Tooth Loss and Oral Health-Related Quality of Life among Adult Dental Patients: A Cross-Sectional Study

Background: Oral diseases seriously impair the quality of life (QoL) in a large number of individuals and they may affect various aspects of life. Aim: To determine the relationship between tooth loss and oral health?related quality of life (OHRQoL) among adult dental patients. Study Setting and Design: A cross?sectional study was carried out among 296 adult dental patients aged 35–44 years attending Department of Oral Medicine and Radiology of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. Materials and Methods: Oral Health Impact Profile?14 (OHIP?14) was used to assess OHRQoL. Dentition status and periodontal status according to WHO criteria 2013 and position, number of teeth lost by Batista et al. (2014) tooth loss classification were assessed. Statistical Analysis: Mann–Whitney U test and analysis of variance were used to find prevalence and severity of OHIP?14 with tooth loss and logistic regression analysis to evaluate the association between OHIP?14 prevalence and severity based on variables. Results: Except for the subjects with history of previous dental visit, variables such as gender and reason for dental visit showed significant difference (P ? 0.05) with tooth loss. Males subjects, who visited dentist with a history of pain, presence of periodontal disease and tooth loss up to 12 teeth (score 3) emerged as significant predictors for OHIP?14 prevalence (OR = 6.7, OR = 1.13, OR = 3.31). Conclusion: The study strongly evidenced that number and position of tooth loss had negative impacts on OHRQoL

Integration of case based learning and bedside teaching in undergraduate students in pediatrics

'Background: Teaching undergraduate students by bedside clinics has remained cornerstone of medical education because it imparts knowledge, teaches proper behaviour and can be used to teach skills effectively. Case based learning (CBL) is a newer modality of teaching in medical education. CBL involves preparing students for clinical practice through use of authentic clinical cases. 'Aim of the study is to study the effect of integration of case based learning and bed side clinic on motivation, deep thinking and cognitive improvement in final MBBS studentsMethods: The study group was undergraduate students of final MBBS posted for clinical posting in pediatric ward. The study was carried out on 59 students posted from March 2018 to September 2018. MCQ based pretest was done initially. The students were taught the topic by case based learning method for one hour. They were asked to take the case and bedside clinic was conducted. Relevant clinical examination was demonstrated to the students. Students were asked to practice the skills in front of the teacher. This was followed by the post-test and'' questionnaires.Results: 88.67% students thought that this method was motivating. 82.7 % students perceived that it increases deep thinking. 52.83% students showed more than 20% improvement in score of pre-test and post-test.Conclusions: Integration of case based learning with bed side clinic was associated with Better motivation of final year MBBS students and development of deep thinking in students.' 3. Significant change in cognitive learning in final MBBS students.

Effect of motivation on oral hygiene and caries status among young adults in Hyderabad City

Background: Motivation is a theoretical construct used to explain behavior, it gives the reasons for people's action, desires, and needs, and it drives an individual to a certain action and determines human behavior. Aim: To determine the effect of motivation on oral hygiene and caries status among young adults in Hyderabad city. Settings and Design: A cross-sectional study was carried out among 18–20-year-old engineering college students of Nagole Institute of Technology and Sciences. Materials and Methods: Intrinsic motivation was evaluated using a self-reported 12-item dental intrinsic motivation scale (DIM-S). The oral examination included simplified oral hygiene index (OHI-S) and decayed, missing, filled teeth index (DMFT index). Statistical Analysis Used: Mann–Whitney U-test and ANOVA test were used for comparison among the variables included in the study. Spearman's correlation was used to correlate DIM-S with oral parameters. Results: A total of 393 students participated in the study with majority of them being male (61.8%). It was observed that 69% of the students were extrinsically motivated and only 31% of them were intrinsically motivated. However, intrinsically motivated females had a higher significant score for calculus index–simplified and OHI-S scores. All oral parameters showed a negative correlation, except decayed component and the overall DMFT. However, no statistical significance was noticed among the variables. Conclusion: The present study revealed that to motivate people successfully, one not only has to give them information but also has to pay attention to the individual reasons which restrict their behavior.

Efficacy of commercially available chlorhexidine mouthrinses against specific oral microflora.

