Modified extrinsic tooth stain index and its clinical applicability.

Aim: The first index for the assessment of extrinsic stain was published by Lobene in 1986. Using the Lobene stain index in the field is very cumbersome as well it does not meet the general requirement of an index, i.e., the index is to be simple, rapid, highly reproducible, and sensitive enough to detect small changes in the staining level. Hence, there was a need to develop an alternative index for the same purpose. Hence, the only present study was undertaken to propose a modified stain index with more simplicity and clarity. Materials and Methods: An observational study was carried out among 16-44-year-old participants who had at least six natural teeth and were generally healthy. For the revised index, the criteria and codes for intensity were kept the same as MacPherson Index but the criteria for recording area were modified. The data scoring for each tooth was mentioned in the proposed table and was recorded for each of the surfaces according to the proposed area and intensity codes. Analysis was carried out using SPSS version 21 (IBM, Inc. Virginia, United States). Inferential statistics were performed using the Mann-Whitney U-test. Nonparametric tests were applied following the imposition of a numerical interval scale the same as the Lobene index. Results: No statistically significant difference was appreciated for the area, intensity, and product of area × intensity when compared for measurements recorded by two indices as P > 0.05. Hence, validating the proposed index for the clinical application. Conclusion: The proposed modified index may be advantageous over its conventional counterpart due to its ease of recording and concise scoring and also less complexity in the area to be recorded.

Knowledge and Acceptance of the COVID-19 Vaccine for COVID-19 Disease Prevention among the Indian Population: A Mixed-Method Study.

Aim: To assess the Knowledge and Acceptance of the COVID vaccine among the Indian population. Materials and methods: The present mixed-method study was conducted in two phases. The first phase: quantitative assessment of knowledge and acceptance for the COVID-19 vaccine using an E survey (N = 606). The second phase: qualitative assessment using semi-structured face-to-face interviews with the study participants (N = 30) and assessment was done using a thematic approach. Study participants were selected using the convenience sampling method. Results: It was found that a large proportion of subjects in the 16−25 year of age group knew the cause of disease. But knowledge about its transmission process was found to be more in >60 years of age gap and almost all the participants in all the age group preferred Covishield. The vaccine acceptance rate was found to be low as compared to the knowledge. Conclusion: Most study participants were found to have satisfactory knowledge, but acceptance rate was comparatively lesser. Hence, more information and awareness campaigns must be launched reassuring the population about vaccine safety.

Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review.

This systematic review's objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci's classification system (n-16) and the four-digit system (n-6).

Knowledge, Attitude, Practices, and Preparedness of Dental Professionals in Prescribing Nicotine Replacement Therapy.

OBJECTIVE: To assess the knowledge, practice, attitude, and preparedness of dental professionals in prescribing nicotine replacement therapy (NRT). Methodology. A prevalidated voluntary web-based questionnaire was generated as a link through Google Drive and was sent to 117 dental professionals in North India using Whatsapp, Messenger, and Instagram social media platforms. A total of 94 responses were received and out of which 76 responses were analyzed (18 forms were excluded due to incomplete or duplicate responses). Frequency analysis was done using SPSS software version 21. RESULT: The participation rate was found to be 80.3%. More than half of the study population were familiar with the term NRT (77.6%) and its uses (67.1%), but approximately less than half of the total study subjects knew the duration (32.9%), cost (27.6%), dosage (25%), and contraindications (36.8%) of the NRT. Approximately 56.6% of the study participants showed a positive attitude towards helping patients to quit smoking through tobacco cessation counseling. Nearly one-fourth of the study population, i.e., 27.6%, were confident in explaining the negative impacts of tobacco, while 22.4% knew about the tobacco cessation protocol. Among the participants, only 27.6% reported that they practice NRT and out of which approximately less than 20% of the study participants were prescribing correct dose of NRT. CONCLUSION: Though study subjects had an ample knowledge regarding NRT use in tobacco cessation, it does not reflect their current attitude and preparedness. Thus, there is a need for continuing education to further train dental professionals for prescribing NRT.

