Oral health knowledge and oral hygiene practices of pre-school teachers in a selected region of Kathmandu city

Background: Dental caries and periodontal diseases are the most common oral health problems seen globally. Schools provides anideal environment for all forms of education, including oral health and teachers can be instrumental in imparting it. The teachers,therefore, need to be well versed in the knowledge regarding oral health as well as practice good oral hygiene measures to teach thechildren. Objectives: The objective of this study is to assess pre-school teachers’ oral health knowledge and oral hygiene practicesin a selected region of Kathmandu city. Methodology: An observational, descriptive cross-sectional study was conducted on preschoolteachers in a selected region of Kathmandu city. The teachers of pre-school level completed a self-administered structuredquestionnaire on knowledge of oral health and oral hygiene practices Result: The pre-school teachers had more knowledge aboutdental caries than about periodontal diseases. Overall, scores of school teacher’s (n=95) oral health knowledge were inadequate(54.7%) but the oral hygiene practices (69.5%) were found to be good. Conclusion: The pre-school teachers had inadequate oralhealth knowledge but good oral hygiene practices. This shows a need for training and motivation of pre-school teachers’ regardingthe oral health education and promotion through school-based programs

Location of Mental Foramen in Dentate Adults using Orthopantomogram

Introduction: Understanding the anatomical variations in the position of mental foramen are significant for different dental procedures. This study identified the position of the mental foramen among a sample of Nepalese population visiting a dental college in Kathmandu. Methods: Total 417 panoramic radiographs (orthopantomograms) were selected from a total of 567 radiographs. The mental foramen location was determined by drawing imaginary line parallel with the long axis of the lower premolars . The mental foramen location was then classified into six classes. Results: In the study population, the mental foramina were located mostly between the lower premolars 163 (39.1%), followed by in line with second premolar 148 (35.5%) of the mental foramen was located under the second premolar apex. Conclusions: The study shows that the anaesthetic solution should be injected between the lower premolars or below the lower 2nd premolar in the Nepalese population for successful and secure mental nerve blocking

Tooth Mobility among Patients visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Periodontitis is a chronic inflammatory disease that results in the destruction of supporting tissue and bone leading to tooth mobility. Tooth mobility if untreated can lead to tooth loss. However, very few studies exist for its assessment. The aim of this study was to find out the prevalence of tooth mobility among patients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among individuals visiting a tertiary care dental hospital from 1st April to 30th June 2022 after obtaining ethical clearance from the Institutional Review Committee (Reference number: 2202202202). Individuals more than 13 years who gave consent and fulfilled the study criteria were enrolled. Tooth mobility was assessed using Lindhe and Nyman’s classification. Proforma also included demographics, simplified oral hygiene index, gingival index, body mass index, and smoking status. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 163 patients, 65 (39.88%) patients (32.36-47.40, 95% Confidence Interval) had tooth mobility. Conclusions: The prevalence of tooth mobility was higher than in studies done in similar settings

Prevalence of Oral Mucosal Lesions in a Tertiary Care Dental Hospital of Kathmandu

Introduction: Oral mucosa can be affected by a variety of soft tissue lesions and conditions. Benign as well as malignant lesions of oral cavity are common. Squamous cell carcinoma is one of the commonest malignancies. The present retrospective study was undertaken to study the prevalence of various oral mucosal lesions in a tertiary care dental hospital of Kathmandu. Methods: This retrospective study was carried out in the Department of Oral and Maxillofacial Pathology at Kantipur Dental College and Teaching hospital from January 2015 to January 2017. The study included biopsy specimen from the oral cavity. The parameters included in the study were age, gender, site of the lesion and histopathological diagnosis. The data collected was statistically analyzed. Results: A total of 111 biopsy cases were included in the present study. Out of which, there was 16 (14.4%) cases of non neoplastic and 16 (14.4%) cases of benign pathology. The oral cavity lesions were commonly seen in age range between 6-74 years where males 59 (53.2%) were mostly affected. The most common site for oral lesion was buccal mucosa 23 (20.7%) and anterior gingiva 23 (20.7%). 15 (13.5%) cases of oral squamous cell carcinoma were seen as the predominant malignancy affecting in the vestibular region 8 (7.2%). Conclusions: The present study shows benign as well as the non neoplastic lesions were more prevalent in oral mucosa with the buccal mucosa and anterior gingiva as the commonest site of occurrence. Keywords: Benign; Malignant; Non neoplastic; Oral mucosal lesion

