Dental Problems Research Articles

Efforts to Improve Knowledge, Attitudes and Behaviors about Dental and Oral Health Through the Use of TikTok App for Pregnant Women

Background: Pregnancy is one of the factors that can cause an increase in dental and oral health problems. This condition occurs due to increased levels of the hormones estrogen and progesterone during pregnancy, which is associated with an increase in the amount of plaque attached to the surface of the teeth and oral hygiene which tends to be neglected due to nausea and vomiting in the morning (morning sickness), especially in the early stages of pregnancy. Providing counseling by utilizing TikTok can be an effective way for pregnant women to increase knowledge, attitudes and behaviors about dental and oral health. Research: The purpose of this research is to create and develop dental health promotion by using the Tiktok App to increase knowledge, attitudes and behaviors about dental and oral health in pregnant women at the posyandu Village in the Mangkubumi Health Center area. Research: The type of research conducted was R&D research. Research: Tiktok App about dental and oral health can improve the knowledge, attitudes and behaviors of pregnant women. P value of knowledge 0.000, attitude 0.000 and behavior 0.000. Conclussion: Dental health promotion using the Tiktok App can increase knowledge, attitudes and behaviors about dental and oral health in pregnant women at the posyandu Village in the Mangkubumi Health Center area

Health Promotion Using Dental Story Sticker Media on Prevention Knowledge Caries in Primary School

Background: The results of basic health research in 2018 show that the biggest dental problem in Indonesia is broken/caved/sick teeth (45.3%). The proportion of problems with damaged, cavities or diseased teeth in Garut Regency is 57.61%. Health promotion is an effort to provide knowledge as a basis for behavior change to improve the health status of individuals, families, groups, and communities through learning activities. Dental Story Stickers are a way of conveying information about dental and oral health by using stickers that can be removed and reattached, as well as using storytelling as an outreach method where the instructor tells information about dental and oral health. Objective: To determine the effect of health promotion using dental story sticker media on knowledge of caries prevention in class IV students at State Elementary School 2 Mulyasari, Garut Regency. Method: The type of research is pre-experimental with a one-group pre and post-test design with total sampling technique, and measuring instruments namely questionnaires and statistical tests using the Wilcoxon test. Results: 18 students (60%) obtained good criteria, 12 students (40%) had sufficient criteria and no good curve criteria (0%). Conclusion: Health promotion using dental story sticker media influences knowledge of preventing dental caries in class IV students at State Elementary School 2 Mulyasari, Garut Regency.

X-ray Image Analysis for Dental Disease: A Deep Learning Approach Using EfficientNets

Dental cavities are a highly common persistent dental problem that impacts populations across different age groups on a global scale. It is crucial to get a dental issue diagnosed as early as possible and with as much accuracy as possible to treat it efficiently and prevent any related issues. If a dental infection is not treated, it will eventually grow and cause tooth loss. Dental X-ray images are crucial and beneficial in the diagnostic process of dental diseases for dentists. By applying Deep Learning (DL) techniques to dental X-ray images, dental experts can efficiently and precisely detect dental conditions, including dental cavities, fillings and implants. The objective of this research is to assess the performance of DL-based methods for dental disease detection via panoramic radiographs. In this study, we evaluated the performance of all of the EfficientNet variants (e.g., EfficientNets B0-B7) to determine which one is the most effective model for detecting dental disease. Moreover, we utilized the Borderline Synthetic Minority Oversampling Technique (SMOTE) to cope with the issue related to the minority classes contained in the dataset. To assess the efficacy of the model, various metrics are employed, including recall, accuracy, precision, loss, and F1-score. As a result, the performance of the EfficientNet-B5 model was superior to that of the other EfficientNet models. The EfficientNet-B5 model achieved the following values for its metrics: F1-score, accuracy, recall, AUC, and precision: 98.37%, 98.32%, 98.32%, 99.21%, and 98.32%, respectively. The accuracy rates for the EfficientNet-B0, EfficientNet-B1, EfficientNet-B2, EfficientNet-B3, EfficientNet-B4, EfficientNet-B6, and EfficientNet-B7, are 91.59%, 94.12%, 93.28%, 85.71%, 94.96%, 96.64% and 90.76%, respectively. The results indicated that the EfficientNet-B5 model performs better than other EfficientNet classifiers, which supports dental professionals significantly in the recognition of dental diseases.