Extensive Evaluation of the Overall Workplace Experience and Job Satisfaction of Dentists in Saudi Arabia.

BACKGROUND: Working conditions, job satisfaction, and their overall impact on a dentist's job satisfaction are critical for future employment and retaining of dentists. OBJECTIVES: This study is aimed at determining the factors influencing the job satisfaction level among dentists. It is also aimed at evaluating how personal (age, gender) and professional (type, type of qualification, and year of practice) characteristics influence overall job satisfaction. METHODS: For data collection, a structured self-administered questionnaire was used, in which one part collected information on personal characteristics. At the same time, the other contained a questionnaire related to job satisfaction. The German validated version of the questionnaire had a 10-point Warr-Cook-Wall (WCW) scale developed by Warr et al. in 1979. Each item was rated on a 5-point Likert scale, with 5 representing excessive satisfaction and 1 representing extreme dissatisfaction. RESULTS: The results revealed that dentists in Saudi Arabia have a higher satisfaction level with "colleagues and fellow workers" (26.5%). The relation between the years of practice was highly significant. However, they were dissatisfied with their "income" (22.6%), and when compared with concerning age, gender, profession, and their practice years, this finding was highly significant. CONCLUSION: A higher percentage of satisfaction was seen with the "fellow and colleague's workers" dimension. At the same time, "income" was the aspect with which the dentists showed extreme dissatisfaction.

Smoking Rationalisation, Tobacco Dependence and Intention to Quit Among Indian Adults and Adolescents.

Introduction: Unfortunately, indicators of tobacco dependence are present even after low levels of exposure in young smokers. Early emergence of these signal risk for subsequent chronic smoking and nicotine dependence is negatively associated with cessation in young adults. One important yet understudied modifiable predictor of intention to quit among smokers is smoking rationalization. Smokers often subscribe to smoking rationalisation beliefs, also known as self-exempting beliefs, to justify or rationalize their smoking behaviors. Smoking rationalizations can predict a lack of intention to quit. Objective: To assess the correlation between smoking rationalisation, tobacco dependence and intention to quit among Indian adults and adults. Methodology: A cross-sectional pilot study was carried out among 18-60-year-old subjects. Data were collected for tobacco dependence, smoking rationalisation and intention to quit (no/yes) by structured interview. Data were analysed using IBM SPSS statistics for windows, version 16 (IBM Corp, Armork, NY.) The independent t-test and one way ANOVA and binary logistic regression were performed for inferential statistics. Results: Smokers with no intention to quit and high tobacco dependence scores had significantly higher smoking rationalisation than those to quit and low dependence scores. Logistic regression models demonstrated that all types of rationalisation beliefs were consistently inversely associated with the intention to quit and low tobacco dependence. Conclusion: Findings suggest that smoking rationalisation plays an important role in the lack of intention to quit among Indian smokers. Future interventions should tackle smoking rationalisation beliefs as a strategy to promote smoking cessation.

Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases.

Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.

Association of sense of coherence with oral health behaviors and gingival bleeding among adolescents.

