Original Article

Year : 2023 | Volume : 11 | Issue : 2 | Page : 91-98

Knowledge and Attitude of ASHA Workers in prevention of Early Childhood Caries: A cross-sectional study

Ashwini Cheruthottathil1 Faizal C Peedikayil2 Adarsh Mohan3 Tony Varghese3 Meenu Sara Manuel3

1* Lecturer, Dept of Pediatric & Preventive Dentistry, Kannur Dental College, Kerala, India 2 Professor and Head, Dept of Pediatric & Preventive Dentistry, Kannur Dental College, Kerala, India 3 Intern, Dept of Pediatric & Preventive Dentistry, Kannur Dental College, Kerala, India.

Address for Correspondence:

Ashwini Cheruthottathil,

Lecturer, Dept of Pediatric & Preventive Dentistry, Kannur Dental College, Kerala, India.

Email-Id: ashwinic261995@gmail.com

Abstract

Introduction:

Accredited social health activists (ASHAs) are government instituted community health workers as part of the National Rural Health Mission. The purpose of this study was to assess the knowledge and attitude of ASHAs regarding Early Childhood caries.

Methods:

A cross sectional survey was carried out among 190 ASHA workers. A self-constructed, 15 items, close-ended questionnaire based on the dental knowledge and the attitude of dental health was translated into regional language using a standardized translation process. The Questionnaire was distributed at the monthly review meeting held at Primary Health centres and their response was taken. The data was analysed and compared on basis on their educational level. The data were analysed by SPSS Version 24.

Results:

The content validity index of the questionnaire was 0.75 and the face validity was 3.2. The internal consistency was assessed with a Cronbach’s alpha coefficient and was found to be 0.876. Test–retest reliability is 0.8. The correct responses on knowledge of participants is 55.76% and for the attitude towards child oral health is 74.76%. Study also showed ASHA workers have poor knowledge about first dental visit and oral hygiene maintenance in children (p < 0.05). No statistical difference in knowledge and attitude of ASHA based on their educational level was noticed

Conclusion:

The ASHA workers have only satisfactory knowledge about ECC but their attitude toward the Child Oral Health is good. Therefore training and motivation can help in educating them for preventive community programmes for ECC. Keywords : ECC, ASHA workers, Dental Caries

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest

How to Cite this article: Cheruthottathil, A., Faizal C Peedikayil, Adarsh Mohan, Tony Varghese, & Meenu Sara Manuel. (2023). Knowledge and Attitude of ASHA workers in prevention of Early Childhood caries: A cross-sectional study: Original Article. International Journal of Community Dentistry, 11(2), 91–98. https://doi.org/10.56501/intjcommunitydent.v11i2.907

Original Article

Year : 2023 | Volume : 11 | Issue : 2 | Page : 61-68

Comparative evaluation of anti-bacterial effect of Caesalpinia sappan aqueous extract and 0.12% Chlorhexidine against Streptococcus mutans – An in vitro study

Madhivathani S M 1 Umesh K 2 Sangeeta Chavan 3 Palanivel Pandian R 4 Prem Kumar P 5

1* Post Graduate student, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu, 2 Professor and Head, Department of Public Health Dentistry, RVS Dental College and Hospital, Coimbatore, Tamil Nadu, 3 Professor and Head, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu, 4 Reader, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu 5 Senior Lecturer, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu

Address for Correspondence:

Madhivathani S M,

Post Graduate student, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu.

Email-Id: madhikuzhali01@gmail.com

Abstract

Introduction :

To evaluate and compare the antimicrobial activity of various concentration of C. sappan wood aqueous extract (100mg/ml, 200mg/ml, 300mg/ml, 400mg/ml, 500mg/ml and 600mg/ml) and 0.12% chlorhexidine mouthwash using agar well diffusion method against St. mutans.

Materials and Methods :

A comparative experimental invitro study was conducted to evaluate and compare antimicrobial activity of various concentration of C. sappan aqueous extract and 0.12% Chlorhexidine. The study enclosed extract of 100mg/ml, 200mg/ml, 300mg/ml, 400mg/ml, 500mg/ml, 600mg/ml and 0.12% Chlorhexidine as control. The antimicrobial activity was assessed by agar well diffusion method, were 50µl of each concentration was poured in the prepared agar well and assessed for zone of inhibition.

