T Rooban

The prevalence of oral mucosal lesions in alcohol misusers in Chennai, south India

AIMS AND OBJECTIVES This study was conducted to assess the prevalence of various oral mucosal lesions (OML) among alcohol misusers attending a rehabilitation center in Chennai, south India. MATERIALS AND METHODS Qualified dental surgeons examined 500 consecutive alcohol misusers at Ragas Dental College and Hospital and TTK Hospital, India. Thorough history and oral findings were recorded in a pre-determined format. Data entry and statistical analysis were done using SPSS 10.0.5beta. The variables for this study were OML, Oral Hygiene Index (OHI), age, smoking, and alcohol misuse (type and units consumed and duration of misuse). RESULTS Of the 500 patients, 77% were in the 25-44 years old age group and 84% were married. The mean age of initiation of alcohol misuse was 34 years. In addition to alcohol, 72% smoked tobacco and 96% used other psychoactive substances. The mean alcohol use duration was 12.6 years. A total of 25% of the study group had at least one OML. The common oral lesions were smokers melanosis (10.2%), oral submucous fibrosis (8%), and leukoplakia (7.4%). Those who misused spirits had a higher incidence of OML than those who misused beer or both. Patients with fair oral hygiene had an odds ratio (OR) of 2.96 for OML compared with an OR of 2.08 for those who had OML with good oral hygiene. CONCLUSION This study indicates that subjects who misuse alcohol have poor oral hygiene and are at risk for the development of periodontal disease and OML. This survey indicates that oral examination and treatment should be a part of the standard care for alcohol misusers at rehabilitation centers.

A light microscopic study of fibrosis involving muscle in oral submucous fibrosis

Oral submucous fibrosis (OSF) is a common pre-malignant condition of the mouth in arecanut chewers in Indian subcontinent. It is characterized by restriction in opening of the mouth, tongue protrusion, and cheek flexibility. Reports of muscle changes in OSF, using light microscopy are few. Incisional biopsy sections of thirty OSF patients were stained with Massons Trichrome stain, to study the fibrosis involving the muscle. Wide spectrum of changes were observed where fibrosis was being evident sub-epithelially, not extending in to the muscle to cases where only a few remnants of muscle fibers were seen and the missing muscle bundle area being replaced by fibrous tissue. The probable mechanism by which these changes occur is discussed.

Tooth decay in alcohol and tobacco abusers.

Background: Alcohol and tobacco abuse are detrimental to general and oral health. Though the effects of these harmful habits on oral mucosa had been demonstrated, their independent and combined effect on the dental caries experience is unknown and worthy of investigation. Materials and Methods: We compared 268 alcohol-only abusers with 2426 alcohol and tobacco abusers in chewing and smoking forms to test the hypothesis that various components of their dental caries experience are significantly different due to plausible sociobiological explanations. Clinical examination, Decay, Missing, Filled Teeth (DMFT) Index and Oral Hygiene Index - Simplified were measured in a predetermined format. Descriptive statistics, Chi-square test and one-way ANOVA analysis were done using SPSS Version 16.0. Result: The mean DMFT were 3.31, 3.24, 4.09, 2.89 for alcohol-only abusers, alcohol and chewing tobacco abusers, smoking tobacco and alcohol abusers, and those who abused tobacco in smoke and smokeless forms respectively. There was no significant difference between the oral hygiene care measures between the study groups. Presence of attrition among chewers and those with extrinsic stains experienced less caries than others. Discussion and conclusion: The entire study population exhibited a higher incidence of caries experience. Use of tobacco in any form appears to substantially increase the risk for dental caries. Attrition with use of chewing tobacco and presence of extrinsic stains with tobacco use appear to provide a protective effect from caries. The changes in oral micro-flora owing to tobacco use and alcohol may play a critical role in the initiation and progression of dental caries.

