Antimicrobial efficacy of Xylitol, Probiotic and Chlorhexidine mouth rinses among children and elderly population at high risk for dental caries - A Randomized Controlled Trial.

Introduction: Chlorhexidine is considered the most potent chemotherapeutic agent against Streptococcus mutans. However, its side effects due to prolonged use, indicates need for alternatives. The study intended to assess and compare antimicrobial efficacies of probiotic, xylitol and chlorhexidine mouth rinses in children and elderly. Methods: The study was a Double blind Randomized Controlled Trial conducted among residential school children aged 5-12 years and elderly greater than 60 years residing in old age homes. (ClinicalTrials.gov ID: NCT04399161). 30 participants each among children and elderly were chosen based on eligibility criterion (high risk for caries). They were further randomly divided into 3 groups with 10 participants in each group. Participants were asked to rinse with 15 ml of freshly prepared mouth rinses once daily for 2 minutes for 14 days. Antimicrobial efficacy was determined by assessing change in Streptococcus mutans levels in dental plaque. Results: Significant reduction in Streptococcus mutans counts were observed in both children and elderly (Chlorhexidine: mean difference = 3.11 log10CFU/g, p = 0.022, Xylitol: mean difference = 0.93 log10CFU/g, p = 0.046, Probiotic: mean difference = 1.91 log10CFU/g, p = 0.023 in children); (Chlorhexidine: mean difference = 2.23 log10CFU/g, p = 0.004, Xylitol: mean difference = 1.39 log10CFU/g, p = 0.009, Probiotic: mean difference = 1.61 log10CFU/g, p = 0.018 in elderly). Intergroup comparison showed no significant difference. Conclusions: Antimicrobial efficacy of xylitol and probiotic mouth rinses were comparable to that of chlorhexidine in both children and elderly. Probiotics could potentially be more efficacious than xylitol among children.

Patterns of Usage of Complementary and Alternative Medicine Among Adults Visiting Health Care Centers in Mysuru, India: A Questionnaire-Based Survey.

The study intended to assess extent of complementary and alternative medicine use among patients visiting health care facilities in Mysuru, India, and factors influencing its choice. Prevalence of complementary and alternative medicine use was 33% and was not influenced by sociodemographic factors and individual health perceptions and habits.

Enhancing identification and counseling skills of dental undergraduate students using a customized Tobacco Counseling Training Module (TCTM) - A piloting of the process using ADDIE framework.

BACKGROUND: Tobacco use has emerged as a major public health problem. But, most graduates in medical and dental schools receive limited systematic training. The objective of this education innovation project was to enhance dental undergraduate student's ability to identify tobacco users through oral manifestations and improve their counseling skills using a customized Tobacco Counseling Training Module (TCTM). METHODS: A TCTM for students of dentistry was developed using ADDIE framework as a guide. Content and construct validation of the module was done by six subject experts using Delphi technique for obtaining consensus. Pilot testing was done on 20 students of third year BDS. Pre- and post-intervention assessment of knowledge, attitude, self-confidence was done using learning outcomes questionnaire. Ability to correctly identify oral manifestations was assessed using extended item MCQs and tobacco counseling skills using a modified KEECC. The difference in mean scores were computed and subjected to further statistical analysis using SPSS version 22. RESULTS: There was a significant improvement in post intervention scores for mean knowledge (5.5 ± 1.4 to 13.2 ± 1.1), attitude (5.6 ± 0.9 and 8.5 ± 0.5), self-confidence (1.5 ± 0.5 and 3.1 ± 0.2), ability to correctly identify oral manifestations (5.2 ± 1.4 and 9.4 ± 0.8) and tobacco counseling skills. CONCLUSION: It is possible to introduce the module in the existing curriculum and its effectiveness evaluation shows benefit in terms of Kirkpatrick's Level 1, 2, 3 (improvement in knowledge, attitude, self-confidence, ability to identify oral manifestations, and tobacco counseling skills) of training effectiveness.

Assessment of knowledge, attitude, and practices and motivation to quit tobacco habits in relation to age and educational status among male tobacco users visiting a Government Dental College Hospital, India.

