Impact of diabetes mellitus and other systemic diseases on oral health and tooth mortality.

Introduction: Poor oral health in systemically diseased individuals besides worsening the glycaemic status also has functional, social consequences such as masticatory inefficiency and stigmatized social participation, respectively. Periodontal problems remain one of the most common reasons for tooth mortality along with tooth decay and trauma. Methodology: The study was conducted in the outpatient department of teaching dental institution among the individuals visiting the institution. Persons with systemic illness were included in the study. In the preliminary step, interviews were conducted among the study participants regarding health status followed by an oral health examination. The oral health examination included recording of community periodontal index and dentition status. Data were collected and statistical analyses were performed. Chi-square test, one-way ANOVA and Bonferroni post-hoc tests were used to analyze the data. Results: Patients with diabetes showed the highest (3.56 ± 2.98) number of missing teeth, followed by other systemic diseases (2.78 ± 2.74), and the patients who were not having any systemic diseases (1.81 ± 1.54). This distinction was found to be statistically significant (P = 0.001), and Bonferroni post-hoc shows statistical significance (P < 0.05) in group-wise comparisons. The number of teeth last due to caries among diabetics was higher (20.8%) when compared to nondiabetic (12.2%), and the most tooth loss due to periodontitis was also observed within the patients with diabetes (21%) when compared to patients with other systemic diseases (12%), which is statistically significant (P = 0.001). Conclusion: The current study revealed tooth loss is more common in the patients who have systemic diseases when compared to the patients who do not have any systemic diseases, while dental caries and periodontal problems are the principle causes of tooth mortality.

The Influence of Dissonance Induction and Assessment Reactivity in Improving Adherence to COVID-19 Precautionary Measures: A Cluster Randomised Controlled Trial.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, adherence to suggested precautionary measures has been emphasized as important in preventing and curtailing its spread. However, strict adherence to precautionary measures can be demanding. METHODS: This cluster randomised controlled trial done among 1517 undergraduate dental students tested the effectiveness of 'dissonance induction' (DI) and 'assessment reactivity' (AR) in improving adherence to World Health Organization (WHO) measures as compared to a control group. At baseline, participants in the DI group were tested for their knowledge of precautionary measures, immediately followed by assessment of their adherence to them. This methodology was adapted to systematically reveal the poor adherence of the participants in their self-held cognitions, should there be any. The magnitude of dissonance was measured as the proportion of such dissonant cognitions held by an individual. In the AR group, at baseline, participants were asked about their attitudes alone toward measures. The control group was neither assessed for knowledge and adherence nor for attitudes toward the measures at baseline. Two weeks after the administration of these interventions in the DI and AR groups, the 3 study groups were assessed for adherence. RESULTS: The follow-up adherence scores in the DI group were found to be significantly higher (15.11 ± 4.1) compared to the AR (13.13 ± 2.01) and control (12.87 ± 2.97) groups as analysed by Kruskal-Wallis analysis of variance (H = 243.5; P < .001). Wilcoxon signed-rank test showed that the adherence scores significantly improved in the DI group from baseline to follow-up (z = -8.84; P < .001). Magnitude of dissonance at baseline was found to be a significant predictor of follow-up adherence scores (R2 = 0.255). CONCLUSION: This study found that DI is an easy intervention to bring an immediate and significant change in adherence to precautionary measures.

Development and psychometric evaluation of COVID-19 Psychological Burden Scale for Indian Health Care Workers.

BACKGROUND: It is beyond doubt that the health care systems across the globe have been experiencing burdens of unprecedented magnitude in the coronavirus disease (COVID-19) era. However, no psychometric tools were validated in India to assess the impact of COVID-19 on the psychological well-being exclusively among health care workers, given their obvious risk for exposure. OBJECTIVES: This study was conducted to develop the first of its kind psychometric tool that measures the psychological burden posed by COVID-19 on Indian health care workers. MATERIALS AND METHODS: One hundred and sixty-nine health care workers attending COVID-19 duties in four different states of India took part in the study. The initial scale designed was tested for face and content validity. Exploratory factor analysis using direct oblimin rotation with Kaiser normalization was employed to determine the factor structure. Differential item functioning (DIF) analysis with ordinal regression based on the type of COVID-19 facility at which the participant is serving, educational background was done for identification of item bias. RESULTS: COVID-19 Psychological Burden Scale for Indian Health Care Workers (CPBS-IHCW), with 17 items loaded on four components, demonstrated good internal consistency reliability (Cronbach's Alpha 0.873). DIF revealed no item bias based on type of facility and educational background. Significant differences in CPBS-IHCW scores were noted between health care workers serving at different COVID-19 facilities and belonging to different educational backgrounds. CONCLUSION: CPBS-IHCW is a 17-item, rapidly administrable scale, demonstrating good internal consistency reliability, and temporal stability, which can be used in the assessment of psychological burden among health care professionals catering to the needs of the COVID-19 affected.

