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Background: Dental students practice on extracted human teeth (EHT) in their preclinical to learn professional and technical skills before performing dental procedures on patients. Aim: The aim of the present investigation was to assess the management of EHT among dental students in the east coastal region of India. Materials and Methods: A cross-sectional study was conducted on II, III, and IV Bachelor of Dental Surgery (BDS) students from five dental colleges in India's east coastal region, which were chosen using the fishbowl technique. Data was collected using a pretested, validated self-administered questionnaire and analysed using the Chi-square test, Mann–Whitney test, Kruskal–Wallis test, and linear regression. Results: A total of 649 students participated from five dental colleges, among them, 43.6% (283) were II BDS, 29.6% (192) were III BDS, and 26.8% (174) were IV BDS. About 66% of the participants do not know that the EHT are a source of infection; 22% of them noted that there was an incidence of infection with the use of EHT; 81.5% do not know that guidelines have to be given by the regulatory body/institution to handle EHT. Only 2% of the people think it was necessary to disinfect/sterilize EHT before use, while 33% of the study population felt that there was a need to wear mouth masks and gloves while working on EHT. In the study group, only 43% know that formalin was used as a storage/disinfecting medium for EHT and 80% of them experienced hazards due to chemicals used for storage/disinfecting medium of EHT. Conclusion: The results of this investigation stipulated that awareness, attitude, and practices of undergraduate students in relation to the handling of EHT were poor. However, deficiencies were observed in relation to teaching the materials and methods suitable for the management of EHT which reveals the need to incorporate the guidelines in their curriculum.

Background: Occupational hazards are common among dental professionals, and musculoskeletal disorders (MSDs) are very common. Aim: The aim is to report the prevalence and distribution of MSD among dental professionals practicing in Nagpur, India. Materials and Methods: A cross-sectional questionnaire study was conducted among 500 dental professionals from December 2016 to November 2017. The professionals were distributed in three groups (Group A, B, and C) based on the work experience in years. The questionnaire was designed to evaluate physical health related to MSD. Statistical analysis was performed by descriptive and inferential statistics using SPSS 17.0 version (Chicago, USA) software and the data were presented in counts and percentages, with P ≤ 0.05 is considered as the level of statistical significance. Results: In Group A, 24% of participants suffered pain in lower back while 4% of participants suffered from pain in multiple regions. In Group B, 27% of participants suffered pain in lower back whereas 5% experienced pain in multiple regions. In Group C, 34% of participants suffered pain in lower back whereas 17% experienced pain in multiple regions. The most common specific disorder among dental professionals was tendonitis of the shoulder and repetitive strain injury. There was an increasing trend in the presence of neurological pain with increase in number of years in dental practice. Conclusions: The musculoskeletal region most frequently affected in all three groups was lower and upper back contributing about 40% regions affected. However, there was no pain recorded among 32% in dental professionals. Pain involving the body parts depends on the posture, time, and procedures. Dental professionals always need to maintain multiple postures for prolonged periods; therefore, dental procedures should be divided into multiple appointments to minimize the time-consuming procedures. A daily routine should be followed with exercise or yoga for strain-free muscular activities.

Lasers were brought into the field of clinical dentistry with the expectation of conquering a portion of the downsides postured by the customary strategies for dental practice. One of the primary objectives in dentistry is to give the treatment as agreeable as conceivable. The laser is being utilized as a part of various dental procedures including soft tissue surgeries, cavity preparation, caries removal, and caries detection. The utilization of current normal lasers in dentistry brought about less pressure and dread in patients amid dental techniques, likewise prompting more moderate nonobtrusive strategies for delicate and hard tissues with insignificant discomfort and bleeding. This article will briefly elaborate uses of laser in dentistry.

Background: The use of rubber dam (RD) has been recommended in dental procedures including root canal treatment. The aim of the study was to identify factors that were associated with patients' satisfaction and acceptance of RD. Setting and Design: This was a cross-sectional study, conducted from January 2015 to December 2016 at Kuwait University School of Dentistry. Materials and Methods: A pretested questionnaire was used by a face-to-face interview of patients after taking informed consent. The study was approved by the Institutional Ethics Review Board. The providers/operators who applied RD were grouped into three categories: undergraduate final year (7th year) dental students; general dentists and postgraduate students; and specialists. Results: Mean age of the patients (n = 175) was 31.6 ± 13.0 years. About 55% had past experience, and 52% expressed a better experience during the current procedure compared with the previous one. A positive experience during the current procedure correlated significantly with the future intention of RD use (r = 0.244, P = 0.001). Time needed for RD application was short (4 min), irrespective of the operators. The duration of RD use during the procedure was significantly shorter among dental specialists compared with the other groups. Time for RD application was the only significant predictor for patient satisfaction, after controlling for other independent variables. Conclusion: Based on the positive influence of current RD use on the future intention, dentists should spend time needed to explain the importance, safety and effectiveness of RD use with their patients.

