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

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

Association of sense of coherence with oral health behaviors and gingival bleeding among adolescents.

CONTEXT: Adolescents experience many types of gingival and periodontal diseases, including gingivitis, localized or generalized aggressive periodontitis, and periodontal complications of various systemic diseases. The occurrence of periodontal diseases is not only related to biotic factors but may also be affected by nonbiotic factors such as oral health behaviors and practices. Various factors that influence an individual's health-related behaviors include a psychosocial construct named sense of coherence (SOC). AIM: The aim of this study is to investigate the association of SOC with oral health behaviors and gingival bleeding. SETTINGS AND DESIGN: This was a cross-sectional, analytical study that was done in the school setting. MATERIALS AND METHODS: A random sample of 850 adolescents was selected from nine schools of the Faridabad block of Faridabad district (Haryana) through the multistage cluster sampling technique. Methods of data collection included a combination of questionnaire administration and clinical examination. The questionnaire comprised sociodemographic variables, questions related to oral health behaviors, and Antonovsky's SOC scale. The questionnaire was interviewer administered. STATISTICAL ANALYSIS: Unadjusted and adjusted rate ratios of gingival units having bleeding on probing were estimated by Poisson regression multilevel analysis in Statistical Package for the Social Sciences (SPSS) software for Microsoft Office. RESULTS: Adolescents whose mothers had studied <8 years (relative risk [RR] 1.26; 95% confidence interval [CI] 1.04-1.38), who were males (RR 1.198; 95% CI 1.01-1.29), low SOC (RR 15.93; 95% CI 13.06-19.35), and toothbrushing frequency of less than once a day (RR 1.43; 95% CI 1.21-1.67) and children with plaque index >1 (RR 2.765; 95% CI 2.12-3.25) presented with the higher number of gingival units having bleeding. CONCLUSION: SOC is associated with gingival bleeding through oral health behaviors.

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

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

Periodontal health of the geriatric population in old-age homes of Delhi, India.

BACKGROUND: Periodontal disease is one of the leading causes of tooth loss in the geriatric population. Assessment of periodontal disease in a population is an important step in planning effective prevention and control programs for periodontal disease. Therefore, a study was carried out in old-age homes of Delhi to assess the periodontal status of 65-74-year-old elderly and recommend interventions to improve their periodontal health. MATERIALS AND METHODS: A cross-sectional study was conducted among 464 elderly from old-age homes of Delhi. Periodontal health status of the participants was determined using the WHO oral health assessment form. Community Periodontal Index (CPI) and loss of attachment (LOA) were recorded. Collected data were analyzed using SPSS version 23. Chi-square test was used to determine statistically significant difference among CPI scores and LOA according to age and gender. P ≤ 0.05 was considered statistically significant. RESULTS: The result of the study showed that 25.4% of the elderly had healthy periodontium, 71.1% had a periodontal pocket of 6 mm or more, and 2.40% had a pocket depth of 4-5 mm. Around 36% had 6-8 mm LOA and 34.70% had 9-11 mm LOA. The difference between CPI scores among gender and age group was not significant (P = 0.20, P = 0.096). However, the difference among gender for LOA was found significant (P = 0.014). CONCLUSION: The results from this study show that periodontal health of elderly residing in old-age homes is very poor. The periodontal status of this population can be enhanced by special collaborative efforts from the government and various nongovernmental organizations toward preventive and curative periodontal health services.

Sugar Clock: A Primordial Approach to Prevent Dental Caries.

AIM AND BACKGROUND: "Prevention is better than cure"; this statement is equally important when it concerns dental caries. Diet is directly linked to causing dental caries. Hence, it becomes of utmost importance that the amount, frequency, and time of sugar intake shall be known so that we can prevent dental caries. HOW TO CITE THIS ARTICLE: Dhingra S, Gupta A, Tandon S, et al. Sugar Clock: A Primordial Approach to Prevent Dental Caries. Int J Clin Pediatr Dent 2020;13(2):174-175.

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

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

Effectiveness of oral health education program using braille text in a group of visually impaired children-before and after comparison trial.

