A Cross-Sectional Study to Assess Diabetes as a Risk Factor for Root Caries Amongst the Elderly Population in Udupi District, Karnataka State, India.

Objectives: To compare the prevalence of root surface carious lesions among the nondiabetic and diabetic elderly population and its association with various risk factors. Methods: An observational analytical cross-sectional study was conducted among 800 elderly participants, 431 males and 369 females, aged 50 years and above, with a minimum of ten teeth present, with 400 being diabetic and 400 nondiabetic from the various hospitals of the Udupi district. Demographics, socioeconomic status, oral hygiene practices, oral abusive habits, and history of type 2 diabetes were collected using an interviewer-administered questionnaire followed by an intraoral examination to assess root caries. The primary outcome measure was the presence of any carious or filled root surface. Binary logistic regression univariate analysis was done for all the predictor variables, and those with significant associations were further analyzed by multivariate analysis with the enter method in a single-step model. An appropriate nomogram was designed for risk prediction. Results: Overall, the root caries prevalence was 37.3%, and the mean root caries index was 14.28%. The prevalence of root caries was 46% in people with diabetes and 28.5% in nondiabetics. Participants with type 2 diabetes, less education, low socioeconomic status, and using finger cleaning had a significantly higher risk of developing root caries. Additionally, those who used removable partial dentures (RPDs) were found to be 4.65 times more likely to have root caries than those who did not use RPDs. Conclusion: Elderly diabetics are at a higher risk for developing root caries and are strongly advised to maintain good oral hygiene practices and to undergo periodic dental evaluations. Therefore, it is crucial to emphasize early diagnosis and treatment of root caries in this population.

Clinical performance of light-cured orthodontic adhesives for bonding brackets - an in-vitro study.

Background: The dental profession is seeing a constant influx of new adhesive systems from manufacturers, each claiming to be more dependable than the last. This study assessed the bond strength and adhesive remnants of different light-cured adhesives used for bonding metal brackets to teeth. Methods: 80 extracted maxillary premolars with the sound crown structure were acid etched and bonded with brackets on their buccal surfaces utilizing primer and light-cured adhesives into four equal groups, which are Transbond XT, Heliosit, Enlight, and Bracepaste. Shear bond strength (SBS) for de-bonding the brackets were evaluated with Instron- testing machine after 48 hours. The de-bonded samples' adhesive remnant index (ARI) scores were also measured. Results: The maximum mean SBS was found for Transbond XT (12.91 ± 2.0 MPa), followed by Bracepaste (12.87 ± 1.59 MPa), Enlight (11.77 ± 1.87 MPa), and lowest for Heliosit (10.93 ± 1.71 MPa). According to the four point scale, adhesive remnant index (ARI), Transbond XT has the least adhesive residue left on the tooth, followed by Heliosit. Enlight and Bracepaste have a similar distribution of adhesive, with both having a maximum amount left. Conclusion: It can be inferred that all groups involved demonstrated a satisfactory level of bond strength from a clinical perspective. Transbond XT is the preferred orthodontic adhesive over the other three adhesives due to its superior SBS and ARI properties.

Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study.

