Autonomy and factors affecting dental health care seeking behaviour in women: An application of theory of planned behaviour

Background

Understanding oral health care seeking behaviour and it's determinants is essential in improving oral health. The health care utilization in women was found to be influenced by their autonomy. A socio-cognitive model that can explain variance in dental attendance behaviour in women including autonomy has yet to be validated. The Theory of Planned Behaviour (TPB), which takes into account women's autonomy, attitude, subjective norms, and perceived behavioural control, is empirically tested in this study with regard to self-reported dental visiting intentions and dental health seeking behaviour.

Method

Cross sectional study using self-administered questionnaires was conducted to assess socio-demographic factors, autonomy, dental visiting behaviors as well as constructs of TPB model in 400 women aged 18 years or older in Bangalore city selected via stratified cluster sampling method. Two-stage structural equation modelling (SEM) was used to test the hypothesized TPB model.

Results

The proposed correlated 5-factor measurement model was confirmed through confirmatory factor analysis (CFA). In SEM subjective norm (β = 0.17), perceived behavioural control (β = -0.27) and autonomy (β = 0.49) significantly predicted dental visiting intentions in women. Intention (β = 0.56) and autonomy (β = 0.25) explained dental visiting behaviour. It also revealed indirect effect of autonomy and perceived behaviour control on dental visiting behaviour through intentions. The hypothesized model predicted 27.6 % and 23.8% of the variance in intention and dental visiting behaviour respectively.

Conclusion

The hypothesized model was successful in predicting intention and dental visiting behaviour in women. This could explain the multidimensional nature of dental care utilization in women which in turn might be helpful in improving access to dental care among them in future.

Arginine: A New Paradigm in Preventive Oral Care

Dental caries is ubiquitous and one of the most prevalent oral diseases and the foremost cause of dental pain and poor quality of life (QoL). Fluoride is an effective caries preventive agent; however, despite its use, there remain some gaps in prevention of dental caries. Arginine, an amino acid, helps to maintain a noncariogenic plaque. It shows synergistic effects with fluoride in dental caries and can help nourish the tooth by enhancing the remineralization effect of fluoride. Supplementing fluoride dentifrices with arginine can bridge the gap in caries prevention. Several clinical studies with 1.5% arginine + fluoride provide evidence for its use in prevention of dental caries. This report throws light on the benefits of arginine in dental caries and guides on its use with fluoride. Recommendations given in the report will help in effective prevention of dental caries.

How to cite this article

Goyal V, Damle S, Puranik MP, et al. Arginine: A New Paradigm in Preventive Oral Care. Int J Clin Pediatr Dent 2023;16(5):698-706.

Association between dental caries experience and salivary profile among autoimmune thyroid disease subjects - a cross-sectional comparative study

Background: Autoimmune thyroid disease (AITD) is an inflammatory condition that primarily affects women between the ages of 30 and 50. It has been hypothesised that AITD causes salivary glands to produce less saliva due to its endocrine effects. Studies showing the effect of AITD on salivary glands are very scarce. The aim of this study was to compare AITD patients with controls who were of a similar age and gender in terms of salivary metrics and the prevalence of dental caries. Methods: 200 subjects in Bangalore city (100 AITD subjects and 100 healthy subjects as controls) participated in a cross-sectional study. Subjective oral dryness was assessed using Farsi's criteria. Salivary parameters and caries were assessed using GC Saliva-Check BUFFER kit and WHO caries criteria respectively. Descriptive and analytical statistics were done. Significant data was defined as a p value of <0.05. Results: When compared to controls, the AITD group had substantially more subjective mouth dryness and dental caries. Unstimulated (USFR) and stimulated salivary flow rate (SFR), pH and buffering capacity were reduced in AITD group whereas viscosity was high. There was a significant negative correlation between USFR, SFR, subjective oral dryness and dental caries. In a linear regression, there was no association between age, gender, socioeconomic status (SES), thyroid stimulating hormone (TSH), salivary viscosity, pH, buffering capacity and dental caries. Dental caries, USFR and SFR demonstrated a substantial relationship. Conclusions: The present research may indicate an underlying association between thyroid and salivary gland dysfunction resulting in oral dryness and high dental caries experience.

Association between mother's behaviour, oral health literacy and children's oral health outcomes: A cross-sectional study

Introduction

Parents' infant and early childhood oral health knowledge is of paramount importance, because oral health behaviours are the exclusive domain of parents during the early years of life. Studies exploring the association between mother's behaviour, oral health literacy and children's oral health outcomes are scarce.

Aim

To evaluate the association between mother's behaviour, oral health literacy and children's dental caries experience.

