Amitha M. Hegde

Salivary antioxidants and oral health in children with autism

UNLABELLED Individuals with autism vary widely in abilities, intelligence, and behaviours. Autistic children have preferences for soft and sweetened food making them susceptible to caries. A wide spectrum of medical and behavioural symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Mental retardation is evident in approximately 70% of individuals with autism and most psychiatric disorders including autism are associated with increased oxidative stress. OBJECTIVES To evaluate the oral health status of children with autism and to determine the salivary pH and total salivary antioxidant concentration (TAC). MATERIALS AND METHODS 101 subjects with autism between age group of 6 and 12 year were part of the study and 50 normal healthy siblings of same age group were taken as control group. Oral health status was analysed using oral hygiene index-simplified and dentition status index. The salivary total anti-oxidant level was estimated using phosphomolybdic acid using spectrophotometric method and the salivary pH using the pH indicating paper. The results were statistically analyzed using Mann-Whitney U test. RESULTS A statistically very highly significant difference was seen in the mean oral hygiene index scores (autistic group--1.2 and control group--1, P<0.001) and the mean salivary total antioxidant concentration (autistic group--5.7 μg/ml and control group--38 μg/ml, P<0.001). No statistical significant difference was observed in the dental caries status and the salivary pH of autistic group and the control group. CONCLUSIONS Similar dental caries status was observed in children with autism and their healthy normal siblings. Oral hygiene was poor in children with autism whereas the Salivary TAC was significantly reduced in autistic children.

Drooling of saliva in children with cerebral palsy—etiology, prevalence, and relationship to salivary flow rate in an Indian population

The prevalence of drooling, the impact of various etiological factors on its severity, and its relationship to salivary flow rate were assessed in 113 individuals with cerebral palsy (CP). In this study, there were 74 males and 39 females with an age range of 6-18 years who were attending a special school in Chennai, India. The severity of drooling was assessed by visual examination; demographics and data regarding severity and control of drooling were collected via a questionnaire. Data regarding the type of CP and drugs taken by the children were obtained from the medical records maintained by the school. The unstimulated salivary flow rate of these children was determined through a passive method. The overall incidence of drooling was 48.7%, with 17.7% having severe drooling. Individuals with athetosis had the least severe amount of drooling. There was a significant relationship between ability to close the mouth and the severity of drooling. The severity of drooling was reduced with age. There was no significant difference in the mean salivary flow rate of those children who drooled and those who did not.

Crouzon's syndrome: A review of literature and case report

Crouzons syndrome is an autosomal dominant disorder with complete penetrance and variable expressivity. Described by a French neurosurgeon in 1912, it is a rare genetic disorder. Crouzons syndrome is caused by mutation in the fibroblast growth factor receptor 2 (FGFR2) gene. Normally, the sutures in the human skull fuse after the complete growth of the brain, but if any of these sutures close early then it may interfere with the growth of the brain. The disease is characterized by premature synostosis of coronal and sagittal sutures which begins in the first year of life. Case report of a 7 year old boy is presented with characteristic features of Crouzons syndrome with mental retardation. The clinical, radiographic features along with the complete oral rehabilitation done under general anesthesia and preventive procedures done are described.

PROP test: prediction of caries risk by genetic taste perception among the visually impaired children

The study sample consisted of 100 children with visual impairment aged 6-14 years. 6-n-propylthiouracil (PROP) sensitivity test was carried out. The Caries experience was recorded, estimation of Streptococcus mutans done and their taste likes and dislikes assessed through a food preference questionnaire. The Caries experience and S. mutans levels were highest in the non-tasters, comparatively low in medium tasters and the least in the supertasters. Dietary preferences indicated tasters were sweet dislikers and non-tasters, sweet likers. PROP test can be a useful tool in determining genetic taste sensitivity levels amongst the visually impaired children and thus used as a screening tool in those children who are at a high risk of developing dental caries.

Problematic eating and its association with early childhood caries among 46-71-month-old children using Children's Eating Behavior Questionnaire (CEBQ): A cross sectional study

CONTEXT Problematic eating behavior in children presents a wide spectrum from anorexia, selective eating, and fussy eating to neophobia. Pouching of food and slow eating represents eating behavioral problems that may be relevant to pediatric dentist as far as early childhood caries (ECC) is concerned. AIM The aim of this study was to determine the prevalence of problematic eating and its association with ECC among 46-71-month-old children in Bengaluru city, India. SETTINGS AND DESIGN A cross-sectional study was carried out in 250 children aged 46-71 months old in various schools of Bengaluru city. SUBJECTS AND METHODS All the selected children were clinically examined for dental caries using decayed, missing, filled surfaces index. Childrens eating behavior was assessed using Childrens Eating Behavior Questionnaire (CEBQ) which was filled by the parents. STATISTICAL ANALYSIS USED Both descriptive statistics as well as Chi-square test was used with SPSS 16.00. RESULTS The prevalence of dental caries was found to be 34%. It was observed that 81.6% of the children did not have a tendency to keep food in their mouth all the time and ECC was found to be significantly less. Furthermore, approximately 90% of the children did not have a tendency to eat too much and in those, 68% of them were caries free which was statistically significant. Prevalence of ECC was highest (52.6%) in children who ate more when they had nothing else to do. CONCLUSION Problematic eating behavior is prevalent in the preschooler group and needs to be considered by the pediatric dentist.

