Unveiling a Health Disparity: Comparative Analysis of Head and Neck Cancer Trends between First Nations People and Non-Indigenous Australians (1998-2015).

BACKGROUND: We aim to assess and compare the HNC trends between the First Nations and non-Indigenous population. METHODS: HNC incidence (1998-2013) and mortality (1998-2015) data in First Nations people and non-Indigenous Australians were utilised from the Australian Cancer Database. The age-standardised incidence and mortality trends along with annual percentage changes were analysed using Joinpoint models. Age-standardised incidence and mortality rates according to remoteness, states, and five-year survival rates among First Nations people and non-Indigenous Australians were presented as graphs. RESULTS: First Nations people had over twice the age-standardised incidence (2013; 29.8/100,000 vs. 14.7/100,000) and over 3.5 times the age-standardised mortality rates (2015; 14.2/100,000 vs. 4.1/100,000) than their non-Indigenous counterparts. Both populations saw a decline in mortality, but the decline was only statistically significant in non-Indigenous Australians (17.1% decline, 1998: 4.8/100,000, 2015: 4.1/100,000; p < 0.05). Across all remoteness levels and states, First Nations people consistently had higher age-standardised incidence and mortality rates. Furthermore, the five-year survival rate was lower by 25% in First Nations people. CONCLUSION: First Nations people continue to shoulder a disproportionate HNC burden compared to non-Indigenous Australians.

Evaluation of the Expression Levels of miR-21-5p and miR-429 Genes in Biopsy Samples from Patients with Oral Squamous Cell Carcinoma.

INTRODUCTION: MicroRNAs (miRs) are a group of endogenous, non-coding, 18-24 nucleotide length single-strand RNAs that mediate gene expression at the post-transcriptional level through mRNA degradation or translational repression. They are involved in regulating diverse cellular biological processes such as cell cycle, differentiation, and apoptosis. The deregulation of miRs affects normal biological processes, leading to malignancies, including oral squamous cell carcinoma (OSCC). This study evaluates the expression level of miR-21-5p and miR-429 genes in biopsy samples from patients with OSCC and performs a comparison with controls. MATERIALS AND METHODS: In this study, tissue samples were obtained from 40 individuals (20 OSCC patients and 20 healthy controls) to determine miR-21-5p and miR-429 expression using the ΔCT method and analyzed by the Mann-Whitney test. RESULTS: The mean age of subjects in the control and patient groups was 47.15 and 53.8 years, respectively. According to the Mann-Whitney test, significant differences were observed in miR-21-5p (p < 0.0001) and miR-429 (p = 0.0191) expression levels between the two groups (p < 0.05). CONCLUSIONS: The expression of miR-21-5p, miR-429, and combined miRNAs in the OSCC group was significantly higher compared to the control group. As a result, changes in the expression of these biomarkers in cancerous tissues could potentially be considered as a marker for the early diagnosis of OSCC.

Premolar maturity index (IPM) for indicating legal age 12 years in a sample of south Indian children - A digital pantomographic study.

Legal age of 12 years has been set as the minimum age of criminal responsibility in many countries. This paper concerned a method for predicting the legal age 12 years based on the maturation of lower first and second premolars. The sample consisted of 900 digital pantomographs of south Indian children (450 males, 450 females) aged between 8 and 16 years. Among them, 580 DPTs were used as test sample and 320 DPTs as validation sample. New cut-offs at the age threshold 12 years were determined by using the measurement of open apices in first premolars (IPM1 < 0.10), second premolars (IPM2 < 0.14) and the combined method (IPM1 + IPM2 < 0.12). The sensitivity (Se), specificity (Sp) and posttest probability (PTP) were established. For IPM1 < 0.10, the Se, Sp and PTP were 92.4 %, 91.3 % and 91.1 % for males and 90.8 %, 87 % and 86.5 % for females. For IPM2 < 0.14, they were 92.6 %, 93.6 % and 93.4 % for males and 91.5 %, 83.1 % and 83.4 % for females. And, for the combined predictor (IPM1 + IPM2 < 0.12), these values were 92.6 %, 94.8 % and 94.6 % and 90.5 %, 84.9 % and 84.7 % in males and females respectively. The best score of positive predictive value and specificity was obtained for males with the combined predictor (IPM1 + IPM2 < 0.12) and with single predictor (IPM1 < 0.10) for females. To conclude, the combined predictor has resulted in better discrimination in males, while in females the single predictor (IMP1 < 0.10) did slightly better. Further studies are warranted to test the combination of dental and skeletal indicators for the prediction of 12 years in the studied population.

