Development and validation of Tamil version of CARIES-QC questionnaire among socially marginalized school children in Chennai City.

BACKGROUND: The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), which was developed to assess dental caries-specific Child Oral Health Related Quality of Life (COHRQoL), has been translated into few world languages. AIM: To develop and validate the Tamil version of Caries Impacts and Experience Questionnaire for Children (CARIES-QC). DESIGN: This cross-sectional study was conducted among socially marginalized school children in Chennai City. The initial translation of the English CARIES-QC questionnaire to Tamil was made by two independent translators followed by an expert committee discussion to derive a prefinal version of the Tamil questionnaire. Subsequently, content validation was performed by bilingual subject experts followed by preliminary pilot testing among 30 school children aged 8-10 years studying in Adidravidar Welfare High School, Chennai, to produce the final version of the questionnaire. Convergent validity, discriminant validity, and test-retest reliability of the translated questionnaire were tested among 191 children. RESULTS: The content validation process revealed that the translated version had relevant questions and content coverage (Scale-wise Content Validity Index score = .91). The children with and without dental caries had mean CARIES-QC scores of 5.39 + 3.7 and 3.71 + 5.1, respectively, and their statistically significant difference (p-value = .04) between them indicates the scale's satisfactory discriminant validity. The Cronbach's alpha was .87 indicating the questionnaire's good internal consistency. CONCLUSION: The newly developed Tamil CARIES-QC questionnaire is a valid and reliable tool for assessing COHRQoL among Tamil-speaking school children.

Influence of tobacco chewing on oral health: A hospital-based cross-sectional study in Odisha.

BACKGROUND: Smokeless tobacco use in the Indian subcontinent is a part of many religious and cultural rituals and has gained a degree of social acceptance. The deleterious effects of smokeless tobacco are not as well-known as those produced by smoking. OBJECTIVES: The study was carried out to assess the influence of tobacco chewing on the oral health of adult patients attending the dental outpatients department of Khordha district headquarter, Odisha. METHODS: A hospital-based cross-sectional study was conducted among 25-64-year-old patients attending the dental outpatient department of Gopabandhu Khordha district headquarter hospital. A total of 512 study participants, who were age and sex matched, were stratified into four age groups such as 25-34 years, 35-44 years, 45-54 years, and 55-64 years old. Oral health status of the participants was assessed using modified WHO Oral Health Assessment Form (2013). Pearson's Chi-square test, binary and multinomial logistic regression was performed to determine the relationship between oral health problems and tobacco chewing. RESULTS: Among the tobacco chewers, 59.8% had gingival bleeding, 40.6% had periodontal pockets, 30.1% had loss of attachment, 48.4% had attrition, and 4.3% had potentially malignant disorders. Compared to the nonchewers, these oral problems were significantly higher among the chewers. Whereas dental caries experience was significantly lower among the chewers (40.6%) compared to the nonchewers (54.7%). Compared to the nonchewers, chewers had 1.71 times increased odds for gingival bleeding, 1.71 times increased odds for periodontal pockets, 2.39 times increased odds for loss of attachment, and 2.49 times increased odds for attrition, which were statistically significant. CONCLUSION: Hence, the study revealed that tobacco chewing definitely had an influence on oral health, with statistically significant increase in oral health problems in chewers compared to nonchewers. Moreover, loss of attachment and potentially malignant disorders increased significantly with the frequency of tobacco chewing. Periodontal pockets, attrition, and loss of attachment significantly increased with the duration of the chewing habit.

Oral Health Behaviour and its Influence on Oral Health Status and Related Quality of Life among Dental Outpatients - A Cross-Sectional Study.

OBJECTIVES: This study aimed to predict oral health behaviour (OHB) using the theory of planned behaviour (TPB) and determine its influence on oral health status and oral health-related quality of life (OHRQoL) among subjects attending the outpatient department of a tertiary dental hospital in India. METHODS: A pre-validated questionnaire was used among 240 randomly selected study subjects to record their demographic details, attitudes (Att), subjective norms (SN) and perceived behaviour control (PBC) with regard to dietary habits (DH), oral hygiene habits (OH) and dental attendance (DA) behaviours. OHRQoL and oral health status of study participants were recorded using Oral Health Impact Profile-14 (OHIP-14) and World Health Organization (WHO) Oral Health Assessment Form (2013), respectively. Multivariate analysis was performed after the necessary bivariate comparisons. RESULTS: Among demographic characteristics, the Socioeconomic status (SES) of the study subjects highly influenced their DH and OH (P < 0.05). DA was largely affected by the age of the study subjects (P < 0.05). While attitude of the study participants greatly affected their DH, PBC largely influenced their OH and DA behaviours (P < 0.05). The OHRQoL and Decayed Missing Filled Teeth (DMFT) levels were strongly influenced by the participants' DA behaviours (P < 0.05). CONCLUSIONS: DMFT scores and OHRQoL were highly influenced by DA behaviour besides others. DA instead was influenced by PBC. Hence, there needs to be a conscious shift towards strengthening the skills of the population to promote oral health.

