Mapping accessibility to oral health care in coastal India – A geospatial approach using a geographic information system (GIS)

Background: It is imperative to have a thorough assessment of the existing distribution of oral healthcare facilities and understand potential accessibility when planning for expansion of oral health services. In the present study, an attempt to measure geographic accessibility to oral healthcare, by locating the availability of dental practitioners in the coastal districts of Karnataka state, India using a geographical information system (GIS), has been made.

Methods: For the study, data on public and private oral health centres were collected for the three coastal districts of Karnataka state, India. Population and income data were collected, along with geographic attributes (latitudes and longitudes) of the practitioners' addresses. Descriptive statistical analyses and dentist-to-population ratios (D:P) were calculated. Correlation between the number of clinics with population and D:P with per capita income were analyzed using Pearson's correlation coefficient. Chi-square test applied to analyze any association between D:P and urbanization.

Results: Among 340 clinics, 8.5% are public and 91.5% are private clinics catering to a population of 4,704,179. Average D:P for the three coastal districts is 1:13,836. There is an uneven urban-rural distribution of dentists with lower D:P in rural areas. Rural population in four taluks have only one dentist for over a lakh population. Six taluks have only one dentist for every 50000 – 100000 population in rural areas. Six rural areas had only public centers to cater to their oral health.  

Conclusions: From the study, it is concluded that oral health services were concentrated in areas with higher annual income per-capita, increased urbanization and population density.

Evaluation of mast cells and burning sensation in various stages of Oral Submucous Fibrosis

Background

Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder and burning sensation is the initial complaint among these patients. Scientific literature has established that mast cells play a major role in various inflammatory disorders. However, OSMF being an inflammatory disorder, the role of mast cells is yet to be established. Hence the aim of this study was to evaluate mast cells and burning sensation in various stages of Oral Submucous Fibrosis.

Methods

The study population comprised of forty subjects, thirty were clinically confirmed cases of OSMF and ten healthy individuals served as control. A complete history and clinical examination followed by an incisional biopsy was performed. Samples obtained were subjected to routine histopathological examination and mast cells evaluation.

Results

Mean number of total mast cells in Stage I, II and III OSMF were 8.5 ± 0.7, 11.31 ± 8.8 and 24.7 ± 21.2 respectively. There was a significant difference in total mast cell count between cases and controls. Degranulated mast cells was a significant predictor (p = 0.028), indicating role in clinical staging of OSMF. Degranulated mast cells had a significant role and was a positive predictor (B = 0.763, OR 2.145[95%CI 1.055-4.630]) at moderate levels of burning sensation. A significant difference (p = 0.029) in burning sensation across histopathological grades was also observed in the study.

Conclusion

Degranulated mast cells were found to have a significant influence in mild to moderate levels of burning sensation among OSMF patients. Role of degranulated mast cells were also found to be significant in various clinical stages of OSMF.

Foldscope as a primary diagnostic tool for oral and urinary tract infections and its effectiveness in oral health education

