Background: Human beta defensin-3 (HβD-3) is an antimicrobial peptide present in saliva that protects tooth surfaces from microbial attack. These peptides are part of innate immunity so levels may be affected by different systemic diseases like anemia. Therefore, anemia may predispose an affected child to an increased risk of dental caries. The objectives of this study were to determine the association of early childhood caries (ECC) with HβD-3 levels and observe the association of HβD-3 levels with childhood anemia. Methods: A total of 80 children admitted in a pediatric medical ward, age 48–71 months, of either sex were included in the study. The included children were categorized as cases (children with ECC n = 40) and controls (children without ECC n = 40). Children were further segregated into the anemic and non-anemic sub-groups based on the hospital record of hemoglobin level. The salivary concentration of HβD-3 was measured by Enzyme-Linked Immuno-sorbent assay (ELISA). IBM SPSS version 20 software was used for statistical analysis. Two sample t-test and one-way ANOVA were used to compare mean values while spearman was used for correlations at p < 0.05. Results: The mean Salivary HβD-3 level in cases (8.87 ± 4.30) was significantly higher (p = 0.042) as compared to controls (7.23 ± 2.57). Salivary HβD-3 level in patients with caries and without anemia was highest (10.80 ± 4.50) whereas salivary HβD-3 level in the presence of caries and anemia was lowest (6.94 ± 3.13) amongst all groups. This difference was statistically significant (p = 0.001). Salivary HβD-3 level was found to be moderately correlated with cases (p = 0.002). An inverse correlation was found between salivary HβD-3 level and anemia (r = -0.479, p = 0.002). Conclusion: Anemia may affect the innate immunity of children, and may result in a decreased level of salivary HβD3, thus increasing vulnerability to decay.

The transition from preclinical to clinical training in dental education represents a critical developmental phase characterized by increased workload, pat

Objective: The objective of this research was to assess differences in postoperative morbidity following prophylactic and symptomatic 3rd molar extraction. Methods: In this randomized controlled trial, two groups of patients were assigned based on whether their third molar extractions were performed as a preventive measure or in response to symptoms. Throughout the treatment period, two follow-up visits were conducted to monitor the patients. Data was collected through assessments conducted before, during, and after the surgery (on days 3 and 10). Patient characteristics such as age, gender, reason for extraction, extraction method, anesthesia type, and the number of maxillary and/or mandibular third molars removed were considered as predictive factors. The objective was to determine the probability of experiencing postoperative discomfort symptoms on days 3 and 10. Statistical analysis using the chi-square test and T-test was performed to compare the outcomes, with a significance level of p < 0.05. Results: A total of 102 patients participated, with 51 in each group. The mean age was 36.366 ± 11.582 years for the prophylactic group and 39.052 ± 10.78 years for the symptomatic group. The age groups were divided into three categories: 18-25, 25-35, and >35. The distribution of age groups varied between the two groups. In terms of gender, both groups had a similar distribution of males and females, with a slight difference in percentages.The results showed varying levels of discomfort among patients immediately after the procedure and at day 10. Pain, trismus, and swelling decreased over time, while the usage of painkillers decreased significantly by day 10. The p-values associated with these outcomes were calculated, indicating statistical significance in the differences observed between the two groups. Conclusion: The results of the study provide valuable insights into the postoperative experiences and outcomes of both prophylactic and symptomatic third molar extractions, highlighting the changes in pain, painkiller usage, trismus, and swelling over the course of the recovery period.

Diagnostic errors and near misses threaten patient safety in dental practice. In Sindh, the service delivery standards require documentation and review of critical incidents, supporting incident reporting as a platform for ensuring patient safety. This study aimed to describe incident patterns using critical incident reports, a structured patient safety reporting mechanism used to document adverse events, near misses, and diagnostic process failures in clinical practice. A sequential mixed-methods study reviewed 300 de-identified incident reports from Karachi from January to June 2024. Associations with urgency were assessed using chi-square or Fisher's exact tests and logistic regression analysis. Reflexive thematic analysis of narrative fields was supplemented by face-to-face interviews with 20 selected reporters. Incidents were classified as urgent in 173/300 (57.7%) cases, and corrective action was required in 289/300 (96.3%) cases. Recurrence was most commonly coded as 20-40% (148/300, 49.3%). The most frequently coded diagnostic domains were pulp diseases (87/300, 29.0%), periodontal ligament diseases (85/300, 28.3%), and temporomandibular joint disorders (80/300, 26.7%). The leading contributing factors were a lack of diagnostic resources (142/300, 47.3%), lack of postgraduate training (119/300, 39.7%), and gaps in undergraduate teaching (103/300, 34.3%). Recurrence category showed the strongest association with urgency (p < 0.001). In multivariable logistic regression, urgent classification was less likely in private clinics (aOR 0.16, p = 0.013) and among male reporters (aOR 0.37, p < 0.001) and more likely in reports filed by senior faculty (aOR 2.48, p = 0.025); the 20-29 patients/week group also had higher adjusted odds of urgency (aOR 2.26, p = 0.023). Qualitative themes highlighted incomplete assessments, limited access to and interpretation of imaging, gaps in supervision and referral pathways, and communication failures. The registry demonstrates recurrent, high-urgency patterns linked to resource and training constraints and supports structured critical incident reporting as a practical tool for teaching triage, escalation, and safer diagnostic workflows for safer and more effective dental care. Not applicable.