Background: Identification of the potential sources of depression and anxiety is important in dentistry, as it gives opportunity to take various measures to prevent these in a dental environment. This study aimed to investigate the causes of anxiety and depression among dental practitioners in a dental school in South Kerala. Materials and Methods: A questionnaire-based cross-sectional study was conducted among 100 dental practitioners working in a dental school in South Kerala. Depression and anxiety status was measured through prevalidated questionnaire Zung Self Rating Anxiety Scale and the Zung Self Rating Depression Scale. A 5-point Likert scale was used to record the responses from the study participants. Statistical analysis was done using SPSS package version 18. Results: The prevalence of depression and anxiety was 48% and 52%, respectively. Gender, educational level, choosing dentistry by chance, part-time practicing, marital status, lack of additional source of income, lack of physical exercise, and smoking were associated significantly with depressive symptoms (P < 0.05). Almost all sociodemographic, work-related characteristics, lifestyle except years of practicing, number of patients, and sleeping time were significantly associated with anxiety symptoms (P < 0.05). Conclusion: Dental practitioners were subject to many sources of anxiety and depression in their workplaces, with significant relationships with educational level, choosing dentistry by chance, part-time practicing, marital status, and lack of additional source of income. Dentists should be encouraged to participate in stress management courses to alleviate stress.

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Aim: To assess the oral health status in patients with various levels of spinal cord injury. Data Sources: Relevant studies were included from the period of January 2007 to October 2017 via MEDLINE, EMBASE and GOOGLE SCHOLAR, TRIP DATABASE. The search identified no randomized control trials for the proposed research question. The first set of terms included 'oral health status of spinal cord injury patient. The second set included the term 'oral health', 'dental health' separated by Boolean operator “OR” 'and the third set included the term 'spinal cord injury patient, 'upper limb paralysed patients 'separated by Boolean operator “OR. Conclusion: Based on inclusion criteria 5 articles were included. The methodological quality of the selected articles were assessed using the Effective Public Health Practice Project (EPHPP) 1998. The study results implied that the oral health among SCI patients was fair which is due to poor oral hygiene practices, greater levels of plaque, gingival bleeding and increase levels of caries experience. Oral hygiene instructions should be given in these patients and the caregivers should be trained adequately to maintain the oral hygiene of these physically compromised patients.

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Background: Good oral hygiene during pregnancy improves oral and general health of the mother, which in turn promotes oral and general health of the child. Hence, a study was done to assess knowledge and practices of pregnant woman regarding oral health. Materials and Methods: A cross-sectional survey was conducted among pregnant women attending a Government hospital, Chennai. A total of 500 samples were selected by convenience sampling technique. A questionnaire containing 16 close-ended questions related to knowledge, attitude, and practices pertaining to oral health during pregnancy along with demographic data was used for collecting baseline information. Descriptive statistics and Chi-square test were used to analyze the data. Results: Majority of the study participants (95%) were not aware that gum disease can cause preterm low birth weight babies. Most of them (93%) were not aware of safe period for undergoing dental treatment during pregnancy. Majority of the study participants (97.4%) used tooth brush and tooth paste to clean their teeth. Nearly half of the study participants (48.6%) replied that they consult dentist while experiencing dental problems. Conclusion: The knowledge related to oral health of pregnant women during pregnancy was found to be low and need to be improved. Oral health practice was not sufficient among the study participants and therefore proper health education is to be given to them regarding the importance of oral hygiene aids to maintain good oral health. Attitude toward dental visit has to be improved.