CONTEXT: Adolescents experience many types of gingival and periodontal diseases, including gingivitis, localized or generalized aggressive periodontitis, and periodontal complications of various systemic diseases. The occurrence of periodontal diseases is not only related to biotic factors but may also be affected by nonbiotic factors such as oral health behaviors and practices. Various factors that influence an individual's health-related behaviors include a psychosocial construct named sense of coherence (SOC). AIM: The aim of this study is to investigate the association of SOC with oral health behaviors and gingival bleeding. SETTINGS AND DESIGN: This was a cross-sectional, analytical study that was done in the school setting. MATERIALS AND METHODS: A random sample of 850 adolescents was selected from nine schools of the Faridabad block of Faridabad district (Haryana) through the multistage cluster sampling technique. Methods of data collection included a combination of questionnaire administration and clinical examination. The questionnaire comprised sociodemographic variables, questions related to oral health behaviors, and Antonovsky's SOC scale. The questionnaire was interviewer administered. STATISTICAL ANALYSIS: Unadjusted and adjusted rate ratios of gingival units having bleeding on probing were estimated by Poisson regression multilevel analysis in Statistical Package for the Social Sciences (SPSS) software for Microsoft Office. RESULTS: Adolescents whose mothers had studied <8 years (relative risk [RR] 1.26; 95% confidence interval [CI] 1.04-1.38), who were males (RR 1.198; 95% CI 1.01-1.29), low SOC (RR 15.93; 95% CI 13.06-19.35), and toothbrushing frequency of less than once a day (RR 1.43; 95% CI 1.21-1.67) and children with plaque index >1 (RR 2.765; 95% CI 2.12-3.25) presented with the higher number of gingival units having bleeding. CONCLUSION: SOC is associated with gingival bleeding through oral health behaviors.

Comparative assessment of low-level laser therapy (LLLT) vs. topical application of amlexanox + lidocaine to treat recurrent aphthous ulcers (RAUs): A randomized controlled trial.

Background. The present study aimed to assess and compare the pain perception and ulcer sizes before and after applying low-level laser therapy (LLLT) and Amlexanox + lidocaine. Methods. Twenty-six patients referring to the out-patient department of the institution and diagnosed with recurrent aphthous ulcers (RAU) were assigned to two groups to receive either LLLT or Amlexanox + lidocaine. In group 1, the patients were provided with amlexanox + lidocaine to apply topically four times daily. In group 2, the patients underwent LLLT with no tissue contact in inward circular motions for two cycles for 30 seconds. This study was registered in "the Clinical Trials Registry- India" (CTRI), with the registration number CTRI/2019/09/028222. The data were analyzed with SPSS 16. Results. The intergroup comparison was performed using Mann-Whitney U test, and intragroup comparisons were made using Wilcoxon's signed-rank test. The level of significance was set at P <0.05. The results showed that pain perception and ulcer size were significantly lower in group 2 subjects than group 1 subjects (P <0.05). Conclusion. LLLT was more effective than amlexanox + lidocaine in the management of RAU. It is a cost-effective therapy for treating RAU.

Comparative Efficacy of Cow Milk, KNO3, and Warm Saline Rinses in Treating Dentin Hypersensitivity Following Nonsurgical Periodontal Treatment: A Randomized Controlled Trial.

AIM: This study aimed to assess the desensitizing efficacy of commercially available cow milk compared to potassium nitrate (KNO3) mouthwash and warm saline rinses after nonsurgical periodontal treatment. MATERIALS AND METHODS: A randomized controlled trial was conducted in the Department of Public Health Dentistry of a dental college from August 21, 2018 to September 10, 2018. A total of 75 patients who reported hypersensitivity after scaling and root planing (SRP) were recruited and randomly assigned into three groups: cow milk (I), KNO3 mouthwash (II), and warm saline rinses (III). Dentine hypersensitivity (DH) was assessed at six time points using the verbal rating scale (VRS) for thermal stimuli and visual analog scale (VAS) for air blast and thermal stimuli. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY). Mean reduction in DH in each group was measured using non-parametric tests. RESULTS: Patients in all the three groups were found to be comparable with respect to baseline characteristics. Mean reduction in VRS and VAS scores for DH in milk and KNO3 mouthwash was found to be significantly high as compared to warm saline rinses group. CONCLUSION: From the results, cow milk was found to be equivalent in efficacy as compared with KNO3 mouthwash but superior to warm saline rinses in treating DH post-SRP.

Oral health indicators of oral health related quality of life among Indian elderly: A cross-sectional study.

