Research

Estimation of Fluoride Level in Drinking Water Sources of Eastern Development Region, Nepal

Singh A, Shrestha A, Bhagat TK

Abstract
Background
Water is essential for the survival of every living organism of this planet, we humans being no exception to this fact. In context of oral health promotion, fluoride when consumed in recommended level improves the strength of dental enamel thereby decreasing the solubility of the enamel to acidic exposure and hence the dental caries. This study was conducted to estimate the fluoride concentration in drinking water of eastern development region Nepal.
Materials and Methods
Water samples (165) were randomly collected from drinking water sources of Eastern Development Region, Nepal. Three categories of water samples (municipal, natural, packaged bottle water) each from three most populated cities of every district in the region were collected. The water samples were collected in autoclaved polypropylene plastic vessels. American Public Health Association (APHA) 4500 F- D method was used for fluoride estimation.
Results
Majority of the water samples (88.2%) had fluoride concentration below the optimum as per WHO guideline. Median fluoride concentration of municipal water supply, natural water resources and packaged bottle water was 0.09 ppm (<0.05 to 1.11 ppm), 0.13 ppm (<0.05 to 1.80 ppm) and 0.05ppm (<0.05 ppm to 0.78 ppm) respectively. Median fluoride concentration of Himalayan region, hill region and terai region was 0.17 ppm, 0.10 ppm and 0.07 ppm respectively. Overall median fluoride concentration of eastern development region Nepal was 0.08 ppm (<0.05 pmm to 1.80 ppm).
Conclusions
This study illustrated that fluoride concentration of most of the drinking water resources of eastern Nepal was below the recommended optimum level as per WHO guidelines.
Key words: Drinking Water Sources, Fluoride Concentration. Eastern Nepal.

“Impact of Community Diagnosis Programme (CDP) on Undergraduate Students at BPKIHS: A Cross Sectional Study”

Singh A, Subedi K, Shrestha A, Bhagat TK, Pyakurel P, Agrawal SK

Abstract
Background
Community Diagnosis Programme (CDP) aims to demonstrate the importance of teamwork in health care to understand the comprehensive health needs of the rural peopleand conceive about theresearch.
Objective:
This study was conducted to assess the impact of community diagnosis program on undergraduate students of BPKIHS, Dharan, Nepal.
Materials and Methods
A cross sectional study with mixed design (quantitative and qualitative) was conducted among the undergraduate students of batch 2017 participating in CDP programme of BPKIHS, Dharan, Nepal. Eight questionnaires assessed the student’s perceptions regarding their abilities about community diagnosis program using six-point Likert Scale and four open ended questions were used to know the students experience and perception of CDP.
 Results
Overall mean ±SD score for pre-exposure response was 30.47±6.18 and for the post-exposure response was 40.49±5.16. The overall mean ±SD score of the students categorized according to streams showed similar results in both pre-exposure response and post-exposure responses. Qualitative analysis revealed the themes like “Research, a reflection of community and new method of learning to medical students”; “method of developing confidence and good communication skills”, “learning to work as a team” and “exposure to rural area”; “Research an adjunct to medical profession”.
Conclusion
CDP had a positive impact on the students about basic survey process, learnt to communicate with rural people, understood the type of data and were willing to participate in similar projects in future. Qualitative analysis showed most of the students had positive experience with some negative experience of CDP.
Key words: Community Diagnosis Programme, Undergraduate Students, BPKIHS, Nepal.

“Assessment of Oral Health Status and Treatment Needs Among People of Foklyan Area, Dharan, Nepal”

Singh A, Shrestha A, Bhagat TK

Abstract
Background
Dental caries is considered a major public health problem globally due to its high prevalence and significant social impact.
Objective
To assess the oral health status and treatment needs among the people of Foklyan area, Dharan.
Methods
House to house survey was conducted on 310 randomly selected participants of Foklyan area, Dharan. The participants were stratified into five age groups (WHO Basic Oral Health Survey Methods 1997) and further categorized by gender. WHO Oral Health Assessment form 1997, WHO oral health assessment questionnaire for adult/children 2013 and questionnaire for oral hygiene practice and cost as a treatment barrier were used. The examinations were done as per WHO standard guidelines.
Results
Most of the participants were from low socioeconomic background (71.3%). About 40.0% of the participants deferred dental visit due to financial burden. Although 90.0% of the participants brushed their teeth, there was high caries experience (DMFT: 3.18±5.85; dft: 2.40±2.65). Mean sextant score for bleeding was 5.58 in 35 – 44 years age group and 5.61 in 65 – 74 years age group. Prosthetic needs of the participants were 31.7% in lower arch and 24.6% in upper arch. Tobacco consumption was seen in about 70.9% of the adults and alcohol consumption was 58.8% among adult age groups. Mandatory orthodontic treatment was needed for 5.8% of participants for esthetics.
Conclusion
The prevalence of dental caries, periodontal diseases, and prosthetic needs was more compared to the findings of NOHPS 2004. There is need for oral health education and promotion in this area to improve their oral health.
Key words
Oral Health Assessment, Dental Caries, Indigenous Population.

