Effectiveness of school-based dental screening in increasing dental care utilization: A systematic review and meta-analysis

Background: School based dental screening has been a popular public health intervention. However, literature provides contrasting evidence regarding effectiveness of such programs on the utilization of dental services. Objectives: We designed this review to understand the differences in dental attendance rates of children below 15 years of age, receiving a school based dental screening versus those not receiving it. Material and Methods: The standard methodological procedures prescribed by The Cochrane Collaboration for Systematic review and meta-analysis was employed. An electronic (MEDLINE via PUBMED, Cochrane trial registry, and Google scholar) and a manual search (2016) were made to identify studies. Results: Five studies met the inclusion criteria, covering a population of 28208 school children of which 21447 were included in the meta-analysis. The review concludes that school based dental screening marginally increases the dental attendance by 16 percent as opposed to a non-screening group (RR 1.16 (95% CI 1.11, 1.21). The quality of evidence was found to be low. Conclusions: There is evidence of marginally increased dental attendance rate of 16 % following screening. As the quality of evidence was found to be low, the results of this review may be used with caution.

Association of Undernutrition and Early Childhood Dental Caries

Objectives: To determine the association between early childhood caries and nutritionalstatus in preschool children. Methods: Cross-sectional study among preschool children(N=550, age 8-60 mo) were selected in tribal, rural and urban health care units of Kerala. Anoral examination for early childhood caries status was done using Deft index. Theanthropometric measurements were recorded. Multiple logistic regression with othercovariates was used to determine the association between the early childhood caries andnutritional status. Results: The mean (SD) Deft scores were 0.93 (1.73), 2.22 (2.92) and 3.40(3.23) for children with normal nutritional status, borderline undernutrition and undernutrition,respectively. Children with borderline undernutrition (adjusted OR 2.05, 95% CI 1.20, 3.49) orundernutrition (adjusted OR 3.46, 95% CI 1.93, 6.29) had higher odds of dental caries incomparison to those with normal nutritional status. Conclusion: Undernutrition is associatedwith early childhood caries among preschool children.

Ethics of dental health screening.

Screening is the detection of disease at a point in its natural history when it is not yet symptomatic. In the natural history of dental caries, for example, the incipient lesions are at a reversible stage, which is a pre-symptomatic or an unrecognised symptomatic disease. Ideally, this is the stage during which screening should identify the risk of dental caries; however, presently, the so-called dental screening employed identifies the clinical cavitation of the tooth, which is very obvious to the individual. The individual already knows that he/she has dental caries and needs treatment, which the screening personnel (dental doctor) explains again during the screening procedure. Is it ethical to call such an event screening? The mushrooming of dental teaching hospitals has promoted regular screening of dental diseases among the communities and schoolchildren through their community dentistry-related activities. More often, it is a dental “check-up” that is carried out on the pretext of screening for dental diseases. Though the basic intention of this activity is to promote awareness of dental diseases and promote good health, there is also a hidden agenda to it. An artificial demand for dental care is created that is easily capitalised on by the dental teaching institutions to enhance its clinical activity. Dental screening is doing more harm than good as patients are made aware of the diseases for which they may not be able to afford treatment. This narrative review gives an account of the scientific evidence on screening for oral diseases, the current practices in screening and the ethical dilemmas of dental screening programmes.

Knowledge, attitudes and practices related to healthcare ethics among medical and dental postgraduate students in south India.

Background: Conventional medical training offers students little help in resolving the ethical dilemmas they will encounter as healthcare professionals.

Periodontal status among tobacco users in Karnataka, India.

A cross-sectional study was designed to assess the prevalence of periodontal diseases among tobacco and non-tobacco users. A total of 2,156 dentate subjects were selected in the age group of 35-44 years through multi-stage sampling method. A total of 350 and 175 subjects were selected from household survey from each district in rural and urban areas. Subjects were interviewed for the tobacco usage status, followed by clinical assessment of periodontal status. Prevalence of calculus, periodontal pockets of 4-5 mm depth and loss of attachment of 0-3 mm and 4-5 mm was significantly more frequent among current tobacco users. The subject with smoking and chewing tobacco has an odds ratio (OR) 1.6 (95% confidence intervals [CI] 1.14-2.31) and OR 1.7 (95% CI 1.38-2.28) respectively. The findings contribute to the evidence of smoking as a risk factor for periodontal disease.