Context: This study evaluates the antimicrobial efficacy of commercially available chlorhexidine (CHX) mouthrinses of different concentrations. Aims: To evaluate and compare the antimicrobial efficacy of commercially available CHX mouthrinses of different concentrations (0.2%, 0.12%, and 0.1%) against specific standard strains of oral microflora at full strength (FS) and 1:1 dilution at 24 h. Settings and Design: Ten commercially available 0.2% (Rexidine, Hexidine, Smilehex, Chlorhex, Hexidale, Hex, Everfresh, and Gargwell), 0.12% (Periogard), and 0.1% (Eludril) CHX mouthrinses were selected to evaluate the efficacy against specific oral microflora using agar well diffusion Method. Materials and Methods: The standard strains of Streptococcus mutans American Type Culture Collection (ATCC 21293), Streptococcus sanguis Microbial Type Culture Collection (MTCC 442), Actinomyces viscosus (ATCC 3268), Staphylococcus aureus (ATCC 25923), Streptococcus pyogenes (MTCC 442), and Candida albicans (MTCC 183) were selected. The antimicrobial efficacy was calculated by measuring mean inhibitory zones formed on agar media. Statistical Analysis Used: Independent t‑test, one‑way ANOVA, Kruskal–Wallis tests, and Tukey’s Post hoc analysis were used. Results: Among 0.2% of CHX mouthrinses at FS and 1:1 dilution, hexidine was effective against most of the microorganisms except with S. pyogenes and C. albicans, where Hex and Hexidale were effective, respectively. When the concentration of 0.1% and 0.12% CHX was considered, Eludril was more effective at FS against all except with S. aureus and S. pyogenes which were more sensitive to Periogard at both FS and 1:1 dilution. Conclusions: 0.12% and 0.1% of CHX mouthrinses showed comparable efficacy with 0.2% CHX mouthrinses irrespective of their formulations.

Oral health status and treatment need among institutionalized elderly in India.

Aim: To assess the oral health status and treatment needs among elderly people aged 60 years and above residing as inmates in the old age homes of Hyderabad and Secunderabad, Andhra Pradesh, India. Settings and Design: A cross‑sectional study was performed to determine the oral health status and treatment needs among elderly people. Materials and Methods: In order to assess the oral health status and treatment needs, the clinical assessment of oral mucosa, community periodontal index, loss of attachment, dentition status and treatment need, prosthetic status and prosthetic need was recorded based on a modified World Health Organization 1997 proforma. Statistical Analysis Used: Multi‑group analysis was done using analysis of variance. P < 0.05 was considered statistically significant. Results: Of the 812 inmates, 431 (64.0%) of the study participants had oral mucosal lesions. In terms of periodontal status, all sextants were excluded (Code “X”) in 324 (39.9%) subjects. Out of dentate population, a majority of the inmates (219; 27.0%) presented with deep pockets (Code “4”) followed by shallow pockets (Code “3” ‑ 183; 22.5%). The majority of the subjects had no prosthesis in the upper arch (85.0%) and lower arch (86.6%). Conclusion: The study demonstrated poor oral health among institutionalized elderly inmates. Oral mucosal lesions were found to be higher and periodontal status was also poor amongst the study population.

Epidemiology of periodontal status in dentate male adults of Jalore, Rajasthan, India: a cross sectional study / Epidemiologia do estado periodontal em homens adultos dentados de Jalore, Rajastão, Índia: um estudo transversal

OBJECTIVE: The purpose of this study was to investigate the epidemiology of periodontal status among dentate male adults in the general population of Jalore, Rajasthan using the Community Periodontal Index. METHODS: The condition of the periodontium was assessed by the Community Periodontal Index with use of the Community Periodontal Index probe. A total of 648 male subjects belonging to five age groups, namely 12, 15, 18, 35-44 and 65-74, were selected by stratified cluster sampling technique and examined. RESULTS: The proportion of total subjects with healthy periodontium was 9.7 percent and the mean number of healthy sextants was 1.7. Bleeding on slight provocation was the most commonly observed condition in all age groups, comprising 38.8 percent of the total subjects. The results showed that the proportions of subjects who reported bleeding, calculus and periodontal pockets decreased steadily with age and a high statistically significant difference was observed among various age groups (p<0.001). CONCLUSION: The results indicate that the study population has more widespread and severe periodontal destruction than other populations. Hence, to maintain periodontal health in this population, appropriate preventive and periodic periodontal therapies should be provided.

