Role of auricular laser acupuncture and psychological counseling in reducing nicotine dependence due to smoking: A randomized controlled trial.

BACKGROUND: Low level laser therapy is a novel noninvasive technology used to stimulate the acupoints recognized for tobacco cessation. OBJECTIVE: To compare the effect of laser auricular acupuncture, psychological counseling, and combination of laser acupuncture and psychological counseling in reducing nicotine dependence due to smoking. METHODS: Smokers (n = 150) fulfilling the eligibility criteria were randomly allocated to three interventional groups. Evaluation of the nicotine dependence and physical effects due to smoking were done using Fagerstrom test and Visual Analog Scale, respectively, at baseline and 1 month postintervention. Person's Chi-square, Kruskal Wallis analysis of variance, and Wilcoxon signed-rank tests were used for the statistical analysis. Statistical significance was set at P ≤ 0.05. RESULTS: There was a statistically significant reduction in nicotine dependence (P = 0.00) and physical effects related to smoking (P < 0.05) in all the interventional groups 1 month postintervention. Reduction in Fagerstrom test scores was significantly higher (P = 0.001) in Group 3 (laser acupuncture with psychological counseling) as compared to other groups. There was significant reduction (P < 0.01) in irritability, tiredness, craving, headaches, and significant increase (P < 0.05) in the unpleasant taste due to smoking and ability to concentrate in laser acupuncture with psychological counseling group as compared to other groups. CONCLUSION: Auricular laser acupuncture with psychological counseling was effective in reducing nicotine dependence due to smoking.

Nicotine Replacement Therapy: An Overview.

Today tobacco use is the single greatest preventable cause of death in the world. Tobacco use is often incorrectly perceived to be solely a personal choice. This is contradicted by the fact that when fully aware of the health impact, most tobacco users want to quit but find it difficult to stop due to the addictiveness of nicotine. Henceforth, Nicotine replacement therapy (NRT) came into existence which temporarily replaces much of the nicotine from tobacco to reduce motivation to consume tobacco and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence. Various alternative nicotine sources (gum, transdermal patch, nasal spray, inhaler and sublingual tablets/lozenges) have been incorporated into tobacco cessation programs. Recent research is more focusing on rapid delivery of nicotine (Nicotine preloading, true pulmonary inhaler) and immunological approaches (nicotine vaccine) to tackle nicotine dependence. These NRTs are in general well tolerated and have minimal adverse effects. The review aims to summarize literature on various modes of nicotine replacement therapy methods currently used to treat nicotine dependence, and to give an overview about future possible approaches to treat tobacco use disorder.

Comparative evaluation of chlorhexidine varnish and fluoride varnish on plaque Streptococcus mutans count--an in vivo study.

AIM: The aim of the study was to assess and compare the effect of chlorhexidine varnish and fluoride varnish application on Streptococcus mutans counts in plaque of occlusal pits and fissures of permanent mandibular first molars. MATERIALS AND METHODS: The study was an in vivo comparative study, conducted among 50 schoolchildren aged 7-8 years under a field setting. The 50 subjects were randomly allocated into two groups. Baseline plaque samples were collected from all the subjects followed by the application of two varnishes, Cervitec and Duraphat. The varnish was applied to pit and fissures of occlusal surface of mandibular first molar. The varnish application was carried out on the first day, fifth day and tenth day after baseline plaque sampling. Subsequent plaque samples were collected at the end of 1 month and at the end of 3 months after the varnish application. RESULTS: The Cervitec varnish has shown a statistically significant reduction at the end of 1 month and at the end of 3 months (P < 0.05). Duraphat varnish did not show a statistically significant difference in reducing the plaque S. mutans count at the end of 1 month and third month (P > 0.05). CONCLUSION: Cervitec varnish was found to be effective in reducing S. mutans count for a 3-month period, when compared to Duraphat varnish.

Comparative assessment of validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional survey among adolescents in Davanagere city, Karnataka, India.

