A scoping review exploring oral health inequalities in India: a call for action to reform policy, practice and research.

INTRODUCTION: Reduction in health inequalities and providing universal access to health care have been identified as two important global milestones by the World Health Organization for countries to achieve by 2030. Therefore, recognizing the magnitude of oral health inequalities in India has become a pressing priority to improve access to dental care within the country. This scoping review was conducted with the aim of reviewing, collating and analysing the current knowledge base on oral health inequalities in India. METHODOLOGY: The scoping review followed Arksey and O'Malley's approach, and reporting was performed in accordance with the PRISMA-ScR guidelines. A systematic search was conducted on Scopus, PubMed, Web of Science, and EMBASE to identify literature addressing one or more dimensions of oral health inequalities in India, published in English between January 2002 and April 2022. The data were charted, and qualitative analysis was performed to derive themes, highlighting the key concepts emerging from this review. RESULTS: In accordance with the eligibility criteria, a total of 71 articles retrieved through database search and backward citation search were included in this scoping review. The major themes ranged from individual to diverse sociodemographic factors acting as barriers to and facilitators of access to dental care. Deficiencies in human resources for oral health, along with a wide diversity in dental service provision and dental education were other major themes contributing to inequality. Subsequently, this has resulted in recommendations on restructuring the dental workforce and their development and modifications in oral health care policies and practices. The qualitative synthesis demonstrates the intertwined nature of the multiple factors that influence the goal of achieving an affordable, accessible, extensive and inclusive oral healthcare system in India. CONCLUSIONS: This comprehensive review provides a broad perspective on oral health inequalities in India, providing valuable insights for both researchers and policymakers in this area and guiding their efforts towards achieving universal oral health coverage in the Indian context.

Clinical effectiveness of resin-modified glass ionomer-based fluoride varnish for preventing occlusal caries lesions in partially erupted permanent molars: A randomised active-controlled trial.

BACKGROUND: Deep pits and fissures in partially erupted permanent molars are vulnerable to dental caries. AIM: To assess the clinical effectiveness of resin-modified glass ionomer-based fluoride varnish (RMGI-F varnish: Clinpro XT™ varnish) in preventing occlusal caries lesions in partially erupted permanent first molars. DESIGN: In this randomised active-controlled superiority trial with a single-blind parallel design, 74 children with 182 partially erupted first permanent molars were allocated into two groups: Group 1: RMGI-F varnish; and Group 2: GI sealant (active control), with an application of 0.1% sodium fluoride varnish for all other teeth. The primary outcome was ICDAS score ≥1 at 12 months of follow-up. Data were analysed using adjusted Chi-square test and GEE regression for binary outcomes. RESULTS: Group 1 (15.7%) and Group 2 (13.8%) did not differ significantly in ICDAS ≥1 scores at 12 months of follow-up (adjusted χ2  = 0.373, p = .541). There was no significant difference in retention between Group 1 (48.3%) and Group 2 (20.7%) at 12 months of follow-up (adjusted χ2  = 0.1, p = .752). Mean application time per tooth (16 ± 5.9 vs 20.2 ± 5.4 min) was significantly different (t = 5.26, p = .014). CONCLUSIONS: RMGI-F varnish was not superior to GI sealant in preventing occlusal caries lesions in partially erupted molars.

Dietary practices among children with early childhood caries and the associated factors: A qualitative study.

BACKGROUND: Parents play a vital role in their children's dietary habits. A comprehensive understanding of the perspectives of parents of children with early childhood caries (ECC) is required for prevention program planning. AIM: To describe the parental perspective of the dietary habits of children with ECC. DESIGN: In this descriptive qualitative study, the participants were parents of children with ECC receiving routine dental care. Data were collected through focus groups using an interview guide. Data were analyzed manually using the content analysis method. RESULTS: Five focus groups involving 27 participants were conducted. Two main categories emerged: cariogenic food literacy and factors that affect food choices. Most of the participants knew that sugary foods are responsible for tooth decay. Parents felt that children's snacking habits were influenced by multiple factors, such as family environment, peers, commercials on television or the Internet, and affordability of food. CONCLUSIONS: Parents are not able to translate their knowledge into action to modify their children's diet as they may lack self-efficacy and feel pressured by their children, the media and the environment in which they live. Motivational interviewing of parents and governmental and school policies to reduce sugary food consumption may be required.

