Modified extrinsic tooth stain index and its clinical applicability.

Aim: The first index for the assessment of extrinsic stain was published by Lobene in 1986. Using the Lobene stain index in the field is very cumbersome as well it does not meet the general requirement of an index, i.e., the index is to be simple, rapid, highly reproducible, and sensitive enough to detect small changes in the staining level. Hence, there was a need to develop an alternative index for the same purpose. Hence, the only present study was undertaken to propose a modified stain index with more simplicity and clarity. Materials and Methods: An observational study was carried out among 16-44-year-old participants who had at least six natural teeth and were generally healthy. For the revised index, the criteria and codes for intensity were kept the same as MacPherson Index but the criteria for recording area were modified. The data scoring for each tooth was mentioned in the proposed table and was recorded for each of the surfaces according to the proposed area and intensity codes. Analysis was carried out using SPSS version 21 (IBM, Inc. Virginia, United States). Inferential statistics were performed using the Mann-Whitney U-test. Nonparametric tests were applied following the imposition of a numerical interval scale the same as the Lobene index. Results: No statistically significant difference was appreciated for the area, intensity, and product of area × intensity when compared for measurements recorded by two indices as P > 0.05. Hence, validating the proposed index for the clinical application. Conclusion: The proposed modified index may be advantageous over its conventional counterpart due to its ease of recording and concise scoring and also less complexity in the area to be recorded.

Knowledge and Acceptance of the COVID-19 Vaccine for COVID-19 Disease Prevention among the Indian Population: A Mixed-Method Study.

Aim: To assess the Knowledge and Acceptance of the COVID vaccine among the Indian population. Materials and methods: The present mixed-method study was conducted in two phases. The first phase: quantitative assessment of knowledge and acceptance for the COVID-19 vaccine using an E survey (N = 606). The second phase: qualitative assessment using semi-structured face-to-face interviews with the study participants (N = 30) and assessment was done using a thematic approach. Study participants were selected using the convenience sampling method. Results: It was found that a large proportion of subjects in the 16−25 year of age group knew the cause of disease. But knowledge about its transmission process was found to be more in >60 years of age gap and almost all the participants in all the age group preferred Covishield. The vaccine acceptance rate was found to be low as compared to the knowledge. Conclusion: Most study participants were found to have satisfactory knowledge, but acceptance rate was comparatively lesser. Hence, more information and awareness campaigns must be launched reassuring the population about vaccine safety.

Morphological Comparison of the Maxillary Arch in Buccal and Palatal Canine Impaction among Asian Population of Gujarati Origin: A Hospital-Based Study.

Aim: To estimate the differences in the maxillary arch morphology in buccal and palatal canine impaction in an Asian population of Gujarati origin. Methodology: An institutional ethics committee's approval was acquired before the commencement of this study. Sixty subjects were enrolled in the study. Thirty subjects (20 females and 10 males) had a maxillary impacted canine either buccal or palatal and thirty control group participants were selected aged 13 to 18 years who sought orthodontic treatment at the tertiary health care center in Ahmedabad, Gujarat, in western India. Routine pre-treatment radiographs and dental plaster models with good anatomic details were recorded. Measurements of the inter-molar width, palatal depth, arch length, sum of the mesio-distal width of the upper incisors, and available arch space were recorded from prepared orthodontic study models using digital vernier calipers with an accuracy of 0.01 mm and brass wire. The ratio of palatal depth to inter-molar width (Ratio 1), arch length to inter-molar width (Ratio 2), and width of the maxillary incisors to available arch space (Ratio 3) were also secondarily calculated. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21, IBM Inc. The normality of the data was assessed by the Shapiro−Wilk test. As the data was found to be normally distributed, bivariate analyses were also performed (one-way ANOVA test, Bonferroni post hoc correction). The level of statistical significance was set at a p-value less than 0.05. Results: The comparison of the inter-molar width, palatal depth, arch length, sum of the mesio-distal width of the upper incisors, available arch space, Ratio 1, Ratio 2, and Ratio 3 among controls and subjects with buccal and palatal canine impaction showed overall significant differences in the inter-molar width, palatal depth, arch length, sum of the mesio-distal width of the upper incisors, and available arch space when compared using one-way ANOVA as p < 0.05. Ratios 1, 2, and 3 also showed significant differences between the buccal and palatal canine impaction. Conclusion: An inadequate arch length (p < 0.0001) and a higher degree of crowding with reduced available arch space (p < 0.0001) may be considered as early risk factors for buccal maxillary canine impaction. An inadequate inter-molar width (p < 0.0001), and an increased palatal depth (p < 0.0001) with a clinically reduced mesiodistal width of the sum of maxillary incisors may be considered as risk factors for palatal maxillary canine impaction in an Asian population of Gujarati origin.

