International Journal of Clinical Pediatric Dentistry

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2021 | September-October | Volume 14 | Issue 5

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Konda Suhasini, Rodda Rajashekhar, Jampanapalli Sharada Reddy, Inguva Hemachandrika, Tarasingh Patloth, Hasanuddin Shaik

Awareness and Attitude of General and Specialist Dentists in Providing Oral Health-related Quality of Life for Children with Special Healthcare Needs

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:3] [Pages No:601 - 603]

Keywords: General dentists, Special healthcare children, Specialist dentist

   DOI: 10.5005/jp-journals-10005-1968  |  Open Access |  How to cite  | 


Special healthcare needs children (SHCNC) requires specialized knowledge acquired by additional training, as well as increased awareness and accommodative measures on part of general practitioners and specialist dentists beyond what is considered routine. Most dentists face challenges in treating these children, due to lack of awareness and insufficient training regarding the management of such children in a dental operatory. Aim and objective: This study was undertaken to investigate the awareness, practices, and hurdles faced by general dentists and dentists of various specialties in providing oral healthcare to children with special healthcare needs. Materials and methods: The study was conducted in dental colleges and private dental clinics in and around Hyderabad. General dentists and dentists of various specialties were assessed through a structured questionnaire. Statistical analysis: The data obtained were analyzed with a Chi-square test (SPSS Version - 20). Results: The study showed that 80% of the dentists were willing to treat these children, but lack of sufficient training has been the major hurdle in the management of these children. Conclusion: The training of dentists in taking care of children with special healthcare needs should be enhanced to provide comprehensive dental care to these children, thereby enabling them to realize their normal level of functioning and lengthening their life span.



Priyanka Bhaje, Abhijeet Faye

Sleep Difficulties and Symptoms of Attention-deficit Hyperactivity Disorder in Children with Mouth Breathing

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:6] [Pages No:604 - 609]

Keywords: Attention-deficit hyperactivity disorder, Mouth breathing, Sleep disturbances

   DOI: 10.5005/jp-journals-10005-1987  |  Open Access |  How to cite  | 


Aims and objectives: Persistent mouth breathing affects stomatognathic functions along with effects on the academics and social life of a child. Sleep-related problems and behavioral symptoms similar to that found in attention-deficit hyperactivity disorder (ADHD) can be present in mouth breathers. This study aims at assessing the sleep disturbances and pattern of symptoms of ADHD in children with mouth breathing. Materials and methods: A cross-sectional study was carried out on 100 children of mouth breathing (consecutively selected) in 7–12 years of age using semi-structured proforma, children's sleep habit questionnaire (CSHQ), and diagnostic and statistical manual of mental disorders, version 5 (DSM 5). Statistical analysis was done using SPSS software version 21. Mean, standard deviation, Chi-square, and Pearson's correlation coefficient test were utilized during the analysis. p value of <0.05 was considered significant. Results: Out of 100 children, 70 were males and 30 were females. On the CSHQ scale, the highest score was found on sleep-disordered breathing followed by sleep onset delay and daytime sleepiness. The commonest symptom of inattention was “failing to give close attention in school” (73%) whereas the commonest symptom of hyperactivity was “trouble waiting for his/her turn” (66%). Seven participants satisfied complete criteria for ADHD. Sleep duration and daytime sleepiness had a significant negative correlation with hyperactivity (p < 0.05). A positive correlation was observed between daytime sleepiness and inattention (p < 0.01). Conclusion: Children with sleep disturbances or ADHD should be assessed for the presence of mouth breathing, as early identification and correction of mouth breathing may help to prevent unnecessary exposure to the medication. Clinical significance: Children with ADHD or sleep disturbances should always be assessed for the presence of mouth breathing. Early identification and correction of mouth breathing may help in preventing unnecessary exposure to medication for treating ADHD.



BK Vanishree, Chidanandeswara Gangadharaiah, Shweta Kajjari, Bharath V Sundararajan, Nisarga Kansar

Comparative Evaluation of the Effect of Alum and Herbal Mouthrinses on Plaque Inhibition in Children: A Randomized Clinical Trial

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:6] [Pages No:610 - 615]

Keywords: Alum, Herbal, Mouthrinses, Plaque, Saline

   DOI: 10.5005/jp-journals-10005-2036  |  Open Access |  How to cite  | 


Background: Gram-positive and gram-negative bacteria that compose oral biofilms produce many metabolites that induce the formation of dental plaque. Dental plaque is the main factor for the initiation and progression of oral diseases. Plaque preventive measures like mechanical or chemical approaches can be used in combination with this. Aims and objectives: A study was done to compare and evaluate the effects of 0.02 M alum mouthrinse, herbal mouthrinse, and saline on plaque inhibition in children. Materials and methods: Sixty healthy children of age-group 9–12 years were included in the study and divided into 3 groups of 20 each: group I: alum containing mouthwash (0.02 M), group II: saline, and group III: herbal mouthwash, rinsing two times daily for 30 days. Plaque index scores were recorded from each individual on the 1st, 15th, and 30th day. Results: Alum group (group I) showed a highly significant reduction of plaque at 1st, 15th, and 30th day when comparison to herbal group (group III) and saline group (group II). Conclusion: Ingredients in the alum group (group I) were effective in plaque inhibition, it may serve as an alternative antimicrobial mouthwash. Further long-term study with a large population group is recommended to determine the efficacy of alum-containing mouthwash and herbal (Hi-ora) mouthwash in improving oral health status.



