Comparative evaluation of dental caries experience using CAST index and WHO criteria among 5 and 15-year-old schoolchildren.

Background: CAST (Caries Assessment Spectrum and Treatment) index is a relatively new caries assessment tool that hierarchically describes the entire caries spectrum. Its comparability with WHO (World Health Organization) criteria in different populations and age groups needs to be investigated. Objective: The objective of this study was to assess caries among 5 and 15-year-old schoolchildren using the CAST index and WHO criteria and to compare both indices on the basis of caries experience and examination time. Methods: A cross-sectional study was conducted among 553 schoolchildren aged 5 and 15 years in the North zone of Bengaluru city, India. Examiners underwent training and calibration for performing the CAST index. The first examination was performed using the CAST index followed by a second examination using the WHO criteria 2013, after some days. Time taken for examination was also recorded. Results: The study sample consisted of 279 five-year-old and 274 fifteen-year-old schoolchildren. The difference in caries experience among 5 and 15-year-old children assessed using the CAST index (52%, 45.6%) and WHO criteria (42.3%, 24.5%) were found to be statistically significant (p < 0.05). The average examination time was longer for the CAST index (93.77±24.77 seconds and 105.04±9.49 seconds) when compared to WHO criteria (61.05±15.91 seconds and 58.72±9.42 seconds) for primary and permanent dentition (p < 0.05). Conclusion: Though the CAST index took a longer examination time, the information obtained was more precise and facilitated researchers in treatment planning encompassing prevention of initial lesions, restoration, and rehabilitation.

IMPACT OF CULTURAL FACTORS ON THE DENTAL HEALTH STATUS AND BEHAVIOUR OF FEMALES IN THEIR GESTATION PERIOD.

Aim - to evaluate the effect of cultural factors on the oral health status and behaviour of pregnant women in Kerala.A cross-sectional study was conducted among 128 females who were pregnant at 2 private hospitals in Kerala. The study tool was a questionnaire for examining the cultural factors impacting the dental health status and behaviour of females in their gestation period, which was framed based on a review of the literature. Oral health status was also examined by examining decay (DMFT), periodontal status (CPI index), oral mucosal lesions etc. Among the participants, 87% reported that oral health care is important during pregnancy brushes twice daily compared to 29.5% of the participants who reported that oral health care was not important during pregnancy (chi-square=22.363, p=0.001). 18.8% and 49.5% of the study subjects who were of the opinion that dental treatment should not be done in their gestational period had CPI-high scores of 4 (deep pocket) and 3 (shallow pocket) respectively.Cultural factors can act as barriers which have to be reduced to enhance oral health behaviour and oral health status.

Attitude of Accredited Social Health Activists towards Creating Awareness on Oral Cancer in Rural Community of Chikkaballapur District, Karnataka.

BACKGROUND: Accredited social health activists (ASHAs) form a link between rural community and health system in India; hence, it is important to understand their attitude to render health services. OBJECTIVES: The objectives of the study were to develop a tool for measuring the attitude to create awareness on oral cancer (OC) using theory of reasoned action and planned behavior (TRA/PB) to the community and to assess the attitude of ASHAs about the same. METHODOLOGY: A culturally relevant self-administered questionnaire was developed based on TRA/PB which was subjected to validity and reliability and then pilot tested. The sample size was estimated to be 278. A cross-sectional research design was used to assess the attitude of ASHAs. Multistage sampling technique was carried out to include ASHAs from three of six taluks of Chikkaballapur district. RESULTS: The content validity ratio of the items was in the range of 0.6-0.7, and Cronbach's alpha was 0.762. Exploratory factor analysis provided three factors with eigenvalue >1. The mean age of study participants was 31.8 years. The mean work experience was 5.7 years. The attitude of ASHAs was favorable (82.45%) as they believed that it was their responsibility to contribute in disease prevention (normative belief). Some had seen suffering of OC patients closely (behavioral beliefs) and few opted to follow their authority instructions (perceived behavioral control). CONCLUSION: The developed tool with good validity and reliability was used to assess the attitude of ASHAs. Their attitude was favorable to educate the community about OC and contribute in disease prevention.

Challenges Faced by Patients Undergoing Radiotherapy for Oral Cancer: A Qualitative Study.

BACKGROUND: Oral cancer is one of the most common types of cancers in India. Radiotherapy is one of the treatment options frequently resulting in complications. These complications affect the patient's quality of life, nutritional intake, and consequently undermine the treatment outcomes. Patients' verbal accounts of experiences regarding their overall oral health during radiotherapy have not been described sufficiently. AIM: The aim of the current study was to identify and analyze the issues experienced by patients while undergoing radiotherapy for oral cancer treatment. MATERIALS AND METHODS: A phenomenology study design was chosen, with in-depth interviews as the selected strategy for data collection. A literature search was conducted based on which an interview guide in English was prepared and modified according to inputs from subject matter experts. The interview guide comprised nine questions, including opening, key, and closing questions, and was also translated into Telugu and Kannada - the two languages predominantly spoken by the patients visiting the hospital. Interviews were conducted with each patient separately, with each interview lasting for 60 min each. The interviews were audio-recorded, transcribed, coded, and categorized, following which themes were derived from the analysis. RESULTS: The key theme that emerged from the study was the "Multifaceted experience of patients undergoing radiotherapy." CONCLUSION: Understanding the specific issues faced by oral cancer patients undergoing radiotherapy drew our attention to the dire need for interprofessional collaboration, which could enable health professionals to share their expertise and perspectives toward achieving the common goal of restoring patients' health and improving health outcomes.

