Modified extrinsic tooth stain index and its clinical applicability

Aim

The first index for the assessment of extrinsic stain was published by Lobene in 1986. Using the Lobene stain index in the field is very cumbersome as well it does not meet the general requirement of an index, i.e., the index is to be simple, rapid, highly reproducible, and sensitive enough to detect small changes in the staining level. Hence, there was a need to develop an alternative index for the same purpose. Hence, the only present study was undertaken to propose a modified stain index with more simplicity and clarity.

Materials and Methods

An observational study was carried out among 16-44-year-old participants who had at least six natural teeth and were generally healthy. For the revised index, the criteria and codes for intensity were kept the same as MacPherson Index but the criteria for recording area were modified. The data scoring for each tooth was mentioned in the proposed table and was recorded for each of the surfaces according to the proposed area and intensity codes. Analysis was carried out using SPSS version 21 (IBM, Inc. Virginia, United States). Inferential statistics were performed using the Mann-Whitney U-test. Nonparametric tests were applied following the imposition of a numerical interval scale the same as the Lobene index.

Results

No statistically significant difference was appreciated for the area, intensity, and product of area × intensity when compared for measurements recorded by two indices as P > 0.05. Hence, validating the proposed index for the clinical application.

Conclusion

The proposed modified index may be advantageous over its conventional counterpart due to its ease of recording and concise scoring and also less complexity in the area to be recorded.

Modifiable and Non-modifiable Risk Factors Affecting Oral and Periodontal Health and Quality of Life in South Asia

Objectives:

The study aimed to review the prevalence of periodontal disease and associated factors among developing South Asian countries. The review was also aimed at providing an insight into how such factors play a role in affecting the Quality of life of patients with compromised oral health.

Background:

It has been observed that Oral health directly correlates with the Quality of life of an individual, so it is imperative to understand this, particularly in the developing parts of the world.

Methods:

A MeSH keyword search was carried out with the keywords: Periodontal diseases, Oral Health, Public Health, Asia, QoL, Quality of Life, Southeast Asia, Tobacco, and Risk Factors, and based on the findings, this detailed review was compiled.

Results:

The South Asian population forms 24.89% of the world population, while periodontal disease is an inflammatory condition that affects 11% of the globe. Several studies previously conducted across developing countries have shown that various factors like the socioeconomic status of an individual, smoking habit, consumption of alcohol, hypertension, history of diabetes, obesity, and stress are indirectly related to the onset of periodontal disease. Characteristics associated with specific populations like ethnicity, behavioral characteristics, and environmental factors may affect causing periodontitis.

Conclusion:

Dental practitioners in this region should consider risk factors that can be altered significantly to uplift the periodontal health status of an individual, which is not being considered in many developing countries.

Assessment of Knowledge, Attitude, and Practice Regarding Oral Cancer among Dental Graduates-A Web-Based Survey

The present study was conducted to assess the knowledge, attitude, and practice among new dental graduates across India. A web-based questionnaire was generated as a link through Google Drive which was sent to approximately 250 dental graduates using Whatsapp messenger. A total of 205 complete responses were received and analyzed. Frequency analysis was done using SPSS software version 21. Oral squamous cell carcinoma (OSCC) was identified as most common cancer by 48% of the subjects while the stage of oral cancer in which it is most often diagnosed was only responded correctly by 15.5% as advanced stage. Approximately one fourth (25.4%) of the participants performed dental examination to detect cancer routinely in all patients. Half of the study subjects were confident in detecting oral cancer, still majority (70.6%) of the subjects were interested in attending continuing education course on oral cancer in the future. This study revealed that the majority of the new dental clinicians were not having legitimate knowledge regarding oral cancer. Thus, this lacuna in knowledge and skills can be eliminated by conducting workshops and continuing education programs. This may subsequently aid to improve patient care.

Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review

This systematic review’s objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci’s classification system (n-16) and the four-digit system (n-6).

A Scanning Electron Microscopic Study on Effect of Blood and Artificial Salivary Contamination on Marginal Adaptation of Mineral Trioxide Aggregate, When Used as a Retrograde Filling Material: An In Vitro Study

Aim and objective

The present study was conducted to evaluate the marginal adaptability of mineral trioxide aggregate (MTA) as a root-end filling material when manipulated using two different IV fluids intended for pediatric usage; in the presence of blood and salivary contamination.

