Oral health status and treatment needs of children with sensory deficits in Chennai, India-A cross-sectional study.

PURPOSE: The negligence of oral health combined with barriers in accessing adequate oral care is more commonly encountered in children with sensory deficits. In a developing country like India, there is a severe lacuna in data regarding the oral health status and treatment needs in this group of population. The purpose of this study is to assess the oral health status and treatment needs of children with sensory deficits, using WHO criteria of Basic Oral Health Survey Methods, 1997. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted using the WHO criteria (Basic Oral Health Survey, 1997); questionnaire data regarding the demographic profile, oral hygiene status, degree of sensory impairment were recorded and tabulated. The Chi-square test was used to determine whether there existed a significant difference in the oral health status. The confidence interval was set at 95% and alpha error was assumed at 0.05. RESULTS: Among the 742 sensory deficit children examined, 371 children are visually impaired and 371 are hearing impaired. Gingival bleeding and poor oral hygiene is diagnosed in more than 70% of the visually impaired children. The prevalence of trauma is estimated to be 8% in children, who are visually impaired. In the hearing impairment group, gingival bleeding because of inadequate oral hygiene is seen in 58% of the population examined. There is no statistically significant difference in the dental caries status between visually impaired and hearing impaired children (P > 0.05). There is also no statistically significant difference in the restorative treatment need and trauma status between visually impaired and hearing impaired children (P > 0.05). CONCLUSION: The present study shows a high prevalence of gingival diseases and dental caries in the special health care group children. The study signifies a wide spread presence of unmet treatment needs among children in this study population.

Barriers to utilisation of dental care services among children with special needs: A systematic review.

BACKGROUND: Disabled population accounts for 2.86 Crore of total Indian population. Among these 27.4% of population consists of children within age group of age 0 to 19 years. Studies have shown oral health status of children with special needs is lower than children without special needs. Though there are various attributing factors, access to dental care delivery and difficulties faced during dental treatment delivery are of major concern. Therefore the aim of this systematic review was set to assess the barriers faced by children with special needs during utilization of dental services; through caregiver's perception. MATERIALS AND METHODS: For this review MEDLINE, EBSCO, COCHRANE, EMBASE and Google Scholar were the electronic data bases searched based on the PICO. PRISMA guidelines were followed for final inclusion of articles. RESULTS: The search generated a total of 259 articles from five different electronic bases: PUBMED, EMBASE, EBSCO, COCHRANE and GOOGLE SCHOLAR. Based on inclusion criteria, 7 articles made it to final analysis. All the 7 studies reported that dentist were unwilling to treat children with special needs as a major barrier followed by fear towards dentist by the children with special needs. CONCLUSION: The cross sectional studies of this review were assessed for quality using a modified Newcastle Ottawa Scale, proposed by Egger et al. in 2003. Even though the available literature forms a lower standard of evidence, further evaluation of barriers are recommended using better designed studies to substantiate the in equal access to healthcare facilities by these marginalized population.

Salivary flow rate, pH and buffering capacity in patients undergoing fixed orthodontic treatment - A prospective study.

BACKGROUND: Human saliva has got many important functions like lubrication of the oral tissues, making oral functions like speech, mastication and deglutition possible and also protecting teeth and oral mucosal surfaces in different ways. Dental Caries is one of the common complications in patients undergoing orthodontic treatment. Subjects with impaired saliva flow rate often show high caries incidence. A low flow rate combined with a low or moderate buffer effect clearly indicates poor salivary resistance against microbial attack. AIM: To investigate the changes in stimulated and unstimulated salivary flow rate, pH and buffer capacity in patients undergoing therapy with fixed orthodontic appliances. MATERIALS AND METHODS: Salivary flow rate, pH and buffering capacity of 20 patients who underwent fixed orthodontic treatment at Department of Orthodontics, Ragas Dental College and Hospital, Chennai were examined using GC saliva check buffer kit. The procedure was carried out during the initiation of orthodontic treatment and subsequently, one month and six months after the placement of appliance. RESULTS: Results showed there was a significant increase in the salivary flow rate one month and six months after placement of fixed appliance while pH and buffering capacity showed no significant changes. CONCLUSION: Salivary flow rate increases significantly during fixed orthodontic treatment. Salivary pH and buffering capacity showed no significant changes suggesting that they are not sole factors for demineralization in orthodontic patients.

