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   Table of Contents - Current issue
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October-December 2022
Volume 20 | Issue 4
Page Nos. 329-438

Online since Monday, December 19, 2022

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PRESIDENTS MESSAGE  

President's Message p. 329
Manjunath P Puranik
DOI:10.4103/jiaphd.jiaphd_254_22  
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HONORARY SECRETARY’S MESSAGE Top

Honorary Secretary's Message p. 330
L Vamsi Krishna Reddy
DOI:10.4103/jiaphd.jiaphd_255_22  
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FROM EDITORS DESK Top

From editors desk p. 331
P G Naveen Kumar
DOI:10.4103/jiaphd.jiaphd_257_22  
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REVIEW ARTICLE Top

Effect of periodontal therapy on endothelial dysfunction – A systematic review p. 332
Bharath Sekhar Nayanar, Hemant Battur, Nusrath Fareed, Jaseela Praveena
DOI:10.4103/jiaphd.jiaphd_6_21  
Background: Endothelial dysfunction is considered a common precursor to and occurs before cardiovascular events. Therefore, endothelial dysfunction is the first step in atherosclerosis growth that leads to cardiovascular disease CVD. Patients with periodontitis are ideal models for determining how endothelium-dependent vasodilation is affected by inflammation. Objective: The objective is to determine the effect of periodontal therapy on endothelial dysfunction. Methodology: This review was conducted as per the Preferred Reporting Items for Systematic reviews and Meta-Analysis and JBI guidelines. A total of twelve randomized clinical trials published over a period of the past 14 years were included in the review (200420018). Results: There were 813 patients in the research, which lasted between 2 and 6 months and looked at the effects of periodontal therapy on endothelial dysfunction. The common interventions given for the intervention group in all of the studies were supra or subgingival scaling and root planing with some studies providing antibiotic medications such as amoxicillin and minocycline as an adjuvant for periodontal therapy. All included studies reported a high level of evidence (LOE) of 1c. Conclusion: This study focused on periodontal therapy and its effect on endothelial dysfunction precisely and compared the levels of endothelial function before and after intervention, however, the studies included in this review did not do matching between cases and controls on endothelial function levels. This review revealed that more multi-centric randomized control trials are required in this area of research with proper randomization and adequate sample size and proper matching done between cases and controls.
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ORIGINAL ARTICLES Top

Online education status at government and private dental college during COVID-19 pandemic in India: A comparative study p. 342
Hansika Popli, Manu Batra, Deeksha Gijwani, Anjali Ahuja
DOI:10.4103/jiaphd.jiaphd_63_21  
Introduction: Pandemic COVID-19 has spread all over the world very profligately in a short interval. This has had disturbed the main determinant of the future economics that is the education sector. India is a country with a vast number of colleges and dental colleges are a part of nurturing budding dentists. Aim: The aim of the study was to assess the status of online education at government and private dental colleges of India during a COVID-19 pandemic. Materials and Methods: This is a cross-sectional questionnaire-based study; conducted among the faculties of all Indian government and private dental colleges taking online classes for bachelor of dental surgery students. A pretested and validated questionnaire was sent to faculty members through a Google form. To assess the differences in perception among faculties of different colleges, the use of Chi-square test was done whereas descriptive statistics surveyed the frequency distribution. Results: More than 70% of faculty members both from private and government colleges agreed that tracking of students is difficult during online classes. A laptop was used by the maximum number of respondents, that is, government (77.8%) and private (81.5%) as the mode for taking online classes. About 50% of government faculties and 59.5% of private faculty members used zoom as an online platform tool for taking classes whereas others used the Google meet app for taking classes. Conclusion: The COVID-19 pandemic has paved the way for E-Learning in dental education in India. Faculties agree to complete the theory syllabus and conduct sessional examinations as an alternative during the lockdown period. However, they show strong reservations in carrying out practical/clinical simulations and university exams online.
