Self-medication Practice Amongst Patients Visiting a Tertiary-care Dental Hospital in Central India.

PURPOSE: To assess self-medication practice-related awareness for correct usage and its association with demographic factors among patients reporting to a dental college. MATERIALS AND METHODS: This descriptive cross-sectional questionnaire-based study was conducted among 300 patients reporting to the People's College of Dental Sciences and Research Centre, Bhopal, India. Only patients ≥ 18 years of age were included and consenting participants anonymously completed the questionnaire, with incomplete questionnaires being excluded from the study. The semi-structured questionnaire containing both open- and closedended questions was prepared in the local language and included demographic data, name of self-medication, frequency of self-medication, periods of illness, duration, dose, frequency of drug administration, symptoms for which drugs were used, satisfaction with healthcare facilities, source of information for self-medication, presence of chronic illness, adverse effects to self-medication seen in patients and drug interactions. The unpaired t-test and chi-square test were used for statistical analysis. p-values < 0.05 were considered statistically significant. RESULTS: A significant association was seen between education and self-medication. It was observed that the subjects who fell ill more frequently consumed medications on their own more often. Medications were most commonly taken for cough, cold and fever. The most preferred medicine was paracetamol. Most of the subjects found the medicines effective in helping them relieve their symptoms. However, not even half of the subjects were aware of the dose, duration, side-effects or interactions of medicines. There was a significant association between knowledge about side-effects and side-effects experienced from medication. A significant association was also seen between knowledge about side-effects and frequency of self-medication. CONCLUSION: Self-medication and non-doctor prescribing are relatively common in Bhopal. Knowledge regarding the appropriate usage of medication is inadequate. Education to help patients decide on the appropriateness of selfmedication is required.

Impact of oral health education by audio aids, braille and tactile models on the oral health status of visually impaired children of Bhopal City.

CONTEXT: Children with special needs face unique challenges in day-to-day practice. They are dependent on their close ones for everything. To improve oral hygiene in such visually impaired children, undue training and education are required. Braille is an important language for reading and writing for the visually impaired. It helps them understand and visualize the world via touch. Audio aids are being used to impart health education to the visually impaired. Tactile models help them perceive things which they cannot visualize and hence are an important learning tool. AIM: This study aimed to assess the improvement in oral hygiene by audio aids and Braille and tactile models in visually impaired children aged 6-16 years of Bhopal city. SETTINGS AND DESIGN: This was a prospective study. MATERIALS AND METHODS: Sixty visually impaired children aged 6-16 years were selected and randomly divided into three groups (20 children each). Group A: audio aids + Braille, Group B: audio aids + tactile models, and Group C: audio aids + Braille + tactile models. Instructions were given for maintaining good oral hygiene and brushing techniques were explained to all children. After 3 months' time, the oral hygiene status was recorded and compared using plaque and gingival index. STATISTICAL ANALYSIS USED: ANNOVA test was used. RESULTS: The present study showed a decrease in the mean plaque and gingival scores at all time intervals in individual group as compared to that of the baseline that was statistically significant. CONCLUSIONS: The study depicts that the combination of audio aids, Braille and tactile models is an effective way to provide oral health education and improve oral health status of visually impaired children.

Frequency of Addictive Habits and its Association with Oral Diseases Among a Cross Section of Indian Police Personnel Connotation.

OBJECTIVE: To assess the frequency of adverse addictive habits, specially alcohol and tobacco usage, among police personnel of Bhopal City, Central India and its association with the frequency of oral mucosal lesions and periodontal diseases. STUDY DESIGN: Across-sectional analytical study. PLACE AND DURATION OF STUDY: Bhopal City, Capital of Madhya Pradesh State, Central India, from February to April 2013. METHODOLOGY: All the police personnel posted at various police stations were interviewed and clinically examined. Police personnel who did not cooperate or were not willing, were excluded from the study. Chi-square test was used to analyze categorical variables. RESULTS: Atotal of 781 subjects were interviewed for the various forms of adverse habits, followed by clinical assessment of oral mucosal lesions and periodontal status using WHO 1997 criteria. The mean age of study subjects was 40.58 ±9.84 years. Usage of tobacco was found among 55% and only 1.3% of subjects consumed alcohol. The prevalence of oral mucosal lesions and periodontal diseases was significantly higher among tobacco users. CONCLUSION: There was high usage of tobacco among police personnel in Bhopal City, India with a detrimental effect on oral health.

Orodental manifestations in cases with partial agenesis of corpus callosum-rare phenomena.

