Photodynamic therapy for oral potentially malignant disorders: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the effectiveness of Photodynamic Therapy (PDT) in the treatment of Oral Potentially Malignant Disorders (OPMDs) patients. METHODOLOGY: An electronic search was conducted to retrieve articles published until September 2021. Meta-analyses were conducted for the outcomes of complete response (CR) and any response (AR) after treatment with PDT using data from single-arm studies, case series and non-randomised controlled trials (NRCTs). RESULTS: In total, 49 articles were included. RCTs revealed insignificant mean difference (MD) in efficacy index between PDT and comparison groups (MD: 1.32; 95% CI:-28.10-30.72, p=0.930). The likelihood of CR (OR:0.84; 95% CI: 0.42-1.71, p=0.637) or AR (OR:2.10; 95% CI: 0.31-14.25, p=0.448) was not different in PDT group when compared with any comparison treatments in NRCTs. CR/AR among single arm studies was 60.6% (95% CI: 50.5-70.7, P<0.001) and 93.7% (95% CI:91.5-95.8, P<0.001) respectively. Higher prevalence of CR and AR was observed for dysplasia or carcinoma insitu (CIS) (CR: 81%, 95% CI: 70.8-91.3, P<0.001; AR: 94.3%; 95% CI: 89-99.6, P<0.001) and actinic cheilitis (AC) (CR: 73.9%, 95% CI: 65.9-81.9, P<0.001; AR:97%; 95% CI:94.9-99, P<0.001). CONCLUSIONS: More than half of the patients receiving PDT showed CR, with more than 90% responding to the treatment. PDT was most effective on oral dysplasias, followed by AC.

Health-related quality of life among oral and oropharyngeal cancer patients: An exploratory study.

OBJECTIVES: To comprehensively explore the effect of several sociodemographic-, patient- and tumour-related factors on the health-related quality of life (HRQoL) of oral and oropharyngeal cancer patients. METHODOLOGY: Patients diagnosed with oral and oropharyngeal cancers were included in the present cross-sectional study. Information pertaining to various sociodemographic-, patient- and tumour-related factors was recorded. HRQoL was assessed using standard 12-item Short Form Health Survey version 2 (SF12V2), and oral health-related quality of life (OHRQoL) was assessed by Oral Health Impact Profile-14 (OHIP). RESULTS: A total of 108 patients participated in the present study. Results revealed that nodal metastasis, histological differentiation and pain were significant predictors of OHRQoL, while site, size, stage, histological differentiation and pain were significant predictors of HRQoL. Pain was the single most significant negative determinant of HRQoL that was associated with worst total OHIP (B = 2.01, ß = 0.45, p < .0001), physical (B = -0.88, ß = -0.21, p = .017) and mental (B = -1.00, ß = -0.22, p = .016) component summary scores. CONCLUSIONS: Number of sociodemographic-, patient- and tumour-related factors emerged as significant predictors of HRQoL and OHRQoL. Study results might help in formulating targeted treatment plan, optimising patient care and follow-up.

Morphological Assessment of TMJ Spaces, Mandibular Condyle, and Glenoid Fossa Using Cone Beam Computed Tomography (CBCT): A Retrospective Analysis.

Background The temporomandibular joint (TMJ) is included in the category of ginglymoarthrodial synovial joints. The mandibular condyle plays a vital part in the development of the craniofacial complex. Hence, the evaluation and assessment of the condylar volume and its morphology are of utmost importance. Aim The aim of this research was to use cone beam computed tomography (CBCT) imaging modality to evaluate the morphology of the mandibular condyle and glenoid fossa in a selected population and document any morphometric changes. Setting and Design It is an observational study. Materials and Methods A retrospective CBCT analysis was performed on 119 patients. The length, width, height, linear measurements of the joint spaces (anterior, posterior, and superior), volume of the condyle, and roof of glenoid fossa thickness were evaluated on both the left and right sides in both males and females. Results The height, width, and length of mandibular condyle were significantly increased in males on both sides. Except for the left anterior space, all other spaces were significantly larger in males. Overall, the volume of the condyles in males was significantly increased on both sides. Conclusion CBCT can be a valuable diagnostic aid in the evaluation of various dimensions, joint spaces, and condylar volume in different planes and thus, can be a useful predictor in the assessment of treatment outcomes of disorders affecting the TMJ.

Content analysis of patient material resources on the internet for oral cancer-An exploratory study.

