Socioeconomic Correlates and Key Aspects of Tobacco Surveillance Using Global Adult Tobacco Survey Among College Students of Mangaluru, South India.

Introduction Tobacco use in recent times has been identified to be the single biggest cause of morbidity and mortality. The epidemic of tobacco use has increased among young adults, which has changed the equation of the prevalence. The contribution of tobacco use to socioeconomic inequalities in health is increasing in India. Adolescent's tobacco use may play an important role in increasing social inequalities related to smoking and smokeless tobacco use. The objective of this research was to study the association between socioeconomic status and tobacco use among college students of Mangaluru, South India Methods To analyze the association between the socioeconomic status and tobacco use, the study was conducted among 18 to 24-year-old college students (n = 802) in different colleges of Mangaluru, South India. A subset of key questions from the Global Adult Tobacco Survey (GATS) was used. The socioeconomic status of the participants was recorded using Kuppuswamy socioeconomic scale (for India) to categorize them into upper class and lower class. Descriptive statistics were applied to assess the factors related to tobacco use and socioeconomic status using SPSS ver. 24.0. Results Approximately 29.7% males and 70.3% of females completed the interview. Among 802 subjects, 69.9% belonged to the upper class and 30.04% belonged to the lower class. The current smokers who smoked daily 1.7% were from the upper class and 1.7% were from the lower class; no statistically significant difference was observed as well (p = 0.97). Approximately 3.4% from the upper class smoked less than daily and 3.1% from lower class smoked less than daily (NS). Among the upper class, 1.8% used daily and 2% subjects from the lower class used smokeless tobacco. A statistically significant difference was observed with subjects between the upper and lower class in noticing cigarette promotions in various forms during the last 30 days of interview. Conclusion Socioeconomic disparities on tobacco use need to be explored to ensure the initiation of new tobacco control activities and monitor the existing tobacco control policies. The current study finding demonstrates a significant but varied role of socioeconomic status on current and past tobacco use.

Effect of Paneer and Cheese Consumption on Salivary Acidogenicity and Calcium Concentration: A Comparative Study.

PURPOSE: To assess and compare the salivary pH reversal phenomenon and calcium concentration in subjects consuming paneer and cheese after an acidogenic challenge and also to compare the salivary pH measurements using pH strips and a portable pen-type pH meter. MATERIAL AND METHODS: Sixty caries free undergraduate students were randomly selected and divided into two group: 1. paneer; 2. cheese. After determining the resting salivary pH using pH strips and a pen-type pH meter, participants were subjected to an acidogenic challenge (10% sucrose). Following consumption of test foods (10-gram cubes), salivary pH was measured at intervals of 5, 10, 15, 30 and 60 min to record the time taken for the salivary pH to return to baseline. Colorimetric salivary calcium concentration was estimated (Biochemical Analyzer) at baseline and after 60 min of test food consumption. The statistical tests used were Shapiro-Wilk's test for normality, repeated measures ANOVA, and the independent t-test. RESULTS: Test meals reversed the fall in pH after acidogenic challenge starting at 5 min and returning to baseline values after 30 min in both groups (p = 1.000). Colorimetric estimates showed higher salivary calcium concentrations with paneer (p < 0.001). The pen-type pH meter showed superior efficiency in terms of time (p < 0.001) compared to pH strips. CONCLUSION: The salivary pH reversal phenomenon was evident after consumption of both paneer and cheese following the acidogenic challenge. Consumption of paneer significantly increased salivary calcium concentration. The pen-type pH meter proved to be more efficient.

The Top 10 Ethical Challenges in Dental Practice in Indian Scenario: Dentist Perspective.

AIM: This exploratory qualitative research is an attempt to assess the health care ethical challenges in dental practice in an Indian scenario. METHODOLOGY: Qualitative indepth interview was conducted on 20 dental professionals to assess the ethical challenges prevailing in dental practice in Indian scenario. After obtaining the responses the verbatims were categorized into categories and finally 36 themes emerged. Later from two group of 6 panellists each after conducting focus group discussion the themes of ethical issues occurring in dental practice were ranked based on order of significance impact on the practice, patient and society using Delphi method. RESULT: The top ten ethical challenges listed by the panellists are inadequate sterilization and waste management in dental clinics, poor knowledge and attitude towards ethics among our dental practitioners, in competence among dental professional, increase in cost of oral health service, poor informed consent process, requirement of consensus about the treatment procedures among dentists, Conflict in Advertising, clustering of dental clinics in urban areas, disagreement with treatment modalities among dentist and patient, poor medical record maintenance among our dental practitioners. CONCLUSION: The study attempts to bring the prevailing ethical challenges in oral health care practice in Indian scenario.

Correlation of CD4 count with cariogenic oral flora indicators and dental caries in HIV-seropositive children undergoing antiretroviral therapy in Mangaluru, South India.

