Assessment of dental professionals' maintenance of management practices developed and incorporated during COVID-19 pandemic - a cross-sectional study.

Background: COVID-19 pandemic has been a source of emerging public health problems for the past few years. Due to its contagious nature, health care professionals especially dentists, incorporated various modifications in their practices to prevent themselves and their patients from the risk of getting infected. Objective: The present study aims to assess whether dental professionals are still continuing with those modifications in practice in current times. Materials and Methods: The present study was conducted on 415 subjects after getting due approval from concerned authorities and consent from the subjects. Systematic random sampling methodology was employed for selection for study sample. The study employed a self-constructed questionnaire which was divided into 2 parts and information regarding demographic profile, practice modifications and safety protocols was gathered from subjects. Statistical analysis was conducted using Chi-square test and multiple regression analysis. Results: Only 8.6% of subjects were currently continuing with their all previous practice modifications. A vast majority of subjects (83.8%) were not deferring treatment of patients showing suspicious symptoms. Approximately 89% of subjects were not sanitizing the operating area at the end of the working day. More than two-thirds (76.4%) of the subjects stated that the pandemic was over. Female gender (OR:1.67) and high level of education (OR:2.45) had an important effect on the continuation of practice modifications. Conclusion: Very few subjects were adhering to all practice modifications previously incorporated. Dental professionals should not let their guard down even if COVID-19 cases have reduced considerably. The information collected will be useful for the dental community and further studies should be carried out.

World Health Organization MPOWER for tobacco control in India: a 6-year retrospective analysis.

Background: Prevalence and practices of tobacco usage in India are diverse and incongruent and Government of India has enacted various laws to overcome this burden. To make tobacco control measures effective and powerful, WHO introduced MPOWER in 2004 and India was one of the first countries that implemented the MPOWER. Objective: This study is aimed to quantify the implementation of MPOWER tobacco control policies in India. Material and Methods: In this retrospective analysis, data was gathered from the WHO MPOWER of India from 2015 to 2021. This analysis was based on the checklist which was designed previously by Iranian and international tobacco control specialists in their study on tobacco control. Results: In the present comparative analysis, India was categorized by scores and these were acquired from each indicator for each activity and 2021 year got the highest scores as compared to the previous year scores i.e. 27 in 2015. In context to individual indicators, noticeable increase in scores has been seen in both health warning on cigarette packages and adult daily smoking prevalence, whereas no progress was observed in smoking related policies. Conclusion: Although MPOWER programmes are widely accepted by the Indian government, but still substantial improvement in fewer sections is required.

Students' preferences regarding teaching methodology in dental education - a cross-sectional study.

INTRODUCTION: The goal of dental education is to prepare competent ethical professionals with critical thinking, reasoning and analyzing skills along with ability of application of clinical skills and judgement in treating a patient. The present study was designed with the objective to elicit the preferences of dental students regarding the utility of the prevailing teaching and learning methods and teaching aids. MATERIAL AND METHODS: A cross-sectional study was conducted among undergraduate dental students. Study population consisted of 382 dental students. A self-designed close-ended questionnaire written in English was constructed specifically for the study. The questionnaire was divided into two sections. Information regarding various teaching and learning methods both in theory and practical/clinical classes was obtained from the students. Results were calculated using numbers and percentages only. RESULTS: The mean age of the students was 20.49 + 2.4 years. Problem based learning (PBL) was rated very useful by 76% (290) and useful by 24% (92) of subjects. Performing clinical/practical procedure individually rather than in group was rated very useful by 31% (118) of subjects. Use of power-point along with the blackboard was rated as the most useful method by 95% (363) of subjects. Majority of subjects (61%, 233) felt that 40 minutes duration of lecture was more useful as compared to 30 minutes. CONCLUSIONS: Our study concludes that dental students prefer active teaching learning methodologies and combination of audiovisual aids. Hence it is suggested that collaboration of different active teaching methods and aids should be adopted by the teachers in order to enhance the student learning process.

Identifying monkeypox: do dental professionals have adequate knowledge and awareness?