Chronic Urticaria in Children: A Single-Center Retrospective Study From Turkey.

The studies on childhood chronic urticaria (CU) are limited. We aimed to investigate the epidemiological and etiological factors of children with CU. Demographic characteristics, laboratory findings, and etiological factors of patients diagnosed with CU younger than the age of 18 were retrospectively evaluated. Of the 124 participants, 68 (54.8%) were aged 12 and older. Angioedema accompanied 18.5% of the patients. Chronic spontaneous urticaria (CSU) was found in 75%, while 24.2% had chronic inducible urticaria. Symptomatic dermographism (16.1%) was the most common among chronic inducible urticaria, followed by cholinergic urticaria (4.8%). No etiological factor could be detected in 56.5% of the children. Infections (29.8%) were the most common etiological factor, followed by drugs (8%). Dental problems (16.9%) were the primary infections associated with CU. Chronic urticaria prevalence in children increased with age, with CSU being the most common type. Infections played a significant role in childhood CU.

Factors Influencing Malnutrition Among Older Adult Residents in the Western Region of Saudi Arabia: Sex Differential Study.

The global population of older adults is on the rise. As people age, their physical functions gradually decline, leading to a decrease in the overall functioning of different organ systems. Due to these changes, older individuals are at a higher risk of encountering various adverse health outcomes and complications, such as malnutrition. This study aims to investigate the prevalence of malnutrition and its associated factors among older adults dwelling in the western region of Saudi Arabia. We have analyzed these factors separately for both men and women to understand any potential sex differences. A nonrandomized cross-sectional study was conducted for older adults aged ≥60 years in the western region of Saudi Arabia. Personal information was obtained through a closed questionnaire. The Mini Nutritional Assessment Short Form was used to determine the malnutrition status of older adults. Consequently, the individuals were divided into 2 groups: normal and malnourished. To assess the risk factors related to malnutrition, the odds ratio (OR) and 95% CI were determined using a binary logistic regression. The prevalence of malnutrition in men and women was around 7% and 5%, respectively. Potential risk factors related to malnutrition in men were higher age (OR 1.263, 95% CI 1.086-1.468; P=.002), being widowed (OR 8.392, 95% CI 1.002-70.258; P=.049), and having dental problems (OR 9.408, 95% CI 1.863-47.514; P=.007). On the other hand, risk factors associated with malnutrition in women were lower BMI (OR 0.843, 95% CI 0.747-0.952; P=.006) and being disabled (OR 18.089, 95% CI 0.747-0.952; P=.006). The findings of this study provide important insights into the risk factors for malnutrition among older adults in the western region of Saudi Arabia. While the overall prevalence of malnutrition was relatively low, the analysis revealed distinct risk factors for older men and women. Interventions developed based on the identified risk factors may prove effective in addressing the issue of malnutrition within this population.

Effect of Peppermint Extract (Mentha Piperita) on Halitosis Problems in Active Smokers

Background: The results of the Basic Health Research (Riskesdas) in 2018 stated that the largest proportion of dental problems in Indonesia was damaged / perforated / diseased teeth 45.3%. While the majority of oral health problems experienced by the Indonesian population are swollen gums and abscesses at 14% 2. Dental caries is one of the many factors that can cause halitosis or bad breath3. Based on the above statement, an innovation is needed to overcome the problem of halitosis, one of which is with peppermint extract (mentha piperita). Research Objective: Proving that peppermint extract mouthwash (mentha piperitha) with a concentration of 10% has an effect on changing the level of halitosis in active smokers. Methods: This type of research uses a pre- experimental method with a pretest-posttest research design with control group design consisting of 2 (two) groups, namely the intervention group and the control group. The sampling method used was purposive sampling. The sampling method used was purposive sampling. Results: Based on the results of the Wilcoxon test, it shows that the average holistosis before and after the intervention group obtained a p-value of 0.001 <0.005, which means that gargling using peppermint extract mouthwash can affect the decrease in halistosis in smokers, while in the control group a p-value of 0.005>0.005 is obtained, which means that gargling using chlorhexidine is not very influential to reduce halistosis in smokers. Conclusion: There is an effect of giving peppermint extract (mentha piperita) with different concentrations on reducing the level of halitosis in active smokers.

