DENTISTRY TODAY... The journal is indexed with ‘Indian Science Abstract’ (ISA) (Published by National Science Library), www.ebscohost.com, www.indianjournals.com The journal is printed on ACID FREE paper. JADCH is available (full text) online: Website- www.adc.org.in/html/viewJournal.php This journal is an official publication of Ahmedabad Dental College and Hospital, published bi-annually in the month of March and September. ISSN 0976-2256 E-ISSN:2249-6653 A Pediatric dentistry provides primary care and comprehensive dental speciality treatments for infants, children, adolescents and individuals with special health care needs. The successful practice of pediatric dentistry is nit merely the completion of any operative procedure but also ensuring a positive dental outcome for the future oral health behaviour of the individual and their family. To this end, an understanding of child development- physical, cognitive and psychosocial - is paramount. Traditionally, dental caries has been regarded as a static phenomenon, eventulation in loss of tooth structure while the basis for treatment and management of this ubiquitious disease has essentially been mechanical. However, with current developments in new dental materials, techniques and preventive strategies, a more precise understanding and appreciation of the nature of the caries process is obtained. The newer concept of using micro-invasive resin infiltrants in enamel and early dentine lesion is promoted. There have been advances in four key areas related to pediatric dentistry ;(1) caries detection tools, (2) early interventions to arrest disease progression, (3) caries risk assesement tools, (4) trends in pediatric procedures and dental materials. It is the only specialization in dentistry that is age defined and not specific to any treatment modality. Hence, with the adoption of newer material and techniques working on a child becomes one of the most satisfying experience in all dental practice. Editor - in - Chief Dr. Darshana Shah Co - Editor Dr. Rupal Vaidya Editorial Board: Dr. Mihir Shah Dr. Vijay Bhaskar Dr. Monali Chalishazar Dr. A. R. Chaudhary Dr. Neha Vyas Dr. Sonali Mahadevia Dr. Shraddha Chokshi Dr. Bhavin Dudhia Dr. M Ganesh Dr. Mahadev Desai Dr. Darshit Dalal Dr. Harsh Shah JADCH
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Dantal College Devang (Vol-5) - Ahmedabad Dental … Journal - Vol.2,Issue No. 2...Malodor and periodontitis: casual or causal? DEPARTMENT OF PERIODONTICS AND ORAL IMPLANTOLOGY, AHMEDABAD
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DENTISTRY TODAY...
The journal is indexed with ‘Indian Science Abstract’ (ISA)(Published by National Science Library), www.ebscohost.com, www.indianjournals.com
The journal is printed on ACID FREE paper.
JADCH is available (full text) online:Website- www.adc.org.in/html/viewJournal.php
This journal is an official publication of Ahmedabad Dental Collegeand Hospital, published bi-annually in the month of March andSeptember.
ISSN 0976-2256E-ISSN:2249-6653
A
Pediatric dentistry provides primary care and comprehensive dental speciality treatments for infants, children, adolescents and individuals with special health care needs.
The successful practice of pediatric dentistry is nit merely the completion of any operative procedure but also ensuring a positive dental outcome for the future oral health behaviour of the individual and their family. To this end, an understanding of child development- physical, cognitive and psychosocial - is paramount. Traditionally, dental caries has been regarded as a static phenomenon, eventulation in loss of tooth structure while the basis for treatment and management of this ubiquitious disease has essentially been mechanical. However, with current developments in new dental materials, techniques and preventive strategies, a more precise understanding and appreciation of the nature of the caries process is obtained. The newer concept of using micro-invasive resin infiltrants in enamel and early dentine lesion is promoted. There have been advances in four key areas related to pediatric dentistry ;(1) caries detection tools, (2) early interventions to arrest disease progression, (3) caries risk assesement tools, (4) trends in pediatric procedures and dental materials. It is the only specialization in dentistry that is age defined and not specific to any treatment modality. Hence, with the adoption of newer material and techniques working on a child becomes one of the most satisfying experience in all dental practice.
