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BACKGROUND: Oral health of preschool children remains a concern globally. Primary healthcare providers are in a vital position to support preventive oral care programmes. This study explored current practices, perception and barriers of primary health care professionals towards oral health promotion program of children in Qatar. METHODS: The qualitative research used focus group discussions and interviewed a total of 108 participants that were audio recorded and transcribed verbatim. Four major themes emerged and were analysed to explore contextual patterns within the data. RESULTS: Participants acknowledged the high prevalence of caries in children and identified the causes in the local context which included parental practices, poor dietary habits, impact of culture lack of oral health knowledge, limitations in the healthcare system, and negative role of the media. However, complex barriers were exposed, including lack of time and ownership, system coordination between organizations, and lack of policy. CONCLUSION: Health professionals and bureaucrats involved in decision-making held a positive attitude towards oral health prevention programs and were enthusiastic to initiate and support these programs.

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BACKGROUND: Electronic cigarette (e-cigarette) use has risen dramatically since its introduction in 2004. Nurses play a critical role in screening, disease prevention and smoking cessation for their patient. Their knowledge and attitude related to e-cigarettes will play a major part in development of tobacco control activities. AIM: Thus, this study was conducted to determine the knowledge and attitude toward e-cigarettes among undergraduate nursing students in the Philippines. METHODS: The participants of the study were 122 level four nursing students of West Visayas State University, Iloilo city, Philippines. A standardized self-administered questionnaire was used to collect the data and statistical analyses were performed. RESULTS: Majority of the participants were female, were never smokers and were aware or conscious of the existence of the e-cigarettes but had poor knowledge on e-cigarettes. Furthermore, in terms of attitude the students as an entire group had a positive attitude opposing e-cigarette use. Never and former smokers had positive attitude opposing e-cigarette use while current smokers had negative attitude supporting e-cigarette use. There was no significant relationship between knowledge and attitude of nursing students towards e-cigarettes. CONCLUSION: Nursing students did not have adequate knowledge regarding e-cigarettes but maintained a positive attitude opposing e-cigarette use. Poor knowledge did not influence the attitude of participants towards e-cigarettes.

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Histone modifications have been demonstrated to play a significant role in oral squamous cell carcinoma (OSCC) epigenetic regulation. An in-silico analysis of The Cancer Genome Atlas (TCGA) of various histone acetyl transferases (HATs) and histone deacetylases (HDACs) suggested that HATs do not differ between normal and tumor samples whereas HDAC2 and HDAC1 change maximally and marginally respectively between normal and tumor patients with no change being noted in HDAC6 expression. Hence, this investigation was carried out to validate the expression states of HDAC 1, 2 and 6 mRNAs in buccal mucosa and tongue SCC samples in an Indian cohort. Buccal mucosa and tongue squamous cell carcinoma tissues with intact histopathology were processed for RNA isolation followed by cDNA synthesis which was then subjected to q-PCR for HDACs. The average RNA yield of the tongue tissue sample was ∼2 µg/mg of tissue and the A260/280 ratios were between 2.03 and 2.06. The average RNA yield of buccal mucosa tissue sample was ∼1 µg/mg of tissue and the A260/280 ratio were between 2.00 and 2.08. We have demonstrated that HDAC2 was overexpressed in tongue and buccal mucosa samples. Over-expression of HDAC2 imply potential use of HDACi along with standard chemotherapeutic drug in oral cancer treatment.

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Introduction: Nurses are in an ideal position to provide special care for anxious children admitted in hospital wards. Thus, the objectives of the study were to identify the common nursing procedures done for children and to measure their level of anxiety. Methods: A cross-sectional descriptive study was conducted at a district hospital in Philippines. The respondents of the study were 235 children aged 3 - 9 years old admitted in the pediatric ward. The descriptive characteristics of the children were recorded. Venham Picture Test was used to assess the level of anxiety in children. The instrument was validated using the Good and Scates criteria and pre-tested on 30 pediatric respondents. The chi-square test and t-test were used to determine the significance of difference between the scores given by the children across different age groups and the P-value was set at 0.05. Results: The mean age of the respondents was 5.1 (3.5) years. Males obtained an "average" mean score of anxiety 4.0 (2.0) whilst females demonstrated a "low" mean score of anxiety 3.6 (2.3). There was a highly statistical difference between the mean anxiety scores amongst patients who had a prior experience and those who had none. Conclusion: Temperature measurement and pulse measurement were the most common procedures performed on children and demonstrated very low level of anxiety. Peripheral cannula insertion caused the maximum anxiety amongst all the procedures performed. Children aged 3 to 4 years old demonstrated the maximum anxiety when compared to children aged 5 to 9 years.