Sociodemographic correlates of male chewable smokeless tobacco users in India: A preliminary report of analysis of national family health survey, 2005-2006

OBJECTIVE To estimate the prevalence, the socioeconomic and demographic correlates of chewable smokeless tobacco consumption among males in India. DESIGN A cross-sectional, nationally representative population-based household survey. SUBJECTS 74,369 males aged 15-54 years who were sampled in the National Family Health Survey-3 (2005-2006). Data on tobacco consumption were elicited from male members in households selected for the study. MATERIALS AND METHODS The prevalence of various smokeless tobacco use currently was used as outcome measures. Simple and two-way cross tabulations and univariate logistic regression analysis were the main analytical methods. RESULTS Thirty-four percent of the study population (15 years or older) used chewable smokeless tobacco. Smokeless tobacco consumption was significantly higher in poor, less educated, scheduled castes, and scheduled tribe populations. The prevalence of tobacco consumption showed variation with types. The prevalence of chewing also varied widely between different states and had a strong association with an individuals sociocultural characteristics. CONCLUSION The findings of the study highlight that an agenda to improve the health outcomes among the poor in India must include effective interventions to control tobacco use. Failure to do so would most probably result in doubling the burden of diseases-both communicable and noncommunicable-among Indias teeming poor. There is a need for periodical surveys using more consistent definitions of tobacco use and eliciting information on different types of tobacco consumed.

Effect of habitual arecanut chewing on resting whole mouth salivary flow rate and pH.

BACKGROUND Resting whole mouth salivary flow rate (SFR) and pH play a significant role in pathogenesis of various oral diseases and conditions. AIM To observe the effect of habitual use of arecanut and various arecanut containing products (AN) on SFR and pH. DESIGN Cross sectional. SETTING Outpatient Department of Dental College. PARTICIPANTS AN chewers and non-chewers attending Dental college. MEASUREMENTS SFR and pH. VARIABLES Type, frequency, duration and exposure time of AN, Smoking and Alcohol habit. MATERIALS AND METHODS Subjects study was divided into chewers (n=110) and non- chewers (n=50). The SFR (expressed in mL/10min) and pH measured. RESULTS The difference between the mean SFR for chewers and non-chewers was not statistically significant. The difference between mean pH of chewers and non-chewers was statistically significant. (P=0.02). Difference in pH was statistically significant among the different types of AN chewers (P=0.024). With chewing raw AN, an increase in frequency and exposure time increased SFR and pH respectively. In processed AN chewers, increase in duration and frequency of consumption increased SFR and decreased pH respectively. For chewers with betel quid with tobacco, increase in duration was significantly associated with decrease in salivary pH. CONCLUSION SFR and pH are altered in AN chewers, rendering the oral mucosa vulnerable to the toxic effects of AN.

Root damage and repair in patients with temporary skeletal anchorage devices

INTRODUCTION The aim of this study was to evaluate the reparative potential of cementum histologically after intentional root contact with a temporary skeletal anchorage device. METHODS Seventeen patients (8 male, 9 female; mean age, 16.2 years; range, 13.5-21.6 years) who were scheduled for extraction of 4 first premolars as part of their orthodontic treatment participated in this study. The roots of the premolars were intentionally injured with a temporary skeletal anchorage device. The teeth were extracted at 4, 8, or 12 weeks after the injury. Root contact with the temporary skeletal anchorage device was confirmed by using a stereomicroscope. Histologic samples were prepared. Demineralized serial sections were stained with eosin and hematoxylin, and cementum repair was assessed histomorphometrically. RESULTS Despite varying depths of the injuries, including involvement of dentin, reparative cementum formation was observed in all sections. Healing cementum was almost exclusively of the cellular type; 70% of all the teeth exhibited good repair by the end of week 12. CONCLUSIONS This study established that healing of cementum takes place after an injury with a temporary skeletal anchorage device, and it is a time-dependent phenomenon.