OBJETIVO: O objetivo deste estudo foi investigar a epidemiologia do estado periodontal em homens adultos dentados na população geral de Jalore, Rajastão, utilizando o Índice Periodontal Comunitário. MÉTODOS: A condição do periodonto foi avaliada pela sonda Índice Periodontal Comunitário. Um total de 648 homens pertencentes a cinco faixas etárias, 12, 15, 18, 35-44 e 65-74, foram selecionados pela técnica de amostragem estratificada por conglomerados e examinados. RESULTADOS: A proporção de sujeitos com um periodonto saudável foi de 9,7 por cento e o número médio de sextantes saudáveis foi 1.7. Sangramento resultante de pouca provocação foi a condição observada mais comum em todas as faixas etárias, atingindo 38.8 por cento da amostra. Os resultados mostraram que as proporções de indivíduos com queixas de sangramento, cálculo e bolsas periodontais diminuíram de forma constante com a idade e houve diferença significativa entre as várias faixas etárias (p<0.001). CONCLUSÃO: Os resultados indicam que a população estudada apresenta uma destruição periodontal mais generalizada e grave que outras populações. Assim, para manter a saúde periodontal desta população, terapias periodontais preventivas adequadas e periódicas devem ser fornecidas.

A paired comparison among siblings of common parents about dental care with and without Down syndrome / Comparação pareada da assistência odontológica entre irmãos de mesmos pais portadores ou não de síndrome de Down

Objetivo: Comparar a assistência odontológica entre irmãos de mesmos pais portadores ou não de síndrome de Down. Método: Um estudo analítico transversal envolvendo 180 indivíduos com Síndrome de Down e 180 irmãos destes sujeitos sem Síndrome de Down, foi conduzido numa escola de ensino especial na cidade de Udaipur, Rajasthan, India. Empregando um modelo de questionário validado, os pais foram solicitados a preencher duas versões do questionário, sendo uma para o filho com Síndrome de Down e outro para o filho com idade mais próxima sem Síndrome de Down. Resultados: Muitos pais apresentaram comportamentos ou experiências diferentes com o filho portador de Síndrome de Down e o respectivo irmão sem Síndrome de Down. As maiores diferenças foram observadas quanto à consulta anual ao dentista (p<0,001), flúor terapia (p<0,001), extrações (p<0,001) e tratamento ortodôntico (p<0,001). As crianças com Síndrome de Down foram menos propensas a visitar o dentista anualmente e a receber flúor terapia e tratamento ortodôntico em comparação aos seus irmãos sem Síndrome de Down. Conclusão: Essa análise pareada sobre diferenças familiares nos comportamentos e experiências de assistência odontológica entre irmãos com e sem Síndrome de Down irmãos demonstrou que crianças com Síndrome de Down têm menor probabilidade de serem levadas ao dentista anualmente, receberem cuidados de prevenção à cárie e tratamento restaurador, e serem submetidas a extrações dentárias.

Objective: To compare dental care among siblings of common parents with and without Down syndrome. Method: A cross sectional analytical study was conducted in 180 mentally retarded subjects with Down syndrome and 180 their siblings without Down syndrome at a special need school in Udaipur city Rajasthan. Using a validated questionnaire, parents were asked to complete two versions of the questionnaire one for their child with Down syndrome and another for the siblings closest in age without Down syndrome. Results: Many respondents showed different behavior or experiences to their child with Down syndrome and a sibling without Down syndrome. The greatest differences were observed for yearly consultation to the dentist (p<0.001), fluoride therapy (p<0.001), extraction (p<0.001) and orthodontic treatment (p<0.001). Down syndrome subjects were less likely to consult a dentist yearly and less likely to receive fluoride therapy and orthodontic treatment in comparison to their siblings without Down syndrome. Conclusion: This paired analysis of within family differences in dental care behaviors and experiences for subject with Down syndrome and non Down syndrome siblings demonstrated that there are differences, subject with Down syndrome are less likely to consult a dentist yearly, less likely to receive caries-preventive and restorative care and less likely to have had a dental extraction.

