To evaluate and compare the staining propensity of SDF, SDF with Potassium iodide and SDF + Glutathione biomolecule on demineralized enamel. Study Design: Forty-five teeth were selected and stratified to receive either 38% SDF; 38% SDF + KI or 38% SDF + 20% GSH. The analysis for staining (E) was done using a UV-Vis Spectrophotometer and was recorded at different intervals for one month. Data analysis was done using Kruskal-Wallis test, Post-hoc analysis (Dunn) and a repeat-measures analysis of variance (RM-ANOVA). Results: SDF caused maximum staining. SDF + KI staining was significantly less (P<0.05) compared to SDF at 1 week, 2 weeks and one month. SDF + GSH showed least staining at 5 minutes and 24 hours among the three groups but the staining increased gradually and had no statistical difference after 1 week, 2 weeks and one month when compared to other groups. Conclusion: Application of KI following SDF helps in reducing the staining. Addition of GSH had no significant effect.
Background: A paradigm shift in the caries management propelled interest in techniques for sealing caries and restorations with selective caries removal. Preformed Metal Crowns (PMCs) and Resin-Modified Glass Ionomer Cement (RMGIC) have been preferred choices of restorations for carious primary molars. This is the first study from India on the Hall Technique used to seal carious primary molars.
Objective: To compare the clinical success and acceptability of the Hall Technique and RMGIC restorations in sealing carious primary molars.
Methods: Sixty 7–8-year-old children having caries with ICDAS scores 3-5, requiring two or more restorations; a total of 140 teeth were randomized into Group A: HT (n1 = 73 teeth) or Group B: RMGIC (n2 = 67 teeth). A single calibrated operator assessed the ‘Major’ failures (abscess, secondary caries, new caries) and ‘Minor’ failures (dislodgement) over a period of 15 months. Children, parents, and operator rated the acceptability. The average time taken for each procedure was recorded.
Results: ‘Major’ failures were statistically significantly higher in the RMGIC group (p=0.008). At the 12-month follow-up, the HT outperformed RMGIC restorations. Additional failures were seen in Group B: RMGIC restorations at 15-month follow-up, whereas no failures were seen with HT. The result was statistically not significant. Children, parents, and the operator preferred the Hall Technique, which was statistically significant (p< 0.001).
Conclusion: HT is a successful and acceptable technique and superior to RMGIC restorations with partial excavation of caries in primary molars but with mild postoperative discomfort.
Having a policy on infection control based on current evidence and guidelines is essential for all dental practices. The evidence shows that all the members of the dental team may not possess adequate knowledge of all relevant aspects related to infection control, such as the transmission of infectious diseases, current regulations, etc. Moreover, there exists evidence to support the value of education and certified training the dental professionals in improving their understanding of infection control policies and procedures. The training must be provided by an expert team comprising of an academician with suitable clinical experience and demonstrable expertize in dentistry, and a microbiologist who understands the needs of dental settings. Evidence suggests that a training over 10 hours is associated with maximal benefits; and the CDC and BDA guidelines recommend training to all dental staff (clinical as well as nonclinical) for optimal benefits. Successful implementation of the infection control policies depends on the adequate provision of time and facilities for the same.
How to cite this article
Jawdekar AM. Infection Control Policy for Dental Practice: An Evidence-based Approach. J Contemp Dent 2013;3(2):82-86.
Dental caries is an increasing burden in the developing countries. A proper budgetary allocation for treating dental diseases in an enormous population such as India is impractical, where resources are inadequate for major health challenges such as malnutrition and gastrointestinal and respiratory infections in children. An integrated, directed population approach targeting children is much needed. The existing machinery of successful public health campaigns such as the “Pulse Polio” and the “Mid-Day-Meals Scheme” of the Government of India can be used for oral health promotion for children. India has about 300 dental colleges and countrywide branches of the Indian Dental Association that can provide manpower for the program. An innovative, large-scale “Fit for School” program in Philippines is a model for an integrated approach for children's health and has proved to be cost-effective and viable. A model for oral health promotion in infants and children of India, combining age-specific initiatives for health education, nutrition, hygiene, and fluoride use, is proposed. The model could be implemented to evaluate the oral health status of children, knowledge and knowledge gain of the community health workers, and acceptability and sustainability of the preventive programs (fluoride varnish and preschool and school tooth brushing) pragmatically.
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