Inferior alveolar nerve canal position among South Indians: A cone beam computed tomographic pilot study

Purpose: To document a clinically relevant position of the inferior alveolar nerve (IAN) in complete dentate south Indian patients in the age group of 20–29 years using cone beam computerized tomograms. Materials and Methods: The investigators used a cross-sectional study design and a study sample of subjects who had a radiographically identifiable IAN canal with complete set of 28 permanent teeth excluding 3rd molars. Predictor variables were age, tooth position, and side. Outcome variables were the linear distances between the buccal and lingual aspect of the IAN canal, buccal and lingual cortical thickness, IAN canal diameter, and the superior aspect of the IAN canal from the periapex of first and second mandibular molar. Descriptive statistics and Mann–Whitney U test were performed. P value of ≤ 0.05 was taken as significant. Results: The study sample was composed of 10 male and 10 female patients with a mean age of 24.2 ± 3.00 years. On average, the lingual cortical thickness was 1.68 mm at 1st molar and 1.44 at 2nd molar level. Gender and side influenced the outcome with varying statistical significance. Conclusions: The range of linear dimension of mandibular canal, cortical bone thickness, and distance between tooth apex and IAN canal have been presented for the South Indian population in the age group of 20–29 years. The implications of the findings will influence on the course of surgery. Further large-scale studies are needed to validate the findings of this study.

Prevalence and correlates of tobacco use among urban adult men in India: A comparison of slum dwellers vs non-slum dwellers

BACKGROUND Tobacco use is reported to be rampant in urban slums in developing countries. Demographical variations in tobacco use between males living in urban slums vs those living in non-slum areas in India has not been reported, and this study was undertaken to address this issue. MATERIALS AND METHODS Secondary data analysis of National Family Health Survey-3 (NFHS-3) was undertaken to study demographical variations in tobacco use between urban slum dwellers and non-slum dwellers in eight Indian cities. Demographic determinants for use of smoking and chewing forms of tobacco in the two groups were analyzed. SPSS version 16.0 (SPSS Inc., IL, USA) was used for statistical analysis. RESULT The study population comprised 6887 (41.8%) males from slum areas and 9588 (58.2%) from non-slum areas of eight urban cities. Cigarette/beedi smoking was the commonest form of tobacco use among the study population. Pan masala use was the least common form of smokeless tobacco use, next only to snuff. There was a high statistical significance observed within the various demographic parameter studied in both the slum and non-slum dwelling males in study population. However, on studying the differences between the two groups, it was observed that statistical significance of P≤.001 was observed with age (15-49), secondary education, religion, household structure and marital status. The difference between the two groups in the mean number of cigarettes/beedis smoked was not statistically significant (P=.598). DISCUSSION AND CONCLUSION Male slum dwellers are a distinct urban population, whose health needs assessment requires a different approach than that for non-slum dwellers who often can afford the services that an urban Indian city can offer.

Contributions of Indian conservative dentists and endodontists to the Medline database during 1996-2009: A bibliometric analysis

Background: Analysis of publication trends will guide the policy framers, administrators, and dentists to frame future policies and design programs for the development of scientific and technological policies in the field of dentistry. Aims and Objectives: This study was undertaken to assess the trends in Indian Conservative dentists and endodontists’ Publication in PubMed-Medline database during 1996–2009. Materials and Methods: Using the time limitation of publication date limit of 1st January 1996 to 31st December 2009, all articles where authors’ affiliation had the words Dental AND India were selected. From this collection of articles, the following were noted down: year of publication, number of authors, name of the journal, reach of the journal, status of the journal, specialty of the first, state of origin, and type of research. From this database, the performance of department of conservative dentistry and endodontics was analyzed. Results: The number of articles published by conservative dentists and endodontists was 124. Among them, 63 got published in international journals and 61 in Indian journals. A majority of 33 journals were published in Indian Journal of Dental Research followed by 25 in the Journal of Conservative Dentistry. Out of these articles, 66 were on the basis of original research done by the authors. Nearly 45.2% of the published articles were from the institutes in Tamil Nadu, followed by Karnataka (30.6%), and Maharashtra (8.1%). Although the overall distribution of the publication trends seems to be constant from 1996 to 2006, there seems to be boom in the publication trend since 2007.

Review of paraneoplastic syndromes associated with oropharyngeal squamous cell carcinoma

Malignancies are usually preceded by the presence of various paraneoplastic syndromes (PNS), which could be the indirect and/or remote effects of the metabolites produced by neoplastic cells. PNS manifested by oropharyngeal squamous cell carcinomas, which is the most common head and neck malignancy, are highlighted in this review. Knowledge of the clinical spectrum of these syndromes will equip the oral physician for early diagnosis and management of these hidden malignancies, especially of the pharyngeal region.