Shashidhar Acharya

Relationship between obesity/overweight status, sugar consumption and dental caries among adolescents in South India.

OBJECTIVE To evaluate the relationship between obesity/overweight status, sugar consumption and dental caries among adolescents in Udupi District, India. METHODS Study population consisted of 463 school children aged between 13 and 15 years. Information on age, sex, type of school attending and frequency of sugar consumption per day was recorded by a structured self-administered questionnaire. Body mass index (BMI) (height in metres and weight in kilograms) and caries measurements (DMFT) were taken by a trained recorder according to standard criteria. RESULTS Majority of the children were having low normal weight, with 18.6% in overweight and 3.5% in obese groups. There was a significant difference in the frequency of sugar consumption between the BMI groups. Obese group of children had more caries than the overweight and low-normal-weight children. Correlation analysis showed significant positive relation with BMI, decayed teeth and DMFT. Regression analysis showed that caries experience had a significant association with male sex (OR = 2.09, CI = 1.01-4.33), overweight/obese (OR = 3.68, CI = 1.79-7.56) and frequency of sugar consumption more than once per day (OR = 3.13, CI = 1.25-7.85). CONCLUSION There was a significant association between overweight/obesity and caries experience among school children of Udupi District. Obesity and dental caries have common risk determinants and require a comprehensive multidisciplinary approach to paediatric patients by both medical and dental healthcare professionals.

Oral health status and treatment needs of children attending special schools in South India: a comparative study

The aim of this study was to assess and compare oral health status and treatment needs of children with special healthcare needs (SHCN) between the ages of 5 and 15, with a matched group of healthy children, in Udupi District of South India. A cross-sectional study of 265 children with SHCN was compared to 310 healthy children to assess differences in periodontal status, dentition status, treatment needs, and dentofacial anomalies using the WHO criteria. Chi-square, t-test, and Z-tests were performed to compare different variables. p ≤ 0.05 was considered statistically significant. A significantly higher prevalence of caries (89.1%), malocclusion, and poorer periodontal status was observed among children with SHCN compared to the healthy control group. Improving the oral health of these children will require maintaining good oral hygiene practices, which can be achieved with appropriate target-based oral health approaches.

Oral-health-related quality of life during pregnancy.

OBJECTIVES The objectives of this study were to assess the differences in oral health and perceived oral-health-related quality of life (OHRQoL) between pregnant and nonpregnant rural Indian women and to describe factors that could possibly influence OHRQoL. METHODS A number of 259 pregnant (mean age 26 +/- 5.5) and 237 nonpregnant (mean age 27.8 + 6.9) women who participated in the cross-sectional study were administered the Oral Health Impact Profile-14 questionnaire and underwent oral examination. RESULTS The results showed that the perceived OHRQoL was significantly poorer among the pregnant women than among nonpregnant women. The mean number of sextants with Community Periodontal Index for Treatment Needs scores of 2 and 3 and the gingival index scores were significantly (P < 0.001) higher among pregnant women than in the comparison groups. Factors such as pregnancy number (P < 0.05), decayed, missing, filled teeth scores (P < 0.001), and Gingival Index scores (P < 0.001) were significant predictors for OHRQoL. CONCLUSION Oral health and perceived OHRQoL were poorer among pregnant women than among nonpregnant women.

Risk factors for preterm birth and low birth weight among pregnant Indian women: A hospital-based prospective study

Objectives: The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes. Methods: A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI). Results: Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent’s intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW. Conclusions: Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.

Efficacy of triphala mouth rinse (aqueous extracts) on dental plaque and gingivitis in children

AIM The aim of the present study was to evaluate the efficacy of triphala mouth rinse (aqueous) in the reduction of plaque and gingivitis among children. METHODS The study was a randomized, double-blinded, controlled trial, with a total of 60 school children (n = 30 in each group; triphala and chlorhexidine groups). Plaque and gingival indices were used to evaluate baseline and follow-up plaque and gingivitis. RESULTS A total of 57 children completed the study. Both chlorhexidine and triphala groups showed significantly lower mean gingival and plaque index scores at follow up than baseline (P < 0.001). There was no significant difference in the percentage change in the mean gingival index between the two groups (P = 0.826). The percentage change in the mean plaque index was significantly higher in the chlorhexidine group compared to the triphala group (P = 0.048). CONCLUSION The effectiveness of triphala in the reduction of plaque and gingivitis was comparable to chlorhexidine, and can be used for short-term purposes without potential side-effects. It is a cost-effective alternative in reducing plaque and gingivitis.

Microbial Contamination of the White Coats of Dental Staff in the Clinical Setting

Background and aims Although wearing a white coat is an accepted part of medical and dental practice, it is a potential source of cross-infection. The objective of this study was to determine the level and type of microbial contamination present on the white coats of dental interns, graduate students and faculty in a dental clinic. Materials and methods Questionnaire and cross-sectional survey of the bacterial contamination of white coats in two predetermined areas (chest and pocket) on the white coats were done in a rural dental care center. Paired sample t-test and chi-square test were used for Statistical analysis. Results 60.8% of the participants reported washing their white coats once a week. Grading by the examiner revealed 15.7% dirty white coats. Also, 82.5% of the interns showed bacterial contamination of their white coats compared to 74.7% graduate students and 75% faculty members irrespective of the area examined. However, chest area was consistently a more bacterio-logically contaminated site as compared to the pocket area. Antibiotic sensitivity testing revealed resistant varieties of micro-organisms against Amoxicillin (60%), Erythromycin (42.5%) and Cotrimoxazole (35.2%). Conclusion The white coats seem to be a potential source of cross-infection in the dental setting. The bacterial contamina-tion carried by white coats, as demonstrated in this study, supports the ban on white coats from non-clinical areas.

