Sumita Kaswan

Bio: Sumita Kaswan is an academic researcher from Jodhpur National University. The author has contributed to research in topics: Population & Oral lichen planus. The author has an hindex of 9, co-authored 11 publications receiving 223 citations.

Prevalence of dental anomalies in Indian population.

Abstract: Objectives: Developmental anomalies of the dentition are not infrequently observed by the dental practitioner. The aim of the present study was to determine the prevalence of dental anomalies in the Indian population. Study design: A retrospective study of 4133 panoramic radiographs of patients, who attended the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 to December 2012 was done. The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The orthopantomographs (OPGs) and dental records were examined for any unusual finding such as congenitally missing teeth, impactions, ectopic eruption, supernumerary teeth, odontoma, dilacerations, taurodontism, dens in dente, germination and fusion, among others. Results: 1519 (36.7%) patients had at least one dental anomaly. The congenitally missing teeth 673 (16.3%) had the highest prevalence, followed by impacted teeth 641 (15.5%), supernumerary teeth 51 (1.2%) and microdontia 41 (1.0%). Other anomalies were found at lower prevalence ranging from transposition 7 (0.1%) to ectopic eruption 30 (0.7%). Conclusion: The most prevalent anomaly in the Indian population was congenitally missing teeth (16.3%), and the second frequent anomaly was impacted teeth (15.5%), whereas, macrodontia, odontoma and transposition were the least frequent anomalies, with a prevalence of 0.2%, 0.2% and 0.1% respectively. While the overall prevalence of these anomalies may be low, the early diagnosis is imperative for the patient management and treatment planning.

Prevalence of tongue lesions in the Indian population.

Abstract: Objective: Tongue lesions are a health concern for the dental practitioners and the patients as they constitute a significant proportion of oral mucosal lesions. The aim of the present study was to determine the prevalence of various tongue lesions in the Indian population. Material and methods: 4926 patients attending the Department of Oral Medicine and Radiology were examined for the presence of various tongue lesions during the period from October, 2010 to September, 2012. The age of the patients ranged from 12-80 years with a mean age of 36.51 years. Results: The prevalence of tongue lesions was 12.07%. The most common lesion diagnosed was coated tongue affecting 28.0% of the subjects, followed by geographic tongue (16.4%), fissured tongue (14.9%) and depapillated tongue (11.5%). Males were more frequently affected than females. The most common systemic condition observed in the patients with tongue lesions was anaemia (189), followed by hypertension (47) and diabetes mellitus (38). Conclusion: The high prevalence necessitates adequate awareness of the various tongue lesions in the general population. The dental clinicians should also be knowledgeable about the etiopathogenesis, clinical presentation, diagnosis, and treatment of these lesions.

Oral manifestations in chronic renal failure patients attending two hospitals in North Karnataka, India.

Abstract: Aim To determine the nature, incidence, and severity of oral manifestations that occur in chronic renal failure (CRF) in patients attending two hospitals in North Karnataka, in comparison with healthy, disease-free controls. Methods The study was carried out with 200 individuals (100 CRF patients and 100 controls). The case group was randomly selected from a population of CRF patients whose glomerular filtration rate (GFR) values were between 15-30 mL/min; the control group was selected in the same age group with normal GFR and was apparently disease free. The patients were asked about dry mouth, taste and halitosis, and mucosal pain, and were examined for oral changes such as tongue coating, pallor, ulceration and enamel hypoplasia. The results obtained from the study were then compared with various other similar studies. Results The most common oral findings in the CRF patients were dry mouth (91%), pallor (87%), altered taste (42%), and halitosis (34%). CRF patients showed significantly more oral changes than those in the control group. These changes could be attributed to metabolic disturbances due to renal failure. Conclusion In the patients studied, the impact of CRF on the oral cavity was evidenced by significant oral changes, which pointed to an inter-relationship between oral health and CRF. Further studies are required to relate the extent of such changes with disease progression.

Treatment modalities of oral lichen planus: an update

Abstract: Oral lichen planus is an immunologically based, chronic, inflammatory, mucocutaneous disorder of undetermined etiology. It is a relatively common disorder affecting stratified squamous epithelia. It is of special importance due to its malignant potential and can be a source of morbidity. The management of oral lichen planus should therefore address both the transformation rate as well as the patient symptoms. Care and management of such patients challenges even the most experienced clinician. There is currently no cure for OLP. Treatment is aimed primarily at reducing the length and severity of symptomatic outbreaks. The review critically analyses the various options in the literature and discusses the practical management from the Indian perspective.