Materials and methods

Sixty single-rooted teeth were selected. Conventional endodontic root canal preparation was performed on all specimens followed by root-end resection and retrograde cavity preparation. The roots were randomly divided into two groups (n = 30). In the specimens of group I, fresh blood was used as a contaminant and in group II artificial saliva was used as a contaminant. In both groups, MTA (e-MTA, Kids-e-Dental®) manipulated using either Ringer's lactate IV fluid (n = 15) or Tetraspan IV fluid (n = 15) was used for root-end filling in blood or artificial saliva-coated retrocavities. Furthermore, these roots were placed in beakers pooled with fresh phlebotomized blood or artificial saliva. After incubating for 48 hours, the roots were divided longitudinally to expose the retrofilled cavities and were then sputter-coated with gold-platinum dust. To assess the marginal adaptation of MTA to radicular dentin "maximum gap width" and "gap perimeter" were measured in images obtained from scanning electron microscopy of root specimens. SPSS 21 was employed for statistical analysis at (p < 0.05). Mann-Whitney U test and ANOVA were used for analyzing the data obtained.

Results

The gap width was more among samples exposed to blood (p < 0.05) than artificial saliva. No significant difference was reported in the gap perimeter when cavities were filled with MTA mixed with either IV fluids (p > 0.05).

Conclusion

Exposure to blood during setting had a negative effect on gap width when retrocavities were filled with MTA using Tetraspan. No effect was seen on the arch perimeter in retrocavities filled with MTA mixed with Ringer's lactate or Tetraspan.

Clinical significance

For avoiding failure, it is critical to select a biocompatible root-end filling material with high sealing ability. Hence, by doing the same, the clinical situation can be simulated.

How to cite this article

Mody A, Arora R, Chauhan P, et al. A Scanning Electron Microscopic Study on Effect of Blood and Artificial Salivary Contamination on Marginal Adaptation of Mineral Trioxide Aggregate, When Used as a Retrograde Filling Material: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(5):674-680.

Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases

Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.

Adverse events occurring post-covid-19 vaccination among healthcare professionals - A mixed method study

BACKGROUND

Healthcare professionals (HCPs) are at the front line of the nation's fight against COVID-19 and are always at a greater risk of contracting contagious disease. But amidst the crisis, the vaccines were not accepted by all the HCPs due to adverse events occurring post-COVID-19 vaccination. Hence, the present study was designed to assess adverse events occurring among HCPs post-COVID-19 vaccination both quantitatively and qualitatively.

METHOD

Sequential mixed-method approach was employed. A cross-sectional E-survey was conducted among the healthcare professionals of a North Indian (*Statistically significant (p < 0.05)) college and hospital. The second phase included a semi-structured qualitative interview of the participants who were willing to participate.

RESULTS

Among all the HCPs with age groups ranging from 20 to 70 years, majority of them experienced pain at the site of injection (88.8-100%) followed by tiredness (87.7-60%) and body ache (86.6-40%) post-vaccination. There is an increased frequency of adverse events in females as compared to males. Qualitative findings are summarised in three major domains i.e vaccine adverse effects, fear and hesitancy for vaccines and vaccine acceptance.

CONCLUSION

Short term adverse events of COVISHIELD vaccine were very few and were mild in severity yet interviews showed hesitancy of study participants for vaccination.

Oral health indicators of oral health related quality of life among Indian elderly: A cross-sectional study

Aim

To assess the impact of tooth loss and periodontal status on oral health related quality of life among Indian elderly.

Methodology

This study was a cross-sectional study conducted among 1200 elderly subjects of Faridabad district of Haryana. Study subjects were selected by a combination of systematic, cluster and multistage sampling techniques. The data were collected through a clinical oral examination for tooth loss and periodontal status assessment (WHO Oral Health Survey 2013) and a self-administered questionnaire to assess the OHRQoL. Dental behaviours such as dental visiting patterns, tobacco chewing habits and oral hygiene practices were also recorded.

Results

In bivariate analysis significant associations were found among age, gender, education, tooth mobility and Oral health related quality of life (OHRQoL). Multivariate logistic regression showed significant impact of number of missing teeth and mobility on OHRQoL (P < 0.05).

Conclusion

The conclusions derived from this study are of considerable importance for Indian policy makers in their work with planning and implementing public oral health strategies for geriatric population.

Association of sense of coherence with oral health behaviors and gingival bleeding among adolescents

Context:

Adolescents experience many types of gingival and periodontal diseases, including gingivitis, localized or generalized aggressive periodontitis, and periodontal complications of various systemic diseases. The occurrence of periodontal diseases is not only related to biotic factors but may also be affected by nonbiotic factors such as oral health behaviors and practices. Various factors that influence an individual's health-related behaviors include a psychosocial construct named sense of coherence (SOC).

Aim:

The aim of this study is to investigate the association of SOC with oral health behaviors and gingival bleeding.

Settings and Design:

This was a cross-sectional, analytical study that was done in the school setting.

