Background: Despite the advances in technology, dental materials, and increased oral health awareness, significant percentage of people suffer from dental anxiety. Dental anxiety is ranked fourth among common fears and ninth among intense fears. Aim: The aim was to assess the level of anxiety of dental treatment among patients in primary health centers (PHCs). Materials and Methods: The sample was made up of 100 patients from both genders over 18 years of age visiting PHCs for dental treatment, who were not suffering from any psychological limitation, between August and September 2017. Data collection was carried out through the administration of validated questionnaires by a calibrated researcher. A self-administered prevalidated questionnaire was used to evaluate the level of anxiety among the patients. The Modified Dental Anxiety Scale was used to evaluate the degree of anxiety among study participants. SPSS 21 was used, and data were analyzed using Chi-square test. Results: The prevalence of dental anxiety among study participants was found to be 94%. Females were found to be significantly more anxious than males. Higher level of anxiety was found to be exhibited by participants for injection (55%), followed by scaling (45%) and tooth drilling (40%). Relative influence of age, education, occupation, type of dental treatment, and previous dental visit were not significantly associated with dental anxiety. However, those participants who had past negative dental experience were found to be significantly more anxious. Conclusion: The study showed that dental anxiety was high among the participants. High level of anxiety was found to be exhibited by participants for injection, followed by scaling and tooth drilling. Level of anxiety is significantly associated with past traumatic dental experience, gender (higher level of anxiety was found to be among women), and low-income group (0–10 K) per month.

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Background: Oral diseases can be considered as a public health problem due to their high prevalence and significant social impact. Aim: This study aimed to assess dental knowledge, oral hygiene, oral hygiene practices, and eating habits among 12- and 15-year-old children in Chennai and to correlate the level of oral hygiene with oral hygiene practices. Materials and Methods: A descriptive cross-sectional survey was conducted among 1600 children from various schools in Chennai. Simple random sampling methodology was used to select the schools from all the four zones. The methodology included a close-ended questionnaire on oral health awareness and recording of Oral Hygiene Index-Simplified (Greene and Vermillion, 1964). The statistical analysis was performed using SPSS software, version 16. Student's t-test and analysis of variance were used for the comparison of two and more than two groups, respectively, followed by post hoc test. Pearson's correlation coefficient was used to find the correlation between two or more variables. The level of significance was set at P < 0.05. Results: Around 1285 (80.3%) children felt that tooth decay is a disease that destroys the teeth and 1101 (68.8%) knew that gum infection makes gums to bleed. Overall distribution reported that 1018 (63.6%) children had fair oral hygiene. Poor oral hygiene score was seen more in government schoolchildren than private schoolchildren with highly statistically significant results. Conclusions: The overall knowledge on oral health was good among the children. Nearly 90% of the children had fair debris score. Oral hygiene practices were positively correlated with the level of oral hygiene.

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Background: Oral health status is dependent on the interplay of multiple etiological and predisposing factors, which have varying ability to cause diseases. However, little is known about maternal factors associated with the oral health of preschoolchildren at different stages of their development. Aim: To assess the association of maternal oral health-related knowledge and attitude with the preschoolchildren's dental caries status. Materials and Methods: The present study was a cross-sectional study conducted among 618 mother–child pairs. Three to 5-year-old preschoolchildren were selected from eight preprimary schools following two-stage random sampling. Responses from the mothers on oral health-related knowledge and attitude were collected through a structured questionnaire. It was followed by dental caries examination of their preschoolchildren based on the WHO criteria for dental caries examination. Chi-square test was done to find the association between the study variables. Model for the prediction of dental caries occurrence in preschoolchildren was generated following multiple logistic regression analysis. Level of significance was set at P < 0.05. Results: The mean correct oral health-related knowledge and attitude scores of mothers were 6.59 ± 2.35 and 7.28 ± 1.83, respectively. Preschoolchildren had a mean untreated dental caries score of 2.73 ± 1.63 and decayed, missing, and filled teeth score of 3.13 ± 1.79. Untreated dental caries in children was found to be statistically significantly associated with maternal oral health-related knowledge ( P = 0.021) and attitude ( P = 0.006). Mothers who were having better knowledge and favorable attitude toward oral health had significantly lower odds of developing dental caries in their children as reflected by the logistic regression analysis (odds ratio = 0.33 [0.22–0.52] and 0.36 [0.24–0.53], respectively). Conclusion: The study concluded that maternal factors were significantly related to children's dental caries status and emphasized the need of raising awareness among mothers for limiting and controlling dental caries among preschoolchildren.

