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   2018| January-March  | Volume 16 | Issue 1  
    Online since March 23, 2018

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Oral health-related quality of life among 12–15-year children suffering from dental fluorosis residing at endemic fluoride belt of Uttar Pradesh, India
Saurabh Singh, Sabyasachi Saha, Sanjay Singh, Neha Shukla, Vamsi K Reddy
January-March 2018, 16(1):54-57
Introduction: Dental fluorosis, a specific disturbance in tooth formation and an esthetic condition, is defined as a chronic fluoride-induced condition in which enamel development is disrupted, and the enamel is hypomineralized. There is potential for excessive exposure to fluorides to cause dental fluorosis, which may change the appearance of teeth and cause negative impacts on oral health-related quality of life (OHRQoL). Aim: The aim of the study was to assess the impact of dental fluorosis on the OHRQoL of 12–15-year-old children residing at an endemic belt of Uttar Pradesh. Materials and Methods: A cross-sectional survey was done with the sample of 220 children aged 12–15 years residing at endemic belt (5.35 ppm f/L) of Uttar Pradesh. Dental fluorosis was measured using Dean's fluorosis index-modified (1942) and quality of life of children was assessed with the help of child's perception questionnaire. Descriptive statistics, ANOVA, and Pearson's correlation coefficient test were used for analysis. Results: The mean overall OHRQoL score for children with questionable fluorosis was 73.9 ± 7.51 and with very mild fluorosis was 81.9 ± 6.88. Statistically significant difference was found across self-assessment (P = 0.012), oral symptoms (P = 0.018), functional limitation (P < 0.001), and spare time activity (P = 0.007) based on dental fluorosis status. Conclusion: This study concluded that there was a high prevalence of dental fluorosis in this area and also dental fluorosis has a greater effect as well as the impact on the OHRQoL.
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Depression, anxiety, and stress among undergraduate dental students in Hyderabad City, Telangana, India: A cross-sectional study
Ambati Sravani, Dolar Doshi, Suhas Kulkarni, Padma Reddy, Srikanth Reddy
January-March 2018, 16(1):26-29
Introduction: Increased levels of psychological disturbances such as depression, anxiety, and stress (DAS) among dental students affect the way these students take care of patients. Aim: The aim of this study is to assess DAS among undergraduate dental students in Hyderabad city, Telangana, India. Materials and Methods: A short version of depression, anxiety, and stress scale was distributed to undergraduate dental students in four dental colleges. Comparison among the variables was done using ANOVA and Independent t-test. Results: The study group comprised 200 (23.7%) males and 645 (76.3%) females. The overall mean DAS score and its dimensions were not significant based on gender. Married students showed significantly more DAS compared to unmarried (P < 0.05). When the year of study was considered for all colleges together, the overall mean DAS score and its individual dimensions score were significantly high among III year students followed by IV, I, and II years (P < 0.05). Conclusion: Clinical years were more stressful than the nonclinical years. This suggests a need for special attention to the structure of the clinical program, particularly at the point of transition from the preclinical to the clinical phase.
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Comparative evaluation of enamel abrasivity of different commercially available dentifrices – An In vitro Study
Rupali Athawale, SK Srinath, Chandralekha Chowdary
January-March 2018, 16(1):78-82
Background: Toothbrushing with toothpaste is a major contributor to dental abrasion. A number of factors such as abrasivity and concentration of the toothpaste, brushing frequency, brushing duration, force of brushing, and toothbrush bristle stiffness have a potential impact on the abrasion process of dental hard tissue. However, the abrasivity of the toothpaste is the most important parameter that affects the abrasion process of dental hard tissue. Aims: This study aims to evaluate the maximum and mean enamel abrasivity of commercially available dentifrices such as Colgate total®, Pepsodent whitening®, Vicco vajradanti®, Dabur red® in primary and permanent teeth. Materials and Methods: Human extracted 60 primary and 60 permanent teeth were randomly selected based on the inclusion criteria. Teeth were sectioned at cementoenamel junction using diamond disc and mounted in an acrylic resin blocks. Baseline profilometric measurements were recorded for all the samples. Four commonly used dentifrices were selected and labeled as Group A (Colgate Total®), B (Pepsodent Whitening®), C (Vicco Vajradanti®), and D (Dabur Red®). Toothpaste slurry was prepared. Tooth specimens were brushed in vitro using a customized brushing machine. After toothbrushing, profilometric measurements were obtained, and the differences in readings served as proxy measure to assess surface abrasion. Data were collected and analyzed using student t-test and ANOVA test. Student t-test was used to compare the enamel abrasivity prebrushing and postbrushing, and ANOVA was used to compare the enamel abrasivity among the four different commercially available toothpastes. Results: In permanent teeth, all the toothpastes were found to cause significant enamel abrasion (P = 0.000) and a significant variation was observed when maximum (P = 0.008) and mean (P = 0.036) enamel abrasivity of these toothpastes were compared. In primary teeth also, all the toothpastes caused significant abrasion (P = 0.000); however, when the maximum and mean abrasivity of these toothpastes were compared, no significant variation was observed (P = 0.438 and 0.163). Conclusions: All the commercially available toothpastes cause significant enamel abrasion. Colgate group caused more enamel abrasion whereas pepsodent caused the least enamel abrasion in permanent teeth.