Periodontal Health Status and Pregnancy Outcomes: A Survey in Medical Doctors

Introduction: Periodontal disease and caries are the most common causes of tooth loss worldwide. Studies have demonstrated strong association between periodontitis and adverse pregnancy outcomes. Medical doctors, who are the primary healthcare providers, seldom advise women to seek dental care during pregnancy. This study was undertaken to explore the knowledge, attitudes and behaviours of medical doctors towards oral health and to identify the barriers of prenatal periodontal healthcare in their practices and its possible implications on pregnancy outcomes. Methods: Total 377 doctors filled the questionnaire. The data collected through personal contacts, social networking, emails, online forms and networking at conferences were analysed using Statistical Package for the Social Sciences 20 software program and presented in tables, charts and diagrams. Results: Out of 263 (69.8%) male and 114 (30.2%) female doctors enrolled in the study, only 52 (13.8%) had received education or training on oral care during pregnancy. Among them 299 (79.3%) agreed that there is possible link between health of teeth-gums and pregnancy. Approximately 105 (27.9%) encountered patients with oral/periodontal problem every week but only 108 (28.6%) “always” advised their patient for regular dental check-ups. Similarly, 358 (95%) agreed that there is need for universal guidelines however, 133 (35.3%) thought there was insufficient time to advice patients on oral health during check-ups. Conclusions: An adequate referral system to oral healthcare providers and biannual check-ups is recommended for both general patient as well as pregnant women for preventing adverse situations related to oral and specifically periodontal diseases

C-reactive Protein in Periodontitis and its Comparison with Body Mass Index and Smoking Behaviour

Introduction: Chronic periodontitis is an infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss. In addition to declining oral health, there is always low grade infection present in periodontitis. Studies show increased levels of systemic biomarkers in periodontal disease such as CRP, which is considered a key-marker of CVD. Research has also shown positive association between BMI and smoking with periodontitis and CRP. The objective of the study was to assess the levels of CRP in patients with and without periodontitis and their relation with BMI and smoking behaviour. Methods: Patients visiting the Dental department of Bir Hospital were invited to participate in the study. Total 31 subjects in each group: Case (periodontitis) and Control (without periodontitis) were selected using convenience sampling technique. All subjects underwent periodontal examination by a single examiner. Serum CRP samples were taken before periodontal treatment. Data analysis was done by SPSS 17 software program. Results: Increase in mean CRP levels in periodontitis (5.8595mg/L) with high statistical significance (p=0.000) in comparison to subjects without periodontitis (1.1214mg/L) was observed. BMI showed positive association with periodontitis (p=0.046) but not with CRP (0.213). Smoking behaviour showed no significant relation with either CRP (p=0.344) or periodontitis (p=0.541). Conclusions: We found highly significant association between periodontitis and CRP levels but not always with BMI and smoking. CRP, which is an established marker for CVD was significantly increased in periodontal infections. Hence, a close interaction among Physician, Periodontist and Patient to prevent adverse health situations is recommended. Keywords: body mass index; cardiovascular disease; c-reactive protein; periodontitis; smoking; systemic inflammation. [PubMed

Dental Implants and General Dental Practitioners of Nepal: A study of existing knowledge and need for further education

