Management of Dental Health Problem of Diabetic Patients Attending in Selected Private Dental Clinic in Dhaka City

Aim: The rising cases of dental problems among diabetic patients have raised health concerns among dentists worldwide. The oral complications of prime concern are gum disease, dental caries, dry mouth, oral soft tissue damage, and pain in the face and mouth. This descriptive type of cross sectional study was conducted among the diabetic patients for their management of dental problems attending in selected dental clinic in Dhaka city from January to June 2012. 44% of the patients were in between 41to 50 years age group.Methods: Data were collected with a pretested semi structured questionnaire and check list was filled in after oral examination.Results: Among the patients 84% were Muslims and 16%. were Hindu. All the patients were married. 58% of the patients had monthly income TK. 25000-40000. Among the patients, 48% had (4-5) family members. Type of family was single for 82% of the patients. Main food was rice for 78% of the patients. 50% of the patients had habit of tobacco use. Tobacco smokers were 88%. Among the patients, calculus and gingivitis was in grade I for 54% and the condition of periodontitis was in grade I for 46%. The condition of oral thrush was in 0 grade for 66% of the patients. Most of the patients’ 1 tooth was affected by dental caries. There was no dry mouth in 80% of the patients, whereas no burning mouth syndrome was in 82% of the patients; 64% of the respondents visited dentists. The reason for visiting dentists, most of them visited for sensitivity. All the patients brushed teeth everyday. 66% of the patients brushed teeth once a day. Among the patients 66% cleaned teeth before breakfast and 52% took 3-4 minutes. Among the patients, 90% used tooth brush and 88% used tooth paste for cleaning the teeth. 84% of them did not floss and the rest 62.5% flossed teeth once a day, 62% got information about type of diabetes, among them 62.5% informed about non insulin dependent type of diabetes. Among the patients, 60% got information about usual oral hygiene, 75.9% got information about usual oral hygiene from doctors.Conclusion: Proper patient management requires close interaction between the dentist and the physician. Working with diabetic patients can be challenging and rewarding when open communications are established and thorough patient education is attained.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 55-58

Androgen tic alopecia (AGA) -New Approach

Androgen tic alopecia is a no scarring progressive miniaturization of the hair follicle with a usual characteristic pattern distribution in genetically predisposed men 1. It is the most common hair loss disorder which causes significant impairment of life 2,3. The frequency and severity of male AGA increases with age in all ethnic groups 4.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 64-65

Annual Clinical Audit of Indoor, Dhaka Dental College and Hospital (January 2004 - December 2005)

Clinical audit of indoor, Dept. of Oral and Maxillofacial Surgery, Dhaka Dental College and Hospital was performed for two years, January 2004 to December 2005. Data included all the indoor patients who were admitted for elective surgery. Day cases were excluded from the study. The audit was performed to assess the nature of pathology and number of patients admitted for surgical treatment. Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 37-39

Synodontia between Permanent Mandibular Central & Lateral Incisors

Dental fusion also called ‘synodontia’ is a rare dental developmental anomaly in which the union of two independently developing primary or permanent tooth buds occurs. Tooth fusion is defined as union between the dentin and / or enamel of two or more separate developing teeth. The fusion may be partial or total depending upon the stage of tooth development at the time of union. The etiology of fusion is still unclear. The overall prevalence of the tooth fusion is approximately 0.5%. Fusion may be unilateral or bilateral and most often occurs in primary teeth with more predilections for anterior teeth. Clinically fused anterior teeth frequently have a groove or notch on the incisal edge that goes in buccolingual direction and radiographically, the dentin of fused teeth always appears to be joined in some region with separate pulp chambers and canals. Hence the cases of fusion of permanent teeth in different ages are presented.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 70-72

Radix Entomolaris in Mandibular First Molar: An Endodontic Challenge

Success of endodontic therapy depends on the proper identification of all the canals, thorough chemo-mechanical preparation followed by three dimensional obturation with fluid tight seal. Failure of any of these steps may occur due to unusual tooth morphology. Proper knowledge of root canal anatomy is a basic prerequisite for the endodontic treatment successful. Mandibular molars may have an additional root located lingually (radix entomolaris) or buccally (radix paramolaris). Awareness and understanding of the presence of unusual external and internal root canal morphology contributes to the successful outcome of the root canal treatment.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 66-69

Assessment of Oral Hygiene Status and Attitude of Dental Students Towards Periodontal Care: An Introspective Mirror

Dental students represent the educated, urbanized, influential and motivated class of individuals. If motivated for oral health, they can transfer the same knowledge and behavior patterns to patients during their practices. With this intention, this study was planned. 200 dental students were assessed by a close-ended, four-item questionnaire. Oral hygiene was assessed by Simplified Oral Hygiene Index (OHI, Greene and Vermilion, 1964) and gingival condition by Gingival Index (GI, Loe & Silness, 1963). A positive change in attitude was observed from first to final year students. 100% of them used tooth brush and paste, but 88%, 88% 96%, 92% in first, second, third and fourth year cleaned their tongue; whereas 70%, 92%, 94%, 92% of them, respectively, were in favor of scientific method of brushing. 92%, 90%, 96%, 100%, respectively, felt visiting the dentist during gingival bleeding. Also, there was statistically significant improvement in GI between first and final year (p=0.00005), between second and final year (p=0.0003) students. OHI showed a consistent improvement from first to final year (p<0.05). A positive change in attitude with reduction in GI and OHI status was observed with the increase in professional years.Key message: The attitude towards periodontal care is quite unsubstantial and oral hygiene status, gingival condition among first and second year dental students is poor as compared to third year and final year students. So, there is need to bring about a change in the attitude and improvement in oral hygiene status and gingival condition of dental students from their initial years of learning.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 44-48

