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BACKGROUND: Oral Submucous Fibrosis, OSF is an inflammatory mucosal disorder prevalent in areca nut chewing belts of the world. Although various treatments are available for its management, none provide complete resolution.Curcumin, an indigenous product, improves burning sensation, mouth opening along with other clinical signs of OSF and is potentially viable therapeutic option for its management. OBJECTIVES: To assess the available evidence for employing curcumin in improving symptoms in patients with OSF. METHODS: Systematic search was carried out in e-databases from January 2010 until July 2023 to identify relevant clinical trials comparing curcumin to active and/or nonactive controls (placebo) for the management of OSF. RESULTS: A total of 20 studies were used for qualitative analysis out of which 11 studies were considered for quantitative synthesis.Curcumin was found to be highly effective in alleviating pain/burning sensation, improving mouth opening (MO), cheek flexibility, tongue protrusion and induces positive histological changes in patients with OSF.The standardized mean difference in mouth opening between both the Curcumin and Multivitamin group showed a statistically significant difference favouring the Curcumin group (SMD, 0.37, 95% CI = 0.18-0.56, p - 0.0001, I2- 0%). CONCLUSION: Statistically curcumin was noted to be as effective as Aloe vera, lycopene and steroids in relieving symptoms of OSF in stages 1 and 2 and improving MO. It is seen to improve histopathological picture of lesions thereby suggesting its active role in preventing malignant transformation. Its found to be more effective than multivitamins in improving mouth opening of patients in OSF.
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Aim: To analyze the effectiveness of motivational interviewing (MI) compared to traditional health education among mothers in improving children's oral health and behavioral changes. Review methods: The search strategy was framed using relevant MeSH terms and free text terms in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Directory of Open Access Journals (DOAJ), Cochrane Library, and Google Scholar for the articles published in the English language between 1st January 2000 and 31st December 2020. Only randomized controlled trials, non-randomized controlled trials, and clinical trials comparing MI with traditional health education were included. Cochrane risk of bias (ROB) tool was used for the quality assessment of the included studies, and Review Manager 5.3 software was used for computing results. Results: A total of 9 studies were included for qualitative synthesis and 5 for quantitative synthesis from an initial search of 3,708 articles. The cumulative mean difference for dental caries was -1.03 [95% confidence interval (CI)-1.37-0.70] p < 0.00001, for frequency of toothbrushing Pooled odds ratio was 1.69 (95% CI-0.68-4.25) p = 0.26 and for in-between snacking was 0.83 with (95% CI-0.48-1.44) p = 0.51. A significant difference was present in dental caries among children with mothers in the MI group, while no difference was present in in-between snacking and frequency of toothbrushing between both the groups. Conclusion: Motivational interviewing (MI) prove to be significantly effective in reducing newer dental caries for shorter duration; however, long-term effectiveness could not be assessed. Clinical significance: Motivational interviewing (MI) can be considered an effective and feasible method for oral health education to mothers, which will, in turn, improve the oral health of their children. Protocol registration: International prospective register of systematic reviews (PROSPERO) under registration code. CRD42021224278. How to cite this article: Karande PH, Shetty VB, Vinay V, et al. Comparative Evaluation of Oral Health and Behavior Changes in Children after Motivational Interviewing and Traditional Method of Oral Health Education among Mothers: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(3):464-473.
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BACKGROUND: Tacrolimus is a powerful macrolide calcineurin inhibitor that has low adverse effects which lead to a rapid response in the control of signs and symptoms in comparison to that of corticosteroids in Oral Lichen Planus(OLP). There have been increasing number of studies establishing the use of topical tacrolimus in oral lichen planus. Still, there is a need to find evidence of the successful use of tacrolimus in comparison to other drugs used in the treatment of OLP, by means of a systematic review and meta-analysis, so that an informed and accurate approach can be utilized. METHODS: A comprehensive literature review was performed, including PubMed, the Cochrane Library, published up to and including December 2021. There were no restrictions on date of publication. Articles available in English language were included. Using the Cochrane Collaboration tool, we assessed the risk of bias for randomized controlled trials. A meta-analysis was performed on the relevant studies. RESULTS: A total of 11 RCTs evaluating the effects of tacrolimus were included in this study after application of inclusion and exclusion criteria. Seven studies revealed a low bias risk, three presented a moderate risk and one had a high risk of bias. The results revealed no significant difference in clinical resolution and adverse effects between tacrolimus and corticosteroids. The pooled data from our meta-analysis shows that there is not sufficient evidence to prove that Tacrolimus is better in efficacy than other topical corticosteroids. CONCLUSION: According to the current systematic study and meta-analysis, there is not sufficient evidence to prove that Tacrolimus is better in efficacy than other drugs. Uniform trials are required with larger sample sizes and standardized methodology are required for a better analysis.