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Background: Bus drivers represent a special population group or community who deserve to be attended both on oral and general health due to the various occupational and environmental hazards they encounter in their daily life. The aim of this study was to assess the oral health status and treatment needs of professional bus drivers in Chennai. Methods: Cross sectional data was collected from 860 professional bus drivers in Chennai city. A specially designed questionnaire was used to assess the demographic variables, oral hygiene practices, tobacco usage, sweet consumption and work related stress. A clinical examination was done according to WHO criteria 1997 and recorded using WHO oral health assessment form. Results: The mean age of the study population was 40.25 years. With regard to sweet score, about 739 (85.9%) drivers were in “watch out” zone. There was significant correlation between sweet scores and DMFT (P = .000). About 524 (60.9%) drivers felt stress at work, 78(9.1%) drivers had leukoplakia, 5 (0.6%) had ulceration, 7 (0.8%) had candidiasis and 30(3.5%) had other conditions. The mean DMFT was 5.53. About 471 (54,8%) had dental calculus, 107 (12.4%) had periodontal pocket depth 6mm or more. Conclusion: The oral health status of bus drivers was poor with high prevalence of periodontal disease and dental caries.

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Background and Aim: It has been well documented that the absence of family support influences the general and oral health of the children. Oral health symbolizes the general health and quality of life of an individual. The socioeconomic status and emotional factor show a direct impact on oral health status of children. Hence, survey was done with an objective to assess the baseline data regarding oral health problems among orphan children of Tumkur, Karnataka. Methods: A cross-sectional survey was conducted among 2- to 15-year-old children residing in five orphanages of Tumkur. Prior permission and consent were obtained from respective authorities, institution, and children. Self-administered questionnaire included demographic details, oral hygiene practice, duration of stay, decayed, missing, filled tooth (DMFT) and tooth fracture status, and gingival status. Collected data were analyzed using descriptive statistics. Results: A total of 110 children in the age group of 2–15 years were examined. The findings of the examination highlighted untreated caries and no filled component which may be attributed to poverty, illiteracy, poor awareness, and lack of oral health services. Conclusion: Survey showed the need for oral health care services at orphanages of Tumkur. Spare time to serve our social responsibility (in the form of health services and psychological comfort) toward society either individually or along with institutions, nongovernmental organization, and public–private partnerships.

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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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Background: Knowledge of the risk factors of tooth wear is necessary for the prevention and effective treatment of tooth wear lesions. The objective of this study was to investigate sociodemographic factors and oral habits associated with tooth wear in the elderly in Port Harcourt, Rivers State, Nigeria. Subjects and Methods: The study was an observational research design in which participants were selected by systematic random sampling. Data were collected using pilot-tested questionnaire and tooth wear recorded using tooth wear index of Smith and Knight. Data were analyzed using Statistical Package for the Social Sciences version 20. Multiple regression analysis and Chi-Square test was used to test association between variables. Significance was inferred at P < 0.05 at 95% confidence interval. Results: Tooth wear was significantly higher in males than in females (P = 0.03). There was a significant increase in tooth wear with increasing age (P = 0.001). Individuals with a lower level of education had significant higher tooth wear than those with a higher level of education (P = 0.01). There was a significant association (P < 0.05) between tooth wear lesions and tooth cleaning technique, materials used for cleaning the teeth, toothbrush texture, and consumption of carbonated soft drink. However, the association between tooth wear and teeth grinding as well as frequency of teeth cleaning was not significant (P > 0.05). Conclusion: Consumption of carbonated soft drinks, toothbrushing technique, toothbrush texture, and materials used for tooth cleaning were risk indicators of tooth wear among the elderly population. Therefore, oral health education of the elderly and the general population on appropriate diet and oral hygiene practices is advocated.

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Background: In India, there are 6149 dental post-graduation seats across 254 dental colleges. The admission to these postgraduation seats is done through a common online NEET-MDS examination. The aim of the present study was to assess the quality of NEET-MDS examination among dental graduates in South India. Materials and Methods: Around 423 participants from five randomly selected entrance coaching centers in the states of Kerala, Tamil Nadu, Andhra Pradesh, Telangana, and Karnataka participated in the survey. The level of significance was set P < 0.05. Statistical analysis was done using Fisher's exact test. Results: The survey demonstrated that 174 (41.1%) of the participants were males and 249 (58.9%) were females. Majority (60.2%) of the participants had one attempt for the examination and only (4.9%) of the participants had three or more attempts for the examination. 58% of the respondents considered the NEET examination as a good assessment of dental graduates. Conclusion: The present survey reveals that most of the students preferred the computer-based NEET- MDS examination. Both male and female students should almost similar responses to the questions in the survey.