Background: The emergence of monkeypox has presented a new challenge for health agencies around the globe. There is significant increase in the number of cases that too in non-endemic countries with more than 18000 cases reported worldwide. Objective: The present study was conducted to assess knowledge and awareness regarding monkeypox among dental professionals. Materials and Method: The present cross-sectional study among 410 subjects who were residing in a northern state of the country. Informed consent was obtained from all the subjects. Study sample was selected on the basis of Systematic random sampling methodology. A self-designed close-ended questionnaire written in English and verified by experts was utilized for the study. The questionnaire was delivered personally to study subjects to collect the required information. Chi-square test and ANOVA were used for statistical analysis. Results: One-fourth (24.8%) of the subjects never heard about monkeypox disease. Negative response was given by 44.8% of subjects regarding resemblance of monkeypox with small pox. Only 31.2% of subjects had knowledge regarding oral manifestations of the disease. High knowledge scores were reported by only 28% of subjects. Higher knowledge levels were significantly related to education level and working profile of study subjects. Online media (Internet) was preferred as the main source to obtain more information by 42.2 of subjects. Conclusion: There was low level of knowledge regarding monkeypox among study subjects. There is an urgent need for dental professionals to keep themselves updated with recent knowledge on new emerging infectious diseases.

Covid-19 and mucormycosis (Black Fungus): An epidemic within the pandemic.

The second wave of the COVID-19 pandemic has affected India significantly with country reporting more than 400,000 cases in the month of May 2021 and health system almost collapsing. This was attributed to the new mutant strain also called as the 'Delta Strain' which led to high surge of cases across the country. As the country was stabilising over this situation, another imminent threat in the form of Covid Associated Mucormycosis (CAM) challenged the already burdened health system of India. Also called as 'Black Fungus,' cases of CAM began to rise rapidly in the last week of May 2021 with multiple states reporting steady rise in the number of cases. Based on the published literature, India contributed to approximately 71% of global cases of CAM from December 2019 to start of April 2021, with majority of the cases occurring during the second wave. The present paper focuses on the epidemic of CAM during the second wave in India highlighting the causes, symptoms and various treatment modalities that have been adopted to cure the disease. Also, spotlight has also been thrown on some other nations where cases of CAM have begun to emerge. Some key recommendations are also mentioned which can prove vital towards disease prevention.

Assessment of satisfaction levels of patients during dental outreach programs in rural part of Udaipur, India.

BACKGROUND: The community-based dental outreach programs play a very crucial role in declining discovery-delivery disconnect by introducing awareness through health education and dental adumbrating services to the community members. However, the success of any oral health programme depends largely on how it meets the needs and expectations of the target community. Therefore, the present study was designed for the assessment of patient satisfaction at various rural outreach dental camps conducted over a period of 2 months. MATERIALS AND METHODS: The present study was conducted on patients visiting weekly and monthly outreach dental programmes organised by the Department of Public Health Dentistry. Data were obtained from a total of 298 patients using a pre-tested questionnaire as a survey instrument. The questionnaire consisted of nine questions, measuring the patient satisfaction levels on a five-point Likert scale. RESULTS: The highest mean satisfaction score (4.97 ± 0.59) was observed for the question on the overall performance of camp, whereas waiting time for treatment, quality of the treatment and explanation of need for referral exhibited lowest mean scores. The mean satisfaction scores for the monthly camp (4.55 ± 0.52) were significantly higher as compared to the weekly camps (4.38 ± 0.55) (P = 0.013). CONCLUSION: The results of the study showed that the patient satisfaction scores were satisfactory to good for various aspects of the weekly and monthly dental outreach programmes. Such programmes should be conducted on regular basis, and comprehensive oral care should be provided.

Evaluation of governmental oral health-care infrastructure in the state of Haryana.

Health system should be organized to meet the needs of entire population of the nation. Oral diseases are the most common of the chronic diseases, but there are few efficient dental care systems to cope with these problems. The present cross-sectional study was conducted among 135 dental care units of various primary health centers, community health centers, and general hospitals existing in the state to evaluate the government oral health-care infrastructure in Haryana. Data regarding provision of water and electricity supply, dental workforce and their qualification, number and type of instruments in the dental operatory unit, etc., were collected on a structured format. There is a shortfall in infrastructure and significant problem with the adequacy of working facilities. This can prove to be a big hurdle in the provision of adequate oral health care to people with greatest health-care needs. A great deal of effort is required to harmonize the oral health-care delivery system.

