Association of tooth loss and nutritional status in adults: an overview of systematic reviews.

BACKGROUND: Association of tooth loss and nutritional status has been widely researched with conflicting results. This overview aimed to analyse and summarize findings from systematic reviews on association of tooth loss with nutritional status, in view of their quality assessment and methodological characteristics. METHODS: Overview was conducted as per Cochrane Overviews of Reviews guidelines. 5 databases (PubMed, Dentistry and Oral Sciences Source, Scopus, Cochrane Register of Systematic Reviews, Epistemonikos.org) and one online source (Google Scholar) were searched for systematic reviews published between 2010 - July 2022, with inclusion criteria; population: participants aged 18 years or above, intervention/exposure: loss of teeth, comparison: not applicable, outcome: nutritional status, study: systematic reviews and meta-analysis. Reviews on association of prosthetic interventions with nutritional status were not included. Data were extracted for study characteristics, details of primary studies, and main findings. Narrative synthesis of data, overlap of primary studies and quality assessment of studies were done using AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews). RESULT: Of 1525 articles found, seven systematic reviews were selected (four were systematic reviews, three were systematic reviews with meta-analysis). Five studies showed some or positive association, one found weak association and for one study the association was unclear. Overlap of primary studies was 'very slight'. Meta-analysis of two studies concluded fully or partially edentulous individuals were more likely to be malnourished or at risk of malnutrition, (RR = 1.095, 95% CI 1.007 to 1.190, p = 0.033. RR = 1.22; 95% CI 1.11 to 1.32 p < 0.01), but one found that edentulism was not associated with malnutrition. (RR = 1.072, 95% CI 0.9657-1.200). Quality assessment revealed four studies were 'high', one was 'low' and two were 'critically low.' CONCLUSION: This overview confirms the association between tooth loss and nutritional status specially in elderly. It is evident that tooth loss increases the likelihood of poor nutritional status. Overall, studies show high heterogeneity in the methodology and quality assessment reveals low confidence in the available evidence. Future studies should use standard assessment tools for tooth loss and nutritional status.

Adherence to the Consolidated Standards of Reporting Trials (CONSORT) Guidelines for Reporting Randomized Controlled Trials Related to Mandibular Third Molars.

PURPOSE: Randomized controlled trials (RCTs) are the backbone of evidence-based medicine. Despite the widespread acceptance of the Consolidated Standards of Reporting Trials (CONSORT), its use for reporting clinical trials in journals remains poor. The purpose of this study was to find out to what extent RCTs related to mandibular third molars have adhered to the CONSORT statement. METHODS: This study was carried out during April 2020 to June 2020. PubMed was used to retrieve RCTs related to mandibular third molars conducted during the last 5 years. The search terms used were mandibular third molar OR lower third molar OR impacted mandibular third molar AND randomized controlled trial. Each article was assessed for adherence to the CONSORT statement. RESULTS: Eighty unique articles were retrieved. The mean percentage adherence to the CONSORT statement noted was 60.26%. Of the 37 CONSORT items, only 4 items showed 100% adherence (2a, 2b, 4a, and 12a). The most underreported items were #10, 12b, 17a, 17b, 18, 19, 23 to 25. Of the 23 journals considered, 6 journals did not recommend CONSORT for reporting RCT in the "Instructions to Authors" guidelines. CONCLUSIONS: Within the limits of the study, it is clear that the RCTs related to third molar do not show 100% adherence to the CONSORT checklist. The editorial policy, peer reviewers, and researchers should endorse the use of the CONSORT checklist for transparent reporting of the RCTs.

Use of PowerPoint presentation as a teaching tool for undergraduate students in the subject of gerodontology.