A systematic review and meta-analysis on serum and salivary levels of total antioxidant capacity and C-reactive protein in oral lichen planus patients.

OBJECTIVE: Oral lichen planus (OLP) is an inflammatory disease that total antioxidant capacity (TAC) and C-reactive protein (CRP) play an important role in its pathogenesis. In this meta-analysis, we compared the salivary and serum levels of TAC and CRP between OLP patients and controls. DESIGN: A comprehensive search was performed in four databases (PubMed, Scopus, Web of Science, and Cochrane Library). Standardized mean difference (SMD) and 95% confidence intervals (CI) were computed by the RevMan 5.3. Sensitivity analysis, subgroup analysis, meta-regression, and publication bias were analyzed by the CMA 2.0. RESULTS: Nineteen articles were included in the meta-analysis. The pooled SMDs were -1.80 µmol/L (95%CI: -2.75, -0.85; p = 0.0002) and -2.56 µmol/L (95%CI: -4.40, -0.72; p = 0.006) for the salivary and serum levels of TAC, respectively. The SMDs for salivary and serum levels of CRP were 0.64 µg/L (95%CI: 0.35, 0.94; p < 0.0001) and 0.97 mg/L (95%CI: 0.56, 1.338; p < 0.00001), respectively. Geographical area based on the country was a significant factor in the subgroup analysis for salivary TAC level. There was adequate evidence supporting the occurrence of less salivary and serum TAC levels in OLP patients than controls, but the amount of information was inadequate to make valid conclusions for salivary CRP level. CONCLUSIONS: In OLP patients, salivary and serum levels of TAC is significantly lower while the salivary and serum levels of CRP is significantly higher than controls.

The Role of Parenting Practices on the Parent Perceived Impact of Child Oral Health on Family Wellbeing.

BACKGROUND: Family characteristics and parenting practices could significantly influence child oral health and the impact of child oral health on family wellbeing. AIM: To determine the association between parenting practices and parent-perceived impact of children's oral health condition on family wellbeing. DESIGN: A cross-sectional survey was conducted among 1539 school children in India. Parents answered the short form of FIS (Family Impact Scale), and PCRQ (parent-child relationship questionnaire) to assess the impact of the child's oral health on family and parenting practices, respectively. Two factors emerged on factor analysis of PCRQ: 'Positive parenting' and 'Power assertive parenting'. The intra-oral examination was conducted for children to assess their dental caries experience and gingival health status. Unadjusted linear regression and hierarchical multiple regression analysis were used to determine the influence of parenting practices on FIS. RESULTS: An increase in power assertion (B = 1.16) parenting was associated with increased FIS scores indicating a higher adverse impact of the child's oral health on family wellbeing when parents used more power assertive parenting practices. On the other hand, an increase in positive parenting (B = -1.27) was associated with decreased FIS scores, indicating a lesser impact of child's oral health on family wellbeing when parents used more positive parenting practices. CONCLUSIONS: Parenting practices were associated with parents' perceptions of the effect of children's oral health on family wellbeing.