Background: There are various medical insurance options available in India. However, unlike many other countries, dental insurance plans are rare. The aim of this study was to assess the utilization of various government and private health insurance schemes by patients admitted for dental surgical procedures at a tertiary care hospital in coastal Karnataka, India. Methods: A study was conducted retrospectively to gather data on the socio-demographics, bill details, insurance, and benefits claimed by patients admitted to the Department of Oral and Maxillofacial Surgery at a tertiary care hospital from May 2016 to September 2022. Results: Out of 1750 patients, only 856 (48.9%) patients had availed of insurance, 395 patients (22.6%) utilized government health insurance policies, and 461 patients (26.3%) availed of private health insurance plans. Among Government schemes, primarily Ayushman Bharat-Arogya Karnataka was used by 262 (30.6%) patients, followed by Employees' State Insurance Scheme by 110 (12.9%) patients. Among private schemes, 212 (24.8%) patients used the policies purchased by them, 19 (2.2%) patients' medical expenses were paid by their employers, 105 (12.3%) patients utilized Manipal Arogya Suraksha and 124 (14.5%) patients used Medicare provided by the hospital. Bivariate linear regression confirmed that the total bill amount, out-of-pocket expenditure by the patient, and insurance amount reimbursed to the hospital were significantly associated with the type of insurance (government vs. private). The study noticed a gradual rise in insured patients every year. Conclusion: Greater utilization of health insurance should be encouraged because the cost of dental treatment has always hindered the use of oral health services worldwide. This study highlights that the benefit available to the patients were mainly through general health insurance schemes, not specifically dental health insurance. Insurance schemes covering dental must be promoted more aggressively in the media, highlighting their available benefits, merits, and demerits.

Seasonal Variations in the Groundwater Fluoride of Swarna River Basin in Southern India: A GIS-based Study.

Objectives: The study aimed (1) to assess fluoride concentration of groundwater along the Swarna river basin in Udupi District; (2) to investigate variations in fluoride concentration with respect to rainfall status in Udupi district; and (3) to develop a spatial distribution map for the groundwater fluoride concentration in Udupi district. Materials and Methods: Water samples were procured from 30 different sampling points across three time zones in a year: pre-monsoon, monsoon, and post-monsoon. The samples thus collected were analyzed for fluoride ion concentration using fluoride ion selective electrodes (Orion™). Mean determination readings at each time zone were calculated. Repeated-measures analysis of variance was done to analyze whether there was a difference in the concentration of fluoride over different time zones. Results: The mean (SD) pre-monsoon concentration was 0.25 (± 0.07) ppm, whereas the mean monsoon and post-monsoon concentrations were 0.26 (± 0.09) and 0.57 (± 0.23) ppm, respectively. There was a significant increase in post-monsoon fluoride levels when compared with the pre-monsoon and monsoon levels. Conclusion: The groundwater fluoride concentration in the Swarna river basin was found acceptable for human consumption at all the sampled sites and across all time zones. As the fluoride concentration was found to be lower than the recommended values for dental caries prevention at most of the sampling sites, use of topical fluorides needs to be encouraged.

Malaysian Patients' Expectations of Orthodontic Treatment in Indian Dental Care Set up: A Questionnaire Survey.

Materials and Methods: A cross-sectional study was conducted on 349 Malaysian patients (182 females and 167 males) aged 18-30 years. A questionnaire consisting of ten items developed by Sawyers and Newton was administered to the patients who visited the department of Orthodontics seeking orthodontic treatment. Outcome measures. Descriptive analysis of the responses and comparison of male and female expectations. Results: Most of the patients expected only a check-up/diagnosis/discussion at their initial appointment, anticipated a fixed type of orthodontic treatment, did not prefer extraction/removal of their teeth, thought the treatment to be painful, and can restrict what they could eat or drink. Positive expectations from the patient included better tooth alignment, enhanced smile, improved confidence, and advancement in professional career. At the same time, nearly half of the patients' assumed speech/mastication does not get affected during the treatment. Moreover, very few patients believed it would be easier to eat/speak/keep their teeth clean after the treatment. Compared to males, more females had significantly anticipated fixed types of orthodontic treatment, thinking the treatment to be painful and restrictive in terms of what they could eat or drink. Most of the females were unsure about the length of the orthodontic treatment and had significantly higher expectations concerning career improvement. Conclusions: To meet the varied expectations of each of the patients, effective communication between the orthodontist and the patient is essential.

Risk Perception and Preparedness of Undergraduate Dental Students to Treat Patients in View of COVID-19 Pandemic: A Questionnaire Survey.