Results :

The antimicrobial potential of test compounds was estimated by measuring the zone of inhibition and all the procedure are done in triplicates and values are assessed using One way ANOVA and Post Hoc analysis. All the concentration used showed zone of inhibition against St. mutans. At the concentration, 600mg/ml of aqueous C. sappan extract have a larger zone of inhibition (22.41±.32). In agar well diffusion method, at the minimal concentration of 600mg/ml and C. sappan aqueous extract was comparatively better than positive control group (0.12%cholorhexidine).

Conclusion :

C. sappan wood aqueous extract could be preferred for routine oral hygiene practice where it can provide maximal antimicrobial effect without side effects of routine aid.

Keywords: Pathimugam, Antibacterial activity, C. sappan wood, Caries prevention

Financial support and sponsorship

Nil

Conflicts of interest

How to Cite this article: Madhivathani S M, K, U., Chavan, S., R, P. P., & P, P. K. (2023). Comparative evaluation of anti-bacterial effect of Caesalpinia sappan aqueous extract and 0.12% Chlorhexidine against Streptococcus mutans – An in vitro study: Original Article. International Journal of Community Dentistry, 11(2), 61–68. https://doi.org/10.56501/intjcommunitydent.v11i2.867

Original Article

Year : 2023 | Volume : 11 | Issue : 1 | Page : 40-49

Clinical practice perception in relation with DEPTh model among dental practitioners in Madurai city -A cross-sectional study

Gayathri P1 Madhivathani S M 2 Umesh K 3 Sangeeta Chawan 4 Palanivel Pandian R 5 Prem Kumar P 6

1*, 2 Post Graduate student, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu, 3 Professor and Head, Department of Public Health Dentistry, RVS Dental College and Hospital, Coimbatore, Tamil Nadu, 4 Professor, and Head, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu, 5 Reader, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu, 6 Senior Lecturer, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu

Address for Correspondence:

Gayathri P,

Post Graduate student, Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu.

Email-Id: gayathrikps31@gmail.com

Abstract

Introduction :

Clinical epidemiology is a science of making predictions, which aims at promoting the quality of clinical and patient oriented health care, in order to make good decision in care of patients. The study aimed to assess the perception of clinical practice in relation with Diagnosis, Etiology, Prognosis, Therapy (DEPTh) Model among dental practitioners in Madurai City.

Materials and Methods :

The Questionnaire based cross sectional study was conducted among Dentist in Madurai city for a period of 1 month and the sample size was about 181. The self-structured questionnaire consisted of 13 closed ended questions which was formulated based on their perception towards practice either as Diagnostic, Etiology, Prognosis or Therapy (DEPTh) Model.

Results :

The present study was conducted among 183 dental practitioners practicing in Madurai city. The result of the study was based on the questionnaire, which revealed that 32.92% of dental practitioners prefer to give importance to diagnosis of disease, 27.15 % of dental practitioners prefer to give importance to the etiology of disease, 19.14 % of dental practitioners preferred to give importance to prognosis of disease and 31.44 % of dental practitioners preferred to give importance to therapy overall.

Conclusion :

The result of the present study highlights the importance of clinical practice decision making, as dental practitioners there a need to investigate the condition in holistic way and not merely the therapy and diagnostic aspect alone. This study attempted to attune their own practice for inculcating effective contribution to overall care and patient well-being

Key words : DEPTh model, clinical decision making, clinical epidemiology, dental practise perception

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest

How to Cite this Article: Gayathri P et al. Clinical Practise perception in relation with DEPTh model among dental practitioners in Madurai city -A cross-sectional study. Int J Comm Dent 2023; 11(1): 40-49.

Original Article

Year : 2023 | Volume : 11 | Issue : 1 | Page : 32-39

Assessment of waste disposal practices among residents in Mappedu, Thiruvallur district, Tamilnadu

Kavin Amuthan A.M 1 Sarika Balaganesh 2

1 Assistant Professor, Department of Orthopedics, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 602105 2 * Postgraduate student, Dept of public health dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600077

Address for Correspondence:

Sarika Balaganesh,

Post graduate student, Dept of public health dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Poonamallee, Chennai-600077, India.

Email-Id: drsarika1995@gmail.com

Abstract

Introduction :

Solid waste is the unneeded or useless which are not liquid or gas generated from human activities in residential, industrial or commercial areas. Various types of solid waste are Municipal waste, Industrial waste, Construction and demolition waste, Electronic waste, Hazardous waste. Outbreak of Dengue fever was most common among the residents of Thiruvallur in 2019. The investigation was started to identify the potential exposure and possible recommendation and education to the villagers on waste management. Hence the aim of the research was to investigate the rural resident’s practices in solid waste disposal and their health hazard implications to the community in Mappedu village.

