International Journal of Clinical Pediatric Dentistry

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2022 | Special Issue-2 (Cariology) | Volume 15 | Issue S2

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Guest Editorial

Neeraj Gugnani

A Caries-free World: Dream or Reality?

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:2] [Pages No:S119 - S120]

   DOI: 10.5005/jp-journals-10005-2335  |  Open Access | 



R Manjushree, Latha Anandakrishna, Keerthi Prasad KS, Ashmitha K Shetty

Evaluation of Salivary Components and Dental Plaque in Relation to Dental Caries Status in Type 1 Diabetes Mellitus

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S121 - S125]

Keywords: Dental caries, Dental plaque, Saliva, Type 1 Diabetes Mellitus

   DOI: 10.5005/jp-journals-10005-2325  |  Open Access | 


Purpose: To evaluate the dental caries prevalence in Type 1 Diabetes Mellitus (T1DM) as compared to healthy children and, to assess the salivary components (flow rate, glucose, α-Amylase, Streptococcus mutans) and dental plaque in relation to their dental caries status. Methods: Dental caries were estimated by using the DMFS index and dental plaque by Sillness and Loe plaque index. The following methods were used to assess the salivary components; draining method to determine the flow rate; glucose oxidase peroxidase method for glucose; substrate method for α-Amylase, Mitis Salivarius Bacitracin agar was used to culture Streptococcus mutans. Results: Caries prevalence was significantly lower in T1DM. In the diabetic group, a significant positive correlation was found between DMFS value and plaque, DMFS value and salivary glucose, and also with DMFS value and salivary α-Amylase. A significant negative correlation was found between the DMFS value and the unstimulated salivary flow rate. The multivariate regression analysis demonstrated that decrease in the unstimulated salivary flow rate to be significantly associated with increasing DMFS values. Conclusion: The caries prevalence was found to be low in T1DM when compared to the healthy children, the cause for it being related to the low plaque scores. Low caries prevalence could also be due to the restriction of sucrose in their diet. Clinical significance: As clinicians, along with restoring the smiles of a child patient, we have to retrospectively analyze the factors involved in the causation of dental caries. Educating the parents and the child in regard to this will help prevent the occurrence of any new carious lesion.



Anand N Patil, Swati Karkare, Haridas S Jadhav, Yogesh Damade, Bhavani Kirthi Punjari

Knowledge, Attitude, and Practice of Parents toward Their Children's Oral Health and its Influence on the Dental Caries Status of 5-10-year-old Schoolchildren in Nashik, Maharashtra: A Cross-sectional Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S126 - S130]

Keywords: Cross-sectional study, Dental caries, Parents, Pediatric dentistry, Primary teeth, Questionnaire

   DOI: 10.5005/jp-journals-10005-2137  |  Open Access | 


Aim: The aim of the present study is to assess the knowledge, attitude, and practices of parents toward their children's oral health and its influence on the dental caries status of 5–10 years old schoolchildren in Nashik, Maharashtra. Materials and methods: A cross-sectional questionnaire-based study was conducted among parents of 5–10 years old school children who visited our hospital. A total of 504 children and their parents were included in the study. Clinical examination of children was done using DMFT and deft index. A self-designed questionnaire was given to the parents to assess their knowledge, attitude and practices toward their children's oral health. Statistical analysis was performed using EPI INFO version 6.04. ANOVA test was used to test the association between dental caries status and KAP. p-value < 0.05 was considered to be statistically significant. Results: The mean DMFT was 1.6 ± 1.5 and mean deft was 6.6 ± 3.4. Majority of the parents (64.9%) showed fair knowledge, attitude, and practices. There was no significant difference between mean DMFT/deft and parental KAP. Conclusion: Overall the parents in the present study had reasonable KAP about oral health of their children. Deficient areas of oral health awareness include importance of milk teeth and their treatment, regular dental visits, and dietary practices. Clinical significance: Oral health awareness programs should be directed toward parents and should emphasize on topics such as importance of milk teeth and their treatment, regular dental visits, and dietary practices.



Shilpa Mahapatra, Preetha E Chaly, Mohammed Junaid, Smruti C Mohapatra, M Madhumitha

Association between Parental Stress and Early Childhood Caries Experience among Preschool Children in Maduravoyal, Chennai: A Cross-sectional Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:4] [Pages No:S131 - S134]

Keywords: Child, Correlation of data, Dental caries, Mothers, Preschool

   DOI: 10.5005/jp-journals-10005-2138  |  Open Access | 


Background: In recent decades stress has emerged as a variable of significant interest in the examination of oral health. Objective: To study the association between parental stress and early childhood caries experience among 3–5 years old children. Methods: A cross-sectional study was conducted among 342 randomly selected mother-child dyads in Maduravoyal, Chennai. The mothers were stratified into four stress categories based on their parental stress scores from the Parental Stress Scale (Berry and Jones, 1995). The children were classified into three subgroups, no caries [dmft = 0], low caries [dmft = 1-2], and high caries [dmft≥3]. Chi-square test with Yates’ continuity correction and Spearman's rank correlation were used as statistical test methods. Results: Among the mothers with no stress, 44.9% had children in the no caries group, compared to 21.6% in the low caries and 7.3% in the high caries group [p < 0 .001]. And among the mothers with mild to moderate stress, 6.3% had children in the no caries group, compared to 5.4% in the low caries and 30% in the high caries group [p < 0 .001]. A positive correlation between parental stress and early childhood caries experience was observed [rho = 0 .461, p < 0 .001]. Conclusion: A significant moderate positive correlation between parental stress and early childhood caries experience was observed. Stressful parents can be a probable risk factor for early childhood caries. Hence, providing prenatal counseling will be of added value to all expecting mothers.



