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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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   2016| January-March  | Volume 34 | Issue 1  
    Online since February 2, 2016

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Association of severe early childhood caries with iron deficiency anemia
Kalpana Bansal, Meetu Goyal, Renuka Dhingra
January-March 2016, 34(1):36-42
DOI:10.4103/0970-4388.175508  PMID:26838146
Background: Severe tooth decay is known to affect the health and well-being of young children. However, there has been minimal research showing the association of severe early childhood caries (S-ECC) and iron deficiency anemia (IDA). Aims: The primary aim of this study was to investigate an association between S-ECC with IDA. The secondary objective was to find an association between severe caries and body weight of the child. The oral health-related quality of life of children with S-ECC was also assessed. Materials and Methods: Following the ethical approval, 60 children aged 2-6 years (30 with S-ECC and 30 controls with caries status <2) were recruited for this cross-sectional association study. Each child received a clinical examination for dental caries status using deft index and a blood investigation to determine various parameters; hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration, and packed cell volume (PCV). Children underwent venipuncture after due parental consent, and 2.5 mL blood was collected from each child to evaluate the above parameters. Following this, the parents filled up a 10 point questionnaire to determine the child's quality of life. Data were then analyzed by t-test and Fischer's exact t-test. Result: On comparison of percentage of children with IDA in S-ECC and control group, it was found that children with S-ECC were more likely to have IDA odds ratio (95% confidence interval): 10.77 (2.0, 104.9), (P = 0.001). In addition to this, S-ECC children were significantly more likely to have low Hb, MCV, and PCV levels (P < 0.001) which imply that S-ECC may be a risk marker for the development of anemia. More children (93%) with severe caries were found to have less body weight than ICMR standard weight for age as compared to children with low caries (P < 0.05%). Conclusion: S-ECC is strongly associated with the anemia due to iron deficiency, and efforts should be made toward the preventive and curative aspects of ECC, which may improve the general well-being and quality of life of a child.
  17 8,905 862
Anti-microbial efficacy of green tea and chlorhexidine mouth rinses against Streptococcus mutans, Lactobacilli spp. and Candida albicans in children with severe early childhood caries: A randomized clinical study
Ann Thomas, Sneha R Thakur, Sowmya B Shetty
January-March 2016, 34(1):65-70
DOI:10.4103/0970-4388.175518  PMID:26838151
Introduction: Green tea is a beverage which is consumed worldwide and is reported to have anti-cariogenic effect. So, if it was as effective as chlorhexidine (CHX) mouth rinse against cariogenic microbes it could be considered a natural, economical alternative. The purpose of this study was to evaluate and compare the anti-microbial efficacy of 0.5% green tea and 0.2% CHX mouth rinses against Streptococcus Mutans, Lactobacilli spp. and Candida Albicans. Materials and Methods: 30 children aged 4-6 years with S-ECC (based ondefs score) were selected. Children were divided randomly into 2 equal groups and were asked to rinse with the prescribed mouth rinse once daily for 2 weeks after breakfast under supervision. A base-line and post rinsing non-stimulated whole salivary sample (2 ml) was collected and tested for the number of colony forming units. The data was statistically analyzed using SPSS v16.0 software with one-way ANOVA and Tukey'sPOSTHOC test. Results: A statistically significant fall in colony count was found with both the mouth rinses in Streptococcus Mutans (P < 0.001, P < 0.001) and lactobacilli (P < 0.001, P < 0.001) but not against Candida albicans (P = 0.264, P = 0.264). Against Streptococcus Mutans, green tea mouth rinse was found to be significantly better than CHX mouth rinse (P = 0.005). Against lactobacilli spp, CHX mouth rinse was significantly better than green tea mouth rinse (P < 0.001). Conclusion: Green tea mouth rinse can be considered safe, economical and used without much concern. However, further studies are recommended.
