Satyawan G Damle

An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities

To evaluate how an intervention, which combined hand washing promotion aimed at 5‐year‐olds with provision of free soap, affected illnesses among the children and their families and childrens school absenteeism.

A study of sports related occurrence of traumatic orodental injuries and associated risk factors in high school students in north India.

Background: Oral and dental injuries contribute to a major part of sports related injuries in children. Trauma occurring in developing years disrupts normal social functioning and brings about a major impact on quality of life due to their cumulative effect. Objectives: To assess the prevalence and causes of various sports related traumatic orodental injuries among 8 to 16 year school students along with identifying the associated risk factors in North India. Patients and Methods: A cross sectional study consisting of high school students of different organized sports teams aged 8-16 years was carried out in geographical area of north India. The students were selected by multistage cluster sampling methodology. 1105 students from 19 school teams (sports teams) and sports academies participated in study through structured interview and clinical examination in different sports situations. Results: 30.3% (n = 335) of students suffered from orodental injuries. A higher number of girls had injury (32%) than boys (29%), though the difference was not significant. Most of the students suffered from soft tissue injuries (48%) followed by tooth fractures (43%). Maximum numbers of injuries were reported in high velocity (44.1%) and medium intensity sports (46.6%) (P < 0.001) Maximum injuries occurred in basketball (50%) and lowest in the field of badminton (6.1%) (P < 0.05). Amateurs (52%) suffered the most from injuries as per level of coaching. Only 6% of boys and 2% of girls used mouthguards. Conclusions: The result of the present study confirmed that students participating in different organized sports at high school level are at a very high risk of getting orodental injury. Hence knowledge and education regarding prevention of traumatic injuries is of paramount importance.

Esthetic management of developmental enamel opacities in young permanent maxillary incisors with two microabrasion techniques--a split mouth study.

PURPOSE This study evaluated the effectiveness of two microabrasion materials for the removal of developmental enamel opacities in young permanent maxillary incisors. MATERIALS AND METHODS Using a split-mouth study design, 37% phosphoric acid and 18% hydrochloric acid were used for removal of visually unesthetic developmental enamel opacities of young permanent maxillary anterior teeth from 25 subjects (11-13 years old) by two microabrasion techniques for 10 and 5 seconds respectively. This procedure was repeated four to six times during each clinical appointment. The subjects were evaluated about their satisfaction with the treatment. Two blinded evaluators appraised both sides of the mouth using visual analog scale. The records were analyzed using Wilcoxon test. RESULTS The majority of the subjects (approximately 97%) reported satisfaction at the end of the treatment (p = 0.001**). Statistical significant reduction in enamel opacities was observed by evaluators immediately after microabrasion technique in group 1 (81.75%) and in group 2 (81.4%) (p < 0.002). Reduction was increased to 97.2% in group 1 and 96.7% in group 2 after 1 month. CONCLUSIONS Both microabrasion techniques showed comparative highly significant successful results in esthetic management of enamel opacities clinically and in terms of subjects satisfaction. CLINICAL SIGNIFICANCE Developmental enamel defects like diffuse opacities due to high-fluoride content in water and demarcated opacities associated with positive dental history and are commonly seen in young permanent maxillary incisors of both boys and girls in their developing years. They are aware of unesthetic appearance of these newly erupted permanent anterior teeth and become highly motivated when informed about minimally invasive, patient friendly, cost-effective, and safe treatment like microabrasion for esthetic improvement. Both noninvasive microabrasion techniques using 37% phosphoric acid (group 1) and 18% hydrochloric acid (group 2) show comparatively high success results in treating enamel defects successfully to the subjects satisfaction along with their parents.

Quantitative Determination of Inorganic Constituents in Saliva and their Relationship with Dental Caries Experience in Children

Background: Saliva is one of the most important factor in regulating oral health, with flow rate and composition changing throughout development and during disease. Saliva can affect incidence of dental caries in four general ways, firstly as a mechanical cleansing, secondly by reducing enamel solubility by means of calcium, phosphate and fluoride, thirdly by buffering and neutralizing the acids produced by cariogenic organisms and finally by anti-bacterial activity. Thus, the present study aimed to assess the levels of salivary immunoglobulin A (IgA), immunoglobulin G (IgG), proteins, calcium, inorganic phosphorous and alkaline phosphatase levels in caries free and caries active children. Material and methods: Forty school children in the age group of 12-15 years with full complement of permanent dentition except third molars were included by stratified random sampling method. They were divided into two groups of 20 each based on DMFS score, Group I – Caries free (DMFS score=0) and Group II – Caries active (DMFS score ≥ 10). Unstimulated midmorning saliva samples were collected and analyzed colorimetrically and by radial immunodiffusion method for constituents of saliva under study. Results: The mean salivary IgA levels in children in Group-I (caries free children) was 10.63±2.85 mg/dl which was statistically higher as compared to caries active children in Group-II (8.50 ± 1.43 mg/dl). The mean salivary protein level in children of Group-II was statistically higher at 3.28 ± 0.12 mg/dl as compared to Group-I (2.89 ± 0.11 mg/dl). Conclusion: An inverse relationship was noticed between the salivary IgA levels and dental caries experience and higher salivary protein levels were associated with high caries experience whereas no significant difference was observed in levels of calcium, inorganic phosphorous, alkaline phosphatase and IgG in saliva samples of children with and without dental caries.