With the gradual resumption of dental services worldwide, it is crucial to focus on returning dental undergraduates to their clinical postings. The assessment of foreseeable concerns from a student's point of view will help the dental schools tailor a comprehensive plan of action that would be in the best interest of everyone. Aim. Hence, this survey was planned to assess dental undergraduates' risk perception and preparedness to provide patient care amidst the COVID-19 pandemic crisis. Material and Methods. It was an online survey carried out among students involved in clinical work at two dental colleges in Manipal and Mangalore, respectively, in Karnataka, India. The online questionnaire was sent to approximately 500 students, with responses from 301 students. The survey comprised 21 closed-ended questions about demographics, risk perception, and preparedness. The descriptive statistics were done on the data. Results. It was found that all the students (99.7%) perceived COVID-19 to be dangerous, and 73.4% chose to avoid treating those patients suspected to have an active COVID-19 infection. The fear of being infected was perceived by 55.1% of students, while 46.2% feared transmitting the infection to friends and family. A majority (87.7%) believed standard infection controls practiced prior to the pandemic were insufficient to work in the current scenario. Nearly 33.6% could not view the guidelines for dental procedures during the pandemic. A majority (87.7%) were not/little confident, and 61.7% were unsure/unprepared to manage suspected patients. Conclusion. It is the prime need of the hour for dental schools to instill self-reliance within students in managing patient care under these circumstances by strictly reinforcing the official protective care guidelines.

Community social responsibility of continued and appropriate use of silver amalgam as dental restorative material in southern India: A cross-sectional study.

Background: For more than 150 years, dental amalgam (DA) has been popular as a dental restorative material. Many organizations oppose its use due to perceived toxicity and environmental concerns. Hence, this study aimed to explore the continued use of DA from a South Indian dental practitioners' perspective. Methods: This cross-sectional study was conducted among fifty-two private and public dental practitioners of Udupi district in Southern India. A self­administered questionnaire was distributed, that involved assessment of their preferences, continuation of use and concerns of using DA as a restorative material. The percentage contribution of each variable was calculated. Preferences for continuation of use of silver amalgam based upon the age, experience and mercury toxicity as a risk factor were analyzed using Students-t test and Fisher's Exact Test test. Results: Most dentists were satisfied (87%) with the results of the DA, found minimal failures (96%) and found DA more economical (89%). More than half (54%) of the participants reported that they would not continue the use of DA owing to mercury toxicity and environmental concerns. Dentists with higher age and longer clinical experience preferred continuation of DA. Conclusions: Despite satisfaction with DA for its minimal failure, longevity and affordability, the authors found that most practitioners did not prefer its continued usage. This highlights their concerns over mercury toxicity and soft tissue lesions and accentuates their community social responsibility. There is also an urgent need to educate dentists on mercury hygiene, mercury waste management and disposal.

Hardware Removal in Maxillofacial Trauma: A Retrospective Study.

BACKGROUND: Miniplates are commonly used for the fixation of maxillofacial fracture segments. Removal of the hardware is controversial. A retrospective study of medical records was performed to observe the reasons for plate removal. MATERIALS AND METHODS: A 10-year retrospective study of medical records was performed. Demographics, type of fracture, location, type of miniplate used, the time gap between the insertion and removal, and causes of hardware removal were assessed. RESULTS: About 1472 patients had undergone internal fixation for the facial fractures. Stainless steel miniplate was used in 489 patients, and titanium was used in 983 patients. Out of the 42 cases, 22 cases involved the removal of titanium hardware and 20 patients involved the removal of stainless steel hardware. Infection/osteomyelitis was the main cause of hardware removal. The maximum amount of hardware failure was in the mandible. 78.6% of hardware removal was performed in males. CONCLUSION: Based on our study, routine removal of titanium miniplates can be performed in children to avoid growth disturbances, not indicated in adult patients unless symptomatic.

Geographic Information Systems in Spatial Epidemiology: Unveiling New Horizons in Dental Public Health.

