Efficacy and Safety of Probiotics for Dental Caries in Preschool Children: A Systematic Review and Meta-analysis.

Background: Early childhood caries is one of the most serious and high-priced oral health conditions among young children. With advancing dental sciences, the focus of dental caries treatment is shifted from restorative procedures to preventive measures, and a modality grabbing attention is probiotics. Probiotics exert their effects in many ways as chemical inhibition of pathogenic bacteria and stimulation of the immune response through the production of immunoglobulin A and many more. Objective: This systematic review aims to explore the efficacy and safety of probiotics in dental caries in preschool children. Methodology: The study was registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42020159058). The search was done for randomized control trials in electronic databases such as Cochrane, PubMed, ClinicalTrials.gov, Medline, and Embase. It has further included manual searches of journals, conference abstracts, and books. Three reviewers done the selection of the study as per the criteria and also did the risk of bias assessment independently and wherever required, a fourth reviewer resolved the discrepancy in case of disagreement. Results: The nine randomized control trials were included in the study, and the pooled analysis revealed probiotics as an effective intervention in preschool children with dental caries. Conclusion: The results about the efficacy of probiotics in the prevention of dental caries are very encouraging, though the level of evidence is still inadequate.

Prevalence of breast imaging reporting and data system (BIRADS) categories and breast consistencies in Central India -A cross-sectional survey.

BACKGROUND: For recognizing the initial stages of breast cancer, mammography is regarded as one of the best modalities and plays a crucial part to lessen morbidity and mortality. For collaborative studies and planning of preventive strategies, it is significant to have baseline data. Thus, in this survey, the frequency distribution of breast imaging reporting and data system (BIRADS) classification and breast consistencies was investigated during the mammographic screening program in the Gwalior region, India. MATERIAL AND METHODS: A descriptive, cross-sectional survey was conducted in the Gwalior region, India, in which 1,838 patients were screened with the aid of mammography. The mammography films were evaluated by a single radiologist who determined the BIRADS score, breast composition, and any other abnormal findings. After tabulating the data into MS Excel (MS Office version 2007 developed by Microsoft, Redmond, WA), descriptive analysis and Chi-square test were performed to determine the association between the BIRADS score and breast consistency and setting significance level at (below) 0.05. RESULTS: The most commonly found BIRADS score was score 1 (53.4%), followed by score 2 (20.4%), and score 5 was of the least frequency (1.3%). Similarly, the most common consistency found was fatty (48.2%) and the least common was heterogeneously dense (3.97%). The most BIRADS category of 0 was seen in heterogeneously dense (n = 22; 26%) followed by dense breast compositions (n = 18; 25%). The most common consistency found with known breast malignancy (BIRADS 6) patients was the extremely dense breast (n = 11; 40.7%). CONCLUSION: In this study, it was observed that about 57.3% of all the cases were categorized as BIRADS 1 and 20.8% as BIRADS 2.

Evaluation of oral health care seeking behavior in rural population of central India.

OBJECTIVES: To study the perception regarding common oral diseases and health seeking behaviour related to those diseases among rural population of central India. METHODS: A cross sectional study was conducted in the rural areas of Wardha, Maharashtra on a population between the age group of 18 and above. Data was recorded by a self administered, structured questionnaire in this study. Questionnaire was based on oral health literacy and health seeking behaviour of participants. RESULTS: Study included 700 participants, 343 males and 347 females. Dental problem was reported by 68% of participants. Toothache was the most common dental problem reported. Government hospitals were chosen by 19% of participants as treatment centre. Fear 24.3% was found to be the major reason for not visiting the dentist. CONCLUSION: Healthcare seeking behaviour among rural population towards oral diseases was poor. So efforts must be made to bring a change in this scenario.

Assessment of the oral health seeking behavior of patients with premalignant lesions.

BACKGROUND: Before choosing/visiting any dental facility for their treatment, patients consider several factors. These factors may be related to the patient or service provider. The health-seeking behavior of a society defines how health services are used. AIMS: To assess the health seeking behavior of patients with premalignant lesions. MATERIAL AND METHOD: A cross sectional study using questionnaire was done among the patients who consulted in the Department of Oral Medicine and Radiology, of age 18 and above suffering from precancerous lesions. The questionnaire included 25 close-ended questions which collected information about the demographic details, oral hygiene habits, oral health issues, deleterious habits. The responses were either on dichotomous scale (yes and no) or on the frequency habits. A total of 218 subjects were included in the study. The data were analyzed using the Chi-square test. The acceptable level of significance was reduced to P < 0.05. RESULT: Slightly over 50% of study participants visited the dentist for their dental problems. Most of the participants visited dental clinic whenever needed. Maximum positive health seeking behavior is seen in fourth and fifth decade and minimum seen in second and third decade. CONCLUSION: The oral premalignant lesions have high chances of transformation into malignancies. The progression of these lesions can be prevented by stopping the progression at an early stage and thus instilling positive health seeking behavior serves as an important key to it.