Knowledge, Attitude, Practices, and Preparedness of Dental Professionals in Prescribing Nicotine Replacement Therapy.

OBJECTIVE: To assess the knowledge, practice, attitude, and preparedness of dental professionals in prescribing nicotine replacement therapy (NRT). Methodology. A prevalidated voluntary web-based questionnaire was generated as a link through Google Drive and was sent to 117 dental professionals in North India using Whatsapp, Messenger, and Instagram social media platforms. A total of 94 responses were received and out of which 76 responses were analyzed (18 forms were excluded due to incomplete or duplicate responses). Frequency analysis was done using SPSS software version 21. RESULT: The participation rate was found to be 80.3%. More than half of the study population were familiar with the term NRT (77.6%) and its uses (67.1%), but approximately less than half of the total study subjects knew the duration (32.9%), cost (27.6%), dosage (25%), and contraindications (36.8%) of the NRT. Approximately 56.6% of the study participants showed a positive attitude towards helping patients to quit smoking through tobacco cessation counseling. Nearly one-fourth of the study population, i.e., 27.6%, were confident in explaining the negative impacts of tobacco, while 22.4% knew about the tobacco cessation protocol. Among the participants, only 27.6% reported that they practice NRT and out of which approximately less than 20% of the study participants were prescribing correct dose of NRT. CONCLUSION: Though study subjects had an ample knowledge regarding NRT use in tobacco cessation, it does not reflect their current attitude and preparedness. Thus, there is a need for continuing education to further train dental professionals for prescribing NRT.

Smoking Rationalisation, Tobacco Dependence and Intention to Quit Among Indian Adults and Adolescents.

Introduction: Unfortunately, indicators of tobacco dependence are present even after low levels of exposure in young smokers. Early emergence of these signal risk for subsequent chronic smoking and nicotine dependence is negatively associated with cessation in young adults. One important yet understudied modifiable predictor of intention to quit among smokers is smoking rationalization. Smokers often subscribe to smoking rationalisation beliefs, also known as self-exempting beliefs, to justify or rationalize their smoking behaviors. Smoking rationalizations can predict a lack of intention to quit. Objective: To assess the correlation between smoking rationalisation, tobacco dependence and intention to quit among Indian adults and adults. Methodology: A cross-sectional pilot study was carried out among 18-60-year-old subjects. Data were collected for tobacco dependence, smoking rationalisation and intention to quit (no/yes) by structured interview. Data were analysed using IBM SPSS statistics for windows, version 16 (IBM Corp, Armork, NY.) The independent t-test and one way ANOVA and binary logistic regression were performed for inferential statistics. Results: Smokers with no intention to quit and high tobacco dependence scores had significantly higher smoking rationalisation than those to quit and low dependence scores. Logistic regression models demonstrated that all types of rationalisation beliefs were consistently inversely associated with the intention to quit and low tobacco dependence. Conclusion: Findings suggest that smoking rationalisation plays an important role in the lack of intention to quit among Indian smokers. Future interventions should tackle smoking rationalisation beliefs as a strategy to promote smoking cessation.

Assessment of Knowledge, Attitude, and Practice Regarding Oral Cancer among Dental Graduates-A Web-Based Survey.

The present study was conducted to assess the knowledge, attitude, and practice among new dental graduates across India. A web-based questionnaire was generated as a link through Google Drive which was sent to approximately 250 dental graduates using Whatsapp messenger. A total of 205 complete responses were received and analyzed. Frequency analysis was done using SPSS software version 21. Oral squamous cell carcinoma (OSCC) was identified as most common cancer by 48% of the subjects while the stage of oral cancer in which it is most often diagnosed was only responded correctly by 15.5% as advanced stage. Approximately one fourth (25.4%) of the participants performed dental examination to detect cancer routinely in all patients. Half of the study subjects were confident in detecting oral cancer, still majority (70.6%) of the subjects were interested in attending continuing education course on oral cancer in the future. This study revealed that the majority of the new dental clinicians were not having legitimate knowledge regarding oral cancer. Thus, this lacuna in knowledge and skills can be eliminated by conducting workshops and continuing education programs. This may subsequently aid to improve patient care.