BACKGROUND: Tobacco use has become an epidemic of modern times. Its use is widespread among young adults and those from lower socioeconomic classes. OBJECTIVE: The objective is to assess knowledge, attitude, and practices (KAP) and motivation to quit tobacco habits in relation to age and educational status among male tobacco users visiting a Government Dental College Hospital, India. MATERIALS AND METHODS: This was a questionnaire survey conducted among 199 male adult smokers visiting the Department of Public Health Dentistry in a Government Dental College in India. Quota sampling was used for recruiting the required number of study participants. Information on KAP related to smoking habits was collected using a predesigned structured questionnaire by two trained and calibrated dentists. Knowledge, attitude toward quitting and their self-confidence toward quitting was compared in relation to age and educational status using Chi-square test. RESULTS: A higher percentage of younger adults aged 18-24 years were interested in quitting the habit (100%) compared to those aged 45-64 years (85.2%). Similarly, a higher percentage of young adults have tried quitting the habit (76.9%) compared to their older counterparts (64.8%) (P < 0.05). Knowledge on ill effects of smoking increased with increasing educational attainment (P < 0.001). People with higher educational attainment had observed the warning sign on packaging (73.7%) compared to those with less than primary education (25.9%) and they also reported that the presence of such warning sign motivated them to think about quitting (54.8% vs. 0%) (P < 0.001). CONCLUSION: Knowledge, positive attitude toward quitting and self-confidence to quit were higher among younger adults and those with secondary education compared to their elder counterparts and those with less than primary education.

Knowledge, attitude, and practice among tobacco and alcohol addicts before and after psychological intervention in a de-addiction center at Madhya Pradesh, India.

CONTEXT: Tobacco and alcohol addiction has emerged as a major public health issue in most of the regions of the world. It has resulted in enormous disability, disease, and death and acquired the dimension of an epidemic. It is estimated that five million preventable deaths occur every year globally, attributable to tobacco use. The number is expected to double by 2020 if death due to tobacco continues to occur at the same rate. Alcohol, on the other hand, contributes to 25% of all deaths in the age group of 20-39 years. The interventions such as supportive pharmacotherapy, nicotine replacement therapy, counseling, behavioral intervention, psychotherapy, and detoxification therapy are being commonly employed in the management of patients with addiction to tobacco and alcohol. AIM: The aim of this study is to compare the knowledge, attitude, and practice (KAP) among tobacco and alcohol addicts before and after psychological intervention in a de-addiction center. SETTINGS AND DESIGN: This study was a randomized control trial, focusing on psychological interventions practiced in a de-addiction center, Indore, Madhya Pradesh, India. MATERIALS AND METHODS: The information on KAP related to tobacco and alcohol was collected at baseline from 83 participants. This was compared with the information collected in the postintervention follow-ups from each participant. STATISTICAL ANALYSIS USED: Statistical tests for parametric analysis were done using one-way ANOVA with Scheffe's post hoc test, RMANOVA with Mauchly's test for sphericity assumption, and Bonferroni test for comparing the main effects. Nonparametric tests included Pearson's Chi-square test, McNemar's Chi-square test, Spearman's rho, and Kruskal-Wallis test. The statistical significance was fixed at 0.05. RESULTS: The mean KAP score for the study population was highest at the first follow-up followed by the second follow-up for both tobacco and alcohol addiction. The least KAP score was observed at the baseline. CONCLUSIONS: Although a significant improvement in the mean KAP score was observed at the first follow-up, subsequent follow-up revealed a reduction in the overall KAP score in the present study. This could be attributed to the fact that following their discharge from the de-addiction center, most of the participants reverted back to their deleterious habits.

Bruxism and oral health-related quality of life among male inmates in a penal institution, Mysore: A cross-sectional study.

BACKGROUND: One of the widespread problems of oral health is bruxism and is defined as a parafunctional habit with involuntary grinding and gnashing of the teeth occurring during sleep. However, bruxism is connected to anxiety and stress, but the published literature on bruxism among prison inmates is scanty. Objective: The objective of the study was to determine the prevalence of active sleep bruxism and its impact on oral health-related quality of life (OHRQoL) among inmates in Central Penal Institution, Mysore. MATERIALS AND METHODS: The study was cross sectional and conducted among eligible male inmates at Central Penal Institution, Mysore. The information on active sleep bruxism and OHRQoL was collected using a predesigned structured questionnaire by means of personal interview by a trained investigator. The active sleep bruxism was assessed using the criteria of American Academy of Sleep Medicine and OHRQoL through modified oral health impact profile (OHIP-14). The data analysis was done using descriptive statistics, Chi-square test, t-test, analysis of variance, and linear regression model. RESULTS: A total of 212 male inmates aged between 18 and 80 years were considered for the study. The prevalence of active sleep bruxism among the study population was 31.6%. The mean OHIP-14 score was significantly higher (P < 0.001) among the inmates having active sleep bruxism (38.52 ± 12.8) suggesting a high oral health impact as compared to inmates without this disorder (31.67 ± 12). CONCLUSION: The prevalence of active sleep bruxism was higher among the inmates of penal institution as compared to the general population. The active sleep bruxism had a negative impact on OHRQoL.

Rapid Estimate of Adult Literacy in Medicine and Dentistry-20 and oral health status among adolescents, India: A cross-sectional study.