Analysis of food frequency and acquired dietary allowance (ADA) in relation to dental caries and dental erosion affecting dental postgraduate students of Sawangi: A cross-sectional survey.

BACKGROUND: The development and integrity of the oral cavity and the progression of oral diseases may be affected by the nutritional status and diet of the person. The most ubiquitous oral diseases are found to be dental caries and periodontal diseases in the world. Therefore, the aim of the present study was to assess the correlation between food frequency with nutrient adequacy ratio (NAR), NAR with dental caries, and dental erosion. MATERIALS AND METHODS: This study was conducted among dental postgraduate (PG) students. A self-administered questionnaire was developed with consisted food frequency, acquired dietary allowance, Decayed, Missing Filled teeth (DMFT) index, and tooth wear index. Correlation was assessed between food frequency and NAR, NAR with dental caries and dental erosion. RESULTS: Out of 123 PGs 100 PGs participated in the study making response rate 81%. Consumption of chapatti, pulses vegetables white rice, sugar, milk and milk products, and acidic food is on the daily basis mostly and it was statistically significant (P < 0.05). A statistically significant difference (P < 0.05) was also seen between frequency of consuming food items in decreasing order is fats, legumes, roots and tubers, fruits, meat and meat products, fried foods, vitamin and mineral supplements those who eat daily and never. CONCLUSION: The significant association between food frequency and nutrient adequacy ratio might be helpful assessing nutritional values. The high use of acidic beverages is a serious threat to the health of the oral cavity.

Effectiveness of "Audio-tactile Performance Technique" to improve the oral hygiene status of visually impaired schoolchildren.

BACKGROUND: Maintaining oral hygiene is a challenging task for the visually impaired population. Oral health is often overlooked because of lack of knowledge about oral health practices. Therefore, there was a need to train visually impaired individuals with the aid of customized techniques so that the understanding of brushing technique could be perceived at its best. AIMS AND OBJECTIVE: Comparative evaluation to check the effectiveness of "Audio-tactile Performance Technique (ATP)" to improve oral hygiene status of visually impaired schoolchildren. SUBJECTS AND METHODS: The present study was an interventional study of 92 visually impaired children in Wardha district. Their knowledge regarding oral hygiene practices was tested with a verbal questionnaire in a pre- and post-test to check the improvement in their knowledge after imparting health education. Fones method of toothbrushing was taught by "ATP," and a health talk was delivered. The plaque scores were recorded using the Quigley-Hein Plaque Index (modified by Turesky et al.) at baseline and at the end of 3 months. Periodic reinforcement was provided twice at an interval of 20 days in between the visits. STATISTICAL ANALYSIS USED: The collected data were tabulated and analyzed using Student's paired t-test in Stata version 15.1, and kappa statistics were done to test inter-rater reliability and agreement was found to be 90%. RESULTS: There was a statistically significant decrease in the postinterventional plaque scores from 2.78 to 1.63 (P < 0.05) and an increase in the posthealth education test scores from 1.98 to 8.21 (P < 0.05). A substantial decrease in the percentage of children, who had high plaque scores initially, was seen postintervention. CONCLUSIONS: The "ATP" along with oral health education served as a very effective customized method of teaching oral hygiene practices and its maintenance to the visually impaired children.

Anesthetic Efficacy of Buccal Infiltration Articaine versus Lidocaine for Extraction of Primary Molar Teeth.

The aim of this study was to compare the efficacy of articaine versus lidocaine, both containing epinephrine, using a single buccal infiltration for extraction of primary molars.A total of 100 children requiring primary molar extraction received buccal infiltration using either 4% articaine or 2% lidocaine, both with epinephrine, with 50 children in each group. The Wong-Baker Facial Pain Scale (FPS) was used to evaluate pain perception subjectively. The heart rate and the blood pressure values were assessed objectively as an indirect measure of physiological pain perception. The Wilcoxon-Mann-Whitney test was used for comparing mean pain scores, heart rate, and blood pressure in both the groups. Single buccal infiltration with articaine was sufficient for achieving palatal or lingual anesthesia in all the children receiving it while all children in the lidocaine group required supplemental anesthesia. The mean FPS value was found to be higher in lidocaine group and was statistically significant. The mean heart rate recorded during the intervention was less than the mean baseline values in the articaine group, which was found to be statistically significant. For pediatric patients age 7 to 12 years, single buccal infiltration with 4% articaine with 1:100,000 epinephrine is more effective compared to 2% lidocaine with 1:80,000 epinephrine for primarly molar extraction.

Knowledge, Attitude, and Practices regarding Pharmacovigilance and Adverse Drug Reaction reporting among Dental Students in a Teaching Hospital, Jodhpur, India: A Cross-sectional Study.

