INTRODUCTIONCancer of the oral cavity is regarded lethal with a fairly low mean 5-year survival rate. The current systematic review and meta-analysis is the first of its kind to examine, if the evidence from the Middle East and North African region indicates an association between oral cancer and tobacco; and evaluates the quality of the evidence that portrays this relationship.METHODSA search for articles was carried out in October 2017 and then cross-checked at the end of June 2018 using Medline, Web of Science, CINAHL, and Cochrane databases. Retrieved articles were later subjected to eligibility criteria. The search was not limited to any particular research design adopted by the investigators. However, dissertations, theses and opinion-based reviews generated from the search were excluded during the screening of titles and abstracts. Quality of included studies was determined objectively (Newcastle Ottawa Scale) and subjectively. Revman (Version 5.3) was used for conducting the meta-analysis.RESULTSSix studies satisfied the selection criteria of the current review. The New Castle Ottawa evaluation scale suggested that the three cross-sectional studies and the three case-control studies included in the current review were of relatively low to moderate quality. All included studies explored the association of only one form of smokeless tobacco, i.e. shammah. Three case-control studies revealed a pooled estimate odds ratio of 38.74 (95% CI: 19.50–76.96), indicating that the odds for the occurrence of oral cancer among shammah users were nearly 39 times higher compared to the non-users.CONCLUSIONSShammah is a potential risk factor for oral cancer; thus, it is necessary that public health practitioners design and implement effective strategies to prevent the abuse of shammah.

Objective: To determine the chronological eruption parameters of primary teeth in Indian children. Study Design: A longitudinal study consisting of 135 healthy children (74 boys and 61 girls) attending three child health centres in the city of Hyderabad, India were randomly selected and followed from the emergence of the first to the last tooth. Ages and order of tooth eruption were studied for both genders. Results: Boys showed tendency towards earlier eruption for all teeth except maxillary second molar and maxillary/mandibular first molars which erupted earlier in girls. Comparison between maxillary and mandibular showed a tendency to earlier mandibular eruption of central incisors, lateral incisors and second molars in both genders. Conclusions: Within the limitations of this study, a baseline data and chronological table for eruption of primary teeth among Indian children has been established. Indian children experienced delayed eruption of primary teeth when compared to their counterparts in other populations.

Background To review the evidence on the oral health-related quality of life (OHRQoL) of head and neck cancer survivors after they have been treated with prosthetic rehabilitation. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were utilized as the framework in designing, implementing and reporting the current review. Search of literature was done electronically using Medline, Embase, and Cochrane databases. Intervention component of the patient, intervention, comparison, outcome (PICO) for the current review was the prosthetic rehabilitation performed on the surgically treated head and neck cancer patients (participants); and outcome was the OHRQoL. Methodological index for non-randomized studies was the assessment tool utilized to report on the quality of the included studies. Results The initial search had identified 799 records and the final level of screening included eight articles. Six studies were experimental in design and two were cross-sectional. Cumulative sample of the head and neck cancer cases from the selected studies was 354, with 35.9 (14.9) and 72.4 (8.7) years as the highest and lowest mean age recorded from the included studies. More male cases (69.5%) were reported than female cases (30.5%) and squamous cell carcinoma was the most commonly diagnosed malignancy. Maxillary reconstruction and implant supported prosthesis were the choice of treatment for most of the cases. Different versions of oral health impact profile (OHIP) constructs were preferred by six studies. While, one study utilized University of Washington quality of life questionnaire and the other utilized European Organization for Research and Treatment of Cancer’s Quality of Life Questionnaire. Arguably, three studies had compared the OHRQoL scores of head and neck cancer patients with healthy counterparts through a follow-up period ranging from 1 to 2 years. Conclusions The included studies did not provide substantial evidence to demonstrate the improvement in OHRQoL of head and neck cancer patients after prosthetic rehabilitation. More prospective studies are needed with representative sample, robust methodology and a longer follow-up period. The current study provides a direction to the clinical decision-making process and the epidemiological research to enhance the patients and public health-related outcomes.

Dens evaginatus (DE) is a rare developmental anomaly characterized by presence of an extra cusp arising from occlusal or lingual surfaces. Isolated occurrence or concomitant presence of DE with other dental anomalies has been reported. DE commonly affects permanent teeth and is rarely seen in primary dentition. Treatment may be conservative or radical. This article presents two unusual cases of concomitant occurrence of a supernumerary tooth and DE affecting maxillary deciduous lateral incisor and conservative management of DE occurring concurrently with a possible Oehler’s type I invagination in maxillary permanent lateral incisor.

Background Tobacco consumption remains a public health issue and is one of the major causes of death in India. This study presents a validated conceptual model to assess the interaction between education, perceived application of tobacco control measures, type of tobacco and their effects on the intention to quit tobacco. Additionally, the direct and mediating roles of tobacco use -frequency, -duration, and -dependency on the intention to quit is also investigated. Methods An analytical cross-sectional study was carried out, and data from tobacco users of six randomly selected states in India was collected via face-to-face interviews. Structural equation modeling (SEM) was performed using R v 3.6.3 to test the model fit and to explore the association between tobacco control measures and the intention to quit tobacco. Results From 1962 tobacco users, 43.7% wanted to quit tobacco immediately. Tambakoo (57.7%) was the most common type of tobacco used and 68.9% said that minors could buy tobacco. Findings from SEM showed that that one standard deviation (SD) increase in the perceived application of tobacco control measures is directly associated with a 0.181 SD increase in the intention to quit tobacco (B = 0.181, P < 0.001), and this effect was partially mediated by frequency of tobacco consumption (B = 0.06, P < 0.05). Also, a better education level was associated with a higher intention to quit tobacco (B = 0.14, P < 0.001). Conclusions To conclude, the application of tobacco control measures and a better education level may positively affect the intention to quit tobacco. The frequency of tobacco use and the number of influencers play an essential role in deciding to quit. In future, longitudinal studies are recommended to further substantiate the evidence.