AIM: To evaluate reliability and validity of an abbreviated version of the Oral Impact on Daily Performance (OIDP) questionnaire and to analyse the interrelationship between OIDP scores, socio-demographic characteristics and oral health status among high school children in Davanagere city, Karnataka, India. MATERIALS AND METHODS: This cross-sectional survey was conducted with 900 school children aged between 12 and 15. The subjects were randomly selected from six high schools. Selected subjects completed a survey instrument predesigned to measure subjective oral health indicators including the eight-item OIDP frequency scores. The study participants were clinically examined for dental caries, and they completed a self-administered questionnaire about demographic information and oral behaviours. RESULTS: 44% of the students reported at least one oral impact in the previous 6 months. The reliability of the instrument was measured in terms of Cronbach's alpha for the OIDP frequency. It was found to be 0.81. Eating was the most common performance affected (33%) followed by cleaning teeth (22%) and speaking (20%). The severity of impacts was low for relaxing and carrying out works. CONCLUSION: The OIDP frequency score has acceptable psychometric properties in the context of an oral health survey among high school children of Davanagere city, Karnataka, India.

Comparative evaluation of marginal integrity of glass ionomer and resin based fissure sealants using invasive and non-invasive techniques: an in vitro study.

BACKGROUND: Occlusal surfaces of the molars are highly susceptible to dental decay. Pit and fissure sealants are one of the best methods of preventing fissure caries. The main problem encountered is microleakage leading to deterioration of material and increased possibility of the development of secondary caries. AIMS: To assess and compare the marginal integrity of glass ionomer (Fuji VII) and resin based (Clinpro) fissure sealants using invasive and non-invasive technique. SETTING AND DESIGN: Experimental in-vitro study. MATERIALS AND METHODS: An in-vitro study was conducted on 40 healthy, extracted premolars. The teeth were divided into 4 groups. Group I: Clinpro-invasive technique, group II: Clinpro-non-invasive technique, group III: Fuji VII-invasive technique, group IV: Fuji VII-non-invasive technique. Sealants were applied and subjected to an evaluation under SEM (scanning electron microscopy) for the width of the marginal gap. ANOVA (analysis of variance) and Duncan's multiple range tests were used for the statistical analysis. RESULTS: The mean width of the marginal gap was 0.4089 µm in group I as compared to 3.0485 µm in group III; and the difference was statistically highly significant (P<0.001). In non-invasive technique, Clinpro and Fuji VII showed a mean marginal gap width of 0.4486 µm and 3.0485 µm, respectively. This difference was statistically highly significant at a P<0.001. There was no statistically significant difference in the mean widths between invasive and non-invasive techniques. CONCLUSION: Clinpro performed better in terms of marginal adaptation than did the Fuji VII sealant. The techniques (Invasive and non-invasive) does not influence the marginal integrity significantly.

Validity and reliability of Oral Impacts on Daily Performances Frequency Scale: a cross-sectional survey among adolescents.

AIM: To examine reliability and validity of an abbreviated version of Oral Impacts on Daily Performances (OIDP) questionnaire and to analyze the interrelationship among OIDP scores, socio-demographic characteristics and oral health status among 12-15 year old adolescents in Davanagere city, Karnataka, India. METHOD: The descriptive cross-sectional survey was conducted among 900 adolescents aged between 12-15 years. The study subjects were randomly selected from six high schools. Selected subjects completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. The study participants were clinically examined for dental caries and completed a self-administered questionnaire about demographic information and oral behaviors. RESULTS: 44% of the students reported at least one oral impact in the last six months. Cronbach's alpha for the OIDP frequency items was 0.81. Eating was the most common performance affected (33%) followed by cleaning teeth (22%) and speaking (20%). The severity of impacts was low for relaxing and carrying out works. CONCLUSION: The OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among 12-15 year old adolescents.

Are we eliminating cures with antibiotic abuse? A study among dentists.

CONTEXT: The theme of "World Health Day 2011" is "combat drug resistance- No action today, No cure tomorrow" which is very pertinent. The present study emphatically demonstrates the current issues related to the overwhelming concerns regarding indiscriminate use of antibiotics, leading to a bleak tomorrow where cures may be few. AIM: To know the prescription pattern of antibiotics for various dental procedures by dental practitioners. MATERIALS AND METHODS: A pretested questionnaire was used which contained two sections pertaining to prescription of antibiotics for healthy and medically compromised patients during various dental procedures, with therapeutic and prophylactic considerations. RESULTS: Questionnaire response rate of 66.6% was observed. Amoxicillin emerged as the most preferred antibiotic for dental procedures both as a therapeutic and a prophylactic drug. 50% of the endodontists and 40% of the general dentists opted to prescribe antibiotics during root canal therapy where ideally operative intervention would have sufficed. Overuse of antibiotics for routine scaling and extraction was observed. CONCLUSION: The dental profession as a whole needs to acquire a deeper understanding of the global effects of superfluous antibiotic prescription. Antibiotics when judiciously used are precise life-saving drugs.