Knowledge and attitudes of pharmacists regarding oral health care and oral hygiene products in Chennai city.

OBJECTIVES: This study was done to find out the knowledge and attitudes of pharmacists regarding oral health care and oral hygiene products in Chennai city. MATERIALS AND METHODS: A cross-sectional survey among a sample of the pharmacists in Chennai city was done and data regarding their knowledge and attitudes towards oral health care and oral hygiene products were obtained using a closed-ended questionnaire. RESULTS: Among the 60 pharmacies approached, 50 pharmacists participated in the study and completed the questionnaire. Though 48% of the participants gave a positive answer when asked whether they had met the dentist practicing close to their pharmacies, the frequency with which they met the dentist ranged from once a week (24%) to once a month (28%). Most of the pharmacists stocked oral health-related products, which comprised 15-25% of their total stock. Of these products toothpaste was the most common (62%), followed by mouth rinses (12%). Toothache or painful teeth was the most common dental problem (78%) for which patients approached the pharmacists for advice. With regard to the advice given, 38.5% of the pharmacists asked the patient to consult a nearby dentist after dispensing medications, while 22.4% of the pharmacists dispensed antibiotics and painkillers without any referral. Seventy percent of the pharmacists expressed interest in giving oral health care advice to patients. However, many of them (38%) felt that lack of proper knowledge is a barrier to providing oral health care advice. CONCLUSION: It is clear from the present study that pharmacists are presently an underutilized resource, and there is a definitive need to improve their training and access to information on available dental services.

Remineralizing potential of CPP-ACP in white spot lesions - A systematic review.

OBJECTIVE: The aim of this systematic review was to assess the long term remineralizing potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) only in paste form compared with fluoride varnish, and or placebo in both naturally occurring and post-orthodontic white spot lesions in vivo. DATA SOURCES: The literature search covered the electronic databases: PubMed and Google scholar from 2005-2016. Only articles published in English were included. Randomized control trials in which CPP-ACP delivered by paste form were included. All studies which met inclusion criteria underwent two independent reviews. STUDY SELECTION: Two ninety five articles were identified from the search after excluding duplications. Abstracts of forty one articles were reviewed independently. Twenty nine articles were excluded after reading abstract. Full text articles were retrieved for fifteen relevant studies. After reviewing articles independently, three articles were excluded after full text reading. Finally twelve studies were selected based on the eligibility criteria. The remineralizing effect of CPP-ACP were compared with placebo and fluoridated toothpaste and fluoride varnish in randomized control trial. CONCLUSION: A high level evidence of remineralizing potential of CPP-ACP on naturally occurring white spot lesion and WSL post orthodontic treatment was found in comparison with placebo/fluoridated toothpaste and fluoride varnish without any statistically significant difference. Well-designed RCTs are, therefore, required to improve the level of evidence in this area.

Patterns of tobacco usage among subjects with potentially malignant oral lesions or conditions in Chennai city: A comparative study.

OBJECTIVE: To determine the patterns of tobacco usage among subjects with potentially malignant oral lesions or conditions through a comparative study design. METHODS: The study was carried out in a span of 2 months on a sample of 120 subjects; 60 in case group (30 subjects with leukoplakia and oral submucous fibrosis [OSMF], respectively) and 60 subjects in control group (30 current smokers and current chewers, respectively), attending the tobacco cessation clinic at a private dental college hospital in Chennai city. Demographic data, details of tobacco usage, and Fagerstrom nicotine dependence scores (FNTD) were recorded in a prevalidated tobacco cessation intake form. RESULTS: Cases with leukoplakia had a higher mean FNTD score when compared to the control group (P = 0.0001). The most common form of smokeless tobacco used by case (OSMF) subjects was found to be mawa (53%) significantly higher than the control group (P = 0.05). Mean FNTD scores of mawa users were higher than other tobacco users in both case and control group. CONCLUSION: The current study has hence put forth the role of mawa form of tobacco in causation of OSMF at a time when implementation of tougher anti-tobacco laws is the talk of the town.

Tobacco use among school children in Chennai city, India.

