Dental caries is one among the major public health problems and has been found to have a multifactorial etiology. Thus, understanding the role of trace elements such as Copper and Zinc in the prevention of dental caries is of utmost importance to the clinicians. The aim is to systematically review the literature on the role of Copper and Zinc in the prevention of Dental Caries. A literature review was performed in PubMed Central and Cochrane library, and Embase, Google Scholar were searched up to February 2019 to identify appropriate studies. Randomized controlled trials and crosssectional studies assessing the role of copper and zinc in the prevention of dental caries in the adult and pediatric population searched above were included. The methodological quality was assessed using a five and sevenpoint ordinal scale, respectively. The search was performed from 1990 to February 2019 for all the mentioned databases. There was no lower limit for the analyzed time frame and no language restrictions. In the various articles available through the electronic database, eight articles fulfilled the inclusion criteria and were selected for the review. The primary outcome measure was salivary concentrations of copper and zinc in caries free and caries active individuals as measured by the World Health Organization (1997) decayed, missing, and filled teeth/decayedextractedfilled teeth index. The limitations were that it cannot definitely establish the negative correlation of salivary concentrations of copper and zinc with caries activity due to the lack of studies done on these trace elements and the inconsistency of the data found in the existing literature. Of the total 58 articles which were searched, 8 articles fulfilled the criteria and were selected for the review. One article which was received through email was also included. It was found that the amount of copper and zinc in low carious individuals is high, whereas it is low in cases of high caries individuals. Copper and zinc have a negative correlation with dental caries activity. There are relatively few studies evaluating the role of Copper and Zinc in the prevention of dental caries. By analyzing the elements affecting caries activity, it can be derived that copper and zinc have a negative effect on the dental caries process.

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Background: Tobacco is a risk factor for oral cancer, adult periodontal diseases, and cleft lip and palate in children. Tobacco cessation counseling has been shown to improve the likelihood of achieving success for quitting the habits. Aim: This study aimed to assess the effectiveness of cognitive-behavioral therapy (CBT) compared with basic health education (BHE) for tobacco cessation among smokers in Bengaluru city. Materials and Methods: A randomized controlled trial was conducted over a period of 6 months among smokers attending a tobacco cessation center in a dental college in Bengaluru city. The participants were assigned to either CBT or BHE groups with 1:1 allocation sequence ratio. Randomization and allocation concealment were done by an investigator who had no clinical involvement in the trial. Nicotine dependence was assessed using the Fagerstrom's Addiction Scale for smokers, while motivational levels were assessed using Transtheoretical model. The groups were followed up for 4 and 12 weeks. Statistical analysis was done using the Statistical Package for Social Sciences (SPSS 22.0, IBM, Armonk, NY, USA). Paired and unpaired “t“-tests, Chi-square test, Fisher's exact test, and analysis of variance test were applied. Statistical significance was considered atP < 0.05. Results: Majority of the study participants started smoking at an early age and had long duration and cigarette smoking years. Among CBT group, the mean Fagerstrom's addiction score at baseline (4.8 ± 7.3) significantly reduced (3.8 ± 3.1) at the 1^st follow-up and at the 2^nd follow-up (3.5 ± 8.9) (P < 0.001). The proportion of smokers with frequency more than ten cigarettes per day reduced from baseline (P = 0.16) to the 2^nd follow-up (P = 0.07) in CBT group compared to BHE group. Conclusion: CBT is effective in reducing tobacco habits and addiction levels when compared to BHE among smokers. Tobacco cessation counseling using CBT has been found to reduce smoking habits, thereby improving the possibility of quitting the habits.

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Background: Tooth eruption is influenced by various factors which include physiological and genetic factors. The first permanent teeth to erupt are the permanent first molars at the age of 6 years. The timing of eruption of permanent teeth can be affected by the body mass index (BMI) which is a predictor of the overall growth of the child. Aim: The aim of the study was to determine the association of eruption timing of the mandibular and maxillary first permanent molars and incisors with BMI of children in Bengaluru city. Materials and Methods: In this cross-sectional study, 3166 schoolchildren (1636 boys and 1530 girls) between the ages of 5 and 10 years were selected. Oral examination was carried out to record the presence of the permanent first molars and incisors. The height in meters and weight in kilograms of each child were recorded and the BMI was calculated. Statistical Package for Social Sciences for Windows, Version 22.0, Released 2013, IBM Corp., Armonk, NY, USA, was used to analyze the data. The median age of eruption was calculated by using Probit analysis. Independent sample Student's t-test was used to compare the distribution of erupted teeth between girls and boys at different age groups. The association between BMI and eruption timing was derived using Pearson's correlation coefficient. Results: The first permanent tooth to erupt was the mandibular first molar at the age of 5.76 ± 1.3 years. Girls showed an earlier age of eruption of all the teeth except the mandibular central incisors. A statistically significant inverse association was seen between BMI and eruption timing of the teeth examined (P < 0.05). Conclusion: The median eruption timing of the mandibular permanent first molar and incisors was earlier than that of the maxillary counterparts. Children with higher BMI values showed earlier eruption timing of the permanent teeth examined.