Assessment of Discomfort Experienced by School Children While Performing 'ART' and 'MCP'-An Experimental Study.

OBJECTIVE: Atraumatic Restorative Treatment (ART) is a minimal intervention technique in the management of carious lesions, which results in negligible discomfort to the patient. The aim of this study was to assess and compare the discomfort levels during Atraumatic Restorative Treatment and Minimal Cavity Preparation (MCP: a method using rotary instruments) treatment procedures in a sample of school children in Davangere city. MATERIALS AND METHODS: An experimental study was performed aimed at comparing discomfort levels as measured by subjective (Venham index) and objective (Heart rate) methods at six specified moments during the treatment. A total of 200 children were randomly divided into two groups of 100 each. In each child, one class II restoration with GIC in a deciduous molar was performed. One group received treatment using rotary instruments (MCP) and the other group with ART. Discomfort levels were measured using Venham index (behavioural dimension) and heart rate (physiological dimension). RESULTS: The behavioural measurement revealed that in ART group the majority of the children(64%) showed an overall Venham score of '<1'(relaxed) as compared to MCP group in which the majority of children (76%) showed a Venham score of '1'(uneasy). The physiological measurement revealed that the children in ART group experienced less discomfort when compared to children in MCP group. CONCLUSION: The results of the study suggest that ART induces less discomfort; is patient friendly and has a higher extent of community acceptance when compared to MCP.

Questionnaire vs clinical surveys: the right choice?--A cross-sectional comparative study.

PURPOSE: To investigate the practical value of using questionnaires (self perceived assessment) as compared with clinical examinations (normative assessment) and to evaluate the role of socioeconomic status and implications of the results in understanding the public perception of oral health. MATERIALS AND METHODS: This was a cross-sectional single-blind study. A purposive sample of 860 bank employees of Belgaum city, India, were asked to fill in a close-ended questionnaire inquiring about their socioeconomic status, dental, periodontal health levels and treatment needs. Clinical examinations, employing the WHO dentition status and Community Periodontal Index, were performed to determine normative status and needs. Perceived and normative assessments were compared for sensitivity, specificity, positive and negative predictive values. RESULTS: The kappa values ranged from 0 (treatment needs) to 0.67 (for prosthesis). The degree of agreement with the following kappa values and sensitivity was seen in filled teeth (0.52, 60%), missing teeth (0.62, 83.8%), and prosthesis (0.67, 58.3%). However, the disagreement was seen with all other questions with average kappa value of 0.20. CONCLUSIONS: Self-assessment questionnaires were of low value in evaluating dental, periodontal health status and treatment needs in the study subjects. Findings reflect a low level of awareness that may influence care-seeking behavior and socioeconomic status has a clear role to play in dental health perception.

Comparative evaluation of efficacy of 0.2% Chlorhexidine, Listerine and Tulsi extract mouth rinses on salivary Streptococcus mutans count of high school children--RCT.

OBJECTIVE: To assess and compare the effect of 0.2% Chlorhexidine mouth rinse, Listerine mouth rinse and 4% Tulsi extract mouth rinse on salivary Streptococcus mutans level. METHODS: The present study is an experimental study of cross over type, employing Latin square design. 45 school children aged 14-15 years were divided into three groups/blocks. The baseline unstimulated saliva samples were obtained from each group and assessed for Streptococcus mutans counts. The study was divided in to three phases, each phase lasted for 8 days separated by a washout period of 15 days in between them. Groups A, B and C were treated with 0.2% Chlorhexidine, Listerine and 4% Tulsi extract mouth rinses respectively in the phase I. The study subjects were instructed to use the assigned mouth rinse twice daily for 1 min for 7 days. On day 8th the subjects were instructed to use the mouth rinse only once in the morning. The follow up unstimulated saliva samples were collected 1h after the use of the assigned mouth rinse and assessed for salivary Streptococcus mutans counts. After phase I, mouth rinses were crossed over as dictated by the Latin square design in phase II and III. RESULTS: All the three mouth rinses have individually shown a statistically significant reduction in the salivary Streptococcus mutans counts. When the three mouth rinses were compared the difference did not reach statistical significance. CONCLUSION: Tulsi has stood the test and is as effective as Chlorhexidine and Listerine in reducing the salivary S. mutans levels.