Krithi Nellamakkada, Sandya S Patil, Madhu Kakanur, Ravi S Kumar, Rachna Thakur

Association of Mothers’ Genetic Taste Perception to Eating Habits and Its Influence on Early Childhood Caries in Preschool Children: An Analytical Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S135 - S139]

Keywords: Caries experience, Early childhood caries, Genetic taste perception, Preschool children, Snacking habits

   DOI: 10.5005/jp-journals-10005-2139  |  Open Access | 


Aims: To examine (1) the association of mothers’ 6-n-propylthiouracil (PROP) sensitivity with snacking habits and caries experience of both the mother and their 2–5-year-old preschool children and (2) the association of feeding habits with caries prevalence in 2–5-year-old children. Materials and methods: In this analytical cross-sectional study, 2–5-year-old preschool children were clinically examined by a single calibrated examiner and divided into two groups of 80 children with early childhood caries (ECC) and 80 without. Mothers of the children were clinically examined and a second blinded investigator determined their genetic taste type using PROP. Data regarding feeding practices of the child and snacking habits of the mother and child were obtained using questionnaires. The data obtained were statistically analyzed. Results: Cariogenic snack consumption was more among nontaster mothers and their children (p value < 0.001). More number of children of the nontaster mothers in the ECC group were bottle-fed with sweetened beverages (n = 24) and received sweet snacks as rewards (n = 32). Caries prevalence of 73%, 20%, and 7% was seen in children of nontaster, medium taster, and supertaster mothers, respectively (p value < 0.05). Significant association was found between mother's caries activity, past bottle-feeding, receiving sweet snacks as reward and their child's caries experience. Conclusion: Mothers’ PROP sensitivity was significantly associated with snacking habits and caries experience of their children. Mothers’ PROP type could be an important factor that may determine and explain the dental caries experience in their 2–5-year-old preschool children. Clinical significance: Early identification of nontaster mothers may prove beneficial in guiding them and consecutively their children toward healthy dietary habits, leading to lesser incidence of caries and their better overall wellbeing.



Vatsala Belagatta, Sanchitha Venkatahaumaiah

Identification, Quantification and Correlation of Hydrogen Peroxide Present in Saliva to Early Childhood Caries: A Randomized Clinical Trial

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:7] [Pages No:S140 - S146]

Keywords: ECC, HPLC/UV, Hydrogen peroxide

   DOI: 10.5005/jp-journals-10005-2142  |  Open Access | 


Aim: The main objective of the present study was to estimate the production of hydrogen peroxide present in saliva and correlate it to early childhood caries using high-performance liquid chromatography [HPLC] method. Design: The study was conducted on children aged 3–6 years with a sample size of 20 who had decayed, missing, or filled teeth in accordance to WHO pro forma and were divided into two groups: Study group: Caries active [CA][n = 10] and Control group caries free [CF] [n = 10]. The whole saliva was collected into the vials with a buffer solution and was stored in cold storage. HPLC was done to estimate, detect, and correlate the amount of production of H2O2 in CA and CF groups. To compare age and gender distribution among two groups, Independent student “t“ test was used. To compare the mean production of H2O2 levels between two study groups with a significance of p > 0.05 was done using Mann-Whitney U test. Spearman's correlation was done between caries and H2O2. Results: Comparison of mean H2O2 levels [in ppm] between groups was statistically significant at p = 0.03, which showed as age increases H2O2 production also increases. Age-wise estimation of H2O2 obtained a statistically significant result [p = 0.04]. However, gender-wise comparison of mean H2O2 levels [in ppm] in both the groups showed no difference. Conclusion: Findings in our study strongly suggested that H2O2 levels are more in children without any caries experience. H2O2 production is the same among males and females but according to age, H2O2 production increases as the child grows with age.



Parul Singhal, Deepak Chauhan

A Comparative Study to Evaluate the Effectiveness of Silver Diamine Fluoride at Different Time Durations of Application in Treating Carious Primary Teeth: A Randomized Trial

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:4] [Pages No:S147 - S150]

Keywords: Deciduous molars caries, Duration of application, ICDAS, Primary tooth, Seconds, Silver diamine fluoride

   DOI: 10.5005/jp-journals-10005-2326  |  Open Access | 


Background and objectives: Ideally every child must have access to preventive and restorative care of greater quality. However, in rural areas, resources and dental care services are limited. Silver diamine fluoride (SDF) has been identified as an efficient topical cariostatic and preventive medicament for managing ECC in children who cannot be treated conventionally. Since SDF is an emerging alternative for caries prevention and arrest, AAPD recommends more practice-based research to evaluate its efficacy. The aim of this study was to evaluate the effectiveness of silver diamine fluoride at different time durations of application in treatment of carious primary teeth in children with least access to dental care. Methodology: This was a prospective, randomized, field trial that included patients with primary tooth. Primary tooth presenting carious lesion in ICDAS 3–6 category were randomly assigned to one of the three groups. Results: At 3-week mean rank of lesions arrested in Group 1 and Group 2 were 73.3 and 72.29, whereas it was 86.9 in case of Group 3. At 6 months it was 79.15, 77.29, and 75.96 in Group 1, 2, and 3 , respectivel (p > 0.05). Conclusion: SDF is effective in controlling caries progression in both cavitated and non-cavitated lesion with minimal time duration of application (30 seconds). This approach may be of great utility as an alternative to other expensive preventive and therapeutic methods in communities with limited resources. Nonetheless obtaining caregiver consent is mandatory.