AIM: Though different teaching learning media have been employed in the instruction of geriatric dentistry, their efficacy has not been adequately evaluated. This study was conducted with the aim to determine the efficacy of a PowerPoint presentation in teaching gerodontology. MATERIALS AND METHODS: This is a prospective follow-up study using a pre- and post-intervention assessment. A pilot study was conducted on the final year students to check the feasibility of the study. A convenience sampling procedure was used. All interns (n = 80) of the Modern Dental College and Research Centre, Indore, India were invited to participate. Interns completed a 24-item questionnaire documenting their current knowledge on gerodontology. One week after a 30 min PowerPoint presentation on gerodontology, the same interns completed the same questionnaire again, providing an indication of the efficacy of the learning tool. Paired t-test and McNemar test were employed for statistical analysis. RESULTS: A statistically significant difference was observed in pre- and post-intervention scores (P < 0.05). CONCLUSION: The results of this study indicated that PowerPoint presentation can be used as an effective tool for improving the knowledge regarding gerodontology.

Perception and knowledge of dental interns toward interdepartmental coordination for successful prosthodontic treatment: A pilot study.

BACKGROUND: The graduating dentist should be trained in providing treatment utilizing the interdisciplinary approach because of the rapid advancements and increase in patient expectations, which demands for collaboration between the different specialists. PURPOSE: A pilot study was undertaken with an aim to assess the perception and knowledge of dental interns toward interdepartmental coordination for successful prosthodontic treatment. SUBJECTS AND METHODS: Dental interns from two dental colleges in Sangli (India) participated in the study. A 24-item self-administered, structured closed-ended questionnaire was used to collect the data. Four questions assessed the perception and 20 questions assessed the knowledge, which were based on the four domains viz.: General, Endodontics, Orthodontics, and Prosthodontics. They were framed from case scenarios reporting to the Department of Prosthodontics, which required interdepartmental consultation. The questionnaire was validated before its application and reliability were also assessed. The final score for each question was calculated based on the correct responses. Descriptive analysis was calculated using the frequencies, percentages, and mean values by using SPSS 16 software. RESULTS: Among 117 interns who participated in the study, 79.5% reported that they lacked training in an interdisciplinary approach. Approximately, 96% reported that the curriculum should be designed to include interdisciplinary training. Nearly, 88% reported that specialist from different specialty should be posted in one interdisciplinary department. Around 60% reported that they did not have the confidence of treating the patient as a whole. When the overall mean scores were considered, the highest scores were obtained for the general domain (95.3) and the lowest for the prosthodontic domain (83.6). CONCLUSION: The dental interns perceived that they lacked training in interdisciplinary approach, and the curriculum should include interdisciplinary training.

Archiving the Natural Dentition to Serve as Pre-extraction Record: Evaluating Perceptions Among Indian Prosthodontists.

This survey is undertaken to: (1) assess the perceptions of prosthodontist towards the concept of natural dentition archival (NDA); and (2) to obtain any further suggestions/recommendations regarding it. 616 prosthodontist across India participated in the study. Data was collected using a self- designed, self-administered, pilot tested, structured 10 item questionnaire. Results indicate that 32.1 % prosthodontists make use of pre-extraction records; 54.4 % seemed to give consideration to natural findings of the patient while denture fabrication; 86.7 % recommended patient aged 25-34 years to archive his/her natural dentition to serve as pre-extraction record; 92.2 % were willing to promote the NDA concept for their patients and 33.7 % thought that it is an extra burden. It was noted that postgraduate students (61.5 %) significantly gave more consideration to natural findings of the patient as compared to practicing prosthodontist and faculty (p < 0.001). Using, pre-extraction records was preferred by the prosthodontists from urban and periurban area as compared to those from rural area (p < 0.05). 67.8 % prosthodontists' viewed NDA as ideal for denture construction which will result in greater patient satisfaction. However, 46 % prosthodontists have raised concerns like: storage and preservation of cast and records being tedious, extra time needed and patient motivation an added burden. 54 % recommended that NDA concept can be introduced and emphasized in the prosthodontic curriculum, so that the dental students learn and promote it to their future patients. Overall, the perception towards NDA is favourable and the prosthodontist needs to be motivated to utilize this concept.

