Waking Up to Antibiotic Resistance.

Background: Antimicrobial resistance (AMR) has emerged as a global concern, particularly in developing countries where its causes seem to entrench the knowledge, attitude, and practice of healthcare professionals and patients toward the use of antimicrobials. Methods: This review aims to provide a compendious yet thorough overview of our understanding of antibiotic resistance pertaining to dentistry. Literature provides evidence of inadequate antibiotic prescribing practices by dental professionals. Considering the growing concern about antibiotic prescribing habits and patient's tendencies of improper use, we attempt to address the interventional efforts of dentists and patients in the context to focus on the root causes specifically to prevention of the antimicrobial resistance. Results: Following the guidelines and flowchart depicted in this article, the members of dental professions will get clear views on the use of antibiotics. This will cause a definite decrease in the growing concern about antibiotic resistance.

Prevalence of Oral Cancer in Western Population of Maharashtra for 3 Years: A Prospective Study.

Introduction: In developing countries, oral cancer (OC) is estimated to be the third most common malignancy after cancer of the cervix and stomach. The aim of this study was to report the prevalence of OC for 3 years and its association with age, gender, type, and duration of habits along with the site of OC. Materials and Methods: This study was conducted in the Department of Oral Medicine and Radiology from January 2019 to December 2021. All the patients were examined after recording their demographic data using a mouth mirror and probe. The diagnosis of OC was arrived based on the clinical features of the lesions. The type and duration of habits and site were recorded in clinical pro forma. The Statistical Package for the Social Sciences (SPSS) software version 21.0 was used for the statistical analysis, the Chi-square test was applied, and the significance level was set at P < 0.05. Results: The prevalence of OC was 0.22% in our study. Of 317 cases, the majority of the patients were males (n = 204), and females (n = 113) accounted for a male: female ratio of 2:1. The most common age affected was 51-70 years with a history of tobacco chewing, followed by patients with multiple habits (smokers, tobacco chewers, and alcoholic). The buccal mucosa was the most common site followed by malignancies of multiple sites. Conclusion: Regular camps regarding tobacco cessation and counseling should be taken care of by dentists. Male patients aged above 40 years are routinely recommended for dental visits.

Effect of an educational intervention on manual toothbrush bristle wear: A light microscopic study.

Background and Objectives: The usage of a toothbrush with the most appropriate bristle type and a correct brushing technique are the most important factors in determining the thoroughness of plaque control. The dental undergraduate course conventionally does not impart tooth brushing techniques in the preclinical years. This study aimed to assess the effect of an educational intervention of correct tooth brushing technique on the wear of toothbrush bristles by light microscopic examination amongst the budding dental professionals. Materials and Methods: Toothbrush bristle wear was measured by light microscopy before and after an educational intervention amongst 30 first-year dental professional students. Wear index (WI), wear rate (WR), and acceptable percentage of bristle end morphology were calculated. Mann-Whitney U-statistics test and unpaired t-test were used to compare measurements of acceptable percentage and gender wise, respectively. The difference was said to be significant if P < 0.05. Results: The mean WI before intervention was 0.29 ± 0.122 and after the intervention was 0.23 ± 0.07, while the mean WR before intervention was 1.6 ± 0.167 and after the intervention was 1.17 ± 0.46% of bristle end morphology before intervention was 52.5 ± 10.064 and after intervention was 64.5 ± 5.625 with the difference being statistically significant with P < 0.05. Interpretations and Conclusion: The present study highlights the importance of imparting a correct tooth brushing technique in reducing the toothbrush bristle wear and improving the efficiency of the toothbrush in maintaining optimum oral hygiene. Early intervention of correct oral hygiene measures is especially prudent for the budding dental professional for future healthcare delivery to the general population.

Prevalence of oral potentially malignant disorders (OPMD) in adults of Western Maharashtra, India: A cross-sectional study.