Social workers' consideration of dental support for people living with dementia: Findings from interviews and care assessment documentation.

Social work assessments underpin support plans for many people living with dementia in their own homes in England, but it is unclear how they acknowledge that dementia places people at greater risk of mouth and dental problems affecting their wellbeing. We explored if and how dental needs are addressed during care assessments and social workers' perceptions of this aspect of personal care. This study analysed (a) semi-structured interviews with 14 social workers providing support to people living with dementia in their own homes, (b) data from 39 care assessments and support plans from two English local authorities. Interviews were recorded online, transcribed, and thematically analysed. Documents were analysed descriptively and presented visually. Participants acknowledged that oral care may be overlooked during assessments and reflected on various reasons, including assumptions of responsibility and role restrictions, limited training, and poor links with dental services. This was further evident in the analysis of assessment documentation. Participants identified potential strategies and practice changes to better integrate oral care in social work practice. These included increased awareness and more discussions around dental needs, skills training and streamlining of support. The findings have implications for social workers, educators, and commissioners or funders engaging with people affected by dementia in social work and beyond.

The Effectiveness of Individualized Oral Hygiene Education in Preventing Dental Diseases: A Clinical Study.

Background: Without mechanical cleaning, gingivitis can develop within three weeks. The first clinical sign is bleeding on positive probing. The accumulation of dental biofilm triggers an inflammatory gingival response. In the past decade, attention has focused mainly on interproximal areas and the use of customized interproximal toothbrushes. The aim of this study was to evaluate the effectiveness of individualized oral hygiene education and its role in dental disease prevention among patients with dental problems. Methods: Altogether, 102 patients, 38 males and 64 females, were included in the study. All patients were aged over 18 years. Before treatment, patients were clinically and radiologically examined, their full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and bleeding on brushing (BOB) were recorded, and matrix-metalloproteinase-8 (MMP-8) was measured by using a chair-side MMP-8 measuring system. Patients in group A had gingivitis but no periodontal damage, and group B had periodontal damage. Patients in both groups were divided into four subgroups based on their toothbrushing habits and the oral health education they received. Three months after the initial examination, each patient was examined three more times (2, 4, and 12 weeks later). Results: It was concluded that subjects in groups A1 and B1 showed a significant reduction in BOB, MMP-8, FMBS, and FMPS levels after two weeks. Solo Prophylaxis (A1 and B1) remained a well-constructed protocol and caused the complete resolution of interdental inflammation after two weeks. Other subgroups achieved significant reductions only after 12 weeks. Conclusions: BOB and MMP-8 tests are valuable complements in preventive dentistry, and are able to detect potential pathological processes. The clinical relevance of BOB testing, in addition to FMBS, FMPS and gingival inflammation testing, can be demonstrated to patients, which may increase compliance.

Patients perception of orthodontic treatment - A questionnaire based study

The patient perception of malocclusion is important in determining orthodontic treatment. The purpose of this study was to determine participant’s perception, attitude, dental awareness, motivation, factors influencing the necessity of treatment and considerations before opting for orthodontic treatment. A questionnaire-based survey including 14 questions, was conducted for 160 participants who came to OPD of Department of Orthodontics, BBDCODS or at private clinics for any dental problem or those who had queries for orthodontic treatment.A google form with multiple choice questions was created to assess the patient’s perception of Orthodontic treatment to investigate aesthetic concern, functional problems, psychological concern, Orthodontic awareness, and other reasons for seeking orthodontic treatment. The data of responses of participants was analysed on google form application itself with the help of spread sheet, pie charts and graphs. The study revealed that aesthetics was the main concern for getting treatment whereas functional concern was less frequently reported. Patient believed that the treatment could make them more beautiful. This survey-based questionnaire helped in assessing the patient perception and attitude towards Orthodontic treatment. Aesthetic was the major issue for seeking orthodontic treatment, and also motivating factor for the start of treatment. Cost and duration of the treatment were major barrier for the start of the orthodontic treatment.

Associations between food insecurity in high-income countries and pregnancy outcomes: A systematic review and meta-analysis.

