Background: A rise in the reported numbers of children with Autism Spectrum Disorder (ASD) highlights the need for dental practitioners to be more familiar with the treatment approaches for these special needs children to ensure comfortable, well-accepted and efficient management while in dental office. Aim: This paper aimed to acquire a deeper understanding of some of the innovative and best approaches to managing children with ASD in dental settings. Design: A systematic literature search was performed in PubMed, Scopus, Web of Science, Cochrane databases, and grey literature based on the PRISMA 2020 statement, using main keywords such as: ‘management’, ‘dental’, ‘children’, and ‘Autism Spectrum Disorder’. Original full-text papers including randomised controlled trials (RCT) and all other designs of non-randomised controlled studies (NRS) reporting relevant intervention studies in English were included without any publication time limit. The quality of the evidence found eligible for the review were then assessed using the ROB-2 and ROBINS-I tools. Subsequently, the details of management interventions and impact of treatment approaches were compared and discussed. Results: Out of the 204 articles found, 109 unrelated articles were excluded during the initial screening. The full papers of remaining 28 were retrieved and only 15 (7%) articles were eligible to be reviewed; eight RCTs with ‘some concerns’ and ‘high risk’ categories particularly concerning their randomisation design, and seven NSRs with ‘serious’ to ‘critical’ bias largely due to confounding factors. Conclusion: Our review found inconclusive evidence on the strength of recent psychological and non-pharmacological approaches used to manage children with ASD in dental settings. Small sample size and lack of a control group in certain studies affected the strength of evidence and credibility of the findings. Nevertheless, this review shared informative details on some innovative approaches for better understanding of the management of children with ASD for dental professionals.

Concerns have been raised about the usage of sodium hypochlorite (NaOCl) in endodontics following its toxic effects. Effective ecoproduce (EEP), an organic solution produced through the fermentation of fruit peels, exhibits antibacterial and antibiofilm action, suggesting its potential as an endodontic irrigant. However, studies on its cytotoxicity are limited. This in vitro study aimed to evaluate the cytotoxic effects of EEP at different concentrations and fermentation periods against the MC3T3-E1 cell. EEP derived from orange and pineapple peel waste and fermented for 3 and 6 months was prepared from 100% to 0.78% concentration. Briefly, 2.5% NaOCl was used as the comparison group. Cell viability was analysed using Alamar Blue and Live and Dead Cell assay. A transmission electron microscope (TEM) was used to evaluate ultrastructural changes to the cells. Data analysis was performed using a two-way mixed Analysis of Variance (ANOVA). EEP exhibited concentration-dependent cytotoxicity regardless of the fermentation period (p > 0.05). A concentration below 6.25% was non-cytotoxic and comparable to the negative control (p > 0.05). Live and Dead Cell assay and TEM analysis complement the findings. The mean cell viability of EEP at all concentrations for both fermentation periods was significantly higher than that of 2.5% NaOCl (p < 0.05). Conclusively, 6.25% EEP fermented for 3 and 6 months are non-cytotoxic and can serve as an alternative endodontic irrigants.

Background: The increasing popularity of fruit juices as part of perceived healthy dietary choices has raised concerns regarding their erosive effects on dental enamel. While prior in vitro studies have largely relied on commercial fruit drinks and non-human enamel samples, this study adopts a more ecologically valid approach by using fresh local fruit juices and extracted human teeth to evaluate enamel erosion. Objectives: This study aimed to assess the consumption patterns, oral hygiene behaviours, and awareness of the erosive potential of fruit juices among Malaysian adults and to evaluate the erosive effects of freshly squeezed local fruit juices on human dental enamel under simulated oral conditions. Methods: A questionnaire-based cross-sectional survey (n = 189) was conducted among dental clinic attendees to assess fruit juice intake habits, oral health practices, and awareness levels. In parallel, an in vitro study was performed using 40 extracted premolar teeth immersed in lime juice, pineapple juice, citric acid (positive control), or distilled water (negative control) over a 10-day period. Enamel volume loss, surface roughness, and microhardness were analysed pre- and post-immersion. Results: Fruit juice consumption was highly prevalent, with lime (57.7%) being the most commonly consumed, followed by watermelon (53.0%), star fruit (15.9%), and pineapple (15.4%). The majority of respondents preferred sweetened juices (75.7%) and demonstrated only moderate oral hygiene, with just 53.4% reporting brushing their teeth twice daily. Awareness of the dental effects of acidic beverages was limited. In vitro results confirmed that both lime and pineapple juices significantly reduced enamel microhardness and increased surface roughness (p < 0.0001), with lime juice causing the greatest enamel volume loss due to its higher acidity. Conclusions: These findings highlight the need for public health strategies that raise awareness on the implications of dietary acids and promote protective oral health behaviours. Dental practitioners should incorporate dietary counselling in routine care, particularly for populations at higher risk.

Fermentation-derived fruit-peel formulations have potential as alternative denture cleansers, but their development requires evidence that they can provide antifungal activity without compromising denture-base materials during repeated use. Objectives: To evaluate the antifungal activity of six-month-fermented mixed pineapple–orange and papaya-based effective eco-produce formulations (M-EEP and P-EEP, respectively) against Candida albicans and determine their time-dependent effects on heat-polymerised polymethyl methacrylate (PMMA) surface roughness and topography. Methods: Antifungal activity against Candida albicans was assessed using broth microdilution to determine the minimum inhibitory concentration and minimum fungicidal concentration. A peroxide-based denture cleanser (PDC) served as the commercial reference. PMMA specimens were allocated to PDC, M-EEP, P-EEP or distilled water (n = 7). Arithmetic mean roughness (R_a) and root mean square roughness (R_q) were measured at baseline, 7, 14, 28 and 90 days using atomic force microscopy. Surface topography was evaluated qualitatively, and longitudinal data were analysed using generalised estimating equations. Results: Both EEP formulations inhibited visible fungal growth when tested as prepared and prevented colony recovery after subculture, demonstrating fungicidal activity. Significant time and medium x time effects were observed for R_a and R_q (p < 0.05). M-EEP showed no significant within-group roughness change, whereas P-EEP and PDC showed early reductions that were not sustained by day 90. No medium produced progressive roughening, and all R_a values remained below the commonly cited 0.2 µm plaque-retentive threshold. Conclusions: Six-month-fermented EEP formulations demonstrated antifungal activity against planktonic Candida albicans ATCC 10231 without progressive increases in mean PMMA surface roughness, thereby addressing both biological efficacy and material compatibility within the same experimental framework.