Oral healthcare-seeking behavior and perception of oral health and general healthcare among WHO indexed age groups in East-Coast India.

INTRODUCTION: In a country where 30,570 dentists graduate per year, it is staggering to acknowledge that only 10% of dentists serve the rural people, who constitute around 68.8% of the country's population. AIM: To find out the oral healthcare-seeking behavior, profile, and pattern in Tenali Mandal among WHO recommended index age groups. MATERIALS AND METHODS: A cross-sectional, multilocality, single-visit study was done to acknowledge the oral healthcare-seeking behavior, profile, and pattern in Tenali Mandal, Guntur, Andhra Pradesh. There are 9 villages, 2 peri-urban, and 1 town present in the Tenali Mandal and the study was conducted following the National Pathfinder Survey. RESULTS: Around 35.4% of the study participants utilized dental services while most of them sought care in the last 1-6 months (23.4%) and the main reason for the last dental visit was tooth pain (13.1%), followed by decayed tooth without pain (6.9%). Dental care-seeking behavior among the age group of 12 years was 1.611 times more when compared to 65-74 years age group which was statistically significant (P ≤ 0.010). For dental care-seeking behavior among gender, the males utilized 0.982 times less when compared to females which was not statistically significant (P ≤ 0.881), while for the place of residence, urban place was 2.707 times more utilizing the services when compared to rural place which was statistically significant (P ≤ 0.001). CONCLUSION: The results of the study indicates that the barriers of oral healthcare-seeking behavior among dental health conditions poses public health problems in the study area, as well as it is an important baseline indicator against which target for oral health improvement can be set and monitored.

Development and Initial Validation of the COVID-19 Anxiety Scale.

BACKGROUND: Safeguarding the psychological well-being of the public is also an integral component of fighting COVID-19. However, there is limited availability of psychometric measures to document COVID-19-related anxiety among the general public. OBJECTIVES: This study was aimed at developing a validated scale to measure COVID-19-related anxiety. METHODS: Three hundred and seven subjects from different gender, educational categories participated in the study. Exploratory factor analysis for the determination of factor structure, Pearson's correlation test, and Kruskal-Wallis ANOVA were employed in data analysis using SPSS version 20 software. RESULTS: COVID-19 Anxiety Scale (CAS) demonstrated a two-component structure identified as: "fear of social interaction;" "illness anxiety." The final scale with seven items demonstrated good internal consistency reliability (Cronbach's Alpha 0.736). CAS exhibited good construct validity showing moderately negative correlation (Pearson's r = -0.417) with the self-rated mental health and resulted in higher scores among individuals with lower educational qualification (Kruskal-Wallis ANOVA χ2 [2, 303] = 38.01; P = 0.001). CONCLUSION: CAS is a rapidly administrable, valid, and reliable tool that can be used to measure COVID-19-related anxiety among the Indian population.

Development and evaluation of a new oral health literacy instrument among telugu speaking population: The indian oral health literacy measure.

PURPOSE: Oral health literacy (OHL) is a relatively unexplored construct in the Indian context. Most of the few previous studies estimating OHL among different populations of India used instruments that were either previously validated in a different country or not tested for psychometric properties. With this background, the objective of this study was to develop an Indian oral health literacy measure and to evaluate the psychometric properties of the instrument among Telugu speaking population of Andhra Pradesh (IOHLM-T). MATERIALS AND METHODS: The initial version of the instrument after evaluated for face and content validity was tested for psychometric properties among 200 adult patients visiting the outpatient department of SIBAR Institute of Dental Sciences. Predictive validity of the instrument was checked by the association between IOHLM-T score and oral health impact profile (OHIP-14), decayed-missing-filled teeth (DMFT) scores. Convergent validity was tested by assessing the correlation between IOHLM-T score and rapid estimate of adult literacy in dentistry (REALD-30) score. STATISTICAL ANALYSIS: SPSS version 20 software was used to analyse the data. Independent samples t-test, Pearson's correlation, one-way ANOVA and stepwise multiple linear regression were done to analyse the data. RESULTS: IOHLM-T demonstrated good internal consistency reliability (Cronbach's alpha 0.75), convergent validity (r = 0.34 between Reald-30 and IOHLM-T scores) and predictive validity (significant negative correlation of IOHLM-T with OHIP-14 and DMFT scores). CONCLUSION: IOHLM-T demonstrates good face validity, content validity, predictive validity, convergent validity and internal consistency reliability and thus can be used among different populations in India after translation to the corresponding languages and evaluation of psychometric properties.

