CONTEXT:Timing of the first dentist and early or late eruption of teeth may be important indicators of susceptibility to caries. A common misconception among the general population is that late-erupting teeth are less susceptible to dental caries, whereas early-erupting teeth are more susceptible to decay. AIMS:This study aimed to examine the relationship between the first dental visit age (FDVA), dental age (DA), and caries experience in children. SETTINGS AND DESIGN:A retrospective observational study was conducted using clinical records and orthopantomograms of children in the early mixed dentition period at a university hospital for the routine dental examination needs. METHODS:FDVA was obtained from patient records, and DA was assessed on orthopantomograms using the Willems method based on the developmental stages of seven mandibular left permanent teeth. Caries status was evaluated radiographically using the Decayed, Missing, and Filled Teeth (DMFT)/decayed, missing, and filled teeth (dmft) indices. STATISTICAL ANALYSIS:Statistical analyses included paired t -tests, one-way analysis of variance, and Pearson correlation tests. RESULTS:Totally, orthopantomograms of 1989 children were examined. The mean FDVA was 7.11 years. Children with lower FDVA had significantly higher dmft scores ( P = 0.0001). The mean DA (8.64 years) was significantly higher than the mean chronological age (CA) (7.93 years) ( P = 0.0001). Children whose DA exceeded their CA had significantly higher DMFT scores ( P = 0.0001), although this association was not observed for dmft. CONCLUSIONS:DA higher than CA is associated with an increased risk of caries, particularly in the permanent dentition. Children with an earlier FDVA exhibited higher dmft values, possibly because those with more existing caries were brought to the dentist earlier.
Context: Over the years, dental caries management strategies have evolved tremendously, and a recent paradigm shift toward the preventive approach has been observed. The use of biotics with conventional preventive measures has been reported to have beneficial effects, especially in children with special healthcare needs (SHCN) having increased oral health risks. Aim: To compare and evaluate the effects of toothpastes containing xylitol and xylitol- Bacillus coagulans, on levels of Streptococcus mutans and Lactobacilli in the saliva of children with SHCN. Materials and Methods: A randomized controlled clinical trial including 90 children, divided into three groups, with an age range of 7–13 years, at a residential school for SHCN children. Group I received conventional (fluoride) toothpaste. Group II received prebiotic (xylitol), and Group III received prebiotic–probiotic (xylitol–B. coagulans) toothpaste. Saliva samples were collected preintervention, at 3 and 6 weeks postintervention, and cultured to quantify S. mutans and Lactobacilli growth. Statistical analysis used repeated measures ANOVA for intragroup and One-way ANOVA for intergroup comparisons, with significance set at P < 0.05. Results: All three groups demonstrated a significant reduction (P < 0.001) in S. mutans CFU counts at all time points in order of Group III > Group II > Group I, whereas for Lactobacilli, none of the toothpaste groups showed a significant reduction (P > 0.001) at 3- and 6-weeks postintervention. Conclusion: Xylitol–B. coagulans containing toothpaste demonstrated the highest antimicrobial efficacy against S. mutans, compared to xylitol and conventional fluoride toothpaste.
Background: Full coronal restorations are essential for managing extensively cariouvarious primary molars. While stainless steel crowns (SSCs) remain the gold standard esthetic alternative, such as hybrid resin polymer (Bioflx) and nanohybrid composite (Edelweiss) crowns have been introduced. Objective: To compare the clinical performance of Bioflx, Edelweiss, and SSCs in mandibular primary second molars. Subjects and Methods: This randomized controlled trial included 42 children (5-9 years), each receiving one crown following pulp therapy, randomly allocated into three groups (n = 14 each). Outcomes assessed at 3, 6, and 12 months included retention, marginal integrity, and proximal contact (United States Public Health System) criteria, gingival health and plaque (Loe and Silness index), opposing tooth wear, parental satisfaction and chairside time. Statistical analysis included analysis of variance, Fisher’s exact test, and Cochran’s Q test (P < 0.05). Results: SSCs and Bioflx crowns showed 100% retention while Edelweiss crowns demonstrated 85.8% retention (P = 0.37). Marginal integrity was highest in SSCs (100% at 3 and 6 months, 92% at 12 months), followed by Bioflx (85.8%) and Edelweiss (71.4%–78.5%) (P > 0.05). Proximal contact exceeded 90% in SSC and Bioflx groups with lower values in Edelweiss (P > 0.05). Plaque accumulation differed significantly between groups at 3 and 12 months (P = 0.0001) with Edelweiss showing 100% plaque-free scores and SSCs the highest plaque levels. Gingival health showed a significant change overtime only in the Edelweiss group (P = 0.02). Parental satisfaction was significantly higher for color in Edelweiss crowns (P = 0.0001). Mean chairside time was highest for Edelweiss (1.61 ± 0.29) followed by Bioflx (0.96 ± 0.50 min) and SSCs (0.72 ± 0.20 min) with significant differences (P = 0.0001). Conclusion: SSCs remain the most reliable option. Bioflx crowns offer comparable performance with improved esthetics, while Edelweiss crowns provide superior esthetics and plaque resistance but require longer chairside time and show slightly reduced retention.