Accidental aspiration of dental crowns and retrieval.

AIM: The aim of this article is to create awareness among the dental practitioners regarding the various accidents which can happen during a dental procedure and stress upon the preventive measures that can be taken to reduce the same. BACKGROUND: This article presents a case of aspiration of dental crowns by the patient and its retrieval by coughing and preventive measures which can be taken to avoid such circumstances. CASE DESCRIPTION: A patient reporting to private dental practice accidentally aspirated the two-unit prosthesis (crowns) in the right lung during cementation. He was immediately taken to the hospital, where chest radiographs and computed tomographic (CT) scan were done in order to locate the actual position of the prosthesis. Bronchoscopy was planned to retrieve the crowns but the patient had a bout of cough and the crowns came out. A chest radiograph was taken to confirm the absence of crowns. CLINICAL SIGNIFICANCE: Taking adequate precautions while performing any dental procedure in supine position can decrease the occurrence of such incidents. Rigid bronchoscopy is the advised method of retrieval in case the crowns are not coughed out.

Acquaintance and Approach in the Direction of Tobacco Cessation Among Dental Practitioners-A Systematic Review.

BACKGROUND: Nowadays, tobacco consumption has become one of the major public health problems and is the leading cause of escapable illness and death. A significant role is played by dental professionals in the identification of smokers; they are, thus, in a better position to offer preventive care. The aim of the present study was to systemically review the knowledge and attitude of dental practitioners toward tobacco cessation. METHODS: A literature search was performed in PubMed Central and Cochrane Library, Medline-PubMed, Embase, Google Scholar up to 2018 to identify appropriate studies. Full-text original research articles of the cross-sectional design were only included in the study. Our target was to systemically review the knowledge and attitude of dental practitioners toward tobacco cessation. RESULTS: The present review included a total of nine articles (studies) that fulfilled the eligibility criteria. Two articles which were hand searched and one article which was obtained through contact with experts were included. The results of the review revealed that the dental practitioners in most of the included studies lack satisfactory knowledge and were unaware of existing referral pathways to specialist smoking cessation services. At the same time, most of the dentists have a positive attitude toward tobacco cessation. CONCLUSIONS: Dental professionals are aware of their obligations toward smoking cessation counseling for patients but certain barriers including lack of time, confidence, and training prevent them from practicing the same in their daily routine. The dental professionals should obtain appropriate training and attain knowledge along with quantifiable skills for the prevention and cessation of tobacco use.

Patient safety in primary and outpatient health care.

Primary care services provide an entry point into the health system which directly impact's people well-being and their use of other health care resources. Patient safety has been recognised as an issue of global importance for the past 10 years. Unsafe primary and ambulatory care results in greater morbidity, higher healthcare usage and economic costs. According to data from World Health Organization (WHO), the risk of a patient dying from preventable medical accident while receiving health care is 1 in 300, which is much higher than risk of dying while travelling in an airplane. Unsafe medication practices and inaccurate and delayed diagnosis are the most common causes of patient harm which affects millions of patients globally. However, majority of the work has been focussed on hospital care and there is very less understanding of what can be done to improve patient safety in primary care. Provision of safe primary care is priority as every day millions of people use primary care services across the world. The present paper focuses on various aspects of patient safety, especially in the primary care settings and also provides some potential solutions in order to reduce patient harm as much as possible. Some important challenges regarding patient safety in India are also highlighted.

H1N1 Influenza: Assessment of knowledge and awareness of private dental health professionals of a Tricity.

