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   Table of Contents - Current issue
October-December 2018
Volume 16 | Issue 4
Page Nos. 271-354

Online since Thursday, November 29, 2018

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President's message p. 271
M Arunadevi
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Hon. Gen. Secretary's message p. 272
Sabyasachi Saha
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From the editor's desk p. 273
KR Sowmya
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Republication: A tribute to Dr Mohandas Bhat p. 274
MR Shankar Aradhya
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Alternative medicinal interventions for oral diseases: Scoping review p. 277
Ananthalekshmy Rajeev, Basavaraj Patthi, Ashish Singla, Ritu Gupta, Ravneet Malhi, Monika Rai
Oral diseases hamper the overall systems of our body. People of all age groups and races of different geographic locations are affected by oral diseases which range from dental caries to oral cancer. Therefore, timely dental treatment is needed. Apart from conventional therapies, complementary alternative medicines are becoming popular nowadays. The aim of this scoping review is to compare the efficacy of alternative medicinal interventions with conventional therapies among the living subjects for treating oral diseases. A literature search was performed in PubMed Central and Cochrane Library, Embase, Google Scholar up to 2017 to identify appropriate studies. Full text of original research articles, observational studies, in vivo studies, and randomized control trials were only included in the study. Our target finding was complementary alternative medicines for oral diseases. In the various articles available through the electronic database, 43 articles fulfilled the inclusion criteria and were selected for the review. Even though different studies explain different alternative treatment options, however, these studies show better efficiency for various oral diseases. Alternative medications with many beneficial properties are a good choice for the prevention or treatment of oral diseases without any side effects. In a developing country like India, where there are people who still cannot afford even their daily expenditure, alternative medicinal interventions will be a boon.
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Oral health status and parental perception of dental anxiety of attention deficit hyperactivity disorder and nonattention deficit hyperactivity disorder children in Bengaluru city: A cross-sectional study p. 291
F Farhanaz, R Yashoda, Manjunath P Puranik
Context: Attention deficit hyperactivity disorder (ADHD) is a complex, multifactorial disorder which is characterized by the symptoms of inattention and/or impulsivity and hyperactivity. In children with ADHD, cognitive and executive functions may be impaired leading to significant behavioral problems that may affect oral health. There is an extreme paucity of the studies related to oral health and dental anxiety among children with ADHD. Aim: The aim of this study is to assess and compare oral health status and parental perception of dental anxiety among ADHD and non-ADHD children. Materials and Methods: A cross-sectional comparative study was conducted among 100 ADHD and 100 non-ADHD children aged 6–17 years in Bengaluru city. A structured validated pro forma was used to collect demographic details, Decayed, Missing, and Filled Teeth (DMFT)/dmft, and gingival index (GI). The Dental Subscale of Children's Fear Survey Schedule was used to assess parental perception of dental anxiety. Data were analyzed using Chi-square test, Mann–Whitney U-test, and Pearson's correlation test (P < 0.05). Results: DMFT was significantly higher in ADHD (1.60 ± 1.6) than in non-ADHD group (1.15 ± 1.32) (P = 0.04). There was no significant difference between the groups for GI (P = 0.3). ADHD children exhibited significantly higher dental anxiety when compared to non-ADHD children (P < 0.001). Dental anxiety was significantly related to the caries experience among ADHD group (P < 0.001). Conclusion: Children with ADHD exhibited a poorer oral health status and higher dental anxiety than non-ADHD children. Hence, there is a need for diligent preventive dental care.