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Reasons for and Perceptions about the COVID-19 Vaccination among dental undergraduate students in India: A questionnaire-based study p. 347
Ashna Mehra, Rutika Awhad, Rajiv Desai, Kulvindersingh Banga, Pankaj Gupta
DOI:10.4103/jiaphd.jiaphd_148_21  
Background: COVID-19 is an infectious disease caused by the newly discovered coronavirus (severe acute respiratory syndrome coronavirus 2). Efforts are being taken to control the spread of this disease, of which the development of vaccine against COVID-19 is a major landmark. However, doubts on the efficacy of the vaccine do exist among the population. Aim: The aim of this study was to know the reasons for, perceptions of, and knowledge about the COVID-19 vaccination among dental undergraduate students. Materials and Methods: The study was conducted using an online survey and distributed among undergraduate dental students throughout India. An online validated and piloted questionnaire was sent to dental colleges throughout India using the Google Forms platform. The responses were downloaded in MS Excel 2019. Descriptive analysis (SPSS IBM, USA version 25) was used. Results: The response rate of the study was 32%. Preventing the spread of COVID-19 infection was the primary reason for getting vaccinated and nonavailability of long-term safety data was the main reason for not getting vaccinated. Majority of the students agree that wearing masks, frequent handwashing, hand sanitation, and social distancing postvaccination are necessary. Conclusion: The study points to a rational wait-and-watch strategy adopted by majority of vaccine-hesitant dental students, though the flaws in reasons for getting vaccinated were observed in the present study. These flaws point to the need for a genuine, consolidated, up-to-date, unified easily available, and succinct source of information on all aspects of the present COVID-19 pandemic.
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Assessment of effect of health song on oral hygiene status among visually impaired children p. 352
J John Smith, Jithesh Jain, SR Ananda, Bhakti Jadduram Sadhu
DOI:10.4103/jiaphd.jiaphd_121_21  
Background: The visually impaired depend much on sound, speech, and touch, and therefore, promotion of oral hygiene maintenance through a health song can improve their oral hygiene practices. Aim and Objectives: To assess the effectiveness of oral health song on oral hygiene status among visually impaired children at baseline and after oral health education (OHE) at different time intervals. Materials and Methods: A study was carried out in Government Blind School, Salem, with prior permission. Out of 63 students, 57 students were taken to the study based on the inclusion and exclusion criteria. Seven students were lost to follow-up during the second visit and 9 students during the last visit. During the first visit, a health talk about brushing techniques was given without using any audiovisual aids, and oral health song which is of 2 min duration was taught to the students. Each of the students was given a tooth cast model and was taught how to brush. The oral hygiene status was assessed at baseline and 15th and 45th day using visible plaque index (VPI) and gingival bleeding index (GBI). Statistical analysis was done using IBM SPSS Statistics 25. The Bonferroni test was to compare the VPI and GBI scores between the baseline, 15 days, and 45 days, and P < 0.05 was considered statistically significant. Results: VPI and GBI scores were found to be statistically significant at different intervals (P < 0.001). The VPI anterior and posterior percentage (P < 0.001) and GBI anterior and posterior percentage (P < 0.001) at different intervals were found to be statistically highly significant. Conclusion: A song with music can increase interest and helps them retain information easily, which was found to be effective in the present study.
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Knowledge, attitude, perception of practicing dentists toward coronavirus disease 2019 in Andhra Pradesh – A cross-sectional study p. 356
Rashmika Kolikipudi, L Vamsi Krishna Reddy, Vineela Parlapalli, Siva Kumar Pydi, Nagarjuna Pottem, Yaswanth Sai Rachuru
DOI:10.4103/jiaphd.jiaphd_131_21  
The epidemic of Coronavirus disease 2019 (COVID-19), originated in Wuhan, China, has become a major public health challenge not only for China but also countries around the world. The repercussions of the current rapid spread of COVID-19, which has affected millions of people worldwide, ranging from being isolated and quarantined to fatality have resulted in considerable psychological stress and fear. Aim: The aim of the study is to assess the knowledge, attitude and perception of practicing dentists toward COVID-19 in Visakhapatnam. Materials and Methods: A self-administered, pretested, and validated questionnaire was designed and mailed to the dental professionals assessing information regarding sociodemographic details, knowledge, attitude, and perception toward COVID-19 among dental practitioners in Visakhapatnam. Convenience sampling was used and a total of 264 participants were included in the study based on inclusion and exclusion criteria. Results: The correct incubation period of the virus was recognized by 43% of participants. Participants in age groups 50–60, 40–50, were more likely to perceive COVID-19 as a very dangerous disease compared to 30–40 and 23–30 years of age groups. Study participants with 15–20 and 20–25 years of practice were more likely to treat those patients and ask them to go to the hospital (74%, 67%, respectively). On the other hand, dentists with 1–5, 5–10, years of practice were more likely to refuse to treat and ask him/her to leave clinic (75%, 63%, of participants, respectively). The study participants showed satisfactory knowledge and a positive attitude toward COVID-19. Conclusion: Although we had faced the prospect of a second wave of virus transmission, we must take certain measures and make changes to minimize the effects of next coming waves of the COVID-19 outbreak on dental practice. This is the time for change and there should be support and enthusiasm for providing valid solutions to reduce this disruption which can be achieved through increasing their accessibility to materials provided by dental health-care authorities, which specifies the best and safest approaches for dealing with patients during and after the outbreak.