Muthumula Daneswari, Nagireddy Venugopal Reddy, Annie P Chris, Nikhila V Reddy, Saigeeta Kondamadugu, P Niharika

A Comparative Evaluation of Microhardness and Chemical Structure of Radicular Dentin with Two Combinations of TAP and MTAP: An In Vitro Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:7] [Pages No:S151 - S157]

Keywords: ATR-FTIR, Microhardness, Modified triple antibiotic paste, Triple antibiotic paste

   DOI: 10.5005/jp-journals-10005-2170  |  Open Access | 


Background: The success of regenerative endodontics depends on various factors and the most vital being the complete eradication of microorganisms in the dentinal tubules. This could lead to changes that leave the radicular dentin prone to fracture. Aim: The purpose of the present study is to investigate the effects of triple antibiotic paste (TAP) and modified triple antibiotic paste (MTAP) of different concentrations on the microhardness and chemical structure of radicular dentin. Materials and methods: Human root cylinders were instrumented and randomized into four treatment groups and an untreated control group. Two treatment groups received 1 g/mL TAP or MTAP, and the other two treatment groups received 1 mg/mL methylcellulose-based TAP or MTAP. Cylinders were stored at 100% relative humidity for 4 weeks. Each root cylinder was subjected to a microhardness test before and after treatment. Different sets of radicular dentin specimens were treated as mentioned previously, and were examined using attenuated total reflection Fourier transform infrared spectroscopy. Results: Significant reductions in microhardness of treated groups was noticed when compared to untreated control roots at 1,000 and/or 500 µm from the pulp-dentin interface. Conclusion: The use of 1 mg/mL methylcellulose-based TAP and MTAP may minimize the reduction in microhardness of roots compared with the currently used 1 g/mL concentration of these antibiotics.



Riddhi Shripad Joshi, Chaitanya Uppin

A Comparative Evaluation of Remineralizing Potential of Commonly Used Fluoridated Toothpaste, Herbal Toothpaste, Toothpaste with Zinc Hydroxyapatite, and Toothpaste with Calcium Sucrose Phosphate in Children: A Scanning Electronic Microscopic Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:6] [Pages No:S158 - S163]

Keywords: Children, Demineralization, Dental caries, Remineralization

   DOI: 10.5005/jp-journals-10005-2143  |  Open Access | 


Aim: The aim of this in vitro study is to evaluate the remineralizing potential of commonly used fluoridated toothpaste, toothpaste with calcium sucrose phosphate, toothpaste with zinc hydroxyapatite, herbal toothpaste, and to compare them. Background: The process of demineralization and remineralization is balanced and occurs concurrently in the oral cavity, but even a mild disruption in this mechanism could lead to dental caries. Dental caries is a threat in the Third World countries and more common entity in childhood. The caries prevalence is reported to be 41% for children within the age of 2–11 years. Materials and method: According to previous studies and standard sample size calculating formula the sample size of 48 was calculated, the teeth were subjected to demineralization – remineralization process and were observed under scanning electron microscope. Results: The outcomes of this study suggest that the remineralizing potential of toothpaste with zinc hydroxyapatite (p = 0.0001*) was highest as compared to toothpaste with fluoride ( p = 0.0087*), herbal toothpaste ( p = 0.9034), and toothpaste with calcium sucrose phosphate (p = 0.0002*). Conclusion: All the four toothpastes showed an adequate amount of remineralization but the highest amount of remineralization potential was seen with toothpaste containing zinc hydroxyapatite. Clinical significance: The clinical significance of our study is to give clear and evidence-based idea to the dentist and the parents about the remineralizing toothpaste available in the market for children. Treating demineralization at an initial stage would help to remineralize the tooth structure and thereby limit further destruction of the tooth structure which will preserve the beautiful smile of the child.



Urvashi Sudani, Medha Wadhwa, Neelam Joshi, Kinjal S Patel

Association of Anthropometric Measurements, Hemoglobin Level and Salivary Parameters among Caries-free and S-ECC Children

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:8] [Pages No:S164 - S171]

Keywords: Body mass index, Buffering capacity, Early childhood caries, Iron deficiency, Salivary pH, Salivary flow, Waist circumference

   DOI: 10.5005/jp-journals-10005-2144  |  Open Access | 


Context: The implication of severe dental caries in children may have its effect on general health apart from affecting the orodental tissues. Many children reporting with severe caries have shown weighing less due to malnourishment resulting in anemia and modified somatic growth. Aims: Study aimed to assess and compare anthropometric measurements, hemoglobin level, and salivary parameters among caries-free and severe early childhood caries (E-CCC) children. Settings and design: For caries-free group [Group I] and S-ECC group [Group II] data were obtained from age-matched children with similar socioeconomic status. Materials and methods: Children with severe caries and without caries from the age-group 36 years participated in the study. Children were measured for height, weight, measurement of mid-upper arm circumference, and waist circumference. Hemoglobin level was recorded. The collected unstimulated saliva was assessed for flow rate, salivary pH, and its buffering capacity. Statistical analysis used: Both descriptive and inferential statistical analyses were carried out using Windows software and SPSS (21). Tests of significance namely t-test and Chi-square test were used along with regression analysis. Results: Caries experience showed no statistical difference for age and gender among the sample population. Significant difference was found for all anthropometric measurements. When comparison for hemoglobin was done for both groups I and II, significant difference was observed [p = 0.003]. Conclusion: Children with severe dental caries in the present study had low hemoglobin which, if persisted, can lead to anemia. Though the anthropometric parameters may appear normal in children diagnosed with severe early childhood caries, pediatric dentist should ensure the hemoglobin level test, as iron deficiency can affect growth and development of the child, if left undiagnosed.



Mahema Sharma, Avantika Tuli, Aditi Singh, Nitin Khanduri

Evaluation of Effect of Silver Diamine Fluoride in Arresting Dental Caries Using International Caries Classification and Management System (ICCMS): An In Vivo Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:4] [Pages No:S172 - S175]

Keywords: Caries arrest, Dental caries, Primary teeth, Silver diamine fluoride

   DOI: 10.5005/jp-journals-10005-2146  |  Open Access | 


Background: In terms of maintaining esthetics and function, reducing pain, and encouraging wellness, primary dentition care is just as important as permanent tooth care. The purpose of this research was to see how efficient silver diamine fluoride is at preventing tooth decay. Materials and method: The 3- month clinical experiment included a sample size of 30 children (both males and females) aged 4–8 years by applying silver diamine fluoride on the carious tooth to evaluate the efficacy of silver dimaine fluoride in arresting the caries. The children were kept on follow-up and IOPA's were taken to check the arrest of caries at baseline, 1 month and after 3 months. To assess the progression of caries radiographic interpretation of IOPA X-rays was done using ICCMS scores at baseline, 1 month and 3 months. Results and conclusion: The current study found that topical 38% silver diamine fluoride arrest tooth decay and was effective for treating dental caries in school-aged children in the short term.



