Perceived barriers to the provision of preventive care among dentists of Udaipur, India.

AIM: To investigate the practice-, patient- and dentist related barriers to the provision of preventive dental care as perceived by dentists of Udaipur city, Rajasthan, India. SETTINGS AND DESIGN: - A cross sectional descriptive survey was conducted among 120 dentists of Udaipur city, Rajasthan. MATERIAL AND METHODS: Mean Content Validity Ratio (CVR) was calculated as 0.87 based on the opinions expressed by a panel of total six academicians. Cronbach's coefficient was found to be 0.88, which showed a high internal reliability of the questionnaire. The questionnaire consisted of demographic questions and 12 specific research questions. STATISTICAL ANALYSIS USED: - Student's t-test and ANOVA test were applied for the statistical evaluation of means. Level of significance was set at 0.05. RESULTS: The barriers correlated strongly with each other (0.60 to 0.85). A significant gender difference was observed in mean sums of scores of practice and patient related barriers. Practice, dentist and patient related barriers for very much hindrance were reported by 8 to 13%, 5 to19% and 0 to 29% of the dentists respectively. A significant difference was observed among mean of sum scores of practice and patient related barriers with age and experience. Qualification was significantly related to practice related barriers. CONCLUSIONS: Perception of dentists showed that patient related barriers were found to be the foremost to the provision of preventive care. Also, dentist's attitude towards health promotion and disease prevention needs a radical transformation. Key words:Dental care, dentists, patients, perception.

Assessment and comparison of clinical dental status and its impact on oral health-related quality of life among rural and urban adults of Udaipur, India: A cross-sectional study.

BACKGROUND: Dental diseases negatively influence people's oral health-related quality of life (OHRQoL) and thus their perceived need for dental care. QoL is increasingly acknowledged as a valid, appropriate and significant indicator of service need and intervention outcomes in contemporary public health research and practice. OBJECTIVES: (1) To assess the psychometric properties of oral health impact profile-14 (OHIP-14) scale among rural and urban OHIP of Udaipur population. (2) To assess and compare clinical dental status (dental caries, periodontal disease and prosthetic status) and its impacts on OHRQoL rural and urban population of Udaipur. MATERIALS AND METHODS: A cross-sectional descriptive survey was conducted among rural (600) and urban (600) population of Udaipur that have age ranges between 20 and 79 years, chosen from outpatient department of Pacific Dental College and Hospital. The OHIP-14 was tested for validity and reliability. Chi-square, Student's t-test, analysis of variance and multiple logistic regression analysis were employed for statistical analysis. RESULTS: The Cronbach's alpha of the scale was found to be 0.85 among the rural population and 0.89 among the urban population. Prevalence of periodontal disease (community periodontal index and loss of attachment) was found greater among the rural population than the urban population. Urban population showed significantly greater proportion of subjects with prosthesis (including partial, fixed and total) as compared to the rural population. Among study population, OHIP-14 was significantly (P ≤ 0.05) associated with age, gender, presence of decayed teeth (DT), missing teeth (MT), and location. Significantly greater odds ratio (OR) (OHIP-14) were revealed among males (OR = 1.35, P = 0.02), urban residents (OR = 1.13, P = 0.002), those < 45 years of age (OR = 1.23, P = 0.01), those without DT (OR = 1.48, P = 0.002) and without MT (OR = 1.08, P = 0.03). CONCLUSION: The rural and urban study subjects had a fair clinical status. The presence of dental caries had greatest impacts on OHRQoL. In addition, rural subjects faced greater impact than urban subjects.

Assessment of oral health among seafarers in Mundra Port, Kutch, Gujarat: a cross-sectional study.

BACKGROUND: A seafarer is a person who navigates waterborne vessels or assists as a crewmember in their operation and maintenance in all tough weather, but little research has been done to identify conditions that may lead to assess seafarer general health as well as oral health. AIM: To assess oral diseases including dental caries and periodontal conditions among seafarer's population arrived in Mundra Port, Kutch, Gujarat, India. MATERIALS AND METHODS: A descriptive cross-sectional survey was conducted to assess oral health condition of seafarer community of Mundra Taluka of Kutch District, Gujarat, India, from July 2014 to September 2014. RESULTS: Total of 385 subjects participated in the survey. Adverse habits show the overall 72.3% prevalence among the study population. Occurrence rate of caries, periodontal disease and prosthetic status were 88%, 75.1% and 6.5%, respectively. The best predictors for Decayed Missing Filled Teeth (DMFT), Community Periodontal Index (CPI) and prosthetic status were oral hygiene practices, adverse habit and educational status. CONCLUSIONS: Findings of the present study suggest that oral health condition of seafarer community was relatively poor, with high caries prevalence and poor periodontal health. This epidemiological survey has provided baseline information to underpin the implementation of oral health programmes.

Correlation between oral lesions and opportunistic infections among human immunodeficiency virus - infected individuals in Indian population.

