Reliability of cast index for dental caries detection

To access the inter-examiner reliability of CAST [Caries Assessment Spectrum and Treatment] index for detecting dental caries status among patients visiting a public sector dental hospital of Karachi, Pakistan. Cross sectional study. This study was conducted in the dental diagnostic outpatient department of a public sector dental hospital, Karachi, Pakistan, over a period of one month from September 2013 to October 2013 Selected/consented participants were examined for dental caries status by the two trained and calibrated examiners using CAST index. A structured and validated proforma was used to record the findings. The inter-examiner reliability was undertaken to find out the reproducibility of this novel method of caries examination. Data entry and analysis was done using SPSS software at 5% level of significance. Descriptive statistics were performed that involved the frequencies of age and gender. Inter-examiner reliability of CAST was assessed using percentage agreement and Cohen's Kappa value. A total of 100 subjects were recruited for the present study. There were 63% females and 37% males with a mean age of 31 +/- 17 years. The percentage agreements obtained for the two examiners were between 70-100% for 9 different codes of the CAST index. The Cohen's Kappa value identified was 0.99. A strong inter-examiner reliability has been observed for scoring the CAST index which exemplifies the entire patho-physiological phases of dental caries. Results of this study substantiate the potential of CAST index for reproducibly scoring the enamel, dentine and pulp lesions

Tool for assessment of professional competencies of dental graduates

Objectives: To develop a consistent and reliable tool for self-assessment measure, which may be used for identifying graduate competencies that can be applied or translated to different environments; and assess self-reported level of competencies in all domains of dental graduate practices

Study Design: A Cross-sectional study design

Place And Duration: Dow University of Health Sciences, Karachi

Methodology: Thirty-seven items questionnaire related to dental competencies was developed and administered to the first batch of final year BDS students. Responses were recorded on a 3- score Likert scale [0-2]. Reliability and internal consistency of questionnaire was analyzed by computing Cronbach's alpha on SAS Version 9.2, SAS Institute, Cary, NC, USA. Mean scores and frequency percentages for each item were calculated using SPSS version 16.0

Results: Cronbach's coefficient alpha obtained for 5 [out of total 6] domains was 0.70 or higher. Highest competency level was reported for "oral health assessment" [38.2%] with mean score 1.27 [SD= 0.65]. Lowest level reported was for "oral health research" [31.5%] with a mean score 0.86 [SD= 0.68]

Conclusion: This tool may be helpful in future to assess dental student's professional competencies. Students reported that they have obtained most of the required dental competencies, however, concrete courses on oral health research and attention towards practice management related competencies is required

Is oral health status of children with beta-Thalassemia worse than that of their normal counterparts?

To determine the association, if any, of patients suffering from beta-Thalassema with dental caries, gingival condition and oral health status and compare it to their normal counterparts. A. total of 90 children suffering from beta-Thalassemia and 60 healthy controls [age range 6-15 years] were selected from similar socio-economic and parental education background. Oral hygiene status and gingival condition were examined using Oral hygiene Index-Simplified and Modified Gingival Index respectively. Dental caries was recorded using DMFT /dmft Index according to the criteria described by the World health Organisation. Dental caries status in both primary and permanent dentition was found similar in both the groups of children [p>0.5]. GI score of thalassemic children was 0.73 +/- 1.08 and of the healthy subjects was 0.85 +/- 0.95 [p>0.5], however oral health status of the two groups was found to be different [p<0.005] with a larger number of healthy group having [good] oral hygiene as compared to their thalassemic counterparts. There was no significant difference in the dental caries status and gingival condition of children with beta-Thalassemia as compared to their normal counterparts; however, oral hygiene status of the healthy children was significantly better than children suffering from beta-Thalassemia

Cytological findings of buccal mucosa in megaloblastic anemia

Megaloblastic anemia is a common problem in Pakistan, that can lead to negative health outcomes with increasing age. Apart from the general effect due to the deficiencies of fo late and vitamin B 12 as observed in blood, bone marrow cells and epithelial cell surfaces, similar changes in oral epithelium have also been found. These cellular findings however have been limited to a very few studies and offers a good research scope for more studies to be conducted. Healthcare strategies that consider the impact of laboratory tests on the overall costs and quality of care should consider the advantages of including cytological findings of buccal mucosal scraps for evaluation of these patients and can serve as a prerequisite of diagnosing this disease

Periodontal status of women during pregnancy

Objectives: Periodontal condition of women is considered to be debilitated during pregnancy. This is suggested to increase the chances of complications during pregnancy. This study aimed at obtaining information regarding periodontal status during pregnancy, which may be necessary for planning periodontal disease preventive programs for pregnant women in our population

Material and Methods: A cross-sectional study was conducted on a sample of 322 registered women at department of Gynecology and Obstetric. Periodontal condition was assessed by CPITN Index and recorded in a semi-structured performa. The data was coded and entered in SPSS version 11.0 and percentage frequencies with their mean and standard deviations were calculated. Exact Chi-sqaure test was used to analyze any significant changes observed in the CPITN scores amongst the study population, where level of significance was p < 0.05 with confidence interval 95%

Results: Only 17% of these women were observed to have healthy periodontal status and 83% of women had some signs involving a mean of 3 out of six sextants with different levels of signs of periodontal disease, with only less than half sextant with periodontal pockets. However, a moderate level of periodontal debilitation was observed in this population with a mean of 3 sextants having healthy periodontal status. The present study observed a constant level of periodontal status assessed by CPITN Index (p>0.05) in women during pregnancy