BACKGROUND: Influenza like Swine flu virus has posed a greater risk of occupational transmission to dental professionals as it can spread through the aerosols. AIM: To assess knowledge and awareness of private dental health care professionals regarding swine flu of a Tricity in India. MATERIALS AND METHODS: A cross-sectional study was conducted among 255 private dentists practising in the Tricity. A self-administered, anonymous, multiple choice type questionnaire was administered to gather information. The questionnaire contained 12 questions on knowledge and awareness regarding swine flu keeping in view the time constraints. Statistical analysis was done using ANOVA and student t-test. RESULTS: Awareness regarding mode of transmission of swine flu were reported positively by 88.5% of subjects. About 24.6% of subjects reported about having encountered a swine flu patient at their clinic. Preventive measures to prevent spread of swine flu were known to 71.2% of subjects. Statistically significant association of mean knowledge scores was noted with education level (P = 0.015) and working profile (P = 0.017) of the subjects. CONCLUSION: The results of the present review showed that some knowledge gaps existed among dentists regarding some important aspects of swine flu. Therefore, there is an urgent need for training and continuous education programs regarding infectious diseases.

Family physicians' knowledge and awareness regarding oral health: A survey.

INTRODUCTION: Oral health is an important component of general health. The World Health Organization has highly recommended the integration of oral health promotion into general health care. In majority of the cases, patients visit their physicians with simultaneous oral and systemic complaints, and primary oral complaints are more frequently encountered. Therefore, primary care physicians can play an expanded role within oral health care to raise the overall health of the patients. AIM: This study aimed to assess the knowledge and awareness of family physicians regarding oral health. MATERIALS AND METHODS: An observational (cross-sectional) study was conducted among 250 family physicians who are practicing in Tricity. A self-structured questionnaire (close-ended) prepared by a panel of oral health experts in English language (close-ended) was administered to the study participants. The questionnaire which was divided into two parts, A and B, contained 15 questions on knowledge and awareness regarding oral health. Categorization of knowledge scores was done at three levels: low, medium, and high. Statistical analysis was performed using analysis of variance and Student's t-test. RESULTS: Males comprised 72.8% (182) of the study population and 55.2% (138) of the participants were doing combined practice (academic and private both). Low knowledge scores were reported in 47.2% (118) of the participants whereas only 22.4% (56) of participants had a high score. The mean knowledge score according to educational level and working profile was statistically significant (P < 0.05). CONCLUSION: The results of our study showed a considerable lack of knowledge among family physicians regarding connection of oral health with general health. Therefore, there is an urgent need to increase their knowledge by various continued medical education and training programs.

Hepatitis C: Knowledge and awareness of private dental practitioners of a tricity in India.

BACKGROUND: Dental health-care personnel are at an increased risk toward infections caused by various microorganisms including hepatitis B and hepatitis C viruses (HCV). A dentist can play an important role in the prevention of HCV by considering every patient as a potential carrier for hepatitis. Therefore, the present study was conducted to assess the knowledge and awareness of dental health-care professionals regarding various aspects of HCV. MATERIALS AND METHODS: A cross-sectional study was conducted among 247 private dental practitioners of tricity. A close-ended self-structured questionnaire was administered which contained 12 questions on knowledge and awareness regarding HCV infection keeping in view the time constraints. Categorization of knowledge scores was done at three levels - poor, moderate, and good. Statistical analysis was done using ANOVA and Student's t-test. RESULTS: Nearly 96% (102) of postgraduates and 84% (117) of graduates had heard about HCV. 45.5% (112) had poor knowledge scores, 33.6% (83) had moderate knowledge scores, and only 21% (52) of participants had good knowledge scores. On the opinion of treating an HCV-infected patient by a dentist, only 61% (65) of postgraduates and 46% (64) of graduates agreed. There was statistically significant association of mean knowledge scores with gender, education level, and experience (P < 0.05). CONCLUSION: Majority of the dental professionals lacked knowledge regarding HCV infection and were not fully aware regarding certain aspects. Therefore, there is an urgent need for modification of the existing dental curriculum so that knowledge regarding these diseases can be imparted during graduation.

Evaluation of surface roughness of enamel after various bonding and clean-up procedures on enamel bonded with three different bonding agents: An in-vitro study.

