Medico-legal aspect of dental practice.

Law influences every aspect of human activity, and dentistry in this regard is no exception. Ethical standards of the dental profession are seeing a steady decline, altruistic concepts being overridden by a market driven system. A deficient knowledge regarding the medico-legal aspects halts the effective implementation and delivery of efficient services. The review thus provides an overview of ethical standards, consents and their types, negligence,, determination of negligence, liabilities of dental practitioners and solicitors in dental practices, which comprehensively form an integral part of the medico-legal aspect of dental practice.

"Impact of comprehendible learning modes on oral health among visually impaired adults".

AIM: To assess changes in oral hygiene status, oral health knowledge and behavior among visually impaired individuals using dental health education material transcribed in Braille and Compressed speech. METHODOLOGY: A nonrandomized before and after comparison study was conducted among 4 purposively selected institutes for visually impaired in Indore region, Central India. A stratified random sampling was employed to select 144 visually impaired individuals aged 15-35 years. Oral health education (OHE) material was developed in Braille and compressed speech. Participants were intervened using OHE material. A self-administered Braille transcribed proforma was used to record participants responses on oral health knowledge and behavior at baseline, 1-week, 1-month, and 3-months followed by clinical examination. Descriptive statistics was used for frequencies, mean, and standard deviation of variables. Bivariate regression analysis was performed to assess the effect of independent variables on self-reported oral health, knowledge score and oral hygiene status. RESULTS: The mean knowledge score of participants in Braille group at 3-month was significantly higher (11.86 ± 2.41) than in compressed speech group (8.59 ± 2.74). Compressed speech showed significant reduction in mean gingival score (1.02 ± 0.73) at 3-month (P ≤ 0.001). Bivariate regression indicated Braille education was significantly effective in improving knowledge (OR: 6.02) and oral hygiene status (OR: 8.24) (P ≤ 0.001). CONCLUSION: Braille method of intervention was more effective in improving knowledge scores and oral hygiene status among visually impaired participants.

Cross-cultural adaptation and psychometric evaluation of oral health impact profile among school teacher community.

AIM: To translate OHIP-14 into Hindi and test its psychometric properties among school teacher community. METHODS: The OHIP-14 was translated to OHIP-14-H using WHO recommended translation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a sample of 10 individuals. The OHIP-14-H was administered on a random sample of 170 primary school teachers. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Intra-class correlation coefficient (ICC) respectively, with 2 weeks interval. Predictive validity was tested by comparing OHIP-14-H scores with clinical parameters. The concurrent validity was assessed using self-reported oral health and discriminant validity was ascertained through negative association with sociodemographic variables. RESULTS: The mean OHIP-14-H score was 9.57 (S.D = 4.58). ICC and Cronbach's alpha for OHIP-14-H was 0.96 and 0.92 respectively. Concurrent validity using binomial regression model indicated that good (OR = 0.56, 95% CI = 0.55 - 4.47) and moderate (OR = 0.25, 95% CI = 0.17 - 1.87) OHIP-14-H scores were negative but significant risk indicators of poor self reported oral health (P < 0.009). Significant predictive validity was observed between OHIP-14-H scores and clinical parameters (P < 0.000). CONCLUSION: Translated and culturally adapted OHIP-14-H indicates good reliability and validity among primary school teachers.

Impact of Having a Mentally Disabled Child in the Family on the Oral Health of the Healthy Sibling: A Comparative Study.

PURPOSE: To determine and compare oral health status, knowledge and attitude among siblings of mentally disabled with siblings of normal healthy children. MATERIALS AND METHODS: 240 study subjects consisting of 120 each of siblings of mentally disabled and normal, healthy children (control group) matched for age and gender were selected by convenience sampling. Oral health was assessed using the WHO-1997 proforma. A pretested questionnaire (30 items) was used for oral health knowledge and attitude assessment. Statistical analysis was performed using the chi-squared and Mann-Whitney tests. RESULTS: Caries prevalence among the siblings of mentally disabled and control group was 82% (mean DMFT 1.68 ± 1.18) and 45% (mean DMFT 0.58 ± 0.72), respectively (p < 0.05). The siblings of mentally disabled children also showed good oral health knowledge (mean 7.1 ± 1.4) and a positive attitude (p < 0.05). CONCLUSION: Siblings of mentally disabled children showed higher caries experience. Knowledge and attitude towards oral health was comparatively good among siblings of mentally disabled children. They exhibited favourable attitudes and involvement in helping their sibling to maintain oral health.