Editor - in - ChiefDr. Darshana Shah
Co - EditorDr. Rupal Vaidya
Editorial Board:Dr. Mihir ShahDr. Vijay BhaskarDr. Monali ChalishazarDr. A. R. ChaudharyDr. Neha VyasDr. Sonali MahadeviaDr. Shraddha ChokshiDr. Bhavin DudhiaDr. M GaneshDr. Mahadev DesaiDr. Darshit DalalDr. Harsh Shah
JADCH
EDITORIAL
FROM THE EDITOR'S DESK .....................................................................................................................................................01
DARSHANA SHAH
REVIEW ARTICLES
1) MALODOR AND PERIODONTITIS: CASUAL OR CAUSAL? ........................................................................................02
Subscription:Rate per issue: Rs. 400/-, for one year: Rs. 750/-, for three years: Rs. 2,000/-Contact: Ahmedabad Dental College & Hospital Vivekanand Society, Bhadaj-Ranchhod Pura Road, Santej, Post: Rancharda, Ta: Kalol, Dist: Gandhinagar, Gujarat, India.
B
Dear friends,
The current method of dental and medical training is dependent on professors, Obsolete Text books and opinion of the seniors who are often dogmatic and unresponsiveto new ideas.
such a method is insufficient to carry on lifelong clinical practice in a very comptent manner.
the younger doctors are computer savvy, inquisitive and want to know more. We in india are known for hardwork, logical reasoning and cultural strengths.
We have to incorporate this evidence based education into our mainstream dental education if we are going to maintain and provide the personnel for the whole global village.
the critical feature of "Evidence-Based Dentistry is that dentists, when faced with any problem in the clinical context of a patient, should be able to: perform a literature search; identify the evidence available pertaining tio the clinical condition; critically evaluate it and determine the "Best evidence" to diagnose /treat/manage the patient.
The crux of the matter in this cycle is the ability of the dentist to search and retrieve the literature in the shortest possible time in an efficient manner and apply it in practice
in the "global scenario", the term EBD became more widely used in the early 1990s, and was later formally defined by Sackett in 1996.
The first National Workshop on Evidence-Base Dentistry in India was held at College of Dental Sciences, Davangere between the 8th and 11th March 2001.
With over 85 delegates registered from all over India, it was perhaps the largest ever dedicated workshop on evidence-based dentistry in the world.
This is the beacon of what th e future holds for Evidence based dentistry in India.
1The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014
Dr. Darshana ShahEditor JADCHEditorial Office:Prof. & Head Dept. of ProsthodonticsAhmedabad Dental College & Hospital,Dist.: Gandhinagar, Gujarat.Email: [email protected]
Malodor and periodontitis: casual or causal?
DEPARTMENT OF PERIODONTICS AND ORAL IMPLANTOLOGY, AHMEDABAD DENTAL COLLEGE AND HOSPITAL, GANDHINAGAR, GUJARAT, INDIA.
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014 2
Halitosis can be a crippling social problem.However, in the last 5 to 6 years, it has come to the forefront of public and dental professional awareness.The mouth is home to hundreds of bacterial species that produce several fetid substances as a result of protein degradation. Volatile sulfur compound (VSC)-producing bacteriacolonizing the lingual dorsum, gingival pockets, and tonsillar crypts have recently been implicated in the generation of halitosis. Understanding causes, assessment, and treatment of oral malodor can help dental professionals find ways to decrease its prevalence and increase their patients' well-being.This article reviews the etiology and various connections among periodontal pathogenic microorganisms, periodontal disease and oral malodor from a periodontal perspective.
Keywords: halitosis, volatile sulphur compounds, gingivitis, periodontitis, role of microflora in malodor, co-relation between halitosis and periodontitis
IntroductionDental Fluorosis is an irreversible but preventable disease commonly caused by excessive intake of fluoride during critical period of teeth development. Dental fluorosis is endemic in many areas of Indian subcontinent including many districts in the North Central part of Gujarat state.