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Oral health related quality of life and its related factors among the elderly population in Davanagere city: A cross sectional survey p. 362
Puja C Yavagal, Vajreshwari Narayanpur, Sushmarani Rajanna, BR Priyanka
DOI:10.4103/jiaphd.jiaphd_161_21  
Background: Identifying factors related to oral health-related quality of life (OHRQoL) helps to plan effective oral health programs among elderly population. Aim: The aim was to assess OHRQoL and factors related to it among elderly population in Davanagere city. Materials and Methods: This cross-sectional survey involved a multistage stratified sample of 380 elderly population aged 60 years and above in Davanagere city. Data related to demographic details and general and oral health-related factors, nutritional status, and geriatric OHRQoL of study participants were recorded using a study pro forma, Mini Nutritional Assessment-Short Form Index, and Geriatric Oral Health Assessment Index (GOHAI), respectively. IBM SPSS Statistics for Windows, Version 21 (IBM Corp., Armonk, N.Y., USA) was used for statistical analysis. The significant level was fixed at P < 0.05. Chi-square test, Pearson's and Spearman's correlation tests, and multiple linear regression analysis tests were applied for data analysis. Results: The participants had good OHRQoL (mean GOHAI = 40.66 ± 7.29). The GOHAI was significantly (P < 0.05) negatively correlated with age, systemic problems, number of missing teeth, source of income, and medications and was positively correlated with nutritional status, occupation, and pan chewing. Age, medical problems, missing teeth, nutritional status, and occupation were significant predictors of GOHAI. (F = 26.36, P < 0.00, r2 = 0.36, B [Constant] =48.65 [confidence interval 33.85–63.46]). Conclusion: Clinicians, public health workers, and policy makers can focus on significant predictors of GOHAI for planning community-based programs targeted at improving OHRQoL of elderly population.
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Assessment of periodontal disease severity in patients with cardiovascular disease: A cross-sectional study p. 370
Amita Rao, K Subramanyam, Ballamoole Krishna Kumar, Neevan D'Souza
DOI:10.4103/jiaphd.jiaphd_151_21  
Background: Periodontitis is a biofilm-induced chronic inflammatory disease that affects the tooth-supporting structures. Transient bacteremia during periodontal infection may lead to direct bacterial invasion of endothelial cells. Aim: To observe if the patient's periodontal status has an influence on the severity of the cardiac disease. Materials and Methods: Subgingival and atherosclerotic plaques were extracted from patients with coronary artery disease in this cross-sectional analytical study. Based on the nested polymerase chain reaction results, 44 patients were age- and gender-matched and divided into two groups based on the presence or absence of periodontal pathogens belonging to the red complex in the atherosclerotic plaque samples. Version 20.0 of IBM SPSS Statistics for the Windows was used to analyze the data. The Pearson Chi-square test was done to investigate the association between periodontal status and pathogen detection, as well as determine the relationship between periodontal severity and cardiac severity. P < 0.05 was considered to be statistically significant. Results: Statistically insignificant association was observed between periodontal severity and the detection of the periodontal pathogens Porphyromonas gingivalis and Tannerella forsythia in the subgingival and atherosclerotic plaques in Group A; however, a significant association was observed for the pathogen Treponema denticola in the subgingival plaque for both Groups A (P = 0.039) and B (P = 0.005). No significant association was observed between the periodontal severity and cardiac severity for Groups A (P = 0.40) and B (P = 0.277). A weak positive but statistically insignificant (P = 0.097) correlation was observed for overall periodontal and cardiac severity. Conclusion: A higher percentage of patients had generalized chronic periodontitis in the group that tested positive for the pathogens in the atherosclerotic plaques, indicating a possible influence of periodontal status on cardiac outcomes.