INTRODUCTION: This is a cross-sectional knowledge, attitude, and practices (KAPs) study on pharmacovigilance (PV) and adverse drug reaction (ADR) reporting among dental students in a teaching hospital in India. AIM: The aim of this study was to assess the KAP of dental students regarding PV, ADR reporting, and barriers toward the same. MATERIALS AND METHODS: A cross-sectional survey using a self-administered, investigator-developed, close-ended questionnaire was conducted in an academic dental hospital in India. All prescribers including third year students, final year students, and house surgeons of the same institute were included for assessment of KAP regarding PV using 16, 8, and 8 items respectively. Data regarding barriers toward ADR reporting and demographics were also collected. Mann-Whitney U-test and Kruskal-Wallis test were applied followed by post hoc test. RESULTS: A total of 241 of 275 respondents participated in the study with a response rate of 87.5%. Overall, 64% reported that they had no idea about the term PV. Age was significantly associated with knowledge (p = 0.045) and attitude (p = 0.016). Barriers contributing to underreporting were difficulty in deciding whether or not an ADR has occurred (52.0%), concerns that the report may be wrong (37%), lack of confidence to discuss ADR with colleagues (29%), and almost no financial benefits (24%). CONCLUSION: Participants had a comparatively favorable attitude toward PV, but their knowledge and practice need considerable improvements. This study highlights the need for appropriate dental curriculum changes and further multicentric studies to shed more light on important issues of PV among dentists in India. CLINICAL SIGNIFICANCE: This study explores dentists' knowledge, attitude, and behavior regarding PV, which could help to improve patient's safety and care. The favorable attitude of dentists is an indication that PV could be added in depth in the curriculum and in general practice. Information on barriers for reporting the ADRs could help to find possible solutions for removing the barriers precisely.

Dental Informatics in India: Time to Embrace the Change.

Dental informatics is comparatively a juvenile and new field that has noteworthy potential for supporting clinical care, research, education and management. This field utilizes computer science, information sciences and the application of same to espouse dentistry. However, in the under-developed and developing countries almost most of the dentists are unacquainted about dental informatics, its goals, what it is capable of achieving and by what means they can get involved into it. Despite of emerging advances, certain conflicts also go along with it such as, professional under representation, security issues of the stored information due to universal access to computers high speed internet connections. Endnote software was used as resource material to collect literature which was carefully arranged in a synchronized way. Hence, the purpose of this review was to give an overall scenario of dental informatics, its applications, challenges and recommendations for further enhancement in this area.

Cognitive Ability as a Determinant of Socioeconomic and Oral Health Status among Adolescent College Students of Bengaluru, India.

INTRODUCTION: Levels of oral health and economic status are unequally distributed throughout the population. Inequality has multiple causes and that the effect of Socio Economic Status (SES) and demographic factors, on oral health is mediated through several factors. Association between cognitive ability and oral health had been demonstrated in older age groups but adolescents and younger adults have received relatively little attention in this field. AIM: To establish the role of cognitive ability as a determinant of SES and oral health status among adolescent college students of Benagluru, Karnataka, India. MATERIALS AND METHODS: A cross-sectional study was conducted among 1000 adolescents aged 17-19 years. Six government and six private first grade colleges were selected by multi-stage random sampling. Cognitive ability was assessed using digit symbol substitution test and digit span test. Dental caries and periodontal status were recorded by extent of bleeding, presence of calculus, periodontal pockets, loss of attachments using Community Periodontal Index, decayed, missing and filled teeth surfaces using Decayed, Missing, Filled Teeth and Surfaces Index. SES status was assessed using Kuppuswamy scale. Chi-square test was used to check the association of cognitive ability with oral health indicators and SES status. Regression analysis was performed to assess the effect of cognitive ability on oral health indicators after adjusting for SES and effect of SES status on oral health indicators after adjusting for indicators of cognitive ability. RESULTS: Significant association and negative correlation between cognitive ability and indicators for oral health was seen in the regression models. Cognitive ability attributed for nearly 30% changes in the indicators for oral health after adjusting for SES and SES attributed for nearly 25% variance in indicators for oral health after adjusting for cognitive ability. CONCLUSION: There is a potential role of cognitive ability in SES and oral health.

Dental anomalies of the deciduous dentition among Indian children: a survey from Jodhpur, Rajasthan, India.