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Objective: To assess the prevalence of aggressive periodontitis and associated risk factors in 15–30-year-old school/college-going adolescent population/adults in district Yamunanagar, Haryana, India. Methodology: A total of 3875 individuals from 12 schools and 6 colleges of 6 blocks of district Yamunanagar were assessed on random basis in two stages. The first stage included assessment of risk factors and any systemic illnesses and periodontal assessment. In the second stage, complete periodontal and radiographic examination including bitewing examination of the molar region and periapical examination of incisor regions was carried out for the confirmation of aggressive periodontitis. Statistical Analysis: Chi-square and Fisher's exact test was applied to find the association between different variables. The overall model was tested by the Chi-square test and goodness of fit of the model was assessed using Hosmer and Lemeshow goodness-of-fit test. Results: In the present study, 2043 participants were male and 1832 were female while 6 participants (2 males and 4 females) were found to be affected with aggressive periodontitis, thus giving the prevalence of aggressive periodontitis in the present study of 0.15% (95% confidence interval: 0.05%–0.34%) with female: male ratio of 2:1. Religion, socioeconomic status, diet, method and frequency of tooth cleaning, and smoking/tobacco were not significantly associated with aggressive periodontitis. Conclusion: This study provides an insight into the existing lifestyle trends, attitude, and oral hygiene behavior of children/young adolescents and their association with the progression of disease.

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Background: In this contemporary world urbanization leads to the development of various industries on an immense scale. Although rapid industrialization symbolizes the growth of any nation but it can impinge on the general as well as the oral health of their employees. Aim: To assess the impact of socioeconomic status (SES) on decayed, missing, filled teeth (DMFT) of industrial recruits of Bhopal city, India. Materials and Methods: A descriptive cross sectional study conducted among 448 industrial recruits of GEI (General Engineering Industry). Modified WHO-2013, oral health Proforma was used to appraise their dentition and related treatment necessities. Statistical analysis was done by using Chi square and ANOVA (Analysis of variance) test used for statistic analysis. Result: The result of this study showed that dental caries prevalence not remarkably exaggerated by socioeconomic status but the mean number of decayed, filled and missing teeth unswervingly allied with socioeconomic status. Conclusion: This study concluded that dentition status of GEI, industrial recruits was not good, especially in the lower class SES. Therefore, to reduce this disparity equitable distribution of oral health of services are required.

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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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Oral diseases are one of the most common diseases found in humans. They can produce serious problems such as pain and discomfort leading to disability, impairment and handicap. Researchers suggest that poor oral health may be associated with medical conditions such as diabetes, pneumonia, and stroke. Some medical conditions do have oral manifestations as well. Despite their high social and economic burdens, oral diseases receive little attention in many countries and remain neglected. Children are especially at higher risk for being in the group of neglect in case of treatment of oral diseases are considered. To overcome this situation in our country, various oral health care programs have been implemented by both central as well as state government for the children. Various community-level programs, Anganwadi programs and school-level programs were developed like mid-day meal scheme, fluoride programs, tooth brushing programs, nutrition programs, health-promoting schools, tobacco-free schools, and oral health care program for special children like special smiles project. Seal-it, Arogya Jagratha and Ardram mission are some of the programs developed by state governments through primary health centers and through accredited social health activist (ASHA) workers. Still disparities are present in the quality of pediatric dental care. This review article highlights various oral health care programs for children in India.

