Linguistic Adaptation and Psychometric Properties of Tamil Version of General Oral Health Assessment Index‑Tml

Background: Oral health has an impact on quality of life hence for research purpose validation of a Tamil version of General Oral Health Assessment Index would enable it to be used as a valuable tool among Tamil speaking population.Aim: In this study, we aimed to assess the psychometric properties of translated Tamil version of General Oral Health Assessment Index (GOHAI‑Tml).Subjects and Methods: Linguistic adaptation involved forward and backward blind translation process. Reliability was analyzed using test‑retest, Cronbach alpha, and split half reliability. Inter‑item and item‑total correlation were evaluated using Spearman rank correlation. Convenience sampling was done, and 265 consecutive patients aged 20–70 years attending the outpatient department were recruited. Subjects were requested to fill a self‑reporting questionnaire along with Tamil GOHAI version. Clinical examination was done on the same visit. Concurrent validity was measured by assessing the relationship between GOHAI scores and self‑perceived oral health and general health status, satisfaction with oral health, need for dental treatment and esthetic satisfaction. Discriminant validity was evaluated by comparing the GOHAI scores with the objectively assessed clinical parameters. Exploratory factor analysis was done to examine the factor structure.Results: Mean GOHAI‑Tml was 52.7 (6.8, range 22–60, median 54). The mean number of negative impacts was 2 (2.4, range 0–11, median 1). The Spearman rank correlation for test‑retest ranged from 0.8 to 0.9 (P < 0.001) for all the 12 items between visits. The Cronbach alpha for 265 samples was 0.8 suggesting good internal consistency and homogeneity between items. Item scale correlation ranged from 0.4 to 0.8 (P < 0.001). Concurrent and discriminant validity was established. Principal component analysis resulted in extraction of four factors which together accounted for 66.4% (7.9/12) variance.Conclusion: GOHAI‑Tml has shown acceptable psychometric properties, so that it can be used as an efficient tool in identifying the impact of oral health on quality of life among the Tamil speaking population.Keywords: General oral health assessment index, Linguistic adaptation, Oral health‑related quality of life, Psychometric properties, Reliability, Validit

Strategies to manage patients with dental anxiety and dental phobia: literature review

Deva Priya Appukuttan Department of Periodontics, Sri Ramakrishna Mission Dental College and Hospital, Chennai, India Abstract: Dental anxiety and phobia result in avoidance of dental care. It is a frequently encountered problem in dental offices. Formulating acceptable evidence-based therapies for such patients is essential, or else they can be a considerable source of stress for the dentist. These patients need to be identified at the earliest opportunity and their concerns addressed. The initial interaction between the dentist and the patient can reveal the presence of anxiety, fear, and phobia. In such situations, subjective evaluation by interviews and self-reporting on fear and anxiety scales and objective assessment of blood pressure, pulse rate, pulse oximetry, finger temperature, and galvanic skin response can greatly enhance the diagnosis and enable categorization of these individuals as mildly, moderately, or highly anxious or dental phobics. Broadly, dental anxiety can be managed by psychotherapeutic interventions, pharmacological interventions, or a combination of both, depending on the level of dental anxiety, patient characteristics, and clinical situations. Psychotherapeutic interventions are either behaviorally or cognitively oriented. Pharmacologically, these patients can be managed using either sedation or general anesthesia. Behavior-modification therapies aim to change unacceptable behaviors through learning, and involve muscle relaxation and relaxation breathing, along with guided imagery and physiological monitoring using biofeedback, hypnosis, acupuncture, distraction, positive reinforcement, stop-signaling, and exposure-based treatments, such as systematic desensitization, “tell-show-do”, and modeling. Cognitive strategies aim to alter and restructure the content of negative cognitions and enhance control over the negative thoughts. Cognitive behavior therapy is a combination of behavior therapy and cognitive therapy, and is currently the most accepted and successful psychological treatment for anxiety and phobia. In certain situations, where the patient is not able to respond to and cooperate well with psychotherapeutic interventions, is not willing to undergo these types of treatment, or is considered dental-phobic, pharmacological therapies such as sedation or general anesthesia should be sought. Keywords: behavioral therapy, cognitive therapy, general anesthesia, psychotherapeutic intervention, pharmacological intervention, conscious sedation&nbsp