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   Table of Contents - Current issue
Coverpage
July-December 2021
Volume 9 | Issue 2
Page Nos. 29-220

Online since Saturday, March 26, 2022

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REVIEW ARTICLES  

A review on geriatric oral health: Nutritional pattern and dynamics Highly accessed article p. 29
Priya Sharma, NL Gupta, Chetan Sharma, Richa Jaswal
DOI:10.4103/ijcd.ijcd_17_21  
Health, a prized possession, has always been a target for generations to achieve. Its vital factor nutritionin every form is an expression of genetic heritage that influences the occurrence and severity of degenerative diseases associated with aging. Nutritional problems may result from changes associated with aging process, medical/psychiatric illness, or other medical conditions. The epidemiological literature on oral health in the elderly is varied across countries and regions, more so as a function of institutionalization. This article intends to present importance of the need to care for oral health, concise review of literature on hardships with repercussions in edentulous patients, and how specific nutrients interact with the body to contribute to an individual's health. The past literature on oral health in elderly was extensively and comprehensibly perused, reviewed, and summarized in terms of descriptions on geriatrics nutrition and changes in diet associated with aging. The search for thorough original and review articles were mainly done from the sites such as Google scholar, PubMed, ResearchGate, etc., on geriatrics nutrition and terms such as genarian, nutrition assessment, edentulism, denture wearing, impact of nutrition, oral and general health, dental sores, and nutritional deficiencies. This review summarized pertinent articles that described the changes in diet associated with edentulism. Most studies suggested that edentulous individuals lack specific nutrients which bring them to risk of various health disorders. Recent research literature highlighted that dental prostheses supported by implants, significantly improve nutritional status in edentulous patients, provided the individual has sound health to undertake procedure for dental prosthesis. Elderly denture wearers are vulnerable to compromised nutritional health due to various factors. Timely and routine evaluation of nutritional status is important for any nutrition or dietary modification. Dietary counseling along with supportive supervision of the family regarding dental health is an integral part of treatment for denture wearers.
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Tobacco awareness among hearing and speech disorders using Indian Sign Language Highly accessed article p. 33
Amisha Nayak, Sandhya Tamgadge
DOI:10.4103/ijcd.ijcd_16_21  
Tobacco consumption is prevalent in most of the countries of the world, including India, and its addiction has subsequently engulfed lengths of populations of all age groups. Many significant tobacco cessation and prevention programs are initiated on a regular basis with an aim of raising awareness and followed by the decline of tobacco use amongst mass populations. Such programs are well received by physically, mentally, and socially balanced masses. However, it becomes a challenge when people who are auditory and speech compromised, namely The deaf and mute are considered. Through the use of Indian Sign Language, tobacco cessation and public awareness can be elevated if learned by the medical professionals, especially dentists, which in due course will aid in the prevention of various diseases caused by tobacco including oral cancers. There is a need of an hour to reach this community through Indian Sign Language.
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Green tobacco sickness among tobacco harvesters: A review of the literature p. 36
B Kumar Raja, Vaishnavi Prashanth, Kavitha Devi
DOI:10.4103/ijcd.ijcd_23_21  
Green tobacco sickness (GTS) is an occupational illness that affects tobacco harvesters. It is a type of acute nicotine intoxication caused by nicotine absorption through the epidermis of a moist green tobacco plant. The purpose of this study was to systematically review the existing literature on the green tobacco sickness and its health impacts on tobacco harvesters. A standard literature search was performed using multiple electronic databases like PubMed, PubMed Central, Cochrane Library, Campbell systematic review Embase, Google Scholar and Scopus for studies published on green tobacco sickness from 2000 to 2020. A total of 11 studies with a total population of 6,253 were reviewed. The prevalence of green tobacco sickness among tobacco harvesters ranged from 6.6% to 56.9%. Exposure to Sunlight, use of pesticides, Stalk removal of tobacco leaves, gender of the farmer, smoking, skin rash, wearing a wet suit, process of curing tobacco leaves, and watering tobacco plants, task, topping, barning and working in wet clothing were some of the risk factors reported by authors. Green tobacco sickness was shown to be common in the study population, indicating that a significant regulatory effort is needed to address the potential dangers of GTS.
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Revised curriculum of BDS with optional subjects: A thought process p. 41
Sandhya Tamgadge, Amisha Nayak, Avinash Tamgadge, Vipin Vasudev S Pai, Shirin Saini
DOI:10.4103/ijcd.ijcd_20_21  
There is a lot of saturation of conventional career opportunities when it comes to practicing in dental sciences. As a result, there is remarked observance of unemployment, drastic shifts in the careers which are seldom related to bachelor studies. This can often lead to a lack of job satisfaction and complete arrest of the conventional clinical practice. In such scenarios, it is necessary to seek for the alternative applied career options where the students as well as established dentists work and manifest expertise in such different career spectrums. In addition to the conventional subjects in masters of dental surgery, these courses might help the students who cannot afford the fees required for the masters. Exposure to the new fields can lead to better demand for jobs and the experience adds on to the expertise, better patient compliance, and development of better interpersonal and interdisciplinary clinical practice.
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Evidence-based decision-making – A review p. 46
Praveenkumar Kannan, KG Gokulkrishanan, S Sushanthi
DOI:10.4103/ijcd.ijcd_25_21  
Evidence-based decision-making gained its popularity because of its unique strength which throws proofs and evidences in the limelight for improving practices. This concept evolved in relation to the necessity for increasing the health-care quality, and also, it should have the acceptance of the changes done by the present-day projects which helps in the utilization of bounded resources. Foremost decisions taken during objective care should be assisted by classical scientific evidence which can improve possibilities of victorious patient results. Evidence usually includes journals, articles, and publications which provide present-day pertinent information based on search. It imparts us the plan of action for ameliorating the effectiveness of combining present evidences into receiver's care more quickly which makes you to tackle an immense high quantity of information. It helps us in innovating new treatment plans and contributing treatment and counsel evidences which are practically defensible. In the era of technological advancements which can give us answers to scientific questions even within a minute in our hands, evidence-based current research provides a best flexible method which will aid to find alternative treatment options, newer technologies/materials, and also clinical decisions too.
