Aim: This study was aimed to evaluate effects of various beverages on microhardness of esthetic restorative materials. Materials and methods: A total of 160 disk-like specimens were prepared with 40 specimens each using nanocomposite resin, nano-ionomer, compomer, and conventional composite resin as experimental groups. Forty primary teeth were prepared and mounted in acrylic to be used as control group. Microhardness of the restorative materials was measured using Vickers microhardness tester at baseline and after immersion in various beverages. The difference between the two readings was evaluated within different groups. Results: In general, low pH beverages adversely affected the properties of the tested materials. Microhardness of tested materials was significantly decreased after immersion in various beverages with the exception of Yakult. After the immersion period, the enamel showed the maximum loss in microhardness followed by nano-ionomer. Conclusion: Low pH beverages were the most aggressive media for enamel, nano-ionomer and compomer, but in contrast, composite resin was relatively less affected. Probiotic drink appeared relatively benign toward the tested materials.

Aim: To evaluate the microtensile bond strength of teeth restored with packable composite after removing caries with three chemomechanical caries removal agents (Carisolv, Papacarie and Carie-care) and also to analyze its effect on chemical composition of dentin using energy-dispersive X-ray (EDX) analysis. Design: A total of 40 carious molars with 1 to 1.5 mm of remaining dentin were selected and divided into four groups of 20 each. Group I (control)—bur, group II—Carisolv, group III—Papacarie, group IV—Carie-care. A total of 15 samples from each group were restored with composite; 1 mm thick sections were made and were debonded under tensile load. Remaining five samples from each group were subjected to EDX for elemental analysis of dentin surface. Results: No statistically significant difference in the bond strength values and Ca/P ratio was observed between control group and three chemomechanical agents tested in the study. Conclusion: None of the chemomechanical agents tested in the study adversely affected the bond strength of composite resin to caries-affected dentin. Therefore, newer papain-based chemomechanical agent Carie-care can be considered as an equally effective economical alternative to commonly used agents Carisolv and Papacarie.

Introduction: The principal goal of dentistry is to maintain and improve the quality of life of the dental patients. As many of these objectives require the replacement or alterations of the existing tooth structure, the main challenge for centuries has been the development and selection of biocompatible materials that can withstand the unique conditions of the oral environment. Finite element analysis (FEA) is a modern technique of numerical stress analysis that has become a solution to the task of predicting failure due to unknown stresses by showing problem areas in a material and allowing designers to see all of theoretical stresses within. Aims and objectives: To evaluate and compare the effect of various temperature changes on the stress distribution, in class II mesial-occlusal-distal (MOD) cavity when restored with different restorative materials, using the finite element method (FEM). Materials and methods: Using FEA, various thermal stresses generated in class II MOD lesion using different restorative materials were studied. Results: The computer-generated models of intact tooth and teeth restored with the different restorative materials were designed, and thermal stress at different temperatures was observed when subjected to the thermal loads of 5°C, 20°C, 36°C, and 55°C. From the results of the study, it can be concluded that glass ionomer cement (GIC) performed best, followed by intact tooth, composite resin, silver amalgam, and zinc oxide eugenol cement. Conclusion: Restoration of class II MOD lesions with materials of lower modulus of elasticity and lower coefficient of thermal expansion will enable better stress distribution.

