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Background: Depigmentation has become an important treatment modality among the general population due to the growing esthetic concern about the pigmentation. Previous studies have not considered parameters such as anatomical distribution of gingiva, intensity of pigmentation, and skin color in their classification systems. The purpose of this study was to assess physiologic gingival pigmentation in individuals based on certain gingival parameters and their correlation with skin color for better treatment strategies using a new classification system. Methods: The study was carried out in Ragas Dental College using a cross-sectional design. A total of 112 female dental students were examined for skin color and gingival parameters. The facial gingiva of upper anterior teeth was assessed for gingival phenotype, intensity and distribution of pigmentation. Descriptive statistics were used to describe the data and the associations between variables were done using chi-square test (P < 0.05). Results: It was found that skin color has a significant association with the intensity of pigmentation (P = 0.0001). In both dark and fair skinned individuals, Class II pigmentation (47%, 23.2%) with thick phenotype (62.5%, 35%) was most prevalent. Dark-skinned individuals were also found to have a generalized distribution of melanin pigmentation (19%) with high intensity of pigmentation (28.5%) predominantly. Fair-skinned individuals had a patchy distribution of melanin pigmentation with low intensity of pigmentation (37%). Conclusions: The association of skin color with various parameters affecting gingival pigmentation can help in determining the depigmentation treatment strategies.

Introduction Oral diseases are a serious public health problem, which affects the overall health of a person. The lack of available and affordable oral health services, especially in a developing country like India, not only results in aggravation of the disease, but also enhances the cost of treatment and care. Education and involvement of community workers like Anganwadi workers aid to remove stigma, discrimination and provide better atmosphere conducive for patients with various diseases. Aim To assess the knowledge and practice of oral health care among the AWWs of the Pulikeezh block Panchayath before and after an oral health education training. Materials and methods A self-administered questionnaire was distributed to anganwadi workers of the Pulikeezh block Panchayath, Thiruvalla, Kerala before and after an oral health education training within a period of 3 months. Result The mean knowledge and practice scores in the pretest were found to be 9.6 + 2.2 and 5.0 + 1.0 respectively. The posttest conducted after a 3-month period showed an increase in the knowledge and practice score with a mean of 10.9 + 2.2 and 5.7 + 0.6 respectively. The increase in knowledge and practice was statistically significant (p Conclusion Empowered women are recognizably key agents in the change process who can play an effective role for health promotion. AWWs can function as oral health guides who can create awareness and help in prevention oral diseases. Clinical significance As the oral health of an individual is set in the preschool period and more than 90% of dental diseases are preventable; preventive factors established around this age will determine the person's dental health for many years to come. The inclusion of oral health education in Anganwadi centers can be helpful in prevention of dental diseases. How to cite this article Cherian SA, Joseph E, et al. Empowerment of Anganwadi Workers in Oral Health Care: A Kerala Experience. Int J Clin Pediatr Dent 2019;12(4):268-272.

Objective The objective of this review is to evaluate the effectiveness of physical stimulation on injection pain in adults receiving intramuscular injections. Introduction Intramuscular injections are the most commonly used modality for administration of pharmacological treatments. Despite this, pain from intramuscular injections is the most commonly reported side effect. Reducing patients' pain from intramuscular injections is important; however, the challenge is in selecting from the current methods available to alleviate pain, which are varied. The findings of this review may identify the most effective physical stimulation method to reduce the side effect of pain from an intramuscular injection. Inclusion criteria This review will consider studies that include adults aged 18 years and over that use physical stimulation interventions during intramuscular injections. Any physical stimulation strategies used during intramuscular injections including devices, skin tapping, manual pressure, massage, pinch, and traction will be considered. Studies that evaluate pain using validated tools such as pain scales will be included. Methods The review will undertake to find both published and unpublished studies. The key information sources to be searched are MEDLINE, Embase, CINAHL, the Cochrane Library, Cochrane Central Register of Controlled Trials, Google Scholar, Dissertation Abstracts International, ProQuest Dissertations and Theses, and MedNar. Two independent reviewers will conduct a critical appraisal of eligible studies, assess the methodological quality, and extract the data. Studies will, where possible, be pooled in a statistical meta-analysis. Systematic review registration number PROSPERO CRD42020168586.