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Knowledge, attitude, and perception about the utilization of dental services during COVID-19 pandemic among the general population: A cross-sectional survey of an indian subpopulation p. 375
Sivagami Nachiyar, Subha Anirudhan, Vineetha Chakravarthy, Ambalavanan Parthasarathy, Minu Koshy, Hari Baskar
DOI:10.4103/jiaphd.jiaphd_106_22  
Background: The impact of the COVID-19 pandemic made many countries impose lockdown, movement control, or “shelter in place” orders on their residents. The effectiveness of these mitigation measures is highly dependent on the cooperation and compliance of all the members of the population. Many patients were observed to approach dental hospitals and clinics for nonemergency procedures without understanding the risk of contracting the disease.Aim: The aim of this study was to assess the knowledge and attitude about the utilization of dental services during the peak of pandemic.Materials and Methods: An online questionnaire survey was prepared, and answers were collected from 355 participants residing in Tamil Nadu. Results: A total of 355 respondents were included in this preliminary report, and the mean knowledge score was 65.37%. The attitude of most respondents toward instituted preventive measures was satisfactory, with an average attitude score of 71.78%. Conclusion: The majority of the respondents had satisfactory knowledge of the disease, but the knowledge about the spread of infection from the dental office was deficient.
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Oral hygiene practices and caries experience among school leaving children in rural area p. 379
Srinivas Ravoori, Suresh Chand Yaddanapalli, Parveen Sultana Shaik, Devaki Talluri, Srinivas Pachava, Nijampatnam P M Pavani
DOI:10.4103/jiaphd.jiaphd_53_21  
Background: Dental caries is the most common chronic childhood disease and its treatment is the most prevalent unmet health need among school-leaving children. Caries experience among school leaving age group is important as India is a rapidly growing nation in terms of population as today's children are tomorrow's future citizens of the nation. Methodology: To know the oral hygiene practices and caries experience among school-leaving children in a rural area, a cross-sectional study was conducted in the Chebrolu Mandal using a multistage random sampling technique to obtain the required sample size. The data were collected using pretested structured questionnaire followed by oral examination using the decayed, missing, and filled teeth (DMFT) index. The descriptive analysis included mean and standard deviations, Chi-square test, unpaired t-test, and one-way analysis of variance. Results: Only a few children have a habit of brushing their teeth twice daily 137 (27.6%); rinse their mouth after every meal 116 (23.4%); dispose of toothbrush every 3 months (11.7%); spends <1-min brushing (4.8%); and cleans their tongue using tongue cleaner (25.2%). When DMFT scores were compared to the brushing techniques of the children, significantly higher mean DMFT scores were observed in children who brush once a day (1.49 ± 1.133). Conclusion: Caries' experience was more in children who brushed their teeth once a day with horizontal brushing technique and this shows that the study subjects do not follow correct brushing techniques and other oral hygiene practices.
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Tobacco habit abstinence through behavioral counseling among transgender persons of pune district: A quasi-experimental design p. 384
Sahana Hegde Shetiya, Abhishek Kumbhalwar, Sonal S Kale
DOI:10.4103/jiaphd.jiaphd_185_21  
Background: Transgender population are a high-risk group in the community, as their oral health gets neglected due to the stigma associated with them. Since it is an impediment to obtain oral care services, a group of such persons were identified with an intention of examining them orally and providing basic oral treatment. Aim: To identify a cohort of transgender persons using tobacco product and provide group behavioral counseling for cessation of their habit. Materials and Methods: A total of five locations wherein transgender persons were residing were identified. Demographic details of the participants such as age, education status, and occupation were recorded. The tobacco product use details regarding frequency, duration of use, and form of tobacco were documented. The identified tobacco users were provided with behavioral tobacco cessation counseling. Follow-up was done every month for 6 months and at 18th month through self-reported abstinence and urine cotinine test at 6th month. The data was analyzed using descriptive statistics in the form of numbers and percentages and the 95% confidence intervals (CIs) (Mid-P) were provided using WinPepi PORTAL. Results: A total of 52 transgender persons aged 18–58 years were identified. Tobacco product use was identified in 73%, out of which 13% smoked tobacco, 84% chewed tobacco, while 2% smoked and chewed both. Postintervention at 6th month, 21% (CI: 0.10–0.36) abstained from the habit of tobacco product use, which was self-reported and 7% (CI: 0.02–0.20) was validated with urine cotinine. By the 18th month, 15% (CI: 0.06–0.29) had self-reported abstinence. Conclusion: The prevalence of tobacco consumption was high among transgender population. Tobacco cessation program helped in quitting the adverse habit in 15% of the population. Cessation programs supplemented with nicotine replacement therapy use in this marginalized section of the society would help achieve a better abstinence.