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Preventive resin restoration - A narrative review Highly accessed article p. 49
Praveenkumar Kannan, KG Gokulkrishanan, S Sushanthi
DOI:10.4103/ijcd.ijcd_24_21  
Conventional restorative dentistry methods persist predominant in the treatment of carious, even incipient carious, lesions when deterrence or remineralization must be the treatment of choice. According to preventative extension, when the tooth is prepared, all pits and fissures are eliminated with a bur to comfort the placement of amalgam. Lacking to acknowledge the significance and advantage of conservation of as much tooth structure as possible is indefensible in light of the technique options that the acid-etch procedure and the new resin materials offer the profession. The preventive resin restoration has several advantages. One of the important advantages is minimal tooth structure is removed compared with a conventional preparation, leaving a much stronger tooth. This is in contrast to the extension for prevention method by which elimination of better tooth structure to prevent repetitive decay at the same time weakens the tooth. As mentioned, the sealed restoration can eliminate recurrent caries.
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At home and in-office bleaching techniques – A literature review p. 52
Shilpa Ajai, K Mahalakshmi
DOI:10.4103/ijcd.ijcd_13_22  
Hydrogen and carbamide peroxides have been successfully used for many years; in the past century, the dental bleaching technique suffered several changes and almost 10 years before new millennium, the technique was finally recognized by the international agencies of regulation. It is important that dentists handle the peroxides with the essential knowledge because it is demonstrated that satisfactory final results of this technique depend on the correct diagnosis of stains, management of the substrates (enamel and dentin) and as well sensitivity. Dentists are exposed to several dental bleaching techniques, products, and brands, and in the last 2 decades, the devices for light activation of the peroxides have become an extensive catalog. Today, the technique is also suffering changes based on the effectiveness of the different light sources for peroxide activation and its relation to satisfactory final results of the technique. The purpose of this literature review is to explain the determinant factors that influence satisfactory final results of the techniques and provide a general overview, to achieve a treatment decision based on evidence.
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Silver nanoparticles and its applications in dentistry − A review p. 56
K Mahalakshmi, Shilpa Ajai
DOI:10.4103/ijcd.ijcd_4_22  
Oral cavity is a gateway to the entire body and protection of this gateway is a major goal in dentistry. Plaque biofilm is a major cause of the majority of dental diseases and although various biomaterials have been applied for their cure, limitations pertaining to the material properties prevent achievement of desired outcomes. Nanoparticle applications have become useful tools for various dental applications in endodontics, periodontics, restorative dentistry, orthodontics and oral cancers. Of these, silver nanoparticles (AgNPs) have been used in medicine and dentistry due to its antimicrobial properties. AgNPs have been incorporated into biomaterials in order to prevent or reduce biofilm formation. Due to greater surface to volume ratio and small particle size, they possess excellent antimicrobial action without affecting the mechanical properties of the material. This unique property of AgNPs makes these materials as fillers of choice in different biomaterials whereby they play a vital role in improving the properties. This review aims to discuss the influence of addition of AgNPs to various biomaterials used in different dental applications.
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Fluoride varnish − A review p. 59
K Mahalakshmi, Shilpa Ajai
DOI:10.4103/ijcd.ijcd_36_21  
The growing emphasis on prevention-based dentistry has led to rapid development of newer and more innovative treatment modalities aimed at early disease prevention. In this context, fluoride varnishes are fast becoming an integral component of prevention-based programs along with patient and parent education. Fluoride varnishes adhere to enamel, and calcium fluoride formed after application acts as a long-term reservoir of fluoride. Four applications per year or three weekly applications once a year have been found to be effective. Application is fast and easy. No acute toxicity has been reported after using any fluoride varnish.
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Recent advances in dental caries diagnosis p. 62
S Sasidharan, P Rahmath Meeral
DOI:10.4103/ijcd.ijcd_34_21  
Dental caries, a progressive bacterial damage to teeth, is one of the most common diseases that affects 95% of the population and is still a major cause of tooth loss. Recent years have seen an increase in research activity surrounding diagnostic methods, particularly in the assessment of early caries lesions. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting and diagnosis of dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time.
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Recent advances in caries prevention – A review article p. 66
V Kalaivani, R Ramiya
DOI:10.4103/ijcd.ijcd_2_22  
Dental caries is a preventable infectious disease, and the early identification of risk factors and implementation of oral health preventive measures at a young age can reduce or even avoid this lesion progression. Some of the important changes that have taken place over the last few years that have influenced caries prevention are changes in disease level among different populations, increased understanding of caries pathogenesis process, material and operative technique development. We have a variety of new agents, which can be used to prevent dental caries, but the application of these agents in clinical trials is still limited in the developing countries. Moreover, dental caries is multifactorial and all preventive measures should be evaluated properly in human trials so that they can be introduced at the community level for the prevention of dental caries.
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Xerostomia diagnosis and management p. 70
Hariprasath Nagarajan, Thanigaivel Gunasekaran
DOI:10.4103/ijcd.ijcd_9_22  
Xerostomia, or dry mouth, is a common complaint that may be caused by several conditions, which include side effects of a wide variety of drugs, such as antidepressants, therapeutic radiation to the head and neck, dehydration, diabetes, and diseases involving salivary glands, such as Sjogren's syndrome. The complaint of dry mouth may or may not be associated with decreased salivary gland function. Individuals with xerostomia complain of problems with eating, speaking, swallowing, and wearing dentures. Some people also complain of salivary gland enlargement or changes in taste. Lack of saliva may predispose one to oral infections, such as candidiasis, and increase the risk of dental caries. Management of the individual patient with xerostomia includes assessment of salivary gland function, replacement therapy, and prevention of caries and oral candidiasis. Early recognition and management of xerostomia may prevent devastating dental disease and help to improve the quality of life.
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Nanoparticles in dentistry - An updated review p. 74
Hariprasath Nagarajan, P Sasikumar Karuppanan
DOI:10.4103/ijcd.ijcd_6_22  
Nanoparticles having a size from 1 nm to 100 nm are present in nature and are successfully used in many products of daily life. In dental materials, nanoparticles are typically embedded but they may also exist as by-products from milling processes. Possible adverse effects of nanoparticles have gained increased interest, with the lungs being the main target organ. Exposure to nanoparticles in the dental laboratory is addressed by legal regulations. In dental practice, nanoparticles are mainly produced by intra-oral grinding/polishing and removal of materials, by wear of restorations or release from dental implants. Based on worst-case mass-based calculations, the additional risk as a result of exposure to nanoparticles is considered to be low. However, more research is needed, especially on vulnerable groups (patients with asthma or chronic obstructive pulmonary disease). An assessment of risks for the environment is not possible because of lack of data. Exposure-reduction measures mainly include avoidance of abrasive processes (e.g., by proper sculpturing), cooling by the use of water spray, and sufficient ventilation of treatment areas.
