An exploration of the oral health beliefs and behaviors of people living with HIV in Mangalore, India: a qualitative study.

INTRODUCTION: People living with HIV (PLWHIV) have increased oral healthcare needs due to an increase in the prevalence of oral and dental diseases. Their oral health is influenced by psychosocial, behavioral and biologic factors. The aim of this study was to explore and obtain a deeper understanding of the oral health beliefs and behaviors of PLWHIV that could potentially affect their oral health. METHODS: We have used the Health Belief Model (HBM) and qualitative methods using in-depth interviews with 16 PLWHIV. Content analysis of the transcribed data was done. The data was grouped under the constructs of the HBM. FINDINGS: The perceived susceptibility to oral diseases and awareness on the importance of good oral health was low. Regular tooth brushing and traditional methods for oral hygiene maintenance were considered beneficial. Regular dental visits were not considered important. Psychosocial issues, time and financial constraints were the barriers. Participants believed that information on oral health should be provided by the health providers in hospitals and dental clinics.  CONCLUSION: The findings on the oral health beliefs and behaviors support the need for education on oral health and preventive healthcare practices among PLWHIV. Oral health promotion should include behavioral change as one of its components.

An epidemiological study of dental caries and associated factors among children residing in orphanages in Kerala, India: Health in Orphanages Project (HOPe).

BACKGROUND: It is estimated that, as of 2010, there were 32 million orphaned children in India. There is little published information on the oral health of children in orphanages in India. AIM: To determine caries status and associated risk factors among children in orphanages in Kerala, India. METHODS: This cross-sectional study assessed caries using World Health Organization (WHO) criteria, and caries experience was reported as decayed, missing and filled primary or secondary teeth (dmft or DMFT, respectively). A brief questionnaire captured information on child oral health behaviours. Mean [standard deviation (SD)] and median [interquartile range (IQR)] scores were used to describe caries rates. Multivariable logistic regression analysis was conducted to identify independent disease predictors. Study design complexities, such as clustering by orphanage and stratification by district, were accounted for in the multivariable regression analysis. This was carried out using the survey commands in STATA 13. A value of P<0.05 was considered as statistically significant. RESULTS: Overall, 1,137 children residing in 31 orphanages across the State of Kerala were recruited to the study. Female children made up 82% of the sample. In 6-year-old children the prevalence of caries was 77% and the mean dmft score was 3.60 (SD= 3.50); in 12-year-old children the prevalence of caries was 44% and the mean DMFT score was 1.35 (SD = 1.96). Among 12-year-old children, those who reported being shown how to clean their teeth were less likely to have caries (odds ratio = 0.62; 95% confidence interval: 0.38-0.95). CONCLUSION: Caries rates among children in orphanages were much higher than among children in the general population in Kerala. There is an urgent need for evidence-based and sustainable primary prevention strategies to reduce the burden of caries in this highly vulnerable population.

Assessment of malocclusion status, dentition status, and treatment needs among 15-year-old school children of Mangalore.

BACKGROUND AND OBJECTIVES: Dental caries and malocclusion are common dental public health problems. Surveys provide us with an insight into the oral health status and treatment needs and also help in proper treatment planning. Hence, the objective of this study was to assess the malocclusion status, dentition status, and treatment needs of 15-year-old school children of Mangalore. METHODOLOGY: A cross-sectional study of 1001 school children aged 15-year-old was conducted in Mangalore. Their malocclusion status, dentition status, and treatment needs were recorded using the WHO oral health assessment pro forma. Statistical analysis was done using Statistical Package for Social Sciences version 17. Descriptive statistics was obtained and Chi-square test was used. The level of significance was set at 0.05. RESULTS: Decayed teeth were prevalent in 45.5% of the study subjects. Malocclusion was present in 30% of the study subjects. Teeth missing due to caries and those requiring extraction and prosthetic rehabilitation were significantly higher in government schools (P < 0.05). Malocclusion and treatment need was significantly higher in government schools (P < 0.05). CONCLUSION: From the present study, we can conclude that the school children aged 15 years of Mangalore had varied malocclusion status, dentition status, and treatment needs with significantly higher treatment needs and malocclusion among children of government school.

