Qualification: 
Ph.D, MDS, MS, DNB
chandrashekarj@aims.amrita.edu

Dr. Chandrashekar Janakiram currently serves as Head of Department in the Department of Public Health Dentistry, School of Dentistry, Health Sciences Campus, Kochi.

Education

  • 2020: Diplomate
    American Board of Dental Public Health, USA, Board certified specialist in Dental Public Health
  • July - 2011: Doctor of Philosophy - Ph. D.
    Specialization: Epidemiology and Public Health, Amrita University, India.
  • 2017 - 2018: Residency in Dental Public Health
    National Institute of Dental Craniofacial Centre, National Institute of Health, USA 
  • 2018 - 2019: Fellowship in Oral Health Informatics
    National Library of Medicine, National Institute of Health USA.
  • 2012 - 2013: Master of Science - MSc
    Specialization: Bioethics.
    An inter-university mobility program jointly organized by KU Leuven (Belgium), Radboud University Nijmegen (The Netherlands) and University of Padova (Italy).
  • March 2007: Diplomate in National Broad Examinations - DNB
    Board certified specialist in Community Dentistry. Awarded Diplomate of National Board of Examinations (Ministry of Health, Govt. of India).
  • September 2001: Master of Dental Surgery - MDS
    Specialization: Community Dentistry (Dental Public Health)
    Rajiv Gandhi University of Health Sciences, India.
  • August 1996: Bachelor of Dental Surgery - BDS
    Clinical Dentistry, General dental practice
    Bangalore University, India, 

Professional Appointments

YEAR AFFILIATION
November 2004 - Present
June 2017 - January 2019 (Sabbatical)
Professor, Department of Public Health
July 2017 - July 2019 Health Informatics Fellow, National Institute of Dental and Craniofacial Centre and National Library of Medicine National Institute of Health USA
June 2014 - December 2015 Academic Consultant & Visiting Professor, Rajiv Gandhi Institute of Public Health and Centre for Disease Control, Rajiv Gandhi University of Health Sciences, Bangalore India
August 2003 - October 2004 Assistant Professor, K.L.E Institute of Dental Sciences Bangalore India
December 2001 - August 2003 Assistant Professor, Ragas Dental College and Hospital Chennai

Professional Enrichment - Short Courses

TITLE CONDUCTED BY PLACE DATE
Introduction to the Principles and Practice of Clinical Research National Institute of Health Bethesda USA September 27- March 8, 2018
Ethics of Clinical Research National Institute of Health Bioethics Centre Bethesda USA September 27- November 8, 2017
Introduction to Health Information Technology in Dentistry Indiana University USA Indianapolis August 30- December 8, 2017
Research Ethics Uppsala University, Sweden April 4- June 62016
Introduction to R programming FAES-NIH Bethesda USA September 14- October 26, 2017
Ethics in Public Health Practice Aziz Premji University Bangalore February 6 - 102017
Religion and Bioethics University of Padova Padova Italy June 3 - 5, 2013
Health Care Ethics committees University of Padova Padova Italy April 22 - 24, 2013
Ethics of Pediatric Research University of Padova Padova Italy May 13 - 15, 2013
Suffering Death and Palliative Care Radboud University Nijmegen Netherlands February 26 -March 1, 2013
Human Genomics and Medical Technology Radboud University Nijmegen Netherlands March 18 - 21, 2013
Ethics of Reproductive Technologies KU Leuven Leuven Belgium November 14 - 15, 2012
Research and Publishing in Bioethics K U Leuven Leuven Belgium October 10 - 12, 2012
GIS in Public Health National Institute of Epidemiology Chennai April - 2011
Clinical trial & Meta Analyses Christian Medical college Vellore India June 2010
Bioethics ICMR -NIH USA Shillong India June 2009
Bioethics ICMR- NIH USA Bangalore India November- December 2009
SAS programming Christian Medical college Vellore India June 2008
Qualitative Research Preconference Course Japan November 2007
Basic Ethical Issues in Research Sree Chitra Tirunal Institute of Medical sciences and Technology Trivandrum India August 2007
Case Control Designs Christian Medical college Vellore January 2007
Statistical Techniques in Clinical Trails Indian Society of Medical Statistics Coimbatore India November 2006
Logistic Regressions, Multiple regression & Survival Analysis Christian Medical College Vellore India June 2006
Biostatistics Amrita School of Medicine Cochin India June 2006
Intensive Course in Epidemiology Sree Chitra Tirunal Institute of Medical sciences and Technology Trivandrum India February 2006
Non-Communicable Disease Epidemiology & surveillance Sree Chitra Tirunal Institute of Medical sciences and Technology Trivandrum India February 2006
Health information system Sree Chitra Tirunal Institute of Medical sciences and Technology Trivandrum India February 2006
Economic basis for Health Care Intervention Christian Medical College Vellore India June 2005
Principles & Practice of Epidemiology Christian Medical College Vellore India June 2004
Research Methodology Rajiv Gandhi University of Health Sciences Bangalore India November 2004

