Effect of Nonsurgical Periodontal Therapy on the Glycaemic Control of Nondiabetic Periodontitis Patients: A Clinical Biochemical Study.

PURPOSE: To compare the HbA1c levels in nondiabetic subjects with periodontitis and periodontally healthy controls and to evaluate the effect of nonsurgical periodontal therapy on the glycaemic control in nondiabetic subjects with periodontitis. MATERIALS AND METHODS: A total of 220 nondiabetic subjects between 35 and 60 years old were selected and divided into two groups: group A (case group), comprised of subjects with chronic periodontitis, and group B (control group), comprised of subjects with healthy periodontium. Periodontal clinical parameters (plaque index, modified sulcular bleeding index, probing depth and clinical attachment level) were used to assign the subjects into the respective groups. The HbA1c level was estimated for both groups using a commercially available kit. Subjects in group A underwent nonsurgical periodontal therapy in two to four sessions along with oral hygiene instructions. The periodontal parameters and HbA1c levels were again evaluated in the test group three months following periodontal therapy. RESULTS: The HbA1c levels were higher in the case group (A) than the control group (B). Three months following periodontal therapy in group A, there was improvement in periodontal parameters. The HbA1c levels decreased significantly from baseline to 3 months. CONCLUSION: The results of this study found chronic periodontitis to be associated with a significant increase in glycosylated haemoglobin levels in nondiabetic periodontitis subjects. Furthermore, with improvement of periodontal status, the glycaemic levels return to near normal values.

Aggressive giant cell lesion of mandible-confusing to common: true neoplasm versus reactive lesion.

Destructive lesions in the craniofacial region especially in the jawbones, if associated with giant cells, include a spectrum of lesions that pose difficulty in diagnosis. The nature of such a lesion in the jawbones is questionable about whether it is a reactive/benign lesion or aggressive/non-aggressive. Clinical, radiological and histopathological correlation may be a reliable indicator to differentiate between the qualities of the lesion, which directly accounts for effective and individual planning of the treatment. Here we present a case of a woman in her late 20s with an unusual destructive lesion of the mandible.

Self-negligence and awareness among oral precancerous and cancer patients - A cross-sectional questionnaire study.

Background: The National Institute of Health and Family Welfare (NIHFW) reports that India has the highest global prevalence of oral cancers. The incidence is significantly more in developing countries when compared to the developed countries. Early detection is key to increasing the survival rate of the patients. Important causes for this late diagnosis could be self-negligence, lack of patient awareness about the causes and asymptomatic and subtle clinical presentation of the lesions. Aim: To assess the causes of self-neglect and awareness levels among oral cancer and pre-cancerous patients. Settings and Design: A cross-sectional questionnaire study was conducted among pre-cancerous and cancerous patients. Methods and Material: A questionnaire with 16 closed-ended questions was framed relating to the causes of self-neglect and awareness of the patients. A total of 45 patients were selected by convenient sampling technique from the Institutional Tumour Board register of which 62 per cent were male patients and 38 per cent were female patients. Statistical Analysis: Data analysis for demographic data, patients' awareness, and causes of self-neglect about precancer and cancer was done using SPSS Version 10. Results and Conclusions: The present study concluded that the patients had adequate awareness that deleterious habits could lead to cancer but had a low level of awareness about the other causes of cancer, symptoms and management options available to treat cancer. The study result emphasizes that the government should plan for more cancer-screening camps in order to prevent the progression of cancer and to increase the awareness. (Reference I.D.: 2015-05006 for funding the project. ICMR).

Burden of oral precancer and cancer among an indigenous tribal population of South India - An evaluative study.

