Teledentistry is a combination of telecommunications and dentistry involving the exchange of clinical information and images over remote distances for dental consultation and treatment planning. Teledentistry has the ability to improve access to oral healthcare, improve the delivery of oral healthcare, and lower its costs. It also has the potential to eliminate the disparities in oral health care between rural and urban communities. This article reviews the origin, rationale, scope, basis, and requirements for teledentistry, along with the current evidence that exists in the literature. This article also reviews the ethical and legal issues related to the practice of teledentistry and the future of this alternative and innovative method of delivering dental care.

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Dengue is an acute viral illness caused by RNA virus of the family Flaviviridae and spread by Aedes mosquitoes. Presenting features may range from asymptomatic fever to dreaded complications such as hemorrhagic fever and shock. A cute-onset high fever, muscle and joint pain, myalgia, cutaneous rash, hemorrhagic episodes, and circulatory shock are the commonly seen symptoms. Oral manifestations are rare in dengue infection; however, some cases may have oral features as the only presenting manifestation. Early and accurate diagnosis is critical to reduce mortality. Although dengue virus infections are usually self-limiting, dengue infection has come up as a public health challenge in the tropical and subtropical nations. This article provide a detailed overview on dengue virus infections, varied clinical manifestations, diagnosis, differential diagnosis, and prevention and treatment.

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Diseases and disorders that damage the mouth and face can disturb well-being and his self-esteem. Oral health-related quality of life (OHRQOL) is a relatively new but rapidly growing notion. The concept of OHRQOL can become a tool to understand and shape not only the state of clinical practice, dental research and dental education but also that of community at large. There are different approaches to measure OHRQOL; the most popular one is multiple item questionnaires. OHRQOL should be the basis for any oral health programme development. Moreover, research at the conceptual level is needed in countries where OHRQOL has not been previously assessed, including India.

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Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms' formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms.

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Restoration is one of the most important things in the field of dentistry, in restoration, there are two main things that must be considered, that was esthetic factors and functional factors. A tooth after endodontics treatment require more complex restoration than normal tooth, because lot of factors needed to be observed first, one of which is tissue residue, root canal anatomy, and even the economics condition of the patient. Post, cores, and crowns themselves have several contra indications in their use, therefore a dentist must be able to have other alternatives in the choice of restoration. Endocrown is an alternative that can be used by a dentist in performing postendodontics restoration.

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Smoking is a prevalent behaviour in the population. The aim of this review is to bring to light the effects of smoking on dental implants. These facts will assist dental professionals when implants are planned in tobacco users. A search of "PubMed" was made with the key words "dental implant," "nicotine," "smoking," "tobacco," and "osseointegration." Also, publications on tobacco control by the Government of India were considered. For review, only those articles published from 1988 onward in English language were selected. Smoking has its influence on general as well as oral health of an individual. Tobacco negatively affects the outcome of almost all therapeutic procedures performed in the oral cavity. The failure rate of implant osseointegration is considerably higher among smokers, and maintenance of oral hygiene around the implants and the risk of peri-implantitis are adversely affected by smoking. To increase implant survival in smokers, various protocols have been recommended. Although osseointegrated dental implants have become the state of the art for tooth replacement, they are not without limitations or complications. In this litigious era, it is extremely important that the practitioner clearly understands and is able and willing to convey the spectrum of possible complications and their frequency to the patients.