Honors

  • National Institute of Health Post-doctoral Fellowship -2017- 2019
  • Scholarship from Uppsala University Sweden for Online Research Ethics course 2016
  • Erasmus Mundus Fellowship- 2012-13 by European Commission
  • Bursary Award - World conference on the Tobacco or Health 2012 in Singapore
  • Bursary Award - IEA World Congress of Epidemiology 7 – 11 August 2011 Edinburgh UK
  • Lois Cohen Travel award for Best Abstract for IADR conference in Toronto 2-5th July 2008
  • Travel Grant - Asia Pacific Consortium for Public Health Conference Japan 2007 November
  • Best Poster- Symposium in 35th Annual Research Meeting 2018, Academy Health Seattle for “Gender and Racial Disparities in Opioid Prescriptions for Dental Diagnosis among Medicaid Populations”
  • Best Scientific Presentation Award in 20th National Conference of Indian Association of Public Health Dentistry Manipal 2015
  • Best Paper award in 3rd National Conference of Forum Ethics Committee Review of India Lucknow India December 2015

Awards

  • Gold Medal - Rajiv Gandhi University of Health Sciences, India Postgraduate course -MDS 2001
  • Best Outgoing student award for Postgraduate course MDS course -2001
  • Best Outgoing student cash award for Undergraduate course {BDS} for the year 1996
  • Cash Award for the securing highest marks in Orthodontics in undergraduate course 1996

Professional Organization Memberships

Life Member International Epidemiological Association
International Union for Health Promotion and Education
Indian Society of Medical Statistics
Forum for Ethics Review Committees in India
Indian Society for Dental Research
Indian Association of Public Health Dentistry

Clinical Experience

  • House Officer, Babu Jagjivan Ram Dental College Hospital, India, 1997 to December 1998
  • Part time - General Dental Practice in Bangalore from 2001 to October 2004.
DESIGNATION PERIOD TOTAL YEARS
Lecturer January 1, 1998 to May 31, 1999 1 year 5 months
Assistant Professor October 8, 2001 to November 31, 2001  3 years 1months
December 1, 2001 to August 31, 2003
September 1, 2003 to October 31, 2004
Associate Professor November 1 2004 to March 31, 2008 4 years 7 months
Professor and Head April 1, 2009 till date 11 years

Research Service

YEAR RESEARCH SERVICE
2018 Quintessence International
2018 - 2019 International peer review, Research Square UK
2018 - 2019 Bulletin of World Health Organization
2018 - 2020 BMC Oral Health
2017 Abstract Reviewer - National Oral Health Conference, AAPHD
2014 - Present Manuscript Reviewer Journal Indian of Public Health Dentistry
2014- Present Indian Journal of Public Health
2012 World Medical and Health Policy
2015 Annals of Medicine
2016 Medical Principles and Practice
2015 Asian Bioethics Review
2012 - Present Cochrane oral health review

Other Appointments and Professional Consultantships

  • Chairperson, Institutional Ethics Committee, Institute of Public Health, Bangalore, India.
  • Member IEC, Dayananda Sagar College of Dental Sciences India
  • Executive Member, National Dental Bioethics Committee of India,UNESCO Bioethics Chair.
  • Bioethics Trainer, UNESCO Bioethics Chair India.
  • Research Methodologist, Cochrane Systematic Review (Oral Health Group).
  • Member, Expert of Committee of Dental Health, Govt of Kerala, Framing the oral health policy for Kerala state-2016-2017.
  • Resource Person, Oral Health Survey for Karnataka (India) 2014-2015.
  • Resource Person, Health Committee, Govt. of Andhra Pradesh, India-2019.

Professional Conferences

CONFERENCE NAME DATE PLACE
International Academy of Dental Research June 2019 Vancouver, Canada
Academy Health Conference June 2018 Seattle, USA
National Oral Health Conference (AAPHD) April 2018 Louisville, USA
American Medical Informatics Association November 2017 Washington DC, USA
3rd National Conference of FERCAP December 2016 Lucknow, India
21st Indian Association of Public Health Dentistry November 2016 Bhubaneshwar, India
3rd Evidence Public Health Policy March 2016 Bangalore, India
20th Indian Association of Public Health Dentistry November 2015 Manipal, India
19th Indian Association of Public Health Dentistry November 2014 Cochin, India
3rd National Bioethics Conference December 2014 Bangalore India
18th Indian Association of Public Health Dentistry November 2013 Lucknow, India
World Conference on Tobacco or Health March 2012 Singapore
World Conference on Epidemiology August 2011 Edinburgh, UK
17th Indian Association of Public Health Dentistry November 2011 Bangalore, India
International on Society for Fluoride Research December 2010 Jaipur, India
86th International Academy of Dental Research April 2009 Miami, USA
85th International Academy of Dental Research July 2008 Toronto, Canada
National Emerging Issues in Public Health India January 2008 Toronto, Canada
Asia Pacific Conference on Public Health November 2007 Tokyo, Japan

