Diet and nutritional factors affects oral health in multiple ways. Carbonated beverages have an inherent acidity due to the presence of carbonic acid, phosphoric acid and citric acid that are added to stimulate taste. Dental Erosion is an irreversible loss of dental hard tissues by a chemical process without bacterial involvement. The objective of this systematic review and meta-analysis was to evaluate the association of carbonated beverages with dental erosion. MEDLINE, Science Direct and Google Scholar were searched for articles published between January 2000 to March 2020. Observational studies reporting odds ratios for comparing the risk of dental erosion in patients reporting a frequent consumption of carbonated drink versus those with infrequent consumption were included for review. Studies not reporting odds ratio or with insufficient information to calculate odds ratio were excluded from the study. Newcastle-Ottawa scale was used to assess the quality of the studies. Pooled odds ratios and 95% confidence interval were calculated using a random-effect, generic inverse variance method. A total of 20978 participants from 21 cross sectional studies and 1 cohort study were included in the analysis. The pooled crude odds ratio (19 studies) was found out to be 1.44 (95% CI, 1.23–1.68) and pooled adjusted odd ratio (12 studies) was found out to be 1.86(95% CI, 1.42–2.42). Several clinical and methodological variation among the studies contributed to statistical heterogeneity (I2 = 69%, P ≤ 0.01 for crude odds ratio and I2 = 88%, P ≤ 0.01 for adjusted odds ratio).This systematic review study demonstrates statistically significant associations between consumption of carbonated beverages and dental erosion. Because of the high clinical and methodological heterogeneity estimated pooled effect cannot be relied upon.

Background: The ongoing pandemic has posed limitations to dental practice. In the current scenario of the coronavirus disease-2019 (COVID-19) pandemic, many patients present with symptoms like burning of the eyes, nose, throat, xerostomia, and mouth ulcers. For this, the Ministry of AYUSH is promoting oil pulling as a preventive measure. Aim: The aim of this study was to increase the awareness and confidence of dental practitioners in prescribing a simple technique for ameliorating common symptoms of COVID-19 infection – by oil pulling, in routine clinical practice. Methods: This study entailed designing a standardized web-based questionnaire for conducting a survey among dental practitioners from all specializations. Here, 100 participants answered 14 questions related to the role of oil pulling in treating oral symptoms common among COVID-19 patients and immunocompromised radiation patients. Statistical analysis was carried out after receiving all responses. Frequencies and percentages were calculated. Results: The results of the present survey indicated that 8.6% of total participants had good awareness (>16 Qs); 56.3% of total participants showed moderate awareness (10–16 Qs); while 35.2% had poor awareness (<10 Qs). Conclusion: Oil pulling can be deemed as an effective method of treating oral symptoms of COVID-19. Dentists should acquire adequate knowledge regarding the role and importance of this simple preventive measure.

Background: Chlorhexidine is considered a gold standard among the chemical plaque control measures. Recently, a search for a natural alternative having similar effectiveness of that of chlorhexidine is gaining importance due to various side effects reported. Honey is a natural product with antibacterial properties that can be used to improve oral health. Manuka honey (MH) is considered superior due to its antibacterial properties. However, studies pertaining to effectiveness of MH and chlorhexidine on oral health are limited. Aim: This study aimed to evaluate the effectiveness of MH and 0.2% chlorhexidine digluconate (CHX) mouthwash on reducing gingivitis and Streptococcus mutans count (SM). Materials and Methods: A randomized controlled trial blinded study was conducted among 12–15 years old children with (Decayed, Missing, Filled Teeth) scores of 1–4, plaque and gingival scores of 1–2 were selected, and an equal number of children (30 each) were randomly allocated to MH and CHX groups. Participants were instructed to rinse 5 ml of MH and 10 ml of CHX twice daily for 14 days. Unstimulated saliva was collected from the children, and plaque and gingival indices were assessed at baseline, 7^th day, and 14^th day. Unstimulated saliva was subjected to microbiological analysis for SM. Student's t-test and repeated-measures analysis of variance test were applied for inter- and intragroup comparison, respectively. P < 0.05 was considered significant. Results: There was no statistically significant difference in plaque and gingival scores and SM count between the groups at baseline, 7^th day, and 14^th day. Statistically significant reductions (P < 0.01) in plaque, gingival scores, and SM count were observed in both the groups at 7^th and 14^th day from baseline. No adverse events were reported during the trial. Conclusion: Effectiveness of MH was comparable with CHX mouthwash in reducing gingivitis and SM count. MH seems to be a promising antimicrobial agent effective in improving gingival health and reducing caries risk.