Due to its speed, accuracy and cost-effectiveness, microscopy has become an integral part of clinical examination for disease diagnosis. However, modern microscopes are very costly and require skilled personnel for their operation and maintenance, and specimen processing and analysis is labour-intensive. Further, lack of such expensive diagnostic tools in remote areas is a serious concern. Affordable point-of-care diagnostic tools are the most useful for timely disease diagnosis and management. The Foldscope is an affordable origami-based microscopy device composed of a series of paper clippings, which, upon assembly, can hold a specimen slide for observation, and this specimen can be viewed via a mobile phone camera attached to it. The present study evaluated the use of the Foldscope in the clinical diagnosis of oral and urinary tract infections and evaluated its efficacy as a motivational tool for improving oral health among school children in India. We qualitatively compared the Foldscope to a clinical microscope by examining five different types of clinical samples. Of the different types of clinical samples, the Foldscope was effective in detecting infection in dental plaque samples and urine samples. Thus, we further analysed 31 dental plaque samples of patients aged 3-13 years and 25 urine samples of patients aged 11-62 years. We also evaluated the use of the Foldscope as an educational tool for motivating oral hygiene among 80 school children aged 12 years and found that students in the Foldscope intervention group had better measures of oral hygiene than did students in the nonintervention group. In summary, our study indicated that the Foldscope is useful in detecting urinary tract infections and kidney stones in urine samples and is a useful motivational tool for oral health education among school-aged children. Furthermore, it may also be useful in oral health monitoring in resource poor settings. LAY DESCRIPTION: Poor and remote population often suffers due to lack of capacity to buy products or avail services which are expensive. In such a society people are not able to afford even the basic detection of diseases. Foldscope may come to rescue here! Foldscope is a paper-based, use-and-throw, affordable microscope. This study explores the use of Foldscope in clinics and diseases diagnosis using patient samples. Preliminary detection of disease associated symptoms in dental and urinary infections and digital record keeping via storage in mobile phone memory and hospital OPD records for monitoring patient's health are some of the advantages of Foldscope for clinical use in resource poor settings. It identifies that Foldscope not only can be used by students or teachers for educational purposes but it can also pave a path for promotion of dental hygiene among young children. The study also suggests that further improvement in design or resolution of Foldscope will broaden the scope of its application, in future.

Tobacco - Use Prevalence, Exposure, Attitudes, Behaviour/Cessation, Curriculum among Health Professional Students in Mangalore City, Karnataka, India

Background

Tobacco use is one of the leading preventable causes of premature death, disease and disability around the world. Medical and Dental graduates have an important role to play in tobacco cessation and prevention. Hence, the present study was undertaken to assess the tobacco use prevalence, practice, attitudes towards policy making and curriculum in medical and dental interns (house surgeons).

Methods

A cross sectional questionnaire based survey was carried out among interns in all the medical and dental colleges of Mangalore city. Global Health Professional Students Survey (GHPSS) questionnaire given by the Center for Disease Control (CDC) was modified and adopted.

Results

In the present study among 512 interns, 263 and 249 interns belonged to dental and medical fraternity respectively The prevalence of current smokers of cigarette was significantly higher among medical interns (32.1%) than the dental interns (20.2%), whereas no significant difference was evident amongst the dental (44.9%) and medical (41.8%) interns under the ever smokers category. A significant difference (p < 0.001) in the attitude of dental and medical college interns was observed towards tobacco use, policy making and their knowledge about the curriculum.

Conclusion

This study shows health professionals lacking specific training in tobacco counseling, all of which indicate a need for including a standardized syllabus to train health professionals in medical and dental schools related to tobacco its ill-effects, cessation and policy making.

Oral health taking a back seat at primary health centers of Bangalore urban district, India - A situation analysis

Background:

Even though a dramatic change in pattern of oral diseases has been observed at a global level, oral health equality still remains as a dream to achieve. Studies have documented disparities in delivery and utilisation of oral health services among urban, suburban, and rural regions of India. Therefore, the aim of the present study was to conduct a situation analysis at PHCs to understand resource availability and oral health seeking behavior from perspective of medical officers of Bangalore City, India.

Materials and Methods:

A structured questionnaire was validated using Lawshe technique and was given across medical and dental officers present at 65 Primary Health Centers. Data collected was entered in Excel sheet and further subjected to Descriptive statistics using SPSS version 20.

Results:

Among 65 PHCs, about 18 PHCs had dental officers posted. In those 18 PHCs only 2 were maintained by the state government and others by Private dental college. In the 65 PHCs , only one PHC maintained a separate register for dental complaints, whereas 48 of them had maintained a combined register for both general and oral complaints. With regard to the management of tooth-related complaints, about 48 of medical officers reported that they dispense the patients affected by providing antibiotics and pain killers (analgesics) and recall, whereas 12 medical officers reported that they get the existing condition treated and refer and the rest refer the patients directly to hospitals. clinics.