Materials and Methods:

A random sample of 850 adolescents was selected from nine schools of the Faridabad block of Faridabad district (Haryana) through the multistage cluster sampling technique. Methods of data collection included a combination of questionnaire administration and clinical examination. The questionnaire comprised sociodemographic variables, questions related to oral health behaviors, and Antonovsky's SOC scale. The questionnaire was interviewer administered.

Statistical Analysis:

Unadjusted and adjusted rate ratios of gingival units having bleeding on probing were estimated by Poisson regression multilevel analysis in Statistical Package for the Social Sciences (SPSS) software for Microsoft Office.

Results:

Adolescents whose mothers had studied <8 years (relative risk [RR] 1.26; 95% confidence interval [CI] 1.04–1.38), who were males (RR 1.198; 95% CI 1.01–1.29), low SOC (RR 15.93; 95% CI 13.06–19.35), and toothbrushing frequency of less than once a day (RR 1.43; 95% CI 1.21–1.67) and children with plaque index >1 (RR 2.765; 95% CI 2.12–3.25) presented with the higher number of gingival units having bleeding.

Conclusion:

SOC is associated with gingival bleeding through oral health behaviors.

Comparative assessment of low-level laser therapy (LLLT) vs. topical application of amlexanox + lidocaine to treat recurrent aphthous ulcers (RAUs): A randomized controlled trial

Background. The present study aimed to assess and compare the pain perception and ulcer sizes before and after applying low-level laser therapy (LLLT) and Amlexanox + lidocaine.

Methods. Twenty-six patients referring to the out-patient department of the institution and diagnosed with recurrent aphthous ulcers (RAU) were assigned to two groups to receive either LLLT or Amlexanox + lidocaine. In group 1, the patients were provided with amlexanox + lidocaine to apply topically four times daily. In group 2, the patients underwent LLLT with no tissue contact in inward circular motions for two cycles for 30 seconds. This study was registered in "the Clinical Trials Registry- India" (CTRI), with the registration number CTRI/2019/09/028222. The data were analyzed with SPSS 16.

Results. The intergroup comparison was performed using Mann-Whitney U test, and intragroup comparisons were made using Wilcoxon’s signed-rank test. The level of significance was set at P <0.05. The results showed that pain perception and ulcer size were significantly lower in group 2 subjects than group 1 subjects (P <0.05).

Conclusion. LLLT was more effective than amlexanox + lidocaine in the management of RAU. It is a cost-effective therapy for treating RAU.

Comparative Efficacy of Cow Milk, KNO3, and Warm Saline Rinses in Treating Dentin Hypersensitivity Following Nonsurgical Periodontal Treatment: A Randomized Controlled Trial

AIM

This study aimed to assess the desensitizing efficacy of commercially available cow milk compared to potassium nitrate (KNO₃) mouthwash and warm saline rinses after nonsurgical periodontal treatment.

MATERIALS AND METHODS

A randomized controlled trial was conducted in the Department of Public Health Dentistry of a dental college from August 21, 2018 to September 10, 2018. A total of 75 patients who reported hypersensitivity after scaling and root planing (SRP) were recruited and randomly assigned into three groups: cow milk (I), KNO₃ mouthwash (II), and warm saline rinses (III). Dentine hypersensitivity (DH) was assessed at six time points using the verbal rating scale (VRS) for thermal stimuli and visual analog scale (VAS) for air blast and thermal stimuli. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY). Mean reduction in DH in each group was measured using non-parametric tests.

RESULTS

Patients in all the three groups were found to be comparable with respect to baseline characteristics. Mean reduction in VRS and VAS scores for DH in milk and KNO₃ mouthwash was found to be significantly high as compared to warm saline rinses group.

CONCLUSION

From the results, cow milk was found to be equivalent in efficacy as compared with KNO₃ mouthwash but superior to warm saline rinses in treating DH post-SRP.

Gender-wise comparison of oral health-related quality of life and its relationship with periodontal status among the Indian elderly

Aim:

The aim of this study is to assess if there are any gender differences in oral health-related quality of life (OHRQoL) and periodontal status among the elderly population of Haryana.

Materials and Methods:

A cross-sectional study was conducted among 1200 geriatric population of Faridabad district of Haryana. Subjects were selected by a combination of systematic, cluster, and multistage sampling techniques. Primary, secondary, and tertiary sampling units were chosen as wards, areas, and households, respectively.

Self-Administered Questionnaire:

Geriatric oral health assessment index was used to assess the OHRQoL among males and females. Periodontal status was assessed using the World Health Organization oral health survey pro forma with some modifications.