Aims & ObjectivesThe study was undertaken to correlate the severity of dental fluorosis with variables like age, gender, drinking water fluoride levels and dental caries.
Materials & MethodsA total of 53 patients (30 males and 23 females) affected with dental fluorosis were selected for the study. The subjects were assessed for their age range, severity of the dental fluorosis (based on Dean's Fluorosis Index) and their drinking water fluoride levels (determined by Ion Selective Electrode method). The subjects were also assessed for their dental caries prevalence using the DMFT index.
ResultsMajority of the subjects belonged to third and fourth decades of life followed by the second decade. The highest number of subjects manifested moderate degree of dental fluorosis followed by severe degree and mild degrees respectively. There was a positive correlation of the severity of dental fluorosis with the level of fluoride in the drinking water as well as the DMFT index of the subjects.
ConclusionA dentist often plays a prime role in detection of dental fluorosis, and hence in identification of the areas with higher water fluoride levels. This necessitates the dentists to be familiar with the clinical presentation of dental fluorosis as well as with areas affected by endemic dental fluorosis.Received: 08-10-2013; Review Completed: 12-12-2013; Accepted: 15-01-2014
INTRODUCTION
Fluorosis is described as a state of toxicity of
the trace element called fluorine within an [1]
organism. In 1901, Dr. Frederick McKay of
Colorado (USA) accidentally discovered that many
patients had apparently permanent stain on their
teeth which was often referred to as COLORADO [2]STAIN. “Shoe Leather Survey” of Trendley Dean
(1931) lead to the establishment that concentration
of fluoride in drinking water was directly correlated
with the severity of fluorosed and mottled enamel. [2,3]
However, the United States Food and Drug
Administration (1973) has listed Fluoride as an
essential nutrient for human health. The report of
WHO expert committee includes Fluoride in its list
of 14 trace elements which are physiologically
essential for normal growth and development of [2,4]
human beings.
Dental Fluorosis develops due to chronic
and excessive use of fluoride compounds, most
common causative factor being use of drinking
water with higher levels of fluoride, especially
during first 6 years of age when teeth are [3,5-12]
developing. Dental Fluorosis is more
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
commonly observed in patients obtaining drinking
water from tube wells, bore wells or hand pumps. [13,14]
Diet, seafood and tea intake does not influence [3]
prevalence of dental fluorosis.
There is no reported significant difference
in prevalence and severity of dental fluorosis [3,14]
related to age and gender. However, certain
studies report it to be least common within first
decade due to higher number of primary teeth and
only a few erupted permanent teeth. It is reportedly
more common in 12 – 14 years of age as maximum [1,5,12,15] permanent teeth have erupted by this age.
Some studies report greater prevalence of fluorosis [5,9,12]
among males than females. One possible
explanation might be that men drink more water
than women to compensate for fluid loss during [16]
field work. This could also be due to greater [5] number of male population in a particular area.
Fluorosis is reported to be more severe in maxillary [14]
teeth than in homologous mandibular teeth. This
was probably related to unrecognized trauma in the
maxillary teeth or other local, unspecified types of [17]
insult during tooth development. Dental
Fluorosis is observed in both primary and
permanent dentition. Primary tooth fluorosis is less
common and usually less severe than in permanent
teeth, as explained by the fact that very high fluoride
levels (> 10 ppm) are required in drinking water for
it to cross placental barrier and affect primary
dentition as most primary teeth develop during [4,8,10,18]
intrauterine life.
Dental fluorosis results in a variety of [19]
pathological changes in the structure of the teeth.
It is characterized by occasional opaque, lusterless
white spots in the enamel which constitute
questionable degree of fluorosis (based on Dean's
Fluorosis index). When the white flecks cover less
than 25% of tooth surfaces, it is said to be very mild
degree fluorosis. When the white flecks cover more
than 25% but less than 50% of tooth surfaces, it is
said to have mild degree fluorosis. Cloudy striations
cation exchange softening, anion exchange, [13] activated carbon, etc. Reverse osmosis water
purification systems remove 90 to 95% of the [13,20]
fluoride content in water.
