Assessment of parental acceptance towards different non-pharmacological behaviour management techniques in pediatric dental care-a cross-sectional study.

It is imperative to manage children with empathy and concern for their well-being in order to carry out any dental procedure smoothly. Owing to the inherent fear of dental operatory, behaviour management of children is an important aspect of pediatric dental care. Many techniques are available to help manage the behaviour of children. It is, however important to educate parents about these techniques and to get their cooperation for these techniques to be used on their children.This study aimed to familiarize the parents with non-pharmacological behavior management techniques and to determine the parental acceptance of such techniques in children seeking dental treatment in specialty care dental units. A total of 303 parents were evaluated through online questionnaires in this research. They were shown videos of randomly selected non-pharmacologic behaviour management techniques including tell-show-do, positive reinforcement, modelling and voice control. Parents were asked to watch the videos and give their response on seven-items inquiring about their acceptance levels regarding the respective techniques. The responses were recorded on a Likert scales ranging from strongly disagree to strongly agree. According to parental acceptance score (PAS), positive reinforcement was the most accepted technique whereas voice control was the least acceptable technique. Majority of the parents were more receptive towards those techniques that involved a healthy and friendly communication between a dentist and the pediatric patient such as, positive reinforcement, tell show do and modelling. Most significantly the people having low socio-economic status (SES) in Pakistan were more acceptable of voice control than people with high SES.

Detection of ABO Blood Groups From Dentin and Pulp by Using the Absorption-Elution Technique: A Forensic Cross-Sectional Study Among the Population of the Al Jouf Province, Saudi Arabia.

Background and objective Human teeth have a significant forensic importance. As they are the hardest of all human tissues, they are not just chemically stable but also their characteristics are maintained for a long time after death even in the most harsh environmental conditions. Despite the advances made in DNA analysis, fingerprinting, etc., ABO blood grouping still plays a significant role in the forensic practice in the field of personal identification, paternity disputes, and several other scenarios including the identification of mass disaster victims. The term blood groups refers to inherited antigens on the surface of red blood cells (RBCs) detected by specific antibodies. Since tooth pulp contains numerous blood vessels, blood group antigens are most certainly bound to be present in tooth pulp. Various studies have shown that blood group antigens in the pulp and dentin are preserved as long as up to two years after the demise of an individual. Absorption-elution technique has been proven to be the most sensitive, reliable, and consistent method to determine the ABO blood group from both the pulp and dentine. This study aimed to ascertain the ABO blood group from both the hard (dentin) as well as the soft tissue (pulp) of the tooth by using the absorption-elution (AE) technique and also to determine if there are any variations in identifying the blood groups from the teeth based on age and gender. Material and methods After obtaining due consent, we included patients of both genders aged between 16-60 years visiting the outpatient department (OPD) clinics at the College of Dentistry for periodontal or orthodontic extractions. One patient's blood type was determined by using the slide agglutination technique before any capillary blood extraction was performed; this patient served as a control. For this investigation, we used the pulp and powdered dentin samples taken from the dental extractions to test for the presence of ABO and Rhesus (Rh) factor antigens by using the AE method. The study samples were compared with the control for blood group determination. Statistical analysis was carried out using the chi-square test with Monte Carlo (MC) simulation to check for any correlation of blood grouping with age and gender. Results The dentin and pulp were shown to have positive blood group antigens for the ABO and Rh factors. While neither pulp nor dentin performed significantly differently in identifying the blood group antigens, pulp showed marginally higher accuracy. There was no discernible difference regarding gender or age in the dentin or pulp of any of the 45 samples studied. Conclusions For determining an individual's blood type and Rh factor, both the hard (dentin) and soft (pulp) tissues of a tooth are valid sources. This is particularly helpful in forensic medicine cases where teeth are the only remains that can be viably used to find out a person's identity.

Analysis of Gender Dimorphism and Assessment of Racial Variation Through Odontometric Technique: A Cross-Sectional Study.