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Tooth loss and associated risk factors among rural population of Wardha District: A cross-sectional study
Sourav Sen, Tanvi Balwani, Aishwarya Sahu, Neha Parate, Apeksha Gehani, Shravani Deolia
January-March 2018, 16(1):11-17
Introduction: Regular dental care and daily cleansing habits are one of the key aspects of keeping healthy teeth for a lifetime. Common Indian concept is, with age people become more prone to oral health problems. If they follow their oral hygiene practices meticulously, then age may not act as a risk factor for tooth loss. Aim: The aim of this study is to evaluate the risk factors associated with tooth loss among adults and the elderly among the rural population of Wardha District. Materials and Methods: In this cross-sectional study, among the rural population, two World Health Organization index age groups (35–44 and 65–74 years) were selected. A self-administered questionnaire was distributed, and complete clinical oral examination was done. The data were statistically analyzed using descriptive statistics and Chi-square test. The value of P < 0.05 was considered statistically significant. Results: Nearly 75.3% of laborers were partially edentulous. Habits, including smoking, tobacco chewing, and alcohol consumption, had an impact on tooth loss. Patients suffering from diabetes and hypertension had 97.5% and 100% had tooth loss, respectively. Regarding the first visit to the dentist, 65.6% population underwent dental treatment from the dental college in the vicinity. “No dental problems” were reported by 68.4% of patients of the total population and among them 81.3% were edentulous. Regarding “Self-perceived treatment” the result revealed that 72% of them had felt the need for dental treatment. Conclusion: The study showed that risk factors such as habits, systemic diseases, and self-perceived oral health played a significant role in tooth loss. Brushing type, method, and material used for cleaning were some other factors that influenced tooth loss.
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Undergraduate dental students' perceptions regarding educational environment in a private dental institute in India
Vaibhav Motghare, K Jayaprakash, Neha Gupta
January-March 2018, 16(1):30-37
Introduction: Developing countries with improper dentist population ratio like India cannot lose health-care students during their undergraduate training period. Educational environment indirectly influences academic outcome of students needed to be assessed quantitatively so that perceptions of students can be acknowledged. The present study is influenced by this concern to understand views of students about the climate of their institute. Aim: The aim of this study is to gauge students' perceptions about their educational climate in a dental college in India and to evaluate the differences if any, related to gender and year of training with regard to perceptions toward educational environment. Subjects and Methods: A cross-sectional study was carried out using the Dundee Ready Educational Environment Measure (DREEM) questionnaire as the survey instrument. Questionnaire was distributed to undergraduate dental students (n = 326) within study duration of 6 months by primary investigator. Data analysis was done using SPSS version 21. Descriptive statistics were computed. t- test and one-way analysis of variance were used with level of statistical significance was set at P ≤ 0.05. Results: Overall DREEM score of institute was 126.46 indicating positive perceptions among students for their educational environment. Statistically significant difference was obtained for gender and year of study (P ≤ 0.05). A total of nine problem areas (individual mean score <2) were identified in the present academic environment. Conclusions: Undergraduate dental students have positive perceptions regarding their educational environment with some problematic areas needing proper action and intervention.