Undergraduate dental students acquire their clinical skills through the hands-on training on phantom heads. This is essential to develop their skills and experience and to ensure they can undertake safe and competent dental procedures on patients. However, the literature lacks a comprehensive approach capable of assessing dental clinical simulation skills objectively and at the same time incorporating all the tools necessary for effective learning. A brief overview of the literature regarding clinical skills assessment was performed to define specific recommendations for implementation of dental clinical skills assessment tools. Selected best theories and methods for a successful package of tools were gleaned from the existing medical and dental literature. This paper defines specific recommendations for implementation of dental clinical skills assessment tools necessary for effective teaching of tooth cavity preparation in clinical simulation laboratories. The recommended approach of comprehensive assessment was broken down into three main components (1) clinical simulation skill assessment, (2) self-assessment, and (3) student feedback and reflection. The conclusions and recommendations offered herein are intended to enhance course design and current teaching methods in dentistry rather than replace them. The following recommendations were made: (1) Dental schools need to seek to ensure that valid and reliable standard settings are applied to their assessments which, if accomplished, are very likely to enhance their educational outcomes. (2) It is important to get students to understand and positively respond to feedback which can be achieved by creating a module culture in which students are encouraged to share and discuss their mistakes openly. Proper feedback will ensure better performance and improved self-assessment skills. (3) Staff members should utilize a more consistent pattern of feedback and review their techniques periodically to continually improve the teaching process. Such recommendations, if enforced thoroughly, would be helpful in aiding tutors and course instructors assess dental clinical simulation skills components objectively and identify the clinically weaker students.

Local anaesthetics (LAs) are considered the most effective drugs for prevention and management of pain associated with dental procedures. Lignocaine is the most preferred LA worldwide. Adverse drug reactions reported with lignocaine use are usually mild, however severe complications have been encountered. This article reports a case of lignocaine-induced seizure in a child. We also reviewed similar cases encountered over the last 10 years. The possible explanations could be placement of the needle in a small vein or hypersensitivity to lignocaine. We hereby reinforce the fact that seemingly safe LA's can cause life-threatening complications and rapid identification of clinical symptoms can drastically change the clinical course. Hence it is vital that primary care physicians and other healthcare professionals should to be aware, alert and be able to diagnose and manage these reactions immediately.

Introduction: Antibiotic overuse and misuse among dentists was found to be substantial. Exploration of scientific literature revealed very limited studies in India assessing the antibiotic prescription pattern among dentists. Antibiotics are one among the most commonly prescribed drugs by dentists for prophylactic and therapeutic management of oro-dental infections. Increasing inappropriate use of antibiotics has helped the bacteria to armor themselves and develop “Antibiotic Resistance.” Antibiotic resistance is an emerging global menace haunting all fields of the medical fraternity. All dentists should have to take moral responsibility to minimize and wisely use antibiotics. Aim: To know the prescription pattern of antibiotics for various dental procedures by dental practitioners. Objective: For treating in a better way to prevent antibiotic resistance. Materials and Methods: A self-administered, 12-item close-ended questionnaire was used. Questionnaire consisted of questions pertaining to knowledge, attitude, and practice of dental health care professionals before prescribing antibiotics. Associations were found out via the Chi-square test with P value kept as P ≤ 0.05. Results: With a response rate of 69.76%, medical representatives, patients' preference, fear of losing patients, and fear of spread of infections can potentially “influence” a dentist's capability to prescribe antibiotics. Conclusion: The dental profession as a whole needs to acquire a deeper understanding of the global effects of superfluous antibiotic prescription. Antibiotics, when judiciously used, are precise life-saving drugs. Proper knowledge about the prescription of antibiotics is the need of the hour. As a nation, we must respond to this growing problem so that antibiotics misuse can be stopped.

Introduction: Lasers in dentistry are considered to be a new technology which is being used in clinical dentistry to overcome some of the drawbacks posed by the conventional dental procedures. Aim: This study aims to assess dental laser education and knowledge among students from dental colleges of Mumbai and Pune city. Materials and Methods: A cross-sectional study was conducted among 150 randomly selected dental students from four dental colleges of Mumbai and Pune city using a questionnaire. Results: All the 150 participants knew what dental laser was, but when asked about the practical experience, only 10 (6.7%) participants had previous dental laser practice experience. Around 126 (84%) participants agreed that both theoretical and practical laser education is needed. Lack of clinical experience (35.3%) followed by lack of knowledge (25.1%) and price of laser unit (22.5%) were the main reasons for the lack of use of dental lasers according to the study participants. Conclusion: Undergraduate dental students had inadequate laser education and insufficient knowledge regarding dental lasers. More education about dental lasers should be added to the curriculum of undergraduate program since it is highly essential for students to know about newer technologies and apply it in their practice.