Materials and methods :

Two methods such as the observation and questionnaire survey was employed in the current research. No waste collection system was present in the village based on observation method. Dumping of waste was most common among the villagers and burning of waste were also common as there was inadequate awareness among the people as burning waste produces harmful gases. Diseases which are very prone to lack of hygiene such as dengue, malaria, diarrhea, dysentery, cholera, typhoid and worm diseases were projected from the questionnaire. To minimize the risk of environment and human health appropriate hygiene practices and proper disposal of waste needs to be practiced.

Results :

Most of the rural residents disposed the waste at a common point and minimal waste were burnt. There was a significant difference between the frequency of hospital visits and the waste disposal method.

Conclusion :

The villagers must be educated on proper solid waste management as it leads to deteriorating health and be fatal.  

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest

Keywords: Solid wastes, Waste disposal facilities, Risk factors, Waste Management, Health knowledge

How to cite this article: Kavin Amuthan A.M, & BG, S. B. (2023). Assessment of waste disposal practices among residents in Mappedu, Thiruvallur district, Tamilnadu: Original Article. International Journal of Community Dentistry, 11(1), 32–39. https://doi.org/10.56501/intjcommunitydent.v11i1.823

Original Article

Year : 2023 | Volume : 11 | Issue : 1 | Page : 7-12

Prevalence of Dental trauma in Permanent anterior teeth among school children in Villupuram District

Vansy Merlin Y 1, Kalaivani V 2, Arungani NS 3

1 MPH Student, University of Aberdeen, United Kingdom 2* Post Graduate Student, Department of Public Health Dentistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai – 600077 3 Post Graduate Student, Indira Gandhi Institute of Dental Sciences, Pondicherry

Address for Correspondence:

Kalaivani V,

Postgraduate student, Dept of public health dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Poonamallee, Chennai-600077, India.

Email-Id: kalai11venki@gmail.com

Abstract

Introduction:

Traumatic tooth injuries range in severity from minor fractures of the enamel to whole tooth displacement (avulsion) brought on by a forceful blow to the tooth's supporting components. The aim of this study is to determine the prevalence of fracture in anterior teeth of children aged between 8 - 15 years, in different villages of Villupuram district.

Materials and Methods:

This cross-sectional epidemiological study has adopted  multi stage sampling design. Study was conducted in various schools in Villupuram district. A Type III clinical examination was carried out in just the correct quantity of natural light. Every participant who showed up on the exam day was included in the study. Patient’s Demographic details were collected followed by screening fractured teeth using Ellis Fracture classification and reason for fracture.

Result:

Nearly 15% of the population had fractures in anterior teeth. Boy children had more fractures in anterior teeth compared to girl children. Most of the children had Ellis Class II Fracture followed by Ellis Class I fracture

Conclusion:

Increased prevalence indicates the importance to formulate treatment plan and facilities in primary health centres to treat the injuries.

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest

How to cite: Vansy Merlin Y, Kalaivani V, Arungani NS. Prevalence of dental trauma in permanent anterior teeth among school children in Villupuram district. Int J Comm Dent 2023; 11(1): 7 - 12. DOI: https://doi.org/10.56501/intjcommunitydent.v11i1.753

Review Article

Year : 2023 | Volume : 11 | Issue : 1 | Page : 1-6

Dental Fluorosis – A Review

Logesh Sidhu 1, Sivashankari Boobalan 2

1 Post Graduate Student, Indira Gandhi Institute of Dental Sciences (IGIDS), Pondicherry – 607402,

2* Post Graduate Student, Department of Public Health Dentistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai – 600077

Address for Correspondence:

Sivashankari Boobalan,

Postgraduate student, Dept of public health dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Poonamallee, Chennai-600077, India.

Email-Id: shankari231998@gmail.com

Abstract

Dental fluorosis is a dental enamel development disturbance caused by repeated exposure to high fluoride concentrations during tooth development, resulting in enamel with a lower mineral content and more porosity. Dental fluorosis shows white opaque appearance of hypomineralized enamel subsurface, with pitting and subsequent loss of enamel surface leads to brown color. The lesions take place in these forms: hypoplasia of dental enamel, pitting, decalcified areas, mottling, brownin. Fluorides are always considered as double-edged sword. Fluorides are necessary for the healthy growth and development of the body, however excessive fluoride intake can be harmful and causes severe deformities by understanding the sources of fluoride, knowing to avoid over exposure, fluorosis can be prevented. They are also treated with bleaching, micro abrasion, resin infiltration, resin infiltration with bleaching, and microabrasion with bleaching.