Measuring the Impact of COVID-19 on Mental Health: A Scoping Review of the Existing Scales.

BACKGROUND: The coronavirus disease (COVID-19) pandemic, associated with the economic consequences of non-pharmaceutical interventions such as lockdown, has led to mental health consequences among people worldwide. Protecting the mental well-being of populations is an imperative component of fighting the COVID-19 pandemic. This scoping review attempts to present an overview of the existing tools to measure COVID-19-related mental health problems. METHODS: Literature search was conducted in the PubMed electronic database using developed key search terms. Reference lists of the identified eligible articles were reviewed to locate relevant articles missed from the electronic database search. Fifteen scales measuring COVID-19-associated mental health problems, validated among diverse populations across the world, were included in this review. RESULTS: The majority of these scales were validated among middle-aged adults in Turkey. Only a few validated scales encompass the negative socioeconomic consequences of COVID-19. None of the available scales focused on the aspects of suicidal ideation or behavioral responses/coping strategies, neither were they inclusive of participants from diverse age, geographic, and COVID-19 exposure groups. CONCLUSION: This scoping review highlights the need for future research to develop and validate comprehensive psychometric tools to assess COVID-19-associated mental health problems. Also, in view of the vulnerable nature of healthcare professionals for developing mental health concerns in the course of providing services for COVID-19-affected individuals, future psychometric research needs to concentrate on the development of measures specific for these professionals.

Utilization of health services in Tenali Mandal, Andhra Pradesh- A cross-sectional study.

INTRODUCTION: India has a plurality of health care with different systems of medicine delivered by government and local bodies in hospitals and clinics. Public hospitals provide 60% of all hospitalizations, while the private sector provides 75% of all routine care. Utilization is the actual attendance by the members of the public at health care facilities, which measures the number of visits per year or the number of people with at least one visit during the previous year, serves as an important tool and acts as a guiding path in understanding disease profile and also helps resource allocation. MATERIALS AND METHODS: A cross-sectional study was done using the National Pathfinder survey (stratified cluster random sampling) to know the health care utilization, profile, and pattern in Tenali Mandal, Guntur, Andhra Pradesh. RESULTS: The study sample comprised of 1,500 subjects who were equally divided among 5 age groups. Out of 1,500 participants, 52.8% were females and 47.2% were males. In total, 71.7% of the study participants have utilized health services, with majority of them (44.5%) had availed services within the last 6 months with prime reason of fevers (15.8%), while the main barrier for not seeking care was distance (17.03%), almost an equal proportion of the population sought care for their problems through home remedies and over-the-counter. CONCLUSION: There is an utmost need to minimize barriers of utilizing by making them aware of the health problems, so that they develop a positive attitude toward health care utilization. Therefore, knowledge of utilization of health services and associated factors is important in planning and delivery of interventions by the primary care physicians to improve health services coverage.

Comparing Caries Experience between Azadirachta indica Chewing Stick Users and Toothbrush Users among 35-44-Year-Old Rural Population of Southern India.

OBJECTIVES: To compare the caries experience between Azadirachta indica chewing stick users and toothbrush users among 35-44-year-old rural population in Southern India. MATERIALS AND METHODS: This ex post facto research was conducted in the rural parts of two sub-administrative areas of a district in the Southern Indian state of Andhra Pradesh. The sample size for the study was determined to be 400, with 200 subjects in each group. Subjects following indigenous oral hygiene methods were identified using an interviewer-administered questionnaire. After obtaining 200 subjects using A. indica chewing sticks, age, gender, and socioeconomic status matched controls using toothbrush were identified. American Dental Association type III examination was carried out to record caries experience (decayed missing filled teeth (DMFT) Index) after obtaining informed consent and thus obtained data were subjected to statistical analysis using the Statistical Package for the Social Sciences (SPSS) software, version 20. RESULTS: It was observed that the caries experience was more in toothbrush users compared to subjects following indigenous methods (DMFT, 4.38 ± 1.93 vs. 3.54 ± 1.02). Similar results were obtained when the decay component of DMFT index was exclusively compared. No significant difference in the plaque scores and the mean number of filled, missing teeth was observed between the two groups. CONCLUSION: Though conclusive results cannot be drawn from this study about the positive influence of indigenous methods on caries experience, the results emphasize the cardinal need to more thoroughly understand the potential benefits of indigenous methods before dismissing them as retrogressive approaches.