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Dental caries is generally considered to be the most common oral disease. According to the studies that have recorded the prevalence of oral diseases, periodontal diseases do not have records about its prevalence as much as dental caries. The periodontal diseases, both gingivitis and periodontitis occur due to various reasons, as they are multifactorial. Based on the correlation of the knowledge of the pathophysiology of diseases affecting periodontium and available data, it can be derived that gingivitis is also as common as dental caries. The authors speculate that sacking of gingivitis into a broader term of periodontal diseases may be the reason that hinders this fact. Hence, there is an obvious need to replace the tradition with actuality by making a deeper investigation.

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Background: Yoga as a holistic approach to health and is classified by the national institutes of health as a form of complementary and alternative medicine. Regular practice of yoga helps to build a better connectivity the mind and body through a series of postures, breathing exercises, and meditation. Materials and Methods: A cross-sectional survey was carried out to assess the level of knowledge regarding yoga and its health benefits among dentists in South Kerala. A total of 280 dentists participated in the survey. The level of significance was set as P < 0.05. Results: The survey revealed that knowledge of yoga and its health benefits was highest among males when compared to females. The survey shows that 57.1% of dentists believe that yoga can have an impact on oral health. Only 27.1% and 21.4% of the dentist knew about Bikram yoga and Kapalbhati yoga, respectively. Conclusion: The survey reveals that dentists had less knowledge about yoga. Proper yoga training for dentists would help them develop a healthy lifestyle and reduce stress-related health problems.

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Background: Medical emergencies in dental clinics are sometimes life-threatening situations requiring immediate attention. Dental professionals should have adequate skills to manage such emergencies in dental setup. The aim of this study was to investigate knowledge, attitude, and practices of dental students regarding medical emergency preparedness. Materials and Methods: One-hundred and thirteen dental students (52 interns and 61 postgraduates) participated in this questionnaire-based survey. A close-ended pretested questionnaire consisting of 17 questions was used to assess the study parameters. Comparison of responses of interns and postgraduates was done using Chi-square test. The level of significance for this study was fixed at P < 0.05. Results: Postgraduates had a better knowledge of diagnosis of medical emergencies than interns (P = 0.001). More postgraduates had attended a workshop on medical emergency management (P < 0.001) and had given intramuscular injections (P = 0.001) than interns. Conclusions: The basic knowledge and practices regarding medical emergency management were better in postgraduates than interns. Expertise in the management of medical emergencies is essential for dental health-care professionals. Students should be trained better in medical emergency management at undergraduate level.

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Introduction: As all the topical fluorides contain a high concentration of fluorides and it is started at an early age when the swallowing reflexes are not well established, there is every chance the child may ingest a high amount of fluoride. As there are inconsistencies related to the usage of fluoride varnish in children, there is a need to study the toxicological aspects of fluoride varnish. Objectives: The objectives of this study were to estimate the amount of fluoride output through urine after the application of fluoride varnish and gel and to assess the safety levels of the same in early childhood caries (ECC) patients. Methodology: This study was conducted on twenty ECC-rehabilitated children of age group 4–6 years who were divided into two phases. In Phase I, the children were subjected to acidulated phosphate fluoride (APF) gel, and in Phase II, they were subjected to Fluor Protector varnish. In Phase I, the urine samples of each child were collected for the estimation of fluoride level which was considered as the baseline sample. After the application of APF gel, two urine samples were collected at 24 and 48 h for the estimation of fluoride levels. The same children were included in Phase II and were given placebo dentifrice for 7 days before commencing the procedure. The same experiment was repeated after the application of Fluor Protector varnish, and the collected urine samples were subjected for the estimation of fluoride level in laboratory with the use of fluoride ion-specific electrode and a miniature calomel reference electrode coupled to potentiometer. Values were recorded and the urinary fluoride concentration at different time intervals in each group was compared using the Friedman test followed by the Wilcoxon signed-rank test. Results: The mean urinary fluoride concentration in Group 1 at 24 h was 1.09 (standard deviation [SD] = 0.52) and at 48 h 0.74 (SD = 0.44). The mean urinary fluoride concentration in Group 2 at 24 h was 1.18 (SD = 0.65) and at 48 h 0.94 (SD = 0.59). There was a gradual increase in the 24^th-h sample of both the groups, which also showed a decline of fluoride concentration at the 48^th h. When both the groups were compared, Group 2 showed a marginal increase in fluoride concentration at different intervals of time, which was statistically nonsignificant. Conclusions: Fluor Protector varnish had an increased sustained release of fluoride ions when compared to APF gel, and there was a gradual decrease in the fluoride concentration which suggested that the fluoride concentration was approximating the baseline level (the safety level). The present study has provided a sound basis of recommendation for the safe and effective use of professionally applied fluoride products.

