Introduction: Most of the initial focus in handling COVID-19 had been based on avoiding exposure by refraining from rendering most treatments other than those considered an emergency or urgent. Post-lockdown, with the resumption of most activities, there has been concern over the possibility of transmission scenarios if sufficient care is not taken. The control and prevention of the spread of infections when elimination of exposure is not possible is chiefly achieved through the judicious use of engineering controls and administrative controls in a clinical setting in addition to the standard protocols and transmission-based protocols. True safety lies in being one step ahead. There have been mentions of the possibility that COVID-19 could be opportunistic airborne in its spread, in addition to being spread via saliva, droplets, and contaminated surfaces or objects. Method: A literature search of PubMed, Google Scholar, Cochrane Library, and advisories released by such organizations as the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), Ministry of Health and Family Welfare (MOFHW), European Centre for Disease Prevention and Control (ECDC), Chinese Center for Disease Control and Prevention (China CDC), American Dental Association (ADA), Canadian Dental Association (CDA), French National Dentists Association, Dental Council of Belgium, National Health Service, England (NHS UK), National Health Service Scotland (NHS Scotland), and International Society for Infectious Diseases (ISID) was performed, with search parameters aimed at gathering information pertaining to infection control and cross infection control in dental settings as related to orthodontics. Result: There have been numerous articles and advisories published over the last 20 years, but the main focus has been on safe practices and to an extent on personal protective equipment, with relatively less emphasis on the need for respiratory protection by way of engineering controls and administrative controls. This review highlights the engineering and administrative controls that can be put into effect to make infection control and prevention much more effective. Conclusion: Any health care facility must be able to prevent, contain, and control infections with no risk of nosocomial infections. For this, an assumption has to be made that every individual in a health care setting is either at risk or a risk, depending on whether the person is infected or not. Meticulous attention to stringent policies of hygiene and infection control and prevention, coupled with suitable supporting engineering and administrative controls, is to be made a standard way of life in such facilities.

Background: Self-perceived orthodontic treatment need is strongly influenced by what is perceived to be the esthetic norm amongst a community, and reluctance toward treatment amongst adolescents with clinically ascertained malocclusion may often be due to readily remediable factors. Of particular interest is the prevalence of malocclusion amongst such communities as a probable indicator of the role of diet and genetics in establishing a predominant clinical phenotype that may also play a role in the construct of what is perceived as the esthetic norm amongst the community, thereby influencing the self-perceived need for treatment. Studies aimed at evaluating the association between self-perceived esthetics, and self-perceived treatment need have not been performed amongst a population with no prior exposure to orthodontic treatment Objectives: The purpose of this study was to evaluate the self-perceived orthodontic treatment need amongst the tribal adolescents belonging to regions with remote access to orthodontic treatment by way of a verbally assigned index and to also identify the reasons of reluctance toward treatment to better understand how to make orthodontic treatment readily accessible to such populations. Participants, Materials, and Methods: The agency areas of Paderu located at 18.0833°N 82.667°E and Parvathipuram located at 18°46'N 83°25'E are 2 revenue districts of Visakhapatnam and Vizianagaram, respectively, in the state of Andhra Pradesh, India, that are home to various tribal populations with remote access to orthodontic treatment. A total of 2,016 school-going tribal adolescents of the Paderu revenue division and 819 tribal adolescents of the Parvathipuram revenue division were examined to ascertain the prevalence of malocclusion. Necessary consent and permissions were obtained from the tribal authorities, the school authorities, parents, and the institutional ethical clearance committee. The screening was done utilizing natural daylight in compliance with infection prevention and control protocol. Clinical examination aimed at categorizing the observed occlusion into either ideal occlusion or one of the three classes of Angle’s class I, II, and III malocclusions. The Simplified Malocclusion Index For Layperson Evaluation (SMILE) was verbally assigned in the vernacular language while interacting with each child and the findings made note of for calculation of relevant scores related to their orthodontic awareness, self-esteem as related to self-perceived esthetics, and their self-perceived need for treatment. Reasons for reluctance to undergo treatment were noted down if expressed. An initial group of 31 adolescents categorized as presenting with clinical malocclusion were randomly picked up and assigned the SMILE index a second time to assess the reliability of the index by way of Cohen’s kappa statistic. Results: The initial test group of 31 individuals assigned the SMILE twice showed a Cohen’s kappa of 0.93 validating almost perfect intraoperator agreement. The SMILE index revealed that 80.95% of the adolescents of Paderu revenue division had orthodontic awareness and 79.51% had self-perceived esthetics but only 15.97% felt a need for orthodontic treatment. Pearson’s Chi squared statistical analysis indicated a gender bias related to the self-perceived need for orthodontic treatment ( X 2 [1, N = 1,371] = 19.71, P < .001). The Index assigned to the Parvathipuram division revealed that 77.04% had orthodontic awareness and 78.38 had self-perceived esthetics but only 6.95% felt the need for orthodontic treatment. Pearson’s Chi squared statistical analysis indicated a gender bias related to the self-perceived need for orthodontic treatment ( X 2 [1, N = 764] = 4.95, P = .02). Conclusion: The self-perceived need for orthodontic treatment is often based on the self-perceived esthetics of an individual or the self-esteem as influenced by the perceived esthetic norm of the community. Orthodontic treatment of adolescents with borderline malocclusion derangements requires careful ascertaining of the actual perceived need of the patient to enable the rendering of a justifiable orthodontic treatment with the complete trust of the young patient. This helps build community trust in regions where orthodontic treatment has not yet made in roads and may help ensure higher end of treatment satisfaction levels.

