Kapil Rajiv Sharma

Impact of school-based oral health education program on oral health of 12 and 15 years old school children

Background: Health education for the school age child is a specialized field within the broad discipline of education. Oral health education program are educational aspects of any curative, preventive and promotional health activity. Aim: The study has been undertaken to evaluate the impact of oral health education on the status of plaque, gingival health and dental caries among 12 and 15 years old children attending government school in Shimla city. Materials and Methods: Two hundred and seventy six school children participated in the study. The study was conducted over a period of 4 months from May 2010 to August 2010 in Government Senior Secondary School, Sanjauli. Plaque, gingival and caries status was assessed by using Silness and Loe plaque index, Loe and Silness gingival index and WHO modified DMFT index, respectively. Data was analyzed using the software SPSS version 15. Paired t-test and Wilcoxon signed rank sum test were used appropriately for statistical comparisons. P value ≤0.05 was considered statistically significant. Results: Overall mean plaque score and gingival score decreased significantly after oral health education irrespective of gender. However, decrease in plaque score among 15 years old female children and gingival scores among 12 and 15 years old female subjects was not significant. Difference in mean caries status was statistically insignificant among all the subjects. Conclusion: Short term oral health education program may be useful in improving oral hygiene and gingival health. Coordinating efforts should be enhanced between school personnel, parents and health professionals to ensure long-term benefits of such program.

Assessment of oral health status and treatment needs of police personnel in Shimla city, Himachal Pradesh: A cross-sectional study

Objectives: To assess the oral health status and treatment needs of police personnel in Shimla city and to suggest measures to improve the present oral health status. Materials and Methods: The cross-sectional study was conducted on 371 subjects, aged 18-58 years who were selected by simple random sampling. Type-III examination of the subjects was conducted by a single investigator and data was recorded on modified W. H .O. format 1997. A value of P ≤ 0.05 and ≤ 0.001 was considered statistically significant and highly significant, respectively. Results: DMFT (decayed, missing, filled teeth) was significantly higher among older age group, males and constables. Subjects brushing once daily had higher DMFT 3.16 (S.D. = 3.29) than those brushing twice daily 2.8 (S.D. = 2.79) ( P P P Conclusion: Most of the police personnel suffer from dental caries, periodontal diseases and edentulousness. Awareness should be created to maintain good oral hygiene, regular dental check up and abstain from smoking and alcohol among police personnel.

Enamel hypoplasia and its correlation with dental caries in 12 and 15 years old school children in Shimla, India

Aim: The aim was to assess the prevalence of enamel hypoplasia and its correlation with dental caries in 12 and 15 years old school children in Shimla city, Himachal Pradesh, India. Materials and Methods: This was a cross-sectional study conducted on a sample of 1011 school children aged ranging between 12 and 15 years old in Shimla city, Himachal Pradesh, India. A modified developmental defects of enamel index was used to classify the enamel defects. The statistical tests used was Chi-square tests. P < 0.05 was considered to be statistically significant. Results: The prevalence of enamel opacities was 18.2%. At 12 years of age, the prevalence was 17.9%, whereas at 15 years it was 18.6%. The tooth prevalence of enamel opacities of the entire sample was 11.8%. At 12 years tooth prevalence was 10.9% and at 15 years it was 12.7%. There was a significantly higher prevalence of Enamel hypoplasia among males at both the age groups. The diffuse type of enamel opacity was the most commonly seen at both the age groups. A significant association was found between caries and enamel opacities (P < 0.01). The occurrence of enamel opacities was statistically higher in children with the youngest mothers. Conclusions: The prevalence of enamel defects in this study is low when compared to National prevalence (22.3% at 12 years and 23.2% at 15 years). This study revealed a significant association between enamel defects and dental caries.

