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   2020| April-June  | Volume 18 | Issue 2  
    Online since June 24, 2020

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Comparative evaluation of indigenous herbal mouthwash with 0.2% chlorhexidine gluconate mouthwash in prevention of plaque and gingivitis: A clinico-microbiological study
Vrushali Ramdas Khobragade, Prashanth Yachrappa Vishwakarma, Arun Suresh Dodamani, Vardhaman Mulchand Jain, Gaurao Vasantrao Mali, Minal Madhukar Kshirsagar
April-June 2020, 18(2):111-117
Background: Plaque control measures are important to maintain proper oral hygiene. Indigenous medicines can be alternatives considered with minimal or no side effects to treat oral diseases. Aim: To determine and compare the antibacterial efficacy of indigenous herbal mouthwash with 0.2% chlorhexidine gluconate. Materials and Methods: The present study was conducted in two parts, and it was registered for the Clinical Trials Registry-India. The first part consisted of in vitro evaluation in which disc diffusion and minimum inhibitory concentration (MIC) methods were used. In the second part, a clinical trial was conducted among 30 participants of 18–40 years' age group to evaluate and compare the antibacterial efficacy of indigenous herbal mouthwash with 0.2% chlorhexidine gluconate. Plaque and gingival health assessments were carried out using the plaque index and gingival index on the 7th day, 14th day, and 21st day. All statistical procedures were performed using the Statistical Package for the Social Sciences 20.0 software (IBM, Armonk, NY, USA). It was assessed at 5% level of significance, i.e., P < 0.05 was considered as statistically significant. Results were statistically analyzed with unpaired t-test for pairwise intergroup multiple comparisons, on the 21st day, when plaque and gingival health were compared using plaque and gingival indices (P < 0.05). Results: Indigenous herbal mouthwash was seen to be sensitive at 12.5 mg/ml, and the zone of inhibition was highest against Prevotella intermedia (23 mm). With 0.2% chlorhexidine gluconate, the zone of inhibition was highest for Porphyromonas gingivalis and Prevotella intermedia (25 mm each) and MIC was seen to be 12.5 mg/ml for Bacteroides forsythus and 0.2 mg/ml for Streptococcus mutans and Lactobacilli by broth technique. In vivo examination showed a decrease in mean scores of plaque index and gingival index with chlorhexidine and indigenous herbal mouthwash from baseline to 21 days. Conclusion: From the present study, it was seen that there was a statistically significant reduction in both clinical and microbiological parameters with the use of an indigenous herbal mouthwash as well as 0.2% chlorhexidine gluconate. However, chlorhexidine mouthwash was statistically efficacious at the 21st day in controlling plaque and gingivitis with potent antimicrobial activity.
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Assessment of microbial contamination of indian currency notes in circulation – An In vitro study
Sruthi Sunil, Ganesh Shenoy Panchmal, Rekha P Shenoy, Vijaya Kumar, Praveen Jodalli, Vinej Somaraj
April-June 2020, 18(2):179-182
Background: Currency notes represent a universal medium for transmission of bacteria in the environment and among humans. Care should be taken by those handling these currencies. Aim: To quantitatively assess and compare the total bacterial load of Staphylococcus aureus, Escherichia coli, and Proteus species present on the currency notes circulating in the open market area and hospitals in Mangalore city. Methodology: A total of 24 frequently circulated currency notes were collected from open markets and hospitals (12 from each group). They were then deposited in sterile pouches. Samples were collected using moistened cotton swabs and inoculated onto MacConkey agar for bacterial growth. The isolated bacteria were then assessed for the percentage of bacteria and colony-forming units (CFUs) on the notes using standardized microbial analysis. Results: Cultures after microbial analysis showed bacterial contamination with S. aureus, E. coli, Klebsiella, and aerobic spore-bearing bacteria. Approximately >103 CFUs/plate were found. In the hospital group, isolated organisms comprised S. aureus (54%) and E. coli(25%); in the open market areas, E. coli(36%) and S. aureus (38%) were found. Proteus species were not present on any of the samples. Intergroup statistical analysis carried out using the Chi-square test was statistically significant (P = 0.034). Conclusion: The study concluded that the notes from hospitals were contaminated more with S.aureus than in open markets, whereas E. coli was found to be more in open market areas than in hospitals.
