Role of dentist in genetic counseling: A critical appraisal of the current practices and future requirements in Indian scenario.

Genetic disorders are showing an upward trend. The social and economic impact of genetic disorders on individual, family and society is enormous. There is an urgent need to explore alternate strategies to mitigate the burden of genetic disorders. This is especially true with regard to developing countries such as India where there is a shortage of health personnel adequately trained in genetic counseling at present. Dental professionals have a unique opportunity to observe the development of preadolescent and adolescent patients during periods when important growth and development changes occur. The objective of this study was to review the existing literature on the role of dentist in genetic counseling with a critical appraisal on the current practices among dentists on genetic services in India, the need, scope, and future requirements. The literature on genetic services and genetic counseling was identified by searching the biomedical databases for primary research material by one investigator over a period of 8 weeks. The articles related to dentist's role in genetic counseling were assessed and discussed in the present review. A total of 239 resource materials were retrieved in the initial search. The literature from these sources was thoroughly scrutinized by the authors, and the literature (review articles, descriptive studies, or any form of study) focusing on role of dentist in genetic counseling was finally considered for critical appraisal in the present review. The role of genetics in health and oral health care has not received due attention of the dental practitioners who otherwise are in a crucial position in identifying the patients with genetic disorders and offer requisite counseling and referral to designated genetic centers. The short training courses for practicing dentists, faculty members, and a small change in dental curriculum to make provision for teaching genetics to undergraduate students may go a long way in filling the void created by these obstacles.

Reconnoitering the association between body mass index and oral health among elementary school children in Hyderabad, Telangana, India.

OBJECTIVE: To evaluate the association between body mass index (BMI) and oral health status among elementary school children in Hyderabad, Telangana, India. MATERIALS AND METHODS: This cross-sectional study was conducted among elementary school children selected from government, private-aided and private-unaided schools in Hyderabad. A stratified cluster random sampling technique was used to select study participants. All parents were requested to be personally present on the day of examination. All eligible children were assembled in a hall and their height in inches and weight in kilograms were recorded by two calibrated investigators. The oral health status of children was assessed using a predesigned oral health assessment proforma. Plaque status was assessed using Sillness and Loe plaque Index and caries using decayed and filled teeth (dft) by a trained and calibrated investigator. RESULTS: One hundred and seventy-one children (89 males and 82 females) were included in the present study. Mean plaque score was 1.4 ± 0.6 with no significant difference in the mean plaque score between children in three different categories of nutritional status (P = 0.07). Mean dft among primary teeth was 1.1 ± 1.1 with a significantly higher score among children who were malnourished (2.4 ± 0.9) compared to children who were overweight (0.9 ± 0.9) and normal (0.4 ± 0.6) (P < 0.001). CONCLUSION: BMI was negatively associated with caries experience in primary dentition with no association with plaque scores. Overweight children with malnutrition had significantly higher caries experience compared to children with normal BMI.

Antimicrobial Efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum and Porphyromonas gingivalis.

BACKGROUND: The herbal extracts have been effectively tried in the treatment and prevention of many oral diseases. AIM: The aim is to assess the antimicrobial efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum (Fn) and Porphyromonas gingivalis (Pg). MATERIALS AND METHODS: The extraction process was carried out by Soxhlet apparatus using ethanol as solvent. The combinations of the four plant extracts were prepared by combining an equal quantity of 10% solution of each of the four plant extracts. The antimicrobial efficacy testing of the plant extracts and their combinations on Fn and Pg was performed using agar well diffusion method. Columbia 5% of sheep blood agar plates were used for antimicrobial efficacy testing under anaerobic conditions. The qualitative assay was carried out to identify the various phytochemical constituents. Dimethyl sulfoxide and 0.2% chlorhexidine acted as negative and positive controls, respectively. The mean diameter of inhibition zone between different categories was compared using one-way analysis of variance. RESULTS: All the individual plant extracts and their double, triple, and quadruple combinations were effective in inhibiting the growth of these bacteria. However, 0.2% chlorhexidine produced the highest mean diameter of inhibition zone. CONCLUSION: The plant extracts in combinations offer enhanced antimicrobial efficacy due to their synergistic action besides slowing the development of bacterial resistance. Hence, these extracts in combinations could be used tried as effective alternates to chlorhexidine.

Antimicrobial efficacy of Acacia nilotica, Murraya koenigii (L.) Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combination on Streptococcus mutans and Lactobacillus acidophilus.