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Objectives: The objective of the study was to determine the association between dental caries and commonly proposed risk factors such as age, gender, body mass index (BMI), sugar intake, junk food consumption, and intermittent snacking habit among school-going children of upper socioeconomic status in Chennai city. Materials and Methods: The present cross-sectional study was carried out among 610 children of age between 7 and 15 years studying in a private school. A preformed content-validated pro forma was used to collect the data regarding demographic details (age, gender, height, and weight), dietary pattern (sugar consumption in the past 24 h assessed through sweet score, snacking in between meals, and junk food consumption in the past 24 h), and dental chart (for the presence of decay, missing, filled, trauma, and other findings). Weight and height of the children were recorded, and BMI was calculated using the formula weight (kg)/height (m²). Results: On the whole, except for age and gender, none of the factors assessed including BMI, junk food intake, and snack intake were found to be associated with dental caries. Conclusion: With the changing dietary patterns and demography, the dynamic nature of dental caries is better assessed if approached in terms of common risk factors.

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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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Background: Ailments pertaining to teeth and jaws were treated in a general manner, not requiring the services of a specialist. It is logical that progress in dentistry would go hand in hand with the progress of dentistry made in ancient civilizations. Materials and Methods: The present study was an online questionnaire-based survey among interns from six dental colleges across Kerala. The survey was conducted by a third party using a mobile application which consisted of nine questions in English. Two hundred and twenty-eight participants had responded by participating in the survey. The level of significance was set as P < 0.05. Results: A total of 228 participants were included in the study. Among the study participants, 87.7% of the participants were female and 12.3% were male. The present study showed that 57.1% of males knew the location of the world's first dental school when compared to females. The study revealed that only 36% of females and 14.3% of males knew when the first dental X-ray was performed in a patient. Only 57.1% of males and 48% of females knew the fact that Dr. GV Black is regarded as the Grand Old Man of Dentistry. Conclusion: The present study showed that the level of knowledge about history of dentistry among dental graduates was less. The levels of knowledge about dentistry among male and female students were almost similar.

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Kerala state in India ranks high in the health-care indicators and is considered to be giving high importance in primary health care. This review of literature was done to know the the prevalence of dental caries in children below 16 years of age in Kerala State. Online search for articles in PubMed, Scopus, and Google Scholar fetched 15 articles. The prevalence of caries in those articles was reviewed and discussed with other studies and systematic reviews published recently on the dental caries in India. This review shows that the prevalence of dental caries in children is high. Considering the status of Kerala in health-care facilities and reach to the grassroots level, it is recommended that government can bring about new initiatives to decrease the prevalence of dental caries in Kerala.

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Background: The prevalence of tobacco use is high in India, with nearly half of males and one-fifth of females using tobacco in some form. An effort has been made to offer help to quit tobacco use among patients by initiating tobacco cessation counseling (TCC) services in our Institution. The aim was to assess the effectiveness of TCC program among tobacco users. Methods: The evaluation of the TCC program was carried out by reviewing of records enrolled from January 2014 to March 2016. The baseline information of the enrolled subjects was assessed for tobacco use status. The post-intervention follow-up details of the current tobacco users were analyzed for quit status, and the tobacco quit rate was determined. Chi-square test was applied for statistical analysis. Results: Of the 1472 current tobacco users, 95.9% were males and 4.1% were females. An overall quit rate of 5.2% was recorded with women having 2.73 times higher quit rate than men (P = 0.004). Losses to follow-up were very high. Conclusion: A lower tobacco quit rate was recorded due to high losses to follow-up. Integration of proactive follow-up measures while designing the public health program is required, to overcome the challenge “high losses to follow-up” and to achieve a better response and outcome.

