Development, validation, and usability testing of prototype mobile application for oral health promotion during pregnancy in India

Background

Oral diseases are a silent epidemic.

Objectives

The objectives of the study were to develop, validate, and assess the usability of an oral health prototype mobile application for oral health promotion among pregnant women in India.

Materials and Methods

A cross-sectional study was conducted in Tertiary Care Hospital in Delhi, India, after obtaining Ethical Clearance from the Institutional Ethical Committee Board. The study was conducted in three phases: development of the prototype app, its validation, followed by usability testing of the app. Mobile app was validated by 30 pregnant women and 30 subject experts using Heuristic Analysis Scale and usability testing by 30 pregnant women based on System Usability Scale (SUS). Data were analyzed with IBM SPSS version 21.0.

Results

Majority (over 90%) of pregnant women and subject experts strongly acknowledged that the app educated the users using positive motivation strategies, instilling comprehensive knowledge and faced no issues with the appropriate functionality of the app. The prototype app scored 73.75 on SUS, indicating high usability.

Conclusion

This study holistically explored various dimensions of oral health care in pregnant women. Its novelty is proven by the fact that the content of the prototype application has been phase wise developed and validated by pregnant women and subject experts. Usability testing of the app indicated its high acceptability and ease of use among pregnant women in India.

Health technology assessment for oral health in the past decade: a scoping review

BACKGROUND

Health technology assessment (HTA) is the systematic evaluation of various properties and effects of a health technology. HTA can serve as a bridge between the world of knowledge and that of decision making, offering decision makers the best summary of scientific evidence. Scoping HTA reports in the context of dentistry can help researchers identify grey areas; help practitioners make evidence-based decisions and further initiate better policy making.

AIM

To provide an overview on HTAs pertaining to oral health and dentistry in the past decade, map the extension and scope of the methodological practices, key findings, and limitations.

METHODOLOGY

A scoping review was conducted using the Joanna Briggs Institute framework. A comprehensive search for HTA reports was done through the International Network of Agencies for Health Technology Assessment Database from January 2010 to December 2020. Consecutively, electronic databases (PubMed and Google Scholar) were searched. Finally, thirty-six reports were included in this review and analyzed.

RESULTS

A total of 709 articles were initially identified, of which thirty-six met the inclusion criteria. Reviewed HTAs focused on various specialties of dentistry worldwide. Maximum number of reports (N = 5) were related to "prosthodontics and dental implants" and technologies related to preventive dentistry were most commonly assessed (N = 4).

CONCLUSION

Functional, appropriate, and evidence-based information provided through HTA pertaining to oral health on a regular basis will enable decision makers to have enough data to make decisions on the future use of new technology, modify existing policies, accelerate its translation into practice, and ensure provision of robust dental healthcare services.

Self-Perceived Halitosis and Related Factors Among the Mask-Wearing Population During the COVID-19 Pandemic in Delhi, India: A Cross-Sectional Study

Introduction Halitosis (oral malodor) is a common health condition throughout the world. In India, data on self-reported halitosis and related factors is limited. Mouth mask usage has been made compulsory after the coronavirus disease 2019 (COVID-19) pandemic. This could possibly alter oral microflora and environment and contribute to halitosis. The aim of the study was to determine the prevalence of self-perceived halitosis (SPH) among mask-wearing patients visiting a tertiary care dental hospital in Delhi, India. Methods A cross‑sectional study was conducted among a convenience sample of 300 patients visiting a tertiary care dental hospital in the capital of India. SPH status was measured using a self-designed and structured questionnaire containing socio-demographic factors, mask-related habits, and self-perceived oral health status. Statistical analysis was done using Jamovi software (The jamovi project, Sydney, Australia) version 1.8. Descriptive analysis followed by a chi-square test and a multivariate logistic regression test was applied. Results Bad breath was perceived by 86 study subjects. Of the participants, 16.7% felt that they had bad breath before the pandemic, and 38% of the participants had an increased perception or feeling of bad breath since regular mask usage. Of the participants, 42.7% felt that they had an increased feeling of dryness in the mouth post-pandemic. SPH status was associated with mask usage frequency (p<0.001), change (p<0.001) and type of mask (p=0.004), increased feeling of dryness (p<0.001), frequency of toothbrushing (p<0.001), self-reported oral disease (p=0.007), and dental treatment in the past 12 months (p=0.005). Conclusion The SPH status of the study population was associated with mask-related habits and self-reported oral health status. The findings highlight the importance of possible amendments in preventive and curative care for patients with halitosis post-COVID-19 pandemic.

