Misconceptions Regarding Essential Oral Health Care Amongst Pregnant Women Visiting a Tertiary Care Hospital in the State of Goa, India: A Descriptive Study.

Background of the Study: Myths regarding oral health are extensively prevalent and have considerable impact on pregnant women's dental behaviour and practices. Thus, this study sought to understand misconceptions (pregnancy and early childhood oral care) and their determinants amongst pregnant women. Methods: A questionnaire designed to assess the participants' demographics, parity, oral health behaviour and misconceptions was administered to 305 pregnant women attending antenatal care. Oral health (DMFT, bleeding on probing and periodontal pocket) was examined. Independent t test, analysis of variance and linear regression were used for statistical computations. Results: Early childhood myths (5.54 ± 1.87) were more prevalent amongst the study population than pregnancy-related myths (3.28 ± 1.89). Bivariate analysis exhibited that myths were significantly more prevalent in mothers who were ≤ 30 years of age (8.79 ± 2.565), primi parous (8.90 ± 2.141), illiterate (9.07 ± 2.764) and who had never visited a dentist (8.46 ± 2.016). Both pregnancy and early childhood myth scores were positively correlated to DMFT (p = 0.00; p = 0.031). Educational status and age were significant negative predictors of myths with p values of 0.00 and 0.34, respectively. Parity emerged as the only significant positive predictor (p = 0.002). Conclusion: The high prevalence of myths in the present study advocates that standardized, culturally appropriate and simple educational messages need to be developed and delivered to break these misconceptions. Minimum one visit to a dental surgeon during second trimester should be advocated and encouraged for all pregnant women.

Pediatric Dental Fluorosis and Its Correlation with Dental Caries and Oral-Health-Related Quality of Life: A Descriptive Cross-Sectional Study among Preschool Children Living in Belagavi.

AIM: This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents' perceptions among preschool children in the 3-5-year-old preschool children living in the Belagavi district of Karnataka, a non-endemic fluorosis region. METHODS: A descriptive cross-sectional questionnaire-based study was conducted among 1200 individuals of the preschool population from 48 government-sponsored child-care development centers in Belagavi, Karnataka, over a three-month period. They were examined following the Dean's fluorosis index (1942) and dmft (decayed, missed, and filled) scores of the participants were also recorded. Parents' perception of oral health was assessed using the self-administered Early Childhood Oral Health Impact Scale (ECOHIS). SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-way ANOVA test was used for multiple group comparisons. p < 0.05 was considered statistically significant. RESULTS: Of the 1200 children examined, 10 (0.83%) children exhibited dental fluorosis. Of the 10 children having fluorosis, six had fluorosis present on two or more of their primary teeth, and four had fluorosis on four or more teeth. The mean dmft score was 3.01 ± 1.38 to 3.60 ± 1.72 in 3-5-year-old children, respectively, with statistical significance difference (p < 0.001). The mean score of oral health-related quality of life was 10.74 ± 2.06, which was significantly correlated to the child's age and parents' education level (p < 0.05). CONCLUSION: The study shows a negligible amount of prevalence of dental fluorosis in the non-endemic fluorosis residential district. It also elucidates that children from lower and lower-middle socioeconomic status are more prone to suffer from dental fluorosis as compared to other groups. The mean score of ECOHIS increased proportionally with the caries experience, indicating a significant relationship between the dmft and ECOHIS score. Deciduous dentition fluorosis is often neglected, especially in areas that are not considered endemic for fluorosis and with only optimum fluoride levels in their groundwater, which supports the disease's nature as multi-factorial and shows that a broader perspective is of prime importance to assess, diagnose, and prevent dental fluorosis among the preschoolers, thereby appraising their overall health and hygiene status.

Interest of Oral and Maxillofacial Surgeons Towards Specialised Training in Facial Aesthetic and Plastic Surgery in India - An Evaluative Study.

Introduction: The Dental Council of India has included facial plastic surgery in the scope of practice of Oral and Maxillofacial Surgeons (OMFSs) in India. However, the knowledge and interests of these specialists towards facial plastic surgery are unexplored. Materials and Methods: A descriptive cross-sectional study consisting of a structured questionnaire tool with six domains and 46 questions was circulated amongst registered OMFSs in India. The study consisted of 950 participants. The data obtained from this questionnaire were coded and entered into Statistical Package for Social Sciences (SPSS) and a descriptive analysis was conducted. Results: The study yielded that only 33% of the participants were completely aware of facial fillers and 30.5% were aware of Botox procedure. However, there was complete awareness of blepharoplasty in 42%, cheiloplasty/palatoplasty in 65.8%, laser facial resurfacing in 23.7% and facial rejuvenation in 23.5% of the participants. Discussion: It was found that a high number of OMFSs felt that their exposure to plastic surgery during their post-graduation years was not sufficient.

