Background:Administration of sweetened medicaments poses many oral health related problems in children due to the lack of awareness among the pediatricians regarding their ill effects.Purpose:To assess pediatricians’ awareness and attitudes toward the use of liquid pediatric medicines and their relationship with dental caries and erosion.Materials and Methods:A cross-sectional descriptive study was conducted among the pediatricians residing in Nellore city. Data were obtained from 55 pediatricians using questionnaires.Results:Among the respondents, 95.6% prescribed liquid medicaments, 51.1% expressed that they may be associated with dental effects, 60% were not aware regarding the sweetness of medicaments, whereas majority of them (77.8%) opined that children complained regarding the taste, 73.3% stated that sugar substitutes were used as sweetening agents, 70.9% believed that they were not acidic, 68.9% did not recommend brushing after intake of medicines, 90% failed to deliver oral health instructions, and 54.5% believed that lack of oral hygiene was a contributing factor for development of dental caries.Conclusion:Majority of the respondents prescribed liquid medicaments and were unaware regarding the sweetening agents and acidity, which cause ill effects on the dental hard tissues. Most of them neither recommended nor delivered oral hygiene instructions (OHI) after prescribing sweetened liquid medicaments. Hence, OHI should be delivered to enhance the oral health related quality of life in children.

Dark chocolate had a high fall in pH and milk chocolate had low salivary sugar clearance which signifies that unfilled chocolates are more cariogenic than other chocolates. Even though mango-flavored candy had maximum fall in plaque pH, its salivary sugar clearance was high.

Subjects with lower Apgar Index exhibited more hypoplastic and hypocalcified teeth both qualitatively and quantitatively. If the Apgar value is less than 6, the vulnerability for the development of enamel defects has considerably increased. Gender of the individuals did not influence the final outcome.

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Dens evaginatus is a variance of odontogenesis, which is characterized by enamel covered conical tubercle that may enclose dentin and pulpal tissue. Central cusps (occlusal supernumerary cusps) are located between the buccal and the lingual cusp tips in the occlusal surface of the premolars and molars and on the lingual surface of the incisors and canines. Pedersen [1] described central tubercle as "a peculiar enamel pearl-like 'cusp' on the occlusal surface" of the right upper molar in an Eskimo from Greenland. The most commonly reported accessory cusps are cusp of carabelli of the molars, talons cusps of the incisors and leong's tubercle of premolar. These variations can be seen both in primary and in permanent dentitions [2].Even though, Dens evaginatus or accessory central cusp was described commonly in premolars, they were infrequent in molars. In primary dentition, they were confined to maxillary second molars, either unilaterally or bilaterally [3]. In permanent molars, they were reported unilaterally in mandibular third molar and maxillary second molar [4]. Within the bounds of our literature search, no central accessory cusp has been reported in permanent maxillary first molars.A 14 year old south Indian male presented to the department of Paediatric Dentistry for routine dental visit. Intra oral examination revealed the presence of age appropriate permanent dentition. The maxillary right and left first permanent molars showed prominent, rounded projection on the occlusal aspects (Figure 1), which were obliterating the central grooves. There were no signs of wear or fracture of these tubercles. The child was otherwise normal related to extra oral findings and temporal mandibular joint. No specific treatment was administered, as they were not interfering with the occlusion. The possible complications in the future were explained to the parents regarding the tubercle and the need for periodic monitoring was emphasized. The etiology of extra cusp formation or abnormal shape is unknown. However, initially, it was noted that, genetically, these features are probably due to over activity of the dental lamina. However, it is presently believed that the PAX and MSX genes are responsible for the abnormal shape of the teeth [5]. The accessory cusps may pose multiple dental problems such as caries in the pits or developmental grooves between the accessory cusp and the tooth, sensitivity or devitalisation of tooth due to fracture or attrition of the tubercle that has pulpal extension [4,6] AbstractAccessory cusps are common variations of tooth morphology that are occasionally seen clinically. However, their incidences differ depending on the type and the tooth affected. This article reports a rare case of bilateral central accessory cusp of Maxillary first permanent in a 14year old boy. The maxillary right and left first permanent molars showed prominent, rounded projection on the occlusal aspects which were obliterating the central grooves. There were no signs of wear or fracture of these tubercles. No specific t...