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Assessment of nicotine dependence among cigarette smokers seeking oral health care using fagerström test for nicotine dependence: A cross-sectional study p. 388
Nalini Parimi, Nalini Bikkina, Vikram Simha Bommireddy, Morampudi Tejaswi, Sirija Edupalli, V Srujana Krishna Adapa
DOI:10.4103/jiaphd.jiaphd_16_22  
Introduction: In the quest of articulating customized tobacco cessation strategies, evaluation of the level of nicotine dependence among participants is quintessential. Objective: This study was conducted to assess the levels of nicotine dependence and its association with age and socioeconomic status among patients seeking oral health care at a teaching dental institution in coastal Andhra Pradesh. Materials and Methods: This cross-sectional study was done among 199 participants with the habit of cigarette smoking who participated in the study. Nicotine dependence scores were assessed using Fagerström Test for Nicotine Dependence (FTND). IBM SPSS version 20 software was used for data analysis. The Chi-square tests and Kruskal–Wallis analyses of variance were done to analyze the study data. P ≤0.05 was considered statistically significant. Results: The mean FTND score was 4.52 ± 2.1. Significant differences in the mean nicotine dependence score were found between different age groups (P < 0.001) and participants belonging to different socioeconomic strata (P < 0.001). While a positive correlation was observed between age and FTND score, an inverse relation was noted between FTND score and socioeconomic status with participants from lower socioeconomic status demonstrating higher FTND scores. The majority of the participants reported smoking <10 cigarettes per day. Conclusion: The study participants demonstrated moderate nicotine dependence. The assessment of nicotine dependence scores as a preliminary step in tobacco cessation counseling is essential to effectively articulate customized cessation strategies.
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Teledentistry: Knowledge, attitude, and perception among undergraduate and postgraduate dental students p. 393
Boddeda Suma Priyanka, L Vamsi Krishna Reddy, Vineela Parlapalli, Siva Kumar Pydi, Nagarjuna Pottem, Yaswanth Sai Rachuru
DOI:10.4103/jiaphd.jiaphd_133_21  
Background: In India, improper access to health services, particularly oral health care, is the main concern. As a result, teledentistry is a novel technique of practicing that ensures an exponential increase in clinical practice and public health-care delivery. Aim: The aim of the study was to assess the knowledge, attitude, and perception regarding teledentistry among dental students of Andhra Pradesh, India. Materials and Methodology: A descriptive cross-sectional study was conducted. Two hundred and fifty dental students are selected through a random sampling technique, including 3rd year Bachelor of Dental Surgery (BDS), 4th year Bachelor of Dental Surgery, interns, and Master of Dental Surgery (MDS) students studying in Andhra Pradesh. Dental students' knowledge, attitude, and perception regarding teledentistry was recorded using a self-administered, structured, pretested, and validated questionnaire administered through Google Forms, and the completed questionnaires were statistically analyzed using Statistical software (SPSS 25). Descriptive statistics included the computation of percentages and inferential statistics; the Chi-square test was used for intergroup comparisons. Statistical significance was set at P ≤ 0.05. Results: A total of 250 (100%) participants participated in the study. Sociodemographic data indicates that most respondents were between 20 and 23 years of age [n = 153 (61.2%)]. Most of the respondents accounted are females [n = 184 (73.6%)], and the remaining were males [n = 66 (26.4%)]. Majority of the participants were BDS [n = 193 (77.2%)] and the remaining were MDS [n = 57 (22.8%)]. The majority of postgraduate students, 77.2% (P = 0.022), were found to be familiar with the definition of teledentistry. It was observed that the majority of postgraduate students, 78.9% (P = 0.02) had knowledge about teledentistry and how to improve the health education of the masses. It shows that 61.4% (P = 0.002) of postgraduates believe that teledentistry can save time in dental practice. The overall study results uncovered that the postgraduates had a greater mean knowledge score than undergraduates. Conclusion: Most dental students were aware of teledentistry, its benefits, drawbacks, and how to use it. As teledentistry is still a nascent technology, this topic should be included in dental education.