INTRODUCTION: Health literacy is an important issue in public health. Individuals with low health literacy skills often have poorer health knowledge and health status than those with higher literacy level. Research documented on the assessment of oral health literacy in health settings and its association with oral health outcomes for adolescents was scarce. AIMS AND OBJECTIVES: The aim of this study is to assess oral health literacy about oral health status among adolescents attending pre-university colleges in Mysore, India. MATERIALS AND METHODS: A cross-sectional study was conducted over a period of 2 months among 401 adolescents attending pre-university colleges. Rapid Estimate of Adult Literacy in Medicine and Dentistry-20 (REALMD-20) and the WHO oral health assessment pro forma for adults (2013) were used. Data were analyzed using SPSS version 22 and tests employed were Chi-square test, ANOVA, and multiple linear regression. RESULTS: Mean REALMD-20 score was 10.31 ± 5.7. The study participants belonging to science course (12.69 ± 5.0) and private pre-university colleges (11.76 ± 5.8) had significantly higher REALMD-20 scores. Mean decayed, missing, and filled teeth among the study participants was (0.42 ± 0.9). Type of college, course, dental history, and number of dental visits was significantly associated with oral health literacy while oral health parameters were not significantly associated. CONCLUSION: Oral health literacy was not significantly associated with oral health status. However, long-term studies are recommended to validate the results of the present study.

The relationship of forensic odontology with various dental specialties in the articles published in a National and an International Forensic Odontology Journal: A 5-year content analysis.

AIMS: The aim of this study is to assess the quantum of articles published by various dental specialties in a National and an International Forensic Odontology Journal from January 1, 2010, to December 31, 2014. SETTINGS AND DESIGN: The present study is a 5-year retrospective content analysis study. SUBJECTS AND METHODS: Data were collected from two forensic odontology journals (Journal of Forensic Odonto Stomatology [JOFS] and Journal of Forensic Dental Sciences [JFDS]) which are subscribed by institutional library. The article contents were scrutinized by one investigator and categorized into nine individual dental specialties based on the new working classification proposed for forensic odontology. STATISTICAL ANALYSIS USED: The quantum of articles published by various dental specialties and the various focus areas in each specialty were assessed using Chi-square test. RESULTS: Among all the published articles, a maximum number of articles were related to the Department of Oral Medicine and Radiology (32.6%) in JFDS with Cheiloscopy (46.7%) being more focused area and to the Department of Prosthodontics (25.7%) in JFOS with Bite mark analysis (66.7%) being more focused area. CONCLUSIONS: There was a scarcity of information about the relationship of forensic odontology with various dental specialties in the articles published in JFDS and JFOS. The editorial board of journals should expand and elaborate their scope of journals to various focus areas of forensic odontology. This will encourage the researchers to explore in the different focus areas which are most neglected as of now.

Periodontal and Dentition Status among Orphans and Children with Parents in Mysore City, India: A Comparative Study.

INTRODUCTION: Oral health symbolises the general health and quality of life of an individual. The socioeconomic status of the parents shows direct impact on oral health status of children. Thus, it can be hypothesised that the pattern of oral diseases would be different among children living with parents and orphans. AIM: To explore periodontal and dentition status among orphans and children with parents in Mysore city, India. MATERIALS AND METHODS: A cross-sectional study was conducted among six to 15-year-old children residing in eight orphanages. Equal number of age and gender matched children living with parents were selected from government schools (non orphans) located in the same geographical areas for comparison. Clinical examination was conducted by a single trained, calibrated examiner and oral findings were recorded according to World Health Organization (WHO) diagnostic criteria 2013. The data collected was analysed using Mann-Whitney U test and Chi-square test. RESULTS: A total of 957 children (478 from orphanages and 479 from government schools) were examined in the study. The mean defs and DMFS were significantly higher among government school children (non orphans) (defs: 3.20±4.0; DMFS: 2.43±2.8) compared to children from orphanages (defs: 2.72±4.4; DMFS: 1.72±2.3). Prevalence of gingival bleeding among orphans (79.49%) was higher compared to non orphans (71.4%). CONCLUSION: The present study concluded that prevalence of caries was lower among orphans but periodontal status was poor among them as compared to non orphans.

Role of Ayurveda in management of oral health.

Oral diseases continue to be a major health problem world-wide. Oral health is integral to general well-being and relates to the quality-of-life that extends beyond the functions of the craniofacial complex. The standard Western medicine has had only limited success in the prevention of periodontal disease and in the treatment of a variety of oral diseases. Hence, the search for alternative products continues and natural phytochemicals isolated from plants used in traditional medicine are considered to be good alternatives to synthetic chemicals. The botanicals in the Ayurvedic material medica have been proven to be safe and effective, through several hundred to several thousand years of use. The exploration of botanicals used in traditional medicine may lead to the development of novel preventive or therapeutic strategies for oral health. The present scientific evidence based review is focused on the possible role of Ayurveda in the management of various orofacial disorders.