Effect of frequent exposures of various indigenous sugars on cariogenicity of a biofilm caries model.

AIM: The aim of this study was to assess and compare the cariogenicity of indigenous sugars (palm sugar, jaggery, and brown sugar) and refined sugar at different frequencies of exposure through a biofilm caries model. METHODOLOGY: This in vitro study was conducted on 60 extracted human premolar teeth which were randomly divided into four groups (refined sugar, jaggery, palm sugar, and brown sugar) with each group being exposed to their respective sugars at one, three, and five frequencies for 5 min at defined time periods with five sample teeth for each exposure (4 × 3 × 5 = 60). The acidogenicity of biofilm was found by a 5-day pH cycling model. After 5 days, enamel demineralization, protein content, and polysaccharide formation of the biofilm following exposure to various sugars at various frequencies were assessed and compared. Statistical analyses were done using a one-way analysis of variance for intergroup comparisons between various sugars at various levels of frequencies. RESULTS: The enamel demineralization was found to be least in palm sugar with mean percentage surface hardness loss of 8%, 17%, and 25% at one, three, and five frequencies of exposures and this was found to be statistically significant compared to other sugars (P < 0.001). The acidogenicity of biofilm increased with an increase in the frequency of exposures, but none of the indigenous sugars had a drop below 5.5 (critical pH) at a single frequency of exposure indicating less acid production at minimal exposure. The protein content of the biofilm exposed to palm sugar was less on comparison with other sugars and it was found to be statistically significant (P < 0.001). The polysaccharide formation of all sugars was similar at each frequency of exposure and was statistically nonsignificant. CONCLUSION: From the results obtained, it was concluded that though cariogenicity increased in all sugars with an increase in frequency of exposure, the level of cariogenicity was least in palm sugar compared to other sugars used in the study. Hence, it is recommended to use palm sugar as an alternative to refined sugar.

Association between ABO, Rh blood groups, lip and dermatoglyphic patterns, and nonsyndromic oral clefts: A case-control study.

OBJECTIVE: The objective of the study is to determine the association between nonsyndromic oral clefts (OC) in children and ABO, Rh blood groups, lip, and dermatoglyphic patterns of their unaffected parents. METHODS: This case-control study was conducted at a tertiary cleft center in Chennai, India, among 240 individuals comprising 80 units (40 cases and controls, respectively). Each unit (triad) was constituted by a child (0-12 years of age) either born with nonsyndromic OC (cases) or with no diagnosed congenital anomaly (control) and their unaffected parents (mother and father). ABO and Rh blood groups, specific lip print, fingerprint pattern, and palmar asymmetry were recorded for each individual. Strength of association of related factors was assessed by multivariable logistic regression reported as adjusted odds ratios and 95% confidence interval. RESULTS: A1-positive blood group was found to be considerably higher among case mothers (14.39 [1.57-32.27]). A higher odds of OCs were observed among case mothers with whorl lip pattern (1.51 [1.16-3.17]) and radial loop pattern in fingers (1.44 [1.09-2.31]) relative to controls. In addition, palmar asymmetry was distinctively higher among case parents compared to controls (P < 0.01). CONCLUSION: Findings indicate that A1-positive blood group, higher frequency of whorl lip, and radial loop finger patterns in mothers and higher ulnar loop pattern in fathers and palmar asymmetry in both parents increases odds of occurrence of OC among their offspring. These identifiable traits offer potential scope for better service planning among resource-constrained disadvantaged communities in India.

Efficacy of a mouthwash containing essential oils and curcumin as an adjunct to nonsurgical periodontal therapy among rheumatoid arthritis patients with chronic periodontitis: A randomized controlled trial.