Photodynamic therapy for oral potentially malignant disorders: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the effectiveness of Photodynamic Therapy (PDT) in the treatment of Oral Potentially Malignant Disorders (OPMDs) patients. METHODOLOGY: An electronic search was conducted to retrieve articles published until September 2021. Meta-analyses were conducted for the outcomes of complete response (CR) and any response (AR) after treatment with PDT using data from single-arm studies, case series and non-randomised controlled trials (NRCTs). RESULTS: In total, 49 articles were included. RCTs revealed insignificant mean difference (MD) in efficacy index between PDT and comparison groups (MD: 1.32; 95% CI:-28.10-30.72, p=0.930). The likelihood of CR (OR:0.84; 95% CI: 0.42-1.71, p=0.637) or AR (OR:2.10; 95% CI: 0.31-14.25, p=0.448) was not different in PDT group when compared with any comparison treatments in NRCTs. CR/AR among single arm studies was 60.6% (95% CI: 50.5-70.7, P<0.001) and 93.7% (95% CI:91.5-95.8, P<0.001) respectively. Higher prevalence of CR and AR was observed for dysplasia or carcinoma insitu (CIS) (CR: 81%, 95% CI: 70.8-91.3, P<0.001; AR: 94.3%; 95% CI: 89-99.6, P<0.001) and actinic cheilitis (AC) (CR: 73.9%, 95% CI: 65.9-81.9, P<0.001; AR:97%; 95% CI:94.9-99, P<0.001). CONCLUSIONS: More than half of the patients receiving PDT showed CR, with more than 90% responding to the treatment. PDT was most effective on oral dysplasias, followed by AC.

Association between Interleukin-1 Polymorphisms and Susceptibility to Dental Peri-Implant Disease: A Meta-Analysis.

BACKGROUND AND OBJECTIVE: Interleukins (ILs), as important biochemical mediators, control the host response to inflammation and are associated with bone resorption. In the present meta-analysis, we investigated the association between IL-1 polymorphisms and susceptibility to dental peri-implant disease (PID). MATERIALS AND METHODS: We searched Web of Science, Cochrane Library, Scopus, and PubMed/Medline databases for studies published until 9 September2021, without any restrictions. We calculated the crude OR and 95% confidence intervals (CI) to estimate the associations between IL-1 polymorphisms and PID risk in the five genetic models. We further performed the subgroup analysis, sensitivity analysis, meta-regression, trial sequential analysis, and calculated the publication bias. RESULTS: Out of 212 retrieved records, sixteen articles were used in the meta-analysis. There was no association between IL-1A (-889), IL-1B (-511), IL-1B (+3953), and IL-1RN (VNTR) polymorphisms and the risk of dental PIDs, but there was an increased risk of IL-1B (+3954) in the patients with PIDs. In addition, an association of the composite genotype of IL-1A (-889)/IL-1B (+3953) was observed with the risk of PIDs, but not for the composite genotype of IL-1A (-889)/IL-1B (+3954). The publication year, the ethnicity, sample size, and the outcome were significantly influenced pooled estimates of some genetic models. Trial sequential analysis showed the lack of sufficient sample sizes in the studies. Conclusions: Among IL-1 polymorphisms evaluated in the meta-analysis, the composite genotype of IL-1A (-889)/IL-1B (+3953) and IL-1B (+3954) were the only polymorphisms associated with the risk of PID. The T allele and CT genotype of IL-1B (+3954) polymorphism were also associated with an elevated risk of PID.

Evaluation of Serum and Salivary Iron and Ferritin Levels in Children with Dental Caries: A Meta-Analysis and Trial Sequential Analysis.

BACKGROUND AND OBJECTIVE: Dental caries appears to be related to iron deficiency anemia and to low ferritin levels. In the present meta-analysis, we report salivary and serum iron and ferritin levels in children with dental caries, compared to healthy controls. MATERIALS AND METHODS: We searched in Web of Science, Cochrane Library, Scopus, and PubMed/Medline databases to extract studies published until 25 July 2021. We calculated mean differences (MD) and 95% confidence intervals (CI) of salivary and serum iron and ferritin levels in children with dental caries, always compared to healthy controls. In addition, we applied a trial sequential analysis (TSA). RESULTS: A total of twelve articles covering thirteen studies were included in the meta-analysis. The pooled MD for salivary iron level was -5.76 µg/dL (p = 0.57), and -27.70 µg/dL (p < 0.00001) for serum iron level: compared to healthy controls, children with dental caries did not show different salivary iron levels, while children with caries had significantly lower serum iron levels. The pooled MD of salivary ferritin level was 34.84 µg/dL (p = 0.28), and the pooled MD of serum ferritin level was -8.95 µg/L (p = 0.04): compared to healthy controls, children with dental caries did not have different salivary iron levels, but significantly lower serum ferritin levels. CONCLUSIONS: The findings of the present meta-analysis showed that salivary levels of iron and ferritin did not differ between children with and without caries, though compared to healthy controls, children with caries had significantly lower salivary and serum iron and ferritin levels. The results are of practical and clinical importance: Possibly, iron and ferritin supplementation might prevent or attenuate dental caries in children at risk. Further, children with caries might suffer from further iron- and ferritin-related health issues. Lastly, serum blood samples, but not saliva samples inform accurately about the current iron and ferritin concentrations in children with or without caries.