Maternal nutrition is crucial for health in pregnancy and across the generations. Experiencing food insecurity during pregnancy is a driver of inequalities in maternal diet with potential maternal and infant health consequences. This systematic review explored associations between food insecurity in pregnancy and maternal and infant health outcomes. Searches included 8 databases (MEDLINE, Embase, Scopus, Web of Science, PsychInfo, ASSIA, SSPC in ProQuest, and CINAHL), grey literature, forwards and backwards citation chaining, and contacting authors. Studies in high-income countries (HICs) reporting data on food insecurity in pregnancy and maternal or infant health, from January 1, 2008 to November 21, 2023 were included. Screening, data extraction, and quality assessment were carried out independently in duplicate. Random effects meta-analysis was performed when data were suitable for pooling, otherwise narrative synthesis was conducted. The protocol was registered on PROSPERO (CRD42022311669), reported with PRISMA checklist (S1 File). Searches identified 24,223 results and 25 studies (n = 93,871 women) were included: 23 from North America and 2 from Europe. Meta-analysis showed that food insecurity was associated with high stress level (OR 4.07, 95% CI [1.22, 13.55], I2 96.40%), mood disorder (OR 2.53, 95% CI [1.46, 4.39], I2 55.62%), gestational diabetes (OR 1.64, 95% CI [1.37, 1.95], I2 0.00%), but not cesarean delivery (OR 1.42, 95% CI [0.78, 2.60], I2 56.35%), birth weight (MD -58.26 g, 95% CI [-128.02, 11.50], I2 38.41%), small-for-gestational-age (OR 1.20, 95%, CI [0.88, 1.63], I2 44.66%), large-for-gestational-age (OR 0.88, 95% CI [0.70, 1.12] I2 11.93%), preterm delivery (OR 1.18, 95% CI [0.98, 1.42], I2 0.00%), or neonatal intensive care (OR 2.01, 95% CI [0.85, 4.78], I2 70.48%). Narrative synthesis showed food insecurity was significantly associated with dental problems, depression, anxiety, and maternal serum concentration of perfluoro-octane sulfonate. There were no significant associations with other organohalogen chemicals, assisted delivery, postpartum haemorrhage, hospital admissions, length of stay, congenital anomalies, or neonatal morbidity. Mixed associations were reported for preeclampsia, hypertension, and community/resilience measures. Maternal food insecurity is associated with some adverse pregnancy outcomes, particularly mental health and gestational diabetes. Most included studies were conducted in North America, primarily the United States of America, highlighting a research gap across other contexts. Further research in other HICs is needed to understand these associations within varied contexts, such as those without embedded interventions in place, to help inform policy and care requirements.

Website-Based Flipbook Model on Changes in Adolescents' Dental and Oral Health Care Behavior

One of the risk factors that causes high levels of dental and oral problems is behavior. To overcome these problems, media is used as a tool, with a model website-based flipbook. It is hoped that this will be a solution to facilitate the education process to help teenagers improve their dental and oral health maintenance behavior. This research is to produce a website-based flipbook model that is feasible and its application is effective in changing the oral health care behavior of adolescents. The method used in this research is Research and Development (R&D) and the research design used is a Quasy Experiment Pretest- Posttest with a Control Group Design. Research subjects were 2 groups: The intervention of 42 people was modeled website-based flipbook control 40 people were given an animated video on dental and oral health. The research results show that website-based flipbooks are suitable as a model for improving adolescent dental and oral health maintenance behavior with expert validation results: 90.8% and p-value = 0.858. The results of the unpaired test stated that its application was effective in increasing knowledge (∆0.001), attitudes (∆0.001), actions (∆0.001), and reducing debris index scores (∆0.010) compared to the control group. The conclusion is the development of the website-based flipbook model and its implementation of effective changes in adolescent dental and oral health maintenance behavior.