UNLABELLED: This article focuses on the associated signs and symptoms of patients with partial agenesis of the corpus callosum. The orodental manifestations of such cases have been given special weightage which will prove to be of great help to oral physician when encountered with such cases. CASE DETAILS: Two siblings, aged 14 and 16 years, reported with a chief complaint of severe crowding of teeth with mouth breathing habit. They were low birth-weight babies and had been born to non-consanguinous parents. The distinguishing features of these children were craniofacial abnormalities, delayed developmental milestones, mild mental retardation and abnormal gait. The nosological features and the clinical manifestations of this syndrome and the plausible autosomal recessive inheritance of this rare syndrome have been elicited. The diagnosis was based on characteristic phenotype, in particular striking craniofacial and skeletal abnormalities and neuroimaging. CONCLUSION: It is a challenge for healthcare professionals to help these youths to maximize their potential as human beings and help them achieve a meaningful adulthood. On the other hand, diagnosing such cases can be a challenge to dentistry. A systematic protocol, if adhered, can lead to a more appropriate diagnosis. Managing such cases in a clinical setup involves a multispeciality and interdisciplinary approach.

Awareness, Attitude and Barriers Towards Evidence Based Dental Practice Amongst Practicing Dentists of Bhopal City.

INTRODUCTION: Evidence based dental practice is said to be the recent best approach to provide treatments or interventions, methodically proven to be safe and sound, efficient and cost effective. So, for providing quality dental care, clinical expertise, research evidence and patient's preferences all should be given equal importance. AIM: To assess the awareness, attitude & barriers of evidence-based dental practice (EBDP) amongst dentists of Bhopal city. MATERIALS AND METHODS: The target population of this cross-sectional study involves dentists of Bhopal city. Two hundred fifty private dentists of Bhopal were selected using convenience sampling technique. Data was collected using a self-administered questionnaire containing 15 questions for assessing Knowledge, attitude, practice & barriers in Evidence based practice. Chi-square, t-test & one-way ANOVA were applied for data analysis and p<0.05 was considered statistically significant. RESULTS: The study revealed that dental practitioners had low knowledge about evidence based dental practices but they showed positive attitude towards adopting it in their future practice. There exist certain barriers in practice of evidence based dentistry. CONCLUSION: Including evidence based dental practice teaching in dental curriculum may prove to be a significant step in effective and efficient dental care delivery to the patients. Barriers in evidence based practice needs to be identified & eliminated.

Oral Health Related Quality of Life in Patients of Head and Neck Cancer Attending Cancer Hospital of Bhopal City, India.

BACKGROUND: To assess the oral health related quality of life (OHRQoL) of head and neck cancer patients and to find association between QoL, demographic and disease variables. METHODS: This cross-sectional study was conducted on 153 patients diagnosed and being treated for head and neck cancer in Jawaharlal Nehru Cancer Hospital, India. Data collected from the survey included demographic details and OHRQoL, which was measured by European Organization of Research for Treatment of Cancer QoL questionnaire head & neck-35. Cancer measurements (location of tumor, stages of cancer, treatment type) were collected from the patient's hospital records. RESULTS: The majority of the population 84 (54.9%) belonged to 41-60 years age group and most of them were male (78.4%). The most frequent site of the primary tumor was the oral cavity (71.3%) and the majority of patients had Stage II and III cancer. Main factors affecting QoL were loss of weight, use of painkillers, sticky saliva, reduced mouth opening and problems in social eating. Significant association found between pain (P = 0.044), swallowing (P = 0.018), sense (P = 0.001), Social eating (P = 0.003), social contact (P = 0.008), reduced mouth opening (P = 0.008) with respect to type of treatment. CONCLUSIONS: We conclude that there was a significant reduction in the QoL in cancer patients resulting from myriad forms of cancers. An assessment of the QoL and symptoms can help the dentist to direct attention to most important symptoms and provide counseling for appropriate interventions towards improving QoL outcomes and the response to the treatment.

Oral health and oral health behaviour among 11-13-year-olds in Bhopal, India.