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Tobacco, alcohol, and drug consumption practices among medical and paramedical students in a government medical college of New Delhi, India
Neha Taneja, Ansh Pal Singh, Sandeep Sachdeva, Nidhi Dwivedi
April-June 2020, 18(2):161-167
Background: Substance abuse is a common practice among health-care workers across the globe. Aim: To assess prevalence and practices of tobacco, alcohol, and non-medicinal drug consumption practices among MBBS (including intern) and medical laboratory technology (MLT) students. Materials and Methods: A cross-sectional study was conducted and students underwent a face-to-face confidential interview using a predesigned, pretested, semi-structured interview schedule adapted from the Global Health Professional Student Survey. Results: A total of 283 (MBBS = 206 and MLT = 77) students participated in the study giving a response rate of 83.3%. The mean age was 20.92 (±1.75) years; 56.9% were male. Among medical students who had “ever” undertaken such practices were as follows: smoking (cigarette) (83, 40.2%), alcohol (98, 47.5%), and drug (38, 18.4%) intake, respectively; current (past 30 days) smokers were 34 (16.5%), and current (past 30 days) alcohol drinkers were 61 (29.6%). Males had a slightly higher prevalence of consumption of all substances in comparison to females except alcohol (P > 0.05). A statistically higher proportion of medical compared to paramedical (29.9% and 3.9%) students had ever drunk alcohol or consumed drug (P < 0.05). About 40 (14.1%) students had consumed all the three substances. On multiple regression analysis it was found that students staying in hostel (OR: 2.57; 95% CI: 1.3–4.8) had ever tried smoking in comparison to day-scholar (P = 0.003). Similarly, medical students (OR: 2.94; 95% CI: 1.1–7.5; P = 0.02) in comparison to paramedical students were ever alcohol drinker, and finally, drug intake was found to be statistically significant with age (above 20 years in reference to <20 years) and current residence (hostel in reference to day-scholar). Conclusion: There is a definitive and palpable unsatisfactory practices of “smoking, alcohol, and drug” consumption among medical in comparison to para-medical students.
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Impact of contextual school and home environmental characteristics on oral health-related quality of life among 11–14 years old children residing in Sri Ganganagar city
Thounaojam Leimaton, Simarpreet Singh, Manu Batra, Deeksha Gijwani, Sakshi Shukla, Parul Mangal
April-June 2020, 18(2):118-123
Background: Environment has shown a significant impact on day-to-day activities like psychological well-being, including oral health-related quality of life (OHRQoL) among children. Aim: To assess the impact of contextual school and home environmental characteristics on OHRQoL among 11–14 years old children residing in Sri Ganganagar city. Materials and Methods: A convenience sample of 345 children aged 11–14 years old were recruited. The present cross-sectional study was conducted among school-going children in Sri Ganganagar, Rajasthan, during November 2018–January 2019. Data were collected on demographic characteristics along with OHRQoL using Child-Oral Impacts on Daily Performances (C-OIDP) index. A prevalidated questionnaire used to collect data on contextual school and home environmental characteristics, oral hygiene, and dental caries were recorded using Oral Hygiene Index-Simplified (OHI-S) and Decayed, Missing, and Filled Teeth (DMFT) index, respectively. The data were analyzed with IBM SPSS Statistics Windows, Version 21.0. (Armonk, NY: IBM Corp). Mean, standard deviation, Chi-square test, t-test, and multivariable Poisson regressions models were analyzed for this study, and the level of significance was set at P < 0.05. Results: The mean C-OIDP extent was significantly higher in 11-year-old (6.11 ± 4.53) (P = 0.008), among those who were living with single parents with a less maternal level of education (<9 years). The mean DMFT score was higher among the participants who did not feel safe at school (3.94 ± 2.24) (P < 0.01) and mean OHI-S score was seen higher among those who were bullied at school (2.50 ± 0.51) (P = 0.018). Mean C-OIDP extent was statistically associated with bullying at school (P = 0.007) and lack of security (P = 0.002). Among all factors of C-OIDP, smiling factor shows a major problem for the children (10.2 ± 4.73) (P = 0.02). Conclusion: Poor school and home environmental characteristics were independently associated with poor OHRQoL in individuals. Actions toward the improvement of schools' security and implementation of anti-bullying campaigns should be components of health promotion strategies.