BACKGROUND: Oral cancer is one of the leading causes of mortality in the world over and is a major public health problem. There are numerous resources on the internet which provide information related to oral cancer. However, they may not be optimal and standardized. The present study was conducted to assess the quality, readability, and content of the online resources for oral cancer. METHODS: The content analysis approach was employed for the present study. Google search engine was employed to search for various online resources on oral cancer. The first 50 websites were evaluated for their quality and readability. Flesch-Kincaid readability tests were used to assess the readability of the internet material and consisted of Flesch reading ease and Flesch-Kincaid grade level. The quality of websites was assessed by Journal of American Medical Association (JAMA) benchmarks and HONcode (Health Over Net code). RESULTS: A total of 12 (32.43%) of the websites were fairly difficult to comprehend, while none of the websites were easy/very easy to comprehend. A total of 8 (21.62%) websites were readable by only college-level graduates. Overall, 21 (56.76%) of the websites did not have HONcode certification. CONCLUSION: The present study revealed that a majority of the websites were fairly difficult to comprehend and readable by college-level graduates. There is a definite need to monitor the quality of the websites on oral cancer. The present study highlights the need for stringent norms and regulations regarding oral cancer made available to the common man on the internet.

Insights into Disaster Management Scenario among Various Health-Care Students in India: A Multi-Institutional, Multi-Professional Study.

BACKGROUND: The frequency of occurrence of disasters is on the rise all over the world. Workforce shortage can be a major impediment toward efficient disaster management. Incorporation of other health-care workers along with conventional medical personnel might be critical for efficient and effective management of disasters. OBJECTIVE: The objective of this study was to assess various aspects pertaining to disaster management among various health-care students in India. METHODS: Final-year students pursuing medicine, dentistry, nursing, physiotherapy, pharmacy, Ayurveda, and homeopathy at various institutions in Mangalore, India, were the study participants. Participants' willingness to partake in disaster management and knowledge, attitude, behavior, and perceived effectiveness pertaining to disaster management was ascertained by a questionnaire method. Their previous history of training and familiarity with standard operating procedures was assessed. RESULTS: A total of 437 students belonging to seven health-care institutions participated in the study. Overall, 98.40% of the participants were willing to partake in disaster management. The mean knowledge, attitude, behavior, and perceived effectiveness scores were 49.19%, 81.75%, 47.28%, and 66.20%, respectively. Step-wise multiple linear regression analysis revealed that course (ß = 0.247, P < 0.001), attitude (ß = 0.154,P = 0.001), and behavior (ß = 0.284, P < 0.001) were significant predictors of perceived effectiveness. CONCLUSIONS: Participants in the present study revealed that they were willing to partake in disaster management. The participants also reported poor behavior and knowledge scores but appropriate attitude scores. The present study highlights the need for curriculum changes and policy implications for effective integration of various sectors for disaster management, particularly in developing nations such as India, which have a definite scarcity of resources.

Counselling as a Tool for Tobacco Cessation in a Dental Institution: Insights from India.

Background: Tobacco related mortality and morbidity is a growing public health problem world over. Counselling has emerged as an important arsenal in the battle against tobacco. Involving experts other than traditional medical health workers may be critical. Aim of the present study was to explore various aspects related to Tobacco cessation counselling among Indian dental students. Methods: Overall, 241 undergraduate students from Manipal College of Dental Sciences, Mangalore participated in the present investigation. A structured, pretested, self-administered questionnaire was used to ascertain knowledge, attitude, behavior, perceived effectiveness and barriers and socio-demographic details. Willingness to counsel patients and undergo further training counselling was also assessed. Results: Mean knowledge, attitude, behavior, perceived effectiveness and barrier scores were 2.94 (±2.08), 51.84 (±5.63), 19.25 (±8.79), 16.17 (±1.96) and 42.39 (±5.65) respectively. Age was significantly correlated with knowledge; while year of study revealed significant correlations with knowledge and behavior (p<0.05). Lack of motivation, poor attitude of patients; lack of knowledge and skills emerged as barriers. Multiple logistic regression analysis indicated that year of study, attitude, behavior and barrier scores were significant predictors for respondents ever counselled their patients (p<0.05). Conclusions: Knowledge and behavior scores of the respondents towards Tobacco cessation counselling were low, but a majority of the subjects were willing to counsel and undergo training. Year of study, attitude, behavior and barrier scores emerged as significant predictors of counselling for Tobacco use. The present study has important policy implications and highlights curriculum changes in making Tobacco cessation counselling more relevant and effective among Indian dental students.