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Antibacterial efficacy of Trachyspermum ammi Oil against Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans: An in vitro study p. 398
Puja C Yavagal, Shraddha Shivakumar Rajeshwar
DOI:10.4103/jiaphd.jiaphd_170_21  
Background: Ajwain (Trachyspermum ammi) oil is used widely because of its nutritional value, antioxidant and antibacterial activity against various microorganisms, but there are no studies that relate the antibacterial activity of Ajwain oil against periodontal pathogens. Aim: To evaluate and compare the minimum inhibitory concentration (MIC) and zone of inhibition of T. ammi (Ajwain seed) oil and 0.2% chlorhexidine gluconate against Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans through serial tube dilution and disc diffusion methods. Materials and Methods: An in vitro study was conducted. Ajwain oil (100%) and chlorhexidine solution (0.2%) were purchased. Blood agar media with hemin, Vitamin K and Kanamycin, crystal violet erythromycin blood agar, and thioglycolate broth with 1% horse serum were used to culture P. gingivalis, F. nucleatum, and A. actinomycetemcomitans, respectively. The MIC and minimum bactericidal concentration of test agents were assessed using the serial dilution method, and the zone of inhibition was assessed by the Agar disc diffusion method. Results: Ajwain oil had the ability to exert antibacterial activity against P. gingivalis, F. nucleatum, and A. actinomycetemcomitans at a MIC of 0.4, 0.4, and 0.8 μg/ml, respectively. Ajwain oil exerted bactericidal effect against P gingivalis, F. nucleatum, and A. actinomycetemcomitans at a minimum concentration of 0.4, 0.4, and 6.25 μg/ml, respectively, and bacteriostatic effect at a minimum concentration of 0.2, 0.2, and 3.12 μg/ml, respectively. At 50% μg/ml concentration, Ajwain oil exhibited a higher zone of inhibition compared to chlorhexidine against P. gingivalis, F. nucleatum, and A. actinomycetemcomitans. Conclusion: Ajwain oil demonstrated antibacterial effect against periodontal pathogens in vitro.
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Oral Health Status and Oral Health-Related Behavior among Schoolchildren of Tumkur p. 403
Darshana Bennadi, H Mythri, JV Bharatesh
DOI:10.4103/jiaphd.jiaphd_119_21  
Background: The health of the mouth and dentition plays a major role in the life of the child and hence given the main concern with objective to assess oral health status and behavior among schoolchildren and action to be taken to maintain good oral health and behavior among schoolchildren through school oral health programs. Aim: To assess oral health status and oral health behavior among schoolchildren of Tumkur. Methodology: A cross-sectional survey was conducted among schoolchildren of Tumkur using the convenience sampling method. Oral health status was assessed using modified World Health Organization pro forma and behaviors related to oral health was assessed using a pretested questionnaire. Data were analyzed using SPSS software version 18 where descriptive statistics and Chi-square test were applied. P <0.05 was considered statistically significant Results: A total of 3641 children were included in the study from 14 randomly selected schools with the age group ranging from 6 to 16 years. Decayed tooth was observed to be more in primary (36%) as well as permanent teeth (62%) and only 30% of the children mentioned they had visited a dentist in the past 1 year and the pain was the main reason for their visit. Majority of their practice was self-relied (94%). Conclusion: Overall scenario of the children's oral health is not deplorable, care should be taken to educate them about proper brushing techniques and reduce consumption of sugar.