OBJECTIVES: Research on the role of environment and place in various aspects of dental public health using geographic information systems (GIS) is escalating rapidly. Yet, the understanding of GIS and the analytical tools that it offers are still vaguely understood. This narrative review therefore draws from the utilization of GIS in the dental public health research. MATERIALS AND METHODS: Electronic databases such as Google Scholar, PUBMED, and Scopus were searched using terms "spatial epidemiology," "GIS," "geographic information systems," "health geography," "environment public health tracking," "spatial distribution," "disease mapping," "geographic correlation studies," "cartography," "big data," and "disease clustering" through December 2019. RESULTS: This review builds upon the prospects of GIS application in various aspects of dental public health. Studies were classified as: (1) GIS for mapping of disease, population at risk, and risk factors; (2) GIS in geographic correlation studies; (3) GIS for gauging healthcare accessibility and spatial distribution of healthcare providers. We also identified the commonly used GIS analytical techniques in oral epidemiology. CONCLUSIONS: We anticipate that this review will spur advancement in the utilization of spatial analytical techniques and GIS in the dental public health research.

Evaluation of quality of life in patients surgically treated for potentially malignant oral lesions.

BACKGROUND: The oral potentially malignant disorders (OPMDs) can impair the quality of life (QOL) of an individual. The evaluation of various aspects of life getting affected will help the health service providers to better comprehend the problems faced by the patients. This study aimed to evaluate the postoperative QOL of surgically treated patients for OPMDs. MATERIALS AND METHODS: It was a cross-sectional study done on 45 follow-up patients, aged 24-80 years, who were surgically treated for OPMDs. A performa with questions regarding sociodemographics, personal, and abusive habits and a questionnaire on QOL was used. Oral examination was done to analyze the oral mucosa for recurrence. Data were analyzed using frequency analysis and unpaired student's t-test to compare the mean scores. RESULTS: Several patients reported to have experienced a lot of pain (15, 33%), burning sensation on having spicy food (36, 80%), great difficulty in opening mouth (15, 33%), alteration in taste sensation (36, 80%), limiting of eating desired food (24, 53%), and dryness of mouth (7, 16%). Many patients felt very frustrated, depressed (9, 20%), and reported their condition to have affected their satisfaction with life (19, 42%). However, neither did social relationship with family and friends got affected by this nor did it add discomfort to them at parties, social functions, or get together. Their main concern was the likelihood of their oral condition progressing into cancer. There was a statistically significant difference in the QOL scores for habit of areca nut chewing (P = 0.05), erythroplakia lesions (P = 0.05), and recurrence of lesion (P = 0.02). CONCLUSION: OPMDs affected the physical, functional, and psychological well-being of study patients, caused discomfort, and affected their daily activities. However, the social well-being of patients was unaltered and a large number of patients were reportedly satisfied with their treatments. The timely diagnosis and management can improve the quality of life and prevent its progression to malignancy.

Attitude towards shared learning activities and Interprofessional education among dental students in South India.

BACKGROUND: Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) are being introduced in healthcare institutions gradually to enable comprehensive learning and its application to enhance community health outcomes. OBJECTIVES: To assess the attitude of dental students towards Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) To assess whether Readiness for Interprofessional Learning Scale (RIPLS) is a suitable instrument to measure the attitude of under graduate dental students towards IPE. To assess how the study year and gender affect the attitude of under graduate dental students towards IPE. METHODS AND MATERIALS: The research design was a cross-sectional survey. The dental students of first to fifth year based on availability of students and the existing academic calendar were participated in the study. A total number of 417 validated RIPLS questionnaire were distributed to dental students studying in two dental institutions at Manipal in South India in the year 2017 with the collected response rate of 81.53%. Principal component analysis of the responses was applied to the data along with Varimax rotation and Cronbach alpha to confirm the internal consistency of the questionnaire. Independent sample t test and ANOVA were used to assess the differences between the groups. RESULTS: Seventy five percent of the respondents were females, and the mean age was 21.26 years (SD = 1.34). The mean scores in RIPLS and all its subscales were high. The mean scores were also higher as the year of study increased and with female students. Senior and female dental students had more encouraging attitudes towards shared learning. CONCLUSIONS: The RIPLS can be utilised to determine the different subscales of learning namely learning behaviour, attitudes, teamwork and collaboration, professional identity perspectives, and roles and responsibilities towards interprofessional education of dental students. The dental students with an Indian outlook, perspective and training had a favourable attitude towards interprofessional learning.