  14 7,663 905
A survey of the dentist attire and gender preferences in dentally anxious children
Alexander Asokan, Haalaswamy V Kambalimath, Raju U Patil, Sathish Maran, KP Bharath
January-March 2016, 34(1):30-35
DOI:10.4103/0970-4388.175507  PMID:26838145
Background: Anxiety about doctors among children is very common. White coat phobia which is a classical conditioning phenomenon is said to be prevalent among children. Objectives: To analyze the association between anxious states of children about dentists and their preference of dentist attire and gender in the dental office. Materials and Methods: The 9-12-year-old middle school children were selected for the study. Children were asked to fill a questionnaire containing children's fear survey schedule-dental subscale (CFSS-DS) and asked to prefer dental attire from four different pictures displaying the single anonymous dentist in four different attires in the same operator. The CFSS-DS gave the anxiety scale, and age, gender, and experience were also plotted against children preference in an apron, protective wear, and gender preference. Results were tabulated and statistically analyzed using Chi-square test. Results: About 718 (62%) were scored as anxious children. Of all anxious children, 502 (69.9%) had preference of colored attires of the dentist, and 408 (66.8%) anxious children preferred dentist with protective wear. Female dentists were preferred by 452 (66%) anxious children. Same gender preference was also prevalent.
  10 7,633 612
Impact of verbal, braille text, and tactile oral hygiene awareness instructions on oral health status of visually impaired children
P Brahmanna Chowdary, KS Uloopi, C Vinay, V Veerabhadra Rao, Chandrasekhar Rayala
January-March 2016, 34(1):43-47
DOI:10.4103/0970-4388.175510  PMID:26838147
Background: Visually impaired children face limitations in interacting with the environment, as they cannot see the facial expression of parents, teachers and cannot perceive social behavior. These children are challenged every day in learning basic life skills and maintenance of oral hygiene being one among them. Aim: To evaluate the impact of verbal, braille text, and tactile oral hygiene awareness instructions on oral health status of visually impaired children. Materials and Methods: One hundred and twenty institutionalized visually impaired children aged 6-16 years were selected and divided into three groups (40 children each). Group I: Verbal and tactile, Group II: Verbal and braille, Group III: Verbal, braille, and tactile. Instructions regarding maintenance of good oral hygiene and brushing technique were explained to all the children, and oral health status of these children using plaque index (Silness and Loe) and gingival index (Loe and Silness) was evaluated at 1, 3, and 6 months interval. Statistical Analysis: ANOVA test was used to analyze the intra- and inter-group comparisons and Tukey post-hoc test for multiple group comparisons. Results: Children in all the groups showed reduction in plaque and gingival scores. There was the highest percentage of reduction in plaque scores in Group III (70.6%), and the decrease in gingival scores was the highest in Group II (84%). Conclusion: Severity of dental plaque and gingivitis in visually impaired individuals can be reduced by a controlled and supervised educational program. The combination of all three, i.e., verbal, braille, and tactile mode of oral health educational aids proved to be effective.
  9 6,352 590
A clinical and radiographic study of four different root canal fillings in primary molars
Alaa O Al-Ostwani, Bashier M Al-Monaqel, Mohamed K Al-Tinawi
January-March 2016, 34(1):55-59
DOI:10.4103/0970-4388.175515  PMID:26838149
Background: Successful treatment of infected primary teeth aims to preserve the child's health. However, the complex morphology of primary root canals and the desire for shorter therapy sessions put the necessity to search for the ideal root canal paste. Aims: To evaluate pulpectomy of nonvital primary molars using four different root canal filling pastes zinc oxide and propolis (ZOP) as a new paste, endoflas-chlorophenol-free as a new paste free of chlorophenol, metapex paste, and zinc oxide and eugenol (ZOE) paste as a control paste. Materials and Methods: Pulpectomy of 64 nonvital primary molars were accomplished in 39 children aged 3-9 years. Teeth were randomly divided into four equal groups of 16 molars according to the type of root canal filling. Pulpectomy was performed in one stage using 5.25% sodium hypochlorite irrigation and stainless-steel crown for final restoration. Clinical and radiographic results were evaluated double-blindly for two periods of 6, 12 months. Data were analyzed using Chi-square/Fisher's exact test, and P-value was set as 0.05. Results: The four pastes achieved convergent clinical and radiographic success within the two observation periods (P > 0.05). ZOE paste was the slowest in its resorption. Conclusions: ZOP is a promising paste with its natural antibacterial component (propolis). ZOE paste had convergent efficacy to the other pastes.
