Oral Hygiene Status, Salivary and Microbiological Parameters Among Visually Impaired and Normal-Sighted Children After Specialized Oral Health Education: An Interventional Study.

Aim and objectives To assess oral hygiene status and salivary and microbiological parameters among 12 to 15-year-old visually impaired and normal-sighted children before and after oral health education (OHE). Methodology An interventional study was conducted among 25 visually impaired children (Group A) and 25 normal-sighted children (Group B) in the age range of 12 to 15 years. Simple random sampling was used to select the study participants. A questionnaire was designed to record socio-demographic data and the dietary habits of the children on pre-decided days. The oral hygiene practices and the Decayed Missing Filled Teeth (DMFT) index were recorded, and salivary physicochemical parameters for all the selected children were evaluated, followed by saliva collection for microbial analysis. After baseline assessment, the Audio-Tactile Performance technique for Group A and the animated visual performance technique for Group B children were used to impart OHE. Periodic assessments of salivary parameters were conducted at one-month and three-month intervals. Unpaired T test/Mann-Whitney U test, repeated measures analysis of variance (ANOVA)/Friedman test, followed by Bonferroni's post hoc test were carried out to determine the difference between and within groups, respectively. All statistical tests were performed at a significance level of 5%. Results Group A demonstrated a greater change in salivary pH (6.20 ± 0.41 to 6.96 ± 0.20), salivary buffering capacity (5.80 ± 0.82 to 7.20 ± 0.65), and Streptococcus mutans count (9.36 ± 0.41 to 8.7 ± 0.45 x 104 CFU/mL) when compared to Group B. Group B demonstrated a greater Lactobacillus acidophilus count reduction (7.96 ± 0.66 to 7.50 ± 0.64 x 104 CFU/mL) when compared to Group A. Conclusion The appropriate use of specialized OHE holds particular significance in the improvement of oral hygiene status and salivary parameters, along with a reduction in the bacterial count in both visually impaired children and normal-sighted children.

Assessment of potential antimicrobial activity of Ocimum basilicum extract and chlorhexidine against Socransky's complex pathogens of oral cavity: An in vitro study.

Background and Objective: Periodontitis is a multifactorial disease initiated by periodontal pathogens and progresses further in destruction of periodontium. Hence, the objective of this study was to test the efficacy of Ocimum basilicum seeds extract on periodontal pathogens. Materials and Methods: O. basilicum seeds were authenticated from a recognized taxonomist. They were coarsely powdered; ethanol-based extract preparation was done by the Soxhlet method and aqueous-based extract by hot infusion procedure. Extracts so obtained were assessed for minimum inhibitory concentration, minimum bactericidal concentration, zone of inhibition, and time-kill assay of O. basilicum seeds extract on periodontal pathogens, and comparatively evaluated the effectiveness against 0.12% chlorhexidine (CHX) gluconate in triplicates. Kruskal-Wallis Test was employed wherein the statistical significance was set at P ≤ 0.05. Results: The concentration of O. basilicum ethanolic extract against periodontal pathogens was determined to be 10 mg/ml, whereas 4.7 mg/ml of aqueous extract was proven effective against periodontal pathogens. Similarly, aqueous extract of O. basilicum developed a wider zone against periodontal pathogens compared to ethanol-based O. basilicum extract. Statistically significant difference found in the effectiveness between both extract and CHX. Conclusion: The antibacterial activity was evident in both the extracts of O. basilicum against anaerobic periodontal pathogens. However, it was more pronounced in aqueous extract, but lower compared to CHX.

Risk of periodontitis & dental caries among 35 to 44 year old diabetic individuals: A case control study.

Background: The World Health Organization (WHO) has recommended the age group of 35-44 years for surveillance of oral health conditions in adults. There is a growing incidence of early onset of Type 2 diabetes mellitus (T2DM) worldwide. Objective: This study was conducted to find the strength of association between dental caries and periodontitis in patients with T2DM. Materials and Methods: This was a case-control study conducted among 35-44-year-old patients with T2DM (n = 185) reporting to various hospitals of Belagavi city and controls (n = 185), who met the inclusion criteria. Group matching was done for age and gender. The study participants were interviewed for their sociodemographic details, relevant medical history, oral health behaviors, and dietary behaviors using a self-designed questionnaire. Dental caries and periodontal status were recorded using the WHO criteria, 2013. Results: The mean decayed missing filled teeth was significantly higher among controls than cases (P = 0.006). A significantly higher number of cases had periodontal pockets (crude odds ratio: 6.6) as compared to controls. Regression analysis showed that loss of attachment was significantly associated with T2DM (adjusted odds ratio: 5.9, 95% confidence interval: 2.81-6.89). Conclusion: Periodontitis was found to be associated with T2DM. However, no such association was found between dental caries and T2DM.