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Social determinants of dental anxiety and utilization of oral health services among young adults in Mangalore City, India p. 297
Sumeet Bhatt, G Rajesh, Ashwini Rao, Ramya Shenoy, Mithun B. H. Pai
Introduction: Dental anxiety is a known barrier to oral health-care utilization. The data on dental anxiety and oral health services utilization of young adults in India are scarce. Aim: The present study was conducted to assess the social determinants of dental anxiety and utilization patterns of oral health services among young adults aged 18–21 years in Mangalore city, India. Materials and Methods: A total of 575 young adults aged 18–21 years were selected from degree colleges in Mangalore city. Dental anxiety was assessed using the Modified Dental Anxiety Scale and utilization of oral health services was assessed using a questionnaire. Data were also collected on age, gender, and socioeconomic factors. Statistical analysis was done using Statistical Package for the Social Sciences software. Level of statistical significance was fixed at P < 0.05. Results: The prevalence of dentally anxious individuals was 81.2%. The mean dental anxiety score of respondents was 14.69 ± 4.29. Females reported a statistically higher dental anxiety than males (P = 0.004). Participants with past negative dental experience also showed greater dental anxiety scores (P = 0.04). Dental anxiety was found to be negatively correlated with age (P = 0.003) and father's occupation (P = 0.037). A total of 48 (8.3%) individuals visited a dentist twice a year, whereas 79 (13.7%) individuals had never visited a dentist. The total number of irregular visitors was 448 (77.9%), out of which 268 respondents (46.6%) visited a dentist only for emergency treatments. Dental anxiety scores and utilization of dental health services did not show a statistically significant association. Conclusions: There was a high prevalence of dental anxiety in this population of young adults. Females and individuals with past negative dental experience showed significantly higher dental anxiety. Age and father's occupation were also correlated with dental anxiety. Focus on the social determinants and measures to reduce dental anxiety and improve oral health utilization are needed.
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Prevalence and pattern of maxillofacial trauma in North Chennai: A retrospective study p. 303
C Prasad, M B. Aswath Narayanan, V Parimala, M Vijjaykanth
Introduction: Trauma is one of the leading causes of death and disability in the world. Maxillofacial injuries cause fractures and disfigurement of different parts of the face and oral cavity. Aim: The aim is to find the prevalence and pattern of maxillofacial trauma in the Department of Dental Surgery, Government Stanley Medical College, Chennai from June 2013, to March 2014. Materials and Methods: The retrospective study of 153 maxillofacial trauma patient's data from the Department of Dental Surgery of Government Stanley Medical College, Chennai from March 2012 to February 2014. Type, cause, and age-wise distribution of the injuries and the influence of alcohol on the injuries were assessed. Results: Majority of the victims were males and from 20 to 30 years age group. Road traffic accidents were found to be the major cause (74%) and out of that 67% occurred under the influence of alcohol consumption and 85% cases were grievous. Injuries to teeth were found more common in the younger age group, and injuries to soft tissue were found more common in elderly persons. Influence of alcohol has been found to have a strong association with the severity of injuries (P < 0.05). Conclusion: This study points out that road traffic accidents are more common with alcohol consumption being the major contributing factor. This has to be taken seriously into consideration by the policymakers so that preventive programs aimed at behavioral modifications in the society are promoted.
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Association between tobacco usage and dental caries among 35–44-year-old fishermen of North Coastal Region of South Indian State, Andhra Pradesh p. 308
Asha Lodagala, Srinivas Pachava, Devaki Talluri, Viswa Chaitanya Chandu
Introduction: Tobacco usage is popular among rural and urban communities of India. Sporadic studies that were conducted to know the caries experience among tobacco users yielded conflicting conclusions. Fisherfolk communities form a special population in light of the variations in their dietary habits compared to general population. Aim: The aim of this study was to explore the dental caries (DC) experience among tobacco users and nonusers in fisherman communities residing in the north coastal region of a south Indian state. Materials and Methods: A comparative cross-sectional survey was done in fisherman community belonging to a north coastal region of a South Indian state. Stratified randomized sampling technique was employed to recruit 374 adult participants aged 35–44 years. The survey included interviewer-administered questionnaire and clinical examination for measuring DC experience. The questionnaire consisted of demographic data, brushing aids, 2 days sweet score, and a detailed record on tobacco use of subjects. Decayed missed and filled index (DMFT) and Simplified Oral Hygiene Index (OHI-S) were recorded. The study participants were dichotomized based on tobacco usage. The tests used were independent samples t-test, analysis of variance, and Chi-square test. Results: DC was present among 46.5% of tobacco users and 65.8% of nonusers. The mean DFT score for tobacco users (0.62 ± 0.23) was less when compared to that of nonusers (1.40 ± 0.52) after excluding missing component, which is statistically significant (P < 0.001). The mean OHI-S was higher among tobacco users than nonusers. There was no statistically significant difference in the mean sweet scores between these two groups (P = 0.172). Conclusion: Despite higher mean OHI-S scores among tobacco users and similar sweet scores among both the groups, DC experience among tobacco users was less when compared to nonusers. Longitudinal studies are recommended for further confirmative evidence.