  7 9,148 1,322
Effect of fixed space maintainers and removable appliances on oral microflora in children: An in vivo study
Ritesh Kundu, Abhay M Tripathi, Jagdish Narain Jaiswal, Ujjala Ghoshal, Madhuchanda Palit, Sonali Khanduja
January-March 2016, 34(1):3-9
DOI:10.4103/0970-4388.175498  PMID:26838141
Background: Oral habits and caries if left untreated may result in crowding and arch length discrepancy in developing dentition. Therefore, appliances are used to maintain the arch length and for proper relationship between dental arches. However, its insertion may cause an increase in bacterial concentration. Aim: This study aimed to evaluate the growth of Streptococcus mutans, Lactobacillus sp., and Candida albicans in saliva during the first 6 months of orthodontic therapy. Materials and Methods: Twenty children in the age group of 6-15 years were selected with regard to indication of orthodontic treatment, and subsequently grouped as patients to be treated with fixed space maintainers or removable appliances. Unstimulated saliva was collected in a sterile container at baseline and at 1-month, 3-month, and 6-month recalls for every selected child. Samples collected were processed for bacterial culture in different culture media at different time intervals. Statistical Analysis: SPSS (Statistical Package for Social Sciences) Version 15.0 statistical software was carried for bacterial counts. Chi-square test and t-test were performed to know the effects of each variable and to reveal the statistical significance. Result: Bacterial counts of Streptococcus mutans, Lactobacillus sp., and Candida albicans were found to be statistically significant (P 0≤ 0.001), (P < 0.05), and (P < 0.001), respectively in both the groups at all intervals. Conclusion: At different time intervals, the total numbers of bacterial count of Streptococcus mutans were comparatively higher, followed by Lactobacillus sp. and Candida albicans.
  6 6,651 915
An in-vitro evaluation of antibacterial effect of Amalgomer CR and Fuji VII against bacteria causing severe early childhood caries
Rajesh Hemant Bariker, Praveenkumar S Mandroli
January-March 2016, 34(1):23-29
DOI:10.4103/0970-4388.175506  PMID:26838144
Objective: To evaluate the antibacterial action of Amalgomer CR and Fuji VII against bacteria causing S-early childhood caries. Materials and Methods: Antibacterial activity of Amalgomer CR and Fuji VII was assessed using the agar diffusion test in triplicate. The powder and liquid of each test material was mixed and inserted in the punched wells (6 mm × 2 mm). A composition of 0.2% chlorhexidine digluconate acted as control. The agar plates were incubated at 37°C for 24 h for Streptococcus mutans, S. salivarius, S. parasanguinis and Actinomyces viscosus, whereas Lactobacillus casei was incubated for 48 h. Sizes of the inhibition zones were calculated by subtracting the diameter of the specimen (6 mm) from the average of the three measurements of the halo. For each test material against each bacteria, 9 measurements were made (3 measurements × 3 times). Kruskal-Wallis test was done to compare the zones of inhibition of test materials against individual bacteria. Pair-wise comparison was done by Mann-Whitney U-test. Results: Amalgomer CR had the most antibacterial against S. mutans (31.0 mm), followed by A. viscosus (21.87 mm), S. salivarius (13.87 mm), S. parasanguinis (10.80 mm), and L. casei (9.69 mm). Fuji VII had the most antibacterial action against S. salivarius (10.65 mm), followed by A. viscosus (9.10 mm). However, it did not inhibit the growth of S. mutans (0 mm), S. parasanguinis (0 mm), and L. casei (0 mm). Conclusion: Amalgomer CR and Fuji VII showed wide variation in antibacterial action against all test organisms.