Antimicrobial Efficacy of Essential Oils and Their Combination Against Microorganisms Associated With Postradiation Therapy in Patients With Head and Neck Cancer: An In Vitro Study.

Background Head and neck cancer ranks as the sixth most common cancer globally. Reduced saliva production brought on by postradiation therapy upsets the delicate balance between bacterial load and a weakened immune system. Oral hygiene is commonly neglected in patients who have undergone radiotherapy and they often develop dry mouth, mucositis due to radiation therapy, etc., as side effects. Despite being a part of the current standard, chlorhexidine carries numerous disadvantages such as taste alteration, teeth staining, and dry mouth. An extensive review of the literature demonstrates the antibacterial properties of essential oils (EOs) derived from plant materials, which may be able to prevent the development of such opportunistic microorganisms in the oral cavity. Methodology The cinnamon bark EO and Cajeput EO were procured and checked for their solubility. The final ratio at which the oils were found to be soluble was the 1:1 (w/v) ratio. The minimum inhibitory concentration (MIC) of cinnamon bark oil (Cinnamomum verum) and Cajeput oil (Melaleuca leucadendron) against Staphylococcus aureus, Enterococcus faecalis, and Candida albicans was determined by serial dilution method using Resazurin dye, and the minimum bactericidal concentration (MBC) was done by a spread plating method. The polyherbal mouthwash was subjected to cytotoxicity assay against human gingival fibroblasts. All the experiments were performed in triplicates. Results The overall results showed that cinnamon bark EO had the strongest efficacy against S. aureus (0.33 ± 0.14 mg/mL) and E. faecalis (0.41 ± 0.14 mg/mL), but not against C. albicans (2.85 ± 2.11 mg/mL). Cajeput EO showed the least efficacy against all the groups; whereas the combination of EOs proved to be the most efficacious and showed good antimicrobial activity against these most commonly encountered microorganisms in head and neck cancer postradiotherapy. Conclusions Cinnamon and Cajeput EOs in combination proved to be effective in this in vitro study against the most common microorganisms encountered in patients with head and neck cancer postradiotherapy and are comparable to 0.2% chlorhexidine.

Evaluation of a "Picture Assisted Illustration Reinforcement" (PAIR) System for Oral Hygiene in Children with Autism: A Double-Blind Randomized Controlled Trial.

This study evaluated the potential of a novel pre-validated "Picture Assisted Illustration Reinforcement" (PAIR) communication system and conventional verbal techniques for Oral Health Education (OHE) in terms of dentition status, gingival health, oral hygiene status, and practices in 7- to 18-year-old children with Autism Spectrum Disorder (ASD). A double-blind randomized controlled trial was undertaken in a school for children with autism from July to September 2022. A total of 60 children were randomly assigned into two groups: a PAIR group (n = 30) and a Conventional group (n = 30). Cognition and pre-evaluation of all the children were assessed by standardized scaling measures. A pre-validated closed-ended questionnaire was administered to caregivers of both groups. At a 12-week post-intervention, a clinical examination was performed using the World Health Organization (WHO) Oral Health Assessment form 2013, gingival and Oral Hygiene Index Simplified (OHI-S). The gingival scores in the PAIR group (0.35 ± 0.12) exhibited a statistically significant decline in scores as compared to Conventional group (0.83 ± 0.37), p = 0.043. Meanwhile, the oral hygiene scores in the PAIR group and Conventional group were 1.22 ± 0.14 and 1.94 ± 0.15, respectively (p < 0.05). A significant improvement in oral hygiene practices was observed in the PAIR group. Incorporating the PAIR technique resulted in significant progress in child cognitive ability and adaptive behavior, which reduced gingival scores and improved oral hygiene scores, consequently improving oral hygiene practices among children with ASD.

Effectiveness of various irrigant activation techniques on the penetration of sodium hypochlorite into lateral canals of mature permanent teeth: A systematic review and meta-analysis.

Objective: This review aimed to systematically review the effectiveness of various irrigant activation techniques (IATs) on the penetration of sodium hypochlorite (NaOCl) into the lateral canals of mature permanent teeth. Methods: Electronic databases including MEDLINE (via PubMed), Scopus, ProQuest, and Cochrane Library were searched to identify laboratory studies evaluating the penetration of NaOCl into lateral canals following the use of apical negative pressure irrigation (ANP), passive ultrasonic irrigation (PUI), sonic irrigation (SI), and/or manual dynamic activation (MDA) techniques. Meta-analysis was performed for individual IATs in comparison with CNI into the lateral canals of both straight and curved root canals. On the basis of the previous literature and parameters, the risk of bias of the selected studies was evaluated with the help of a customized tool. Results: Of the 983 records screened, 12 studies were selected to include in the systematic review, and 10 studies were selected for the meta-analysis. The total quality assessment across the included studies indicated a high quality (83.3%). Overall, the meta-analysis demonstrated IATs had significant improvement in the penetration of NaOCl into the lateral canals of straight canals (34.3%) over CNI. The subgroup analysis of individual IATs demonstrated PUI (60.9%) to be superior in the penetration into lateral canals of straight canals. Conclusions: IATs improved the irrigant penetration into lateral canals and therefore their use during routine endodontic practice is recommended. In straight canals, PUI is the most effective IAT followed by ANP, SI, and MDA techniques.

