1001 ± 0.0920, with a standard error of the mean of 0.0291. In the nylon bristles group, nine (90%) of bristles had acceptable morphology, whereas one (10%) had nonacceptable morphology. In the bamboo bristles group, three (30%) of bristles had acceptable morphology, whereas seven (70%) had nonacceptable morphology. Conclusion: This study compares the wear between nylon-bristled toothbrushes and bamboo toothbrushes with plant-based bio-bristles and indicates that nylon-bristled toothbrushes exhibit lower wear compared to bamboo toothbrushes with plant-based bio-bristles.

Adhesive dentistry depends on cautious tooth preparation for long-term cosmetic maintenance. New instruments and methods have been developing continuously to address this. When it comes to anterior teeth, esthetics is crucial. Direct and indirect laminate veneers are preferred over full-ceramic crowns due to their conservative and esthetically pleasing nature. Aim: As an alternative to crowns and veneers, this article intends to preserve primary tooth structure through digital workflow for individualized restorative preparation. Materials and methods: In order to produce a customized restoration using Chairside Economical Restoration of Esthetic Ceramics (CEREC), the palatal margins are tailored in this restoration without affecting the occlusion. Under local anesthesia, just the labial and modest proximal reductions were performed. Results: A beautiful and effective restoration was provided. Conclusion: Here, the customized restoration is not only esthetic but is minimally invasive as compared to prefabricated crowns covering all tooth surfaces. This acknowledged for sustainable functional customized restoration which restored the natural appearance of the tooth.

The solid malignant tumor of undifferentiated myeloid cells with extramedullary infiltration is known as myeloid sarcoma (MS), which is uncommon in occurrence. Other names for MS include myeloblastoma, extramedullary myeloid cell tumor, and granulocytic sarcoma. Lymph nodes, skin, and bones are the most frequent sites, while the orbits and central nervous system are less frequently affected. Comprehensive research on this condition has been hindered by the rarity of MS in pediatric populations. The main objective of this paper was to provide a case report of bilateral mandibular MS diagnosed in an 8-year-old female child.

Background: Supernumerary teeth are developmental anomalies caused by excessive cell proliferation in the dental lamina or by continuing bud formation in the enamel organ. There have been instances where supernumerary teeth lead to cystic formation, aberrant diastema, crowding of the affected region, anterior crossbite, delayed or blocked eruption of succedaneous teeth, displacement or rotation, and occasionally eruption into the nasal cavity. Upon encountering an anterior dental crossbite, different treatment options can be implemented, including the use of tongue blades, reverse stainless-steel crowns, fixed acrylic devices, bonded resin-composite inclines, and removable acrylic appliances equipped with finger springs. Case description: This particular case report illustrates a unique instance of correcting an anterior crossbite in the mixed dentition stage, induced by supernumerary teeth, in a 10-year-old boy through the application of removable Planas direct tracks (PDTs). Conclusion: Early surgical intervention and minimally invasive orthodontic forces may be utilized to address potential occurrences of such situations with minimal disruption to the adjacent oral structures.

Traumatic dental injuries (TDIs) are common in children and young adults, with maxillary incisors being most commonly affected. Crown-root fractures account for 5% of TDIs affecting permanent dentition. Management of these requires consideration of endodontic, periodontal, and restorative factors. Various treatment options are available that need to be chosen based on the clinical scenario. This article reports two cases of crown-root fractures in children, which were managed using a multidisciplinary approach. The two major challenges faced during the treatment were salivary contamination during endodontic treatment and subgingival fracture margins. These challenges were successfully managed, and the remaining tooth structure was preserved, which maintained the alveolar bone height around the area and prevented malalignment of the adjacent teeth. This also helped in the psychological and social well-being of the child.