A variety of treatment modalities are
available for Dental Fluorosis, with cost being a
major limitation. In – Office bleaching is the most
commonly used method for the removal of stains.
Moreover, depending upon the clinical condition, a
synergistic approach of combining bleaching with
other modalities such as micro abrasion and
fabrication of veneers can help in gaining an [26]
excellent clinical outcome. A minimal invasive
technique combining the triad of micro reduction,
micro abrasion and conventional vital bleaching
allows good esthetics and a possible cost reduction [16]for treating mild to moderate fluorosis.
The purpose of this study is to evaluate the
correlation between high ground water fluoride
content & severity as well as extent of Dental
Fluorosis in rural areas in and around Gandhinagar
district of Gujarat state.
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014 12
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
AIMS AND OBJECTIVESØ To estimate the occurrence of Dental Fluorosis
in patients coming to the Out Patient Department (OPD) of Ahmedabad Dental College and Hospital
Ø To evaluate the association of Dental Fluorosis with Age and Sex
Ø To estimate water fluoride level and correlate it with the degree of Dental Fluorosis
Ø To evaluate different degrees of Dental Fluorosis in terms of type and severity
Ø To estimate the incidence and severity of dental caries in patients having Dental Fluorosis
MATERIALS AND METHODS
Ø The study was conducted on 53 patients from amongst all the patients coming to the Out Patient Department (OPD) of the Oral Medicine and Radiology Department of Ahmedabad Dental College and Hospital during the period of June 2009 to September 2010
Ø Inclusion Criteria• Patients having chalky white spots or brown
staining or structural abnormalities of teeth• Patients who have lived in the same place
where they were born and have procured drinking water from the same source throughout their life
Ø Exclusion Criteria• Patients with history of being treated by
long term antibiotic medication in early childhood or whose mother has been treated by such medication during pregnancy
• Patients who had migrated to some other place after birth or who were not permanent residents of any one place since birth
• Patients who have obtained drinking water from more than one source since birth
• Patients having some severe systemic disease or condition
Ø The severity of Dental Fluorosis was estimated based on Dean's Fluorosis Index.
Ø Patients selected for the study were evaluated and examined thoroughly and the findings were recorded in a Proforma prepared specially for
the study
Ø The drinking water samples were procured from patients and sent to laboratory for estimation of fluoride content in ppm (parts per million) based on Ion Selective Electrode Method.
COLLECTION OF WATER SAMPLE
Ø The ground water pumped from the borewell into overhead water tanks comprised the source of water for samples collected in the study
Ø The water samples were collected from overhead water tanks after obtaining permission from the respective Gram Panchayats of villages under study.
Ø The water sample collected from a single place was equally divided into two unused plastic containers and precoded by the investigator and then submitted to the laboratory technician on the same day. Thus, the laboratory technician was kept unaware of the place to which the water sample belonged, to eliminate any potential bias.
Ø The same procedure was repeated for all places under study.
Ø Two samples were thus submitted from each place to the technician in order to test the same sample twice and hence eliminate major errors. The mean of two samples was taken as final reading. If the difference between the two readings was greater than 0.5 ppm, the sample was discarded; a new sample was obtained from the same place and submitted for water fluoride estimation.
Ø From the ppm content of water samples procured, a chart of fluoride content of different areas of Gandhinagar district was prepared.
RESULTS
A total of 53 patients with Fluorosis were selected for the study from the patients coming to the Out Patient Department (OPD) at Oral Medicine, Diagnosis & Radiology Department
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014 13
14
of Ahmedabad Dental College & Hospital.