Materials and Methods

A cross-sectional study was conducted among one hundred pre-school children aged 2-6 years and their mothers from pre-schools in Bangalore, India. Data regarding their demographics, mother's knowledge, attitude and practice (KAP) was collected through a questionnaire. Mother's oral health literacy was assessed with Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30) scale. Caries experience of the children was recorded using Decayed Missing Filled Teeth (DMFT) Index. Data was entered into excel sheet and analysed using statistical package for SPSS 22.0.

Results

: The mean KAP, REALD-30 and DMFT scores were 13.17 ± 4.57, 17.68 ± 5.85, 2.61 ± 2.21, respectively. In this study, REALD-30 score negatively correlated with DMFT score and positively correlated with KAP score. In a linear regression, KAP and REALD-30 scores showed a highly significant association with dental caries.

Conclusion

Mother's behaviour and oral health literacy influenced caries experience of the children. Therefore, improving the behaviour and oral health literacy of the mothers is the key to influence child's oral health.

Oral health perceptions, behaviors, and barriers among differently abled and healthy children

AIM

To describe and compare the oral health perceptions, behaviors, and barriers for utilization of dental care among differently abled and healthy children.

METHODS

Participants in this cross-sectional study were differently abled and healthy children belonging to the age group of 7-15 years. A questionnaire for measuring the children's perceptions, behaviors, and barriers was developed, validated, and applied to this study. Cronbach's α was calculated to test reliability, and test-retest reliability was assessed by Pearson's correlation test. Chi-square/Fisher exact test, Mann-Whitney U test, and factor analysis were also applied. Statistical significant differences were defined as P < 0.05, two-tailed.

RESULTS

A total number of 300 children in each group participated in the study. The correlations of test and retest for the questionnaire ranged from 0.69 to 0.86 (P < 0.05) with Cronbach's α score of 0.862. More than half in both the groups were aware of the presence of fluoride in their toothpaste, and parents agreed that a child's dental health is satisfactory yet only one-third of them perceived dental problems as serious. Regarding brushing twice daily, the frequency was better in the study group (26.3% and 17.3%, P = 0.01), most of them changed their toothbrush between 3 and 6 months (67.3% and 82.0%, P < 0.001), and tongue cleaner were regularly used as an oral hygiene aid (62.3% and 88.5%, P = 0.01). Members of the study group appear to have visited the dentist (26.0%) more as compared to the control group (17.7%) (P = 0.01), and most of the respondents (50.0% and 41.5%) consulted the dentist on account of dental caries. In the study group, no priority care (8.82±2.81), difficulty in communicating with the dentist (7.85±1.92), treatment cost (6.90±1.98) and fear of dental instruments (6.90±1.98), respectively, were the barriers with the highest means of scores, whereas in the control group it was related to affordability and fear. Facilities in dental clinics excluding wheelchairs (76.3% and 76.7%) and corridor signs (66.3% and 61.7%) were lacking.

CONCLUSION

Knowledge and attitude scores were adequate but there was a discrepancy present concerning oral health practices. Dental health was not viewed as a threat, and therefore, not many visited the dentist. Priority care and communication problems were the central issues among differently abled children, while among healthy children, the main factor was cost and fear.

Oral health status and parental perception of child oral health-related quality of life among children with cerebral palsy in Bangalore city: A cross-sectional study

AIM

To assess and compare the oral health status and parental perception of child oral health-related quality of life (OHRQoL) among children with and without cerebral palsy (CP).

METHODS AND RESULTS

A cross-sectional comparative study was conducted among 300 children aged 5-15 years with and without CP in Bangalore city. Oral health status was assessed using WHO 2013 criteria, and malocclusion was assessed using Angle's classification of malocclusion. Parental perception of child OHRQoL was assessed using parental caregivers perceptions questionnaire. Chi-square test, Student's t-tests and logistic regression were applied. Majority of the study participants were males with a mean age of 10 years. Caries experience, gingivitis, dental trauma, and dental erosion were significantly higher among children with CP than the comparison group. Mean parental perception of child OHRQoL score among CP was significantly higher than that of comparison group (P < .001). Odds of having caries experience, gingivitis, dental trauma, and Angle's Class II/III malocclusion were significantly higher among CP children with poor OHRQoL compared to those without these conditions.

CONCLUSION

Oral health status among children with CP was poor than the children without CP. Parents perceived poor OHRQoL among children with CP when compared to those without CP. Hence CP has an impact on oral health necessitating preventive care.

Exploring the educational opportunity and implementation of CARE among dental students in India

CONTEXT

Empathy is considered to be backbone of the patient-physician relationship. The consultation and relational empathy (CARE) measure is widely used internationally to measure empathy. However, no validated tool is available to gather patient feedback on dentists' empathy in India.