Remineralising potential of Ocimum basilicum varnish and fluoride varnish on initial enamel caries: An in vitro microscopic study.

Background: The focus of caries research has switched to early identification and non-invasive treatment of carious lesions. Aim: This study aimed to evaluate and compare the remineralising potential of Ocimum (O.) basilicum varnish and fluoride varnish on initial enamel caries. Method: The authenticated O. basilicum seeds were procured from a repository, and the extract was prepared using the Soxhlet method, which was vortexed with Indian Pharmaceutical (IP)-graded chemicals to obtain varnish. Extracted premolar tooth samples were divided into three groups of 33 each after demineralisation with a pH of 4.5 for 48 hours at 37°C. Each group was subjected to remineralisation twice daily with respective agents for 4 minutes for 30 consecutive days. Each sample was ground-sectioned through an enamel window. The lesion depth was measured using a light microscope (Leica™ DM2500) and ImageJ software. The data were evaluated using analysis of variance (ANOVA) and post hoc analysis. Results: The mean (± SD) pre-treatment lesion depth across the groups ranged from 242.11 ± 26.144 µm to 352.66 ± 34.531 µm. The highest lesion depth recovery rate of 45.938% was recorded for the fluoride varnish group, followed by 36.015% in the O. basilicum varnish group, which was statistically significant by Tukey's post hoc analysis (p < 0.001). The gingival fibroblast cells were viable by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Conclusion: The O. basilicum varnish demonstrated a homogenous layer of mineral deposition. However, the remineralising efficacy was slightly lesser than that of the fluoride varnish. Hence, the novel O. basilicum-based remineralisation agent appears to have potential as a non-invasive alternative to topical fluorides in the therapy of early caries lesions.

Effectiveness of a Visual Interactive Game on Oral Hygiene Knowledge, Practices, and Clinical Parameters among Adolescents: A Randomized Controlled Trial.

This study aimed to evaluate the effect of a novel interactive game-based visual performance technique (IGVP) and conventional oral health educational (OHE) talk on plaque control, gingival health, and oral hygiene knowledge and practices in 12−15-year-old schoolchildren. A single-blinded randomized controlled trial was undertaken in a private primary school in Belagavi, Karnataka, India. A total of 100 children aged 12−15 years were randomly assigned to either a conventional OHE talk (control group, n = 50) or the IGVP technique (test group, n = 50), using a computer-generated table of random numbers. A self-designed, pre-validated closed-ended questionnaire was collected from both groups, followed by clinical examination carried out using gingival and plaque index, pre- and post-intervention, at three months follow-up. There was a significant reduction in the mean gingival score and plaque score in the test group after intervention, indicating a 58.7% and 63.4% reduction, when compared to the control group, which had a 2.8% and 0.7% reduction, respectively (p < 0.001). The test group showed a significant increase in the percentage of knowledge gained (22.4%), compared to control group (7.8%). The IGVP technique proved to be more effective than a conventional OHE talk in the reduction of the plaque score, gingival score, and in the improvement of the knowledge of oral hygiene maintenance and its application.

Impact of the Visual Performance Reinforcement Technique on Oral Hygiene Knowledge and Practices, Gingival Health, and Plaque Control in Hearing- and Speech-Impaired Adolescents: A Randomized Controlled Trial.

This study aimed to evaluate the impact of oral health education (OHE), incorporating a novel pre-validated visual performance reinforcement (VPR) technique and sign language, on gingival health, plaque control, and oral hygiene knowledge and practices in 12 to 15-year-old hearing- and speech-impaired adolescents. A double-blinded randomized controlled trial was conducted in a government school for deaf children in Belagavi, Karnataka, India. A total of 80 adolescents, aged 12-15 years, were randomly assigned, using a computer-generated table of random numbers, into two groups: Group A receiving the VPR technique (n = 40), and Group B receiving sign language (n = 40). A specially designed pre-validated closed-ended questionnaire was administered to both groups, followed by clinical examination to obtain the gingival and plaque index, before intervention and at a 16-week follow-up period. Group A showed a significant increase in the knowledge gained when compared to Group B. Similarly, a significant improvement in oral hygiene practices was also observed in Group A. However, at the 16-week follow-up, there were no statistically significant differences in gingival and plaque scores between the groups. OHE using the VPR technique can be as effective and satisfactory as sign language in the reduction of gingival and plaque scores and in the improvement of knowledge and its application in oral hygiene maintenance among hearing- and speech-impaired adolescents.

