Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains - a clinical trial.

OBJECTIVE: To compare the effectiveness of abrasive component (perlite/calcium carbonate) and enzymatic component (papain and bromelain) of whitening toothpaste in removal of extrinsic stains. METHODS: This study is a randomized, triple blind and parallel group study in which 90 subjects aged 18-40 years were included. At baseline, stains scores were assessed by Macpherson's modification of Lobene Stain Index and subjects were randomly assigned to two groups with 45 subjects in each. Group 1 used whitening toothpaste with enzymatic action and group 2 with abrasive action. After 1 month, stain scores were assessed for the effectiveness of the two toothpastes and 2 months later to check the stain prevention efficacy. Wilcoxson's test was used to compare between baseline 1 and 2 months stain scores, and Mann-Witney U-test was applied for intragroup comparison. RESULTS: The mean baseline total stain score for the subjects allocated to the enzymatic toothpaste was 37.24 ± 2.11 which reduced to 30.77 ± 2.48 in 1 month, and for the abrasive paste, total stain reduced from 35.08 ± 2.96 to 32.89 ± 1.95. The reductions in total stain scores with both the pastes were significant compared with baseline stain scores (at 1 month Group 1, P = 0.0233 and Group 2, P = 0.0324; at 2 months, Group 1 P = 0.0356). Both the toothpastes proved to be equally good in removal of extrinsic stains; however, the enzymatic paste showed better results as compared to abrasive toothpaste. CONCLUSION: Whitening toothpaste with abrasive action and enzymatic action are equally effective in removal of extrinsic stains; however, whitening toothpaste with abrasive action needs to be used with caution.

Aesthetic perceptions regarding fluorosis by children from an area of endemic fluorosis in India.

OBJECTIVES: To assess the perceptions of and concerns regarding dental fluorosis among 12-15 year-old schoolchildren in an area where fluorosis is endemic and to find any association with Tooth Surface Index of Fluorosis (TSIF) scores. BASIC RESEARCH DESIGN: A cross sectional study. PARTICIPANTS: 316 children aged 12-15 years with varying level of dental fluorosis selected from 696 children screened for fluorosis. METHODS: The study was undertaken in three villages in rural Gadag, Karnataka, India, with fluoride levels in the drinking water ranging from 2.2 to 4.5 ppm as estimated by the SPADNS spectrophotometric method. Children's fluorosis was assessed under natural lighting conditions on the labial surface of upper anterior teeth using the TSIF 8-point scale. A self-administered questionnaire assessed knowledge, perceptions and concerns. Data were analysed by frequency distributions and Spearman's correlation coefficients. MAIN OUTCOME MEASURES: Aesthetic perceptions and TSIF scores. RESULTS: The children were aware of the fluoride presence and its health effects. TSIF scores correlated with: the appearance of front teeth (r = 0.135, p = 0.015); feeling fluorosis would hinder smiling (r = 0.116, p = 0.040); feeling distress due to fluorosis (r = 0.111, p = 0.048). CONCLUSION: Children were aware of fluoride and its health effects. They also perceived dental fluorosis as an aesthetic problem.

Attitude and tendency of cheating behaviours amongst undergraduate students in a Dental Institution of India.

Honesty and integrity are key characteristics expected of a doctor, although academic misconduct amongst medical students is not new. Academic integrity provides the foundation upon, which a flourishing academic life rests. The aim of this study was to investigate the attitude of undergraduate dental students about the seriousness of cheating behaviours and to determine the rate of malpractice amongst these students. A self designed closed ended questionnaire was distributed to 300 undergraduate students in a Dental Institution in India, to rate the seriousness of six cheating behaviours and to assess the rate of malpractice. The response rate was 100%. Two of the six cheating behaviours were considered by at least 61% of the students as very serious cheating behaviours. Almost 70% of the students agreed that they have involved in malpractice in examinations at least once. The majority also felt that cheating in examinations will not have any significant effect on their future. This study has revealed that cheating is an important issue, which needs to be addressed for the benefit of the society at large.

How clean is the toothbrush that cleans your tooth?

Until recently, little attention has been directed towards the role the toothbrush may play in human health, even though a report of toothbrush as a significant factor in the infection appeared in 1920. It is common knowledge that the human mouth harbours a wide variety of microorganisms, some of which, at any given time, can be assumed to be potential pathogens. This was not known when toothbrushes were originally designed, yet the common toothbrush has been used in basically the same form for about 200 years. In today's world of organ transplantation and alteration of the immune system, it is important to consider the toothbrush as a source of potential pathogens. Given the fact that very often people will traumatize themselves with their toothbrush, this trauma may become a potential portal of entry for organisms. In this article, we have attempted to demonstrate the importance of toothbrush disinfection, given tips on home toothbrush care and hope to motivate the dentists to educate the patients on the importance of toothbrush disinfection.

