Toolkit for delivering the 3Es and 6As tobacco interventions in dental care

Tobacco use is one of the major public health problems in India and also the single most important remediable public health problem. Tobacco cessation is the need of the hour. The dentists have a unique opportunity and professional obligation to be a positive influence in reducing the economic and social burden inflicted by tobacco use on dental and general health. However, dentists, in general, have not widely embraced tobacco cessation in practice. In this article, an evidence-based model (an adaptation of the World Health Organization “5As” tobacco cessation model) is presented for the dentist to help patients avoid tobacco initiation, to encourage and assist patients in tobacco cessation

GSTM1 null polymorphism prevalence in tobacco users, oral leukoplakia and oral squamous cell carcinoma patients in South Indian population: A polymerase chain reaction study.

Context: Tobacco abuse is a well‑known risk factor for potentially malignant disorders as well as oral squamous cell carcinoma. Factors that influence tobacco‑exposed individuals developing a malignancy may include the combination of total tobacco exposure and genetic susceptibility. Aim: This study was undertaken to determine the prevalence of the glutathione S‑transferase M1 (GSTM1) null polymorphism in oral leukoplakia and oral squamous cell carcinoma patients in South Indian population. Settings and Design: This case–control study was conducted in hospital setting on South Indian population. Materials and Methods: About 280 subjects with history of tobacco use, oral leukoplakia, oral squamous cell carcinoma were included in this study. Three milliliter of blood was collected and transported under cold cycle and taken for evaluation of GSTM1 null polymorphism using multiplex polymerase chain reaction. Results and Discussion: On comparing the prevalence of GSTM1 null polymorphism among the group with subjects with habits and no oral lesions, oral leukoplakia, and oral squamous cell carcinoma, it was observed that there was a statistically significant association between GSTM1 null polymorphism and the different groups (P < 0.01). Conclusion: The lack of GSTM1 activity would make the oral tissues more susceptible to action of tobacco carcinogens and to the development of a high‑grade level of dysplasia in oral leukoplakia and thereby increases the susceptibility of lesion to undergo malignant changes.

Brief Perspective on Burning Mouth Syndrome: A Review.

Burning mouth syndrome (BMS) also called as stomatopyrosis, is an enigmatic disorder causing chronic pain of the intraoral soft tissues. It is a distinctive nosological entity including all forms of burning sensation in the mouth and described as stinging sensation or pain in association with oral mucosa that appears clinically normal in the absence of local or systemic diseases or alterations. The etiology of BMS is not known although a number of factors have been suggested. These include hormonal changes associated with menopause, allergic reactions, chronic low-grade trauma, genetic polymorphisms, psychosocial and personality disorders namely alexithymic traits, cancer phobia somatisation, obsession-compulsion disorders, etc. Among the proposed causative factors, psychological disorders have been frequently associated. These findings suggest a need for an interdisciplinary treatment which apart from dental therapy demands a certain kind of psychotherapy. A number of treatment modalities have been used, but they are found to be variable, unpredictable and outcome is often discouraging. Nevertheless, newer forms of therapy are being described in the literature. This presentation will highlight the various strategies employed in diagnosis and newer modalities of the treatment for such patients.

Blood Urea & Salivary Urea levels in End Stage Renal Failure.

Elevation of Blood Urea Nitrogen in renal diseases results concomitant increase in Salivary Urea levels. Aims : Determine if there was any correlation between the Salivary Urea levels with that of Blood Urea levels. Material & Methods : samples of blood and saliva were taken from Hemodialysis and control groups to assess the Blood Urea Nitrogen (BUN) and Salivary Urea (SU) levels respectively under strict aseptic precautions. Informed consent was taken from patients and ethical committee approval taken. Results : showed no statistically significant difference between Blood Urea and Salivary Urea in the Hemodialysis group (p>0.05). There was a statistically significant difference between Hemodialysis group and Control group with respect to Blood Urea and Salivary Urea levels. (p<0.001). Conclusion : saliva can be used as a noninvasive diagnostic marker tool.

