Importance and Potential of Dentists in Identifying Patients at High Risk of Diabetes.

OBJECTIVES: The study was conducted to assess the utilization of medical and dental services by dental patients at two dental school hospitals and to approximate the number of patients having no known previous diagnosis of type 2 diabetes but are at high risk of acquiring it. METHODS: A cross-sectional study was conducted at two dental school hospitals in India. A 20-item questionnaire was administered as interviews among the dental patients aged 35 to 55 years. Data was collected on past dental and medical visits, medical history, family history relevant to diabetes, cardiovascular health, BMI and waist circumference (measured). RESULTS: A total of 413 adult patients (males 61.26%, females 38.74%) participated in the surveys. The mean age was 43.06 years. Results revealed that nearly 50% did not have a medical or a dental visit in the last 1 year, 33% had Cardiovascular Diseases (CVD). Among those who did not have medical visit in last one year 45% had BMI >25 kg, 55% had waist circumference above the normal range and 38% were at high risk of diabetes. CONCLUSION: The high number of patients without a medical visit in the past year or more, as well as the high levels of diabetes risk indicators, affirms the need for dentists to perform chair-side screenings for diabetes. These results suggest the need for additional training among dental students to improve early detection and identification of high-risk patients to minimize potential morbidity due to diabetes.

Feasibility of including APF gel application in a school oral health promotion program as a caries-preventive agent: a community intervention trial.

A community intervention trial was conducted to assess the feasibility of APF gel as a caries-preventive agent in a high-risk group of school children in Bangalore City. The study was conducted in two schools, randomly selected from a list of schools catering to underprivileged children. These schools were randomly allocated into experimental and control groups. Children aged 9-16 years having three or more incipient or cavitated primary or secondary carious lesions were enrolled in the study. In the experimental group, APF gel was applied and oral health education was provided to both groups at baseline and 6 months. Follow-up examination was performed at 6 and 12 months and the caries status was recorded by an investigator who was blinded to the allocation of intervention. There was no statistically significant difference in DMFT and DMFS values, but a significant difference was seen in incipient carious lesions between the experimental and control groups at 6 and 12 months. These results suggest that biannual APF gel application is an effective preventive measure in reversing incipient carious lesions.

Assessment of antibacterial efficacy of triphala against mutans streptococci: a randomised control trial.

PURPOSE: Triphala is an ayurvedic preparation with known antimicrobial action. This study was carried out to assess the antibacterial efficacy of triphala against salivary mutans streptococci in comparison with the 'gold standard' chlorhexidine. MATERIALS AND METHODS: A double blind randomised control trial was conducted among 57 volunteers who were assessed to be in the high caries risk category. They were randomly allocated into three study groups: 1) 15 ml of 6% triphala mouthwash; 2) 15 ml of 0.2% chlorhexidine (active control); 3) no mouthwash (passive control). Mouthwashes were given twice a day for 15 days. Unstimulated saliva samples were collected at baseline and at 15 and 45 days. Mutans streptococci (MS) were cultured on MSB agar and colony counts obtained. The α error was fixed at 5%. ANOVA and post-hoc LSD tests were performed using SPSS version 14. RESULTS: After using mouthwash for 15 days, an 83% and 80% reduction and at 45 days a 67% and 65% reduction in salivary MS colony count was observed in the triphala and chlorhexidine groups, respectively (P = 0.0001). The control group showed an increase of 3% in MS colony count at 15 days and a reduction of 7% at 45 days. (P = 0.116). CONCLUSION: The antimicrobial action of triphala against mutans streptococci closely parallels that of chlorhexidine. It does not have the side effects commonly associated with chlorhexidine and is cost effective.

The relationship of malocclusion as assessed by the Dental Aesthetic Index (DAI) with perceptions of aesthetics, function, speech and treatment needs among 14- to 15-year-old schoolchildren of Bangalore, India.

PURPOSE: The present study was primarily carried out to assess the severity of malocclusion and treatment needs of 14- to 15-year-old schoolchildren of Bangalore, India, using the Dental Aesthetic Index (DAI) and to correlate them with the subjective perception of aesthetics, function, speech and treatment needs. METHODS: A total of 1618 students aged 14 to 15 years, who were randomly selected from 40 government and private schools, were included in the present study. The subjects were asked about their self-perception of malocclusion using a structured questionnaire. A Likert scale was used to assess their perception. They were then subjected to a clinical examination, wherein the malocclusion and the treatment needs were assessed using the DAI. The data were analysed using the SPSS® version 10 statistical package. RESULTS: Most of the subjects were satisfied with the arrangement of their teeth. Weak but statistically significant correlations were found between all of the variables (P < 0.01). Correlation was found to be greater between aesthetics and speech (r = 0.489; P < 0.01), aesthetics and the DAI component (r = 0.342; P < 0.01), and subjectively and objectively perceived treatment needs (r = 0.476; P < 0.01). There was no significant difference observed between the children in private and government schools (P > 0.05). Aesthetics was the most common reason for seeking treatment. CONCLUSIONS: Most of the subjects were satisfied with the appearance of their teeth, masticatory function and speech. The perception of dissatisfaction with dental appearance increased with increasing severity of malocclusion. However, the same did not apply for masticatory function and speech. Self-perception of treatment need was low.

Perceptions and concerns about dental fluorosis as assessed by tooth surface index of fluorosis among high school children in an area of endemic fluorosis--Kaiwara.

PURPOSE: The aim of this study was to assess the perceptions and concerns about dental fluorosis among high school children in an area that is endemic to fluorosis, and to correlate the children's perceptions of dental fluorosis with different scores of tooth surface index of fluorosis. MATERIALS AND METHODS: The study was conducted among 155 children affected with fluorosis, aged between 12 and 16 years, studying in all four high schools of Kaiwara, Karnataka, India. Fluorosis was assessed on labial surfaces of maxillary anterior teeth using tooth surface index of fluorosis, and the data were collected using a self-administered pretested questionnaire that was given to the study subjects. Analysis was performed using frequency distribution, chi-square test and Spearman's correlation coefficients. RESULTS: Significant high correlations were found between tooth surface index of fluorosis scores and the perception of the importance of the condition (r = 0.226, chi2 = 72.065, P < 0.01), considering the condition to be a disadvantage in the future (r = 0.166, chi2 = 73.097, P < 0.05) and also the last visit to the clinician for the condition (r = -0.184, chi2 = 14.252, P < 0.05). CONCLUSION: Perceptions and concerns of dental fluorosis among this age group of children appear to be of aesthetic concern making it essential to focus on this issue and to intervene.