Ramya Shenoy

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.

Effect of three indigenous food stains on resin-based, microhybrid-, and nanocomposites.

PURPOSE This study investigated the effects of three indigenous food stains (tea, tobacco, turmeric) on a nanocomposite (Ceram-X-Mono, Dentsply DeTery, Konstanz, Germany), a microhybrid posterior (P60, 3M ESPE, St. Paul, MN, USA), and a universal microhybrid (Z100, 3M ESPE) resin-based composite (RBC). MATERIALS AND METHODS Thirty-six disk-shaped specimens were fabricated (10 × 2 mm) for each type of RBC material, using a polytetraflouroethylene (PTFE) sheet. Specimens from each group were randomly distributed into three subgroups for each of the used stains. The baseline color values were measured using a spectrophotometer. The specimens were immersed in the staining solutions for a period of 3 hours per day for 15 days (3 hours/day × 15 days). Following this, the color change value (ΔE) was calculated. RESULTS AND CONCLUSION All the tested groups showed a clinically perceptible color change (ΔE values = 3.3 or >3.3), except for tea-stained P60 (ΔE = 3.15) and Z100 (ΔE = 1.63) groups. Turmeric caused the most significant color change for all the tested RBCs. The least amount of color change was observed with the Z100 (tea, ΔE = 1.63; tobacco, ΔE = 13.59; turmeric, ΔE = 38.77) group that was statistically significant from P60 (tea, ΔE = 3.15; tobacco, ΔE = 18.83; turmeric, ΔE = 57.72), and Ceram-X-Mono (tea, ΔE = 3.32; tobacco, ΔE = 18.83; turmeric, ΔE = 53.95) groups.

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.

Evaluation of tooth preparations for Class II cavities using magnification loupes among dental interns and final year BDS students in preclinical laboratory

Background: With the advances in optical technology, dentistry has been benefitted in varied ways over the ages. Aim: The aim of this study was to assess the effect of dental magnification loupes on psychomotor skill acquisition during preclinical operative exercise. Methods: 40 Typhodont teeth tooth no. 36 and 46 (Frasaco - U.S.A.) were mounted on the acrylic lower jaw base of Phantom Head. Teeth are prepared for class II (MO) cavity with conservative design using micromotor, mouth mirror and probe. Tooth no.36 was prepared using magnifying loupes while tooth no.46 was prepared without the loupes. Data collected was statistically analyzed using Chi square test. Results: The results revealed that tooth preparations were better under magnifying loupes as compared to those without it with statistically significant difference with Kappa value 0.64 for samples with loupes and 0.76 for without loupes. Moreover, the study samples expressed their difficulty for using the magnifying loupes during the tooth preparation since they were using it for the first time. Conclusions: Magnifying loupes help the dental students to have better vision, thus improved dexterity with hands while preparing the tooth for restoration. However, dental students have to get adapted to the loupes for the ease of using loupes. Using loupes frequently may help them to get adapted to the loupes.

Utilization of dental services due to dental pain by pregnant women in India: A qualitative analysis

Objectives: The purpose of this cross-sectional survey was to evaluate the utilization of dental services by pregnant women due to dental pain and also to evaluate the role of their educational qualification on utilization. Materials and Methods: The research tool was a semi-structured questionnaire, which was completed by 175 pregnant women attending various primary health centers, private clinics and nursing homes in Mangalore. The women were divided into two groups namely, Group 1: Who have not been graduated and Group 2: Who have been graduated. Comparisons were made between Group 1 and Group 2. The data collected was analyzed using descriptive statistics, Chi-square test and odds ratio (OR). Results: Decayed teeth were found to be the predominant factor of pain as reported by women in both groups. However, the number of women who utilized dental services during this period was almost identical in both the groups, with 23.5% women in Group 1 and 24.7% women in Group 2. However, the association between utilization of dental care among pregnant women in both groups who did not report dental pain during pregnancy and those who did report showed statistical significance (OR = 13.63; 95% confidence interval = 3.81, 48.75). Conclusion: The present study showed that despite the presence of pain due to dental causes, utilization of dental services by pregnant women was poor. It was also revealed that those with a graduate qualification were more likely to visit a dentist for preventive treatment during pregnancy Clinical Relevance to Interdisciplinary Dentistry Utilization of oral health-care services will provide insight to dental clinicians about treatment planning and also to educate about the treatment option to patients. Pregnant women being one of the target groups for oral health services, oral health professionals must know in detail about their utilization history. Pain is an important factor for utilization of the dental services, which may be due to pulpal, periodontal and oral lesions. Etiology and treatment planning requires an interdisciplinary approach.

