DISSERTATION – SYNOPSIS
DEPARTMENT OF PEDODONTICS
AND
PREVENTIVE CHILDREN DENTISTRY
A.B.SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES
DERALAKATTE,
MANGALORE.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
Bangalore, Karnataka
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1.
Name of the Candidate and
Address
(In block letters)
Dr. GURURAJ.G
POST GRADUATE STUDENT,
DEPARTMENT OF PEDODONTICS AND
PREVENTIVE CHILDREN DENTISTRY,
A.B.SHETTY MEMORIAL INSTITUTE OF
DENTAL SCIENCES
NITYANANDA NAGAR P.O.,
DERALAKATTE,
MANGALORE - 575018
2.
Name of the Institution
A.B.SHETTY MEMORIAL INSTITUTE OF
DENTAL SCIENCES
NITYANANDA NAGAR P.O.,
DERALAKATTE,
MANGALORE - 575018
3.
Course of study and subject
MASTER OF DENTAL SURGERY
PEDODONTICS AND PREVENTIVE CHILDREN
4.
5.
DENTISTRY
MAY 2008
Date of admission of course
Title Of The Topic: “TOTAL SALIVARY ANTI OXIDANT LEVELS, ORAL
HEALTH STATUS AND DENTAL DEVELOPMENT IN CHILDHOOD
OBESITY”
6.
Brief resume of the intended work :
6.1 Need for the study :
Obesity is chronic disease with global epidemic spread1, The
prevalence of overweight and obesity in children is rapidly increasing in many
countries around the world including India, the World health organization has
compared this marked change in body weight to a ‘Global epidemic disease’2.
India s economy growing at GDP of 8% and part of emerging markets in the world
along with china is said to become one of the global financial superpower by 2025,
so India is undergoing rapid nutrition, lifestyle transition, rapid urbanization and
mechanization which has led to reduction in energy expenditure along with an
increase in energy intake due to increased purchasing power and availability of high
fat, energy-dense fast foods3.
The overall prevalence of overweight/obesity in urban children in New Delhi
has shown an increase from 16% in 2002 to about 24% in 2006-20073.
Because of this changing diet, children may not be getting enough antioxidants
and phytonutrients to neutralize the high levels of free radicals produced from
eating foods grossly deficient in essential nutrients.
Over-production of free radicals in the body occurs when the availability of
antioxidants and phytonutrients are low—this triggers oxidative stress and low-grade
silent inflammation—which is the underlying cause of chronic diseases like diabetes,
high blood pressure, heart disease, loss of energy , premature aging and even
obesity4.
Even tooth decay and Gum disease in addition to food could be source for this
silent inflammation.
Recent studies have shown high level of dental caries and mild gingival
inflammation associated with obese children5.
Children who were overweight or obese had accelerated dental development,
even after adjusting for age and gender6.
Both obesity and caries have common determinants and require a
comprehensive, integrated management approach by multidisciplinary medical
teams, pediatric dentists should thus be involved in multi-disciplinary in patient
management of obese children. Healthcare professionals are trusted by both children
and parents and are thus in a position to discuss the weight and dental status of
adolescents and make credible recommendations for a well-balanced diet and for
physical activity7.
Obesity is related to several aspects of oral health. An association between overweight and oral health has been suggested in adults, whereas evidence supporting this
association in children is controversial5.
Hence the study is required to establish the correlation of total antioxidant levels oral
health status and dental development in obese children.
6.2 REVIEW OF LITERATURE
 On evaluation of implication of total anti oxidant capacity in apparently healthy
men and women shows inverse relationship between body fat, central adiposity
and antioxidant capacity irrespective of age and various other potential
confounders, namely smoking physical activity, dietary habits, blood pressure,
glucose levels, and lipid concentration8.
 On evaluation of dietary-induced obesity on lipid peroxidation, antioxidant
enzymes and total plasma antioxidants capacity in adult male wistar rats showed
plasma total antioxidants measuring the combined free radicals scavenging ability
of non enzymatic antioxidants was lower in high-calorie high-fat group and highcalorie normal fat group9.
 On evaluation of life style and body mass index, implication for oral health in a
group of Egyptian children shows the relationship between nutrition and caries is
complex and controversial, Non-significant association was found between
obesity and dental caries, thus it is not what children eat that causes dental caries
but rather how and when they eat it5.
 On exploring the association between overweight and dental caries among US
children found to be associated with lower geometric mean DMFT, although it
was hypothesized that age-specific body mass index would be associated with
increased dental caries prevalence and severity, these association were not
found10.
 On evaluation of caries experience in a severely obese adolescent population
showed there was significant association between BMI and DMFT indices
(p=0.01) in the severely obese group. The obese adolescents were more likely to
have caries than the non obese ones7.
 On evaluation of relation between childhood obesity and dental development
showed that children who were overweight and obese had accelerated dental
development ,even after adjusting for age and gender, which is an important
variable to consider in pediatric dental and orthodontic treatment planning where
timing is crucial6.
6.3 OBJECTIVES OF THE STUDY
 To determine the Total salivary antioxidants levels in childhood obesity.
 To assess the oral health status in childhood obesity.
 To determine the dental development in childhood obesity.
 Correlate the above parameters.
7.
MATERIALS AND METHODS :
7.1 STUDY DESIGNStudy group
30 subjects in over weight
30 subjects in obese category.