Feasibility of the novel 'Tobacco-Free Hospital' model and its compliance assessment at a tertiary care hospital of New Delhi, India

BACKGROUND

Tobacco is one of the biggest threats to the public health. Tobacco harms not only human health but also the environment. The Cigarette and Other Tobacco Products Act (COTPA) was implemented in India in 2003. Compliance of these laws in public places is mandatory. This study presents an innovative model to make hospitals tobacco-free. The aim is to assess the effectiveness of implementation of tobacco-free hospitals among security guards, tobacco users, and key observers visiting a tertiary care dental hospital through a comprehensive strategy.

MATERIALS AND METHODS

An exploratory study was conducted in three phases. Structured training was organized for all security guards (n = 25) along with pre- and post-assessment using a validated questionnaire. All the patients and attendants entering the hospital were screened for tobacco products by security guards. Those patients who were carrying tobacco products to the hospital (n = 107) were interviewed using a validated questionnaire. Opinions of key observers (n = 223) who witnessed the event were also recorded. Descriptive statistics (means, frequency distribution) and inferential statistics (Chi-square test) were calculated.

RESULTS

At the baseline, only 20% security guards were aware about tobacco legislations, whereas after 1 month, more than 80% security guards were aware about the laws. Around two-third of study participants of both the groups were aware of COTPA Section 4. Approximately 33.6% of tobacco users and 58.4% of key observers were aware of COTPA Section 6b. Forty tobacco users in the study availed tobacco cessation services of the hospital.

CONCLUSION

Every staff should be a torch bearer of tobacco control. The study highlights a comprehensive approach of integrating hospital staff and linking vital cessation services by implementing Sections of COTPA.

Development and Validation of a Comic Tool: An Innovative Approach to Raise Awareness about Tobacco Control among School Teachers

Background

National legislation (COTPA) in India has focused on school children with dedicated section (6a and 6b) for tobacco control at Educational Institutions. Innovative mediums like Comic offer unique and engaging medium for dissemination of health information. However, its true potential remains unexplored in tobacco control. The study was conducted to develop and validate Comic for promotion of tobacco control laws in school settings.

Materials and Methods

The present cross-sectional study was conducted among school teachers in Delhi in three phases: (1) need assessment, (2) development of Comic, and (3) validation (face/content validity by experts in public health/tobacco control, and construct validity by school teachers). Ethical clearance was obtained from Institutional Ethical Review Board. Prevalidated, structured, close-ended, and self-administered Questionnaire was used for the data collection. SPSS version 21 was used for descriptive and inferential results.

Results

Phase 1 showed, out of 150 school teachers, 121 participated (80.66%). Mean age and teaching experience was 41.85 ± 9.76 years and 10.35 ± 6.53 years, respectively. Overall awareness about COTPA was 47.9% (n = 58) and COTPA sections 4 and 6 were 37.2% (n = 45). Majority 59.5% (n = 72) reported lack of access to training material. Phase 2 and 3 showed overall content validity index (CVI) score of 0.84. Construct validity evaluation from pre-postintervention yield mean ± SD scores of 3.94 ± 0.99 and 7.97 ± 1.17, respectively, (P < 0.001).

Conclusion

Comic was developed on sound theoretical basis with satisfactory face, content and construct validity, to raise awareness about tobacco control among school children, and teachers to promote tobacco-free school.

Role of Digital Media in Promoting Oral Health: A Systematic Review

Oral disease has affected almost half of the world’s population, causing an enormous economic burden. To overcome this huge problem, oral health promotion is one of the most cost-effective methods. Digital media can play a pivotal role in achieving the goal of reducing this burden by providing a wider platform to reach out to the population even in the areas of deficit oral health care service.

The aim of this systematic review is to assess the effectiveness of digital media in oral health promotion.

The combinations of terms in the following two broad categories were used to search the literature on PubMed, Cochrane Library articles, WHO guidelines on oral health promotion through digital media, and Google Scholar: Intervention (digital media, Mobile phones, Text messages, social media, Cell phones, MHealth application, Telemedicine, Television, Videos) and Outcome (Oral Health education, Oral health, Oral health promotion, Oral health literacy, Oral health knowledge, Oral health attitude, Oral health practice, Oral hygiene improvement). The review was conducted in two phases, using the standardized checklist applicable to studies. Initially, abstracts were retrieved, followed by the assessment of the full papers against the review criteria.