K Reshma Pai, Lakshmi K Pallavi, Sundeep K Hegde

Evaluation of Antimicrobial Activity of Aqueous Extract of “Ocimum Sanctum–Queen of Herb” on Dental Caries Microorganisms: An In Vitro Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:4] [Pages No:S176 - S179]

Keywords: Caries, Children, Chlorhexidine, Mouthwash

   DOI: 10.5005/jp-journals-10005-2147  |  Open Access | 


Aim: To evaluate the efficacy of three different concentrations of Ocimum sanctum aqueous extract against various caries causing microorganisms, Streptococcus mutans, Streptococcus mitis, Streptococcus sanguis, and Lactobacillus acidophilus. Materials and methods: Aqueous extract of Ocimum sanctum was prepared by the cold extraction method. The extract was diluted with milli Q water, to obtain 3 different concentrations [2%, 3%, and 4%] of the extract. Glycerol 6%v/v and tween-80, 0.1%v/v were also added to get a stable suspension. About 0.2% chlorhexidine was used as a positive control and milli Q water was used as a negative control . The extract, along with the controls, was then subjected to microbiological investigation to determine which concentration among the three different concentrations of extract gave a wider inhibition zone against Streptococcus mutans, Streptococcus mitis, Streptococcus sanguis, and Lactobacillus acidophilus. The zones of inhibition were measured in millimeters. Results: Ocimum sanctum aqueous extract demonstrated maximum antimicrobial activity against microorganisms responsible for dental caries at the 4% concentration level although 3% and 2% were also effective. Maximum activity was seen against S. mutans and S. sanguis with 4% extract. Conclusion: Ocimum sanctum aqueous extract was effective against all caries causing the microorganisms. Clinical significance: Dental caries is still a major oral disease in children which affects their quality of life. It is important to come up with an alternative oral hygiene aid which is easily available and with lesser side effects and maximum benefits by acting against caries causing microbes. Thus aqueous extract of commonly available tulsi is studied to know its effect on caries causing microorganisms.



Aditi Goel, Hind P Bhatia

Effect of Perceived Stress, BMI and Emotional Eating on Dental Caries in School-going Children: A Cross-sectional Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:6] [Pages No:S180 - S185]

Keywords: Anxiety, Body Mass Index (BMI), Cross-sectional Study, Eating Behavior, Emotional Eating, Obesity, Perceived Stress, Stress

   DOI: 10.5005/jp-journals-10005-2145  |  Open Access | 


Aim: The following study aims to describe the relationship of dental caries with the body mass index, perceived stress, and emotional eating among 11 to 13-year-old schoolchildren. Methodology: A cross-sectional study on 400 school-going children was conducted in which two questionnaires consisting of Perceived Stress Scale and Emotional Eating were collected from the children. Dental caries was examined using the dft/DMFT Index. The body mass index was calculated using the value obtained from body weight and height (kg/m2) of each child. Results: Body mass index score was not found to be significantly different among subjects with and without caries in primary and permanent teeth. It was found that Perceived Stress Scale score was found to be significantly more among subjects without caries in permanent dentition as compared to those who had caries. EES score was found to be significantly high among caries-free subjects as compared to those who were having mean dmft score > 0. Conclusion: Dental caries is independent of the body mass index whereas Perceived Stress Scale and Emotional Eating score was found to be more in children without caries as compared to those whose mean dmft score > 0. Clinical significance: This study was conducted to evaluate if perceived stress, body mass index, and emotional eating have an effect on progression of dental caries. This study helps parents and pedodontists for better knowledge about a child's oral health and overall growth.



Sharada R Jampanapally, Suhasini Konda, Hemachandrika Inguva, Swetha B Achaladi, Vamshi K Kancharidasu

Prevalence of Arrested Caries in Three Areas of South India with Different Groundwater Fluoride Levels: An Epidemiological Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S186 - S190]

Keywords: Arrested caries, Groundwater fluoride level, Prevalence, Schoolchildren, South India

   DOI: 10.5005/jp-journals-10005-2148  |  Open Access | 


Background: Dental caries, though a progressive disease, if intervened early may become arrested, provided there is a change in the oral environment. One such factor which may lead to caries arrest is prolonged exposure to naturally available groundwater fluoride. Aim: The aim of the study is to know the prevalence of arrested caries in three geographical areas with different levels of fluoride in groundwater and to attribute if there is any correlation between the natural high fluoride levels in groundwater and the prevalence of arrested caries. Design: A cross-sectional study is conducted on schoolchildren residing in three geographical areas of south India with high, moderate, and low groundwater fluoride levels. A total of 5,982 children, from all the three regions between the age-groups 5–9 years, are examined and 1,514 children with caries are included in the study. The teeth and surfaces with active and arrested caries are identified and recorded in a structured pro forma. All the data obtained was tabulated and subjected to statistical analysis. Results: The prevalence of arrested carious lesions is found to be significantly higher in areas with high groundwater fluoride level when compared to the other two areas. Conclusion: It can be concluded that the progression of caries in children residing in areas with high groundwater fluoride level is slow and gets arrested early in the presence of a high amount of fluoride.



