Orofacial manifestations of child maltreatment: A review.

The recognition and reporting of child abuse and neglect continues to be a challenge in the healthcare setting. All healthcare providers, including dentists, should be aware of the high prevalence of orofacial injuries and conditions that are concerning for abuse and neglect. Sentinel injuries may appear trivial and do not require medical attention, but are unlikely caused by accidental mechanisms and, if not properly identified, often precede more severe abusive injuries. Concerning orofacial findings can manifest as bruising, eye injuries, intraoral injuries, pharyngeal perforations, facial bone fractures, and sexually transmitted infections. Abusive caregivers are likely to give inadequate explanations or no history at all to explain concerning findings. Medical providers' failure to make mandated reports about their concerns to the appropriate agencies can have significant long-term impacts on the physical and psychological well-being of children.

British Society of Paediatric Dentistry: A policy document on dental neglect in children.

The British Society of Paediatric Dentistry's (BSPD) first policy document on dental neglect was published online in 2009. It proposed a new original definition of dental neglect, discussed the identification of dental neglect and recommended adopting a tiered response, with three stages of intervention according to level of concern. Furthermore, it detailed how the dental team should both contribute to the child protection process and implement wider measures to safeguard and promote children's welfare. Since 2009, these concepts have been widely adopted in the UK and beyond. Furthermore, there have been significant advances in both research and practice. Policy documents produced by the BSPD represent a majority view, based on the consideration of currently available evidence, and are tailored to a UK working environment. Although this updated document's recommendations remain broadly unchanged, this version reflects the professions' progress in understanding dental neglect and minor updates to terminology and, following a consultation process, has been amended to address the needs of two main audiences-dental professionals and nondental health and social care professionals-in order to enhance interdisciplinary working.

Exposure to screen time and dental neglect.

AIM: Dental neglect is the failure of parents to meet a child's basic oral health needs and causes complications. Long screen time, and its health impact, is an important public health issue. This study is aimed at determining whether there is a relationship between screen time of children and parents and dental neglect. METHODS: Two hundred and fifteen patients were included in this cross-sectional observational study. A questionnaire including questions exploring demographic data, children's life-styles and, screen time of both parents and children. A dental neglect scale was administered to the parents. The children's intraoral examinations were evaluated using the decayed, missing, filled teeth (dmft) and pulp, ulcers, fistula, abscess (pufa) indices. RESULTS: Multivariable linear regression analysis showed that dental neglect was statistically significantly associated with brushing teeth unsupervised and infrequently, frequent snacking, rarely doing exercise, screen exposure at an early age and presence of dental plaque (P < 0.05). Long screen time was statistically significantly associated with high dmft scores, reflecting poor oral health. It was found that children who did not attend daycare, had statistically significantly longer exposure to screens, compared to those who attended daycare. CONCLUSIONS: Early exposure to screens and long-term screen use are associated with adverse outcomes pertaining to children's oral health.

Dento-facial infections in children - A potential red flag for child neglect?

BACKGROUND: Healthcare professionals are often confronted with children presenting to the emergency department with dento-facial infections. These infections may be associated with dental neglect and as such could be a marker for general neglect. The aim of this retrospective study was to ascertain whether dento-facial infections can be used as an indicator for general neglect. METHOD: All children aged 16 years and under, who were admitted for surgical incision and drainage of dento-facial infection between January 2017 and January 2019 at King's College Hospital were examined retrospectively. All patients were discussed with the local safeguarding team/local authority to establish whether they were previously known to social services. RESULTS: This study showed that in our cohort, 48% of children admitted with dento-facial infection were already known to social services and one (2%) had been recently referred. The most commonly affected age group were 5-8-year-olds (50%) indicating that these children have an increased risk of neglect. An average of 5.6 teeth were extracted and four (10%) patients required extra-oral drainage. The average hospital stay was 2.26 days. CONCLUSION: Our retrospective study revealed that social services were already aware of 48% of patients under the age of 16, who were admitted to hospital with a dento-facial infection. This suggests a relationship between dental neglect and generalised neglect. Families of children presenting with dento-facial infection should be supported in accessing appropriate dental services for their children and clinicians should consider dento-facial infection a potential 'red flag' for generalised neglect.

Dental health personnel's experience with receiving inquiries from child welfare services: a national cross-sectional study.