Lakshimi Lakshmanan, Vignesh Ravindran

Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:5] [Pages No:616 - 620]

Keywords: Cryotherapy, Local anesthesia injection, Pain, Topical anesthesia

   DOI: 10.5005/jp-journals-10005-2032  |  Open Access |  How to cite  | 


Background: Profound local anesthetic delivery promotes successful treatment for children in terms of easing their fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the utmost anticipated or anxious stimuli in the dental operatory. Precooling the oral mucosa by application of cryotherapy before local anesthetic injections can alter the pain perception in children. Aim and objectives: To compare the efficacy of cryotherapy application and 20% benzocaine gel at reducing pain perception during buccal infiltration in pediatric patients. Materials and methods: In this split-mouth study, 30 pediatric patients between 7 years and 10 years of age who needed maxillary buccal infiltration of local anesthetics bilaterally for dental treatment were selected. They received cryotherapy (ice pack) on one quadrant (test group) for 2 minutes and 20% benzocaine topical gel on the contralateral quadrant (control group). A pediatric dentist blinded to the study assessed sound, eye, motor (SEM) scale based on patients’ reaction during injection (objective method), and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection (subjective method). Statistical analyses were performed using Wilcoxon and Mann–Whitney U tests. Results: The cryotherapy group had significantly reduced pain scores on the VAS scale (40.66 ± 14.60) when compared with the topical anesthetic gel group (61.33 ± 9.73). The cryotherapy group had reduced pain scores on the SEM scale as well (1.2 ± 0.1) when compared with the topical anesthetic gel group (1.6 ± 0.1), which was not statistically significant. Conclusion: When compared with topical anesthetic gel, precooling the injection site with cryotherapy is beneficial in reducing pain before local anesthesia injection in pediatric patients. Clinical significance: Cryotherapy application eliminates the fear of pain ascribed to injection of local anesthesia and assists in providing pertinent dental care.



Arpita Deb, Veena Pai, Roopa R Nadig

Evaluation of Immediate and Delayed Microleakage of Class V Cavities Restored with Chitosan-incorporated Composite Resins: An In Vitro Study

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:7] [Pages No:621 - 627]

Keywords: Dye extraction, Hybrid composite, Microhybrid composite, Microleakage, Resin-based composites

   DOI: 10.5005/jp-journals-10005-2043  |  Open Access |  How to cite  | 


Aim and objective: To evaluate and compare the microleakage of unmodified microhybrid composite and 0.2% chitosan-incorporated composite in class V cavities restored immediately and after 3 months of storage in artificial saliva. Materials and methods: Sixty human permanent maxillary premolars were collected and standardized class V cavity prepared on the buccal surface of each tooth with dimensions: mesiodistally 3 mm, occluso cervically 2 mm, and depth of 1.5 mm and restored with microhybrid composite and chitosan-incorporated composite resins respectively and randomly divided: Group I: control-microhybrid composite (n = 30): (a) 15 teeth tested immediately (b) 15 teeth tested after 3 months. Group II–restored with chitosan + composite (n = 30): (a) 15 teeth tested immediately (b) 15 teeth tested after 3 months. Specimens were stored in artificial saliva following which a dye extraction test was carried out using a spectrophotometer. Results: There was no statistically significant difference in microleakage score between the chitosan-composite group and unmodified composite group when evaluated immediately after placing the restoration. Microleakage values of the unmodified composite group increased significantly after 3 months of storage in artificial saliva and values of the chitosan-composite group did not differ significantly even after 3 months of storage. Microleakage was seen significantly less in the chitosan-composite group compared to the unmodified composite group after 3 months of storage in artificial saliva. Conclusion: It can be concluded that chitosan-incorporated composite seems to have improved mechanical properties and forms a more stable bond when compared with unmodified microhybrid composite in addition to being antibacterial. Clinical significance: Considering the advantageous properties of this material, it may be clinically useful in restoring class V cavities in patients with high caries risk. However, further in vitro and in vivo studies need to be carried out.



Sharon Jose, Prasanna K Bhat

Evaluation of Anatomical Variations in Root and Canal Morphology of Primary Maxillary Second Molars: A Cone-beam Computed Tomography Study

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:5] [Pages No:628 - 632]

