Vinay Kumar Bhardwaj

Impact of school-based oral health education program on oral health of 12 and 15 years old school children

Background: Health education for the school age child is a specialized field within the broad discipline of education. Oral health education program are educational aspects of any curative, preventive and promotional health activity. Aim: The study has been undertaken to evaluate the impact of oral health education on the status of plaque, gingival health and dental caries among 12 and 15 years old children attending government school in Shimla city. Materials and Methods: Two hundred and seventy six school children participated in the study. The study was conducted over a period of 4 months from May 2010 to August 2010 in Government Senior Secondary School, Sanjauli. Plaque, gingival and caries status was assessed by using Silness and Loe plaque index, Loe and Silness gingival index and WHO modified DMFT index, respectively. Data was analyzed using the software SPSS version 15. Paired t-test and Wilcoxon signed rank sum test were used appropriately for statistical comparisons. P value ≤0.05 was considered statistically significant. Results: Overall mean plaque score and gingival score decreased significantly after oral health education irrespective of gender. However, decrease in plaque score among 15 years old female children and gingival scores among 12 and 15 years old female subjects was not significant. Difference in mean caries status was statistically insignificant among all the subjects. Conclusion: Short term oral health education program may be useful in improving oral hygiene and gingival health. Coordinating efforts should be enhanced between school personnel, parents and health professionals to ensure long-term benefits of such program.

Effect of hydrogen peroxide mouthwash as an adjunct to chlorhexidine on stains and plaque

Aim: To investigate whether the use of an oxidizing mouth rinse as an adjunct to chlorhexidine is efficacious in reducing stains and plaque. Materials and Methods: This study had a single-blind, three-group (n = 35 each) parallel design, including a 21 days experimental period during which group I rinsed with chlorhexidine (CHX) 0.2% alone, group II used chlorhexidine (CHX) followed by hydrogen peroxide (H2O2) 1.5%. Group III rinsed with the same mouthwashes in reverse order. Patients were randomly assigned to one of the three groups. The examination for plaque, and stains was done after 1, 2, and 3 weeks of rinsing. Results: Group II showed significantly less stain intensity in comparison with group I after 14 and 21 days (P values 0.025 and 0.005, respectively). The proportion of stained surfaces was less in the group II than in the group I and was significant at the end of 1 week. The plaque formation was significantly less in groups II and III than group I at 7, 14, and 21 days. Conclusion: The adjunctive use of hydrogen peroxide to chlorhexidine proved to be superior to chlorhexidine alone with regard to the inhibition of plaque and development of stains.

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.

Association of chronic periodontitis with metabolic syndrome: A cross-sectional study

Background: Prevalence of metabolic syndrome (MeS) is high among Asians, including Indians and is rising, particularly with the adoption of modernized lifestyle. Various studies have reported a significant relationship between periodontal status and MeS. The objective of this study is to investigate the association between periodontitis and MeS. Materials and Methods: The study included 259 subjects (130 cases with chronic periodontitis, 129 controls without chronic periodontitis) who underwent medical and periodontal checkup. Five components (obesity, high blood pressure, low- and high-density lipoproteins, cholesterol, hypertriglyceridemia, and high plasma glucose) of MeS were evaluated, and individuals with ≥3 positive components were defined as having MeS. The periodontal parameter was clinical attachment level (CAL) on the basis of which cases were selected with moderate (CAL loss 3–4 mm) and severe (CAL loss ≥5 mm) generalized chronic periodontitis. The association between chronic periodontitis and MeS components was investigated using odds ratios (ORs) and 95% confidence intervals (CIs). Results: The association of MeS and chronic periodontitis was strong and significant with OR: 2.64, 95% CI: 1.36–5.18, and P< 0.003. Comparison of mean values of components of MeS between cases and controls reveals that the mean waist circumference (mean difference: −4.8 [95% CI: 7.75–−1.84], P< 0.002) and mean triglycerides level (mean difference: −25.75 [95% CI: −49.22–−2.28], P< 0.032) were significantly higher in cases than in control groups. Although mean systolic blood pressure, diastolic blood pressure, and fasting blood sugar level were higher in cases (125.77, 82.99 and 86.38, respectively) compared with control (122.81, 81.3 and 83.68, respectively), it was statistically insignificant. Conclusion: The results of this study suggest that there is a strong association between chronic periodontitis and MeS. The association was independent of the various potential confounding risk factors affecting the chronic periodontitis such as age, sex, residential background, and tobacco consumption.