Effect of injection site pre-cooling on pain perception in patients attending a dental camp at Life Line Express: a split mouth interventional study.

BACKGROUND AND AIM: To determine the effect of pre-cooling injection site on pain perception in patients attending a dental camp at lifeline express, Habibganj. METHODS: A split mouth interventional study assessed the effect of pre cooling the injection site in patients (n=33) requiring bilateral buccal infiltration prior to extraction. One side of the patient's mouth received the intervention after the injection site was pre cooled with ice for 3 minutes along with topical Lidocaine, while the other mouth side of the same patient received only topical Lidocaine and served as control group. A structured proforma assessed the demographic characteristics and risk factors that influence pain perception in patients. Mann-Whitney U tests and Wicoxon rank sum test were used for statistical analysis. Statistical significance was defined at P<0.05. RESULTS: The results revealed a significant difference in pain perception between control and intervention group as assessed using both Heft-Parker Visual Analog Scale (median score 3.0 and 1.0) and Sound Eye Motor scale (median score=1.0 and 0.0) (P<0.01). For both the scales the assessed and self reported variables Gender, Location, Chief Complaint, Region and Arch were found to be statistically significant. CONCLUSION: Pre cooling injection site reduced pain perception in patients.

Linguistic adaptation and psychometric evaluation of original Oral Health Literacy-Adult Questionnaire (OHL-AQ).

INTRODUCTION: Linguistically adapted oral health literacy tools are helpful to assess oral health literacy among local population with clarity and understandability. The original oral health literacy adult questionnaire, Oral Health Literacy Adult Questionnaire, was given in English (2013), consisting of 17 items under 4 domains. The present study rationalizes to culturally adapt and validate Oral Health Literacy Adult Questionnaire into Hindi language. Thus, we objectified to translate Oral Health Literacy Adult Questionnaire into Hindi and test its psychometric properties like reliability and validity among primary school teachers. METHODS: The Oral Health Literacy Adult Questionnaire was translated into Oral Health Literacy Adult Questionnaire - Hindi Version using the World Health Organization recommended translation back-translation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a small sample of 10 individuals. A cross-sectional study was conducted (June-July 2015) and OHL-AQ-H was administered on a convenient sample of 170 primary school teachers. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Intra-class correlation coefficient (ICC), respectively, with 2 weeks interval to ascertain adherence to the questionnaire response. Predictive validity was tested by comparing OHL-AQ-H scores with clinical indicators like oral hygiene scores and dental caries scores. The concurrent and discriminant validity was assessed through self-reported oral health and through negative association with sociodemographic variables. The data was analyzed by descriptive tests using chi-square and bivariate logistic regression in SPSS software, version 20 and p<0.05 was considered as the significance level. RESULTS: The mean OHL-AQ-H score was 13.58±2.82. ICC and Cronbach's alpha for Oral Health Literacy Adult Questionnaire - Hindi Version were 0.94 and 0.70, respectively. Comparisons of varying levels of oral health literacy with self-reported oral health established significant concurrent validity (p=0.01). Significant predictive validity was observed between OHL-AQ-H scores and clinical parameters like oral hygiene status (p=0.005) and dentition status (p=0.001). CONCLUSION: The translated and culturally adapted Oral Health Literacy Adult Questionnaire - Hindi Version indicated good reliability and validity among primary school teachers to assess oral health literacy among Hindi speaking population. Hence, improving OHL levels and implementing education oriented policies can improve the quality of life.

Impact of different oral hygiene aids for the reduction of morning bad breath among dental students: a crossover clinical trial.

BACKGROUND AND AIMS: To assess and compare the effects of different oral hygiene procedures on the reduction of morning bad breath, plaque and gingival status in healthy subjects. METHODS: A four step cross-over trial was performed on 32 study subjects. They were allocated into four groups: Group I: tooth brushing; Group II: tooth brushing and tongue scraping; Group III: tooth brushing and mouth washing; and Group IV: tooth brushing, tongue scraping and use of mouthwash. A washout interval of 7 days was employed. At the beginning and at the end of all intervention periods, breath score was measured by hand held sulfide monitor (Breath Alert) at four time intervals. The Plaque and Gingival status was evaluated using Plaque and Gingival Index. RESULTS: The highest reduction in mean breath score (2.12±0.65), plaque score (0.75±0.47) and gingival score (0.67±0.41) were found in the Group IV followed by Group II and Group III. A significant positive correlation was observed between plaque scores and gingival scores before intervention (r=0.443; p value<0.001) and after intervention (r=0.846; p value<0.001). CONCLUSION: The study findings suggest that mechanical aids in conjunction with chemical regimens are considered as the most effective method for reducing the morning bad breath in healthy subjects and should be incorporated in daily oral hygiene practices.