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Impact of sociodemographic factors on oral health among 35- to 44-year-old adults of Sri Ganganagar City
Deeksha Gijwani, Simarpreet Singh, Manu Batra, Yogesh Garg, Aditi Sharma
April-June 2020, 18(2):156-160
Background: Dental caries and periodontal diseases are the most prevalent dental diseases and important contributors to the global burden of oral disease, and socioeconomic factors are recognized as being the key determinants of oral health inequalities. Aim: To assess the impact of sociodemographic factors on oral health among 35- to 44-year-old adults of Sri Ganganagar city. Methods: The present cross-sectional study was conducted among the index age group of 35–44 years as recommended by the World Health Organization, and the total sample comprised of 995 adults. Data collection was carried out with the help of a predesigned and pretested questionnaire, and the clinical assessment of dental caries and periodontal status was done using the guidelines of WHO Oral Health Assessment form (2013). The data were analyzed statistically using the SPSS Version 22.0 software with tests such as Student's t-test, Chi-square test, and Kruskal–Wallis test, and level of statistical significance was set at P < 0.05. Results: Males had a higher prevalence of periodontal disease and dental caries compared to females (P = 0.03). The mean decayed teeth component (5.50 ± 1.91) was higher among the participants those having lower socioeconomic status (SES) (P = 0.02). The gingival pocket depth (4–5 mm) and loss of attachment was seen maximum among lower SES (P = 0.001). Conclusion: The prevalence of dental caries and periodontal disease was higher among the study participants. In light of the high treatment needs of the study population, the health policy that emphasizes oral health promotion and prevention would seem more advantageous in addition to the traditional curative cure.
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Attitudes and perceived barriers in geriatric dental care among undergraduate dental students in capital region of Andhra Pradesh
Talluri Devaki, Krishna Priya Mallikapuram, Bommireddy Vikram Simha, Viswa Chaitanya Chandu, Nijampatnam P M Pavani, Ravoori Srinivas
April-June 2020, 18(2):134-138
Background: This is the era of the elderly. In India, there is an exponential increase in the aging population. Increase in longevity means that the community will have to bear a greater burden of disease. The general health and well-being of older adults are related to their oral health. Aim: The to study the perceived barriers and attitudes of undergraduate dental students towards geriatric dental care. Materials and Methods: Four hundred and eighty senior dental students participated in the present cross-sectional questionnaire study. The first sought background information including gender, age, prior treating in geriatric dental care, and prior experience in treating the elderly in their education. The responses were categorized in a Likert scale. Data were analyzed using SPSS version 20. P < 0.05 was considered as statistically significant. Fisher exact test was used to know the attitude to work with elderly and the barriers in elderly dental care. Gender-wise comparison of mean attitude score toward the elderly was done. Results: The perceived barriers of dental students' showed significant association with respect to financial ability of the elderly (P = 0.017), follow-up of elderly patients (P = 0.04), elderly patient compliance (P = 0.05), and inadequate communication skills in treating elderly patients (P = 0.05). Females (2.500 ± 0.48) showed positive attitude when compared to male (1.166 ± 0.19) study subjects. The total attitudes mean score was 1.87 ± 0.34. Conclusions: Even though dental students were willing for elderly dental care, student's inadequate knowledge of geriatric care, poor communication skills, and lack of confidence in management of elderly patients are the identified barriers.
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Oral health-related quality of life of older patients attending a government dental hospital in India
Abhishek Mehta, Murali Govind, Jonathan Broadbent
April-June 2020, 18(2):151-155
Background: Caries, periodontal disease, and tooth loss affect the quality of life of older people. There is a need for research on the oral health of older Indians. Aim: To assess oral health and its impact on the quality of life of older adults visiting a government dental hospital in New Delhi, India. Methods: A cross-sectional study was conducted on a convenience sample of 255 older adults (above 60 years). Dental caries experience was quantified by a count of teeth that were carious, restored, and missing due to caries (Decayed, Missing, and Filled Teeth), while periodontal health was quantified using the Community Periodontal Index. Oral health-related quality of life (OHRQoL) was assessed using a Hindi version of the General Oral Health Assessment Index (GOHAI). Results: The mean GOHAI score was 24.2 (SD 4.3). More than half of the study participants had untreated caries and periodontal problems. Regression analysis showed that OHRQoL scores were associated with age, female sex, poorer educational level, and number of missing teeth in the sample population. Conclusion: Unmet need for dental treatment was prevalent and affects the quality of life of older Indians. Self-care and the use of preventive dental services should be promoted, while access to treatment services should be improved for this population group.