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Knowledge, attitudes, and perceptions toward informed consent and its implications among dental professionals in South India: A cross-sectional study p. 407
Kuna Vandana, Ghanta Shruti, J Narendra Babu
DOI:10.4103/jiaphd.jiaphd_10_21  
Objectives: To assess the current knowledge, attitudes, and perceptions toward informed consent and legal conflicts among Dental professionals in the Dental colleges of South India. Methods: This descriptive cross-sectional study was carried out at eight dental teaching institutions of Andhra Pradesh and Telangana. A structured close-ended questionnaire was used to obtain data from the dentists, including the postgraduates and teaching staff. The aim was to assess the knowledge on informed consent in the routine practice of dentistry. Results: A total of 450 professionals were approached; among them, 368 were included in the survey. Independent variables such as age, gender, clinical practice experience, and levels of designation were assessed for association with perceptions of informed consent. Majority of the study population felt the necessity of informed consent in daily dental practices. In addition, 75.2% of the professional population were aware of legal conflicts as they reported that if a doctor working in an institution does fault in providing treatment services without consent, then they will be liable before the law. There was a statistically significant association between the age of the study population and their attitude toward the necessity of consent in treating patients (P = 0.03). Similarly, there were variations in the opinions of gender toward the nature of informed consent, which was proved to be statistically significant (P = 0.027). Moreover, clinical practice experience was significantly associated with knowledge of informed consent evolution and types of consent required for a child between 7 and 17 years of age (P = 0.002 and 0.028), respectively. Conclusion: About 86% of the surveyed dentists are aware of the importance of informed consent in practical dentistry and consider it as an ethical and legal obligation. Moreover, expressed consent is the preferred means of obtaining consent from patients for the most dental procedure. Majority (89%) of them responded that the questionnaire gave them additional information about lawsuits and preferred streamlining the process of informed consent through Institutional review boards to avoid legal conflicts.
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Impact of social media on dental treatment choices: A web-based survey p. 415
Pratibha Taneja, Soumya Mahapatra, Charu Mohan Marya, Ruchi Nagpal, Sakshi Kataria
DOI:10.4103/jiaphd.jiaphd_194_21  
Background: Social media also helps to attract a diverse group of people that we may not have thought would be interested in oral health; working together, we can keep the oral health message alive. Objectives: The objective is to assess the impact of social media on dental treatment choices and to find the best social media platform to promote oral health based on their use. Materials and Methods: The present cross-sectional web-based survey was conducted among the users of Facebook, Instagram, and Whatsapp. Online questionnaire link was constructed using the Google survey tool of Gmail. Questionnaire was circulated through snowball methodology, i.e., link was sent to friends or added contact person on the phone and then was forwarded to the next friend circle. The questionnaire was comprised of 14 questions and was sent to 700 participants. For descriptive and inferential statistics, SPSS 21 was used. KMO and Bartlett's test was used for factorial analysis. P < 0.05 was considered statistically significant. Results: Majority of the participants reported Whatsapp to be the most used app, and the frequency of usage is several times a day (81.8%). Significantly more number of the subjects (43.9%) followed dentists on Instagram. However, more number of the participants reported promotion on Facebook as the reason for their dental visit. The majority (62.4%) of the participants would get affected by written experiences and criticism about dental care on social networking sites and almost half of them get affected in choosing a dentist by the activity of their account. A high proportion of the participants (69.7%) claimed that they watch instructional videos uploaded on social media, but majority of them (78.5%) do not have any applications related to dentistry. Conclusion: Whatsapp can be used as an informative tool for self-oral health promotion as it was found to be the most preferred app.
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Cost-Effective analysis of silver diamine fluoride in comparison to glass ionomer cement along with fluoride varnish in the management of early childhood caries in anganwadi centers of Mangalore: A randomized control trail p. 420
Prakash Babu Kodali, Vijaya Hegde, Rasheed Minhaz, P Prasanna Mithra, Shubhan Alva, Joe Joseph, Roshni R S
DOI:10.4103/jiaphd.jiaphd_221_21  
Introduction: Early childhood caries (ECC) is a major public health challenge affecting preschool children. Silver diamine fluoride (SDF) is a noninvasive, alternative method to surgical intervention in the treatment of ECC. It has also shown to inhibit the development of new carious lesions. Materials and Methods: An open-labeled randomized controlled trail was conducted among 200 Anganwadi children. They were divided into two groups: Group A received oral prophylaxis and application of 38% SDF and Group B received oral prophylaxis, restoration using glass ionomer cement (GIC) and application of 5% sodium fluoride varnish (FV). The effectiveness in reduction of dental caries was assessed based on its ability to result in a positive outcome postintervention. Cost-effectiveness analysis, from the service provider perspective, was conducted to evaluate the effectiveness of SDF when compared to GIC followed by the application of FV. Average cost-effectiveness ratio and incremental cost-effectiveness ratio (ICER) for all the specific outcomes were assessed. Results: The average cost for converting an individual tooth from active caries to inactive caries using SDF was 67.30 Indian Rupees (INR), whereas the same was 225.5 INR using GIC with FV. The ICER of the interventions for the total number of inactive caries postintervention was measured at −89.9, implying that Incremental costs of one extra tooth of active caries to be converted into inactive caries using SDF will cost 89.9 INR less compared to the same outcome using GIC with FV. Conclusions: Thus, the study showed that SDF was cost-effective when compared to GIC in restoring active carious lesions.
