Asaad Javaid Mirza

Oral health, generally overlooked amidst pressing health concerns in Pakistan, significantly impacts women's well-being, affecting nutrition, self-esteem, and pregnancy outcomes. This write-up highlights the critical need to address the silent burden through enhanced education and awareness, particularly within rural and marginalized urban communities where traditional roles, misinformation, and limited access to care perpetuate a cycle of neglect. Educational disparity directly correlates with poor oral health outcomes, underscoring the transformative potential of integrating oral hygiene into school curricula and community outreach programs. Leveraging the existing infrastructure of PMDC-approved dental colleges for community-based educational initiatives can provide valuable hands-on experience for students while disseminating crucial knowledge on brushing techniques and dietary impacts.Culturally sensitive messaging, delivered in local languages by trusted community health workers, is essential for effective knowledge dissemination. In addition, promoting the scientifically-backed benefits of the miswak, a religiously significant and readily available tool, offers a culturally resonant and cost-effective solution. Simultaneously, raising awareness about affordable modern options like diluted sodium hypochlorite mouth rinse can provide accessible and effective oral hygiene practices. Utilizing mass media and real-life testimonials can further dispel myths and encourage proactive dental care. While awareness is paramount, it must be coupled with increased access to affordable, quality dental services through clinic establishment and subsidized care. Ultimately, tackling this calamity necessitates a cultural shift driven by education, community engagement, and systemic reforms to ensure that oral health is no longer the forgotten thread in Pakistani women's systemic health.

Dental caries remains one of the most prevalent yet neglected childhood health challenges in Pakistan, affecting over 60% of children due to poor oral hygiene, limited access to care, and a critical shortage of pediatric dental specialists. Early childhood caries (ECC) not only causes pain and infection but also impairs nutrition, speech development, and quality of life, with long-term consequences for educational and economic outcomes. Despite global evidence demonstrating the effectiveness of preventive programs (e.g., fluoride varnishes, school-based screenings), Pakistan’s oral health system remains ill-equipped to address this crisis, with fewer than 0.5 pedodontists per 100,000 children and stark urban-rural disparities. General dentists, who comprise the majority of the workforce, often lack specialized training in child behavior management or advanced sedation techniques, leading to delayed treatment and preventable complications. This letter highlights the urgent need for policy reforms, including integrating pediatric dentistry into undergraduate dental curricula, expanding postgraduate training programs, incentivizing rural service through scholarships and infrastructure investments, and launching national preventive campaigns modeled after successful initiatives like Scotland’s Childsmile and Thailand’s school-based fluoride programs. Without immediate action, Pakistan’s pediatric caries epidemic will continue to exacerbate health inequities and strain the healthcare system. Policymakers, educators, and professional associations must collaborate to prioritize children’s oral health as a national public health imperative. Keywords: Pediatric dentistry, dental caries, oral health policy, preventive care, health disparities.

Progressive periodontal disease causes loss of supporting structures of teeth resulting in deep bony defects. In this case a report of 22-year old female patient is being presented with clinical findings of vertical bone loss in two adjacent teeth, on distal surface of 2nd upper right premolar and mesial surface of upper right 1st molar. Root canal treatment, non-surgical periodontal therapy followed by guided tissue regeneration was carried out using decalcified freeze-dried bone allograft (DFDBA) and collagen membrane. Analysis of clinical and radiographic findings showed marked reduction in pocket depth up to 12mm with hard tissue repair on 3-month, 2-year and 5- year follow ups.

IntroductionControversy among dentists exists to use conventional hand files or contemporary rotary protapers for intracanal instrumentation.The controversy arose because of variable findings on post-instrumentation pain felt by the under treatment patient that acts as adeterrent to receive further endodontic treatment. This study has been planned to assess post-instrumentation pain, swelling, tendernessor redness using the hand files and rotary protapers in confined environment where rubber dam is not used for operativefield isolation from oral fluids.Material and MethodsOne hundred and sixty vital and non-vital teeth were root treated. The subjects were randomly divided into two groups. “GroupA” was treated using hand files with step-back technique and “Group B” with rotary protapers. All the root therapies were accomplishedin two or multiple visits depending on the satisfactory disinfection of the canal. Access to pulp chambers was obtainedusing sterile bur without rubber dam isolation and the preparation in either group was performed under normal saline irrigation.Drying of canal was obtained using paper points followed by cotton and temporary packing to ensure tight leak proof coronalseal and the subjects were recalled on subsequent day.ResultsResults revealed that the highest symptomatic adversity was faced by n=40 subjects with non-vital pulps after hand filing. Leastfrequent symptomatic complaints were made by the group with vital pulps and were treated by rotary protapers. In vital teeth, painwas reported more in hand filed teeth than in teeth that were treated with protapers. Non-vital teeth showed a similar pattern withgreater number of complaints about pain in both hand filed and protaper subjects.ConclusionRotary protapers induced less post-instrumentation symptoms than hand files in vital as well as non-vital teeth.

Dental | Oral Health Education | Oral Health Promotion | Saudi Arabia | School Teachers

This is a case report of a young boy who had a physical trauma to his right maxillary central Incisor. As it remained untreated for many years, it underwent severe inflammatory external root resorption causing perforation. The root of the tooth was damaged to an extent that extraction of the tooth was indicated. But keeping the site of the tooth, age of the patient and his interest in saving the tooth in view, we decided to take a chance to save the tooth in an innovative manner. Firmness of the tooth in its socket also motivated us to opt for a restorative treatment instead of referring him to surgery for extraction. A hopelessly damaged tooth which was very much indicated for extraction has been saved which satisfies patient’s cosmetic demands on lower cost. He otherwise, would have to bear the cost of either 3-unit Bridge or Implant supported crown. Quarterly radiographic examination shows progressive apical and periodontal healing after the treatment since last six months.

This study was done to assess the influence of alkaline surface modification on interfacial bond strength of existing fractured (old) amalgam restoration bonded to fresh amalgam. Old and Fresh amalgam interfaced samples were prepared by applying a 4-methacryloyloxyethy trimellitate anhydride (4-META) containing adhesive. The adhesive used was Amalgabond (Parkell, Farmingdale, NY 11735, USA). Four concentrations of calcium hydroxide Ca(OH)2 solutions were used as a surface modifiers for old amalgam to increase the pH of the amalgam surfaces. The concentrations used were 2.5, 5, 10 and 15%. Direct measurement of the interfacial bond strength was carried out using an electromechanical universal tensile testing machine at crosshead speed of 10mm per minute. Results show that all the calcium hydroxide modified samples produced the increased tensile bond strength (TBS) as compared to their control group. The highest values of bond strength were achieved using 15% Ca(OH)2 solution as surface modifier. Pretreatment of fractured amalgam with calcium hydroxide improves the bond strength of 4-META adhesives. Its use in repair of amalgam may therefore be considered.