Shailee Fotedar

Oral health-related quality of life in Indian patients with temporomandibular disorders

Objective: The objective was to determine the impact of temporomandibular disorders (TMDs) to the self-perceived oral health-related quality of life (OHRQoL) and to compare the OHRQoL with a control group. Materials and Methods: Eighty three patients who were diagnosed [according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I] and seeking treatment in the Department of Oral Medicine and Radiology were evaluated for the impact on the OHRQoL by the Oral Health Impact Profile-14 (OHIP-14). SPSS 17 (SPSS Inc., Chicago, IL) was used to analyze the data. Statistical tests used were the t-test, Chi-square test, and analysis of variance (ANOVA). Results: The mean age of the sample was 34.8 years with the male: female ratio as 1:5.9. The mean OHIP summary score of the TMD population was 23.3 ± 19.2, compared to 3.32 ± 4.41 for the general population. The mean OHIP score was not statistically different for males (20.6 ± 13.9) and females (25.0 ± 19.2) P = 0.189. The highest mean OHIP score (4.71 ± 3.91) was calculated for osteoarthrosis of the temporomandibular joint (TMJ), followed by disc displacement without reduction with limited opening (4.21 ± 3.86). Conclusion: The patients with TMD had lower OHRQoL as compared to the general population. The patients of muscular disorders and osteoarthrosis were found to have a greater impact on the quality of life (QoL) as compared to the disc displacement group.

Oral health‑related quality of life‑ A changing revolution in dental practice

Quality of life (QoL) creates positive associations for most of the people. Perception of QoL varies between individuals and is dynamic amongst them. People who have different expectations report that they have a different QoL even when they have the same clinical condition. People are now demanding a better QoL. It is conceded that a rise in the standard of living of people is not enough to achieve satisfaction and happiness. Clinical indication of a problematic tooth may be many, but the presence of a toothache or pain, described by the individual as a symptom or functional barrier, affects well-being and is not measured by any traditional epidemiological indicator. Thus, a major shortcoming in traditional oral epidemiological indicators is the inability to reflect the capacity of the individuals to perform desired roles and activities. When oral health related quality of life (OHRQoL) measures are used alongside traditional clinical methods of measuring oral health status, a more comprehensive assessment of the impact of oral diseases on the several dimensions of subjective well-being becomes possible.

Assessment of relationship between body mass index and periodontal status among state government employees in Shimla, Himachal Pradesh

Background: The literature shows that an increased body mass index (BMI) may be a potential risk factor for periodontitis. Association between BMI and periodontitis has been ascribed to unhealthy dietary patterns with insufficient micronutrients and excess sugar and fat content. Aim: The present study intended to assess the relation between BMI and periodontal status among state government employees in Shimla city, Himachal Pradesh in India. Materials and Methods: The study sample comprised 1,008 subjects aged 18-58 years, drawn by a proportional sample from 10,908 employees. BMI was calculated by the Quetelet index as the ratio of the subjects body weight (in kg) to the square of the height (in meters). Periodontal status was recorded using the Community Periodontal Index (CPI). Binary multiple logistic regression analysis was done to assess the relation between BMI and periodontal status. The dependent variable for logistic regression analysis was categorized into control group (scores 0-2 of the CPI) and periodontitis group (scores 3 and 4 of the CPI). Results: The overall prevalence of periodontal disease was 98.9%. Score 2 (bleeding and calculus) was the highest score prevailing among the subjects. They had an increased risk of periodontitis by 56% for each 1 kg/m2 increase in BMI, which means that a higher BMI could be a potential risk factor for periodontitis among the adults aged 18 to 58 years. Conclusion: BMI evaluation could be used in the assessment of periodontal risk.

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.

Green Tobacco Sickness: A Brief Review

Green tobacco sickness (GTS) is the condition that mainly affects the tobacco harvesters. The condition is prevalent in Asian and South American tobacco harvesters. The present review was conducted to discuss the etiology, epidemiology, symptoms, and prevention of GTS. It is caused by the absorption of nicotine through the skin while the workers are engaged in handling the uncured tobacco leaves. The symptoms include nausea, vomiting, pallor, dizziness, headaches, increased perspiration, chills, abdominal pain, diarrhea, increased salivation, prostration, weakness, breathlessness, and occasional lowering of blood pressure. The prevalence of GTS varies from 8.2 to 47% globally. The use of personal protective equipment like water-resistant clothing, chemical-resistant gloves, plastic aprons, and rain-suits with boots should be used by the tobacco farmers to prevent its occurrence. An international-level awareness campaign has to be taken up and more stringent workers safety regulations have to be formulated.

What should dentists know and advise about electronic cigarettes to their patients

Electronic cigarettes (e-cigarettes) are battery-powered devices that convert nicotine into a vapor which can be inhaled. The vapors from e-cigarettes are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in e-cigarette vapors is safe. Worldwide use of electronic cigarettes has increased significantly over recent years but varies markedly between countries. The legal status of e-cigarettes is pending in most of the countries which are the need of the hour. The efficacy and effectiveness of e-cigarettes in smoking cessation or reducing the tobacco use are not established. The following review discusses the current data regarding e-cigarette, prevalence of e-cigarette, legislation of e-cigarettes, issues concerned with the use of the e-cigarette, and finally, the dentists being the health caregivers should be prepared to answer the patients′ questions about the advisability of using e-cigarettes as a smoking cessation device.

