Treatment of Gingival Recession Defects with Pouch and Tunnel Technique Using Connective Tissue Graft and Lyophilized Chorion Membrane in Smokers.

BACKGROUND The chorion membrane has been used for several decades as an allograft in tissue repair and various periodontal regenerative procedures. The present study, conducted at a single center in India, aimed to evaluate and compare the clinical outcomes of 26 gingival recession sites in chronic smokers treated using a pouch and tunnel technique with connective tissue graft (CTG) and lyophilized chorion membrane (LCM). MATERIAL AND METHODS The study included 22 smokers with 26 sites of recession defect, with Miller's class I and class II gingival recession, which were allotted into control and test groups. The control group (13 sites) was treated with CTG, and the test group (13 sites) was treated with LCM. Clinical parameters like recession depth, recession width, relative clinical attachment level (RCAL), relative gingival position, width of attached gingiva, and width of keratinized gingiva were recorded at baseline and 6 months postoperatively. Visual analogue scores for pain and wound-healing index scores were assessed in the first week after surgery. RESULTS All clinical parameters showed significant improvements from baseline to 6 months postoperatively in the control and test groups. Recession width, RCAL, width of attached gingiva, and width of keratinized gingiva demonstrated significant differences, whereas mean root coverage percentage and recession depth did not show any significant differences between the study groups at 6 months postoperatively. CONCLUSIONS This study supports the role of LCM allograft as a scaffold to promote soft tissue regeneration and has demonstrated a favorable role for its use in root coverage procedures in patients who smoke.

Role of miRNA-155 in the regulation of osteoclast differentiation mediated by MITF in stage III/IV periodontitis: a case-control study.

BACKGROUND: Monocyte-macrophage lineage cells are committed towards osteoclast differentiation in vitro by the downregulation of microphthalmia-induced transcription factor (MITF) by miRNA-155. Therefore, we aimed to evaluate miRNA-155 expression and explore the regulation of MITF by miRNA-155 during osteoclastogenesis in periodontitis. MATERIALS AND METHODS: Ninety-eight subjects were recruited and categorized into the following: group I (cases)-systemically healthy with localized stage III/IV periodontitis (N = 49) and group II (controls)-systemically and periodontally healthy (N = 49). Gingival tissue samples were procured and qRT-PCR analysis was carried out for relative gene expression. RESULTS: The mean ΔCT of miRNA-155 expression was -1.04 ± 2.26 and -0.01 ± 1.4 respectively for groups I and II. There was a statistically significant difference in the miRNA-155 expression (P ≤ 0.01) between the groups. The mean ΔCT of MITF expression for groups I and II was 4.15± 2.16 and 3.51± 1.57 respectively with no significant difference (P > 0.01) between the groups. In the periodontitis group, miRNA-155 expression increased by fivefolds (P ≤ 0.01) whereas MITF expression showed no significant difference in the fold change between the groups (P > 0.01). The site-specific clinical parameters showed a statistically significant strong negative and positive correlation with the ΔCT and fold change values of miRNA-155 respectively in the total 98 samples (P < 0.01). miRNA-155 was able to discriminate between periodontal health and disease with a diagnostic accuracy of 96.9% (95%CI: 91.38-98.95) and the AUC was 0.98 (95%CI: 0.97-1.0, SE = 0.008, P < 0.001) in ROC analysis with a sensitivity of 93.8% (95%CI: 83.48-97.9) and specificity of 100% (95%CI: 92.73-100). CONCLUSIONS: miRNA-155 was dysregulated and upregulated by fivefolds in periodontal disease. It can be used as a potential biomarker to discriminate between periodontal health and disease. No difference in the MITF gene expression was demonstrated between periodontal health and disease. The result suggested that miRNA-155 does not affect the expression of MITF gene in the process of osteoclastogenesis in localized stage III/IV periodontitis within this study design and limitations.

Effect of microsurgical technique for root coverage using modified coronally advanced flap with connective tissue graft- Randomized controlled clinical trial.