BACKGROUND: When conducting a forensic investigation, one of the most important steps is establishing the biological profile of a victim who cannot be positively recognized or is just a skeleton. It has been shown that, among the other clinical indicators, the diameters of dental crowns are a good and dependable source for determining gender in a particular population sample. However, the literature is sparse regarding their assessment as a viable marker for the determination of a particular race. In addition, the need for population-specific data has also been advocated while determining gender dimorphism based on tooth size. AIM AND OBJECTIVES: To study the bisexual variation in the permanent dentition of individuals from three different sets of populations: Arabian, South Asian, and East Asian. The other objective is to explore the role of this odontometric analysis in predicting the racial identity of the subjects belonging to the aforementioned population. METHODOLOGY: The research was conducted at the College of Dentistry, AlJouf University in Sakaka. Measurements of mesiodistal and buccolingual (BL) distances were taken using a digital vernier caliper on a total of 75 pairs of research models or casts. Statistical tests were run on the information gathered. RESULTS: Of the 75 casts, 38 (50.7%) were of male and 37 (49.3%) were of female. Our analysis showed between genders, a significant difference in maxillary central incisor (P = 0.001), first premolar (P = 0.01), and first molar (P = 0.02) while for a mandibular arch, a significant difference was noted for incisors (P = 0.002) with greater tooth dimension in male than in the female. Concerning the BL dimensions, only the mandibular canine showed a significant difference between males and females (P = 0.001). Comparisons of the crown dimensions between population groups showed that the Arabian population consistently exhibits larger tooth dimensions than the other two populations in both arches. CONCLUSION: A few crown dimensions can be used as an adjunctive tool for the identification of the gender and race of an individual.

Exploring an Association between Body Mass Index and Oral Health-A Scoping Review.

BACKGROUND: Basal metabolic index (BMI) is a unique anthropometric indicator used to define the relative amount of body fat on an individual's frame. There are many diseases and conditions associated with obesity and underweight. Recent research trials suggest that there is a significant association between oral health indicators and BMI as both are attributed to common risk factors such as dietary, genetic, socioeconomic, and lifestyle issues. OBJECTIVES: The main objective of this review paper is to emphasize the association between BMI and oral health with available literature evidence. METHODOLOGY: A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were "body mass index", "periodontitis", "dental caries", and "tooth loss". RESULTS: In total, 2839 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 1135 articles were excluded. The main reasons for excluding the articles were: they were dietary guidelines and policy statements. A total of 66 studies were finally included in the review. CONCLUSION: The presence of dental caries, periodontitis and tooth loss may be associated with a higher BMI or obesity, whereas, improved oral health might be associated with lower BMI. Promoting general and oral health should be a hand in hand feature, as common risk factors can be embattled.

Oral Health-Related Quality of Life in Breast Cancer Patients in the Northern Region of Saudi Arabia.

BACKGROUND: Breast cancer is one of the most prevalent diseases, and ignoring dental health care before and after treatment can have severe long-term consequences. Additionally, this may have a negative impact on the patient's general quality of life. AIM: The aim of the present study was to assess oral health-related quality of life (OHRQoL) among breast cancer patients and identify possible factors associated with the outcome. METHODOLOGY: In this observational cross-sectional study, 200 women who had received breast cancer therapy and were being followed up at a hospital made up the sample. The study was conducted between January 2021 and July 2022. Information on sociodemographic characteristics, general health, and breast cancer was recorded. The decayed, missing, and filled teeth index was used in clinical examinations to identify caries experience. OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14) questionnaire. After adjusting for confounding variables, a logistic regression analysis was used to determine the related factors. RESULTS: The mean OHIP-14 score was 11.48 (SD 1.35). There was a 63.0% prevalence of negative impacts. Age and the time frame from cancer diagnosis were found to be significantly linked with the outcome by binary logistic regression analysis. CONCLUSIONS: Breast cancer survivors who were ≤55 years old and the time elapsed since diagnosis was less than 36 months had a poor OHRQoL. To lessen the negative impacts of cancer treatment and enhance quality of life, patients with breast cancer need special oral care and should be monitored before, during, and after cancer treatment.

Long-pulsed Nd:YAG laser-assisted hair removal in Fitzpatrick skin types IV-VI.