Cognizance towards implementation and adherence of Cigarette and other Tobacco Products Act (COTPA) directives - A descriptive cross-sectional study among security guards in Goa.

Objective: The use of tobacco has proven to be one of the leading cause of preventable premature deaths and diseases across the globe. The World Health Organization (WHO) claims that tobacco consumption alone kills more people annually as compared to Acquired Immunodeficiency Syndrome (AIDS), alcohol, and other addictions (drugs, etc.) put together. Although the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law to curb the tobacco epidemic, the effectiveness of its implementation remains disputed. The current study aims to examine the role of the security guards in the implementation of the COTPA by assessing their awareness. Method: A cross-sectional questionnaire-based study was conducted among 258 security guards in Goa to ascertain the knowledge regarding the tobacco legislation in the country. A self-administered 20-item close-ended questionnaire was used to collect information regarding the demographic variables, tobacco use, and knowledge regarding COTPA. Data analysis was done using SPSS version 22.0. Results: The mean age of the study participants was 29.93 ± 6.93 years. Overall, 68.6% of the study participants were aware of any tobacco control law in India. It was observed that 71% of the subjects had adequate knowledge of the COTPA. The participants with higher secondary educational levels had significantly higher knowledge scores. Conclusion: The overall awareness of the security guard was good but there is a need to provide in-depth knowledge on certain key aspects of the COTPA. Efforts should be made to train the security personnel to increase their awareness of the act.

Evaluation of the safety and effectiveness of intradermal administration of QR678 Neo® hair growth factor formulation: A phase-IV, open-label, single-arm multi-ethnicity clinical trial.

BACKGROUND: Intradermal administration of QR678 Neo® hair re-growth factor formulation has already proven its effectiveness and safety in treating androgenetic alopecia and female pattern hair loss. AIM: This study aims to evaluate effectiveness and safety of hair re-growth factor formulation at multiple centers for reduction of hair fall and regrowth of hair in androgenetic alopecia and female pattern hair loss. MATERIALS AND METHODS: An open-label, prospective, and interventional study was carried out at multiple centers of different countries. A total of 2428 patients with androgenetic alopecia and female pattern hair loss within the age range of 18-65 years were included in the study. Hair pull test, global photographic assessment, videomicroscopic assessment tests were performed at the beginning, after fourth and eighth sessions, and self-assessment through questionnaire related to satisfaction and side effects was carried out at beginning and at after eight session. RESULTS: Hair pull test was positive in only 12% of the patients after eight sessions. Beneficial results were noted in the global assessment score (mean-6) after fourth session and eighth session (mean-8). Huge improvement was noted in terminal hair count, vellus hair count, and hair density after eighth sessions. Also, with self-assessment score, a higher satisfaction score was noted. On long-term follow-up as well, no side effects were noted. CONCLUSION: Intradermal administration of QR678 Neo® is an innovative, efficacious, and safe technique for the treatment of androgenetic alopecia and female pattern hair loss.

Oral Mucosal Lesions' propensity as an Outcome Eventuated by Exhaled Carbon Monoxide (CO) Levels and Nicotine Dependency.

OBJECTIVE: This study aims to assess the correlation of exhaled CO and nicotine dependence with the occurrence of oral mucosal lesions while also taking into consideration socio-demographic, clinical and anthropometrical characteristics of participants. METHODS: An observational cross-sectional study was carried out among smokers who visited the tobacco cessation center at Tertiary Care Dental Hospital in Goa, India. An intra-oral soft tissue examination for detecting presence of oral mucosal lesions followed by a questionnaire-based interview for the measurement of exposure, sociodemographic factors, body mass index, cooking habits and nicotine dependence was conducted. The exhaled CO levels were measured with a CO breath analyzer. Statistical analysis was performed using IBM SPSS version 20.0 Descriptive statistics were calculated and multivariable analysis was done to assess the association of different variables with oral mucosal lesions and carbon monoxide levels. p-value ≤ 0.05 was considered as statistically significant. RESULTS: Of the 173 subjects enrolled in the study, 69.36% were without any lesions while 30.63% were diagnosed with some lesion. In the regression analysis, the variables of physical activity (present vs absent OR: 5.808), exhaled CO levels (OR: 1.098) and nicotine dependence (mild vs moderate OR: 6.518) were significant risk factors influencing the presence of oral mucosal lesions. Usage of both cigarettes and bidis by smokers exhibited highest mean exhaled CO values of 19.67±1.506 ppm. Exhaled CO levels were significantly higher in smokers who were overweight (14.96±9.14 ppm), physically inactive (13.98±8.26 ppm), highly nicotine dependent (20.67±8.30) and used coal for cooking (12.55±8.17). CONCLUSION: A robust correlation between exhaled CO levels, nicotine dependence and incidence of oral mucosal lesions was established. The multifactorial tenacity of exhaled CO which is affected by smoked tobacco as well as variables such as physical activity, BMI, cooking habits and type of smoking habit should be noted.