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Objective: Higher protein content in the maturing enamel could hamper adequate etching for sealant application. Removing the organic content could improve its adhesion due surface alterations in the enamel. To enhance retention of sealants, higher protein content in immature permanent molar enamel could be deproteinized with sodium hypochlorite. Hence, the purpose of the study was to evaluate the effect of deproteinization with 5% sodium hypochlorite before and after acid etching on the longevity of pit and fissure sealants. Methodology: One hundred and five immature first permanent molar in 35 children aged 6–9 years were included. In Group A, a protocol of etching, bonding and sealant application was followed. In Group B and Group C, deproteinization was done after and before etching, respectively, followed by bonding and sealant application. Groups were examined at 3, 6, and 9 months for sealant retention using Simonsen's criteria. Results: Intergroup comparison for retained sealants across all three groups over 9 months revealed that retention is more in Group A, followed by Group B and least in Group C. Conclusion: Deproteinization does not have an added advantage in the retention of pit and fissure sealant over routine acid etching method. Deproteinization after etching is better compared to deproteinization before etching.

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Dental caries is a chronic, transmissible disease of multifactorial etiology. There are a number of factors involved in the process of caries development. Xerostomia, resulting from medication use, may act synergistically with other known caries risk factors and indicators. We present a case report of a patient with high caries risk complicated by reduced salivary flow due to medications used in the treatment of glaucoma (Brimodin and Xalacom). A 36-year-old woman presented was referred to the Preventive Dentistry Clinic of the Lagos State University Teaching Hospital, Ikeja, Nigeria, on account of a 3-week history of toothache in the upper right quadrant. She had a high caries risk and a decayed, missing, and filled teeth index of 19. Consumption of cariogenic meals, poor plaque control, and treatment of glaucoma since childhood, with xerogenic medication, including xalacom and brimodin were determined to be part of the multifactorial etiology in this case. After relief of pain through pulp extirpation, the patient motivation and counseling on caries process, the need for good oral hygiene, and proper diet were done. Scaling and polishing were also done in addition to fluoride therapy and chemical plaque control. Improvement of salivary flow with the use of sugar-free chewing gum, artificial saliva, and frequent sipping of small quantities of water was also prescribed while the patient was referred to the restorative and oral surgery units for extraction of retained roots, composite fillings, and denture fabrication. Patients that present to any dental clinic with multiple carious lesions must be reviewed by the preventive dentistry specialists and have their caries risk assessed. It is also imperative that ophthalmologists include a dental consultation in the overall management of their patients, especially when they prescribe medication that has known oral side effects.

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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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Background: Between 2009 and 2016, India has made progress in reducing the prevalence of the use of both smoked and smokeless forms of tobacco. Efforts to quit tobacco use have increased, but successful quitting remains low. One of the known factors that hindered smoking cessation is nicotine dependence. There are two methods of measurement that are currently being used in order to assess the nicotine dependence, a self-reported method by the smokers, and the other being biochemical assessment of nicotine metabolite. The aim of our study was to determine the prevalence of smokers among truck drivers in Chennai city and to assess the association between the Fagerstrom Test for Nicotine Dependence (FTND) and the exhaled carbon monoxide (CO) level among them. Materials and Method: A cross-sectional study was conducted with a convenient sample of 493 truck drivers above 18 years of age. Dependence was assessed using the modified FTND scale. A CO breath analyzer was used to assess the amount of CO in the breath. Results: The mean age of the participants was 38.92 ± 10.43 ranging from 19 to 75 years. Nicotine dependence of smokers had a significant moderate correlation with CO level. Conclusions: The result of the present study showed that the exhaled CO level was associated with self-reported nicotine dependence and it may serve as a more objective method in detecting smoking.

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