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Background: Tobacco use is one of the leading causes of premature death and preventable illness. Tobacco cessation counseling (TCC) is one of the ways to prevent the rising mortality. Dentists hold an important role in TCC. Aim: The aim of this study was to assess the attitudes, practices, and perceived barriers in TCC among dental practitioners in Goa, India. Materials and Methods: A cross-sectional questionnaire study was conducted among 150 dentists in Goa. The survey instrument included a close-ended self-administered 27-item questionnaire, assessing demographics, attitudes toward TCC, practices in TCC, and perceived barriers in performing TCC. The data were evaluated using SPSS version 22.0. Chi-square/Fisher's exact test, Pearson's correlation, and unconditional logistic regression were used keeping P value at 5%. Results: The mean age of the study participants was 30.91 ± 5.28 years (24–42 years) and 111 (74.0%) were female. Seventy-three percent of the dentists agreed that TCC is their responsibility. Very few (18.0%) dentists provide tobacco cessation pamphlets and posters in waiting room. The most common barrier (70.0%) was “patient disinterest” in receiving advice. The respondents who have used tobacco were more likely (odds ratio [OR] =2.02, 1.49–2.46) to have positive attitude toward TCC than those who never used tobacco. Older respondents (OR = 2.10, 2.05–2.80) and those having more years of experience (OR = 3.10, 2.86–3.54) were more likely to practice TCC. Conclusion: This study shows that very few dentists were current smokers in Goa. They showed a constructive attitude toward TCC, especially those who were older than 29 years and never used tobacco. Dentists who were positive for TCC were practicing TCC better.

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Background: Oral health is fundamental to general health and well-being. Schools may serve as the best platform for the promotion of oral health. Thus, it is essential to promote oral health in schoolchildren as they are the future of our nation. Aim: The aim of this study was to assess the impact of oral health education (OHE) on the knowledge, attitude, and practice of 13–15-year-old schoolchildren. Materials and Methods: A quasi-experimental study was conducted on a total of 876 schoolchildren aged 13–15 years of age. They were assessed for their oral health knowledge, attitude, and practice at the start of the study using a specially designed questionnaire. OHE was imparted to the children at baseline, 2 months, 4 months, and 6 months. All the children were later reassessed for their oral health knowledge, attitude, and practice using the same specially designed questionnaire after 6 months. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 21. Chi-square test was used for comparing the categorical data. Results: The schoolchildren in the study group showed higher levels of knowledge, attitude, and oral hygiene practices after OHE at the end of 6 months. Before and after the intervention, the scores were found to be statistically significant (P < 0.001). Conclusion: The OHE imparted proved to be effective in improving the oral health knowledge, attitude, and practices of schoolchildren.

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Background: The severity of oral health problems in intellectually disabled population is worse than in general population, and they tend to have more untreated dental problems. Aim: The aim of this study was to assess the influence of intellectual disability on oral health among 127 children. Materials and Methods: A self-administered parental questionnaire was used to collect data on sociodemographic characteristics and oral health behavior variables. Type III clinical examination was done using Decayed, Missing, and Filled Teeth (DMFT)/decayed, missing, and filled teeth (dmft) index, plaque index, and gingival index. Data collected were statistically analyzed using SPSS (version 19.0, IBM Corp., Armonk, NY, USA). Mann–Whitney test and Kruskal–Wallis test were used. Results: The mean age of the study participants was 11.71 ± 2.03 years. The mean DMFT and dmft of study participants were 2.55 ± 2.99 and 1.54 ± 2.66, respectively. There was no statistically significant difference in DMFT scores between mild, moderate, and severe disability levels (P = 0.28). The mean plaque score and gingival score were 11.71 ± 2.03 and 0.78 ± 0.56, respectively, and there was no statistically significant difference in plaque scores (P = 0.11) and gingival scores (P = 0.10) between mild, moderate, and severe disability levels. Conclusion: Children with intellectual disabilities presented with poor oral health conditions. There was a trend of increase in DMFT and plaque scores with the level of the disability although there was no statistically significant difference.