Early childhood caries and parents' challenges in implementing oral hygiene practices: a qualitative study.

BACKGROUND: Early childhood caries (ECC) is highly prevalent with significant long-term consequences. Parents are primarily responsible for the oral health practices of their children. Parents' health beliefs, attitudes, and cultural factors influence oral health practices. AIM: To explore and understand the perceptions and challenges faced by the parents of the children with ECC in performing routine oral hygiene practices for their children. DESIGN: We conducted a qualitative description study with the parents of children with ECC. Data were collected through five focus groups using culturally appropriate, semi-structured, open-ended questions and probes. Focus groups were audiotaped, and field notes were taken, which were transcribed verbatim after each focus group session. Data were analyzed using content analyses. RESULTS: A vast majority of the participants were aware of the significance of oral hygiene. However, they faced challenges in implementing proper home hygiene practices at home and lacked knowledge about the type of toothpaste and toothbrush to be used for their children. CONCLUSION: The parents of the children with ECC face a severe knowledge gap, which is interfering with the selection of proper oral hygiene aids for their children. They also face barriers in implementing oral hygiene routines for their children, in spite of awareness that tooth brushing is important.

Association of temperament with dental anxiety and behaviour of the preschool child during the initial dental visit.

The aim of this study was to investigate whether there is an association between temperament characteristics of preschool children, dental anxiety, and their dental behaviour. A total of 100 children, aged 3-5 yr, who were attending their initial dental visit accompanied by a parent, were included in this cross-sectional study. Dental anxiety of children was measured using the Facial Image Scale. The behaviour of children during the initial oral examination and oral prophylaxis was assessed using Frankl's behaviour rating scale. Temperament was assessed using Emotionality, Activity, Shyness Temperament Survey for Children (parental ratings). Statistically significant weak linear positive correlations were seen between the following: the percentage duration of definitely negative behaviour and shyness scores (rs  = 0.28); anxiety level and emotionality scores (rs  = 0.28); and anxiety level and shyness scores (rs  = 0.26). Multinomial logistic regression analysis revealed that children with higher anxiety had higher odds of showing definitely negative behaviour, which decreased with increasing age of the child. Emotionality and shyness temperaments may be weakly associated with dental anxiety, and shyness may be weakly associated with the dental behaviour of the preschool child. Definitely negative dental behaviour is associated with dental anxiety and age of the child.

Effect of a relaxation training exercise on behaviour, anxiety, and pain during buccal infiltration anaesthesia in children: Randomized clinical trial.

BACKGROUND: Cognitive behavioural techniques can decrease procedural pain and anxiety in children. Bubble breath exercise, a play therapy technique, may be used as a relaxation strategy to manage anxiety and pain. The objective of the study was to evaluate the effect of bubble breath exercise on dental anxiety, dental behaviour, and pain intensity during buccal infiltration of local anaesthetic in children. STUDY DESIGN: This randomized controlled trial involved 66 children aged 7-11 years, randomly allocated to two groups: Group 1 (control) and Group 2 (intervention group). Group 2 was trained in bubble breath exercise. The reaction during buccal infiltration anaesthesia was recorded in terms of behaviour (Frankl's behaviour rating scale), anxiety (Facial Image Scale and pulse rate), and pain perception (Wong-Baker FACES pain rating scale and the Faces, Leg, Activity, Cry, and Consolability scale). RESULTS: The bubble breath exercise significantly reduced the pain perceived, as measured by both the Wong-Baker FACES pain rating scale (P < 0.001) and the FLACC scale (P < 0.001). There was no statistically significant difference in dental anxiety and behaviour among the groups. CONCLUSION: Use of bubble breath exercise may be beneficial in decreasing the pain perceived during maxillary buccal infiltration anaesthesia in 7- to 11-year-old children.

Parenting style and oral health practices in early childhood caries: a case-control study.