  5 4,804 453
Effect of the video output of the dental operating microscope on anxiety levels in a pediatric population during restorative procedures
Abrar Sayed, Vinisha Ranna, Dimple Padawe, Vilas Takate
January-March 2016, 34(1):60-64
DOI:10.4103/0970-4388.175516  PMID:26838150
Background: Adapting a child to the alien settings of a dental operatory is a major challenge to the dentist. Fear of the unknown and preconceived notions of dental pain causes anxiety in the pediatric patient. This often leads to disruptive and uncooperative behavior in the dental operatory. Many methods of behavior management have been described, of which the Tell-Show-Do (TSD) is an established and time-tested technique of behavior management. Aim: To determine if a live visual output of the dental operating microscope (DOM) could be used as an adjunct to the TSD technique, to involve the child more completely in the procedure and reduce the fear of the unknown. Materials and Methods: The study was a randomized, controlled, crossover, and cross-sectional clinical trial. Data were obtained from two visits. 90 children having carious lesions on both lower first molars, in the 7-9 years age group were selected and divided randomly into two groups. Restorative procedures were performed on one tooth per visit, with visits 1 week apart. Live display of the procedure was shown to the patient using video output of the DOM displayed on a 72 inch LCD monitor, angled for best visibility of the child. Anxiety levels were evaluated using Venhams picture selection test and pulse oximetry. Statistical Analysis: Student's t-test was used to compare the anxiety scores obtained from the two groups. Results: The results showed there was a decrease in the anxiety from the first visit to the second visit. (P = 0.05 for Group A and P = 0.003 for Group B). The patients preferred the visit in which the DOM was used. The operator reported an increased patient compliance and reduced patient movement in the visits in which the DOM was used. Conclusion: There is a reduction in anxiety from the first visit to the second visit for restorative treatment when the DOM is used.
  5 4,959 468
Dental health in children with congenital bleeding disorders in and around Davangere: A case-control study
NB Nagaveni, Shruthi Arekal, P Poornima, Suresh Hanagawady, Sneha Yadav
January-March 2016, 34(1):76-81
DOI:10.4103/0970-4388.175522  PMID:26838153
Aim: The present study was carried out to investigate the dental and some other aspects of oral health status of young patients with congenital bleeding disorders (CBDs) and compared with controls. Materials and Methods: Decayed, missed, filled tooth surfaces (DMFS-dmfs) in permanent and primary teeth scores, simplified oral hygiene index, occlusion, occurrence of hypoplasia, fluorosis other hard tissue and soft tissue findings of 50 CBD patients at the age range of 4-15 years and 50 of other children as control were compared. Data were analyzed by Chi-square and Student's unpaired t-test. Results: Patients were significantly more caries-free with less decayed teeth in primary-permanent dentition (P < 0.05) and with lower scores for overall hygiene. Conclusion: By this, it can be concluded that children with CBD have a significantly lower prevalence of dental caries and better oral hygiene compared with matched, healthy controls.
  3 5,150 399
pH modulation and salivary sugar clearance of different chocolates in children: A randomized clinical trial
SVSG Nirmala, Mohammed Akhil Quadar, Sindhuri Veluru
January-March 2016, 34(1):10-16
DOI:10.4103/0970-4388.175502  PMID:26838142
Background: Sugars that occur naturally in foods and those added in processed foods may act as the source for fermentable carbohydrates and may initiate caries process. Among all the foods consumed by children, chocolates form an important constituent. A wide variety of chocolates are available in the Indian market and very few studies have compared their acidogenicity and salivary sugar clearance. Objectives: To compare the acidogenicity and salivary sugar clearance of 6 different commercially available chocolates in the Indian market. Materials and Methods: Thirty subjects aged 10-15 years were selected randomly from one of the available public schools in Nellore city. Six commercially available chocolates in the Indian market were divided into three groups, unfilled (dark and milk chocolate), filled (wafer and fruit and nuts chocolate), and candy (hard milk and mango-flavored candy) groups. Plaque pH values and salivary sugar clearance rates are assessed at baseline, 5, 10, 15, 20, and 30 min after consumption. All the data obtained were statistically evaluated using independent sample t-test and one-way ANOVA for multiple group comparisons. Results: Mango-flavored candy had maximum fall in plaque pH and least fall in plaque pH was recorded with milk chocolate. Fruit and nuts chocolate had a maximum clearance of salivary sugar and least fall in the salivary sugar clearance was recorded with dark chocolate. When the plaque pH and salivary sugar clearance of all the chocolates were assessed, it was seen that the values were statistically significant at all the time intervals (P < 0.05). Conclusion: Dark chocolate had a high fall in pH and milk chocolate had low salivary sugar clearance which signifies that unfilled chocolates are more cariogenic than other chocolates. Even though mango-flavored candy had maximum fall in plaque pH, its salivary sugar clearance was high.