Introduction: Endogamous tribal cultures often have certain preserved clinical phenotypes that serve almost like a window to the past. Culturally sequestered populations often share certain habits and viewpoints including those related to preferences and aesthetics. The present study aims to throw light on the perception of aesthetics as based on the most prevalent form of malocclusion in a tribal population. Materials and Methods: Of the 819 adolescents screened in the age group of 13–19 years, 63% (516) were boys and 37% (303) were girls. The evaluated occlusion of the students was categorised into four groups as ideal occlusion and the three categories of Angle's malocclusion (Class I, II and III). A simple set of questions were posed to elicit awareness of orthodontic treatment and perceived treatment needs. All results were tabulated for further analysis. Results: Analysis of the tabulated findings revealed a percentage distribution as follows. About 7% had ideal occlusion and 93% (762) had malocclusion categorised as 72% with Angle's Class I, 26% with Angle's Class II and 2% with Angle's Class III. A Chi-square test of independence showed that there was no significant association between gender and the prevalence of malocclusion, 2 (2, n = 762) = 2.5, P = 0.28. Questions posed to elicit awareness of orthodontic treatment and perceived treatment needs revealed that while 77% of the individuals screened were aware of orthodontic treatment, only 7% of those questioned felt they had a perceived need for treatment. Conclusion: Aesthetic perception including a perceived need for orthodontic treatment in a population might be strongly influenced not only by the viewpoint of peers but also by what is considered to be normal to the majority.

Background An analysis of the factors influencing the decision-making process in accepting orthodontic treatment can be of profound importance in establishing trust and ensuring an overall positive outcome. This is all the more significant when dealing with a patient who has not had any prior interaction with an orthodontist. The Simplified Malocclusion Index for Layperson Evaluation (SMILE Index) allows an unbiased cross-evaluation between the perceived need for treatment and the factors of orthodontic awareness and self-perceived esthetics. Objectives Tribal adolescents belonging to 2 regions with no prior access to orthodontic treatment were chosen for the study. Most adolescents of this region were assumed to have orthodontic awareness by way of information from their schools and dental camps. During the orthodontic screening process, a verbally assigned questionnaire base index was used to elicit their willingness to undergo treatment and to understand influencing factors. Methods A total of 2,835 tribal adolescents between the ages of 13 and 19 years belonging to the Revenue divisions of Paderu (Visakhapatnam) and Parvathipuram (Vizianagaram) were screened in this study. Chosen candidates presented with normal growth and development, and had no nutritional deficiencies or metabolic disorders. Consent and permissions were obtained from the regional tribal authorities, institutional ethical clearance committee, the school authorities, and the parents or guardians of the adolescents. The orthodontic screening was performed under natural daylight with strict adherence to infection prevention protocol. Observed occlusions were categorized into either an ideal occlusion or Angle’s Class I, II, and III malocclusions. During the screening, the SMILE index was assigned in the vernacular Telugu. A percentage distribution analysis was made of the responses of those presenting with malocclusion. Results An analysis of the SMILE index results of the adolescents of Paderu Revenue division revealed higher SMILE index scores in categories III and V with a percentage distribution of 24.46% for males and 26.86% for females in SMILE Index Score Category III and 63.40% for the males and 52.13% for the females in Category V. Similarly, the results of Parvathipuram division had a higher score distribution in the categories of III and V with a percentage distribution of 16.07% for males and 15.84% for females in category III and 78.67% for males and 74.25% for females in category V. Conclusion Orthodontic treatment with proper counseling providing clarity of facts facilitates an easier decision-making process and enables both the patient and the orthodontist to understand one another and the treatment process better for a much more predictable overall treatment outcome.