OBJECTIVES: To assess if and to what extent public dental health personnel (PDHP) receive inquiries from child welfare services (CWS), and to assess whether PDHP's experience of receiving inquiries is associated with PDHP's characteristics and whether the associations are influenced by PDHP's experience of reporting to CWS. MATERIAL AND METHODS: Questionnaires were distributed to 1542 PDHP in Norway. Descriptive statistics were used for analysis. Negative-binominal-regression analyses with incidence rate ratios (IRRs) and confidence intervals (CIs) were used to estimate the association between received inquiries from CWS and PDHP characteristics. RESULTS: From a total of 1074 respondents, 52.4% had received inquiries from CWS (2012-2014) with a mean number of 3.9 (SD = 4.5). PDHP's likelihood of receiving inquiries was significantly associated with having many patients, working in small municipalities, working in eastern Norway, having good knowledge of the Health Personnel Act, and having experience reporting to CWS. Regional differences were the only association that varied according to PDHP reporting activity. CONCLUSIONS: PDHP receive inquiries from the CWS. The likelihood of receiving inquiries is associated with several characteristics of PDHP. To increase PDHP's likelihood of receiving inquiries, it is important to establish contact between the CWS and PDHS and ensure that the PDHP has good knowledge of the Health Personnel Act.

Prevalence of dental neglect and associated risk factors in children and adolescents-A systematic review.

BACKGROUND: Dental neglect (DN) is characterized within the wider framework of child neglect, though it is under-recognized by professionals. AIM: To get an overview of the prevalence of DN worldwide and highlight the possible risk factors associated with it. METHODS: A systematic review was conducted according to PRISMA guidelines. Studies on children and adolescents aged 0-19 years were included. Studies were identified by searching in the various scientific databases up to 14 January 2020. RESULTS: Ten primary studies were included in which DN or indicators of DN were examined. The prevalence estimate range of DN reported by seven of the included studies after removing the outliers is from 34% to 56%. The prevalence of untreated caries reported by three of the included studies ranged from 38.9% to 99%. The education level and SES of parents and parental attitudes towards dental health affect children's oral health. Moreover, looked-after children and children of refugees are at higher risk of DN. CONCLUSION: The study showed a high prevalence of DN and untreated caries. Due to the under-reporting of DN and a limited number of included studies, the results cannot be generalized worldwide. There is a need to make policies that include reporting of DN to higher authorities by dental professionals.

Dental Neglect in Children: A Comprehensive Review of the Literature.

AIM: The purpose of this review is to present the most recent bibliography regarding the etiology, risk factor indicators, types of dental neglect, and the epidemiological studies, showing the relationship between neglect and dental caries indices. Moreover, the review will focus on the role of oral healthcare professionals in evaluating such conditions. BACKGROUND: Untreated oral diseases, like dental caries, can lead to a variety of negative impacts on children including pain and infection. However, such complications can be prevented if a child's basic oral health needs are fulfilled. In addition, it is important to be aware that there are significant inequalities in accessing dental care and poverty, and such cases have to be distinguished from neglect. However, when there is adequate access to oral healthcare services and the parent or the guardian persistently fails to ensure appropriate medical care or treatment for his/her child, the possibility of dental neglect has to be seriously considered. REVIEW RESULTS: Dental neglect can be apart of a child's general neglect with short-term complications, such as caries, as well as long-term consequences that extend to adulthood, such as poor growth and impaired quality of life. CONCLUSION: Early diagnosis of dental neglect plays an important role in avoiding adverse impacts on children. Signs and risk factors for dental neglect should alert the dental team in order to intervene in time and prevent suspected cases. CLINICAL SIGNIFICANCE: Diagnosis of dental neglect can be difficult. However, identifying dental neglect at an early stage and making a child protection referral may safeguard the child and prevent further harm. For this reason, dentists should be informed about dental neglect and they should know how to deal with these cases. Effective education is necessary to increase knowledge and awareness of all aspects of child neglect.

Associations of socioeconomic status and lifestyle factors with dental neglect of elementary school children: the MEXT Super Shokuiku School Project.