Unwanted hair is a common problem for which a variety of laser treatments is available. Laser treatment in dark-skinned individuals carries a higher risk of complications like hyperpigmentation and burn. The objective of this study was to evaluate efficacy and safety profile of laser-assisted hair removal in individuals with Fitzpatrick type IV-VI skin using long-pulsed Nd:YAG laser. Retrospective data was collected from 150 individuals with Fitzpatrick type IV-VI skin who underwent laser-assisted hair removal. This included area treated, fluence, number of treatments, and outcome. Data was also gathered on patient satisfaction and complications. The most common phototype was type IV (94%). The most frequently treated area was the face (84.7%) followed by the underarms and legs. Among the facial areas, the chin was the most frequently treated area followed by the upper lip and jaw line. The mean number of treatments was 8.9 (range 4-22). The maximum fluence averaged 26.8 Joules/cm(2) and was significantly higher for facial hair. Of the patients, 78.7% felt that their treatment was good or satisfactory. Mean hair reduction was 54.3%. Satisfaction from the treatment was significantly higher in individuals undergoing treatment of non-facial areas. Subsequent hair growth was slower and finer in 79.3% of the patients. There were no complications in 86% of the patients. All the complications were transient, with hyperpigmentation being the most frequent complication. Our results show that laser hair removal using the long-pulsed Nd:YAG laser is safe and effective in dark-skinned individuals with satisfactory results in most patients.

An Ultrastructural Study on the Effect of High Temperatures on Teeth and Restorative Materials That Aids in the Identification of Human Remains.

INTRODUCTION: In most disasters, teeth are the only means of positive identification of an otherwise unrecognizable body, as there has been tremendous increase in the use of dental restorations that have different resistance to prolonged high temperature which is an important aid in identifying burned victims. Application of SEM/EDS in forensics was found useful in areas where there is a need for good imaging with high magnification combined with elemental analysis. The objective of this study was to analyze incineration effects on teeth and restorative materials using SEM/EDS. Materials and Method. 128 extracted teeth were collected, 96 were restored with silver amalgam, composite, and GIC of 32 each, and crown preparation was done in 32 teeth for which metal ceramic crowns were prepared. These teeth were subjected to 4 different temperatures (500°C, 700°C, 900°C, and 1100°C) for 20 minutes, and they were analyzed macroscopically and by using SEM for the changes subsequent to their exposure to such high temperatures. RESULTS: All the restorations which were very difficult to identify by naked eye were identified with the help of SEM/EDS. CONCLUSION: Elemental analysis of the specific restorative material proves to be an essential tool for the forensic odontologist.

Ameloblastic fibrosarcoma - A rarity?

Ameloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumour classified by the WHO (1992) as an odontogenic sarcoma and defined as "a neoplasm with a similar structure to ameloblastic fibroma (AF) but in which the ectomesenchymal component shows the features of a sarcoma." The first report of AFS was published by Heath in 1887. AFS and related lesions are less frequently diagnosed than odontogenic carcinomas. Approximately two-thirds of AFSs seem to arise de novo, but others have developed in recurrent AF, in which the ectomesenchymal cells retain their embryonic appearance and develop malignant characteristics. We report a rare case of an aggressive odontogenic neoplasm, the incisional biopsy of which showed the features of AF, while the excisional biopsy revealed the features of malignancy, suggestive of AFS. The purpose of this report is to discuss the diagnostic difficulties, whether AFS is truly an extremely rare tumour as reported earlier and, lastly, should the treatment protocols of AFs be revised, as 44% of AFSs arise from recurrent AFs.

Composition and distribution of the health workforce in India: estimates based on data from the National Sample Survey.

BACKGROUND: The availability of reliable and comprehensive information on the health workforce is crucial for workforce planning. In India, routine information sources on the health workforce are incomplete and unreliable. This paper addresses this issue and provides a comprehensive picture of India's health workforce. METHODS: Data from the 68th round (July 2011 to June 2012) of the National Sample Survey on the Employment and unemployment situation in India were analysed to produce estimates of the health workforce in India. The estimates were based on self-reported occupations, categorized using a combination of both National Classification of Occupations (2004) and National Industrial Classification (2008) codes. RESULTS: Findings suggest that in 2011-2012, there were 2.5 million health workers (density of 20.9 workers per 10 000 population) in India. However, 56.4% of all health workers were unqualified, including 42.3% of allopathic doctors, 27.5% of dentists, 56.1% of Ayurveda, yoga and naturopathy, Unani, Siddha and homoeopathy (AYUSH) practitioners, 58.4% of nurses and midwives and 69.2% of health associates. By cadre, there were 3.3 qualified allopathic doctors and 3.1 nurses and midwives per 10 000 population; this is around one quarter of the World Health Organization benchmark of 22.8 doctors, nurses and midwives per 10 000 population. Out of all qualified workers, 77.4% were located in urban areas, even though the urban population is only 31% of the total population of the country. This urban-rural difference was higher for allopathic doctors (density 11.4 times higher in urban areas) compared to nurses and midwives (5.5 times higher in urban areas). CONCLUSION: The study highlights several areas of concern: overall low numbers of qualified health workers; a large presence of unqualified health workers, particularly in rural areas; and large urban-rural differences in the distribution of qualified health workers.