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Assessment of oral health status in orphanage inmates of north-eastern part of Rajasthan: A descriptive cross-sectional study
Apurv Soni, Hunny Sharma, Vaibhav Motghare, Swati Verma
April-June 2020, 18(2):139-142
Background: A child is dependent on their parents for care and affection, but, unfortunately, millions of children have to live without parents. Health problems of orphan children can be compromised and directly depend on the living conditions of the institution. Aim: To assess the oral health status in orphanage inmates of north-eastern part of Rajasthan. Materials and Methods: A cross-sectional survey among 1005 orphan children was conducted. The Oral Health Assessment Form for Children, 2013, was used to assess the oral health status of the study participants. IBM SPSS software vs 24 for windows (New York, USA) was used for statistical analysis. To estimate frequency and percentage, descriptive statistics were performed, while the need of inferential statistics necessitated the use of Chi-square test. A P < 0.05 was considered statistically significant. Results: The prevalence of dental caries in primary and permanent dentition was found to be 13.83% and 20.70%, respectively. Comparatively higher prevalence of dental caries was observed in female inmates. Bleeding on probing was detected in 225 (22.39%) participants. While, assessment of fluorotic lesions showed 0.80% with questionable fluorosis, followed by 2.89% with very mild, 2.69% with mild, and 0.40% with moderate fluorosis. Enamel erosion was found in 2.39% of the participants. Abscess was the only oral mucosal lesion found in sulci of 15 (1.49%) study participants. Conclusion: Our study findings showed that there is very limited accessibility and availability of any oral health care for orphanage residents. Children living in Rajasthan orphanages are suffering from dental caries that need to be urgently treated. There was no proof of any dedicated oral health-care services for these orphaned children.
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An observational study to find the patterns of out-of-pocket expenditure for oral healthcare among sanitary workers in Coimbatore, India
A Alice Nobelika, Arun K Simon
April-June 2020, 18(2):143-150
Background: Out-of-pocket (OOP) expenditure for health care and dental care has been steadily increasing. The OOP expenditure may precipitate existing financial distress in the households and lead to unmet dental needs. In India, OOP health expenditure is on the higher side due to low public spending on health. Aim: To find the patterns of oral health-care expenditure, factors associated with catastrophic dental health expenditure (CDHE), and knowledge about health insurance of sanitary workers in Coimbatore, India. Materials and Methods: The study employed a cross-sectional design based on an interview schedule. The final sample consisted of 246 study participants, randomly selected from sanitary workers presently working in Coimbatore Municipal Corporation. Data were collected regarding demographic information, and the interview schedule oral health-care expenditure inventory consisting of 48 questions was administered. Data were coded and analyzed using the Statistical Package for the Social Sciences (SPSS, ver. 20.0), and Chi-square test was applied for categorical variables. Results: The reported prevalence of CDHE was 15.4%. For dental care, 5.3% of the participants have spent more than Rs. 5000/month, and for dental medications, 11% have spent more than Rs. 2000/month. Respondent's monthly income (P < 0.05), number of family members (P < 0.001), socioeconomic status (P < 0.001), monthly expenditure (P < 0.001), duration of work (P < 0.001), dental problems (self-assessment) (P < 0.001), irregular dental visits (P < 0.001), self-medication (P < 0.001), and postponement of dental care (P < 0.001) were significantly associated with CDHE. Conclusions: This study provides evidence that OOP payments for dental care were high among the sanitary workers in Coimbatore putting burden on the financial security of their families, and 15.4% of the respondents were affected by CDHE.
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Association between health locus of control and oral health status in type 2 diabetics - A cross sectional comparative study
B Santhiya, Manjunath P Puranik, KR Sowmya
April-June 2020, 18(2):124-133
Background: Diabetes mellitus (DM) is a highly prevalent metabolic disorder which has life-long acute and chronic complications, constituting a huge global public health burden. The influence of diabetes on oral health is established. However, literature assessing psychosocial aspects that are necessary for managing metabolic control and oral health in diabetics is scarce. Aim: To determine the association between health locus of control and oral health among patients with Type 2 DM in Bengaluru City. Materials and Methods: A cross-sectional conducted among 300 participants with and without type 2 DM visiting government hospitals in Bengaluru City from November 2017 to September 2019. The Multidimensional Health Locus of Control (MHLC) Scale (Internal [IHLC], Powerful Others [PHLC], and Chance [CHLC]) and the WHO pro forma 2013 were used to assess health locus of control and oral health, respectively. Chi-square, Spearman's correlation, and multivariate hierarchical linear regression were applied. The statistical significance was considered at P < 0.05. Results: Diabetic participants were equivocal in their perceptions on IHLC, whereas nondiabetic participants were in agreement. Majority of diabetic and nondiabetic participants were in disagreement on PHLC. Nondiabetics were in disagreement on CHLC, whereas diabetics had elusive perception. Significantly higher proportion of diabetics had caries experience, deep pockets, and loss of attachment (LOA) than nondiabetic participants. Statistically significant association was found between health locus of control and dental caries experience, periodontitis, and denture use. Glycemic control, IHLC, and PHLC were found to be significant predictors of LOA. Conclusion: Oral health status was significantly poorer and associated with health locus of control. Glycemic control and health locus of control influenced oral health in diabetic participants.