BACKGROUND: The purpose of this study was to analyze and compare the enamel surface roughness before bonding and after debonding, to find correlation between the adhesive remnant index and its effect on enamel surface roughness and to evaluate which clean-up method is most efficient to provide a smoother enamel surface. MATERIAL AND METHODS: 135 premolars were divided into 3 groups containing 45 premolars in each group. Group I was bonded by using moisture insensitive primer, Group II by using conventional orthodontic adhesive and Group III by using self-etching primer. Each group was divided into 3 sub-groups on the basis of type of clean-up method applied i,e scaling followed by polishing, tungsten carbide bur and Sof-Lex disc. Enamel surface roughness was measured and compared before bonding and after clean-up. RESULTS: Evaluation of pre bonding and post clean-up enamel surface roughness (Ra value) with the t test showed that Post clean-up Ra values were greater than Pre bonding Ra values in all the groups except in teeth bonded with self-etching primer cleaned with Sof-Lex disc. Reliability of ARI score taken at different time interval tested with Kruskal Wallis test suggested that all the readings were reliable. CONCLUSIONS: No clean-up procedure was able to restore the enamel to its original smoothness. Self-etching primer and Sof-Lex disc clean-up method combination restored the enamel surface roughness (Ra value) closest to its pre-treatment value. Key words:Enamel surface roughness, clean-up method, adhesive remnant index.

Significance of mandibular canine index in sexual dimorphism and aid in personal identification in forensic odontology.

BACKGROUND: Forensic odontology is basically the science dealing with establishing identity by teeth and has played an important, often crucial, role in the identification of victims of mass disasters. Among all teeth, the mandibular canines are found to exhibit greatest sexual dimorphism. Hence, this study was undertaken to evaluate the effectiveness of mandibular canine index (MCI) in the determination of sex. MATERIALS AND METHODS: The study was conducted on 62 subjects (31 males, 31 females). Mesiodistal diameter of mandibular canines was measured with the help of digital Vernier calipers. Intercanine distance was measured with the help of a divider. The standard MCI value is used as a cut off point to differentiate males from females. Statistical analysis was done using t-test. RESULTS: The width of mandibular canine was higher in males than in females, which was statistically significant. The left canine is found to exhibit greater sexual dimorphism, i.e., 7.62% as compared with right canine, i.e., 6.85%. The calculated standard MCI for both male and female was 0.247. With these calculations, the overall percentage of sex determination was 79.03%. CONCLUSION: The ability to determine gender using Standard MCI was estimated to be 73.33% in males and 80% in females. It was concluded that with standard MCI, it was possible to detect sex for forensic purposes.

Knowledge and awareness of forensic odontology among dentists in India: A systematic review.

Forensic dentistry involves the processing, review, evaluation, and presentation of dental evidence with the purpose of contributing scientific and objective data to legal processes. The present, systematic review was conducted to assess knowledge and awareness of forensic odontology among dentists in India. A systematic review of relevant cross-sectional studies was conducted regarding the level of knowledge, awareness, and practical application of forensic odontology among dentists in India. Four out of 129 studies were finally included in the present review after conducting a search of both electronic and manual scientific databases. Potential biases were addressed and the relevant data were extracted by the concerned investigators. Almost all the subjects were familiar with the subject of forensic odontology in one of the study reports. Only 12% of dentists were maintaining complete dental records in the findings of another study. Only 4% of dentists reported to have contributed to the identification of victims in a mass disaster in yet another study. The findings of another study revealed that 40% of dental practitioners did not have the expertise to identify child abuse. The results of the present review showed that the knowledge and awareness level of subjects was inadequate and that there is considerable variation in the practice of forensic odontology among dentists. It is necessary to expose dentists to the basic principles and techniques of the subject.

Knowledge and Awareness Regarding Swine-Influenza A (H1N1) Virus Infection among Dental Professionals in India - A Systematic Review.

INTRODUCTION: Swine flu or Influenza A (H1N1) flu is the most recent of the pandemic disease that has affected the world's population. We, as health care providers should feel responsible for reducing the transmission of influenza. AIM: To conduct a systematic review of observational studies and to assess dental professionals' knowledge and awareness regarding swine flu. MATERIALS AND METHODS: Relevant cross-sectional observational studies were included in the systematic review to assess the level of knowledge and awareness regarding swine flu among dental professionals. Three studies out of 28 were finally included in the present review after conducting both electronic and manual search of scientific databases like Pubmed, Medline, and EMBASE. No limitation in terms of publication date and language was considered. Potential biases were reported and appropriate data were extracted by the concerned investigators. Descriptive statistics, student t-test were used for analysis. RESULTS: Majority of the subjects (92.6%) had heard about swine flu, and 64.3% of them knew about the H1N1 virus in one of the study reports. More than 80% of subjects were aware regarding the availability of swine flu vaccine in one study reports as compared to another study in which only 31.5% had awareness. Majority of the subjects were of the opinion that frequent hand washing and use of sanitizer are one of the effective methods to prevent swine flu in all the three studies. CONCLUSION: The results of the present review showed that some knowledge gaps existed among dental professionals regarding swine flu. Therefore, there is an urgent need for training and continuous education programs regarding infectious diseases.