The Pie chart shows the distribution of 53 patients into mild, moderate and severe degrees of Fluorosis based on Dean's Fluorosis Index. There were no patients falling into 'Questionable' and 'Very Mild' categories of Fluorosis. There were 4(7.55%), 31(58.49%) & 18(33.96%) patients in 'Mild', 'Moderate' and 'Severe' categories respectively. (Fig. 1 – 3)
Figure 1: Patient with mild degree of DentalFluorosis
Figure 2: Patient with moderate degree of Dental Fluorosis
Figure 3: Patient with severe degree of Dental Fluorosis
PIE CHART
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014
Table I demonstrates age distribution of 53 patients under the study. The patients belonged to age range from 11 to 65 years. Out of 53 patients, 14(26.41%) were in second decade; while 17(32.07%) were in third decade and the same number of patients were in the fourth decade of life
Table II shows the sex distribution of patients under study. Out of 53 patients, 30(56.60%) were males while 23(43.40%) were females.
Table III shows distribution of patients selected for the study with their birth places and the community water fluoride levels (ppm) of those places as estimated by means of Ion Selective Electrode method.The patients selected for the study were divided into two groups. Group I included 10 patients who came from places having community water fluoride level 1.5 ppm or below. Group II included 43 patients who came from places having community water fluoride level above 1.5 ppm. There were more patients having moderate and severe degree fluorosis in Group II as compared to Group I.
Table I
-
Distribution of patients with various degrees of Fluorosis according to Age
Distribution of age
Mild
Moderate Severe Total
0 to 9
0
0
0 010 to 19
1 (25%)
7 (22.58%) 6 (33.33%) 14 (26.41%)20 to 29
1 (25%)
9 (29.03%) 7 (38.89%) 17 (32.07%)30 to 39 2 (50%) 12 (38.71%) 3 (16.67%) 17 (32.07%)40 to 49 0 1 (3.22%) 0 1 (1.89%)50 to 59 0 2 (6.45%) 0 2 (3.77%)60 to 69 0 0 2 (11.11%) 2 (3.77%)
70 and above 0 0 0 0Total 4 31 18 53
Table II - Distribution of patients with various degrees of Fluorosis according to Sex
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014
Table III – Distribution of patients with various degree of Fluorosis
according to Community Water Fluoride Level
Group Place Water F level (ppm)
Mild Moderate Severe Total
Patients
Group
I (≤ 1.5
ppm)
Vadsar
1.3
0
2
0
2
Nasmed
1.4
0
2
1
3
Chandlodiya
1.5
1
2 0
3
Bhamriya 1.5 1 0 1 2
2 (20%)
6 (60%)
2 (20%) 10
Group
II ( >
1.5
ppm)
Ghatlodiya
1.6
0
1
1
2
Thol
1.8
1
1
0
2
Nava Vadaj
1.9
0
2
0
2
Odhav
2
0
3
2
5
Santej
2
0
2
3
5
Julasan
2.7
0
2
2
4
Pansar
2.8
0
5
1
6
Bapunagar
2.8
1
2
6
9
Rakanpur 3 0 2 1 3
Mehsana 3 0 2 0 2
Kadi 3 0 3 0 3
2 (4.65%) 25 (58.14%) 16 (37.21%) 43
Total 4 31 18 53
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
Table IV demonstrates the distribution of patients selected for the study based on their chief complains.
Table IV - Distribution of patients with various degrees of Fluorosis based on Chief Complain
Chief Complain
Mild
Moderate
Severe
Total
Stains
2 (50%)
13 (41.93%)
13 (72.22%) 28 (52.83%)
Pain
1 (25%)
10 (32.26%)
3 (16.67%)
14 (26.41%)
Decay
1 (25%)
3 (9.68%)
0
4 (7.55%)
Extraction 0 3 (9.68%) 1 (5.55%) 4 (7.55%)
Gum Problems 0 1 (3.22%) 0 1 (1.89%)
Prosthetic Problems
0 1 (3.22%) 1 (5.55%) 2 (3.77%)
Total 4 31 18 53
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014 16
Table VI shows caries experience of patients based on DMF Index (Decayed, Missing, and Filled) in each of the mild, moderate and severe fluorosis categories. Out of 53 patients selected for the study, there were 7(13.20%) patients with DMF score 0, 10(18.87%) patients had DMF score 1 or 2, 16(30.19%) patients had DMF score 3 to 5, while 20(37.74%) patients had DMF score from 6 to 12 or beyond. Among the 31 patients with moderate degree Fluorosis, 11(35.48%) patients had DMF score of 3 to 5 and other 11(35.48%) patients had DMF score equal or above 6. Among the 18 patients with severe degree Fluorosis, 4(22.22%) had DMF Score 3 to 5, 9 (50%) patients had DMF score equal to or above 6.