Association of socio-economic status and dietary habits with early childhood caries among 3- to 5-year-old children of Belgaum city.

AIM: To ascertain if there were any association of socio-demographic factors and dietary habits with early childhood caries (ECC). METHODS: A cross-sectional study was conducted on 1,250 children 3-5 years of age. A self-designed validated questionnaire was prepared comprising two parts, one pertaining to socio-demographic data and the other related to a 3-day diet diary. Socio-economic stratification was based on Kuppuswamy's classification. Diet history was obtained via a 3-day diet diary completed by the parents. A calibrated examiner conducted the oral examinations of the preschool children. Dental caries was assessed by using WHO criteria. Chi-square test and logistic regressions described the strength of the associations. RESULTS: The prevalence rate of ECC was 63.17 %. Significant associations were obtained between ECC and age of the child, number of siblings in the family, mother's education, sucrose exposure in between meals, sucrose exposure at meals, total frequency of sucrose exposure, and total sweet score. However, non-significant association of ECC was observed with socio-economic status. CONCLUSION: Many of the socio-demographic and dietary factors were significantly associated with ECC. It would be appropriate to plan health education strategies for parents and care takers by inculcating socio-demographic factors with emphasis on reduced sucrose intake. ECC should be regarded as a serious public health problem.

Development of a new technique (ATP) for training visually impaired children in oral hygiene maintenance.

AIM: To develop a special oral health education technique and compare plaque scores before and after health education. STUDY DESIGN: Non-randomised before and after comparison trial without controls. METHODS: The final study population comprised of 96 visually impaired children aged 6-18 years old. Silness and Loe plaque index scores were recorded at baseline. 'Audio tactile performance technique' (ATP Technique) a specially designed health education method was used to educate these children regarding oral hygiene maintenance. Periodic reinforcement of health education was performed at an interval of 9 months. Re-examination was carried out after 18 months of health education to assess plaque scores. STATISTICS: Wilcoxon's sign rank test and paired t test was used to assess the difference between the scores before and after health education. RESULTS: There was increase in frequency of tooth brushing after health education. The mean plaque scores pre- and post-health education were 1.41 (+/-0.58) and 0.63 (+/-0.39) respectively. The difference was statistically significant (p<0.001). CONCLUSION: Visually impaired children could maintain an acceptable level of oral hygiene when taught using special customised methods.

Effectiveness of mouthrinse formulated from ethanol extract of Terminalia chebula fruit on salivary Streptococcus mutans among 12 to 15 year old school children of Belgaum city: a randomized field trial.

OBJECTIVES: Dental caries is the most prevalent oral disease. Streptococcus mutans plays a major role in the occurrence of dental caries. Many antibacterial agents have been developed against dental caries. However, they lack the qualities of an ideal agent. Thus presently, antibacterial activity of herbal agents is being extensively studied. MATERIALS AND METHODS: In the present study, ethanol extract of Terminalia chebula was prepared and mouthrinse was formulated. A total of 60 children meeting the inclusion criteria were randomly divided into study and control group and respective mouthrinses were administered. Salivary Streptococcus mutans count was assessed at 5 and 60 minutes after rinsing and compared with baseline values. Substantivity of the rinse was assessed among 10 children. Mouthrinse was given to the children and salivary Streptococcus mutans counts were assessed at baseline, 6 and 12 hours postrinsing. Mann-Whitney U test was used to assess the variance of factors like Decayed Missed Filled Teeth, plaque scores, and gingival scores. ANCOVA (Analysis of covariance) was used to determine the change in salivary Streptococcus mutans colony forming units taking baseline values as covariates. RESULTS: It was observed that there was 44.42% reduction in salivary Streptococcus mutans colony forming units 5 minutes after rinsing as compared with baseline values and 64.14% reduction in Streptococcus mutans colony forming units at 60 minutes after rinsing as compared with baseline values. There was a reduction of 35.48% in salivary Streptococcus mutans colony forming units at 60 minutes after rinsing as compared with 5 minutes sample. CONCLUSION: Streptococcus mutans counts were low up to 6 hours postrinsing among 80% of the children.