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In recent years, attention has been drawn toward assessing the effectiveness of oral health education programs. This is in line with demand for evidence based research and will help to inform policy makers on how to allocate resources. (1) Collect and collate all information on oral health education programs. (2) Assess the programs based on various coding criteria. (3) Assess effectiveness of oral health education programs on oral health status and knowledge, attitude and practice. A search of all published articles in Medline was done using the keywords "oral health education, dental health education, oral health promotion". The resulting titles and abstracts provided the basis for initial decisions and selection of articles. Out of the primary list of articles, a total number of 40 articles were selected as they fulfilled the following inclusion criteria: (1). Articles on oral health programs with an oral health education component (2). Articles published after the year 1990 (3). Articles published in English. The full text of the articles was then obtained from either the internet or libraries of dental research colleges and hospitals in and around Bangalore. A set of important variables were identified and grouped under five headings to make them amenable for coding. The coding variables were then described under various subheadings to allow us to compare the chosen articles. Oral health education is effective in improving the knowledge attitude and practice of oral health and in reducing plaque, bleeding on probing of the gingiva and caries increment. This study identifies a few important variables which contribute to the effectiveness of the programs. There is an indication in this review that the most successful oral health programs are labor intensive, involve significant others and has received funding and additional support. A balance between inputs and outputs and health care resources available will determine if the program can be recommended for general use.

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Cleft lip and cleft palate are the most common craniofacial anomalies that have an incidence of 0.28 to 3.74 per 1000 live births globally. Due to the great advancements in the field of medical science, these anomalies can today be corrected. However, it cannot be ignored that the parents of these patients may face psychological stress due to the cleft defects in the baby. Also, these conditions may cause financial difficulties to the parents and cause anxiety to the mother about the proper feeding of their infant. Feeding problems can range from excessive air intake to failure to thrive. As the management of such cases is lengthy and includes a multi-disciplinary team approach, it is the role of the Pediatrician/Pedodontist to educate the mother about the proper feeding techniques. In this article, we have reviewed and highlighted the various traditional and advanced devices and techniques which help in the successful management of these individuals.

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Modern dentistry has changed tremendously with implant therapy. For the successful implant therapy, making a proper treatment plan considering both surgical and prosthetic part in mind is the key of success. Often practitioners tend to create a treatment plan overlooking the basic principles of prosthetic part. This present review has discussed various prosthetic consideration of implant-supported prosthesis. A step-by-step detailed prosthetic option with their indications has been discussed to help all dental implant practitioners in making of an optimal treatment plan for each case.

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Background : Toothbrushes are rapidly contaminated with different microorganisms representing a possible cause of infection or reinfection especially in the periodontal patients under therapy. The purpose of this study was to evaluate the sanitization of toothbrushes previously contaminated by various oral microorganisms using a domestic microwave oven and commercial ultraviolet (UV) light toothbrush sanitizer. Materials and Methods : Thirty male dental graduates were randomly assigned to control or experimental groups and received standardized toothbrushes for home use. Each subject was instructed to use it with the standardized modified Bass technique for 1 week and submit it to the investigator after use. Collected toothbrushes were cultured and analyzed for the number of colony-forming units (CFUs). In the next phase, once again a new set of toothbrush was given to each subject and instructed to use it for one more week and follow the same instructions as given earlier. Subsequently, the used toothbrushes were again collected and were sanitized by microwave irradiation, UV radiation, or were not sanitized (control group). After the sanitization procedure, toothbrushes were again cultured for the number of CFUs. The collected data of the presanitized and postsanitized CFU count were log transformed to normalize their distributions prior to analysis. Furthermore, log CFU data were compared and analyzed by one-way ANOVA, Tukey's post hoc procedure, and paired t-test for the difference in the mean at P<0.05. Results : Result showed that after the sanitization procedure, there was a significant (P<0.001) reduction in microbial contamination in both microwave and UV group toothbrushes compared to control group toothbrushes whereas the microbial count in the microwave group was significantly less (P<0.001) compared to the UV group. Conclusions : The evidence presented in this study suggests that microwave irradiation is an effective disinfectant agent for bacteria and fungi on toothbrushes.