OBJECTIVE

The objective of this study was to explore the reliability and validity of a CARE measure and to assess the factors influencing CARE score and to determine if there was an association between their CARE score and satisfaction of the patient.

SETTING AND DESIGN

A cross-sectional study was done in dental colleges.

SUBJECTS AND METHODS

A questionnaire study was carried out among 100 patients from 6 dental colleges in Bangalore using validated CARE measure.

STATISTICAL ANALYSIS

Internal consistency of items was evaluated by the Cronbach's alpha, and construct validity was assessed by confirmatory factor analysis. Satisfaction was assessed by a question response on 5-point Likert scale. Descriptive and inferential statistics were performed with significance set at 5%.

RESULTS

The mean CARE score was 43.80 ± 5.36. Internal reliability was high (Cronbach's alpha: 0.859) and was reduced by the removal of any of 10 items. High corrected item-total correlations ranged from 0.752 to 0.847. Factor analysis showed a single solution with high item loadings (>0.80). Self-perception of overall health (odds ratio [OR] = 3.78), relationship with family (OR = 4.61) and friends (OR = 3.78), and previous dental experience (OR = 16.00) were more likely, whereas dentist-provided treatment (OR = 0.20), number (OR = 0.07) and dental treatment taken (OR = 0.13), presence of anxiety (OR = 0.03), and fear (OR = 0.05) were less likely to have CARE score. The satisfaction of the patient regressed significantly with the relationship with family members (ß = 0.77) and CARE score (ß = 0.21).

CONCLUSION

This study confirms the educational opportunity and implementation of CARE in dental students. CARE scores among patients varied depending on personal factors and dental treatment-related factors. The satisfaction of the patient was influenced by the relationship with family members and CARE scores.

Association between cognitive vulnerability, dental fear, and oral health status among schoolchildren in Bangalore city - A cross-sectional study

CONTEXT

Dental anxiety and fear is not only a psychological problem but also a dental health problem. It is important to understand how the cognitive elements influence child's dental anxiety/fear and interact with their oral health.

OBJECTIVE

This study was conducted among children to determine the association between cognitive vulnerability (CV) with dental fear and their oral health status.

SETTINGS AND DESIGN

A cross-sectional study was conducted among 500 schoolchildren aged 12-15 years in Bengaluru city.

METHODOLOGY

The schools and participants were selected by cluster random and systematic random sampling method, respectively. Cognitive vulnerability and Index of Dental Anxiety and Fear (IDAF-4C+) were assessed by a self-administered questionnaire. Oral health status was recorded using the World Health Organization 2013 proforma for children.

STATISTICAL ANALYSIS USED

Chi-square test, Student's t-test, Spearman's correlation, and multivariate hierarchical linear regression were used in this study. The statistical significance was considered at P < 0.05.

RESULTS

Nearly half of the study participants had cognitive perceptions, dental anxiety/fear, phobia, and stimulus toward dental treatment. Majority had dental caries and gingival bleeding. Cognitive vulnerability, dental anxiety/fear, phobia, and stimulus were independent of the age and gender and were associated with socioeconomic status. A significant correlation was found between participants' CV, IDAF-4C+, dental caries, and gingival bleeding. Cognitive vulnerability was a significant predictor of dental caries and gingival bleeding. Dental anxiety/fear and dental phobia were significant predictors of dental caries.

CONCLUSION

Oral health status was significantly poorer and was associated with CV, dental anxiety/fear, phobia, and stimulus. Cognitive elements together with dental fear influenced oral health.

Impact of asthma and its medication on salivary characteristics and oral health in adolescents: A cross-sectional comparative study

OBJECTIVE

To assess and compare the salivary characteristics and oral health and to evaluate the impact of asthma and its medication on dental caries among adolescents with and without asthma.

METHODS

A cross-sectional comparative study was conducted among 50 asthmatic and 50 nonasthmatic adolescents aged 12-15 years in Bangalore City. Data were acquired using a structured questionnaire. Salivary samples were collected to determine the flow rate, pH, buffering capacity, and Streptococcus mutans and Lactobacilli counts. Oral health assessment was performed using WHO 2013 proforma. Inferential statistics such as chi-square, student's t-test, spearman's correlation, multinomial logistic. and stepwise linear regression were applied with P < .05 considered as significant.