Oral and dental health status in patients with chronic headache

IntroductionHeadache is an illness with high prevalence and adverse effects on quality of life. As oral or dental problems such as pain can trigger or aggravate it, we aimed to investigate and compare oral and dental health status in patients affected with chronic headaches and healthy individuals.MethodsThe present case-control study included 60 patients with chronic headaches (case) and 60 healthy individuals (control) in Rasht, Iran. The demographic characteristics and clinical examinations, including decayed/missing/filled teeth (DMF-T) and community periodontal index of treatment needs (CPITN) indices, as well as bruxism, frequency of tooth brushing and flossing, and maxillary and mandibular tooth wear were recorded in a checklist. Data analysis was performed using the IBM SPSS version 28 at a significance level of 0.05.ResultsThe case group consisted of 25 men (41.7%) and 35 women (58.3%) with an average age of 32.55 ± 6.62 years, while the control group had 27 men (45%) and 33 women (55%) with an average age of 30.95 ± 6.33 years. The study groups were not significantly different in bruxism, frequency of tooth brushing and flossing, DMFT, CPTIN, and maxillary and mandibular tooth wear.ConclusionIt seems that chronic headaches do not significantly affect the oral and dental health of the sufferers. Moreover, it appears that these patients are well aware of the role of oral and dental hygiene in triggering or aggravating the episodes of headaches.

Oral health in obese children common findings, prevention, treatment and outcome

Childhood obesity is a significant global public health issue, closely linked to various oral health challenges, including dental caries, periodontal disease, and malocclusion. Obese children are more prone to these dental problems due to dietary habits that include high sugar and carbohydrate intake, poor oral hygiene practices, and systemic inflammation. This review explores the common oral health issues faced by obese children and emphasizes the importance of preventive strategies and tailored treatment approaches. Preventive measures include promoting healthy dietary habits, improving oral hygiene practices, and ensuring regular dental check-ups. Dietary modifications, such as reducing the intake of sugary snacks and beverages, play a crucial role in preventing tooth decay and other dental problems. Educating children and caregivers about proper brushing and flossing techniques and the use of fluoride toothpaste and dental sealants further supports oral health. Regular dental visits allow for early detection and management of dental issues, with professional cleanings, fluoride treatments, and appropriate restorative and periodontal therapies being integral components of care. The outcomes of these comprehensive treatment strategies are generally positive, leading to improved oral health and overall quality of life for obese children. Multidisciplinary collaboration among healthcare providers, including dentists, pediatricians, and nutritionists, is essential to develop effective care plans that address both obesity and oral health. This integrated approach ensures that obese children receive holistic care that promotes lifelong healthy habits, reducing the risk of future dental and systemic health problems. The review underscores the necessity of a concerted effort to address the intertwined issues of obesity and oral health in children, highlighting the potential for significant health improvements through targeted prevention and treatment strategies.

Performance Evaluation of Deep Learning Models for Dental Caries Classification via Panoramic Radiograph Images

Objective: The purpose of this study is to evaluate the ability of deep learning models to classify mandibular molar teeth according to the presence and proximity of caries to the dental pulp. This research summarizes the progress of artificial intelligence and potential dental problems in diagnosis, treatment, and disease prediction in medicine. It discusses data limitations, computational power, ethical considerations, and their implications for dentists. This can lay the groundwork for future research in this rapidly expanding field. Methods: The dataset used in this study consists of 1200 panoramic radiographs, which have been evaluated and classified into three categories: free of dental caries, coded as (H); enamel-dentin caries lesions treated with restorative filling, coded as (R); and deep dental caries that underwent root canal treatment, coded as (E). The images are prepared for the training-testing process using the k-fold crossevaluation technique and then fed into the pre-trained deep learning models for classification. Results: The VGG-19 model achieved superior results compared to the other models, with macro-average scores of 0.9111 for precision, 0.9127 for recall, and 0.9115 for f1-score, respectively. Conclusion: The promising results obtained in this study give confidence in endorsing the use of deep learning models in the dental treatments sector.