Table V - Arch wise distribution of fluorosed TeethTeeth affected Maxillary teeth Mandibular teeth Total
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
DISCUSSION
Dental Fluorosis develops due to chronic and excessive use of fluoride compounds by the patients, most common causative factor being use of drinking water with higher levels of fluoride,
[3,5-12]especially during first 6 years of age.
According to the present study, Dental Fluorosis is most common in second and third decades of life. This is in accordance with literature which reports it to be least common within 5 – 7 years of age due to higher number of primary teeth and only few erupted permanent teeth. It is reportedly more common around 12 – 14 years of age as all permanent teeth (except third molars) have
[1,5,12,15]erupted by this age. However, some authors report no significant difference in prevalence and severity of dental fluorosis between various ages. [3,14]
There is no reported significant difference in prevalence and severity of dental fluorosis
[3,14]between males and females. However, some studies report greater prevalence of Fluorosis
[5,9,12]among males than females. This is in accordance with the present study. One possible explanation might be that men drink more water than women to compensate for fluid loss during
[12,14]field work.
All the patients in the present study were residing (since birth) at places having community water fluoride levels well above the optimum level (0.7 – 1.2 ppm) as suggested by World Health
Organization and Environmental Protection Agency as well as above that of Indian standards (0.5 ppm).The places under present study belong to Ahmedabad, Gandhinagar & Mehsana districts of Gujarat state, which is an Endemic Fluorosis state, as reported in National
[3-6,14]Oral Health Survey. This is in accordance with reports in literature that fluorosis is caused by consumption of water with fluoride level
[1,13,15,21,22]above optimum. Most of patients under study consumed drinking water provided by community supplies since birth, which contained optimal water fluoride above normal. Dental fluorosis is reported to be more commonly observed in patients obtaining drinking water from tube wells, bore wells or hand pumps rather than tap water, draw wells or rivers, because the surface water is known to
[13,14]contain less fluoride than ground water. There is a tendency of increase in severity of Dental Fluorosis in patients with increase in
[3,19]Community Water Fluoride level. This is in accordance with the present study.
Among the patients under the moderate and severe categories, most reported with chief complain of brown stains and mottled teeth since childhood or adolescence. This is in accordance with high fluoride content of drinking water consumed by them during critical period for development of dentition, as
[3,5-12]revealed by this study. The other major chief complaint was that of pain associated with a carious tooth, which is common in fluorosed
[5,19]teeth. Very few patients with mild degree of
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014 17
Fluorosis presented for the study, which reflects the fact that Fluorosis of a moderate degree is much more noticeable due to presence of brown stains than mild degree of Fluorosis which often goes unnoticed.
Dental Fluorosis is found to be more severe in maxillary teeth than in homologous mandibular teeth, with maxillary incisors as most commonly involved teeth group, in the present study. This is in accordance with the reports in
[14]literature. This was probably related to unrecognized trauma in the maxillary teeth or other local, unspecified types of insult during
[17]tooth development.
There is an increase in prevalence of dental caries with increase in severity of Dental Fluorosis in the present study. This is in accordance with studies reporting elevated caries levels associated with the brittleness of
[3]moderately and severely mottled teeth. However, some authors have reported that when Fluorosis severity increased from normal to moderate, the DMFT value correspondingly decreased, while as the fluorosis level increased beyond moderate, the DMFT rate increased. The DMFT increased in cases of severe Fluorosis due to pitting of enamel surface which promoted the accumulation of microbial plaque. [9] While, some authors have reported that as the severity of Dental Fluorosis increased the DMFT increased upto the level of mild Fluorosis and then decreased as the severity
[5]increased from moderate to severe Fluorosis.
