Arathi Rao

Child dental fear and behavior: the role of environmental factors in a hospital cohort.

INTRODUCTION Information on the origin of dental fear and uncooperative behavior in a child patient is important for behavior management strategy. The effects of environmental factors have been comparatively less studied, especially in an Indian scenario. OBJECTIVES To find the association of (1) age, gender, family characteristics, previous medical, and dental experiences with dental fear and behavior (2) dental fear with dental behavior. MATERIALS AND METHODS A cross-sectional questionnaire study involving 125 children aged between 7 and 14 years undergoing dental treatment under local anesthesia. The parent completed a questionnaire on family situation, medical history, and past dental experiences of the child. Childs dental fear was recorded using Childrens Fear Survey Schedule-Dental Subscale and behavior was rated using Frankl Behaviour Rating Scale. STATISTICAL ANALYSIS Data were analyzed using chi square test and binary logistic regression analysis. RESULTS Unpleasant experience in dental clinic and age of the child significantly influenced dental behavior. Visited pediatrician in the past one year, prior history of hospital admission, previous visit to dentist, experience at the first dental visit, and age of the child were contributing factors for dental fear. There was also significant association between dental fear levels and behavior. CONCLUSIONS In 7 to 14 year olds, dental fear influences dental behavior, but the factors affecting them are not the same. Although dental fear decreases and dental behavior improves with age, experiences at the previous dental visits seem to influence both dental fear and behavior. Past medical experiences are likely to influence dental fear but not dental behavior.

Comparative evaluation of the influence of television advertisements on children and caries prevalence

Introduction : Children watch television during most of their free time. They are exposed to advertisers’ messages and are vulnerable to sophisticated advertisements of foods often detrimental to oral and general health. Objectives : To evaluate the influence of television advertisements on children, the relationship with oral health and to analyze the content of those advertisements. Methodology : A questionnaire-based study was performed among 600 schoolchildren of Mangalore, Karnataka, followed by oral examination. Based on the survey, favorite and non-favorite channels and viewing times were analyzed. Advertisements on childrens favorite and non-favorite channels were then viewed, analyzed, and compared. Results : Higher caries prevalence was found among children who watched television and asked for more food and soft drinks. Cariogenic food advertisements were popular on childrens favorite channels. Conclusion : Television advertisements may strongly influence childrens food preferences and eating habits, resulting in higher caries prevalence. Advertisements regarding healthy food, oral hygiene maintenance, prevention of diseases such as caries should be given priority for the benefit of the health of children.

Parenting style and oral health practices in early childhood caries: a case–control study

BACKGROUND There is a need to carry out controlled investigations regarding risk factors for early childhood caries (ECC). AIM To study the type of parenting style and oral health practices as risk factors among children with ECC in an Indian preschool population. METHODS Two hundred and eleven children with ECC and equal number of controls participated in this case-control study. A questionnaire was answered by parents regarding oral health practices such as oral hygiene methods, feeding habits, daily sugar intake, and dental attendance pattern along with socioeconomic and demographic status. The parenting style was determined using Parenting Styles Dimension Questionnaire (PSDQ) index. Data were statistically analyzed using chi-square test and multiple logistic regression analysis. RESULTS Risk factors associated with ECC were higher birth order, lower socioeconomic status, non-use of fluoridated toothpaste, breast/bottle feeding for more than one year, presence of formula milk or milk with sugar in the feeding bottle while falling asleep, higher sweet scores in the diet chart, and visiting dentist only when a problem was perceived. Majority of parents of children with and without ECC had authoritative parenting style. CONCLUSION Improper oral health practices are the risk factors for ECC. The association of parenting style with ECC could not be confirmed.

Fluoride rechargability of a non-resin auto-cured glass ionomer cement from a fluoridated dentifrice: an in vitro study.