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Fluoridation of drinking water has been recognized as one of the most effective ways of achieving community-wide exposure to the caries prevention effects of fluoride (F). A vast majority of people in Qatar use bottled water for drinking. Use of bottled water without knowing the F level may expose children to dental caries risk if the F level is lower than optimal or to dental fluorosis if the F level is too high. The aim of this study was to determine the F concentration of bottled water available in Qatar. A total of 32 brands of bottled water were evaluated. The F concentrations displayed on the labels were recorded. The F ion-selective electrode method was used to measure the F concentration in water samples, and three measurements were taken for every sample to ensure reproducibility. The p value was set at 0.05. The F concentration ranged from 0.06 to 3.0 ppm with a mean value of 0.8 ppm (±0.88). The F levels were provided by the manufacturers on the labels of 60 % of the samples, but this was significantly lower than the measured F levels (p < 0.0001). Moreover, bottled water that was produced in Saudi Arabia had significantly higher levels of F when compared to those produced in other countries (p < 0.05). There was a wide variation in the F levels in the different brands of bottled water. Furthermore, there was a significant disparity between the F levels which were measured and those that were provided on the labels.

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Background. School teachers have an internationally recognized potential role in school-based dental education and considerable importance has therefore been attributed to their dental knowledge. The objectives of this study were to determine the oral health related knowledge, attitudes, and approaches of pre-primary and primary school teachers in the city of Mumbai. Methods. The descriptive cross-sectional study was conducted in the suburban regions of Mumbai using a self-administered questionnaire and involved 511 teachers. Results. Teachers demonstrated inappropriate or incomplete knowledge regarding children's oral health. Only 53.2% knew that an individual has two sets of dentition. Moreover, only 45.4% of the teachers knew that a primary dentition consists of 20 teeth. Only 56.9% of the teachers asked their children to clean their mouth after snacking during school hours. 45.0% of the teachers were unaware of fluoridated tooth pastes whilst 78.9% of them were unaware of school water fluoridation programmes. Also, 54.8% of the teachers never discussed the oral health of children with their parents during parents meet. Conclusions. The studied school teachers demonstrated incomplete oral health knowledge, inappropriate oral practices, and unfavourable approaches to children's oral health. There is a definite and immediate need for organized training of school teachers on basic oral health knowledge.

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The position of the permanent maxillary canine at the angle of the mouth is strategically significant in maintaining the harmony and symmetry of the occlusal relationship. However, the maxillary canine is the second most frequently impacted tooth, with prevalence reported to be between 1% and 2%. Moreover, treatment of this condition is often complex and involves substantial time and financial cost. Hence, it is only prudent to monitor the eruption and identify the etiological factors that lead to impaction of the maxillary canine. Numerous researchers have tried to identify specific and nonspecific etiological factors responsible for displacement of canines. The purpose of this review was to track the development processes of maxillary canines and determine the hindrances that affect the eruption at different ages. Awareness of the eruption process and etiology of noneruption will help to reduce the incidence of impacted canines by allowing for early recognition and interceptive treatment.

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AIM: The aim of the present study was to investigate the success rate of various treatment modalities and complications associated with the occurrence and treatment of impacted mandibular permanent canines. METHODS: Seventy-four southern Chinese children and adolescents who received treatment for impacted mandibular canines over a 27-year period were included in the analysis. Treatment modalities and complications that had been recorded in the clinical and surgical notes and that could be diagnosed from the available radiographs were noted. RESULTS: The most commonly-performed treatment for the correction of an impacted mandibular canine was surgical removal of the impacted tooth (n = 59). In cases where surgical exposure of the impacted canine followed by bonding an attachment was performed (n = 7), the average time required for the canine to erupt postoperatively through the soft tissue was 12.2 months (±10.2 months). Lack of movement of the tooth after traction was the only complication reported in these patients (n = 3). The most frequently-reported postoperative sequela observed for all treatment modalities was swelling of the soft tissues around the surgical site (n = 6), and this was persistent even after 48 h. CONCLUSIONS: The success rate after surgical intervention and orthodontic traction was 57.1%.