Efficacy of stevioside sweetener on pH of plaque among young adults.

BACKGROUND: Stevioside is a natural herbal sweetener extracted from Stevia rebaudiana. An in vitro study has proved the antibacterial efficacy of 0.2% Stevia aqueous solution against Streptococcus mutans and Lactobacillus acidophilus, and the present study was conducted to clinically evaluate the efficacy of Stevia leaf extract and Stevia product on plaque pH, when compared with sucrose solution. MATERIALS AND METHODS: A clinical trial was conducted among a sample of 22 undergraduate students who volunteered. After obtaining consent, students were instructed not to brush at night and not to use any mouth rinse during the course of the study. Baseline plaque pH was measured in situ using digital pH meter. Students were asked to rinse for 1 min with 0.2% aqueous solution of Stevia leaf extract and plaque pH was measured in situ at 4 time points (5, 10, 15, and 30 min) after each rinse. After a washout period of 2 days, 10% sucrose and 1% Stevia product solutions were similarly tested. Statistical analysis was performed using analysis of variance (ANOVA) test and repeated measures ANOVA. Tukey's HSD test was used to obtain multiple comparisons. The level of significance was set to be at P < 0.05. RESULTS: At 5, 10, 15, and 30 min, a significant difference in mean plaque pH values was observed between three test solutions (P < 0.000). Post hoc Tukey's HSD test showed that the difference in mean pH values between aqueous Stevia extract and sucrose and Stevia product and sucrose was highly significant (P < 0.000). CONCLUSION: Stevia leaf extract and commercially available Stevia product did not significantly affect plaque pH values, implying that two solutions are non-fermentable and do not support bacterial survival.

Nicotine Dependence, Its Risk Indicators, and Exhaled Carbon Monoxide Levels among the Smokers in Bengaluru, India.

BACKGROUND: Tobacco is the significant cause of preventable death worldwide. The prevalence of smoking in India is 13.3%. Among the chemical constituents in the cigarette, nicotine is the one most often associated with dependence resulting in increased consumption of them. Studies have proven the dose-dependent relationship of cigarette smoking with lung and oropharyngeal cancer. Hence, assessment of nicotine dependence among the smokers is essential as it influences the tailor-made intervention. OBJECTIVES: The objectives of this study were to assess the nicotine dependence and exhaled carbon monoxide (CO) levels among the smokers in Bengaluru. MATERIALS AND METHODS: A cross-sectional survey was conducted among 396 smokers selected using probability proportional to size sampling technique. Fagerstrom Test for Nicotine Dependence was used to assess the levels of nicotine dependence. Exhaled CO levels were measured using the Smokerlyzer to indicate the nicotine dependence. RESULTS: About 23.7% of the participants had the very low dependence on nicotine. Nearly 26% and 22.5% of the participants had the high and very high dependence on nicotine correspondingly. The number of years of smoking was found as a significant risk indicator for nicotine dependence. Exhaled CO levels were significantly correlated with the nicotine dependence (P = 0.000) indicating it as a marker for nicotine dependence. CONCLUSION: The high nicotine dependence among the participants warrants effective public health policies to prevent tobacco-related diseases. Considering the risk indicator, the number of years of smoking, smoking cessation programs should target the participants with the habit of continuous smoking with tailor-made interventions to prevent the relapse among them.

The cross cultural adaptation and validity of the child-OIDP scale among school children in Karnataka, South India.

OBJECTIVE: To carry out a cross-cultural translation and adaptation of the Child-O1DP instrument and to assess its reliability and validity among 11-12 year olds in Karnataka, South India. METHODS: The original Child-OIDP was obtained from the author, cross-culturally adapted to the Kannada language then the translation's content, face criterion and construct validity and internal and external reliability were evaluated. Children recorded their oral health problems and rated their oral health in a cross sectional study of 505, 11-12 year olds selected from a list of Karnataka schools by using simple random sampling (89.7% participation rate). RESULTS: The child OIDP revealed good validity and reliability. In relation to construct validity; an exploratory factor analysis provided two factors with eigenvalues greater than 1, which represented the physical and psychosocial health components. Cronbach's alpha was 0.60 and test-retest reliability, 0.85 (intra-class correlation coefficient). CONCLUSIONS: The Kannada Child-OIDP is a valid and reliable interviewer-administered instrument to measure the impact of the oral conditions on quality of life in children in Karnataka, South India.