Background: Children with molar incisor hypomineralization (MIH) frequently experience high caries burden. Although preventive interventions such as silver diamine fluoride (SDF) and other agents are increasingly used, the natural progression of untreated MIH-related caries remains poorly documented, limiting policy-relevant evaluation of proven benefits in the long term. Objective: To compare the 2-year caries progression in MIH-affected posterior teeth that were untreated versus those previously treated with SDF or universal bonding agents (UBAs). Materials and Methods: The retrospective cohort study was conducted among schoolchildren aged 6–16 years. Children diagnosed with MIH according to the European Academy of Paediatric Dentistry criteria and presenting with International Caries Detection and Assessment System (ICDAS) 1–4 lesions were included. Exposure was defined as prior treatment with SDF or UBA; comparator was untreated teeth from children who had previously declined treatment. Caries progression was assessed using the ICDAS criteria over a 2-year follow-up. Relative risk (RR), absolute risk reduction (ARR), and number needed to treat (NNT) were calculated. Results: A total of 252 teeth had complete follow-up data: 142 untreated (56.3%) and 110 previously treated (43.7%). Caries progression occurred in 57.3% of treated teeth and 52.8% of untreated teeth. The unadjusted RR was 1.08 (95% confidence interval [CI]: 0.87–1.36). The ARR was − 4.5% (95% CI: −16.8% to 7.9%), indicating no statistically significant difference (χ2; P = 0.48). The corresponding NNT suggested a number needed to harm of -23 (minus 23), though this estimate was unstable due to CIs crossing zero. Conclusion: Over 2 years, prior preventive treatment with SDF or UBA did not confer a measurable advantage over no treatment, highlighting the importance of long-term metrics to make inform decisions.
Background: Molar–incisor hypomineralization (MIH) is associated with hypersensitivity and resistance to local anesthesia (LA), which complicates treatment in children. No nationwide study has examined the frequency of these anesthetic challenges among pediatric dentists or their association with clinician stress and burnout. The aim of the study was to assess the prevalence of LA inadequacy in MIH-affected teeth and its relationship with stress, burnout, and job satisfaction among pediatric dentists. Materials and Methods: A cross-sectional online survey was conducted among qualified pediatric dentists across India using a validated questionnaire. Convenience and snowball sampling yielded 100 complete responses after exclusion. The instrument covered sociodemographics, MIH clinical experience, anesthetic difficulties, escalation practices, and well-being (modified Mini Copenhagen Burnout Inventory). Data were analyzed using descriptive statistics, nonparametric tests, Chi-squared tests, Spearman correlations, and multivariable linear regression adjusted for confounders. Results: Most respondents reported routine LA inadequacy in MIH cases, commonly with supplemental buccal infiltration and intraligamentary injections. Higher perceived LA failure was strongly associated with treatment postponement, extraction, and general anesthesia referral. MIH-related anesthetic stress was strongly correlated with higher burnout and lower job satisfaction. Multivariate analysis identified elevated MIH workload, corporate/private college settings, and longer experience as independent predictors of poorer well-being. Conclusion: LA challenges in MIH management are prevalent among Indian pediatric dentists and significantly contribute to occupational stress and burnout. Targeted training in adjunctive techniques and institutional wellness support are recommended to improve clinician resilience and patient care.