Background: The aim of the study was to compare the root coverage percentage and other clinical outcomes in Millers Class I and Class II gingival recessions (GR) treated with modified coronally advanced flap (MCAF) combined with connective tissue graft (CTG) using macro and microsurgical approaches. Materials and Methods: In this controlled clinical trial, a total of 32 Miller's Class I and Class II GR defects were randomly assigned to the control and test groups (16 in each group). All the patients were treated with MCAF with CTG as the root coverage procedure. For the control and test groups, the procedure was performed using a macro and microsurgical approach, respectively. Clinical parameters were assessed at baseline and in 6th month. Wilcoxon signed-rank test was used to compare the values between baseline and 6 months. Statistical significance was set at P < 0.05. 1 week after surgery, wound healing index (WHI) and Visual Analog Scale (VAS) scores were recorded. Results: Intragroup comparisons revealed significant improvement in all the parameters in both the groups at 6 months. The proportion of root coverage achieved in the control and test groups was 78% and 86%, respectively. At 6 months, the root coverage percentage between the study groups showed no significant difference (P = 0.207). Intergroup analysis of WHI and VAS scores showed better healing and less postoperative pain in the microsurgical group compared to macrosurgical group (P < 0.05). Conclusion: At 6 months, there were no significant differences in root coverage percentage or other clinical parameters between the groups based on whether a macro or microsurgical method was used. However, better wound healing, less pain, and discomfort were observed in the microsurgical group.

The Effect of Laser Micro Grooved Platform Switched Implants and Abutments on Early Crestal Bone Levels and Peri-Implant Soft Tissues Post 1 Year Loading among Diabetic Patients-A Controlled Clinical Trial.

Background and Objectives: The study aimed to compare the mean crestal bone level (CBL) and peri-implant soft tissue parameters in laser micro-grooved (LMG) platform switched implants and abutments (I&A) post 1 year of functional loading among non-diabetic and type II diabetic individuals. Materials and methods: Patients with an edentulous site having minimum bone height and width of ≥13 mm and ≥6 mm, respectively, were divided into two groups: (i) Non-diabetic-8 (control) and (ii) diabetic-8 (test). LMG Implants were placed and loaded immediately with a provisional prosthesis. Mean crestal bone level (MCBL) was evaluated radiographically at baseline and at 1 year. Peri-implant attachment level (PIAL) and relative position of the gingival margin (R-PGM) were recorded. Implant stability quotient (ISQ) level and implant survival rate (ISR) were evaluated at 1 year. Results: Early MCBL within the groups 1 year postloading was similar both mesially and distally (control-0.00 to 0.16 mm and 0.00 to 0.17 mm, respectively; test-0.00 to 0.21 mm and 0.00 to 0.22 mm, respectively) with statistical significance (p ≤ 0.003, p ≤ 0.001 and p ≤ 0.001, p ≤ 0.001, respectively). However, intergroup comparison showed no significant difference statistically in the MCBL in 1 year post functional loading. The peri-implant soft tissue parameters showed no significant difference between the groups. ISQ level between both groups did not reveal any significant changes (p ≤ 0.92), and ISR was 100%. Conclusions: LMG Implants resulted in minimal and comparable early crestal bone loss and soft tissue changes post 1 year of functional loading in moderately controlled diabetic and non-diabetic individuals, suggesting that this could be a reliable system for use in systemically compromised individuals.

Interdental Papillary Reconstruction by Microtunnelling Technique Using Autologous Biomatrices-A Randomised Controlled Clinical Trial.

Background and objectives: The study aimed to evaluate and compare the amount of papillary gain and black triangle height reduction after intervention with a microtunnelling technique with either Connective tissue graft (CTG) or Platelet-rich fibrin (PRF) as a biomatrix at 6 months using a microsurgical approach. Materials and Methods: Twenty-six patients with interdental papillary loss were included in the study. The patients were selected randomly for the study groups with thirteen patients in each group: a control group where CTG was utilised as a matrix, and a test group where PRF was utilised as a matrix, for interdental papillary reconstruction. A microtunnelling technique was performed for both the study groups under a surgical microscope. The primary parameters assessed were interdental Papillary height (PH) and Black triangle height (BTH) at baseline, with secondary parameters Visual analogue score by dentist (VAS-D) and patient (VAS-P) assessed at 6 months. Results: Both the control and test groups showed a significant reduction in BTH within their respective group at six months (p < 0.05). The gain in papillary height significantly improved only in the CTG group at 6 months. However, significant differences could not be demonstrated for any of the variables such as BTH (p value = 0.582) and PH (p-value = 0.892) between the study groups at 6 months. Conclusions: IDP reconstruction utilising a microtunnelling approach with CTG or PRF was successful without any significant differences between the groups for the parameters assessed at 6 months.

Rationale for anxiety associated with dental visits during the COVID-19 pandemic among the general public - an observational study.

