Assessment of dental caries based on ICDAS and WHO criteria: A comparative study

BACKGROUND

The decayed, missing, and filled teeth (DMFT/dmft) index recommended by the World Health Organization (WHO), which measures the prevalence of caries based on the presence of cavitated caries lesions, is the most used dental caries index in epidemiological studies. Early diagnosis of noncavitated carious lesions enables preventive measures, which has the potential to prevent dental caries-related morbidity and reduce the financial burden associated with restorative or rehabilitative dental care. The International Caries Detection and Assessment System (ICDAS II) incorporates both the cavitated and noncavitated carious lesions with acceptable reliability.

AIM

To compare dental caries prevalence based on ICDAS II and WHO criteria.

DESIGN

A cross-sectional study was conducted among 362 children visiting People's Dental College and Hospital, Nayabazar, Kathmandu, Nepal to study dental caries prevalence based on the ICDAS II and WHO criteria.

RESULTS

Among the study population, 290 (90.34%) and 169 (68.42%) children had dental caries in primary and permanent teeth according to the ICDAS II criteria, whereas according to WHO criteria, 267 (83.18%) and 107 (43.32%) had dental caries in primary and permanent teeth, respectively. The prevalence of dental caries was significantly higher (p < .001) according to ICDAS II criteria than the prevalence based on WHO criteria in both dentitions.

CONCLUSION

This study showed a significant difference in dental caries prevalence between the ICDAS II and WHO methods of caries diagnosis. The presence of noncavitated carious lesions was alarming. To enable detection of early/noncavitated carious lesions, ICDAS II rather than WHO criteria of caries diagnosis may be a more a valuable tool.

Assessment of Sequelae of Untreated Dental Caries using PUFA index in Children Visiting a Tertiary Center in Kathmandu

Introduction: Dental caries is still a major health problem in most countries as it school-aged children and adults also. Dental caries continues to be a major public health problem, especially in low- and middle- income countries. It can be prevented and treated with proper utilization of dental services. Untreated dental caries can have pain and infection with significant impact on general health. Method: This study was conducted to assess the untreated dental caries in children using the pufa/PUFA index. A hospital based cross sectional study was carried out in 297 children aged 2-12 years old. Caries status was assessed by dmft/DMFT index and untreated caries by pufa/PUFA index. Results: The “untreated caries PUFA ratio” of the population was 30.69%. The mean dmft index was 5.51+3.59, mean pufa 1.39+1.48 and mean DMFT 0.43+1.03 mean PUFA 0.11+0.46 respectively for primary and permanent teeth. Primary dentition had more caries and pufa score than the permanent teeth. Conclusion: There were untreated caries present in the children showing lack of timely utilization of dental services.

Dental Caries among Adult Population of a Municipality: A Descriptive Cross-sectional Study

Introduction

Oral disease as a public health problem poses a serious burden globally. The most common oral disease affecting adults is dental caries followed by periodontal disease leading to tooth loss. Early detection of dental caries can help reduce the severity and prevent further complications. This study aimed to ind out the prevalence of dental caries among adult population of a municipality.

Methods

This descriptive cross-sectional study was conducted among adults attending ive different dental camps in a municipality from 1 April 2022 to 2 June 2022. Ethical approval was obtained from Institutional Review Committee (Reference number: 060-078/079). Convenience sampling method was used. The prevalence of dental caries was determined by dentition status adopted from basic oral health surveys recommended by World Health Organization. Point estimate and 95% Conidence Interval were calculated.

Results

Among 239 adults, 138 (57.74%) (51.48-64, 95% Conidence Interval) had dental caries.

Conclusions

The prevalence of dental caries among adults in the municipality was lower than in similar studies done in similar settings.

Keywords

cross-sectional study; dental decay; prevalence.