Context: Oral cancer is of major concern in the Indian subcontinent and is found to be high among low socioeconomic groups. One such high-risk group is considered to be the tribal people, who are economically and socially marginalised. Aims: The aim of the present study is to assess the prevalence of oral cancer and precancer lesions among the Narikurava population in Puducherry state, India. Methods and Material: A total of 329 Narikurava tribal people were included in this study. Data was collected by clinical examination of the oral cavity by door-to-door screening. The oral cavity was examined for white/red lesions, ulcerative changes, leathery changes and tissue growths. Statistical Analysis Used: Prevalence was calculated in terms of percentages. Descriptive statistics included the calculation of percentages, mean, and standard deviation. Results: The prevalence of precancer in the population is 48.3%. The majority of the lesions were observed in the buccal mucosa: 41.6% had white lesions, 9.1% had red lesions, 0.3% had ulcerations or growth, and 28.3% had leathery changes followed by the labial mucosa: 0.6% had white lesions, 0.6% had red lesions, 0.3% had ulcerations or growth and 16.4% had leathery changes. Conclusions: The present study observed a high prevalence of precancerous lesions among the Narikurava tribe. The main reason for the high prevalence is attributed to tobacco and tobacco-related habits. Hence, cancer control activities should be prioritised. Designing a model to detect precancer and cancer early and to constantly monitor the detected cases in such populations is of utmost importance.

Understanding Cachexia in Head and Neck Cancer.

One of the major comorbidities of cancer and cancer therapy is posing a global health problem in cancer cachexia. Cancer cachexia is now considered a multifactorial syndrome that presents with drastic loss of body weight, anorexia, asthenia, and anemia. Head and neck cancer (HNC) patients are at a greater risk for development and severity of cachexia syndrome as there is direct involvement of structures associated with nutritional intake. Yet, the scientific evidence, approach, and management of cachexia in HNCs are yet to be largely explored. The article aims to succinctly review the concepts of cancer cachexia with relevance to HNCs and summarizes the current findings from recent research.

Assessment of Knowledge, Awareness and Attitude towards Oral Precancer and Cancer among Narikuravar Population in Pondicherry State.

Objective Literature revealed that oral health status and awareness about oral hygiene measures of Narikuravar tribes were very poor. There was also an increased prevalence of tobacco usage among this population. Considering this, incidence and prevalence of oral precancerous and cancerous lesions are expected to be high in this population. Surprisingly, the literature search revealed a lack of data on the awareness, knowledge, and prevalence of oral cancer and precancer in this group. The primary objective of this survey is to assess knowledge, awareness and attitude toward oral precancer and cancer among the Narikuravar tribal population in Pondicherry state. Materials and Methods This questionnaire survey is a part of the Model for Oral Cancer Eradication project conducted among the Narikuravar population in Pondicherry, which is funded by Indian Council of Medical Research (ICMR). A total of 153 participants were recruited for the survey. A prevalidated questionnaire was used for the survey. Results The results indicated that 47% of the participants were aware of what is oral precancer and cancer. As much as 62% knew that chewing tobacco causes oral cancer and 44% thought that the growth of tissue in the mouth could be a sign of oral cancer. Almost 100% did not think that the presence of a red lesion, white lesion, or limitation of mouth opening could be signs of cancer or precancer. Only 16% thought that oral cancer is preventable. Conclusion Awareness about oral cancer and precancer is inadequate among the Narikuravar population of Pondicherry. Majority of the population is not aware of the risks, signs, or treatment options of oral precancer and cancer. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) identified the people's knowledge gaps, and improving awareness is one of the strategies of the program.

Assessment of Self Perception of Competencies among a Group of Dental interns in Pondicherry, India.