Aim: To determine the frequency and reasons of missed and canceled pediatric dental appointments and identifying the factors associated with it among the patients visiting the pediatric dental clinic of the dental college in Navi Mumbai, Maharashtra, India. To assess the parents’ perception regarding the treatment of their children and to explore the merit of different management strategies regarding the missed appointments. Materials and methods: Self-administered questionnaires were handed over to the parents in the waiting area, whose children were undergoing treatment in the pediatric dental clinic. Questionnaire included questions pertaining to the sociodemographic characteristics, methods of remembering appointments, and satisfaction with the overall past clinic experience. Results: Of the 294 surveyed sample, 52.0% stated that they have missed an appointment. Highest percentage of the patients had missed due to parents’ forgetfulness and patient's exams; 52.0% relied on their memory to remember their appointments, and 44.5% used their diaries and mobiles as a means of reminders. For canceling an appointment, most of them stated that patient was unwell and parents’ commitments toward other work led to an increase in rates of no-shows. Socioeconomic status and the methods of remembering the appointment date were found to be significantly correlated with missing an appointment among the surveyed sample (p < 0.05); 48.3% said that they would want a call from the dentist a day prior to their appointment as a reminder. Conclusion: Around one half of the patients attending the pediatric dental clinic missed their appointments. Patients most likely to fail to keep an appointment was the one who was young, remembered appointment via memory, came from a high socioeconomic class, most of them were males, and had previously broken appointments, while patients preferred receiving a call from the dentist as a reminder aide. Clinical significance: Missing appointment creates a series of problems. Firstly, it deprives another patient the opportunity of getting treated. Secondly, it contributes to the development of long waiting list for dental services. Thirdly, it affects the atient's treatment time and may cause increase in the dental emergencies leading to a disruption in the doctor–patient relationship and behavioral management problems.

Introduction: Dissolution of the enamel in the form of erosion has increased due to shift in eating habits toward carbonated drinks like soft drink and chocolates. Aim: The purpose of this study was to evaluate changes in the salivary pH after intake of different eatables and beverages in children at different time intervals. Study design: Using standard salivary tests, this study was conducted as a case–control study. Fifty children between ages of 8 and 12 years having strict vegetarian diet were included in the study. Materials and methods: Oral prophylaxis was done and salivary buffer capacity for stimulated saliva was measured. Before the saliva collection, each of the children was informed not to eat or drink anything for up to 2 hours just before the appointment. Results: On pairwise evaluation, all the differences were found to be significant statistically except between baseline vs 30 minutes. Maximum mean difference was calculated and observed between baseline and immediately after intake of fruit juice and immediate after 30 minutes, 0.953 and 0.963 respectively, while minimum difference was calculated and observed between baseline and 30 minutes after intake of fruit juice (0.010). Conclusion: Maximum drop was seen in cold drink when compared with fruit juice. The maximum pH increase was observed in cream biscuits with 7.63 ± 0.20. It was observed that in all the groups, the pH gradually got back to near normal levels due to the buffering mechanism of saliva.

Objectives: The objective of this in vitro study was to assess the surface hardness through Vickers hardness (VH) test of one conventional hybrid resin composites (Filtek Z350), compared with that of two bulk cure resin composites (SDR™, Tetric N Ceram®). Materials and methods: Twenty specimens of each material were prepared in cylindrical aluminum molds with an internal diameter of 5 mm and depth of 4 mm, 10 (incremental curing) and 10 (bulk curing). The surface of each specimen was covered with a transparent plastic matrix strip before light curing with conventional visible light for 40 seconds. The specimens thus obtained were stored in deionized water and transferred to an incubator at 37°C for 24 hours to simulate clinical conditions. After 24 hours, the microhardness of each specimen was measured using a Vickers indenter, with a load of 100 gm and dwell time of 15 seconds (HV 0.2/40). The specimens were further subjected to VH test in an interval of 7, 30, and 90 days. The data were subjected to statistical analysis—Student's t test, analysis of variance, and post hoc Tukey's test. Results: The present study showed that SDR™ in bulk curing showed consistently greater value of hardness and was comparable to traditional incremental cured Filtek Z350, highlighting the advantages of the new SDR technology.

Introduction: Although selective caries tissue removal decreases the number and diversity of bacteria, stops the caries process, and reduces the risk of pulp exposure, the studies on the minimally removal of caries tissue are limited and further clinical research is necessary in this field. Aim: This study aimed to evaluate through clinical and radiographic assessments the in vivo response of the dentin–pulp complex of human deciduous teeth after either partial or total caries removal (TCR). Materials and methods: A total of 49 deciduous molars of children aged between 5 and 9 years were carefully selected. The teeth were divided into two groups: Group I: Partial removal of caries; group II: Total removal of caries. Clinical and radiographic evaluations were performed during the period of 4 to 6 months after the procedure. The intraexaminer reproducibility was determined by Kappa test. Fisher's exact test was used to determine the statistical difference between groups. Results: All teeth showed clinical success during the 4- to 6-month evaluation period. The radiographic evaluation showed 94.2 and 89.6% of success rate in groups I and II respectively. Radiographic results did not show statistically significant differences between the studied groups (p > 0.05). Conclusion: The partial caries removal (PCR) showed satisfactory clinical and radiographic outcomes, suggesting that this minimally invasive approach might replace the TCR when correctly indicated.