BACKGROUND: Despite the fact that there are parents who do not take children with untreated dental caries to a dental clinic, few studies have been conducted to identify the responsible underlying social and family factors. The aim of this study was to investigate whether socioeconomic status and lifestyle factors are associated with dental neglect in elementary school children. METHODS: This study was conducted in 2016 with 1655 children from the Super Shokuiku School Project in Toyama. Using Breslow's seven health behaviors, the survey assessed: the grade, sex, and lifestyle of the children; parental internet and game use and lifestyle; socioeconomic status. The odds ratios (OR) and 95% confidence intervals (CIs) for having untreated dental caries were calculated using logistic regression analysis. RESULTS: Among the children participating, 152 (3.2%) had untreated dental caries. Among them, 53 (34.9%) had not been taken to a dental clinic despite the school dentist's advice. Dental neglect was significantly associated with children in higher grades (OR, 2.08; 95% CI, 1.14-3.78), father's Internet and game use ≥ 2 h/day (OR, 1.99; 95% CI, 1.02-3.88), not being affluent (OR, 2.78; 95% CI, 1.14-6.81), and non-engagement in afterschool activities (OR, 1.99; 95% CI, 1.10-3.62). CONCLUSIONS: Socioeconomic status was the strongest factor associated with dental neglect despite the fact that the children's medical expenses are paid in full by the National Health Insurance in Toyama, Japan. Future studies should investigate what factors prevent parents of non-affluent families from taking their children to dental clinics and how they can be socially supported to access adequate medical care.

Mandatory reporting of child physical abuse and dental neglect by Australian dentists.

Child protection measures are organized into three major themes: laws; service programs; and status of outcomes of these interventions. Contextually, mandatory reporting of child abuse and neglect is governed by a complex system of State legislation across Australia. The purpose of this review was to investigate the evidence base for the legislative obligations of Australian dentists as mandatory reporters; the functionality of dental practice in the determination of orofacial signs of abuse and neglect; and, relevant knowledge and practice demonstrated by the Australian dental work force. Our research question explores the role of Australian dentists in intervention of child physical abuse and dental neglect. Information was sourced from literature and web-based reviews. Peer reviewed articles included reviews and empirical studies. Official websites/databases were accessed for relevant legislation. The study found that child protection laws lack an evidence base for including/excluding dentists as reporters. Child abuse and neglect is associated with strong orofacial signs, thus imparting a key advantage to utilizing dentists as potential notifiers. An action response to child abuse is not seen in the Australian dental service. This review identifies gaps in the dental literature concerning mandatory reporting, calls for optimization of the related evidence base, and uniform Australian child abuse reporting requirements.

Care for children with dental neglect: identification of problems and approaches to solving them.

Dental neglect may have serious consequences for children's health. Moreover, it may indicate general negligence and it can be associated with child abuse. Therefore, a highly professional case management is of utmost importance, but also poses a great challenge for dentists. In order to develop effective strategies for an optimization of dental care in cases of dental neglect, a better understanding of the situation, and in particular an investigation into the unsolved questions of dentists in these cases, is needed. A prospective clinical examination with ten dentists was carried out to identify their challenges in the treatment of and the care for children facing suspicion of dental neglect. The practice of dental care in the cases of 102 children with suspicion of dental neglect (ages 3-14 years) was analyzed by collecting quantitative data (questionnaires) as well as qualitative data (focus group interviews). Severe and complex challenges in the handling of dental neglect in dental practice were identified. The study revealed that steps towards an optimization of the care for children with suspicion on dental neglect, which is much more than the treatment of caries, are needed. As such steps, we propose (1) the drafting of precise guidelines, (2) the education and training of dental students and dentists in general, (3) mandatory periodical dental health screenings, (4) the establishment of an interdisciplinary cooperation within the public health system, (5) the education of families, and (6) an adequate financial compensation for a professional and optimized case management. The establishment of efficient strategies of prevention and treatment of dental neglect and associated risks for the health of affected children will only be achieved with intense public and governmental support.

Reasons for reported suspicion of child maltreatment and responses from the child welfare - a cross-sectional study of Norwegian public dental health personnel.