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Background: Promoting oral self-care capacity and the use of fluoride toothpaste is an appropriate strategy for the prevention of oral diseases among schoolchildren, especially in a developing country like India. Aim: To assess the oral health behavior of fluoridated toothpaste usage among parents of 12-year-old schoolchildren in Mangalore, South India. Materials and Methods: Around 523, 12-year-old school students selected by cluster random sampling were given questionnaires to be completed by the parents to elicit their dental health behavior. Data were analyzed using SPSS software version 16.0. Bivariate analysis of the association of dental health behavior and the type of the school was conducted using Chi-square test. Finally, we fitted a multivariate binary logistic regression model to estimate the strength of association, and P < 0.05 was considered statistically significant. Results: In this study, all the schoolchildren used toothpaste to clean their teeth, and the major factors which influenced the selection of toothpaste were promotional offer and advertisement for government and private schools, respectively. Multivariate analysis revealed that private schoolchildren had higher odds for using fluoridated toothpaste (odds ratio [OR] – 6.04 confidence interval [CI]: 1.929–18.912), receiving instructions from dentist (OR – 4.63 [CI: 2.770–7.741]), and brushing twice daily (OR – 0.37 [CI: 0.219–0.629]). Enrollment in government schools was associated with lower odds for selecting toothpaste based on professional advice (OR – 0.11 [CI: 0.072–0.177]). Conclusions: Private schoolchildren had higher usage of fluoridated toothpaste. Private schoolchildren had higher usage of fluoridated toothpaste and receiving instructions from dentist about dental health behavior. To overcome the Inverse Care Law, it is of utmost importance to create awareness among government schoolchildren.

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Background: Quality of future dental workforce is passively determined by their perceptions to curriculum and academic environment. Aim: The aim of the study is to know the anticipations of the freshly joined dental students about their educational environment using Dundee Ready Educational Environment Measure (DREEM) questionnaire and comparing it after the completion of the 1^st year. Materials and Methods: This was a longitudinal study conducted in a private dental institute. DREEM questionnaire was given to 84 freshman students on the day of joining institute and after completion of 1 year. The Statistical Package for the Social Science, version 21 (SPSS Inc., Chicago, IL, USA) was used for analysis of data, and 95% confidence interval was used for analysis of data. Mean and standard deviation were calculated. Wilcoxon signed rank test was used to compare overall mean DREEM scores, subscales scores, and individual scores on two occasions. Level of statistical significance was set at P ≤ 0.05. Results: Mean DREEM score on the first occasion was 147.8 and completion of the 1^st year was 124.6 with a discrepancy of 23.2. Conclusions: Students have positive perceptions for their academic environment at the time of joining institute and after completion of 1 year in the institute with DREEM score obtained was above 101 (indicating more positive than negative environment) on both occasion.

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Background: The hands of health-care workers are the primary mode of transmission of the pathogens to patients, so hand hygiene is considered to be the most important and least expensive means of preventing nosocomial infections. Aim: The aim of this study is to assess and compare the antimicrobial efficacy of different hand sanitizers. Subjects and Methods: An in vitro study was conducted in the Department of Public Health Dentistry in the Dental College, Delhi NCR, to evaluate the antimicrobial efficacy of Green Apple (Himalaya), Lemon (Lifebuoy), Aloe vera (Tempo) hand sanitizers and compared them with the antimicrobial efficacy of sterillium hand sanitizers which is considered as the gold standard in hand sterilization. Twenty five participants were divided into five groups. The Gloves worn by the participants were swabbed after oral prophylaxis using different hand sanitizers. The inoculation of the sample was done and incubated for 48 h at 37°C, and colony-forming units were counted. The data obtained were compiled systematically using Microsoft Excel and were analyzed using the SPSS version 19.0. Data were statistically analyzed using descriptive statistics to assess the mean, standard deviation, standard error of the mean, and ANOVA and post hoc test for group-wise comparisons. A value of P < 0.05 was considered statistically significant. Results: Sterillium group showed the highest antimicrobial effectiveness followed by lemon group (71.4 ± 11.80), Green Apple group (112 ± 13.78), and A. vera group (156.4 ± 34.37), respectively, against all the organisms in the study. Conclusion: Sterillium possessed maximum antimicrobial effect against all the Gram-positive as well as Gram-negative bacteria as compared to lemon, green apple, and A. vera hand sanitizers.