Aim: To study the prevalence of orofacial manifestations in leukemic children undergoing treatment and to correlate these manifestations with various stages of chemotherapy. Materials and methods: A prospective noninvasive study comprising 43 acute lymphocytic leukemic pediatric patients at various stages of therapy. They were examined on day of their each blood examination, and lesions were recorded on a self-designed pro forma. A total of 133 observations were recorded by a single observer. The treatment was divided into the phase of induction, consolidation, maintenance, and relapse. Results: The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 10.1. There were 24 males and 19 females in this study, aged between 3 and 13 years. The common oral lesions seen were dental caries, lymphadenopathy (86.04%), pallor (65.11%), ulcers (13.95%), mucositis (16.27%), gingival enlargement, hemorrhages (20.93%), candidiasis, herpes simplex virus (HSV) infection, xerostomia (44.18%), paresthesia, and tooth mobility. Herpes simplex virus infection was seen only during induction and consolidation phases. Ulcers were seen during all phases of therapy. Clinical significance: Orofacial manifestations may be seen as the first sign of leukemia and a dentist may play a significant role in the diagnosis of the disease per se. This study highlights not only about commonly occurring lesions but also their variation during various phases of therapy. To the best of our knowledge, no study has such an extensive reporting of orofacial manifestations of acute lymphocytic leukemia (ALL) patients under treatment.

Aim: To compare the levels of vitamin D in children with severe early childhood caries (SECC) and children without caries and to determine the association of vitamin D deficiency and SECC. Materials and methods: A total of 30 children each from case (with caries) and control group (without caries) of age between 3 and 6 years were selected from the Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, SGT University, Gurugram. Caries status of the children was recorded using decayed, extracted, and filled teeth (deft) index. Blood samples for serum 25(OH) vitamin D were taken from each child. All the data collected were compiled and subjected to appropriate statistical analysis. Results: Case group has mean serum 25(OH) vitamin D level of 12.19 ng/mL [4.37 standard deviation (SD), 95% confidence interval of 10.5–13.8] and control group has mean serum 25(OH) vitamin D level of 20.11 ng/mL (4.12 SD, 95% confidence interval of 18.56–21.65). When the mean levels of serum 25(OH) vitamin D were compared between case and control groups, there was a statistically significant difference (p-value <0.0001). Simple linear regression in case group shows statistically significant inverse correlation between vitamin D levels and SECC (p-value<0.0001). Conclusion: Our results showed that vitamin D deficiency is risk factor both for incidence of dental caries and for its severity in children. Clinical significance: Vitamin D deficiency is an important modifiable risk factor for dental caries in children. Hence, by supplementing vitamin D in children and preventing the deficiency of vitamin D, dental caries can be prevented.

Aim: Parental presence often provides unique challenge in dental operatory and is directly related to the quality dental treatment. The present study was done to investigate parent's ability to assess dental anxiety of their 6- to 10-year-old child and to determine how parent's and children's fear assessments correlate with each other. Materials and methods: Prior to dental treatment, 94 child– parent combinations were included to complete Children's Fear Survey Schedule—Dental Subscale (CFSS-DS) questionnaire, and Frankl score was assigned to children during treatment by operator. Results: Mean dental anxiety score reported by the children was 27.74, whereas by their parents was 39.64. There was a poor consistency of parents to predict their child dental fear (p < 0.05). Parents reported higher dental fear for their children. Conclusion: Parents assessment of their child's fear may vary in accordance to factors, including their own dental fear. Such input may prevent dentists from establishing an accurate association with the child's patient.