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Critical review on root canal irrigants used in dentistry p. 77
S Sasidharan, P Rahmath Meeral
DOI:10.4103/ijcd.ijcd_37_21  
The purpose of the endodontic treatment is to eliminating the entire pulp including both vital and necrotic tissues along with the microorganisms and its byproducts from root canal system, with the help of chemical and mechanical aids. The present article summarizes a brief note on endodontic irrigant solutions and also its negative impact which should also be considered to lead a discovery of better endodontic treatment systems.
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Therapeutic application of fluoride varnish p. 79
M Indumathy, Hamrith Hari
DOI:10.4103/ijcd.ijcd_32_21  
Fluoride is the safest, economical, and effective tool for the prevention of dental caries. Food and Drug Administration has listed fluoride as an essential nutrient for human health. The World Health Organization (WHO) expert committee has included fluoride in its list of 14 trace elements that are essential for normal growth and development. Approximately half the population of the USA is consuming optimally fluoridated water since 1980 and countries like the UK, New Zealand, and Australia are protected by water fluoridation. In India, the preventive measures are not so effective and the caries incidence is still on the rise. The average DMFT in India by the age of 15 years is about 3. This high incidence could also be attributed to a low dentist–population ratio of 1:80,000 in India. According to WHO, the DMFT of 2 by the age of 15 should cause alarm. The answer for this health problem is prevention. Although many measures are available, the best option is to use systemic and topical fluorides. Approximately 5% of the population lives in endemic fluoride areas and 3% lives in optimal fluoride areas. About 85%–90% of the population lives in fluoride deficient areas and preventive measures should be directed toward this segment of the population. The use of fluoride in communal water supply and dentifrices does not interfere with normal oral hygiene measures. Fluorides in dentifrices had led to the decrease in the incidence of dental caries in the US, UK and Scandinavia.
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Recent trends in forensic odontology: An overview p. 82
Soundarya Prabhakar
DOI:10.4103/ijcd.ijcd_22_21  
Every human being has unique identity in life. Forensic odontology is an emerging branch of science which has a greatest scope of development. The most challenging feature of forensic dentistry includes the identification of dental remains, recovery, and analysis of evidence which match with the suspects. An objective comparison using recent technology would strengthen the validity of evidence in forensic dentistry. It has been established as an irreplaceable science in medicolegal matters and in the recognition of the deceased individuals. The forensic odontologist makes use of the knowledge of dentistry in bite mark analysis, fixation of identity in mass disaster, age determination, domestic violence, and child abuse cases. Therefore, the duty and responsibility of forensic odontologist have enhanced in recent times in various medicolegal cases. This article provides an overview of the trends that are evolving in recent times which are used in the field of forensic odontology.
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Variants of oral squamous cell carcinoma with emphasis on histopathological features, biomarkers p. 87
Prasanna Sekhar, L S Makesh Raj
DOI:10.4103/ijcd.ijcd_26_21  
Squamous cell carcinoma (SCC) is a malignant epithelial neoplasm exhibiting squamous differentiation as characterized by the formation of keratin and/or the presence of intercellular bridges. The epidermoid carcinoma is the most common malignant neoplasm of the oral cavity which also certain histopathological variations. The present review article focuses on histopathological variations seen in SCC along with brief emphasis on the biomarkers and prognostic factors which help in accurate diagnosis of SCC.
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Biomagnification of diseases: The exposome concept p. 94
Vijayashree Priyadharsini Jayaseelan, Arumugam Paramasivam
DOI:10.4103/ijcd.ijcd_5_22  
The human race has gone through levels of destruction and extinctions happening for millions of years. Yet, the species tend to survive the most catastrophic situations presented before them. People have made their way into existence surpassing the mishaps simply quoted as “natural disasters.” However in recent times, humankind experiences a lot of annihilation due to “man-made” factors that impose deleterious effects on health and the economy. Exposome refers to all the factors related to exposure which can influence the state of health or well being of an individual. Hence, exposome is a collective term that includes factors exposed by an individual, even before birth as a fetus and include sources from the environment, lifestyle, and occupation. The authors have made an attempt to address the consequences of exposome on human health and disease, relating it to the present pandemic situation. More studies pertaining to the gene-environment interaction in different populations would provide insight into the development of diseases and evolutionary mechanisms conferring susceptibility or resistance to complex disease phenotypes.
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Minimally invasive dentistry – A review p. 97
Shilpa Ajai, K Mahalakshmi
DOI:10.4103/ijcd.ijcd_3_22  
Minimal intervention dentistry initiates from the traditional surgical approach to the elimination of caries lesions seen as radiolucencies in the inner half of the enamel, at the dentin-enamel junction, and slightly into dentin, with the removal of the minimal amount of healthy tooth structure. Dental adhesives and restorative materials, changes in remineralization, caries process, and prevalence have revolutionized the caries management from G. V. Black's “extension for prevention” to “minimally invasive.”
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Herbal extracts in dentistry - A review of the current scenario and its future implications p. 100
Sathya Kumaresan, Channesh Patel
DOI:10.4103/ijcd.ijcd_7_22  
There have been several in vitro studies that have investigated the activity of natural plant extracts against oral pathogens. These studies have focused on bacteria that are involved in the etiology of oral and dental diseases. Early studies have clearly established that a number of substances had potential against cariogenic bacteria in dentistry. Dental health is an inevitable part of general health. Oral diseases are chronic diseases and contribute to the major public health problems. The use of natural products for the control of oral diseases is considered as an alternative to synthetic antimicrobials and is also of great help to overcome primary or secondary resistance to the drug. To review the current evidence on the antimicrobial efficacy of several plant extracts on dental caries and plaque microbiology. Over 750 species of bacteria inhabit the oral cavity (~50% of which are yet to be identified) and a number of these are implicated in oral diseases. The initiation of dental caries involves acidogenic and aciduric Gram-positive bacteria, primarily the mutans streptococci (Streptococcus mutans and Streptococcus sobrinus), lactobacilli and actinomycetes.
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Review on professionally applied disclosing agents p. 104
S Sasidharan, P Rahmath Meeral
DOI:10.4103/ijcd.ijcd_39_21  
Dental caries and periodontal diseases are plaque-mediated diseases. Poor oral hygiene and inappropriate dietary behavior can lead to increased plaque accumulation. Dental plaque is a biofilm that is formed over the teeth and prosthetic appliances placed in the oral cavity. As dental plaque is not easily visible to the naked eye, its removal is difficult and complex. To remove dental plaque and improve oral hygiene, the use of disclosing agents has been recommended. Disclosing agents are preparations containing dye or other coloring agents which are used for the identification of bacterial plaque that can be distinctly seen providing a valuable visual aid and help in the maintenance of good oral health.