BACKGROUND In addition to their fluoride-releasing properties, glass ionomer cement (GICs) have the ability to reuptake and release fluorides from commonly used sources like fluoridated dentifrices. This property has the potential to provide a continuous low concentration of fluoride in the saliva aiding in caries prevention. The superior fluoride-recharging abilities of resin-modified GICs over conventional GICs have been documented. The manufacturer of a non-resin, auto-cured GIC (GC Fuji VII) claims fluoride release from the product to be about six times that of conventional GIC. It was hypothesized that perhaps this high fluoride release could translate into a high reuptake and release, when exposed to a 1 000 ppm fluoridated dentifrice every day, thus providing increased fluoride levels in saliva. AIMS This study therefore examined fluoride-recharging abilities of the non-resin, auto-cured glass ionomer cement from a 1 000 ppm fluoridated dentifrice and compared it with resin-modified glass ionomer cement. MATERIALS AND METHODS Twelve glass ionomer discs each of resin-modified glass ionomer cement (GC Fuji II L C, Group 1) and the non-resin, auto-cured glass ionomer cement (GC Fuji VII, Group 2) were prepared with precise dimensions of 9 x 2 mm. The 12 specimens in each group were further subdivided into two subgroups of six each. Subgroup A involved no fluoride treatment (Control). Subgroup B involved application of a 1 000 ppm dentifrice for 2 minutes twice daily with a soft toothbrush. The disc-specimens were then suspended in airtight plastic bottles containing exactly 20 ml double distilled water. The fluoride concentration of the water in which the specimen discs were immersed was measured by means of a fluoride ion selective electrode connected to an ion selective electrode meter/digital ion analyzer at 1, 2, 7, 15, and 30 days. STATISTICAL ANALYSIS It was performed using the Kruskal-Wallis Test. RESULTS AND CONCLUSION Fuji VII, despite a high fluoride release, did not significantly recharge when exposed to a 1 000 ppm fluoridated dentifrice.

Efficacy of lesion sterilization and tissue repair in primary tooth with internal resorption: A case series

Lesion sterilization and tissue repair (LSTR) treatment involves the use of a triple antibiotic mixture in a suitable vehicle, which is used to disinfect root canal systems. This report highlights three cases where LSTR therapy using triple antibiotic paste was attempted in primary molars exhibiting gross periradicular pathosis and internal resorption. Follow-up examinations revealed reduction of periradicular pathosis and reversal of internal resorption in all the three cases. This case series opens a perspective on the use of LSTR therapy as an alternative option to extraction in treating primary teeth with gross periradicular pathosis and internal resorption.

Remineralizing effectiveness of calcium sucrose phosphate and fluoride dentifrices: An In vitro study

Context: Dentifrices-containing remineralizing agents are known to be effective in remineralization of early enamel lesions. Aims: This study aimed to compare and evaluate the changes in surface roughness, surface morphology, and mineral content of demineralized enamel lesion after treatment with dentifrices-containing sodium monofluorophosphate, amine fluoride, and Anticay® (calcium sucrose phosphate with inorganic amorphous calcium phosphate). Settings and Design: This was an in vitro study. Subjects and Methods: Eighteen extracted maxillary molars were decoronated and sectioned into four to obtain 72 specimens. Specimens were demineralized and randomly divided into four different test groups: Group A: no treatment (control), Group B: sodium monofluorophosphate dentifrice (Colgate), Group C: amine fluoride dentifrice (Amflor), Group D: Anticay® dentifrice (EnaFix) and subjected to pH-cycling for 4 weeks. After 4 weeks, they were assessed using a profi lometer and scanning electron microscope (SEM)-energy dispersive X-ray analysis (EDAX) for changes in surface roughness, surface morphology, and mineral content. Statistical Analysis Used: Intergroup comparison was done using repeated measures ANOVA. Results: Intergroup comparison revealed no significant difference in surface roughness and mineral content after remineralization between the groups. SEM images showed mineral deposition in all the dentifrice groups obliterating the defects caused due to demineralization. Conclusions: Sodium monofluorophosphate, amine fluoride-containing dentifrices, and calcium sucrose phosphate with inorganic amorphous calcium phosphate-containing dentifrice were found equivocal in their remineralizing effectiveness of early enamel lesions.