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Background: The primary dentition for children is, perhaps, the most essential and yet the most neglected concern by a parent. Often, these parents who are responsible for the health of the primary dentition of their children feel that primary teeth eventually shed, and hence does not deserve heed on providing adequate oral health. Aim: The aim of this study was to evaluate the parental knowledge, attitude, and practices on the importance of primary dentition of their children. Materials and Methods: An institution-based cross-sectional study was done among parents of children below 12 years of age. A 25-item semi-structured questionnaire, in both English and Malayalam languages, was prepared for the data collection. Statistical analysis was done using the Statistical Package for the Social Sciences. The quantitative variables were described as mean and standard deviation. To find out the association between categorical variables, the Chi-square test was applied. A multivariate logistic regression was done to find the independent predictors of knowledge. P <0.05 was considered statistically significant. Results: A total of 473 parents participated in the study. About 55.4% of the parents were found to have poor knowledge, while 58.4% and 55.2% of the parents were found to have good attitude and practice about the importance of primary dentition, respectively. There was a significant relationship between knowledge ( P = 0.0001), attitude ( P = 0.001), and practices ( P = 0.017) of the parents with their level of education. Furthermore, a significant association was found between the knowledge of parent and the area of residence ( P = 0.036) and attitude of the parent with that of the gender of the child ( P = 0.043). Conclusions: Majority agreed that primary teeth were important along with the knowledge that dental diseases were related to health problems. Education played a major role in parental awareness of primary dentition.

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Background: Dental caries and periodontal diseases have been considered the most important global oral health burdens. The dentist-to-population ratio is 1:10,000 in urban areas, whereas 1:50,000 in rural areas. There are several challenges being faced in delivery of oral health care to the Indian population, such as lack of workforce and poor accessibility which is compounded by poverty and illiteracy. In view of the above, the present study was carried out. Aim: The aim of the study is to assess dentition status, oral mucosal lesions, and periodontal status of patients and to determine the level of access barriers of the population in utilization of oral health services of dental college in Lucknow. Materials and Methods: A hospital-based survey was designed to assess the dentition status, oral mucosal lesions, periodontal status, and access barriers of patients reporting to dental college in Lucknow. The study was conducted among patients aged above 15 years coming to the Outpatient Department of Oral Medicine and Radiology in Dental College. The participants completed a self-administered questionnaire regarding accessibility and utilization of dental services across different socioeconomic groups. Caries status, Community Periodontal Index, and oral mucosal lesions were recorded as per the WHO 2013 pro forma. All descriptive as well as inferential statistical analysis using Chi-square was carried out using SPSS version 21.0 for Windows and the value of P < 0.05 was considered statistically significant. Results: Dental caries was found to be 55.8%, prevalence of oromucosal lesions was 11.1%, and only 1.6% had loss of attachment (6–8 mm) and prevalence of periodontal disease was 40.3%. Access to dental care in the present study was high 80.1%. Regarding the utilization of dental services, a large percentage of the respondents visited the dental college only when they have a toothache (48.1%) or hole in the tooth (14.8%). Only very few visit the dentist for regular checkups or cleaning (2.2%). Conclusion: The prevalence of dental caries was 55.8% and mean decayed-missing-filled teeth was 8.57%. The periodontal changes were 40.3% and severe periodontal disease was uncommon. The most important barrier in the utilization of the available services was cost of seeking oral care and individual variations in perceived need of care.

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Background: Endosulfan, an organochlorine pesticide, is a broad-spectrum contact insecticide widely used in pest control. Aerial spraying of this pesticide was being carried out in the cashew plantations in the Kasaragod district of Kerala, India, for several years. Various reports have been published on the serious adverse effects of this chemical on human health. Data on the oral health of endosulfan victims are scarce in the literature. Aim: This study aimed to assess the oral health status and developmental disturbances of oral structures among endosulfan victims of Kasaragod district, Kerala. Materials and Methods: A cross-sectional study was conducted among the endosulfan victims of 12–60 years of age using World Health Organization Oral Health Survey pro forma 2013 and a separate form to record the developmental disturbances of oral structures at BUDS Special School for Endosulfan Victims and Primary Health Center, Perla, Kasaragod. Descriptive statistics were used to analyze the data. Results: There were a total of 25 subjects in the age range of 12–60 years. The mean DMFT score of the subjects aged below 15 years (n = 12) was 3 ± 2.94 and for the subjects aged above 15 years was 4.23 ± 3.81. Bleeding on probing was present in all the participants. Micrognathia, microglossia, and fissured tongue were the main features observed in the study. Conclusion: The overall oral health status was found to be unsatisfactory due to the disabilities of the endosulfan victims. The current study has set a milestone and calls for the need of the assessment of endosulfan victims of other parts of the state.