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Proposed solutions to reduce the impact of air pollution on oral and dental public health p. 107
Maryam Salah H R. Ali
DOI:10.4103/ijcd.ijcd_14_22  
Air pollution plays an important role in affecting the general health of people. It can also affect their comfort and well-being and hence the quality of life. Whereas, no one can doubt that air pollution is one of the most harmful things in our daily life. Despite this, air pollution is now a common term that rings in our ears. Therefore, this is a sufficient justification that requires more studies in this important field to increase health awareness and maintain public health. Air pollution is one of those that refer to environmental pollution through gaseous, liquid, solid, or other waste products that have bad effects on the health of all creatures. The paper aims to present the impact of some sources of air pollution on animals and plants as they are among the main sources of people's food. This is in addition to presenting some diseases that affect the general health of humans as a result of air pollution, through a descriptive and observational review of the problem under study as a case in the field of oral and dental medicine. In conclusion, proposed solutions were presented to reduce the sources of air pollution for the benefit of human public health, especially in the current period as a result of the multiple mutations of the coronavirus.
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Role of sign language in oral health education: A review p. 113
Amisha Nayak, Sandhya Tamgadge, Avinash Tamgadge
DOI:10.4103/ijcd.ijcd_19_21  
Hearing and speech impaired patients are often illiterate; and communicate using Sign Language; which hinders dental care and causes increased levels of oral morbidity; followed by feeling of unfairness by the dental staff. It is very difficult for dentists to communicate and treat them. A dentist who has learned Sign Language can help understand and communicate with these patients and treat them effectively. This review aims to study the need of dentists to learn sign language to communicate with such patients for effective diagnosis, treatment, and even oral health education. If oral health education such as oral cancer and other oral diseases is given in sign language too, it will surely contribute in the prevention of various diseases.
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An overview of different scales used in tobacco cessation p. 116
S Vaishnavi, B Kumara Raja
DOI:10.4103/ijcd.ijcd_35_21  
Cigarette smoking is still a major cause of many preventable diseases. The pharmacologic effect of nicotine plays a crucial role in tobacco addiction. When issues around tobacco use are considered, “nicotine addiction” can be regarded as a roadblock that needs to be overcome. There are a number of questionnaires that have been designed specifically to measure tobacco dependence and few among them will be discussed in this article.
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ORIGINAL ARTICLES Top

A survey into parent's outlook to child's oral health checkup during COVID-19: A safe endeavor or a dangerous escapade in crisis time p. 121
Khooshbu Gayen, Supreet Shirolkar, Rajib Sikdar, Anisha Bag, Soumen Pal, Subir Sarkar
DOI:10.4103/ijcd.ijcd_13_21  
Objective: This study aimed to assess the knowledge of and evaluate the attitude regarding coronavirus disease 2019 (COVID-19) among the parents of child dental patients visiting the pedodontics department of dental hospital in West Bengal. Materials and Methods: A structured multiple-choice questionnaire containing 16 questions was distributed among the parents of a child (5–14 years) who visited in the department of pedodontics in our hospital. Three hundred and fifteen parents participated in this study and consent was taken from all of them. Chi-squared test for multiple comparisons was used to compare pooled questionnaire responses by age group, education level, and gender. Results: 57.14% of the participants were found to be very well aware of this pandemic situation and 54.28% of them talk to their children regarding this very often. 37.14% believed the dental department had a higher risk of virus infection; and 40% said they will take their children to the dental department again if the children have any dental problem. 57.14% said that there is a chance of their children get infected from the armamentarium that is used for treatment; and 41.91% of them said that they had taken well care of the oral health of their child to avoid visiting a dentist. Conclusion: More knowledge about this pandemic should be delivered to the parents and more reassuring information regarding the preventive measures at dental set up should be delivered to the parents of this population.
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Effectiveness of probiotic and herbal mouthwashes on gingival health among children with intellectual disability: An interventional study p. 129
CS Aarthy, Swetha Gadde, Parangimalai Diwakar Madankumar
DOI:10.4103/ijcd.ijcd_15_21  
Background: Maintaining good oral health is particularly challenging among children with intellectual disability (ID) because of increased oral health risks due to underlying disease, limitations on access to care, and competing demands. For ID children, the standard oral hygiene procedures such as brushing and flossing are too difficult to practice due to reduced manual dexterity and difficulty for the caregivers to handle these tools. Moreover, usage of mouth rinses is a nightmare for parents of children with ID as they lack the dexterity to spit the mouthwashes. Although many studies support the use of chlorhexidine mouth rinses, it should be taken into account that the side effects of chlorhexidine are well documented, but the same is not so in case of herbal and probiotic mouth washes. With this milleu, this interventional study was formulated to compare the efficacy of probiotic and herbal mouth rinses on gingival health among intellectually disabled children. Materials and Methods: The present study included thirty children with ID aged 10–15 years at New Hope Child Development Centre. The participants were randomly divided into two Groups: I and II, with 15 children in each group as follows: group I: probiotic mouthwash and Group II: herbal mouth wash. Baseline scores of plaque index (PI) and gingival index (GI) were recorded. The designated mouth rinses were distributed to the respective groups, and they were instructed to rinse once daily. Their parents supervised the children during the use of mouthwash. At the end of 3 months, the children were assessed to the same clinical measurements. Results: Intragroup comparisons for both the GI and PI scores were statistically significant (P ≤ 0.001) in both the groups. Intergroup comparisons between the two groups were not statistically significant. There was a significant difference in the effect of herbal and probiotic mouthwashes on plaque accumulation, gingival health status of these children. Conclusion: Herbal and probiotic mouthwashes can prove to be effective in reducing plaque and in improving the gingival status of children.