Evaluation of conventional, protaper hand and protaper rotary instrumentation system for apical extrusion of debris, irrigants and bacteria- An in vitro randomized trial

Background Endodontic instrumentation carries the risk of over extrusion of debris and bacteria. The technique used and the type of instrumentation influences this risk. Aim The purpose of this study was to evaluate and compare the K-file, ProTaper hand and ProTaper rotary instrumentation systems for the amount of apically extruded debris, irrigant solution and intracanal bacteria. Design Experimental single blinded randomized type of in vitro study with sample of 30 single rooted teeth. Endodontic access cavities were prepared and the root canals were filled with the suspension of E. faecalis. Myers and Montogomery Model was used to collect apically extruded debris and irrigant. Canals were prepared using K files, Hand protapers and Protaper rotary files. Statistical analysis Non Parametric test like Kruskal-Wallis and Mann-Whitney U test were applied to determine the significant differences among the group. Results Tests revealed statistically significant difference between the amount of debris and number of bacteria extruded by the ProTaper hand and the K-files. No statistically significant difference was observed between the amounts of irrigant extruded by the ProTaper hand and the K-file system. Statistically significant differences were observed between the amounts of bacteria and irrigant extruded by the ProTaper rotary and the Protaper hand. No statistically significant difference was observed between the amounts of debris extruded by the ProTaper hand and the K-file system. Conclusions Amount of apical extrusion of irrigant solution, bacteria and debris are significantly greater with K File instruments and least with Protaper rotary instruments. Key words:Protaper, rotary, periapical extrusion.

Evaluation of nitrous oxide inhalation sedation during inferior alveolar block administration in children aged 7-10 years: A randomized control trial

Background: Nitrous oxide-oxygen (N 2 O-O 2 ) is being used in combination with many drugs and this possess risk for leading to deep sedation or reflexes being compromised. Aim: The purpose of our study was to use N 2 O-O 2 alone, to evaluate its effectiveness for pain control during inferior alveolar nerve block administration in children. Design: This was a single-centered, simple randomized, double-blinded, placebo-controlled parallel-group study involving 40 children in the age group of 7-10 years divided into 2 groups: N 2 O-O 2 sedation and oxygen. Pain perception for local anesthesia was assessed using face, legs, activity, cry, consolability scale. Children′s behavior was assessed using Frankl ratings, depth of sedation using Observer′s Assessment of Alertness/Sedation scale. The vital signs and oxygen saturation were recorded. Results: There was a significantly lower pain reaction to local anesthetic administration in the N 2 O-O 2 group (P < 0.01). Improvement in the behavior of the children belonging to N 2 O-O 2 group during and after the procedure as compared to the O 2 group (P < 0.01) was also observed. All the vital signs recorded were in the normal physiologic limits in both the groups. Conclusion: Pain experienced by children receiving N 2 O-O 2 sedation was significantly lower. N 2 O-O 2 inhalation sedation produces adequate sedation with vital signs within normal limits and treatments successfully completed.

Clinical Evaluation of Chemo‑mechanical Method (Carisolv)for Removal of Carious Dentine

Background: This is an in vivo study that evaluated the efficacy and efficiency of Carisolv gel on dentinal caries removal as well as evaluated the need of anesthesia and pain perception ability by pediatric patients. Materials and Methods: The proposed sample size consisted of 42 children from 7 to 10 years of age. The chemo-mechanical method was used for excavation of caries. The caries removal time, pain during caries removal, anesthesia required and patient behavior was evaluated. Results: Complete caries removal was achieved in 30 patients (71.4%) with chemo-mechanical method. For complete removal of caries the average time taken was 8.0855 ± 1.1024 (SD). There was no statistical difference between the time taken for score 0, 1 and 2. 23.8% of the children experienced little pain during caries removal using Carisolv. None of the patients showed negative behavior during the procedure, favoring that the Carisolv method as mostly accepted treatment. Conclusions: Carisolv is effective alternative treatment for removal of carious dentine and appeared to be more comfortable for pediatric patients although the clinical time spent is longer.