Danish Bilal, Girish M Sogi, Jasneet Sudan

Early Childhood Caries in Preschool Children of Ambala District: A Cross-sectional Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:6] [Pages No:S191 - S196]

Keywords: Early childhood caries [ECC], ICDAS-II, pufa/PUFA

   DOI: 10.5005/jp-journals-10005-2150  |  Open Access | 


Introduction: With increased focus on preventive and promotive interventions in recent years, initial noncavitated carious lesions have drawn attention of healthcare planners as a relevant dental health indicator.
Aim and objectives: The aim of the present study was to assess the prevalence and clinical sequelae of early childhood caries in District Ambala, Haryana.
Materials and method: The present cross-sectional study was conducted among 1,474 children aged 36–71 months old from randomly selected anganwadi centers or preschools. Clinical examination was carried out by single trained calibrated principal investigator and data was recorded on self-structured recording format. The caries assessment was made using International Caries Detection and Assessment system-II [ICDAS -II] and Pulpal Involvement, Ulceration, Fistula and Abscess [pufa/PUFA] Index, respectively. Later decayed, missing, and filled teeth [dmft] values were deduced from ICDAS codes to compare with known indices.
Results: The prevalence of ECC was found to be 65.5 % [ICDAS code other than 0] and 38.2% [dmft < 0]. Prevalence of clinical sequelae [pufa < 0] was found to be 16.5%. There was increase in prevalence of dental caries [ICDAS code other than 0] with increasing age, and difference was statistically significant.
Conclusion: The high prevalence of dental caries in this younger age-group suggests the need to curate strategies for prevention of early childhood caries and oral health promotion that include supportive and practical advice for parents and caregivers of preschool and anganwadi children.
Clinical significance: Traditionally, dental caries are detected at cavitation stage however last 20 years have seen the shift to detection of noncavitated lesions that have slow rate of progression and it is the right time for controlling the severity of the lesion. The present study also highlights the need for the non-surgical management of noncavitated lesions.



Shanthi Vanka, Amit Vanka, Othman Wali, Neeraj S Chauhan, Lama S Alhazmi, Abdulmajeed A Alqazlan

Prevalence of Early Childhood Caries among the 3–5-year-old Children in Jeddah, Saudi Arabia

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:4] [Pages No:S197 - S200]

Keywords: Children, Early childhood caries, Jeddah, Prevalence, WHO criteria

   DOI: 10.5005/jp-journals-10005-2152  |  Open Access | 


Introduction: Dental caries is a significant dental public health issue and it is the world's most common oral health condition among children. In the Kingdom, the prevalence and severity of early childhood caries has been rising. Aim: The aim of the study is to establish the prevalence of early childhood caries among children aged 3–5 years in Jeddah as well as the associated risk factor of visiting a dentist. Methodology: The research is based on a cross-sectional observational design. Children from both private and public schools were randomly selected from schools in all of Jeddah's regions until a sufficient sample size was attained. For the diagnosis of early childhood caries, the American Academy of Pediatric Dentistry criteria were used. Results: In Jeddah, the prevalence of early childhood caries is 57% among children aged 3–5 years. Conclusion: Caries in young children is a public health issue. There should be an increased emphasis to the parents that the child should visit the dentist by 12 months of age as recommended by many professional organizations. Regular dental appointments would then help to lessen the caries burden on children at an early age. The Four A's treatment regimen is recommended to aid in the prevention and early detection of early childhood caries.



Manasa Poludasu, George Manoj Kumar Mallela, Ravindar Puppala, Deepakraj Dandotikar

Comparison of Three Treatment Techniques for Deep Carious Lesions in Primary Teeth: An In Vivo Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:6] [Pages No:S201 - S206]

Keywords: Hall technique, Indirect pulp capping, Mineral Trioxide Aggregate, Primary dentition, Pulpotomy, Stainless steel crown, Rampant caries

   DOI: 10.5005/jp-journals-10005-2151  |  Open Access | 


Aims: To evaluate and compare three different treatment modalities in the management of deep carious lesions in primary molars. Material and methods: A total of 60 primary molars from patients aged 4–9 years were randomly divided into three groups with 20 samples each. Sample in Group I received indirect pulp therapy with Mineral Trioxide Aggregate [MTA] as lining material, Group II received the modified Hall technique, and Group III MTA pulpotomy. The patients were evaluated at 1, 3, 6, and 9 months as per evaluation criteria for success or failure of the same. A Chi-square test was used for proportions and for comparison between groups. Results: Clinically, the success rate for the modified Hall technique and MTA pulpotomy was higher than indirect pulp therapy. Radiographically, the modified Hall technique had the highest success rate of 100 percent among the indirect pulp therapy and MTA pulpotomy. This success rate was however not statistically significant. Conclusion: All three techniques had promising results clinically and radiographically. Since the results were not statistically significant, conservative treatment like Modified Hall's technique can be preferred over the surgical approach [MTA Pulpotomy]. Clinical significance: This study compares newer techniques called Hall's technique with traditional techniques like indirect pulp capping and MTA pulpotomy. Hall's technique is a quick and noninvasive procedure, which involves fitting the crown and seating it over the tooth without any caries removal/ tooth preparation and no local anesthesia is being practiced. In the present study Hall's technique showed higher rates of success compared to the other two procedures.



Anuja Kamble, Zohra Jabin

Effectiveness of Oral Probiotics in Reducing S. Mutans Count in Caries-active Children: A Comparison with Chlorhexidine and Herbal Mouthrinse (Hiora®)

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S207 - S211]

Keywords: Dental caries, Mouthrinses, Probiotics, S. mutans

   DOI: 10.5005/jp-journals-10005-2149  |  Open Access | 


Aim: The purpose of this study was to compare the reduction in salivary mutans streptococci counts and to evaluate any change in the salivary pH values after the use of oral probiotics, chlorhexidine, and herbal mouthrinse. Method: Oral probiotics, chlorhexidine, and herbal mouthrinse [Hiora®] were evaluated for their efficacy against S. mutans in 75 caries-active children, aged 6–14 years. Results: The values obtained were subjected to statistical analysis. Oral probiotics showed lesser reduction in the S. mutans count as compared to chlorhexidine but the values were statistically insignificant. Herbal mouthrinse was not as effective as the oral probiotics or chlorhexidine in reducing the S. mutans count. Conclusion: Oral probiotics show a similar efficacy as the gold standard, chlorhexidine, in reduction of oral S. mutans.