Introduction Oral diseases are a serious public health problem, which affects the overall health of a person. The lack of available and affordable oral health services, especially in a developing country like India, not only results in aggravation of the disease, but also enhances the cost of treatment and care. Education and involvement of community workers like Anganwadi workers aid to remove stigma, discrimination and provide better atmosphere conducive for patients with various diseases. Aim To assess the knowledge and practice of oral health care among the AWWs of the Pulikeezh block Panchayath before and after an oral health education training. Materials and methods A self-administered questionnaire was distributed to anganwadi workers of the Pulikeezh block Panchayath, Thiruvalla, Kerala before and after an oral health education training within a period of 3 months. Result The mean knowledge and practice scores in the pretest were found to be 9.6 + 2.2 and 5.0 + 1.0 respectively. The posttest conducted after a 3-month period showed an increase in the knowledge and practice score with a mean of 10.9 + 2.2 and 5.7 + 0.6 respectively. The increase in knowledge and practice was statistically significant (p < 0.0001). Conclusion Empowered women are recognizably key agents in the change process who can play an effective role for health promotion. AWWs can function as oral health guides who can create awareness and help in prevention oral diseases. Clinical significance As the oral health of an individual is set in the preschool period and more than 90% of dental diseases are preventable; preventive factors established around this age will determine the person's dental health for many years to come. The inclusion of oral health education in Anganwadi centers can be helpful in prevention of dental diseases. How to cite this article Cherian SA, Joseph E, et al. Empowerment of Anganwadi Workers in Oral Health Care: A Kerala Experience. Int J Clin Pediatr Dent 2019;12(4):268–272.

Introduction: Supernumerary teeth are the presence of more number of teeth over the normal dental formula and may occur in permanent as well as early mixed dentition. This study determined the prevalence, characteristics, and complications caused by supernumerary teeth in nonsyndromic South Indian pediatric population. Materials and Methods: Characteristics of supernumerary teeth determined by clinical and radiographic examination were recorded. The age, sex, number of supernumerary teeth, eruption status, morphology, position, orientation, and complications (if any) associated with supernumerary teeth were recorded for each patient who had supernumerary teeth. The data collected were statistically analyzed. Results: Supernumerary teeth were detected in 45 subjects (1.1%), of which 34 (75.6%) were male and 11 (24.4%) were female. There was no association between the number of supernumerary teeth and the gender of the patient. The total number of supernumerary teeth among the affected 45 patients was 54. The average number of supernumerary teeth per person was 1.2. The number of supernumerary teeth was one in 35 cases, two in 8 cases, and 3 in 1 case. Of the 45 patients, 8 patients with supernumerary teeth were in deciduous dentition stage, 29 patients were in mixed dentition stage, and 8 patients were in permanent dentition stage. Most supernumerary teeth presented in the anterior maxilla. Morphologically, conical-shaped supernumerary teeth were the most common finding. 68.5% of supernumerary teeth presented with straight orientation and inverted orientation was seen in 24.1%. Complications seen in patients with supernumerary teeth were delayed or noneruption of adjacent tooth malposition or rotation of adjacent teeth, diastema formation, and formation of dentigerous cyst. Conclusions: Supernumerary teeth have an incidence of 1.1% in South Indian population and can cause many complications that can harm the developing occlusion. Knowledge about supernumerary teeth may help the dentist in early diagnosis and early intervention.

Introduction: Although dentists are ideally placed to deliver smoking cessation advice and assistance to their patients, smoking cessation interventions are not often incorporated as a routine part of dental care. Aim: To assess the awareness on smoking cessation counseling among dental practitioners in Kerala. Materials and Methods: A pretested questionnaire was used for the study. Four hundred and sixteen registered dentists practicing all over Kerala participated in the survey. Results: Dentists are willing to ask and advise patients about smoking, but are less inclined to assist patients to quit or arrange follow-up. Dentists are more likely to implement one-off, opportunistic interventions rather than take a systematic preventive approach. Dentists are interested in attending further education and say they require training to be relevant to the context of their day-to-day running of the dental practice. Conclusions: Training should aim to legitimize the dentist′s role in smoking cessation and provide strategies and resources so that dentists can practice interventions as part of their day-to-day work.