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Oral candidiasis is caused by an unregulated overgrowth of candidal species which remains in saprophytic form under healthy conditions. Probiotics can be a biologically acceptable alternative in promoting beneficial microbial flora. This review aims to provide a potential evidence for an effect of probiotic supplementation on oral candidal count as assessed by laboratory culture in randomized controlled trials (RCTs) conducted in human. PubMed (1975 to till date), Cochrane Central Register of Controlled Trials (CENTRAL, Till August 2016, Issue– 8) and Google Scholar were searched. Randomized controlled clinical trials which compared the probiotics used as single or mixture of strains, any dosage regimen, and by any form of edible or palatable vehicle either with a placebo or other controls were selected to assess the change in oral candidal count. All the in vitro studies, animal experiments, and clinical trials which had no control group/groups in the parallel arm were excluded from our final review. We screened titles and abstracts, obtained full reports of relevant trials and independently appraised them for eligibility. A total number of nine studies were included in this review and JADAD scale was used for quality assessment. In all the included studies, oral candidal count was measured by counting the CFUs after culturing the candidal colonies on selective culture mediums. Overall, this review demonstrated that there is a lack of evidence for effects of probiotics on oral Candida in lower age group but has consistent results in elderly individuals reducing high candidal count compared to any control group.

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Background: The riverine islanders of Brahmaputra (Assam, India) are among the most economically backward population group of Assam. Recurring floods results in eclectic damage affecting their everyday lives. Medical Relief is limited due to vast water body, which pose a challenge in providing and accessing health services with limited or no provision for oral health services. Objectives: Planning and implementing a program for delivery of dental services on an already existing model of 'Boat Clinics' in Assam, India. Setting and Design: Isolated riverine islands of Brahmaputra River in North eastern State of Assam, India. Materials and Methods: A service model was designed to implement and provide dental services on an already existing model of 'Boat Clinics' in Assam. Dentals services were provided via two dental units installed (in March 2016) in two different boats on a trial basis. Situation analysis of the setting was done prior to implementation. Challenges encountered were overcome using alternative strategy. Results: Situation analysis revealed dental caries affecting about 59.8 percent of the islanders (DMFT=3). The number of beneficiaries almost doubled from 2016. More than 750 islanders have been treated in 2017 from one 'boat dental clinic'. Women seem to utilize oral health services more than men and extraction was preferred over restoration. The main challenge had been the unavailability of full time dentists, auxillary dental personnel and management of complex dental cases. Discussion: Boat Dental Clinic Program is in accordance with objectives of National Oral Health Program. Corporate social Responsibility is excellent option that provide resources instrumental in initiating projects and more importantly sustaining them. Public Private Not for Profit Partnership (PPNP) is another way to bridge the disparity in the present setting having a downstream effect at the grass root level.

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Background: Individuals with burning mouth suffer from a variety of difficulties in their day-to-day life. Studies related to the role of saliva in burning mouth complaining individuals and their effect on oral health conditions are scarce. Aim: The aim of the study was to determine an association of the salivary flow rate and oral health among individuals with and without burning mouth. Materials and Methods: A case–control study was conducted among 200 individuals aged 18–75 years with and without burning mouth in Bangalore city. Demographic profile, medical, dental and personal history were recorded. Unstimulated and stimulated salivary flow rate and oral health status were assessed. Chi-square test, unpaired t-test, Spearman's correlation, and binary logistic regression were applied.P < 0.05 was considered statistically significant. Results: Majority of individuals who complained of burning mouth were females aged 45–64 years. The most common systemic condition and lesion were anemia and oral submucous fibrosis. A statistically significant very weak negative correlation was present between unstimulated and stimulated salivary flow rate and Decayed, Missing and Filled teeth. Individuals with reduced salivary flow rate had 3–5 times higher odds of having burning mouth (P < 0.001). Conclusions: There is an association between salivary flow and caries experience among individuals with a burning mouth. Hence, proper diagnosis and appropriate management of these individuals must be done to reduce the difficulties faced by them.