SOURCE OF FUNDING:

Not applicable

CONFLICTS OF INTEREST:

The authors declare no conflicts of interest.

How to Cite this article : Sivashankari Boobalan, & Logesh Sidhu. (2023). Dental Fluorosis – A Review. International Journal of Community Dentistry, 11(1), 1–6. https://doi.org/10.56501/intjcommunitydent.v11i1.695

Review Article

Year : 2022 | Volume : 10 | Issue : 2 | Page : 103-108

Effect of lifestyle in oral health patterns

Satyaranjan Mishra1, Ayesh Das2

1Professor And Head, Department of Oral Medicine and Radiology, Institute of Dental Science, Bhubaneswar, Odisha, India 2* Post Graduate Student, Department of Public Health Dentistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai – 600077.

Address for Correspondence:

Ayesh Das,

Post graduate student, Dept of public health dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Poonamallee, Chennai-600077, India.

Email-Id: drayesh03@gmail.com

Abstract

Socialization is learned through social interactions with parents, peers, friends, and siblings as well as through school and mass media. It also has an impact on health, where evidence of some contemporary health issues, such as cancer, coronary heart disease, and drug addiction, has been found in developing nations and elsewhere, with oral health detrimental behaviors being more prevalent in subjects of lower socio-demographic status. As a result, an effort is made to research the literature and gain insight into how lifestyle choices affect oral health.

Keywords: Oral health, lifestyle, tobacco

SOURCE OF FUNDING:

Not applicable

CONFLICTS OF INTEREST:

The authors declare no conflicts of interest.

How to Cite this article: Satyaranjan Mishra, & Ayesh Das. (2022). Effect of lifestyle in oral health patterns : Review Article. International Journal of Community Dentistry, 10(2), 103–108. https://doi.org/10.56501/intjcommunitydent.v10i2.724

Original Article

Year : 2022 | Volume : 10 | Issue : 2 | Page : 91-102

Perception of Politics and Voting Behaviour among Healthcare Students in Chennai: A Cross – Sectional Study

Vinita Mary A 1* , Kesavan R 2 , Abirami Vetriselvan 3 , Silambarasan R V 3 Narmadha Devi P 3 , Magdline A 3

1* Professor and Head, Department of Public Health Dentistry, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India 2 Professor, Department of Public Health Dentistry, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India 3 Junior Resident, Department of Public Health Dentistry, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India

Address for Correspondence:

A. Vinita Mary, MDS, PhD,

Professor and Head, Department of Public Health Dentistry, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India

Email-Id: viniebe@gmail.com Contact Number - +919486135017

Abstract

Background :

For the progress of a nation, active participation of healthcare professionals in decision making is important.

Aim :

To evaluate the political awareness and voting behavior among the students belonging to various streams of healthcare profession.

Materials and Method :

This cross-sectional survey was conducted among 381 students aged between 17-28 years from various Healthcare Educational Institutes in Chennai by means of a self-administered questionnaire comprising 20 questions.

Results :

On analysis, the mean knowledge score was found to be 4.189±1.45. The participants from the lower socio-economic class had a higher mean knowledge score of 4.38±1.72. The psychology of participants towards political participation revealed a disparaging opinion regarding the veracity and transparency of Indian political system.

Conclusion :

The true spirit of patriotism had been dampened over years with the false political propaganda due to widespread political illiteracy. Active socio-political participation from healthcare professionals can aid in the progress of the nation.

Keywords : Healthcare Leadership, Human Experience, Healthcare professional, Political Awareness, Political Factors, Voting Behavior, Young adults.

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest

How to Cite this article :

A, V. M., R, K., Abirami Vetriselvan, Silambarasan R V, Narmadha Devi P, & Magdline A. (2022). Perception of Politics and Voting Behaviour among Healthcare Students in Chennai: A Cross – Sectional Study: Original Article. International Journal of Community Dentistry, 10(2), 91–102. https://doi.org/10.56501/intjcommunitydent.v10i2.715

Original Article

Year : 2022 | Volume : 10 | Issue : 2 | Page : 79-84

Prevalence of dental caries among primary school children in Poonamallee, Chennai

Shilpa A 1* , Mahalakshmi.K 2 1*Private Dental Practitioner, Teynampet, Chennai-600018

2 Post Graduate Student, Department of Public Health Dentistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai – 600077

Address for Correspondence:

Shilpa A,

Private Dental Practitioner, Teynampet, Chennai-600018

Email-Id: ajaishilpa@gmail.com

Abstract

Background: The two most prevalent oral diseases are dental caries and periodontal disease. Humans of all ages suffer from dental caries, but schoolchildren represent the highest priority risk group. The aim of the current study was to utilize the dft/DMFT (DMFT : Decayed missing filled teeth, dft : decayed filled teeth) index to assess the prevalence of dental caries among primary school-aged children in Poonamallee, Chennai.