Tobacco Cessation Scenarios Among Healthcare Profession Students: A Multidisciplinary Study

Background: It is acknowledged that the most effective means to contain the tobacco epidemic is to involve healthcare providers across various disciplines. The present study was undertaken to gain a comprehensive insight into various factors that determine the efficacy of multidisciplinary approaches in tobacco control. Methods: A cross sectional study design using a structured, pretested and self-administered questionnaire was employed in the present study, conducted among medical and dental interns and final year nursing students. Respondent demographics, knowledge, attitude, behaviour, perceived effectiveness and barriers, and willingness to participate in tobacco cessation were assessed. Results: A total of 268 subjects participated, with mean knowledge, attitude, behaviour, perceived effectiveness and barrier scores of 69. 7%, 89.0%, 72.0%, 80.6% and 88.6% respectively. There were significant differences among the mean scores of the study domains across the 3 disciplines. The majority (92.91%) of the respondents were willing to participate in tobacco cessation activities, but only 14.2% had previously received relevant training. Regression analysis revealed that the significant predictors of behaviour scores were gender, course, attitude and perceived effectiveness; those for willingness to undertake tobacco cessation activities were course, attitude, behaviour and perceived barriers. Conclusions: The study highlighted the willingness but low previous training among the participants and also identified factors that determine t behaviour and willingness to undertake tobacco cessation activities. The study emphasizes the need for modification in the policies pertaining to curricula of medical, dental and nursing training programs.

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.

Determinants of Smokeless Tobacco Consumption and its Cessation among its Current Users in India.

INTRODUCTION: Global Smokeless Tobacco (SLT) consumption is on the rise and constitutes a major Public Health problem. Controlling SLT intake is central to containing the increasing tobacco menace. AIM: The present study was undertaken to comprehensively explore various factors involved in SLT consumption and its cessation among current SLT users. MATERIALS AND METHODS: Present study was conducted among current SLT users visiting Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore, Karnataka, India. A structured, pretested and self-administered questionnaire was employed for the present study. Knowledge, attitude, behaviour, worksite practices of respondents towards SLT consumption and its cessation, barriers to SLT cessation were explored. Information about socio-demographic variables was also collected. RESULTS: Overall, 170 current SLT users participated in the present study. Results revealed that the mean knowledge, attitude, worksite related practices and barrier scores were 9.96(55.33%), 48.89(81.48%), 2.70(33.75%) and 54.25(60.27%) respectively. Correlation analysis revealed significant association of socio-demographic factors with knowledge, attitude and worksite related practices (p<0.05). SLT cessation related practices revealed that majority wished to quit (90%) and significant associations were noted amongst wish to quit with higher attitude scores; actual quit attempts with higher attitude, lower barrier scores and difficulty to quit with higher barrier scores (p<0.05). CONCLUSION: The present study draws attention towards involvement of complex interactions of various parameters including socio-demographic factors in SLT consumption and its cessation. Hence, it is imperative to implement multifactorial SLT control approach in order to contain tobacco menace spread across the globe.

Disaster Management and General Dental Practitioners in India: An Overlooked Resource.

OBJECTIVE: To assess General Dental Practitioners' (GDPs) in India willingness to participate in disaster management and their previous training pertaining to disaster management, and to assess GDP objective knowledge, attitude, and behavior regarding disaster management. MATERIALS AND METHODS: This study was a cross-sectional survey conducted on all GDPs of Jodhpur, Rajasthan, India. Willingness to participate, perceived knowledge, perceived effectiveness, objective knowledge, attitude, and behavior regarding disaster management were assessed through questionnaire method. Information also was collected regarding age, gender, religion, and residence. RESULTS: A total of 142 out of 180 GDPs participated in the study, representing a response rate of 79%. A majority (85%) of respondents were willing to participate in disaster management. Mean score for knowledge was 12.21%, for attitude was 33.56%, for behavior was 14.50%, and for perceived effectiveness was 9.08%. Significant correlations were observed between qualification and perceived effectiveness (P=.003), and between attitude and years of practice (P=.04). Willingness to participate in disaster management and age showed significant association (P=.000). CONCLUSIONS: High willingness and attitude to participate in disaster management was observed among respondents. Low knowledge and behavior scores were observed among GDPs.

Assessment of quality of life in patients with chronic oral mucosal diseases: a questionnaire-based study.