CONTEXT: The general dentist must not only have a broad biomedical and clinical education but also be able to demonstrate professional and ethical behavior as well as effective communication and interpersonal skills. In addition he or she must have the ability to evaluate and utilize emerging technologies, continuing professional development opportunities, and problem-solving and critical thinking skills to effectively address current and future issues in health care. But the extent to which the core competencies are taught and the students' level of proficiency in these competencies in Indian scenario is to be explored at large. AIMS: The present study aims at assessing the self-perceived level of competencies and their importance for future practice and the extent to which the competencies are taught in the curriculum among interns of dental college in Pondicherry, India. SETTINGS AND DESIGN: The cross-sectional observational study was conducted among dental interns of Indira Gandhi Institute of Dental Sciences, Pondicherry. SUBJECTS AND METHODS: A total of 72 interns participated in the study. A short version of the Freiburg Questionnaire to Assess Competencies in Medicine" was used in this study. Questionnaire has three sections with same set of questions, which the student had to rate: (i) To what extent do you have the following competencies at your disposal? (ii) To what extent will your future job require the following competencies? and (iii) To what extent is competencies taught to you? After the results were obtained a focused group discussion with the responders was done. Focused group discussion consisted of open questions to the groups in all the four domains and the responses of the students were scribed. RESULTS: In all four domains, self-perceived level of competency was not satisfactory. However, all students stated that the competencies were highly relevant for their future practice. Despite this, most of the competencies are not taught to necessary extent in the curriculum. The results of the present survey revealed that the participating students perceived deficiencies in all domains of competencies. CONCLUSIONS: These results indicate that the core competencies are still barely integrated into dental curricula and that further research in this field is needed.

Fibrotic encapsulation of orthodontic appliance in palate.

Iatrogenic trauma though not serious is very common in dental practice. Orthodontic treatment can inflict such injuries as they are prolonged over a long period of time. Ill-fabricated orthodontic appliances, such as wires and brackets, or the patients' habits such as application of constant pressure over the appliance can traumatize the adjacent oral soft tissues. In rare cases, these appliances can get embedded into the mucosa and gingival tissues. This case report describes one such case of iatrogenic trauma to the palatal mucosa due to entrapment of a tongue spike appliance and its surgical management.

Mouth the mirror of lungs: where does the connection lie?

Periodontitis is the chronic destructive disease of the periodontium (Gums) caused by host bacterial interactions. The effect of such host bacterial interactions in oral cavity also evokes a systemic response. Numerous studies have found common mechanisms of destruction for periodontal diseases and other chronic diseases like diabetes mellitus, atherosclerosis, respiratory diseases, and adverse pregnancy outcomes. Oral colonization by respiratory pathogens appears to be a risk factor for development of respiratory diseases and oral interventions aimed at reducing oral bacterial count have resulted in reduced incidence of these reparatory illness. This reflects the importance of oral hygiene among patients with respiratory illness. This review highlights the association between periodontal diseases and respiratory diseases.

Evaluation of oral health attitude and behavior among a group of dental students in Puducherry, India: A preliminary cross-sectional study.

CONTEXT: Oral behavior reflects individual perception on oral health. Behavior and attitude of oral health providers, especially dentists, towards oral health affect their capacity to deliver oral health care services. This attitude plays a important role in determining the oral health condition of population. AIM: The purpose of this study is to evaluate the oral health attitude and behavior among a group of dental students in India and to find any gender-based differences in terms of oral health attitude and behavior. MATERIALS AND METHODS: A total of 282 dental students of Indira Gandhi Institute of Dental Sciences, SBV University, Puducherry, India participated in the study. A simplified English version of Hiroshima University Dental-Behavioral Inventory (HU-DBI) was adopted. STATISTICAL ANALYSIS USED: SSP version 2.80 software was used to analyze the data. Chi-square test was used to find the differences in the distribution of "yes" among students from the different academic year as well as between male and female students. Statistical significance was set at P ≤ 0.05. RESULTS: Statistical significance was observed for the responses between the students from different academic years brushing frequency, careful brushing of teeth, using brush with hard bristles, careful self-evaluation of brushing and satisfied appearance of teeth and gums. Male students preferred to use a tooth brush with hard bristles and regular mouth washes than female students. With regards to worrying about bad breath, male students had more "yes" responses than females. CONCLUSIONS: Oral health attitude and behavior increased with the increasing levels of dental education, and no significant differences were observed among male and female dental students.