EFFECTIVENESS OF HEALTH PROMOTION USING ASSEMBLR EDU ON INCREASING KNOWLEDGE AND ATTITUDE OF MAINTAINING DENTAL AND ORAL HEALTH

Background: The increase dental and oral health problems in children can be caused by an attitude of neglecting dental and oral hygiene which is based on a lack of knowledge. One example is the low attitude and behavior when brushing teeth and dental visit in Banjarmasin City. Purpose: This study aims To analyze the effectiveness of health promotion using Assemblr Edu on increasing knowledge and attitudes about maintaining oral health in students aged 10-12 years at SDN Kebun Bunga 4 Banjarmasin. Method: This research uses a type of quasy-experimental design with a nonequivalent control group design and uses non-probability sampling technique as purposive sampling. The population is students aged 10-12 years at SDN Kebun Bunga 4 Banjarmasin. The sample consisted of 16 people in the Assemblr Edu group and 16 people in the control group. The instrument used in this research is a questionnaire. Data analysis used Wilcoxon test and Mann Whitney test. Results : The Wilcoxon test showed that there were differences in knowledge and attitudes before and after health promotion in the Assemblr Edu intervention group (knowledge : p=0,000; attitudes : p=0,000), in the control group there was no difference in knowledge and attitudes between pretest and posttest (knowledge : p=0,755; attitudes : p=0,290). The results of the Mann Whitney between the intervention and control groups (knowledge : p=0,000; attitudes : p=0,001). Conclusion: Health promotion using Assemblr Edu is effective in increasing knowledge and attitudes about maintaining oral health.

EFFECT OF FREEZE-DRIED SUPER RED DRAGON FRUIT ANTHOCYANIN DISCLOSING SOLUTION ON DENTAL PLAQUE INDEX

Background: Accumulation of dental plaque can cause of dental and oral health problems such as caries and periodontitis. Dental plaque is colorless so it is difficult to see visually. Super red dragon fruit can be an alternative disclosing solution because it contains. Objectives: The purpose of this research was to determine the content and the effect of anthocyanin disclosing solution freeze dry super red dragon fruit on dental plaque index. Methods: This research is a type of the Experimental Laboratory and Quasi Experimental design research with post-test control group design method. Thirty samples were used and there were three treatment groups: the application of aquadest, super red dragon fruit disclosing solution, and synthetic disclosing solution. Super red dragon fruit freeze dry was tested for antioxidants and tested total anthocyanin levels using the pH difference method at Unjani Pharmaceutical Laboratory. Research on plaque index examination was carried out in the Integrated Dentistry Laboratory Unjani. Dental plaque index assessment is measured using PHPI (Patient Hygiene Performance Index) method. Data were analyzed using Kruskall Wallis and Mann-Whitney tests (p<0.05). Results: The results showed an anthocyanin content of 9.0764 mg/100 g and a significant difference in the anthocyanin disclosing solution freeze dry treatment of super red dragon fruit on the dental plaque index with a value of p = 0.000. Conclusion: In conclusion this research indicates that the freeze-dried super red dragon fruit disclosing solution contains anthocyanin and has an effect on the dental plaque index. This shows the potential of anthocyanin disclosing solution freeze dry super red dragon fruit can be used to detect and control dental plaque, but further research is needed to determine the length of time attached to anthocyanin disclosing solution super red dragon fruit to the tooth surface

The role of orthodontics in the management of tooth wear.

Pathological tooth wear is a dental problem that affects all age groups and appears to be increasing in prevalence. A subset of these patients may benefit from a combination of orthodontic and restorative care which will be discussed in this article. Orthodontics can help to create the necessary vertical, anterior-posterior and mesio-distal space for restorative work, reducing the need for tooth reduction and lessening the biological costs of restorative care, helping to reposition the gingival margins where this impacts upon aesthetics, as well as correcting co-existing malocclusion.

Cleft lip and palate surgery in the Otolaryngology and Head-neck surgery department of a Medical College Hospital in Bangladesh

