Local Dental Emergencies and Mitigation Strategies Adopted by Private Dental Practitioners of South India during COVID-19 Shelter in Place Warning - Multi-Centric Online Survey

Objective: To evaluate the common dental emergencies reported to dental practitioners and to compare the mitigation strategies implemented during the Shelter-In-Place (SIP) warning with dental practitioners’ age and sex. Methods: We conducted a cross-sectional online survey among the dental practitioners of south India during the period of COVID-19 SIP warning. An initial pool of items was prepared to capture the mitigation strategies in managing local dental emergencies. A structured questionnaire was then prepared in English based on the inputs of four expert dentist panel. Age and sex of the practitioners were also recorded. Results: The mean age of the dental practitioners was 37.11(range: 23 - 63) years.Of 159 dental practitioners that responded to survey, 90 were male. Most dental practitioners responded that they were contacted through a phone call (n=140) and WhatsApp messaging (n=108). The common dental emergencies reported were tooth pain (100%), swelling (91.7%), a decayed tooth (81.3%), and gum pain (78.6%). A higher number of male than female dental practitioners had “scheduled the treatment immediately” (OR=3.45; P=0.002) after adjusting for age. Conclusion:The most common dental emergencies during COVID-19 SIP were tooth pain, swelling, decayed teeth, and gum pain. Males and older dental practitioners scheduled appointments immediately.

Early Childhood Caries in Obese Children: The Status and Associated Factors in the Suburban Areas in Hanoi, Vietnam

Obesity and early childhood caries are two prominent health problems affecting the majority of children worldwide. Thus, early childhood caries in obese children must be studied. This study was conducted to investigate the status of early childhood caries in obese children in Hanoi, Vietnam, and its associated factors. A cross-sectional study was conducted on 234 obese children, 234 normal children (non-obese) aged 36 to 71 months, and their mothers at some kindergartens in Hanoi. Study subjects were randomly selected with similarities in age, gender, and study location. Decayed tooth of children was detected by clinical examination and Diagnodent Kavo 2190 machine of Germany. In addition, a questionnaire for their mothers was used to find out related factors. We found that, in the Obese Group, the rate of early childhood caries (ECC), severe-early childhood caries (S-ECC), dmft index (the number of decayed teeth, teeth lost due to cavities, filled decayed teeth or filled cavity), and dmfs index (the number of surfaces of the teeth decay, surfaces of teeth were lost due to cavities, surfaces of filled decayed teeth) were 82.91%, 59.83%, 6.84 ± 4.92, and 9.10 ± 7.48, respectively. In the Normal Group, these rates were smaller than in the Obese Group, but the difference was not statistically significant. Regarding related factors, the hobby of drinking soft drinks, the habits and frequency of drinking milk at night and eating sweet marshmallows were associated with ECC in the Obese Group with p < 0.05. In conclusion, the higher rates of ECC were seen in obese children, with eating hobbies and habits being the related factors. Therefore, it is necessary to have appropriate policies and effective communication strategies to minimize ECC in the future.

sCD14 Level in Saliva of Children and Adolescents with and without Dental Caries, a Hurdle Model

Objective: Soluble CD14 (sCD14) plays an important role in the innate immune response of the oral cavity. The investigation of this biomarker for detection of carious lesions is an even more actual procedure due to its non-invasiveness and the ease of withdrawal. The purpose of the present observational case-control study was to evaluate whether the quantification of sCD14 in children and adolescent’s saliva can discriminate healthy subjects from those suffering from tooth decay. Materials and Methods: 164 subjects (6 to 17 years) were selected and divided into 2 groups: those with at least 1 decayed tooth were assigned to group Decayed (n = 82) and those free from dental caries to group Healthy (n = 82). The amount of salivary soluble CD14 was quantified. Results: Mean salivary soluble CD14 was 28.3 ± 10.8 μg/mL in the Healthy group and 22 ± 9.6 μg/mL in the Decayed group. A hurdle model was applied to the data to estimate both the probability of having carious lesions and their number in relation to sCD14 levels. sCD14 was strongly associated (p < 0.01) with an inverse relation to both the probability of having caries and their number (falling rate of 5% per unit CD14 μg/mL). Conclusions: This data confirms the relationship between sCD14 and the presence of dental caries. However, there is no clear cut off level between healthy and unhealthy subjects, so it is currently not possible to use sCD14 as a biomarker to determine the risk of decays.

