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

Insight into nicotine addiction

The emergence of the epidemic of nicotine addiction in India and other nations is a global public health tragedy of untoward proportions. Smoking or chewing tobacco can seriously affect general, as well as oral health. Smoking-caused disease is a consequence of exposure to toxins in tobacco smoke and addiction to nicotine is the proximate cause of these diseases. This article focuses on nicotine as a determinant of addiction to tobacco and the pharmacologic effects of nicotine that sustain cigarette smoking. The pharmacologic reasons for nicotine use are an enhancement of mood, either directly or through relief of withdrawal symptoms and augmentation of mental or physical functions. Tobacco cessation is necessary to reduce morbidity and mortality related to tobacco use. Strategies for tobacco cessation involves 5A's and 5R's approach and pharmacotherapy. Dental professionals play an important role in helping patients to quit tobacco at the community and national levels, to promote tobacco prevention and control nicotine addiction. Dentists are in a unique position to educate and motivate patients concerning the hazards of tobacco to their oral and systemic health, and to provide intervention programs as a part of routine patient care

A crossover clinical trial to assess the effectiveness of different oral hygiene regimens on the reduction of morning bad breath in healthy young adults

Context: Bad breath causes embarrassment and affects interpersonal social communication. Morning breath odor is a commonly encountered oral problem which should be rectified with effective oral hygiene measure. Aim: The aim of this study was to assess and compare the effectiveness of different oral hygiene regimens on the reduction of morning bad breath, plaque formation, and gingivitis in healthy young adults. Settings and Design: A four-step, crossover clinical trial was conducted among 40 young adults aged 18–22 years residing in one of the nongovernmental organizations in New Delhi. Materials and Methods: Study participants were divided into four groups, which underwent intervention for 7 days each. Group 1: tooth brushing; Group 2: tooth brushing and mouthwashing; Group 3: tooth brushing and tongue scraping; and Group 4: combination of all. A washout interval of 14 days was employed in between the groups. Breath scores were measured at three time intervals whereas oral health status was recorded at the beginning and the end of each interventional period. Statistical Analysis Used: Appropriate tests such as paired t-test, ANOVA test, and Pearson correlation tests were used in the study. Results: The highest reduction in mean value of breath scores (2.03 ± 0.69) was found in Group 4 followed by Group 3. Similarly, Group 4 showed the highest reduction in mean value of plaque score (0.79 ± 0.19) and gingival score (0.54 ± 0.23) followed by Group 2. Conclusion: Combination of mechanical and chemical oral hygiene measures is an effective regimen for the reduction of morning bad breath

Student's perception: A core indicator in building academia in today's world

Introduction: The perception of students considering their educational environment is a useful source to modify or to improve the quality of education. Whereas the education is a dynamic process, researches about this topic are important to improve education methods and strategies. Equally essential is to know opinion of the students about teachers and educational environment. Aim: The aim of this study is to assess students' perceptions of educational environment using Dundee ready education environment measure (DREEM) among four different health science courses. Materials and Methods: A cross-sectional survey design was conducted on 398 students enrolled in undergraduate health science programs offered at a multispecialty university in Haryana, whose courses consisted of traditional classes and clinical fieldwork. This comprised of students from bachelor degrees in Dental Sciences, Physiotherapy, Nursing, and Allied health sciences. The survey was conducted using a standardized self-report questionnaire DREEM, which is 50-item, close-ended, and scored on 5-point Likert scale. Results: The mean total DREEM score was 77.2 ± 13.07, which according to the interpretation guide was seen to be more positive than negative. More positive results were seen among students of dental sciences (76.7 ± 12.8) and physiotheray (78.06 ± 13.1). Statistical significant difference (P ≤ 0.05) was seen among all the courses in each subscale. Students' perception of teachers and students' self-perception showed statistically nonsignificant results when compared between gender. Conclusion: Students rated their learning environment as positive. This suggests a student-centered approach from the university and may lead to positive outcomes for the students

Effectiveness of oral health education program using braille text in a group of visually impaired children-before and after comparison trial