Keywords: Cone-beam computed tomography, Deciduous molars, Root canal morphology

   DOI: 10.5005/jp-journals-10005-2030  |  Open Access |  How to cite  | 


Introduction: Visualizing the pulp cavity requires adequate knowledge of the size, morphology, and variation of the root canals of primary teeth. The morphology of the root canals in deciduous teeth causes difficulties during endodontic treatment. There have not been many studies on root canal variations in primary teeth in the Indian population. Aim and objective: To assess the variation in the root and canal morphology of primary maxillary second molars using cone-beam computed tomography (CBCT) in the pediatric Indian population. Materials and methods: The institutional database and private diagnostic centers were used to gather CBCT images of 25 children (50 images) between the age-group of 5 years and 9 years. The CBCT images were rebuilt using Scanora software, and the data were assessed and analyzed using the SPSS version for Windows. Results: Out of 50 primary maxillary second molars, the majority of the second molars had three roots and three canals (Variant I) which account for 66% of teeth. Variant II had three roots and three canals with distobuccal and palatal roots fused in 14% of cases whereas 18% of cases showed three roots and four canals in which mesiobuccal root had two canals (Variant III). The remaining 2% of cases showed four roots with four canals (Variant IV) which were statistically significant. Conclusion: We concluded that within the constraints of our study, there was a difference in the root canal configuration of primary maxillary second molars in the investigated group of the Indian population.



PG Naveen Kumar, Arun R Nair, Alok KR Singh

Determining the Influence of Oral Health Infotainment Module on Behavior and Oral Hygiene of 6-year-old School-children and their Mothers in Davangere City

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:7] [Pages No:633 - 639]

Keywords: Infotainment module, Mothers’ knowledge, Oral health promotion, Oral hygiene

   DOI: 10.5005/jp-journals-10005-2031  |  Open Access |  How to cite  | 


Aim and background: Dental plaque and calculus are common in school-aged children worldwide causing unsatisfactory oral health. This stage is a critical time to establish attitudes, beliefs, and shape an individual's health-related behavior. Moreover, parental oral health knowledge and attitudes are known to influence their child's oral health and hygiene. Materials and methods: A cross-sectional study with a two-stage intervention trial involving a sample of 6-year-olds from two schools in Davangere city was done. Children were randomly allocated into three intervention groups by lottery method. Data included plaque index (PI) modified for 6-year-old children at baseline, 30th day, and at 60th day. Children and their mothers were requested to fill a self-administered questionnaire. The statistical analysis used ANOVA followed by Tukey's post hoc test and measures ANOVA. p ≤ 0.05 was considered statistically significant. Results: There was a significant reduction in the PI modified in 6-year-olds within and among the three groups at the end of 60 days (p = 0.001). Maximum reduction was seen in group II followed by group III and thereafter group I in both the age-groups. Conclusion: The study shows that at 60 days, the oral health infotainment module involving parental support was able to achieve appreciable improvement in the child's oral health and hygiene and inculcate a better attitude toward oral self-care.



Maria A Sruthi, Mahesh Ramakrishnan

Transpapillary Injection Technique as a Substitute for Palatal Infiltration: A Split-mouth Randomized Clinical Trial

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:640 - 643]

Keywords: LA administration, Pain during injection, Palatal infiltration, Randomized clinical trial, Transpapillary injection technique

   DOI: 10.5005/jp-journals-10005-2026  |  Open Access |  How to cite  | 


Aim and objective: To assess and compare the degree of pain during local anesthesia administration and to evaluate the efficacy of transpapillary injection as a substitute for palatal injection in simple maxillary tooth extractions. Materials and methods: A split-mouth study was conducted among children aged 7–11 years who required bilateral extraction of maxillary molars. The individuals were subjected to conventional buccal and palatal infiltration for the first extraction. The transpapillary injection was administered for the subsequent extraction in place of palatal administration. 2% lignocaine with 1:100,000 adrenaline was used for both techniques. Faces pain score scale and visual analog scale were utilized to record pain during injection administration and during the extraction process. A p < 0.05 was considered to be statistically significant. Results: The difference in pain scores was observed during injection administration and was found to be statistically significant (p < 0.05) whereas pain scores for extraction were insignificant (p > 0.05). Conclusion: The transpapillary injection technique was efficacious in eliminating the pain of the palatal injection technique for maxillary extractions. Clinical significance: Owing to the results of this study, the transpapillary injection technique can be used as a distinguished substitute for conventional palatal infiltration, thereby lessening the level of distress experienced by a pediatric patient during local anesthesia administration.



Farah Asad, Neerja Singh, Ahsan Abdullah, Rishab Malhotra

Effect of Addition of Incipient Carious Lesions in Caries Diagnostic Criteria on Prevalence of Caries in North Indian Preschool Children of East Lucknow Region

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:644 - 647]

Keywords: Carious lesions, Infection control, White spot lesions

   DOI: 10.5005/jp-journals-10005-2042  |  Open Access |  How to cite  | 


Aim and objective: To investigate the effect of the addition of incipient carious lesions into the WHO caries index on the prevalence of caries in preschoolers of East Lucknow city. Study design: A cross-sectional observational study was conducted on 530 participants in the age-group of 3–6 years. Materials and methods: The participants were randomly selected from nursery schools of the East Lucknow region. The dental caries status was assessed according to WHO and Ekstrand's criteria. In addition, the prevalence of cavitated and incipient carious lesions was also evaluated. The data were then subjected to statistical analysis. Statistics: Chi-square test and Wilcoxon signed-rank test were performed to carry out statistical analysis. p value < 0.005 was taken as statistically significant. Results: Out of 530 participants examined, caries prevalence by WHO and Ekstrand's criteria was (36.8%) and (57.4%), respectively. The mean dmft values according to WHO criteria and Ekstrand's criteria were 1.16 and 1.60, respectively. The prevalence of cavitated carious lesions was higher (66.27%) when compared with that of incipient carious lesions (33.73%). Conclusion: A significant number of incipient carious lesions observed in the present study is an indication to include these lesions in caries diagnostic criteria. This would help in determining the exact prevalence of caries and aid in implementing proper preventive protocols for remineralization of incipient carious lesions.