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Home remedy for dental pain during lockdown p. 134
Zoha Abdullah, M Pon Suriya Prakash, GS Pournami, S Prithivi, Parvathy Premnath
DOI:10.4103/ijcd.ijcd_7_21  
Context: Since the coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic on March 11, 2020. several dental care facilities across countries have been completely closed or have been only providing minimal treatment for emergency cases. The primary objectives of the study were to explore the awareness and utilization of home remedies for dental pain during the lockdown. Aims: The main aim of the study is to assess the attitude, knowledge, awareness, and utilization of home remedies for dental pain during lockdown. Settings and Design: Cross-sectional study. Materials and Methods: An online questionnaire (Google Form) consisting 16 questions related to awareness, attitude toward and utilization of home remedies for dental pain was distributed through online platforms. Statistical Analysis Used: Data were collected and analyzed using the SPSS software. Bivariate analysis (Chi-square test) was used to assess the association between the independent variables with each of the main outcomes of interest. Results: Four hundred and seventeen responses were collected which included 204 males and 213 females. Dental pain was the most common dental problem faced by the study population, 68.5% were aware of home remedies and 56.5% had experienced relief from dental pain. Twenty-one percent rural study participants said that home remedy for tooth pain is better than conventional treatment. Conclusions: The surveyed population adopted home remedies as a first line of treatment for temporary relief from the tooth pain during the lockdown. Although it should be stated that majority preferred conventional treatment for permanent relief from the dental pain. During the lockdown due to the COVID-19 pandemic, the general public had little or in some remote areas no other choice but to follow the traditional methods to relieve their pain temporarily.
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Awareness of coronavirus disease-19 preventive measures among general population in Chengalpet District, Tamil Nadu p. 140
Prabhu Subramani, P Thereesha, M Thenmozhi, J Vinoth Kumar
DOI:10.4103/ijcd.ijcd_30_21  
Background and Aim: Measures to prevent and control coronavirus disease (COVID-19) include regular handwashing, physical distancing, and covering the mouth and nose, thereby reducing the spread of droplets. It is advised to follow preventive measures such as the use of facemask, social distancing, hand sanitizer during this pandemic for reducing the risk of infection transmission. The current survey was conducted to understand the public awareness about the preventive measures and its importance in preventing the spread of COVID-19 at the community level in Chengalpattu district, Tamil Nadu. Materials and Methods: A cross-sectional survey was conducted to assess the awareness among the general population concerning the preventive measures of COVID-19 in the public area in Chengalpattu district, Tamil Nadu. The data collection was done in the month of December 2020, the sample size for the present study was estimated to be N = 268. Results: Altogether 308 individuals, male (129 [49.1%]), female (179 [59.1%]). Maximum 299 (97.1%) were aware of the COVID-19 pandemic. Almost 274 (89%) feel that wearing mask protect them from COVID-19 and knew that wearing mask would protect themselves as well as others at the same time. N = 144 (46.8%) unaware that they should not share their facemask with their family members. N = 266 (86%) use the hand wash/sanitizer before and after removing their mask. N = 223 (72.4%) practice social distancing in day-to-day life. N = 186 (60.4%) population believe that preventive measures at personal level will reduce the spread. Conclusion: The study population was well aware of the preventive measures to contain the transmission and spread of COVID-19; however, there is a lacunae in the application of their awareness on practice, which has to be overcome by continuous health education and motivational measures.
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Patients attitude toward professionalism practiced by dental students p. 144
Prabhu Subramani, V Jude Aldo Paul, Kalaiarasi Subramaniyan, Jisha Acsah Samuel
DOI:10.4103/ijcd.ijcd_4_21  
Background: Professionalism includes working within a regulatory framework with adherence to ethical practice; situational judgement and awareness; the ability to interact and communicate with patients as well as inter-professionally; and the commitment to continually enhance and improve the knowledge, values, skills and understanding required to provide consistently high-quality dental care. The objective of the study was to assess patient attitude towards professionalism practiced by dental students. Materials and Methods: A self administered validated questionnaire was given to N = 170 patients reporting to Asan Memorial Dental college and Hospital. They were asked to respond to questions regarding student behaviour and communication during treatment. Data was entered in Excel and analysed using SPSS Version 23. Results: Most of the younger age group patients agreed that the student's attire inspired assurance in their abilities and also confidence level was increased by students of younger and middle age group. Simple languages used by the students helped them understand technical terms easily and it helped them clarify their doubts. Most of the male patients agreed that the first impression of the students and the way of receiving them in clinics increased their confidence level. Conclusion: Inculcating professionalism right from the beginning of the dental education will be the root cause in moulding up professional dentist in the further run.
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“Bond for Biscuits” – A survey to assess consumption of biscuits among children in Chengalpattu District, Tamil Nadu p. 148
Prabhu Subramani, Anjali Anilkumar, Rofina Gomez, Merlet Ann Thomas
DOI:10.4103/ijcd.ijcd_29_21  
Aims: Biscuit is one of the oldest bakery snack items, consumed by all age groups worldwide, and one of the most consumed bakery products by children. This study aims to determine the biscuit consumption pattern of children and the knowledge of parents about the sugar content in the biscuit consumed by their children. Materials and Methods: A cross-sectional study was conducted among 218 parents of children. A self administered validated questionnaire survey was conducted among N = 218 parents of children, the questionnaire consists of information about the demographic profile, followed by assessment of biscuits consumption pattern among children. Results: A total of 218 parents participated in the study; among all the children, 117 (53.7%) children take biscuits in the evening, 118 (54.1%) reported rinsing with water after consumption, 77 (35.3%) do not have the habit of either rinsing or brushing after biscuit consumption, 125 (57.3%) parents were not aware of the sugar content of the biscuits, 168 (77.1%) parents were aware that biscuits can cause dental caries, and 50 (22.9%) were still unaware of the role of biscuits in caries. Conclusion: The study showed that parents' knowledge of the sugar content present in biscuits and its impact on oral health was low, and there can be a reduction in the amount of dental health problems among children by imparting diet-related oral health education to the parents and children.
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Comparison between effectiveness of text and pictorial health warnings of tobacco packages in informing tobacco users about risk of oral cancers p. 152
Snehal Kailash Yerne
DOI:10.4103/ijcd.ijcd_11_20  
Background: Tobacco use continues to be the leading global cause of preventable deaths, killing nearly 6 million people worldwide each year. Tobacco control must be given high priority by scaling up tobacco control measures. In India under the Control of Tobacco Product Act, it is mandatory to keep the warning labels over all kinds of tobacco products to minimize the use of tobacco. Objectives: To determine whether tobacco packages with graphic warning labels or text-only warning labels had a stronger impact on addicting behavior. Materials and Methods: A cross-sectional study was carried out among the group of people using tobacco in any form. A total of 776 tobacco users were enrolled in the study. Results: The mean age of tobacco users was 41.4 years. Out of the total of 776 tobacco users, 561 (72.3%) had noticed warning signals over the tobacco products. Among those who had noticed warning labels, 64.4% became aware about health effects and 66% had thought to quit tobacco. Tobacco users of the young age group (15–45) were more aware regarding warning labels. Females were less aware. As the level of education increases the number of tobacco users who tried to quit or reduce the daily quantity of tobacco intake also increases. Conclusions: The positive impact of warning labels has been seen among the tobacco users who have noticed them. Not all tobacco users were aware regarding the presence of warning labels as per the findings of the present study.