Aim: Oral habits during and beyond preschool age are one of the important etiological factors in developing malocclusion and other ill effects on orofacial structures. The objective of the present study was to know the prevalence of deleterious oral habits among 3- to 5-year-old preschool children in Bhubaneswar, Odisha, India. Materials and methods: This cross-sectional study was conducted among preschool children, in the age group of 3 to 5 years in the city of Bhubaneswar, Odisha, India. To carry out this study, six private schools, two from each of the three electoral constituency, were selected using cluster sampling technique. A total of 500 students, studying in LKG and UKG and their respective mothers/caregivers were selected for the study as per the inclusion/exclusion criteria. Prevalence of different oral habits in children was calculated from the data obtained. Using Statistical Package for the Social Sciences (SPSS), version 17.0 software, Chi-square test was applied to compare the differences present between boys and girls and their significant values (p < 0.05). Results: The result of this study showed a high prevalence of oral habits (36%) among preschool children in Bhubaneswar, Odisha, India. Lip biting was found to be the most prevalent habit (13.4%), followed closely by thumb sucking (12.8%), bruxism (12.8%), and mouth breathing (11%). Conclusion: The study revealed a great dearth of a wellestablished dental education program for preschool children as well as their parents, caretakers, teachers, and pediatricians in order to provide an effective and timely care to the children.

Aim: The anxiety of dental procedure evokes physiological response in the human body similar to fear. The level of cortisol and alpha-amylase in saliva can be considered as one of the major biomarkers of stress and anxiety. Our study was aimed to correlate the stress and anxiety with the levels of salivary cortisol (SC) and salivary alpha-amylase (SAA) in patients undergoing routine dental extraction. Materials and methods: The levels of SC and SAA were assessed pre- and postextraction in the salivary samples of 20 children. Results: The values of cortisol and alpha-amylase showed a significant increase postextraction. Conclusion: Salivary cortisol and SAA can be considered an important and noninvasive tool for assessment of anxiety, such as dental extraction, in children. Clinical significance: Increase in the stress levels of a child in the dental operatory procedures like tooth extraction suggests the use of some behavior modification and shaping techniques by dentists to overcome the anxiety of the child before commencement of the procedure. This can aid in better cooperation of the child during treatment as well as helps in internal motivation toward future dental treatment.

Autism is an intellectual developmental disorder characterized by insidious disability in communication, social interaction, and using language and abstract concepts. This organic disorder is known to have deformities in brain, i.e., cerebellum and limbic system, showing wide spectrum of systemic and behavioral symptoms. The oral health care of such patients can be complicated as they cannot verbalize complaints about any dental problems they may be experiencing and can display a variety of behaviors and reactions to small changes also. This study summarizes etiology and diagnosis of this disorder with the special emphasis on the issues encountered while coping with children with autistic spectrum.

Introduction: This review was undertaken to analyze the relationship between body mass index (BMI) and dental caries with the available literature evidence. Materials and methods: The articles were searched from Medline/PubMed and Journal of Web published between 2005 and 2016. Results: Out of the 146 references obtained, 16 articles in English language were read in full, which fulfilled the inclusion criteria after assessing by Down and Black criteria. Conclusion: No consensus was reached in the relationship between BMI and dental caries in the present review due to varied associations

Introduction: Childhood obesity, dental caries, and periodontal disease are major public health problems due to their adverse impact on the growth and development of children. Obesity and oral health are associated as both share some common risk factors. Aim: The specific aim of the study was to determine the correlation, if there is any, between obesity and oral health in children. Materials and methods: A cross-sectional survey was conducted in five districts of West Bengal, India. A total of 1,227 school-going children of 6 to 12 years were examined from the districts of Howrah, Hooghly, West Midnapore, South 24-parganas, and North 24-parganas. Following indices were analyzed: Decayed-missing-filled teeth (DMFT), decayed, extracted, filled teeth (deft), simplified oral hygiene index (OHI-S). Depending on their nutritional status, subjects were categorized as being normal weight, overweight, and obese. Logistic regression analysis were applied to the study to find out the association between the above-mentioned dental indices and independent variables: Gender and nutritional status. Result: A positive association was found between obesity and oral health status in children. Conclusion: Considering the results of this study, it was concluded that obesity is related to oral hygiene status of children. In order to improve oral hygiene status in children, dietary modifications need to be done.