Anju Jha, Sovendu Jha, Richa Shree, Kumari Menka, Manisha Shrikaar

Association between Serum Ferritin, Hemoglobin, Vitamin D3, Serum Albumin, Calcium, Thyrotropin-releasing Hormone with Early Childhood Caries: A Case–Control Study

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:648 - 651]

Keywords: FeDA, Hemoglobin, Preschool child, Serum ferritin, Severe caries, Vitamin D3, Ca++, Thyrotropin-releasing hormone, Serum albumin level

   DOI: 10.5005/jp-journals-10005-2028  |  Open Access |  How to cite  | 


Aim and objective: This study aimed to contrast and compare serum ferritin, hemoglobin, Vitamin D3, Ca++, thyrotropin-releasing hormone (TRH), and serum albumin levels between preschoolers with severe caries (SC) and measures taken for caries control. Materials and methods: A sample size of 300 children was selected but only 266 participated; 54.14% with SC and 45.86% caries-free. Blood samples for serum ferritin, hemoglobin, Vitamin D3, Ca++, TRH, and serum albumin levels were taken. Results: The mean age was estimated to be 40.82 + 14.09 months. The serum ferritin level estimated mean value for sample pedodontic subjects came to be 29.58 ± 17.87 μg/L whereas their hemoglobin level with mean value 115.13 ± 10.12 g/L was measured. Logistic regression analysis (LRA) suggested that children with SC were nearly two times as likely to have ferritin level depreciation and likely six times more chance of FeDA (iron deficiency anemia) than in children with caries control. Children with SC had significantly lower mean Vitamin D3 value (p < 0.001), Ca++ (p < 0.001), and serum albumin (p < 0.001) levels, and significantly higher thyrotropin-releasing factor (p < 0.001) levels than those subjects without caries. Conclusion: Analysis of children with SC at a very young age significantly showed an increased chance of low ferritin levels than children with a caries-free mouth. The level of hemoglobin was deficient in children with SC at a very young age. Children with SC at a very young age appeared to be malnourished when compared with children without dental caries. Other contrasting parameters like FeDA, Vitamin D3, Ca++, and serum albumin concentrations were significantly deficient in children with SC at a very young age, in contrast, to a sample of children with a caries-free mouth. The analysis also suggested an increased level of TRH. Clinical significance: The following research study sets a benchmark for the dental fraternity and other health specialists to analyze serum ferritin, hemoglobin, Vitamin D3, Ca++, TRH, and serum albumin levels while generally treating pediatric patients. Accordingly, supplements should be prescribed rationally even in dental caries.



Pininti BN Mounika, Subbaraya K Dwijendra, Naseemoon Shaik, Prakhya Uma Ramana, Chiramchetty Meghana

Sports Cult in Hyderabad: Role of a Pedodontist in Protecting Winning Smile

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:5] [Pages No:652 - 656]

Keywords: Avulsion, Dental trauma, Prevention, Protective devices, Sports injuries

   DOI: 10.5005/jp-journals-10005-2007  |  Open Access |  How to cite  | 


Aim and objective: To assess dental trauma, level of knowledge of participants about the preventive measures, and management of traumatic dental injuries during sports in children aged 6–15 years in private sports academies in Hyderabad. Materials and methods: A cross-sectional study was carried out among 317 children aged 6–15 years and 25 coaches by a structured questionnaire to assess the prevalence of dental trauma during sports followed by an awareness program on prevention. Data obtained were analyzed. Results: Twenty-two percent (76) of children reported an incidence of dental injuries. Thirty-five percent (111) of children were aware that reimplantation was possible. Forty-three percent (139) of children knew that mouthguards can prevent orofacial injuries, but none are using them. Seventy-six percent (19) coaches would refer the child to a general physician in cases of reported trauma. Conclusion: In our study, most of the children and coaches lack awareness about sports-related dental injuries, their prevention, and initial management. None of the children were using mouthguards. Pediatric dentists should conduct programs at schools/sports academies to spread knowledge and awareness about sports-related dental injuries. Further studies are required in this aspect with a larger sample size.