Conclusion: Although CPITN scores remained constant through out pregnancy and no significant change observed in this moderate level of diseased condition. However, shallow and deep periodontal pockets, although not very severe, are observed to be more prevalent. Therefore, special preventive and prophylaxis oral health care programs remain the need for these women during pregnancy

Blood glucose level, salivary PH and oral bacterial count in type 1 diabetic children

Laboratory tests and animal studies have shown a relationship between dental caries and high blood glucose level because of reduction in salivary pH level and the subsequent increase in salivary microbial count. If the acidic environment is left unregulated, it would eventually result in greatly disrupted oral microbial and mineral balance resulting in dental caries and subsequent tooth cavitations. Most bacteria have an optimum pH for growth in the range 6.5 - 7.5 with limits somewhere between 5 and 9. Acidophilic bacteria can grow at a low pH, and such organisms are very important in oral microbiology as the causative agents of caries: Lactobacilli and Streptococcus mutans produce acid as end products of metabolism of dietary sugars, are able to survive and grow in acidic conditions and have been found to have tendency toward higher count in diabetic patients. Subjects with juvenile diabetes are more likely to have higher oral bacterial count as compared to those suffering from adult-onset diabetes mellitus, which accounts for more risk in the progression of oral complications in these patients. No studies have so far been conducted in Pakistan that compares the prevalence of dental caries in diabetic children. This review therefore signifies the scope of such analysis especially in relation to the salivary pH level and salivary bacterial count. Hence, prophylaxis and treatment can be targeted more efficiently to the at risk subjects

Maternal attitudes and practices towards child dental health of 3[1/2] to 4[1/2] year old in Lahore, Pakistan

The present study is a cross-sectional survey undertaken to assess the dental health attitudes and behaviours of 95 mothers of preschool children, from middle and low socio-economic groups, in urban Lahore, using a questionnaire adapted from the one used in an international collaborative study on child dental health. The results fail to achieve significance for the frequency of sugar consumption, consumption of sweetened milk, Toothache experience, history of dental visits and the choice of professional in case of dental problem, quantity of toothpaste used for the child and dental health beliefs of the mothers

Periodontal infection: a potential risk factor for p re-term delivery of Low birth weight [PLBW] babies

Pre-term delivery of low-birth-weight [PLBW] babies is considered a major peri-natal problem in many countries and is contributing substantially to infant mortality and to childhood handicap. There is a reported incidence of pre-term delivery of low-birth-weight [PLBW] babies of 37% of all live births in Pakistan, which has a tremendous impact on health care system in this community. The prevalence of periodontal disease in Pakistan is also very high in all age groups and women of child bearing age [18-34 years] are no exception. Recent studies indicate periodontal infection as a potential independent risk factor for PLBW, and is considered to be 7 times more likely to be associated than any other risk factors. Several postulated mechanisms have been reviewed, including the virulence effects and role of asymptomatic bacteraemia, focusing on the bacterial load in periodontium facilitating its transmission from oral cavity to the uterus. The indication that periodontal disease is a potential risk factor for the delivery of PLBW; a high level of periodontal disease in women of child bearing age and similar high level of PLBW babies in country, calls for further longitudinal investigations that validate a causal relationship between periodontal infection and pre-term delivery of LBW babies in Pakistan. A review of literature and preliminary communication for a planned study is presented

Periodontal infection: a potential risk factor for pre-term delivery of low birth weight [PLBW] babies

Pre-term delivery of low-birth-weight [PLBW] babies is considered a major peri-natal problem in many countries and is contributing substantially to infant mortality and to childhood handicap. There is a reported incidence of pre-term delivery of low-birth-weight [PLBW] babies of 37% of all live births in Pakistan, which has a tremendous impact on health care system in this community. The prevalence of periodontal disease in Pakistan is also very high in all age groups and women of child bearing age [18-34 years] are no exception.Recent studies indicate periodontal infection as a potential independent risk factor for PLBW, and is considered to be 7 times more likely to be associated than any other risk factors. Several postulated mechanisms have been reviewed, including the virulence effects and role of asymptomatic bacteraemia, focusing on the bacterial load in periodontium facilitating its transmission from oral cavity to the uterus.The indication that periodontal disease is a potential risk factor for the delivery of PLBW; a high level of periodontal disease in women of child bearing age and similar high level of PLBW babies in country, calls for further longitudinal investigations that validate a causal relationship between periodontal infection and pre-term delivery of LBW babies in Pakistan. A review of literature and preliminary communication for a planned study is presented

Tea as a source of dietary fluoride in Pakistan

OBJECTIVE: Exposure to fluoride in the modern world has expanded far beyond the degree envisaged by the fluoride pioneers of 60 years ago, who dealt exclusively with fluoride in drinking water. Given that increasing numbers of people are consuming beverages instead of water, fluoride intake should also consider the different beverages consumed and their fluoride content. This study was conducted to assess the levels of fluoride in 11 different varieties of tea available in Pakistan. Materials and This study was conducted with ten different brands and an unbranded variety of tea. Samples were prepared for each brand of tea and were subdivided into 4 groups comprising tea brewed for I min and 3 min. and boiled for 1 min and 3 min. A total of 44 tea infusion samples comprising of 4 samples of each brand were evaluated for their fluoride content. To measure fluoride concentration, a dual range fluoride ion selective tester was used. Leaching of fluoride on brewing ranged from 1.6 ppm to 4.3. A concentration range of 2.8 and 10.7 ppm was observed when the tea leaves were boiled in water. The results of this preliminary study indicate that tea can be considered as an effective vehicle for fluoride delivery and an additional source of dietary fluoride in Pakistan