Background: Oral cavity cancer is estimated to be the third most common malignancy after cancer of cervix and stomach in developing countries. Objectives: The objective of this study is to investigate the relationship between smoking, alcoholic consumption, betel quid chewing, and OPMD in a prospective manner. Materials and Methods: A descriptive, cross-sectional study was conducted among 35-55-year-old adults of Western Maharashtra, India. Oral cavity examination as recommended by the American Dental Association specification was followed. Data recorded were transferred from precoded survey pro forma to the computer. The prevalence of OPMD was assessed by determining the percentage of the study population affected. Analysis was done to find out the risk of oral premalignant disorders. The Chi-square (x2) test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated. The Statistical Package for the Social Sciences (SPSS) software version 21.0 was used for the statistical analysis and significance level was set at P < 0.05. Results: Odds of having OPMD are five times higher for those who smoke (OR = 5.78; 95% CI, [6.18, 7.82]) as compared to those who do not. The odds of suffering from OPMD are about five times higher among those who chew as compared to those who do not (OR = 4.98; 95%CI, [2.91, 7.28]). The mean frequency of tobacco chewing per day and duration in years in participants with OPMDs was significantly higher as compared with normal oral mucosa (P < 0.05 and P < 0.05), respectively, in the use of different tobacco forms. Conclusion: These findings can be used to design case control or cohort studies to further understand the relation between habits and OPMD.

Awareness and knowledge of tobacco associated risk of development of oral cancer and oral potentially malignant disorders among patients visiting a dental college.

INTRODUCTION: Cancer is considered as a serious health problem in public with an increasing number of cancer patients reported every year hence public health awareness/knowledge on oral cancers oral potentially malignant disorders (OPMDs) and their risk factors is crucial for prevention and early detection of OPMD and it is important to prevent transformation of oral cancer. MATERIALS AND METHODS: A cross-sectional survey with an interviewer-administered questionnaire was conducted. The questionnaire consists of relevant questions to ascertain sociodemographic information, awareness, and knowledge of Oral cancer and OPMDs, and their associated risk factors, and participants exposure to risk factors. Subjects above the age of 20 years (n = 200) were randomly selected, and the questionnaires were administered by the interviewer while they were waiting for treatment. RESULTS: Results showed lack of awareness for OPMDs based on the evaluation of the questionnaires for sociodemographic data. CONCLUSION: Awareness about oral cancer is relatively significant; however, for OPMDs, awareness is low in our study and the subjects were unaware of the risk factors. So a high level of public awareness and knowledge of OPMDs should be brought to people via mass media as it is a very effective source of information. Early detection of oral cancer is the most effective means to improve survival and to reduce morbidity.

Analysis of expression of p53, p63 and proliferating cell nuclear antigen proteins in odontogenic keratocyst: An immunohistochemical study.

BACKGROUND: Odontogenic keratocyst (OKC) is a benign intraosseous lesions (within the jaw bone) of odontogenic origin that account for about 10% of jaw cysts. They are characterized by an aggressive behavior with a relatively high recurrence rate. Early diagnosis and follow-up of the patient with OKC is important because the possibility of such patient there is develop to other features of Nevoid basal cell carcinoma syndrome in future. Considering the roles and effects of p53, p63 and proliferating cell nuclear antigen (PCNA) in cells proliferation, this study was designed. OBJECTIVES: To understand the behavior of epithelial cells in pathogenesis and biological aspects of OKC in diagnosis. MATERIALS AND METHODS: Immunohistochemical (IHC)technique was performed in 21 cases of OKCs. RESULTS: Immunological stained p53 cells were mainly located in the suprabasal layers. p63 and PCNA-positive cells were found throughout the lining epithelium including basal and suprabasal cell layers. The intensity of staining was more in p63 and PCNA than the p53 expression of the cystic epithelial lining. CONCLUSIONS: It is possible that the biological behavior of OKCs may be related to the suprabasal proliferative compartment in the cystic epithelium as observed. These proteins may participate in the regulation of epithelial cell differentiation. Taken together, these data may favor tumerigenesis on OKCs.

Correlation and Comparison of Cheiloscopy and Dactyloscopy with Blood Groups ­ An Institutional Study

Background: The most crucial evidence that is left behind at the crime scenarios that might narrow down the suspect pool are lip prints and fingerprints. These are undoubtedly the most reliable and valuable evidence till date in the court of law. One more biological record that remains unchanged throughout the lifespan of a person is the blood group. Aim and Objectives: To study, correlate and compare cheiloscopy and dactyloscopy with blood group among dental students in the Western Maharashtra population. Materials and Methods: A total of 200 dental students with age groups ranging between 18-25 years were included in the study. Lip print pattern, fingerprint pattern and ABO blood groups were collected and compared. SPSS version 20.0 was used to analyse the data. Results: There was a statistically significant correlation between lip prints and ABO - Rh (χ2 37.56, P < 0.05) as well as between fingerprints and ABO-Rh blood groups (χ2 30.6, P < 0.05). Conclusion: Hence, this study concluded that fingerprints-ABO blood group and lip prints-ABO blood groups are valuable evidence that can be relied upon in forensic investigations for the identification of the suspect in crime.