BACKGROUND: To prevent child maltreatment, the identification of vulnerable children is essential. In Norway, public dental health personnel (PDHP) report suspicion of child maltreatment to child welfare services (CWS) at a relatively high rate. However, their reasons for reporting and the response from CWS have not been investigated. The objectives of this study were to (1) explore the reasons that PDHP send reports of concern, (2) examine how CWS responds to PDHP reports, and (3) assess whether different reasons for concern are associated with a given response from CWS. METHODS: A national cross-sectional study was conducted by an electronic survey distributed to public dental hygienists and dentists in Norway. Descriptive statistics were calculated in terms of mean (SD) distributions and frequency, expressed as % (n). To account for clustering of responses among respondents, binomial generalized estimating equation analysis was used to estimate odds ratios (ORs) and confidence intervals (CIs) of CWS responses across number of reports with different reasons for concern. RESULTS: Of a total of 1542 questionnaire recipients, 1200 (77.8%) responded to the survey. From 2012 to 2014, 42.5% of the respondents sent 1214 reports to CWS, with a mean number of 2.7 (SD = 2.0) reports per respondent. The PDHP sent the reports due to suspicion of neglect or physical, sexual and/or psychological abuse. Non-attendance at dental appointments and grave caries were reported most frequently. Among the reports, 24.5% resulted in measures being taken by CWS, 20.7% were dropped, and 29.4% lacked information from CWS on the outcome. Reports due to suspicion of sexual abuse, (OR 1.979, 95% CI (1.047-3.742), P = 0.036), grave caries (OR 1.628, 95% CI (1.148-2.309), P = 0.006), and suspicion of neglect (OR 1.649, 95% CI (1.190-2.285), P = 0.003) had the highest association with the implementation of measures. CONCLUSIONS: PDHP report on several forms of child maltreatment and contributes in detection of victimized children. However, the relatively low number of measures being taken by CWS and the number of reports that lack a response to reporters reveal a need for a closer cooperation between the services, as this would benefit both the children at risk and the services.

Exploring dental anxiety as a mediator in the relationship between mindfulness or self-compassion and dental neglect.

Dental anxiety and dental neglect are interconnected constructs with profound consequences for oral health and corresponding challenges for dental professionals. Meanwhile, other literature has indicated that mindfulness and self-compassion relate negatively to different forms of anxiety, and propose elements of potential interventions. This study aimed to explore the potential impact of dental anxiety as a mediator on the relationships between mindfulness or self-compassion and dental neglect. The results showed significant negative associations between mindfulness and self-compassion with dental anxiety and dental neglect. Mediation analyses supported the hypothesis that dental anxiety mediates the positive associations between mindfulness or self-compassion and dental neglect, providing preliminary evidence for the potential effectiveness of mindfulness and self-compassion interventions in addressing dental anxiety and dental neglect. Future research and potential clinical implications are discussed.

Cervical Facial Actinomycosis Complicated by Bacteremia After 30 Years of Dental Neglect: Successful Treatment With Ceftriaxone and Metronidazole.

Actinomycosis is an uncommon bacterial infection, caused by the Actinomyces species, and it most commonly presents as cervicofacial actinomycosis. The most common risk factors for actinomycosis are poor dental hygiene, oral surgery, maxillofacial trauma, local tissue inflammation, and diabetes. We discuss a case of a male patient in his 50s with 30 years of poor dental hygiene, complicated by tobacco use, who presented with septic shock and was found to have cervicofacial actinomycosis and bacteremia. The treatment of severe actinomycosis often involves prolonged penicillin-based antibiotic therapy. This is the first case in the literature to describe the successful treatment of cervicofacial actinomycosis and bacteremia with intravenous cefepime (later narrowed to ceftriaxone) and oral metronidazole.

A Cross-Sectional Study to Analyze the Correlation Between Alexithymia and Dental Neglect in Persons Pursuing Dental Care.

Background Alexithymia is a personality trait involving difficulties in emotional regulation (difficulties in identifying feelings, difficulties in describing feelings, and externally oriented thinking). It has a negative impact on health as it evokes poor personal hygiene, poor nutrition, and unhealthy behaviors in affected subjects. Identifying alexithymia in the dental setup is vital as it can compromise the patient-dentist relationship, especially in subjects neglecting oral hygiene. Aims The present study aimed to establish an association between alexithymia and dental neglect among adult subjects seeking dental care by using Dental Neglect Scale (DNS), and alexithymia was assessed on the 20-item Toronto Alexithymia Scale (TAS-20). Methods The present cross-sectional survey study included adult subjects of age 20 years or more. For all included participants, a structured questionnaire was given to assess dental neglect on demographic profile, six items of the DNS, and alexithymia was assessed on the 20-item TAS-20. The collected data were analyzed using a Chi-square test keeping significance at the p-value of <0.05. Results In 534 adult subjects, females had high scores for both TAS-20 and DNS along with their related factors. With higher education and increasing age, a significant increase in the mean TAS-20 scores and mean DNS scores was seen in the study participants (high mean DNS scores in females (19.55±3.98) compared to male subjects 19.36±4.34). TAS-20 scores were higher in females (59.31±10.78), factor 1 (DIF) (19.54±5.54), factor 2 (DDF) (15.46±4.05), and factor 3 (EOT) (24.34±4.64). Conclusion The present study, considering its limitations, concludes that there is no association between dental neglect and alexithymia in adult subjects seeking dental care. However, higher DNS and TAS-20 scores are seen in females showing them have difficult descriptions and identification of feelings in dental set-up increasing dental neglect among them.

