Fluoride - an adjunctive therapeutic agent for periodontal disease? Evidence from a cross-sectional study

Objective: To assess the influence of the water fluoride level on periodontal status, by determining the periodontal health status of subjects residing in low, optimum and high fluoride areas. Study design: A cross sectional survey was carried out on 967 adults aged 35-44 years old, from the Udaipur district of India. A stratified cluster random sampling technique was implemented in order to collect a representative sample from low (3ppm) areas, based on the fluoride concentration in drinking water. Periodontal status was assessed in accordance to WHO criteria. The Chi-square test was used to compare proportions, and logistic regression analysis was used to determine the contribution of water fluoride levels to periodontal disease. Results: Those residing in areas of low fluoride levels were more likely to present periodontal pockets than those living in high fluoride areas 1.3 (95 % CI 1.11±1.86). Subjects living in areas of low fluoride were noted to have a higher risk of periodontal attachment loss of more than 8mm (OR = 1.94, 95% CI 1.67±3.85). The risk for presence of periodontal pockets and attachment loss of more than 8mm increased by 1.17 (95 % CI 1.02±1.69) and 1.59 (95 % CI 1.27±3.29) respectively for those residing in areas of optimum fluoride levels. Deep periodontal pockets were more prevalent (6.3%) among those residing in areas of low fluoride, followed by optimum (5.2%) and high (3.1%). Conclusions: As the fluoride concentrations increased, the prevalence of shallow and deep periodontal pockets decreased. The severity of periodontal disease was significantly associated with fluoride levels, with cases of loss of attachment gradually decreasing when moving from low fluoride areas to high fluoride areas. It appears that longitudinal studies need to be conducted in order to ascertain the benefits; and microbiological analysis of dental plaque and periodontium should be carried out in order to confirm the effects of fluoride on periodontal conditions

Factors influencing caries status and treatment needs among pregnant women attending a maternity hospital in Udaipur city, India

To estimate the prevalence and severity of dental caries along with the treatment needs; to determine the factors that influence dental caries status among pregnant women attending a district maternity hospital in Udaipur, India. Study design: Study sample comprised of 206 pregnant women attending a district maternity hospital in Udaipur, India. Clinical data were collected on dental caries by DMFT and treatment needs as described in World Health Organization Dentition status and Treatment needs. Results: The overall caries prevalence was 87%. Mean caries experience differed significantly among women in various trimesters, it was found to be 3.59 and 3.00 in 1st and 2nd trimester subjects respectively while it was greatest (4.13) among those in 3rd trimester. One surface filling was the most predominant treatment need. Age and occupation of husband explained a variance of 6.8% and 4.2% for decayed and filled components respectively while the only predictor for missing teeth and DMFT that explained a variance of 9.6% and 5.7% respectively was trimester of pregnancy. Conclusions: Dental caries experience and the need for one surface restoration increased with age. Trimester of pregnancy was a significant predictor for missing teeth and DMFT, while decayed teeth and filled teeth were in - fluenced by age and socio-economic level respectivel

Prevalence of leukoplakia, oral submucous fibrosis, papilloma and its relation with stress among green marbles mine laborers, India

Objectives: To determine the prevalence of leukoplakia, oral submucous fibrosis and papilloma among ?Green Marble Mines? laborer and uncover its relation with occupational stress. Methods: Mines were divided in four geographic zones, and participants were selected by stratified cluster sampling technique. A total of 513 subjects were included in final study which were alienated among the four age cohort 15-24 , 25-34 , 35-44, 45-54 respectively. The study was been conducted following the research methodology recommended by World Health Organization- Oral Health Surveys 1997. A questionnaire from ?Union of Shops, Distribution and Allied Worker (USDAW) Nationwide, Manchester? was used for stress assessment of mine workers and clinical examination for oral mucosa was conducted by one of the three examiner with the aid of an artificial light source. The kappa statistics for diagnosis of leukoplakia, oral submucous fibrosis and papilloma was determined (field teams versus expert) 0.81, 0.92 and 0.89 respectively two days prior to the examination. Data was analyzed using bivariate and multivariate analysis. Results: An overall elevated prevalence of all three oral-mucosal lesion was found among mine workers (36.7%), mainly leukoplakia affecting 171 mine workers (33.3%). The affected workers were having body problems like headache, backache and stressed due to under-payment. Individuals having papilloma have faced problem at work like noise, dust or fumes and poor maintenance of equipment. Multiple logistic regression analysis model of oral-mucosal lesion have shown highly significant relation (p<0.01) with increased stress, age, alcohol habits and malnutrition. Conclusion: The prevalence of oral mucosal lesion is higher, among marble mine laborers, and occupational stress can intensify the disease condition. Curative services along with prevention and stress reduction program, requires primary anticipation