In the present study, there are more patients with greater DMFT scores among the patients with moderate and severe degree of Fluorosis as compared to those with mild degree of Fluorosis.
SUMMARY AND CONCLUSION
• Majority of patients came from Ahmedabad, Gandhinagar & Mehsana districts of Gujarat state, which are areas of Endemic Fluorosis according to National Oral Health Survey
• Majority of patients affected with Dental Fluorosis belonged to second, third and fourth decades of life.
• There was a slight male predominance among the affected patients.
• Amongst the patients with Dental Fluorosis, a step wise increase in severity of fluorosis was noted with increase in drinking water fluoride content (estimated by Ion Selective Electrode Method).
• Majority of patients fell into moderate to severe degree Fluorosis categories of Dean's Fluorosis Index
• There was an increase in Caries prevalence with corresponding increase in severity of Dental Fluorosis.
• Among the treatment modalities evaluated, Bleaching was found to give esthetically acceptable results in patients with brown stains while veneers were satisfactory as treatment modality for hypoplastic enamel with surface irregularities in patients with severe degree of Fluorosis.
2. Amrit T, Ved J. Fluorides and Dental Caries – A Compendium. Publication of the Journal of Indian Dental Association 1986.
3. Jagan Kumar B, Clement R, Aswath N. Prevalence of dental fluorosis and associated risk factors in 11 – 15 year old school children of Kanyakumari District, Tamilnadu, India: A Cross Sectional survey. Indian J Dent Res 2008; 19(4): 297 – 303.
4. Vineet D, Maheep B. Physiology and toxicity of fluoride. Indian J Dent Res 2009; 20(3): 350 – 5.
5. Tuli A, Rehani U, Aggrawal A. Caries experience evidenced in children having dental fluorosis. Int J Clinical Ped Dent 2009; 2(2): 25 – 31.
6. Bronckers A, Lyaruu D, DenBesten P. The Impact of Fluoride on Ameloblasts and the mechanisms of Enamel Fluorosis. J Dent Res 2009; 88(10): 877 – 93.
7. Fatemeh V, Anne M, Paula J. Sources of dietary fluoride Intake in 6-7 year old english children
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014 18
receiving optimally, sub-optimally, and non-fluoridated water. Journal Public Health Dent 2006; 66(4): 227 – 34.
8. Teresa A, Steven M, John J, Barbara B, Julie M, Phyllis J. Associations between intakes of fluoride from beverages during infancy and dental fluorosis of primary teeth. Journal of the American College of Nutrition 2004; 23(2): 108 – 16.
9. Ramezani G, Valaei N, Eikani H. Prevalence of DMFT and Fluorosis in the students of Dayer City (Iran). J Indian Soc Pedod Prevent Dent 2004; 22(2): 49 – 53.
10. Jian R, Asgeir R, Anne S, RuiZhe H, ZhiLun W, Kjell B. Dental fluorosis in children in areas with fluoride polluted air, high fluoride water, and low fluoride water as well as low fluoride air: A study of deciduous and permanent teeth in the Shaanxi p rov ince , China . Acta Odontologica Scandinavica 2007; 65: 65 – 71.
11. Ana A, Carlo E, Juan F, Gerardo M, Mirna M, Sayde O. Dental fluorosis in cohorts born before, during, and after the national salt fluoridation program in a community in Mexico. Acta Odontologica Scandinavica 2006; 64: 209 – 13.
12. Choubisa S. Endemic fluorosis in Southern Rajasthan, India. Fluoride 2001; 34(1): 61 – 70.
13. Prabhakar A, Raju O, Kurthukoti A, Vishwas T. The effect of water purification systems on fluoride content of drinking water. J Indian Soc Pedod Prevent Dent 2008; 26(1): 6 – 11.
14. Sudhir K, Prashant G, Subba Reddy V, Mohandas U, Chandu G. Prevalence and severity of dental fluorosis among 13 to 15 year old school children of an area known for endemic fluorosis: Nalgonda district of Andhra Pradesh. J Indian Soc Pedod Prevent Dent 2009; 27(4): 190 – 6.