AIM: To assess the impact of tooth loss and periodontal status on oral health related quality of life among Indian elderly. METHODOLOGY: This study was a cross-sectional study conducted among 1200 elderly subjects of Faridabad district of Haryana. Study subjects were selected by a combination of systematic, cluster and multistage sampling techniques. The data were collected through a clinical oral examination for tooth loss and periodontal status assessment (WHO Oral Health Survey 2013) and a self-administered questionnaire to assess the OHRQoL. Dental behaviours such as dental visiting patterns, tobacco chewing habits and oral hygiene practices were also recorded. RESULTS: In bivariate analysis significant associations were found among age, gender, education, tooth mobility and Oral health related quality of life (OHRQoL). Multivariate logistic regression showed significant impact of number of missing teeth and mobility on OHRQoL (P < 0.05). CONCLUSION: The conclusions derived from this study are of considerable importance for Indian policy makers in their work with planning and implementing public oral health strategies for geriatric population.

Gender-wise comparison of oral health-related quality of life and its relationship with periodontal status among the Indian elderly.

AIM: The aim of this study is to assess if there are any gender differences in oral health-related quality of life (OHRQoL) and periodontal status among the elderly population of Haryana. MATERIALS AND METHODS: A cross-sectional study was conducted among 1200 geriatric population of Faridabad district of Haryana. Subjects were selected by a combination of systematic, cluster, and multistage sampling techniques. Primary, secondary, and tertiary sampling units were chosen as wards, areas, and households, respectively. SELF-ADMINISTERED QUESTIONNAIRE: Geriatric oral health assessment index was used to assess the OHRQoL among males and females. Periodontal status was assessed using the World Health Organization oral health survey pro forma with some modifications. RESULTS: Results were analyzed using the Statistical Package for the Social Sciences 21 software. Gender-wise association of periodontal status with OHRQoL revealed a significant association with mobile teeth (P < 0.05). No relation was seen between OHRQoL, gingival bleeding, periodontal pocket, and loss of attachment (P > 0.05). CONCLUSION: No significant differences were observed in periodontal status among males and females, but OHRQoL was found to be better among males than females. Indian policymakers can use the conclusion derived from this study for planning and implementing public oral health strategies for the geriatric population.

Assessment of Oral Health Related Quality of Life Among the Institutionalised Elderly in Delhi, India.

PURPOSE: To assess the oral health related quality of life (OHRQoL) among older people residing in old-age homes in Delhi, India. MATERIALS AND METHODS: Oral health related quality of life was measured by using the Hindi version of Geriatric Oral Health Assessment Index (GOHAI) which was tested for its reliability and validity. Sociodemographic data were collected and questions regarding the self-perception of general health, oral health and perceived need for dental treatment were put forward. Clinical assessment was also performed. RESULTS: The mean additive-GOHAI score of the study population was found to be 41.57 ± 6.07. Statistically significant associations were found between GOHAI and perceived measures. GOHAI scores decreased with a decrease in the number of teeth present and a decrease in the number of teeth having coronal and root caries. Those subjects who were in need of multi-unit prostheses or full prostheses had significantly poorer OHRQoL compared to those without any prosthetic need or need of single-unit prostheses. CONCLUSION: This study revealed the extent of dental problems in old-age home residents and may help to plan appropriate preventive measures.

Efficacy of Chlorhexidine, Xylitol, and Chlorhexidine + Xylitol against Dental Plaque, Gingivitis, and Salivary Streptococcus mutans Load: A Randomised Controlled Trial.