Rashi L Jain, Kamal K Soni, Manju Rawat

A Comparative Evaluation of Xylitol Chewing Gum and a Combination of IgY + Xylitol Chewable Tablet on Salivary Streptococcus mutans Count in Children: A Double-blind Randomized Controlled Trial

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:9] [Pages No:S212 - S220]

Keywords: Dental caries, Double-blind, IgY, Immunoglobulin Y, Randomized clinical trial, Streptococcus mutans, Xylitol

   DOI: 10.5005/jp-journals-10005-2162  |  Open Access | 


Aim: The study was designed for evaluation and comparison of the efficacy of Xylitol chewing gum and a combination of IgY + Xylitol chewable tablet (Nodecay TM) against the “salivary Streptococcus mutans” count in children. Materials and methods: About 120 children belonging to 6–12 years age–group were enrolled into this “double-blind randomized control clinical trial” according to the selection criteria. They were randomly assigned to three groups of 40 each: Group I–Xylitol chewing gum, Group II–IgY + Xylitol Chewable tablet (Nodecay TM), and Group III–Control. Children in all the groups had to chew the gum/tablet twice daily for 5 minutes during the 15-day period. The salivary samples at baseline, 15 days, 1, 2, and 3 months were inoculated on mitis salivarius bacitracin agar with potassium tellurite medium and the number of colony-forming units (CFUs) of Streptococcus mutans were determined. The data obtained was subjected to statistical analysis. Result: There was a “significant” difference in the number of “S. mutans CFUs” amongst the three groups at 15 days, 1st month, 2nd month, 3rd month with highest levels of S. mutans CFUs in Group III–Control and least in Group II–IgY + Xylitol (NodecayTM). Conclusion: The combination of IgY + Xylitol (NodecayTM) when administered for 15 days had significant efficacy against “S. mutans” when compared to Xylitol and control group. Clinical significance: Passive immunization with immunoglobulin Y is known not only to decrease the S. mutans count but also confers extended immunity by preventing recolonization of the tooth surface by persistence of the antibodies in saliva.



Deepa V Bhat, Kiran L Awchat, Pooja Singh, Manish Jha, Kashika Arora

Evaluation of Remineralizing Potential of CPP-ACP, CPP-ACP + F and β TCP + F and Their Effect on Microhardness of Enamel Using Vickers Microhardness Test: An In Vitro Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S221 - S225]

Keywords: Demineralization, Remineralization, Surface microhardness, Vickers hardness test

   DOI: 10.5005/jp-journals-10005-2161  |  Open Access | 


Context: The change in understanding of dental caries which is now believed to be a reversible lesion has led to the change in its management. Aim: To evaluate the remineralizing potential of three remineralizing agents [casein phosphopeptide (CPP)—amorphous calcium phosphate (ACP), CPP-ACP + F, and beta-tricalcium phosphate (β TCP) + F] and their effect on microhardness of enamel using Vickers microhardness test. Materials and method: Forty freshly extracted premolars, extracted for orthodontic purpose were collected and specimen prepared. The specimens were equally divided into four groups. Baseline surface microhardness measurement was taken for the specimens. Demineralization of enamel was carried out by keeping the specimens in 20 mL of demineralizing solution for 72 hours, and microhardness was evaluated. Remineralizing agents CPP-ACP, CPP-ACP + F, and β TCP + F was applied to Group A, Group B, and Group C, respectively for 28 days and microhardness was evaluated again. Group D was kept as control group. Statistical analysis was done by One-way ANOVA test. Percentage microhardness recovery was calculated to evaluate the regain in microhardness after remineralization and thus assess the remineralizing efficacy of the agents. Results: After demineralization surface microhardness of enamel decreased to the range of Vickers hardness number (VHN) 155–167 but after application of remineralizing agents surface microhardness for Group B was found to be highest, in other words, VHN 240.78 followed by Group C, in other words, VHN 214.29 and Group A the least VHN 197.90. Conclusion: The result of this study concludes that surface microhardness of enamel decreased after demineralization procedure and increased after application of all the remineralizing agents. The highest increase was seen in group tested with CPP-ACP + F followed by β TCP and least for CPP-ACP. The values for all the three groups were higher than the control so we can conclude that all the agents can be used as remineralizing agent with CPP-ACP + F being the best among the three.



Harsha V Nembhwani, Indu Varkey

Caries Experience and Its Relationship with Mother's Educational Level and Occupational Status: A Cross-sectional Survey

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:4] [Pages No:S226 - S229]

Keywords: Dental caries, Education, Mother-child, Occupation

   DOI: 10.5005/jp-journals-10005-2163  |  Open Access | 


Aim: Most studies have investigated established risk factors contributing to dental caries in children, however, with the growing incidence of caries in children more risk factors are being included in literature. Thus, this cross-sectional study was conducted to assess the relationship between mother's educational level and occupational status with the caries experience of the child. Materials and method: About 120 mother–child pairs participated in the study. Children below 12 years were screened for their dental caries status using DMFT index. The pairs were equally divided into three groups according to the mother's education and occupational status as: Group I–Mothers who did not receive any formal education, Group II–Educated mothers but unemployed, and Group III–Educated employed mothers. Mother's knowledge and attitude regarding the child's oral health was recorded analyzed using Chi-square test with statistical significance set at p < 0.05. Results: In the present study, the lower DMFT score has been significantly related to higher levels of education and occupation of the mother. It was also observed that the knowledge and attitude of the mother related to the child's oral health is directly proportional to the education and occupational status. Conclusion: The findings of our study suggest that mother's level of education increases the awareness of the child's oral health. Therefore, it is utmost important to educate a mother to help the child maintain his oral health and reduce the caries prevalence. Clinical significance: The results of the present study conducted will help the clinician to keep in sight the relationship of mother's education and occupational level and its impact on their child's teeth, which will in turn help them for creating further dental awareness in the society.