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BACKGROUND: The aim of this study was to evaluate the complications associated with the occurrence and treatment of impacted maxillary canines. METHODS: This retrospective study was conducted on 533 Southern Chinese children and adolescents who attended the Paediatric Dentistry and Orthodontics Clinics and had at least one impacted maxillary canine. The study material included all the documentation files and radiographs of these patients. Complications that had been recorded in the clinical and surgical notes and that could be diagnosed from the available radiographs were noted. The data obtained were descriptively analyzed. RESULTS: The most frequently reported phenomenon associated with the occurrence of impacted maxillary canine (prior to surgical treatment) was root resorption of an adjacent permanent tooth in 22 (4.1%) patients. The most frequently reported sequelae observed after any surgical procedure was swelling of the soft tissues around the operation site which often persisted for 48h as seen in 76 (18.8%) patients. Complications reported most commonly after any form of surgery included post-operative bleeding: 7(1.7%), hematoma: 7(1.7%), post-operative pain: 6(1.5%) and purulent discharge: 6(1.5%), post-operative complications in relation to surgical exposure and bonding of an attachment which included breakage of ligature wire: 5.7%; de-bonding of the attachment: 4.3% and inability to bond the attachment during surgery: 1.4% occurred rarely. CONCLUSIONS: The frequency of root resorption of teeth adjacent to an impacted maxillary canine was low. Swelling of the soft tissue 48h post-operatively was the most commonly occurring complication after surgical intervention.

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PURPOSE: The incidence of impacted mandibular canines in Caucasians reportedly ranges from 0.2 percent to 0.7 percent. The objective of this study was to estimate the prevalence and to determine the characteristics of impacted mandibular canines in southern Chinese children and adolescents. METHODS: This retrospective audit involved 63 patients (32 females and 31 males) with impacted mandibular canines, who were identified from a population of 20,347 patients, representing a prevalence of 0.3 percent. A customized data entry form was prepared to record and evaluate the status of impacted canines. RESULTS: Sixty-two (98.4%) of the patients had unilaterally impacted canines (30 on the left side and 32 on the right side),while only one patient (1.6%) had bilateral impaction. Forty-four (64.5%) were buccally located, 16 (25.8%) were lingually located, and six (9.7%) were found to lie within the arch. CONCLUSIONS: The prevalence of impacted mandibular canines in a large group of southern Chinese children and adolescents was 0.3 percent, which is similar to several studies conducted on Caucasian populations. Buccally-impacted canines were twice as common as lingually-impacted canines.

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AIM: The incidence of impacted maxillary canines in Caucasians reportedly ranges from 1% to 3%. The objectives of this study were to estimate the prevalence and determine the characteristics of impacted maxillary canines in southern Chinese children and adolescents. METHODS: This retrospective audit involved 533 subjects with impacted maxillary canines that had been treated between February 1982 and February 2009. A customized data entry form was prepared to record and evaluate the status of impacted canines. RESULTS: The 533 subjects (327 females and 206 males) with impacted maxillary canines, who were identified from the population of 26 039 subjects, represented a prevalence of 2.1%. Four hundred and forty-two (82.9%) of these subjects had unilaterally impacted canines, while 91 (17.1%) of them had bilateral impactions. In 442 subjects with unilateral canine impactions, 220 (49.8%) were buccally placed, 194 (43.9%) were palatally placed, and 28 (6.3%) of the canines were found to lie within the arch. CONCLUSIONS: The overall prevalence of impacted maxillary canines in this study of 2.1% was similar to the figures quoted for Caucasian populations. In subjects with unilateral impactions, buccally impacted canines demonstrated a slightly higher incidence (49.8%) compared to palatally impacted canines (43.9%).

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AIM: The aim of the present study was to determine the association of both buccally- and palatally-impacted canines with other dental anomalies. METHODS: This retrospective study was conducted on a population of 533 southern Chinese children and adolescents who had impacted maxillary canines that had been treated in the Paediatric Dentistry and Orthodontics Clinic, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong. Descriptions of the impacted canine and other associated anomalies were obtained from the case notes and radiographs. Clinical photographs and study casts were used, where available. RESULTS: A total of 253 (47.5%) patients with impacted maxillary canines were diagnosed with other dental anomalies. Microdontia was the most frequently-occurring anomaly reported in these patients, with the maxillary lateral incisor the most commonly affected tooth. Other odontogenic anomalies that were associated with both buccally- and palatally-impacted canines included hypodontia, supernumerary teeth, transposition of other teeth, enamel hypoplasia, other impacted teeth, and dens invaginatus. CONCLUSION: Both buccally- and palatally-impacted canines were found to be associated with other odontogenic anomalies.