Results:

Results were analyzed using the Statistical Package for the Social Sciences 21 software. Gender-wise association of periodontal status with OHRQoL revealed a significant association with mobile teeth (P < 0.05). No relation was seen between OHRQoL, gingival bleeding, periodontal pocket, and loss of attachment (P > 0.05).

Conclusion:

No significant differences were observed in periodontal status among males and females, but OHRQoL was found to be better among males than females. Indian policymakers can use the conclusion derived from this study for planning and implementing public oral health strategies for the geriatric population.

Assessment of Oral Health Related Quality of Life Among the Institutionalised Elderly in Delhi, India

PURPOSE

To assess the oral health related quality of life (OHRQoL) among older people residing in old-age homes in Delhi, India.

MATERIALS AND METHODS

Oral health related quality of life was measured by using the Hindi version of Geriatric Oral Health Assessment Index (GOHAI) which was tested for its reliability and validity. Sociodemographic data were collected and questions regarding the self-perception of general health, oral health and perceived need for dental treatment were put forward. Clinical assessment was also performed.

RESULTS

The mean additive-GOHAI score of the study population was found to be 41.57 ± 6.07. Statistically significant associations were found between GOHAI and perceived measures. GOHAI scores decreased with a decrease in the number of teeth present and a decrease in the number of teeth having coronal and root caries. Those subjects who were in need of multi-unit prostheses or full prostheses had significantly poorer OHRQoL compared to those without any prosthetic need or need of single-unit prostheses.

CONCLUSION

This study revealed the extent of dental problems in old-age home residents and may help to plan appropriate preventive measures.

Efficacy of Chlorhexidine, Xylitol, and Chlorhexidine + Xylitol against Dental Plaque, Gingivitis, and Salivary Streptococcus mutans Load: A Randomised Controlled Trial

PURPOSE

To compare the antiplaque, antigingivitis and antibacterial efficacy of chlorhexidine (CHX), XYL and a mouthwash combining CHX and XYL against Streptococcus mutans (S. mutans).

MATERIALS AND METHODS

A parallel design, randomised controlled trial was conducted among 75 dental students. Participants were randomised into CHX, CHX+XYL and XYL-only groups using the lottery method. Subjects were instructed to use 10 ml of the provided mouthwash for 15 s twice daily for 3 weeks. All the outcome measures, gingival index (GI), plaque index (PI) and number of salivary S. mutans CFU were recorded at baseline and 3 weeks post intervention. Nonparametric tests were used for inferential statistics.

RESULTS

All outcome variables (GI, PI scores and log10 salivary S. mutans counts) decreased significantly from baseline compared to post intervention among all three groups. Intergroup comparison demonstrated that reduction in GI was not significantly different among the three groups. The decrease in PI scores was found to be significantly higher in the XYL group, while the decrease in the log10 salivary S. mutans count was significantly higher in the CHX+XYL group.

CONCLUSION

The present study provided sufficient data to suggest that all the three mouthwashes are effective against plaque, gingivitis and S. mutans load in saliva. Further investigations should be carried out to confirm the results and develop strategies for using such products to prevent tooth decay.

A Review of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and Enamel Remineralization

White-spot lesions are the earliest macroscopic evidence of enamel caries. In such a situation, the enamel surface layer stays intact during subsurface demineralization, but without treatment the subsurface loss will continue, and eventually the surface layer will collapse and lead to a cavity formation. By introducing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) at this stage the lesion can be reversed. CPP-ACP is a unique, naturally derived protein-based remineralizing technology that is now used globally in chewing gums and topical creams. The aim of this review is to expound on the potential for reversal of demineralization through the use of products such as CPP-ACP, and to provide guidance to clinicians considering remineralization as a viable treatment option.

Study on relationship between the nutritional status and dental caries in 8-12 year old children of Udaipur City, India

BACKGROUND

The future health of individuals depends on the well being of the children of today. Proper nutrition for children is very important. The most commonly used index of obesity and over weight is Body Mass Index. The growth of children should be monitored using the Body Mass Index (BMI) and risk factors assessed through a dietary and physical activity history. The increase in obesity is attributed to increased carbohydrate consumption among children. Obesity and caries are both diet-based conditions that share a cause that is, excessive ingestion of fermentable carbohydrates.

OBJECTIVE

This study was undertaken to determine the association of nutritional status with dental caries in 8 to 12 year old children of Udaipur city.

METHOD

The present study was conducted on a random sample of 1000 boys and girls, aged 8-12 years. The children were selected from schools located in the Udaipur City, Rajasthan. The schools examined were of government and private sector schools in Udaipur city. The children from schools of Udaipur city was taken in the study with male, female and age group ratio as per distribution in population. A proforma was used to record children's age, gender, school, year, height, weight, parental income and dental caries status. Statistical analysis was done using Statistical Package of Social Science (SPSS Version 15; Chicago Inc., USA).