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Use of dental lasers among teaching faculty of private dental colleges in Chennai – A questionnaire-based cross-sectional study p. 156
S Vaishnavi, V Indra Priyadarshni, Soundarya Prabhakar, B Kumara Raja
DOI:10.4103/ijcd.ijcd_28_21  
Background: Lasers were developed with the hope of overcoming some of the drawbacks posed by conventional methods of dental procedures. Aim: The aim of this study was to assess the knowledge, attitude, and practices of lasers among teaching faculty of private dental colleges in Chennai. Materials and Methods: The cross-sectional survey was conducted among teaching faculty of several private dental colleges in Chennai. The self-administered validated questionnaire consisting of 15 questions regarding the dental lasers was designed and answered by 150 teaching faculty. Pearson Chi-square test was used for statistical analysis. Results: Overall, 126 (84%) responded that lasers should be the part of undergraduate curriculum and 131 (87.3%) felt that cost factor is the main reason for not using lasers in dentistry. Conclusion: Most of the dental faculty felt that they have sufficient knowledge about lasers and hands-on courses in continuous dental education (CDE) program will be the efficient method to gain knowledge about dental lasers.
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Prevalence of tobacco usage in young urban Indian males: A survey p. 160
Prasanna Sekhar
DOI:10.4103/ijcd.ijcd_27_21  
Aim of the Study: The aim of this study was to find out the prevalence of use of tobacco in smoking form among young males. Methodology: One hundred Indian subjects (young males) between 15 and 40 years of age were given a questionnaire to carry out a study. Results: Among 68 tobacco users, there were 13, 25 and 30 people in the age group of 15-20, 21-30 and 31 – 40 year respectively. Conclusion: A study was done in 100 young males in urban Indian subjects to assess the prevalence of tobacco usage. Among young males, smoking habit is more prevalent than chewing tobacco usage.
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Knowledge, attitude, practice about prevention of oral diseases among government higher secondary school teachers in Madurai p. 164
P Mercy, Sarika Balaganesh
DOI:10.4103/ijcd.ijcd_11_22  
Background: A teacher with adequate knowledge, positive attitude toward oral health can always play an important role in health education of school children and be an inspiration for children. Objective: The objective of the study is to assess the knowledge, attitude, and practice about oral disease government higher secondary school teachers in Madurai. Materials and Methods: A cross-sectional questionnaire study was conducted among 250 higher secondary school teachers in Madurai. The data on oral health knowledge, attitude, and practices were collected using a structured questionnaire. The data were analyzed using descriptive statistics and Chi-square test. Results: A cross-sectional study was conducted among 250 school teachers, one hundred and seventy-four were male, and seventy-six were female. Out of 250 study participants, only (2.4%) reported tooth decay as infectious. Most of the study subjects were aware that tobacco usage may lead to oral cancer. Majority of the study participants 236 (94.4%) used tooth brush and tooth paste to clean their teeth. Majority of them that is 236 (94.4%) used tooth brush and tooth paste to clean their teeth. Conclusion: The study found the school teachers having better tooth brushing practices, poor knowledge about dental caries, and better knowledge about tobacco ill effects. It was also found that they believed better training to the teachers in the subject of oral disease prevention improves oral health in school children.
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Assessment of dental caries using caries assessment spectrum and treatment index in children of age 5-10 years p. 168
V Kalaivani, R Ramiya, N Khaaviya
DOI:10.4103/ijcd.ijcd_38_21  
Introduction: Dental caries is the most prevalent disease of oral health in school-aged children around the world. Although different caries detection/diagnosis criteria are available, none of them includes the total spectrum of dental caries (which ranges from a sound tooth to tooth loss due to caries) other than caries assessment spectrum and treatment (CAST) Index. CAST index covers the total dental caries spectrum from no carious lesion through caries protection (sealant) and caries cure (restoration) to carious lesions in enamel and dentin, and the advanced stages of carious lesion progression in pulp and tooth surrounding tissue. Methodology: A cross-sectional study was conducted among children of age 5–10 years to detect the prevalence of dental caries using CAST index in Panchayat Union Primary School in Sundharipalayam and Koot-road (east), Villupuram. A total of 100 samples were selected based on inclusion criteria. Results: Only 33% had sound dentition, 0% had sealant and restoration, presence of caries in enamel and/or dentine ranged from 9% to 33%. Pulpal involvement was observed in 13% and abscess/fistula was present in 7% of participants in at least one tooth. 5% had lost at least one tooth due to caries. Conclusion: CAST index has been found useful in epidemiological surveys, especially in recording early carious lesions. Developers of the CAST index should throw more light on the treatment needs part of the index as well as how each code of this index can be utilized in controlling dental caries in a community.