PURPOSE: To compare the antiplaque, antigingivitis and antibacterial efficacy of chlorhexidine (CHX), XYL and a mouthwash combining CHX and XYL against Streptococcus mutans (S. mutans). MATERIALS AND METHODS: A parallel design, randomised controlled trial was conducted among 75 dental students. Participants were randomised into CHX, CHX+XYL and XYL-only groups using the lottery method. Subjects were instructed to use 10 ml of the provided mouthwash for 15 s twice daily for 3 weeks. All the outcome measures, gingival index (GI), plaque index (PI) and number of salivary S. mutans CFU were recorded at baseline and 3 weeks post intervention. Nonparametric tests were used for inferential statistics. RESULTS: All outcome variables (GI, PI scores and log10 salivary S. mutans counts) decreased significantly from baseline compared to post intervention among all three groups. Intergroup comparison demonstrated that reduction in GI was not significantly different among the three groups. The decrease in PI scores was found to be significantly higher in the XYL group, while the decrease in the log10 salivary S. mutans count was significantly higher in the CHX+XYL group. CONCLUSION: The present study provided sufficient data to suggest that all the three mouthwashes are effective against plaque, gingivitis and S. mutans load in saliva. Further investigations should be carried out to confirm the results and develop strategies for using such products to prevent tooth decay.

Periodontal status and oral health-related quality of life in elderly residents of aged care homes in Delhi.

AIM: The aim of the present study was to explore the associations between clinical periodontal findings and oral health-related quality of life in elderly people residing in the aged care homes of Delhi, India. METHODS: A cross-sectional study was carried out among 500 residents of aged care homes across Delhi. Data were collected by carrying out clinical oral examinations and by filling a self-administered questionnaire. Oral health-related quality of life was assessed by a pretested Hindi version of the Geriatric Oral Health Assessment Index (GOHAI-Hi). Periodontal status was assessed using the Community Periodontal Index - CPI, and loss of attachment and tooth mobility was assessed using a modified Miller's index. RESULTS: Of a total of 500 participants, 221 (44.20%) were men and 279 (55.80%) were women The mean additive score GOHAI score was 41.57 ± 6.07 and the mean number of negative impacts or mean simple count GOHAI score was 6.27 ± 1.54. Mean GOHAI scores were significantly higher among men than women, and were found to be decreasing continuously with the increasing age categories. Tooth mobility and loss of attachment scores were found to be significantly associated with oral health-related quality of life, whereas Community Periodontal Index scores showed a negative correlation with it. CONCLUSION: The geriatric population, especially those in aged care homes, is a special need group because of their inability to access dental care rather than some particular feature of their oral or general health The findings of the present study point to a need to improve access to oral healthcare for this elderly population.

Cross sectional survey on association between alcohol, betel- nut, cigarette consumption and health promoting behavior of industrial workers in Ghaziabad.

BACKGROUND: The work force in industries are at risk of developing unduly high rates of health and behaviour related problems including abuse of alcohol, betel nut and cigarette (alcohol, betel nut and cigarette consumption). This study describes the relationships between alcohol, betel nut and cigarette consumption and health promoting behaviour among industrial workers. MATERIALS AND METHODS: A cross sectional survey was conducted on workers in various industries of Ghaziabad city with concerned authority permission. A sample size of 732 workers was calculated based on pilot study. Through Simple random sampling 732 workers in 20 to 50 years age group with informed consent were interviewed through structured, pretested, validated questionnaire in vernacular language by one calibrated investigator. Data on socio demography, alcohol, betel nut and cigarette consumption pattern and health behaviour were collected. The association between health promoting behaviour and alcohol, betel nut and cigarette consumption was analysed by Logistic regression and Chi-square test through SPSS 16 at p<0.05 and 95%CI as significant. RESULTS: Total prevalence of alcohol, betel nut and cigarette consumption in study population was 88%. The prevalence of individual alcohol, betel nut and cigarette consumption were 82%, 68% and 79% respectively. Combined alcohol, betel nut and cigarette prevalence in study population was 58%. Alcohol and cigarette users were significantly higher (p<0.001) in 30 to 40 years age group with lower level of education having poor attitude towards health promoting behaviour, poor oral hygiene practices and rare indulgence in regular physical exercise. CONCLUSIONS: This study stimulate further research on exploring methods to prevent initiation of health risk behaviour and promote healthy behaviour with cessation help for the current alcohol, betel nut and cigarette users.

Knowledge and attitude of Indian clinical dental students towards the dental treatment of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS).