RESULTS

Asthmatic participants had significantly higher mean number of teeth with dental caries, gingival bleeding, and dental erosion than nonasthmatics (P < .05). The prevalence of fluorosis, traumatic dental injuries, and oral mucosal lesions in asthmatics were 34.0%, 38.0%, and 28.0%, respectively. Most of the asthmatic participants required preventive or routine (18.0%) and prompt treatment (30.0%). Statistically significant difference was found in the flow rate, pH, buffering capacity, S. mutans and Lactobacilli counts, and Decayed, Missing, Filled Teeth (DMFT) index between asthmatic and nonasthmatic participants. Severity of asthma, medication use, and dental caries experience significantly correlated with low salivary flow rate, pH and buffering capacity, and higher levels of S. mutans and Lactobacilli (P < .001). Asthmatic participants had significantly higher odds of having very low unstimulated salivary flow rate (odds ratio [OR] = 3.2), buffering capacity (OR = 2.94), highly acidic pH (OR = 3.65), high risk of S. mutans (OR = 6.02), and DMFT ≥ 1 (OR = 2.06) than nonasthmatics (P < .05).

CONCLUSION

Salivary characteristics and oral health were significantly poor in asthmatic adolescents. Asthma and its medications had significant impact on salivary characteristics and dental caries among asthmatic adolescents.

Factors affecting empathy among indian dentists

Background

Empathy is one of the major essential elements in patient and dentist relationship. Interpersonal Reactivity Index (IRI) has been used extensively to measure empathy among medical and other health professions. However, its validity in dental profession remains to be explored.

Aims

To examine the psychometric properties of IRI and also to assess the factors influencing the dental students' empathy.

Setting and Design

A cross-sectional questionnaire study was carried out among 100 dental interns and postgraduates using IRI.

Materials and Methods

Patients were selected randomly from six dental colleges in Bangalore. Internal consistency of items was evaluated by Cronbach's alpha and construct validity was assessed by confirmatory factor analysis with an orthogonal varimax rotation of factors.

Statistical Analysis Used

The data were evaluated using SPSS 22. Descriptive and inferential statistics were performed with significance set at 5%.

Results

Internal consistency of IRI (Cronbach's alpha: perspective taking = 0.76, fantasy = 0.80, empathic concern = 0.72, and personal distress = 0.79) was good. A four-factor solution emerged, accounting for 52% of total variance. The mean age of the participants was 24.25 ± 1.95 years. The mean for empathic concern domain was highest (20.75 ± 1.64). Gender, career choice, academic performance, and work satisfaction were associated with increased empathy scores, whereas depression and stress were associated with decreased empathy scores (P < 0.05).

Conclusion

This study confirms the construct validity and reliability of the IRI for assessing empathy in dental students. Empathy scores among students varied depending on professional/personal factors.

Association between Parental Behavior and Child's Oral Health among 3-5-year-old Children in Bengaluru City

Aim

Parental behavior is known to influence the well-being and disease outcomes in children. The environment which they create for the child can influence oral health behaviors and status. Hence, the present study aimed to determine the association of parental behavior with oral health status among 3-5-year-old children in Bengaluru city.

Materials and methods

A cross-sectional study was conducted among 300 children aged 3-5 years. The child's demographic profile including socioeconomic status, dental history, oral habits, and oral hygiene practices was recorded. A 21-item prevalidated Parenting Style and Dimension Questionnaire (PSDQ) was used to assess parental behavior. WHO oral health pro forma (2013) was used to assess the oral health status of children. Chi-square test, Kruskal-Wallis, and Mann-Whitney U-test and binary logistic regression were applied. Statistical significance was considered at p < 0.05.

Results

The majority of parents were authoritative (64.0%). The mean age of children was 4.15 ± 0.74 years. Sixty-one percent of the children had caries experience. The permissive group had a higher mean dmft (4.25 ± 3.43) than the authoritarian (2.1 ± 1.67) and authoritative group (1.51 ± 1.94) (p < 0.001). There was a statistically significant difference between authoritative and permissive (p < 0.001) and authoritarian and permissive (p < 0.001) groups for dt and dmft. Parenting style was significantly associated with dental caries and trauma.

Conclusion

There is an association between parental behavior and oral health status among 3-5-year-old children. Hence, a prior appraisal of parental behavior is suggested for better oral health outcomes in children.

Clinical significance

A prior appraisal of parenting style aids the clinician in the more efficient management of children through proper choice of behavior guidance technique.

How to cite this article

Sabbarwal B, Puranik MP, SR Uma. Association between Parental Behavior and Child's Oral Health among 3-5-year-old Children in Bengaluru City. Int J Clin Pediatr Dent 2020;13(6):677-681.

Exploring educational and promotional opportunities for implementing oral rapid human immunodeficiency virus testing among dentists in India

CONTEXT

Human immunodeficiency virus (HIV) is a public health problem in India. Dentist plays an important role in diagnosing since oral lesions are common in HIV-positive patients and have an ethical responsibility to provide treatment to them.

AIMS

This study aims to explore educational and promotional opportunities for implementing oral rapid HIV testing (ORHT) among dentists in Bengaluru, India.