Clinical and radiographic comparison of various medicaments used for pulpotomy in primary molars: A randomized clinical trial.

OBJECTIVE: To evaluate and compare the efficacy of ferric sulfate, glutaraldehyde, and mineral trioxide aggregate (MTA) as pulpotomy medicaments in primary molars. MATERIALS AND METHODS: This was a perspective randomized clinical trial. A total of 90 molars from 42 children aged 4-8 years were selected for pulpotomy procedure. Teeth were randomly divided into three equal groups of 30 teeth each. Teeth in Group I were intended to be treated with ferric sulfate, Group II were intended to be treated with buffered glutaraldehyde and Group III with MTA. All the molars were evaluated clinically at 24 h and both clinically and radio graphically at 1, 3, and 6 months. The observations were statistically analyzed using Chi-square test and Fisher's exact test. RESULTS: After 1 month, there was no clinical finding observed in all the three groups. At 3 months postoperative evaluation, 13.3% of teeth in Group I and 12.5% of teeth in Group II had mobility. At 6 months interval, pain and sinus formation each was noted in 9.1% of primary teeth in Group I while periodontal ligament widening was reported in 66.7% of teeth in Group I and 85.7% of teeth in Group II. CONCLUSION: MTA exhibited overall best results as pulpotomy agent for primary molars followed by 15.5% ferric sulfate, whereas 2% buffered glutaraldehyde was found to be least effective as a pulpotomy agent.

Dental public health in India: An insight.

Oral diseases are a major public health problem, and their burden is on increase in many low- and middle-income countries. Dental public health (DPH) aims to improve the oral health of the population through preventive and curative services. However, its achievements in India are being questioned probably because of lack of proficiency and skill among DPH personnel. The literature search for the present study was conducted utilizing various search engines and electronic databases such as PubMed and MEDLINE. Documents related to the Central and State Governments of India were also considered. Finally, 26 articles were selected for the present study from which relevant information can be extracted. The present study focuses on some of the important aspects relating to DPH in India such as priority for oral health, DPH workforce and curriculum, utilization of DPH personnel in providing primary oral health care, role of mobile dental vans, and research in DPH. It was concluded that more attention should be given toward preventive oral health care by employing more number of public health dentists in public sector, strengthening DPH education and research, and combining oral health programs with general health-care programs.

Status of governmental oral health care delivery system in Haryana, India.

BACKGROUND: Health system should be organized to meet the needs of entire population of the nation. This means that the state has the direct responsibility for the health of its population and improving the quality of life through research, education, and provision of health services. The present study was conducted to evaluate the government oral health care delivery system in Haryana, India. MATERIALS AND METHODS: The present cross-sectional study was conducted among 135 dental care units (DCUs) of various primary health centers (PHCs), community health centers (CHCs), and general hospitals (GHs) existing in the state by employing a cluster random sampling technique. Data regarding the provision of water and electricity supply, dental man power and their qualification, number and type of instruments in the dental operatory unit, etc., were collected on a structured format. Statistical analysis was done using number and percentages (SPSS package version 16). RESULTS: Alternative source of electricity (generator) existed in only a few of health centers. About 93.4% (155) of the staff were graduates (BDS) and 6.6% (11) were postgraduates (MDS). Ultrasonic scaler was available at dental units of 83.1% (64) of PHCs, 73.1% (19) of CHCs, and 93.8% (30) of GHs. Patient drapes were provided in 48.1% (65) of the DCUs, doctor's aprons were provided in 74.1% (100) of the places. CONCLUSION: There is a shortfall in infrastructure and significant problem with the adequacy of working facilities. A great deal of effort is required to harmonize the oral health care delivery system.