Conclusion:

The results highlight the challenges experienced by nondental primary-care providers and their views on access to oral health to be improved. It is high time that the state government should put oral health policies into practice by recruiting adequate dental officers and providing separate dental infrastructure at the urban PHCs for better utilisation of dental care services.

Correlations between gingival crevicular blood glucose and capillary blood glucose: A preliminary report

INTRODUCTION

Oral health plays an important role for screening of many systemic diseases. Hence, dentists play an important role in screening for systemic diseases as well. Early diagnosis of any systemic diseases can prevent long-term complications. Diabetic is one of the common chronic diseases. Hence, the study had been undertaken to evaluate whether gingival crevicular blood (GCB) can be used to screen for diabetes during routine oral health checkups.

MATERIALS AND METHODS

This analytical study included thirty participants who visited the Department of Periodontics, who fulfilled inclusion criteria and were willing to participate. Blood samples were collected by finger stick method and periodontal probing. The glucose levels of both the samples were estimated using glucometer and correlated the levels from both the methods.

RESULTS

Correlation between capillary finger stick blood glucose and GCB glucose was high (0.97) and was significant at 0.01 level.

CONCLUSION

Blood oozing during routine periodontal examination can be used for diabetes mellitus screening in dental office.

Assessment of Oral Health Knowledge, Attitude and Self-Care Practice Among Adolescents - A State Wide Cross- Sectional Study in Manipur, North Eastern India

INTRODUCTION

The World Health Organization global strategy of promoting oral health have shown vast improvements in developed countries but the scenario is glum among underprivileged communities due to lacunae in implementation of these promotional programs. Manipur, a North Eastern state in India, is one such marginalized area.

AIM

The study aimed to evaluate Knowledge, Attitude and Practice (KAP) towards oral health in 15-18 year adolescents residing in Manipur together with the association of these variables to sociodemographic factors.

MATERIALS AND METHODS

This cross-sectional study included 810 healthy adolescents drawn from various primary health care centers spanning in all the nine districts of Manipur. A closed ended questionnaire for the purpose of collecting data was used in the survey.

RESULTS

Of the total participants 90.9% had high knowledge, 79.8% had favorable attitude and 70.4% had adequate practice towards oral health. Education of the parents and respondents was the only factor significantly associated with all three variables, knowledge, attitude and practice. Significant and positive linear correlation between knowledge-attitude (r=0.369, p<0.01) knowledge-practice (r=0.405, p<0.01) and attitude-practice (r =0.353, p<0.01), were observed.

CONCLUSION

An overwhelming majority of the respondents had high knowledge, favorable attitude and sound practice with respect to oral health. A positive linear correlation exists between the knowledge, attitude and practice. Evidence based reinforcement programs should be introduced to further reduce the gap between knowledge, attitude and practice. The study will also serve as a reference value for use in future evaluation to help measure the effectiveness of the planned activities. Future research needs to focus on establishing the dental caries prevalence and oral hygiene status of Manipuri youth.

Ethical Conventions: A Study on Dental Practitioner's Knowledge and Practice of Ethics in their Line of Work in Bangalore, India

INTRODUCTION

Dentistry, being one of the healing professions, has an obligation to society that its members will stick on to high ethical standards of conduct. In India, studies done to assess whether the dental practitioners adhere to ethics in their line of work are very meager.

AIM

The present study was conducted to assess the knowledge and practice of ethics in their line of work among practicing dentists from various dental colleges in Bangalore, India.

MATERIALS AND METHODS

A descriptive cross-sectional survey was conducted among 258 practicing dentists attached to various dental colleges in Bangalore city of Karnataka, India. Independent sample t-test was used to compare the knowledge and practice scores according to gender and qualification. One way ANOVA was used to compare knowledge and practice score according to practice type and practice period.