Control group
60 subjects in normal weight category.
A total of 120 subjects with an age group of 6-12yrs will be included in the study.
Body Mass Index (BMI) is a number calculated from a child’s weight and height...
For children and teens, BMI is age-and sex-specific and is often referred to as BMIfor-age.
INCLUSION CRITERIAIndividuals who fall in overweight and obesity category without any
systemic disease.
EXCLUSION CRITERIAa. Uncooperative children.
b. Parents of the child not willing for the child’s oral health checkup & saliva
collection.
7.2) Method of collection of data
Method of collection of saliva
The patient will be seated, head slightly down and will be asked not to swallow or
move his tongue or lips during the period of collection. The saliva will be
allowed to accumulate in the mouth for 2 minutes and he or she will be ask to spit
the accumulated saliva into the receiving vessel.14
2ml of unstimulated saliva will be collected and stored at a temperature of 4 o C in
plastic or glass vials
1 The collected saliva will be stored in glass or plastic vials, in the chiller at 4◦C
temperature and the evaluation will be done within 24hours.
The Salivary total antioxidant capacity will be measured by Phosphomolybdic
acid method.11
2 Oral hygiene status will be evaluated using Modified OHI-S index.12
3 Chronological age of the child, last erupted tooth is noted and correlated with
chronology of human dentition.13
7.3) Statistical Method For Analysis:
The results thus obtained will be subjected to student t test and logistic
regression analysis.
7.4) Does the study require any investigations or interventions to be
conducted on patients or other humans or animals?
Yes, the study requires collection of saliva which will be performed after
informed consent from the parents /guardian of children.
7.5) Does the study require any ethical clearance?
Yes, the study requires the ethical clearance and the document is to be enclosed
8. List of references
1 M.H Mathus-vligen, D.nikkel and H.S Brand Amsterdam, oral aspects of obesity.
International dental journal(2007)57,249-256.
2 Anita Alm,Christina Fahraeus, lill-kari Wendt,Goran Koch, Boel Andersson-Gare
& Dowen Birkhed. Body adiposity status in teenagers and snacking habit in early
childhood in relation to approximal caries at 15 years of age. International dental
journal(2008)18:189-196.
3 Swati Bhardwaj MSc1, Anoop Misra MD et al Childhood obesity in Asian
Indians: A burgeoning cause of insulin resistance, diabetes and sub-clinical
Inflammation.
4 New priscription for childhood obesity: Fight childhood obesity with Antioxidants
and phytonutrint by Billy C Johnson,MD,PhD; iUniverse
5 Life-style and body mass index, implication for oral health in a group of Egyptian
children.Cairo Dental Journal (23) Part (II), 183:192May, 2007.
6 kelly k hilger, matthew akridge, james p. scheetz, Denis F.Kinane childhood
obesity and dental development. pediatr dent 2006;28:18-22.
7
ISABELLE BAILLEUL-FORESTIER,KARINE LOPES et al caries experience
in a severly obese adolescent population; international journal of paediatric
dentistry 2007;17:358-363.
8
The implication of obesity on total antioxidant capacity in apparently healthy
men and women : The ATTICA study :Nutrition, Metabolism and Cardiovascular
Diseases , Volume 17 , Issue 8 , Pages 590 - 597 .
9
J.BElTOWSKI, G. WOJCICKA, D. GORNY, A. MARCINIAK: The effect of
dietary-induced obesity on lipid peroxidation, antioxidants enzymes and total
antioxidant capacity. Journal of physiology and pharmacology 2000 Dec; 51,
4:883-96.
10 Mark d macek, david j.mitola Exploring the association between overweight and
dental caries among US children. pediatr dent 2006;28:375-380.
11 Prieto, Pineda. Spectrophotometric quantification of antioxidant capacity by
formation of phosphomolybdenum complex. Analytical biochemistry Nov 1999:
337-341.
12 World Health Organization. Oral health survey: Basic method 4th ed. Geneva.
WHO ;1997.
13 Logan WHG and Kronfeld R :J Am Dent Assoc 20:379,1933, slightly modified
by Mccall and Schour.
14 FDI Working group 10, CORE; Saliva: its role in health and
disease.IDJ.1992;42,291-304
9.
Signature of the candidate
Remarks of the guide
10
11
Name and designation( in
block letters) of
11.1 Guide
PROF. (DR).Y. RAJMOHAN SHETTY
PROFESSOR
DEPARTMENT OF PEDODONTICS,
A.B.SHETTY MEMORIAL INSTITUTE OF DENTAL
SCIENCES.
11.2 Signature
11.3 Co-Guide
PROF.(DR) SUMANTH SHETTY BALLIPADY
PROFESSOR
DEPARTMENT OF PAEDIATRICS
JUSTICE K S HEGDE CHARITABLE HOSPITAL,
DERALAKATTE.
11.4 Signature
11.5 Head of the
department
PROF(DR) AMITHA M. HEGDE
PROFESSOR AND HEAD
DEPARTMENT OF PEDODONTICS,
A.B.SHETTY MEMORIAL INSTITUTE OF
DENTAL SCIENCES.
11.6 Signature
12
12.1 Remarks of the
chairman and principal
12.2 Signature
PROF(DR) B.RAJENDRA PRASAD