RESULT

It was found that caries free individuals were more from normal nutritional status group with 134 (13.4 %) subjects where as only 11 (1.1 %) of subjects obese children were found caries free.

CONCLUSION

Study shows that the children with normal BMI for age had more caries in their primary teeth, as well as in their permanent teeth, than the overweight children.

Periodontal status and oral health-related quality of life in elderly residents of aged care homes in Delhi

AIM

The aim of the present study was to explore the associations between clinical periodontal findings and oral health-related quality of life in elderly people residing in the aged care homes of Delhi, India.

METHODS

A cross-sectional study was carried out among 500 residents of aged care homes across Delhi. Data were collected by carrying out clinical oral examinations and by filling a self-administered questionnaire. Oral health-related quality of life was assessed by a pretested Hindi version of the Geriatric Oral Health Assessment Index (GOHAI-Hi). Periodontal status was assessed using the Community Periodontal Index - CPI, and loss of attachment and tooth mobility was assessed using a modified Miller's index.

RESULTS

Of a total of 500 participants, 221 (44.20%) were men and 279 (55.80%) were women The mean additive score GOHAI score was 41.57 ± 6.07 and the mean number of negative impacts or mean simple count GOHAI score was 6.27 ± 1.54. Mean GOHAI scores were significantly higher among men than women, and were found to be decreasing continuously with the increasing age categories. Tooth mobility and loss of attachment scores were found to be significantly associated with oral health-related quality of life, whereas Community Periodontal Index scores showed a negative correlation with it.

CONCLUSION

The geriatric population, especially those in aged care homes, is a special need group because of their inability to access dental care rather than some particular feature of their oral or general health The findings of the present study point to a need to improve access to oral healthcare for this elderly population.

Cross sectional survey on association between alcohol, betel- nut, cigarette consumption and health promoting behavior of industrial workers in Ghaziabad

BACKGROUND

The work force in industries are at risk of developing unduly high rates of health and behaviour related problems including abuse of alcohol, betel nut and cigarette (alcohol, betel nut and cigarette consumption). This study describes the relationships between alcohol, betel nut and cigarette consumption and health promoting behaviour among industrial workers.

MATERIALS AND METHODS

A cross sectional survey was conducted on workers in various industries of Ghaziabad city with concerned authority permission. A sample size of 732 workers was calculated based on pilot study. Through Simple random sampling 732 workers in 20 to 50 years age group with informed consent were interviewed through structured, pretested, validated questionnaire in vernacular language by one calibrated investigator. Data on socio demography, alcohol, betel nut and cigarette consumption pattern and health behaviour were collected. The association between health promoting behaviour and alcohol, betel nut and cigarette consumption was analysed by Logistic regression and Chi-square test through SPSS 16 at p<0.05 and 95%CI as significant.

RESULTS

Total prevalence of alcohol, betel nut and cigarette consumption in study population was 88%. The prevalence of individual alcohol, betel nut and cigarette consumption were 82%, 68% and 79% respectively. Combined alcohol, betel nut and cigarette prevalence in study population was 58%. Alcohol and cigarette users were significantly higher (p<0.001) in 30 to 40 years age group with lower level of education having poor attitude towards health promoting behaviour, poor oral hygiene practices and rare indulgence in regular physical exercise.

CONCLUSIONS

This study stimulate further research on exploring methods to prevent initiation of health risk behaviour and promote healthy behaviour with cessation help for the current alcohol, betel nut and cigarette users.

Knowledge and attitude of Indian clinical dental students towards the dental treatment of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS)

OBJECTIVES

Oral health care of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS) is a growing area of concern. Information on HIV- and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS. The purpose of this study was to assess the knowledge and attitude of Indian clinical dental students towards the treatment of patients with HIV/AIDS and perceived sources of information regarding HIV-related issues.

MATERIALS AND METHODS

Data were collected from clinical dental students (third year, fourth year and internship) from three dental institutions in Delhi National Capital Region (NCR). The questions assessed the knowledge and attitude towards treatment of patients with HIV and the perceived source of information related to HIV.

RESULTS

The willingness to treat HIV-positive patients among dental students was 67.0%, and 74.20% were confident of treating a patient with HIV/AIDS. The potential problems in rendering treatment to these patients were effect on the attitude of other patients (49.90%) and staff fears (52.50%). The correct knowledge regarding the infection-control practice (barrier technique) was found among only 15.50% of respondents. The respondents had sufficient knowledge regarding the oral manifestations of HIV/AIDS.