GSTM1 null polymorphism: a possible key for oral carcinogenesis

Introduction: Carcinogenesis is a multistep process and individual risk to development of cancer depends not only on environmental factors or extrinsic exposure to carcinogens but also on genetic susceptibility of an individual. In head and neck cancer, tobacco exposure and alcohol consumption are predominantly the most significant external factors for tumor formation. Individual's susceptibility to cancer may be partly explained by variability in enzymatic activities of metabolic genes. Mutations in genes concerned with production of enzymes for metabolism of tobacco products may lead to increased risk of carcinogenesis with respect to oral mucosa. Therefore variations in the expression of these genes due to heritable genetic polymorphisms might modulate the process of carcinogenesis by altering the exposure levels of tobacco derived carcinogens. Objective:This non systematic review summarizes current data available on the role of environment gene interaction in form of GSTM1 null polymorphism and oral carcinogenesis. Literature review: Relevant data was selected in order to summarize the studies conducted on GSTM1 null polymorphism and oral cancer. Conclusion: Relationship between GSTM1 null polymorphism in oral cancer needs to be established to confirm the role of environment gene interaction in oral carcinogenesis.

Comparative study between cervical vertebrae and hand-wrist maturation for the assessment of skeletal age / Estudo comparativo entre maturação de vértebras cervicais e da mão e punho para a determinação da idade esqueletal

Objectives: The aim of the study was to compare the cervical vertebrae maturity, using a lateral cephalogram,which is routinely taken before orthodontic treatment and is included as a part of the patient’srecord, with hand-wrist maturation method. Materials and methods: The study group comprised ofsixty subjects of Bangalore, Indian, origin, aged between 9-18 years. Hand wrist radiograph and lateralcephalograms were taken for these subjects. Assessment of skeletal maturation was done using SkeletalMaturity Indicators (SMI’s) from hand-wrist radiograph and Cervical Vertebrae Maturity Indicators(CVMI’s) from lateral cephalogram. A pair wise comparison for skeletal age assessment stages was doneusing Wilcoxon sign rank test and proportions was compared using Chi-Square test for statistical analysis.Results: Skeletal maturity assessed using the cervical vertebrae maturation index (CVMI) method andhand-wrist skeletal maturational index (SMI) method showed no statistical signifi cant difference for malesand females. However, females showed maturation at an early age as compared to males. Conclusions:Since properly utilized cervical vertebrae assessment provided a reliable assessment of pubertal growthspurt, it would be benefi cial to use a lateral cephalogram for skeletal maturity assessment and thereby eliminate the need for an additional radiograph (hand-wrist radiograph). This is cost effective and will alsoreduce the radiation exposure to the patient.

Objetivos: O objetivo do presente estudo foi comparar a maturidade das vértebras cervicais, por meio de umcefalograma lateral, que é rotineiramente obtido antes de tratamentos ortodônticos, com um método de medição dematuração de mão e punho. Materiais e métodos: O grupo estudado consistiu de sessenta indivíduos da região deBangalore, Índia, com idades entre 9 e 18 anos, de ambos os sexos. Radiografi as de mão e punho e cefalogramas emnorma lateral foram obtidos. A determinação da maturação esquelética foi determinada com o uso de Indicadoresde Maturidade Esquelética para radiografi as de mão e punho e Indicadores de Maturidade de Vértebras Cervicaispara cefalogramas em norma lateral. A comparação por pareamento para determinação da idade esqueletal foi feitautilizando o teste de ranqueamento de Wilcoxon e as proporções comparadas pelo teste Qui-Quadrado para análiseestatística. Resultados: A maturidade esquelética determinada pelo índice de maturação esquelética não mostroudiferença estatística signifi cante para homens e mulheres. Entretanto, em mulheres a maturação ocorreu em idademais precoce quando comparadas com os homens. Conclusões: Uma vez utilizado adequadamente, o método dedeterminação da maturidade das vértebras cervicais proporciona um indicativo confi ável do crescimento no estirãoda puberdade, o qual pode ser útil no estabelecimento da maturidade esqueletal por meio de cefalogramas laterais,eliminando assim a necessidade de radiografi as adicionais de mão e punho. Essa eliminação das radiografi as de mãoe punho é custo-efetiva e igualmente reduz a exposição do paciente à radiação ionizante.