SETTINGS AND DESIGN

A cross-sectional study was conducted among 300 dentists. Dentists were included from private practice, dental practice in general hospital, and dental teaching/hospitals.

SUBJECTS AND METHODS

A 43-item questionnaire was used to assess demographics, educational knowledge on HIV and ORHT, attitude toward HIV patients, and willingness to promote ORHT and perceived barriers of performing ORHT.

STATISTICAL ANALYSIS USED

The data were evaluated using SPSS 22. Student's t-test, Chi-square, Pearson correlation, and binary logistics were used keeping P value at 5%.

RESULTS

Mean age of the participants was 38.97 ± 7.69 years with equal distribution of gender and practice. Majority were postgraduates (63.0%) and having general practice (56.6%). Although two-thirds of the participants belong to high score category, the mean knowledge level is below 50%. Mean score of knowledge was 10.70 ± 2.5. One hundred and thirty (43.3%) dentists were aware of ORHT, and 228 (76%) thought that ORHT was needed in the dental clinic. Dentist having specialty practice felt more accepting of ORHT (odds ratio = 2.455, 95% confidence interval 1.186-5.463). The lack of knowledge and training was the main barrier (39%) to conduct ORHT.

CONCLUSIONS

The level of knowledge of the dentist about HIV/AIDS was acceptable. Majority of the dentist thought that ORHT is needed in a dental clinic. Overall, there was positive attitude toward HIV patients and ORHT.

Oral health inequalities between differently abled and healthy school children in Bengaluru-A cross-sectional study

AIM

To assess oral health inequalities between differently-abled and healthy school children.

METHODS

The study was conducted on a sample of 300 differently-abled and 300 healthy school children in Bengaluru. A calibrated investigator recorded oral health status according to World Health Organization (WHO) proforma 2013. Chi-square/Fisher exact test, Mann-Whitney U test, and multiple logistic regression were applied. A p-value < 0.05 was considered to be statistically significant.

RESULTS

Mean DMFT in the study group and the control group was 1.32 ± 1.36 and 1.25 ± 1.21 respectively. In the study group, 52.7% had gingival bleeding compared to 41.0% in the control group. Within the study group, children who belonged to the lower middle class (aOR = 2.02) were more likely to have caries experience whereas visually impaired children (aOR = 0.32), speech and hearing impaired children (OR = 0.10), children suffering from polio (aOR = 0.80), and those with caries-free in deciduous dentition (aOR = 0.42) were less likely to have caries experience in permanent teeth (p < 0.05).

CONCLUSION

Oral health inequalities exist for differently-abled children. Hence, improvement of their oral health status and priority care are needed.

Impact of occupational dental erosion on oral health-related quality of life among battery factory workers in Bengaluru, India

BACKGROUND

A greater understanding of impact of occupational dental erosion on oral health-related quality of life (OHRQoL) will sensitize both employee and employers to adopt strict protective measures for oral health. The research aimed to determine the relationship between occupational dental erosion and OHRQoL among battery and other factory workers in Bengaluru, India.

MATERIALS AND METHODS

This cross-sectional comparative study enrolled a total of 400 workers. Structured proforma assessed information on sociodemographic details, oral hygiene practices, adverse oral habits, and work-related practices. OHRQoL was determined using oral health impact profile-14 (OHIP-14). Dental erosion was measured using Smith and Knight's tooth wear index modified by Millward et al. 1994 scoring system independent t-test, Mann-Whitney U-test and Spearman's correlation was performed. P < 0.05 was considered statistically significant.

RESULTS

The mean age of the participants in the study and control groups was 43.11 ± 8.02 and 45.93 ± 6.16 years, respectively. Less than half of the participants in the study group had positive behavioral work practice. The prevalence and severity of dental erosion was significantly higher in study group (39.5%) than control group (11.5%). Mean OHIP-14 score was significantly lower in study group (23.88 ± 0.88) than control group (26.06 ± 9.67). Dental erosion significantly correlated with work experience and OHIP-14.

CONCLUSION

The findings highlight the impact of occupational dental erosion on OHRQoL. Measures to enhance occupational safety thereby reducing exposure to occupational hazards are needed.

Perceptions about toothbrush contamination and disinfection among dental students in Bengaluru City: A cross-sectional study

INTRODUCTION

Toothbrushes are vital to remove dental biofilm and to prevent dental caries and periodontal disease. Repeated use of toothbrushes leads to contamination; hence, disinfection is essential in the maintenance of a brush. Current understanding and perception among dental students about toothbrush contamination and disinfection are essential.

AIM

The aim of this study was to assess the perceptions about toothbrush contamination and disinfection among postgraduates and interns in Bengaluru city.