Knowledge, Attitude, and Practice towards HIV Patients among Dentists.

AIMS AND OBJECTIVES: Discrimination by some health care workers, including dentists, against human immunodeficiency virus (HIV) infected persons has been noted. The main aim of the present study was to assess the knowledge, attitude, and practice towards HIV patients among the dentists of Trichur district, Kerala. MATERIALS AND METHODS: A cross-sectional survey was conducted among 206 dentists practicing in Trichur district of Kerala. Data was collected using a pretested, self-administered 26-item questionnaire and was statistically analyzed using SPSS software version 20. RESULTS: Out of 206 participants, 39.3% were unwilling to treat HIV patients. A statistical significance was found between willingness to treat HIV infected patients and age groups (P = 0.0001) as well as between the willingness to treat HIV infected patients and ethical responsibility (P = 0.0001). CONCLUSION: Staff fears and increased personal risk are found to be the most frequently reported concerns in treating HIV patients among dentists of Trichur district, Kerala. Senior dentists showed more reluctance to treat HIV positive individuals.

A clinicopathological study of interface dermatitis.

BACKGROUND: Interface dermatitis (ID) refers to a pattern of skin reaction characterized by an inflammatory infiltrate that appears to obscure the dermo-epidermal junction when observed at low power examination and referred to as lichenoid tissue reaction. A wide range of inflammatory skin diseases exhibits interface change with considerable overlap of histological features. The aim of the present study was to study the clinical features and microscopic features of ID. MATERIALS AND METHODS: The material for the present study consisted of skin biopsy samples collected from patients attending the outpatient Department of Dermatology. The study was conducted for a period of 3 years from 2007 to 2010. During this period, a total of 125 cases was studied. RESULTS: In the present study, a total of 125 cases of ID was studied which presented clinically as papulosquamous disorders. Majority of the cases of ID were seen in women (57.6%). Majority of ID were lichen planus (LP) and its variants (63.2%). Clinicopathological concordance was seen in 109 cases (87.2%) and discordance in 16 cases (12.8%). CONCLUSION: The mere presence of an interface lichenoid inflammatory reaction should not be the sole criterion for the diagnosis of LP or one of its many variants, as now seems to be the case. A clinicopathologic correlation is absolutely essential for a conclusive diagnosis of ID.

Anticandidal efficacy of denture cleansing tablet, Triphala, Aloe vera, and Cashew leaf on complete dentures of institutionalized elderly.

With an increase in the number of dependent elderly, there is a need to introduce few natural products for denture cleansing, which are easily and economically available. Hence the aim of this study was to compare the anticandidal efficacy of denture cleansing tablet (sodium bicarbonate and sodium perborate monohydrate), Triphala (Phyllanthus emblica, Terminalia chebula and Terminalia belerica fruits powders in equal proportion), cashew leaf, Aloe vera and water (control) on complete dentures of institutionalized elderly. Study population consisted of 50 institutionalized elderly of Mangalore, Karnataka, with 10 in each group. Swabs were collected from the dentures before and after the use of denture cleansing tablet, Triphala, cashew leaf, Aloe vera, and water (control). Thereafter, the swabs were cultured on Sabouraud dextrose agar and the total candida counts were determined. Denture cleansing tablet and Triphala Churna showed a statistically significant reduction in Candida counts (P < 0.05). Denture cleansing tablet and Triphala Churna were found to be more effective.

Dental prosthetic status and prosthetic need of the institutionalized elderly living in geriatric homes in mangalore: a pilot study.

Introduction. To promote oral health among the elderly, we need to know their prosthetic status and prosthetic need. Hence, a survey of prosthetic status and need of elderly inmates of old age homes in Mangalore was done. Materials and Methods. A cross-sectional study was undertaken, and 133 subjects aged 60 years and above were examined (54.9% males and 45.1% females). Results. Eighty-eight percent of those examined were fully edentulous, and only 12% had complete dentures; none of the study subjects had partial dentures. Prosthetic status was significantly associated with gender (P = .024), while prosthetic need and gender were not significantly associated (P = .395). Conclusions. A high unmet need for prosthetic care existed among the institutionalized elderly surveyed.