BACKGROUND: The effect of COVID-19 on various facets such as physical, psychological, financial, social, and so on has been investigated extensively. However, the wariness influencing the decision to visit the dentist during this pandemic has received relatively little attention in Indian scenario. The study sought to investigate the general public's anxiety regarding visiting a dentist during the COVID-19 pandemic, including the factors that possibly contribute towards this apprehension among Indian nationals. METHODS: Structured questionnaire based cross sectional observational study. Completed responses were received from 259 individuals. Information was collected on demographic details, medical history, history of COVID-19 infection, history of dental problems, anxiety associated with dental visit and reason for dental visit during the pandemic, whether vaccinated and expecting the dentist to be vaccinated. Apprehension or concerns regarding dental visits were acquired via nine closed-ended questions with dichotomous responses. RESULTS: During the pandemic, 25.9% had dental problems, 24.7% visited the dentist and 81% were anxious about dental visits. 72.6% were concerned about contracting infection from the clinic, 81.5% were concerned about contracting infection in the waiting area, and 87.3% were concerned about whether the clinicians/assistants would meticulously follow standard operating protocols, 88% were concerned about disinfection between patients and 75.7% expressed concern on higher treatment charges due to the pandemic. CONCLUSIONS: The general public is concerned about disease transmission in the dentist's office and increased treatment costs, both of which could have a negative impact on the use of dental services during this COVID-19 pandemic.

Clinical and Radiological Outcomes for Guided Implant Placement in Sites Preserved with Bioactive Glass Bone Graft after Tooth Extraction: A Controlled Clinical Trial.

The goal of the study was to evaluate marginal bone loss (MBL) after 1-year implant placement using a guided implant surgical (GIS) protocol in grafted sockets compared to non-grafted sites. We followed a parallel study design with patients divided into two groups: grafted group (Test group, n = 10) and non-grafted group (Control, n = 10). A bioactive glass bone graft was used for grafting. A single edentulous site with a minimum bone height ≥11 mm and bone width ≥6 mm confirmed by cone-beam computerized tomography (CBCT) was chosen for implant placement. Tapered hybrid implants that were sandblasted and acid-etched (HSA) were placed using the GIS protocol and immediately loaded with a provisional prosthesis. MBL and implant survival rates (ISR) were assessed based on standardized radiographs and clinical exams. Patients were followed up for 1-year post-loading. MBL after one year, in the control group, was −0.31 ± 0.11 mm (mesial) and −0.28 ± 0.09 mm (distal); and in the test group was −0.35 ± 0.11 mm (mesial) and −0.33 ± 0.13 mm (distal), with no statistical significance (p > 0.05). ISR was 100% in both groups after one year. ISR was similar between groups and the marginal bone changes were comparable one year after functional loading, without statistical significance, suggesting that bioactive glass permitted adequate bone formation. The GIS protocol avoided raising flaps and provided a better position to place implants, preserving the marginal bone around implants.

The influence of laser-microgrooved implant and abutment surfaces on mean crestal bone levels and peri-implant soft tissue healing: a 3-year longitudinal randomized controlled clinical trial.

PURPOSE: The study aimed to compare clinical and radiographic parameters of peri-implant site of laser-microgrooved implants with either laser-microgrooved or regular machined prosthetic abutment post 3 years of early loading. METHOD: Twenty edentulous sites of systemically and periodontally healthy individuals were allocated into two groups in this prospective, two-armed, randomized double-blinded clinical trial in 1:1 ratio, wherein each site received laser-microgrooved implants with either laser-microgrooved or machined prosthetic abutments. Outcome measures included full-mouth plaque (FMPS%) and bleeding score (FMBS%), site-specific plaque (SPS%) and bleeding score (SBS%), peri-implant sulcus depth (PISD mm), and mean crestal bone loss (MCBL mm) evaluated at baseline (6 weeks), 1 and 3 years post-early loading. Mean and standard deviation of all parameters were estimated, between groups and at different time points using independent and paired t-test, respectively, Normality was checked using Kolmogorov-Smirnov test and Shapiro-Wilk test, P value ≤ 0.05 was considered as statistically significant. RESULTS: Three-year follow-up of test group showed statistically significant reduction in SPS, SBS, PISD (P value ≤ 0.001). The MCBL reduced from 1.93 mm to 0.61 mm (P value ≤ 0.001); in other words, a bone gain of 0.15 mm was obtained in the test group. CONCLUSION: Within the limitations of the present study, laser-microgrooved implants loaded with laser-microgrooved prosthetic abutments showed superior results clinically and radiographically when compared to loading with machined abutments.

