Challenges for dental professionals during COVID-19 pandemic: Are we prepared?

BACKGROUND: With the emerging knowledge and understanding of novel coronavirus infection, dentists must be capable of resuming their practice with necessary precautions in near future; hence, the aim of the present study was to evaluate the knowledge, attitude, and practices along with felt challenges by the dentists concerning practicing dentistry during pandemic in India. MATERIALS AND METHODS: An online cross-sectional questionnaire study was conducted on the dental practitioners of Uttarakhand, India. The dentists were approached by obtaining their E-mail address from the heads of dental institutions or dental association branches in the state. The knowledge, attitude, and practices along with apparent challenges of practicing during pandemic were assessed using closed-ended questionnaire. The relationship between the mean scores and demographic variables was determined using Student's unpaired t-test by keeping the significance level below 0.05. RESULTS: Out of 759 respondents, a total of 458 respondents were male (60%), whereas 301 (40%) were female. The mean knowledge scores were higher in females (11.06 ± 2.12) compared to males (9.72 ± 4.53), which was statistically significant (P < 0.05). The mean practice score was lower in males (17.49 ± 6.47) compared to females (19.26 ± 6.69) and likewise lower scores were seen in graduates compared to specialists and these differences were again statistically significant (P < 0.05). Majority of the study participants felt that following various safety guidelines were not feasible (96.97%) and too expensive (96.44%) and considered them as a challenge. CONCLUSION: It is imperative that dentists should be fully prepared before resuming their services and reach the right kind of awareness to limit the spread of the disease.

Evaluation of salivary flow rate, pH, and buffer capacities in end-stage renal disease patients versus control - A prospective comparative study.

BACKGROUND: Saliva plays a major role in preserving the integrity of oral tissues. Chronic renal failure patient undergoes many oral and salivary changes for which they require special oral health care. The patient undergoing hemodialysis session has altered salivary composition. Many changes occur during hemodialysis that severely affect the flow rate and the biochemical composition of saliva. METHODS: A total of 50 patients of end-stage renal disease undergoing hemodialysis for renal insufficiency were selected based on inclusion and exclusion criteria set prior to the study. These patients were compared with the control group who had already undergone hemodialysis. A total of 30 patients were selected as a control group. In this study, unstimulated whole saliva was collected by the spitting method before and after the dialysis session. Salivary flow rate, pH, and buffering capacities were measured. RESULTS: Hemodialysis had a significant effect on the salivary flow rate. The mean pH of unstimulated whole saliva showed no significant changes before and after dialysis. The concentrations of urea, creatinine, chloride, and potassium in the whole saliva changed markedly before and after a hemodialysis session, whereas no significant difference was seen in the concentration of sodium and calcium. CONCLUSION: Through this study, we came into a conclusion that hemodialysis had a significant effect on salivary secretion and the biochemical composition of saliva. We conclude that the observed changes in salivary concentrations and the flow rate are mainly due to an increased watery secretion from the salivary glands and also saliva can be used as a tool for monitoring hemodialysis.

Salivary and Serum Glucose Levels in Diabetes Mellitus Patients versus Control - A Randomised Control Trial.

Oral fluids provide a readily available and non-invasive medium for the diagnosis of a wide range of diseases and clinical situations. Diabetes mellitus is a common chronic metabolic disorder that affects millions of people. Our objective was to compare the salivary and serum glucose levels in patients with diabetes mellitus and healthy individuals. Two ml of unstimulated whole saliva was collected by the spitting method. Also, 2 ml of the patient's intravenous blood was obtained from the forearm's median cephalic vein. Both the samples were centrifuged at 2000 rpm for 2-3 minutes. Ten µl of both saliva and serum were taken out and added to glucose reagent. These were kept in a temperature-controlled water bath at 37°C for 10 minutes. The color change was noted, and the optical density was measured in a semi-auto analyzer. The presence of glucose was detected in both groups; however, the levels were raised in people with diabetes compared to healthy individuals. The present study indicated a substantial increase in salivary and serum glucose levels in diabetic patients compared to healthy controls. The concentration of glucose in saliva increases with the increase in serum glucose concentration.

Cariostatic Efficacy of Aqueous and Ethanolic Extracts of Liquorice in the Schoolchildren: In Vivo Comparative Study.

AIM: The present study was done to evaluate the in vivo cariostatic efficacy of aqueous and ethanolic extracts of liquorice to ascertain whether it could be developed into a caries-preventive regimen basically targeted for use in the pediatric population. MATERIALS AND METHODS: Thirty schoolchildren of 6-12-year-old were selected for the study. Powder of Glycyrrhiza glabra is used to prepare the gel with various concentration of aqueous and ethanolic liquorice gel. The preweighed dose was delivered through the vials. The drug concentrations were based on their respective minimum bactericidal concentration (MBC) values against Streptococcus mutans, which were calculated earlier. And it is divided into three groups, i.e., group I: aqueous liquorice extract 1.75 g/10 mL saline, group II: ethanolic liquorice extract 350 mg/10 mL, and group III: hexidine (0.2% chlorhexidine, CHX). For statistical analysis, Tukey's post hoc with one-way analysis of variance (ANOVA) and t test were applied. RESULTS: It was found that hexigel has a potential antibacterial activity against S. mutans, with minimum inhibitory concentration (MIC) of 3.14 ± 2.02. Ethanolic liquorice shows MIC of 2.15 ± 0.91 and aqueous liquorice shows MIC of 1.30 ± 1.08. Tukey's post hoc test showed statistically nonsignificant difference between hexigel and ethanolic liquorice against S. mutans. CONCLUSION: On conclusion, the present study found that hexigel was better than both the ethanolic and aqueous solutions of liquorice. And ethanolic liquorice was found to be better than aqueous solution, but it was not statistically significant, which could be due to the small sample size. CLINICAL SIGNIFICANCE: Dental caries is one of the most common infectious microbial diseases. Various steps have been taken to prevent dental caries, fluoride being the most common among them. Nowadays, G. glabra, commonly known as liquorice (mulethi), is one such medicinal plant used by various cultures for thousands of years to relieve coughs, sore throats, and gastric inflammation. This drug in our study demonstrated inhibitory effect on the growth of S. mutans.

Psychological Impact on Maxillofacial Trauma Patients - An Observational Study.

Facial disfigurement due to trauma is very common as the face is a prominent part of the body and is susceptible to injuries. A protocol for the diagnosis and intervention for psychological problems of trauma patients should be implemented in the Indian hospitals as they lack policies for assessing the mental status of such patients. This study was conducted to analyze and determine the psychological implications and need for mental health services of maxillofacial trauma patients. Fifty patients with maxillofacial trauma above 18 years of age were included in this study. The assessment was done using the Hospital Anxiety and Depression Scale (HADS) and Trauma Screening Questionnaire (TSQ), which are considered as the standard tools for assessment of psychological disorders post-trauma. We observed psychological stress in 84% of the patients at the baseline, which reduced to 24% after one month at the first follow-up visit and further reduced to 22% at the second follow-up visit. The reduction in the percentage from the first to the second follow-up visit was less significant. However, the change in HADS and TSQ scores was found to be significant, suggesting that the intensity of trauma decreases with the time-lapse. Anxiety, depression, and post-traumatic stress are prevalent in patients with maxillofacial trauma, which may lead to impaired day-to-day life. Our results suggest that there is a need for psychological care in patients with maxillofacial trauma.