ANTIBIOTICS FOR PAEDIATRIC PATIENTS IN DENTISTRY: AN OVERVIEW OF AVAILABLE GUIDELINES The administration of antibiotics in children undergoing dental procedures is generally contemplated in specific instances to prevent or address potential infections. This thorough review aims to enhance current guidelines by integrating additional evidence regarding the need for administering antibiotics to children undergoing dental treatments. We conducted an extensive review of literature, focusing solely on English-language sources retrieved from SCOPUS, MEDLINE, and PubMed databases up to August 2023. Our primary focus was on exploring the utilisation of antibiotics in paediatric dental care. Inaccurate antibiotic prescriptions can result in widespread consequences, such as the development of bacterial resistance, complications in the gastrointestinal and haematological systems, and disruptions in the bacterial microbiota. This review highlights the importance of following existing guidelines for prescribing antibiotics in paediatric dental care, underscoring the crucial role of dentists' clinical judgement before authorising prescriptions. Additionally, it strongly promotes collaborative communication with medical practitioners to evaluate the patient's clinical condition. Consequently, it is imperative to establish comprehensive antibiotic prescribing guidelines for dental professionals.

MANAGEMENT OF PERIPHERAL OSSIFYING FIBROMA IN AN ADOLESCENT: A CASE REPORT Introduction: Peripheral ossifying fibroma (POF) makes up between 2-9% of all gingival lesions and a third of all localized hyperplastic gingival lesions. It is commonly seen in the anterior segment of both maxilla and mandible. Case report: This case describes the management of peripheral ossifying fibroma (POF) associated with tooth displacement affecting the anterior segment of the maxilla of a 15-year-old boy. Complete surgical removal was done followed by the placement of a BIPP dressing at the surgical site. The post-operative clinical outcome was successful whereby the pathologically displaced tooth erupted into the arch spontaneously and was well-aligned without the need for any orthodontic treatment. Conclusion: Complete removal of POF lesion followed by good oral hygiene maintenance ensures a favourable outcome and no evidence of recurrence.

RESIN INFILTRATION FOR THE MANAGEMENT OF ENAMEL OPACITY - A CASE SERIES AND LITERATURE REVIEW Resin infiltration (RI) technique was introduced as one of the minimally invasive dentistry techniques for the management of enamel opacity. Six young patients with post-orthodontic white spot lesions, molar incisor hypomineralization, fluorosis, and amelogenesis imperfecta were treated with resin infiltration (RI). RI was used alone or in conjunction with bleaching or microabrasion. The esthetic improvement of lesions is immediately noticeable following treatment, even though some enamel discoloration remained visible. No color changes of the treated teeth noted after 6-month review. The use of RI alone or in combination with the other interventions has been shown to be successfully masking enamel opacities in young patients. Therefore, RI technique can be an option in managing enamel opacity of anterior teeth due to demineralization or developmental defects of enamel.

THE USE OF HYPNOSIS AS AN ADJUNCT TO NITROUS OXIDE/OXYGEN SEDATION: A CASE SERIES It is known that managing patients with dental fear and anxiety is challenging for clinicians and patients. This series of case reports highlights the importance and benefits of dental management under clinical hypnosis as an adjunct to nitrous oxide inhalation sedation for ages six to fifteen. These treatments range from pulp therapy, extraction and minor oral surgery. Customised hypnosis scripts were utilised for each patient, and the metaphors used were tailored to the patient’s interest and preference. The intended treatment was successfully carried out in all the patients. Five cases discussed in this case series were initially indicated for treatment under general anaesthesia, but treatment was successfully carried out using hypnosis and nitrous oxide/oxygen sedation. In the two surgical cases, nitrous oxide was tapered off once local anaesthesia was achieved, and the state of relaxation was maintained using a hypnotic trance, reducing the anaesthetic agent’s utilisation. Hypnosis successfully reduces patients’ anxiety, allowing them to feel more relaxed and confident about accepting future dental treatment without the need for pharmacological intervention.