Background: Cleft lip and palate (CLP) are one of the most common developmental anomalies in orofacial region. CLP surgery lies in the anatomical domain of Ear Nose Throat and Head - Neck Surgery. In Bangladesh specialty of plastic surgery is still in developing stage and plastic surgeons are not easily available everywhere. ENT and Head-Neck surgeon had to take up the responsibility of some of cleft patients. This article is a retrospective analysis of a series of 200 cases of cheiloplasty and palatoplasty done in ENT and Head-Neck Surgery department of Khulna City Medical College Hospital, Bangladesh. Results were satisfactory in our, patient and parent's consideration. Objective: Our aim is to discuss the demographic profile, presentations, degree & type of cleft and outcome of CLP surgery in Otolaryngology and Head-Neck Surgery department of a Medical College Hospital of Bangladesh. We will also discuss the embryology of face & historical background of the cleft surgery. Materials and Methods: This is a retrospective analysis of CLP surgery for 200 cleft patients. We based on inclusion and exclusion criteria for selection of patients. Majority of cleft lip patients were operated following the Millard modified rotation advancement technique and isolated cleft palate patients were operated following Von Langenbeck bipedicle flap and Veau-Wardil-Kilner V-Y pushback technique in the ENT and Head-Neck Surgery Department of a Medical College Hospital. Patients were advised for periodic follow up. Results: Total of 200 patients of CLP were operated in our department out of which male was 92 (46%) and female was108 (54%)), male and female ratio being 1:1.08. The age range was 3 months to 40 years with a mean of 8.38 years. Pre alveolar group both male and female comprised of 134 (67%) and alveolar group 66 (33%) patients and that of isolated cleft palate 7 (10.60%) patients. Pre alveolar unilateral CLP was high. The results of surgery were satisfactory in our postoperative evaluation. Patients and parents were also satisfied with the outcome. Conclusion: Majority of CLP patients don’t suffer functional problem apart from facial disfigurement. Restoration of normal anatomy, facial appearance and function can be achieved by surgery in appropriate time and age. Few cases may be associated with feeding difficulties, dental and hearing problems. Some cases are associated with other congenital anomalies and syndromes. Those cases demand team approach of different specialty.

Dental and anesthesiology problems in nicotine dependents (literature review)

Nowadays, smoking is one of the significant factors for the development of inflammatory periodontal diseases. The effect of nicotine on the microcirculation is manifested in the deterioration of the trophic level of the gums and a decrease in their resistance to infection. Atrophy of acinar parts of small salivary glands develops and other morphological changes characteristic of progressive sialadenitis occur. A change in the microflora of the oral cavity was found depending on the duration of smoking. Epithelial dysplasia, which covers the entire thickness of the epithelium, but does not affect the connective tissue, is called carcinoma. Worldwide, more than 300 million people use smokeless tobacco. Malignant changes at the site of precancerous diseases occur after a couple of years of using the product. In smokers, nicotine blocks H-cholinergic receptors and reduces sensitivity to local anesthetics. Nicotine promotes the production of the CYP2E1 enzyme, which is responsible for the metabolism of halogen anesthetics: halothane, enflurane, diethyl ether, trichlorethylene, chloroform, isoflurane and methoxyflurane. Chronic smokers show reduced pain tolerance. Before morphine loading, the assessment of pain threshold in nicotine-dependent individuals was significantly lower than in non-smokers. Smokers require higher doses of opiates and benzodiazepines than nonsmokers. Smoking reduces the potency of aminosteroid muscle relaxants, the required doses of vecuronium and rocuronium in smokers were 25 % higher than in patients leading a healthy lifestyle. Smokers also need more frequent doses to maintain neuromuscular block. Quitting smoking 4–6 weeks (ideally 8 weeks) before general anesthesia reduces the frequency of peri- and postoperative complications.

Age, Purpose, and Perception With Regard to the First Dental Visit of Children of Goa State in India.

Early first dental visits (FDVs) are crucial for educating and informing parents about their children's oral health. The age for the FDV is dependent on several factors and data regarding the same is unavailable in Goa state. The aim of the study was to determine the age, purpose, and parental perception with regard to the FDV of children in Goa State. A cross-sectional study was conducted in the Department of Pedodontics and Preventive Dentistry for children reporting for their FDV. Data for the study was recorded from validated and pilot-tested questionnaires. Statistical analysis was performed using the STATA (version 17; StataCorp LLC, College Station, TX) software. Categorical variables were summarized using frequencies and percentages. Continuous variables were summarized using means and standard deviations. A total of 544 children were included in the study. The mean age of the FDV was 7.15 ± 2.98 years. Out of the total, 257 (47.24%) children reported with pain. The absence of dental problems was the reason why 485 (89.01%) children and their parents had not visited earlier. Most parents perceived the FDV to be importantbut were unaware of the ideal age for the same. Children in Goa state have delayed FDVs. Although parents recognized the importance of early dental visits and oral health, their knowledge regarding the recommended age was found to be deficient.