BACKGROUND: There is a need to carry out controlled investigations regarding risk factors for early childhood caries (ECC). AIM: To study the type of parenting style and oral health practices as risk factors among children with ECC in an Indian preschool population. METHODS: Two hundred and eleven children with ECC and equal number of controls participated in this case-control study. A questionnaire was answered by parents regarding oral health practices such as oral hygiene methods, feeding habits, daily sugar intake, and dental attendance pattern along with socioeconomic and demographic status. The parenting style was determined using Parenting Styles Dimension Questionnaire (PSDQ) index. Data were statistically analyzed using chi-square test and multiple logistic regression analysis. RESULTS: Risk factors associated with ECC were higher birth order, lower socioeconomic status, non-use of fluoridated toothpaste, breast/bottle feeding for more than one year, presence of formula milk or milk with sugar in the feeding bottle while falling asleep, higher sweet scores in the diet chart, and visiting dentist only when a problem was perceived. Majority of parents of children with and without ECC had authoritative parenting style. CONCLUSION: Improper oral health practices are the risk factors for ECC. The association of parenting style with ECC could not be confirmed.

Evaluation of pit-and-fissure sealants placed with four different bonding protocols: a randomized clinical trial.

BACKGROUND: Application of adhesive after acid etching may increase the retention of pit-and-fissure sealants and improve clinical effectiveness. AIMS: To clinically evaluate the retention, marginal discoloration and caries incidence of pit-and-fissure sealants applied using four bonding protocols: conventional acid etching, etch-and-rinse adhesive, multimode universal adhesive and self-etch adhesive used after acid etching. DESIGN: In this split-mouth design study, the four adhesive protocols were randomly assigned to the four erupted, non-carious first permanent molars and involved 52 patients between 6 and 10 years of age. The sealants were evaluated at 3-, 6- and 12-month intervals. Statistical analysis was carried out using Friedman test and Kruskal-Wallis test. RESULTS: At 12 months, the retention rate was maximum in etch-and-rinse and universal adhesive groups (77.1%) followed by self-etch adhesive (58.3%) and conventional acid etching group (45.8%). Dental caries was observed only in one tooth, and marginal discoloration was found to be the highest in conventional group and least in etch-and-rinse group. CONCLUSIONS: Use of adhesives during pit-and-fissure sealant application does not significantly enhance sealant retention nor decrease marginal discoloration. Etch-and-rinse adhesive is advantageous only at short term.

General Dental Practitioners as Potential Responders to Disaster Scenario in a Highly Disaster-prone Area: An Explorative Study.

AIM: The aim of this study is to obtain insights pertaining to disaster management among Indian general dental practitioners (GDPs). MATERIALS AND METHODS: All GDPs in Mangaluru city, Karnataka, India, were included in the present study. Their willingness to participate in disaster management and their objective knowledge, attitude, behavior, and perceived effectiveness related to disaster management were assessed by a structured, pretested, self-administered questionnaire. Demographic information was also collected. RESULTS: Overall, 101 GDPs volunteered for the study, and 96.04% of respondents were willing to participate in disaster management. Mean knowledge, attitude, behavior, and perceived effectiveness scores were 52.65, 79.60, 41.55, and 64.20% respectively. Religion (odds ratio [OR] = -0.194, p = 0.022), marital status (OR = -0.222, p = 0.040), attachment to college (OR = -0.256, p = 0.037), familiarity with standard operating procedures (SOP; OR = -0.502, p = 0.000), and knowledge (OR = 0.265, p = 0.003) were significant predictors of behavior. CONCLUSION: The GDPs reported knowledge and behavior scores which were low, while their attitude and willingness to participate were high. Demographic determinants might be critical indicators in disaster management scenario among GDPs. CLINICAL SIGNIFICANCE: The present study has crucial implications for policymakers and curriculum changes to integrate dentists effectively into disaster response teams. As responsible members of the society, the dental fraternity has critical contributions to make toward disaster mitigation. Integration of GDPs in a multidisciplinary team managing disasters might be crucial, especially in highly disaster-prone areas, such as India, with a definite paucity of resources.

Impact of occlusal support and perceived chewing ability on oral health-related quality of life among patients attending a private dental institution in India.