Occupational health problems among government dentists in Himachal Pradesh-India

Background : No information is available regarding the occupational health problems among dentists working in government institution in Himachal Pradesh, although related studies in other regions suggests that musculoskeletal pain, contact dermatitis and injury from sharp instrument are common. Aim : To collect information from dentists working in the government institutions in Himachal Pradesh concerning common occupational health problems and the precaution they commonly take during their practice. Materials and Methods : Questionnaire survey was conducted on a systematic random sample of 154 dentists amongst the dentists working in government health institutions in Himachal Pradesh. Questionnaires were sent by mail in September 2011.The dentists were asked to complete the questionnaire and return it by mail using the stamped addressed envelope provided. The data was analyzed using the software SPSS version 15 (SPSS Inc., Chicago). The student ′t′ test and Chi square test were used appropriately. Results : The response rate from the dentists was 81.8%. The most common problem experienced was musculoskeletal pain (65.8%) followed by allergic dermatitis of the hands (8.7%). Nearly all of the respondent dentists wore gloves 100% and face masks 96.8% during work. Very few respondents reported that they had received instructions or training through interactive workshops on occupational health and safety. Conclusions : There seems to be a substantial demand among government dentists in Himachal Pradesh for continuing education on occupational health and safety. More emphasis on this issue to be put into dental training, with more continuing education activities on occupational health and safety to this group of professionals.

Impact of socioeconomic status on decayed, missing, filled teeth (DMFT) among state government employees in Shimla City, Himachal Pradesh

Objectives: To assess the impact of socioeconomic status (SES) on decayed, missing, filled teeth (DMFT) among state government employees in Shimla city, Himachal Pradesh. Design: Cross-sectional study. Materials and Methods: This study was conducted on 1008 dentate subject 705 (69.9%) males and 303 (30.1%) females out of 10908 government employees. Data regarding dentition status and treatment needs was recorded on a W.H.O. format 1997. Type III examination was conducted under good illumination by the investigator himself. Student′s t-test or ANOVA was applied for statistical evaluation of means and the comparisons of proportions. P value ≤ 0.5 and ≤ 0.01 was considered statistically significant and highly significant respectively. Results: Total teeth examined were 29575 out of which 14.84% were decayed. Overall mean DMFT was 3.29 (1.86). Females were reported significantly higher ( P < 0.05) DMFT 3.49 (2.31) than males 3.12 (1.42). Subjects who belong to upper SES had lesser mean DMFT than lower SES 2.31 (2.4) vs 4 (3.89), which was statistically highly significant ( P < 0.01). Employees who brush their teeth once a day presented with higher DMFT 4.01 (2.01) than those who brush once daily 2.57 (1.96). The difference was highly significant ( P < 0.01). Conclusions: A preventive and curative oral health policy for the government employees in Shimla city needs to be planned and implemented to maintain their commitment in their official work. Also they must be educated the importance of oral health and methods how to maintain it.

Prevalence of anterior teeth fracture among institutionalized visually impaired individuals in Himachal Pradesh, India - A cross-sectional study

Background: Trauma is the major cause of the injury to the anterior teeth superimposed by many local factors, such as anatomy of the teeth, proclination, and lip coverage. Because of their impaired vision, blind children are at greater risk for anterior tooth trauma. Aim: The aim of the study was to determine the prevalence of anterior tooth fracture among visually impaired individuals and to know the probable cause and risk factors of anterior teeth trauma. Settings and Designs: This cross-sectional study was conducted among visually impaired children in two special needs schools at Dhalli, district Shimla and at Sunder Nagar, district Mandi, in Himachal Pradesh. Materials and Methods: This study was carried out on a conveniently sampled group of 99 blind individuals (64 males and 35 females) aged 9-22 years in December 2011. The study was carried out by a single examiner according to World Health Organization (WHO) criteria and using the WHO classification for teeth fracture. Statistical Analysis: Statistical analysis was carried out using SPSS version 15 (SPSS Inc., Chicago, IL, USA). Chi-square test was used for comparison. P < 0.05 and P < 0.01 were considered as statistically significant and highly significant respectively. Results: An overall prevalence of 33.3% of traumatic injuries to anterior teeth was found in the study population. Females experienced significantly more trauma than males and indoor fall injuries were the most common cause. The permanent maxillary central incisors were most commonly injured, involving enamel and dentin. Increased overjet and inadequate lip coverage were significantly associated with the occurrence of trauma. Conclusion: The present study revealed a higher prevalence of traumatic injuries to anterior teeth among blind individuals. Hence, there is a distinct need for strengthening the provision of oral health-care facilities to these  disabled children, such as preventive orthodontic treatment and the use of mouthguards.