Patient’s expectation of orthodontic treatment attending tertiary care dental hospital in Kathmandu

Introduction: Understanding of patient’s expectation and attitude towards orthodontic treatment plays an importantrole towards a successful treatment outcome and behavioral management. Materials and Method: All the patients (270) attending department of Orthodontics in Nepal Medical College for the first time were included in the study. The descriptive study is done. A structured questionnaire was used to obtain the socio-demographic information and responses to questions on their expectation of orthodontic treatment. Results: Majority of the respondents had higher expectations on aesthetic outcome of orthodontic treatment than the functional outcomes. They expected to have better smile, teeth straightened and have confidence socially. The lowest mean scores were obtained in the domains of improvement in career and making speech easier. Females had significant higher scores than male participants in all domains explored with the mean highest score in the domain of better smiles; while the highest male mean score was in the domain of straightened teeth. Conclusion: To achieve successful orthodontic treatment result, patient cooperation is necessary. Agreeing with the patient on realistic expected treatment outcomes by the orthodontist before the treatment is required so that they are not disappointed with the final appearance.

Awareness of aerosol-related transmission of COVID-19 among the dentists of Nepal

Objective

To access the awareness of dental practitioners of Nepal towards COVID-19 transmission through aerosols.

Materials and methods

The study involved 384 dentists from all over Nepal and was conducted for a period of 3 months. A self-reported online questionnaire was developed using Google forms and the link was shared. It emphasized the awareness related to the aerosol and ventilation system in their daily practices was prepared. The data were analyzed in Statistical Package for Social Sciences version 20.0 software.

Results

The majority of participants were female 52.9% (n = 203) and within the age groups of <30 years 57% (n = 219). Participants from Bagmati Province were 60.4% (n = 232), with least from Sudurpaschim Province 0.5% (n = 2). 60% of participants provided only emergency services during the COVID-19 pandemic and few (7%) provided consultations via telephone. The current ventilation system used was a well-ventilated room with open windows 65.4% (n = 251). However, 52.8% (n = 203) preferred specialized operatory incorporating high-efficiency particulate air (HEPA) filters and ultraviolet (UV) light. More than 60% of respondents were unaware of the particle size of the aerosol.

Conclusions

The obtained results signify the need for the proper ventilation system with appropriate air filtration systems in dental clinical setups.

Impact of sociodemographic factors, duration of edentulism, and medical comorbidities on the mental attitudes of individuals with complete edentulism

STATEMENT OF PROBLEM

Understanding the attitude of elderly patients is important for successful complete denture therapy. However, data regarding the impact of sociodemographic factors, impact of medical comorbidities, and duration of edentulism on the mental attitudes of such patients are lacking.

PURPOSE

The purpose of this clinical study was to explore the association of sociodemographic factors, duration of edentulism, and medical comorbidities on the attitudes of completely edentulous patients.

MATERIAL AND METHODS

The study was conducted among 125 completely edentulous patients visiting the Department of Prosthodontics, Nepal Medical College from August 2020 to October 2020. General information including age, sex, education level, medical history, and duration of edentulism were collected during a routine clinical evaluation. The mental attitudes of the participants were categorized according to M.M. House Classification into philosophical mind, exacting mind, hysterical mind, or indifferent mind. The participants were categorized into 3 age groups: 45 to 54 years, 55 to 64 years, and 65 years and above. Similarly, they were divided into 3 categories depending upon the duration of edentulism: 0 to 2 years, 2 to 5 years, and more than 5 years. Data were entered in a statistical software program for descriptive analysis using frequency distributions, and the chi-square statistical test and the Freeman-Halton extension of the Fisher exact test were used to determine the association between categorical variables.

RESULTS

The highest number of participants was in the philosophical category (34.4%) with the fewest in the hysterical group (12%). Men had more philosophical and indifferent attitudes, whereas women were more exacting (P<.001). Those with a recent history of extraction had an increased exacting attitude (P<.001). The respondents without any comorbid diseases were more philosophical, whereas a higher percentage of respondents with different comorbid conditions were assessed to be in the hysterical category (P<.001). Significant relationships were not found between mental attitude and educational status or age (P>.05).