Pregnant Women's Oral Health-Related Quality of Life and Lifestyle Factors.

Introduction: Pregnancy is often associated with a number of oral manifestations. There is a change in lifestyle factors and dental care during pregnancy. Aim: We conducted this cross-sectional study to determine how lifestyle factors affect oral health-related quality of life (OHRQOL) in pregnant women residing in Bero block, Jharkhand. Methods: The study included a total of 400 pregnant women aged 18-45. The assessment of lifestyle factors and OHRQOL was done using Health Practice Index (HPI) Index and Oral Health Impact Profile-14 (OHIP-14), respectively. Data was collected through face-to-face interviews. Results: Forty percent of the pregnant women showed low OHRQOL. The majority of them were not using mouthwash and were brushing their teeth using faulty techniques. The results of logistic regression analysis showed that women with poor lifestyle scores (Odds Ratio [OR] =3.8, P-value <0.0001*), and systemic diseases (OR = 2.6, P-value < 0.001*) were more likely to have poor OHRQOL. Conclusion: Pregnancy is associated with poor OHRQOL and poor lifestyle scores. Effective policies for oral health need to be drafted for this group.

Validity and Reliability of the Dental Neglect Scale among Romanian Adults.

The Dental Neglect Scale (DNS) is a well-known measure for assessing behaviours and attitudes related to oral health. However, the factor inconsistency revealed by the literature involves further investigations. The study focuses on the validation of the DNS in the case of a sample of the adult population from Romania. In this regard, data were collected online from 872 adults (616 females and 256 males). DNS reliability was examined from the perspective of internal consistency. Convergent validity was performed by associating DNS with different scales from the oral health field. In order to examine and confirm the factorial structure, the sample was broken down into two subsamples which made the subject of the exploratory factorial analysis (EFA) and confirmatory factorial analysis (CFA), respectively. DNS-RO is positively associated with the scale which measures the values related to oral health (OHVS) and negatively with those that assess the impact of the oral health on life quality (OHIP-14), the distrust of the benefits of oral health services (R-DBS), and reduced need for oral care (DIS). The Cronbach's α = 0.70, McDonald's ω = 0.70 and CR = 0.77 are acceptable. Both EFA and CFA (χ2/df = 1.13; CFI = 0.99; RMSEA = 0.017; SRMR = 0.059) support the unifactorial structure of the scale. The gender differences show that females evince greater care for oral health than male subjects. The study shows that the DNS-RO can be used to assess the behaviours and attitudes towards oral health in the case of the Romanian adult population in epidemiological studies and health promotion programs through health education.

Dental Neglect and Its Perception in the Dental Practice.

In 2020, the number of reported cases of child maltreatment in Germany has never been higher and most of them showed signs of neglect. Most of the time, dental neglect (DN) appears together with a general form of neglect, and includes, apart from caries, many other negative short- and long-term effects for the affected child. In this study, the prevalence of DN in Germany and the way dental practices are currently addressing the topic are examined. Moreover, this study explored whether the experiences of German dentists with DN are related to their work experience, their gender or further education about DN. The data was collected using an anonymous questionnaire. The hypotheses were tested using unpaired t-tests based on differences in mean values. The three most common reasons for a suspected case of child maltreatment were the interaction of children with parents, or a legal guardian, insufficient oral or general hygiene, and grave caries. Even though most of the participating dentists agree that it is the task of the dentist to report suspected cases of child maltreatment, only few of them have done so in the past themselves. Not only insecurity about recognition and whom to contact in the suspected case, but also concern about unfounded suspicion were the most common reasons not to report a suspected case of DN. The detection and communication of suspected cases should be encouraged in order to protect affected children.