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Introduction: The children residing in orphanages suffer from poor oral health. Early identification of oral diseases is at most necessary in these high-risk group children so that the prevention and controlling of the diseases can be done at the earliest. Aim: This study aims to assess the oral health status of children residing in orphanages of Hassan city, India. Materials and Methods: In this descriptive cross-sectional study, children without parents, aged 6–14 years were selected from government-run orphanages. Children willing to participate were included. Each child was examined by a single investigator. Each child was examined on an upright chair in an adequate natural light using. The data obtained were subjected to statistical analysis using Student's t-test and SPSS software 19.0. P < 0.05 was considered as statistically significant. Results: The mean oral hygiene score among males was 1.32 ± 0.69 and among females was 0.89 ± 0.80 ( P = 0.006). On comparison of mean gingival index score between males and females, it was not statistically significant ( P = 0.160). The prevalence of dental caries in primary and permanent dentition was 26.21% and 23.07%, respectively. The prevalence of fractured tooth was found to be 8.57%. Conclusions: The oral hygiene status and gingival health status of the orphan children were good. The prevalence of dental caries and dental trauma was low among them.

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Background: Oral health is always an inseparable part of general health. The inequalities in socioeconomic status (SES) are the causes of many health disparities including oral health in the world. Aim: To document the differences in oral health status leading to tooth mortality based on socioeconomic stratification. Materials and Methods: A cross-sectional study was done using stratified random sampling. Centers/facilities providing dental care were stratified into government general hospital (GGH), teaching dental hospital (TDH), and private dental clinics (PDCs). Sample size was taken as 750. Demographic data were taken from each patient; clinical examination of existing teeth was done, while decayed-missing-filled teeth (DMFT) and community periodontal indices were recorded. Data were analyzed by Statistical Package for the Social Sciences software version 20, and Chi-square, ANOVA, and Spearman correlation tests were used for statistical analysis. Significance level was set at P ≤ 0.05. Results: Of the total study subjects, 40% (n = 300) were taken from TDH, 33.3% (n = 250) were taken GGH, and 26.7% (n = 200) were taken from PDCs. A majority (50.5%) of them belongs to the upper-lower class. Majority (n = 412) were with community periodontal index (CPI) score of 2, and most of the people (n = 175) had loss of attachment (LOA) score below 2 6–8 mm), of which a majority of them belonged to upper-lower and lower SES. Both CPI and LOA were statistically significantly related with SES ( P < 0.001). As SES decreased, the mean DMFT increased and this relation was highly significant ( P < 0.001). The mean number of teeth to be extracted was increased with increased SES. Conclusion: Inverse correlation was observed between SES and mean DMFT. Majority of the low socioeconomic people were with sub- and supra-gingival calculus. It implies that socio-economically disadvantaged people are in great need of dental treatment. Hence, dental health education programs should be targeted to uneducated and low-income groups to reduce the rate of extractions.

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Background: Occupational hazards are common among dental professionals, and musculoskeletal disorders (MSDs) are very common. Aim: The aim is to report the prevalence and distribution of MSD among dental professionals practicing in Nagpur, India. Materials and Methods: A cross-sectional questionnaire study was conducted among 500 dental professionals from December 2016 to November 2017. The professionals were distributed in three groups (Group A, B, and C) based on the work experience in years. The questionnaire was designed to evaluate physical health related to MSD. Statistical analysis was performed by descriptive and inferential statistics using SPSS 17.0 version (Chicago, USA) software and the data were presented in counts and percentages, with P ≤ 0.05 is considered as the level of statistical significance. Results: In Group A, 24% of participants suffered pain in lower back while 4% of participants suffered from pain in multiple regions. In Group B, 27% of participants suffered pain in lower back whereas 5% experienced pain in multiple regions. In Group C, 34% of participants suffered pain in lower back whereas 17% experienced pain in multiple regions. The most common specific disorder among dental professionals was tendonitis of the shoulder and repetitive strain injury. There was an increasing trend in the presence of neurological pain with increase in number of years in dental practice. Conclusions: The musculoskeletal region most frequently affected in all three groups was lower and upper back contributing about 40% regions affected. However, there was no pain recorded among 32% in dental professionals. Pain involving the body parts depends on the posture, time, and procedures. Dental professionals always need to maintain multiple postures for prolonged periods; therefore, dental procedures should be divided into multiple appointments to minimize the time-consuming procedures. A daily routine should be followed with exercise or yoga for strain-free muscular activities.