CONCLUSIONS

Socioeconomic factors, duration of edentulism, and existing comorbidities had a significant impact on the attitudes of edentulous patients. The role of these factors should be assessed during the appraisal of the mental attitudes of edentulous patients.

Assessment and Correlation of Uric Acid Concentration in Saliva and Serum of Patients Attending Tertiary Care Centre

ABSTRACT Background Serum uric acid (UA) is associated with many health conditions, including renal, cardiovascular and metabolic disorders. Diagnosis and monitoring often require painful invasive procedures which will add undue stress to the patients. The aim of this study was to correlate salivary and serum UA, so that, salivary sampling will help to bypass these measures and evaluate the condition of both healthy and the diseased. Methods This hospital based descriptive cross sectional study was conducted in 100 participants between age groups 21 to 82 years. Demographic data including height, weight and blood pressure were recorded. Serum and salivary samples were collected and UA level in both type of samples were estimated and correlation statistics was carried out. Results Total participants are categorized in three groups, 20-40, 41-60 and more than 60 years, among which maximum participants 43% are between 41-60 years of age. Average of body mass index (BMI) was found to be 24.46, where 50% were within normal range. Mean serum and salivary UA(mg/dl) was 4.15 and 1.90 respectively, exhibiting moderate positive correlation. They were correlated with significant “p-value” according to gender, age groups and disease conditions. Paired t- test was done between the measured and calculated salivary UA and no statistically significant difference in mean of these two values was obtained. Conclusions Salivary and serum UA are associated in our study so salivary UA can be used as a biomarker. Salivary UA was found to be more gender specific and specific among adults. Salivary UA can also be used as a screening tools for young and adult population.

Comparison of Accuracy of Gonial Angle of Orthopantomogram and Lateral Cephalogram for Mandibular Measurements among Orthodontic Patients Attending Tertiary Care Dental Hospital in Kathmandu

Introduction: Gonial angle is an important parameter of the craniofacial complex which is generally used to evaluate the vertical parameters and symmetry of the facial skeleton. Gonial angle can be measured in both orthopantomogram (OPG) and lateral cephalograms. Due to the superimpositions seen while measuring the bilateral strucuture on lateral cephalograms, reliable measurement of the gonial angle becomes difficult. This study is done to clarify the possible application of orthopantomogram (OPG) for evaluating angular measurement of the mandible specifically gonial angle by comparing with lateral cephalogram. Materials and Method: All the patients (104) being treated from January 2018 to August 2020 in department of Orthodontics in Nepal Medical College were included in the study. Gonial angle measurements were made on lateral cephalograms and orthopantomograms of 104 patients – 54 males and 50 females with mean age of 22.20 ± 3.25 years. Patients aged 15-35 years were included in the study. Data was processed in SPSS version 16.0. Result: Mean Gonial angle in lateral cephalogram was greater than mean gonial angle in OPG and this difference was found to be statistically significant (p-value < 0.05). The difference in mean gonial angle was found to be statistically significant when compared between right gonial angle in OPG and gonial angle in lateral cephalogram (p-value < 0.05) and also between left gonial angle in OPG and gonial angle in lateral cephalogram (p-value < 0.05). Conclusion: When gonial angle values obtained from both sides of OPG were compared, no statistically significant difference was found. Significant differences were found when gonial angle values obtained from OPG right and left sides were compared with that of lateral cephalogram.

Sub Sinus Ridge Height at First Molar Region- A Panoramic Radiograph Based Study

BACKGROUND

Among various replacement options available for maxillary molars, implants necessitate the need to examine available ridge height and width. Panoramic radiographs (orthopantomograms) are routinely used for preliminary determination of ridge height which is helpful in communicating with patients regarding treatment needs and options. This study was designed with the aim to assess the sub sinus ridge height at dentulous and edentulous first molar sites.

