Ramandeep Singh Gambhir

Utilization of dental care: An Indian outlook

Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities.

Water Pollution: Impact of Pollutants and New Promising Techniques in Purification Process

Abstract Water is a critical resource in the lives of people who both benefit from its use and who are harmed by its misuse and unpredictability (flooding, droughts, salinity, acidity, and degraded quality). Water is a finite and vulnerable resource. Consequently, consumption of polluted water puts lives and livelihoods at risk because water has no substitute. There are many ways in which water intended for human consumption can get polluted. These include wastes from industries like mining and construction, food processing, radioactive wastes from power generating industries, domestic and agricultural wastes and by various microbiological agents. Nowadays, water is being purified by various methods but research is being conducted to look for more reliable and cheaper methods that can purify water at an affordable cost. Various techniques have been developed like utilizing rechargeable polymer beads, seeds of Moringa Oleifera tree, aerobic granular sludge technology, resin based treatment and two-pronged water treatment technology.

Correlation of oral hygiene practices, smoking and oral health conditions with self perceived halitosis amongst undergraduate dental students

Objective: The present study was undertaken to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodour. Materials and Methods: A self-administered questionnaire was distributed among 277 male and female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating. Results: The results indicate female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.007) was found in female dental students (40%) as compared to their male counterparts (58%). It was found that smoking and dryness of mouth had statistically significant correlation with halitosis (P = 0.026, P = 0.001). Presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students. Conclusion: A direct correlation exists between oral hygiene practices and oral health conditions with halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students.

Vaccine against Dental Caries- An Urgent Need

Dental caries, the disease that causes tooth decay, is infectious, and the mutans streptococci bacteria have long been identified as the primary disease-causing agents. Most treatments are now aimed at either elimination of this bacterium or suppression of its virulence. Thanks to numerous scientific advances, tooth decay is not as rampant as it once was, but it is still five times more common in children than asthma and seven times more common than hay fever. And about 25% of the population (in the United States) carries about 80% of the disease burden. So it is still a serious problem, especially for those populations who are very young, very old, economically disadvantaged, chronically ill, or institutionalized. Contemporary research is aimed at evolving a potent and effective caries vaccine to prevent dental caries. Various experimental trials have been conducted utilizing rat and primate models with protein antigens derived from S. mutans or S. sobrinus to prevent oral colonization by S. mutans and subsequent dental caries. Numerous strategies have been developed to induce high levels of salivary antibodies that can persist for prolonged periods and to establish immune memory by through different routes of administration. Therefore elimination of caries is the main objective of the health professionals. Still more clinical trials are needed to evaluate the safety of these vaccines so that potential risks are eliminated.

Dental health status and treatment needs of transport workers of a northern Indian city: A cross-sectional study

Aim: To assess the dental health status and treatment needs of transport workers working in Chandigarh Transport Undertaking (C.T.U.) buses, Chandigarh. Materials and Methods: A cross-sectional study was conducted on all the available C.T.U. workers at all three bus depots. The data were recorded on a modified W.H.O. format (1997). A total of 1008 subjects constituted the final sample size. Results: The mean age of the subjects was 45.3 ± 7.8 years, and 97% (978) were males. Prevalence of dental caries was 63.4% and mean DMFT was 5.02. 47.6% of subjects needed some prosthesis in the maxillary arch while 53.3% needed some prosthesis in the mandibular arch. Regarding highest CPI (Community Periodontal Index) score, 8.13% of the subjects had healthy periodontium while maximum subjects (73.2%) had a score 2 (Calculus). Conclusion: Mean DMFT (Decayed, Missing and Filled Teeth) was satisfactory. Prosthetic need of the subjects was high with only a few subjects possessing prosthesis. Advanced periodontal disease (CPI score, 4) affected small number of subjects with maximum subjects (73%) having a CPI score of 2.

Primary care in dentistry - an untapped potential.

Dentistry is neither an allied health profession nor a paramedical profession. It is the only anatomically focused health care profession that is university-based and for which primary care responsibility is maintained by the profession. Dentists must have a reliable knowledge of basic clinical medicine for safely and effectively treating individuals with chronic and other diseases, which make them biologically and pharmacologically compromised. With changes in the life expectancy of people and lifestyles, as well as rapid advancement in biomedical sciences, dentists should have similar knowledge like a physician in any other fields of medicine. There are number of primary care activities that can be conducted in the dental office like screening of diabetics, managing hypertension etc., The present review was conducted after doing extensive literature search of peer-reviewed journals. The review throws a spotlight on these activities and also suggests some the measures that can be adopted to modify dental education to turn dentists to oral physicians.

Impact of school based oral health education programmes in India: a systematic review.

The teaching of Oral Health Education aims at preventing the dental disease and promoting dental health at early stages. Schools are powerful places to shape the health, education and well-being of our children. The objective of this study was to determine the impact of school dental health education programmes conducted in various parts of India. A systematic review from available literature was carried out. The study examined papers relating to oral health interventions which were published between 1992 and 2012. Ten articles were selected and included in the review. All the studies were found to contain the required information on the outcomes of school dental health programmes in India. Different methods were used to deliver oral health education. All the studies reported significant improvement in oral hygiene of school children after imparting dental health education. In some studies, school teachers were also trained to impart oral health education. Decreased level of awareness was found in children coming from low income families. Longer duration studies are needed to improve the results. School dental education programmes should be more focused on north-eastern Indian population.

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 Fishers 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.

Dentin hypersensitivity following tooth preparation: A clinical study in the spectrum of gender

Objective: The objective of this study was to estimate and compare the incidence of dentin hypersensitivity among men and women in an adult population who required replacement of missing tooth/teeth with a fixed partial prosthesis (FPD). Materials and Methods: The study population included 124 subjects (62 men and 62 women), who visited the out-patient department in need of FPD for replacement of missing teeth. After conducting routine examinations, each abutment tooth received two stimuli: Tactile and thermal to assess the sensitivity. The measurement of sensitivity was carried out by using a 10 cm visual analog scale before preparation and after preparation. The results were analyzed statistically using the Mann-Whitney U test. Results: The results showed that women reported more dentin hypersensitivity than men before and after tooth preparation. Conclusion: The results of the present study demonstrated that women reported more dentin hypersensitivity than men before and after tooth preparation. More studies are needed to explore this nature on gender basis.

Knowledge and awareness of the Consumer Protection Act among dental professionals in India: A systematic review.

Background: The medical profession has been included in the Consumer Protection Act (CPA), to protect the interests of the patients in case of any unethical treatment rendered by the doctor. The present systematic review was conducted to assess the knowledge and awareness of CPA among dental professionals in India. Materials and Methods: A systematic review of relevant cross-sectional observational studies was conducted regarding the level of knowledge and awareness of CPA among dental professionals in India. Five studies out of 44 were finally included in the present review, after conducting both an electronic and manual search of scientific databases. The potential biases were reported and appropriate data was extracted by the concerned investigators. Results: More than 90% of the study subjects in one of the studies were aware of the CPA, as compared to other studies. In two studies, when queried about the correct time period during which a patient can sue a doctor, very few subjects (18 and 23.2%) answered correctly. Almost 90% of the subjects were taking some form of consent in one of the studies. Private practitioners had more awareness as compared to academicians and combined practitioners. Conclusion: The results of the present review showed that a majority of the subjects were aware of the existence of CPA, but knowledge about the basic rules and regulations was lacking in a few studies. Therefore, dental professionals need to keep themselves updated on the various rules and latest amendments to save themselves from any litigation.