RESULTS

Mean knowledge score among males is 8.9 as compared to 9.43 among females and mean practice scores among males was 8.25 as compared to 8.29 in females. Statistically significant differences were found in the mean knowledge and practice scores among graduate dentists and specialists. Mean knowledge score among graduate dentists was 8.44 as compared to 9.36 among specialists and mean practice scores among graduate dentists was 7.7 as compared to 8.53 in specialists.

CONCLUSION

A significant association between the knowledge and practice scores was observed, implying that with an increase in knowledge, there was also an increase in the practices of ethics among study population.

Oral health related knowledge, attitude, and practice among the pre-university students of Mysore city

Objectives:

To determine the oral health related behavior, knowledge, attitudes, and practices of pre-university students of Mysore city.

Design:

A cross-sectional descriptive study was conducted among 1000 pre-university students of Mysore city.

Results:

Statistical tests such as percentage distribution and Chi-square were used. P values <0.05 were considered statistically significant. Most of the students (88%, n = 880) knew that dental health reflects on the general health. Eighty-nine percent (n = 890) of students were aware that sweets and sticky food cause dental decay. Majority of the students (90%, n = 900) agreed that they visited dentist only when they had pain and cleaned their teeth once daily using toothbrush and tooth paste in vertical and horizontal motion.

Conclusion:

The study showed that the students had good knowledge about the basic oral health measures necessary to maintain proper oral health, but their attitude and practices toward oral health was relatively poor.

Oral Health status of 3-6 year old children and their mother’s oral health related knowledge, attitude and practices in Mysore City, India

Aims and Objectives: The study was carried out to assess oral health status of 3-6 year old children and their mother’s oral health related knowledge, attitude and practices in Mysore city. Moreover, this study also carried out to determine whether mother’s oral health related knowledge, attitude and practices influences oral health of their children. Materials and Methods: A total of 500 children belonging to the age group of 3-6 years old attending both governments sponsored and private preschools from five sectors accompanied by their mothers formed the study group. Oral health status was assessed by using decayed missing filled teeth index (dmft) and plaque index. Mother’s knowledge, attitude and practices were assessed by direct contact with mothers using closed ended questionnaire. Results: The results of the study showed that the prevalence of dental caries among children was 64% with mean dmft of 3.20 ± 3.08 and mean plaque scores was 0.87 ± 0.33. There was significant correlation between plaque scores and dmft. dmft and plaque score was higher in older individuals and the difference was highly significant. Mean plaque score was more among the government preschool children (1.02 ± 0.31). 46% of mothers had medium level knowledge, 63.2% mothers had average attitude and 51% mothers had high level practices related to oral health. An inverse relationship was found between mean dmft, caries prevalence, mean plaque score in children and mother’s knowledge, attitude and practices about oral health and the findings were highly significant. Conclusion: Results showed that mother’s oral health related knowledge; attitude and practices had influence on oral health status of their children  DOI: http://dx.doi.org/10.3126/ajms.v6i2.11097 Asian Journal of Medical Sciences Vol.6(2) 2015 66-71

Prevalence of hepatitis B vaccination among oral health care personnel in Mysore city, India

BACKGROUND

The transmission of blood borne virus in health care workers is a potential occupational hazard to patients as well as to the Oral Health Care Personnel (OHCP). Hepatitis B remains a serious threat to dental team.

PATIENTS AND METHODS

To assess the vaccination status and post vaccination antibody status of oral health care personnel against Hepatitis B Virus (HBV) infection. Descriptive Cross-sectional questionnaire study was conducted among the oral health care personnel of Mysore city.

RESULTS

Out of 300 oral health care personnel 256 (85.4%) were vaccinated for HBV infection and 44 (14.6%) had not taken vaccination. Highest frequency of vaccination was seen among dentists and least amongst dental lab technicians and other workers. This difference was highly significant among the different occupation groups (p= 0.001).