BACKGROUND: The aim of this in vitro study was to assess antimicrobial efficacy of Acacia nilotica, Murraya koenigii (L.) Sprengel, Eucalyptus hybrid, Psidium guajava extracts, and their combination on Streptococcus mutans and Lactobacillus acidophilus. MATERIALS AND METHODS: The branches of four plants were collected, identified, and authenticated by a taxonomist. The plants were rinsed in water, healthy leaves were separated and shade dried over a period of 3-4 weeks. Soxhlet apparatus using ethanol was employed for extraction procedure. The combinations of plant extracts were prepared by mixing equal quantities of 10% solutions of each of these extracts. 0.2% chlorhexidine and dimethyl sulfoxide were used as positive and negative controls, respectively. The antimicrobial efficacy testing was done using agar well-diffusion method under anaerobic conditions. The mean diameter of inhibition zone was computed and compared between different categories using one-way analysis of variance and Tukey's post-hoc test. A qualitative assay was carried out to identify the various phytochemical constituents in the plants. The data was assessed by SPSS version 20. The statistical significance was fixed at 0.05. RESULTS: All the plants extracts and their combinations inhibited S. mutans and L. acidophilus. However, the quadruple combination of A. nilotica + M. koenigii (L.) Sprengel + Eucalyptus hybrid + P. guajava produced the maximum inhibition zone (23.5 ± 2.2 mm) against S. mutans. Although, 0.2% chlorhexidine produced the highest inhibition zone against L. acidophilus (18.8 ± 1.2 mm), A. nilotica extract produced maximum inhibition among the various plant extracts and their combinations (14.1 ± 1.8 mm). CONCLUSION: All the individual plant extracts and their combinations were effective against S. mutans and L. acidophilus. These could be tried as herbal alternates to chlorhexidine. However, these in vitro results have to be further evaluated for any toxicity of the polyherbal combinations in animal models and effectiveness has to be assessed using in vivo studies on humans.

Disinfecting efficacy of three chemical disinfectants on contaminated diagnostic instruments: A randomized trial.

CONTEXT: Cross infection remains one of the major challenges in the dental profession, especially in field settings. Transmission of hepatitis B, hepatitis C, and human immunodeficiency virus have raised a major concern for patients and dental staff. These risks can be eliminated by effective sterilization and disinfection techniques. AIM: The aim was to compare the disinfecting efficacy of three chemical disinfectants on contaminated diagnostic instruments. SETTINGS AND DESIGN: This was a randomized, cross over trial conducted among three participants selected from a research laboratory, Bhopal, Madhya Pradesh, India. MATERIALS AND METHODS: The study participants were examined 4 times on different days. Each time, the coded mouth mirrors of different make were used, and the disinfection was accomplished using coded disinfectants. The reduction in total viable count was compared between the three groups (2% glutaraldehyde, 6% hydrogen peroxide (H2O2) and 99.9% ethyl alcohol) with distilled water as negative control and autoclaving as a positive control. Furthermore, the predisinfection count was compared between the instruments of different make. STATISTICAL ANALYSIS USED: Statistical analysis was performed using paired t-test and One-way ANOVA. The statistical significance was fixed at 0.05. RESULTS: Autoclaved instruments resulted in complete elimination of viable micro-organisms. Maximum reduction in microbial load was observed after disinfection with H2O2 followed by glutaraldehyde, ethyl alcohol and distilled water in descending order. Furthermore, maximum microbial contamination was recorded on locally manufactured mirrors, while standard plain mirrors showed least contamination. CONCLUSIONS: Although, a significant reduction in total viable count was observed with all the disinfectants evaluated in the present study, none of the disinfectants was successful in completely eliminating the viable micro-organisms.

Antimicrobial efficacy of the combinations of Acacia nilotica, Murraya koenigii L. sprengel, Eucalyptus hybrid and Psidium guajava on primary plaque colonizers.

BACKGROUND: There is an urgent need for innovative strategies to combat the two most common dental diseases of mankind namely dental caries and periodontitis. OBJECTIVE: The aim was to assess the antimicrobial efficacy of the double combinations of Acacia nilotica (AN), Murraya koenigii L. Sprengel (MKL), Eucalyptus hybrid and Psidium guajava on primary plaque colonizers. MATERIALS AND METHODS: The plant extracts of AN, MKL. Sprengel, Eucalyptus hybrid and P. guajava were prepared using Soxhlet apparatus. The stock solutions of individual plant extracts (100 mg/ml) were prepared. Equal quantities of stock solutions were mixed to obtain six double combinations of herbal extracts. The antimicrobial efficacy testing was done against three primary plaque colonizers using agar well-diffusion method. 0.2% chlorhexidine and dimethyl sulfoxide were used as positive and as negative controls. The mean inhibition zone between the categories was compared using one-way Analysis of Variance and Tukey's post hoc test. RESULTS: The combination of AN and P. guajava produced the highest mean diameter of inhibition zone (21.08 mm ± 2.11) against Streptococcus mutans. The chlorhexidine produced the least inhibition zone against S. mutans (14.50 ± 2.07). The combination of AN and P. guajava produced the maximum antimicrobial efficacy against Streptococcus sanguis (19.67 ± 1.03) and Streptococcus salivarius (20.33 ± 1.86). CONCLUSION: All the combinations of plant extracts have the potential to be used as antiplaque and anticaries agents. The combinations of herbal extracts offer enhanced antimicrobial efficacy due to the synergistic effects besides slowing the development of resistance.

The effect of air abrasion on the retention of metallic brackets bonded to fluorosed enamel surface.