Microbial Assessment of Two Different Abutment Designs in Peri-implant Sulcus and Implant Abutment Interface: A Case Control Postloading Study.

This study evaluates the microbial colonization in the peri-implant sulci and in implant-abutment interfaces of Laser-Lok implants (BioHorizons) with laser-microgrooved abutments (test group) and machined abutments (control group) 18 months after functional loading Real-time polymerase chain reaction revealed significantly greater total and specific microbial load in both the peri-implant sulcus and implant-abutment interface in the control group (P ≤ .05) Similarly, there was a significant reduction in the radiographic crestal bone loss in the test group (P ≤ .05) In total, 14 patients were assessed for clinical and radiographic parameters and microbial evaluation Peptostreptococcus micros and Porphyromonas gingivalis were positively correlated with site-specific plaque scores and bleeding scores, and mean crestal bone loss, respectively Hence, the authors propose using Laser-Lok implants with laser-microgrooved abutments to reduce microbial colonization and consequently preserve the crestal bone levels.

Association of Receptor for advanced glycation end products G82S polymorphism with chronic periodontitis in type II diabetic and non-diabetic South Indians.

AIM The current study investigated the association of RAGE G82S polymorphism with chronic periodontitis in South Indians with and without type II Diabetes mellitus. MATERIALS AND METHODS: 405 individuals were enrolled into 3 groups-systemically and periodontally healthy with no attachment loss (n = 135), generalized chronic periodontitis (n = 135)and generalized chronic periodontitis with type II diabetes mellitus(n = 135). Periodontal clinical parameters were recorded. RFLP-PCR was utilized for genotyping. RESULTS: Frequencies of genotype GG, GA and AA were 133, 2, 0 in group I respectively, 131, 4, 0 in group II respectively and 118, 13, 4 in group III respectively. Pearson's Chi squared test demonstrated a significant difference in the genotype distribution between the three groups (χ2 = 19.88,P < 0.001). Fischer exact-test showed that the variant GA/AA genotype was associated with a significantly increased risk for generalized chronic periodontitis in type II diabetics when compared with the GG genotype of systemically and periodontally healthy subjects (OR-9.58, 95% CI 2.168-42.339, P < 0.001) and non-diabetic chronic periodontitis subjects (OR- 4.71, 95% CI: 1.54-14.42, P < 0.05). No association and increased susceptibility to chronic periodontitis was observed in subjects with GA/AA genotype when compared with systemically and periodontally healthy subjects (OR- 2.031, 95% CI: 0.366-11.277 P > 0.05). Furthermore, comparison of clinical parameters based on genotype distribution revealed statistically significant higher mean plaque (P < 0.05) and sulcus bleeding score (P < 0.001) in group-III subjects. CONCLUSION: RAGE G82S gene polymorphism confers susceptibility to generalized chronic periodontitis in type II diabetic subjects of South Indian Tamilian ethnicity.

Oxidative stress in chronic periodontitis patients with type II diabetes mellitus.

OBJECTIVE: Oxidative stress (OS) refers to the disequilibrium between free radicals and antioxidant defense mechanisms and is significantly implicated in the pathogenesis of chronic degenerative and inflammatory diseases such as chronic periodontal disease (CP) and diabetes mellitus (DM). This study aimed to evaluate the total antioxidants capacity (TAOC) and total oxidants status (TOS) in the gingival crevicular fluid (GCF) in CP participants with type II DM. MATERIALS AND METHODS: A total of 80 participants were allotted into four groups as follows: Group 1: Generalized CP (GCP) without type II DM (n = 20); Group 2: GCP with type II DM (n = 20); Group 3: Type II DM without CP (n = 20); and Group 4: Systemically and periodontally healthy (PH) (n = 20). Clinical parameters such as plaque index, gingival index, probing pocket depth, and clinical attachment level were recorded. Pooled GCF was collected followed by the estimation of TAOC, TOS, and OS index (OSI) using Erel O Colorimetric analysis. RESULTS: The clinical parameters recorded showed the statistically significant difference (P < 0.001) between the groups. The mean TAOC value was the highest in PH group. The mean TOS and OSI were higher in Group 1, 2, and 3 participants when compared to the PH participants. All the biochemical parameters evaluated showed a statistically significant difference (P < 0.001) between groups. CONCLUSIONS: The study further validates the use of OSI as a marker for periodontal disease activity and emphasizes the role of OS in the pathogenesis of Type II diabetic patients with the chronic periodontal disease.