15. Lia Silva C, Efigenia F, Leila N, Lucia M, Edson P. Beliefs and attitudes about endemic dental fluorosis among adolescents in rural Brazil. Rev Saude Publica 2010; 44(2): 261 – 6.
16. Harikumar V, Arun A. Management of mild to moderate fluorosis with a combined chemomechanical approach. Annals and Essences of Dentistry 2010; 2(3): 73 – 6.
17. Vera S, Dorte H, Carolina T, Thais M, Sven P. Prevalence and distribution of demarcated opacities and their sequelae in permanent 1st molars and incisors in 7 to 13 year old Brazilian children. Acta Odontologica Scandinavica 2009; 67: 170 – 5.
18. Dhar V, Jain A, Van Dyke T, Kohli A. Prevalence of gingival diseases, malocclusion and fluorosis in school going children of rural areas in Udaipur district. J Indian Soc Pedod Prevent Dent 2007; 25(2): 103 – 5.
19. Susheela A, Bhatnagar M, Gnanasundaram N, Saraswathy T. Structural aberrations in fluorosed human teeth: Biochemical and scanning electron microscopic studies. Current Science 1999; 77: 1677 – 81.
20. Pediatric Dentistry – Special Supplemental Issue. Access, January 2000.
21. Parkar S, Ajithkrishnan C. Estimation of fluoride concentration in Community water supply & packaged drinking water sold in Vadodara City – A Comparative Study. J Indian Assoc Public Health Dent 2010(15): 105 – 9.
22. Martin S Spiller. Fluoride. Doctor Spiller.com 2000.
23. Bali R, Mathura V, Stalwart P, Canaan H. National Oral Health Survey and Fluoride Mapping 2002 – 2003, Gujarat. Dental Council of India, New Delhi, 2004.
24. Kolashi J, Dastjerdi M. Assay of fluoride levels in drinking water. Ann Saudi Med 2005; 25(2): 175.
25. Wolfgang A, Anabel H, Julia H, Zeno G, Jolan B, Peter G. Effect of pH of amine fluoride c o n t a i n i n g t o o t h p a s t e s o n e n a m e l remineralization in vitro. BMC Oral Health 2007; 7: 14.
PURV PATEL Dental Fluorosis – A Retrospective Study in Gandhinagar District et. al. :
The Journal of Ahmedabad Dental College and Hospital; 5 (1), March 2014 - August 2014 19
KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING ORAL CANCER AND SCREENING PROCEDURES AMONG PRIMARY HEALTH CARE AND COMMUNITY HEALTHCARE WORKERS OF WAGHODIA, GUJARATBAFNA HARSHAL P *, AJITHKRISHNAN CG**, KALANTHARAKATH THANVEER***, RICKY PAL SING*, HEMAL PATEL****
ABSTRACT
Background: India has the highest rate of oral cancer in world and there is a 60% rise in past three decades. Mortality rate for oral cancer is higher in population with poor access to oral health care. With 72% of Indians residing in rural areas they have a better access to community health care providers (CCPs) and primary health care providers (PCPs) who, could play a major role in oral cancer prevention and reduce death rate.
Objectives: The study aimed at evaluating knowledge, attitude and practice regarding oral cancer and screening practices among CCP's and PCP's by using pretested questionnaire.
Material and Methods: A cross sectional questionnaire study was conducted among all CCP's and PCP's of Waghodia, Vadodara. A self designed, modified close ended and pre-piloted questionnaire was used for recording data. Mean and percentage were used for statistical analysis.
Results: 78.24% believed that prevention and early detection was important, while 53% had actually referred cases in past one year. All believed tobacco to be a risk factor for oral cancer but only 49% answered for other factors. 91.37% were ready to be a part of continuing education (CE).
Conclusion: The participants had deficient knowledge about the risk factors for oral cancer and were ready to participate in CE.
Key-words: Oral Cancer, Health Care Workers, Gujarat