OBJECTIVES: To assess the prevalence of dental caries, to describe the periodontal conditions, and to assess the level of attitude, knowledge and practice in relation to oral health and oral health behaviour among 11-13 year-old children in Bhopal, India. The data would aim to provide a baseline for planning and evaluation of oral health education programmes for children in the region. BASIC RESEARCH DESIGN AND OUTCOME MEASURES: A cross sectional study of 599 children 11-13 years was conducted. Random sampling procedures were used to obtain representative samples of children in rural (n = 181) and urban areas (n = 277). In urban slum areas convenience sampling was applied (n = 141). The data were collected through clinical examinations by means of WHO standard method, and a sub-sample completed a self-administered questionnaire on oral health behaviour, knowledge, and attitude. RESULTS: The caries prevalence proportion in both dentitions was 57% with a mean DMFT+dmft of 1.6. The caries experience was 2.5 times higher among children in slum areas compared to children living in rural areas. Fifteen per cent of the children had healthy gingiva and 91% of rural children had maximum CPI score 2. Mean number of sextants with CPI score 0 was 3.5 among children in urban areas and 0.6 for children in slum areas. Seventy-five per cent of the children reported toothbrushing once a day, 31% used a plastic toothbrush and the general level of knowledge on oral health was low. Intake of sugary food and soft drinks were more frequent in the slum areas compared to rural areas. CONCLUSION: Implementation of community-oriented oral health promotion programmes is needed in order to increase the level of knowledge and to change attitudes and practices in relation to oral health among children. Essential care should be provided to control oral disease symptoms.

Prevalence of Gingivitis among Children of Urban and Rural Areas of Bhopal District, India.

BACKGROUND: Gingivitis is inflammation of the soft tissue without apical migration of the junctional epithelium. Redness, oedema and bleeding on probing characterize this condition. Untreated cases may lead to a more complex and destructive entity known as chronic periodontitis. Periodontitis are the main cause of tooth loss. Poor oral health has thus the potential of hampering the quality of life. So the aim of this study was to find the prevalence of gingivitis, among school-going children of urban and rural areas of Bhopal district, India. MATERIALS AND METHODS: The present descriptive, cross-sectional study was conducted among 12 & 15 y old middle and high school government rural and urban school children of Bhopal district. It was conducted of a period of two months. 1100 Children were examined by using WHO (modified) oral health assessment form, Loe and Silness index was used for recording gingival status. For statistical analysis SPSS version 20 was used. The chi-square test was applied for categorical data. p<0.05 was considered statistically significant. RESULTS: Prevalence of gingivitis was 59% found. 584 (53.09 %) children had mild gingivitis,61(5.5%) children had moderate gingivitis. CONCLUSION: This indicates the need for community health activities and awareness program.

Effectiveness of Pentoxifylline in the treatment of oral submucous fibrosis patients: a case-control study

Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder largely seen in the South-Asian countries where areca nut is found to be the main predisposing factor. Pentoxifylline, a methylxanthine derivative, has vasodilating properties and is believed to increase the vascularity of the mucosal layer. This study was designed to determine the effect of pentoxifylline (Trental) on the clinical progression of oral submucous fibrosis. Aim: The present study was aimed to evaluate the effectiveness of drug pentoxifylline in the management of OSMF and to correlate the clinical parameters evaluated before and after treatment. Methods: Study Design: This investigation was conducted as a case-control study incorporating a Control Group in comparison to a Study Group where pentoxifylline 400 mg was administered 3 times daily, as coated, sustainedrelease tablets for prescribed for 3 months. The stipulated period for the study was 8 months and a total of 80 cases of oral submucous fibrosis (40 test subjects and 40 controls) were included in this study and 100% acquiescence was reported at the end of the test period. Results: Mild dizziness and gastric irritation were the only untoward symptoms reported in 2 of the volunteers in the study group during this trial. These were managed by diet protocols. A review of the patients and controls was done at an interval of every 4 weeks for 3 months. The subjective and objective measurements were recorded. The follow-up data at each visit concerning each other and to base-line values were calibrated using nonparametric tests of the Chi-Square test and Mann-Whitney. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (u value =1.137, p = 0.260), tongue protrusion (u value = 0.262, p = 0.794 and cheek flexibility (u value =0.990, p = 0.326). Subjective symptoms of burning sensation of mouth (U value = 2.673, p = 0.008), pain on opening the mouth (U value = 4.320, p < 0.0001), difficulty in swallowing and difficulty in the speech were also recorded. Conclusion: This study showed the effectiveness of pentoxifylline as an additional therapy in the routine management of oral submucous fibrosis.

A comparison of oral hygiene status and dental caries experience among institutionalized visually impaired and hearing impaired children of age between 7 and 17 years in central India.