Preprocedural Anxiety and Pain Perception Following Root Surface Debridement in Chronic Periodontitis Patients.

BACKGROUND: The aim of this study was to evaluate and compare preprocedural dental anxiety levels and postprocedural pain perception in chronic periodontitis patients during conventional-staged root surface debridement (RSD) and single-stage RSD. MATERIALS AND METHODS: Thirty-seven adult generalized chronic periodontitis patients requiring RSD were recruited in this study. Preprocedural anxiety levels were assessed using a self-reported questionnaire and postprocedural pain perceptions were assessed using 0-10 cm visual analog scale. The subject population was divided into two groups: staged RSD (n = 18) and single-stage RSD (n = 19). Staged RSD patients visited four times as opposed to single-stage RSD patients. Data were subjected to Pearson Chi-square test, Mann-Whitney U-test, and Spearman's rank correlation. RESULTS: There was no statistically significant difference in dental anxiety levels or pain perceptions in both the groups. Within Group 1, there was statistical significant difference in dental anxiety levels between visit 4 and visit 3 (P = 0.037) and pain perception between visit 3 and visit 1 (P = 0.005), visit 4 and visit 1 (P = 0.002), and visit 4 and visit 2 (0.04) was statistically significant. There was a positive correlation of anxiety questionnaire (Q1-Q4) to the pain score in Group 1 which was statistically significant and in single-stage RSD. CONCLUSION: Conventional quadrant-wise RSD tends to cognitively condition the anxiety experience thus influencing pain experience.

Root Conditioning with Citric Acid and Ethylenediaminetetraacetic Acid and their Effect on Fibrin Clot Adhesion to Dentin-A Scanning Electron Microscopic Study.

INTRODUCTION: Root biomodifiers are used to remove the smear layer formed on the roots as a result of mechanical debridement and also to expose collagen fibers making the root surfaces biologically acceptable. Further, the blood element linkage to demineralized roots and clot stabilization by collagen fibres are vital for the wound healing and success of periodontal surgery. AIM: The aim of this study was to evaluate and compare the distribution of fibrin network to dentin surfaces conditioned with citric acid and Ethylenediaminetetraacetic Acid (EDTA) using Scanning Electron Microscope (SEM). MATERIALS AND METHODS: Thirty human dentin blocks (4 mm x 3 mm x 1 mm) were prepared and equally divided into three groups. The control Group A specimens were treated with Phosphate Buffered Saline (PBS). The study Group B and C specimens were treated with citric Acid and EDTA respectively. After conditioning, a drop of fresh human whole blood was placed on the dentin specimens and was allowed to clot. The specimens were then processed using standardized protocol for SEM. The dentin surfaces were then analysed for fibrin network linkage under SEM and scored according to the degree of fibrin linkage to the dentin surface. Statistical analysis was done using Kruskal Wallis test to compare the score values between the study groups. Pairwise comparison between the study groups was done using Mann Whitney U test with Bonferroni correction. RESULTS: The fibrin network formed on the dentin network were analysed and scores were given. Kruskal Wallis test and Mann Whitney U test with Bonferroni correction were used for statistical analysis. It was found that most of the dentin specimens conditioned with citric acid and covered with human blood exhibited dense fibrin network compared to EDTA. However, statistical analysis showed that there were no significant differences found between the groups (p=0.35). CONCLUSION: Citric acid and EDTA has almost comparable effect in promoting the adhesion of fibrin network onto the dentin surface which may further enhance connective tissue attachment to the root surface.

Dental anxiety among adults: an epidemiological study in South India.