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Student's perception: A core indicator in building academia in today's world p. 313
Sonia Raina, Shourya Tandon, Sachin Chand, Charu Khurana
Introduction: The perception of students considering their educational environment is a useful source to modify or to improve the quality of education. Whereas the education is a dynamic process, researches about this topic are important to improve education methods and strategies. Equally essential is to know opinion of the students about teachers and educational environment. Aim: The aim of this study is to assess students' perceptions of educational environment using Dundee ready education environment measure (DREEM) among four different health science courses. Materials and Methods: A cross-sectional survey design was conducted on 398 students enrolled in undergraduate health science programs offered at a multispecialty university in Haryana, whose courses consisted of traditional classes and clinical fieldwork. This comprised of students from bachelor degrees in Dental Sciences, Physiotherapy, Nursing, and Allied health sciences. The survey was conducted using a standardized self-report questionnaire DREEM, which is 50-item, close-ended, and scored on 5-point Likert scale. Results: The mean total DREEM score was 77.2 ± 13.07, which according to the interpretation guide was seen to be more positive than negative. More positive results were seen among students of dental sciences (76.7 ± 12.8) and physiotheray (78.06 ± 13.1). Statistical significant difference (P ≤ 0.05) was seen among all the courses in each subscale. Students' perception of teachers and students' self-perception showed statistically nonsignificant results when compared between gender. Conclusion: Students rated their learning environment as positive. This suggests a student-centered approach from the university and may lead to positive outcomes for the students.
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Knowledge, attitude, and practices among dental practitioners and postgraduate students on the preparedness of medical emergencies in Mathura City p. 318
Himanshu Gupta, DJ Bhaskar, Navpreet Kaur, Vivek Sharma, Manish Bhalla, Rinki Hans
Introduction: Medical emergencies can frequently happen in dental settings and the inability to cope with them can lead to tragic outcomes. Some factors can increase the risk of medical emergencies in dental settings. Aim: The aim of this study was to assess the knowledge, attitude, and practices among dental practitioners and postgraduate students on the preparedness of medical emergencies. Materials and Methods: A questionnaire-based study was conducted on 86 postgraduates students and 56 dental practitioners in Mathura city to evaluate their knowledge, attitude, and practices regarding the preparedness of medical emergencies. A self-administered, multiple-choice type of questionnaire was administered to each participant in person, who took approximately 12 min to complete the questionnaire. SPSS Version 22.0 (IBM Corp) was used for statistical analysis. Fisher's exact test was used and the value of P < 0.001 was considered to be statistically significant. Results: A total of 83 (96.5%) postgraduate students and 51 (94.4%) dental practitioners had knowledge regarding how to perform basic life support and first-aid, and only 28 (51.9%) dental practitioners could handle any emergency condition at their dental office. Furthermore, 45 (52.3%) postgraduate students and 49 (90.7%) dental practitioners attended workshops on emergency training (P < 0.001). Conclusion: Basic knowledge regarding diagnosis of medical emergencies and dealing with the same was better among the postgraduate students. They also had a better attitude toward handling of medical emergencies compared to dental practitioners. The dental practitioners ranked higher in majority of the aspects in handling medical emergencies.
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Assessment of compliance with tobacco regulations on ban of advertisements at the point of sale in urban areas of Bengaluru City p. 322
KB Shilpashree, Aishwarya Sampath, Archana Krishnamurthy, S Madhusudhan, Monika Prasad, Silpi Chatterjee
Introduction: Tobacco accounts for the largest number of preventable deaths. Along with creating awareness and educating people regarding the ill effects of tobacco on health, it is necessary to have laws regulating the sales of tobacco and its product. Cigarettes and other tobacco products act give the regulations for it. Aim: The aim of this study was to conduct an audit of the point of sales (POS) tobacco advertising and assess compliance with advertising ban in Bengaluru city. Materials and Methods: A cross-sectional observational study was conducted over a period of 2 months. Data were collected from stores in urban areas from eight zones of Bengaluru city using multistage random sampling. Four wards were randomly selected from each of the 8 zones, 4 areas were randomly selected from each ward and 10 shops were randomly selected from each area in the ratio of 1 supermarket: 1 liquor store: 3 convenience store: 5 tuck shops. Results: Results indicated that the 93.9% of the existing shops were not within the 100 yards of any educational institute, 75.8% of them had product showcasing, 81.9% of the stores had boards displayed promotional message, 30.6% had tobacco logo at POS, 93.6% of the stores had more than one interior advertisements, 85.25 of the stores had product placement <1 m of snacks counter, 88.2% of the stores did not display warning signage, 88.3% of the stores did not display no smoking signage, and 85.7% of the stores did not display no smoking area or smoking here is an offense. Conclusion: The results of the present study suggested that there is a lack of compliance with tobacco advertising ban among stores selling tobacco in Bengaluru city. POS advertising has become strategic locations for tobacco companies to advertise their brands.