Comparison of different caries diagnostic thresholds under epidemiological and clinical settings among 7-15 year old school children from Bangalore city.

AIM: The aim of this study is to compare the different caries diagnostic thresholds under epidemiological and clinical settings among 7-15 year old school children. MATERIALS AND METHODS: A cross-sectional study was undertaken among 7-15 years old school children of Bangalore city. Total 738 children were enrolled in the study. General information was collected regarding oral hygiene practice and personal habits of the schoolchildren. Subsequently, examination was done under both the settings to record Decayed, missing and filled surfaces index for permanent teeth (DMFS) and Decayed, missing and filled surfaces index for deciduous teeth (dmfs) using the World Health Organization (WHO) and WHO + IL criteria. RESULTS: The present study showed that both the settings (clinical and epidemiological) and diagnostic thresholds (WHO and WHO + IL), could influence the detection of carious lesions. Mean Ds under WHO + Initial lesions (IL) criteria (3.92 + 3.49) was nearly double of WHO criteria (1.88 + 2.73,) and the influence observed was more in 14 years of age, where mean Ds under WHO + IL criteria (5.43 + 2.5) which was more than double of WHO criteria (2.02 + 1.9). CONCLUSION: The choice of a diagnostic threshold (WHO and WHO + IL) and the conditions of examination (epidemiological and clinical) are important for the detection of caries.

Tobacco cessation in India: a contemporary issue in public health dentistry.

In India, tobacco use is incredibly linked to poverty and accounts for the high public health costs of treating tobacco-related diseases. Dental public health programs aid in detecting the tobacco-related periodontal diseases, oral cancers, etc., where the majority belongs to the submerged portion of iceberg, which otherwise leads to substantial morbidity and mortality. Moreover, public health dentists plays a key role in identifying both clinical and subclinical cases and aid in tobacco use cessation through various modes of health education and counseling. Therefore, the community-based measures are deemed to be the most cost-effective tool for tobacco cessation.

Assessment and comparison of periodontal status among young smokers and nonsmokers of Bangalore, India--a cross sectional study.

OBJECTIVES: To compare the periodontal status among young smokers and nonsmokers and to assess the influence of frequency and duration of smoking on the periodontal status. BASIC RESEARCH DESIGN: A cross sectional study. PARTICIPANTS: The study was conducted among 1,081 male employees (aged between 20-35 years) working in Bharat Electronics Limited (BEL), a factory located in Bangalore, India. SETTING: Two medical centers (FMC-North and FMC-South) situated within the factory premises. METHOD: A specially designed form was used for collecting the information on socio-demographic factors, oral hygiene practices, smoking habits including the frequency and duration of smoking in addition to recording community periodontal index (CPI index) together with its loss of attachment (LA) component. Independent t-test, one-way analysis of variance (ANOVA), post hoc test (Bonferroni), chi square test and logistic regression analysis were carried out. MAIN OUTCOME MEASURES: CPI scores and LA codes. RESULTS: Mean number of sextants per person with both periodontal pockets and loss of attachment measuring 4 mm or more was significantly higher (p < 0.001) in smokers when compared to nonsmokers. Increase in the extent and severity of periodontitis was evident with an increase in the frequency and duration of cigarette smoking. Smokers were eight times more at risk of periodontal pockets (C.I: 5.79-10.68) and five times more at risk for loss of attachment (C.I: 3.79 -6.52) when compared to nonsmokers (p < 0.001). CONCLUSIONS: Smoking is a risk factor strongly associated with periodontal disease among this young population of male employees working in BEL factory located in Bangalore. The extent and severity of the periodontitis was related to the amount of cigarettes smoked and the duration of the habit.

Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India.

BACKGROUND: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. MATERIALS AND METHODS: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth), which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. CONCLUSION: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in.

The relationship of dental extrinsic stains with the concentration of trace elements in water sources in a district of Nepal.

PURPOSE: To assess the relationship of dental extrinsic stains (DES) with levels of trace elements in drinking water sources. MATERIALS AND METHODS: A cross-sectional study among the population of Madesha VDC. A sample of 551 residents aged between 4 years and above was examined. A questionnaire was prepared to assess the dietary habits, oral hygiene practices, age, period of residency (POR), followed by clinical examination regarding the presence or absence of DES. Water samples were collected and sent for analysis by AAS method for trace elements. RESULTS: The prevalence of DES was 39%. Twenty-eight water samples had Fe levels that exceeded permissible levels and all samples were negative for other trace elements. Stains were associated with POR and levels of Fe in water (P value < 0.001). There was a positive correlation by ward of Fe levels and stain distribution. CONCLUSION: The results revealed an association between DES with age, POR, and Fe levels in water. The positive correlation between stain distribution by ward and levels of Fe in water indicated the causative role of Fe in stains.