Introduction: Dental caries is one of the major widespread health issues that continue to negatively affect the oral health of children globally. Aim: To estimate the prevalence of dental caries and its risk factors among preschool children of Bhubaneswar, Odisha, India. Materials and methods: The study was a community-based cross-sectional one among preschool children with (N = 425) participants recruited from the Anganwadi centers (AWCs) of Bhubaneswar, Odisha, India. By using a cross-sectional study design, dental caries was assessed using the World Health Organization (WHO) guidelines, and other socioeconomic and risk factors data were collected through parental interview using questionnaires. Caries was identified at both tooth and surface levels through visual dental examinations by trained and calibrated dentists. Logistic regression analyses were used to identify associations among variables and caries. Results: The proportion of preschool children suffering from dental caries was found to be 47.29%. The multivariableadjusted model depicted that longer duration of breastfeeding was a significant predictor as follows: Those who had breastfed for more than 36 months [adjusted odds ratio (AOR): 5.41; 95% confidence interval (CI): 2.97–9.85; p = 0.001], 12 to 24 months (AOR: 2.1; 95% CI: 1.04–4.36; p = 0.037), followed by increase in age 61 to 72 months (AOR: 5.39; 95% CI: 2.72–10.67; p = 0.001), 49 to 60 months (AOR: 2.53; 95% CI: 1.41–4.52; p = 0.002), more than two children in the family (AOR: 2.70; 95% CI: 1.55–4.69; p = 0.001), and children who did not brush the teeth under the parent's supervision (AOR: 2.70; 95% CI: 1.55–4.69; p = 0.001). Conclusion: The study highlights the need to increase awareness about the oral health and hygiene among parents of preschool children in India.

Most of the lesions in the oral cavity have papillary appearance. Oral squamous papilloma (SP) is one such type, which is a benign proliferation of the stratified squamous epithelium and presents as papillary or verrucous exophytic mass induced by human papillomavirus (HPV). Most of the oral mucosal lesions are often asymptomatic and have small progression. The common sites of occurrence include tongue, soft palate, and uvula. Squamous papilloma arising on hard palate is described in this article. Surgical excision of the lesion was done and sent for histopathological analyses that confirmed the clinical diagnosis. In larynx and trachea, malignant transformation of papillomas has been reported. The potentially malignant nature of SP if present needs to be explored.

Trauma is a common cause of fractured teeth with exposed canals in growing children. These children use foreign bodies like stapler pin, lead pencil, nail, etc., to explore the canal of fractured tooth. Sometimes, these foreign objects may get stuck in the canal, which the children do not reveal to their parents because of fear. These foreign objects may act as a potential source of infection. We herewith present a case of a 12-yearold boy who presented with a stick lodged in the root canal of maxillary right lateral incisor along with the displaced fractured tooth segment at the apex and the associated management.

Hereditary gingival fibromatosis (HGF) is an uncommon gingival disease of attached gingiva, which is manifested as localized or generalized form. The HGF inheritance is transmitted through both autosomal dominant and recessive modes. Here, we are discussing a rare case report of an 8-year-old child with gingival fibromatosis in mixed dentition, which caused damage to his speech, mastication, and esthetics and led to significant change in his facial profile. The patient noticed that the gingival enlargement was simultaneous with deciduous dentition eruption and gradually covered entire dentition. Gingival enlargement covered all teeth anteriorly and posteriorly and only occlusal surfaces were visible. The enlarged tissue was resected by the external bevel gingivectomy under general anesthesia arch wise. The postoperative healing was satisfactory, uneventful, and there was significant change in patient's esthetics. Patient has been kept on regular recall visits.

Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder, characterized by extremely short attention span, impulsivity with resultant behavioral problems. They are prone to trauma and frequent dental injuries. The behavioral issues, cognitive deficits, and short attention span pose a challenge to the dental health team. Management of these children requires several modifications in approach at all levels of prevention and treatment. This study reviews all the pertinent oral health issues in these children and also presents the case report of a 14-year-old boy diagnosed with ADHD.