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Knowledge and practice of rubber dam usage among dental practitioners p. 171
Hariprasath Nagarajan, P Sasikumar Karuppanan
DOI:10.4103/ijcd.ijcd_40_21  
Background: The purpose of the present study is to determine the rubber dam usage among dental practitioners, specifically focusing on endodontic treatment, evaluate the problems they encountered, and gather information about their prospective presumptions about using it in future. Aim: The aim of this study is to evaluate the information regarding the use of rubber dam among dental practitioners. Materials and Methods: The usage of rubber dam use has been quantified based on the questionnaires which were distributed to dental practitioners. Questions were asked about areas where the practitioners used rubber dam, its advantages and difficulties, and whether they agreed or disagreed with some aspects of the rubber dam. The questionnaire was then collected and evaluated. Descriptive statistics were calculated. Results: About 78% of the dental practitioners have adequate and satisfactory education regarding the use of rubber dam. Conclusion: Rubber dam makes dentistry easier, faster, safer, and more satisfying for the operator. This research concludes that it is necessary to increase the knowledge and awareness of dental practitioners about the rubber dam and its application
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Development of oral potentially malignant disorders in tobacco using population in Union Territory, Chandigarh – An observational study p. 175
Saikat Chakraborty, Kashish Singh, Vimal Kalia, Shikha Tyagi, Bir Singh Chavan
DOI:10.4103/ijcd.ijcd_11_21  
Introduction: Oral potentially malignant disorders (OPMDs) are characterized by suspicious mucosal changes in oral mucosa that predispose it to malignancy. It is a general consensus that OPMDs show higher risk of malignant changes within the first 5 years of diagnosis, if not promptly treated. Agreeably, tobacco is the most important etiological factor in this scenario. In our pilot study, we attempted to observe the frequency of OPMD in a cohort of tobacco users in Union Tertiary, Chandigarh. Materials and Methods: The study was undertaken in rehabilitation colonies under the Municipal Corporation Chandigarh using a household survey approach. The sociodemographic forms were filled out for the participants. Risk assessment was done on:-• Using tobacco in any form. • Presence of any chronic nonhealing ulcer. After obtaining the written informed consent, the oral pathologist conducted the visual inspection of oral cavity. The subjects with clinical lesions underwent vital staining using 1% toluidine blue. The results of the test were categorized as positive and negative staining. Demonstration of self-examination of the mouth was given to all the participants. Results: The results are mentioned in tables provided. Discussion: High prevalence of oral and oropharyngeal cancers in India is due to tobacco usage. Changes in oral tissues developing in tobacco consumers have greater potential for malignant transformation as those developing in nonconsumers. Conclusion: In conclusion, we attempted to put forth 3 A's i.e., Awareness, Action and Agreement.
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Perception, impact, and barriers of online learning among dental students in Chennai City p. 180
R Kesavan, A Vinita Mary, Preethi Ganesh, P Rithika Raj, V Lalitha Priya, S Elakiya
DOI:10.4103/ijcd.ijcd_33_21  
Background: Electronic learning is an influential technological tool that blends the traditional teaching and electronic resources and had become an imperative platform in supporting the education system in recent years due to COVID-19 pandemic. Materials and Methods: A cross-sectional questionnaire survey was conducted among the dental students across Chennai to evaluate the impact of online learning and to identify the barriers faced that will aid in formulating alternative strategies to reduce the difficulties and improve the quality of learning. The study population was selected based on certain inclusion and exclusion criteria. The data collection was done through a validated questionnaire with assistance from Google Forms. Results: It was found that around 67% of the participants had not attended any online classes before COVID-19. Half of them had Internet connectivity issues during online classes and about 62% of the students faced lots of distractions during online classes. When the participants were asked about their learning preference, majority of them responded that they were comfortable with the traditional method. Conclusion: It was concluded that students had experienced connectivity and other technical issues during these classes and most of them were able to manage it. The major disadvantage of online classes was they were not able to reproduce a practical and clinical hands-on experience, which is indispensable for health-care students. However, the students were able to cope up with it since there was the only choice existing.
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Knowledge, attitude, and practice related to tobacco use among IT professionals in Chennai – A cross-sectional study p. 185
Selvamani Baskaran, R Palanivel Pandian, Sathish Rajendran
DOI:10.4103/ijcd.ijcd_10_22  
Aim: The aim of this study was to assess the knowledge, attitude, and practice related to tobacco usage among IT professionals in Chennai. Subjects and Methods: A cross-sectional descriptive study was conducted among 615 IT professionals in Chennai. A preformed questionnaire was used to assess the knowledge, attitude, and practice related to tobacco use. Statistical tests used were frequency distribution and Chi-square test. Results: Out of 615 study participants, 495 (486 males and 9 females) have consumed tobacco. Among 486 males who consumed tobacco, 481 consumed cigarettes and 5 consumed pan zarda. Among the 9 females who consumed tobacco, all of them consumed cigarettes. Majority of the tobacco consumers (244) reported that they consume tobacco to relieve from tension. Out of 495 tobacco users, only 214 tobacco users attempted to quit the habit. Out of 214 tobacco users who attempted to quit, only 97 tobacco users quit the habit. Among the 97 tobacco users who quit the habit, 56 stated that they encountered health hazards and 41 reported that they quit the tobacco habit for the sake of family members. Among the tobacco users who have not attempted to quit the habit, 155 tobacco users stated that they did not felt it was necessary to quit the habit. Out of 615 study participants, only 255 study participants support strict legislation on tobacco use. Out of 486 males, 354 study participants stated that smoking near them was not harmful, while out of 129 females, majority of them, i.e., 122 study participants, stated that smoking near them was harmful (P < 0.001). Conclusion: It was found from the study that majority of the study participants were tobacco users and cigarette was the most commonly used form of tobacco. Although majority of the study participants reported that they were aware of the ill effects of tobacco, they were not reported to support strict legislation related to tobacco use.
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Problems faced with complete dentures by elderly people attending clinics in dental hospital, Peradeniya p. 189
Gayathiry Nesarajah, R Manori Jayasinghe, Sachith P Abeysundara
DOI:10.4103/ijcd.ijcd_8_22  
Purpose: This study aimed at assessing physical, social and psychological problems faced by complete denture wearers and to identify the association of socioeconomic factors of the individual with the problems related to complete denture-wearing for early identification and treatment planning to improve their oral health and wellbeing. Materials and Methods: This was a descriptive cross-sectional study conducted at the Dental Hospital, among 96 complete denture wearers, who were 60 years and above. A pre-tested and structured interviewer-administered questionnaire was used to collect data through telephone interviews. Descriptive statistics were obtained as frequencies and percentages. Chi-Square test was used to assess the association between selected demographic variables and denture information. Results: Most of the participants (71.9%) used their present dentures for 0-5 years. Gender and occupation significantly influenced the frequency of cleaning the mouth. The most common problems were loose dentures, longer time is taken to complete meals, consciousness while eating, difficulty in chewing and food accumulation beneath dentures. Occupation, family support and family income had significant associations with some problems related to complete dentures. Family support was the major factor that had significant association with social interactions such as difficulty in speaking, limitation in facial expression, avoiding going to parties and avoiding leaving home/resident environment. Most of the socioeconomic factors had a strong influence on participants' self-confidence. Conclusion: Complete denture prosthodontics should focus on patients' physical and psychosocial problems with their socioeconomic background to identify problems, to restore their confidence level and improve quality of life.