Oral cancer management in the SARS-CoV-2 Pandemic-Indian scenario.

The global burden of oral cancer rests on India's shoulders. Distant metastasis and extensive loco-regional spread result in a dismal 5-year prognosis. Tobacco chewing is the leading etiological factor. A lack of education among the masses combined with an inundated cancer care system account for high morbidity and mortality rates. The SARS-CoV-2 shows tropism for the oral mucosa. This viral tropism is thought to get augmented in oral cancer because of the upregulation of oral mucosal receptors and enzymes which enhance viral attachment and entry. The COVID-19 disease has caused a heavy blow to the cancer care sector in India because of paucity of COVID-19 centred health care regulations. This review highlights the need for the prompt creation of a national health policy which would prioritize and allow for the resumption of oral onco-surgical in light of COVID-19 pandemic.

A bio-behavioral intervention combining task analysis with skill-based training to train toothbrushing among children with intellectual disability.

AIMS: Individuals with intellectual disability (ID) have special health care needs. Teaching self-care behaviors like toothbrushing helps reduce their dependence on adult caregivers. We present a bio-behavioral intervention combining task analysis with skill-based teaching of toothbrushing behavior aimed to promote autonomy in children with various types of ID. METHODS: One hundred twenty children with ID enrolled at a special school in the State were included in the study. After baseline measurements using task analysis, four methods were used to train the children - instruction, three-phase modeling, physical guidance, and descriptive praise. The caregiver was trained and given instructional videos for reinforcement. After 4 weeks, the children were asked to brush their teeth and performance was evaluated. RESULTS: There was increased independence in the performance of toothbrushing behavior, the mild and moderate ID groups showing the most improvement. Steps like oral manipulation of the toothbrush showed the greatest improvement in these groups. The severe ID group showed improvement in certain skills, while requiring assistance for others that demanded dexterity. CONCLUSION: This intervention can be implemented by special schools and special care dentistry centers to foster autonomy in oral self-care skills in the mild and moderate ID children, and complemented with other methods for severe ID children.

Assessment of Hypoxia and Physiological Stress Evinced by Usage of N95 Masks among Frontline Dental Healthcare Workers in a Humid Western Coastal Region of India-A Repeated Measure Observational Study.

AIM: To assess the oxygen saturation in DHCWs using N95 and 3 ply surgical masks and determine the presence of any other subjective discomfort in them. SETTINGS AND DESIGN: A repeated measure observational study conducted at the Tertiary Care Dental Institute situated in Goa, a western coastal region of India recording humid conditions year around. METHODS AND MATERIAL: Participants constituted 60 frontline DHCWs wearing N95 masks and 60 DHCWs working in non-clinical setting wearing surgical masks. After completion of a self-administered questionnaire their oxygen saturation and pulse rate were monitored at baseline, 60mins and 120mins using pulse oximetry. Statistical Analysis: Mann Whitney u test compared oxygen saturation between the two groups. Friedmann and Wilcoxon signed rank test with Bonferroni correction computed differences within group at various time intervals. Binary logistic and linear regression was used to compare the study variables with outcome measure. p value was set at < 0.05. RESULTS AND CONCLUSION: Oxygen saturation reported a significant drop post one hour of wearing N95 masks which increased in the second hour. Prolonged use of N95 mask in humid environment adds to the body's physiological burden or perceptions of discomfort and exertion. Efforts need to be taken to address this for better compliance to the use of these protective gears.

COVID-19 in Smokeless Tobacco Habitués: Increased Susceptibility and Transmission.