INTERPRETATION OF EMOJI® IN MALAY LANGUAGE AMONG CHILDREN IN MALAYSIA The existing dental anxiety scales for paediatric patients tend to categorize and label children according to their level of cooperation. However, human emotions are more complex, and each child is unique. Hence, a more dynamic and interactive method should be introduced for a better understanding of the patient’s current state of emotion. The aim of this study was to investigate the interpretation and understanding of children towards frequently used emoji® for the development of an emoji® dental emotional spectrum. Both online and physical surveys were conducted among 147 Malay language-speaking children aged between 4-to-16 years in Malaysia. The children were asked to interpret 30 pre-selected emoji® images in their own words using the Malay Language. The pre-selected emoji® represent happiness, neutral, fear, sadness, and anger. The interpretations were subsequently based on their similar meaning, a process that was validated by two experts in the field of linguistics. The study involved participants with an average age of 9.2 years, with the majority of them being female (61.2%). Of the 30 pre-selected emoji® images used in this study, 13 had respondent agreement exceeding 60% which was the threshold set for suitability for use in evaluating dental emotion. The remaining 17 emoji® images have a remarkable variability in the interpretation which indicates potential misinterpretation by the respondents. The 13 emoji® images range from happiness, neutral, fear, dislike, unhappy, sad, anxious, and angry with the emoji® images which represent “excited” (94.0%), “loudly crying” (97.3%) and “angry” (91.8%) had the highest agreement. Meanwhile, the emoji® images represented “confounded” and “downcast” had the least agreement among respondents (1.3%). Despite the universal meaning imposed by emoji®, the interpretations may vary in different populations and age groups. Emoji® images hold the potential to serve as a valuable tool for identifying and managing children’s behaviour.

RESIN INFILTRATION – A NARRATIVE REVIEW OF PROPERTIES Resin infiltration ICON® has made it possible to treat initial caries lesions in a novel manner that is consistent with the concept of minimal intervention dentistry. Infiltration of caries lesions is a novel technique for treating non-cavitated lesions on the proximal and smooth surfaces of primary and permanent teeth. The greatest benefit of this method is that it is non-invasive, preserves tooth structure and can be completed in a single visit. This narrative review intends to discuss the properties of the material, its clinical applications and its effectiveness in terms of caries inhibition and esthetics effect, surface roughness, microhardness and penetration ability. There are a number of high-quality studies that support the use of ICON® in arresting non-cavitated proximal caries lesions in primary and permanent teeth. However, the masking ability in managing anterior white spot lesions and fluorosis is still doubtful. Among the material limitations were its questionable long-term color and material stability.

FEASIBILITY OF THE NEWLY DEVELOPED INDEX FOR INTERCEPTIVE ORTHODONTICS REFERRAL (IIOR) AND THE USER'S PERCEPTION: A PILOT STUDY Introduction: The Index for Interceptive Orthodontics Referral (IIOR), a tool designed to guide the timely referral of developing malocclusion was recently developed and validated. The IIOR may facilitate the timely identification and referral of cases that may benefit from interceptive orthodontics. This pilot study aimed to assess the feasibility of the IIOR and perception among its users. Objectives: (1) To assess the feasibility of using IIOR among dental frontliners. (2) To investigate the perception of IIOR usage among dental frontliners. Methodology: Thirteen participants (6 dental officers, 3 orthodontic postgraduate students, and 4 dental therapists) were briefed about the IIOR through a pre-recorded video presentation. Subsequently, the participants were asked to grade 10 study models with a case summary of each, using the IIOR. The participants' responses were compared to the grading by experts on the 10 study models of various malocclusion using IIOR, which was established before this pilot study. After grading, they were asked to complete a questionnaire that assessed their perception towards the IIOR, in an interactive method. The questionnaire had undergone content and face validation. Results: The Fleiss Kappa scoring by the participants resulted in moderate agreement of 0.5. A total of 79.23% of participants matched the gold standard scoring. Additionally, 92.3% of the participants were happy to have a screening tool such as the IIOR to guide and assist them during patient screening. They found IIOR to be very useful, efficient, and easy to understand. Conclusions: In this pilot study, the IIOR was found to be feasible to use and was highly accepted by the dental frontliners. The IIOR was found to be simple and convenient to use by the dental frontliners during dental screening.

Objective: The absence of a guideline to refer to developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity. Methods: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics. Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores. Conclusions The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

ABSTRACT Dental caries is a commonly progressive disease that proceeds through various degrees of severity that a dentist can detect. The aims of the in vivo study were to assess the accuracy of the individual model (near-infrared light transillumination [NILT] device, visual and radiographic examinations) in detecting occlusal caries, and to evaluate the performance of visual and NILT device combination for occlusal caries detection in deciding the treatment options. Fifty-two non-cavitated occlusal surfaces from 16 patients were assessed with three different diagnostic devices in random order. Identified lesions were prepared and validated. Logistic regression analysis was performed for each method. The sensitivity and specificity values for each method and the combined models were statistically measured using RStudio version 0.97.551. At the enamel level, visual detection was the most sensitive method (0.88), while NILT was the most specific (0.93). NILT scored the highest for sensitivity (0.93) at the dentine level and visual detection scored the highest for specificity (0.88). Visual detection + NILT model was significantly better (p = 0.04) compared to visual detection or NILT alone (df = 1). The visual-NILT combination is a superior model in detecting occlusal caries on permanent teeth. The model provided surplus value in caries detection hence improving the treatment decision-making in occlusal surfaces.
Dental Caries Activity Tests