The risk of ocular injury in dentistry is mainly attributed to the use of power driven high speed Handpieces and ultrasonics. These ocular injuries may vary from mild irritation to grave implications such as blindness. Various studies have reported about such injuries and their consequences. The guidelines are laid by health associations regarding protective eyewear use during dental procedures. This study emphasizes about the need to protect the eye with protective eye wear, failing which a dental student suffered a serious ocular injury while performing manual scaling procedure.

Aim: The present cross-sectional study was conducted to determine the decayed, missing, filled primary and permanent teeth (dmft-DMFT) indices and its association with the type of disability in 856 disabled individuals attending special schools in twin cities of Hyderabad and Secunderabad, Andhra Pradesh State, India. Materials and Methods: Participants were grouped according to their disability such as: Mild, moderate, severe mental retardation, hearing and speech defect and others (39) (including Down′s syndrome [20], autism [9], hyperactive [4], microcephaly [2], border line cases [4]). Examination was carried out at their schools, with participants seated in ordinary chairs and examined under natural light with mouth mirror and probe. Subjects were of different age groups ranging from 1 to 55 years. Statistical Analysis Used: Analysis of variance with post-hoc Games-Howell test was used for statistical analysis. Results: Mean dmft; DMFT scores were as follows: 2-6 years: 1.58 ± 1.9; 2.18 ± 2.94, 7-12 years: 1.1 ± 2.4; 1.9 ± 2.13, 13-30 years: 2.38 ± 2.5, 30+ years: 2.13 ± 3.2. Overall only 23% of subjects were caries free. "dmft" was statistically higher among moderate mentally retarded group while DMFT was statistically higher in mild and moderate mentally retarded groups. Conclusions: These findings emphasize the need of educating parents and caregivers of disabled individuals in preventive dental procedures, especially those of the mild and moderate mentally challenged group.

BACKGROUND AND OBJECTIVE: Dental students and practitioners are frequently prone to work-related musculoskeletal disorders (WMSDs) due to the unawareness of ergonomic principles when practicing dentistry. The aim of this study was to assess the dental student knowledge, attitude, and practice toward ergonomics in three different dental schools. METHODOLOGY: A cross-sectional study was conducted among 1166 dental students from three different dental schools of Andhra Pradesh, India, to assess knowledge, attitude, and practice regarding ergonomics. All the participants were provided with prestructured questionnaire form comprising 13 questions to know their knowledge, attitude, and practice related to ergonomics before and after providing guidelines on ergonomic principles. RESULTS: The majority of the dental students appreciate that the most affected regions due to work-related disorders were back (475 before and 559 after instructions), neck (354 and 420), hand and wrist (205 and 117), and shoulder and elbow (132 and 70), respectively. Knowledge and practice scores of dental students (mean and standard deviation) regarding WMSDs before and after applying ergonomic principles were 3.92 ± 2.44, 1.29 ± 1.67 and 5.81 ± 0.87, 3.03 ± 0.60, respectively. CONCLUSION: The present study provides an insight into ergonomics for dental students during routine dental procedures. The knowledge, attitude, and practice related to ergonomics were satisfactorily increased among the participants. Thus, ergonomic education of the dental health-care personnel must be focused in all the educational institutions and at continuing dental health programs by delivering ergonomic principles both theoretically and practically and should be a part of the curriculum.

ABSTRA C T Introduction: Hyperactive gag reflex can make dental treatment procedures intolerable for some patients; so, it is highly important for the dentist to control it. Acupuncture is a technique used to control this phenomenon. In this study, the effects of two acupoints, anti-gagging and P6, on the gag r eflex control were analyzed. Materials and Methods: In this clinical trial study, a total number of 100 healthy people were classified into four groups. Acupuncture and psuedo-acupuncture procedures were performed on anti-gagging and P6 points based on the group. Before and after acupuncture or pseudo-acupuncture, gag reflex severity was measured via stimulation of the soft palate, tonsils, and root of the tongue. Obtained data was analyzed using statistical package of social sciences (SPSS) 22 statistical software. Results: Acupuncture reduced gag reflex at both points, but psuedo-acupuncture did not reduce the gag reflex. Moreover, no significant difference was observed between acupuncture on P6 and anti-gagging points. Conclusion: Acupuncture on anti-gagging and P6 points can be effective in controlling the gag reflex during routine dental procedures.