As the coronavirus disease (COVID-19) pandemic continues to sweep across the globe, the world is responding by implementing public awareness campaigns, social distancing measures, and other preventive strategies to arrest the spread of this lethal disease. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exacts a heavy toll on patients with existing comorbidities. Smokeless tobacco (SLT) consumption is of particular concern in countries in South Asia with high population densities, as it facilitates exposure to SARS-CoV-2 within or between communities by the act of public spitting. Salivary droplets generated in this act are a potential threat because they can transmit this airborne infection. Moreover, large gatherings at tobacco retail outlets, frequent hand-to-mouth contact, and sharing of apparatus by SLT habitués could also aid in increasing the spread of SARS-CoV-2. SLT-induced higher expression of angiotensin-converting enzyme 2 receptors along with the presence of furin in the oral mucosa and dysfunctional immune responses among SLT habitués increase viral dissemination and an individual's susceptibility to COVID-19. Issuing rigorous regulations to restrict the use of various forms of SLT products and the obnoxious act of spitting in public can assist in arresting the spread of COVID-19. Widespread education campaigns enlightening the community regarding the adverse effects of SLT consumption and its relationship with COVID-19, along with providing effective assistance to quit for those who are addicted, would decrease the spread of COVID-19.

Impact of oral health-related behaviors on dental caries among children with special health-care needs in Goa: A cross-sectional study.

BACKGROUND: Children with special health-care needs (CSHCNs) have high unmet dental needs and are at increased risk of poor oral health. The aim of the present study was to evaluate the relationship between oral health behavior and dental caries experience among CSHCN. MATERIALS AND METHODS: The cross-sectional study sample comprised of 223 CSHCNs from special educational schools in Goa. A self-administered parental questionnaire was used to collect data on sociodemographic characteristics and oral health behavior variables. Type III clinical examination for dental caries was done using the World Health Organization criteria. Statistical analysis was done using SPSS version 19.0. RESULTS: The mean age of the study sample was 13.85 ± 7.2 years. Seventy-two percent of the study sample had never visited a dentist. Majority of the study participants (57.4%) brushed their teeth once daily. The caries prevalence was 68.6%. The mean decayed, missing, and filled teeth index for permanent dentition and primary dentition of the study participants was 2.83 ± 3.23 and 0.35 ± 1.00, respectively. Dental caries was significantly associated with frequency of brushing and dental visits. CONCLUSION: The caries experience was high among children with special needs in Goa. There is a significant association between oral health behavior and dental caries experience. Oral health promotion may lead to reduction in dental caries level, thus reducing the emotional, physical, and financial drain on their caregivers.

Assessment of readiness to quit tobacco among patients with oral potentially malignant disorders using transtheoretical model.

BACKGROUND: Tobacco use is a disease of addiction and a behavior choice. It is valuable to understand the psychosocial dimension of disease. OBJECTIVES: The research aimed to assess the (I) behavioral determinants and pattern of tobacco use (II) readiness to quit tobacco among patients with oral potentially malignant disorders (OPMDs) using transtheoretical model (TTM) approach visiting the dental college in Goa, India. MATERIALS AND METHODS: This cross-sectional analytical study was conducted among 300 patients over 3 months. Information about sociodemographics, determinants including age and reason of onset, behavioral stages, and the presence of OPMDs was collected using specially designed pro forma. Descriptive and inferential statistics were performed using SPSS 18.0. RESULTS: Smokeless form of tobacco 199 (66.34%) was most prevalent followed by smoking 79 (26.33%) and dual tobacco use 22 (07.33%) in males. Majority belonged to low socioeconomic class. Peer influence was the most-cited reason. Around 1/3rd of the participants had OPMDs associated with tobacco use. Significant association was observed between the presence of OPMDs and TTM behavioral stages. Patients with OPMDs are more motivated for tobacco cessation (odd's ratio = 2.30, P = 0.002), that is, they are more in preparation and action stages. CONCLUSION: The findings reflect that smokeless tobacco use is more prevalent in males with low level of education and socioeconomic class. Readiness to quit tobacco increases among patients with OPMDs using TTM.

Knowledge, attitude, and practice of dental professionals regarding the effect and management of food impaction associated with fixed partial denture prostheses: A survey.