Prevalence of taurodontism in the North Indian population.

Abstract: Objectives: Taurodontism affects primarily molars and premolars in both the deciduous and permanent dentition. The aim of the study was to assess the prevalence of taurodontism in the North Indian population. Study Design: 4143 patients were studied by analyzing the panoramic radiographs for the presence of taurodontism which is defined as the presence of an apically displaced pulp chamber and the tooth lacks the usual constriction at the cementoenamel junction. The age of the patients ranged from 13 to 38 years with a mean age of 21.8 years. Results: Taurodontism was found in 17 patients with a prevalence of 0.4% of which 0.21% were males and 0.19% females. Taurodonts were significantly more common in the maxilla (65.6%) than in the mandible (34.4%) (p 0.05). Conclusion: Taurodontism is relatively uncommon in the North Indian population. Further large scale studies need to be carried out to assess its prevalence in the general population. A family history of other anomalies should also be considered for affected patients. Key words:Taurodontism, prevalence, maxillary second molar.

Davidson's Principles and Practice of Medicine

Abstract: I first read Davidson 30 years ago: at that time it was already in its 5th edition. A brief comparison shows that it then contained about 440,000 words in 1,100 pages: the current edition has compressed 625,000 words into 800 pages. I think I bought it as a student because it was cheap: but also because it seemed to be comprehensive and straightforward, and I have used it as a basis for my medical knowledge ever since. So I miss some of the old pictures of the acute skin rashes such as scarlet fever: in fact infectious disease has been transferred to the back and genetic factors take the first chapters. But careful linguistic comparison will still uncover the old phrases which some of us know by heart-there are minor changes such as 'alarming reactions to intravenous iron are uncommon, but have occasionally been noted', which becomes 'alarming systemic anaphyllactic reactions can occur'. Sir Stanley Davidson made 'no attempt to describe every rare disease or syndrome, but devoted most of the space available to those disorders most commonly encountered in practice'. I have grown up with successive editions, and have gradually come to appreciate the problems of the authors in the compression of knowledge. Having got to know many of them personally as real people rather than as names I can still recommend the book. It is the essential starting point for the study of internal medicine and for many doctors will remain their base reference work. The present editors have kept up-to-date and been prepared to prune the dead wood. There are many competitors in the market, and the publishers must take care with layout and illustration, although Davidson is still the best value for money. I will continue to recommend it to my clinical students: they will need to read it and know it to pass final MB. Postgraduates will need to remember the facts, but also to be able to place them in a broader perspective. The older consultant will still happily read it, and to get to know the authors themselves is really to complete your medical education. Dr John Macleod and his team have successfully kept alive the primary objective 'to provide a rational and easily comprehensible basis for the practice of medicine'. The book is economical in price and compact in size, but still contains the essential truths for the practice of good medicine.

Oral lichen planus: An update on etiology, pathogenesis, clinical presentation, diagnosis and management

Abstract: The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP.

Oral manifestations of systemic disease

Abstract: Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition, and allow for early diagnosis and treatment Examination should include evaluation for mucosal changes, periodontal inflammation and bleeding, and general condition of the teeth Oral findings of anemia may include mucosal pallor, atrophic glossitis, and candidiasis Oral ulceration may be found in patients with lupus erythematosus, pemphigus vulgaris, or Crohn disease Additional oral manifestations of lupus erythematosus may include honeycomb plaques (silvery white, scarred plaques); raised keratotic plaques (verrucous lupus erythematosus); and nonspecific erythema, purpura, petechiae, and cheilitis Additional oral findings in patients with Crohn disease may include diffuse mucosal swelling, cobblestone mucosa, and localized mucogingivitis Diffuse melanin pigmentation may be an early manifestation of Addison disease Severe periodontal inflammation or bleeding should prompt investigation of conditions such as diabetes mellitus, human immunodeficiency virus infection, thrombocytopenia, and leukemia In patients with gastroesophageal reflux disease, bulimia, or anorexia, exposure of tooth enamel to acidic gastric contents may cause irreversible dental erosion Severe erosion may require dental restorative treatment In patients with pemphigus vulgaris, thrombocytopenia, or Crohn disease, oral changes may be the first sign of disease