The Impact of Lifestyles on Dental Caries of Adult Patients in Udupi District: A Cross-Sectional Study.

BACKGROUND: Dental caries is preventable if favorable health behavior is successfully established. Exploring the broader concept of lifestyle will be useful to determine that how lifestyle of people can affect dental caries. AIM: The aim of this study was to determine the impact of overall lifestyle of an individual (analyzed using health practice index) on dental caries of adult population. MATERIAL AND METHODS: This cross-sectional study comprising structured questions on health practice index, sociodemographic variables, and oral health-related behavior was conducted on 800 study subjects of age 20-50 years attending outreach dental setups of a dental school in India. Dental caries was recorded with decayed, missing, and filled teeth (DMFT) index.Statistical analysis was carried out using frequency distribution for variables related to lifestyle, mean ± standard deviation for DMFT, and negative binomial regression to predict a dependent variable (DMFT) that consisted of "count data." RESULTS: The study subjects who were older age, women, unemployed, and unskilled; those with lower education, lesser income, and lower socioeconomic status; those never visited dentist; and those with lesser frequency of cleaning teeth, overall poorer lifestyles, and moderate lifestyles were more prone to have dental caries than their counterparts. CONCLUSION: Dental caries is a multifactorial disease. Patients' involvement in self-care by promoting healthy behaviors such as brushing twice a day, visiting dentist regularly, negating orally abusive substance addiction, having breakfast every day, eating a balanced diet, and reducing stress leads to an overall good lifestyle. These factors along with sleeping a minimum of 7-8h per night and working for 8-9h per day and ample daily exercise may help patients improve or protect their oral health for years to come.

Efficacy of chlorhexidine, hydrogen peroxide and tulsi extract mouthwash in reducing halitosis using spectrophotometric analysis: A randomized controlled trial.

BACKGROUND: To evaluate the efficacy of tulsi extract mouthrinse in reducing halitosis as compared to chlorhexidine and hydrogen peroxide mouthrinses using spectrophotometric analysis. MATERIAL AND METHODS: It was a parallel, single center, double blinded randomized controlled trial of 15 days duration. A total of 300 participants were screened, out of which 45 subjects those fulfilled inclusion criteria of age range 17-35 years were included in the trial. The participants were randomly provided with tulsi, hydrogen peroxide or chlorhexidine mouthwashes (control group) to use 10 ml twice daily for 15 days. Clinical measurements were taken at baseline and 15 days using arbitrary 0-5 scale for organoleptic odor assessments, spectrophotometric analysis for Volatile Sulphide Compounds (VSCs) from saliva samples, Löe & Silness gingival index and Silness & Löe plaque index. RESULTS: After intervention, organoleptic, VSCs, gingival and plaque scores showed statistically significant decrease in all the three study groups. The mean percentage reduction in VSC and organoleptic scores was significantly greater in chlorhexidine and hydrogen peroxide groups than in the tulsi group and the mean percentage reduction in plaque and gingival scores was significantly greater in chlorhexidine group than in hydrogen peroxide and tulsi group. CONCLUSIONS: Tulsi may not have the efficacy of chlorhexidine and hydrogen peroxide mouthrinses. But, Tulsi is effective in reducing halitosis, plaque and gingivitis and with its lack of side effects & cost effectiveness, can be an effective & economic tool to deal with halitosis. The spectrophotometric technique appears to be a promising method for evaluation of oral malodor. Key words:Halitosis, tulsi mouthwash, chlorhexidine, hydrogen peroxide, spectrophotometric analysis.