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Background: Dental anxiety is a recognized problem for both patients and dental professionals. The data on dental anxiety of professional students in India are limited. It has been suggested that repeated exposure to dental treatment environment could result in lowering of dental anxiety. Aim: The aim of this study was to compare the self-reported levels of dental anxiety among dental and pharmacy students at an Indian institute. Materials and Methods: A total of 437 students of dentistry and pharmacy participated in the study. Dental anxiety of the students was assessed using the Modified Dental Anxiety Scale. Data on demographic details and previous dental experience were also collected using a self-administered closed-ended questionnaire. Statistical Package for the Social Sciences (SPSS V.16) was used for statistical analysis. Kruskal–Wallis test and Mann–Whitney U-test were used to assess differences in dental anxiety between student groups. The level of significance was considered to be P < 0.05. Results: There were about 69% women and 31% men with the mean age of 21.01 ± 2.91 years. Senior dental students showed a significantly lower dental anxiety than pharmacy ( P < 0.001) and dental students in the early years ( P < 0.001). Women reported significantly higher dental anxiety than men ( P = 0.001). Dental anxiety was also associated with having no prior dental experience ( P < 0.001). The most fearful situation reported by the participants was local anesthetic injection. Conclusions: Dental anxiety was significantly associated with sex, level of study, and the past dental experience. Dental education and awareness might be a significant factor in reducing dental anxiety.

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Background: Tobacco consumption is a major contributor to deaths from cancer, cardiovascular diseases, and other chronic diseases. The prevention of tobacco use among adolescents appears to be the single greatest opportunity for preventing noncommunicable diseases. Aim: The study aimed to assess the risk factors for current tobacco use among urban and rural school-going adolescents in Mangalore taluk. Materials and Methods: This cross-sectional study was conducted among 620 adolescents, and an equal number of participants were surveyed from urban and rural areas. After obtaining necessary approvals, schools were selected by stratified cluster sampling. A 10-item structured, self-administered questionnaire was used for data collection. Data were analyzed in the SPSS version 20.0 using the Chi-squared test with a significance level set at P < 0.05. Results: Current tobacco use was 12.7%. It was higher among males ( P < 0.001) and urban adolescents. Smokeless tobacco use was reported by 72.1% of current users; 68.3% of users reported starting habit in the past year. Rural boys formed a statistically significant component of frequent users ( P = 0.0024). Predominant reasons for initiation were used by family and friends/peers. Enhanced self-esteem was reported by 19.0% of users, whereas 39.2% experienced ill-effects. Desire to quit habit was expressed by 31.7% of users; 88.6% of users and 78.9% of nonusers stated that tobacco use was harmful. Conclusions: The prevalence of current tobacco use was 12.7%, and the smokeless form was predominantly used. Major influences on habit initiation were used by family and friends. While one-fifth reported enhanced self-esteem and 31.7% users wanted to quit habit. Enforcement of comprehensive tobacco control legislations is essential to protect this vulnerable population.

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Introduction: Periodontal disease is a common inflammatory disease of the teeth. There is mounting evidence that poor dental health, especially the occurrence of periodontal disease, increases the probability of the occurrence of cardiovascular disease (CVD) which, in turn, is the leading cause of mortality and morbidity throughout the world. Objectives: The study objective was to systematically review the literature and check the risk factors of myocardial infarction (MI) in periodontal disease patients. Materials and Methods: A literature published in PubMed/Medline, PubMed Central, Scopus, Complementary index, Ebscohost, SciELO, Open DOAR, Science Citation Index, and Web of Science was evaluated. Cross-sectional studies assessing the prevalence of periodontal disease among MI patients searched above were included. The methodological quality was assessed using a 10-item ordinal scale for cross-sectional studies. Two authors extracted the information and assessed the methodological quality of the included studies. The search was performed from 1990 till date for all the mentioned databases. There was no lower limit for the analyzed time frame and no language restrictions. The primary outcome measure was the proportion of MI in periodontal disease patients of each study. Results: Out of the total 46 titles appeared, 11 articles fulfilled the criteria and were selected for the review; most of the literature showed an association between MI and periodontal disease. There is a statistically significant increase in MI in periodontal disease patients. CVDs are associated with an increased incidence of periodontal disease, but the association is weak when adjusted with other potential cofounders. The lack of good-quality studies is a major limitation to assess the association between MI and periodontal diseases. Conclusion: Periodontal disease is mostly associated with MI and CVD. The association between periodontal disease and CVD may be confounded by other cofactors such as age, diabetes mellitus, and smoking. However, the association remains weak, and the quality of study is low.

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