Periodontal health and oral hygiene status during the second trimester and its effects on pregnancy outcomes - preterm and low birth weight

Periodontal disease is one of the most prevalent chronic diseases known to mankind. Recently there have been studies that suggest a possible inter-relationship between periodontal disease and systemic diseases including, cardiovascular disease, diabetes, and adverse pregnancy outcomes including pre-term and low birth weight deliveries. However, most of these studies are carried out in the western part of the world and the results may not be directly applicable to the population in Pakistan. This research is an exploratory study that aims to find the relationship between periodontal disease and adverse pregnancy outcomes including preterm and low-birth weight in Pakistani population. The periodontal status in forty-five medically healthy pregnant females aged less than 35 years during the second trimester of pregnancy were assessed. A detailed periodontal examination, including plaque score, bleeding score, probing pocket depth and clinical attachment loss were recorded. Postpartum data was collected and the outcomes were recorded as pre-term [<32 weeks of gestation], term [on or >37 weeks], post term [>40 weeks] and low birth weight [< 2.5 kg]. Pregnant females in the second trimester had an average plaque score of 84% [95% C.I. 51.1-87], average bleeding on probing score of 66.3% [95% C.I= 60.4-72.2], and average clinical attachment loss of 2.5 mm [95% C.I= 2.35-2.6]. Thirty-four participants delivered on or term [>37 weeks] and 8 participants delivered pre-term [<32 weeks of gestation]. Only one patient delivered post term [>40 weeks]. This exploratory study highlights that the oral hygiene and periodontal status of these female patients in the second trimester of pregnancy is poor. These patients had high plaque scores, marked gingival inflammation as evidenced by high gingival bleeding score, and were diagnosed with mild generalized periodontitis. None of the periodontal variables had a significant correlation with pre-term or post-term pregnancy outcomes [p>0.05]

Dentists perceptions about practices, undergraduate training and training needs of local anesthesia

The objective of this study was to assess dentists perceptions about safety and efficacy of their practices; their undergraduate training; and training requirements about local anesthesia [LA]. A prospective, questionnaire-based survey of 181 dentists from Lahore and Karachi was carried out. The questionnaire was designed to collect information about general dentists perceptions about their salient local anesthesia practices, the level of training provided to them at under-graduate level and the training needs at different levels of professional careers. Sixty eight percent of the participants did not aspirate during inferior alveolar nerve block LA injections. Training in important LA nerve block injections was not provided to the majority of participants at the undergraduate level. Most of the participants felt that improvement in training of LA at under-graduate, post-graduate and continuing professional development levels were needed. Serious shortcomings in the practice and training of safe and effective LA were noticed in this survey. In accordance with the need felt by the survey participants for improved teaching and training of LA, the curriculum for local anesthesia training should be revised and implemented

Diagnosis of temporomandibular disorders based on research diagnostic criteria

The Research diagnostic criteria for Temporomandibular Disorders [RDC/TMD] is a tool used by International RDC/TMD Consortium [A Designated Network of the International Association for Dental Research], to diagnose and categorize TMD patients. The aim of the present study was to investigate the frequency of TMD in undergraduate dental and medical students based on RDC/TMD; and its relation with depression and somatization. 37 male and 48 female dental and medical students from FMH College of Medicine and Dentistry, Lahore, Pakistan were evaluated. A clinical physical diagnosis [Axis I] and pain related disability and psychological status [Axis II] were assessed using a questionnaire and clinical examination on RDC/TMD protocol. Seventeen students diagnosed with TMD showed significantly higher incidence in females [p=0.003]. Maximum number of TMD was in internal derangement group, followed by pathosis and muscle disorder groups. Significantly higher TMD incidence was noted in; participants [p = 0.00, Likelihood ratio = 10.80] with Axis II than those without Axis II. Significant TMD participants showed somatization than those without TMD [p = 0.000, Likelihood ratio = 12.04]. A comparatively lower incidence of TMD in young adults, with much higher prevalence in females was found. Disc displacement was the commonest Axis I diagnosis. TMD patients showed greater RDC/TMD Axis II