Oral health impact, dental caries, and oral health behaviors among the National Cadets Corps in South India

AIM The aim of the present study was to assess the oral health impact and to evaluate the association between socioeconomic status, oral health behaviors, dental caries experience, and oral health impacts among children enrolled in the National Cadets Corps. METHODS A cross-sectional survey was conducted among 389 male cadets aged between 13 and 15 years. Sociodemographic and oral health behavior-related information was collected using a self-administered questionnaire. The Child-Oral Impacts on Daily Performances (OIDP) Index was used to assess the oral impacts. The cadets were clinically examined for caries experience using decayed, missing, filled tooth index. RESULTS A total of 359 children completed all stages of the survey. The mean age of the children was 13.96 ± 0.6 years. Fifty-five percent of the participants experienced at least one impact in the last 3 months. The mean OIDP score for the population was 12.13 ± 5.85. The most prevalent impact was difficulty in eating (37%), and the least affected daily performance was social contact (17%). Dental attendance and caries experience were significant predictors of oral impacts. CONCLUSIONS The present study revealed that oral health had a significant impact on quality of life. Caries experience and past dental visits were associated with oral health-related quality of life among this study population.

Effect of Aloe vera, chlorine dioxide, and chlorhexidine mouth rinses on plaque and gingivitis: A randomized controlled trial

OBJECTIVE To evaluate the effect of Aloe vera, chlorine dioxide, and chlorhexidine mouth rinses on plaque and gingivitis in orthodontic treatment. MATERIALS AND METHODS A randomized single-center, single-blind, parallel group, controlled trial was conducted among 90 subjects undergoing fixed orthodontic treatment. The subjects were randomly divided into one of the three study groups (Aloe vera, chlorhexidine, chlorine dioxide). Plaque and gingivitis were assessed using modified Silness and Loe Plaque Index and Gingival Index at baseline and at follow-up after 15 days. Paired t-test and ANOVA with post hoc Dunnett test were used. A p-value of <0.05 was considered statistically significant. RESULTS A total of 85 participants completed the study; among them, 40 were male and 45 were female. There was significant reduction in mean plaque and gingival scores in all the 3 groups at follow-up when compared to baseline. A significantly higher reduction (plaque and gingival scores) was found in chlorhexidine when compared with the Aloe vera group. However, no significant difference was seen between chlorhexidine and chlorine dioxide with respect to mean reduction in plaque and gingival scores. CONCLUSION Chlorine dioxide can be a suitable and economical alternative for chlorhexidine. Further long-term studies are recommended for evaluating their effectiveness.

Oral health status of 5-year-old Aborigine children compared with similar aged marginalised group in south western India.

OBJECTIVE   To compare and assess oral health status of 5-year-old Aborigine children with similar aged, marginalised children in coastal region of south western India. MATERIALS AND METHODS   A total of 418 Aborigine children were invited to participate in the study and a total of 428, 5-year-olds were selected randomly for comparison from other government schools to form the other marginalised group. The WHO (1997) proforma was used for clinical examinations. Chi Square test was used to compare between categorical variables. Mann-Whitney U-test was used for comparison between the two groups for quantitative variables. Logistic and linear regression analysis was performed to determine the importance of the factors associated with caries status. Odds ratio was calculated for all variables with 95% confidence intervals. P≤0.05 was considered as statistically significant. RESULTS   Dental fluorosis was present in 50 (11.9%) Aborigine children, whereas in the other marginalised group 7 (1.6%) children had dental fluorosis (P≤0.001). Untreated dental caries was 76.3% for the Aborigine children and 70.3% in the comparison group. Mean dmft values in the two groups were 4.13±3.90 and 3.58±3.60, respectively (P>0.01). High frequency of between-meal sugar consumption was related to dental caries (OR =1.20; P=0.001). Utilisation of dental care and dental fluorosis were inversely related to dental caries (OR=1.16; P=0.001 and OR=1.91; P=0.001). CONCLUSION   The study revealed poor oral health status among both the marginalised groups. Significant differences were noted between the two groups with respect to oral hygiene practices, dietary habits, and dental utilisation pattern. Schools for tribal children, male gender, low frequency of cleaning teeth and higher in between-meal sugar consumption were significantly related to dental caries.

Microbiological analysis after complete or partial removal of carious dentin using two different techniques in primary teeth: A randomized clinical trial.

Background: The management of deep carious lesions can be done by various techniques but residual caries dilemma still persists and bacterial reduction in cavities treated by either partial or complete caries removal techniques is debatable. So the objective of the present randomized clinical trial was to compare microbial counts in cavities submitted to complete caries removal and partial caries removal using either hand instruments or burs before and after 3 weeks of restoration. Materials and Methods: Primary molars with acute carious lesions in inner half of dentine and vital pulp were randomly divided into three groups of 14 each: Group A: Partial caries removal using hand instruments atraumatic restorative treatment (ART) only; Group B: Partial caries removal using bur; Group C: Complete caries removal using bur and caries detector dye. Dentine sample obtained after caries removal and 3 weeks after restoration, were subjected to microbial culture and counting (colony-forming units [CFU]/mg of dentine) for total viable bacterial count, Streptococcus spp., mutans streptococci, Lactobacillus spp. Results: Three techniques of caries removal showed significant (P < 0.05) reduction in all microorganisms studied after 3 weeks of evaluation, but there was no statistically significant difference in percentage reduction of microbial count among three groups. Conclusion: Results suggest the use of partial caries removal in a single session as compared to complete caries removal as a part of treatment of deep lesions in deciduous teeth in order to reduce the risk of pulp exposure. Partial caries removal using ART can be preferred for community settings as public health procedure for caries management.