CONCLUSION

Majority of the OHCP of Mysore city have been vaccinated. Among them, dentists formed the majority group of vaccinated. But there was ignorance and less awareness regarding Hepatitis B vaccination among dental lab technicians and other workers like dental assistants and cleaning staff. Awareness amongst OHCPS against Hepatitis B vaccination has increased significantly over the years, but there are few who do not intend to get vaccinated.

Malocclusion and related quality of life among 13- to 19-year-old students in Mysore City - a cross-sectional study

PURPOSE

To assess malocclusion and related quality of life among 13- to 19-year-old students in Mysore City.

MATERIALS AND METHODS

A total of 900 students aged 13-19 years selected based on multistage stratified random sampling were included in this cross-sectional study. A pre-designed format was used to record the sociodemographic details, oral hygiene practices, personal habits, malocclusion and oral health related quality of life. Malocclusion was assessed using Dental Aesthetic Index (DAI ) and quality of life using Oral Health Impact Profile-14 (OHIP-14). Further, the association between malocclusion and related quality of life was assessed.

RESULTS

Normal or slight malocclusion was seen in 79.2% (n = 713). Definite malocclusion was seen in 12.8%, severe malocclusion in 5.7% and handicapping malocclusion in 2.3% of the subjects. The overall prevalence of malocclusion was found to be 20.8%. Out of the 900 study subjects 46.6% (n = 419) reported that malocclusion had some impact on their oral health related quality of life. The results of logistic regression demonstrated that those with malocclusion experienced a significant impact on quality of life (OR = 16.07, CI = 9.17-28.17).

CONCLUSION

Malocclusion has an impact on the oral health related quality of life among 13- to 19-year-old students in Mysore City.

Toothpaste Utilization Profiles among Preschool Children

BACKGROUND

Oral healthcare for pre-school children is given due priority, as their oral health will determine the oral health status of future generations. Generally, the type, frequency and quantity of toothpaste used by children are based purely on parental preferences.

METHODOLOGY

A descriptive, cross-sectional study was conducted among mothers of preschool children by using a questionnaire.

RESULTS

Sixty two percent (n=154) mothers started brushing their children's teeth more than one year after eruption of their teeth. A majority of the mothers used adult toothpaste to brush their children's teeth and supervised their children while brushing. Fiftytwo percent mothers were aware about presence of fluoride in tooth paste but its clinical significance. Half the mothers applied full length of tooth paste to their children's brushes and most mothers made their children brush their teeth twice daily.

CONCLUSION

Based on the findings of this study, it appears that there is still much lack of awareness on the proper guidelines on the selection and usage of toothpastes in children. Dental professionals should use this knowledge to help and motivate parents to properly supervise and assist their children's brushing, with the goal of reducing the potential risk of fluorosis.

Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India

OBJECTIVE

To assess whether oral health-related quality of life (OHRQoL) is associated with nutritional status in the institutionalised elderly population of Mysore.

BACKGROUND

Malnutrition in the elderly has an evident impact on their general health and quality of life. Analysis of data of the Geriatric Oral Health Assessment Index (GOHAI) and their association with the Mini Nutritional Assessment (MNA) results improves our understanding of the complex relationship between oral health and malnutrition.

MATERIALS AND METHODS

The study was conducted among the institutionalised elderly population in Mysore city, Karnataka. Data on socio-demographic, oral health status were gathered. OHRQoL was evaluated using GOHAI, and malnutrition risk using MNA.

RESULTS

Out of 141 elderly, 41.1% were men and 58.9% were women with mean age of 72.2 ±7.5 years. Mean GOHAI score was 47.03 ± 9.2, with 69.5% had low perception of oral health. Mean MNA score was 9.91 ± 2.4, 15.6% were malnourished, 52.5% were at risk of malnutrition and 31.9% were adequately nourished. A strong association was found between the mean GOHAI and MNA scores.

CONCLUSION

 Oral health-related quality of life was associated with nutritional deficit, and it requires a greater integration between dentistry and nutrition in the health promotion of older adults.