Tarannum Ghavri, Anuradha Pathak, Navroop K Bajwa

Comparative Evaluation of the Effect of Different Beverages on the Surface Roughness and Microhardness of Human Enamel Surface: An In Vitro Study

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:5] [Pages No:657 - 661]

Keywords: Laboratory research, Microhardness, Surface roughness, pH, Titratable acidity

   DOI: 10.5005/jp-journals-10005-2011  |  Open Access |  How to cite  | 


Milk-derived beverages are considered to be beneficial to not only health but also to dental tissue. However, the exact nature of the effect of these beverages should be studied to formulate an exact diet plan for a child so that only good effects can be obtained from a dietary derivative. Aim and objective: To evaluate and compare the surface roughness and microhardness of human enamel surface after exposure to different immersion regimes in milk-based beverages. Materials and methods: A total of 90 samples were prepared from caries-free premolars extracted for orthodontic purposes. The samples were then randomly divided into three groups based on the immersion beverage used vis-a-vis chocolate milk, sweet lassi, and soy milk. The immersion cycles were done for 7 days. After the immersions were complete, the samples were dried and subjected to microhardness and surface roughness testing. Results: The surface roughness of the exposed surface of enamel was found to be in the following order: sweet lassi (verka) > control > soya milk chocolate (sofit) > chocolate milk (Amul Kool Koko). The microhardness of the exposed surface of enamel was found to be in the following order: chocolate milk (Amul Kool Koko) > soya milk chocolate (sofit) > sweet lassi (verka) > control.



Abdullah Faraj Alshammari, Rana Homoud Alenzi, Ashwaq Abdullah Alanezi, Abdulmjeed Sadoon Enizy, Ahmed Mohmmed Aldakhil, Khlood Abdulkader Alkurdi

Knowledge and Attitude of Dentists toward Silver Diamine Fluoride in Saudi Arabia

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:662 - 665]

Keywords: Arrested caries, Caries, Pediatric dentist, Prevention, Primary dentition, Silver diamine fluoride

   DOI: 10.5005/jp-journals-10005-2009  |  Open Access |  How to cite  | 


Introduction: Dental caries is managed by two approaches: prevention which focuses on inhibiting the caries progression, and the traditional approach which is treating caries by drilling and filling. Logically, the first approach is more effective. One of the recently marketed preventive methods for preventing and inhibiting the progression of dental caries is silver diamine fluoride (SDF), which is proven to be minimally invasive and cost-effective, SDF has proven to have a significant success rate in caries prevention, especially in the early childhood caries. Objective: The study aims to evaluate general practitioners’ SDF clinical experience, knowledge, professional behavior, and attitudes. Materials and methods: The study was a cross-sectional study and we utilized a random sampling of Saudi general dental practitioners from different places in the Hail region, KSA. The study was conducted using papered interview and an online questionnaire followed by educating the dentists about SDF. Results: Dentists were asked about SDF, 62.7% answered that they heard about SDF topical application, but the dentists who answered all questions correctly are only 14.89% with no statistically significant difference among gender, age, or sector. Conclusion: This study had several limitations. It only included the dental GPA in the Hail region, Saudi Arabia. As is the case with all surveys, only a limited number of questions could be asked. Thus, the information to be obtained is also limited. Future research should therefore include other questions to clarify other aspects which we could not explore in this research.



Neha Singh, Shashank Gaur, Manish Kumar, Tanveer Akhtar, Shaili Agarwal

Comparative Study of Dental Health Status and Its Determinants among Children Attending Government and Private Schools in Kanpur City

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:8] [Pages No:666 - 673]

Keywords: Dental caries, Gingival growth, Prevalence

   DOI: 10.5005/jp-journals-10005-2010  |  Open Access |  How to cite  | 


The purpose of this study was to evaluate the prevalence of dental caries and gingivitis and its relation to various determinants like dietary habits, habits related to oral health, and oral hygiene practice among private and government school children of age 6–12 years in Kanpur City. A total of 1,550 children (775 from government school and 775 from private school) were selected. Overall, 60% children presented with caries. Prevalence of caries was significantly more associated with government school children (63.1%) compared with private school children (56.9%). The mean deft scores were high in government school children (1.08 ± 1.91) compared with private school children (0.93 ± 1.53). This was statistically significant (p < 0.05). The DMFT scores were also high among government school children (0.84 ± 1.25) compared with private school children (0.67 ± 1.19). This was statistically significant (p < 0.05). On the whole, out of 1,550 children only 17.8% children presented with gingivitis, in which majority had mild form of gingivitis when compared with moderate and severe forms. The prevalence of gingivitis was relatively high among government school children (55%) compared with private school children (45%). This was statistically significant (p < 0.05). Summing up, a conclusion could be drawn that the prevalence of both dental caries and gingivitis depends on the state of the oral hygiene habits and practices, correspondingly, due to schoolchildren's knowledge of individual oral hygiene and skills.



Anuja Mody, Ruchi Arora, Prabhav Chauhan, Kompal Gautam, Pratibha Taneja, CM Marya

A Scanning Electron Microscopic Study on Effect of Blood and Artificial Salivary Contamination on Marginal Adaptation of Mineral Trioxide Aggregate, When Used as a Retrograde Filling Material: An In Vitro Study

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:7] [Pages No:674 - 680]

Keywords: Biocompatibility, Intravenous fluids, Mineral trioxide aggregate, Retrograde filling