Evaluation of anti-epileptic property of Marsilea quadrifolia Linn. in maximal electroshock and pentylenetetrazole-induced rat models of epilepsy.

OBJECTIVE: To study the anti-epileptic effects of methanolic extract of Marsilea quadrifolia Linn. (MQ) in maximal electroshock (MES) and pentylenetetrazole (PTZ) induced rat models of epilepsy. METHOD: A total of 84 adult male Wistar rats were used. An acute oral toxicity study was conducted on 36 rats and the remaining were used for other experiments. Each model had 24 rats which were allotted into four groups (n = 6). Group I (Control) received 1% carboxymethyl cellulose solution, Group II (Positive control) received phenytoin 300 mg kg(-1) b.w. in the MES model; sodium valproate 200 mg kg(-1) b.w. in the PTZ model, Group III (MQ) received 400 mg kg(-1) b.w. MQ extract and Group IV (MQ) received 600 mg kg(-1) b.w. MQ extract. Hind limb extension (HLE) time and recovery time were noted in the MES model. Latency for myoclonic jerk, seizures and EEG was recorded in the PTZ model. RESULTS: When compared to control, the phenytoin received group did not show HLE. In MQ pre-treated groups only 50% of rats showed HLE. Sodium valproate and various doses of MQ significantly increased the latency for onset of clonus and seizures. PTZ-induced EEG alterations were significantly attenuated by MQ administration and this was comparable to that of the sodium valproate effect. CONCLUSION: Marsilea quadrifolia Linn. showed significant anti-epileptic efficacy against various epilepsy models.

A clinical efficacy of 30% ethenolic extract of Indian propolis and Recaldent™ in management of dentinal hypersensitivity: A comparative randomized clinical trial.

OBJECTIVE: The aim of this study is to evaluate the efficacy of 30% ethenolic extract of Indian propolis compared with Recaldent(™) (casein phosphopeptide-amorphous calcium phosphate) in reduction of dentinals hypersensitivity, a randomized, double-blind, split mouth, controlled clinical trial was conducted among the patients residing in Central Jail. MATERIALS AND METHODS: A sample of 73 teeth from 13 patients having at least three teeth with dentinal hypersensitivity (DH) were randomly allocated into three treatment groups: Group A: 30% ethenolic extract of Indian propolis, Group B: Recaldent(™), Group C: Sterile water. Verbal rating scale was used to record the degree of hypersensitivity based on patient's response to tactile and air blast stimuli. The baseline scores were obtained. Each intervention group received applications of their respective agents consecutively on 1(st), 7(th), 14(th), and 21(st) day. After each application the scores were recorded. RESULTS: Both the 30% Indian propolis and Recaldent(™) showed significant reduction in DH. CONCLUSION: Recaldent(™) was found to be significantly better in reducing the DH compared to propolis and sterile water (P < 0.01).

DNA profiling and forensic dentistry--a review of the recent concepts and trends.

BACKGROUND: Teeth are amongst the hardest structures of the human body which are resistant to adverse conditions such as incineration, immersion, trauma, mutilation, decomposition and hence, used in forensic investigations. It is also a valuable source of DNA as other parts of the body gets destroyed or degraded in mass disasters. The fast technological advancements in DNA research have revolutionized the field of forensic medicine and the present work was undertaken to provide an insight in to the recent concepts of DNA profiling in Forensic dentistry. METHODS: Articles were identified by searches in PubMed and Embase electronic databases from 1980 through July 2010. RESULTS: DNA profiling provides an exact identification of an individual in mass disasters, identification of culprits in crime scene investigations and solving paternity issues as well. It also provides information regarding the physical characteristics, ethnicity and sex determination. CONCLUSION: Teeth should be considered for DNA analysis as they are rich sources of quality DNA which can be utilised in all forensic investigations. From variable number tandem repeats (VNTRs) to single nucleotide polymorphism (SNP), the field of forensic DNA research has been true to the characteristics of any scientific process and it has never been static but represents a continuous evolution of technological development.

Periodontal infections: a risk factor for various systemic diseases.

A healthy periodontium is vital for the general well-being of an individual. However, periodontal diseases are common and periodontal infections are increasingly associated with systemic diseases. We aimed to critically evaluate the literature on the association between periodontal infections and systemic diseases. We searched the PubMed database over a 20-year period for literature on periodontal diseases and their links to various systemic diseases, and examined the strength of association between periodontal disease and each systemic disease, the dose-response relationship, and the biological plausibility. We found that individuals with periodontal disease may be at higher risk for adverse medical outcomes including cardiovascular diseases, respiratory infections, adverse pregnancy outcomes, rheumatoid arthritis and diabetes mellitus. Many cohort, in vitro and animal studies suggest that systemic inflammation due to pathogens associated with periodontal disease may play a role in the initiation and progression of some systemic diseases. Periodontal infections should therefore be considered as a risk factor for various systemic diseases.