BACKGROUND: Dental anxiety is a major barrier for dental care utilization. Hence, identifying anxious individuals and their appropriate management becomes crucial in clinical practice. AIM: The study aims to assess dental anxiety, factors influencing dental anxiety, and anxiety towards tooth extraction procedure among patients attending a dental hospital in India. MATERIALS AND METHODS: The study sample consisted of 1,148 consecutive patients aged 18-70 years. The assessment tools consisted of a consent form, history form, a questionnaire form containing the Modified Dental Anxiety Scale (MDAS) which was used to assess the level of dental anxiety, and an additional question on anxiety towards dental extraction procedure. RESULTS: Among the study group, 63.7% were men and 36.3% were women. Based on the MDAS score, 45.2% of the participants were identified to be less anxious, 51.8% were moderately or extremely anxious, and 3% were suffering from dental phobia. Mean MDAS total score was 10.4 (standard deviation (SD) = 3.91). Female participants and younger subjects were more anxious (P < 0.001). Subjects who were anxious had postponed their dental visit (P < 0.001). Participants who had negative dental experience were more anxious (P < 0.05). Notably, 82.6% reported anxiety towards extraction procedure. Significant association was seen between anxiety towards extraction procedure and the respondents gender (P < 0.05), age (P < 0.001), education level (P < 0.05), employment status (P < 0.001), income (P < 0.001), self-perceived oral health status (P < 0.05), and their history of visit to dentist (P < 0.05). CONCLUSION: Significant percentage of population was suffering from dental anxiety in this study population. A plethora of factors like age, gender, education level, occupation, financial stability, and previous bad dental experience influences dental anxiety to various levels. Extraction followed by drilling of tooth and receiving local anesthetic injection provoked more anxiety.

Utility and validity of a single-item visual analog scale for measuring dental anxiety in clinical practice.

We evaluated whether a visual analog scale (VAS) was comparable to the multi-item Modified Dental Anxiety Scale (MDAS) in assessing dental anxiety in clinical practice. In total, 200 consecutive patients aged 20-70 years who presented at the dental outpatient department of SRM Dental College, Chennai were enrolled. The test-retest value for the VAS was 0.968. The Spearman rank correlations between the VAS and MDAS items and total score were significant (P < 0.001). The Spearman rank correlation between postponement of a dental visit and the VAS also showed a strong correlation (r = 0.473, P < 0.001). On linear regression analysis, the coefficient of determination showed a strong relationship between the two variables; the MDAS accounted for 74% of the variation. The regression coefficient was statistically significant (P < 0.001). On the basis of receiver-operating-characteristic curve analysis, a VAS cut-off value of ≥4.8 was selected to discriminate between patients who were and were not anxious, and a cut-off value of ≥7 was selected to identify patients with dental phobia. The weighted kappa was 69% for agreement between MDAS and the VAS in identifying patients with and without dental anxiety at cut-offs of 13 and 4.75, respectively. The VAS was found to be a valid measure and was comparable to the multi-item MDAS.

A Novel Esthetic Approach using Connective Tissue Graft for Soft Tissue Defect Following Surgical Excision of Gingival Fibrolipoma.

The aim of the present case report is to evaluate the adjunctive use of a connective tissue graft to overcome soft tissue defects following excision of a gingival fibrolipoma in the aesthetic region. Connective tissue graft has been well documented for treating defects of esthetic concern. However, the literature does not contain many reports on the esthetic clinical outcome following the use of connective tissue graft secondary to excision of soft tissue tumours. A 28-year-old male patient reported with a complaint of a recurrent growth in relation to his lower front tooth region. The lesion which was provisionally diagnosed as fibroma was treated with a complete surgical excision, following which a modified coronally advanced flap and connective tissue graft was adopted to overcome the soft tissue defect. The excised growth was diagnosed histologically as fibrolipoma. One year follow up showed no recurrence of the lesion and good esthetics.The adjunctive use of the connective tissue graft and modified coronally advanced flap predictably yields optimal soft tissue fill and excellent esthetics. Hence, routine use of this procedure may be recommended for surgical excision of soft tissue growths in esthetically sensitive areas.

Reliability and validity of the Tamil version of Modified Dental Anxiety Scale.

The aim of this study was to test the reliability and validity of the Tamil version of the Modified Dental Anxiety Scale (MDAS). One hundred and forty-six patients attending the Outpatient Department of SRM Dental College, Chennai, India consented to participate in the study. The assessment tools consisted of a history form, Tamil version of the MDAS questionnaire and a form for Visual Analogue Scale (VAS). The Tamil version of MDAS had a good internal consistency of 0.839. The mean total score decreased with age. Females were more anxious than males (10.16 and 9.43, respectively). Uneducated, unemployed and low income subjects were more anxious than their counterparts who were educated, employed and from a higher income group. Persons who perceived their oral health as poor were more anxious. Independent t-test showed a highly significant difference in the mean total score of the respondents who had postponed their dental visit due to anxiety (t-test 6.494, P < 0.001). VAS and MDAS scores showed a highly significant correlation (r = 0.827, P < 0.001). This supported the convergent validity of MDAS. The Tamil version of MDAS showed acceptable psychometric properties.