Association of body mass index with dental caries among malnourished tribal children of Indore division.

BACKGROUND AND AIM: Nutrition is an essential component in human growth, development and maintenance of healthy life. Tribal communities are highly disease prone and do not have the required access to basic health facilities, also having a high degree of malnutrition. The aim of this study was to determine the association of body mass index with dental caries among malnourished tribal children of Indore division (M.P.). METHODS: A cross-sectional house to house survey was carried out among 275 study subjects, 6-15 years old tribal children in two major tribal districts of Indore division. Permissions and consent was obtained from local administrative authorities, ethical committee and parents respectively. Anthropometric measurements like height, weight, mid-arm and head circumference were recorded. Children with confirmed malnourishment on basis of BMI index were considered for data collection. Oral examination for caries was conducted according to WHO 1997 survey methods. Descriptive tables and analytical tests such as ANOVA and chi-square test were employed. Independent effects of age, gender, BMI, oral hygiene status and daily intake sugar on caries status were tested using logistic regression analysis. RESULTS: The mean age was 9.75 (±2.43) years. The caries prevalence among permanent dentition of malnourished children was 61.4% with a mean of 1.61 (±0.48). Among tribes, malnourished children of Bhilala tribe showed significantly higher caries prevalence (1.82±0.46, p<0.01). Increase in caries prevalence was seen with increase in severity of malnourishment (p<0.05). Logistic regression indicated gender (males OR=1.19), age (5-10years OR=1.11) and high sugar intake (OR=1.49) were significantly associated with caries occurrence (p=0.001). CONCLUSION: Caries was more prevalent in malnourished tribal children and was seen to increase with severity of malnourishment.

Knowledge,attitude and anxiety towards pandemic flu a potential bio weapon among health professionals in Indore City.

BACKGROUND: Flu is one of the oldest medical concerns, causing high mortality rates among humans. Swine flu has not only emerged as a fatal disease omong Indian population but has also created havoc among various sections of society. OBJECTIVE: To determine Knowledge, Attitude and Anxiety towards pandemic flu a potential bioweapon among health care professionals in Indore City. METHOD: The study design used was a cross sectional descriptive study was carried out between February-March 2015 during the outbreak of Swine Flu. The survey was administered to a sample of 271 health professionals. Participants comprised of 148 medical professionals and 123 dental professionals practicing in Sri Aurobindo Institute of Medical Science. The data collection tools comprised of a questionnaire on demographic characteristics, knowledge and attitude. Beck Anxiety Inventory was used to assess the anxiety among professionals. RESULTS: The medical professionals (95.9%) had significantly higher (p value=0.007) knowledge about available vaccines against Swine Flu. The dental professionals (33.3%) were more hesistant in treating patients suffering from Swine Flu compared to medical. CONCLUSION: The results of the present study suggest that the health care professionals had good knowledge, showed positive attitude, and demonstrated lower anxiety levels.

Impact of Dental Neglect Scale on Oral Health Status Among Different Professionals in Indore City-A Cross- Sectional Study.

BACKGROUND: Young educated Indian generation are very much health conscious. They take adequate nutritious balanced diet and practice physical exercise regularly to keep themselves active and healthy. Oral health is a part of general health care system. If oral health is neglected it may affect our general health and as a result it affects our quality of life too. AIM: To assess dental negligence and oral health status by using Dental Neglect scale questionnaire among different professionals of Indore city. MATERIALS AND METHODS: The study consisted of a convenient sample of 400 students of aged 18-25 years from 4 different professional colleges of Sri Aurobindo Group of Institutes of the same campus. A pretested validated questionnaire was used for assessing dental neglect and home dental care practices. Oral health examination was conducted to assess dental caries and oral hygiene status by using DMFT and OHIS respectively. Data was analysed using SPSS Software (version 20). RESULTS: For OHI(S), majority of the respondents (57.7%) showed fair oral hygiene for DNS score <15, whereas majority of the professionals (63.7%), showed poor oral hygiene for DNS score >15. The Dental Neglect Scale (DNS) score was found statistically significant with OHIS and caries experience at 95% Confidence Interval. There was no statistically significant difference between DNS score and frequency of Decayed, Missing and Filled teeth DMFT. CONCLUSION: The Dental Neglect Scale appears to be a sound method for objectifying dental neglect. It has many of the features of a satisfying health index. However, further validation with other age groups, cultures, place and a larger population is required in order to justify the utility of Dental Neglect Scale in different situations.