BACKGROUND: Human immunodeficiency virus (HIV) infection is a major global health problem. Tuberculosis and cryptococcal meningitis are the leading cause of death among people living with HIV. AIM: The purpose of this study was to determine whether any relationship exists between the occurrence of oral lesions and opportunistic infections among HIV-infected patients in Indian population. MATERIALS AND METHODS: A cross-sectional analytical study was performed in 232 HIV-infected persons (148 males and 84 females, aged 20-60 years, mean 33.6 ± 2.3 years). c2 test and logistic regression were used for statistical analysis. RESULTS: Oral candidiasis was the most common oral lesion seen in 28.4% males and 22.6% females of HIV-infected persons, followed by hairy leukoplakia in 27% males and 20.2% females which was statistically significant. Tuberculosis (21.6%) followed by cryptococcosis (9.9%) and pneumocystis carinii pneumonia (4.7%) were the most commonly found opportunistic infections. Logistic regression analysis revealed a significant association, between the occurrence of tuberculosis and candidiasis (OR 2.3; 95% CI 1.4-2.9), cryptococcosis and candidiasis (OR 1.4; 95% CI 1.0-1.9), and pneumocystis carinii pneumonia with hairy leukoplakia (OR 1.6; 95% CI 1.0-2.9). Mean CD4 count was also less. CONCLUSIONS: The results suggest a definite relationship in occurrence of oral lesions and opportunistic infections among HIV-infected patients.

Comparison of the Debonding Characteristics of Conventional and New Debonding Instrument used for Ceramic, Composite and Metallic Brackets - An Invitro Study.

BACKGROUND: Debonding procedure is time consuming and damaging to the enamel if performed with improper technique. Various debonding methods include: the conventional methods that use pliers or wrenches, an ultrasonic method, electrothermal devices, air pressure impulse devices, diamond burs to grind the brackets off the tooth surface and lasers. Among all these methods, using debonding pliers is most convenient and effective method but has been reported to cause damage to the teeth. Recently, a New Debonding Instrument designed specifically for ceramic and composite brackets has been introduced. As this is a new instrument, little information is available on efficacy of this instrument. The purpose of this study was to evaluate the debonding characteristics of both "the conventional debonding Pliers" and "the New debonding instrument" when removing ceramic, composite and metallic brackets. MATERIALS AND METHODS: One Hundred Thirty eight extracted maxillary premolar teeth were collected and divided into two Groups: Group A and Group B (n = 69) respectively. They were further divided into 3 subGroups (n = 23) each according to the types of brackets to be bonded. In subGroups A1 and B1{stainless steel};A2 and B2{ceramic};A3 and B3{composite}adhesive precoated maxillary premolar brackets were used. Among them {ceramic and composite} adhesive pre-coated maxillary premolar brackets were bonded. All the teeth were etched using 37% phosphoric acid for 15 seconds and the brackets were bonded using Transbond XT primer. Brackets were debonded using Conventional Debonding Plier and New Debonding Instrument (Group B). After debonding, the enamel surface of each tooth was examined under stereo microscope (10X magnifications). Amodifiedadhesive remnant index (ARI) was used to quantify the amount of remaining adhesive on each tooth. RESULTS: The observations demonstrate that the results of New Debonding Instrument for debonding of metal, ceramic and composite brackets were statistically significantly different (p = 0.04) and superior from the results of conventional debonding Pliers. CONCLUSION: The debonding efficiency of New Debonding Instrument is better than the debonding efficiency of Conventional Debonding Pliers for use of metal, ceramic and composite brackets respectively.

Oral health status of fishermen and non-fishermen community of Kutch district, Gujarat, India: a comparative study.

BACKGROUND: Fishing is one such hazardous occupation, which involves irregular diet, stress, alcoholism, tobacco and pernicious habits. Fishermen have lower socio-economic status and their illiteracy adds to their poor oral hygiene, which may influence general and oral health. AIM: The aim of the study was to assess and compare the oral health status of fishermen and non-fishermen population of Kutch District, Gujarat, India. MATERIALS AND METHODS: A descriptive cross-sectional survey was conducted to assess and compare the oral health status of the fishermen and non-fishermen community of Mundra taluka of Kutch district, Gujarat, India, from January 2013 to June 2013. RESULTS: Fishermen had significantly higher periodontal disease and dental caries than non-fishermen group (p = 0.001). Malocclusion was significantly higher in non-fishermen group (p = 0.001). Extraction was the most prevalent treatment need among both groups. Occupation and educational status were respectively identified as the best predictors for dental caries and periodontal disease. CONCLUSIONS: Findings of the present study suggest that oral health status of the fishermen population was relatively poor, with high caries prevalence and poor periodontal health when compared to the non-fishermen population. In the light of high treatment needs of the study population, health policy that emphasises oral health promotion and prevention would seem more advantageous in addition to traditional curative care.

Comparative Assessment of Intelligence Quotient among Children Living in High and Low Fluoride Areas of Kutch, India-a Pilot Study.

BACKGROUND: Long-term ingestion of large amounts of fluoride can lead to potentially severe skeletal problems and neurological consequences. The study was conducted to assess and compare intelligence quotient of children living in high and low fluoride areas in Kutch, Gujarat, India. METHODS: A cross-sectional descriptive survey was conducted among 100 school children aged 8 to 10 years, living in Kutch District, Gujarat, India during July 2012. Mundra (2.4 to 3.5 mg/L) and Bhuj (0.5mg/L) were the two villages randomly selected to represent the high and low water fluoride areas respectively. Seguin Form Board Test was used to assess the intelligence quotient (IQ) level of children. Descriptive statistics and independent sample t-test was used for analysis. RESULTS: Mean scores for average, shortest and total timing category were found to be significantly higher (P<0.05) among children living in Mundra (30.45±4.97) than those living in Bhuj (23.20±6.21). Mean differences at 95% confidence interval for these timings were found to be 7.24, 7.28 and 21.78 respectively. In both the villages, females had lower mean timing scores than males but the difference was not statistically significant (P>0.05). CONCLUSION: Chronic exposure to high levels of fluoride in water was observed to be associated with lower intelligence quotient.