Capacity of Candida species to produce acetaldehyde at various concentrations of alcohol.

Background: Along with tobacco use, alcohol consumption is one of the crucial factors for oral cancer. Acetaldehyde (ACH), a byproduct of alcohol, is reported as carcinogenic. One of the producers of ACH from alcohol is Candida species. The aim of the study was to quantify the ACH produced by Candida species at various concentrations of alcohol. Materials and Methods: Clinical isolates of Candida, namely Candida albicans, Candida krusei and Candida tropicalis and C. albicans ATCC 18,804, were subjected to various concentrations of alcohol. Alcohol dehydrogenase and ACH were estimated using spectrophotometry and headspace gas chromatography, respectively. Results: Out of all three clinical isolates, C. tropicalis produced more ACH (412.1 µM) at 10 mM alcohol concentration by 105colony-forming unit/ml followed by C. albicans (233 µM) and C. krusei (53.7 µM). C. albicans of clinical isolate and ATCC species (222 µM) did not show much difference. Conclusion: The study results conclude that Candida species are capable of producing carcinogenic levels of ACH on exposure to various concentrations of alcohol.

Golden Ager Chyawanprash with Meager Evidential Base from Human Clinical Trials.

Chyawanprash (CP) is one of the most revered, effective, and best-selling health supplements of Indian Ayurvedic system of medicine, which is high on the trust and health quotient among Indian consumers. CP is an ancient synergistic blend of around fifty (50) medicinal herbs, herbal extracts with jam-like consistency, traditionally used to improve respiratory health, strengthen the immune system, prevent recurrence of infections, and over the decades is known for its anti-inflammatory and antioxidant properties. With the recent growth of commercialization, this traditional preparation is gaining popularity across the world. Various pharma firms are engaged in its commercial production, and this recipe is easily available on market shelves, with a common brand name "Chyawanprash." The consumers generally pop up with some genuine queries or doubts regarding its usage and benefits. Though CP is well-trusted traditional preparation, however, limited scientific literature is available on understanding its clinical role. This critical review discusses the general consumer queries apropos its usage, critically analyzing the reported clinical studies, perspectives, and unmapped areas for future research.

Combating the psychological impact of COVID-19 pandemic through yoga: Recommendation from an overview.

Globally, the psychological health of the people is being affected due to the COVID-19 pandemic. Given the fact that numerous systematic reviews already exist on yoga and mental health, it becomes vital to undertake an overview on the same. The objective of the overview was to summarise the evidence from different systematic reviews of distinct yoga interventions used to improve mental health and recommend yoga practices for the same. The protocol was registered on PROSPERO (CRD42020185221). MEDLINE via Pubmed, Cochrane Database of Systematic Reviews and Google Scholar were searched for relevant literature. Search terms used were "Yoga practice, mental health and systematic review". Reviews from earliest possible date till May 2020, including those examining the effects of any single or combination of yoga interventions on mental health reported on children, youth and adults were selected. The Assessment of Multiple Systematic Reviews (AMSTAR) tool was used to evaluate the evidence of the included reviews. Out of the 90 reviews found, eight unique reviews were selected for the overview. Overall, 243 studies were analyzed, with an overlap of only 6 studies across the reviews. Out of 8 reviews, only 2 were of high quality and the rest were of moderate quality. Owing to heterogeneity of the included studies, only descriptive analysis was possible. The results of the review indicate moderate to positive effects of yoga on the mental health parameters. Practicing yoga (physical postures, Bhramary Pranayam, mindfulness meditation, sahaj yoga and laughter therapy) can be beneficial to improve psychological health of the people during the COVID-19 pandemic.

Systematic review of school-based tobacco prevention programs for the adolescents in India from 2000 to 2020.