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Readiness for interprofessional learning among dental undergraduate students: An institutional study p. 328
S Sibyl, Darshana Bennadi, Nandita Kshetrimayum, C.V.K. Reddy
Introduction: In today's health-care services, there is no clear-cut role of each profession. These roles have been shaded or blended with the roles of each other professions, which shows an interconnection between each profession. Interprofessional learning is an approach of learning with each other's professional knowledge and skills. This type of learning will be helpful for the students to enhance their knowledge, skills, interaction, and provision of health-care services. Aim: The objective of this study was to assess the attitude of dental undergraduate students toward interprofessional learning. Materials and Methods: This descriptive questionnaire study was conducted on dental undergraduate students in Mysore city. A total of 250 dental students were selected using stratified random sampling method. Data were collected using a questionnaire on Readiness for Interprofessional Learning Scale. Results: Among the 250 dental undergraduate students who completed the survey, 27.6% (n = 69) were males and 72.4% (n = 181) were females. Nearly 84% (n = 210) showed positive attitude toward team work and collaboration as a result of shared learning and 16% (n = 40) had negative attitude. When asked about their view toward professional identity, 85.6% (n = 214) felt that interprofessional learning will help them understand their professional identity better and 15.4% (n = 36) disagreed it. Conclusion: Dental undergraduate students in general have a positive view toward interprofessional learning.
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Perception of teachers regarding dental student's classroom behavior: A qualitative study p. 333
Sonal Sadashiv Kale, Pradnya Kakodkar, Sahana Hegde Shetiya
Introduction: Effective teaching is critical for student learning, especially in professional fields such as dentistry and dental hygiene and further, the effective behavior of educator must include organization, enthusiasm, empathy, rapport, clarity, general knowledge, and being available for students. Aim: The aim of this study is to assess teachers' perception regarding the final-year dental students' classroom behavior. Materials and Methods: Data for this qualitative study came from three focus group discussions (FGDs) with teachers teaching final-year BDS students. Participants (n = 15) represented the department of pedodontics, prosthodontics, and conservative and endodontic dentistry. FGD was conducted department wise with participation of five teachers each. A conceptual framework was prepared with seven questions for conducting FGD. Data from the FGD were analyzed by combining similar quotes into categories. Results: The data from the FGD led to the formation of seven categories with similar quotes in each category. Teachers reported about different behaviors of students depicting their lack of attention in lectures with the most common reason being: engaging in electronic gadgets, chatting with each other, yawning, and getting bored after 5 min of commencement of lecture. Teachers also mentioned the hectic schedule of students being one of the reasons for lack of attention. Suggestions of improving students' behavior were also reported which included different meditation techniques and change in classroom structure. Conclusion: The study reveals that teachers face a lot of inappropriate behavior from the students' side while delivering a lecture in the classroom. Different ways can be employed to increase the concentration of the students.
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Knowledge, attitude, and practice in treating pregnant women: A questionnaire survey among dental students of Mangalore city p. 338
Sherin James, Priyal Rohan
Introduction: Good oral health is a key to overall health and wellbeing. It is essential and safe and can prevent long-term health issues. The role of oral health professionals includes providing preventive services and restorative treatment along with anticipatory guidance for pregnant women and their children. Aim: The objective of the study was to assess the knowledge, attitude, and practice among dental interns and final-year students in treating pregnant women. Materials and Methods: A questionnaire study was conducted in a private dental college in Mangalore city which included 140 students. A study-specific questionnaire was prepared to collect the data. Descriptive analysis was done. Statistical analysis was done with the help of the Statistical Package for Social Sciences version 17 (SPSS Inc., IBM, Chicago, IL, USA). Results: On average, there was enough knowledge among students regarding oral health. Nearly 39.3% of students had sufficient knowledge regarding management of pregnant women in a dental chair, and the students considered textbooks (49%) and lecture (25%) as their prime source of knowledge. About 39.3% of the clinical students educated the pregnant patients regarding their oral health and its influence on the fetus. About 42.1% educated occasionally and 18.6% never took pain to bring awareness among pregnant ladies. Regarding the antibiotic and analgesic of choice for pregnant women, very few had other options other than amoxicillin (77.1%) and paracetamol (73.6%). Single prescription over polypharmacy was supported by 77.7% students. Conclusion: The finding underscores the knowledge and information of dental students in the fundamentals of dental management of pregnant women to be satisfactory. Improvement is needed to increase the awareness of clinical students toward different types of critical treatment.