“Oral Health Status of Martyr Memorial Residential School Children of Sunsari, Nepal”

Agrawal S, Shrestha A, Bhagat TK

Abstract
Aims
The aim of this study was to assess the oral health status of Martyr Memorial Residential School Children of Sunsari, Nepal, during 5-year period and also to assess the effectiveness of school oral health program
Settings and Design
A retrospective longitudinal study was carried out among Martyr Memorial Residential School children. A retrospective longitudinal study was performed among 411 school children of Martyr Memorial Residential School, Sunsari, Nepal. Five years’ data of children were collected from the department record forms from 2009 to 2014. Data on demographic parameters, oral health condition (Decayed, Missing, and Filled Teeth [DMFT], oral hygiene status, type of dentition, malocclusion, and diet history), and treatment done for each child were collected from the surveyed forms. Frequency distribution, prevalence, and incidence of dental caries were calculated.
Results
This study showed that the prevalence of dental caries in 2009, 2010, 2011, 2012, 2013, and 2014 was 21.0%, 23%, 29.1%, 10.0%, 13.5%, and 30.9%, respectively. The incidence of dental caries in permanent dentition was high (22.0%) in 2011 follow-up. None of the dentition developed new cavity in 2010 follow-up period. More than half of the children had good oral hygiene status in 2012, whereas only 32.9% had so in 2009. Majority (95.5%) of the enrolled children had normal occlusion.Conclusions
This study showed the overall positive impact on the children’s prevalence and incidence of dental caries as well as on oral hygiene status. The incidence of developing new caries in both types of dentition decreased. There was an increase in filled component of DMFT/decayed, filled teeth index. Most of them had good oral hygiene status at the end of the study.

“Assessment of oral health impact profile (ohip-14) among villagers of Jyamirgadi VDC, Nepal: A cross-sectional study”

Agrawal S, Shrestha A, Bhagat TK

Abstract
Introduction
Oral health is multidimensional and is visualized from a perspective of health-related quality of life. Not only objective indicators but also focus on patient’s perception is recognized to be important when evaluating oral diseases or treatment outcomes. It may be done by assessing oral health-related quality of life. This study was conducted to assess the Oral Health related Quality of life among villagers of Jyamirgadi VDC, Jhapa, Nepal.
Methods
A cross-sectional study was conducted in Jyamirgadi VDC, Jhapa among 200 villagers of age ≥30 years. Convenience sampling was done and the study participants were interviewed using OHIP-14 (Nepali version) for assessment of Oral Health related Quality of life.
Results
Mean OHIP-14 score of the population was 8.09±10.53. Among them, 35% of the individuals had OHIP-14 score of zero. Oral Health related Quality of life was found to have significant positive correlation with age (r=0.362, P<0.001). Also, statistically significant difference of OHIP-14 score was seen among different socioeconomic class groups (P<0.001).
Conclusion
Most of the people surveyed (65%) of Jyamirgadi VDC had some impact of their oral health conditions on their lifestyle (OHIP-14 score more than zero). Also, increasing age and socioeconomic status had some impact on their quality of life.
Keywords: OHIP-14, Oral health.

“Translation and validation of the Nepalese version of the “Geriatric Oral Health Assessment Index”

Agrawal S, Shrestha A, Bhagat TK

Abstract
Objective
To translate and validate the Geriatric Oral Health Assessment Index (GOHAI) (Nepali version) from original English version.

Background
Growing numbers of elderly people have problems in different aspects of oral health increasing the demand for dental care services among them GOHAI may be one of the effective means of gathering information on oral health problems of the elderly people.
Materials and methods
A total of 168 individuals ≥60 years from seven old‐age homes located in Eastern Nepal were included in the study. The Nepali version of GOHAI was translated and validated.
Results
A total of 168 elderly people (79 male and 89 female participants) completed GOHAI questionnaire. The mean age (±SD) of the participants was 72.49 (±10.00) years. The mean GOHAI score (±SD) was 42.29 (±6.93) and ranged from 17 to 59. Cronbach’s alpha coefficient for the Nepali version of GOHAI (GOHAI‐N) was 0.74, which is categorised as very good agreement. Analysis of discriminant validity showed that lower mean GOHAI score was seen in study participants with more number of missing and decayed teeth. However, those who had more than one filled surface had higher mean GOHAI score.
Conclusion
The Nepali version of the GOHAI exhibited acceptable reliability and validity when used for older people residing in old age homes. The GOHAI‐N showed good consistency and homogeneity among the items.
Keywordelderly people, Geriatric Oral Health Assessment Index, old age homes, oral health‐relatedquality of life

“Evaluating Sanitization of Toothbrushes Using Various Decontamination Methods: A Meta-Analysis”

Agrawal S, Shrestha A, Bhagat TK

Abstract
Toothbrushes play an essential role in personal oral hygiene by effective plaque removal. However, they get heavily contaminated by bacteria, viruses, yeasts, and fungi which may originate from the oral cavity after every use as well as from the environment where they are stored. This systematic review was conducted to identify various decontamination interventions attempted scientifically and it summarizes the efficacy of each. Meta-analysis illustrated that the use of Ultra-violet rays and Microwave had a significant effect on reduction of the microbial count of a used toothbrush with a mean difference of -2.61 and CI (-4.66,- 0.76) with I2=98%. When compared with non-active treatment group, the natural agents (garlic, green tree and tea-tree oil) proved to sterilize the toothbrushes effectively with mean difference of -483.34, CI (-914.79, -51.88) and I2=100%.In contrast, chlorhexidine showed the insignificant result with a mean difference of -347.55 and CI (-951.90, 256.80) with I2=100%. The evidence from this review suggests that decontaminating toothbrush reduces bacterial load. Toothbrushes exposed to radiation and natural agents proved to sanitize them effectively but chlorhexidine rendered insignificant results.
Keywords
Chemical agent; disinfection; radiation; microbial load; natural agent; toothbrush.