In India, 14.6% of adolescents are currently using tobacco in any form and tobacco control is a major public health challenge. The objective of this systematic review is to analyze all the existing literature and evaluate the effectiveness of school-based tobacco use prevention programs for adolescents in India. The review protocol was registered in PROSPERO (CRD42020159535). Studies were selected using database search, manual search, gray literature, reference chasing, and contacting the authors. All randomized controlled trials, cluster-randomized trials, quasi-experimental, and non-randomized studies reporting school-based tobacco use preventive interventions for adolescents in India; articles published in English (other languages where it can be translated to English) published between January 2000 till May 2020 were included. Data was independently extracted by two reviewers. The Risk of bias (RoB) and quality of the study were assessed using appropriate tools. Among 7972 identified articles, only 13 studies met the inclusion criteria. Each study implemented a unique intervention and measured distinct outcomes. Postintervention, all the studies reported improvements in the study group with respect to the reduction of tobacco use and change in the knowledge, attitude, practices, and/or behavior outcome parameters. Twelve study results were based on short-term assessment. Overall, a 5.17-17.0% tobacco use reduction rate was noted. RoB was high for six studies. Key methodological problems related to study design, duration, outcome parameter, follow-up time, type of intervention, and attrition were identified. School-based tobacco use prevention programs for adolescents in India might have shown positive outcomes but are associated with significant limitations.

Effectiveness of Behavioral Counseling in Smokeless Tobacco Cessation Among Adult Users Reporting to a Dental Hospital in Pune: A Randomized Controlled Trial.

Aim To assess the effectiveness of behavioral counseling for smokeless tobacco cessation among adult users in a dental hospital setting. Methods A total of 200 patients visiting a dental hospital who were exclusively using smokeless tobacco (SLT) were enrolled in the study. A randomized controlled trial with a concurrent parallel study design, which consisted of two arms, was conducted. Fagerstrom test for nicotine dependence level and the transtheoretical stage of change was assessed at the baseline. Behavioral cessation counseling and motivational interviewing were provided in the study arm and brief advice was given to those in the control arm. The counseling was provided at baseline and followed up till six months through telephone to assess the change in the frequency of use of SLT products and abstinence from SLT use. A biochemical validation with a urine cotinine test was done to confirm abstinence. Results At six months, there was a significant difference within and between the study and control groups, indicating the role played by behavioral tobacco cessation in reducing the frequency of consumption. About 24.4% of participants in the study group and 10% in the control group abstained from the habit at the sixth month, with an odd's ratio (OR)=2.91 and with a loss to follow-up of 10% in each of the groups. The cotinine test, which was used for validation, revealed a significant difference between the study and the control group. The number needed to treat (NNT) shows that to motivate one additional person to give up the SLT habit, we need to intervene with about seven people. Conclusion Behavior intervention with motivational interviewing was considered an effective method in promoting smokeless tobacco cessation among adults. Transtheoretical stages of change have proven to be an effective model to assess the stage of behavior change of the population toward SLT use and was also helpful for changing the behavior.

Effect of Octreotide in stopping post surgical chyle leak in neck Dissection-A systematic review.

Objective: Neck dissection causes an unusual and challenging complication called Chyle Leak. Octreotide, a long-acting somatostatin analogue, is one way Chyle Leak can be managed faster and effectively. The objective of the review was to evaluate the efficiency of Octreotide in stopping post surgical Chyle Leak in neck dissection. Methods: Three electronic database and manual search was undertaken to identify the literature. All the published articles, which included data about Octreotide used to stop post-surgical Chyle leak in neck dissection, published in the English language between January 1, 2010 to May 31, 2022 were included. Joanna Briggs critical assessment tool was used to assess the included studies. Results: Preliminary screening of 206 studies from data sources and ten from additional sources was done. After necessary exclusion, ten studies were included for qualitative synthesis. The data included 65 patients with neck dissections followed by Chyle leak postoperatively. Chyle leak was presented from 0-8th POD (range of 150 ml-2500 ml). 100mcg-eight hourly subcutaneously was given in maximum studies for 2-14 days. A gradual reduction in chyle leak started 2-4 days after the administration. The chyle leak completely resolved within 2-11 days in the majority of cases with conservative treatment and Octreotide. Conclusion: Octreotide Therapy with primary treatment is an effective way of stopping Chyle Leak in Neck Dissection. However, well-designed and robust randomized controlled studies are needed to confirm the results in the future.