Assessment of microbial contamination of toothbrush head: an in vitro study.

BACKGROUND: The most common oral hygiene aid used to improve the oral health of an individual is toothbrush and it is often neglected to maintain in a proper aseptic condition, which could probably result in contamination by various micro-organisms. AIMS: 1) To assess the microbial contamination of the hard deposit on the toothbrush head, between the bristle tufts, after 1 and 3 months of use. 2) To assess the microbial contamination of the hard deposit on the toothbrush head, between the bristle tufts, which were kept in the bathrooms with and without attached toilet. SETTING AND DESIGN: An in vitro study. MATERIALS AND METHODS: Twenty toothbrushes kept in the bathrooms with an attached toilet and 20 toothbrushes kept in the bathrooms without an attached toilet were collected from the participants, making it a total of 40. Among these 20 toothbrushes in each group, 10 were used for 1 month duration and 10 were used for 3 months duration. RESULTS: Streptococcus mutans, Staphylococcus aureus, Pseudomonas, Lactobacillus, Klebsiella, Candida species were isolated in 1 month and 3 months used toothbrushes kept in the bathrooms without attached toilet. Escherichia coli was found in 3 months used toothbrushes kept in the bathrooms with attached toilet. Micro-organisms were found in isolated form in toothbrushes used for 1 month, whereas in toothbrushes used for 3 months they are found in clumps. CONCLUSION: Hard deposit on the toothbrush head between bristle tufts is a nidus for growth of micro-organisms, which not only affects the oral health but also affects the general health of an individual.

Evaluation of the antimicrobial activity of various concentrations of Tulsi (Ocimum sanctum) extract against Streptococcus mutans: an in vitro study.

AIM: To determine if Tulsi (Ocimum sanctum) extract has an antimicrobial activity against Streptococcus mutans and to determine which concentration of Tulsi (Ocimum sanctum) extract among the 15 concentrations investigated has the maximum antimicrobial activity. SETTING AND DESIGN: Experimental design, in vitro study, Lab setting. MATERIALS AND METHODS: Ethanolic extract of Tulsi was prepared by the cold extraction method. The extract was then diluted with an inert solvent, dimethyl formamide, to obtain 15 different concentrations (0.5%, 1%, 1.5%, 2%, 2.5%, 3%, 3.5%, 4%, 4.5%, 5%, 6%, 7% 8%, 9%, 10%) of the extract. 0.2% chlorhexidine was used as a positive control and dimethyl formamide was used as a negative control. The extract, along with the controls, was then subjected to microbiological investigation to determine which concentration among the 15 different concentrations of the extract gave a wider inhibition zone against Streptococcus mutans. The zones of inhibition were measured in millimeters using a vernier caliper. RESULTS: At the 4% concentration of Tulsi extract, a zone of inhibition of 22 mm was obtained. This was the widest zone of inhibition observed among all the 15 different concentrations of Tulsi that were investigated. CONCLUSION: Tulsi extract demonstrated an antimicrobial property against Streptococcus mutans.

Antimicrobial efficacy of various disinfecting solutions in reducing the contamination of the toothbrush -- a comparative study.