CONCLUSIONS

There was no correlation between the knowledge and attitude score, demonstrating a gap between knowledge and attitude among dental students regarding treatment of HIV-infected patients. Appropriate knowledge has to be delivered through the dental education curriculum, which can instil confidence in students about their ability to manage HIV-positive patients.

Estimation of stature in a young adult indian population using the Carrea's index

The stature or height of an individual is useful for assisting in forensic identifications. Teeth can act as a valuable tool for stature estimation when only the skull is available. Carrea's index estimates the stature of a person from the dimensions of lower anterior teeth. The aim of this study was to assess the reliability of the Carrea's index in an Indian population. Data was collected from plaster models of 125 undergraduate students for examination. Each hemiarch was considered separately equaling 250 inferior hemi-arches, which were divided according to the dental alignment into normal, crowded and diastema and the measurements (Arch and Chord) were made with a 'divider caliper'. A statistically significant difference between the types of dental arch was obtained for both males and females with regards to the different dental alignments; where normal dentition (94.03%) obtained the highest success rates for males and crowded dentition (87.87%) for females. Statistically significant differences were also found between the types of arches for both right and left side (p < 0.001; p=0.004). The presence of diastema reduced the success rates when compared in terms of both sex and side of the arch. It was concluded that the Carrea ́s index is a reliable method for height estimation in arches with normal and crowded dentitions, useful for both sexes, and for both right and left side of the arch. However, the method was not reliable for hemiarches with a diastema.

Usage of betel quid, areca nut, tobacco, alcohol and level of awareness towards their adverse effects on health in a north Indian rural population

AIM

To assess the overall prevalence of betel quid, areca nut, tobacco and alcohol use in the rural population of Muradnagar tehsil of Ghaziabad district and their awareness level towards adverse effects of these habits on general as well as oral health.

METHODS

A total of 422 persons from 63 households of four (4) villages were enrolled for the participation in the study. A preformed, pretested questionnaire was used to collect the information on prevalence of risk behaviours of chewing tobacco, areca nut, betel quid, smoking and alcohol consumption.

RESULTS

72.5% of respondents reported indulgence in one or more habits of chewing areca nut, betel quid, tobacco, smoking and alcohol consumption. Smoking tobacco was the most common type of adverse habit in males while chewing tobacco in females. 26% of respondents believed that the community residents would quit the habit only if they personally experience any health problem due to the habit.

CONCLUSION

In spite of being aware of risk of having multiple health problems, a major proportion of respondents were using betel quid, areca nut, tobacco and alcohol.

Internet usage among dental students in north India

The study was conducted to investigate the extent to which students of two dental schools in northern India make use of internet during their undergraduate course and to assess their attitude towards the internet in general. All undergraduate students were assessed using a specially designed, self-administered questionnaire. Overall, 470 (88.84%) students used the internet. Among the internet users, only 207 (44%) accessed it for academic purposes. Also, 356 (75.7%) found information about dentistry easily accessible, whereas 114 (24.3%) reported difficulty in doing so. The study showed that a good number of Indian dental students are using internet, but they are lagging behind their counterparts in the western world.

Fluoride concentration in community water and bottled drinking water: a dilemma today

BACKGROUND

Because of the potential for contamination of municipal water supplies, people appear to be turning to alternative sources for their pure drinking water.

OBJECTIVES

The present study analyzed the fluoride concentration in community water and bottled drinking water sold in Faridabad city.

METHODS

A comparative evaluation of fluoride content in community water supply and bottled drinking water was done using ion-selective electrode method. The community water samples were collected from six different areas (i.e. north zone, south zone, east zone, west zone and central zone) in the city from public health water supply taps while bottled drinking water samples were randomly picked from grocery shops or supermarkets.

RESULTS

The fluoride concentration in the community water supply in this study ranges from 0.11 to 0.26 mg/L with mean fluoride concentration of 0.17 mg/L. The mean concentration of fluoride in bottled drinking water was 0.06 mg/L. The differences observed between mean of two water samples was statistically significant.

CONCLUSION

The results obtained from the present study clearly state that the fluoride concentration was insufficient in community water supply from all the areas and also was deficient in bottled drinking water sold in Faridabad city. So, Alternative sources of fluorides should be supplemented for optimal dental benefits from the use of fluoride.

Tobacco consumption among 12- to 15-year-old schoolchildren in Delhi

OBJECTIVE

This study aims to assess the knowledge, attitude, and practice of tobacco use and its cessation among children in schools of Delhi.

METHODS

A cross-sectional study involving 1094 schoolchildren (577 boys and 517 girls), 12-15 years old, was conducted using the modified Global Youth Tobacco Survey questionnaire. Mann-Whitney U-test and Kruskal-Wallis test were applied (p<0.05).