Effect of using tobacco on taste perception.

BACKGROUND: Impaired taste perception has impact on quality of life. Tobacco is a perilous factor that contributes to an impaired taste. OBJECTIVE: To evaluate and compare taste perception among tobacco chewers and nonchewers. MATERIALS AND METHODS: Sixty subjects (30 tobacco chewers + 30 nonchewers as controls) were enrolled in the study for evaluating taste perception. Taste identification time using four aqueous solutions of basic tastes - sweet, salty, sour, and bitter - was recorded (in seconds) and compared between tobacco chewers and controls. The data were analyzed using Student's t-test and analysis of variance using SPSS 20 version software. RESULTS: A statistically significant increase in taste identification time for salty taste in tobacco chewers (12.32 s) was noted compared with nonchewers (10.21 s) (P = 0.03). The average taste identification time was higher for tobacco chewers than nonchewers for sweet and salty taste. However, the average taste identification time was lower for tobacco chewers than nonchewers for sour and bitter taste. In nonchewers, the average taste identification time was 13.01, 10.21, 8.43, and 7.56 s for sweet, salty, bitter, and sour taste, respectively. In tobacco chewers, the average taste identification time was 15.16, 12.32, 7.75, and 7.04 s for sweet, salty, bitter, and sour taste, respectively. CONCLUSION: The results of the study demonstrated noticeable decrease in taste perception to salty taste among tobacco chewers when compared with tobacco nonchewers. There is a remarkable difference in taste perception to basic tastes among tobacco chewers and controls.

Prevalence and awareness of nutritional anemia among female medical students in Karad, Maharashtra, India: A cross-sectional study.

INTRODUCTION: Anemia is a global public health problem affecting both developing and developed countries. According to the World Health Organization, the highest number of individuals affected by anemia is observed in nonpregnant women aged 15-49.99 years. Though nutritional anemia can affect any age group, female medical students form a vulnerable population due to their hectic schedules, erratic mealtimes, and long working hours while staying in hostel for majority of times. Therefore, this study is aimed at determining the prevalence and awareness of anemia among the apparently healthy female students studying at a health institute. METHODS: A cross-sectional study is conducted among 300 female students studying at a health institute in western Maharashtra after their written informed consent. A structured questionnaire elicits their general information, the knowledge about signs and symptoms of anemia, and dietary habits. Basal metabolic index and hemoglobin using the spectroscopy method are estimated for each participant. RESULTS: Anemia prevalence in our population is 86 (28.6%). Based upon the severity of anemia, about 54 (18%) has mild anemia and 32 (10.6%) has moderate anemia. No case of severe anemia is noted in our study sample. CONCLUSION: The findings of the study highlight that anemia can affect even medical female students who are a vulnerable group unexpectedly suffering from nutritional deficiencies. Thus, this study highlights the need for interventional programs at primary health-care systems and colleges for improvement in the nutritional status of anemic students to reduce its complications.

Effect of socioeconomic status on dental caries during pregnancy.

BACKGROUND AND OBJECTIVE: It is generally agreed that people with low socioeconomic status have a significantly worse oral and general health compared to people with higher socioeconomic status. The aim of the study was to find out the role of socioeconomic status of pregnant women on their oral health by evaluating the dental caries risk factor, the salivary Streptococcus mutans count and DMFT index. MATERIALS AND METHODS: A total of 50 first time pregnant women were randomly sampled and were divided into different socioeconomic strata following the Kuppuswamy socioeconomic status scale. DMFT index and microbiological assessment of dental caries risk factor parameter, the salivary Streptococcus mutans colony forming units, were carried out during the three trimesters and postpartum period. The observations were compared with 50 non-pregnant women of same age group. RESULTS: Of the randomly sampled subjects, majority of the pregnant women (28/50) of the study group were of middle/lower middle class, 11 pregnant women were of upper middle class, and 11 were of the lower/upper lower class. When followed in their three trimesters and postpartum period, statistically significant increase in the salivary Streptococcus mutans colony forming units was noted in 2nd trimester, 3rd trimester and postpartum period (P value < 0.05) of all pregnant women. Comparison of the caries risk factor between the pregnant women of three socioeconomic strata, however, revealed that no particular class was at a higher risk for dental caries. CONCLUSION: This study gives an insight into the possible changing trends towards awareness for oral hygiene in various socioeconomic strata of pregnant women.