Association of N-acetyltransferases 1 and 2 Polymorphisms with Susceptibility to Head and Neck Cancers-A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis.

Background and objective:N-acetyltransferases 1 and 2 (NAT1 and NAT2) genes have polymorphisms in accordance with slow and rapid acetylator phenotypes with a role in the development of head and neck cancers (HNCs). Herein, we aimed to evaluate the association of NAT1 and NAT2 polymorphisms with susceptibility to HNCs in an updated meta-analysis. Materials and methods: A search was comprehensively performed in four databases (Web of Science, Scopus, PubMed/Medline, and Cochrane Library until 8 July 2021). The effect sizes, odds ratio (OR) along with 95% confidence interval (CI) were computed. Trial sequential analysis (TSA), publication bias and sensitivity analysis were conducted. Results: Twenty-eight articles including eight studies reporting NAT1 polymorphism and twenty-five studies reporting NAT2 polymorphism were involved in the meta-analysis. The results showed that individuals with slow acetylators of NAT2 polymorphism are at higher risk for HNC OR: 1.22 (95% CI: 1.02, 1.46; p = 0.03). On subgroup analysis, ethnicity, control source, and genotyping methods were found to be significant factors in the association of NAT2 polymorphism with the HNC risk. TSA identified that the amount of information was not large enough and that more studies are needed to establish associations. Conclusions: Slow acetylators in NAT2 polymorphism were related to a high risk of HNC. However, there was no relationship between NAT1 polymorphism and the risk of HNC.

Impact of the Poor Oral Health Status of Children on Their Families: An Analytical Cross-Sectional Study.

The impact of poor oral health may not just be limited to the children themselves but can impact their families. The current study aims to perform psychometric analyses of the Arabic version of the Family Impact Scale and investigate the association of its domains with the oral health status of children. This cross-sectional study was carried out in a sample of 500 parent-child dyads from high schools of Jazan city of the Kingdom of Saudi Arabia. The Arabic version of the Family Impact Scale was subjected to reliability and validity tests. The explanatory variables in the current study are: the oral health status, parents combined income, parents' education, age and sex of the child. The descriptive analysis was reported using proportions, this was followed by the bivariate and multivariable analyses. About 24.2% of children were reported to have fair, poor, and very poor oral health. A lower frequency of family impact corresponded with better oral health (OH) status of children (p < 0.001). The likelihood of parent's taking time off from work and having financial difficulties was nearly two-times greater if their children had poor oral health. Similarly, interruption in sleep and other normal activities of parents is four times and five times greater, respectively, if the child has poor oral health status. Thus, the poor oral health of school children in the Jazan region of Saudi Arabia is a matter of grave concern as it is observed to be associated with family impacts; particularly affecting the parent's work, sleep, and other normal family activities.

In vitro studies evaluating the efficacy of mouth rinses on Sars-Cov-2: A systematic review.

This systematic review aims to evaluate the evidence on the efficacy of mouth rinses on SARS-CoV-2 from in vitro studies. Five electronic databases were searched up to February 2021; no language or time restrictions were used. Two independent reviewers conducted both selection and data extraction processes. The toxicological data reliability assessment tool was used to evaluate the risk of bias. Starting from 239 articles, retrieved by the electronic search, only eight studies were included in our systematic review. Povidone Iodine (PVP-I) was effective in killing SARS-CoV-2, demonstrated higher virucidal activity than other commonly used active ingredients. Conflicting results were found about the effectiveness of Chlorhexidine (CHX) while hydrogen peroxide (H2O2) proved less effective than PVP-I. Other active ingredients, such as quaternary ammonium compounds and Ethanol (particularly when combined with essential oils), have also shown promising results in reducing viral load, with results comparable to PVP-I.