BACKGROUND: Anomalies and enamel hypoplasia of deciduous dentition are routinely encountered by dental professionals and early detection and careful management of such conditions facilitates may help in customary occlusal development. OBJECTIVE: The aim of this study was to determine the prevalence of hypodontia, microdontia, double teeth, and hyperdontia of deciduous teeth among Indian children. MATERIALS AND METHODS: The study group comprised 1,398 children (735 boys, 633 girls). The children were examined in department of Pedodontics and Preventive Dentistry in Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India. Clinical data were collected by single dentist according to Kreiborg criteria, which includes double teeth, hypodontia, microdontia, and supernumerary teeth. Statistical analysis of the data was performed using the descriptive analysis and chi-square test. RESULTS: Dental anomalies were found in 4% of children. The distribution of dental anomalies were significantly more frequent (P = 0.001) in girls (5.8%, n = 38) than in boys (2.7%, n = 18). In relation to anomaly frequencies at different ages, significant difference was found between 2 and 3 years (P = 0.001). CONCLUSION: Double teeth were the most frequently (2.3%) observed anomaly. The other anomalies followed as 0.3% supernumerary teeth, 0.6% microdontia, 0.6% hypodontia. Identification of dental anomalies at an early age is of great importance as it prevents malocclusions, functional and certain psychological problems.

Insights into ergonomics among dental professionals of a dental institute and private practitioners in hubli-dharwad twin cities, India.

BACKGROUND: To assess the knowledge, attitude, and practice of ergonomics among dental professionals of Hubli-Dharwad twin cities, India. METHODS: Investigator-developed, self-administered, closed-ended questionnaire assessing knowledge, attitude, and practices regarding ergonomics during dental practice was filled in by undergraduates, house surgeons, postgraduates, and faculty members of dental institutions and private practitioners from Hubli-Dharwad twin cities. RESULTS: Data were collected from a total of 250 participants, 50 belonging to each academic group. Overall mean knowledge, attitude, and practice scores were 52%, 75%, and 55%, respectively. Significant correlation was found for age with attitude (χ(2) = 10.734, p = 0.030) and behavior (χ(2) = 12.984, p = 0.011). Marital status was significantly associated with all the three domains; knowledge (χ(2) = 29.369, p = 0.000), attitude (χ(2) = 29.023, p = 0.000), and practices (χ(2) = 13.648, p = 0.009). CONCLUSION: Participants had considerable awareness and behavior toward ergonomics in dental practice. The high attitude score indicates stronger acceptance of ergonomics principles and guidelines during routine dental procedures. The current study highlights the situation of ergonomics in dental practice in the form of knowledge, attitude, and practices.

An Insight Into Research Ethics among Dental Professionals in A Dental Institute, India- A Pilot Study.

BACKGROUND: Research activities are increasing in all the fields of medicine including dentistry but there is dearth of information about the knowledge, attitude and behaviour of dental professionals for ethical principles in research, especially in the developing countries like India. OBJECTIVE: To assess knowledge, attitude and behaviour among dental professionals pertaining to research ethics. MATERIALS AND METHODS: A self-administered, close ended questionnaire survey with cross-sectional design was conducted in a private dental institute in India. All the house-surgeons, post-graduate students and the faculty of the same institute were included for the assessment of the knowledge, attitude and behaviour regarding research ethics using a 24, 8 and 8 items. RESULTS: A total of 213 of 230 dental professionals participated (response rate of 92.6%). Mean knowledge, attitude and behaviour scores were 43.3%, 82.5% and 46.37%, respectively. Significant correlations were observed of age and gender with the attitude about the research ethics among study subjects (χ(2)=14.383, p=0.006 and χ(2)=7.769, p=0.021, respectively). CONCLUSION: Participants had favorable attitude towards research ethics, but their knowledge and behaviour needs considerable improvements. The age and gender were associated with attitude. The present pilot study highlights the need for further nationwide study and development of research ethics curriculum in detail for dental education in India.

Comparison of different caries diagnostic thresholds under epidemiological and clinical settings among 7-15 year old school children from Bangalore city.

AIM: The aim of this study is to compare the different caries diagnostic thresholds under epidemiological and clinical settings among 7-15 year old school children. MATERIALS AND METHODS: A cross-sectional study was undertaken among 7-15 years old school children of Bangalore city. Total 738 children were enrolled in the study. General information was collected regarding oral hygiene practice and personal habits of the schoolchildren. Subsequently, examination was done under both the settings to record Decayed, missing and filled surfaces index for permanent teeth (DMFS) and Decayed, missing and filled surfaces index for deciduous teeth (dmfs) using the World Health Organization (WHO) and WHO + IL criteria. RESULTS: The present study showed that both the settings (clinical and epidemiological) and diagnostic thresholds (WHO and WHO + IL), could influence the detection of carious lesions. Mean Ds under WHO + Initial lesions (IL) criteria (3.92 + 3.49) was nearly double of WHO criteria (1.88 + 2.73,) and the influence observed was more in 14 years of age, where mean Ds under WHO + IL criteria (5.43 + 2.5) which was more than double of WHO criteria (2.02 + 1.9). CONCLUSION: The choice of a diagnostic threshold (WHO and WHO + IL) and the conditions of examination (epidemiological and clinical) are important for the detection of caries.