A Scanning Electron Microscopic Study on Effect of Blood and Artificial Salivary Contamination on Marginal Adaptation of Mineral Trioxide Aggregate, When Used as a Retrograde Filling Material: An In Vitro Study.

AIM AND OBJECTIVE: The present study was conducted to evaluate the marginal adaptability of mineral trioxide aggregate (MTA) as a root-end filling material when manipulated using two different IV fluids intended for pediatric usage; in the presence of blood and salivary contamination. MATERIALS AND METHODS: Sixty single-rooted teeth were selected. Conventional endodontic root canal preparation was performed on all specimens followed by root-end resection and retrograde cavity preparation. The roots were randomly divided into two groups (n = 30). In the specimens of group I, fresh blood was used as a contaminant and in group II artificial saliva was used as a contaminant. In both groups, MTA (e-MTA, Kids-e-Dental®) manipulated using either Ringer's lactate IV fluid (n = 15) or Tetraspan IV fluid (n = 15) was used for root-end filling in blood or artificial saliva-coated retrocavities. Furthermore, these roots were placed in beakers pooled with fresh phlebotomized blood or artificial saliva. After incubating for 48 hours, the roots were divided longitudinally to expose the retrofilled cavities and were then sputter-coated with gold-platinum dust. To assess the marginal adaptation of MTA to radicular dentin "maximum gap width" and "gap perimeter" were measured in images obtained from scanning electron microscopy of root specimens. SPSS 21 was employed for statistical analysis at (p < 0.05). Mann-Whitney U test and ANOVA were used for analyzing the data obtained. RESULTS: The gap width was more among samples exposed to blood (p < 0.05) than artificial saliva. No significant difference was reported in the gap perimeter when cavities were filled with MTA mixed with either IV fluids (p > 0.05). CONCLUSION: Exposure to blood during setting had a negative effect on gap width when retrocavities were filled with MTA using Tetraspan. No effect was seen on the arch perimeter in retrocavities filled with MTA mixed with Ringer's lactate or Tetraspan. CLINICAL SIGNIFICANCE: For avoiding failure, it is critical to select a biocompatible root-end filling material with high sealing ability. Hence, by doing the same, the clinical situation can be simulated. HOW TO CITE THIS ARTICLE: Mody A, Arora R, Chauhan P, et al. A Scanning Electron Microscopic Study on Effect of Blood and Artificial Salivary Contamination on Marginal Adaptation of Mineral Trioxide Aggregate, When Used as a Retrograde Filling Material: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(5):674-680.

Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases.

Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.

Oral Hygiene Status and Gingival Status of the 12- to 15-year-old Orphanage Children Residing in Delhi State: A Cross-sectional Study.

AIM AND OBJECTIVE: To assess oral hygiene status and practices among 12- to 15-year-old orphanage children in Delhi State, India. STUDY DESIGN: In this cross-sectional study, a one-stage cluster sampling design was carried out with orphanages as a cluster unit to assess oral hygiene status and practices among orphanage children in Delhi state, India. RESULTS: The majority of the orphanage children had good oral hygiene status (53.8%) followed by fair (32.3%) and poor (13.9%) oral hygiene status. A large proportion (48.3%) of the orphanage children had mild gingival status followed by moderate (34.9%) and severe (16.8%) gingival status. No statistical difference was reported for the distribution of oral hygiene status and gingival score across all the age-groups. Most (53%) of the orphanage children among all age-groups had good plaque status. The correlation of gingival index (GI) scores with plaque index (PI) score and oral hygiene index-simplified (OHI-S) scores showed a significant correlation of GI scores with PI scores (r = 0.815) and OHI-S scores (r = 0.799). CONCLUSION: The oral hygiene practices and oral hygiene status along with gingival status were found to be satisfactory among orphanage children in the present study. CLINICAL SIGNIFICANCE: Gingival and periodontal diseases have a high prevalence among orphanages because of poor hygiene practices. Untreated oral diseases could lead to general health problems. Thus, the preventive strategies can be planned with the exact knowledge of the oral hygiene status of these special needs children in Delhi state. HOW TO CITE THIS ARTICLE: Kumari A, Marya C, Oberoi SS, et al. Oral Hygiene Status and Gingival Status of the 12- to 15-year-old Orphanage Children Residing in Delhi State: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(4):482-487.