   DOI: 10.5005/jp-journals-10005-2012  |  Open Access |  How to cite  | 


Aim and objective: The present study was conducted to evaluate the marginal adaptability of mineral trioxide aggregate (MTA) as a root-end filling material when manipulated using two different IV fluids intended for pediatric usage; in the presence of blood and salivary contamination. Materials and methods: Sixty single-rooted teeth were selected. Conventional endodontic root canal preparation was performed on all specimens followed by root-end resection and retrograde cavity preparation. The roots were randomly divided into two groups (n = 30). In the specimens of group I, fresh blood was used as a contaminant and in group II artificial saliva was used as a contaminant. In both groups, MTA (e-MTA, Kids-e-Dental®) manipulated using either Ringer's lactate IV fluid (n = 15) or Tetraspan IV fluid (n = 15) was used for root-end filling in blood or artificial saliva-coated retrocavities. Furthermore, these roots were placed in beakers pooled with fresh phlebotomized blood or artificial saliva. After incubating for 48 hours, the roots were divided longitudinally to expose the retrofilled cavities and were then sputter-coated with gold-platinum dust. To assess the marginal adaptation of MTA to radicular dentin “maximum gap width” and “gap perimeter” were measured in images obtained from scanning electron microscopy of root specimens. SPSS 21 was employed for statistical analysis at (p < 0.05). Mann–Whitney U test and ANOVA were used for analyzing the data obtained. Results: The gap width was more among samples exposed to blood (p < 0.05) than artificial saliva. No significant difference was reported in the gap perimeter when cavities were filled with MTA mixed with either IV fluids (p > 0.05). Conclusion: Exposure to blood during setting had a negative effect on gap width when retrocavities were filled with MTA using Tetraspan. No effect was seen on the arch perimeter in retrocavities filled with MTA mixed with Ringer's lactate or Tetraspan. Clinical significance: For avoiding failure, it is critical to select a biocompatible root-end filling material with high sealing ability. Hence, by doing the same, the clinical situation can be simulated.



Neha Sikka, Ruchi Juneja, Varun Kumar

Effect of Dental Environment Stressors and Coping Mechanisms on Perceived Stress in Postgraduate Dental Students

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:8] [Pages No:681 - 688]

Keywords: Coping, Dental, Perceived stress, Postgraduate students

   DOI: 10.5005/jp-journals-10005-2005  |  Open Access |  How to cite  | 


Aim and objective: To investigate the effect of dental environment stressors and coping mechanisms on perceived stress in postgraduate dental students. Materials and methods: This cross-sectional study enrolled 250 postgraduate students from four dental colleges. Modified dental environment stress (DES) questionnaire was used to study the dental environment-related stressors, perceived stress score (PSS) to measure the extent of stress perception, and brief COPE (BC) scale to measure the use of various coping strategies deployed to combat stress. An independent T-test was used to determine the associations of these measures with gender and marital status and one-way ANOVA for associations with year of study. Hierarchical regression was used to determine the effect of demographic factors, career-related psychological background, health-related habits, DES, and BC score on PSS. Results: “Synopsis, thesis, library dissertation” and “lack of adequate infrastructure” were reported as the highest stressors by the postgraduate students. Only 4.8% of respondents perceived low stress, while 65.2% perceived high stress. A high correlation between the DES score and PSS was observed. Active coping, acceptance, and positive reframing were the most commonly utilized coping strategies. Planning and use of emotional support were the only coping strategies that were significant negative predictors of PSS. Problem-focused coping strategies had a positive, but non-significant correlation with PSS, while emotion-focused coping strategies had a significant negative correlation with PSS. Conclusion: Postgraduate dental environment causes a high-stress perception in students and reactive coping strategies have only a limited role in reducing stress perception.



Deeksha Khurana, Harshit Srivastava, Prachi Mital, Namita Somani

Comparison of Ribbond and Everstick Post in Reinforcing the Re-attached Maxillary Incisors Having Two Oblique Fracture Patterns: An In Vitro Study

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:689 - 692]

Keywords: Everstick post, Fracture resistance, Re-attachment, Ribbond

   DOI: 10.5005/jp-journals-10005-2035  |  Open Access |  How to cite  | 


Aim and objective: This study aims to compare the resistance to fracture in maxillary incisors which were fractured in two different oblique patterns and then were re-attached and reinforced using anatomic fiber-reinforced composite (FRC) post. Materials and methods: Sixty extracted and intact human maxillary incisors were obtained and divided into two groups (A and B; n = 30). “Labiopalatal” and “palatolabial” fractures were induced in group A and group B, respectively. These two groups were further subdivided into two subgroups (n = 15). In subgroup I Ribbond fiber (Ribbond Inc., Seattle, WA, USA) and in subgroup II Everstick post (everStick Post™, GC Corporation, Tokyo, Japan) were used. Fractured fragments were re-attached using resin and tested for fracture resistance in universal testing machine. Statistical analysis was done with ANOVA one-way test and post hoc test. Results: The labiopalatal fracture pattern of group A showed significantly increased resistance to fracture than the palatolabial fracture pattern of group B in both the subgroups. Similarly, subgroup II with Everstick post exhibited significantly higher fracture resistance than subgroup I with Ribbond in both groups A and B (p value < 0.05). Clinical significance: The study simulates a clinical scenario of coronal fracture of a tooth and focuses on the techniques and materials which can be used for successful management of such cases.