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Background: Incorporation of information technology (IT) advancements in health care has gained wide acceptance in the last two decades. Developed countries have successfully incorporated this in their health-care system, thus improving health care. However, only a limited application of IT is seen in developing countries. Aim: The aim of the study was to assess the knowledge and utilization of computers among health-care professionals in Mumbai, India. Methodology: A cross-sectional questionnaire study was conducted among dental, medical, Ayurveda, and homeopathy practitioners. A total of 1000 respondents (250/group) were included in the study. The first section of the questionnaire sought sociodemographic information of respondents, and the second section sought information on the level to which health-care practitioners apply computers to tasks at their places of work, accessibility of the Internet, views regarding the cost of a computer, and the problems associated with the medical recording system at their places of work. Data were entered into Microsoft Excel and analyzed using SPSS version 17. P ≤ 0.05 was considered statistically significant. Results: Two hundred and fifty participants in each profession were included in the study. The age ranged between 23 and 65 years. Majority (>80%) of the participants had knowledge about word processing program and slide preparation for presentation. On comparison, knowledge was more in medical and dental professionals (P = 0.04). Almost 80% were in the opinion that electronic system for records is better than paper-based recording system, but majority of them reported lack of such facility at their workplace. Knowledge and utilization was higher among the doctors having postgraduate qualification compared to undergraduates (P = 0.002). Conclusion: The study showed average knowledge but lack of utilization of computers by health-care professionals in routine practice. More research should be done into the factors that play an important role in computer use among health-care professionals in developing societies.

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Background: Public transportation is an example of high-strain occupation and its workers are dealing with immense stress. Occupational stress has been seen to promote tobacco use and this habit is widely present among the transit workers. Both occupational stress and tobacco habit have their adverse effect on general as well as oral health. Aim: This study aims to assess the association of occupational stress and nicotine dependence with oral health status among public transit workers in Bangalore city. Materials and Methods: This cross-sectional survey was conducted among 450 public transit workers in Bangalore. The extent of occupational stress was assessed using 20-item questionnaire. Nicotine dependence was measured using the Modified Fagerstrom Tolerance scale for smoking and smokeless tobacco. Recording of oral mucosal lesion and community periodontal index were done for the assessment of oral health status. Data were analyzed using statistical Package for Social Sciences software (SPSS version 24) using Chi-square test and binary logistic regression (P < 0.05). Results: The results of bivariate and multivariate analysis elicited significant association of periodontal health with gender (P = 0.011), level of nicotine dependence for smoking (P = 0.008) and smokeless tobacco (P = 0.002) and occupational stress (P = 0.035). The oral mucosal lesion was seen to be associated only with level of nicotine dependence for smoking (P = 0.008) and smokeless tobacco (P < 0.001). Conclusion: In the present study, poor oral health status was associated with occupational stress and nicotine dependence. As these factors have individual as well as synergistic effect on oral health, a multirisk approach and workplace interventions to reduce job stress and strategies to promote oral health are the need for status quo.

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Background: Distress is common among people affected by cancer. Distress can influence the quality of life and participation in medical treatment. Although not everyone wants to openly discuss their feelings and emotional distress, research shows that early advice, support, education, and intervention can avoid the demand for intensive intervention. Aims: This study aimed to evaluate the extent and source of distress among cancer patients using the National Comprehensive Cancer Networks Distress Thermometer (DT). Materials and Methods: A cross-sectional descriptive study was carried out at a tertiary care hospital, Bengaluru. A study was conducted among 384 cancer patients attending a tertiary care hospital, Bengaluru, from June to August 2012, after obtaining the consent. The DT consisted of a 48-item questionnaire representing the problems commonly experienced by cancer patients. The patients were asked to mark any sources of distress. Mann–Whitney U-test, Kruskal–Wallis, and Spearman's rho were employed using SPSS software 16.0 version. Results: Out of 384 cancer patients, 88 (22.92%) had a distress score of 7. Age and socioeconomic status were significantly associated with distress, whereas gender was not. Practical problems, family problems, emotional problems, religious concerns, and physical problems were significantly associated with the distress. Statistically significant difference was noted between patients with head-and-neck cancer against other cancers with regard to practical problems, religious concerns, and physical problems. Conclusion: This study documents a significant level of distress among cancer patients. Hence, there is a need to develop appropriate coping strategies in cancer patients.