Modal decomposition of Laguerre Gaussian beams with different radial orders using optical correlation technique.

In this paper, we explore the use of an optical correlation technique to decompose different radial as well as azimuthal order modes of Laguerre Gaussian (LG) beams. We experimentally demonstrate the decomposition of single as well as composite LG beams and compare it with simulations. We report the modal decomposition with 27 dB extinction over several radial and azimuthal orders. Finally, we show that our modal decomposition is capable of sorting mode spectrum consisting of up to 10 LG modes with an accuracy of better than 97.8%.

Awareness and attitude toward pictographs on tobacco products: A population-based study in field practice area.

BACKGROUND: Tobacco use is a major global public health threat for all countries and no form of tobacco use is safe. Pictorial warnings covering 40% area of tobacco products are made mandatory from May 31, 2009 in India. The present study was aimed to investigate the awareness and attitude toward pictorial warnings on tobacco products among age 15 years and above population in field-practice area. MATERIALS AND METHODS: A total of 1064 individuals were selected by systematic random sampling. A model containing the pictorial warnings were shown to the study subjects, and data were collected by semi-structured questionnaire. Data was analyzed using SPSS 20 and statistical tests used were Chi-square test. Significance level set at P ≤ 0.05. RESULTS: Of the 1064 individuals participated in the study, 53.9% were male and the mean age of the study population was 31.24 ± 5.8. Nearly 45.8% reported using tobacco in some form and all of them were males. 51.3% of both males and females reported that they never came across antitobacco messages (pictorial warnings). 71.2% believed that the size and position of pictorial warnings on tobacco products were not sufficient to understand the harmful effects of tobacco. There was statistically significant difference between different age groups in their responses to the aforementioned questions. CONCLUSION: The results of present study demonstrate that the need for pictorial warnings on tobacco products to be more clear and explanatory since there is little point in having pictorial warnings when the prime purpose of having them is not being served.

Is accredited social health activists' basic oral health knowledge appropriate in educating rural Indian population?

INTRODUCTION: Accredited social health activists (ASHAs) are the grassroot level health activists in the community who are involved in health education and community mobilization toward utilizing the health services. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out to assess the oral health knowledge among ASHAs working in Guntur district of Andhra Pradesh, India. Five Primary Health Centers were randomly selected, and the total sample was 275. Categorical data were analyzed using Chi-square test. P ≤ 0.05 was considered to be statistically significant. RESULTS: The mean age was 32 ± 5.11 years and mean education was 9 ± 1.329 years of schooling. ASHAs were categorized into two groups based on their education levels, i.e., Group I whose education qualification is <10th class and Group II whose education qualification is above 10th class to observe any difference in knowledge based on their education. Overall knowledge among ASHAs was poor and also it was observed that both the groups were having poor knowledge regarding dental caries, calculus, dental plaque, oral cancer, and change of tooth brush. About 69.5% of the ASHAs were approached by public with dental problems, but only a few, i.e., 15.8% have referred the patients to the nearby dentist. CONCLUSION: As we know that most of the dental diseases are preventable, there is a dire need that ASHAs should be thoroughly educated in the aspects of oral health and diseases during their training period. This not only helps in creating awareness among them but also serves the ultimate purpose of improving the oral health of rural population.

Dental Service Utilization: Patterns and Barriers among Rural Elderly in Guntur District, Andhra Pradesh.

INTRODUCTION: The biological process of ageing is outside human control and has its own dynamics. It is a known fact that elderly people have more treatment needs compared to the younger population and at the same time elderly people are facing a multitude of barriers in utilization of health care as well as oral health care. AIM: To identify the utilization patterns of oral health care and barriers for utilization among rural population. MATERIALS AND METHODS: A cross-sectional study was done on 621 rural elderly subjects to identify the utilization of oral health care services and the barriers for utilization. Using stratified cluster sampling study area was stratified into 13 rural clusters, fifty houses were randomly selected from each stratum. All the elderly subjects, as defined by the age criteria were considered for study. The data were analysed using SPSS 20 v and Chi-square tests were used to analyse the data. RESULTS: Only 31.9% of participants reported visiting a dentist in the past while 36.7% reported experiencing a dental problem at some point in their life. There were no significant differences in utilization of dental services based on gender, socio-economic status, age groups and religion. However, significant differences were found in utilization of dental services based on the response of participants to past experience of dental problems. CONCLUSION: The present study results conclude that fear was one of the most commonly reported barriers for utilisation of dental services and there is a need for oral health education and promotion among elderly population.