PURPOSE: Presence of functional tooth units is essential for preserving masticatory function among individuals. Representing the essence of health promotion practice, demand to measure varied evaluation outcomes is highlighted. AIM AND OBJECTIVES: (1) To assess the influence of occlusal support and perceived chewing ability on oral health-related quality of life (OHRQoL) among adults attending a private dental institution in Mangalore. (2) To evaluate occlusal support using Eichner index (EI), perceived chewing ability using a self-administered questionnaire and OHRQoL using Oral Health Impact Profile-14 (OHIP-14). MATERIALS AND METHODS: Overall, 300 adults attending a private dental institution in Mangalore were included. EI was used to group participants into three groups. The chewing ability was assessed using a questionnaire on perceived difficulty while chewing eight common foods. OHRQoL was measured employing OHIP-14. Perceived general and oral health status and demographic information were collected. RESULTS: The mean perceived chewing ability score was 12.98 ± 6.2 and the mean total OHIP score was 9.23 ± 8.9. EI showed a significant relation with perceived chewing ability, OHIP, and perceived general health status (P < 0.05). Perceived chewing ability and OHIP demonstrated a significant correlation (r = 0.31, P < 0.001). Age, gender, education, occupation, monthly income, family income, and number of family members demonstrated a significant association with EI (P < 0.05). Binary logistic regression analysis revealed that EI, perceived chewing ability, and perceived oral health emerged as significant predictors of OHRQoL (P < 0.05). CONCLUSIONS: Occlusal support was significantly associated with perceived chewing ability, OHRQoL, and perceived general health status.

Reporting guidelines in health research: A review.

Contemporary health research has come under close scrutiny, exposing alarming flaws in the reporting of research. The reporting guidelines can aid in identification of poorly reported studies and can bring transparency to health research. The guidelines also help journal editors, peer reviewers, funding agencies, and readers to better discern health research. Reporting guidelines encourage accurate and thorough reporting of fundamental aspects of health research so that the results of studies can be replicated by others. Reporting guidelines are potent tools to improve the practice of research and in reducing reporting bias. For the present review, both electronic and manual literature search was carried out. Electronic databases like PubMed, MEDLINE, EBSCO host, and Science Direct were searched for extracting relevant articles. Various key words and their combinations were used for literature search like reporting guidelines, checklist, research, publishing standards, study design, medicine, and dentistry. The search results were scrutinized for relevance to the topic and only full text articles in English were incorporated. Various reporting guidelines were identified and grouped under headings based on study design. This review article attempts to highlight the various reporting guidelines in literature relating to health research, its potential applications, and its limitations.

Effect of fluoride varnish and chlorhexidine-thymol varnish on mutans streptococci levels in human dental plaque: a double-blinded randomized controlled trial.

BACKGROUND: Recent systematic reviews on clinical trials comparing the efficacy of chlorhexidine and fluoride varnish found that the evidence was inconclusive and further well-conducted randomized controlled clinical trials were advocated. AIM: To compare the effect of fluoride varnish (F) and Chlorhexidine-thymol varnish (CHX/T) with intensive application regimen on mutans streptococci (MS) levels in human dental plaque. DESIGN: Seventy-five subjects between 6 and 10 years of age were allocated into three groups: Group 1-F varnish (n = 29); Group 2-CHX/T varnish(n = 29); Group 3-placebo varnish (n = 17) by stratified block randomization. After baseline plaque samples were obtained, varnish application was applied and repeated at an interval of 3 days in each group. Plaque samples were repeated at 48 h, 1 month, and 3 months. The samples were spread over mitis-salivarius-bacitracin (MSB) culture media, and the colony-forming units per ml (CFU) were measured. RESULTS: In both Groups 1 and 2, Wilcoxon matched-pairs signed-rank test revealed significant differences in log CFU values of MS between baseline and 48 h, baseline and 1 month but no significant difference between baseline and 3 months. An intergroup comparison at different time intervals showed that the difference between three groups was statistically insignificant. CONCLUSION: F varnish and CHX/T varnish, with an intensive regimen application have equivocal effect on MS levels in dental plaque.