Background: Second-hand smoke (SHS) causes more than 1.2 million premature deaths per year and other serious diseases. Aim: The aim of the present study was to determine exposure to SHS among college students in Mangalore, South India. Methods: This cross-sectional study was done among 2063 college students aged 18–24 years in Mangalore. Data regarding exposure to SHS at home and indoor work areas were collected. Chi square test was used to test the association between study variables. Multinomial logistic regression was used to find factors influencing SHS exposure. Results: In the present study, 9.9% of the respondents were exposed to tobacco smoke at home of which 8.4% were nonsmokers. Among the respondents, 21.7% were exposed to tobacco smoke at indoor work areas of which 19.3% were nonsmokers. Significant association was found between current tobacco smoking status and anyone smoking inside the home or workplace. Logistic regression analysis revealed that males had 1.814 more odds of getting exposed to SHS at home and 1.976 more odds of getting exposed to SHS at indoor work areas than females. Conclusion: Exposure to SHS was higher at indoor work areas than at home and majority of the respondents exposed to SHS were nonsmokers. The findings emphasize the need for increased efforts to implement strategies to control SHS exposure.

Background: The population of geriatric patients in India is increasing, and the uneven geographic distribution of dentists and the various age-related factors are likely to pose an oral health challenge in the near future. Aim: The aim of this study was to assess perceived needs and identify and describe the barriers associated with oral health service utilization among the elderly population aged 65–74 years in Davangere city. Methodology: A cross-sectional door-to-door survey using a self-designed, structured, validated questionnaire was carried out with a sample of 1440 elders. They were randomly selected through multistage sampling technique. Information regarding demographic details, systemic conditions, oral hygiene practices, perceived need, utilization rate of dental services, and factors acting as barriers for the utilization of dental services among the elderly were collected. Chi-square test and Pearson correlation were applied. Results: About 70.5% of the subjects had utilized the dental services in their lifetime, but only 41.4% had utilized in the previous year. Fifty percent of the elders perceived a problem in their oral cavity. Most of our respondents suffered from more than one chronic disease and had utilized the dental services. The cost of treatment, nonsuitability of location of clinic, indirect cost due to transport, the appointment system, and no availability of services on weekends acted as the important barriers to utilize the dental services. Conclusion: Financial constraint and lack of perceiving dental problems as severe acted as major barriers. Preventive oral hygiene measures tailored to meet the unique needs of the individual patient are essential.

Background: Gingivitis is the most prevalent oral disease among children with a strong influence of social gradients. To date, its studies in the Uttarakhand state are scarce and inconclusive. This study aimed to investigate the epidemiologic parameters of gingivitis and its association with sociodemographic and clinical risk factors in the 6–19-year-old children in Uttarakhand state. Materials and Methods: Cross-sectional data from 1400 children 6–19 years old from Rudraprayag district, Uttarakhand, were analyzed. Sociodemographic status and oral hygiene habits were assessed by questionnaires answered by parents and children. Oral health status and anthropometric examination of each participant were also conducted. Multivariable logistic regression modeling was used to evaluate relationships between gingivitis and risk factors. Results: The prevalence of gingivitis was 20.0% of which 5.4% of children had severe gingivitis affecting gums around more than 6 teeth. Older children (>12 years), children with good oral hygiene habits, and normally aligned teeth with Angle's Class 1 occlusion displayed better gingival conditions, whereas, poor Socioeconomic status had a negative effect on gingival health. Conclusions: As compared to other states of the country, the prevalence of gingivitis was lower in Uttarakhand. The children belonging to lower socioeconomic status and who do not brush daily were more frequently affected by gingivitis. Children with maligned teeth (crowding or spacing), and Angle's Class 2 and 3 occlusions had a high prevalence of gingivitis.

Background: Working with emotions is an important aspect of the nurse–patient relationship: the nurse will better manage his/her own emotions, and will also influence patient's emotions on investigations, treatments, fears, vision about disease, etc., Aggression is one of the important factors that significantly affect the performance of an individual. Aim: The aim of this study was to identify the level of emotional intelligence (EI) and aggression among nursing students and to assess its correlations with sociodemographic variables. Materials and Methods: A cross sectional study was done among 242 nursing students of various nursing colleges of Sri Ganganagar, Rajasthan. Data collection was done using two questionnaires one for emotional intelligence and another for aggression level. The results were determined using the mean, standard deviation, T test and Pearson's correlation coefficient with level of significance was set at P < 0.05. Results: There is a nonsignificant negative relationship of verbal aggression (r = −0.0192) with EI. Higher aggression was seen in male participants in the age group of 18–21 years and in the 1^st year of nursing students (P ≤ 0.01). Conclusion: Males were more aggressive whereas females were found to be more emotionally intelligent in the current study.