Knowledge, attitude, and practices toward tobacco control among rural community health care workers of primary subcenters in Belagavi district, Karnataka.

Context: Tobacco is the common cause to a number of illnesses affecting millions of individuals all over the world. Primary care physicians are the initial point of contact for tobacco users, yet reaching everyone is impossible. Therefore, it is important to understand community health workers attitude to render community services in tobacco cessation counseling. Aim: To assess knowledge, attitude, practices, and occupational barriers toward tobacco control among community health care workers in Belagavi district, Karnataka. Settings and Design: This cross-sectional study was conducted in various subcenters of Belagavi district, Karnataka. Methods and Material: Simple random sampling technique was employed and 220 participants were interviewed using an interviewer administered questionnaire comprising of 22 close ended questions. Reliability of the questionnaire assessed with Cronbach's a value of 0.85, face validity 84%, and content validity ratio 0.78. Statistical Analysis Used: The data were analyzed using descriptive analysis, chi square analysis, correlation, and regression. Results: The mean knowledge score among Accredited Social Health Activist (ASHA) workers was 4.77 ± 2.11 and it was lower in Anganwadi workers 2.93 ± 2.55. There was a statistically significant difference in the attitude scores (P < 0.05) between the community health workers. The majority of the ASHA workers would spread awareness, on the other hand, Anganwadi workers did not take any specific step which showed statistically significant difference with a P value of 0.018. Conclusion: ASHA workers had been superior to Anganwadi workers with regard to knowledge and attitude toward tobacco control. However, knowledge regarding tobacco and its ill effects was below optimal level among community health workers which desires to thoroughly educate in the aspects of oral health and disorders as part of their training.

Comparison of routine teaching with fishbowl and 1-min preceptor for dental undergraduate students: An interventional study.

AIM: To compare routine teaching method with fishbowl and a one-minute preceptor for undergraduate students. OBJECTIVES: 1. Evaluation of theoretical knowledge for WHO dentition status and treatment need by fish bowl and routine teaching. 2. Effectiveness of the combination of fish bowl and one-minute preceptor in understanding WHO dentition status and treatment need. MATERIALS AND METHODS: This study was conducted on 38 third year undergraduate students, which was divided into two groups (Group A: Fishbowl, Group B: One-minute preceptor). Routine lecture for WHO dentition status and treatment need was taken, followed by baseline evaluation which was done by giving 10 sets of clinical images to students and asked them to give WHO score. Furthermore, fish bowl and one-minute preceptor method were performed and students were subjected with the same set of clinical images again. At the end of the session, feedback was taken from the students by means of five open-ended questions about their views on fish bowl and one-minute preceptor. Data were analyzed with SPSS version 20 (Chicago IL). Wilcoxon Sign Rank test and Mann Whitney 'U' test was performed for intragroup and intergroup comparison respectively. RESULTS: Combination of fishbowl and one-minute preceptor shows statistically significant result over routine teaching method with P value of .000. CONCLUSION: Combination of Fish Bowl and OMP could be used for better teaching method for students, as the students are actively involved and more learning takes place; the deficiencies of one method would be compensated by the other.

Effectiveness of different oral health education interventions in visually impaired school children.

AIM: To assess the oral hygiene status, knowledge, attitude and practices (KAP) in visually impaired children before and after imparting 3 different modes of oral health education. METHODOLOGY AND RESULTS: The present study was a nonrandomized interventional study conducted among visually impaired school children. Ninety visually impaired children aged 12-15 years were selected by lottery method and divided into 3 groups (30 children each). Group 1: ATP (audio, tactile, performance technique), Group 2: Braille, and Group 3: ATP + Braille. Twenty-item verbal questionnaire was developed to record their knowledge, attitude, and practice (KAP) regarding oral hygiene before and after imparting oral health education. The oral hygiene status was recorded and compared using plaque and gingival index after 21-day, 1-, 6-, and 9-month interval. ANOVA, Tukey's post hoc, repeated measures ANOVA, and McNemar test were used. Group 3 showed highest percentage of reduction in plaque (55%) and gingival (52%) scores when compared with Group 1 and Group 2. CONCLUSION: The combination of ATP (audio, tactile, and performance technique) and Braille is an effective way to improve oral hygiene status in visually impaired children. The KAP among these children also improved significantly after imparting oral health education.