Background &amp; Objectives: The use of dental implants in partially or completely edentulous patients has proved effective and an accepted treatment modality with predictable long-term success. Dental implants are becoming a popular choice for replacing the missing teeth because of increased awareness about implants both in dentists and patients. The objective of the study was to assess the basic knowledge and education about dental implants among general dental practitioners (GDPs) of Nepal.Materials &amp; Methods:  A cross sectional questionnaire was carried out among 110 GDPs which consist of twenty questions that were divided into three categories; first with some basic knowledge in implant dentistry, second with clinical knowledge of dental implants and third with dental implant education and training.Results: Out of 110 GDPs, 72.7% had basic knowledge about implant dentistry and 65.5% were not aware about advance surgical procedures like sinus lift and guided bone regeneration. All the GDPs were positive regarding more training and education in dental implants and 95.5% of them would like to incorporate dental implant treatment in their practice in future. Conclusion: GDPs should have adequate knowledge and training of dental implants which can be incorporated at undergraduate or post doctoral level so that they are skilled to provide quality dental implant therapy to their patients confidently.</p

Knowledge of Use of Antibiotic, Its Resistance and Consequences Among Students in Private Schools.

Introduction: Self-medication among adolescents has become a serious global problem that plays an important role in irrational use of medication and tends to increase with the age of adolescents. Limited research has been done in Nepal regarding antibiotic knowledge among non-medical students. Hence, this study aims to assess the knowledge of higher secondary non-science students regarding antibiotic use, resistance and its consequences. Methods: A cross-sectional descriptive study was done during antibiotic awareness week 2017 among 471 grade 11 and 12 non-science students of private schools in Kathmandu. Convenience sampling technique was used. Data was collected through self-administered questionnaires. Descriptive statistics was utilised to find out the knowledge level of the students. Results: The mean age of the students 245 (52%) male, 226 (48%) female) was 17.19 years and 335 (71.1%) were from grade 12. Approximately all 462 (98.1%) the participants had inadequate knowledge regarding antibiotic and their knowledge mean score was 5.8±2.56. More than half 277 (58.8%) of the students had not heard about antibiotic resistance, among those who have heard 113 (24%) said that doctor and nurses were the source of information. Conclusions: Almost all of the participating students lacked adequate knowledge regarding antibiotic. Thus, it is imperative to create school and community based awareness programs by policy makers for adolescents to upgrade their knowledge on safe use of antibiotics as well as to prevent the consequences of antibiotic resistance during their adult life

Assessment of Palatal Plane and Occlusal Plane for Determining Anteroposterior Jaw Relation.

INTRODUCTION: Sagittal jaw relationship is an important parameter for orthodontic treatment planning. Angular and linear measurements both have been proposed and used in orthodontic cephalometrics to assess the sagittal jaw relationships. However, angular measurement has been questioned over the years for its reliability as a result of changes in facial height, jaw inclination and the variable positions of Nasion. So, the objective of our study was to assess the linear anteroposterior jaw relation in a sample of Nepali population using occlusal (Wits appraisal) and palatal planes as reference lines. METHODS: A descriptive cross-sectional study was conducted using the lateral cephalogram of 101 individuals visiting the Department of Orthodontics, Kantipur Dental College, Kathmandu, Nepal. Individuals with Class I skeletal relation were selected using convenience sampling method. Radiographs were standardised and traced. Occlusal and palatal planes were drawn that were bisected by the perpendicular lines from Point A and Point B. The linear distances between the intersections were measured to determine sagittal jaw relations. RESULTS: In Nepali individuals with normal ANB angle (3.05°±2.511°), the sagittal jaw relation with reference to occlusal (Wits appraisal) and palatal planes were found to be 0.203±3.343mm and 3.574±4.074mm respectively. CONCLUSIONS: Various methods has been proposed and used to assess the sagittal jaw relation and each method has its own strength and limitations. So, it is well advised to use additional cephalometric analysis whenever possible before arriving at any diagnosis and treatment plans