Association of IL-10 and TNF-α Polymorphisms with Dental Peri-Implant Disease Risk: A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis.

Genetic susceptibility has been reported to be an important risk factor for peri-implant disease (PID). The aim of this meta-analysis was to assess the association between TNF-α and IL-10 polymorphisms and PID susceptibility. The Web of Science, Cochrane Library, Scopus, and PubMed/Medline databases were searched for studies published until 12 April 2021. RevMan 5.3, CMA 2.0, SPSS 22.0, and trial sequential analysis software were used. Twelve studies were included in our analysis. The pooled ORs for the association of TNF-α (-308 G > A), IL-10 (-1082 A > G), IL-10 (-819 C > T), and IL-10 (-592 A > C) polymorphisms were 1.12, 0.93, 1.35, and 0.77 for allelic; 1.42, 0.95, 3.41, and 0.34 for homozygous; 1.19, 1.88, 1.23, and 0.49 for heterozygous, 1.53, 1.12, 1.41, and 0.39 for recessive; and 1.16, 1.87, 2.65, and 0.75 for dominant models, respectively, with all the estimates being insignificant. The results showed an association between TNF-α (-308 G > A) polymorphism and the risk of PID in patients of Asian ethnicity (OR = 1.59; p = 0.03). The present meta-analysis illustrated that TNF-α (-308 G > A), IL-10 (-1082 A > G), IL-10 (-819 C > T), and IL-10 (-592 A > C) polymorphisms were not associated with the risk of PID, whereas TNF-α (-308 G > A) polymorphism was associated with an elevated risk of PID in Asian patients.

Psychometric Analyses of the Indian (Hindi) Version of the Child Perception Questionnaire (CPQ11-14).

The current research aims to evaluate the reliability and validity of the Hindi Child Perception Questionnaire (CPQ11-14) in a child population of India. A randomly selected sample of children aged 11-14 years (n = 331) and their parents completed the Hindi translation of CPQ11-14 and the Parental-Caregiver Perceptions Questionnaire (P-CPQ), respectively, in this cross-sectional study. Children also provided a self-rating of oral health and were examined for dental caries. Exploratory Factor Analysis (EFA) was conducted to assess the dimensionality of the Hindi-CPQ11-14. Internal consistency and reliability on repeated administration were evaluated. Convergent and divergent validities were determined by estimating correlation coefficients between items and the hypothesised subscales. Concurrent validity was assessed using multiple linear regression analyses. The four factors extracted in EFA had a total variance of 38.5%, comprising 31 items. Cronbach's alpha for the internal consistency of the overall scale was 0.90; reliability on repeated administration was 0.92. All the Hindi CPQ11-14 items had an item-hypothesised subscale correlation coefficient of ≥0.4, and these were greater than item-other hypothesised subscale correlations, demonstrating good convergent and divergent validities respectively. Hindi-CPQ11-14 was associated with self-ratings of the oral health and overall P-CPQ scores demonstrating good concurrent validity. Hindi-CPQ11-14 showed a factor structure different from the English CPQ11-14 and exhibited good validity and reliability.

A Call for Action to Safely Deliver Oral Health Care during and Post COVID-19 Pandemic.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started just a couple of months ago and it grew rapidly causing several deaths and morbidities. The mechanism behind the transmission of the virus is still not completely understood despite a multitude of new specific manuscripts being published daily. This article highlights the oral cavity as a possible viral transmission route into the body via the Angiotensin converting enzyme 2 receptor. It also provides guidelines for routine protective measures in the dental office while delivering oral health care.

Effect of family characteristics on periodontal diseases in children and adolescents-A systematic review.