Dentition status and treatment needs among institutionalized hearing and speech impaired children in Himachal Pradesh in India: A cross-sectional study

Background: The oral health of the disabled may be neglected because of the disability condition, demanding diseases or limited access to oral health care. It has been reported that dental treatment is the greatest unattended health need of the disabled. Aim: Present study was conducted to assess the prevalence of dental caries and treatment needs among hearing and speech impaired children in Shimla city, Himachal Pradesh. Materials and Methods: 202 institutionalised subjects aged 5-22 years attending special school were examined. Data was recorded using modified WHO survey 1997 proforma. Dentition status and treatment needs using DMFT, DMFS, dmft, dmfs were recorded. The data was analysed using the software version 15 (SPSS Inc. Chicago). ANOVA, chi-square test and multiple regressions were applied appropriately. Results: Among study subjects, largest component of DMFT was the D component, with a mean of 1.47. Highest mean DMFS was recorded for the age group 18-22 years. Missing surfaces and filled surfaces did not account for a major proportion. Mean dmft and dmfs scores were 1.04 and 1.73, respectively. Out of 202 subjects examined, 182 (90.1%) required treatment. One surface restoration was the most common treatment required followed by two surface restorations, pit and fissure sealants and pulp care. Conclusion: High prevalence of dental caries among special children is a highly alarming situation and needs immediate attention. Filled teeth are very less, which reflects the provision, and availing of dental care is almost negligible. Awareness should be created among parents and teachers by oral health educators about the importance of oral health and regular dental checkup.

Precautions in dentistry against swine flu

Swine flu or influenza A (H1N1) flu, which was officially declared as a pandemic is causing havoc all over the world, with the large number of people constantly getting infected and where the government is helpless about a situation, we have to protect ourselves. Apart, we as health care providers should feel responsible for reducing the transmission of influenza. During a pandemic, reducing transmission of influenza to health care workers may not only help support the health care workforce, but may also prevent influenza transmission to patients. This is possible by proper infection control measures during patient assessment as well as during treatment. Apart there are specific recommendations for Dental Health Care Personnel which are summarized here. Hence we as dental health care professionals should try to fight that all the dental health care professionals should try to fight the barriers like fear and use all the necessary precautions to prevent the H1NI infection. It is the duty of every health care professional to follow the preventive procedures so that there would be no infections that spreads through the dental operatory.

Congenital gingival cyst of neonate: Dentist's enigma

Gingival cysts of the newborn are small keratin-filled cysts on the alveolar mucosa of infants that exists at birth. They are remnants of the dental lamina and are usually multiple in numbers, but do not increase in size. The diagnosis is made at the clinical level. Since, this lesion tends to undergo involution or regresses spontaneously within a few weeks or months after birth so unnecessary therapeutic intervention is avoided. Complications are rarely observed. Pain on sucking, refusal to feed and airway obstruction can occur in rare instances. However parents remain anxious about the prevailing condition. Hence they should be reassured by providing suitable information about the simple nature of this lesion.

Periodontal status and treatment needs among state government employees in Shimla city, Himachal Pradesh (India): A cross-sectional study

Aim : The aim of this study was to assess the periodontal status and treatment needs among state government employees in Shimla city, Himachal Pradesh, India. Materials and Methods : The observational cross-sectional study was conducted on 1008 dentate subjects between 25th February 2009 and 10th April 2009. The community periodontal index (CPI) was used in accordance with WHO criteria. The examinations were carried out at the working place of the employees by a single examiner; the intra-observer Kappa index was 0.83. Results: As regards the percentage of subjects in each highest CPI code group, it was found that only 1.45% of the sample was healthy, while 3.42% presented bleeding, calculus was present in 59.8%, and 19.32% and 15.7% had pockets of 4-5 mm or of ≥ 6 mm, respectively. A higher percentage of females than males were healthy in all their sextants (2.91 vs. 2.36). Score 2 (calculus) was highest irrespective of age, gender and gazetted status. The presence of 4-5 mm pocket and calculus was significantly higher among non-gazetted than gazetted employees. The males presented a significantly higher need for oral hygiene instructions than the women (94.2% vs. 84.6%) and a greater need for scaling and root planning (82.9% vs. 69.1%). Complex treatments requirement increased with advancing age. Conclusion: Keeping in view the periodontal status and treatment needs, the government employees should be health educated and motivated to get periodontal treatment done at regular intervals.