Oral hygiene practices in primary school children and their teachers in a peri-urban locality of Islamabad

The objective of this descriptive, cross-sectional study was to assess the oral hygiene practices of primary school children in Bara Kahu, a peri-urban locality in the outskirts of Islamabad Capital Territory. From a list of 17 primary schools in the area, five schools were randomly selected using the dice roll method. With consent from school authorities and parents, a convenience sample of 384 children aged 4-10 years were selected from the five schools and, in the presence of a class teacher, oral hygiene practices were assessed via a questionnaire filled out by the investigator team members. Teachers were also included in the assessment. With analysis by SPSS version 20, the results showed that the oral hygiene practices of the children was below standard where one-third of the children did not brush their teeth at all, 66.1% brushed their teeth at least once daily and only 2.86% followed the recommended twice a day. Only 6.1% children had been to a dentist. Teachers also exhibited deficient oral hygiene practices with only 33.33% following the twice a day protocol. Use of miswak was popular. It is recommended that oral health education and awareness program, modified to include miswak as an additional oral hygiene tool, are essential for improve the standard of oral health practices by children from rural and peri-urban settings

Dental management of haemophilic pediatric patients

The aim of the study was to evaluate the effectiveness of a standard protocol to prevent bleeding episode/s after dental procedures. Eighty-six pediatric patients [5-13 yrs] of both genders requiring minor invasive dental procedures were screened by the Haemophilic Center and referred to Dental Department of Children's hospital, Pakistan Institute of Medical Sciences [PIMS], Islamabad. Protocols observed to provide correct homeostasis included pre-operative intravenous factor replacement therapy and post-operative local and systemic application of tranexamic acid. Treatment outcome rated as excellent [achievement of normal haemostatic with local and orally agents] was achieved in 57% patients. A good outcome [mildly abnormal haemostatis requiring systemic agents but not requiring factor therapy] was found in 39% while only 3 patients exhibited a poor outcome [severely abnormal haemostatis requiring factor therapy]. No bleeding event required hospitalization. It was concluded that strict observance of this protocol can be termed successful in achieving haemostatis in haemophilic patients undergoing minor invasive dental treatment

Writing a research proposal

As researchers in dentistry, we have a quest to learn more, to look beyond what is written and to contribute a little to the field we plan to dedicate our lives to. For a beginner, writing a research proposal is probably one of the most challenging and arduous tasks, especially since research is a new area for the majority of Pakistani dentists. This article provides the necessary guidelines for the inexperienced potential researcher to produce a standard research protocol. It is outlined in a comprehensible, easy-to-grasp and systematic manner. Obtaining a grant for a research project generally determines the academic and administrative success of any project. Therefore the quality of a research protocol is of paramount importance for viable competition. Despite the uphill daunting task of producing a protocol of high quality, it is nonetheless one of the most interesting and satisfying part of research. Conquering this arena opens the door to an exciting unending world of knowledge yet to be discovered

Tobacco cessation and the dental profession

Tobacco is an established leading cause of preventable morbidity and mortality. The prevalence of tobacco use in the developed world is declining but unfortunately the reverse is true for developing countries. Pakistan is one of the four most rapidly growing tobacco markets in the Asia-Pacific region. As oral health professionals, knowledge of the oral ramifications of tobacco use and its cessation strategies is eminent. The oral manifestations of tobacco use covers a range of implications from mild to moderate morbidity that lead to a diminished quality of life to potentially fatal conditions such as oral cancers. Tobacco cessation is a central part of the practice of dentistry since the oral cavity is the first site that reveals tobacco use and dentists are the only health professionals who frequently see healthyf patients. The WHO/FDI Tobacco Cessation Advocacy Guide specifically designed for oral health professionals details the 4A's [Ask, Advise, Arrange and Assist]; steps of interventions that can be incorporated into daily practice. Given that most tobacco-induced oral disease are reversible if addressed within time, it is mandatory for all dentists to acquire and apply the requisite knowledge and skills in identifying oral ramifications of tobacco use and its cessation strategies

Role and control of mercury exposure in dental settings

Mercury is a metal with toxic and bio-accumulative characteristics. It has biogenic and anthropogenic origins. A neurotoxin and nephro-toxin, mercury exposure is mainly via inhalation, ingestion, and dermal absorption. The degree of toxicity hinges upon exposure route, frequency, dose level, nutritional status, individual susceptibility, and genetic predispositions. Mercury as an environmental hazard operates on a global scale with an end result of bio-concentration of methyl mercury in fish that is used for human consumption. As an industry, dentistry is one of the largest end-users of mercury. Dental amalgams have been used as filling material for over 150 years. However the risk of mercury exposure as an occupational risk is considered higher for dentists and dental workers than for patients with amalgam fillings. Although, Scandinavian countries are in the process of phasing out use of amalgam filling material, the WHO, American Dental Association [ADA] and the US Center for Disease Control, [CDC] support the use of dental amalgam to fill cavities. Specific risk control strategies for amalgam related occupational safety and environmental protection have been outlined and their implementation enforced through legislative measures in the developed nations. Amalgam waste management protocols are completely lacking in developing nations. The UN Environment Mercury Program, based on the fact that mercury exposure is a global problem, has recommended that the precautionary principle should be evoked to initiate international action in terms of policies that should be enforced through a variable mechanism, unique to each country

fluoridation controversy

Fluoridation of drinking water supply has been hailed as one of the top ten public health achievements of the twentieth century. At an optimal level of 1.0 ppm, it is considered the most cost-effective, safe and efficient strategy of reducing dental decay in all social strata of the community. The anticariogenic mechanism of fluoride does not differentiate between the benefits of topical fluoride or ingested fluoride. Fluoride toxicity leads to dental and skeletal fluorosis. The irreversible, debilitating effects of fluoride toxicity, the transient effects with the continuous need of exposure to fluoride to maintain caries resistance and the fact that benefits of topical use of fluoride are as good as ingested fluoride are some of the leading contributing factors that have sparked the fluoridation controversy. Anti-fluoride lobby claims range from declaring fluoride as a slow, cumulative poison to fluoridation of community drinking water as a violation of human rights. Adopting the precautionary principle categorizes fluoridation of community drinking water supply as an unreasonable risk. It is recommended to limit fluoride to dentifrices and mouthwashes