Sumeet Rajpal, Anu Bhat

Knowledge, Attitudes, and Perception of Parents toward Dental Treatment of Children during the COVID-19 Outbreak

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:7] [Pages No:693 - 699]

Keywords: Coronavirus infections, COVID-19, Pandemic

   DOI: 10.5005/jp-journals-10005-2041  |  Open Access |  How to cite  | 


This study aimed to evaluate the knowledge of parents regarding the coronavirus outbreak and to assess the change in attitude and perception toward dental treatment during the coronavirus (COVID-19) pandemic. A structured questionnaire (on google format) containing 13 questions was used, and each question had 2 or 3 possible answers. The parents/guardians of children (aged 3–14 years) who were school-going were eligible to participate in this study. A total of 800 parents/guardians were interviewed on google reporting format from June to December 2020. A simple random sampling technique was used to select 800 parents/guardians of children, aged 3–14 years, studying in different schools in Chandigarh. According to the survey, a total of 86% of respondents said that they paid high attention to COVID-19 and explained it to their children; 97% reported that they emphasized the importance of hand hygiene and sanitation during the outbreak; 72% admitted that the outbreak has made them more conscious of the importance of maintaining good oral health and hygiene, to avoid visiting the dentist and 84% felt that the routine dental check-ups and appointments should be avoided during the COVID-19 outbreak; almost half of the respondents (47%) thought that the dental environment was a potential source of infection to their kids; 37% felt getting treatment at a dental setup may expose their child to risks of COVID-19; 71% said they would take their child to a dental department if he/she had a severe toothache. Approximately 46% of the respondents expressed confidence about the preventive measures taken in the dental department to ensure safe treatment for their children. In conclusion, all respondents were concerned about COVID-19 and most of them had talked about it with their children often. In addition, a considerable percentage of them showed apprehensions about the preventive measures being taken at the dental operatory and thought that the dental environment could be more dangerous than other environments.



Sarbojit Chakraborty, Natasha Gambhir, Rashi Singh

Efficacy of Silver Diamine Fluoride on Streptococcus mutans Count Present in Saliva

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:5] [Pages No:700 - 704]

Keywords: 38% SDF, Carious primary tooth, Silver diamine fluoride, Streptococcus mutans

   DOI: 10.5005/jp-journals-10005-2037  |  Open Access |  How to cite  | 


Aim and objective: Evaluate the efficacy and longevity of silver diamine fluoride (SDF) to inhibit the dental caries initiator bacteria; Streptococcus mutans count in saliva. Study design: Twenty children having class I and II dental caries with no prior restorations were included in the study. Unstipulated saliva samples were collected before and immediately after application of SDF, 1, 3, and 6 months after application, and intergroup comparison was done. Materials and methods: Silver diamine fluoride was applied on the cavitated surfaces with microbrush tip under isolation, then wait for 4 minutes and washed away all surfaces with water spray. Saliva was collected in a sterile saliva collection tube and sent for microbiological culture assessment. CFU/mL of S. mutans count was done with the Digital colony counter. For statistical analysis, paired T-test was performed. Results: Silver diamine fluoride showed a significant drop in CFU/mL of S. mutans count at 1 month then 3 and 6 months accordingly. Conclusion: Silver diamine fluoride can be used to prevent and arrest dental caries and the best result can be achieved by quarterly application.



Selvabalaji Arumugam, Nandakumar Sundaramurthy

Posts in Primary Teeth–Past to Present: A Review of Literature

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:6] [Pages No:705 - 710]

Keywords: Dentin post, Glass fiber post, Metal post, Post, Primary teeth

   DOI: 10.5005/jp-journals-10005-2034  |  Open Access |  How to cite  | 


Early childhood caries is indeed a devastative situation for both patients’ parents and pediatric dentists. The primary goal in treating severe early childhood caries is to restore normal function such as maintenance of mesiodistal and vertical dimension, prevention of alteration of mastication, phonetics (due to premature loss), development of parafunctional habits, and prevention of psychological problems affecting the self-esteem of a child. The restoration of primary dentition with extensive carious lesions is a complex clinical challenge of several dimensions. The severity of this condition in maxillary anterior teeth has prompted the extraction of teeth due to inadequate esthetic treatment options. The only concern with the severely destructed primary incisors is a lack of crown structure, which fails to support and adhere to a composite crown. Clinicians have preferred many restorative modalities for esthetic rehabilitation of badly decayed anterior primary teeth with numerous root canal retentive post and core systems with appropriate techniques to preserve those teeth until they are replaced by permanent teeth. This review highlights the various posts, their indications, principles, ideal properties, and the current concepts on their use in pediatric dentistry.



Minal M Kshirsagar, Arun S Dodamani, Rahul N Deokar, Yogesh Garg, Vrushali R Khobragade, Kamal Garg

Impact of COVID-19 on Dentistry

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:711 - 714]

Keywords: COVID-19, Dentistry, Novel coronavirus

   DOI: 10.5005/jp-journals-10005-2025  |  Open Access |  How to cite  | 


Pandemic situations always impose devastating aftereffects on communities and cause chronic damaging effects on the healthcare system. Novel coronavirus disese-2019 (COVID-19) which has originated in China (Wuhan) is nowadays an emerging threat to public health across the world. It is spreading worldwide so rapidly and has started infecting people in all possible ways. Several dental care facilities in affected countries are completely closed or have been only providing minimal treatment for emergency cases since the whole lockdown has been announced. However, in some affected countries, they are still providing regular dental treatment. This discrepancy could be because of the dearth of proper awareness, knowledge, protocol, or guidelines.