Context: Dental anxiety significantly affects the delivery of dental care in children, often leading to poor cooperation. Behavior management techniques such as Tell-Show-Do (TSD), Reverse TSD (RTSD), and RTSD with Filmed Modeling (RTSD + FM) are commonly used to reduce anxiety and improve co-operation, but limited evidence exists comparing their effectiveness in highly anxious children. Aim: To evaluate and compare the effectiveness of TSD, RTSD, and RTSD with FM in reducing dental anxiety among children aged 4–8 years. Methodology: This randomized controlled trial included 45 anxious children aged 4–8 years (Venham’s Picture Test [VPT] ≥4) who were randomly assigned to three groups: TSD, RTSD, and RTSD + FM (n = 15 each). Pulse rate, oxygen saturation, and dental anxiety (VPT) were recorded before and after treatment, and data were analyzed using the one-way ANOVA, Kruskal–Wallis, and post hoc tests. Results: Subsequent to the intervention, all three groups showed statistically significant decrease in VPT scores and pulse rate. While RTSD and RTSD + FM demonstrated greater mean VPT reductions than TSD, RTSD had the largest mean pulse rate reduction. However, neither the VPT score nor the pulse rate showed statistically significant intergroup differences. Conclusion: In children aged 4–8 years, TSD, RTSD, and RTSD + FM all significantly reduced dental anxiety. Although RTSD methods showed greater numerical reduction, the difference was not statistically significant, indicating that all three techniques are effective for managing dental anxiety.
Background: The objective of this study was to determine the effect of familiar or unfamiliar music with different rhythmic patterns on pediatric patients undergoing exodontia. Materials and Methods: Eighty-eighty children aged 5–9 years requiring dental extraction were divided into five groups based on the rhythmic pattern and familiarity of the musical interventions Group I (Control), Group II (Familiar-Synchronized), Group III (Familiar-Syncopated), Group IV (Unfamiliar-Synchronized), and Group V (Unfamiliar-Syncopated). During exodontia, a music therapist controlled the auditory input. Calibrated examiners assessed the patients’ behavior, pain, and anxiety using the Houpt scale, the Face, Legs, Activity, Cry, and Consolability scale, and a pulse oximeter, respectively. The recorded data was tabulated and sent for statistical analysis using Python (v3.11) in the Julius Code Sandbox. Results: Intergroup comparisons using the Kruskal–Wallis test did not reveal a significant reduction in anxiety (P > 0.05) and showed a marginally nonsignificant difference in behavior (P = 0.07). Intragroup comparisons using Wilcoxon signed-rank tests showed a significant decrease in anxiety scores in Groups III (P = 0.04) and IV (P = 0.04). Nonparametric testing revealed no significant differences in pain between groups (P = 0.70). Regression analysis and a goodness-of-fit test revealed that neither age nor gender influenced the patient, regardless of the intervention. Pooled contrasts for a simple linear regression model showed that comparisons among the interventional musical pieces were not clinically significant. Conclusion: The rhythmic pattern or the patient’s familiarity with the musical piece influenced the patient’s behavior, anxiety, and pain assessment, but with no clinical significance.
Background: Advances in three-dimensional (3D) printing have enabled the fabrication of resin crowns, including conservative designs such as endocrowns (ECs), which may improve esthetics and periodontal outcomes. However, clinical evidence comparing them with stainless steel crowns (SSCs) in primary teeth is limited. This study aimed to evaluate and compare the clinical efficiency of 3D-printed resin ECs and full coverage crowns (FCCs) with SSCs in primary molars. Methodology: A randomized controlled trial was conducted on 37 children aged 4–9 years. Forty-five primary mandibular second molars were allocated into three groups (n = 15 each): Group A (ECs), Group B (FCCs), and Group C (SSCs). Pulpectomy was performed on all the teeth. Following intraoral scanning, the resin crowns were digitally designed and 3D printed. The clinical performance of the crowns was assessed using revised FDI criteria over a 6-month follow-up period. Periodontal health was assessed using the plaque index (PI) and gingival index (GI). Statistical Analysis: Kruskal–Wallis and Mann–Whitney U-tests were used. Results: The overall success rate was ranked as follows: Group C (100%) > Group A (86%) > Group B (79%), which was not statistically significant (P = 0.185). Periodontal health was superior in Group A, followed by Groups C and B. A statistically significant difference in GI was found between Groups A and B (P = 0.007), as well as between Groups B and C (P = 0.019). Conclusion: 3D-printed resin crowns may serve as an esthetic alternative to SSCs, with ECs preferable in children with compromised gingival health.