Introduction: Cultural competence of health-care professionals has a vital role in health-care system. The first step toward this orientation is the assessment of cultural competence level of clinical graduate students. Objective: The objective of the study was to assess the cultural competence of clinical graduate students of various courses in a health-care university, Kerala, India. Methods: A cross-sectional study was conducted among 398 clinical graduate students in a health-care university in Kerala, India. The self-administered questionnaire had 27 items adapted from various validated scales. Data analysis was done by the analysis of variance (ANOVA) using SPSS software (version 23). P < 0.05 was considered statistically significant. Results: The overall mean of the responses ranged from 2.81 (confidence interval [CI]: 2.70–2.93) to 4.50 (CI: 4.43–4.57). ANOVA revealed statistically significant differences between the courses in competencies related to specific competencies. Conclusion: Our findings suggest that cultural competence of health-care graduates can be improved by incorporating cultural competence training in the curriculum.

Background: Burnout syndrome (BS) is related to work and is generally seen among health-care professionals including students. Students use various coping mechanisms to deal with stress and burnout and extracurricular activities are one among them. Aim: The aim of the study is to assess the burnout levels of dental students and its association with the indulgence in extracurricular activities (ECA). Materials and Methods: A cross-sectional questionnaire study was conducted among students of a deemed university dental school in south India. All the students from 1^st year to 5^th year (internship), both regular and supplementary batches were included. Maslach Burnout Inventory-Student Survey was used to assess burnout which consists of 15 items on three domains emotional exhaustion (EE), cynicism (CY), and professional efficacy (PE). All the responses were scored on a five point Likert scale. Mann–Whitney U-test and Poisson log-linear model were used. A P ≤ 0.05 was considered as statistically significant. Results: A total of 208 participants were included in the final analyses. Majority of the participants were females (84.1%) and 1^st-year students (26.4%). The mean age of the participants was 20.6 ± 1.8 years. The prevalence of BS was 19.7%. A significant difference was seen for the participation in ECA and all the three domains (EE, CY, PE) of BS (P values 0.029, 0.004 and 0.006, respectively). Conclusion: The prevalence of burnout can be considered as high among the participants. Early screening for burnout in dental students and effective interventions at earlier stages is required.

Introduction: Social media platforms play an important role in the dissemination of information on the COVID-19 pandemic. Fake news had spread more rapidly on social media during the pandemic. Frequent exposure to fake news on coronavirus disease in social media creates panic and affects people's mental health. Aim: This study aims to assess the effect of social media on spreading panic over COVID–19 among dental students in Nellore city of Andhra Pradesh. Methodology: A descriptive cross-sectional study was conducted over a period of 1 month on 534 dental students of Nellore city of Andhra Pradesh. A specially designed and validated 20-item questionnaire was used to collect the data. SPSS version 21.0 was used for the statistical analysis. The Chi-square test used for categorical data. P < 0.05 was considered statistically significant. Results: Majority of the subjects used Instagram (50.3%) and Whatsapp (79.4%) to obtain and share information related to COVID-19 respectively. There was statistically significant association between the BDS and MDS dental students' responses on the questions relating to panic created over COVID-19 in social media. 54.2% of subjects felt that filters need to be set up for social media during a humanitarian crisis. Conclusion: The study concluded that the panic created in social media over COVID-19 had an impact on dental students.