PURPOSE: The purpose of this study was to assess the efficacy of mouthwash containing essential oils and curcumin (MEC) as an adjunct to nonsurgical periodontal therapy on the disease activity of rheumatoid arthritis (RA) among RA patients with chronic periodontitis (CP). MATERIALS AND METHODS: A triple-blinded controlled trial was conducted among 45 female RA patients with CP randomized into three treatment groups as follows: Group A: scaling and root planing (SRP) with 0.2% chlorhexidine mouthwash as an adjunct (n = 15), Group B: SRP with MEC as an adjunct (n = 15), and Group C: SRP alone (n = 15). RA disease activity was assessed using erythrocyte sedimentation rate, serum C-reactive protein, serum anti-citrullinated protein antibody, and serum rheumatoid factor. Periodontal disease activity was assessed using plaque index, clinical attachment level (CAL), and pocket depth (PD). All parameters were recorded at baseline and 6 weeks thereafter. Data were assessed using one-way ANOVA and paired t-test. RESULTS: A significant reduction in periodontal and RA disease activity parameters was observed from baseline to 6 weeks following intervention (P < 0.05). The highest percentage of mean reduction in plaque index and RA parameters from baseline to 6 weeks was observed in Group B followed by Groups A and C. The highest percentage of mean reduction in PD and CAL was observed in Group A followed by Groups B and C (P < 0.001). CONCLUSION: This study reveals that MEC as an adjunct to SRP is effective in reducing the disease activity of RA and CP, thereby warranting the use of the same.

Tobacco control in India.

Portuguese introduced tobacco to India 400 years ago. Ever since, Indians have used tobacco in various forms. Sixty five per cent of all men and 33% of all women use tobacco in some form. Tobacco causes over 20 categories of fatal and disabling diseases including oral cancer. By 2020 it is predicted that tobacco will account for 13% of all deaths in India. A major step has to be taken to control what the World Health Organization, has labeled a 'smoking epidemic' in developing countries. India's anti-tobacco legislation, first passed in 1975, was largely limited to health warnings and proved to be insufficient. A new piece of national legislation, proposed in 2001, represents an advance including banning smoking in public places, advertising and forbidding sale of tobacco to minors. Preventing the use of tobacco in various forms as well as treating nicotine addiction is the major concern of dentists and physicians. The dental encounter probably constitutes a "teachable moment" when the patient is receptive to counseling about life- style issues. Both policy makers and health professionals must work together for achieving a smoke free society for our coming generations.

Road blocks perceived by the dentists toward the treatment of early childhood caries in Chennai city - A cross-sectional study.

BACKGROUND: The problem of early childhood caries remains a worldwide public concern, as most of the caries remains untreated. Despite advances in dental care, most children fail to benefit from oral health-care services not only due to differences in attitudes in parents but also in oral health-care providers. OBJECTIVES: The objective of the study is to determine the road blocks perceived by the dentist in Chennai, toward the treatment of early childhood caries. METHODS: Following a simple random sampling technique, a cross-sectional questionnaire study was conducted among general dentists (n = 50) and pediatric dentists (n = 50) in Chennai city. Each selected dentist was asked to complete the Barriers to Childhood Caries Treatment (BaCCT) questionnaire: a 29-item measure considering child, parent, dentist, and healthcare system factors. RESULTS: The mean BaCCT score was found to be significantly higher among general dentists 2.68 ± 0.36 when compared to pediatric dentists 2.36 ± 0.45 (P = 0.0001). Similarly, mean BaCCT score was found to be significantly higher among general dentists in Domain-I (child coping abilities), Domain-II (dentist attitudes toward offering restorative treatment), and Domain-III (dentist attitudes toward restoring primary teeth) when compared to the pediatric dentists (P < 0.001). CONCLUSIONS: The general dentists exhibited inherent barriers in providing treatment for early childhood caries compared to pediatric dentists. Training in the field of pediatric dentistry enhances their ability to handle early child caries better.

Caries risk assessment among 12-13 year old school-going children of government and private schools of Tirupur district, Tamil Nadu.

BACKGROUND: Dental caries is as ancient as humankind and has the longest association with the dental profession, an association that is punctuated with agony and ecstasy. The agonizing fact is that despite several efforts toward total eradication, this disease is still prevalent. Nevertheless, an ecstatic success of the profession is the global decline in the incidence compared to the yesteryears' epidemics. Hence, predicting dental caries earlier is a boon. One such model to predict is cariogram developed by Bratthall in 1996. AIM: The aim of this study was to assess the caries risk among 12-13 year old school-going children of government and private schools of Tirupur district in Tamil Nadu using cariogram computer model. METHODS: A cross-sectional survey was carried out among 136 study subjects of 12-13 year of age, who fulfilled the inclusion and exclusion criteria. Data were collected using a predesigned questionnaire and scored according to a standardized protocol. The Chi-square test was used to find differences between caries-related factors and cariogram group. The correlation was acquired using Spearman's correlation. RESULTS: Government school study subjects had 56% of chance of avoiding caries whereas the private school study subjects had 66% of chance of avoiding caries in future and the differences were statistically significant (P = 0.001). A negative correlation was observed between the chance to avoid dental caries and cariogram sectors. CONCLUSION: The majority of the study subjects from government school belonged to medium-risk category and private school subjects belonged to low-risk category which inferred that private school students have high chance to avoid dental caries compared to government study subjects.