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   Table of Contents - Current issue
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April-June 2019
Volume 17 | Issue 2
Page Nos. 87-169

Online since Thursday, June 20, 2019

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PRESIDENTS MESSAGE  

Presidents message p. 87
V Gopikrishna
DOI:10.4103/jiaphd.jiaphd_67_19  
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HONORARY SECRETARY’S MESSAGE Top

Honorary secretary's message p. 88
Sabyasachi Saha
DOI:10.4103/jiaphd.jiaphd_68_19  
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FROM THE EDITOR’S DESK Top

From the editor's desk p. 89
KR Sowmya
DOI:10.4103/jiaphd.jiaphd_69_19  
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REVIEW ARTICLE Top

Role of probiotics in the treatment and prevention of oral malodor/halitosis: A systematic review p. 90
Pragati Ishwar Shringeri, Nusrath Fareed, Hemant Battur, Sanjeev Khanagar
DOI:10.4103/jiaphd.jiaphd_171_18  
Oral malodor is a condition which impedes people's social life and self-esteem. With more widespread acceptance of the potential for probiotic intervention providing health benefits for nonintestinal body sites, application of it on alternative target tissues has increased, to obtain more specific and enduring benefits. From the periodontal perspective, several studies have revealed the role of probiotic in the reduction of gingival inflammation. However, the studies of stronger evidence pertaining to the role of probiotics in the treatment and prevention of halitosis is limited. The aim of this study was to determine the role of probiotic strains in the treatment and prevention of oral malodor. Records were searched from various databases such as PubMed/Medline, Cochrane, and EMBASE. Articles published over the past 11 years were identified using the key search terms. A total of 178 records were identified by title/abstracts/full-text articles and were retrieved. After thorough assessment, 11 manuscripts were included in qualitative synthesis in this systematic review. Analysis of studies revealed 666 participants, aged 4–76 years, and about 20 probiotic strains were assigned to the test groups and control groups with a varying follow-up period. The effect size for randomized control trials ranged from 0.08 to 0.7 which suggests low-to-moderate practical significance. The results of this systematic review confirm that more studies are necessary to evaluate the efficacy of probiotics with correct methodological design, in broader population samples, and over longer periods.
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ORIGINAL ARTICLES Top