Aim: To evaluate the characteristics, engagement, content, and quality of YouTube videos addressing toothbrushing considerations for children with special healthcare needs (CSHCN). Settings and Design: A cross-sectional content analysis of information provided on YouTube regarding toothbrushing information for special children. Methodology: Two independent reviewers screened 200 YouTube videos using two search terms based on Google Trends, followed by screening and scoring of the included videos using a 13-point customized scale and a 5-point Global Quality Scale. Statistical Analysis Used: Kruskal–Wallis and Chi-square tests were used. Results: Thirty-one videos met the inclusion criteria. The majority (48%) of the videos were found to have moderate information content. Less than 10% of the videos received a good quality rating, highlighting a general lack of high-quality content. Nonprofessional sources performed better in terms of views, likes, interaction indices, and Video Power Index; however, these results were statistically significant only for likes (P = 0.048). Conclusion: The findings of this study reveal that while the majority of uploaded YouTube videos contain useful information on oral health maintenance for CSHCN, the content is often incomplete and varies significantly in quality. Clinical Significance: The lack of high-quality professional content for oral care for CSHCN on YouTube necessitates that clinicians actively vet digital resources for caregivers. Dental professionals must evolve into curators of digital health information to counter the popularity of nonprofessional, low-quality content.
Background: Dental caries is one of the most widespread chronic diseases, impacting over 2.4 billion people globally. Silver diamine fluoride (SDF) is a minimally invasive treatment known for its strong antimicrobial and remineralizing effects. However, the primary esthetic drawback of SDF is the black staining it causes on the treated tooth structure. To address this issue, adjunctive anti-staining agents such as potassium iodide (KI), glutathione (GSH), and tannic acid (TA) have been explored. These agents may not only mitigate discoloration but also affect the bonding efficiency of restorative materials applied afterward. Materials and Methods: Forty extracted permanent posterior teeth were collected, debrided, cleaned, and stored in normal saline. Each tooth was embedded in acrylic resin, and flat dentin surfaces were prepared by grinding the occlusal surface. The samples were randomly divided into four groups: Group 1 – 38% SDF only; Group 2 – SDF + 10% KI; Group 3 – SDF + 10% GSH; and Group 4 – SDF + 10% TA. Treatments were applied to dentin surfaces using a microbrush following standard protocols. A universal adhesive was then applied and light-cured, followed by the placement of composite resin. All specimens underwent shear bond strength (SBS) testing using a universal testing machine to evaluate the adhesive performance of each combination. Results: The mean SBS values (±standard deviation) for Group 1, Group 2, Group 3, and Group 4 were 10.32 ± 0.56, 14.08 ± 0.70, 18.24 ± 0.81, and 17.05 ± 0.47 MPa, respectively. The highest bond strength was observed in Group 3 (GSH), followed by Group 4 (TA), Group 2 (KI), and Group 1 (SDF alone). Conclusion: Pretreatment of dentin with GSH before SDF application significantly enhanced SBS when used with universal adhesive and composite resin.
Background: Vitamin D is essential for bone and tooth mineralization, and its deficiency may contribute to delayed tooth eruption (DTE) in children. Evidence on this association remains limited and inconsistent. Aim: To systematically review and analyze the relationship between Vitamin D deficiency and delayed eruption of primary and permanent teeth in children. Methods: A systematic search of major databases was conducted up to May 2025 following meta-analysis of observational studies in epidemiology guidelines. Observational studies assessing serum Vitamin D in relation to DTE were included. Study quality was evaluated using the Newcastle–Ottawa Scale, and meta-analysis was performed using Review Manager 5. Results: Five studies met the criteria for qualitative review and three for meta-analysis. Although all studies measured Vitamin D in ng/mL and commonly defined deficiency as <20 ng/mL, considerable methodological heterogeneity was observed. Meta-analysis for primary dentition showed no significant association (mean difference [MD] = −11.90; confidence interval [CI]: −30.77–6.97; I2 = 95%). Combined analysis of primary and permanent dentition demonstrated a significant difference (MD = −16.46; CI: −23.86 to −9.05; I2 = 91%). Sensitivity analysis improved consistency (MD = −21.89; CI: −23.78 to −20.00; I2 = 0%). Calcium levels showed no significant association with DTE. Conclusion: The findings suggest a possible association between low Vitamin D levels and DTE; however, high heterogeneity and limited evidence reduce certainty. Further well-designed studies are needed to confirm this relationship.