Among the selected studies, digital interventions helped in providing continuity of care and services in seven studies, eight addressed the increase in knowledge, attitude, and practice, and all the studies analyzed oral health needs.

The findings concluded that digital media-based interventions can enhance oral health literacy and help in tackling this problem among different age groups.

Infodemiology for oral health and disease: A scoping review

INTRODUCTION

Increasing affordability, accessibility and penetration of internet services worldwide, have substantially changed the ways of gathering health-related information. This has led to the origin of concept infodemiology that allows the information to be collected and analysed in near real time. Globally, oral diseases affect nearly 3.5 billion people; thus, volume and profile of oral health searches would help in understanding specific community dental needs and formulation of pertinent oral health strategies.

AIM

To review the published literature on infodemiological aspects of oral health and disease.

METHODOLOGY

This scoping review was conducted in accordance with PRISMA-ScR guidelines. Electronic search engines (Google Scholar) and databases (PubMed, Web of science, Scopus) were searched from 2002 onwards.

RESULTS

Thirty-eight articles were included in this review. The infodemiological studies for oral health and disease were mainly used in two domains. Out of 38 articles, 24 accessed the quality of available online information and 15 studied online oral health-related information seeking behaviour.

CONCLUSION

The most commonly searched oral diseases were toothache, oral cancer, dental caries, periodontal disease, oral maxillofacial surgical procedures and paediatric oral diseases. Most of the studies belonged to developed countries and Google was the most researched search engine.

Primary Health Care Workforce in Southeast Asia Region, Existing Status and Strategies for Non-Communicable Diseases and Oral Health Alliance: A Scoping Review

Oral diseases and non-communicable diseases (NCD) share modifiable risk factors and common social determinants, thus creating new opportunities for improving oral health. The existing primary health care workers can play an integral role in NCD and oral health care integration by creating awareness, promoting oral health, controlling risk factors, and referring for timely dental care. This study aimed to identify and understand the roles of the existed human health resources working at primary health care and develop strategies to build on a unified NCD and oral health alliance human resources at this level.

A scoping review was conducted to identify the primary health workforce in the Southeast Asia region, their roles and responsibility, and integration in oral health care. Various databases like NCBI (PubMed), Google Scholar, World Health Organisation (WHO)-Southeast Asia region (SEAR), Ministry of Health and Family Welfare websites in SEAR were comprehensively searched from January 1980 to December 2020 for reports, reviews, and original research. The keywords used were “primary health care workers,” “community health care workers,” “primary oral health care in SEAR,” etc. Only full-text articles in English language and reports available in Ministry of Health and Family Welfare (MOHFW) sites of SEAR were included in the study.

Information was taken from 39 full-text articles, six WHO reports, and two reports from Ministry of Health sites of SEAR. Primary health workers (PHW) are known by multiple names in different countries of Southeast Asia. They share various common roles and responsibilities. There are many opportunities for the prevention and control of oral diseases in the SEAR. Basic systems and human resources for the control of NCD are in place in many countries. Oral health can be integrated with NCD programs and policies to reduce the burden of diseases.

Effectiveness of two tobacco cessation methods among TB patients

BACKGROUND: Tobacco and TB are the world´s two greatest public health problems. Exposure to tobacco has been shown to be associated with higher risk of acquiring TB and adverse outcomes such as relapse and TB mortality.OBJECTIVE: To assess and compare self-reported tobacco quit status and biochemically verified cotinine levels among TB patients at different time intervals among two study groups.METHODS: A cluster, randomised controlled trial was conducted on TB patients attending DOTS centres in Delhi, India, who reported using tobacco in any form. Participants were assigned into one of two treatment groups. Centres were randomly assigned to two intervention groups: 1) integrated intervention using behavioural counselling with nicotine replacement therapy (NRT) gum, and 2) intervention using behavioural counselling alone (50 each in intervention and control group). The subjects were followed at Week 1, Month 1, Month 3 and Month 6 for tobacco cessation.RESULTS: At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting tobacco than those who received the conventional TB treatment alone (78.7% vs. 57.8%; P < 0.03).CONCLUSION: DOTS with tobacco use dependence treatment was successful in our study in helping TB patients to quit tobacco dependence and should therefore be offered to every tobacco user.

