Modified extrinsic tooth stain index and its clinical applicability.

Aim: The first index for the assessment of extrinsic stain was published by Lobene in 1986. Using the Lobene stain index in the field is very cumbersome as well it does not meet the general requirement of an index, i.e., the index is to be simple, rapid, highly reproducible, and sensitive enough to detect small changes in the staining level. Hence, there was a need to develop an alternative index for the same purpose. Hence, the only present study was undertaken to propose a modified stain index with more simplicity and clarity. Materials and Methods: An observational study was carried out among 16-44-year-old participants who had at least six natural teeth and were generally healthy. For the revised index, the criteria and codes for intensity were kept the same as MacPherson Index but the criteria for recording area were modified. The data scoring for each tooth was mentioned in the proposed table and was recorded for each of the surfaces according to the proposed area and intensity codes. Analysis was carried out using SPSS version 21 (IBM, Inc. Virginia, United States). Inferential statistics were performed using the Mann-Whitney U-test. Nonparametric tests were applied following the imposition of a numerical interval scale the same as the Lobene index. Results: No statistically significant difference was appreciated for the area, intensity, and product of area × intensity when compared for measurements recorded by two indices as P > 0.05. Hence, validating the proposed index for the clinical application. Conclusion: The proposed modified index may be advantageous over its conventional counterpart due to its ease of recording and concise scoring and also less complexity in the area to be recorded.

Knowledge and Acceptance of the COVID-19 Vaccine for COVID-19 Disease Prevention among the Indian Population: A Mixed-Method Study.

Aim: To assess the Knowledge and Acceptance of the COVID vaccine among the Indian population. Materials and methods: The present mixed-method study was conducted in two phases. The first phase: quantitative assessment of knowledge and acceptance for the COVID-19 vaccine using an E survey (N = 606). The second phase: qualitative assessment using semi-structured face-to-face interviews with the study participants (N = 30) and assessment was done using a thematic approach. Study participants were selected using the convenience sampling method. Results: It was found that a large proportion of subjects in the 16−25 year of age group knew the cause of disease. But knowledge about its transmission process was found to be more in >60 years of age gap and almost all the participants in all the age group preferred Covishield. The vaccine acceptance rate was found to be low as compared to the knowledge. Conclusion: Most study participants were found to have satisfactory knowledge, but acceptance rate was comparatively lesser. Hence, more information and awareness campaigns must be launched reassuring the population about vaccine safety.

Knowledge, Attitude, Practices, and Preparedness of Dental Professionals in Prescribing Nicotine Replacement Therapy.

OBJECTIVE: To assess the knowledge, practice, attitude, and preparedness of dental professionals in prescribing nicotine replacement therapy (NRT). Methodology. A prevalidated voluntary web-based questionnaire was generated as a link through Google Drive and was sent to 117 dental professionals in North India using Whatsapp, Messenger, and Instagram social media platforms. A total of 94 responses were received and out of which 76 responses were analyzed (18 forms were excluded due to incomplete or duplicate responses). Frequency analysis was done using SPSS software version 21. RESULT: The participation rate was found to be 80.3%. More than half of the study population were familiar with the term NRT (77.6%) and its uses (67.1%), but approximately less than half of the total study subjects knew the duration (32.9%), cost (27.6%), dosage (25%), and contraindications (36.8%) of the NRT. Approximately 56.6% of the study participants showed a positive attitude towards helping patients to quit smoking through tobacco cessation counseling. Nearly one-fourth of the study population, i.e., 27.6%, were confident in explaining the negative impacts of tobacco, while 22.4% knew about the tobacco cessation protocol. Among the participants, only 27.6% reported that they practice NRT and out of which approximately less than 20% of the study participants were prescribing correct dose of NRT. CONCLUSION: Though study subjects had an ample knowledge regarding NRT use in tobacco cessation, it does not reflect their current attitude and preparedness. Thus, there is a need for continuing education to further train dental professionals for prescribing NRT.

Smoking Rationalisation, Tobacco Dependence and Intention to Quit Among Indian Adults and Adolescents.