INTRODUCTION:Dental caries remains one of the most prevalent diseases in children, requiring early and accurate detection to prevent progression. Conventional visual examination, although widely used, is subjective and operator-dependent. With advancements in artificial intelligence (AI), image-based AI tools offer potential for more consistent caries detection. This study aimed to compare the validity and reliability of an AI tool (ScanO) with conventional visual examination in identifying dental caries in children. MATERIALS AND METHODS:This observational study included 200 children attending the Department of Pediatric and Preventive Dentistry. Visual examination was performed independently by two trained examiners, and decayed, missing, and filled teeth (DMFT)/deft scores were recorded. Standardized intraoral photographs were captured and analyzed using the AI tool ScanO, which generated corresponding DMFT/deft scores. Data were analyzed using SPSS version 21. RESULTS:The AI tool successfully detected dental caries but consistently underestimated DMFT/deft scores compared to clinical examination (3.48 ± 2.94 vs. 4.70 ± 3.31; P < 0.001). Despite this, the intraclass correlation coefficient (ICC) analysis demonstrated excellent reliability for the AI tool (ICC = 0.968 single, 0.984 average) and near-perfect reliability for clinical examination (ICC = 0.999). CONCLUSION:The AI tool demonstrated good reliability in detecting dental caries but consistently underestimated DMFT/deft scores compared to clinical examination. The clinical method identified more carious lesions, reaffirming its role as the gold standard. Within the limitations of this study, the AI tool can be considered a supplementary screening aid in pediatric dentistry but cannot replace clinical judgment.
Aim: Early childhood caries (ECC) remains a major public health concern, particularly in developing countries. This study aimed to assess parental knowledge, attitude, and practices (KAPs) regarding ECC and to evaluate its association with sociodemographic factors. Materials and Methods: A cross-sectional questionnaire study was conducted among parents attending a district hospital in Eastern Uttar Pradesh with children aged ≤71 months. A structured, pretested questionnaire comprising sociodemographic details and KAP domains (eight knowledge, five attitude, and five practice items) was administered. After excluding incomplete responses, 375 out of 377 recruited participants were included in the final analysis. Statistical Analysis: Descriptive statistics summarized participant characteristics and KAP scores. Normality was assessed using the Shapiro–Wilk test. Since the data were not normally distributed, the Mann–Whitney U and Kruskal–Wallis tests were used for univariable comparisons. Spearman’s correlation assessed relationships among KAP domains, and multiple linear regression with robust standard errors identified independent predictors. P < 0.05 was considered statistically significant. Results: The mean knowledge score was low (0.81 ± 0.98), while attitudes were moderately positive (2.89 ± 0.79). Practice scores were relatively higher (3.15 ± 0.53). Income showed a significant association with knowledge scores (P < 0.001) and remained an independent predictor in multivariable analysis, whereas no significant associations were observed for attitude or practice scores. Conclusion: Parents demonstrated limited knowledge but positive attitudes toward ECC, while preventive practices were inconsistently followed. These findings highlight the need for targeted oral health education and structured parental counselling programs to strengthen preventive behaviors and enhance effective ECC prevention.
Background: Effective moisture control is essential in pediatric dentistry. Cotton rolls provide limited isolation, while a rubber dam offers better control but may cause discomfort in children. Saliva absorbers have been introduced as an alternative. This study compares saliva absorbers with cotton rolls and a rubber dam for isolation in children. Aim: To evaluate and compare the effectiveness of cotton rolls, rubber dam, and parotid and sublingual saliva absorbers during class ii restorations in primary molars among children aged 4–9 years. Methodology: This randomized clinical trial included 36 children aged 4–9 years requiring class ii restorations in primary molars. Participants were randomly allocated into three groups (n = 12 each): cotton roll isolation, rubber dam isolation, and parotid and sublingual saliva absorbers. Standardized cavity preparation and restoration with high-strength glass ionomer cement were performed. Patient anxiety was assessed using pulse rate, face, legs, cry, consolability score scale, and animated emoji scale. Operator ease was evaluated using a questionnaire. Statistical significance was set at P < 0.05. Results: Saliva absorbers showed better patient acceptance and satisfactory moisture control compared to cotton rolls and rubber dams. Rubber dam provided superior isolation but was associated with higher anxiety scores and longer placement time. Operator ease was the highest with saliva absorbers. Conclusion: Saliva absorbers were an effective isolation method, providing adequate moisture control with ease of handling.