Background: Edentulism among the elderly deteriorates the physical, social, and mental dimensions of oral and general health. Objectives: This study compared the changes in oral health-related quality of life (OHRQoL) of the edentulous elderly following prosthetic rehabilitation with complete dentures among beneficiaries of public denture programs. The study also compared the responsiveness of Oral Health Impact Profile-14 (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI). Methodology: This prospective pre–post comparison study was conducted among beneficiaries of two public-funded oral rehabilitation programs (P1 and P2) organized by local self-government institutions. OHRQoL was recorded using OHIP-14 and GOHAI in P1 and P2, respectively. Data collection was done at baseline using direct interview and 4 weeks after denture insertion using telephonic interview. Wilcoxon signed-rank tests were used to compare differences in responses between baseline and posttreatment. Statistical significance was considered at P < 0.05. Psychometric properties of tools were determined using Cronbach's alpha and exploratory factor analysis. Results: The mean change in OHIP-14 and GOHAI at 4 weeks after denture insertion was 15.39 ± 12.61 and 10.73 ± 8.71, respectively (P < 0.05). Cronbach's alpha for the modified OHIP-14 and GOHAI scales was 0.73 and 0.65, respectively. Conclusions: Prosthetic dental rehabilitation provides psychological, social, and functional benefits to the edentulous elderly. Public-funded denture programs are effective to improve OHRQoL among the edentulous elderly from a poor socioeconomic background.

Background: The fluoride intake in the general population derives chiefly from drinking water and dietary sources. The presence of fluoride in groundwater for drinking purposes may be beneficial or detrimental depending on its concentration and the amount ingested. Objective: The objective of the study was to estimate the concentration of fluoride in drinking water sources of Raipur district. Methodology: A descriptive cross-sectional study was carried out for fluoride mapping of Raipur district. Samples of drinking water were collected from 50 different sites of 20 villages. The concentration of fluoride in drinking water was analyzed using ion-selective electrode method. Results: In all the water samples analyzed, there was the presence of trace amount of fluoride, which ranged from 0.2 ± 1.22 ppm with the mean concentration of 0.411 ± 0.180 ppm. Conclusion: Fluoride levels in groundwater were in trace quantity and well below the optimal level of fluoride necessary for caries prevention.

Background: Oral health is an integral part of general health and toothbrushes are the most commonly used oral hygiene aid. Unfortunately, proper care of toothbrush is often neglected and is kept in bathrooms which are a good place to harbor millions of microorganisms. Aim: To assess the bacterial contamination of toothbrushes for Streptococcus mutans, Staphylococcus aureus, Candida albicans, and Lactobacillus when kept in different sanitary settings before and after the use of disinfectant. Materials and Methods: A total of 60 volunteers were randomly selected between the age of 6–16 years. Toothbrushes were grouped into two categories: Group 1: Outside the bathroom. Group 2: Within the bathroom with attached toilet. Group 2 was further divided into two subgroups: Group 2 (i): Kept individually in separate containers. Group 2 (ii) kept with that of family members and siblings within the same container. The present study was carried for 3 months in two phases with the same participants both before and after the use of disinfectant. Results: Microbial contamination was highest in Streptococcus and least in Lactobacillus before and after the use of disinfectant when toothbrushes were kept outside the bathroom and microbial contamination was similar in both Streptococcus and Lacctobacilus when kept inside the bathroom with attached toilet in separate container and same container both before and after the use of disinfectant. Conclusion: A high level of pathogenic microorganisms were seen in toothbrushes kept in the bathroom for 3 months which were reduced by dipping them in 0.12-% chlorhexidine gluconate.

Background and Objectives: Dental caries is an infectious transmissible disease resulting from tooth-adherent specific bacteria, primarily Mutans streptococci. Fluoride varnish is an effective antimicrobial agent against Streptococcus mutans (S. mutans). The aim of the study was to evaluate the levels of S. mutans in children following application of a fluoride varnish containing CPP-ACP in mother–child pairs. Materials and Methods: Sixty children aged 18–36 months, at high caries risk along with their mothers formed the study group. Baseline levels of S. mutans in saliva of mothers and dental plaque of children was microbiologically assessed for S. mutans using the culture method. They were divided into three groups, consisting of 20 mother–child pairs. Group 1: Application of varnish to mother and saline as a placebo to child; Group 2: Applying varnish to child and saline as a placebo to mother; Group 3: Applying varnish to both mother and child. S. mutans levels in dental plaque of children were assessed at 3, 6, 9, and 12 months. Data obtained were subjected to statistical analysis using one way analysis of variance, paired t-test and multiple Post hoc tukey. The level of Significance was considered at 5% Results: In all the groups, there was a significant reduction of S. mutans levels in dental plaque of children at 3, 6, 9, and 12 months. The highest reduction in S. mutans was in Group 3 (95.33%) followed by (95.12%) in Group 2 and 40.6% in Group 1 (P < 0.05). Conclusion: Application of fluoride varnish containing CPP-ACP to the children gave equivocally significant reduction in S. mutans levels of dental plaque in children, as compared to applying in both mother and child.