MATERIALS AND METHODS

A cross-sectional study was conducted using self-administered questionnaire among 400 postgraduates and interns from five dental colleges in Bengaluru. The statistics were computed with the Statistical Package of Social Sciences (SPSS) version 22 software and Chi-square test was used. A P < 0.05 was considered statistically significant.

RESULTS

There was a statistically significant difference regarding the source of information on tooth brush contamination (P = 0.008) and common mode of transmission of contamination (P = 0.01) between the two groups. The difference was found to be statistically significant (P = 0.01) regarding sharing of toothpaste. Only less than half of the participants, in both the groups practiced disinfection.

CONCLUSION

There was a statistically significant difference in the perceptions about tooth brush contamination and disinfection among postgraduates and interns that might be attributed to their higher academic knowledge and clinical experience.

Dentinal Tubule Occluding Effect of Potassium Nitrate in Varied Forms, Frequencies and Duration: An In vitro SEM Analysis

INTRODUCTION

Dentinal hypersensitivity is an exaggerated response to non-noxious sensory stimuli (osmotic, thermal or mechanical changes). An inverse relationship between occluding open tubules and the intensity of sensitivity has been reported. Studies on the efficacy of potassium nitrate used in different forms and frequencies to occlude dentinal tubules are scarce.

AIM

To evaluate, in vitro the dentinal tubule occluding effect of potassium nitrate which differ in form, frequency and duration of application.

MATERIALS AND METHODS

In an in vitro study, 45 extracted human maxillary and mandibular premolars were sectioned using diamond disc to obtain 90 samples which were treated with 6% citric acid and were randomly assigned to three groups: Group 1 was treated with potassium nitrate toothpaste (once and twice daily for two minutes); Group 2 with potassium nitrate mouthwash (once and twice daily for two minutes) and Group 3 served as control (distilled water). Post-treatment, the samples were immersed in distilled water. The samples were subjected to Scanning Electron Microscopy (SEM) at the end of 3, 7 and 14 days. SEM photographs were analysed based on extent of tubular occlusion. Chi-square test was applied to assess the significant difference between the groups.

RESULTS

There was detectable difference in the dentinal tubule occlusion at the end of 3^rd, 7^th and 14^th day between three groups. When compared to the mouthwash, toothpaste yielded better results. Twice daily application for a period of two minutes each was better when compared to once daily for two minutes.

CONCLUSION

Potassium nitrate is effective in occluding dentinal tubules when applied twice daily in toothpaste form than mouthwash form. However, randomised control trials are needed to confirm its efficacy in human subjects.

Association of Feeding Methods and Streptococcus mutans Count with Early Childhood Caries: A Cross-sectional Study

Introduction

Early childhood caries (ECC) is a virulent form of dental caries that can destroy the primary dentition of toddlers and preschool children. The aim was to determine the relationship of feeding methods and oral Streptococcus mutans count in 3- to 5-year-old children with ECC.

Materials and methods

A cross-sectional study was conducted in children aged 3 to 5 years. Participating mothers were interviewed regarding child’s demographic profile, educational level and socioeconomic status of parents, past medical and dental history of the mother and child, child’s feeding habits, and dietary habits and oral hygiene practices of mother and child. Clinical examination for dental caries was done using the World Health Organization criteria (1997). Salivary samples of mother-child pair were collected to determine the pH, flow rate, and S. mutans count. Statistical tests, such as Student’s t-test, analysis of variance, and Pearson’s correlation were applied.

Results

Out of 150 mother-child pair, statistically significant difference in the caries experience was found between mothers and children with high and low S. mutans count. Moderate but statistically significant negative correlation was found between mean decayed, missing, and filled teeth of mothers and mean decayed, extracted and filled teeth (deft) of children with high S. mutans count. Regarding deft, there was no statistically significant difference between children who were exclusively breast fed (7.85 ± 2.94), exclusively bottle-fed (8.67 ± 3.98), and both breast and bottle-fed (7.77 ± 2.91).

Conclusion

The mean caries experience of mothers and children was 2.66 ± 2.01 and 7.82 ± 2.94 respectively, with decayed component being maximum. Moderate and significant correlation (r = 0.5) was found between S. mutans of mothers and children in saliva. Significant negative correlation was found between mothers and children with high S. mutans count (r = -0.0284; p = 0.046).

How to cite this article

Bullappa D, Puranik MP, Sowmya KR, Nagarathnamma T. Association of Feeding Methods and Streptococcus mutans Count with Early Childhood Caries: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(2):119-125.

Practice Perspectives of Left-Handed Clinical Dental Students in India

INTRODUCTION

Handedness becomes important for students during their training period. Limited literature is available regarding the same.