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Over the past two decades, the nickel–titanium (NiTi) rotary instruments have highly improved the quality of the cleaning and shaping of the root canals. The superelasticity and shape memory of these instruments reduce the possibility of the canal transportation along with saving the time for both the patients and the clinicians. Several commercial types of these instruments, produced by different manufacturers, have currently become available by modifying the characteristics of the wonder NiTi alloy and also the cross-sectional shapes, cutting edges, tapering and numbers and distances of the flutes of the instruments. Up to this date, five generations for NiTi rotary instruments have been described according to the time of introduction, properties, and method of application. The aim of this article is to review the evolution of these five generations of NiTi rotary instruments since their inception.

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Background Antibacterial treatments currently used for treatment cause several side effects, and bacterial resistance to the antibiotics is also increasing. Therefore, there is need to find better alternatives. Essential oils (EOs) have been used for treatment of various ailments since ancient times and have gained popularity over the years. Safety and efficacy of EOs have been proved by several clinical trials. This review gives an overview on the EOs, their uses, and adverse effects. Materials and Methods: A literature search was performed in the PubMed for clinical trial studies and review articles on EOs published up to February 2015. The search was performed during March 2015. The following keywords were used: “Lavender essential oil,” “cinnamon oil,” “clove oil,” “eucalyptus oil,” “peppermint oil,” “lemon EOs,” and “tea tree oil.” Results: Total 70 relevant articles were found in PubMed database. After screening of abstracts, 52 articles were selected to be included in the present review. Conclusion: On the basis of the available information, it can be concluded that EOs have the potential to be developed as preventive or therapeutic agents for various oral diseases, but further clinical trials are required to establish their safety and efficacy.

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Cancer cells, besides reproducing uncontrollably, lose cohesiveness and orderliness of normal tissue, invade and get detached from the primary tumor to travel and set up colonies elsewhere. Dislodging neoplastically altered cells from a tumor during biopsy or surgical intervention or during simple procedure like needle aspiration is a possibility because they lack cohesiveness, and they attain the capacity to migrate and colonize. Considering the fact that, every tumor cell, is bathed in interstitial fluid, which drains into the lymphatic system and has an individualized arterial blood supply and venous drainage like any other normal cell in our body, inserting a needle or a knife into a tumor, there is a jeopardy of dislodging a loose tumor cell into either the circulation or into the tissue fluid. Tumor cells are easier to dislodge due to lower cell-to-cell adhesion. This theory with the possibility of seeding of tumor cells is supported by several case studies that have shown that after diagnostic biopsy of a tumor, many patients developed cancer at multiple sites and showed the presence of circulating cancer cells in the blood stream on examination. In this review, we evaluate the risk of exposure to seeding of tumor cells by biopsy and aspiration cytology and provide some suggested practices to prevent tumor cell seeding.

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Objectives : Maintaining good oral hygiene is important to combat periodontal diseases. The use of tooth brush alone does not serve the purpose, especially in inaccessible areas like proximal embrasures, which demand the use of some adjuncts like proximal cleaning aids. Hence, the objective of this study was to compare the clinical efficacy of two antimicrobial mouth rinses (Cool mint Listerine and 0.2% Chlorhexidine gluconate) with dental floss in reducing interproximal gingivitis and dental plaque in an unsupervised condition. Materials and Methods : A randomized, controlled, single-blind (observer), parallel-group clinical trial in accordance with the ADA guidelines was conducted for a period of 6 months. Four index age groups (12, 15, 35-44, and 65-74 years) were divided into four groups, i.e., brushing, brushing and flossing, brushing and rinsing with Listerine, and brushing and rinsing with Chlorhexidine, so that each group comprised 40 subjects. Interproximal gingivitis and dental plaque were assessed using Modified Gingival Index, Turesky-Gilmore-Glickman modified Quigley-Hein Plaque Index and Gingival Bleeding Index. Analysis of variance (ANOVA) was used for multiple group comparisons, followed by Tukey's post hoc for group-wise comparisons. Results : Chlorhexidine and Listerine showed significant reduction in plaque and gingivitis level compared to others, the activity of Chlorhexidine being more significant. Conclusions : The level of interproximal gingivitis control efficacy provided by the Listerine and Chlorhexidine was "at least as good as" that provided by the dental floss. Hence, they can be recommended for the patients with gingivitis as an adjunctive to the usual home care routine.