Prevalence of tooth loss and associated factors in institutionalized adolescents: a cross-sectional study

This study aimed to assess the prevalence of tooth loss and associated factors in institutionalized adolescents. This cross-sectional study included 68 male adolescents incarcerated from Socio-Educational Assistance Center (CASE) aged between 15 and 19 years. Questionnaires were applied individually to assess sociodemographical, economical, medical, behavioral and oral health self-perception variables. All present teeth were evaluated by Decay, Missing, Filling (DMF) Index. The prevalence of tooth loss was analyzed in individuals with ≥1 tooth loss. Associations between tooth loss and exposure variables studied were analyzed by Poisson Regression with robust variance estimation. The prevalence of tooth loss was 47.06%. First molars in the mandible and maxilla and central incisor in the maxilla were the most absent teeth. In the multivariate model, number of decayed teeth, and those that reported daily use of medication were associated with higher tooth loss. Besides, tooth loss was associated with decayed tooth and daily use of medication. Oral health promotion and treatment should be implemented in these institutions to reduce the prevalence of dental loss in these adolescents.

Prevalence of Dental Caries in Children

This cross sectional study on oral condition among school going children in Sylhet city was conducted at Osmani Medical High School, Dorgah Gate, Sylhet, Bangladesh. This study was carried out on 8th October, 2019 among 208 students, mostly 12 years aged studying in Class VI. The main objective of the study was to assess the oral health condition of school going children through decayed, missing, and filled teeth (DMFT) status. Data was collected by personal interview and clinical examination of the respondents. Among 208 children, 96 (46.2%) were boys and 112 (53.8%) were girls. Among all, 63 (30.3%) respondents brush their teeth once daily while 137 (65.9 %) respondents brush twice a day, and 8 (3.8 %) of them brush their teeth more than twice daily. Fluoride containing toothpaste is used by 73 (35.1 %) students, 112 (53.8 %) students did not know whether their toothpaste contain fluoride or not, and 23 (11.1 %) students do not use fluoride. Among all respondents, 125(60.09 %) did not have any decayed tooth, while 83(39.90 %) had tooth decay, and 20(9.6 %) had their teeth filled. Normal gingival condition was found in 185 (88.94 %) subjects, but 23(11.06 %) of them had red or swollen gingiva. The mean DMFT of the study population was 1.19 which is considered as “low” according to “WHO quantification for the DMFT index”. Update Dent. Coll. j: 2021; 11 (1): 4-6

THE CONDITION OF THE HARD TISSUES OF THE TEETH IN CHILDREN WITH ACUTE FORMS OF LEUKEMIA

Relevance. Children with oncohematological pathology have a high level of dental diseases since the use of high doses of cytostatic drugs leads to damage to the hard tissues of the teeth. In recent years, the number of children with acute leukemia has increased in Ukraine from 2.5 to 4.1 cases per 100,000 child population. Objective: to study the indicators of the intensity of caries of temporary and permanent teeth in children with acute forms of leukemia: lymphoblastic and myeloblastic. Materials and methods. Clinically examined 98 children aged 2-18 years, with acute forms of leukemia. The examined children were divided into groups: the first group – 61 children with acute lymphoblastic leukemia, and the second – 37 children with acute myeloblastic leukemia. Served as control 63 practically healthy children. The analysis of the structure of the constituent elements of the indicators of the intensity of decay teeth caries (df) in children 2-5 years old and caries of permanent teeth (DMF) in children 6-18 years old was performed. The constituent elements of the df indicator are "d" – decayed tooth that is subject to treatment, "f" – filled teeth. The constituent elements of the DMF indicator are "D" – decayed tooth that is subject to treatment; "F" – filled teeth; "M" – missing teeth. Results. When studying the intensity of caries of temporary and permanent teeth in children with acute lymphoblastic leukemia, it was found that in children 2-5 years old, cf is equal to 6.64 affected teeth per child. In this case, the "d" element was 75.30%, compared with the control group of children, where the "f" element was 45.28%. Element "f" was 24.6%, and in the control group, it was significantly higher and was equal to 54.92%. In children with acute lymphoblastic leukemia 6-18 years old, the DMF is 5.34 teeth. At the same time, the "D" element was 53.13%, and in the control group – 11.06%. Element "F" was 44.24%, in the control group – 85.9%. Element "M" in the main group was equal to 2.63%. When studying the intensity of caries in temporary and permanent teeth in children with acute myeloid leukemia, it was determined that in children 2-5 years of age, df is equal to 6.25 affected teeth per child. In this case, the "d" element was 80.64%, in comparison with the control group, where the "d" element was 45.28%. Element "f" was 19.36%, and in the control group, it was significantly higher and equal to 54.92%. In children 6-18 years old, the DMF is 5.53 teeth. At the same time, the element "D" in the main group was 41.5%, and in the control group – 11.06%. Element "F" was equal to 57.8%, in the control group - 85.94%. Element "M" in the main group was equal to 0.6%. Conclusion. Children with acute forms of leukemia have high rates of caries intensity in temporary and permanent teeth.