Efficacy of lignocaine in gel and spray form during buccal infiltration anesthesia in children: a randomized clinical trial.

AIM: To compare the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic, in reducing pain, during buccal infiltration in children. MATERIALS AND METHODS: Forty-two patients aged between 7 and 12 years requiring restorative procedures/extraction/pulp therapy of primary/ permanent teeth in the maxillary arch, under buccal infiltration anesthesia were selected for the study. The participants were randomly allocated into 2 groups of 21 each. In group A, 8% lignocaine gel and in group B, 15% lignocaine spray was applied prior to buccal infiltration. Pain was assessed using Wong-Baker faces pain rating scale (WBFPRS) and faces legs activity cry and consolability (FLACC) painscale. RESULTS: Pearson's chi-square test revealed that there was no significant difference in the FLACC scores of the two groups (p = 0.54). Independent t-test demonstrated that there was no significant difference in Wong-Bakers faces pain score between the two agents (p = 0.07). CONCLUSION: There is no significant difference in the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic in controlling pain during buccal infiltration anesthesia, in children.

Knowledge of ocular infections among the dental practitioners across India: a cross sectional survey.

BACKGROUND: Ocular issues such as impaired vision, ophthalmia, orbital cellulitis, and blindness are not common with dental infections. However, there is absence of set guidelines in prevention and management of ocular issues arising from dental infections. Hence the knowledge and vantage point of the dentists with respect to ocular complications arising from dental infections was evaluated. OBJECTIVE: This study reviews the knowledge of dentists with association of eye infection due to dental contamination. METHOD: A cross sectional survey using standardized questionnaires were sent suing social media platform among the academicians and practicing dental clinicians. All the questionnaires were content validated by three ophthalmologists. Descriptive statistics was scrutinized and tabulated by employing the Statistical Package for Social Sciences (SPSS), version 17 (SPSS Inc., Chicago IL). Chi square tests was used. RESULTS: About 69.1%(65) and 30.9%( 29) of BDS and MDS grduates have experienced ocular complications because of dental contamination. This distribution showed no statistical significance (p = 0.25). 73.8% (183) and 28.2%( 65) had compliance with the eye protection, 77.7% (160) of BDS graduates and 22.3% (46) of MDS graduates preferred safety eye wear. This distribution showed statistical significance (p = 0.00). About 76.2% (279) of BDS graduates and 23.8%( 67) of MDS graduates faced ocular infections because of different types of splashes which included water, blood and saliva. (p = 0.23) CONCLUSION: This study puts an emphasis on the knowledge assessment among the dental practitioners on the importance of preventive barriers, and how special protective gear is required for doing cases undergoing dental treatment.

Understanding rapid oral health deterioration and its associated factors among older adults: A scoping review.

Background: Understanding the pivotal interplay between systemic and oral health is paramount to ensuring holistic care, particularly among the aging demographic. Therefore, this review article aims to explore the emerging concept of Rapid Oral Health Deterioration (ROHD) by reviewing the current knowledge base among older adults and identifying knowledge gaps in this area of research. Methods: This scoping review was conducted in line with Arksey and O'Malley's framework between December 2023 and March 2024 and reported while adhering to the PRISMA-ScR guidelines. A systematic database search was performed across three databases i.e. PubMed, Scopus, and EMBASE to collate the existing literature published in English between January 2013 and February 2024 addressing ROHD among older adults. After data charting, a critical appraisal of the selected studies was followed by qualitative thematic analysis. Results: Among the 12 papers in this scoping review, 10 were cross-sectional studies, with one each of retrospective cohort and case-control studies. The qualitative thematic analysis of the selected articles resulted in the emergence of four main themes: risk factors for ROHD, attributes related to ROHD, challenges encountered in the management of ROHD, and management approaches for ROHD among older adults. Conclusions: This scoping review provides an overview of the rapid deterioration of oral health among older adults. Age-related dental disease harms the quality of life and overall health. To avoid dental disorders and to maintain and improve oral health in older adults, an integrated and multidisciplinary approach is essential. If ROHD is not treated, it may lead to poor health, a lower quality of life, and in severe cases, systemic infections that increase hospitalizations and possibly cause death.