Influence of lifestyle on oral health behavior among rural residents of Udaipur district, India

Objectives: To determine the relation of life style with dental health behavior such as tooth brushing frequency, use of extra cleansing devices and regular visits to dentist among rural residents of Udaipur district, India. Study design: The study population comprised of 1001 rural population between the ages 18 to 69 years selected by multi stage stratified cluster sampling procedure. Personal interviews were conducted by three trained interviewers who collected information on socio-demographic and lifestyle factors in addition to some aspects of dental health behavior including tooth brushing frequency, use of extra cleaning devices like dental floss and regular visits to dentist. Results: Majority of the population (63.3%) brushed their teeth once a day and only a few subjects (19.8%) brushed twice a day whereas 8.6 % never brushed their teeth. Logistic regression analysis revealed that females were more apt in every aspect of dental health behavior. House wives were more regular in brushing their teeth (OR=1.51) and using extra cleansing devices as compared to other occupation groups. Subjects who suffered from systemic disease showed negative association with use of extra cleansing devices but showed positive association with regular visits to dentist. Conclusions: The results indicate that dental health behavior is related with life style factors as well as socio-demographic variables. © Medicina Oral S. L

Relationship of Body Mass Index with periodontal health status of green marble mine laborers in Kesariyaji, India

It is evident from literature that an increased body mass index (BMI) may be a potential risk factor for periodontitis. Association between BMI and periodontitis has been ascribed to unhealthy dietary patterns with insufficient micronutrients and excess sugar and fat content. The present study population has been plagued by unhealthy nutritional practices, hence the present study intended to assess the relation between BMI and periodontal status among green marble mine laborers of Kesariyaji, in the Udaipur district of Rajasthan, India. The study sample comprised of 513 subjects aged 18-54 years, drawn using the stratified cluster sampling procedure. BMI was calculated as the ratio of the subject's body weight (in kg) to the square of their height (in meters). Periodontal status was recorded using the Community Periodontal Index (CPI). Binary multiple logistic regression analysis was executed to assess the relation between body mass index and periodontitis. The dependent variable for logistic regression analysis was categorized into control group (scores 0 - 2 of the CPI) and periodontitis group (scores 3 and 4 of the CPI). The overall prevalence of periodontal disease was 98.2%. Caries status and mean number of teeth present deteriorated with the poor periodontal status. Subjects had an increased risk of periodontitis by 57% for each 1kg/m² increase in the body mass index, which means that a higher body mass index could be a potential risk factor for periodontitis among the adults aged 18 to 54 years. In conclusion, evaluation of the body mass index could be used in periodontal risk assessment

Dental caries experience and treatment needs of green marble mine laborers in Udaipur district, Rajasthan, India

<b>Background and Objectives:</b> The study was undertaken at Kesariyaji, located in Udaipur district of Rajasthan. There are about 3 million workers who marble mine at Rajasthan. Living conditions of these workers are substandard and most of them are immigrant workers living in tiny shacks. Majority of them belong to lower socioeconomic status with poor educational background. The present study was carried out to estimate dental caries prevalence and treatment needs of laborers working in the green marble mines of Udaipur district. <b> Basic Research Design:</b> The data was collected using the methods and standards recommended by the WHO. Dentition status and treatment needs along with decayed, missing, and filled teeth (DMFT) index, and decayed, missing, and filled surfaces score were recorded. Standard error of mean was calculated for all the mean values of treatment needs. There were three examiners, who were trained before the survey for inter-examiner variability, and the reliability was tested by means of weighted kappa statistics, which was 90&#x0025;. <b> Participants:</b> The study population comprised 513 men in four age groups of 18-25, 26-34, 35-44, and 45-54 years, respectively. <b> Results:</b> The mean DMFT for all age groups was 3.13 with highest mean of 4.0 for the age group of 45-54 years. Mean decayed teeth were 2.60, 3.33, 1.46, and 1.5 for the age groups 15-24, 25-34, 35-44, and 45-54 years, respectively. Filled component was nil for all age groups. Most of the subjects required one surface filling with a very less proportion needing pulp care. <b> Conclusions:</b> The missing component constituted the major part of DMFT index in the 45-54 years age group and the absence of filled component in the whole study population implies that the treatment needs of the study population are unmet. Thus, intervention in the form of oral health promotion and curative services are the need of the hour