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Assessment of repetitive effect of change in salivary pH and sugar exposure on dentition status among tea vendors p. 342
N Naveen, V Balasubramanyam, GY Yunus, N Kiran Kumar, Ram Tiwari, Abhinav Patel
Introduction: Tea is the most common beverage that is consumed by almost every strata of society. Tea, when consumed with sugar, is more detrimental and influences the onset of dental caries. Tea vendors consume tea many times a day that has a detrimental effect toward their oral cavity. Aim: The present study was undertaken to evaluate the effect of salivary ph and sugar exposure on dental caries experience among tea vendors. Materials and Methods: In total, 30 tea vendors were selected who fulfilled the exclusion and inclusion criteria. Saliva sample was collected at three different time intervals (i.e., before tea preparation, 5 min after tea tasting, and 30 min after the last tea tasted). Salivary pH estimation was done using a portable standard digital pH meter. Sugar exposure was recorded using a questionnaire. The dental caries experience of the tea vendors was recorded using the WHO oral health assessment form for adults, 2013. Descriptive statistics, ANOVA and post hoc Tukey test, Kruskal–Wallis ANOVA, and Pearson's correlation were applied for analyzing data using SPSS vs. 16 (IBM, Chicago). Results: Mean and standard deviation of salivary pH at baseline, after 5 min, and after 30 min was 5.85 ± 0.58, 3.86 ± 0.524, 6.38 ± 0.396, respectively, which was statistically significant (P < 0.001). Mean sugar exposure among males and females were 8.36 ± 5.28 and 5.4 ± 1.6. Mean DMFT for male and female was 4.96 ± 5.054, 5.00 ± 2.449, respectively (P = 0.007). Positive correlation was found between number of years as tea vendors and dental caries experience (r = 0.737). Conclusion: Increased frequency of liquid sugar consumption led to repetitive pH drop of the saliva that had a positive correlation on the caries experience among tea vendors.
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In vitro evaluation of soft drinks containing calcium lactate p. 346
Arun R Nair, GM Prashant, VH Sushanth, Mohamad Imranulla, Priyanka Paul Madhu
Introduction: Over the past 2 years, the soft drink industry has seen a value growth of 11%. In total, 1.3 billion people in India drink nearly 5.9 billion liters of soft drinks per year making it one of the highest soft drink-consuming countries in the world. Hence, products such as calcium lactate which efficiently reduce the erosive action of drinks should be better incorporated in soft drinks to limit its adverse effects. Aim: The objective of this study was to assess the degree of dental erosion due to soft drinks with and without the presence of 5% calcium lactate. Materials and Methods: Three soft drinks (MaazaCoca-Cola, AppyFizParleAgro, and PepsiPepsiCo) and normal water were taken. A total of 40 dental blocks were randomly allocated into four groups. Surface loss (SL) was assessed using Digital Surfometry. Surfometry readings were taken before and after adding calcium lactate in the above soft drinks for definite time intervals. Data were analyzed using SPSS version 22. ANOVA was used to assess separately degree of erosion of tooth blocks in all the soft drinks samples with and without 5% calcium lactate. The paired t-test was used to determine the degree of SL within each group before and after adding 5% calcium lactate. Results: In the present study, PepsiPepsiCo had the highest acidic pH (2.7) and showed the highest degree of erosion with a mean value of 1.55 μ ± 0.07. After adding calcium lactate, the highest acidic pH was shown by AppyFizParle Agro (4.45); however, the degree of erosion was still the highest for Pepsi with a mean value of 1.36 μ ± 0.09. Later, each group was compared for SL among themselves with and without the presence of calcium lactate. AppyFizParleAgro showed the highest degree of erosion with a mean value of 0.22 μ ± 0.08. P ≤ 0.05 was considered as statistically significant. Conclusion: The erosive action of soft drinks varies widely. The results demonstrate that the addition of 5% calcium lactate to soft drinks significantly decreased dental erosion.
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Time to lend an inner ear: Vestibular stimulation methods in the management of chronic orofacial pain p. 350
Sai Sailesh Kumar Goothy, Ravikanth Manyam
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IAPHD News p. 352

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