Stakeholder perspectives on the integration of oral health into national health schemes: A mixed-method study research design in Delhi, India

Aim and Objectives:

To assess the factors and perception of various stakeholders on the integration of oral health into the national health schemes using a mixed-method research design.

Materials and Method:

A mixed-method study was carried out in 2018 in two phases. In the first phase of the study, a pretested and prevalidated self-designed close-ended questionnaire was used to assess the knowledge, attitude, perception, barriers, myths, and feasibility of the integration of oral health in national health schemes. This questionnaire was administered to 96 stakeholders consisting of a medical officer (MO), accredited social health activists (ASHA), auxiliary nurse midwifery (ANM), and dental surgeon in nine Delhi Government dispensaries. The questionnaire consisted of 42 close-ended questions and four open-ended questions. The domains and themes were identified along with the challenges and opportunities of integration for focus group discussion (FGD) after analyzing the results of the first phase. The FGD consisted of seven members representing each of the above stakeholders along with one moderator and one recorder.

Results:

88.3% of the ASHA workers and 85.7% of the ANM accepted that oral screening should be incorporated in their routine practice. The major barrier to the incorporation of oral health in general health was the lack of training and insufficient provision of monetary incentives. Job burnout, work situation, inadequate pay, opportunities, workload, and limited carrier development were the demotivators, whereas respect, goodwill, and recognition from the general public were the inducers.

Conclusion:

There was a strong agreement for National Oral Health schemes to be given space and priority in India. The majority agreed that they can be used as a medium for imparting oral health education. The majority of the stakeholders believed that oral health should be a part of general health and they are open to any scheme or program which would add an oral health component.

Emotional Intelligence and Perceived Stress among Dental Undergraduates in Delhi

Background

Emotional intelligence (EI) is understanding one's own feeling and able to handle those feelings without disturbing themselves. Medical schools are stressful and the ability to manage stress is a major factor of success for these students. The current study contributes further insight to body of research in EI as it relates to students’ stress in education, especially among dental undergraduates of Delhi.

Materials and methods

A cross-sectional, convenient sampling-based survey was conducted among 323 dental undergraduates from all the 3 dental Institutions across Delhi. The Schutte Emotional Intelligence and Perceived Stress scale instruments were administered to all the students of four professional years. The data analysis was done using SPSS V.17 and various statistical tests were used to determine significant difference.

Results

No significant differences were found among gender as well as among professional groups for EI. There was a significant difference (0.008) among gender with respect to perceived stress. Correlation analysis showed an inverse relationship between EI and PS (r = −0.227) which was found to be statistically significant.

Conclusion

Training in dental education could be quite stressful due to their time-bound work, but regular student performance assessment and associated factors would allow understanding student behavior in handling situations.

How to cite this article

Yadav V, Mohanty V, Balappanavar AY, et al. Emotional Intelligence and Perceived Stress among Dental Undergraduates in Delhi. Int J Clin Pediatr Dent 2020;13(4):344–347.

Effectiveness of different parenting interventions on oral hygiene of cerebral palsy children: A randomized controlled trial

AIM

To assess the effectiveness of different parenting interventions for improving oral hygiene of cerebral palsy (CP) children aged 4-12 years.

METHODOLOGY AND RESULTS

A randomized controlled trial was done among 60 CP children and parents visiting a tertiary care center in New Delhi. The study population was randomly assigned to experimental or control group (30 in each group). Parents/caregivers in the experimental group (Group 1) received video-based dental health education (DHE) and the control group (Group 2) received conventional DHE. Each group also received two telephonic reinforcements at fourth and eighth week after the first intervention at baseline. The groups were assessed for sociodemographic, familial factors, medical history, oral hygiene practices, and oral hygiene status. At 3-month follow-up, the mean reduction in simplified oral hygiene index (OHI-S), plaque index (PI), and gingival index (GI) scores was 0.27, 0.17, and 0.09, respectively, in Group 1 (P-value < .05). The mean reductions seen in Group 2 were 0.03 in OHI-S, 0.14 in PI, and 0.04 in GI index (P-value < .05, except for GI score: P-value = .6).

CONCLUSION

Video-based DHE is effective and brings about significant improvement in oral hygiene status and oral health among CP children.