Introduction: Unfortunately, indicators of tobacco dependence are present even after low levels of exposure in young smokers. Early emergence of these signal risk for subsequent chronic smoking and nicotine dependence is negatively associated with cessation in young adults. One important yet understudied modifiable predictor of intention to quit among smokers is smoking rationalization. Smokers often subscribe to smoking rationalisation beliefs, also known as self-exempting beliefs, to justify or rationalize their smoking behaviors. Smoking rationalizations can predict a lack of intention to quit. Objective: To assess the correlation between smoking rationalisation, tobacco dependence and intention to quit among Indian adults and adults. Methodology: A cross-sectional pilot study was carried out among 18-60-year-old subjects. Data were collected for tobacco dependence, smoking rationalisation and intention to quit (no/yes) by structured interview. Data were analysed using IBM SPSS statistics for windows, version 16 (IBM Corp, Armork, NY.) The independent t-test and one way ANOVA and binary logistic regression were performed for inferential statistics. Results: Smokers with no intention to quit and high tobacco dependence scores had significantly higher smoking rationalisation than those to quit and low dependence scores. Logistic regression models demonstrated that all types of rationalisation beliefs were consistently inversely associated with the intention to quit and low tobacco dependence. Conclusion: Findings suggest that smoking rationalisation plays an important role in the lack of intention to quit among Indian smokers. Future interventions should tackle smoking rationalisation beliefs as a strategy to promote smoking cessation.

Assessment of Knowledge, Attitude, and Practice Regarding Oral Cancer among Dental Graduates-A Web-Based Survey.

The present study was conducted to assess the knowledge, attitude, and practice among new dental graduates across India. A web-based questionnaire was generated as a link through Google Drive which was sent to approximately 250 dental graduates using Whatsapp messenger. A total of 205 complete responses were received and analyzed. Frequency analysis was done using SPSS software version 21. Oral squamous cell carcinoma (OSCC) was identified as most common cancer by 48% of the subjects while the stage of oral cancer in which it is most often diagnosed was only responded correctly by 15.5% as advanced stage. Approximately one fourth (25.4%) of the participants performed dental examination to detect cancer routinely in all patients. Half of the study subjects were confident in detecting oral cancer, still majority (70.6%) of the subjects were interested in attending continuing education course on oral cancer in the future. This study revealed that the majority of the new dental clinicians were not having legitimate knowledge regarding oral cancer. Thus, this lacuna in knowledge and skills can be eliminated by conducting workshops and continuing education programs. This may subsequently aid to improve patient care.

Adverse events occurring post-covid-19 vaccination among healthcare professionals - A mixed method study.

BACKGROUND: Healthcare professionals (HCPs) are at the front line of the nation's fight against COVID-19 and are always at a greater risk of contracting contagious disease. But amidst the crisis, the vaccines were not accepted by all the HCPs due to adverse events occurring post-COVID-19 vaccination. Hence, the present study was designed to assess adverse events occurring among HCPs post-COVID-19 vaccination both quantitatively and qualitatively. METHOD: Sequential mixed-method approach was employed. A cross-sectional E-survey was conducted among the healthcare professionals of a North Indian (*Statistically significant (p < 0.05)) college and hospital. The second phase included a semi-structured qualitative interview of the participants who were willing to participate. RESULTS: Among all the HCPs with age groups ranging from 20 to 70 years, majority of them experienced pain at the site of injection (88.8-100%) followed by tiredness (87.7-60%) and body ache (86.6-40%) post-vaccination. There is an increased frequency of adverse events in females as compared to males. Qualitative findings are summarised in three major domains i.e vaccine adverse effects, fear and hesitancy for vaccines and vaccine acceptance. CONCLUSION: Short term adverse events of COVISHIELD vaccine were very few and were mild in severity yet interviews showed hesitancy of study participants for vaccination.

Comparative assessment of low-level laser therapy (LLLT) vs. topical application of amlexanox + lidocaine to treat recurrent aphthous ulcers (RAUs): A randomized controlled trial.

Background. The present study aimed to assess and compare the pain perception and ulcer sizes before and after applying low-level laser therapy (LLLT) and Amlexanox + lidocaine. Methods. Twenty-six patients referring to the out-patient department of the institution and diagnosed with recurrent aphthous ulcers (RAU) were assigned to two groups to receive either LLLT or Amlexanox + lidocaine. In group 1, the patients were provided with amlexanox + lidocaine to apply topically four times daily. In group 2, the patients underwent LLLT with no tissue contact in inward circular motions for two cycles for 30 seconds. This study was registered in "the Clinical Trials Registry- India" (CTRI), with the registration number CTRI/2019/09/028222. The data were analyzed with SPSS 16. Results. The intergroup comparison was performed using Mann-Whitney U test, and intragroup comparisons were made using Wilcoxon's signed-rank test. The level of significance was set at P <0.05. The results showed that pain perception and ulcer size were significantly lower in group 2 subjects than group 1 subjects (P <0.05). Conclusion. LLLT was more effective than amlexanox + lidocaine in the management of RAU. It is a cost-effective therapy for treating RAU.