Methodology:

Before the study, examiners underwent a series of clinical training to calibrate them. After gathering demographic data which included name, gender, age and socioeconomic class, a clinical examination for dental caries was conducted and the results were documented on a pro forma.

Results:

The study's findings suggest that caries prevalence was more in females than males and also primary dentition had higher prevalence of caries.

Conclusion:

The research shows that dental caries is still a major public health problem even in urbanized areas such as Poonamallee, Chennai. Keywords : primary dentition, dental caries, school children

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest

How to cite: Shilpa A & Mahalakshmi.K. Prevalence of dental caries among primary school children in Poonamallee, Chennai. Int J Comm Dent 2022; 10(2): 79- 84. DOI: https://doi.org/10.56501/intjcommunitydent.v10i2.636

Review Article

Year : 2022 | Volume : 10 | Issue : 1 | Page : 13-7

NON-NUTRITIVE SWEETENERS AND ITS HEALTH IMPLICATIONS -A REVIEW

Channesh Patel 1, SathyaKumaresan 2

1 Department of Conservative and Endodontics, College of Dental Sciences, Davangere-577004, 2 Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai-600077

Address for Correspondence:

Dr. Sathya Kumaresan,

Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai-600077

E-mail address-sathu.kumaresan@gmail.com

Abstract

Nonnutritive sweeteners (NNS) have been widely used in various therapeutic and dairy   products and have become an inseparable part of our routine life. They deliver far less calories and intense sweetness than their sugar-containing counterparts. The United States Food and Drug Administration recognizes Aspartame, saccharine, sucralose, neotame, acesulfame-K, and stevia safe for consumption by diabetics. They also aid in weight loss. However, there is inconclusive evidence to support most of their uses. In addition, the lack of interventional studies has proven inadequate to evaluate their efficacy in different populations like pregnant, breastfeeding women. Furthermore, the susceptible population comprising of diabetics, epileptic patients are more likely to sustain the deteriorating effects of NNS-containing products. The current review signifies the benefits and the potential risks of using them based on dietary guidelines.

Keywords:

Diabetes, metabolic disorder, non-nutritive sweeteners, obesity

CONFLICT OF INTERESTS:

All the authors declare that there was no conflict of interest in the present study.

SOURCE OF FUNDING:

Nil

How to cite this article: Channesh P &, Sathya K. Non-Nutritive Sweeteners and Its Health Implications -A Review.Int J Comm Dent 2022;10(1):13-17. DOI:https://doi.org/10.56501/intjcommunitydent.v10i1.601

Case Report

Year : 2021 | Volume : 9 | Issue : 2 | Page : 215 - 220

Comprehensive Management of an Autistic Patient with Mental Retardation under General Anesthesia

Allwin Antony, R. Ramesh

Department of Pedodontics and Preventive Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India

Address for correspondence:

Dr. R. Ramesh,

Tc 85/1984(2), Geetha Bhavan, Seeveli Nagar, Kaithamukku, Thiruvananthapuram ‐ 695 024, Kerala, India.

E‐mail: rameshkdc@gmail.com

Abstract

Background:

Autism is a developmental disorder characterized by severe deficits in social interaction and communication and one of the most heritable complex genetic disorders in psychiatry. Comprehensive management of these children requires multidisciplinary teamwork.

Case Report:

A 16‐year‐old male patient was brought to the Department of Pedodontics and preventive dentistry by his parents with complaints of pain and sensitivity of teeth and consequent difficulty in eating in the lower left back tooth region for 2 weeks. Since the patient was combative in nature comprehensive management was planned under general anesthesia. Complete rehabilitation including pulpectomy, restoration, fluoride varnish application, and parental counseling was done. After the procedure, the patient recovered well from the pain discomfort he was having and significant improvement in his oral hygiene was noted. After 4 weeks, follow visit revealed significant improvement in his behavior.

Keywords: Autistic disorder, dental care for children, dental care for people with disabilities, epilepsy, oral health, special‐care dentistry

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

How to cite this article:

Antony A, Ramesh R. Comprehensive management of an autistic patient with mental retardation under general anesthesia. Int J Community Dent 2021;9:215-20.