Bacterial contamination of packaged smokeless tobacco sold in India

INTRODUCTION

About 21.4% of India's population uses smokeless tobacco products (SLT), yet limited data are available on their microbial contamination. To understand the potential microbiological risks associated with SLT use, the present study aims to investigate bacterial contamination of tobacco and the types of microbes that could be cultured from SLT products.

METHODS

Twenty-two brands of SLT products, including paan masala, khaini, gutka and tobacco-containing dentifrices were examined and cultured by using appropriate selective and differential media including MacConkey agar and CLED agar. This was followed by a sequence of further identification by biochemical tests.

RESULTS

All 22 types of SLT products showed growth of aerobic bacteria. The most common bacteria isolated were Pseudomonas aeruginosa followed by Streptococcus faecalis. Other bacteria that were isolated from products, in traces, included Klebsiella spp., E. coli, and Bacillus subtilus.

CONCLUSIONS

This study raises and addresses the issue of bacterial contamination of packaged SLT products. SLT users might be subjected to a significant health hazard, especially those who are immunocompromised.

Hookah products and online retail marketing strategies in India: A content analysis

INTRODUCTION

Hookah smoking is becoming increasingly popular among the youth. Evidence shows that exposure to marketing of the unhealthy products through social media platforms may impact adolescent health behaviors. The aim of the study was to perform a content analysis of online portals selling hookah products.

MATERIALS AND METHODS

A content analysis of online retail market was conducted on Google India using three keywords hookah, hookah products, and shisha. Retail websites popular in India that were selling hookah products were randomly selected and explored. A total of 15 themes were developed and used to describe various promotional strategies for hookah products.

RESULTS

In all, 41 (19.2%) products claimed to be tobacco/nicotine-free and only 14 products (6.5%) displayed age/health-specific warnings. About 86% of products were available at discounted rates; glamorizing words for describing products in form of superior, premium, and legendary were found on 189 (88.3%) products. Phrases such as "ultimate way to celebrate," "perfect excuse to chill with your friends," and "now enjoy the world of smoking without any doubt of harm" are commonly used to promote hookah products.

CONCLUSION

Easy availability of newer forms of smoking at online markets could play a role in promoting the use of hookah among the youth. Most products are being sold without any warnings and there is no means to control the selling of the products to minors. There is a need to raise the issue of hookah products in the same tune as done for other forms of tobacco.

Compliance Assessment of Cigarette and Other Tobacco Products Act in Public Places in Delhi Government Hospitals

Objective:

Tobacco-free policies in hospital campus reduce exposure to tobacco smoke; change the demeanour of the professionals, patients and people visiting hospitals towards tobacco use. Section-4, 5 and 6 of COTPA (Cigarettes and Other Tobacco Products Act) necessitates the need for implementation of the prohibition on smoking in public places. Against this background, the present work was designed to evaluate the status of compliance Section 4, 5 and 6 of COTPA in Delhi Government hospitals

Methods:

A cross-sectional observational study was conducted within Government hospitals. Multistage random sampling was used to select 18 hospitals out of 39 hospitals from 5 zones. Standard assessment Proforma developed by John Hopkins School of Public Health for assessing compliance to Tobacco-Free Law was used and modified to address certain aspects of Section-4, 5 and 6 of COTPA. Hospital campuses were assessed by dividing them into zones like hospital buildings, office buildings, public places outside the hospital and residential areas.

Result:

Signs of active tobacco use observed in 40.6% of hospital buildings, 35.3% in office buildings, and 75.4% in public places outside the buildings. ‘No smoking signage was not as per the COTPA guidelines in 21.4% of the hospitals and 72% were not tobacco free outdoors in these positions.

Conclusion:

The study highlighted a lower compliance rate than expected which raises questions on law enforcement concerning tobacco. Hence necessary measures have to be used up for sustained awareness campaigns, backed by enforcement drives. Periodic compliance surveys will strengthen the implementation of tobacco free legislation in health care institutions.