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Effect of pomegranate mouthrinse on gingival health: A 21 day randomised controlled clinical trial p. 427
Charu Mohan Marya, Swati Singroha, Ruchi Nagpal, Pratibha Taneja, Sakshi Kataria, Parul Kashyap
DOI:10.4103/jiaphd.jiaphd_193_21  
Aim: To evaluate the efficacy of Punica granatum mouthrinse as compared to 0.12% chlorhexidine (CHX) on periodontal health. Settings and Design: This was a randomized controlled trial among patients aged ≥40 years selected from the outpatient department of Sudha Rustagi College of Dental Sciences and Research. Methodology: Fifty subjects diagnosed with chronic generalized gingivitis were selected and randomly divided into two groups, i.e., P. granatum mouthrinse group and CHX group. The mouthrinse extract was prepared using peel of P. granatum fruit. Patients were advised to use their prescribed mouthwash for 21 days. Clinical evaluation was done at baseline, 7 days, 14 days, and 21 days using the gingival index and the plaque index. Statistical Analysis Used: SPSS Inc 21 software (Statistical Package for the Social Sciences) was used. For inferential statistics, Friedman test, Wilcoxon signed-rank test, and Mann–Whitney U-test were used. Results: There was significant improvement in gingival status in both the sites. Subjects using P. granatum rinse showed significant improvement in gingival scores as compared with CHX. In contrast, P. granatum was shown not to be so effective in reducing plaque scores. Conclusions: P. granatum rinse is beneficial in improving gingival status due to its profound styptic action, with sufficient reduction in plaque scores.
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Assessing the sudden shift from classroom to online learning due to the COVID-19 pandemic: Students' perspective p. 432
Sahil Thakar, Swati Sharma, KP Anuradha, KK Shivalingesh, Mansimranjit Kaur Uppal, Shraddha Mishra, Priya Pokharel
DOI:10.4103/jiaphd.jiaphd_189_21  
Context: The COVID-19 pandemic has led all educational institutions to temporarily close and provide online learning to their students. Aim: This study aims to assess students' perspectives of such a “sudden shift” from classroom-based teaching methodologies to the use of online platforms due to the COVID-19 pandemic. Materials and Methods: An online questionnaire was distributed among students across the globe using a combination of convenience and snowball sampling. The questionnaire was pretested, prevalidated, and contained 24 close ended and one open-ended question (s) divided into 4 sections. Data obtained were transferred to SPSS version 21.0 and on applying the Shapiro–Wilk test, data were found to be parametric. Therefore, the independent samples t-test and multivariate linear regression were applied to analyze the data keeping P value significant at ≤0.5. Results: Of the total of 715 responses received, most students belonged to India (35.2%) followed by Saudi Arabia (14.5%). Majority of them belonged to the dental background (30.2%) followed by medical (16.1%) and architecture (12.9%). 50.1% used their cellular data to access the Internet and 59.2% of students preferred using a mobile phone. 44.8% of students reported technical issues (P = 0.01), resulting in only 33.4% of the students being able to understand the entire lecture/activity completely (P = 0.01). 58.7% of the students did not prefer online learning (P = 0.03). Linear regression revealed a significant preference for offline learning between students pursuing all levels of education. Conclusions: Although students preferred offline learning, universities are encouraged to sensitize their students to online learning techniques so that they are prepared to “suddenly shift” to online learning due to a variety of reasons (pandemics, natural disasters, and chronic illness).
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