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Interdental papilla construction, especially in the esthetic area, is one of the most challenging tasks. Interdental papilla loss might occur due to several reasons as a consequence of periodontal surgery or trauma. The purpose of this study is to report the reconstruction of lost interdental papilla using hyaluronic acid gel. Hyaluronic acid is a glycosaminoglycan molecule with anti-inflammatory, anti-edematous properties on periodontal tissues invaded by submicrobial flora. It enhances wound healing and accelerates periodontal repair and regeneration. In addition to the field of dentistry, it has been used in other fields such as orthopedics, ophthalmology, and dermatology. It shows growth factor interaction, regulates osmotic pressure, and enhances tissue lubrication, which helps in maintaining the structural and homeostatic integrity of tissues, hence resulting in beneficial effect on lost interdental papilla. This study was aimed to reconstruct the lost interdental papilla by injecting 0.2% hyaluronic acid via nonsurgical approach. It is a noninvasive approach which reduces patient's postoperative discomfort with marked variations in the volume of interdental papilla before and after the procedure. As sufficient information is not available regarding the effectiveness of hyaluronic acid in interdental papilla construction, this study was conducted.

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Context: Dental caries is a disease of multifactorial etiology. A variety of potential predictors have been examined for the association with caries increments in longitudinal and cross-sectional studies. Aims: The aim of this study was to assess the possible relationship among salivary cariogenic microflora, buffer capacity, secretion rate, and caries experience among 6-year-old school-going children in Davangere city, India. Settings and Design: A total of 196 6-year-old school children were selected by a two-stage random sampling method. Materials and Methods: Parents were interrogated regarding sociodemographic details. Clinical examination of children was conducted to assess dental caries experience, and stimulated saliva was collected to assess S. mutans levels, lactobacilli, salivary flow, and buffering capacity of saliva. Statistical Analysis: The difference in proportions was tested using Kruskal-Wallis analysis of variance (ANOVA) followed by the Mann-Whitney U-test for intragroup comparison, and the difference in mean was tested using ANOVA and independent sample t-test as necessary. Caries experience was correlated with salivary factors using Spearman's correlation coefficient. Results: Out of 196 children, 96 were boys and 100 were girls. Overall, 97 (49.49%) children were caries free (dmft, DMFT = 0) and 99 (50.51%) children presented with caries (dmft, DMFT>0). The mean dmft and dmfs score for the overall group was 3.20 and 5.43, respectively. The mean DMFT and DMFS score was 0.23 and 0.25, respectively. A highly significant correlation was seen between mean the caries score and salivary variables. Conclusions: High levels of salivary microbiological counts in correlation with the caries data stress the importance of these factors and urge the necessity of elective preventive programs in this region.

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Aims: Streptococcus mutans is the most common organism causing dental caries. Various chemotherapeutic agents are available that help in treating the bacteria, with each having their own merits and demerits. Recent research has shown that coconut oil has anti-inflammatory and antimicrobial action. Therefore, the present was conducted to determine the antibacterial efficacy of coconut oil and to compare it with chlorhexidine. Materials and Methods: A total of fifty female children aged 8–12 years were included in the study. Twenty five children were randomly distributed to each group, i.e., the study group (coconut oil) and the control group (chlorhexidine). The participants were asked to routinely perform oil swishing with coconut oil and chlorhexidine and rinse every day in the morning after brushing for 2–3 minutes. S. mutans in saliva and plaque were determined using a chairside method, i.e., the Dentocult SM Strip Mutans test. Patients were instructed to continue oil swishing for 30 days. S. mutans. counts in plaque and saliva on day 1, day 15, and day 30 were recorded and the results were compared using Wilcoxon matched pairs signed ranks test. Results: The results showed that there is a statistically significant decrease in S. mutans. count from coconut oil as well as chlorhexidine group from baseline to 30 days. The study also showed that in comparison of coconut oil and chlorhexidine there is no statistically significant change regarding the antibacterial efficacy. Conclusion: Coconut oil is as effective as chlorhexidine in the reduction of S. mutans.