Internet usage among undergraduate dental students in India / Uso da internet entre alunos de odontologia na India

Purpose: To assess the internet usage among dental students at a private dental institution in India.Methods: Internet usage was assessed among the first- to senior-year undergraduate dental students at the Darshan Dental College and Hospital, Udaipur, India. The study was conducted during the beginning of the academic year 2007-2008. Data were collected by using a questionnaire, which consisted of nine multiple choice questions. The chi-square test was used to compare the responses between male and female students and to analyze the difference among year classes. Results: The total sample size was 247, and the overall response rate was 66%. Only 5.7% and 4.1% of the students used the internet daily for general and dental purposes, respectively. More than half the subjects (55.5%) never used the internet for academic purposes in comparison to 9.3% for general use. Nearly half of the subjects preferred home for internet access; only 7.9% accessed the internet at school. About 60% of the subjects used search engines to access dental subjects, and the students from clinical years used the search engines for dental education more often than the preclinical students (78% versus 41.2%, P=0.001).Conclusion: Dental students at this private dental institution in India reported lower levels of internet use than students in other countries, which may be due to limited access and availability at the present institution.

Objetivo: Este trabalho avaliou o uso de Internet entre estudantes de Odontologia em uma instituição privada na India. Metodologia: O uso de Internet foi analisado entre 247 alunos do primeiro ao último ano do curso de Odontologia de Darshan Dental College and Hospital, Udaipur, na India. O estudo foi realizado no início do ano acadêmico de 2007-2008. Os dados foram coletados através de um questionário com nove perguntas de múltipla escolha. O teste qui-quadrado foi utilizado para comparar as respostas entre os sexos masculino e feminino e para analisar as diferenças entre os alunos de classes diferentes. Resultados: O tamanho da amostra foi de 247 sujeitos, com uma taxa de resposta total de 66%. Somente 5.7% e 4.1% dos estudantes utilizavam diariamente a Internet para pesquisa com finalidades gerais e odontológicas, respectivamente. Mais da metade dos alunos (55.5%) nunca usou a Internet para finalidades acadêmicas em comparação com 9.3% das respostas para uso geral. Quase a metade dos alunos preferiu acessar a Internet de sua residência; somente 7.9% utilizavam a Internet na faculdade. Cerca de 60% dos alunos utilizou as ferramentas de busca da Internet para obter material relacionado a assuntos de Odontologia, sendo que os estudantes dos últimos anos utilizavam mais a Internet para assuntos acadêmicos que os alunos dos anos pré-clínicos (78% vs. 41.2%, P=0,001). Conclusão: Os estudantes de Odontologia desta instituição na India relataram menores níveis de utilização da Internet que alunos de outros países. Isso pode ser devido a acesso e disponibilidade limitados na instituição avaliada.

Prevalence of dental erosion among asthmatic patients in India / Prevalência de erosão dentária em pacientes asmáticos na India

OBJETIVOS: O presente estudo foi realizado para investigar a associacao entre erosao dentaria e asma e estabelecer relacao com a historia medica, dieta e nivel de erosao dentaria. MATERIAL E METODO: O estudo transversal foi realizado entre 102 asmaticos e nao asmaticos, com idades entre 18 e 65 anos, em Udaipur, Rajasthan, India, em janeiro de 2009. A erosao dentaria foi determinada pelo uso de index de erosao utilizado em trabalho no Reino Unido em 1993. Os dados foram coletados por meio de questionarios. Os individuos foram examinados utilizando um procedimento do tipo III, por um unico examinador. A variacao intra examinadores foi testada estatisticamente, com acuracia de 90,3%. O teste qui-quadrado foi aplicado com utilizacao do programa SPSS, versao 11.0. RESULTADOS: Erosao dentaria estava presente em 76.5% de adultos com asma e em 66,7% de pacientes sem asma. 86% das drogas prescritas para asma tinham um pH abaixo de 5,5 %. Ocorreu tambem associacao entre erosao dentaria e consumo de refrigerantes, bebidas carbonatadas e frutas frescas. CONCLUSOES: Ha diferenca significativa na prevalencia de erosao, sendo que adultos com asma tem maior prevalencia do que nos grupos controle. Embora ocorra uma relacao entre niveis de erosao, ha tambem relacao dos niveis de erosao relacionadas com a historia medica e componentes acidos da dieta.