Dental anxiety levels and factors associated with it among patients attending a dental teaching institute in Himachal Pradesh

Background: Dental anxiety is often reported as a cause of irregular attendance, delay in seeking dental care, or even avoidance of seeking dental care, resulting in a poor oral health-related quality of life. Aim: To assess the dental anxiety levels and factors associated with it among patients attending a dental teaching institute in Himachal Pradesh. Methods: A cross-sectional questionnaire study was conducted on a sample of 246 subjects. The dental anxiety was measured by Modified Dental Anxiety Scale. (MDAS). The questionnaire consisted of questions on various demographic factors, experience about dental treatments, and various questions as mentioned MDAS. Data were analyzed by SPSS package 16. Tests used were t-test and analysis of variance. A P < 0.05 was considered statistically significant. Results: The prevalence of dental anxiety was 29.2%. The mean dental anxiety score was 9.22. ± 4.5. Females, those residing in villages, those who had past negative dental history, and students were significantly associated with dental anxiety. On multiple logistic regression analysis, only gender and residence were the strong predictors of association. There was a strong association between dental anxiety and postponement of treatment. Conclusion: The anxiety levels are low among the present population as compared to other states of India. However, we should try to prevent the dental anxiety among patients as dental anxiety leads to postponement of treatment, which ultimately affects the oral health-related quality of life.

Oral health status and treatment needs among health-care workers in Shimla district, Himachal Pradesh India

Objectives: To assess oral health status and treatment needs of the health workers in Shimla district, Himachal Pradesh. Materials and Methods: A cross-sectional study was conducted among health workers in Shimla district, Himachal Pradesh. A sample of 130 was selected by selecting three blocks randomly to get a required sample size of 126. Clinical recordings were done according to the World Health Organization diagnostic criteria 1997. The data were analyzed using SPSS package, Chicago, IL, version 16.0. The statistical tests used were t-test and ANOVA. A P < 0.05 was considered to be statistically significant. Results: The mean age of the study population was 48.42 ± 5.94 with a range of 25-57. The prevalence of dental caries in the present study was 80%. The mean decayed, missing, and filled teeth were 6 ± 5.42 and were higher in females and the age group of 55-64 years. Only 17 (13.1%) had healthy periodontium and calculus was found in 49 (47.7%) subjects. The need for prosthesis in upper jaw and lower jaw was for 33 (25.3%) and 61 (46.9%), respectively. Conclusion: The caries experience of the population was quite high. Hence, there is a need for treatment camps, and regular follow-up checkups for the health workers in Shimla district.

Awareness of pictorial warning on cigarette packets and its impact on smoking cessation among smokers in Shimla, Himachal Pradesh: A cross-sectional study

Background: Pictorial warnings are effective in promoting smoking cessation as shown by researches in the developed countries. The Government of India has also introduced pictorial warnings as one of the strategies among different tobacco control strategies. Objective: The objective of this study was to find the awareness of pictorial warnings present on cigarette packets and its impact on smoking cessation among cigarette smokers in Shimla, Himachal Pradesh. Materials and Methods: The study was conducted among 200 patients attending the outpatient department in the Department of Oral Medicine and Diagnosis from May 1, 2010 to August 31, 2010. Structured questionnaire consisted of demographic details, health-related issues of smoking, awareness about pictorial warning, and impact to quit smoking. Results: Among the study patients, maximum number of patients who were using any form of tobacco products were 35-44-year-old, and higher consumption was seen among the people from lower socioeconomic status. Younger age group, i.e., ≤25 years, those with higher socioeconomic status, urban residence, and literate were more aware about pictorial warning on cigarette packs and majority of them were about to quit smoking. Conclusion: Pictorial warning is an effective method to improve the awareness among smokers on the deleterious effects of smoking. The present study has shown significant results as the youngsters are less involved in the habit of smoking, aware about pictorial warning on the cigarette pack depicts, and motivated to quit smoking after knowing the harmful effects which the warning on packs reveals.

Association between oral health status and oral health-related quality of life among the prison inmate population of kanda model jail, Shimla, Himachal Pradesh, India

The prison population is a challenging one with many health problems including oral health. In a country such as India, the information regarding the oral health status in prisoners is scant. So, a cross-sectional study was carried out among a 311 prison inmate population of Kanda model jail, Shimla, Himachal Pradesh, India, to assess the dental caries levels, periodontal health status, and oral health-related quality of life (OHRQoL). Dental caries was present among 71.8% of the population and the mean decayed missing and filled teeth index (DMFT) of the population was 5.1 ± 2.1. Calculus was seen among 54.9% of the population. The mean severity score, summed for the 14 items in the scale was 14.57. Dental caries, periodontal disease, the number of missing teeth were significantly associated with OHRQoL. The population had a higher level of oral diseases and one half of the population reported that their oral condition had negatively impacted them in some way, thereby affecting their quality of life.