Karishma Chhabra, Sankalp Nigam

Dental Management of Pediatric Patients with Bronchial Asthma

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:715 - 718]

Keywords: Asthma, Pediatric dentistry, Pediatric patient

   DOI: 10.5005/jp-journals-10005-2024  |  Open Access |  How to cite  | 


Asthma is a disease marked by recurrent dyspnea caused by spasmodic bronchoconstriction. Bronchial asthma is a serious global problem that has steadily increased in prevalence during the past two decades. Oral manifestations of pediatric patients suffering from bronchial asthma are an increased upper anterior and total anterior facial height, higher palatal vaults, greater overjets, and a higher prevalence of posterior crossbites. Dental treatment of such patients requires the role of a pedodontist. Behavior management techniques, conscious sedation techniques along with medical management, and comprehensive dental treatment by a pediatric dentist may prove beneficial to such patients.



Rafif A Mandura, Moaz H Attar, Rana A Alamoudi

Diabetes Mellitus and Dental Health in Children: A Review of Literature

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:7] [Pages No:719 - 725]

Keywords: Children, Dental health, Diabetes mellitus, Gingival health, Oral hygiene, Periodontal health, Review, Tooth eruption

   DOI: 10.5005/jp-journals-10005-2006  |  Open Access |  How to cite  | 


Aim and objective: To illustrate the most important general findings significant for dentists dealing with pediatric diabetic patients, as well as the effect of type 1 diabetes mellitus (T1DM) on children's oral health. Background: Type 1 DM is considered to be the most popular type of diabetes in children and adolescents which has a strong impact on their lifestyle. Diabetes mellitus (DM) mainly affect organs and tissues that are affluent with blood vessels including kidneys, eyes, and nerves. Adding to that oral cavity is covered with epithelial tissues that are rich with small blood vessels. Materials and methods: An electronic search of English scientific papers was accomplished using PubMed, Google Scholar, and King Abdulaziz University digital library. Search terms used were children, DM, dental health, gingival health, oral hygiene, periodontal health, and teeth eruption. Review results: Thirty-six articles were obtained from the electronic search and references of selected studies. In addition, other references were included from selected studies about DM and its relationship to oral health. Multiple studies confirmed that T1DM has a negative impact on oral hygiene, gingival and periodontal health, and teeth eruption. While other studies contradict these results. Conclusion: There are contradictory studies regarding the effect of T1DM on oral health in children and adolescents. Well-established high-quality research with clear and concise materials and methods are required to have representative results. Clinical significance: Studying the effect of T1DM on oral health in children and adolescents is indicated to set well-established guidelines to reach a high standard of care for those children.



Haseeb Ahammed, Seema Thakur, Ashish Justa

Surgical Management of Impacted Supernumerary Tooth: A Case Series

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:726 - 729]

Keywords: Cone-beam computed tomography, Impaction, Supernumerary tooth

   DOI: 10.5005/jp-journals-10005-2008  |  Open Access |  How to cite  | 


Supernumerary teeth are extra teeth in addition to the normal dentition. It is a developmental anomaly with multiple etiology. The present paper describes a series of three cases of impacted supernumerary teeth with some unique features located anterior maxillary region. All of them were extracted surgically.



Gajula Shivashankarappa Prathima, Venkatachalamoorthi Vinothini, Subramaniam Kalaiyarasu Vigneshwari

Recurrent Episodes of Oral Pyogenic Granuloma at Different Site in an 8-year-old Girl: An Unusual Presentation

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:4] [Pages No:730 - 733]

Keywords: Oral pyogenic granuloma, Reactive hyperplasia, Recurrent episodes

   DOI: 10.5005/jp-journals-10005-2033  |  Open Access |  How to cite  | 


Pyogenic granuloma is one of the benign vascular neoplasms seen in the first and second decade of life, with a female predilection. Pyogenic granuloma presents as a small reddish exophytic lesion, gingiva being the commonest site. This report presents a case of recurrent episodes of pyogenic granuloma at a different site at different time intervals in an 8-year-old girl child which was found to be an unusual presentation, and it highlights the importance of early diagnosis and management of the pyogenic granuloma to avoid the discomfort.



Use of Puzzles as an Effective Teaching–Learning Method for Dental Undergraduates

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:1] [Pages No:734 - 734]

   DOI: 10.5005/jp-journals-10005-2048  |  Open Access |  How to cite  | 



Comparative Evaluation of Two Remineralizing Agents on Artificial Carious Lesion Using DIAGNOdent

[Year:2021] [Month:September-October] [Volume:14] [Number:5] [Pages:1] [Pages No:735 - 735]

   DOI: 10.5005/jp-journals-10005-2047  |  Open Access |  How to cite  | 


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