Sunita Agarwalla, Biswaroop Chandra, Arnab Santra, Gautam Kumar Kundu

Impact of Intelligence Quotient (IQ) on Dental Caries amongst Socially Handicapped Orphan Children and Children Living with Their Parents

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:4] [Pages No:S230 - S233]

Keywords: Dental caries, Intelligence Quotient (IQ), Orphanage, Parented Children, RCPM

   DOI: 10.5005/jp-journals-10005-2164  |  Open Access | 


Objective: To evaluate the IQ and dental caries status of socially deprived orphan children and compare with children living with their parents. Study design: For comparison, 100 children in age-group 7–11 years, were divided in two groups: 50 orphanage children (orphanage-group) and 50 school-going children living with their families were included (home group). Raven's colored progressive matrices test was used to record the intelligence quotient (IQ) and dental caries status of children was recorded using dmft Index. Results: There was statistically significant difference between children with different levels of IQ for both the groups. However, the majority of children who belong to below average IQ score had higher dental caries. Conclusion: Children with better IQ had less dental caries. There was no difference in IQ and DMFT/dmft score between both the genders. The overall DMFT/dmft was high in children living with their parents when compared to orphanage children.



Sapna Konde, Shruthi Ravindran, Manisha Agarwal, Preetha Peethambar

Prebiotics—A Primeval Measure to Combat Dental Caries: A Short-term Clinical Study

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S234 - S238]

Keywords: Immunoglobulin A, Prebiotics, Probiotics, Streptococcus mutans, Synbiotics

   DOI: 10.5005/jp-journals-10005-2165  |  Open Access | 


Background: Prevention of dental caries is paramount in reducing the global burden of the disease. The consumption of probiotics as a prophylactic and therapeutic agent for dental caries, has certain limitations. Prebiotics are nondigestible food ingredients, that enhance the growth and activity of probiotic microorganism, thereby help in the establishment of a healthy oral environment. Aim: The aim of this study was to evaluate and compare the effect of prebiotics, probiotics, and synbiotics on the salivary Streptococcus mutans (S. mutans) counts and salivary IgA concentrations. Methodology: Children of age-group 6–9 years with DMFT score of 5 and above were divided into three groups of 10 each: Group 1 (prebiotics), Group 2 (probiotics), and Group 3 (synbiotics). The functional food therapy was done for a period of 1 month twice daily. The S. mutans count and IgA concentrations were assessed pre- and postintervention. The obtained results were subjected to statistical analysis. Results: A statistically significant reduction of S. mutans was seen in all three groups after 1 month. However, no statistically significant difference was noted between the groups. Conclusion: Prebitoics can serve as an unfortified and natural means of combating dental caries.



Soheila Darmiani, Masoud Yousefi, Masoome Saeedi Rad

Comparison of the Effect of Diode Laser Irradiation and Fluoride Varnish on Salivary Streptococcus mutans Bacterial Colonies Counts: A Randomized Controlled Clinical Trial

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:3] [Pages No:S239 - S241]

Keywords: Colony-forming units assay, Laser therapy, Saliva, Sodium fluoride, Streptococcus mutans

   DOI: 10.5005/jp-journals-10005-2166  |  Open Access | 


Aim: The aim of this study was to assess antibacterial effects of diode laser irradiation and fluoride varnish on Streptococcus (S) mutans bacterial colonies counts in saliva. Materials and Methods: This was a randomized controlled clinical trial research, in which 36 healthy caries-free schoolchildren aged 7–10 years referred to Birjand University dental school were selected randomly. None of the subjects had used any fluoride products before sampling. They divided into three groups: Group A: Diode laser irradiation, Group B: Fluoride varnish (FV) + diode laser irradiation, and Group C: FV. From each child, the baseline unstimulated saliva samples were obtained, transferred to the mitis salivarius agar (MSA) culture media and assessed for S. mutans colonies counts. The follow-up unstimulated saliva samples were collected one day after the treatments. Then the number of colony-forming units per milliliter were counted and analyzed statistically using Wilcoxon, Mann Whitney U and Kruskal-Wallis tests (p ≤ 0.05). Results: No adverse events were reported. Salivary count of S. mutans significantly decreased in all groups. The highest and lowest number of the colonies of S. mutans in treated groups was observed in group I and group II, respectively. S. mutans was not completely eliminated by any of the treatments. Conclusion: Considering the limitations of this study, antimicrobial efficacy of fluoride varnish + diode laser was higher than that of FV or diode laser alone. So this laser in combination with fluoride varnish may be useful in prevention of dental caries and antimicrobial treatment protocols. Clinical trial registry: IRCTID: IRCT 201,706 181,7756N20



NS Venkatesh Babu, Abhipsa Roy

Comparative Analysis of the Status of Dental Caries and Selected Salivary Electrolytes in Children with Autism

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S242 - S246]