AIM: To synthesize the literature on the influence of family/parents characteristics on periodontal diseases in children and adolescents. METHODS: An electronic search for relevant literature published between 2007 and 2017 was undertaken in PubMed, Embase, Cinahl and Cochrane databases; the search was updated in April 2018. Two reviewers independently reviewed the abstracts of these; of which, 43 articles were reviewed in full. RESULTS: Of the 746 retrieved titles, 649 remained after removing duplicates. Thirty articles met the inclusion criteria, and 13 were excluded. Also, two were included from the updated search. Data from the reviewed articles indicate that all three indicators of parent's socioeconomic status (income, education and occupation) are significantly associated with periodontal diseases in children. Better periodontal status was observed in children of parents with higher SES than those whose parents were of lower SES. Although the association between parent's smoking practices, level of periodontal diseases and children's periodontal status was explored only in few studies, findings indicate that children exposed to passive smoking and having parents with periodontal diseases are more likely to present with periodontal diseases as well. CONCLUSIONS: Most of the studies considered socioeconomic factors and had not attempted to explore the impact of parental psychosocial variables on periodontal diseases in children. The literature indicates that these variables significantly influence health practices, including oral hygiene practices, which could ultimately affect periodontal health. More studies are required to explore the association of these variables with periodontal outcomes in children.

Knowledge and attitudes towards HIV/AIDS among dental students of Jazan University, Kingdom Saudi Arabia.

OBJECTIVES: To evaluate the knowledge and attitudes of dental students at Jazan University, Saudi Arabia; compare the differences in HIV/AIDS related knowledge and attitudes between the genders and years of study. METHODS: This cross-sectional survey was conducted among dental students of Jazan University (N = 208; Response rate = 88.1%). RESULTS: Most of the students (93%) knew "HIV/AIDS patients can infect dental workers" and 14% were unaware of the fact that HIV/AIDS patients can be diagnosed with oral manifestations. Less than half the subjects (47.6%) were confident on their ability to safely treat HIV/AIDS patients and only 28.8% of the study population believed that their knowledge about infection control is enough to treat HIV/AIDS patients. Males and 4th year students had significantly greater HIV/AIDS related knowledge and attitudes than their comparative counterparts. CONCLUSIONS: HIV/AIDS related knowledge and attitudes in dental students of Jazan University are comparable to other studies from Saudi but are poor when compared to other countries.

Impact of oral potentially malignant disorders on quality of life.

BACKGROUND: Oral potentially malignant disorders (OPMDs) could have a significant psychological impact on patients, principally because of the unknown risk of malignant transformation, while the physical and functional impairments could differ. This study aimed to assess the impact of three different OPMDs and their disease stages on the quality of life (QoL) of affected patients. METHODS: Oral leukoplakia (OL), oral lichen planus (OLP) and oral submucous fibrosis (OSF) patients who were undergoing treatment at an oral medicine clinic of a dental teaching hospital in India were the study population. All subjects completed the recently developed OPMDQoL questionnaire and a short form 12 item (version 2) health survey questionnaire (SF-12v2). OPMDQoL questionnaire consists of 20 items over four dimensions. A higher score denotes poor OHRQoL. SF-12v2 has two components, a Physical Component Summary (PCS) and Mental Component Summary (MCS). RESULTS: A total of 150 subjects (50 each of OL, OLP and OSF) participated. OL patients (37.7 ± 7.9) reported significantly better OPMDQoL scores than OLP (47.3 ± 5.8) and OSF (45.4 ± 9.2) patients. OLP patients reported significant problems in obtaining a clear diagnosis for their condition, more so than the other OPMDs. OL patients reported fewer problems for the dimension, "physical impairment and functional limitations" than the OLP and OSF patients. A significant trend was observed with the overall OPMDQoL and MCS, deteriorating as the disease stage increased. CONCLUSIONS: OLP and OSF have a significant impact on the QoL of affected individuals: OL less so. Increasing stage of the disease is associated with worsening QoL.

Qualitative analysis of the impact of Oral Potentially Malignant Disorders on daily life activities.