Compliance with Tobacco Promotion and Sale Laws in School Neighbourhoods in India

Objective: Regulation of sale of tobacco has given sufficient attention in India and little information exists about the impact of bans near schools. Our study aim was to check the levels of tobacco promotion, advertising and sales in school neighborhoods’ of Central Delhi. Methods: Using multistage random sampling 15 schools were selected in Central Delhi. Areas 100 meters around each were mapped using a map tool and screened using a self designed questionnaire consisting of 26 questions, both closed and open ended, to determine the details of outlets, sales of tobacco and tobacco products, advertising, promotions, school roles, and children seeking tobacco. The data were subjected to statistical analysis. Results: The response rate was 65%. Outlet licenses were present in only 6 (3.47%). The point sale of tobacco was most frequently in tea stalls and a total of 173 (41.2%) outlets had some form of tobacco sale. The brands of smokeless tobacco sold more were shikar (50%) and classic citrus (30%). Advertisement or promotion of sales was mainly in the form of signs and displays (53%). Major schools did not have any no tobacco boards displayed. Conclusion: Sale of tobacco continues in central Delhi with a lack of compliance with the rules of COPTA. The implications of this non compliance in the Capital region is of major significance for the rest of the country.

Morphometric analysis of pulp size in maxillary permanent central incisors correlated with age: An indirect digital study

Context:

Teeth are hardest part of the body and are least affected by the taphonomic process. They are considered as one of the reliable methods of identification of a person in forensic sciences.

Aim:

The aim of the following study is to establish morphometeric measurements by AutoCad 2009 (Autodesk, Inc) of permanent maxillary central incisors in different age groups of Udaipur population.

Setting and Design:

Hospital-based descriptive cross-sectional study carried out in Udaipur.

Materials and Methods:

A study was carried out on 308 subjects of both genders with the age range of 9-68 years. Standardized intra-oral radiographs were made by paralleling technique and processed. The radiographs were scanned and the obtained images were standardized to the actual size of radiographic film. This was followed by measuring them using software AutoCad 2009.

Statistical Analysis Used:

F-test, post-hoc test, Pearson's correlation test.

Results:

For left maxillary central incisor, the total pulp area was found to be of 38.41 ± 12.88 mm and 14.32 ± 7.04 mm respectively. For right maxillary central incisor, the total pulp size was 38.39 ± 14.95 mm and 12.35 ± 5 mm respectively. Males (32.50, 32.87 mm²) had more pulp area when compared with females (28.82, 30.05 mm²).

Conclusion:

There was a decrease in total pulp area with increasing age which may be attributed to secondary dentin formation.

Comparison of the effectiveness of 0.5% tea, 2% neem and 0.2% chlorhexidine mouthwashes on oral health: a randomized control trial

BACKGROUND

The aim of this study was to evaluate and compare the effectiveness of 0.5% tea, 2% neem, and 0.2% chlorhexidine mouthwashes on oral health.

MATERIALS AND METHODS

A randomized blinded controlled trial with 30 healthy human volunteers of age group 18-25 years was carried out. The subjects were randomly assigned to 3 groups i.e., group A - 0.2% chlorhexidine gluconate (bench mark control), Group B - 2% neem, and group C - 0.5% tea of 10 subjects per group. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. Oral hygiene was assessed by simplified oral hygiene index (OHIS). Salivary pH was assessed by indikrom pH strips. Plaque, gingival, and simplified OHI scores as well as salivary pH were recorded at baseline, immediately after 1 st rinse, after 1 week, 2 nd week, and 3 rd week. The 3 rd week was skipped for group A.

RESULTS

Mean plaque and gingival scores were reduced over the 3 week trial period for experimental and control groups. Anti-plaque effectiveness was observed in all groups and the highest being in group C (P < 0.05). Neem and tea showed comparative effectiveness on gingiva better than chlorhexidine (P < 0.05). The salivary pH rise was sustained and significant in Group B and C compared to Group A. Oral hygiene improvement was better appreciated in Group B and Group C.

CONCLUSION

The effectiveness of 0.5% tea was more compared to 2% neem and 0.2% chlorhexidine mouth rinse.

Evaluation of marginal alveolar bone height for early detection of periodontal disease in pediatric population: clinical and radiographic study

OBJECTIVES

To establish a normal range for the radiographic distance between cementoenamel junction and alveolar bone crest and the factors affecting distances for the early assessment of periodontal disease in Dravidian pediatric population.

METHODS

Fifty children aged 6 to 8 years were selected based on inclusion and exclusion criteria. Clinical and radiographic examination was performed. All the surfaces were examined starting from the distal surface of primary canine to the mesial surface of first permanent molar. The various risk factors like plaque, calculus, proximal caries, restoration and bleeding on probing were recorded. A pair of bitewing radiographs was taken for each child. Bitewing radiographs were traced and analyzed.