Context (Background): Effective irrigation is essential for successful pulpectomy in primary teeth. Sodium hypochlorite (NaOCl), although widely used, has cytotoxic and demineralizing effects. Bioactive alternatives such as silver diamine fluoride (SDF) and fluoridated mouthwash require evaluation. Aims: This study aimed to compare the effects of NaOCl, SDF, and fluoridated mouthwash on dentinal surface morphology and elemental composition using scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy analysis. Settings and Design: In vitro experimental study conducted in a tertiary dental institution. Materials and Methods: Thirty-six extracted primary maxillary incisors were randomly divided into three groups (n = 12): 1% NaOCl, 3.8% SDF, and 0.05% fluoridated mouthwash. Standardized access preparation and irrigation were performed. SEM assessed smear layer removal, and EDX evaluated elemental composition (Ca, P, Ag, F). Statistical Analysis Used: One-way ANOVA and Kruskal–Wallis tests were used with significance set at P < 0.05. Results: NaOCl demonstrated complete smear layer removal (Score 0) across all root thirds with significantly reduced calcium and phosphorus content and no silver or fluoride deposition. SDF showed effective smear layer removal with dentinal tubule occlusion, significant silver (4.97%) and fluoride deposition, and preserved mineral content compared to NaOCl. Fluoridated mouthwash exhibited the highest calcium preservation with minimal residual smear layer and moderate fluoride uptake, with all intergroup differences being statistically significant (P < 0.05). Conclusions: SDF and fluoridated mouthwash are effective bioactive alternatives to NaOCl, offering smear layer removal while preserving dentinal integrity and enhancing mineral deposition.
BACKGROUND:Dental anxiety is one of the most frequently encountered behavioral challenges in pediatric dentistry. Art therapy has been proposed as a means of alleviating pediatric anxiety. AIM:To evaluate the effectiveness of structured art therapy in reducing dental anxiety among children aged 6-12 years attending a pediatric dental clinic. MATERIALS AND METHODS:A randomized controlled clinical trial was conducted on 150 children (87 females, 63 males) aged 6-12 years. Participants were randomly assigned into two groups: Study Group (n=75) received structured art therapy (drawing, coloring, collage) for 15 minutes before each dental visit, while Control Group (n=75) underwent routine tell-show-do behavior management. Anxiety levels were assessed using the Frankl Behavior Rating Scale (FBRS), Five-Facial Anxiety Scale (FFAS), and Child Drawing: Hospital (CD:H) scale at baseline and after three visits. Data were analyzed using paired t-test, chi-square test, and Pearson correlation, with p<0.05 considered significant. RESULTS:At baseline, 58.6% of participants demonstrated high or very high anxiety. Post-intervention, the study group exhibited significant reduction: 68% had little or no anxiety compared to 14.6% in controls (P<0.001). Strong correlations were observed between CD:H and FFAS (r=0.29, P<0.01) and between CD:H and Frankl scores (r=-0.32, P<0.01). CONCLUSION:Art therapy is a simple, cost-effective adjunct that significantly reduces dental anxiety and improves cooperation in children.