Salivary Human Chorionic Gonadotropin as a Novel Biomarker for Early Detection of Pregnancy: A Pilot Study.

CONTEXT: The role of saliva in detection of pregnancy has not received the due importance it deserves. AIMS: The present paper aims at determining the role of saliva in detection of pregnancy using home-based pregnancy detection kits to provide an alternative biofluid that is more user friendly, acceptable, noninvasive, rapid, and easy for home use. SETTINGS AND DESIGN: The study was conducted among 35 women visiting a gynecology clinic for confirmation of pregnancy, who gave a history of a missed menstrual cycle not more than 4 weeks. SUBJECTS AND METHODS: A home-based pregnancy detection kit meant for urinary human chorionic gonadotropin (hCG) detection with 20 mIU specification was used in the study for estimation of salivary hCG. Routine test that was prescribed to the patient such as laboratory-based urine hCG and/or ultrasound examination was used for confirmation of pregnancy status and correlation with the saliva-based result. RESULTS: A positive test was obtained in 74% participants, with a dark band in 43% participants and a light band in 31% participants. A negative result was noted in 26% participants. We observed that salivary hCG estimation showed a 77% accuracy and 23% false-negative results. CONCLUSIONS: An astounding 74% of participants showed a positive result with an existing pregnancy kit which indicates a strong plausibility of using salivary hCG as a biomarker for detection of pregnancy. With the findings obtained from our study, we could positively affirm that salivary hCG can be used as a potential, user friendly, and more acceptable biomarker for early detection of pregnancy.

Oral Health Status and Dental Treatment Needs of 5-12-year-old Children with Disabilities Attending Special Schools in Western Maharashtra, India.

INTRODUCTION: The individuals suffering from various disabilities form a considerable proportion of the community. The psychological reactions associated with a deformity can be devastating to the disabled, parents, caregivers, and family which often lead to attitudes of hopelessness in the lives of these disabled individuals. OBJECTIVES: To assess the oral health status and treatment needs among 5-12-year-old children attending special school in Western Maharashtra, India. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 5-12-year-old children attending specials school in Western Maharashtra, India. The study group consisted of 100 children (62 males and 38 females). The oral health status was assessed by using decayed, missing, and filled teeth (DMFT) index, Community Periodontal Index, Dentition status and treatment needs. Information on disability status, intelligent quotient, and systemic diseases were recorded. RESULTS: The mean age of the study population was 9.35 ± 2.92 years. There were 62 (62%) males and 38 (38%) females in the study population. Among the total children examined, 50% of the children were suffering from mental retardation (MR), followed by MR with cerebral palsy (20%). The overall mean decayed and filled teeth and DMFT scores were 3.53 ± 1.02 and 3.89 ± 1.30, respectively, and decayed component had the highest score in both the groups. A statistically significant difference has been observed among the gender (P < 0.001). CONCLUSION: There is a high proportion of dental treatment needs required for these children which reflect the barriers to access and utilize oral health care among these children. As dentist, we should emphasize on health education, periodic recall, and monitoring among these individuals.

An insight into diagnosis of a hidden entity: Impacted food material.