Oral health knowledge and practices: their influence on oral health status of auxiliary health workers in health centers of Mangalore, India p. 97
Mallikarjun Sajjanshetty, Ashwini Rao, Rajesh Gururaghavendran, Ramya Shenoy, BH Mithun Pai
DOI:10.4103/jiaphd.jiaphd_173_18  
Background: Disparity exists in the availability of dental care services in rural India as compared to urban setup. Majority of dental offices are set in urban areas, with little access to rural population, driving people to primary health centers for all health needs. In situations like these, auxiliary health workers can be delegated with the duties of oral health education to the masses provided they possess adequate information/knowledge regarding oral healthcare and practices. Aim: The aim of this study is to assess the influence of oral health knowledge (OHK) and oral health practices on the oral health status among auxiliary health workers in the health centers of Mangalore. Material and Methods: A cross-sectional study was carried out among the auxiliary health workers in Mangalore. OHK and practices were analyzed using a pretested, screening questionnaire. Oral health status was analyzed using the WHO Oral Health Assessment Form-1997. Data were analyzed using the Statistical Package for the Social Sciences software, version 16.0 (SPSS Inc., Chicago, IL, USA). Chi-square test and binary logistic regression test were employed. P < 0.05 was considered statistically significant. Results: Majority (72.8%) of the auxiliary workers had good OHK and followed recommended dental practices. Better OHK was associated with better oral health, namely lesser decayed teeth and more filled teeth (P < 0.05). Better OHK correlated negatively with missing teeth among participants (P < 0.05). Visiting a dentist in previous 6 months, brushing twice a day, and changing brush every 3 months were the important predictors of improved oral health (P < 0.05). Conclusion: Better OHK and practices can significantly impact the oral health status of auxiliary health workers in Mangalore. It also projects the impact that it can have on the oral health of rural population as auxiliary health workers are the first line of information for the underprivileged masses. Dedicated oral health programs to educate/train auxiliary workers in health centers can form an alternative approach to reach rural population.
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Assessment of oral mucosal condition and periodontal status of the institutionalized elderly living in geriatric homes of Dakshina Kannada District, Karnataka, India p. 103
R Pandya Sajankumar, Vijaya Hegde
DOI:10.4103/jiaphd.jiaphd_184_18  
Background: It is recognized that in developing countries like India, institutionalized health care is expensive. Thus, individual residing in geriatric homes have a higher rate of oral disease. To promote the oral health of the elderly, we need to know the oral mucosal condition and periodontal status. Aim: The aim of this study is to assess the oral mucosal conditions and periodontal status of the institutionalized elderly living in geriatric homes. Material and Methods: A cross-sectional survey was conducted in geriatric homes of Dakshina Kannada district. The sample size was estimated to be 384. The WHO oral health assessment pro forma (1997) was used to collect the data. The American Dental Association Type III examination method was used. The data obtained was coded and fed into the Statistical Package for the Social Sciences (Chicago, IL, USA) version 16.0 for analysis. Differences in proportions were compared using the Chi-squared test. Results: In terms of oral mucosal conditions, 13.80% and 16.15% of the total study participants had oral submucous fibrosis and denture stomatitis, respectively. On periodontal examination, 1.82% of participants had bleeding on probing. Calculus was present in 21.36% of participants. 49.47% of study participants had pocket depth measuring 4–5 mm. Conclusion: The present study concludes that oral mucosal condition and periodontal status are poor in the institutionalized elderly living in geriatric homes of Dakshina Kannada district.
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Special care dentistry: Knowledge and attitudes among Indian dental students p. 108
Shivam Kapoor, Puneet Chahar, Vikrant Mohanty, Aswini Y Balappanavar
DOI:10.4103/jiaphd.jiaphd_206_18  
Background: Special care dentistry (SCD) includes the provision of oral care for individuals with any disability or impairment. Published studies have reported poor oral health and quality of life. Providing quality treatment to the disabled population requires essential knowledge acquired by additional training. Objectives: The study aimed to explore the preparedness of dental students in Delhi to manage patients with special needs. Material and Methods: A cross-sectional survey was carried out in December 2017, among 117 students of a tertiary care government dental hospital in Delhi. A questionnaire was developed using literature and previously administered surveys to assess knowledge, attitude, and institutional provisions pertaining to special care patients. Validity and reliability testing was carried out. Data were subjected to appropriate statistical measures and analyzed using SPSS version 22 (P < 0.05). Results: The study sample included postgraduate students (28.3%), undergraduate students (47.8%), and interns (23.9%). All of them felt that some special precautions are to be taken while treating a patient with special needs, whereas only half considered SCD as a different specialty. The majority (60%) were unaware regarding the availability of any special equipment for the disabled. However, they had some idea regarding the institutional provisions for special care patients. Conclusions: This survey reported positive attitude and comfort levels among dental students toward special care patients. However, there is an urgent need for professional associations to reorient dental curriculum with regard to SCD and train students appropriately.
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Assessment of musculoskeletal disorders and associated risk factors among dentists in Rajahmundry City: A cross-sectional study p. 114