Adverse events occurring post-covid-19 vaccination among healthcare professionals - A mixed method study.

BACKGROUND: Healthcare professionals (HCPs) are at the front line of the nation's fight against COVID-19 and are always at a greater risk of contracting contagious disease. But amidst the crisis, the vaccines were not accepted by all the HCPs due to adverse events occurring post-COVID-19 vaccination. Hence, the present study was designed to assess adverse events occurring among HCPs post-COVID-19 vaccination both quantitatively and qualitatively. METHOD: Sequential mixed-method approach was employed. A cross-sectional E-survey was conducted among the healthcare professionals of a North Indian (*Statistically significant (p < 0.05)) college and hospital. The second phase included a semi-structured qualitative interview of the participants who were willing to participate. RESULTS: Among all the HCPs with age groups ranging from 20 to 70 years, majority of them experienced pain at the site of injection (88.8-100%) followed by tiredness (87.7-60%) and body ache (86.6-40%) post-vaccination. There is an increased frequency of adverse events in females as compared to males. Qualitative findings are summarised in three major domains i.e vaccine adverse effects, fear and hesitancy for vaccines and vaccine acceptance. CONCLUSION: Short term adverse events of COVISHIELD vaccine were very few and were mild in severity yet interviews showed hesitancy of study participants for vaccination.

Effectiveness of tobacco cessation counselling and behavioural changes Using Multi Theory Model (MTM): A follow-up study.

BACKGROUND: Effective tobacco cessation programs using advice and counselling, have helped a substantial proportion of people quit smoking. Effectiveness of this tobacco cessation counselling needs to be evaluated. AIM: The aim of the present study was to evaluate the effectiveness of tobacco cessation counselling and behavioural changes using Multi Theory Model (MTM). SETTING AND DESIGN: A non-randomised uncontrolled trial was conducted on 100 tobacco users visiting dental college in Bangalore. METHODS AND MATERIALS: A 28 item questionnaire multi-theory model (MTM) for health behaviour was administered at baseline, 2 weeks, 6 weeks and 12 weeks after providing standardized tobacco cessation counselling (TCC) intervention at baseline. STATISTICAL ANALYSIS: Data were analysed and comparison were made using repeated measure ANOVA and Bonferroni adjustment (p < 0.05). RESULTS: A total of 64 participants completed the 12 week follow-up. The mean age was 44.3 ± 10.1 years and 75.8% were males. There was significantly increase in mean MTM behaviour change score from baseline (32.78 ± 4.8) to 2 weeks (52.37 ± 5.27), 6 weeks (49.81 ± 4.34) and 12 weeks (48.7 ± 3.50) (p < 0.001). CONCLUSION: There was increase in MTM model scores in subsequent follow up suggesting behavioural changes and overall effectiveness of the Tobacco cessation counselling (TCC) among tobacco users.

Comparative assessment of low-level laser therapy (LLLT) vs. topical application of amlexanox + lidocaine to treat recurrent aphthous ulcers (RAUs): A randomized controlled trial.

Background. The present study aimed to assess and compare the pain perception and ulcer sizes before and after applying low-level laser therapy (LLLT) and Amlexanox + lidocaine. Methods. Twenty-six patients referring to the out-patient department of the institution and diagnosed with recurrent aphthous ulcers (RAU) were assigned to two groups to receive either LLLT or Amlexanox + lidocaine. In group 1, the patients were provided with amlexanox + lidocaine to apply topically four times daily. In group 2, the patients underwent LLLT with no tissue contact in inward circular motions for two cycles for 30 seconds. This study was registered in "the Clinical Trials Registry- India" (CTRI), with the registration number CTRI/2019/09/028222. The data were analyzed with SPSS 16. Results. The intergroup comparison was performed using Mann-Whitney U test, and intragroup comparisons were made using Wilcoxon's signed-rank test. The level of significance was set at P <0.05. The results showed that pain perception and ulcer size were significantly lower in group 2 subjects than group 1 subjects (P <0.05). Conclusion. LLLT was more effective than amlexanox + lidocaine in the management of RAU. It is a cost-effective therapy for treating RAU.