  2 5,255 502
Self healing hemophilic pseudotumor of the mandible in a 5-year-old boy, an interesting and rare finding: Case report and review
Ruchika Keshaw Prasad, B Siva, Jaisika Rajpal, Ankur Singh
January-March 2016, 34(1):82-86
DOI:10.4103/0970-4388.175524  PMID:26838154
Hemophilic pseudotumor (PT) is a very rare complication of hemophilia consisting of a chronic, encapsulated, hemorrhagic fluid collection occurring both in the soft tissues and/or bone. Radiological features of osseous hemophilic PT are nonspecific and mimic several other benign or malignant bone tumors or infectious processes. Although the diagnosis is usually made on the location of the lesion and by the knowledge of the underlying disease, the radiologist should be aware of the imaging characteristics, in order to avoid misinterpretation as a malignant tumor, as biopsy of these lesions is contraindicated. [1]
  1 3,575 273
Correlation of plaque nitric oxide levels with plaque Streptococcus mutans, plaque pH and decayed, missing and filled teeth index of children of different age groups
Sawinderjit Saini, Hina Noorani, PK Shivaprakash
January-March 2016, 34(1):17-22
DOI:10.4103/0970-4388.175505  PMID:26838143
Context: Dental plaque is considered one of the most important etiological factors for dental caries. Nitrate and Nitrite levels in saliva are considered protective against oral and gastrointestinal disease. Plaque nitric oxide (NO) levels and its role in dental caries has not be explored in the literature. Aim: Determine the correlation of the plaque nitric oxide (NO) with dental caries in vivo. Materials and Method: 75 healthy children between ages of 3-15 years were selected. The age, state of dentition and the level of caries in all individuals were determined by the same examiner, using DMFT/deft index. The plaque samples collected were subjected to nitric oxide estimation, streptococcus mutans count and pH for correlation. Statistical Analysis Used: SPSS computer based software was used for descriptive data analysis. ANOVA one way analysis and Karl pearson's correlation was carried out. Results and Conclusion: Statistically significant relationship was observed between plaque nitric oxide and dental caries in all age groups. Similarly, significant correlation of nitric oxide was found in relation to plaque streptococcus mutans and plaque pH. Thus concluded, plaque nitric oxide can be considered as a risk assessment tool for prediction of dental caries.
  1 11,444 320
Cheiloscopy and dermatoglyphics as genetic markers in the transmission of cleft lip and palate: A case-control study
K Saujanya, M Ghanashyam Prasad, B Sushma, J Raghavendra Kumar, YSN Reddy, K Niranjani
January-March 2016, 34(1):48-54
DOI:10.4103/0970-4388.175512  PMID:26838148
Background: Determining the relative risk of cleft lip and palate (CL[P]) on the basis of lip prints and dermatoglyphics as genetic background may be useful for genetic counseling, and the development of future preventive measures. Aims and Objectives: (1) To analyze the various pattern types of lip prints and dermatoglyphics in parents of CL(P) children and to detect if any specific type can be contemplated as a genetic marker in the transmission of CL(P). (2) To compare these patterns with that of parents of unaffected children. Materials and Methods: 31 parents of children with CL(P) as a study group, and 31 parents of unaffected children as control group were included. Lip prints and finger prints were collected from all subjects and analysis of both patterns was carried out followed by a comparison of the patterns of unaffected parents with the controls statistically. Results: Among the mothers of the study group, type O followed by type IIa lip patterns were found to be significantly higher in upper and lower lips, and in fathers type IIa followed by type O were significantly higher. In the control group, type IIb followed by type III were higher in both fathers and mothers. Dermatoglyphic analysis of palm and finger prints revealed no significant difference in the pattern types and total ridge counts, but the Atd angle asymmetry was found to be significant between study and control group. Conclusion: Types IIa and O lip patterns, asymmetry of Atd angles can be considered as genetic markers for the transmission of CL(P) deformity to offsprings.
  1 5,859 383
Central hemangioma: A case report and review of literature
Sandeep Jain, Sasidhar Singaraju, Medhini Singaraju
January-March 2016, 34(1):87-91
DOI:10.4103/0970-4388.175525  PMID:26838155
Hemangioma is a benign self-involuting tumor of endothelial cells. They are the most common benign congenital lesions in humans and are characterized by the proliferation of blood vessels. They are often present at birth or appear soon after, and grow rapidly by endothelial proliferation. This article presents a rare case of central hemangioma occurring in the mandible of a 13-year-old boy, and a brief review on clinical, radiological, and histopathological characteristics of central hemangiomas.