Rationally synthesized coumarin based pyrazolines ameliorate carrageenan induced inflammation through COX-2/pro-inflammatory cytokine inhibition.

In the present work, coumarin based pyrazolines (7a-g) have been synthesized and investigated for their in vitro and in vivo anti-inflammatory potential. Amongst the synthesized compounds, compounds 7a, 7d and 7f exhibited significant in vitro anti-inflammatory activity as compared to the standard etoricoxib. Keeping this in mind, in vivo investigations were carried out via carrageenan induced inflammation and acetic acid induced writhing models in male Wistar rats and compound 7a was found to possess appreciable anti-inflammatory and analgesic potential. The mode of action of compound 7a was also investigated by using substance P as the biomarker, which shows promising results. Further, the selectivity of the most active compound 7a against the cyclooxygenase enzyme was supported by molecular docking studies which reveal that compound 7a has greater binding affinity towards COX-2 over COX-1 and 5-LOX enzymes. In silico ADME analysis of compound 7a confirms the drug-like characteristics and the in vivo acute toxicity study showed the safety of the compound even up to a 2000 mg kg-1 dose. Thus, compound 7a was identified as an effective anti-inflammatory agent, and can be explored for further analgesic/anti-inflammatory drug design and development.

Prosthetic treatment need and associated life course determinants in partially edentulous adults of age 18-35 years in Udupi taluk: A cross-sectional study.

AIM: The aims of this study were to assess the prevalence of use and need for dental prostheses and to associate need with the life course determinants in young adults of age 18-35 years in Udupi taluk, Karnataka, India. MATERIALS AND METHODS: It was a cross-sectional survey conducted on a total of 580 individuals those attended dental screening camps organized at random locations. A self-administered questionnaire was administered to participants to assess their life course determinants such as socioeconomic, behavioral, and psychological circumstances followed by an oral examination to assess their prosthetic status (WHO, 1997). Bivariate analysis followed by multivariate logistic regression analysis was carried out to determine the adjusted odds ratios (ORs) with 95% confidence interval (CI) for independent variables and the outcome. RESULTS: The need and use of dental prostheses was observed in 38% and 2.2% of young adults, respectively. Adjusted multivariable analysis revealed that life course determinants such as parental rearing style (OR = 7.66 [95% CI: 3.88-15.14]) and interaction between expenditure at 10 years of age and economic hardships at 10 years of age (OR = 9.63 [95% CI: 3.12-29.72] and OR = 6.43 [95% CI: 1.89-21.88]) were significantly associated with the need for prostheses. CONCLUSION: The need for dental prostheses in the young adults can be related to socioeconomic and psychosocial circumstances during childhood, and thus the concept of life course approach has been highlighted.

The impact of lifestyles on the periodontal health of adults in Udupi district: A cross sectional study.

OBJECTIVES: (1) To assess the impact of different lifestyle factors on periodontal health of adults. (2) To assess the impact of overall/combined lifestyle variable (calculated by health practice index [HPI]) on periodontal health of adults. MATERIALS AND METHODS: A cross-sectional study consisting of a structured questionnaire on HPI, oral health-related behavior, and personal habits as well as sociodemographic variables was conducted on 800 subjects aged 20-50 years attending dental outreach set-ups of Manipal College of Dental Sciences, Manipal. Clinical examination for periodontal status was done by recording loss of attachment scores using community periodontal index (FDI/WHO-1982). Statistical analysis was done by bivariate analysis using Chi-square followed by multivariate analysis to obtain adjusted odds ratio with 95% confidence interval. RESULTS: After adjusting for all the confounding variables in multivariate logistic regression analysis, the variables that showed an independent association with periodontitis were age, location, marital status, smoking, hours of sleep per night, physical activity, and overall poor lifestyles. CONCLUSION: Our results support studying a combined approach using various lifestyle behaviors for controlling chronic periodontitis. Necessary public health action on conditions which determine unhealthy lifestyle behaviors across population is needed which is possible by patient's involvement in self-care by promoting healthy lifestyles.