Prevalence of precancerous lesions and conditions in India: A systematic review and meta-analysis.

BACKGROUND: Smoking and chewing tobacco are associated with numerous oral mucosal lesions and conditions, often leading to cancer progression. AIM: To investigate the prevalence of precancerous lesions and conditions among the Indian population. METHODS: Systematic search was conducted for population or community-based observational epidemiological studies in PubMed, EMBASE, Web of Science, IndMED, Google Scholar, reports of the WHO South-East Asia Region, MOHFW India reports, Science Citation Index, WHO Index Medicus of the South-East Asian Region, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Open Grey from the earliest available up to 31st January 2022. The effect size was calculated for the prevalence of precancerous lesions and conditions. RESULTS: One hundred sixty-two estimates from 130 studies yielded 52 high, 71 moderate, and seven low-quality studies from 823845. Point estimate based on cross-sectional studies for leukoplakia was 4.3% (95%CI: 4.0-4.6), oral submucous fibrosis was 2.7% (95%CI: 2.5-3.0), palatal lesions in reverse smokers and nicotine palatine were 5.8% (95%CI: 4.4-7.2), and Erythroplakia was 1.2% (95%CI: 0.7-1.7), and lichen planus was 1.1% (95%CI: 0.9-1.2). Amongst hospital-based studies, the pooled prevalence for Leukoplakia was 6.7% (95%CI: 6.0-7.3), oral submucous fibrosis was 4.5% (95%CI: 4.2-4.9), lichen planus was 7.5% (95%CI: 5.3-9.6), and erythroplakia was 2.5% (95%CI: 0.4-4.5), and palatal lesions in reverse smokers and nicotine palatini were 11.5% (95%CI: 8.0-15.0). CONCLUSION: Precancerous lesions and conditions are prevailing problems among the Indian population. It is mainly due to tobacco use, the smokeless form of tobacco. The meta-analysis indicates that hospital-based studies have a higher effect size of 6.7% than community-based studies. Patients who have already developed this condition may be advised to reduce their exposure to the risk factor to prevent the condition from progressing further.

DentalVibe reduces pain during the administration of local anesthetic injection in comparison to 2% lignocaine gel: results from a clinical study.

BACKGROUND: This study was designed to compare the efficacy of DentalVibe against 2% lidocaine gel in reducing pain during the administration of local anesthetic injection in the adult population. METHODS: This was a split-mouth open-label, randomized, controlled clinical study conducted in the Department of Oral and Maxillofacial Surgery of a dental institute. Fifty patients who were scheduled for bilateral dental extractions requiring an inferior alveolar nerve block were enrolled in the study. Site A (n = 50) was coated with 2% lidocaine gel followed by a local anesthetic injection, and DentalVibe with local anesthetic injection was used for Site B (n = 50). The primary outcome was pain, which was recorded immediately after the administration of anesthetic injection using the Visual Analogue Scale [VAS 0 - 10]. RESULTS: The VAS pain scores ranged from 4 to 10 for site A and 0 to 6 for site B. Comparison between the two sites showed a statistically significant difference [Mann-Whitney U test value = 51.50, P < 0.001] favoring site B. CONCLUSION: This study showed that DentalVibe reduces pain during injection of local anesthesia compared to topical anesthetic gel.

Evaluation and Comparison of Human Chorionic Amniotic Membrane and Platelet-Rich Fibrin in Achieving Bone Formation and Soft Tissue Healing in Extraction Sockets Indicated for Rehabilitation with Implants: A Preliminary Study.