Comparative Efficacy of Cow Milk, KNO3, and Warm Saline Rinses in Treating Dentin Hypersensitivity Following Nonsurgical Periodontal Treatment: A Randomized Controlled Trial.

AIM: This study aimed to assess the desensitizing efficacy of commercially available cow milk compared to potassium nitrate (KNO3) mouthwash and warm saline rinses after nonsurgical periodontal treatment. MATERIALS AND METHODS: A randomized controlled trial was conducted in the Department of Public Health Dentistry of a dental college from August 21, 2018 to September 10, 2018. A total of 75 patients who reported hypersensitivity after scaling and root planing (SRP) were recruited and randomly assigned into three groups: cow milk (I), KNO3 mouthwash (II), and warm saline rinses (III). Dentine hypersensitivity (DH) was assessed at six time points using the verbal rating scale (VRS) for thermal stimuli and visual analog scale (VAS) for air blast and thermal stimuli. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY). Mean reduction in DH in each group was measured using non-parametric tests. RESULTS: Patients in all the three groups were found to be comparable with respect to baseline characteristics. Mean reduction in VRS and VAS scores for DH in milk and KNO3 mouthwash was found to be significantly high as compared to warm saline rinses group. CONCLUSION: From the results, cow milk was found to be equivalent in efficacy as compared with KNO3 mouthwash but superior to warm saline rinses in treating DH post-SRP.

Effect of Nonsurgical Treatment on Salivary HGF Levels in Population with Periodontal Disease: A Quasi-experimental Study.

AIM: To assess the effect of nonsurgical treatment on salivary hepatocyte growth factor (sHGF) levels in a population with periodontal disease: a quasi-experimental study. METHODS: Eighty-one patients (aged 30-70 years) were divided into three groups based on the gingival index, probing depth, clinical attachment loss, and radiographic evidence of bone loss: healthy (group I), gingivitis (group II), and chronic periodontitis (group III). Saliva samples were collected from these groups at baseline. At 8 weeks, saliva samples were collected again from group II and group III after the patients went through nonsurgical periodontal treatment. The levels of HGF were estimated using enzyme-linked immunosorbent assay (ELISA). The clinical parameters and HGF levels among all groups were analyzed using a one-way analysis of variance (ANOVA) using SPSS 17 version. RESULTS: At baseline, the highest mean HGF concentration in saliva was observed for group III (3455.83 ± 1463.44 pg/mL), and the least in group I (469.43 ± 317.13 pg/mL). Following nonsurgical periodontal treatment, the mean HGF concentration decreased significantly in group III and group II (p < 0.05). A significant positive correlation between clinical parameters and HGF levels was also seen (p < 0.05). CONCLUSION: HGF concentration showed a positive correlation with the progression of periodontal disease. CLINICAL SIGNIFICANCE: Following nonsurgical periodontal therapy, the levels of HGF decreased significantly, suggesting that HGF could be useful for monitoring the response to periodontal therapy. HOW TO CITE THIS ARTICLE: Alreja D, Rao JR, Kataria S, et al. Effect of Nonsurgical Treatment on Salivary HGF Levels in Population with Periodontal Disease: A Quasi-experimental Study. Euroasian J Hepato-Gastroenterol 2020;10(2):51-55.

Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4-6-year-old Children Attending Delhi Schools: A Cross-sectional Study.

INTRODUCTION: Oral diseases like early childhood caries (ECC), trauma, teething pain, and eruption disturbances are widely prevalent among the 4-6-year subgroup of population and are considered a public health problem worldwide. AIM: To assess the impact of ECC on oral health-related quality of life (OHRQoL) among 4-6-year-old children attending schools in Delhi. MATERIALS AND METHODS: A cross-sectional epidemiological study was carried out to assess the impact of ECC on OHRQoL among 4-6-year old children. Data were collected by a combination of the structured questionnaire of sociodemographic details and early childhood oral health impact scale (ECOHIS). The clinical examination was conducted for the assessment of dentition status and pufa index according to WHO criteria 2013. Statistical analysis was performed using the Chi-square test, the Kruskal-Wallis test, and the Mann-Whitney U test. RESULTS: The prevalence of ECC was found to be 20% among preschoolers which was lower among younger children and increased with age. The ECOHIS responses reported that items related to pain, irritation, difficulty in eating some foods, and difficulty to drink hot or cold beverages, felt guilty, feeling of frustration, and been upset were the most frequent on the child impact section (CIS). HOW TO CITE THIS ARTICLE: Jaggi A, Marya CM, et al. Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4-6-year-old Children Attending Delhi Schools: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(3):215-221.