CONTEXT:Lateral mandibular functional shifts (LFMSH) have been found to be associated with facial asymmetry (FA), posterior crossbite, midline shift, and dissimilar molar occlusion, including uneven biting or unilateral chewing. AIMS:The aim is to evaluate the prevalence of LFMSH and its known associated factors, i.e., FA, midline deviation (MD), unilateral posterior crossbite (UPXB), posterior occlusion (PO), preferred chewing side (PCHWS), premature contacts (PC), and correlation of each factor with LFMSH among children with deciduous and early mixed dentition in a North-Indian city. SETTINGS AND DESIGN:This cross-sectional study was conducted among the schoolchildren of North-Indian city. METHODS:This study assessed 400 school children. Extra- and intra-oral static examination was done in the maximum intercuspation position (MIP). CR was attained, and functional mandibular shift (FMSH) in any direction, with special emphasis on LFMSH, was confirmed when mandible got shifted from PC to MIP. Causative factors for PC were further assessed. STATISTICAL ANALYSIS:The correlation between LFMSH and associated variables was tested by the Chi-square test. RESULTS:The prevalence of LFMSH, FA, MD, UPXB, PCHWS, and PC were 11.8%, 10.3%, 13.2%, 13.8%, 32.8%, and 15.0%, respectively. Significant correlation (P < 0.001) was found between LFMSH and FA (74.5%), MD (100%), UPXB (100%), dissimilar PO (93.7%), PCHWS (100%), and correction of CR postphonetics (100%). PCs were found in deciduous canine and maxillary incisor regions. Crossbites in the permanent first molar and primary second molar were coexisting. CONCLUSIONS:Significant correlation of LFMSH with associated factors emphasizes early detection, understanding of the predisposing factors for their prevention and/or early interception. Long phonetics was clinically successful in observing FMSH in the field.
INTRODUCTION:Molar-incisor hypomineralization/MIH's high prevalence, early-onset, rapid progression, multiple teeth involvement is concerning. Providing individualized care for all affected children globally is often unfeasible, costly, and requires a significant workforce and time. This necessitates scalable solutions suitable for population level rather than traditional clinical models. Hence, practical, simplified, and effective interventions at the point of care (communities) are urgently needed. Silver diamine fluoride (SDF) and universal bonding agent (UBA) are potential field-based interventions for MIH, but comparative evidence is limited. AIM:To evaluate the efficacies of SDF and UBA in arresting caries in MIH-affected teeth in a community-based setting using ICDAS scores. MATERIALS AND METHODS:A double-blind (participants, assessors, and statisticians), randomized controlled trial was conducted in four schools in India. Of over 5000 children screened, 186 had MIH pathology; 103 consented, 89 received treatment, and 79 were followed up. A total of 212 teeth (SDF: 111, UBA: 101) were assessed after 1 year. The primary outcome was caries arrest, measured by changes in ICDAS scores. Subgroup analysis and faceted plots were used to explore clinical trends. RESULTS:McNemar-Bowker test showed no statistically significant change in ICDAS scores from baseline to 1 year in either group (SDF: P =0.133; UBA: P =0.125). Subgroup trends showed more stable and improved outcomes in the UBA group, particularly in ICDAS-1 and -2. SDF was limited by discoloration concerns. CONCLUSION:While both materials were clinically effective, UBA demonstrated a more favorable clinical trend. The study's large sample size, real-world setting, and balanced design strengthen its applicability for population-level MIH management strategies.
CONTEXT:Oral health-related quality of life (OHRQoL) emphasizes not only prolonging life but also enhancing health and quality. Children with special healthcare needs (CSHCN) encounter numerous barriers to dental care, necessitating tailored healthcare strategies. Adaptation of conventional protocols is essential, and focus group discussions (FGDs) have shown potential as an effective approach. AIM:The aim of this study was to evaluate the OHRQoL of CSHCNs and assess the role of FGDs in improving their oral health. MATERIALS AND METHODS:A cross-sectional study was conducted among 6-14-year-old SHCNs children. Ethical approval was obtained, and informed parental consent was secured. Fifty participants were recruited through convenience sampling. Data collection included: (1) qualitative assessment using the Oral Health Impact Profile-14 (OHIP-14) questionnaire and (2) quantitative assessment using the Oral Hygiene Index-Simplified (OHI-S) in three phases: baseline recording, regular FGDs with mobile networking, and motivational strategy and education were done. Data were analyzed using SPSS Version 25; a paired t-test was applied for OHI-S score comparison (P < 0.005). RESULTS:The mean participant age was 10.14 ± 2.08 years (62% of males and 38% of females). OHIP-14 domain mean scores were functional limitation -4.42 ± 1.37, functional disorder -4.30 ± 1.24, psychological disorder -4.26 ± 1.17, functional disability -4.96 ± 1.69, psychological disability -4.66 ± 1.49, and social disability -5.24 ± 1.93. The OHI-S mean scores improved significantly from 2.71 ± 0.69 to 1.90 ± 0.71 (P = 0.001). CONCLUSION:CSHCNs exhibited compromised OHRQoL. FGDs significantly improved oral hygiene, demonstrating potential for preventive oral health programs.