Comparative Efficacy of Cow Milk, KNO3, and Warm Saline Rinses in Treating Dentin Hypersensitivity Following Nonsurgical Periodontal Treatment: A Randomized Controlled Trial.

AIM: This study aimed to assess the desensitizing efficacy of commercially available cow milk compared to potassium nitrate (KNO3) mouthwash and warm saline rinses after nonsurgical periodontal treatment. MATERIALS AND METHODS: A randomized controlled trial was conducted in the Department of Public Health Dentistry of a dental college from August 21, 2018 to September 10, 2018. A total of 75 patients who reported hypersensitivity after scaling and root planing (SRP) were recruited and randomly assigned into three groups: cow milk (I), KNO3 mouthwash (II), and warm saline rinses (III). Dentine hypersensitivity (DH) was assessed at six time points using the verbal rating scale (VRS) for thermal stimuli and visual analog scale (VAS) for air blast and thermal stimuli. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY). Mean reduction in DH in each group was measured using non-parametric tests. RESULTS: Patients in all the three groups were found to be comparable with respect to baseline characteristics. Mean reduction in VRS and VAS scores for DH in milk and KNO3 mouthwash was found to be significantly high as compared to warm saline rinses group. CONCLUSION: From the results, cow milk was found to be equivalent in efficacy as compared with KNO3 mouthwash but superior to warm saline rinses in treating DH post-SRP.

Oral health indicators of oral health related quality of life among Indian elderly: A cross-sectional study.

AIM: To assess the impact of tooth loss and periodontal status on oral health related quality of life among Indian elderly. METHODOLOGY: This study was a cross-sectional study conducted among 1200 elderly subjects of Faridabad district of Haryana. Study subjects were selected by a combination of systematic, cluster and multistage sampling techniques. The data were collected through a clinical oral examination for tooth loss and periodontal status assessment (WHO Oral Health Survey 2013) and a self-administered questionnaire to assess the OHRQoL. Dental behaviours such as dental visiting patterns, tobacco chewing habits and oral hygiene practices were also recorded. RESULTS: In bivariate analysis significant associations were found among age, gender, education, tooth mobility and Oral health related quality of life (OHRQoL). Multivariate logistic regression showed significant impact of number of missing teeth and mobility on OHRQoL (P < 0.05). CONCLUSION: The conclusions derived from this study are of considerable importance for Indian policy makers in their work with planning and implementing public oral health strategies for geriatric population.

Gender-wise comparison of oral health-related quality of life and its relationship with periodontal status among the Indian elderly.

AIM: The aim of this study is to assess if there are any gender differences in oral health-related quality of life (OHRQoL) and periodontal status among the elderly population of Haryana. MATERIALS AND METHODS: A cross-sectional study was conducted among 1200 geriatric population of Faridabad district of Haryana. Subjects were selected by a combination of systematic, cluster, and multistage sampling techniques. Primary, secondary, and tertiary sampling units were chosen as wards, areas, and households, respectively. SELF-ADMINISTERED QUESTIONNAIRE: Geriatric oral health assessment index was used to assess the OHRQoL among males and females. Periodontal status was assessed using the World Health Organization oral health survey pro forma with some modifications. RESULTS: Results were analyzed using the Statistical Package for the Social Sciences 21 software. Gender-wise association of periodontal status with OHRQoL revealed a significant association with mobile teeth (P < 0.05). No relation was seen between OHRQoL, gingival bleeding, periodontal pocket, and loss of attachment (P > 0.05). CONCLUSION: No significant differences were observed in periodontal status among males and females, but OHRQoL was found to be better among males than females. Indian policymakers can use the conclusion derived from this study for planning and implementing public oral health strategies for the geriatric population.

Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4-6-year-old Children Attending Delhi Schools: A Cross-sectional Study.