AIM

The purpose of this study was to assess the dental practice perspectives and determine the hand preference and discomfort level among the Left-Handed (LH) clinical dental students.

MATERIALS AND METHODS

A 30-item survey tool was used to conduct a cross-sectional survey among four successive LH cohorts (third and final year undergraduates, dental interns and postgraduates) in all the dental colleges of Bengaluru, Karnataka, India, during the year 2014.

RESULTS

A total of 84 students completed the survey, response rate being 100%. About one-third (37%) reported that their institution was not properly equipped to accommodate LH students. Majority felt that LH dentists were at a higher risk of developing musculoskeletal complications. Mouth mirror handling showed equal distribution for handedness as compared to the other dental activities, whereas discomfort levels were negligible ("without any difficulty"). Dental practice perspective scores significantly correlated with the difficulty levels (r=-0.333, p<0.001).

CONCLUSION

Overall, the left-handers had a right dental practice perspective and their responses indicate a need to address their issues empathetically.

Association between osteoporosis and periodontal disease among postmenopausal Indian women

AIM

The aim of the present study was to determine the association between osteoporosis and periodontal disease among postmenopausal Indian women.

METHODS

A cross-sectional comparative study was conducted among postmenopausal women aged 45-65 years attending various hospitals in Bangalore, India. The examination was performed using the plaque index, gingival index, modified sulcus bleeding index, and community periodontal index. The women then underwent a bone mineral density (BMD) test using an ultrasonometer. Based on the BMD scores, participants were divided into osteoporotic and non-osteoporotic groups. For the statistical analysis, χ² -test, Student's t-test, and multiple regression analysis were applied.

RESULTS

The mean plaque, gingival, and bleeding scores were significantly higher among osteoporotic women (1.83 ± 0.47, 1.73 ± 0.49, 1.82 ± 0.52) compared to the non-osteoporotic women (1.31 ± 0.40, 1.09 ± 0.52, 1.25 ± 0.50). The mean number of sextants affected for codes 3 and 4 of the community periodontal index and codes 1, 2, and 3 of loss of attachment were significantly higher among osteoporotic group compared to the non-osteoporotic group. Multiple logistic regression tests confirmed the statistically-significant association between osteoporosis and menopause duration, loss of attachment, bleeding, and gingivitis scores.

CONCLUSIONS

Skeletal BMD is related to clinical attachment loss, bleeding, and gingivitis, which suggests that there is an association between osteoporosis and periodontal diseases.

Association Between Dental Students' Emotional Intelligence and Academic Performance: A Study at Six Dental Colleges in India

Since the role of emotional intelligence (EI) in achieving academic excellence requires further research, the aims of this cross-sectional study were to assess EI and its associated factors and to determine any association between EI and academic performance among final-year dental students in Bengaluru, India. In 2015, 208 dental students from six dental colleges in Bengaluru were invited to participate in the study. Their demographic and lifestyle data were collected, and EI was assessed with the 30-item Emotional Quotient Self-Assessment Checklist developed by Sterrett. Academic performance was assessed using grades obtained in the final-year undergraduate examination. The response rate was 96% (N=200). Overall, 54.5% of the participants had high EI scores (≥120), although only 51 (25.5%) had a high EI score in all the domains (≥20). EI was significantly greater in females than males. Gender, sleep, meeting friends, physical exercise, recreational activities, and academic performance were significantly associated with EI and accounted for 42% variance in hierarchical regression analysis. EI was also positively associated with academic performance. Gender and healthy lifestyle habits were positively associated with EI, which in turn influenced these students' academic performance. These findings suggest a possible need for attention to developing dental students' EI.

Nicotine Replacement Therapy in Dental Settings: An Exploratory Survey in Bangalore City, India

BACKGROUND

Smoking and other forms of tobacco use remain the most significant worldwide public health problem. The dental practice is being identified as potential location for smoking cessation activity. Nicotine replacement therapy (NRT) promotes the chances of tobacco cessation, however, evidence related to prescription of the NRT in dental settings is lacking. This study aimed to assess and compare the attitudes, practices, beliefs, and barriers in prescribing NRT for tobacco cessation among dental interns and post-graduates (PGs).

METHODS

For a cross-sectional survey among 232 participants from 10 dental colleges in Bangalore, India, a 21-item questionnaire was developed: 11-item based on attitudes and practices toward tobacco cessation and 10-items regarding scope and challenges in prescribing NRT. The data were analyzed using descriptive statistics, chi-square test, and test of proportions.