METHODS

A cross-sectional study was conducted from March to November 2019 among patients visiting the dental college. The orthopantomograms of 455 patients were prospectively collected and analysed using Carestream imaging software (version 7.0.0). Distance from alveolar crest to maxillary sinus was measured in first molar region.

RESULTS

Mean minimal sub sinus ridge height at non-missing maxillary first molar site was 8.16 ± 2.6 mm, whereas for missing maxillary first molar site it was 5.25 ± 2.28 mm and the difference was statistically significant (p<0.001). Statistically significant difference among the age groups and minimum subsinus ridge height (p<0.001) was observed.

CONCLUSIONS

Missing maxillary first molar sites may often require vertical bone augmentation with direct sinus lifting procedures if it has to undergo replacement with dental implants in the representative Nepalese population.

Prevalence and Pattern of Canine Impaction and Its Associated Anomalies among Orthodontic Patients Attending Tertiary Care Dental Hospital in Kathmandu

Introduction: Permanent canines are considered as the cornerstone of mouth. Canines are important for esthetics and function as they are located in the anterior segment of the mouth and help in tearing of food. An impacted tooth is that tooth that cannot or will not erupt into its normal functional occlusion due to some circumstances. Those impacted tooth are considered pathologic as they might lead to various problems like resorption of roots of adjacent teeth, cystic formation, and infection with partial eruption leading to pain and trismus. Materials & Method: All the patients (550) being treated in department of Orthodontics in Nepal Medical College from January 2017 to December 2019 were included in the study. Patients aged 13-30 years were included in the study. Clinical examinations and panoramic radiographs of patients were taken. Anterior occlusal view was done in those patients having canine impaction to determine the patterns of impaction. Data was processed in SPSS version 16.0. Result: Among 550 orthodontic patients, 31 patients were found to have canine impaction. Among them 18 (58.1%) were females and 13 (41.9%) were males. The overall prevalence of canine impaction was found to be 5.6%. Various dental anomalies were observed in the participants’ radiographs, the most common being the retained deciduous teeth (54.8%) followed by dilacerations of adjacent teeth (51.6%). Peg shaped lateral incisors and root resorption of adjacent tooth were almost equal (22.6%) with least being the odontomas and other impacted teeth. Conclusion: The prevalence of canine impaction in tertiary care dental hospital in Kathmandu was found to be 5.6%. Patients with impacted canines also had other dental anomalies. Knowing the prevalence of impacted canines, will encourage the community to be aware about canine impaction and educate the population about the clinical implications and the importance of performing preventive and interceptive procedures.

Dental Floss Prescription Pattern among the Dental Interns of Nepal

Introduction:

Periodontal disease is regarded as one of the preventable diseases. It can be prevented through effective plaque control measures that require mechanical instrumentation with various surgical or non-surgical periodontal therapies as well as daily oral hygiene measures. Dental professionals must be competent enough to promote good oral health by educating patients with daily oral hygiene practice measures. In this regard, the study was designed to assess the knowledge, attitude, and practice behaviour for using as well as prescribing dental floss among the dental interns of Nepal.

Methods:

An online questionnaire consisting of two sections; the first comprised of the sociodemographic and professional aspects and the second consisted of questions related to knowledge, attitude, and practice regarding the use of dental floss, and its prescription was prepared using Google forms and the link was shared. The data were analysed in Statistical Package for Social Sciences (SPSS) version 20 software.

Results:

In this study, the participants were familiar with the dental floss, but many lacked awareness regarding its proper use. Ninety-nine (64.3%) of the participants personally used dental floss. Only six (3.9%) never prescribed it to their patients. Among those who prescribed, only 37 (25%) always demonstrated the techniques.

Conclusions:

The study indicated that many participants used dental floss, however, educating and recommending the patient about it was comparatively low. This emphasizes the need to increase the awareness and use of interdental aids among dental interns to provide good oral self-care practices for the patient.