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Drug-Related Side Effects and Adverse Reactions , Lichen Planus, Oral , Humans , Calcineurin Inhibitors/adverse effects , Tacrolimus/adverse effects , Retinoids , Lichen Planus, Oral/drug therapy , MacrolidesABSTRACT
In India, 14.6% of adolescents are currently using tobacco in any form and tobacco control is a major public health challenge. The objective of this systematic review is to analyze all the existing literature and evaluate the effectiveness of school-based tobacco use prevention programs for adolescents in India. The review protocol was registered in PROSPERO (CRD42020159535). Studies were selected using database search, manual search, gray literature, reference chasing, and contacting the authors. All randomized controlled trials, cluster-randomized trials, quasi-experimental, and non-randomized studies reporting school-based tobacco use preventive interventions for adolescents in India; articles published in English (other languages where it can be translated to English) published between January 2000 till May 2020 were included. Data was independently extracted by two reviewers. The Risk of bias (RoB) and quality of the study were assessed using appropriate tools. Among 7972 identified articles, only 13 studies met the inclusion criteria. Each study implemented a unique intervention and measured distinct outcomes. Postintervention, all the studies reported improvements in the study group with respect to the reduction of tobacco use and change in the knowledge, attitude, practices, and/or behavior outcome parameters. Twelve study results were based on short-term assessment. Overall, a 5.17-17.0% tobacco use reduction rate was noted. RoB was high for six studies. Key methodological problems related to study design, duration, outcome parameter, follow-up time, type of intervention, and attrition were identified. School-based tobacco use prevention programs for adolescents in India might have shown positive outcomes but are associated with significant limitations.
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Nicotiana , School Health Services , Adolescent , Humans , Tobacco Use/prevention & control , Schools , Public HealthABSTRACT
Background: Oral health is an essential component of health throughout life. Two major oral diseases, dental caries and gingival conditions are prevalent in young population. School-based oral health education (OHE) programs with recognized technology and traditional lecturing could be strategic in promotion of oral health behavior in developed and developing countries. Aim: The aim of the study is to summarize existing evidence in order to evaluate the effectiveness of OHE programs in school children aged 5-16 years in improving their oral health status. Methodology: Clinical trials with school children between 5 and 16 years were included. Eligible studies were those which had outcomes as caries, plaque and gingival indices, and oral hygiene status. Articles published from 2010 to 2019 in English language from PubMed, Directory of Open Access Journal (DOAJ), and Google Scholar were searched. Forty-one articles were identified and relevance was determined by examining title and full article. Nine articles were included for qualitative synthesis and seven were eligible for meta-analysis. The risk of bias was assessed by Cochrane Handbook. A meta-analysis was done using Review Manager 5.3 software. Results: After the meta-analysis results for cumulative mean difference was found as 0.05 (-0.17, 0.27), -0.37 (-0.74, 0.00), -0.20 (-0.33, -0.07), and -0.17 (-0.73, 0.38) for plaque status, Oral Hygiene Index-Simplified (OHI-S), debris status, and dental caries, respectively showing a significant difference favoring the experimental group than traditional group. Conclusion: Interventions given by various aids like lectures, albums, models, flipcharts, leaflets, E-programs, games, drawings, and presentations proved effective in improving oral hygiene status and dental caries, but no reduction in plaque levels and gingival inflammation as compared to oral health talk/counseling by dentists. How to cite this article: Gurav KM, Shetty V, Vinay V, et al. Effectiveness of Oral Health Educational Methods among School Children Aged 5-16 Years in Improving their Oral Health Status: A Meta-analysis. Int J Clin Pediatr Dent 2022;15(3):338-349.