FINDINGS

Majority of participants reported ongoing tobacco cessation activity in their college. Statistically significant difference was found between interns and PGs for items related to tobacco cessation practice (assisting, providing follow-up visit). Regarding NRT, significant differences were seen for items related to practice (assisting, assessing motivation for NRT), belief (not an appropriate activity for dentist, a valuable resource, increase in quit attempts) and barriers (bitter taste, cost, and fear of addiction) (P < 0.050). The majority of the PGs suggested cessation center followed by health care workers and pharmacists for the provision of subsidized nicotine gums.

CONCLUSION

Favorable practices and beliefs are seen regarding the prescription of NRT among interns and PGs although differences exist. Time, cost, and taste emerged as major barriers.

Cross-Cultural Adaptation of Kannada Version of Modified Dental Anxiety Scale Among an Adult Indian Population

BACKGROUND

Dental anxiety is one of the most common barriers in seeking dental care. In order to overcome this barrier dentist need to screen patients to successfully help in treatment. A scale is thus needed to measure dental anxiety which is socially & culturally acceptable.

AIM

This study aimed to assess the Cross cultural adaptation and validity of the Kannada translation of the Modified Dental Anxiety Scale (MDAS-K).

MATERIALS AND METHODS

A test-retest was conducted on 30 patients visiting a dental institution to assess the reliability of MDAS- K. A cross-sectional survey of 301 patients was conducted in different departments at a dental institution to test the psychometric properties of MDAS-K. The assessment tool consisted of a proforma containing socio-demographic, non socio- demographic variables, MDAS-K and Visual analogue scale (VAS).

STATISTICAL ANALYSIS

Reliability was assessed using Cronbach's alpha, inter-item Spearman's correlation. Independent t-test, ANOVA and post hoc Bonferroni were used to analyse dental anxiety in the psychometric constructs.

RESULTS

The internal consistency of MDAS-K was good with Cronbach's alpha of 0.83. The test-retest reliability for MDAS K had a good correlation of 0.901. The psychometric variables established the construct validity of MDAS-K.MDAS-K also showed good convergent validity with VAS score. The anxiety levels differed in patients visiting different dental departments.

CONCLUSION

The high reliability and validity of the MDAS-K supports its cross cultural adaptation and indicates that it can be a valuable tool for dental practioners in quantifying anxiety among patients and provide quality dental care.

Approaches to Arresting Dental Caries: An Update

BACKGROUND

Dental caries is one of the most prevalent chronic oral diseases across the globe that can be both treated and prevented. Preventive management strategies can effectively arrest and even completely reverse the caries process. This article aimed to review the literature on different approaches explored towards arresting caries progression.

MATERIALS AND METHODS

Literature search of publications in Pubmed/Medline was carried out. Total 73 articles including clinical trials, invitro studies, case reports and review articles were reviewed.

RESULTS

Twenty-two clinical trials and invitro studies were selected for review. Most studies suggested use of Silver Diamine Fluoride (SDF) as simple and effective caries arresting approach. Fluoride varnish treatment effectively arrests caries by inhibiting demineralization, resulting in highly significant caries reductions. Arginine with an insoluble calcium compound enhances arresting and reversing buccal, coronal and root caries. A few clinical studies have shown that sealants placed in caries fissures can arrest the caries process.

CONCLUSION

Various fluoride containing agents are clinically effective in arresting progression of carious lesion. However, these materials should be used appropriately understanding their scope and limitations to arrest dental caries.

Oral health status and parental perception of child oral health related quality-of-life of children with autism in Bangalore, India

BACKGROUND

Children with autism present with the physical-mental impairments and oral problems, which may have an impact on their quality-of-life (QoL). The aim of the following study was to assess oral health status and parental perception of child oral health related quality of life (OHRQoL) among children with autism.

MATERIALS AND METHODS

A cross-sectional study was conducted in 4-15-year-old children with autism (n = 135) and children without autism (n = 135). Oral health status was evaluated using Oral Hygiene Index-Simplified (OHI-S), its Miglani's modification for deciduous teeth, Decayed, missing and filled teeth (DMFT/dmft) and Decayed, missing and filled surface (DMFS/dmfs) indices. Parents answered the Parental-Caregivers Perception Questionnaire for assessing children's OHRQoL. Mann-Whitney U, Chi-square test and Pearson's correlation analysis were performed.

RESULTS

Mean OHI-S, DMFT, dmft scores were significantly high among children with autism (2.07 ± 0.83; 0.86 ± 1.22, 1.40 ± 2.48) when compared to children without autism (0.46 ± 0.58; 0.46 ± 1.06, 0.59 ± 1.28) respectively. Out of all domains of OHRQoL, mean score of functional limitations related to teeth problem was significantly higher among children with autism (8.87 ± 5.65) as compared to non-autism group (6.66 ± 4.97).

CONCLUSION

Functional limitations may have a negative impact on oral health status that might influence OHRQoL.