AIM: The aim of the present study was to compare the association of CD4 count with cariogenic oral flora indicators and dental caries in HIV-seropositive children receiving antiretroviral therapy (ART). METHODS: A descriptive study was conducted among HIV-seropositive children receiving ART at Snehasadan Camillian Care and Support Center HIV/AIDS in Mangaluru, India. Demographic details and r recent CD4 counts were recorded. For dental caries, the Decayed, Missing, Filled Teeth (DMFT)/decayed, missing, filled/decayed, extracted, filled index was used. Data were analyzed using SPSS version 22. Spearman's correlation was used to correlate CD4 count with dental caries and cariogenic oral flora indicators (mutans streptococci and lactobacilli). RESULTS: The study population comprised 35 patients. Dental caries prevalence was 54.1% in deciduous teeth and 41.2% in permanent teeth. Age and DMFT showed a significant, positive correlation; age and dmft showed a negative correlation (P < .05). A weak, negative correlation was found between age and Streptococcus mutans (S. mutans), and also CD4 count; S. mutans and CD4 count and dmft were not found to be statistically significant (P < .05). CONCLUSION: No statistically-significant correlation was found between CD4 count and cariogenic oral flora indicators in HIV-positive patients. The presence of a minimum number of restored teeth compared to decayed teeth suggests a lack of dental care being given to HIV-positive patients.

Changes in the Oral Environment after Placement of Fixed Orthodontic Appliance for the Treatment of Malocclusion - a Descriptive Longitudinal Study.

PURPOSE: The aim of this study was to determine the changes of salivary flow rate, pH, buffering capacity, total antioxidant capacity and changes in streptococci and lactobacilli counts at baseline, 1 month and 6 months of fixed orthodontic treatment. MATERIALS AND METHODS: An unstimulated salivary sample was collected from 30 out of 43 patients who were in need of fixed orthodontic treatment (mean age 17.8 ± 5.01 years). Salivary samples were collected from the patients before the placement of fixed orthodontic appliance (Gemini MBT 0223M) at 1 month and 6 months following start of the treatment. Samples were tested for significant changes in flow rate, pH, buffering capacity, total antioxidant capacity and streptococci and lactobacilli counts. Results were compared using ANOVA. RESULTS: The study results showed that orthodontic appliances significantly changed the unstimulated salivary flow rate (p < 0.05) (baseline: 0.40 ± 0.11, 1 month: 0.45 ± 0.09, 6 months: 0.44 ± 0.07) and buffering capacity (p < 0.05) (baseline: 5.01 ± 0.50,1 month: 3 .98 ± 0.78, 6 months: 4.02 ± 0.78) at the end of 1 month and 6 months whereas lactobacilli count showed significant changes at the end of 6 months (p < 0.05) (baseline: 6.20 ± 2.07, 1 month: 7.09 ± 3.78, 6 months: 7.85 ± 1.88). The pH, total antioxidant capacity and streptococci counts did not show any significant changes during the study period. CONCLUSION: It appears that 6 months of treatment with fixed orthodontic appliance resulted in a significant increase in unstimulated salivary flow rate and lactobacilli counts, whereas buffering capacity decreased significantly during the study period.

Knowledge, attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City, India.

BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences (P<0.05) between assessed knowledge and anxiety. RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant (P=0.983). CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Salivary Thiocyanate, Uric Acid and pH as Biomarkers of Periodontal Disease in Tobacco Users and Non-Users- An In-Vitro Study.

INTRODUCTION: Biomarkers of tobacco exposure are used to confirm the absorption of specific smoke constituents in a quantitative manner. MATERIALS AND METHODS: Periodontal status was measured by Community periodontal Index (WHO). Salivary thiocyanate was determined using spectrophotometric analysis, Salivary uric acid concentration was determined using the enzymatic uric acid assay reagent. pH was measured using pH strips. RESULTS: Proportion of participants with periodontal pockets of 4-5mm was highest among tobacco smokers (80.0%) and periodontal pockets of 6mm or more were observed to be higher among tobacco chewers (26.67%). When LOA scores among tobacco chewers were recorded 26.7% of them presented with attachment loss of 0-3mm. 46.7% of them were affected with loss of attachment of 4-5mm and loss of attachment 6-8mm was found in 16.7%. 6.7% of them were found to be having loss of attachment of 9-11mm. 3.3% of them were found to be having loss of attachment of 12mm or more. The LOA scores in non- tobacco users showed 46.7% of 0-3mm, 50.0% of 4-5mm and 3.33% of 6-8mm attachment loss. The mean level of thiocyanate level detected in saliva of tobacco smokers was 172 ± 54.7 µg/ml and 203.70± 45.7 µg/ml in tobacco chewers. The mean uric acid levels was found to be 2.54 ±0.63 (µg/dl) in smokers and 2.65 ± 0.37(µg/dl) in chewers and in non tobacco users it was 2.33 ± 0.47 µg/dl. CONCLUSION: Tobacco users had significantly higher concentration of SCN levels than non-users.

A descriptive assessment of oral hygiene and salivary parameters among identical and non- identical twins

AIM: This study was to evaluate saliva parameters of identical and non identical twins with their dental caries and oral hygiene status. MATERIAL AND METHODS: A cross sectional study was conducted to assess the oral health status and investigate the salivary parameters of identical and non­identical twins in Kodhini Village, Kerala. The WHO Oral Health Assessment Form was used to record the oral health status. The Simplified Oral Hygiene Index and Gingival Bleeding Index were also included. Unstimulated saliva was collected. Immunoglobulin A levels in saliva was estimated by Turbidimetric Immunoassay. Salivary Cortisol was analysed using ELISA method. For TAC thiobarbituric acid reactive from Fenton's reaction. RESULTS: Since the absolute difference of the salivary parameters between the pairs of twins was not symmetrically distributed, we report median and interquartile range to describe these differences. There were no observed significant variations in the above salivary parameters. CONCLUSION: The similarity in their environmental factors as well as perhaps the similar genetic predisposition on salivary factors has led to the similarity in the dental caries experience in these twin children.