INTRODUCTION: Foreign bodies and tissue reactions to foreign materials are commonly encountered in the oral cavity. Exogenous materials causing foreign body reactions may be metallic (amalgam) or nonmetallic (suture materials, vegetable matter). Implantation of food particles in the oral tissues has been known to cause reactive lesions such as oral pulse granuloma. Implantation could be through extraction sockets, deep periodontal pockets, associated with tumor growth, interdental areas of teeth, unfilled root canals, and grossly decayed teeth. These get rapidly digested and altered by host responses. Cellulose persists as hyaline material and invokes chronic granulomatous response. This change may mimic other pathologies. MATERIALS AND METHODS: Representative specimens from commonly consumed food groups were selected, fixed in 10% neutral buffered formalin, processed, sectioned, stained with hematoxylin and eosin stain and observed under light microscope. RESULTS: Each specimen revealed unique, distinct histology of each food type. The plant materials had a characteristic appearance of rigid double cell wall while rigid regular partitions containing nutrient material were revealed in seeds and beans. Starch-contained lentils exhibited clear spaces. Following is a brief description of some of the significant histological findings of each of the specimens processed and stained. CONCLUSION: Thus, the study of histological structure of vegetables and legumes will enable their easy recognition in oral biopsy samples and help in distinguishing them from other pathologies and artifact.

Dietary habits amongst medical students: An institution-based study.

INTRODUCTION: In recent times, with the increasing burden caused by the lifestyle diseases on the health sector, there has been a renewed interest in the relationship between food and health. Research regarding nutritional status in college students in western Maharashtra, India, has been found lacking. Therefore, this study was undertaken to ascertain the dietary habits in the undergraduate students of a health institute. MATERIALS AND METHODS: This questionnaire-based study was conducted amongst 130 students from a health university regarding their dietary attitudes and lifestyle practices. The students had the option of choosing more than one answer based on the nature of the question. All the data were tabulated and relevant inferences were drawn. RESULTS: A total of 130 students comprising 74 girls and 56 boys from a health university participated in the study. Daily consumption of fruits and vegetables was only 1-2 portions for 98 (75%) of the participating students. Twenty-four (18%) participants were noted to be underweight and 11 (8%) students were either overweight or obese. CONCLUSION: Thus, the findings of the study indicate that the diet and nutritional aspects of our future medical health professionals should be researched in further details and timely interventions initiated for ensuring the knowledge and practice of the WHO principles regarding the same to be incorporated.

Evaluation of Radiation-induced Cytological Changes in Lesional Oral Cancer Cells and Adjacent Normal Mucosal Cells.

AIM: To assess various cytological changes for predicting radiosensitivity of oral squamous cell carcinoma by exfoliative cytology. MATERIALS AND METHODS: Histologically proven 30 cases of oral squamous cell carcinoma who underwent fractionated radiotherapy in a dose of 45-60 Gy in 5 fractions/week were enrolled in the study. The exfoliative cytology smear was evaluated on lesional and adjacent oral mucosa before radiotherapy, during radiotherapy (8 and 11th fraction) and post radiotherapy (4, 6 and 8 weeks). Various parameters like multinucleation, cellular enlargement, nuclear enlargement, cytoplasmic vacuolation, cytoplasmic granulation, leukocytic infiltration were evaluated. RESULTS: Statistical significant values were seen in the inter-group comparison of all the parameters when compared adjacent mucosa and normal mucosa for leukocytic infiltration in pretreatment smear. CONCLUSION: The study showed that radiation-induced cytological changes in oral squamous cell carcinoma have a significant dose-related increase. This dose-response relationship and the high intratumoral variations suggest that serial assay of these changes has potential use for radiosensitivity prediction. CLINICAL SIGNIFICANCE: Radiosensitivity prediction can be evaluated by means of cytological smears in one stop crisis centre (OSCC) individuals subjected to fractionated radiotherapy by evaluating the cytological parameters.

Trending Speculations of Tumor-Initiating Cells in Squamous Cell Cancers of Head and Neck.

Tumor-initiating cells are a diminutive subpopulation of stem cells that have ability of long term self-renewal and generation of varied traits of tumor cell population. Understanding the concept of tumor-initiating cells may have a great implicative intimation for our comprehension of cancer pathobiology and for the delineation of new therapies directed towards these stem cells. The present review is an endeavor to conceptualize the role of tumor-initiating cells in the Squamous Cell Cancers (SCC) of head and neck, their role in tumorigenesis and the possible supplementary approach in the latest treatment modalities.

Influence of risk factors on patients suffering from potentially malignant disorders and oral cancer: A case-control study.

