Assessment of oral mucositis during concurrent chemoradiation of head and neck cancers using patient-reported measurement scale

Introduction: Oral mucositis (OM) is a major challenge encountered in concurrent radiochemotherapy for the treatment of head and neck cancers. The patient reported OM symptoms scale (PROMS) was administered on these patients. The objective was to develop the similar scale in an Indian language and prescribe it population undergoing cancer treatment. Materials and Methods: PROMS scale was converted to Telugu language. Fifty-one patients took part in the study. All of them answered the 10-point questions marked their responses on 100 mm visual analog scale after thorough oral examination using WHO grading by the same examiner. Results: Internal consistency of Cronbach's alpha on PROMS scale was 0.81–0.97. The questionnaire study was administered on 35 males and 16 females with the mean age of 54.9 ± 11.8. The decrease in the total PROMS score was marked on day 35 in almost all patients, with a mean value of 34.04 ± 30.2 followed by a further significant decrease on day 60 (follow-up) with a mean of 3.71 ± 7.8. The PROMS scores correlated strongly with the clinician-rated OM scores during the first 35 weeks from the baseline at 0.84 with P < 0.01 and poor correlation was at day 60, i.e. 0.32 with P < 0.05 using Spearman's Rho correlation. Conclusion: The study showed a good correlation between patient-reported items and clinical score by standard grading scale. This questionnaire may not be a sole guide in assessing the severity of OM but could be definitely used as an adjunct to clinical oral examination at assessment levels

A questionnaire cross-sectional study on application of CBCT in dental postgraduate students

BACKGROUND: CBCT is a new emerging imaging technique which uses a cone-shaped radiation beam that is centered on a 2D detector. It is now routinely evaluated for oral and para-oral disorders. It has been widely accepted in practice in radiology in academic and hospital settings and included in the curricula of some countries. The present study aimed to evaluate the awareness of and knowledge on CBCT among postgraduates. MATERIAL AND METHODS: After obtaining permission and ethical clearance from concerned authorities, an anonymous survey on CBCT was conducted in a dental college by using a close-ended validated questionnaire to get to know the knowledge on CBCT among postgraduates in a dental college in India. RESULTS: A total of 100 volunteers participated but only 88 postgraduates responded to the questionnaire. Among the respondents, 54.5% were not using CBCT for diagnostic purposes at their work place. A total of 68.2% of respondents were partially aware of common terminologies used in CBCT. Most of the respondents were unsure about radiation exposure of CBCT when compared to other types of imaging. Almost nobody had any idea on relative importance of image characteristics. Only half of the respondents were willing to attend a hands-on course on CBCT interpretations versus pathology. CONCLUSIONS: In the present study it was apparent that most of the respondents were lacking adequate knowledge on CBCT. Hence, there is an urgent need for more training programs on CBCT which would result in better diagnosis and treatment planning

Evaluation of preference and purpose of utilisation of cone beam computed tomography (CBCT) compared to orthopantomogram (OPG) by dental practitioners : a cross-sectional study

BACKGROUND: Cone beam computed tomography (CBCT) has become a reliable adjunctive tool for both diagnosis and treatment planning in the field of dentistry. There are numerous advantages of CBCT over 2D imaging techniques (OPG). There is a need to evaluate the changing trend of preference and purpose of utilisation of these imaging modalities by dental practitioners. This study was carried out to evaluate and compare the purpose and preference of utilisation of CBCT and OPG by various dental practitioners in their clinical practice. MATERIAL AND METHODS: A retrospective, cross-sectional study was carried out on CBCT and OPG data of 620 different cases treated by different dental practitioners from imaging centres in the twin cities of Telangana (Hyderabad & Secunderabad). For comparisons, we used the Mann-Whitney U test (Z test). RESULTS: The analysis of data showed that among the dental practitioners OPG was more commonly ordered by general dentists (31%) followed by prosthodontists (30%), whereas CBCT was more advocated by general dental practitioners (25%) followed by OMFS (23%). OPG preference was greater for fixed partial denture planning (FPD) 59%, whereas CBCT was highly preferred for implant planning 61%. CONCLUSIONS: The present study showed that general dentists preferred OPG and CBCT compared to other dental practitioners, and OPG was advocated for FPD planning, whereas CBCT was advocated for implant planning. Moreover, and it was found that there had been a drastic increase in the preference of CBCT over OPG in recent times

A systematic analysis on possibility of water fluoridation causing hypothyroidism

Background: Community water fluoridation is widely used worldwide and its role in preventive dental health care is well established. However, there is sufficient evidence of the ill effects of excessive fluoride content in water, causing skeletal and dental fluorosis. Alongside, there was also extraskeletal and dental manifestations of excessive fluorides reported. They include the effect on thyroid function, but the literature regarding this is sparse. Aim: The present systematic review aims to analyze the data from controlled studies about the effect of fluoride on thyroid function. Materials and Methods: A systematic literature search was performed using PUBMED, MEDLINE, EMBASE, COCHRANE Library, EBSCO search, and the internet search, with language restriction to English. The search included published studies which dealt with the association of fluorine with hypothyroidism, from January 1981 to November 2015. Literature search was done using keywords: fluoride and hypothyroidism, dental fluorosis and thyroid disorders, systemic fluorosis and thyroid disease, excessive water fluoridation and hypothyroidism, thyroid and fluoride, fluorosis and its adverse effects. Results: Out of 166 publications, related to search strategy, 37 full articles which were related with the association of fluoride and hypothyroidism were acquired for further inspection. Out of the 37 articles, 10 articles met the inclusion criteria. The data were extracted and placed in an excel sheet and were analyzed. The analysis suggested a positive correlation of excess fluoride and hypothyroidism. Conclusion: The present systematic review suggests a positive correlation between excess fluoride and hypothyroidism. This calls the need for further well-controlled studies in this otherwise emerging alarming issue. It also calls for considerable community network through health informatics for problem sensitization

A New Intraoral Appliance for Trismus in Oral Submucous Fibrosis

Trismus is the most common sequelae of various pathological processes leading to compromised nutritional state in addition to physical and psychological disabilities. Therapeutic interventions are available to relieve trismus, which range from oral usage of pharmacological agents to intralesional steroid therapy. Intraoral appliance therapy can be employed as an alternative or adjuvant treatment for radiotherapy-induced fibrosis and autoimmune disorders such as scleroderma, psychogenic trismus, and oral submucous fibrosis, decreasing the adverse effects associated with other pharmacological interventions. A novel intraoral appliance—“Nallan C-H”—has been developed and tried for trismus producing better results. A report on three such cases having trismus due to a premalignancy has been presented. It is hypothesized that the same appliance can be used for treating inoperable trismus in palliative care setting additionally or as an adjuvant to pharmacological approach