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Do the dental students have enough nutritional knowledge? A survey among students of a dental college in Telangana State
Yajesh Chalmuri, T Madhavi Padma, K. V. N. R. Pratap, P Vineela, L Surya Chandra Varma, Y Vidyasagar
January-March 2018, 16(1):38-47
Introduction: Nutritional knowledge affects nutritional status and nutritional habits of individuals, families, and society. It is important to know the current level of nutritional knowledge among health-care professionals for successful health promotion. Aim: The aim of this study is to assess the nutritional knowledge among students of a dental college in Telangana state. Materials and Methods: A cross-sectional questionnaire study was conducted among dental students. A standard questionnaire which consisted of questions on awareness of current dietary recommendations, knowledge of food sources and nutrients, and on diet-disease relationships was administered to the students during college hours. The data collected was analyzed using descriptive statistics. Results: Among 400 dental students, majority of them were female (59.75%). The mean age of the participants was 22.29 ± 2.64 years. The nutritional knowledge on dietary recommendations was similar in both females (88.58%), and males (87.63%) which was not statistically significant (P = 0.5660) Postgraduates had more nutritional knowledge than undergraduates. Conclusion: It is learnt that males and females had similar nutritional knowledge; however, postgraduate students had more nutritional knowledge compared to undergraduates irrespective of the gender, and there is a need to improve the nutritional knowledge of undergraduate students.
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Association between overweight and dental caries among 8-13 year old school children in central India
K Venugopal Reddy, Amit Singh Thakur, Ninad Moon, K Eshwar Reddy, Sujitha Chandrakala, Sudhanshu Saxena
January-March 2018, 16(1):22-25
Introduction: Overweight is becoming a major public health problem in the modern world. The prevalence of this disorder is steadily growing globally affecting majority of the population, especially children resulting from a paradigm shift in the lifestyle of the modern generation. On the other hand, dental caries is a dental problem worldwide. The magnitude of the disease is increasing in recent years among child population due to modern dietary habits. Aim: This study aims to find an association between overweight and dental caries among 8–13-year-old school children in Bhopal, India and to analyze the role of demographic variables on the association. Materials and Methods: A total of 353 school children aged 8–13 years were recruited from four randomly selected schools located at four different geographic zones of Bhopal city. Body mass index for age was recorded for assessing overweight using Centers for Disease Control growth curves. Dental caries was recorded based on the WHO criteria 1997. Data were analyzed. P < 0.05 was considered statistically significant. Results: The prevalence of dental caries among school children was 57.5% and overweight was 33.7%. A significant association between dental caries and overweight was observed (P < 0.05). Socioeconomic status was found to be the predictor of dental caries among overweight children. Conclusion: There was an association between overweight and dental caries in school children. Overweight and dental caries have common risk determinants and require a comprehensive multidisciplinary approach by health professionals.
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From the Editor's Desk
KR Sowmya
January-March 2018, 16(1):3-3
  - 1,147 132
Hon. Gen. Secretary's Message
Sabyasachi Saha
January-March 2018, 16(1):2-2
  - 1,094 139

January-March 2018, 16(1):83-89
  - 950 154
Knowledge, attitude, and practice about infant oral hygiene care among Indian professional working mothers: A questionnaire study
Pranav Pramod Shinde, Sahana Hegde Shetiya, Deepti Agarwal, Anmol Mathur
January-March 2018, 16(1):58-61
Background: The knowledge of the parents toward the oral hygiene care might get affected by the family structure. Objective: Trend of capsular families in Urban India has led to change in infant oral health practices. Hence, the study was carried out to evaluate the knowledge, attitude, and practice about infant oral care among professional working mothers in Pune city, India. Methods: A 28-item semi-closed, closed-ended questionnaire was administered to 111 professional working mothers in Pune city, India. The data for demographic details, knowledge, attitude, and practice regarding infant oral care were collected with the help of this predesigned self-administered questionnaire from working professional mothers attending outpatient department of Pediatric Hospitals in Pune city. Results: An average, there was limited knowledge among mothers regarding oral health. However, only 13.5% mothers were aware about commercially available tooth wipes, 18% knew when the infant's first dental visit should be scheduled. About 22.5% had practice of bottlefeeding before nap time and 16.2% mothers added sugars/additives in milk while bottlefeeding. Conclusion: All the mothers had overall limited knowledge, positive attitude, and practices were inadequate about infant oral care.