BACKGROUND: Tobacco use can alone lead to death worldwide, especially in developing and underdeveloped countries. China and Brazil are the world's largest producer of tobacco. India holds the third place in producing, and it is the fourth largest consumer of tobacco and its products in the world. OBJECTIVES: A case-control study was carried out to assess the influence of risk factors on patients with potentially malignant disorders (PMD) and oral cancer. MATERIALS AND METHODS: Fifty cases diagnosed with PMD and oral cancer patients were selected for the study. An equal number 50 healthy controls who were also selected after age and gender matching. Multivariate logistic regression analysis was used to estimate the suspected risk factors for PMD and oral cancers. Chi-square test, Adjusted odd's ratios with 95% confidence interval were also used for the statistical analysis. RESULTS: There is a statistically significant difference between the different age group, duration, frequency, exposure time, and synergistic effect of tobacco chewing, smoking and alcohol drinking. CONCLUSIONS: Chewing tobacco is one of the major risk factors in the initiation of PMD which can lead to oral cancer.

Glucose Level Estimation in Diabetes Mellitus By Saliva: A Bloodless Revolution.

BACKGROUND: Diabetes mellitus is a massive, growing, silent epidemic that has the potential to cripple health services in all parts of the world. Currently, a diagnosis of diabetes is achieved by evaluating plasma glucose levels. Saliva offers some distinctive advantages. Whole saliva can be collected non-invasively and by individuals with limited training. The present study was aimed to estimate and correlate the plasma and salivary glucose levels in diabetic and non diabetic subjects, with special reference to age. METHOD: The study population consisted of three groups: Group I consisted of diabetics with BGL>200mg/dl and Group 2 consisted of diabetics with BGL 130-200mg/dl based on their random plasma glucose levels. Group 3 consisted of healthy population as controls with BGL <130 mg/dl. 2 ml of peripheral blood was collected for the estimation of random plasma glucose levels and unstimulated saliva was collected for the estimation of salivary glucose RESULTS: The salivary glucose levels were significantly higher in group 1 and group 2 diabetics when compared with controls. The salivary glucose levels show a significant correlation with plasma glucose levels between study populations, suggesting that salivary glucose levels can be used as a monitoring tool for predicting glucose level in diabetic patients. CONCLUSION: The present study found that estimation of salivary glucose levels can be used as a noninvasive, painless technique for the measurement of diabetic status of a patient in a dental set up.

Analysis of various risk factors affecting potentially malignant disorders and oral cancer patients of Central India.

CONTEXT: The use of tobacco/betel quid can alone lead to death. India is the fourth largest consumer of tobacco/betel quid in the world and the third-largest producer of tobacco/betel quid after China and Brazil. AIMS: A case-control study was carried out to assess the prevalence and various risk factors among potentially malignant disorders (PMD) and oral cancer patients of central India. SETTINGS AND DESIGN: A total of 100 clinically and histopathologically diagnosed PMD and oral cancer patients were selected for the study. MATERIALS AND METHODS: A histopathologically confirmed 100 patients who were suffering from PMD and oral cancers were selected and an equal number 100 healthy controls who were age- and sex-matched at par with the cases were also examined and interviewed. Chi-square (χ(2)) test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated to estimate the suspected risk factors for PMD and oral cancers by using multivariate logistic regression analysis. Significance level was set at P < 0.05. RESULTS: Statistically significant difference was observed in the age group, socioeconomic status (SES), duration, frequency, exposure time and synergistic effect of tobacco/betel quid chewing, smoking, and alcohol drinking in our study population. CONCLUSIONS: Chewing tobacco/betel quid is a strong risk factor in the development of PMD and oral cancer. Also age, gender, SES, education, and occupation influence the development of PMD and oral cancer.

Proposing national identification number on dental prostheses as universal personal identification code - A revolution in forensic odontology.

The proper identification of a decedent is not only important for humanitarian and emotional reasons, but also for legal and administrative purposes. During the reconstructive identification process, all necessary information is gathered from the unknown body of the victim and hence that an objective reconstructed profile can be established. Denture marking systems are being used in various situations, and a number of direct and indirect methods are reported. We propose that national identification numbers be incorporated in all removable and fixed prostheses, so as to adopt a single and definitive universal personal identification code with the aim of achieving a uniform, standardized, easy, and fast identification method worldwide for forensic identification.