RESULTS

Among these, 132 boys (22.87%) and 120 girls (23.21%) were smokers. "Ever smokers" were 13.80% and "current smokers" were 9.23%, whereas 76.97% were "never smokers".

CONCLUSION

Interventions that raise awareness at a young age, equip students to overcome peer influence, and provide counseling to quit using tobacco need to be designed.

Exposure to high-fluoride drinking water and risk of dental caries and dental fluorosis in Haryana, India

The present study aimed to determine the prevalence of and relationship between dental caries and dental fluorosis at varying levels of fluoride in drinking water. The study was conducted among 3007 school children in the age group of 12 to 16 years in 2 districts of Haryana having varying fluoride levels in drinking water. Type III examination for dental caries according to the WHO index and dental fluorosis estimation according to Dean's index was done. The prevalence of dental caries decreased from 48.02% to 28.07% as fluoride levels increased from 0.5 to 1.13 ppm, but as the fluoride level increased further to 1.51 ppm, there was no further reduction in caries prevalence, but there was a substantial increase in fluorosis prevalence. The optimum level of fluoride in drinking water was found to be 1.13 ppm, at which there was maximum caries reduction with minimum amount of esthetically objectionable fluorosis.

Preventing dental caries in children: Indian scenario

The prevalence of dental caries in developing countries like India is increasing to an alarming level in contrast to developed countries where it has decreased because of variety of preventive measures at the community and individual level. There is no State or Centre funded programs for prevention of dental diseases in India. The present review enlists the targeted prevention of dental caries in permanent teeth of 6 to 16 years old children presenting for dental care.

Mucosal fixed drug eruption in a patient treated with ornidazole

BACKGROUND

Therapeutic drugs have been observed to cause a wide spectrum of adverse oral effects such as dry mouth, gingival enlargement, taste disturbance, oral mucosal ulceration, halitosis, etc.

OBSERVATIONS

A rare case of intra-oral fixed drug eruption (FDE) induced by ornidazole presenting on the hard palate, an extremely rare site for FDE, in a 40-year-old male is reported.

CONCLUSIONS

Ornidazole is a relatively newer 5-nitroimidazole derivative commonly prescribed for Amoebic dysentery in developing countries. FDE is a rare adverse drug effect characterized by onset of round/oval, erythematous macules on the skin or mucosa that can be associated with itching and burning sensation. The exact mechanism causing FDE is unknown.

Dental anxiety among patients visiting a dental institute in Faridabad, India

Despite advances in dentistry, anxiety about dental treatment and the fear of pain remains widespread among patients and is a significant barrier to dental treatment. This study would therefore provide information so as to minimize levels of anxiety and aid in planning stress-free treatment. The cross-sectional study utilizing a self-reported questionnaire based on Modified Corah's Dental Anxiety Scale (MDAS) framed in Hindi (local language) was performed on 1032 patients (aged 14-68 years). Around 1004 questionnaires were returned (response rate--97.3%). Overall, prevalence of dental anxiety was high (50.2%), but severe anxiety (phobia) was low (4.38%). The prevalence of anxiety was seen mostly in the 20-30-year age group (37.3%). Anxiety was also seen to be significantly higher in females (mean - 11.79) than in males [mean - 9.47] (p < 0.0000). Patients anxious about dental procedures are often more difficult to treat. Anxious patients should be identified and managed appropriately by behavioural/pharmacological measures.

Mandibular midline supernumerary tooth associated with agenesis of permanent central incisors: a diagnostic conundrum

Concomitant hypo-hyperdontia is a rare mixed numeric anomalous condition. The presence of this condition in the same area of dental arch and specifically in the mandibular anterior region is reported very infrequently. This case report presents a case of 20 years old male with congenitally missing permanent mandibular central incisors in conjunction with a mandibular midline supernumerary tooth. Only 3 cases have been documented in English literature till date. The article focuses on the review of mandibular mesiodens and the clarity regarding the usage of the terminology "mesiodens".

Estimation of dental age and its comparison with chronological age: accuracy of two radiographic methods

INTRODUCTION

Accurate age data are always necessary in medicine and dentistry, and are also important to assess maturity and estimate age in a number of disciplines, such as forensic odontology, paediatric and preventive dentistry, orthodontics, etc.

AIM

This investigation determines the accuracy of dental age estimation and its comparison with chronological age by two methods: Demirjian's and Willems'.

MATERIALS AND METHODS

Tooth development was assessed in seven left mandibular teeth from 215 orthopantomograms (OPGs) belonging to healthy children aged 6-15 years selected by convenience sampling, from patients of the Sudha Rustagi College of Dental Sciences & Research, Faridabad, and were staged according to Demirjian's and Willems' scales. The statistical analysis was performed using the unpaired 't'-test and the correlation was analysed using Karl Pearson's correlation coefficients test.