Frequency and Characteristics of Mesiodens in Indian School Children: A Retrospective Radiographic Study

Abstract Objective: To determine the frequency and characteristics of mesiodens in Indian school children. Material and Methods: 1232 radiographs of patients attending the Department of Oral Medicine and Radiology of the age group of 4-15 years studied for the present retrospective study. The intraoral periapical radiographs and occlusal radiographs of the premaxilla were examined to determine the presence of mesiodens. The data regarding the presence of mesiodens, number, position, location on the arch, shape and associated complications were recorded. Results: Eleven patients had 14 mesiodens, with a frequency of 0.8%. The ratio of boys to girls was 1.2:1. Maximum mesiodens observed in the age group of 7-9 years. Most of the mesiodens were conical in shape and found on the palatal side. Fifty percent of the mesiodens were unerupted. The majority of patients (57.1%) had vertically positioned mesiodens. Midline diastema was the most common complication due to mesiodens (66.7%). Conclusion: Routine check-up during the primary dentition and mixed dentition stages helps for early detection of mesiodens and thus preventing complications. Early identification is useful for planning comprehensive management, initiating proper consultation and referral for evaluation and treatment.

The role of simultaneous gap arthroplasty and distraction osteogenesis in the management of temporo-mandibular joint ankylosis with mandibular deformity in children.

INTRODUCTION: Temporo-mandibular joint ankylosis is a common cause of acquired deformity in children. PURPOSE: Surgical correction of the ankylosis only leaves the patient with an uncorrected mandibular deformity. This study was to evaluate the use of distraction osteogenesis for simultaneous correction of the mandibular deformity. MATERIAL: This study was done on six children with temporo-mandibular joint ankylosis and mandibular deformity. Uniaxial double pin distractors with Schanz pins were used in this study. METHODS: The patients underwent simultaneous gap arthroplasty and mandibular osteotomy (retromolar) with distractor insertion. Distraction was started on the fifth post-operative day. The patients were put on dynamic temporo-mandibular joint exercises on the first post-operative day. RESULTS: All patients had a satisfactory mouth opening on follow-up. Satisfactory cosmetic correction of the mandibular deformity was also achieved in all these patients. Some degree of malocclusion resulted from treatment due to which the patients were placed on orthodontic treatment. CONCLUSIONS: Distraction osteogenesis can be used simultaneously with gap arthroplasty in patients with temporo-mandibular ankylosis, for the correction of the mandibular deformity.

Physical activity correlates and barriers in head and neck cancer patients.

PURPOSE: Our study purpose was to determine physical activity correlates and barriers among head and neck cancer patients. MATERIALS AND METHODS: Fifty-nine (response rate = 91%) head and neck cancer patients from an academic oncology clinic enrolled in a cross-sectional study utilizing chart review and self-administered questionnaire. RESULTS: The majority were men (83%) and white (92%) with mean age of 58 +/- 12.8 years and mean months since diagnosis of 18.6 +/- 51.9. The strongest bivariate correlates of physical activity included enjoyment (r = 0.41; p = 0.002), symptom index (r = -0.36; p = 0.006), alcohol use (r = 0.36; p = 0.007), task self-efficacy (r = 0.33; p = 0.013), perceived barriers (r = -0.27; p = 0.047), and comorbidity score (r = -0.27; p = 0.042). Stepwise regression demonstrated independent associations with physical activity for enjoyment (beta = 0.38; p = 0.002) and symptom index (beta = -0.33; p = 0.006; R (2) = 0.28). The most prevalent barriers significantly associated with physical activity included dry mouth or throat (r = -0.32; p = 0.016), fatigue (r = -0.27; p = 0.043), drainage in mouth or throat (r = -0.41; p = 0.002), difficulty eating (r = -0.32; p = 0.015), shortness of breath (r = -0.30; p = 0.024), and muscle weakness (r = -0.29; p = 0.033). CONCLUSIONS: Our results showed that the strongest independent correlates of physical activity were social cognitive (i.e., enjoyment) and treatment-related (i.e., symptom index). Treatment-related activity barriers were frequent and significantly associated with reduced activity. Efforts to enhance exercise adherence in head and neck cancer patients should focus on optimizing enjoyment and managing treatment-related barriers.