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Health-related quality of life among dentists in Middle-East countries – A cross-sectional study
Sami S AlAbdulwahab, Shaji John Kachanathu, Abdulelah A Alaulami
April-June 2020, 18(2):168-172
Background: Health-related quality of life (HRQoL) is an essential concept for all health professionals. It is used to assess material, physical, social, emotional, and productive well-being. Health professionals investigate the HRQoL for their patients but rarely for themselves. Aim: To investigate the HRQoL among dentists in Middle-East countries. Materials and Methods: A multicenter and multi-regional stratified sample of 339 dentists (220 females and 119 males) with a mean age of 37 ± 9 years and 13 ± 8 years of experiences in dental practices in Middle-East countries participated in the study. HRQoL was assessed using the short form-8 (SF-8) health survey. The study group was examined based on HRQOL differences in age, gender, income, and overall QoL. The IBM® SPSS Statistics version 21 (IBM Corp., Armonk, USA) statistical software package was used for data analysis. The Spearman correlation coefficient and independent t-tests were used and significance was set at P ≤0.05. Results: The study observed that HRQoL among Middle East dental practitioners were within the published accepted general population range, in both physical component summary and mental component summary summaries of SF-8. The study also observed that gender differences had no role in terms of HRQoL among dental practitioners (P = 0.64). Conclusions: The study concluded that dentists have a positive HRQoL and no gender differences in HRQoL along with their years of dental practice. It is important that rehabilitation specialists have enough HRQoL information on different health-care professionals and geographical distribution to enable them to adopt an appropriate strategy and healthcare polices for a better outcome.
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President's Message
K Pushpanjali
April-June 2020, 18(2):107-108
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Documentation of oral health care seeking behavior and influencing factors through community consultations in the field practice area of a teaching dental institution
Suresh Chand Yaddanapalli, Srinivas Pachava, Srinivas Ravoori, Vikram Simha Bommireddy, Devaki Talluri, Pranoti Hiralkar
April-June 2020, 18(2):173-178
Background: Preventive dental visits help in the prior detection and treatment of oral diseases; therefore, to improve oral health outcomes, an opposite knowledge of the way the individuals use health services and the factors apocalyptic of this behavior is essential. Aim: To quantify oral health-care-seeking behavior and influencing factors in the field practice area. Materials and Methods: A cross-sectional study was done in the field practice area among WHO indexed age groups using a pretested and validated questionnaire in August 2017. A stratified random sampling technique was used resulting in a sample size of 200 to assess oral health-care-seeking behavior and influencing factors in this population. Obtained data were analyzed using SPSS version 20. Descriptive statistics, Chi-square test, and binomial logistic regression analysis were used to summarize the results, whereP ≤ 0.05 was considered as statistically significant. Results: The results of this study evinced a female preponderance of 64% with less proportionate (26%) of the study population seeking oral health services, out of which private dental clinic occupied the first choice in using dental services (17%). A carious tooth without pain was the most common dental problem irrespective of age (47.5%). Females were 0.392 times more likely to attend dental visits when compared to males (P = 0.003), while considering social class, people belonging to the upper-middle class were 0.24 times more likely to avail dental services when compared to lower social class (P = 0.015). Conclusion: This study revealed lower rates of dental services sought among the field practice area where most of them availed private clinics compared to government clinics.
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Honorary Secretary's Message
Vamsi Krishna Reddy
April-June 2020, 18(2):109-109
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From the Editor's Desk
KR Sowmya
April-June 2020, 18(2):110-110
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The need to harmonize research submission and publication
Meena Jain, Ankur Sharma, Nisha Rani Yadav, Vishal Jain
April-June 2020, 18(2):183-183
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Indian association of public health dentistry webinar series

April-June 2020, 18(2):184-187
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