AIMS: The present study was done to build a database on prevalence of tobacco use among students of grade 8 to 10 in Chennai city, for the purpose of advocacy of tobacco control and planning tobacco control interventions and evaluation. MATERIALS AND METHODS: A two-stage stratified probability sample of students in grades 8-10 corresponding to 13 to 15 years of age were selected from private/government aided private schools and purely government aided corporation schools. Data was collected by a pretested, closed-ended self-administered questionnaire. RESULTS: A total of 1255 students participated in this survey. Among them 64.4 boys and 35.6% were girls. Ever tobacco use was reported by 37.6% of the students (41.6 males and 30.2% females). Current users of tobacco (any products) were reported by 41.1% of the students. Prevalence was more among boy students (46.3%) when compared to that of girl students (31.6%). There existed no significant difference between current users of tobacco based on the zones of the school. Tobacco users prevalence was found more in corporation schools when compared to that of private schools. Parental and friends tobacco use was reported more often by tobacco users compared to never users. Purchasing tobacco products in a store was reported by 82.5% and almost no one was refused because of age. Almost everyone reported watching a lot of cigarette advertisements on TV, whereas about half reported watching advertisements on other medias like outdoor hoardings (45.7%), newspapers (65.3%) and social events (67.4%). CONCLUSION: This study demonstrates that among the 13 to 15-year old school going children (corresponding to grades 8 to 10) in Chennai city, the current tobacco use is high.

In vitro antibacterial activity of Camellia sinensis extract against cariogenic microorganisms.

CONTEXT: Dental caries, a ubiquitous multifactorial infectious disease, is primarily caused by microorganisms like Streptococcus mutans and Lactobacillus acidophilus. Use of antimicrobials is an important strategy to curb cariogenic microorganisms. AIM: The aim was to evaluate the in vitro antimicrobial activity of C. sinensis extract on S. mutans and L. acidophilus. STUDY SETTING AND DESIGN: Experimental design, in vitro study, lab setting. MATERIALS AND METHODS: Aqueous, acetone and ethanolic extracts of C. sinensis were subjected to antioxidant analysis. The ethanolic extract was used for assessment of antimicrobial properties. Ethanolic green tea extract at ten different concentrations and 0.2% chlorhexidine was used. Microbiological investigations were carried out to determine the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and zone of Inhibition of the test and control agents against S. mutans and L. acidophilus. STATISTICAL ANALYSIS: Kruskall-Wallis and Mann-Whitney U-test. RESULTS: MIC of green tea extract on S. mutans and L. acidophilus was found to be 0.2% and 0.3% respectively, MBC was found to be 0.8% and 0.9%, respectively. The mean zone of inhibition for 30 µl containing 300 µg of ethanolic extract of green tea and control against S. mutans were 18.33 mm and 14.67 mm, respectively. The mean zone of inhibition for 30 µl containing 300 µg of ethanolic extract of green tea and control against L. acidophilus were 12.67 mm and 7.33 mm, respectively. CONCLUSION: Green tea has antibacterial activity against predominant cariogenic bacteria namely S. mutans and L. acidophilus.

Reach of mass media among tobacco users in India: a preliminary report.

BACKGROUND: Tobacco use is a health hazard and its use is attributed to a lack of knowledge regarding the ill effects of tobacco. AIM AND OBJECTIVE: To identify the exposure of different mass media among a representative cohort population in the Indian subcontinent and compare the reach of the different mass media among tobacco users and nonusers using the "reach of HIV information" as a model. DESIGN: Secondary Data Analysis of Indian National Family Health Survey-3. PREDICTOR VARIABLES: Any tobacco use, gender, source of HIV information. OUTCOME VARIABLES: Use of mass media. RESULTS: Of the study group, 27% of males and 54.4% of females never read newspaper or magazine; 29.3% of males and 52.6% of females never heard radio; 12.4% of males and 25% of females never see television; and 79.3% of males and 93.46% of females did not see a movie at least once a month. The most common source of information of HIV was television among males (71.8%) and females (81%), whereas the least common source was leaders among males (0.8%) and females (0.2%). DISCUSSION: Television is the single largest media used by both genders and was a major source of HIV information dissemination. A well-designed tobacco control program similar to HIV awareness program will help to curb tobacco use. CONCLUSION: The reach of different media among Indian tobacco users is presented and HIV model of information dissemination may prove to be effective in tobacco control.