Effectiveness of supervised toothbrushing and oral health education in improving oral hygiene status and practices of urban and rural school children: A comparative study.

Objective: To evaluate and compare the oral health status and the impact of supervised toothbrushing and oral health education among school children of urban and rural areas of Maharashtra, India. Materials and Methods: A total of 200 school children in the age group 12-15 years were selected by stratified random sampling technique from two schools and were further divided into two groups: Group A (urban school) and Group B (rural school). Both the groups were again subdivided into control group and study group. Supervised toothbrushing was recommended for both the groups. The toothbrushing teaching program included session on oral health education, individual toothbrushing instructions, and supervised toothbrushing. Dental caries increment, plaque scores, and gingival status were assessed as per the World Health Organization (WHO) criteria (1997), Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index, and Loe-Silness Gingival Index (1963), respectively. Cronbachs alpha, Chi-square test, paired t-test, and unpaired t-test were utilized for data analysis. Results: The mean plaque and gingival score reduction was significantly higher in the study groups as compared to the control groups. An increase in the mean of Decayed, missing, filled teeth (DMFT) and Decayed, missing, filled teeth and surfaces (DMFS) scores throughout the study period was seen in children who participated in study. Conclusion: Oral health education was effective in establishing good oral health habits among school children and also in enhancing the knowledge of their parents about good oral health.

Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly

Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible.Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region.

Comparative efficacy of dentifrice containing sodium monofluorophosphate + calcium glycerophosphate and non-fluoridated dentifrice: A randomized, double-blind, prospective study.

Background: The efficacy of fluoridated dentifrices in caries prevention has been well documented and research into various formulations continues for a more effective dentifrice. This study evaluated the anti-caries and anti-plaque efficacy of a dentifrice containing sodium monofluorophosphate (1000 ppm) and calcium glycerophosphate, and compared it with a non-fluoridated dentifrice. Materials and Methods: A total of 595 school children (12–15 years) were divided into test (302 children) and control (293 children) groups. The test group used the dentifrice containing sodium monofluorophosphate (1000 ppm) and calcium glycerophosphate, whereas the control group was given a placebo dentifrice. Oral examination for dental caries and plaque assessment was carried out at the start of the study and the children were followed up semiannually up to 18 months. Data were analyzed using repeated-measure analysis of variance (ANOVA) followed by one-way ANOVA. Results: The values for decayed missing filled teeth (DMFT) increased from baseline to 18 month examination from 4.43±2.03 and 4.67±2.25 (P=0.175) to 5.84±2.29 and 5.13±2.30 (P=0.001) for control and test groups, respectively. Similarly, the increase in decayed missing filled surface (DMFS) values were from 6.42±4.10 and 7.06±4.77 (P=0.082) to 8.64±4.51 and 7.92±5.07 (P=0.095) for test and control groups, respectively. The mean DMFT and DMFS values increased for both the groups; however, the increase was less in test group as compared to control group. The baseline plaque score reduced from 2.94±0.72 and 2.91±0.72 (P=0.679), respectively, for control and test groups to 1.33±0.46 and 0.91±0.38 (P<0.001), respectively, at 18 month examination. Conclusion: Results revealed that the test dentifrice was effective in inhibiting the progression of plaque and control of dental caries as compared to the placebo dentifrice.

Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study

Background: To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH)2) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. Materials and Methods: The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH)2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH)2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). Results: In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH)2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH)2 group. Conclusion: MTA and Ca(OH)2, as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.

The effect of consumption of carbonated beverages on the oral health of children: a study in real life situation

Objective: To assess the oral health of children consuming carbonated beverages and also to ascertain the reasons for excess consumpti on of these beverages....

Effect of dentifrices on their remineralizing potential in artificial carious lesions: An in situ study.

Background: The eventual sequel of dental caries is determined by the dynamic equilibrium between pathological factors which lead to demineralization and protective elements, which in turn leads to remineralization. Remineralization is the natural process for noncavitated demineralized lesions and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. Hence, the present study was designed to evaluate the efficacy of fluoride dentifrices in remineralizing artificial caries-like lesions in situ. Materials and Methods: A double-blind, randomized study with an initial washout period of 7 days was carried out for 3 weeks. Twenty volunteers were enrolled, who wore the intraoral cariogenicity test appliance having enamel slabs incorporated into them, for 3 weeks. 10 participants were instructed to use Group A dentifrice (fluoride) and the other 10 Group B dentifrice (nonfluoride) for brushing their teeth. The enamel slabs were analyzed by surface microhardness testing and scanning electron microscopy (SEM) at 3 intervals. Results: No significant differences was seen in the microhardness values recorded for Group A and Group B at baseline and after demineralization (P > 0.05); however Group B exhibited lesser microhardness compared to Group A, after intra-oral exposure (P < 0.05). In the SEM analysis, the Group A enamel surfaces had more regular and longer crystallites to those of the Group B. Conclusion: Fluoride dentifrices avert the decrease in enamel hardness and loss of minerals from the enamel surface to a large extent as compared to the nonfluoride dentifrices.