Occupational Hepatitis B Exposure: A Peek into Indian Dental Students' Knowledge, Opinion, and Preventive Practices.

Objective. To determine the level of knowledge, opinions, and preventive practices followed by dental students against Hepatitis B. The study also explored if any correlation existed between knowledge, opinion, and preventive practices score. Materials and Methods. A cross-sectional study was conducted in a dental teaching institution. The subjects comprised 216 dental students. The study was conducted using a pretested, self-administered questionnaire. The questionnaire was prepared to assess knowledge, opinion, and preventive practices against Hepatitis B. Kruskal-Wallis and Kendall Tau test were performed. Results. The study found that only 44.4% of the students were vaccinated with Hepatitis B vaccine. 59.3% of the students reported washing their hands after contact with patient's body fluids. 63.9% used personal protective measures like facemask, aprons, head cap, eye shields, and so forth, while treating patients. Median knowledge, opinion, and practice scores were found to be 5.00, 3.00, and 3.00, respectively. Significant correlation was obtained between knowledge and preventive practices score (r = 0.385, p value <0.0001). Conclusion. Effective measures need to be taken to improve preventive practices of the students to prevent them from risk of Hepatitis transmission. Mandatory vaccination against Hepatitis B needs to be implemented.

Assessment of relationship between oral health behavior, oral hygiene and gingival status of dental students.

BACKGROUND: The behavior of oral health providers toward their own oral health reflects their understanding of the importance of preventive dental procedures and of improving the oral health of their target population. AIM: This study was done with an aim to assess the relationship between oral health behavior, oral hygiene and gingival status of third and final year dental students from a Dental College in Indore City, India. METHODS: A total of 137 dental students participated in the study. The students were invited to complete the Hiroshima University-Dental Behavioral Inventory (HU-DBI) questionnaire. The HU-DBI questionnaire consisted of twenty polar responses (agree/disagree) regarding oral health-related behavior. In addition, two further questions about the frequency of brushing and flossing were included. Subsequently, oral health examination was conducted to assess plaque and gingival status. Data were analyzed using Chi-square test, Independent sample t-test, and Pearson's correlation. The significance level was set at P ≤ 0.05. RESULT: The results showed that about 66.6% of the students checked their teeth in the mirror after brushing. Only 20.1% of the students reported bleeding from gums. The mean oral heath behavior score (HU-DBI) was 6.47 ± 2.0. A negative correlation of HU-DBI scores with plaque (r = -0.501) and gingival scores (r = -0.580) was observed. CONCLUSION: Thus, it is concluded that there is a significant relationship between the oral health behavior, oral hygiene, and gingival status of dental students. Dental students with better self-reported oral health behavior had lower plaque and gingival scores indicating a better attitude toward oral health.

Dental Camp Experience in Lifeline Express (LLE) Train among Rural Population of Central, India.

INTRODUCTION: The lifeline express is the world's first hospital train. To date, over 800,000 patients living in the remote rural interiors of India where medical facilities are scarce, have been treated. OBJECTIVE: To evaluate the application and feasibility of providing screening, diagnosis, preventive dental treatment for rural population through mobile dental unit in lifeline express train from last three years in Madhya Pradesh, India. MATERIALS AND METHODS: The study was retrospective and the data was extracted from six dental camps which have been conducted by Life line Express/ Impact India foundation in between 2011 to 2013 in rural and remote area of Madhya Pradesh. RESULTS: Out of six dental camps 14,081 patients were registered and 6,526 received dental treatment. The type of dental treatment like extractions (3,441), scaling (2,119) and restoration (966) were performed. CONCLUSION: The study shows a mobile dental hospital like LLE can provide an excellent opportunity for rural populations regarding oral health care.