OBJECTIVE: This survey was undertaken to assess dentist's opinion regarding the occurrence and pattern of food impaction in relation to fixed partial denture (FPD) prostheses, its commonly observed consequences, factors contributing to it, and its management. METHODS: A descriptive survey was conducted on a sample size of 150 dental practitioners. The pro forma consisted of informed consent, demographic information, and questionnaire. The results were tallied and quantitative analysis was performed to obtain the descriptive statistics for the data using SPSS version 20. RESULTS AND INTERPRETATION: All the study respondents had come across patients who complained of food impaction in relation to FPD. The most common consequences of food impaction were proximal caries of the adjacent teeth and interdental bone loss. Majority of the dentists considered faulty FPD design with improper contact relation, improper crown contour, poor margin adaptation, and faulty pontic design as the most likely reason for food impaction. Repeating the FPD with emphasis on prescribing and reinforcing the use of proper interdental aids was considered as the ideal treatment option. It was also observed that about half of the dentists always communicated inadequate information of the FPD prostheses that needed replacement to the dental laboratory technician for the successive bridge. Most of the times, prosthodontists were consulted to rectify the problem of food impaction resulting from faulty FPD prostheses. However, it is obvious that it is easier and more prudent to prevent rather than treat food impaction. This study gives an overview of some of the common errors in designing the FPD prostheses which often lead to food impaction and measures to be taken to overcome them. CONCLUSION: It may be concluded as all the dentists participating in the survey agreed that food impaction is one of the common complaint among FPD Patients. Proximal caries and interdental bone loss were the prevalent outcomes of food impaction. Faulty FPD design was allegedly attributed as the reason for food impaction. Prosthodontists were routinely consulted to resolve the dilemma of food impaction. However, it is rational to prevent food impaction rather than to tackle the sequel later.

Perception of Dental Public Health Competency among recent graduates.

AIMS AND OBJECTIVES: This study aimed to assess how competent the recent dental graduates perceive themselves to be in Dental Public Health. MATERIALS AND METHODS: A 21-item structured, close-ended questionnaire study was carried out at the KLEVK Institute of Dental Sciences, Belgaum, India. Students assessed their competencies using a three-point ordinal scale. One hundred and thirty-three students were asked to rate their proficiency on a 21-item matrix of the dental public health program. The responses were grouped using the Likert-type scale. Frequencies descriptive data were generated, and statistical analysis of examined variables was carried out using the Chi-square test. Mann-Whitney test was conducted to identify the correlation between variables. RESULTS: The overall mean score was 22.61 ± 10.94, highlighting confidence of the graduates in managing the oral health problems at the community level. Females showed higher competencies in functions related "to develop activities to motivate the community development," "to motivate health and oral health through health education," and "to motivate health and oral health through the creation of healthy settings." While males reported greater competency for the function "to adjust the dental practice to situations of restrictions that limits it." CONCLUSION: Recent dental graduates at the Institute perceived themselves competent in managing oral and dental health problems at the public level. Additional countrywide evidence regarding teaching and learning of public health dentistry is essential to compare the current experiences of dental graduates and ultimately enhance patient care.

Comment on "Evaluation of Manual and Two-Rotary NiTi Retreatment Systems in Removing Gutta-Percha Obturated with Two Root Canal Sealers".

Proper research design, appropriate evaluation and measurement methods, use of correct statistical tests, interpretation, and inference are the essentials without which any scientific research reporting is incomplete and does not serve its proposed purpose. In this communication, some common flaws in research designing, evaluation, analysis, and inference have been explained using a published article as a reference. The purpose of the paper is to help the scientific community recognize the significance of proper research designing and planning in order to achieve the results which are worthwhile.

Comment on "dental prosthetic status and prosthetic need of the institutionalized elderly living in geriatric homes in mangalore: a pilot study".

Public Health Dentistry is a speciality which is targeted towards the larger benefit of community and society. Dental health surveys in specific population groups should be planned adequately and the data should be analyzed in such a way so that it may help in making strategies for the intervention to improve the existing status. This could be only done with the help of proper planning, analysis and interpretation of a sample survey. The present study highlights the research design, statistical and inferential errors in a published work of public health dentistry in order to bring about the common mistakes and errors made. The renewed suggested approach helps in interpreting the results in a better way and makes them objective-oriented.

Comment on "Computed Tomography Evaluation of Craniomandibular Articulation in Class II Division 1 Malocclusion and Class I Normal Occlusion Subjects in North Indian Population".

Clear statement of objective, appropriate location of landmarks and removal of subjective bias in measurement is essential in all kinds of research, especially, orthodontics. The research design should be rationalistic, purposeful, and in accordance with the objectives of the study. In this communication, we highlight the errors in research design, measurement, analysis, and inferences drawn with the help of a published article as the primary source to explain these simple but useful points.