OBJECTIVE: This study was done to investigate association between tooth erosion and asthma and to find out the relationship between medical history, dietary practices and the level of dental erosion. MATERIAL AND METHOD: A cross sectional survey was conducted among 102 asthmatic and non asthmatic patient aged from 18 to 65 years old in Udaipur, Rajasthan, in January 2009. Tooth erosion was assessed using tooth erosion index employed in the childrenfs dental health in UK survey 1993. Data was collected by using self-prepared questionnaire. The subjects were examined using a type III examination procedure by single examiner. Intra examiner variability was tested by weighted kappa statistic which was 90.3%. Chi-square test was applied by using SPSS software (version 11.0). RESULTS: Tooth erosion was present in 76.5% of adults with asthma and in 66.7% asthma free subjects. 86% drugs which were prescribed for asthma had a pH below 5.5. There were also association between dental erosion and consumption of soft drinks, carbonated beverages and fresh fruits. CONCLUSION: There was significant difference in prevalence of erosion, adults with asthma having a higher prevalence than controlled group, although there is relationship between levels of erosion, medical history and acidic dietary components.

Oral hygiene and periodontal status among Terapanthi Svetambar Jain monks in India

The main objective of the study was to determine the oral hygiene levels and periodontal status among Jain monks attending a Chaturmass in Udaipur, India. To date, no study has been conducted on Jain monks. The study comprises of 180 subjects and the overall response rate was 76 percent among them. Oral hygiene status was assessed by the Simplified Oral Hygiene Index (OHI-S) of Greene, Vermillion14 (1964), and periodontal status was assessed by the Community Periodontal Index. Additional information was collected regarding food habits, education level and oral hygiene habits. Analysis of variance (ANOVA), Chi Square Test and Step-wise multiple linear regression analysis were carried out using SPSS Software (11.0). The results showed that the oral hygiene status of Jain monks was poor and only 5.6 percent of the subjects had good oral hygiene. Overall periodontal disease prevalence was 100 percent with bleeding and shallow pocket contributing a major part (72.8 percent) among all the age groups (p < 0.001). Multiple linear regression analysis revealed that oral hygiene habits, caloric intake and education level explained a variance of 11.7 percent for the Oral hygiene index collectively. The findings confirmed that Jain monks have poor oral hygiene and an increased prevalence of periodontal disease compared to that of the similarly aged general population because, as a part of their religion, many Jain individuals avoid brushing their teeth especially during fasting, keeping in mind not to harm the microorganisms present in the mouth.

Infection control practices among undergraduate students from a private dental school in India / Práticas de controle de infecção entre estudantes de Odontologia de uma instituição privada na Índia

Purpose: To investigate compliance with recommended infection control procedures among junior and senior dental students from a private dental school in India. Methods: The study sample comprised 142 (76 males and 66 females) junior and senior dental students from a private dental institution located in Udaipur city, India. A self applied, closed ended questionnaire (response as "yes" or "no") was used to collect data. The questionnaire consisted of 15 items related to medical history taking, vaccination status, barrier techniques, and infection control practices. Results: Only one tenth of the subjects (9.9%) reported adherence to all infection control procedures. Barely one tenth of the population surveyed used plastic wrappings for sterilized instruments, and approximately three fourths of the subjects were vaccinated against Hepatitis B. Changing of face masks and handpieces between patients was reported by 21.7% and 24.6% of senior students, respectively, in contrast to 1.4% and 8.3% of the junior students. Conclusion: The undergraduate students at this private dental institution in India exhibited poor infection control practices. These findings show the need to change organizational and administrative procedures to enable dental students to follow a strict infection control protocol.