Atraumatic restorative treatment for dental caries among pregnant women attending primary health centres: A small scale demonstration

Background: ART consists of a simplified, low-cost technique that uses only hand instruments in the removal of carious tissues to reduce contamination and viability of microorganisms. This technique requires immediate restoration of the cavity with adhesive restorative material, namely glass ionomer. Since ART approach causes lesser anxiety than the traditional restorative procedure, it may be a very useful tool for providing dental treatment to pregnant women. Objective: The present study was carried out to assess the pregnant women’s response to undergo ART in Primary Health Centre set up and clinical evaluation of restoration at 6 month interval. Methods: Pregnant women visiting Primary health centres (PHCs) for prenatal check- up were examined. Those having cavities were restored using ART after taking informed consent. These were followed up telephonically 24 hours later and examined at the end of six months. Results: Of the 308 pregnant women examined, fifty teeth of forty five subjects (83%) were restored using ART. Out of that 45 (90%) were one surface restoration and five (10%) two surface restorations. None of the subjects felt pain during the procedure, 24 hours later or at the end of six months. All the subjects were satisfied with the treatment. All one surface fillings were intact and one out of five, two-surface filling was broken which was replaced with new restoration. Conclusion: This study demonstrates that the patients were satisfied with the ART which can be undertaken at lower cost. Together with preventive and promotional activities, oral health status of pregnant women who visit PHCs can be improved. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY • Being based on the contemporary philosophy of minimum intervention and maximum preservation of the tooth structure, atraumatic restorative treatment (ART) has been considered a feasible treatment option for moderate to deep carious lesions and can be applied to the entire population. • As ART approach causes lesser anxiety than the traditional restorative procedure using dental rotary instruments, it can be used among target groups like children and pregnant women to treat dental caries. • This article is an attempt at demonstrating the effectiveness of ART in pregnant women attending primary health centres. This could be utilized for preventive care in low resource and low-cost settings

Comparative study of a stabilized 0.1 %chlorine dioxide with 0.2% chlorhexidine mouthrinse in inhibiting the formation of volatile sulphur compounds (VSC)

Background: Research has been done previously on the oxidizing property and the clinical efficacy of chlorine dioxide (ClO2) on malodor. The aim of the present study was to compare the inhibitory effect of a mouthwash containing 0.1% ClO2 with 0.2% Chlorhexidine mouthwash.on morning oral malodor. Materials and methods: A randomized, double blind, crossover trial was conducted among18 healthy male volunteers, who were divided into 2 groups. Group-1 subjects were instructed to rinse with the experimental mouthwash containing 0.1% ClO2 and group-2 subjects were asked to rinse with 0.2% chlorhexidine, twice per day for 7 days. After a one week washout period, each group then used the opposite mouthwash for 7 days. At baseline and after 7 days, oral malodor was evaluated with halimeter which measures Volatile Sulphur Compounds (VSCs) in parts per billion. The clinical variables that were measured included the plaque and gingival indices. Results and conclusion: A decrease in the amount of VSCs was noted after a 7 day use of ClO2 as well as with the use of chlorhexidine mouthwash, which were statistically significant, with greater significance after the use of ClO2. Also, a significant reduction in plaque scores was noted after the use of test mouthwash .The decrease in the amount of VSCs indicates a reduction in oral malodor. Future research is needed to examine the long-term effects, as well as effects of ClO2 on plaque accumulation and periodontal diseases in a well-defined sample of oral malodor patients and broader population samples.

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.