CONTEXT: Vision is the most important sense for interpreting the world and when sight is impaired, especially in childhood it can have detrimental effects on one's life. To maintain the oral health status of such group requires special approach. AIM: The aim of this study is to evaluate the impact of Braille text and verbal, oral hygiene instructions on the oral health status of visually impaired children. SETTINGS AND DESIGN: A prospective nonrandomized before and after comparison trial without any control group was conducted among 165 children aged 7–19 years residing in one of the blind schools in Delhi. MATERIALS AND METHODS: A questionnaire was developed to record the source of oral health knowledge and practices. Oral health status of the children was evaluated by recording plaque index (PI) and gingival index (GI) scores at 1, 3, and 5 months intervals. Periodic reinforcement of oral health education was performed with the help of instructions in Braille language. STATISTICAL ANALYSIS: Paired t-test and McNemar tests were used to assess the difference between the scores before and after oral health education. RESULTS: Among completely blind children, the mean difference of PI and GI score from baseline to the last evaluation was found to be 0.56 and 0.28, whereas among partially blind children, it was found to be 0.58 and 0.25, respectively. All the above values were statistically significant (P < 0.001). CONCLUSION: Visually impaired children irrespective of the degree of blindness could maintain an acceptable level of oral hygiene when taught using Braille text for instructions. However, continuous motivation and reinforcement at regular intervals are required for the maintenance of oral health status

Dermatoglyphics: An indicator of dental caries in humans

Introduction: Fingerprint analysis for personal identification is well-known, as it is unique to all individuals and remains unchanged over a lifetime. Now it is getting identified as a useful tool in understanding the basic questions in genetics and is emerging as an independent field in dentistry as dermatoglyphics. Aim: The aim of this study is to assess if any relationship can be established between fingerprint patterns with dental caries. Materials and Methods: A total of 76 dental students aged 18–26 years were selected using simple random sampling. Their fingerprints were recorded with duplicating InkPad and analyzed by Cummins Method and caries experience was clinically assessed by decayed, missing, and filled teeth index. Results: The dental caries experience was highest among students with whorl pattern (μ = 2.82) followed by the central pocket loop (μ = 2.60) and least among students with loop pattern (μ = 1.58). Furthermore, a significant relationship between twin loop pattern and dental caries was noticed (μ = 2.41); however, a negative correlation was observed for loops and arches with dental caries. Conclusion: The dental caries experience of an individual was associated fingerprints. Dermatoglyphics may be considered as a indicator of dental caries in humans

Prevalence and Determinants of Domestic Violence among Attendees of an Antenatal Clinic in a Tertiary Care Teaching Hospital in Delhi, India

Apparently healthy pregnant women with a gestational age of < 20 weeks were interviewed about sociodemographic details, marital history, antenatal history and presence of domestic violence. Of the 428 pregnant women, 31.3% suffered from domestic violence. Emotional and verbal abuse (58.2%) was the most common form. Women with younger age at marriage and with assisted conception were at a higher risk for suffering from domestic violence. Pregnant wives of men with a lower level of education, unemployment or employment as unskilled labourers and addiction to alcohol and tobacco were at higher risk for domestic violence.

Complete Genome Analysis of Thermus parvatiensis and Comparative Genomics of Thermus spp. Provide Insights into Genetic Variability and Evolution of Natural Competence as Strategic Survival Attributes

Thermophilic environments represent an interesting niche. Among thermophiles, the genus Thermus is among the most studied genera. In this study, we have sequenced the genome of Thermus parvatiensis strain RL, a thermophile isolated from Himalayan hot water springs (temperature &gt;96°C) using PacBio RSII SMRT technique. The small genome (2.01 Mbp) comprises a chromosome (1.87 Mbp) and a plasmid (143 Kbp), designated in this study as pTP143. Annotation revealed a high number of repair genes, a squeezed genome but containing highly plastic plasmid with transposases, integrases, mobile elements and hypothetical proteins (44%). We performed a comparative genomic study of the group Thermus with an aim of analysing the phylogenetic relatedness as well as niche specific attributes prevalent among the group. We compared the reference genome RL with 16 Thermus genomes to assess their phylogenetic relationships based on 16S rRNA gene sequences, average nucleotide identity (ANI), conserved marker genes (31 and 400), pan genome and tetranucleotide frequency. The core genome of the analyzed genomes contained 1,177 core genes and many singleton genes were detected in individual genomes, reflecting a conserved core but adaptive pan repertoire. We demonstrated the presence of metagenomic islands (chromosome:5, plasmid:5) by recruiting raw metagenomic data (from the same niche) against the genomic replicons of T. parvatiensis. We also dissected the CRISPR loci wide all genomes and found widespread presence of this system across Thermus genomes. Additionally, we performed a comparative analysis of competence loci wide Thermus genomes and found evidence for recent horizontal acquisition of the locus and continued dispersal among members reflecting that natural competence is a beneficial survival trait among Thermus members and its acquisition depicts unending evolution in order to accomplish optimal fitness