OBJECTIVE: To evaluate the impact of Oral Potentially Malignant Disorders (OPMD) on daily life activities. MATERIALS AND METHODS: Patients diagnosed with Oral Leukoplakia, Oral submucous fibrosis and Oral Lichen Planus attending the Oral Medicine clinic of Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, India were invited to participate. Eighteen interviews and three focus groups were conducted in a non-clinical setting. Voice recordings were transcribed and translated from Telugu to English. Data coding was performed using the NVivo software. RESULTS: Sample size for this qualitative study comprised 32 patients. Four main themes emerged: (1) difficulties with diagnosis and knowledge about the condition, (2) physical impairment and functional limitations, (3) psychological and social wellbeing and (4) effects of treatment on daily life. In a majority of the patients, most of the interview time was spent discussing physical impairment and functional limitations. Patients also reported their mouth condition having a debilitating effect on their psychological well-being and social interactions. CONCLUSIONS: 'Physical impairment and functional limitations' was the most important theme for many of the patients. However, the impacts of OPMD also extended beyond physical impairment and functional limitations to aspects of daily living, notably psychological and social wellbeing.

The Effect of Parenting Practices on the Severity of Gingival Bleeding in Children.

BACKGROUND: Studies have consistently reported that parenting practices have an impact on eating styles which determine obesity levels in children. However, to the best knowledge of the authors, there is no study that evaluates the association of parenting practices on gingivitis in children using path analysis to evaluate if oral health-related behavior mediates this association. This study aims to test a model of parenting and family demographic factors that could account for gingivitis in children, with a focus on the mediational roles of oral health-related behaviors and oral hygiene status. METHODS: Clinical examination of oral hygiene status and gingivitis was conducted using simplified oral hygiene and modified Community Periodontal Indices, respectively, on sixth-grade school children (n = 1,539) of Medak District in Telangana State, India. Children also answered a questionnaire consisting of five closed-ended questions on oral health-related behavior. Parents responded to queries related to socioeconomic status (SES), family structure, number of children, oral health-related behavior, and parenting practices. RESULTS: Prevalence of gingival bleeding was 92.4%. Power assertion parenting (representing coercive or controlling parenting practices) had a negative effect on oral hygiene status (ß = 0.044; P = 0.07), and also had an indirect effect on gingival bleeding (ß = 0.011; P = 0.05). Oral hygiene status was positively associated with the extent of gingival bleeding (ß = 0.24; P = 0.01). Children living in families with lower SES had worse oral hygiene (ß = -0.101; P = 0.01) and gingival bleeding status (ß = -0.024; P = 0.01). CONCLUSION: Power assertion parenting had a deleterious effect on the extent of gingival bleeding via a worse oral hygiene status of children, but SES was also important for predicting oral hygiene and gingival bleeding.

Development and validation of a quality-of-life questionnaire for patients with oral potentially malignant disorders.

OBJECTIVE: The aim of this study was to develop and evaluate the validity and reliability of a quality-of-life (QoL) questionnaire for patients with oral potentially malignant disorders (OPMDs). STUDY DESIGN: For item generation, 15 personal interviews and three focus group discussions were conducted with OPMD patients existing QoL questionnaires were reviewed, and inputs from specialist clinicians (n = 10) were considered. Data collected from patients were analyzed by using NVivo. This led to the identification of themes, item writing, scaling, item reduction, formatting, and pretesting of the newly developed questionnaire. The validity and reliability of the questionnaire were assessed in a separate sample of 300 patients (150 each of patients with OPMD and healthy individuals). RESULTS: Sixty items were generated from the qualitative data and by reviewing existing questionnaires. After item reduction, the final questionnaire comprised 20 questions, which could be categorized under four domains. Exploratory factor analysis revealed a four-factor structure conforming to the four domains. The OPMD QoL questionnaire exhibited good discriminant and convergent validity, with OPMD patients reporting poorer QoL compared with healthy individuals and correlating significantly with existing questionnaires designed for similar purposes respectively. CONCLUSIONS: Our OPMD QoL questionnaire was found to be valid and reliable. We recommend that it be applied in epidemiologic and treatment studies of these disorders.