Anvesh Gandham, Naveen Kumar Boppana, Narayana Rao Vinnakota, Kiran Karthik Burri, Usha Kiran Th, Akhil Pallepati
DOI:10.4103/jiaphd.jiaphd_9_19  
Background: Like any other profession, dentistry is also plagued by many occupational health hazards (OHHs). Musculoskeletal disorders (MSDs) are one of the most common OHHs witnessed among dental practitioners. Aim: This study aimed to assess the prevalence and associated risk factors for MSDs among dental practitioners. Material and Methods: A prevalidated questionnaire was distributed among 150 dentists practicing in Rajahmundry city. The questionnaire was designed to procure information on demographic details and associated risk factors of MSDs experienced by them in the last 6 months. Chi-square test and multivariate regression analysis were employed to find significance among the study parameters and associated risk factors. Statistical analysis was performed using SPSS software (version 23.0, IBM, Chicago, IL, USA), and P < 0.05 was considered to be statistically significant. Results: Among the 150 respondents, 62.7% were males and 37.3% were females. The prevalence of MSD was observed as 58.7% and showed higher rates of pain in the neck (24%) followed by lower back region (20%) and upper back (14.7%). The associated risk factors were found to be number of working hours, number of cases treated per day, posture, and repetitive shoulder and hand movements (P < 0.05). Conclusion: This study revealed a relatively high prevalence of musculoskeletal pain among dentists, and there is a need to implement and practice preventive measures in order to minimize the problem.
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”Tobacco” – The silent slayer for oral premalignant lesions/ conditions among beedi rolling workers of Durg City, Chhattisgarh, India: A cross-sectional study p. 119
GY Yunus, Heena Sahni, N Naveen, Ram Tiwari, Balasubramanyam Vasant, Sudha Suman
DOI:10.4103/jiaphd.jiaphd_215_18  
Background: Tobacco use is a major public health challenge and established risk factor for oral premalignant lesions and conditions in India. Workplace hazards are known to compromise the oral health of beedi-rolling workers. There is a scarcity of data about tobacco habits among these workers of Durg-Bhilai. Aim: This study aimed to assess the prevalence of tobacco-related habits and its associated lesions/conditions among beedi rolling workers of Durg-Bhilai, Chhattisgarh. Material and Methods: A cross-sectional study was conducted for 1 month among 185 beedi rolling workers of Durg-Bhilai city. Data were collected using a 25-item, self-structured, close-ended questionnaire based on oral hygiene habits, tobacco usage habits, awareness regarding tobacco, and its ill effects. After taking detailed habitual history, workers were screened for oral premalignant lesions. Oral cavity was only clinically diagnosed using World Health Organization assessment form of oral premalignant lesions and conditions. Descriptive statistics using Chi-square test were applied using SPSS software version 16 (IBM, Chicago, IL, USA), and P < 0.05 was considered statistically significant. Results: The prevalence of tobacco use was found to be 82.2%, with 15 (8.1%), 101 (54.6%), and 19.5% of workers involved in smoked, smokeless, and dual use, respectively. A total of 152 (82.1%) participants had one or more oral lesions. Leukoplakia and oral submucous fibrosis were observed in 27.6% and 13.5% of participants, respectively. Gudaku was used by 7.8% of participants, but it was not associated with any kind of oral lesions. Conclusion: The present study revealed a high prevalence of oral premalignant lesions with rampant misuse of tobacco products by these workers. There is an urgent need to create awareness regarding the ill effects of tobacco and also to initiate cessation programs among these workers.
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Sleep quality impact on the oral health status of sugar mill workers of Fazilka, Punjab: A cross-sectional study p. 125
Salvi Setia, Simarpreet Singh, Anmol Mathur, Manu Batra, Vikram Pal Aggarwal, Deeksha Gijwani
DOI:10.4103/jiaphd.jiaphd_109_18  
Background: A trend toward adopting a 24/7 lifestyle, long working hours, and shift works in industries can adversely affect the sleep health of workers. Sleep deprivation not only has an adverse effect on physical health but may also affect oral health. Aim: The aim of the study is to assess the impact of sleep quality on the oral health status of sugar mill workers of Fazilka, Punjab. Material and Methods: This cross-sectional study comprised 237 participants. The oral health status of mill workers was assessed using simplified oral hygiene index (OHI-S), decayed-missing-filled surface (DMFS), community periodontal index (CPI), loss of attachment (LOA) indices, and sleep quality by Pittsburgh Sleep Quality Index (PSQI) questionnaire. The data were analyzed using IBM SPSS Statistics Windows, Version 20.0. (Armonk, NY, USA: IBM Corp) for statistical analysis. Chi-square test and t-test were applied, and the level of statistical significance was set at P < 0.05. Results: Production line workers (72.25%) reported poor sleep quality in comparison to administrative workers. The oral health assessment showed statistically significantly higher DMFS, OHI-S, CPI, and LOA scores in workers with poor sleep (P < 0.05). Conclusion: Working environment of sugar mill was associated with the sleep quality of the workers which in turn affects their oral health as sleep deprivation leads to neglected oral care, more adverse habits, and thus poor oral health.
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Knowledge and perceptions about dental health insurance among dental practitioners of Jaipur City p. 130
Preyas Joshi, Jitender Solanki, Pankaj Chaudhary, Dushyant Singh Jadoun, Priyanka Mishra, Prachi Sharma
DOI:10.4103/jiaphd.jiaphd_193_18  