AIM: The aim of this study is to compare the oral hygiene status and dental caries experience among institutionalized visually impaired and hearing impaired children of age between 7 and 17 years in Bhopal city of Madhya Pradesh located in Central India. MATERIALS AND METHODS: A total of 95 hearing impaired and 48 visually impaired children of age between 7 and 17 years were recruited from special care institutions (one institution of hearing impaired and two institutions of visually impaired) in Bhopal city. Information related to different study variables was obtained from both groups. Oral hygiene index simplified (OHI[S]), decayed,extracted, filled teeth (deft and DECAYED, MISSING, FILLED TETTH (DMFT)) indices were used to record the oral hygiene status and dental caries experience. RESULTS: Mean OHI(S) score for hearing impaired was 1.15 ± 0.72 while it was 1.51 ± 0.93 for visually impaired children (P < 0.05). Mean DMFT score was 1.4 ± 1.95 and 0.94 ± 1.45 among hearing impaired and visually impaired respectively. The hearing impaired had a mean deft score of 0.47 ± 1.01 and in visually impaired it was 0.19 ± 0.79 and the difference was statistically significant (P < 0.05). CONCLUSION: Oral hygiene status of hearing impaired children was better than visually impaired and the difference was statistically significant. There was no significant difference between both groups with respect to DMFT. The hearing impaired children had significantly higher deft than visually impaired.

Association of pregnant women periodontal status to preterm and low-birth weight babies: A systematic and evidence-based review.

The mouth serves as a mirror to general health and also as a portal for disease to the rest of the body. Since the old wives' tale of "the loss of a tooth for every pregnancy", oral health during pregnancy has long been a focus of interest. In the past decade, there has been mounting scientific evidence suggesting that periodontal disease may play an important role as a risk factor for adverse pregnancy outcomes. Considering all the above stated factors this systematic review is aimed to focus on the association of periodontal diseases to preterm and low-birth weight (LBW) babies. In view of the large body of literature the review is limited to studies identified by computer searching. Hand searching of journals and gathering of unpublished reports and conference proceedings was outside the scope of the review. The PubMed database was searched using the search terms: periodontitis, preterm, LBW. The titles, authors, and abstracts from all studies identified by the electronic search were printed and reviewed independently on the basis of keywords, title and abstract, to determine whether these met the inclusion criteria. The electronic search identified 68 papers. After review of the study title, keywords and abstracts, 62 papers were identified potentially meeting inclusion criteria. Generally, all the studies reviewed in the paper suggest that periodontal disease may be a potential risk factor for preterm LBW babies.

Knowledge, attitudes, and practice regarding infection control measures among dental students in Central India.

A questionnaire study was conducted among 245 dental students from Bhopal city, Central India, to determine their level of knowledge, attitudes, and practice regarding infection control measures and if any correlation exists among the knowledge, attitudes, and practice scores. The self-administered questionnaire consisted of three parts: knowledge, attitudes, and practice. Analysis of Variance (ANOVA) was used to compare mean of knowledge, attitudes, and practice scores and Kendall's test to compute the correlation between knowledge, attitudes, and practice scores. A p value of ≤0.05 was considered significant for all statistical analyses. We found that 61.2 percent of the dental students had not been vaccinated with hepatitis B. Use of face mask, gloves, eyewear, and protective clothing as standard infection control measures was practiced only by two students. Mean knowledge, attitude, and practice scores were 3.75 (1.01), 3.40 (0.75), and 3.35 (1.04), respectively. Significant linear correlation was seen between attitude and practice scores (r=0.20, p≤0.01). The level of knowledge and practice of infection control measures was poor among dental students. The attitude towards infection control measures was positive, but a greater compliance was needed. We recommend rigorous training on infection control measures prior to graduation and mandatory hepatitis B immunization of students before exposure to clinical practice.

Tobacco cessation and counseling: a dentists' perspective in Bhopal city, Madhya Pradesh.

INTRODUCTION: Dental team has high potential to help smokers to better oral/general health but to achieve this; they need to be clear about their role. Considering the importance of tobacco cessation, the authors carried out this study aimed at assessing the role, knowledge, current practices, different barriers, and tools to overcome the same as perceived by dentists in Bhopal city. MATERIALS AND METHODS: A self-administered structured, coded questionnaire was distributed to 200 private practitioners and the teaching staff in all the dental colleges in Bhopal city. RESULTS: Out of 200 dentists to whom questionnaire was administered, 168 responded within a week's time resulting in a high response rate of 84%. A total of 97% of the dentists agreed that it is the duty of every dentist to advice patients about tobacco cessation. A total of 58% strongly agree that formal training will be an effective tool to provide the guidelines to dentists in tobacco cessation and counseling. CONCLUSION: Monitoring of effective planning and execution of these programs by appropriate authorities at regular intervals is vital for successful achievement of the goal of "Tobacco Free Society."