Relation of caries status on the salivary total antioxidant levels in asthmatic children

Aim: To study the correlation between the caries status and the salivary antioxidant levels among asthmatic children. Settings and Design: One hundred children within the age group of 6 12 years were selected and equally subdivided into children having a history of asthma and their healthy siblings. Materials and Methods: Salivary antioxidant levels were assessed using spectrophotometric method, and the caries status was recorded using DMFT (Decayed, missing and Filled Teeth Index) and dft (decayed, filled teeth index) index. Result: The salivary antioxidant levels were reduced among the asthmatic children which was statistically highly significant, whereas the caries prevalence was reduced, but not statistically significant.

Knowledge and Oral Health Attitudes among Parents of Children with Congenital Heart Disease

ABSTRACT Congenital heart disease (CHD) is a devastating complex of diseases resulting from defects of development. It affects more than 1 of every 100 live births. Early preventive dental care should be adjusted to the special needs of these children in their first years of life. Knowledge of parental attitudes and experiences of dental care are therefore important. Aim : This study was done to assess the knowledge and attitudes among parents of children with congenital heart disease towards oral health and dental care. Materials and methods : Parents (n = 105) of children with congenital heart disease of an age ranging from 0 to 16 years were included in the study. A questionnaire was used to assess the knowledge and oral health attitudes. Results : The parents’ knowledge was fair but the oral health attitudes were not very satisfactory. The parents in this study also recognized the importance of oral health for the well-being of rest of the body. Conclusion : The results of this study indicate that parents’ and children’s attitudes toward oral health and dental care need to be improved.

Oral Rehabilitation of a Case of Amelogenesis Imperfecta with Multiple Periapical Cysts

Amelogenesis Imperfecta is a hereditary anomaly that affects the enamel of human teeth and is not associated with any systemic disorder of affected patients. The affected teeth are disturbed in coloration, thickness and resistance. The rehabilitation of amelogenesis imperfecta in a child must take into account the development of the child’s teeth, the health of the periodontal tissues and the maxillary and mandibular growth. This article reports the endodontic and occlusal rehabilitation of a 14-year-old girl affected with autosomal recessive hypocalcified type of amelogenesis imperfecta with multiple periapical cysts.

Breaking the sound barrier: oral health education for children with hearing impairment.

In our study, a visual oral health education (OHE) program was specially designed for children with hearing impairment. Its efficacy in improving their oral health status was evaluated after periods of reinforcement and nonreinforcement. One hundred and ten institutionalized children with moderate-to-severe hearing impairment aged 6–14 years were selected for the study. Oral health status was evaluated at the start of the study (pre-OHE level) using the Modified Gingival Index (MGI) and the Turesky–Gilmore–Glickman modification of the Quigley Hein Plaque Index (MQPI). Salivary Streptococcus mutans levels of the children were also evaluated. Brushing skills were assessed using the Simmons index at the start of the study. Significant decreases were observed in the mean values of both the MGI and MQPI from the baseline up to the values obtained at the end of both periods of reinforcement and nonreinforcement. Significant reduction in S. mutans counts was observed, from Pre-OHE levels up to the levels at the end of the period of nonreinforcement. Brushing skills of children improved significantly at the end of study, notably in areas where brushing was previously deemed unsatisfactory. The OHE program specially formulated for the hearing impaired children was effective in improving their oral health status significantly.In our study, a visual oral health education (OHE) program was specially designed for children with hearing impairment. Its efficacy in improving their oral health status was evaluated after periods of reinforcement and nonreinforcement. One hundred and ten institutionalized children with moderate-to-severe hearing impairment aged 6-14 years were selected for the study. Oral health status was evaluated at the start of the study (pre-OHE level) using the Modified Gingival Index (MGI) and the Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index (MQPI). Salivary Streptococcus mutans levels of the children were also evaluated. Brushing skills were assessed using the Simmons index at the start of the study. Significant decreases were observed in the mean values of both the MGI and MQPI from the baseline up to the values obtained at the end of both periods of reinforcement and nonreinforcement. Significant reduction in S. mutans counts was observed, from Pre-OHE levels up to the levels at the end of the period of nonreinforcement. Brushing skills of children improved significantly at the end of study, notably in areas where brushing was previously deemed unsatisfactory. The OHE program specially formulated for the hearing impaired children was effective in improving their oral health status significantly.

Environmental arsenic contamination and its effect on intelligence quotient of school children in a historic gold mining area Hutti, North Karnataka, India: A pilot study

Context: Arsenic is a rare crystal element that naturally occurs in all environmental media. A combination of regional and site-specific biogeochemical and hydrological factors governs its dispersion in the environment. It has far reaching consequences on human health. Exposure to arsenic in drinking water has been associated with a decline in intellectual function in children. Aim: The aim of this study is to assess the relationship between exposure to arsenic by drinking water and childrens intelligence in Karnataka state, India. Settings and Design: Twenty school children of age 10–14 years from Sandur, Bellary, Karnataka, and from Hutti, Raichur, Karnataka, were categorized as control and study group, respectively. Subjects and Methods: Water samples were collected from both the villages for the analysis of arsenic and fluoride levels. Hair and nail samples were collected from the participants, and the arsenic levels were determined. Intelligence quotient (IQ) assessment was done using the Ravens Standard Progressive Matrices. Statistical Analysis Used: Chi-square test, Mann–Whitney U-test, and Fishers exact test. P < 0.05 was considered statistically significant. Results: There was a significant increase in the arsenic content in the hair and nail samples of children in the study group. The mean IQ tests score in the control group and study group was 30.55 and 17.95, respectively, and this difference was statistically significant. Conclusion: Chronic arsenic exposure could be a possible cause for the reduced IQ scores seen in children residing in Hutti, Raichur District, North Karnataka.