Oral manifestations of dengue fever: A rarity and literature review

Dengue is a viral infection with fatal potential complications. It is also called break-bone fever. Worldwide, dengue infection is the most common mosquito-borne viral disease. It is caused by vector Aedes aegypti and represents a major public health issue in more than 100 tropical countries. This may be associated with a variety of mucocutaneous manifestations, which may be of help in early diagnosis. Dengue viral infections are characterized by abrupt febrile illness, but can also lead to significant morbidity and mortality. Hence, it requires an early and correct diagnosis. Gingival bleeding is the most common oral manifestation of dengue infections. Many biochemical assays and hematological investigations may aid in the further diagnosis and treatment of the fatal disease. Although oral lesions are uncommon in dengue infections and if occur, may be mistaken for platelet abnormality or hemorrhagic disorders. This review emphasizes the significance of oral lesions as it may be the early indicators of dengue hemorrhagic fever.

Ayurveda and holistic approach in oro-dental care: An overview

Dentistry was not a well recognized specialized branch of Ayurveda, literature shows it was included in its Shalakya Tantra. Before the inception and regular use of modern allopathic system, problems related to the oral cavity, plaques and infections were managed in ancient India. Traditional medicine can treat various infectious and chronic conditions. Various researchers have revealed that all kinds of chewing sticks described in ancient Ayurveda literature have medicinal and anti-cariogenic properties. Its oil pulling (Kabla Graham, Kabla Gardoosa) practice is claimed to cure about 30 systemic diseases. Use of safe, quality products and practices should be ensured based on available evidence if traditional medicine is to be acknowledged as part of primary health care. Traditional medicine is the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses. Traditional medicine that has been adopted by other populations (outside its indigenous culture) is often termed complementary or alternative medicine. Herbal medicines include herbs, herbal materials, herbal preparations, and finished herbal products that contain parts of plants or other plant materials as active ingredients. Scientific validations of the Ayurveda dental health practices could justify their incorporation into modern oro dental care. Publicity of these techniques using appropriate media would benefit the general population by giving more confidence in the ancient practices, thus preventing various oro dental problems

Dental caries prevalence in individual tooth in primary and permanent dentition among 6-12-year-old school children in Shimla, Himachal Pradesh

Background: Prevalence of dental caries not only varies according to age, gender, and arch but also according to the involvement of individual tooth. The study on individual tooth will help in providing incremental dental care and reducing burden of dental caries in this group of population. Objective: To find out the prevalence of dental caries in individual tooth among 6-12-year-old school children in Shimla city, Himachal Pradesh. Materials and Methods: This study was conducted among 1,200 school-going children over a span of 5 months from 11 government schools in Shimla city, in the state of Himachal Pradesh in India. Examination was performed using a mouth mirror and blunt sickle-shaped explorer under natural light, according to World Health Organization (WHO) oral health survey 1997. Results: Females were having higher prevalence of dental caries than males of the same age-group in both primary and permanent dentition (79.3% vs. 74.9%). First molars were most affected with dental caries than other teeth in both the dentitions (78.69% and 48.93%, respectively). Dental caries prevalence was high in mandibular arch than in the maxillary arch i.e. (80.0% vs. 77.38%) in permanent dentition and (51.3% vs. 46.56%) in deciduous, dentition respectively. Statistically, this difference was significant (Fischers exact test P Conclusion: High prevalence of dental caries among government school children in Shimla city is a cause of concern. There is utmost necessity of regular periodic check-up, application of preventive measures, and treatment modalities as soon as teeth erupt in the oral cavity.

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.