CONTEXT: A validated discipline-specific questionnaire has been developed recently to assess the quality of life (QOL) in patients with chronic oral mucosal diseases. OBJECTIVE: Use the Chronic Oral Mucosal Diseases Questionnaire for evaluating a diverse group of patients with chronic oral mucosal disease after therapy. DESIGN: Prospective convenience sample. MAIN OUTCOME MEASURE: Quality of life. METHODS: Seventy patients seen in the Department of Oral Medicine and Radiology with oral lichen planus, recurrent aphthous ulcers, pemphigus, and other chronic oral mucosal diseases were included in the study. Patients completed the questionnaire after undergoing treatment of their oral mucosal disease to assess their QOL. RESULTS: Patients older than age 35 years reported significantly lower QOL (p = 0.015) in the domain of social and emotional status. Significant age-related differences in QOL were not observed in other domains. Older individuals also reported a significantly lower overall QOL. Men reported significantly better oral health-related QOL than women did in pain and functional limitation: 16.14 ± 8.94 vs 21.44 ± 7.696, respectively (p = 0.010). Significant differences were not observed between sexes for other domains. Significant differences were observed between the disease groups only for recurrent aphthous ulcers and pemphigus (p = 0.005). Patients with pemphigus had the worst overall QOL (73.6 ± 5.6). CONCLUSION: Even after treatment, chronic oral mucosal diseases negatively affect patients' QOL. Use of the Chronic Oral Mucosal Diseases Questionnaire may allow physicians to more effectively care for their patients with these diseases.

Insights into smoking and its cessation among current smokers in India.

BACKGROUND: Initiation, perpetuation and cessation of smoking are all multifactorial. It is essential to explore interactions among various parameters influencing smoking and its cessation for effective smoking cessation interventions. OBJECTIVES: To obtain insights into smoking and its cessation among current smokers in India. MATERIALS AND METHODS: The present study was conducted among current smokers visiting the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore. Knowledge, attitudes, behavior, worksite practices towards smoking and its cessation, barriers to smoking cessation and socio-demographic variables were explored using a structured, pretested, self-administered questionnaire. RESULTS: A total of 175 current smokers participated in the study. Mean knowledge, attitude, worksite practice and barrier scores were 15.2±5.67 (66.1%), 57.5±7.67(82.1%), 4.18±2.02 (41.8%) and 57.4±12.37 (63.7%) respectively. Correlation analysis revealed: association of knowledge with education, occupation and religion; attitude with education and occupation; worksite practices with occupation; knowledge with attitude; and barriers negatively with worksite practices. The majority (85.7%) of respondents intended to quit smoking and this was associated with higher attitude scores, whereas actual quit attempts were associated with high knowledge, attitudes, worksite practices and low barrier scores. CONCLUSIONS: Various socio-demographic factors associated with smoking and its cessation were identified. The present study highlights the importance of identifying and targeting these interactions while framing guidelines and interventions for effective tobacco cessation in a developing country like India.

Insights into the state of radiation protection among a subpopulation of Indian dental practitioners.

PURPOSE: Radiographs is an integral part of patient management in dentistry, despite their detrimental effects. As the literature pertaining to radiation protection among Indian dental practitioners is sparse, exploring such protection is needed. MATERIALS AND METHODS: All private dental practitioners in Mangalore, India were included in the study. A structured, pre-tested, self-administered questionnaire was employed to assess the knowledge, attitudes, practices, previous training, perceptions towards the need to spread awareness, and willingness to gain and implement knowledge about radiation hazards and protection. Information regarding each respondent's age, gender, education, and type and duration of practice was collected. RESULTS: Overall, 87 out of 120 practitioners participated in the study. The mean knowledge, attitude, and practice scores were 9.54±2.54, 59.39±7.01, and 5.80±3.19, respectively. Overall, 25.3% of the respondents had undergone training in radiation protection, 98.9% perceived a need to spread awareness, and 94.3% were willing to improve their knowledge. Previous training showed a significant correlation with age, sex, and duration of practice; attitude was significantly correlated with education and type of practice; and knowledge scores showed a significant correlation with type of practice. CONCLUSION: Although the knowledge and practices of respondents were poor, they had a positive attitude and were willing to improve their knowledge. Age, sex, and duration of practice were associated with previous training; education and type of practice with attitude scores; and type of practice with knowledge scores. The findings of this study suggest a policy is needed to ensure the adherence of dental practitioners to radiation protection guidelines.

Wiscott Aldrich syndrome with oral involvement: a case report.

Wiskott Aldrich syndrome is an X-linked recessive disorder characterized by thrombocytopenia with microplatelets, eczema, recurrent infections, and predisposition to autoimmune disease and malignancy. It is a rare syndrome, and the incidence rate is approximately 4 in every 1 million live male births with no clear ethnic or racial predilection. The purpose of this paper was to report a case of Wiskott Aldrich syndrome with oral involvement demonstrated by 2 male siblings.