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OBJECTIVES: Numerous clinical signs may be indicative of a canine impaction; however, studies determining the efficiency of visual inspection and digital palpation in localizing an impacted maxillary canine are sparse. Of the radiographic techniques, no studies have compared the accuracy of the horizontal and the vertical parallax techniques to determine the location of an impacted canine. Hence, the objectives of this study were to evaluate the efficiency of visual inspection and digital palpation, and to compare the accuracy of the horizontal and vertical parallax techniques in determining the location of an impacted maxillary canine. METHODS: The study sample comprised the records of 522 patients who had attended a dental hospital. The location of an impacted maxillary canine was determined radiographically using the vertical and the horizontal parallax principles. The findings were then confirmed from the surgical records in those cases that had undergone surgical intervention of the impacted canine. RESULTS: The position of the impacted canine was determined successfully by visual inspection and digital palpation in 85.3 and 85.2% of the cases respectively. CONCLUSIONS: The vertical parallax technique demonstrated a higher degree of accuracy (97.7%) and a greater degree of diagnostic capability (98.2%) when compared with the horizontal parallax technique (92.6 and 78.0% respectively).

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INTRODUCTION: Treatment of impacted maxillary canines frequently requires surgical intervention, which can involve substantial complications. Thus, it is desirable to identify a reliable method for the early diagnosis of canine displacement. In this study, we sought to determine whether impaction of a maxillary canine can be predicted using measurements made on a panoramic radiograph. METHODS: This retrospective study was conducted at a dental hospital in Hong Kong with panoramic radiographs. Geometric measurements were made on 384 panoramic radiographs of patients with a unilaterally impacted maxillary canine (group I) to characterize its presentation and compare them with the unaffected antimere (group II). RESULTS: There was a clinically discernible difference of 4 mm at the age of 8 years and beyond between the mean distance of the tip of the impacted canine (group I) and that of the antimere (group II) from the occlusal plane (P <0.05). Furthermore, there was a statistically significant difference at the age of 9 years and beyond between the 2 groups according to the position in different sectors and according to the mean angle made with the midline (P <0.05). CONCLUSIONS: Diagnosis of maxillary canine impaction is possible at 8 years of age by using geometric measurements on panoramic radiographs.

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The aetiology of impacted maxillary canines remains obscure. Numerous researchers have focused on identifying specific and non-specific aetiological factors responsible for canine displacement. Currently, the two most popular hypotheses that have gained consensus worldwide are the guidance theory and the genetic theory. However, no single hypotheses, can completely explain the aetiology of impaction of maxillary canines. This retrospective study was used to develop and postulate the aetiology of both buccally and palatally impacted maxillary canines. The study was conducted on a sample of 533 patients for whom the pattern and distribution of the impacted maxillary canines, sex differences, the dental age of the patients, dental anomalies and various geometric measurements which were made on the panoramic radiographs were recorded. Based on these findings, the sequential hypothesis of impaction of the maxillary canine was postulated. The hypothesis states that both buccally and palatally impacted canines have similar aetiological factors leading to their impaction. It is suggested that genetic mechanisms strongly influence the potential of the maxillary canine to be impacted and the guidance from the lateral incisor and the stage of development plays a vital role in determining the ultimate position of the impacted canine.

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PURPOSE: Impaction of a maxillary canine is a frequent occurrence and often requires a multidisciplinary approach for proper management. The success of different treatment modalities used to treat impacted maxillary canines is largely based on clinical experience and anecdotal evidence, with only a few studies published in the literature on the subject. Hence the aim of this study was to determine the success rate and the difference in duration of the various treatment modalities for impacted maxillary canines. MATERIALS AND METHODS: Four hundred forty-eight southern Chinese children and adolescents who were provided treatment for their impacted maxillary canines between February 1982 and February 2009 were included in the analysis. Because this was a retrospective study and did not involve human subjects, it was exempt from requiring review board approval. RESULTS: The most commonly performed treatment for correction of an impacted maxillary canine was surgical removal of the impacted tooth. In cases where surgical exposure of the impacted canine followed by bonding an attachment was performed, the mean time required for the impacted canine to erupt postoperatively through the soft tissue was 12.6 months (SD, 7.5 months). CONCLUSIONS: The success rate of all forms of treatment modalities used to treat impacted maxillary canines was 90.9%, which was commensurate with figures reported at other centers.

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Larsen syndrome is a rare genetic disorder characterized by multiple dislocations of the large joints and characteristic craniofacial abnormalities. It exists in both a severe autosomal recessive form and a mild autosomal dominant variety. To date, only three authors have reported oral findings for this syndrome. This paper describes an 8-year-old Chinese boy with Larsen syndrome who had advanced periodontitis. The need for periodontal therapy and regular monitoring of such patients has been highlighted.

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