PURPOSE: To evaluate and compare human chorionic amniotic membrane and platelet-rich fibrin on new bone formation and soft tissue healing in extraction sockets indicated for rehabilitation with dental implants. MATERIALS AND METHODS: A prospective, triple blind clinical study was conducted. The inclusion criteria were as follows: patient with two extraction sites each in the same arch, intact buccal bone and soft tissue around the socket, and recommended rehabilitation with dental implants. Postextraction, the sockets were randomly placed with human chorionic amniotic membrane in one site and platelet-rich fibrin in the other site. After 3 months, a trephine drill was used to take a biopsy of the respective sites for soft and hard tissue samples. The outcome parameters that were assessed histologically were percentage of new bone formation and lymphocyte density. RESULTS: After screening 80 patients, eight participants were recruited for the study. The mean percentage of new bone formation in the human chorionic amniotic membrane group was 45.71% ± 4.82%, and for the plasma-rich fibrin group, it was 41.39% ± 6.29%, showing no statistically significant difference (z = 0.99, P = .31). In the human chorionic amniotic membrane group, six out of eight sites had mild lymphocyte density, while the plasmarich fibrin group had equal numbers of mild and moderate lymphocyte density. No statistically significant difference between the groups (Fischer test value = 0.60, P = .25) was noted. CONCLUSION: Within the limitations of the study, the results showed that there is no difference in the efficiency of human chorionic amniotic membrane compared with platelet-rich fibrin in achieving new bone formation and soft tissue healing in the extraction socket.

Comparative evaluation of the efficacy of wound healing with and without dehydrated human amniotic/chorionic membrane in alveoloplasty: a pilot study.

OBJECTIVES: Wound healing is an integral part of any surgical procedure. Appropriate wound closure is critical to any successful surgical procedure, especially intraoral procedures. Various factors aid in wound healing, both pharmacological and non-pharmacological. Dehydrated human amniotic/chorionic membrane (dHACM) is an emerging bioinert material that contains anti-inflammatory properties, angiogenetic properties, osteogenic potential, and various growth factors. The purpose of this study was to evaluate the efficacy of wound healing properties of dHACM in bilateral alveoloplasty patients. MATERIALS AND METHODS: A prospective split-mouth study was conducted on 10 patients. Site A received sutures with dHACM and site B was sutured without dHACM. Wound healing was assessed with the Landry, Turnbull, and Howley Index. RESULTS: Sites A and site B were compared. A P<0.05 and a test value of 22 was obtained, indicating a statistical difference between the two sites. CONCLUSION: Our study showed better healing with dHACM than without.

Obstructive sleep apnea domains: Knowledge, attitude and practice results of dentists from a dental college in India.

OBJECTIVE: To assess the knowledge, attitude and practice regarding different domains of obstructive sleep apnea (OSA) amongst dentists from a dental college in India. METHODS: 112 dentists participated in the study. A 23-item, self-designed, pre-tested and validated questionnaire assessing the knowledge, attitude and practice (KAP) regarding nine different domains was used to collect the data. Knowledge and practice was categorized domain wise as good/poor, while attitude as favorable/unfavorable. RESULTS: Dentists were observed to have good knowledge about OSA, for domains concerning to the definition (60.71%), general findings (76.19%) and risk factors of OSA (66.96%). For the domain of screening and diagnosis (38.83%) along with treatment and referral (36.01%) dentists presented poor knowledge. 100% favorable attitude was reported for all the domains, while the dentists poorly faired (<50%) for both the practice domains. CONCLUSION: In spite of dentists showcasing favorable attitude towards OSA, they possessed poor knowledge for domains concerning screening, diagnosis and treatment modalities of OSA which may be linked to the hurdle in their way of practice. Thus a special attention towards these domains needs to be given so as to improve the handling skills of dentist for OSA patients coming to their clinics and prevent further health related issues.

