Summary Initially, it was reported that coronavirus 2019 disease (Covid‐19) affects respiratory, gastrointestinal and neurological systems, but the oral, olfactory and integumentary systems are also involved. This review discusses various oral manifestations of Covid‐19 reported in the literature along with possible underlying mechanisms. The reported manifestations include taste impairment, oral mucosal changes (petechiae, ulcers, plaque‐like lesions, reactivation of herpes simplex virus 1(HSV1), geographical tongue and desquamative gingivitis) and dry mouth. The prominent location for mucosal lesions are tongue, palate and labial mucosa. The exact pathogenesis of these oral symptoms is not known. Angiotensin‐converting enzyme 2 (ACE2) cell receptors are expressed in abundance on oral mucosa allowing severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) to infect them. Gustatory impairment along with olfactory changes is now listed as a symptom of Covid‐19 by the World Health Organization, but further research is needed to confirm a link between reported additional oral symptoms and Covid‐19. Dental professionals may encounter individuals with Covid‐19 and be called upon to identify various oral manifestations of this disease.

Context:There are limited studies on comparison of Total etch (TE) and Self etch (SE) adhesive for placement of sealants.Aims:The aim of the study was to compare the retention of fissure sealants placed using TE adhesive to those sealants placed using SE (seventh generation) adhesive.Settings and Design:The study was conducted in the dental section, Aga Khan University Hospital. This study was a randomized single blinded trial with a split mouth design.Materials and Methods:The study included 37 patients, 101 teeth were included in both study groups. The intervention arm was treated with SE Adhesive (Adper Easy One, 3M ESPE, US). Control arm received TE adhesive (Adper Single Bond 2, 3M ESPE, US) before sealant application. The patients were followed after 6 months for assessment of sealant retention.Statistical analysis used:Interexaminer agreement for outcome assessment was assessed by Kappa Statistics and outcome in intervention group was assessed by McNemar's test.Results:Ninety-one pairs of molar (90%) were reevaluated for sealant retention. Complete retention was 56% in TE arm and 28% in SE arm with an odds ratio (OR) of 3.7.Conclusions:Sealants applied with TE adhesives show higher rate of complete sealant retention than SE adhesive.

Dental fluorosis is defined as hypomineralisation of enamel resulting from excessive ingestion of fluoride (more than 1 ppm) during tooth development. Mild-to-moderate forms of dental fluorosis are often unnoticed by the patients whereas severe fluorosis presents with dark brown-to-black discolouration of teeth along with enamel pitting and hypoplasia. Such discolouration results in an unpleasing appearance as well as psychological distress to the affected individual. Dental fluorosis can be managed by bleaching, micro/macroabrasion, veneering or crowning. The choice between different treatment options depends on the severity of fluorosis and patients' aesthetic demands. The aim of this case report was to describe the stepwise oral rehabilitation of an adult with severe fluorosis along with multiple carious teeth. After restoration of carious teeth and extraction of unsalvageable teeth, bleaching and full-coverage restorations were used for the management of fluorosis.

Background The objective of the current study was to adapt the Index of Dental Anxiety and Fear (IDAF-4C) in the Urdu language and measure its validity and reliability. Methods Original English questionnaire of IDAF-4C was translated into Urdu language by a panel of dentists and language experts (Urdu and English) followed by critical evaluation, modification and back translation into English language. A final Urdu questionnaire was distributed among 250 patients visiting the Endodontics section at Margalla Institute of Health Sciences (MIHS), Rawalpindi, Pakistan. Cronbach’s alpha was used to determine the reliability of the Index whereas validity was assessed by exploratory factor analysis (EFA). Mean rank scores of IDAF-4C for male and female participants were evaluated using Mann-Whitney U tests ( P < 0.05). Results Of 250 questionnaires, 209 were returned with a response rate of 84%. Cronbach’s alpha for the Urdu version of IDAF-4C was 0.88. Exploratory factor analysis of the IDAF-4C revealed one factor explaining 55.55% of the common variance (Eigenvalue = 4.5). The mean rank scores of all eight items of IDAF-4C were greater for female participants as compared to male participants with a statistically significant association ( P < 0.05). Conclusion The psychometric analysis of the Urdu version of IDAF-4C showed good reliability and consistency compared to the original version as well as other translated versions.

Root canal treatment (RCT) has high success rate, still many patients are apprehensive of this procedure. Objective: To determine the frequency of patients’ avoiding RCT in endodontically treatable teeth and identify the reasons given by the patients to avoid RCT. Methods: This cross-sectional study was conducted at the department of operative dentistry at Margalla Institute of Health Sciences, Rawalpindi including patients who refused RCT in endodontically treatable teeth (n= 250). Patient’s demographics, tooth related variables and reason for not pursuing root canal treatment were recorded. Descriptive statistics and Chi-Square test were run to report sample characteristics with level of significance at ≤ 0.05. Results: Two hundred and fifty (250, 21.09%) out of 1185 patients advised for RCT refused the procedure. Majority of the participants were female (169, 67.6%). The mean age of the patients was 32.66 years (SD ± 12.313). The most common reason as reported by almost half of the patients (106, 43%) for avoiding RCT was “financial constraints” followed by a desire to take a “second opinion or advice” (46,18%). The majority of the male participants as compared to female participants refused RCT due to financial constraints with statistically significant association (p˂0.001).  A reasonable number of female patients also identified “want second opinion/advice” as a reason for avoiding RCT(p˂0.001).  Conclusions: The frequency of patients avoiding RCT in endodontically treatable teeth was 21.09%. Financial constraints followed by seeking a second opinion or advice were the most common reasons identified by the patients avoiding RCT in endodontically treatable teeth.