Oral cancer management in the SARS-CoV-2 Pandemic-Indian scenario.

The global burden of oral cancer rests on India's shoulders. Distant metastasis and extensive loco-regional spread result in a dismal 5-year prognosis. Tobacco chewing is the leading etiological factor. A lack of education among the masses combined with an inundated cancer care system account for high morbidity and mortality rates. The SARS-CoV-2 shows tropism for the oral mucosa. This viral tropism is thought to get augmented in oral cancer because of the upregulation of oral mucosal receptors and enzymes which enhance viral attachment and entry. The COVID-19 disease has caused a heavy blow to the cancer care sector in India because of paucity of COVID-19 centred health care regulations. This review highlights the need for the prompt creation of a national health policy which would prioritize and allow for the resumption of oral onco-surgical in light of COVID-19 pandemic.

Assessment of Hypoxia and Physiological Stress Evinced by Usage of N95 Masks among Frontline Dental Healthcare Workers in a Humid Western Coastal Region of India-A Repeated Measure Observational Study.

AIM: To assess the oxygen saturation in DHCWs using N95 and 3 ply surgical masks and determine the presence of any other subjective discomfort in them. SETTINGS AND DESIGN: A repeated measure observational study conducted at the Tertiary Care Dental Institute situated in Goa, a western coastal region of India recording humid conditions year around. METHODS AND MATERIAL: Participants constituted 60 frontline DHCWs wearing N95 masks and 60 DHCWs working in non-clinical setting wearing surgical masks. After completion of a self-administered questionnaire their oxygen saturation and pulse rate were monitored at baseline, 60mins and 120mins using pulse oximetry. Statistical Analysis: Mann Whitney u test compared oxygen saturation between the two groups. Friedmann and Wilcoxon signed rank test with Bonferroni correction computed differences within group at various time intervals. Binary logistic and linear regression was used to compare the study variables with outcome measure. p value was set at < 0.05. RESULTS AND CONCLUSION: Oxygen saturation reported a significant drop post one hour of wearing N95 masks which increased in the second hour. Prolonged use of N95 mask in humid environment adds to the body's physiological burden or perceptions of discomfort and exertion. Efforts need to be taken to address this for better compliance to the use of these protective gears.

COVID-19 in Smokeless Tobacco Habitués: Increased Susceptibility and Transmission.

As the coronavirus disease (COVID-19) pandemic continues to sweep across the globe, the world is responding by implementing public awareness campaigns, social distancing measures, and other preventive strategies to arrest the spread of this lethal disease. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exacts a heavy toll on patients with existing comorbidities. Smokeless tobacco (SLT) consumption is of particular concern in countries in South Asia with high population densities, as it facilitates exposure to SARS-CoV-2 within or between communities by the act of public spitting. Salivary droplets generated in this act are a potential threat because they can transmit this airborne infection. Moreover, large gatherings at tobacco retail outlets, frequent hand-to-mouth contact, and sharing of apparatus by SLT habitués could also aid in increasing the spread of SARS-CoV-2. SLT-induced higher expression of angiotensin-converting enzyme 2 receptors along with the presence of furin in the oral mucosa and dysfunctional immune responses among SLT habitués increase viral dissemination and an individual's susceptibility to COVID-19. Issuing rigorous regulations to restrict the use of various forms of SLT products and the obnoxious act of spitting in public can assist in arresting the spread of COVID-19. Widespread education campaigns enlightening the community regarding the adverse effects of SLT consumption and its relationship with COVID-19, along with providing effective assistance to quit for those who are addicted, would decrease the spread of COVID-19.

Assessment of readiness to quit tobacco among patients with oral potentially malignant disorders using transtheoretical model.

BACKGROUND: Tobacco use is a disease of addiction and a behavior choice. It is valuable to understand the psychosocial dimension of disease. OBJECTIVES: The research aimed to assess the (I) behavioral determinants and pattern of tobacco use (II) readiness to quit tobacco among patients with oral potentially malignant disorders (OPMDs) using transtheoretical model (TTM) approach visiting the dental college in Goa, India. MATERIALS AND METHODS: This cross-sectional analytical study was conducted among 300 patients over 3 months. Information about sociodemographics, determinants including age and reason of onset, behavioral stages, and the presence of OPMDs was collected using specially designed pro forma. Descriptive and inferential statistics were performed using SPSS 18.0. RESULTS: Smokeless form of tobacco 199 (66.34%) was most prevalent followed by smoking 79 (26.33%) and dual tobacco use 22 (07.33%) in males. Majority belonged to low socioeconomic class. Peer influence was the most-cited reason. Around 1/3rd of the participants had OPMDs associated with tobacco use. Significant association was observed between the presence of OPMDs and TTM behavioral stages. Patients with OPMDs are more motivated for tobacco cessation (odd's ratio = 2.30, P = 0.002), that is, they are more in preparation and action stages. CONCLUSION: The findings reflect that smokeless tobacco use is more prevalent in males with low level of education and socioeconomic class. Readiness to quit tobacco increases among patients with OPMDs using TTM.

Perception of Dental Public Health Competency among recent graduates.

AIMS AND OBJECTIVES: This study aimed to assess how competent the recent dental graduates perceive themselves to be in Dental Public Health. MATERIALS AND METHODS: A 21-item structured, close-ended questionnaire study was carried out at the KLEVK Institute of Dental Sciences, Belgaum, India. Students assessed their competencies using a three-point ordinal scale. One hundred and thirty-three students were asked to rate their proficiency on a 21-item matrix of the dental public health program. The responses were grouped using the Likert-type scale. Frequencies descriptive data were generated, and statistical analysis of examined variables was carried out using the Chi-square test. Mann-Whitney test was conducted to identify the correlation between variables. RESULTS: The overall mean score was 22.61 ± 10.94, highlighting confidence of the graduates in managing the oral health problems at the community level. Females showed higher competencies in functions related "to develop activities to motivate the community development," "to motivate health and oral health through health education," and "to motivate health and oral health through the creation of healthy settings." While males reported greater competency for the function "to adjust the dental practice to situations of restrictions that limits it." CONCLUSION: Recent dental graduates at the Institute perceived themselves competent in managing oral and dental health problems at the public level. Additional countrywide evidence regarding teaching and learning of public health dentistry is essential to compare the current experiences of dental graduates and ultimately enhance patient care.