INTRODUCTION: Oral diseases like early childhood caries (ECC), trauma, teething pain, and eruption disturbances are widely prevalent among the 4-6-year subgroup of population and are considered a public health problem worldwide. AIM: To assess the impact of ECC on oral health-related quality of life (OHRQoL) among 4-6-year-old children attending schools in Delhi. MATERIALS AND METHODS: A cross-sectional epidemiological study was carried out to assess the impact of ECC on OHRQoL among 4-6-year old children. Data were collected by a combination of the structured questionnaire of sociodemographic details and early childhood oral health impact scale (ECOHIS). The clinical examination was conducted for the assessment of dentition status and pufa index according to WHO criteria 2013. Statistical analysis was performed using the Chi-square test, the Kruskal-Wallis test, and the Mann-Whitney U test. RESULTS: The prevalence of ECC was found to be 20% among preschoolers which was lower among younger children and increased with age. The ECOHIS responses reported that items related to pain, irritation, difficulty in eating some foods, and difficulty to drink hot or cold beverages, felt guilty, feeling of frustration, and been upset were the most frequent on the child impact section (CIS). HOW TO CITE THIS ARTICLE: Jaggi A, Marya CM, et al. Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4-6-year-old Children Attending Delhi Schools: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(3):215-221.

Temporomandibular Disorders among Adolescents of Haryana, India: A Cross-sectional Study.

AIM: The aim of the present study was to determine the prevalence and determinants of temporomandibular disorders (TMD) among 12- to 15-year-old adolescents of Faridabad. MATERIALS AND METHODS: The study included a sample of 300 adolescents (132 males and 168 females) with age ranging from 12 to 15 years. Data were collected through clinical examination and Fonseca anamnestic questionnaire. The prevalence of TMD signs was assessed through Fonseca anamnestic questionnaire while TMD symptoms were measured by clinical examination. Various determinants of TMDs such as Angle's classification, crossbite, overjet, overbite were also recorded. Data were then analyzed using SPSS version 21. Inferential statistics were performed using Chi-square test. RESULTS: The overall prevalence of both TMD signs and symptoms was 51%. Females had higher prevalence (57.1%) of TMD symptoms when compared to males (43.2%). TMD signs has shown a statistical significant relationship with overbite (p = 0.007) and bruxism (p < 0.0001) only. No significant association was found between age, gender, Angle's molar relation, crossbite, and TMD signs. Statistical significant association was found between gender (p = 0.016), Angle's molar relation (p = 0.005), overbite (p = 0.001), crossbite (p = 0.030), bruxism (p < 0.0001), and TMD symptoms. CONCLUSION: No Significant relationship was reported between malocclusions and TMD sign except for overbite and bruxism, but significant relationship were found between TMD symptoms and malocclusion. HOW TO CITE THIS ARTICLE: Taneja P, Nagpal R, Marya CM, et al. Temporomandibular Disorders among Adolescents of Haryana, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(6):500-506.

Efficacy of Chlorhexidine, Xylitol, and Chlorhexidine + Xylitol against Dental Plaque, Gingivitis, and Salivary Streptococcus mutans Load: A Randomised Controlled Trial.

PURPOSE: To compare the antiplaque, antigingivitis and antibacterial efficacy of chlorhexidine (CHX), XYL and a mouthwash combining CHX and XYL against Streptococcus mutans (S. mutans). MATERIALS AND METHODS: A parallel design, randomised controlled trial was conducted among 75 dental students. Participants were randomised into CHX, CHX+XYL and XYL-only groups using the lottery method. Subjects were instructed to use 10 ml of the provided mouthwash for 15 s twice daily for 3 weeks. All the outcome measures, gingival index (GI), plaque index (PI) and number of salivary S. mutans CFU were recorded at baseline and 3 weeks post intervention. Nonparametric tests were used for inferential statistics. RESULTS: All outcome variables (GI, PI scores and log10 salivary S. mutans counts) decreased significantly from baseline compared to post intervention among all three groups. Intergroup comparison demonstrated that reduction in GI was not significantly different among the three groups. The decrease in PI scores was found to be significantly higher in the XYL group, while the decrease in the log10 salivary S. mutans count was significantly higher in the CHX+XYL group. CONCLUSION: The present study provided sufficient data to suggest that all the three mouthwashes are effective against plaque, gingivitis and S. mutans load in saliva. Further investigations should be carried out to confirm the results and develop strategies for using such products to prevent tooth decay.