Association between dental neglect and alexithymia among adult dental patients.

Aims: To show the association between dental neglect and alexithymia among adult dental patients. Settings and Design: At times, certain individuals with dental neglect may experience trouble in communicating and/or understanding information, ability to identify, and describe their feelings termed as alexithymia. Hence, recognition of alexithymia in a dental setting is important, because it worsens the dentist-patient relationship, especially among patients who neglect their dental health. Materials and Methods: A cross-sectional survey was conducted among adult patients (≥20 years). Patients received a questionnaire assessing dental neglect [six-item Dental Neglect Scale (DNS)], alexithymia [20-item Toronto Alexithymia Scale (TAS-20)], and demographic profile. Statistical Analysis: Data were analyzed with standard statistical software (Statistical Package for the Social Sciences, version 22). P <0.05 was considered statistically significant. Results: A total sample of 1067 individuals comprising 553 (51.8%) females and 514 (48.2%) males with a mean age 35.33 ± 11.49 years participated in the study. Our findings showed that females had higher mean scores for both DNS and total TAS-20 and its factors. With increase in age and education, the mean scores of the DNS had significantly increased and mean scores of total TAS-20 and its factors had decreased with increase in age and education. Conclusion: The above study findings have supported the hypothesis that there is no association between dental neglect and alexithymia among adult dental patients.

Comparative evaluation of audio-visual and verbal education method on OHRQoL, dental anxiety, dental neglect of diabetes mellitus patients attending a teaching hospital in India.

AIM: The aim of this study was to compare audio-visual and verbal education on oral health related quality of life, dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad. MATERIALS AND METHOD: The current longitudinal interventional study was conducted to check the efficiency of audio-visual and verbal education on OHRQoL, Dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad, U.P., India. A 14-item questionnaire, OHIP-14, with emphasis on seven proportions of impact was used to collect information on OHRQoL. Corah Dental Anxiety Scale (DAS) will be used to collect data on Dental Anxiety. A prevalidated revised proforma of Dental Neglect Scale (DNS) was used to gather information on Dental Neglect. The questionnaire was a six-question instrument related to dental problems. After collecting the initial baseline data, the sample was divided into two groups: verbal education group (n = 1030) and audio-visual education group (n = 1030). Then oral health education (OHE) was provided verbally to Group I patients and OHE with audio-visual aids was given to Group II patients visiting Teerthanker Mahaveer Hospital. OHE was repeated every 2 months. At every 6, 12 and 18 months, questionnaire was repeated to evaluate the effectiveness of OHE. Inspection will be conducted under natural daylight in hospital premises. To avoid the disruption while conducting the examination, adequate supply of instruments was taken. Instruments were sterilized by autoclaving in the college. RESULTS: A total of 1926 patients attended all the follow-up and review examinations. Subject dropout for Group I was 2% with 1009 at 6th month; 3% with 978 at 12th month and 1% with 967 at 18th month. Subject dropout rate for Group II was 3% with 999 at 6th month; 0% with 999 at 12th month and 4% with 959 at 18th month. The difference of subject dropout among the groups was not statistically significant (P = 0.23). Group mean total OHIP-14 score after 18 months was recorded as 15.36 ± 8.61, whereas in Audio-visual education group mean total OHIP-14 score after 18 months was recorded as 14.42 ± 7.59. At the end of study mean DAS score for DAS ≥15 (severe anxiety) was found to be 1.95 ± 2.18 in verbal education group, whereas in audio-visual education group mean DAS score for DAS ≥15 (severe anxiety) was found to be 2.24 ± 1.98. At the end of the study mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 3.54 ± 2.63 in verbal education group, whereas audiovisual education group mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 2.59 ± 2.75. CONCLUSION: The quality of life is a factor that can be considerably affected by oral health, which in turn reflects the general health of an individual. The main part of oral disease prevention is done by use of personal oral hygiene measures and maintaining oral hygiene. It is the duty of dental professionals to motivate, show and instruct patients to maintain appropriate oral health and oral hygiene. The study concludes that the program of this kind may be beneficial in improving many dimensions of dental health of an individual that includes physical health, emotional well-being, OHRQoL, inter-personal relationship and the fear related to dental treatment.