Current Scenario of Teledentistry in Public Healthcare in India

India is the largest democracy and the second most populated nation in the world. Although with 190,000   dentists, India ranks top in the absolute number of dental graduates, rural Indians and urban slums remain deprived of quality dental healthcare due to unequal distribution and access. About 1,000 telemedicine nodes have been established by Government/Private/Trust agencies to reinforce the national healthcare delivery system in India however an organised and dedicated teledentistry network is non-existent but for the Collaborative Digital Diagnosis System (CollabDDS). CollabDDS was developed in India for tele-consultation, diagnosis, remote education and as a data repository. It is a remote expert dental programme served between three dental schools with the Centre for Dental Education and Research at the All India Institute of Medical Sciences in New Delhi. There are some major challenges which exist and need to be addressed including lack of government initiatives, reimbursement schemes, data protection laws, technical infrastructure, advanced biological sensors, bandwidth support, orientation among doctors, and linguistic diversity, along with patients’ fear and unfamiliarity. With an area of 3,287 million km2, an urban-rural divide, inaccessible areas, the country is an ideal setting for the provision of eHealth. This paper highlights the present status, challenges and future of teledentistry in India

Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children

<p>Abstract</p> <p>Background</p> <p>Nail biting (NB) is a very common unwanted behavior. The majority of children are motivated to stop NB and have already tried to stop it, but are generally unsuccessful in doing so. It is a difficult behavior to modify or treat. The objective of this study was to investigate the prevalence of co-morbid psychiatric disorders in a clinical sample of children with NB who present at a child and adolescent mental healthcare outpatient clinic and the prevalence of psychiatric disorders in their parents.</p> <p>Method</p> <p>A consecutive sample of 450 referred children was examined for NB and 63 (14%) were found to have NB. The children and adolescents with nail biting and their parents were interviewed according to DSM-IV diagnostic criteria. They were also asked about lip biting, head banging, skin biting, and hair pulling behaviors.</p> <p>Results</p> <p>Nail biting is common amongst children and adolescents referred to a child and adolescent mental health clinic. The most common co-morbid psychiatric disorders in these children were attention deficit hyperactivity disorder (74.6%), oppositional defiant disorder (36%), separation anxiety disorder (20.6%), enuresis (15.6%), tic disorder (12.7%) and obsessive compulsive disorder (11.1%). The rates of major depressive disorder, mental retardation, and pervasive developmental disorder were 6.7%, 9.5%, 3.2%, respectively. There was no association between the age of onset of nail biting and the co-morbid psychiatric disorder. Severity and frequency of NB were not associated with any co-morbid psychiatric disorder. About 56.8% of the mothers and 45.9% of the fathers were suffering from at least one psychiatric disorder. The most common psychiatric disorder found in these parents was major depression.</p> <p>Conclusion</p> <p>Nail biting presents in a significant proportion of referrals to a mental healthcare clinic setting. Nail biting should be routinely looked for and asked for in the child and adolescent mental healthcare setting because it is common in a clinical population, easily visible in consultation and relatively unintrusive to ask about. If present, its detection can then be followed by looking for other more subtle stereotypic or self-mutilating behaviors.</p

Prevalence of non-communicable diseases in Brazilian children: follow-up at school age of two Brazilian birth cohorts of the 1990's

<p>Abstract</p> <p>Background</p> <p>Few cohort studies have been conducted in low and middle-income countries to investigate non-communicable diseases among school-aged children. This article aims to describe the methodology of two birth cohorts, started in 1994 in Ribeirão Preto (RP), a more developed city, and in 1997/98 in São Luís (SL), a less developed town.</p> <p>Methods</p> <p>Prevalences of some non-communicable diseases during the first follow-up of these cohorts were estimated and compared. Data on singleton live births were obtained at birth (2858 in RP and 2443 in SL). The follow-up at school age was conducted in RP in 2004/05, when the children were 9-11 years old and in SL in 2005/06, when the children were 7-9 years old. Follow-up rates were 68.7% in RP (790 included) and 72.7% in SL (673 participants). The groups of low (<2500 g) and high (≥ 4250 g) birthweight were oversampled and estimates were corrected by weighting.</p> <p>Results</p> <p>In the more developed city there was a higher percentage of non-nutritive sucking habits (69.1% vs 47.9%), lifetime bottle use (89.6% vs 68.3%), higher prevalence of primary headache in the last 15 days (27.9% vs 13.0%), higher positive skin tests for allergens (44.3% vs 25.3%) and higher prevalence of overweight (18.2% vs 3.6%), obesity (9.5% vs 1.8%) and hypertension (10.9% vs 4.6%). In the less developed city there was a larger percentage of children with below average cognitive function (28.9% vs 12.2%), mental health problems (47.4% vs 38.4%), depression (21.6% vs 6.0%) and underweight (5.8% vs 3.6%). There was no difference in the prevalence of bruxism, recurrent abdominal pain, asthma and bronchial hyperresponsiveness between cities.</p> <p>Conclusions</p> <p>Some non-communicable diseases were highly prevalent, especially in the more developed city. Some high rates suggest that the burden of non-communicable diseases will be high in the future, especially mental health problems.</p