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Awareness about dental complications among diabetic patients in Madurai p. 195
Channesh Patel, Sathya Kumaresan
DOI:10.4103/ijcd.ijcd_12_22  
Diabetes mellitus is a growing public health concern. Preventive dental care is found to be associated with dental knowledge and hence a study was done to assess knowledge, attitude, and practices of diabetic patients attending outward patient in a government hospital in Madurai. Methodology: A cross-sectional study was conducted among 308 diabetic patients attending the government hospital in Madurai. A pretested questionnaire was used. Descriptive statistics was done to describe the frequency. Results: It was found from the study that effect of diabetes on oral health was known by about 52 (16.9%) study subjects. Out of 308 respondents, 266 (86.4%) brushed their teeth once daily and 42 (13.6%) brushed twice daily. Only 38 (12.3%) study participants said that they want to get education on oral health and diabetes. Conclusion: The level of awareness about oral complication in diabetic patients was found to be deficient. Most diabetic patients were not aware about various complications of diabetes and the effect of diabetes on the oral health. The attitude of the diabetic patients toward oral health was found to be deficient. The practice of the diabetic patients toward oral health was found to be good.
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Awareness and availability of different treatment options in dentistry among the general population in Chengalpattu District, Tamil Nadu p. 199
Prabhu Subramani, Yuvaraj Baskaran, Anjana Mohan, Sathish Elugundan, Mouniga Pitchaimani
DOI:10.4103/ijcd.ijcd_21_21  
Aim: Oral health problems are common among the general population. People have the habit to undergo dental treatment only during dental pain due to the ignorance. The present study was conducted with the aim to assess the awareness about treatment procedures and various options toward dental treatment among the general population in Chengalpattu District, Tamil Nadu. Materials and Methods: A cross-sectional descriptive study conducted among outpatients reporting to Asan Memorial Dental College and Hospital. A self-administered, closed-ended questionnaire was used to assess the awareness and availability of treatment options in dentistry. The results were analyzed using SPSS Software version 23. Statistical analysis was performed by Chi-square test for comparison. Results: Among 200 patients, n = 129 (64%) were aware of oral prophylaxis as treatment for bad breath and stained teeth. N = 187 (93.5%) aware of the treatment of decayed tooth. N = 192 (96%) were aware of the treatments for fractured tooth. N = 188 (94%) were aware of the treatment options for missing tooth. N = 177 (88.5%) were aware of the different orthodontic treatments for malocclusion. Conclusion: The majority of the study population investigated, were aware of various treatment options available in dental practice.
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Influence of mother's knowledge on the oral hygiene habits of their preschool children p. 203
N Khaaviya, R Ramiya, V Kalaivani
DOI:10.4103/ijcd.ijcd_1_22  
Aim: Children under 7 years of age generally spend most of their time with parents or guardians, especially mothers. Parents play a central role in giving children the information and encouragement needed for healthy lives. Parental oral health knowledge, belief, and attitudes influence the oral health maintenance, dietary habits, and healthy behavior of their children. The aim of this study was to assess the mother's oral health care knowledge and to assess the oral health status of their child. Materials and Methods: A total of 130 mothers along with their child of 1–7 years were randomly selected for the study. A 19-point questionnaire including dietary practices and oral hygiene practices was designed to assess the knowledge of the mothers regarding oral health of their child. Oral examination of the children was done by the World Health Organization criteria for recording children's oral health status. Results: About 87% of the mothers agreed that intake of food with excessive sugars can cause cavities, and 95.8% admitted that chocolates cause the most decay. 80.5% agreed to the fact that leaving a milk bottle all night increases the risk for tooth decay, however, 59.3% of mothers were of the opinion that dental visit is must only in the presence of decay. 59.3% of mothers were unaware about the optimal fluoride content. 71.7% of mothers agreed that caries in deciduous teeth are a matter of concern. The average decayed score of the children was 2.9% and 77.9% of the children had a fair to good oral hygiene status. Conclusion: Instead of the fact that most of the health care knowledge that the mothers had was primarily from the family elders, they were aware of caries risk factors, toothbrushes and amount of toothpaste and bacteria from mother's cavities can infect the child. This could be observed by less number of decayed teeth and good oral hygiene status of the children. However, parent's knowledge, attitudes, and few beliefs regarding dental care need to be improved.
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A hospital-based case–Control study to explore the association of bruxism and cardiovascular diseases in Himachal Pradesh, India p. 208
Ragini Bhatia, Chaudhary Rajesh, Sood Saloni
DOI:10.4103/ijcd.ijcd_15_20  
Aims and Objectives: The cardiovascular diseases (CVDs) all over the world results in huge disease burden that has catastrophic social and economic effects. The main objectives of this study are to explore possible association of bruxism with CVD and to document other factors associated with (CVDs) and bruxism. Subjects and Methods: It is an observational study done in two hospitals of district Kangra, Himachal Pradesh. A case–control study design was used to study the association of bruxism and CVDs. Cases were patients having history of CVDs and controls were without CVDs. Self-reporting questionnaire and tooth wear index were used as research instruments. Results: A total of 80 subjects with CVD (62 years, standard deviation [SD] - 11.8, 53% men) were compared with 80 controls (58.9 years, SD - 11.15, 55% men). Bruxism was found to be more prevalent in patients with CVD (71.3% vs. 57.3%, P = 0.00043). On multivariate logistic regression analysis, bruxism was independently associated with CVD (adjusted odds ratio (OR) 2.61, 95% confidence interval [CI] 1.2–5.8, P = 0.016 and an unadjusted OR 3.16,95% CI, 1.66–6.21, P = 0.000529), explaining that the odds of having CVD is 3.16 times higher in patients with bruxism than participants without bruxism. Conclusions: More research (cohort studies) needs to be conducted to find the emerging risk factors for CVDs. Through the help of dentists, doctors, and community health workers, the general population shall be made aware of bruxism, CVDs, and their possible association.
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CASE REPORT Top

Comprehensive management of an autistic patient with mental retardation under general anesthesia p. 215
Allwin Antony, R Ramesh
DOI:10.4103/ijcd.ijcd_18_21  
Background: Autism is a developmental disorder characterized by severe deficits in social interaction and communication and one of the most heritable complex genetic disorders in psychiatry. Comprehensive management of these children requires multidisciplinary teamwork. Case Report: A 16-year-old male patient was brought to the Department of Pedodontics and preventive dentistry by his parents with complaints of pain and sensitivity of teeth and consequent difficulty in eating in the lower left back tooth region for 2 weeks. Since the patient was combative in nature comprehensive management was planned under general anesthesia. Complete rehabilitation including pulpectomy, restoration, fluoride varnish application, and parental counseling was done. After the procedure, the patient recovered well from the pain discomfort he was having and significant improvement in his oral hygiene was noted. After 4 weeks, follow visit revealed significant improvement in his behavior.
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