OBJECTIVES: Oral health care of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS) is a growing area of concern. Information on HIV- and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS. The purpose of this study was to assess the knowledge and attitude of Indian clinical dental students towards the treatment of patients with HIV/AIDS and perceived sources of information regarding HIV-related issues. MATERIALS AND METHODS: Data were collected from clinical dental students (third year, fourth year and internship) from three dental institutions in Delhi National Capital Region (NCR). The questions assessed the knowledge and attitude towards treatment of patients with HIV and the perceived source of information related to HIV. RESULTS: The willingness to treat HIV-positive patients among dental students was 67.0%, and 74.20% were confident of treating a patient with HIV/AIDS. The potential problems in rendering treatment to these patients were effect on the attitude of other patients (49.90%) and staff fears (52.50%). The correct knowledge regarding the infection-control practice (barrier technique) was found among only 15.50% of respondents. The respondents had sufficient knowledge regarding the oral manifestations of HIV/AIDS. CONCLUSIONS: There was no correlation between the knowledge and attitude score, demonstrating a gap between knowledge and attitude among dental students regarding treatment of HIV-infected patients. Appropriate knowledge has to be delivered through the dental education curriculum, which can instil confidence in students about their ability to manage HIV-positive patients.

Usage of betel quid, areca nut, tobacco, alcohol and level of awareness towards their adverse effects on health in a north Indian rural population.

AIM: To assess the overall prevalence of betel quid, areca nut, tobacco and alcohol use in the rural population of Muradnagar tehsil of Ghaziabad district and their awareness level towards adverse effects of these habits on general as well as oral health. METHODS: A total of 422 persons from 63 households of four (4) villages were enrolled for the participation in the study. A preformed, pretested questionnaire was used to collect the information on prevalence of risk behaviours of chewing tobacco, areca nut, betel quid, smoking and alcohol consumption. RESULTS: 72.5% of respondents reported indulgence in one or more habits of chewing areca nut, betel quid, tobacco, smoking and alcohol consumption. Smoking tobacco was the most common type of adverse habit in males while chewing tobacco in females. 26% of respondents believed that the community residents would quit the habit only if they personally experience any health problem due to the habit. CONCLUSION: In spite of being aware of risk of having multiple health problems, a major proportion of respondents were using betel quid, areca nut, tobacco and alcohol.

Tobacco consumption among 12- to 15-year-old schoolchildren in Delhi.

OBJECTIVE: This study aims to assess the knowledge, attitude, and practice of tobacco use and its cessation among children in schools of Delhi. METHODS: A cross-sectional study involving 1094 schoolchildren (577 boys and 517 girls), 12-15 years old, was conducted using the modified Global Youth Tobacco Survey questionnaire. Mann-Whitney U-test and Kruskal-Wallis test were applied (p<0.05). RESULTS: Among these, 132 boys (22.87%) and 120 girls (23.21%) were smokers. "Ever smokers" were 13.80% and "current smokers" were 9.23%, whereas 76.97% were "never smokers". CONCLUSION: Interventions that raise awareness at a young age, equip students to overcome peer influence, and provide counseling to quit using tobacco need to be designed.

Exposure to high-fluoride drinking water and risk of dental caries and dental fluorosis in Haryana, India.

The present study aimed to determine the prevalence of and relationship between dental caries and dental fluorosis at varying levels of fluoride in drinking water. The study was conducted among 3007 school children in the age group of 12 to 16 years in 2 districts of Haryana having varying fluoride levels in drinking water. Type III examination for dental caries according to the WHO index and dental fluorosis estimation according to Dean's index was done. The prevalence of dental caries decreased from 48.02% to 28.07% as fluoride levels increased from 0.5 to 1.13 ppm, but as the fluoride level increased further to 1.51 ppm, there was no further reduction in caries prevalence, but there was a substantial increase in fluorosis prevalence. The optimum level of fluoride in drinking water was found to be 1.13 ppm, at which there was maximum caries reduction with minimum amount of esthetically objectionable fluorosis.