High prevalence of dental fluorosis among adolescents is a growing concern: a school based cross-sectional study from Southern India.

BACKGROUND: Fluorosis, caused by ingestion of excessive amount of fluoride through food or water, is a major public health problem in India. This study was undertaken to quantify the dental fluorosis burden among school going adolescents and to find factors associated with dental fluorosis in Kolar taluka, Karnataka, India. METHODS: A total of 1026 high school adolescents (12-17 years) were enrolled from different schools selected by stratified sampling method. Dental examination was done to record Dean's fluorosis index, and socio-demographic, food consumption and oral hygiene data were recorded using a pre-tested structured questionnaire. Fluoride content was measured using Orion apparatus, and Community Fluorosis Index (CFI) was calculated from drinking water samples from various drinking sources. Multivariable analysis with generalized estimating equation (GEE) regression model was used to explore the factors associated with dental fluorosis. RESULT: Among 1026 enrolled students, 64.3% of adolescents were detected with dental fluorosis; more than 50% had either severe or moderate fluorosis according to the Dean's Fluorosis Index and Community Fluorosis Index (CFI). The majority of affected students were from government schools. The significantly associated factors with dental fluorosis were living in study area for more than 5 years and studying in government school. A strong positive correlation between the amount of fluoride content in drinking water sample collected and CFI was observed (rho = 0.570). CONCLUSION: Prevalence of dental fluorosis was considerably high, affecting nearly two-thirds of the students, and mainly in government schools and long-term residents of the area. Health education and community awareness for preventing fluorosis, apart from setting-up defluoridation plants or training for home based defluoridation techniques in study villages, should be considered.

Risk of oral cancer associated with gutka and other tobacco products: a hospital-based case-control study.

BACKGROUND: Although tobacco deaths rarely make headlines, tobacco kills one person every six seconds. Tobacco kills a third to half of all people who use it, on average 15 years prematurely. AIM OF THE STUDY: To study the risk of oral cancer associated with gutka consumption and other tobacco products. OBJECTIVE: (1) To find the association between gutka consumption and oral cancer. (2) To study the association between oral cancer and other tobacco products. METHODOLOGY: A case-control study of 134 cases and 268 controls, over a period of 5 months, from March 2013 to July 2013, was carried out at the Kasturba medical hospital in Manipal, India. The participants were personally interviewed by the investigator using a structured questionnaire on consumption of tobacco, poly-ingredient dip products, alcohol, dietary practices, oral hygiene practices and demographic status. RESULTS: Univariate logistic regression followed by multivariate logistic regression was done for identifying the risk factors and adjusted for the confounding variables. Analysis showed that gutka (<0.001, OR = 5.1 95% CI = 2.0-10.3), chewing tobacco (P < 0.001, OR = 6.0 95% CI = 2.3-15.7), supari (P < 0.001, OR = 11.4 95% CI = 3.4,38.2), betel quid (P < 0.001, OR = 6.4 95% CI = 2.6-15.5), bidi (P < 0.05, OR = 2.3 95% CI = 1.1-4.8) and alcohol (P < 0.001, OR = 3.7 95%CI = 1.8-7.5) had strong association with oral cancer upon adjustment. CONCLUSION: The study provided strong evidence that gutka, supari, chewing tobacco, betel quid, bidi and alcohol are independent risk factors for oral cancer.