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Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction, consisting of progressive bone destruction in the maxillofacial region of patients. ONJ can be caused by two pharmacological agents: Antiresorptive (including bisphosphonates (BPs) and receptor activator of nuclear factor kappa-B ligand inhibitors) and antiangiogenic. MRONJ pathophysiology is not completely elucidated. There are several suggested hypothesis that could explain its unique localization to the jaws: Inflammation or infection, microtrauma, altered bone remodeling or over suppression of bone resorption, angiogenesis inhibition, soft tissue BPs toxicity, peculiar biofilm of the oral cavity, terminal vascularization of the mandible, suppression of immunity, or Vitamin D deficiency. Dental screening and adequate treatment are fundamental to reduce the risk of osteonecrosis in patients under antiresorptive or antiangiogenic therapy, or before initiating the administration. The treatment of MRONJ is generally difficult and the optimal therapy strategy is still to be established. For this reason, prevention is even more important. It is suggested that a multidisciplinary team approach including a dentist, an oncologist, and a maxillofacial surgeon to evaluate and decide the best therapy for the patient. The choice between a conservative treatment and surgery is not easy, and it should be made on a case by case basis. However, the initial approach should be as conservative as possible. The most important goals of treatment for patients with established MRONJ are primarily the control of infection, bone necrosis progression, and pain. The aim of this paper is to represent the current knowledge about MRONJ, its preventive measures and management strategies.

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Oral cancers often occurs out of long standing potentially malignant lesions and conditions so called premalignant lesions and conditions. Oral precancer is a intermediate state with increased cancer rate which can be recognized and treated obviously with much better prognosis than a full blown malignancy. Oral cancer risk can be lowered or even prevented by simply understanding basic oral hygiene, different bacteria found in the mouth, and how diet influences oral cancers. Currently, research is being done on the relationship between diet and oral cancer. Oral cancer is a very serious disease that can be prevented. Practicing good oral hygiene is key to help keep the oral cavity clean. Limiting the use of tobacco and alcohol products is also important because these are the causes of most oral cancers. Lastly, eating a well balanced diet that has protective affects can reduce the risk of oral cancer. This includes a diet high in fruits, vegetables, and fish and low in high fat and cholesterol meats, rice, and refined grains.

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Dental trauma in sports is the major linking channel between sports and dentistry. Sports dentistry is the prevention of oral/facial athletic injuries and related oral diseases and manifestations. In children, sports activities were found to be responsible for 13% of overall oral trauma. It is emphasized that there is a great need for "Team Dentist" from high schools to professional teams. In this review, we discuss the relationship between sports and dentistry, and the importance of educating parents, teachers, and children in prevention of injuries related to the sports.

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Context: Survey. Aims: To evaluate dental awareness and periodontal health status in different socioeconomic groups in the population of Sundernagar, Himachal Pradesh, India. Settings and Design: Cross-sectional study. Malerials and Methods: This cross-sectional study was conducted in 300 patients with different socioeconomic status who visited Himachal Dental College, Sundernagar, and Dental OPD of the Civil Hospital, Sundernagar. Mouth mirror, CPI probe, and illuminated light source were used for examination. Periodontal health status was recorded using CPI index. Information about their lifestyle, education level, and socioeconomic status was recorded using a questionnaire and correlated with the periodontal status. Statistical Analysis Used: Chi-square test. Results: Majority of the subjects used toothbrush and toothpaste to clean their teeth once daily. Lower socioeconomic groups exhibited higher CPI scores characterized by bleeding gums and calculus deposition. The differences were statistically significant across various social strata (P < 0.01). Conclusions: The utilization of the questionnaire on dental awareness facilitates the inclusion of multiple aspects of patient information. The study revealed that oral hygiene awareness and periodontal condition were significantly associated with socioeconomic status. The socioeconomic status and oral hygiene practices were significantly associated with CPI (P < 0.01).