  - 10,103 425
Fetal hydantoin syndrome: A case report
A Singh, HP Bhatia, A Mohan, N Sharma
January-March 2016, 34(1):92-95
DOI:10.4103/0970-4388.175526  PMID:26838156
Fetal hydantoin syndrome (FHS) is a spectrum of defects caused to the developing fetus by exposure to the teratogenic effects of antiepileptic drug (AED) phenytoin during pregnancy. Its clinical manifestations include limb abnormalities, ocular defects, central nervous system anomalies, intrauterine growth restriction, and hand and phalangeal anomalies. This case report presents an 8-year-old child born to an epileptic mother with a history of AED therapy, with features suggestive of FHS.
  - 5,344 292
Dental root agenesis following radiation and antineoplastic therapy: A Case Report
Abdul Hafiz, Abdulla Mufeed, Punit Bharadwaj, Dinesh Rao
January-March 2016, 34(1):96-99
DOI:10.4103/0970-4388.175528  PMID:26838157
The survival rates of patients suffering from various childhood neoplasms have improved dramatically with the advent of chemo-radiation therapy. The harmful effects of chemo-radiation therapy in the oro-facial region such as root agenesis, short roots, impaired amelogenesis, dentinogenesis, radiation caries, and other soft tissue pathologies are well recognized. In spite of these documented risks, the antineoplastic treatment modalities continue to serve the patient for overall improvement in survival and quality of life. However, a thorough understanding of the growth and development process and its relation with the complex antineoplastic treatment is very important for all clinicians. Such awareness could significantly improve the status of patients in the posttreatment period with the implementation of proper preventive and interceptive measures. This article intends to document a case of root agenesis that developed secondary to chemo-radiation therapy in a 12-year-old girl.
  - 11,057 315
Publicationomics: Delusion demystified
ND Shashikiran
January-March 2016, 34(1):1-2
DOI:10.4103/0970-4388.175496  PMID:26838140
  - 2,570 252
Comparison of linear and zero-inflated negative binomial regression models for appraisal of risk factors associated with dental caries
Manu Batra, Aasim Farooq Shah, Prashant Rajput, Ishrat Aasim Shah
January-March 2016, 34(1):71-75
DOI:10.4103/0970-4388.175521  PMID:26838152
Context: Dental caries among children has been described as a pandemic disease with a multifactorial nature. Various sociodemographic factors and oral hygiene practices are commonly tested for their influence on dental caries. In recent years, a recent statistical model that allows for covariate adjustment has been developed and is commonly referred zero-inflated negative binomial (ZINB) models. Aim: To compare the fit of the two models, the conventional linear regression (LR) model and ZINB model to assess the risk factors associated with dental caries. Materials and Methods: A cross-sectional survey was conducted on 1138 12-year-old school children in Moradabad Town, Uttar Pradesh during months of February-August 2014. Selected participants were interviewed using a questionnaire. Dental caries was assessed by recording decayed, missing, or filled teeth (DMFT) index. Statistical Analysis Used: To assess the risk factor associated with dental caries in children, two approaches have been applied - LR model and ZINB model. Results: The prevalence of caries-free subjects was 24.1%, and mean DMFT was 3.4 ± 1.8. In LR model, all the variables were statistically significant. Whereas in ZINB model, negative binomial part showed place of residence, father's education level, tooth brushing frequency, and dental visit statistically significant implying that the degree of being caries-free (DMFT = 0) increases for group of children who are living in urban, whose father is university pass out, who brushes twice a day and if have ever visited a dentist. Conclusion: The current study report that the LR model is a poorly fitted model and may lead to spurious conclusions whereas ZINB model has shown better goodness of fit (Akaike information criterion values - LR: 3.94; ZINB: 2.39) and can be preferred if high variance and number of an excess of zeroes are present.
  - 4,102 332
A tribute
Deepak Chauhan
January-March 2016, 34(1):100-100
DOI:10.4103/0970-4388.175530  PMID:26838158
  - 2,725 157
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