Prevalence of dental caries among children aged 5-15 years from 9 countries in the Eastern Mediterranean Region: a meta-analysis.

BACKGROUND: Dental caries affects all age groups, although children are affected to a greater extent. Several studies have assessed the prevalence of dental caries in the World Health Organization (WHO) Eastern Mediterranean Region. However, prevalence data for dental caries have not been pooled for all countries in the Region. AIMS: To estimate by meta-analysis the pooled prevalence of dental caries among children aged 5-15 years in the Region. METHODS: The study protocol was registered in PROSPERO with registration number CRD42016037157. Twenty-one studies (37 estimates) were identified through systematic search for articles published between 1 January 2005 and 5 July 2018. The required data from each article were extracted into the datasheet. A random-effects meta-analysis was performed for the overall age group and for age 5, 12 and 15 years individually. RESULTS: Data were available for only 9 of the 21 countries in the Region. Heterogeneity between studies was high (I²>98%). There was considerable variation among the countries for the prevalence of dental caries at different ages. The pooled prevalence for deciduous dentition in children aged 5 years was 65% (45-85%); 61% (50-72%) for permanent dentition in children aged 12 years; 70% (64-75%) for children aged 15 years; and 66% (59-73%) for children aged 6-15 years. The most common index used for oral examination to calculate caries experience was WHO Basic Oral Health Survey Criteria, 1997. CONCLUSIONS: Dental caries continues to be an oral health concern among children in 9 countries in the Region.

Efficacy of T. Cordifolia (Guduchi) against plaque and gingivitis-A clinico-microbiological study.

OBJECTIVES: The present study was conducted to assess the clinical efficacy (against plaque and gingivitis) and antimicrobial efficacy (against gram negative, gram positive and S. mutans counts) of T. cordifolia (Guduchi). METHODOLOGY: A nonrandomized before and after trial for 21 days of intervention was performed involving 17 participants. Plaque index, gingival index were recorded and saliva samples were collected at baseline, 13th day and 22nd day. Repeated measures ANOVA test was performed to compare the before and after results of the clinical parameters, i.e. score of plaque index and gingival index. Freidman's test was applied for comparison between the three intervals (for microbiological evaluation of colony counts). RESULTS: There was statistically significant reduction inplaque score, gingival score, and colony forming units of gram negative organisms and S. mutans from baseline to 22nd day (P = 0.001). There was no significant reduction with gram positive organisms. CONCLUSION: This clinico-microbiological study concluded that twice rinsing of T.cordifolia decoction as mouth rinse in adjunct to scaling and routine brushing of teeth for 21 days shows anti-plaque, anti-gingivitis, and antimicrobial action against gram negative organisms and S. 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.

Assessment of mother's ability in caries diagnosis, utilizing the smartphone photographic method.

BACKGROUND: Smartphone is proved to be reliable in teledentistry model. The aim of the study was to assess the mother's ability in caries diagnosis, utilizing the smartphone-based photographic method. HYPOTHESIS: Mothers have the ability for caries diagnosis utilizing the smartphone photographic method. METHODS: A cohort of 100 mothers was given health education regarding dental caries diagnosis. Then, their children from the preschools were screened by the dentist for dental caries using visual examination, followed by clicking intraoral photographs using Motorola 3G phone. The photographs were sent through WhatsApp to respective mothers, and they were asked to diagnose their child's dental status. Accuracy and reliability measures of mother's diagnosis were estimated by calculating the sensitivity, specificity, predictive values, and kappa value. RESULTS: The calculated value for sensitivity was 88.3%, specificity was 98.3%, positive predictive value was 92%, negative predictive value was 97%, and accuracy was 96%. There was a strong agreement between mother's and dentist's diagnosis (kappa value of 0.87). CONCLUSION: Following the dental health education, it can be concluded that mothers are in a better position to diagnose their child's dental status through smartphone-based photographs.