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Aim: To review hemophilia A with emphasis on its oral manifestations, investigations, and dental management. Materials and Methods: Search was conducted using internet-based search engines, scholarly bibliographic databases, PubMed, and Medline with key words such as "Hemophilia A," "factor VIII," "bleeding and clotting disorders," and "dental management." Results: Hemophilia comprises a group of hereditary disorders caused due to the deficiency of one or more clotting factors leading to prolonged clotting time and excessive bleeding tendencies. It is broadly divided into hemophilia A, B, and C, which occur due to deficiency of factor VIII, IX, and XI, respectively. Hemophilia A is an X-linked recessive hereditary disorder and is the most common of the three, accounting for 80-85% of the cases. Conclusion: Understanding this complex entity is very important for a dentist to provide appropriate dental treatment and avoid undesirable consequences.

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Aim: The aim of this study is to determine the etiology, frequency of mandibular fractures among different age and sex, to determine the frequency of anatomic distribution, and to report the different modalities of treatment provided to the patients reported at our institution from February 2008 to September 2009. Materials and Methods: All patients fulfilling the selection criteria and having mandible fracture were selected for the study. Patient information was collected by means of a medical data form specifically designed for the present study. The values were subjected to Z and Chi-square tests. Results: Out of 35 patients, thirty one were males (88.57%) and four were females (11.43%) with a male:female ratio of 8:1. We found a peak occurrence in young adults, aged 21-30 years (n = 15, 42.86%). In case of etiology of fracture, road traffic accidents (RTAs) was the most common (n = 25, 71.43%) and condyle was most frequently involved site (n = 19, 38.78%). In most (n = 16, 45.71%) of the patients, an open reduction and rigid internal fixation using bone plate and screws was done. Conclusion: In the present study, the prevalence of mandible fractures was more prevalent in male patients, especially during the 3 ^rd decade of life. The most common cause was road traffic accident and the more frequently affected region was condyle of the mandible. Open reduction and rigid internal fixation using miniplates and screws was the most commonly used treatment.

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Aim: Evaluation and co-relation of the caries susceptibility using Oratest, colorimetric Snyder's test and salivary Streptococcus mutans count amongst children in the age group of 6-8 years. Materials and Methods: A total of 120 healthy children were grouped into control and test groups according to their dmft/DMFT scores. Snyder's test, salivary S. mutans count and Oratest were performed for each individual. Results: The relationship of three caries activity tests with each other and with existing caries status was found out. Conclusion and Clinical Implications : The present study has shown that Oratest has a definite clinical relationship with caries status and microbiological relationship with S. mutans count of the individual.

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This article provides information on the origin of tobacco and its subsequent spread throughout the world. In the era of the migration of communities, tobacco use gradually gained access and subsequently migrated along with the migrants, establishing in different locations. Probably at that time people were unaware of the health hazards and were using tobacco in treating certain ailments. Much has been known and written about tobacco in the context of oral and general health hazards but little has been explored and is known to many about where from and how this plant, which is now used in various forms, and speading widely. In what form, where, and how it had been served in religious rituals and considered for treatment or remedy of certain ailments in those days could not certainly be known. In the 21 ^st century, people are considering hazardous tobacco as beneficial for their teeth, good for concentration of mind, and something which keeps them engaged. Even many professionals, though knowing the deleterious effects, are still using tobacco and gutkha in one or the other form. This article has been designed to revive the awareness for health hazards of tobacco and similar products. A pilot project questionnaire survey comprising this subject involving the educated mass has already been started and will be produced after analysis of data in part II of this paper.

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