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BACKGROUND: Biopsy is the gold standard for oral squamous cell carcinoma (OSCC) diagnosis. Salivary biomarkers provide promising complementary alternative diagnostic adjunct for its simple non- invasive collection and technique and to screen large population. OBJECTIVE: To summarize and compare the existing evidence on diagnostic accuracy of salivary biomarkers with their estimation method in detecting early oral squamous cell carcinoma. METHODS: The review protocol is registered under PROSPERO(CRD42021225704). PubMed, Google Scholar, EBSCOhost were searched from 2000 to 2020 to identify the screening potential of eight salivary biomarkers: mRNA, miRNA, DUSP100, s100P, IL-8, IL-1B, TNF-a and MMP-9. True-positive, false-positive, true-negative, false-negative, sensitivity, specificity values were extracted or calculated if not present for each study. Quality of selected studies was evaluated based on QUADAS 2 tool. Meta-analysis was performed using a bivariate model parameter for the sensitivity and specificity and summary points, summary receiver operating curve (SROC), confidence region, and prediction region were calculated. RESULTS: Eighteen studies were included for qualitative synthesis and out of that 13 for meta-analysis. Sensitivity and specificity were calculated with AUC. For mRNA it was 91% and 90% with 0.96 AUC, miRNA had 91% and 91% with 0.95 AUC for PCR. IL-1B had 46% and 60% with 0.61 AUC, S100p had 45% and 90% with 0.57 AUC for ELISA. IL-8 had 54% and 74% for ELISA and 89% and 90% for PCR with 0.79 AUC and DUSP1 had 32% and 87% for ELISA and 76% and 83% for PCR with 0.83 AUC respectively. CONCLUSION: Early detection of OSCC was best achieved by screening for salivary mRNA and miRNA estimated by PCR. Further investigation is required into salivary RNA as novel biomarkers and these salivary biomarkers may be potentially used for non-invasive diagnosis of early OSCC.
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Mouth Neoplasms , Squamous Cell Carcinoma of Head and Neck , Biomarkers, Tumor/genetics , Humans , MicroRNAs/genetics , Mouth Neoplasms/diagnosis , Mouth Neoplasms/genetics , RNA, Messenger/genetics , Saliva , Squamous Cell Carcinoma of Head and Neck/diagnosis , Squamous Cell Carcinoma of Head and Neck/geneticsABSTRACT
Dentists have a wide variety of techniques available to them such as tell -show-do, relaxation, distraction, systematic desensitisation, modelling, audio analgesia, hypnosis, and behaviour rehearsal. There is no concrete research as systematic review and meta-analysis indicating which explains the most effective distraction technique. AIM: To summarize effectiveness of audio and audio-visual (AV) distraction aids for management of pain and anxiety in children undergoing dental treatment. STUDY DESIGN: Literature search: PubMed/MEDLINE, DOAJ, Science Direct from June - July 2020 with randomized control clinical trials conducted on children with audio and AV distraction aids as intervention and those which had anxiety and pain as outcomes were searched. Fifty articles were identified and relevance was determined. 14 studies were included for qualitative synthesis and 05 were eligible for meta-analysis. Cochrane handbook used to assess the risk of bias. The meta analysis conducted using review manager 5.3 software. RESULTS: Meta-analysis, cumulative mean difference for audio and AV distraction techniques was calculated with main outcomes as pulse rate, O2 level, Vehman's picture and clinical test. These findings showed significant difference favoring the intervention (audio and AV) group when compared with control but indicating more effectiveness of AV distractions. CONCLUSION: Different audio-visual aids assist in reducing pain and anxiety in children but using audio distraction aids when audio-visual aids are not available could be acceptable way for distracting and treating children.