RESULTS

Overall, Willems' method was found to be more accurate with a mean age overestimation of 0.36 years (SD = 0.38) in boys and 0.24 years (SD = 0.36) in girls, and Demirjian's method produced a mean overestimation of 0.66 years (SD = 0.41) in boys and 0.56 years (SD = 0.43) in girls, respectively. Also, correlation between the two methods revealed a high coefficient value, 0.9947 for boys and 0.9944 for girls (P < 0.05).

CONCLUSION

Despite the favourable result of Willems' method in comparison with Demirjian's method, this study demonstrated a high correlation coefficient between both chronological and obtained dental age, thus confirming their potential applicability in clinical practice and forensic dentistry.

Current status of disinfection of dental impressions in Indian dental colleges: a cause of concern

INTRODUCTION

Dentistry is predominantly a field of surgery, involving exposure to blood and other potentially infectious materials and therefore requires a high standard of infection control and safety practice in controlling cross-contamination and occupational exposures to blood- and saliva-borne diseases.

METHODOLOGY

A questionnaire survey was conducted in 60 dental colleges throughout India to establish routine methods of treating impressions of the oral cavity for disinfection. An email describing the purpose of the study along with a short questionnaire was sent to one of the teaching faculty of concerned departments of the colleges. Questions were asked regarding availability of materials required to disinfect the impressions, the preferred method to treat the impression, and whether postgraduate courses were offered by the department.

RESULTS

The routine method of treating the impression reported by 75.9% of the respondents was washing under running water, while 24.1% of the respondents reported that impressions were treated by chemical disinfectants.

CONCLUSION

Strict infection control measures are necessary to ensure the health and safety of dental workers and patients. The present study showed that there is a lack of commitment to high standards of infection control practices in dental colleges in India.

A rare case of dens evaginatus and dens invaginatus in the same tooth, with a review of treatment options

Dens evaginatus (DE) and dens invaginatus (DI) are rare developmental anomalies of tooth formation. These variations in odontogenesis have been individually observed and reported in the literature. This report describes the radiographic appearance and management of a 16-year-old boy who came to the clinic with a rare occurrence of both DE and DI in the same tooth and examines the criteria used in identifying and classifying such anomalies. This report also discusses the importance of early identification and efficient management of dental anomalies, which can prevent irreversible pulpal pathology that requires endodontic therapy or tooth loss.

Rheumatoid arthritis: a review and dental care considerations

Rheumatoid arthritis (RA), is a chronic multisystem disease of presumed autoimmune etiology. Medical complications due to RA and its treatment may affect the provision of oral health care. Associated syndromes may contribute to a patient's susceptibility to infections and impaired hemostasis. Therefore oral health care providers need to recognize and identify modificationsof dental care based on the medical status of patients with RA. As with many other chronic conditions, early intervention can reduce the severity of the disease. Furthermore, oral health care providers play an important role in the overall care of these patients as it relates to early recognition, as well as control of the disease.

Childhood bruxism: a clinical review and case report

The present case report refers to a patient who reported to the department with the complaint of teeth grinding (Bruxism). A brief review of the literature is reported concerning the aetiology, clinical diagnosis and the therapeutic approach of the disease.

Prevalence of Periodontal Diseases in India

Periodontal diseases, dental caries, malocclusion and oral cancer are among the most prevalent dental diseases affecting people worldwide as well as in Indian community. There is no national oral health data bank in India which reflects the prevalence of different oral diseases and risk factors responsible for them. No national oral health survey has been conducted in the country till date. Prevalence of disease is the key factor for effective and sound oral health care planning. Some cross sectional surveys has been conducted in various regions of the country at local level but those observations cannot be generalized for the whole community because of the great diversity in composition of Indian populations e.g. literacy rate in Kerala is more than 90% and in Bihar it is about 40%. Males are more literate than females. 70% of the population in India continues to live in rural areas. Different cross sectional surveys or studies showing prevalence of periodontal diseases mainly in the last twenty years have been collected from different sources and compiled in this article to give a comprehensive outlook of the present status and scenario of periodontal diseases in different population of Indian community.

Familial occurrence of mesiodentes with unusual findings: case reports

Supernumerary teeth are common and can occur throughout the oral cavity. Molariform supernumerary teeth in the maxillary central incisor area have rarely been reported. This article reports the presence of mesiodentes in two siblings, one of whom exhibited an unusual molariform mesiodens. The clinical and radiographic appearance of the anomalies and treatment modalities are discussed.