Background: The general health insurance plans merely cover the hospitalization and medicinal costs. Dental insurance is meant to insure people against the dental disease and their expense of treatment. Aim: The aim of the study is to assess the knowledge and perceptions regarding dental health insurance among private dental practitioners of Jaipur city. Material and Methods: A cross-sectional study was conducted among private dental practitioners aged 25–59 years in Jaipur city, a 20-item self-designed questionnaire was used to assess the knowledge and perceptions regarding dental health insurance. Data were analyzed using MedCalc software version 14.2.1.0. Chi-square test was applied for analyzing the categorical data. The confidence interval and level of significance were set at 95% and P ≤ 0.05, respectively. Results: The dental practitioners were aware of dental insurance, and the Internet was found to be the major source of knowledge (57.00%) regarding dental health insurance, and there was statistically significant (P = 0.026) difference between male and female dental practitioners (39 males and 18 females). Overall, 80% of the dental practitioners felt that individuals with numerous or ongoing oral health problems are more likely to purchase dental insurance. Cashless treatment facility was found to be the biggest (62.00%) influencing factor affecting the health insurance subscriptions; also, there was a statistically significant difference (P = 0.001) between male and female dental practitioners about the same. Conclusion: In the present study, dental insurance has been found to be associated with higher rates of visiting for a checkup and regular dental visiting and was correlated with patient acceptance of prescribed dental treatment, which suggests that insured individuals may face fewer financial barriers to comprehensive dental care.
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Dental health-care waste management among dentists of Nellore City - A cross-sectional study p. 136
Swati Gurusamy Naidu, V Chandra Sekhara Reddy, R V. S. Krishna Kumar, KM Sudhir, G Srinivasulu, Deepthi Athuluru
DOI:10.4103/jiaphd.jiaphd_160_18  
Background: Waste produced in the course of health-care activities carries a higher potential for infection and injury than any other type of waste. Hence, to avoid the hazards caused by hospital waste, the Government of India issued notification on bio-medical waste (BMW) (management and handling) Rules 1998 which was amended in 2016 under Environment (protection) Act. These new rules fill up the gaps in the old rules to regulate disposal of various categories of BMW. Aim: To assess the awareness and practices toward dental health-care waste management among dentists of Nellore city. Material and Methods: A cross sectional study in Nellore City was conducted among 204 private dental practitioners using a close ended questionnaire. The questionnaire was distributed in the dental clinics by the investigator and collected back the same or consecutive day. Data were analyzed using SPSS version 22 (IBM Corp, Armonk, NY, USA). Chi-square test was used, and P < 0.05 was considered statistically significant. Results: The study results showed that there was no statistically significant association between the responses by dentists on majority of the questions relating to BMW Management and Handling rules. 86.6% of clinicians and 78.1% of academicians responded that they were aware of the BMW rules. 87.8% and 84.4% of clinicians and academicians, respectively, were aware of different categories of waste, whereas 97.1% and 93.8%, respectively, reported that they knew about different color codings of BMW and these responses were not statistically significant (P = 0.05). Majority of the dentists (85.3%) were aware of the category of wastes, but not aware of the color coding followed for the same. Majority of the respondents did not segregate the waste generated in their working place, 85.8% used chair side bins for disposal. Conclusion: Though most of the dentists were aware of the BMW management rules, majority of them practiced inappropriate waste disposal techniques.
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Awareness, attitude, and prevalence of periodontal diseases in West Godavari District of Andhra Pradesh p. 141
Praveen Gadde, Gautami S Penmetsa, M A. K. V Raju, A V. Rama Raju
DOI:10.4103/jiaphd.jiaphd_121_18  
Background: Prevention and control of oral diseases, in general, and periodontal diseases, in particular, are influenced by the knowledge attitude and personal behavior of the individual. Aim: The aim of this study was to determine the prevalence of periodontal disease as well as awareness and attitude of the individuals toward periodontal diseases. Material and Methods: This descriptive, cross-sectional epidemiological survey included a total of 3200 individuals with an age range of 18–65 years. For sample selection, West Godavari district was divided into four revenue divisions. From each division, two mandals were selected, and from each mandal, two villages were selected randomly. The examination process included the recording of the indices, namely, Community Periodontal Index (CPI) and Loss of Attachment Index in an attempt to estimate the prevalence of periodontitis. On the other hand, a 23-item questionnaire was given to all the participants involved in the study to assess the knowledge and attitude of the involved individuals. The data collected were analyzed using IBM SPSS version 21.0. Descriptive statistics were computed. T-test and one-way analysis of variance were employed. P < 0.05 was considered statistically significant for all the comparisons. Results: The results of our study showed a prevalence rate of 55.3% in the West Godavari population. Poor knowledge regarding periodontal status was observed in our study in patients above 45 years of age. There was no significant difference in periodontal knowledge score between males and females (P = 0.788). The graduates elicited greater periodontal knowledge compared to illiterates (P < 0.001). Conclusion: Our results showed higher prevalence of periodontal diseases with poor periodontal knowledge score alongside a generally positive attitude toward periodontal health and disease among the West Godavari population. Health education programs should place more emphasis on causes and manifestations of periodontal diseases
