Impact of oral health preventive program using specialized audio and tactile aids in visually impaired school children. A cross-sectional study

BACKGROUND

The maintenance of oral hygiene and subsequent health related issues in visually handicapped children is a challenging task. Hence, tools must be used to ensure good oral health in these children. The study aimed to analyze the effectiveness of preventive programs on oral health using specialized audio and tactile aids in visually impaired school children.

MATERIALS AND METHODS

100 visually handicapped children were selected for the study. They were divided into two groups: Group A (Training using Braille) and Group B (training by means of audio aids). Children were trained using appropriate tools and oral health was assessed using Plaque and Gingival bleeding indices.

STATISTICAL ANALYSIS

Independent 'T-test' was used for comparing mean ± SD values.

RESULTS

Statistically significant improvements in both plaque and gingival bleeding indices were obtained on follow-up observations at 3rd and 6th months.

CONCLUSION

The use of specialized tactile and audio tools significantly improved the oral health status of visually impaired school children.

Dental trauma experience of visually impaired and sighted children residing in residential schools - a comparative cross-sectional study

AIM

To assess and compare the prevalence of dental trauma in a population of 9- to 16-year-old children with partially impaired vision and sighted children of Jodhpur city, Rajasthan State in India.

METHODS

In this cross-sectional study, 121 children with partial impairment of vision were compared with a control group of 356 sighted children for traumatic injuries to the permanent dentition. Children in both the group were aged between 9 and 16 years and residing in a residential school. The survey was carried out using Ellis and Davy's classification of tooth fracture. Data were analyzed using descriptive statistical analysis, and the Chi-square test was used to compare different variables with P < .05.

RESULTS

The overall prevalence rates of traumatic dental injury (TDI) in the visually impaired and sighted groups were 24.79% and 9.39%, respectively (P = .000). Enamel fracture was the most common type of injury, and the maxillary central incisor was most frequently involved in both the groups. Children with overjet >3 mm sustained TDI more frequently in visually impaired children. TDI was higher in children with overjet ≤3 mm in sighted groups (P = .000). In both the groups children with inadequate lip coverage had higher occurrence of TDI (P = .000).

CONCLUSION

Dental trauma appeared to be more frequent in visually impaired compared to sighted children. The unmet treatment need for children with TDI was very high.

[The search for balance in the therapeutic decision-making process: the example of Class II malocclusion treatments in children and adolescents]

INTRODUCTION

Therapeutic decision-making is essentially the key to our clinical practice, and its most medical feature. The history of orthodontics is studded with multiple intellectual debates and stand-offs between conflicting treatment philosophies, the authors of which all aspire to a balance guaranteeing optimal treatment for their patients. Among the wealth of published data, which items should we select to ensure balanced treatment decisions in our daily practice and how can we remain serene in the face of the uncertainty and loneliness engendered by therapeutic decision-making process?

MATERIALS AND METHODS

Evidence-based orthodontics is an aid to clinical decisionmaking. Its main features are illustrated by four clinical cases describing the treatment of class II malocclusions in children and adolescents.

RESULTS

A search for the best pre-evaluated data on two-step treatments shows that : (1) a significant reduction in the prevalence of incisive trauma is observed in children when an increased overjet is corrected by an initial treatment phase, compared to single-stage treatments conducted in early adolescence; (2) the long-term impact of the first treatment phase on the amount of mandibular growth is at best weak and clinically insignificant.

DISCUSSION

The evidence-based approach, particularly when performed in user mode, enables us to reach more balanced clinical decisions. However, the article points out the key role of the clinician and the double risk of reducing the evidence-based approach to a mere standard of care - which it is not - and the subordination of treatment management to the strict clinical application of data in the literature.

Over two hundred million injuries to anterior teeth attributable to large overjet: a meta-analysis

BACKGROUND/AIM

The association between large overjet and traumatic dental injuries (TDIs) to anterior teeth is documented. However, observational studies are discrepant and generalizability (i.e. external validity) of meta-analyses is limited. Therefore, this meta-analysis sought to reconcile such discrepancies seeking to provide reliable risk estimates which could be generalizable at global level.

MATERIAL AND METHODS

Literature search (years 1990-2014) was performed (Scopus, GOOGLE Scholar, Medline). Selected primary studies were divided into subsets: 'primary teeth, overjet threshold 3-4 mm' (Primary3); 'permanent teeth, overjet threshold 3-4 mm' (Permanent3); 'permanent teeth, overjet threshold 6 ± 1 mm' (Permanent6). The adjusted odds ratios (ORs) were extracted. To obtain the highest level of reliability (i.e. internal validity), the pooled OR estimates were assessed accounting for between-study heterogeneity, publication bias and confounding. Result robustness was investigated with sensitivity and subgroup analyses.

RESULTS

Fifty-four primary studies from Africa, America, Asia and Europe were included. The sampled individuals were children, adolescents and adults. Overall, there were >10 000 patients with TDI. The pooled OR estimates resulted 2.31 (95% confidence interval - 95CI, 1.01-5.27), 2.01 (95CI, 1.39-2.91) and 2.24 (95CI, 1.56-3.21) for Primary3, Permanent3 and Permant6, respectively. Sensitivity and subgroup analyses corroborated these estimates.

CONCLUSIONS

Reliability and generalizability of pooled ORs were high enough and made it possible to assess that the fraction of global TDIs attributable to large overjet is 21.8% (95CI, 9.7-34.5%) and that large overjet is co-responsible for 235 008 000 global TDI cases (95CI, 104,760,000-372,168,000). This high global burden of TDI suggests that preventive measures must be implemented in patients with large overjet.