BACKGROUND: Contaminated toothbrushes may play a role in the transmission of local or systemic diseases. As modern dentistry emphasises prevention and infection control, toothbrushes should be correctly stored, disinfected and changed at regular intervals. PURPOSE: The aim of this study was to test the efficacy of 3% neem, 2% triclosan, 0.2% chlorhexidine gluconate and 1% sodium hypochlorite as toothbrush disinfectants against Streptococcus mutans. MATERIALS AND METHODS: This was a double-blind, linear crossover, within-group comparative experimental trial conducted among 40 children aged 12 to 15 years. The study was divided into five phases: (1) distilled water (control); (2) 3% neem; (3) 2% triclosan; (4) 0.2% chlorhexidine gluconate; and (5) 1% sodium hypochlorite. The toothbrushes were collected after 5 days of brushing and were soaked for 12 h in antimicrobial solutions of separate phases, after which the toothbrushes were submitted for microbial analysis to check for the presence of S. mutans. RESULTS: The mean colony-forming units (CFUs) of S. mutans at phase 1 when compared with baseline was not significant (P = 0.17). The other phases had a significant drop in mean CFUs of S. mutans from baseline (P < 0.001). The percentage reduction of mean CFUs of S. mutans from baseline was the highest in phase 2 (86%). CONCLUSION: It can be concluded that all the solutions are effective in toothbrush decontamination, but 3% neem has greater efficacy than other solutions.

Dental caries status and treatment needs of children of fisher folk communities, residing in the coastal areas of Karnataka region, south India.

OBJECTIVE: To assess the dental caries status and treatment needs of children belonging to the fisher folk communities. METHOD: Two hundred and sixty-seven children up to the age of 14 years were examined using the World Health Organization (WHO) oral health assessment criteria, 1997. RESULTS: The prevalence of dental caries was found to be high in the study population. The unmet treatment need was also high. CONCLUSION: Further research is suggested in order to explore and identify the prevailing aetiological factors responsible for the current status.

Dental caries status and treatment needs of children of fisher folk communities, residing in the coastal areas of Karnataka region, south India / El estatus de las caries dentales y necesidades de tratamiento de los niños en las comunidades de pescadores, residentes en las áreas costeras de la región de karnataka, al sur de la india

OBJECTIVE: To assess the dental caries status and treatment needs of children belonging to the fisher folk communities. METHOD: Two hundred and sixty-seven children up to the age of 14 years were examined using the World Health Organization (WHO) oral health assessment criteria, 1997. RESULTS: The prevalence of dental caries was found to be high in the study population. The unmet treatment need was also high. CONCLUSION: Further research is suggested in order to explore and identify the prevailing aetiological factors responsible for the current status.

Primary dentition status and treatment needs of children with cleft lip and/or palate.

The aim of this study was to assess the primary dentition status and treatment needs in children with cleft lip, cleft palate and or both. A descriptive, cross-sectional study was done through oral examination on a sample of 83, 2-5 years old cleft lip/palate children (46 boys and 37 girls). A self-designed questionnaire to obtain pertinent data related to level of education of parents and infant-feeding practices was used for recording the data while examining the children. Majority of cleft affected children had dental caries experience and required different types of treatment. The result of this study shows that: (1) all age groups of cleft affected children had dental caries experience, (2) children with primary type of cleft had less dental caries prevalence than children with cleft of secondary or combination type ( P < 0.05), (3) treatment needs due to caries were more in combination type of cleft compared to primary and secondary.

The effect of different methods of drinking a carbonated beverage on the pH of dental plaque: an in vivo study.

PURPOSE: Fizzy drinks are known to be erosive or cariogenic, but little is known about the ways of reducing their harmfulness by altering the method of drinking. The purpose of this study was to assess the changes in plaque pH, at different time intervals in vivo after consuming a carbonated beverage (sprite, pH = 2.98) with plastic glass, straw and directly from bottle. DESIGN: A clinical study. MATERIAL AND METHODS: Eighteen subjects aged 18-25 years were recruited for the study and were divided randomly into three groups, six in each (group A- plastic glass, B- straw and C- directly from bottle) after the salivary pH was measured. Subjects were requested to refrain from brushing for 24 hours prior to the study. Collection of pooled plaque was done before and after consuming the drink at five, 10-, 20- and 30-minute intervals. Plaque pH was assessed by glass combination electrode. ANOVA and post hoc Tukey's test was used for statistical analysis. RESULTS: Highest mean pH drop (5.29) was recorded when consumed with plastic glass at all time intervals. There was a significant difference between group A and B at 5 min and 10 min (P < 0.05). However, no difference was seen between group B and C, A and C (P > 0.05). CONCLUSIONS: The use of a straw and direct consumption of beverage from the bottle could limit harmful effects on dentition.