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Relationship between academic procrastination and self-esteem among dental students in Bengaluru City p. 146
Priya Babu, K Mahesh Chandra, MK Vanishree, N Amritha
DOI:10.4103/jiaphd.jiaphd_182_18  
Background: Procrastination may be conceptualized as a behavioral self-handicap. In education and training, the term academic procrastination is commonly used to denote the delay in academic activities. A person who procrastinates starts feeling powerless and hopeless; his confidence suffers and future seems dark and can lead to low self-esteem. Aim: The aim of this study was to assess the relationship between academic procrastination and self-esteem among dental students in Bengaluru City, Karnataka, India. Material and Methods: The current cross-sectional study was conducted among dental students from three different dental institutions in Bengaluru. The sample consisted of 255 dental students. Data were collected through questionnaire using the Tuckman Academic Procrastination Scale and Rosenberg Self-Esteem Scale. The data collected were analyzed using SPSS software version 14.0. Independent Student's t-test, ANOVA, and Pearson's correlation test were performed. P < 0.05 was considered statistically significant. Results: The results indicated that a significant weak positive correlation (r = 0.25, P < 0.001) existed between academic procrastination scores and self-esteem scores. There was a significant difference in the mean score of academic procrastination between males (40.81 ± 6.87) and females (42.80 ± 7.25) (P = 0.03). Conclusions: The current study found out that students with high self-esteem procrastinate less, whereas those who procrastinate more have comparatively lower self-esteem. Timely intervention can help students improve their skills such as time management and study habits.
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Physical activity among dentists in neo-capital area of a South Indian State: A cross-sectional study p. 152
Sunil Kumar Bonu, Srinivas Pachava, Vikram Simha Bommireddy, Srinivas Ravoori
DOI:10.4103/jiaphd.jiaphd_138_18  
Background: Sedentary work, which the dental profession demands, causes repeated strain in muscles, tendons, and other body tissues, which could lead to the development of musculoskeletal disorders (MSDs). The prevalence and severity of MSDs can overcome by performing regular physical exercises. Aim: To assess the physical activity among dentists in neo-capital area of Andhra Pradesh, India. Material and Methods: A cross-sectional study with the help of a self-administered, closed-ended questionnaire was conducted in dental clinics and dental institutions of capital area of Andhra Pradesh, India. A total of 200 dentists were included in the study. Data analysis was performed using SPSS version 20, and Spearman's correlation coefficient, Chi-square test, and Fisher's exact tests were used to analyze the data, and P ≤ 0.05 was considered statistically significant. Results: The study sample consists of 119 (59.5%) males and 81 (40.5%) females, with 50% of individuals belonging to 31–40 years of age group. Majority of individuals belonged to the category of normal (43.5%) and overweight (43.5%) categories of body mass index (BMI) scores. The prevalence of physical activity among the study population was 57.5%, and 53 (26.5%) individuals had suffered from MSD. There was a statistical significance between age groups and BMI scores (P = 0.01). Conclusion: The demanding and busy life of a dentist should not be perceived as a deterrent to physical activity. Dentists should be at forefront in doing physical activity because of its positive effect on the physical stress and strain, which, in turn, can have effect on delivering services.
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Factors influencing the prevalence of tobacco use among high schoolchildren: A pilot study p. 157
G Radha, Bobby Joseph, HL Jayakumar, Varadharajula Venkata Ramaiah
DOI:10.4103/jiaphd.jiaphd_102_18  
Background: The health risks of tobacco use are well known, but kids and teens continue to smoke and use tobacco. Many young people pick up tobacco habits every year; in fact, 90% of all adult smokers began smoking started when they were kids. Aims: The aim of this study was to estimate factors influencing the prevalence of tobacco use among 13–15-year-old high schoolchildren and to assess their knowledge, attitude, and behavior regarding tobacco use. Material and Methods: This pilot study was conducted among 210 schoolchildren selected from three schools based on convenient sampling method. The modified version of Global Youth Tobacco Questionnaire (World Health Organization) was used to measure the knowledge, attitude, and tobacco use of children. The analysis was carried out using the Statistical Package for the Social Sciences software version 17. Descriptive statistics were used for the analysis of the study variables. Chi-square and Fisher's exact tests were applied to test the association of knowledge of and attitude toward factors influencing tobacco use. The level of significance was set at 5%. Results: Of the 210 children participated in the study, 54.8% were boys and 45.2% were girls. Ever tobacco use was reported by 31.4% of children, of which, over 10% reported initiation around 8–10 years of age and 21% of them at 12–15 years of age. Among them, 32 (15.2%) children used the smoking form of tobacco (cigarette, beedi, and other unspecified forms), 27 (12.9%) used the chewing form of tobacco, and 7 (3.3%) participants used both forms. The association was found to be statistically significant with regard to the knowledge (P = 0.03) and attitude scores (P < 0.001). Conclusion: It was found that tobacco use by parents, siblings, and teachers influences the children to initiate tobacco. Knowledge about the harmful effects of tobacco use among children was poor.
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IAPHD NEWS Top

IAPHD News p. 163

DOI:10.4103/2319-5932.238595  
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