Temporomandibular Disorders among Adolescents of Haryana, India: A Cross-sectional Study.

AIM: The aim of the present study was to determine the prevalence and determinants of temporomandibular disorders (TMD) among 12- to 15-year-old adolescents of Faridabad. MATERIALS AND METHODS: The study included a sample of 300 adolescents (132 males and 168 females) with age ranging from 12 to 15 years. Data were collected through clinical examination and Fonseca anamnestic questionnaire. The prevalence of TMD signs was assessed through Fonseca anamnestic questionnaire while TMD symptoms were measured by clinical examination. Various determinants of TMDs such as Angle's classification, crossbite, overjet, overbite were also recorded. Data were then analyzed using SPSS version 21. Inferential statistics were performed using Chi-square test. RESULTS: The overall prevalence of both TMD signs and symptoms was 51%. Females had higher prevalence (57.1%) of TMD symptoms when compared to males (43.2%). TMD signs has shown a statistical significant relationship with overbite (p = 0.007) and bruxism (p < 0.0001) only. No significant association was found between age, gender, Angle's molar relation, crossbite, and TMD signs. Statistical significant association was found between gender (p = 0.016), Angle's molar relation (p = 0.005), overbite (p = 0.001), crossbite (p = 0.030), bruxism (p < 0.0001), and TMD symptoms. CONCLUSION: No Significant relationship was reported between malocclusions and TMD sign except for overbite and bruxism, but significant relationship were found between TMD symptoms and malocclusion. HOW TO CITE THIS ARTICLE: Taneja P, Nagpal R, Marya CM, et al. Temporomandibular Disorders among Adolescents of Haryana, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(6):500-506.

A Cross-sectional Study for Assessment of Untreated Dental Caries and Its Consequences among Slum-dwelling Children.

INTRODUCTION: Dental caries affects humans of all ages throughout the world and remains the major dental public health problem among children globally. MATERIALS AND METHODS: A cross-sectional study was conducted using the cluster sampling technique to obtain the required sample size of 400 children from urban slum population of Faridabad, Haryana, India. Data were collected using World Health Organization dentition status 1997 criteria and PUFA/pufa index. TYPE OF STUDY: Cross-sectional study. RESULTS: Among 6- to 12-year-age group, 68.5% subjects had one or more decayed deciduous teeth, of which 65.3% subjects had one or more pufa score, and 26.4% subjects were having one or more decayed permanent teeth, of which 16.7% subjects were having one or more PUFA score. The overall caries prevalence was 79.64% and overall prevalence of one or more than one PUFA+pufa was reported in 69.2% subjects. CONCLUSION: The findings of the study showed the relevance of PUFA/pufa index to address the neglected problem of untreated caries and its consequences. The study also suggests the importance for implementation of the primary oral care programs for this deprived population. HOW TO CITE THIS ARTICLE: Marya C, Kataria S, Nagpal R, Oberoi SS, Dhingra C, Arora D. A Cross-sectional Study for Assessment of Untreated Dental Caries and Its Consequences among Slum-dwelling Children. Int J Clin Pediatr Dent 2017;10(1):29-33.

Periodontal status and oral health-related quality of life in elderly residents of aged care homes in Delhi.

AIM: The aim of the present study was to explore the associations between clinical periodontal findings and oral health-related quality of life in elderly people residing in the aged care homes of Delhi, India. METHODS: A cross-sectional study was carried out among 500 residents of aged care homes across Delhi. Data were collected by carrying out clinical oral examinations and by filling a self-administered questionnaire. Oral health-related quality of life was assessed by a pretested Hindi version of the Geriatric Oral Health Assessment Index (GOHAI-Hi). Periodontal status was assessed using the Community Periodontal Index - CPI, and loss of attachment and tooth mobility was assessed using a modified Miller's index. RESULTS: Of a total of 500 participants, 221 (44.20%) were men and 279 (55.80%) were women The mean additive score GOHAI score was 41.57 ± 6.07 and the mean number of negative impacts or mean simple count GOHAI score was 6.27 ± 1.54. Mean GOHAI scores were significantly higher among men than women, and were found to be decreasing continuously with the increasing age categories. Tooth mobility and loss of attachment scores were found to be significantly associated with oral health-related quality of life, whereas Community Periodontal Index scores showed a negative correlation with it. CONCLUSION: The geriatric population, especially those in aged care homes, is a special need group because of their inability to access dental care rather than some particular feature of their oral or general health The findings of the present study point to a need to improve access to oral healthcare for this elderly population.