Prophylactic use of cephradine in dental procedures: A observational study in Bangladesh

Bacteremia is common with manipulation of the teeth and periodontal tissues during dental procedures. Majority of dental office visits result in some degree of bacteremia that warrants antibiotic prophylaxis before a dental procedure to reduce the frequency, nature or duration of bacteremia. This study aimed to collect data on prophylactic use of cephradine which is most preferred in dental procedures in Bangladesh. A total 2219 of patients both adult and children above 5 years were enrolled to assess use of antibiotic, its dose and duration for antibiotic prophylaxis during dental procedures. Efficacy of antibiotic prophylaxis in terms of clinical cure, further dose modification and need to change antibiotic was evaluated at day 10 of antibiotic use and in case of root canal therapy at day 30. Any side effect of antibiotic use recorded within 3 days was considered for safety evaluation. This was a non-controlled, multicentre, observational study. 2016 (90.9%) of the patients received cephradine as prophylactic antibiotic with a mean dosage of 500mg (487.48+60.99) and duration of treatment was 3-7 days (5.47+1.03). Some of the dentists also preferred amoxicillin (149, 6.7%) and cephalexin (54, 2.4%) for prophylaxis. The majority of the patients (1657, 82.2%) who had prophylaxis with cephradine had no clinical sign of infection and some of the patients needed to change their initial dose or change of the antibiotic. Overall 1816 (81.8%) patients were found having no clinical sign of infection on antibiotic prophylaxis. Among the patients 239 (10.7%) needed to change the dose of prescribed antibiotic and 55 (2.4%) were required to change their prescribed antibiotic. However, the data on type of infection was not recorded. 109 (4.9%) patients were lost to follow up on Day 10. Prescribed antibiotic prophylaxis was not associated with adverse events in majority (91%) of the patients. Some of the patients reported diarrhea (104, 4.7%), stomach upset (68, 3.1%) and dizziness (31, 1.4%) during antibiotic use. However, those were self-limiting and no dose adjustment, discontinuation of therapy or withdrawal from the study was required. No serious adverse events were reported. Cephradine 500 mg for 5 days course was preferred as prophylactic antibiotic in dental procedures in this study. Majority of the patients had no clinical sign of infection on evaluation at day 10. Cephradine therapy was mostly not associated with adverse events in patients; however, diarrhea, stomach upset and dizziness were reported in some patients that were self-limiting.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 49-54

Loss of First Permanent Molar Teeth in Patients Attending in OPDs of Selected Dental Hospitals in Dhaka City

Teeth loss, especially first permanent molar teeth loss is the ultimate barometer of failure or success in dentistry and dental health programs. A cross-sectional study was conducted among 210 patients attending in outpatient department of selected dental hospitals in Dhaka city to find out the loss of first permanent molar teeth among them. Regarding age (34.8%) of the respondents were below 25 years followed by 25.5% between 25 – 35 years (mean age 33.16 ± 14.10 years). In case of educational status (31%) completed primary education followed by 16.2% were graduates and 33.3% were illiterates. Majority (59.5%) of the respondents had monthly family income below 5000 BDT (mean income 6802.39 ± 6630. 39 BDT). Among the respondents, 33.8% knew brushing technique and 79.5% of them brushed once in a day. Majority (68.5%) of them used tooth paste for brushing and tooth brush was used by 67.1% of the respondents. In case of first permanent molar tooth missing, 50% missed lower left, 19.6% lower right, 17.4% upper left and 13% upper right. Among the respondents, 86% teeth loss was due to caries followed by periodontal disease (12.4%) and orthodontic reason (5.2%). Among the respondents who lost tooth, 55.7% were below 15 years followed by 15 - 30 years (34.3%) and above 30 years (10%). Regarding oral hygiene status, 19% had satisfactory and 81% had unsatisfactory oral hygiene. So it can be concluded that loss of permanent first molars can be avoided if good preventive measures are used before these teeth erupt and are continued after they have erupted in addition to maintaining proper oral hygiene. Further large scale study regarding this topic is recommended.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 40-43

Different Methods of Studying Root Canal Morphology of Human Tooth: A Review

Successful root canal therapy requires an in-depth knowledge of root canal morphology.False assumptions about the root canal anatomy of teeth may lead to misdiagnosis, missed canals, improper debridement and breakage of root canal instruments during root canal treatment. The objective of this paper was to review the various methods used to study and understand root canal systems. The complexity of root canal morphology presents a challenge to any clinician. Any attempt to perform root canal therapy must be preceded with a thorough understanding of the anatomy of both the pulp chamber and the root canal system.Several methods have been used to examine the root canal system ranging from in vitro methods such as sectioning of teeth, metal castings to advanced in vivo tomographic imaging, along with the use of magnificationBangladesh Journal of Dental Research and Education Vol.5(2) 2015: 59-63

Accidentally Broken Lateral Incisor Tooth at the Gingival Margin Treated by Endodontics, Cast Post and Core Finally Porcelain Jacket Crown: A Case Report

A successful treatment of a badly broken tooth in accidental case depends not only on good endodontic therapy but also on good prosthetic reconstruction of the tooth after the endodontic treatment is complete. In accidental case, sometimes it is found that there is very little or no clinical crown after root canal treatment. In such cases, additional retention & support of the restoration are difficult to achieve. In this case report endodontically treated tooth by suing cast post is discussed to achieve additional retention and supportBangladesh Journal of Dental Research and Education Vol.5(2) 2015: 73-74