A qualitative exploration of patients' perception regarding the comprehensive dental services availed at a primary health center.

Introduction: Comprehensive oral care is a service centered around the patient, and individuals who need it the most often face limited access. Patient perception acts as a guide for enhancing quality, ensuring patients' future intent to utilize the services and facilitating recommendations to others. The present study aimed to assess the patients' perception of comprehensive dental services availed at a Primary Health Center (PHC). Methods: This qualitative study was based on a phenomenological interpretive approach, and judgment sampling method was employed. A validated interview guide, developed from relevant literature was employed in the local language to conduct interviews among adults visiting the PHC, gathering their views regarding the services provided. The interviews were audio recorded on a digital voice recorder, and files were password protected. Content saturation guided the determination of the final number of participants interviewed. After translating and transcribing the interviews, thematic analysis and coding were performed using ATLAS. ti 23 for Windows. Results: A total of 12 participants were included in the study, following data saturation. Among them, there were 8(66.7%) female and 4(33.3%) male participants. Ten overarching main themes were discerned through the assigned codes, including positive views, neutral views, negative views, previous dental clinics visited, previous experience with dental treatment, treatments sought at the center, referrals, source of information about the dental center, subsequent visits and suggestions for improvement. Conclusions: The findings of this study revealed a positive patient perception of the comprehensive dental services offered at the PHC. Through insightful interviews, various strengths, and areas for improvement regarding the center and care provision were identified. These insights provide valuable suggestions that can be applied to elevate the utilization of dental services, ensuring continuous improvement in patient care.

Effect of ethylenediaminetetraacetic acid, maleic acid, and fumaric acid on postendodontic treatment root fracture toughness - An in vitro study.

Aim: The aim of this study was to evaluate the effectiveness of ultrasonic activation of ethylenediaminetetraacetic acid (EDTA), maleic acid (MA), and fumaric acid (FA) in combination with sodium hypochlorite (NaOCl) on postendodontic treatment root fracture toughness. Materials and Methods: Forty single-rooted mandibular premolars were sectioned below the cementoenamel junction and were kept on average 14 mm long. With the exception of eight randomly selected teeth acting as a negative control group (Group I/nonprepared), the rest were prepared till F3. Thirty-two specimens were randomly placed into four groups equally and then irrigated using the final irrigation protocols. Saline and NaOCl were used to irrigate Group II, 17% EDTA and NaOCl were used to irrigate Group III, 7% MA and NaOCl were used to irrigate Group IV, and 0.7% FA and NaOCl were used to irrigate Group V. The irrigants were ultrasonically activated in every group. The root canals were obturated with gutta-percha and AH Plus sealer. The roots were embedded along the long axis in the self-curing acrylic blocks along with polyvinyl siloxane, leaving the coronal 2 mm of the root exposed. The specimens were tested using a universal testing machine. Statistical Analysis: The Post hoc Tamhane's and one-way ANOVA tests were applied to examine the data. Results: The result of the study revealed that 0.7% FA (598.09 N) provided better root fracture resistance than EDTA (428.07 N) and MA (511.87 N). Conclusion: The conclusion derived from the study was that 0.7% FA provided better fracture resistance of endodontically treated teeth when compared to 17% EDTA and 7% MA.

Evaluation of Anxiety Levels in Children While Using Rubber Dam and OptraDam Isolation Techniques.