CONTEXT: Vision is the most important sense for interpreting the world and when sight is impaired, especially in childhood it can have detrimental effects on one's life. To maintain the oral health status of such group requires special approach. AIM: The aim of this study is to evaluate the impact of Braille text and verbal, oral hygiene instructions on the oral health status of visually impaired children. SETTINGS AND DESIGN: A prospective nonrandomized before and after comparison trial without any control group was conducted among 165 children aged 7-19 years residing in one of the blind schools in Delhi. MATERIALS AND METHODS: A questionnaire was developed to record the source of oral health knowledge and practices. Oral health status of the children was evaluated by recording plaque index (PI) and gingival index (GI) scores at 1, 3, and 5 months intervals. Periodic reinforcement of oral health education was performed with the help of instructions in Braille language. STATISTICAL ANALYSIS: Paired t-test and McNemar tests were used to assess the difference between the scores before and after oral health education. RESULTS: Among completely blind children, the mean difference of PI and GI score from baseline to the last evaluation was found to be 0.56 and 0.28, whereas among partially blind children, it was found to be 0.58 and 0.25, respectively. All the above values were statistically significant (P < 0.001). CONCLUSION: Visually impaired children irrespective of the degree of blindness could maintain an acceptable level of oral hygiene when taught using Braille text for instructions. However, continuous motivation and reinforcement at regular intervals are required for the maintenance of oral health status.

A crossover clinical trial to assess the effectiveness of different oral hygiene regimens on the reduction of morning bad breath in healthy young adults.

CONTEXT: Bad breath causes embarrassment and affects interpersonal social communication. Morning breath odor is a commonly encountered oral problem which should be rectified with effective oral hygiene measure. AIM: The aim of this study was to assess and compare the effectiveness of different oral hygiene regimens on the reduction of morning bad breath, plaque formation, and gingivitis in healthy young adults. SETTINGS AND DESIGN: A four-step, crossover clinical trial was conducted among 40 young adults aged 18-22 years residing in one of the nongovernmental organizations in New Delhi. MATERIALS AND METHODS: Study participants were divided into four groups, which underwent intervention for 7 days each. Group 1: tooth brushing; Group 2: tooth brushing and mouthwashing; Group 3: tooth brushing and tongue scraping; and Group 4: combination of all. A washout interval of 14 days was employed in between the groups. Breath scores were measured at three time intervals whereas oral health status was recorded at the beginning and the end of each interventional period. STATISTICAL ANALYSIS USED: Appropriate tests such as paired t-test, ANOVA test, and Pearson correlation tests were used in the study. RESULTS: The highest reduction in mean value of breath scores (2.03 ± 0.69) was found in Group 4 followed by Group 3. Similarly, Group 4 showed the highest reduction in mean value of plaque score (0.79 ± 0.19) and gingival score (0.54 ± 0.23) followed by Group 2. CONCLUSION: Combination of mechanical and chemical oral hygiene measures is an effective regimen for the reduction of morning bad breath.

Cross-Cultural adaption, validity and reliability of a Hindi version of the Corah's Dental Anxiety Scale.

Background: An appropriate scale to assess the dental anxiety of Hindi speaking population is lacking. This study, therefore, aims to evaluate the psychometric properties of Hindi version of one of the oldest dental anxiety scale, Corah's Dental Anxiety Scale (CDAS) in Hindi speaking Indian adults. Methods: A total of 348 subjects from the outpatient department of a dental hospital in India participated in this cross-sectional study. The scale was cross-culturally adapted by forward and backward translation, committee review and pretesting method. The construct validity of the translated scale was explored with exploratory factor analysis. The correlation of the Hindi version of CDAS with visual analogue scale (VAS) was used to measure the convergent validity. Reliability was assessed through calculations of Cronbach's alpha and intra class correlation 48 forms were completed for test-retest. Results: Prevalence of dental anxiety in the sample within the age range of 18-80 years was 85.63% [95% CI: 0.815-0.891]. The response rate was 100 %. Kaiser-Meyer-Olkin (KMO) test value was 0.776. After factor analysis, a single factor (dental anxiety) was obtained with 4 items.The single factor model explained 61% variance. Pearson correlation coefficient between CDASand VAS was 0.494. Test-retest showed the Cronbach's alpha value of 0.814. The test-retest intraclass correlation coefficient of the total CDAS score was 0.881 [95% CI: 0.318-0.554]. Conclusion: Hindi version of CDAS is a valid and reliable scale to assess dental anxiety in Hindi speaking population. Convergent validity is well recognized but discriminant validity is limited and requires further study.