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Knowledge of diagnosis, treatment strategies, and opinions on periodontal treatment procedures among general dentists in an Indian urban population: A questionnaire survey
Priya Sathyamurthy, Ashvini Padhye, Himani Swatantrakumar Gupta
January-March 2018, 16(1):62-71
Aim: A greater proportion of general dentists are unaware of the basic periodontal treatment needs as evidenced by the documented rise in advanced periodontal diseases culminating in tooth loss. Furthermore, limited data exist regarding the demographic predictors of referral for the specialty of periodontics. Therefore, the aim of the survey was to explore and evaluate the knowledge of diagnosis, treatment strategies, and opinions of general dentists on periodontal treatment procedures. Methods: This was a pilot survey utilizing a self-administered close-ended questionnaire consisting of 18 questions undertaken for 100 general dentists with a Bachelor of Dental Surgery degree. The questions were divided under 3 domains assessing the diagnosing ability, the treatment planning skills, and the dentists' perception of periodontal treatment outcomes. Based on their experience, the survey population was divided under three groups; Group I (n = 17) with <5 years of experience, Group II (n = 42) with 5 to <10 years of experience, and Group III (n = 33) with ≥10 years of practice. Pearson's correlation coefficient test was used to identify any significant associations between the responses. Results: On an average, 64.7% of correct responses were noted. About 95.7% of general dentists agreed that they performed complete scaling for all patients. Nearly 85.9% felt that there were higher chances for the recurrence of periodontal diseases and opted to retreat it. Maximum erroneous responses were given by Group II. A weak positive correlation between diagnosis and treatment planning questions was found. Conclusion: The current knowledge on diagnosis and treatment planning among dentists' is still truncated, and hence, the overall perception of the general dentists toward periodontal treatment in India needs to be gauged so that the general dentists can call for introspection and betterment of their services.
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Demirjian method of age estimation using correction factor among Indian children: A retrospective survey
Priyadarshini Chandramohan, Manjunath P Puranik, SR Uma
January-March 2018, 16(1):72-74
Introduction: Age estimation is relevant in the field of medicine and dentistry, especially when matters of consent or identification or criminal liability arise. Dental age (DA) estimation is one of the most accurate, reliable methods of age determination. Among various radiological methods reported, Demirjian method is widely used for DA determination in children. Very few studies are reported using this method among the Indian population. Aim: The aim of this study is to assess and compare DA using Demirjian method with chronological age (CA) and determine correction factor if any among 11–16-year-old children in Bengaluru city, India. Materials and Methods: A retrospective study was performed from the archives of case records and panoramic radiographs of 200 children aged 11–16 years in a dental college in Bengaluru. DA was estimated using Demirjian method and compared with the CA that was obtained from records. Statistical Analysis Used: Student's t-test and Pearson's correlation test were used. A P < 0.05 was considered to be statistically significant. Results: There was statistically significant difference between DA and CA for boys and girls (boys: 13.80 ± 1.34 and 14.19 ± 1.54; girls: 13.80 ± 1.55 and 14.29 ± 1.46) (P < 0.01). Overall positive correlation was observed between CA and DA (r = 0.685) (P < 0.001). The correction factor was found to be 0.809. Conclusion: Considering the correlation between estimated DA and CA, it is concluded that Demirjian method can be applied in this population with a suitable correction factor.
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Comparative evaluation of antibacterial effect of three commercially available herbal products against Streptococcus mutans: An In vitro Study
Sharanya Sreekumar, Vijaya Kiran Hegde
January-March 2018, 16(1):75-77
Background: In recent years, the researches concerning the use of herbal products have been vastly analyzed to decrease the disease burden caused by dental caries. It has been found that certain phytochemicals present in the plants have certain inhibitory effect toward Streptococcus mutans which is currently the main causative organism for dental caries initiation. Hence, in the present study, certain commercial herbal products have been tested for their antibacterial effect. Aim: This study aims to compare the antibacterial action of three commercially available herbal products against S. mutans. Material and Methods: An in vitro study was conducted with commercially available herbal products. They were Aloe Barbadensis Miller (Aloe vera), Ocimum tenuiflorum (Thulasi), and Stevia rebaudiana (Stevia). The antimicrobial effectiveness (zone of inhibition) of herbal products was determined using agar well diffusion method. Pure strains of S. mutans MTCC 890 were procured from culture collection center, Imtech, Chandigarh. The culture was grown in Brain Heart Infusion Agar, and around 20 ml each was poured into sterile petri plates. Chlorhexidine (CHX) was taken as positive control, and distilled water was taken as negative control. Statistical analysis was done using SPSS version 17 software. Results: All herbal products were found to be having variable antimicrobial activity against S. mutans. The mean zone of inhibition after 24 h incubation measured for Stevia, Thulasi, and A. vera was 22.33 mm, 11 mm, and 0 mm, respectively. The mean zone of inhibition of positive control CHX was found to be 13.6 mm. Conclusion: The antibacterial effect shown by Stevia was superior when compared with CHX and Thulasi. The Thulasi have more inhibitory effect than A. vera, and A. vera fails to show any zone of inhibition against S. mutans when compared with other herbal products. Thus, Stevia product can be strongly recommended as a caries preventing agent after sufficient clinical trials by future research.