BACKGROUND: Bonding brackets to fluorosed enamel remains a clinical challenge and bracket failure at the compromised enamel interface is common. OBJECTIVE: To check the effect of air abrasion on the retention of metallic brackets bonded to fluorosed enamel surface. MATERIALS AND METHODS: Sixty freshly extracted human premolar teeth having moderate to severe dental fluorosis as per Dean's criteria were collected and divided into three groups of 20 each. The groups were treated as follows: In group I, acid etching was followed by bonding with Transbond XT ; in group II, sandblasting and acid etching was followed by bonding with Transbond XT ; and in group III, sandblasting and acid etching was followed by bonding with Enlight LC . An Instron universal testing machine was used for determining the debonding force, and from this the shear bond strength was computed. The sample with highest shear bond strength from each group was selected for the scanning electron microscopy (SEM) study. The prepared specimens were examined under a JSM-840A scanning electron microscope (JEOL Ltd, Tokyo, Japan) operated at 20 kV. Photographs were taken at progressively higher magnifications of ×50, ×100, ×500, and ×1000 to view the enamel surface and the adhesive remaining on the enamel surface after debonding. The shear bond strengths of the groups were compared using the one-way ANOVA (analysis of variance) and Tukey post hoc test. The distribution of adhesive remnant index (ARI) score was compared using the Chi-square test. RESULTS: The mean shear bond strength in group I was 10.36 MPa, with a standard deviation of 0.225. The corresponding values in group II and group III were 11.41 ± 0.237 MPa and 11.39 ± 0.201 Mpa, respectively. There was a statistically significant difference between the three groups in the mean shear bond strength values. CONCLUSION: Sandblasting followed by acid etching provides significantly higher bond strength values compared to acid etching alone, irrespective of the bonding material employed.

Oral health status in relation to socioeconomic factors among the municipal employees of Mysore city.

AIM: To assess the prevalence of dental caries, periodontal diseases, oral pre-malignant and malignant lesions in relation to socioeconomic factors among the municipal employees of Mysore city. SETTINGS AND DESIGN: The study was cross sectional in nature. MATERIALS AND METHODS: All the available employees (1187) during the study period were considered. World Health Organization (WHO) Oral Health Assessment form (1997) and a preformed questionnaire were used to collect the required data. Modified Kuppuswamy scale with readjustment of the per capita income to suit the present levels was used for classifying the individuals into different socioeconomic status (SES) categories. Data were collected by a single, trained and calibrated examiner (dentist) using mouth mirror and community periodontal index (CPI) probe under natural daylight. Data analysis was done using SPSS windows version 10. Quantitative data were analyzed using one-way analysis of variance (ANOVA) with Tukey's post hoc test and qualitative data were analyzed using chi-square or contingency coefficient. RESULTS: The age range of the study population was 19-57 years (mean 40.74 years, standard deviation 9.17). The prevalence of dental caries in the upper SES category was lesser (43.3%) compared to that in lower SES category (78.6%). 16.4% of the subjects in the upper category had a CPI score of 0 (healthy periodontium) and none of the subjects in the lower middle, upper lower and lower SES category had this score. The prevalence of oral pre-malignant and malignant lesions was higher in lower SES category (17.9%) than in upper class (0%). CONCLUSION: There was an inverse relationship between oral health status and SES. The overall treatment need was more in the lower class people than in the upper class.

Role of dentist in person identification.

To reinforce awareness among dentists about their role in person identification and the importance of maintaining dental records of all their patients. The article reviews basic procedures of dental identification and some cases where dental identification played a key role in eventual identification of the person. Forensic odontology is an integral part of forensic sciences. Forensic dental identifications, especially in times of mass disasters, depend mainly on the availability of ante mortem dental records. It is the social responsibility of each and every dentist to maintain dental records of their patients for the noble cause of identification in the event of mass disaster.

A five-year retrospective statistical analysis of maxillofacial injuries in patients admitted and treated at two hospitals of Mysore city.

OBJECTIVES: This study aims to provide a five-year retrospective statistical analysis of maxillofacial injuries in patients admitted and treated during 1 st January 1998 and 31 st December 2002 in two hospitals of Mysore city; to determine the age and sex distribution, etiology, type of injury, day and time of accident, and the influence of alcohol and other drugs; and to suggest measures to prevent such injuries. MATERIALS AND METHODS: After obtaining permission from the concerned authorities, a pre-designed questionnaire was used to collect the necessary data from the two hospitals. The data was then computerized and statistical analysis was done using statistical package for the social sciences (SPSS) windows version 10. RESULTS: Road traffic accident (RTA) was the common cause for maxillofacial injuries. Men sustained more injuries compared to women. The injuries were mostly sustained in the age group of 11-40 years, constituting about 78% of all the injuries. Two wheelers were the most commonly involved compared to other vehicle types. Influence of alcohol at the time of injury was found in about 58% of the patients with maxillofacial injuries. The most number of accidents occurred in the weekends. Mandibular fractures were the most common. CONCLUSION: RTAs are the most common cause for maxillofacial injuries. If RTAs are considered an epidemic of modern times, then prevention is its vaccine.