Dental health care workers are increasingly called upon to provide quality dental care to individuals whose bleeding and clotting mechanisms have been altered by inherited or acquired diseases. This provides an opportunity for the dentist who is trained in the recognition of oral and systemic signs of altered hemostasis to assist in the diagnosis of the underlying condition. A number of dental procedures result in the risk of bleeding that can have serious consequences, such as severe hemorrhage or possibly death, for the patient with a bleeding disorder. Oral care providers must be aware of the impact of bleeding disorders on the management of their patients. These disorders must be recognized from history, clinical examinations, and laboratory investigations, if indicated, prior to surgical procedures including those in dental surgery to prevent bleeding related complications. Safe dental care may require consultation with the patient's physician, systemic management, and dental treatment modifications. The purpose of this article is how to identify these patients with bleeding disorders.

Chronic pain is more prevalent in the head and neck region than other parts of the body. Almost one-third of patients attending a facial pain clinic have history of undergoing some dental procedures often without success. Literature review reveals that atypical odontalgia, atypical facial pain or if teeth have been extracted phantom tooth pain are used to describe a common pain syndrome. At present, chronic pain disorders are diagnosed mainly on the basis of clinical signs and symptoms, since the mechanism underlying the pathophysiology is not well understood. Many diagnostic criteria for atypical facial pain has been proposed without much benefit however, it remains a diagnosis of exclusion after ruling out all other pathologies of the head and neck. Clinically, phantom tooth pain is similar in many essential characteristics to deafferentation pain syndrome. In the absence of controlled clinical trials specifically directed to phantom tooth pain, treatment should be guided by standards used for other neuropathic pain disorders.

Introduction: Dental anxiety is an abnormal fear or dread of visiting the dentist for preventive care or therapy and unwarranted anxiety over dental procedures. It is a common problem that affects people of all ages and appears to develop mostly in childhood and adolescence. The present study assesses dental anxiety among children in a nonclinical setting among Saudi Arabian children who underwent preventive treatment procedure using Abeer Children Dental Anxiety Scale (ACDAS). Materials and Methods: The children attending an oral health program were screened for oral health problems and preventive treatment such as topical fluoride applications. The dental anxiety among children was assessed using ACDAS. Results: A total of 51 children participated in the research. The results showed that maximum children were not scared of dentist in nonclinical setting and had low dental anxiety levels. Overall, 74% of the child subjects had ACDAS scores below 26. Conclusions: Knowing the degree of anxiety of dental children is important to guide them through their dental experience and carry on the preventive dental treatments at an early age in nonclinical setting. Their level of cooperation will improve, and anxiety will be reduced as well. Further research is required to compare dental anxiety levels in children between clinical and nonclinical setting.

Ingestion of instruments is a potential complication that can occur during dental procedures. We report a case of accidental ingestion of an endodontic barbed wire broach during root canal treatment and its subsequent retrieval by endoscopic methods. Although prevention is the best approach, proper management of such an event is also crucial. The objective of this report is to draw attention to the potentially serious complications that can occur if preventive techniques are not practised, and to discuss the accepted guidelines for management of such an event.

One of the most distressing aspects of dentistry for pediatric patients is the fear and anxiety caused by the dental environment, particularly the dental injection. The application and induction of local anesthetics has always been a difficult task, and this demands an alternative method that is convenient and effective. Electronic dental anesthesia, based on the principal of transcutaneous electric nerve stimulation (TENS), promises to be a viable mode of pain control during various pediatric clinical procedures. Therefore, the aim of the present study was to evaluate the effectiveness of TENS and to compare its efficacy with 2% lignocaine during various minor pediatric dental procedures. Pain, comfort and effectiveness of both the anesthetics were evaluated using various scales and no significant difference was observed between 2% lignocaine and TENS in the various pain scales, while TENS was perceived to be significantly effective in comfort and efficacy as judged by the operator and quite comfortable as judged by the patient himself/herself.

PURPOSE: To assess role of oral flora in causing bacteraemia following dental manipulations. METHODS: Fifty patients undergoing dental manipulations were assessed to study the incidence and nature of bacteraemia following dental procedures with special emphasis on Actinomyces. RESULTS: Incidence of bacteraemia was seen to be 80% of which Actinomycotic bacteraemia was found to be 30 %. Common species of Actinomyces isolated were A.viscosus (58.33 %), A.odontolyticus (8.33 %) and A. naeslundi (8.33 %). Aerobic bacteraemia was seen in 48% patients. Common aerobes isolated from bacteraemia following dental procedures were alpha haemolytic streptococci (25.93 %) and diphtheroides (20.38 %). Anaerobic bacteraemia was seen in 6% patients. Common Anaerobes isolated were Peptostreptococcus spp (33.32 %), Prevotella spp. (16.66%) and Bacteroides spp (16.66%). Mixed aerobic and anaerobic bacteraemia was present in 26 % of the patients. CONCLUSIONS: Actinomycotic bacteraemia was more commonly seen in patients with periodontal infections. Thus, prophylactic measures need to be instituted in such patients to prevent cervicofacial, thoracic or abdominal Actinomycosis developing later on.