Objetivo: Investigar a adoção de procedimentos de controle de infecção por estudantes de Odontologia de uma faculdade privada na Índia. Metodologia: A amostra constituiu-se de 142 (76 homens e 66 mulheres) alunos de Odontologia do terceiro ano e do último ano de uma faculdade privada na cidade de Udaipur, Índia. Um questionário autoaplicado com respostas fechadas (respostas "sim" ou "não") foi utilizado para coletar os dados. O questionário consistiu de 15 perguntas relacionadas à obtenção da história médica, estado de vacinação, técnicas para barreiras e práticas de controle de infecção. Resultados: Apenas um décimo dos sujeitos (9,9%) aderiu a todos os procedimentos de controle de infecção. Quase 10% relataram uso de envoltórios plásticos para instrumentos esterilizados e aproximadamente três quartos dos sujeitos foram vacinados contra hepatite B. Troca de máscaras e de peças de mão esterilizadas entre pacientes foi relatada por 21,7% e 24,6% de estudantes do último ano da faculdade, respectivamente, em contraste com 1,4% e 8.3% dos alunos do terceiro ano. Conclusão: Os alunos de Odontologia desta faculdade privada na Índia exibiram deficiência de práticas de controle de infecção. Estes resultados mostram a necessidade de mudar os procedimentos organizacionais e administrativos para possibilitar que os estudantes de Odontologia sigam um protocolo rigoroso de controle de infecção.

Tobacco as risk factor for periodontal disease in green marble mine laborers of Rajasthan, India

Aim: To determine the effect of tobacco usage on the severity of periodontal disease in green marble mine laborers. Methods: Marble mine laborers (n=585) aged 15–54 years were selected from four geographic zones in green marble mines area using a stratifiedrandom sampling procedure. A total of 517 (88%) laborers participated in the study. The sample were classified as tobacco users, non users, occasional users, ex users and the data regarding form, duration and frequency of tobacco consumption was also collected by personal interviews. Periodontal status was assessed by community periodontal index. Results: Nearly three fourth (71.9%) of the population was tobacco users. Among the smokers, bleeding and calculus accounted to 33% each whereas the prevalence of these periodontal indicators was 38% and 44% respectively among smokeless tobacco users. Logistic regression analyses revealed that smokeless tobacco users were more liable for presence of periodontal pockets than smokers. Duration had a significant influence with users since more than 20 years being liable for presence of pockets at least twice (OR = 2.625, 95% CI 1.529 – 4.507) than the <5 years group. The odds ratio for presence of periodontal pockets increased by 2.143 (95 % CI 1.060 – 4.333) and 5.596 (95 % CI 2.901 – 10.639) for users of 6 – 10 units/ day and more than 10 units/day than the 1-2 times/day category. Conclusions: Tobacco usage had a significant impact on the severity of periodontal disease with users being more likely to present periodontal pockets than non users. Moreover, the risk of periodontal pockets increased as the duration and frequency of tobacco consumption increased.

Dental caries experience and treatment needs of green marble mine laborers in Udaipur district, Rajasthan, India.

BACKGROUND AND OBJECTIVES: The study was undertaken at Kesariyaji, located in Udaipur district of Rajasthan. There are about 3 million workers who marble mine at Rajasthan. Living conditions of these workers are substandard and most of them are immigrant workers living in tiny shacks. Majority of them belong to lower socioeconomic status with poor educational background. The present study was carried out to estimate dental caries prevalence and treatment needs of laborers working in the green marble mines of Udaipur district. BASIC RESEARCH DESIGN: The data was collected using the methods and standards recommended by the WHO. Dentition status and treatment needs along with decayed, missing, and filled teeth (DMFT) index, and decayed, missing, and filled surfaces score were recorded. Standard error of mean was calculated for all the mean values of treatment needs. There were three examiners, who were trained before the survey for inter-examiner variability, and the reliability was tested by means of weighted kappa statistics, which was 90%. PARTICIPANTS: The study population comprised 513 men in four age groups of 18-25, 26-34, 35-44, and 45-54 years, respectively. RESULTS: The mean DMFT for all age groups was 3.13 with highest mean of 4.0 for the age group of 45-54 years. Mean decayed teeth were 2.60, 3.33, 1.46, and 1.5 for the age groups 15-24, 25-34, 35-44, and 45-54 years, respectively. Filled component was nil for all age groups. Most of the subjects required one surface filling with a very less proportion needing pulp care. CONCLUSIONS: The missing component constituted the major part of DMFT index in the 45-54 years age group and the absence of filled component in the whole study population implies that the treatment needs of the study population are unmet. Thus, intervention in the form of oral health promotion and curative services are the need of the hour.