Perceptions of Dental Students Towards Learning Environment in an Indian Scenario

Background: Dental students constitute a stakeholder group that is able to provide unique information concerning the effectiveness of the dental curriculum. The purpose of this study was to determine students′ perceptions of the learning environment, intellectual climate and teacher student relationships in dental school. Methods : This study was conducted among 341 dental students of two dental college of Udaipur, Rajasthan, India. Response rate was 85%. In this study, the dental version of Medical Student Learning Environment Survey has been used. The questionnaires were divided in to 7 subscales like flexibility, student to student interaction, emotional climate, meaningful experience, organization, supportiveness, and breadth of interest. The students were divided in to two groups of preclinical and clinical for the purpose of comparison. The data were analyzed using ANOVA and t-test. Results: The results were statistically analyzed and differentiated in to preclinical and clinical phases. The preclinical and clinical students rated the student to student interaction as the most favorable whereas the lowest score was given to flexibility by both preclinical and clinical students. Preclinical students rated emotional climate as the lowest after flexibility whereas clinical students rated breadth of interest and meaningful experience as the lowest score after flexibility. Conclusion: This study emphasized the areas of improvement in dental school learning environment based on students′ perspective by making these required and much needed changes in the curriculum. Students′ satisfaction with their dental education can be increased

Effect of smoking on oral pigmentation and its relationship with periodontal status

Background: To assess the effect of smoking on lip and gingival pigmentation and also to assess the relationship of pigmentation with periodontal parameters. Materials and Methods: 109 smokers and an equal number of control subjects who were nonsmokers in the age range of 35 - 44 years comprised the study sample. All the participants were assessed for pigmentation on lip and gingiva and a total periodontal status examination was done with measurements on gingival bleeding, probing depth and loss of attachment at six points in each tooth. Results: Melanin pigmentation on lips and gingiva was observed in all the smokers except for one who did not exhibit gingival pigmentation. Significantly greater number of smokers exhibited pigmentation than nonsmokers. Gingival bleeding on probing, probing depth and loss of attachment differed significantly in relation to gingival and lip pigmentation. Conclusions: Oral pigmentation was widespread and more commonly observed in smokers than nonsmokers and there was a relationship between pigmentation and periodontal deterioration

Knowledge, attitude and practice towards droplet and airborne isolation precautions among dental health care professionals in Udaipur, Rajasthan, India

Aims and Objective- The purpose of this study is to obtain comprehensive information about the knowledge, attitude and practices in regard to droplet and airborne infection related precautions among faculty member and the undergraduate students in Udaipur, Rajasthan, India. Material and Methods- A cross sectional survey was conducted among 311 dental faculty and the undergraduate students under clinical training in Udaipur, Rajasthan. A self-assessment questionnaire composed of queries on three levels, namely knowledge, attitude and practices with respect to airborne and droplet isolation precautions was used. The data was collected and analyzed by using SPSS software. Results- Frequency distribution scores of knowledge, attitude and practice in relation to droplet and airborne isolation precautions were revealed that even the students under training along with the faculty member were quite aware of the precautions and the principles of airborne and droplet isolation. Mean score for knowledge was 9.17±2.07; Mean scores for attitude and practice were 48.65±7.47 and 6.88±3.51 respectively. There were no significant difference in all groups regarding knowledge, attitude and practice. In addition, a positive linear correlation was found between two items of survey including knowledge- attitude, knowledgepractice and attitude- practice (P<0.01). Conclusion- The results highlighted that though the professionals had good knowledge and attitude but the practice levels for the same were low. The study confirms from the findings that the infection control measures among the health care professionals are fairly good and an educational programme on isolation precautions can further enhance these levels and thereby, reducing the risk of infection transmission risks