Keywords: Autism, Dental caries, Magnesium, Salivary constituents, Urea

   DOI: 10.5005/jp-journals-10005-2153  |  Open Access | 


Aim: Autism has been defined as a neurological developmental disability. Children with autism have a higher risk of developing dental caries, due to various factors. The study focuses to compare the dental caries status with respect to the variation in selected salivary constituents [calcium, phosphorus, sodium, potassium, magnesium, and urea] in autistic children and healthy children. Materials and methods: Hundred children participated in the study. The study group included 50 children who were prediagnosed with autism from various autistic institutions across Bengaluru. The control group comprised of 50 healthy children who visited the Department of Pediatric and Preventive Dentistry for a routine check-up. Assessment of salivary constituents was done using salivary kits and dental caries status was recorded. Descriptive statistics was implemented to evaluate the mean and standard deviation of the study and control groups. Normality of the data was assessed using Shapiro Wilkinson test. The difference in results between the groups was calculated using the independent t-test. Results: A significant decrease was observed in the concentration levels of calcium, sodium, potassium, phosphorus, urea and a significant increase was observed in the concentration level of magnesium in the study group consisting of autistic children when compared to the control group consisting of healthy children. DMFT/dmft scores were seen to be higher in autistic children when compared to healthy children. Conclusion: In this study, children with autism were seen to have a higher susceptibility to developing dental caries when compared to healthy children from the same age-group. Clinical significance: The variations in the electrolytic salivary concentrations of calcium, sodium, potassium, chloride, phosphorus, and urea in autistic children could be stated as one of causative factors for the increased DMFT/dmft scores in them when compared to the control group consisting of healthy children.



Padmapriya Surendranath, Srinath Krishnappa

Silver Diamine Fluoride in Preventing Caries: A Review of Current Trends

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:5] [Pages No:S247 - S251]

Keywords: Silver diamine fluoride, Caries, Primary dentition, Minimal invasive dentistry

   DOI: 10.5005/jp-journals-10005-2167  |  Open Access | 


Aim and objective: To evaluate whether silver diamine fluoride (SDF) is effective in the management of dental caries. Background: Dental caries is most common chronic disease and conventional treatment method could not tackle the problem completely. The use of silver compounds in dentistry is over a 100 years. Silver diamine fluoride has become a newer trend in handling the caries especially in young and apprehensive children. It is a noninvasive method of arresting caries which is painless, safe, and cost effective. This article describes the trends in silver diamine fluoride in arresting caries. The combined effects of remineralizing and antibacterial property make SDF an effective cariostatic agent. Review results: Articles were searched in electronic data bases for literature. In vivo studies, in vitro studies, systematic reviews and case reports were included. Conclusion: Silver diamine fluoride is effective in the management of caries in primary dentition. There is a little effect of silver diamine fluoride in permanent molars. Clinical importance: In the current scenario of raising importance of minimal invasive dentistry and preventive dentistry, silver diamine fluoride is an efficient tool in the management of caries.



Hemraj Badhe, Ritesh Kalaskar, Shruti Balasubramanian, Henpu Kamki

Antimicrobial Effect of Ozone Therapy in Deep Dentinal Carious Lesion: A Systematic Review

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:9] [Pages No:S252 - S260]

Keywords: Deep carious lesion, Microbial count, Ozone therapy, Systematic review

   DOI: 10.5005/jp-journals-10005-2168  |  Open Access | 


Aim: This systematic review aimed to answer the following focused question: Is ozone therapy more effective in reducing microbial count as compared to conventional methods in deep dentinal carious lesion? Objective: The purpose of this systematic review was to perform a review on the effectiveness of ozone therapy in reduction of microbial count in deep dentinal carious lesion. Study eligibility criteria, participants, and interventions: The inclusion criteria comprised studies that compared effect on microbial count in deep dentinal carious lesion after treatments with ozone and other disinfectants in primary or permanent teeth in randomized clinical trials. Materials and methods: This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRIMSA) guidelines. The searched databases included Medline (via PubMed), Cochrane, and Google scholar. Articles published until 29 February 2020 without year restriction but only in English language were included. Results: The search resulted in 359 published studies. After removal of duplicate studies and full-text analysis, seven studies were selected. Overall, the results demonstrated the promising effects of ozone therapy in reduction of microbial count as compared to other disinfectant. Conclusions: Within the limitations of this review, it can be asserted that the ozone therapy is effective in reduction of microbial count in deep dentinal carious lesion. Clinical significance: Ozone therapy can be a useful tool to reduce the microorganisms in deep dentinal carious lesion.



S Abirami, Noopur Tushar Panchanadikar, KC Vignesh

Dental Caries Experience among Children and Adolescents with Cleft Lip and/or Palate: An Umbrella Review

[Year:2022] [Month:Special Issue-2 (Cariology)] [Volume:15] [Number:S2] [Pages:8] [Pages No:S261 - S268]

Keywords: Children and adolescents, Cleft lip and/or palate, Dental caries, Umbrella review

   DOI: 10.5005/jp-journals-10005-2169  |  Open Access | 


Aim and objective: To assess the systematic reviews and meta-analyses investigating the dental caries experience in children with cleft lip and/or palate (CL/P). Study design and methodology: A systematic search was carried out from MEDLINE Via PubMed, JBI Database of Systematic Reviews and Implementation Reports, EMBASE, OVID, Cochrane Database of Systematic Review, and Epistemonikos databases. Two independent reviewers carried out the collection and analysis of the study data. Methodological quality was assessed by ROBIS (Risk of bias assessment in systematic review) tool. Review results: An initial search of electronic databases yielded a total of 25 relevant reviews, of which only three systematic reviews were taken into consideration for qualitative synthesis. The total number of unique primary studies among the three included systematic reviews were 25, of which overlap of the studies was calculated using citation matrix. The corrected covered area (CCA) was estimated to be 0.26. Based on the ROBIS tool, only one systematic review reported with low risk of bias. Conclusion: Individuals with CL/P report more decayed, missing, or filled teeth/surfaces than those without CL/P in primary, mixed, and permanent dentition. Future studies should focus on the factors which could modify the caries risk of an individual with CL/P. Clinical significance: This umbrella review offers a more reliable and balanced view regarding the dental caries experience among individuals with cleft lip and/or palate. This paper also highlights the important role of pediatric dentist in multidisciplinary health care team in implementing first dental visit and anticipatory guidance to consider early diagnosis and specific preventive interventions for Early Childhood Caries (ECC) in individuals with CL/P.


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