Aim: The aim of the study was to evaluate the anxiety levels in children while using rubber dam and OptraDam isolation techniques. Materials and methods: This study was a crossover trial conducted on 27 selected 6-12-year-old children. The procedure of placement of either of the isolation techniques was told and demonstrated using audiovisual aid. The sequence of the proceedings on each child (rubber dam or OptraDam) was determined randomly using toss of coin. Second demonstration was carried out 7 days after the first demonstration. The anxiety experienced was recorded using Venham's anxiety scale at two time points-after verbal explanation and after the audiovisual demonstration. The study also objectively assessed the anxiety by measuring the salivary malondialdehyde (MDA) levels of two patients. Results: When mean values of Venham's anxiety scores after verbal explanation and after audiovisual demonstration were compared for each of the two techniques using paired Student's t test, there was statistically significant decrease in the anxiety score following audiovisual demonstration in both the techniques. When the scores between two groups after verbal explanation and after audiovisual demonstration were compared using repeated measures of analysis of variance (ANOVA), the reported anxiety scores were significantly lesser for the OptraDam technique (p = 0.000). Conclusion: Audiovisual demonstration reduced the anxiety of children when compared to verbal explanation for both isolation techniques. OptraDam isolation was found to be less anxiety generating in children compared to rubber dam isolation. Clinical significance: When using modern adhesive techniques, a good isolation of the working field is an important requirement for better prognosis. OptraDam being the latest addition to the rubber dam family, if found to be more children friendly can solve majority of the problems related to isolation in pediatric dentistry. How to cite this article: S Mahima, YM Karuna, Shenoy R, et al. Evaluation of Anxiety Levels in Children while using Rubber Dam and OptraDam Isolation Techniques. Int J Clin Pediatr Dent 2023;16(2):287-291.

Validation of ageism scale for dental students in India: (Ageism Scale for Dental Students- India) - a cross sectional study.

Background: Ageism persists in many different societies as it is innate and subconscious in nature. Negative effects such as loneliness, mistreatment, and occupational discrimination are frequently present due to ageism. The dental students in our study were wary of the possible benefits of expensive dental care because ageism is rife in their field. There is no validated and reliable ageism scale to assess how dental students perceive ageism in India. The current study was carried out to validate the ageism scale for dental students in the Indian context. METHODS: This was a cross sectional analytical study carried out among both males and females in Manipal College of Dental Sciences, Mangalore in which the instrument was 27-item Ageism scale for dental students. Content validity was done by six subject experts. The final version was administered to 213 students/Residents of dental school. The factorability of data was confirmed with KMO = 0.61 and Bartlett's Test of Sphericity resulting in p < 0.001. RESULTS: Final PCA model resulted in 15 items and six components that together accounted for 70.37% of overall variance. The six components had reliability ranging from marginal 0.51 (Component 6) to a high of 0.81 (Component 3). As per the gender differences by component females showed less ageism than men in "non-compliance" (-0.9(-1.66-0.14), p<0.05) and "practitioner perspective" (1.43 (0.84, 2.03), p<0.01). Statistical significance was seen in Barriers/concerns in dental treatment of elderly where residents showed reversed (1.4 (0.41, 2.38), p<0.01). Urban group showed more ageism for component 'time restraint' (-0.79 (-1.57, -0.02), p<0.05. CONCLUSION: Preliminary validation resulted in 15 item scale with six components with acceptable validity of the ageism scale and could be further tested in large samples. This scale will help recognize ageism in Indian context and provide necessary information to make changes in the curriculum as required.

Role of nutritional supplements on oral health in adults - A systematic review.

Purpose: The word 'diet' usually encompasses the consumption of food that includes all the necessary nutrients required for the optimal functioning of the body. Nutritional supplements hold a supreme position due to the demanding lifestyles or medical conditions in this current era. Although medical literature has sufficient evidence exploring the effect of nutrients on general health, this systematic review aimed at specifically evaluating the role of nutritional supplements on oral health in adults. Methods: PRISMA guidelines were followed in conducting this systematic review where four electronic databases including Scopus, PubMed, EMBASE, and Web of Science were reviewed. Based on the inclusion criteria, four studies exploring the effect of oral nutritional supplements on oral health among the adult population were included in this systematic review. Results: This review generated evidence suggesting a positive effect of nutritional supplements on oral health. These findings were depicted in the form of a reduction in plaque scores, probing depths, gingival inflammation, and greater improvement in periodontal healing among individuals with higher intakes of nutritional supplements within recommended doses. Conclusions: The systematic review outlines the positive impact of consuming nutritional supplements in the recommended dosage on oral health. Additionally, this review stresses the necessity for interventional studies to further investigate the effects of nutritional supplements on oral health, particularly in regard to periodontal healing. PROSPERO registration: CRD42021287797 (27/11/2021).