RESULTS

It showed that CEJ-ABC distance in primary teeth is about 1 ± 0.5 mm. In the permanent teeth, it was found to be 0.6 ± 0.5 mm in 6 to 8 years age group. CEJ-ABC distance was also affected by different variables like physiologic (eruption and exfoliation) and pathologic factors (plaque, calculus, dental caries, restorations, stainless steel crowns, bleeding on probing and probing depth).

CONCLUSION

CEJ-ABC distances greater than 2.5 mm should be considered under recall and follow-up. Children and adolescents susceptible to periodontal disease should be identified by radiographic means as early as possible in order to prevent the advance of an otherwise possibly destructive disease. The concept of oral health examination and treatment must include examination of the periodontal status of the patient.

Nationwide survey of fifth-year dental students' perceptions about tobacco prevention, control, and curriculum in India

The objective of this study was to assess the tobacco cessation knowledge, attitudes, practices, and perceived barriers of dental interns (students in their last year of the five-year dental curriculum) in India as well as to assess the adequacy of training in tobacco use cessation (TUC) counselling. This was a cross-sectional questionnaire study conducted with 1,521 interns at fiftyone dental colleges of India selected by multistage random sampling. The survey instrument was a fifty-nine-item, self-structured, and self-administered questionnaire. Fifteen questions were about knowledge and attitudes, with twenty-two about practices, fifteen about barriers, and seven about curriculum adequacy; demographic data were also collected. The response rate was 99.7 percent. The results showed that 38.8 percent had knowledge, 30.8 percent had positive attitudes, 19.2 percent practiced TUC, 43 percent experienced barriers, and 85.2 percent agreed on receiving extensive curriculum on tobacco cessation. Only 1 percent were aware of the 5As, the 5Rs protocol, and the motivational interviewing technique of TUC. These respondents' knowledge, attitudes, and practices were below normative level, and they took a superficial approach to TUC. The perceived barriers were very high and included curriculum inadequacy. The results of this study help show there is an urgent need to revise the tobacco curriculum in dental schools in India to make students more confident to practice this aspect of dentistry independently.

Cyclin B1 overexpression in conventional oral squamous cell carcinoma and verrucous carcinoma- A correlation with clinicopathological features

Background: Nuclear localization of cyclin B1 is an indicator for cells undergoing mitotic division, and the overexpression has shown promising results as a good prognostic predictor for patients of squamous cell carcinoma (SCC). Cyclin B1 overexpression among histological grades of conventional oral squamous cell carcinoma (COSCC), as well as comparison with verrucous carcinoma (VC) has been less investigated. Study Design: Immunohistochemical expression of cyclin B1 was compared with various clinicopathological features in 30 primary COSCC and 31 primary VC cases. Result: Cyclin B1 showed significant overexpression for some clinical features for both the variants of oral squamous cell carcinoma. In histopathological variants, statistical significance was observed among grades of COSCC, as well as COSCC and its grades with VC. The concomitant increase in cyclin B1 overexpression from VC to grades COSCC was observed. Conclusion: Our study findings draw attention to cyclin B1 overexpression is involved in early carcinogenesis, cell differentiation and tumor proliferation.

Key words:Cyclin B1, oral squamous cell carcinoma, verrucous carcinoma, head and neck cancer.

Cheiloscopy: A new role as a marker of sagittal jaw relation

Context:

It has been proved that lip prints are analogous to thumb prints. A correlation between thumb prints and sagittal dental malocclusion has already been established. Soft tissue is gaining more importance in judgement of deformity or identity of a patient.

Aim:

To find a correlation between sagittal skeletal jaw relation and lip prints.

Settings and Design:

Descriptive, cross-sectional, comparative, single-blind, hospital-based study.

Materials and Methods:

A total of 90 patients were categorized into skeletal class I, class II, and class III, comprising 30 patients in each group with equal gender distribution. Dolphin imaging (10.5) software was used for analyzing sagittal jaw relation. Lip prints obtained from these 90 patients were analyzed.

Statistical Analyses Used:

Karl Pearson's correlation coefficient, Chi-square test, t-test, Spearman's co-efficient, analysis of variance (ANOVA).

Results:

It was observed that angle ANB (Angle formed between points nasion[N] to Subnasal[A] and nasion[N] to supramental [B]) and beta angle were statistically significant, revealing a strong negative correlation (-0.9060) with different classes of jaw relation. Significant difference was observed between genders in all the three classes. Significant difference was observed in relation to lip print and the quadrants of upper and lower lips. A statistical significance was noted on the right side of both upper and lower arches.