Recent advances in polymer drug conjugates.

Polymer drug conjugates play an important role in the delivery of drugs. In the polymeric drug conjugates, the bioactive agent is combined covalently with polymer to achieve the efficient delivery of bioactive agents in the required or specific period of time along with the enhancement of permeability and retention time. A large number of biodegradable polymers have been widely used in the area of biomedical science. Among them, polyphosphazene, is a biodegradable polymer having versatile nature because of its two chlorine atoms attached on both sides of phosphorus atom of its polymeric backbone, it can be easily replaced by nucleophilic substitution reaction. A plenty of work has been explored for its biomedical applications such as tissue engineering, vaccine drug delivery, polyphosphazene- anticancer drug conjugates with doxorubicin, paclitaxel, platinum complexes, methotrexate and gemcitabine for the targeted drug delivery etc. This review is focused on the recent advances in the biomedical applications of polyphosphazene-drug conjugates.

Effect of oil gum massage therapy on common pathogenic oral microorganisms - A randomized controlled trial.

OBJECTIVES: (i) To assess reduction in Streptococcus mutans and Lactobacillus species count in saliva sample after ten minutes of oil gum massage therapy (massage of gingival tissues) per day for three weeks with sesame oil, olive oil, and coconut oil in three different groups of subjects. (ii) To compare the efficacy between three different oils and the "gold standard" chlorhexidine gel. (iii) To assess reduction in gingival scores and plaque scores of study subjects. MATERIALS AND METHODS: Study design - Single center, parallel design, and triple blind randomized clinical study with four treatment groups. PARTICIPANTS: 32 of the 40 study subjects working as housekeeping personnel at Kasturba Hospital, Manipal; aged 18-55 years completed the three-week study period. INTERVENTIONS: Subjects were randomly assigned to massage their gingiva everyday for three weeks with sesame oil, olive oil, coconut oil (tests), and Chlorhexidine gel (control). Oral health status and paraffin stimulated saliva samples were obtained at baseline and after three weeks of oil gum massage therapy. OUTCOME MEASURES: Microbial culture, plaque index, and gingival index. STATISTICAL ANALYSIS: Paired t test and Kruskal Wallis test. RESULTS: There was a significant reduction in mean Streptococcus mutans count, Lactobacillus count, plaque scores, and gingival scores in all four groups after the study. However, there was no significant difference found in percentage reduction of these variables between the four groups. CONCLUSION: These oils can be used as valuable preventive agents in maintaining and improving oral health in low socioeconomic status population. However, it is recommended that further research should be conducted in other populations with a larger sample and longer duration of follow-up period.

Design, synthesis and ex vivo evaluation of colon-specific azo based prodrugs of anticancer agents.

Colon-specific azo based prodrugs of anticancer agents like methotrexate (6), gemcitabine (7) and analogue of oxaliplatin (RTB-4) (8) were synthesized and characterized by modern analytical techniques. The prepared prodrugs were stable in acidic (pH 1.2) and basic (pH 7.4) buffers which showed their stability in upper GIT environment. Further, an assay was performed which demonstrated the presence of azoreductase enzyme in the rat fecal material, rat cecum content and other parts of intestinal content which reduce specifically the azo bond and release the drug. The in vitro cytotoxicity assay was also performed which clearly indicated that these azo based prodrugs are active against human colorectal cancer cell lines (COLO 205, COLO 320 DM and HT-29). The release behavior of prodrugs (10, 11 and 15) was 60-70% after 24h incubation at 37°C. Therefore, the synthesized azo linked prodrugs of methotrexate, gemcitabine and RTB-4 are the potential candidates for colon targeted drug delivery system with minimal undesirable side effects.