Subject(s)
Anxiety , Pain , Adult , Anxiety/prevention & control , Audiovisual Aids , Child , Dental Anxiety/prevention & control , Dental Care , Humans , Pain ManagementABSTRACT
CONTEXT: A strong correlation exists between plaque and dental caries and periodontal diseases. Ayurvedic drugs have been used since ancient times; oral rinses made from these are used in periodontal therapy. Triphala is one of these with wide spectrum of activity. AIMS: To assess and compare the effect of 0.4% Triphala and 0.12% chlorhexidine (CHX) mouthwash on dental plaque, gingival inflammation, and microbial count of Streptococcus mutans, Streptococcus sanguinis, and Lactobacilli from dental plaque sample of 14-15-year-old schoolchildren of Pune city during 90 days supervised use. SETTINGS AND DESIGN: A randomized, controlled, double-blind, parallel-group clinical trial was conducted among 72 schoolchildren aged 14-15 years. SUBJECTS AND METHODS: Children were divided into two study groups: Group A with 0.4% Triphala mouthwash (n = 36) and Group B with 0.12% CHX mouthwash (n = 36). The plaque Index (Loe H [1967]), gingival index (Loe H and Silness J [1963]), and microbial analysis were recorded at baseline, 30 days, and 90 days interval. STATISTICAL ANALYSIS USED: Statistical analysis was done using unpaired t-test for group-wise comparison and one-way analysis of variance test, followed by Tukey's post hoc test for intragroup comparison. P < 0.05 was considered statistically significant. RESULTS: The results showed that 0.4% Triphala and 0.12% CHX have similar inhibitory effect on plaque accumulation, gingivitis, and growth of S. mutans, S. sanguinis, and Lactobacilli. CONCLUSION: Herbal mouthwash proved to be helpful in reducing plaque microbial counts, plaque, and gingival inflammation and opens new arenas in the field of herbal dentistry and chemical plaque control.
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AIM: To evaluate the effect of newer and traditional oral health education (OHE) methods in improving oral health knowledge, oral hygiene status and practices, plaque, gingival, and dental caries status of visually impaired children. METHODOLOGY: Comprehensive literature search was performed by using PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google scholar, and Open Gray from 2010 to 2020 for studies in English language. Two reviewers critically assessed the studies for eligibility criteria, and data extraction was performed. Quality assessment of selected studies was executed according to the study designs. A meta-analysis was carried out using Review Manager 5.3 software. RESULTS: Twenty-four articles were included for qualitative synthesis and out that 11 in meta-analysis. Cumulative standardized mean difference for plaque (Silness and Loe, 1964) and gingival index (Loe and Silness, 1963) was -0.45 (-0.88, -0.02, p = 0.04) and -0.54 (-1.10, 0.03, p = 0.06), respectively favoring newer OHE group as compared to traditional OHE group. Comparison of different newer OHE methods had similar effects on the oral health of visually impaired children. CONCLUSION: The study period of included studies was short-term, so long-term effectiveness could not be assessed, however newer OHE methods were effective in improving plaque and gingival scores over a short period.
Subject(s)
Dental Caries , Dental Plaque , Child , Dental Plaque/prevention & control , Health Education, Dental , Humans , Oral Health , SchoolsABSTRACT
BACKGROUND: The etiological relationship between the plaque and the gingival inflammation has been long established. The long-term use of chemical antiplaque agents may lead to side effects such as teeth staining and alteration of taste. Therefore, natural plant extracts with potential antibacterial and anti-inflammatory activity have been explored, which are equally effective and safe for long-term use. OBJECTIVE: The aim of this study was to compare and evaluate effect of neem gel and chlorhexidine (CHX) gel on dental plaque, gingivitis, and bacterial count of Streptococcus mutans and Lactobacilli among 20-30-year-old school teachers in a city of western Maharashtra, over 90 days' usage. MATERIALS AND METHODS: A double-blind, parallel armed, controlled, randomized clinical study was conducted among 60 school teachers of 20-30 years' age group for 90 days. The two study groups were as follows: Group A--2.5% neem gel (n = 30) and Group B--0.2% CHX gel (n = 30). The plaque scores were recorded by Plaque Index (Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38:610-6) and gingival scores by Gingival Index (Löe H, Silness J. Periodontal disease in pregnancy. Acta Odontol Scand 1963;21:533-51). Streptococcus mutans and Lactobacilli species count by conventional culture method was carried out at baseline, 30th day and 90thday. Considering P value <0.05 as statistically significant, intergroup comparison was performed using unpaired t test. One-way analysis of variance (ANOVA) test was used followed by Tukey's post hoc test for intragroup comparison. RESULTS: The mean plaque, gingival scores, and microbial count of S. mutans and Lactobacilli showed significant reduction at 30th and 90th day in neem gel group as well as CHX gel group (P < 0.05). None of the parameter showed any significant change at 30th and 90th day (P > 0.05) on intergroup comparison. CONCLUSION: The neem gel showed significant decrease in dental plaque, gingival inflammation, and microbial counts, which was comparable to CHX gel proving to be a good herbal alternative. No side effects were reported for use of neem gel over considered period of time.