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Background: Diabetes mellitus is a chronic metabolic disease, which is characterized by elevated levels of glucose in the blood. According to the International Diabetes Federation, around 366 million people are currently estimated to have diabetes. Aim: The aim of the study was to find out the association of oral health-related quality of life (OHRQoL) with diabetes among controlled diabetic patients of Modinagar city. Materials and Methods: This cross-sectional study with a sample of 163 respondents was conducted in a private hospital in Modinagar city, to assess the OHRQoL in a well-controlled diabetic patient. OHRQoL was estimated by the oral health impact profile-20 questionnaire. In addition, general health questionnaire (GHQ) – a 12-item questionnaire was included in this study to distinguish the impact of diabetes on general health of the patient. The analysis was performed using Statistical Package for the Social Sciences 21.0 (SPSS Inc., Chicago, IL, USA). Logistic regression was used to determine the association between OHRQoL and diabetes. Correlation between OHQoRL and GHQ was analyzed using Spearman's rho. P < 0.05 was considered statistically significant. Results: The study results showed that 93 patients (57.4%) had good and 69 patients (42.5%) had low OHRQoL. The study also found out a statistically significant association of OHRQoL with diabetes in case of age of the participants (2.375 [1.094–2.528], P = 0.029**), educational level (0.511 [0.268–0.974], P = 0.041**), and frequency of toothbrushing (0.446 [0.208–0.957], P = 0.038**), whereas its association with smoking status (0.527 [0.235–1.182]), duration of disease (0.757 [0.343–1.671]), and mouth dryness (0.692 [0.316–1.513]) was statistically nonsignificant. There was a highly significant correlation between the OHRQoL and general health of the participants (Spearman's rho [r (162) =0.996], whereP < 0.05). Conclusion: There is a good correlation between OHRQoL and general health among controlled diabetic patients. The association between diabetes and OHRQoL is confined only to some of the variables. The study findings emphasize the importance of oral health in maintaining the overall health of diabetic patients.

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Background: Oral health is an important aspect of health for all children and is all the more important for differently abled who face unique challenges during routine dental care. Aim: To assess and compare the perceptions of dental health officers and parents of differentially abled children regarding architectural, geographical, organizational, and communicational accessibility of the public dental services. Materials and Methods: A cross-sectional study was conducted among 100 parents of differently abled children and 15 dental health officers working in government hospitals under the Department of Health and Family Welfare, Government of Karnataka, from June to October 2017, in Bengaluru city. Differently abled children with locomotor, speech and hearing, and visual and cognitive disabilities aged 6–12 years were included. A structured self-administered questionnaire was used to evaluate the perceptions regarding architectural, geographical, organizational, and communicational accessibility of the public dental services. Descriptive and analytical statistics was done. A P < 0.05 was considered statistically significant. Results: Higher proportion of dental health officers compared to parents of differentially abled children had a positive perception regarding architectural, geographical, organizational, and communicational accessibility of public dental services. Finding a dentist willing to treat was the most difficult barrier according to the parents of differently abled children (52.6%) and dental health officers (46.66%). Conclusion: A higher proportion of dental health officers compared to parents of differentially abled children had a positive perception regarding architectural, geographical, organizational, and communicational accessibility of the public dental services.

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Background: Urbanization shows the way of the development of plentiful industries in a large and small scale and provides the main source of employment worldwide. Apart from providing employment, industrialization also improves the standard of living but makes the life hectic. Thus, time is a constraint for employees to implement healthy performances and overlook their oral health. Aim: This study aims to estimate oral health approaches among industrial employees of Bhopal city. Materials and Methods: A descriptive cross-sectional study conducted among 448 industrial employees of the General Engineering Industry from 4^th to 10^th December 2016 to estimate oral health approaches in the form of their comprehensive awareness, stance, and practices. The data collection was done with a predesigned close-ended and pretested questionnaire encompassed with 16 questions. Statistical analysis was done using the Statistical Package of Social Science (SPSS Version 20; Chicago Inc., Chicago, Illinois, USA). Chi-square test was used for statistical analysis. Results: The results of this study showed that 48.7% of employees said, oral health is good for general health (P = 0.001). About 90.6% of employees used a toothbrush for cleaning their teeth (P = 0.37), 74.1% brushed once a day (P = 0.001), 36.6% changed their brushes in every 4–6 months (P = 0.001). Conclusion: This study concluded industrial employees had adequate knowledge about their oral health. Oral hygiene practices to acclimatize toothbrush and toothpaste are quite satisfactory. Nevertheless, attitude regarding oral health is not very good; might because of the difference in socioeconomic status.

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