Automatic Landmark Identification in Lateral Cephalometric Images Using Optimized Template Matching

Cephalometric analysis has long helped researchers and orthodontic practitioners for evaluation of facial growth, understanding facial morphology and its ethnic variations, orthodontic diagnosis and treatment planning for patients presenting with malocclusion and dentofacial deformities. Mostly, inaccuracy in cephalometric measurements is a reflection of errors in identification and accurate localization of anatomical landmarks. The accuracy of landmark identification is greatly influenced by knowledge of the operator and experience. Moreover, the process of manual detection is tedious and time consuming. Therefore, a need for development of robust and accurate algorithms for automatic detection of landmarks on cephalometric images has been comprehended. In this work, we hereby propose an optimized template matching (OTM) algorithm which could automatically localize hard and soft tissue anatomical landmarks on lateral cephalometric images. This algorithm was tested for sixteen hard and eight soft tissue landmarks chosen in 12 regions on 37 lateral cephalograms obtained from subjects of either sex covering wide spectrum of malocclusion cases. The results of proposed automatic algorithm were compared to that of manual marking conducted by three experienced orthodontic specialists. All the 24 landmarks (100%) were detected within 3.0 mm error range of manual marking, 23 (96%) were detected within 2.5 mm error range and 16 (66.6%) landmarks were detected within 2.0 mm error range. The optimized template matching (OTM) algorithm may prove to be a promising approach in automatic detection of anatomical landmarks on cephalometric images

Physical properties of root cementum: part 2. Effect of different storage methods.

This study examined the effect of 5 disinfection and storage protocols over different time periods on the hardness and elastic modulus of human premolar cementum. The sample consisted of 20 first premolars, which were divided into 5 groups of 4 teeth and stored in 1 of the following ways: (1) Miltons solution (1% sodium hypochlorite) for 10 minutes, (2) Miltons solution for 24 hours, (3) 70% alcohol, (4) desiccation, or (5) Milli Q (deionized water, Millipore, Bedford, Mass). Teeth in groups 1 and 2 were initially stored in Milli Q, tested within 6 hours, placed in their respective media, and retested. Groups 3, 4, and 5 were tested within 6 hours, then at 1 month, 2 months, and 3 months after extraction. Group 5 was further studied at 9 months, and 2 teeth in Group 4 were tested at 4 months. The hardness and elastic modulus of cementum was tested with the Ultra-Micro Indentation System (UMIS-2000, Commonwealth Scientific Industrial Research Organization, Australia) on unprepared specimens mounted on a 3-dimensional jig assembly. The results showed that storage in Miltons solution for 10 minutes had no significant effect on the hardness or elastic modulus, whereas storage for 24 hours caused a significant decrease in the hardness of cementum (P =.03). Storage in 70% alcohol for up to 4 months and in Milli Q for up to 9 months had no significant effects. Desiccation caused a significant increase in both the hardness and the elastic modulus from baseline to 3 months (P =.02 and P =.04, respectively), with most changes occurring within the first month. It was concluded that Miltons solution for 10 minutes could be considered an appropriate method for disinfection and removal of periodontal ligament fragments; however, its use for 24 hours should be avoided. Seventy percent alcohol and Milli Q are better storage methods, and desiccation should be avoided

Building Oral Health Research Capacity in India: Identifying Barriers and Enablers Using Mixed Methods

This article will provide a brief overview of the methods in finding barriers and enablers in doing oral health research in India. This mixed-methods approach can be used by researchers in finding barriers and enablers in doing oral health research in other developing countries and building oral health research capacities.</p