Correlation between microbial host factors and caries among older adults

Background There is little knowledge about factors which may affect oral health among older adults. The objective of this study was to determine the relationship between Streptococcus mutans (MS) and Lactobacilli (LB) counts and caries among older adults. Methods In this community-based observation study, 141 participants aged 60 years and above were recruited from the west district of Singapore. Alongside the clinical examination, saliva samples were collected to determine Streptococcus mutans (MS) and Lactobacilli (LB) counts, as well as to record salivary flow rate and buffering capacity of saliva. Results Of the 141 participants, 63.8% were female and 94.3% were of Chinese ethnicity. The mean DMFT was 11.08 (s.d. 8.27). 9.9% of participants had at least one decayed tooth, 52.5% had minimum one missing tooth and 86.5% had at least one filled tooth. 67.4% had MS counts of ≥ 105 while LB counts were ≥ 105 for 48.2%. 83.7% had normal salivary flow or hypersalivation (> = 1 mL/min), the buffering capacity of the saliva was alkaline in 61% of the participants. Multivariate analysis showed that participants who had high MS counts were less likely to have a DMFT < 12 [OR (95% CI), 0.29 (0.11–0.77)] whereas participants who had high LB counts were less likely to have a DMFT ≤ 14 [OR (95% CI), 0.45 (0.20–1.002)]. Conclusion Our study showed a positive correlation between MS and LB counts and caries experience in older adults. The mean DMFT was on the low side in our sample despite having a relatively high MS count. This suggests that there are many other factors which vary according to host environment, physiological and biological conditions that may affect MS and LB counts in the oral cavity. Clinical relevance Our study supports the knowledge that the aetiology of dental caries among older adults is a complex process and it would be wrong to consider caries as a same problem with the same solution for all age groups.

Prevalence of Dental Caries Among Costa Rican Male Students Aged 12-22 Years Using ICDAS-II

Objective: Dental decay is a public health challenge in Low- and Middle-Income Countries, particularly for young people, often confronted to healthcare access barriers. The aim of this study was to determine the prevalence and severity of dental caries among young male students in Costa Rica. Study design: A cross-sectional study was performed in 428 Costa Rican male students aged 12-22 years, who attended a nonprofit social welfare boarding school in 2019. A clinical examination was ran by three calibrated examiners following the International Caries Detection and Assessment System (ICDAS-II). Results: Caries prevalence was estimated at 83%, 15% have lost a tooth due to dental decay, 61% have at least one filled tooth, 36% have at least one filled and decayed tooth. The most frequent caries lesions were codes 2-Inactive (46.7%), and code 1-Inactive (23.8%). DMFT indicated a mean index using ICDAS-II 1-6>0 codes of 7.89. Using ICDAS-II 3-6>0 as threshold, the index decreases to 3.94. Finally, the lower and upper first permanent molars were found to be the most affected teeth. Conclusions: Dental caries experience represents a significant public health burden in young people, requiring better access to public dental healthcare.

A Novel Approach to Restore a Decayed Mandibular Posterior Tooth by Immediate Implant Placement Using Autogenous Tooth Graft Material Mixed with Platelet-Rich Fibrin: A Case Report

A dental implant is the most accepted treatment option to replace the badly decayed tooth or missing tooth. The jumping gap left after the placement of the implant in the socket will require augmentation of bone graft material. In this case report, the extracted root stumps are used as an autogenous tooth graft material after its preparation. And PRF is mixed with graft material for additive advantage. So, the present case report discusses the feasibility of the use of autogenous tooth graft material along with PRF for the better osseointegration of the implant.

Odontogenic Infections: General Principles

When the host defense mechanism is low, a highly virulent pathogen from a decayed tooth, either through a periapical or periodontal route, may get an environment that favours it growth, leading to odontogenic infection that follows the path of least resistance. Such an infection may spread locally into various facial spaces or may present systemic involvement, leading to mild, moderate or severe infection. Management of such infection involves assessment of the cause, severity, hosts immune response, removal of the cause, surgical intervention including drainage along with pharmacotherapeutics and regular follow ups till it is completely resolved.