Assessment of the Status of National Oral Health Policy in India.

BACKGROUND: National oral health policy was conscripted by the Indian Dental Association (IDA) in 1986 and was accepted as an integral part of National Health Policy (NHP) by the Central Council of Health and Family Welfare in one of its conferences in the year 1995. Objectives of this paper were to find out the efforts made or going on towards its execution, its current status and recent oral health-related affairs or programs, if any. METHODS: Literature search was done using the institutional library, web-based search engines like 'Google' and 'PubMed' and also by cross referencing. It yielded 108 articles, of which 50 were excluded as they were not pertinent to the topic. Twenty-four were of global perspective rather than Indian and hence were not taken into account and finally 34 articles were considered for analyses. Documents related to central and state governments of India were also considered. RESULTS: All the articles considered for analysis were published within the past 10 years with gradual increase in number which depicts the researchers' increasing focus towards oral health policy. Criticisms, suggestions and recommendations regarding national oral health programs, dental manpower issues, geriatric dentistry, public health dentistry, dental insurance, oral health inequality, and public-private partnerships have taken major occupancies in the articles. Proposals like "model for infant and child oral health promotion" and "oral health policy phase 1 for Karnataka" were among the initiatives towards national oral health policy. CONCLUSION: The need for implementation of the drafted oral health policy with modification that suits the rapidly changing oral health system of this country is inevitable.

Dental pain and self-care: a cross-sectional study of people with low socio-economic status residing in rural India.

CONTEXT: Self-care is one of the ways in which people without access to professional care can actively engage in managing their oral health problems. AIM: To find out the prevalence of dental pain and the type of self-care remedies utilised for pain relief by people with low socio-economic status residing in Kollipara mandal, Guntur district, Andhra Pradesh. SETTINGS AND DESIGN: This was a cross-sectional population-based study. METHODS AND MATERIAL: A multistage simple random-sampling technique was adopted to obtain an appropriate sample. A questionnaire, which consisted of sections on socio-economic and demographic variables, dental pain, pain characteristics and self-care remedies utilised to combat dental pain, was used to collect data. Statistical analysis used the chi-square test and descriptive statistics. RESULTS: The survey covered a total population of 630 individuals. The mean age of the population was 32.8±16.7 years. Among the total study subjects, 44.1% were male and 55.9% were female. The prevalence of dental pain reported during the preceding 6 months was 28.3%. Subjects who experienced dental pain reported the home remedies and self-care methods that they utilised to get relief from the pain. They more frequently reported using over-the-counter medication (49.6%) for pain relief. CONCLUSIONS: This study provides an insight into the type and usage of self-care in relief of dental pain. Pain sufferers used a variety of self-care methods to deal with their problems.

Socio-economic Status, Needs, and Utilization of Dental Services among Rural Adults in a Primary Health Center Area in Southern India.

BACKGROUND: The oral disease burden in India is showing a steady increase in the recent years. Utilization of dental care being the major factor affecting the oral health status of the population is used as an important tool in oral health policy decision-making and is measured in terms of the number of dental visits per annum. MATERIALS AND METHODS: A cross-sectional house to house questionnaire survey was conducted in three rural clusters which were randomly selected from a total of eight clusters served by a primary health center. Simple random sampling was used to select 100 houses from each cluster. Screening was done to examine the existing oral diseases. A total of 385 completed questionnaires were collected from 300 houses. RESULTS: Of 385 study subjects, 183 have experienced previous dental problems. Major dental problem experienced by the study subjects was toothache (68.85%) and the treatment underwent was extraction (50.27%). Most preferred treatment centers by the study subjects were private dental hospital (68.25%) and reason identified was accessibility which constituted (45.24%) of all the reasons given. Negative attitude toward dental care is one of the important barriers; 50.8% of the non-utilizers felt dental treatment is not much important. CONCLUSION: Person's attitude, lack of awareness, and affordability remain the barriers for utilization of dental services. Effective methods have to be exercised to breach such barriers.