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Risk indicators for root caries in geriatric population of Lucknow City: A cross-sectional study
Avnica Agarwal, L Vamsi Krishna Reddy, Sabyasachi Saha, Shivanjali Grover, Pooja Sinha
January-March 2018, 16(1):18-21
Introduction: Prevention of root caries among geriatric population is of concern for both general and oral health. It is generally accepted that appropriate prevention regimes for root caries should be based on accurate risk assessments. Aim: This study aims to assess the risk indicators for root caries in geriatric population of Lucknow. Materials and Methods: A cross-sectional study was designed to determine the risk indicators for root caries in elderly population of Lucknow. A sample of 295 subjects was taken, aged 60–74 years. Data collection was done using a pro forma and all relevant information was noted. Statistical analysis was performed using Statistical Package for the Social Sciences 17.0 (Chicago, Inc., USA). Chi-square test and multiple logistic regression analysis were applied to know the statistical significance. Results: The prevalence of root caries was 93.5%. Statistically significant differences (P < 0.05) observed across family income, education, tobacco history, oral hygiene index simplified, and community periodontal index. Conclusion: Overall, the prevalence of root caries was very high among geriatric population. Oral health policies and preventive measures are needed focusing on the special needs and socially deprived population to improve the quality of life.
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Oral health status and barriers to utilization of services among down syndrome children in Bengaluru City: A cross-sectional, comparative study
Bhavna Sabbarwal, Manjunath P Puranik, SR Uma
January-March 2018, 16(1):4-10
Introduction: Down syndrome (DS) is a common genetic disorder caused by the presence of an extra chromosome 21. Individuals with DS present with high prevalence of oral health conditions but oral health services are underutilized due to various reasons. Aim: The aim is to assess oral health status and barriers to utilization of oral health services among children with DS in Bengaluru city. Materials and Methods: A cross-sectional, comparative study was conducted among 100 DS children and compared with 100 non-DS (NDS) children in Bengaluru city. Clinical levels of oral hygiene were assessed using Oral Hygiene Index-Simplified (OHI-S) and caries according to WHO criteria (1997). Parents completed a structured questionnaire used to determine barriers to utilization of oral health services. Chi-square test, unpaired t-test, and Spearman's correlation were applied. Statistical significance was considered at P < 0.05. Results: Children with DS had a significantly higher mean OHI-S (3.05 ± 1.26) as compared to NDS children (1.65 ± 1.02) (P < 0.001). Mean decayed, missing, and filled teeth for DS and NDS group was 2.38 ± 3.41 and 0.66 ± 1.19, respectively, (P < 0.001), whereas mean Decayed, Missing, and Filled Teeth for DS and NDS group was 1.22 ± 1.63 and 1.78 ± 1.9, respectively, (P = 0.03). Mean awareness about child's dental problem was found to be significantly higher among DS group compared to NDS group. Accessibility was found to be positively correlated to dental visits among DS group (r = 0.30, P = 0.003). Conclusion: DS children had poor oral hygiene and considerable caries experience and faced certain barriers to utilization of oral health care services. Parental education as an integral component of oral health promotion programs should be introduced in special schools for better oral health.
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Is jargon deterrent to effective communication in dental practice? the budding dentists' outlook
Nupur Sharma, Swati Patnaik
January-March 2018, 16(1):48-53
Background: Patient–professional communication is a fundamental skill of medical practice. Health-care professionals have to be aware of their own communication practices and need to undergo periodic appraisal of the same. Overzealous and unrepressed use of jargon hinders effective communication between the doctors and patients, leading to a series of misunderstanding. The aim of the study was to assess the use of jargon and its acceptance in clinical history taking among dental students and interns in a dental teaching hospital of Bhubaneswar, Odisha, India. Materials and Methods: A cross-sectional questionnaire-based survey was carried out, consisting of 16 questions on BDS 3rd-year, 4th-year dental students and dental interns. Both descriptive and inferential statistics were computed. Differences between groups were examined using Chi-square test. The level of statistical significance was set at P ≤ 0.05. Results: Two hundred and sixty-seven individuals participated in the present survey, representing an overall response rate of 92.4%. Nearly, 78.9%, 89.6%, and 78% of BDS 3rd-year, 4th-year, and dental interns, respectively, used jargon in case history taking. Almost 61.6% of dental interns admitted that they always used jargon and 22% admitted that they used jargon only when there was a lack of time. Conclusion: This study showed widespread use of jargon/abbreviations in case history taking among the respondents. More medical/dental schools, residency programs, and continuing education programs for practicing physicians need to include training in clinical communication skills to enhance health outcomes.
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President's Message
M Arunadevi
January-March 2018, 16(1):1-1
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