Conclusion:

This study shows that lip prints can be employed for sagittal jaw relation recognition. A further study on various ethnic backgrounds with a larger sample size in individual group is necessary for comparing lip prints and malocclusion.

Impact of a modified carbonated beverage on human dental plaque and salivary pH: an in vivo study

BACKGROUND

To assess the plaque and salivary pH changes at different time intervals in vivo after consumption of a carbonated beverage modified with sodium fluoride and calcium phosphate.

MATERIALS AND METHODS

Twenty-four subjects aged 18-25 years were recruited and randomly assigned to three groups (group A, original drink Sprite; group B, Sprite with sodium fluoride; group C, Sprite with calcium phosphate). Collection of pooled plaque and unstimulated saliva was done before and after the drinks were consumed by the subjects at 5-, 10-, 20- and 30-minute intervals.

RESULTS

The pH rise was higher with group C for plaque and group B for saliva.

CONCLUSIONS

Modification of the test carbonated beverage with calcium phosphate and fluoride may exert some protective potential, especially in high caries risk candidates.

Periodontal health status among permanent residents of low, optimum and high fluoride areas in Kolar District, India

PURPOSE

To assess and compare the periodontal health status among permanent residents of low, optimum and high fluoride areas in Kolar District, India.

MATERIALS AND METHODS

A house-to-house survey was conducted in a population consisting of 925 permanent residents aged 35 to 44 years in three villages having different levels of fluoride concentrations in the drinking water. The fluoride concentrations in selected villages were 0.48 ppm (low), 1.03 ppm (optimum) and 3.21 ppm (high). The ion selective electrode method was used to estimate the fluoride concentration in the drinking water. Periodontal status was assessed using the Community Periodontal Index (CPI) and loss of attachment (LOA). Results were analysed using the chi-square test and logistic regression. The chi-square test was used to find the group differences and logistic regression to find association between the variables.

RESULTS

The overall prevalence of periodontitis was 72.9%; specifically, prevalences were 95.4%, 76.3% and 45.7% in low, optimum and high fluoride areas, respectively. The number of sextants with shallow or deep pockets decreased (shallow pockets: 525, 438, 217; deep pockets: 183, 81, 34) from low to high fluoride areas (odds ratio: 71.3). The low fluoride area had a 7.9-fold higher risk of periodontitis than the optimum fluoride area and a 30-fold higher risk than the high fluoride area, which was highly significant (χ2 = 53.5, P < 0.0001 and χ2 = 192.8, P < 0.001, respectively).

CONCLUSIONS

The severity of periodontal disease is inversely associated with the fluoride concentrations in drinking water. This relation can provide an approach to fluoride treatments to reduce the prevalence or incidence of this disease.

Antimicrobial efficacy of various disinfecting solutions in reducing the contamination of the toothbrush -- a comparative study

BACKGROUND

Contaminated toothbrushes may play a role in the transmission of local or systemic diseases. As modern dentistry emphasises prevention and infection control, toothbrushes should be correctly stored, disinfected and changed at regular intervals.

PURPOSE

The aim of this study was to test the efficacy of 3% neem, 2% triclosan, 0.2% chlorhexidine gluconate and 1% sodium hypochlorite as toothbrush disinfectants against Streptococcus mutans.

MATERIALS AND METHODS

This was a double-blind, linear crossover, within-group comparative experimental trial conducted among 40 children aged 12 to 15 years. The study was divided into five phases: (1) distilled water (control); (2) 3% neem; (3) 2% triclosan; (4) 0.2% chlorhexidine gluconate; and (5) 1% sodium hypochlorite. The toothbrushes were collected after 5 days of brushing and were soaked for 12 h in antimicrobial solutions of separate phases, after which the toothbrushes were submitted for microbial analysis to check for the presence of S. mutans.

RESULTS

The mean colony-forming units (CFUs) of S. mutans at phase 1 when compared with baseline was not significant (P = 0.17). The other phases had a significant drop in mean CFUs of S. mutans from baseline (P < 0.001). The percentage reduction of mean CFUs of S. mutans from baseline was the highest in phase 2 (86%).

CONCLUSION

It can be concluded that all the solutions are effective in toothbrush decontamination, but 3% neem has greater efficacy than other solutions.