Grants Received

NAME OF THE FUNDER TITLE OF THE PROJECT AWARDED BUDGET WITH CURRENCIES ROLE IN THE PROJECT START DATE END DATE
Indian Council of Medical Research Effectiveness of Silver Diamine Fluoride applications for dental caries cessation in tribal Preschool children in India INR 39,00,000 Supervisor and Principal Guide November 2019 November 2022
National Institute of Health Opioid Prescriptions patterns in Medicaid Population USA 140,000 US Dollars Post-Doctoral fellowship July 17, 2017 June 30, 2019
Uppsala University Online Research Ethics 1900 Swedish currency Fellow April 1, 2016 August 31, 2018
Erasmus Mundus Fellowship Advanced Masters in Bioethics 24000 Euros Fellow August 1, 2012 August 31, 2013
ICMR Fogarty Fellow Long term training in Bioethics   Fellow April 2008 August 2008
GRANTS APPLIED
India Alliance DBT  Common risk factor approach for prevention of Periodontal Diseases (oral diseases) with Non-Communicable disease: An Integrated approach INR ₹3,71,69,000.00 PI Review
SPARC Scheme for Promotion of Academic and Research Collaboration Effectiveness of Prosthetic Rehabilitation on Temporomandibular disorders among the Indigenous population of Kerala INR 62,40,000 PI Review

Publications

Publication Type: Book

Year of Publication Title

2020

Chandrashekar Janakiram, Surgeon General Report . 2020.

2016

Chandrashekar Janakiram, R, V., and Joseph, J., Understanding Oral health Systems - A case study from India. 2016.

Publication Type: Journal Article

Year of Publication Title

2020

Chandrashekar Janakiram, Varghese, N., Dr. R. Venkitachalam, Joseph, J., and Vineetha Karuveettil, “Comparison of modified Bass, Fones and normal tooth brushing technique for the efficacy of plaque control in young adults- A randomized clinical trial.”, J Clin Exp Dent, vol. 12, no. 2, pp. e123-e129, 2020.[Abstract]


Background: To compare the anti plaque efficacy of Modified Bass, Fones and Normal brushing techniques in young adults.

Material and Methods: An investigator blinded randomized controlled trial with parallel design was adopted to compare the anti plaque efficacy of three tooth brushing techniques. The study population consisted of 120 dental students aged between 18 and 30 years.

Results: At the baseline, the mean plaque scores were 0.74 ± 0.39, 0.77 ± 0.34 and 0.98 ± 0.36 respectively, for Modified Bass, Fones and Normal brushing technique. After 24 hours without any oral hygiene activity, the plaque scores increased to 1.04 ± 0.30, 1.11 ± 0.32 and 1.21 ± 0.40, respectively. After 1 week of using the intervention, the mean plaque scores were 0.78 ± 0.36, 0.94 ± 0.34 and 1.03 ± 0.43, respectively and increased to 1.13 ± 0.44, 1.14 ± 0.40 and 1.08 ± 0.34 after 28 days. The mean gingival scores were 0.23 ± 0.66, 0.02 ± 0.52 and 0.42 ± 0.74 for Modified Bass, Fones and Normal Brushing technique during baseline visit and after 28 days.

Conclusions: There was a significant reduction in the amount of plaque with the three brushing techniques. Although the short-term outcomes with the Modified Bass method were promising, a long-term effect was not evident. Further, there was no significant difference in plaque control between the three groups. Gingival scores, plaque scores, tooth brushing techniques, young adults.

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2020

A. Rajeev, Patthi, B., Chandrashekar Janakiram, Singla, A., Malhi, R., and Kumari, M., “Influence of the previous dental visit experience in seeking dental care among young adults.”, J Family Med Prim Care, vol. 9, no. 2, pp. 609-613, 2020.[Abstract]


Introduction: Dental fear is one of the highly prevalent types of fear which deters patients from seeking dental cares.

Aim: This study aims to assess the influence of a previous dental visit experience for seeking dental care among adults.

Methodology: Young adults ( = 150, 15-26 years) with previous dental visit for care were selected randomly among outpatients' visit in tertiary dental teaching hospital. To assess the influence of previous experience of dental visit in seeking care, we self-administered a Post-traumatic Check List-Civilian Version [posttraumatic stress disorder (PTSD)], an Autobiographical Memory Questionnaire (AMQ), and a Dental Fear Survey (DFS). The relationship of negative and positive experience of previous dental treatment, dental fear, and symptoms of PTSD was assessed using Pearson's correlations. Spearman's rho was used to find out the correlation between the DFS and PCL-C and history of dental treatment undergone.

Results: The mean score of the DFS and PCL-C was found to be 69.57 and 40.17, respectively. The characteristics of the most negative experience including physical reactions ( = 0.936), emotional intensity ( = 0.935), sight ( = 0.941), smell ( = 0.917), and sound ( = 0.911) of dental treatment showed a significant relationship with dental fear, whereas the characteristics of the most positive memory of dental treatment showed only a few statistically significant associations with dental fear. Most of the symptoms of PTSD also show significant associations ( < 0.05) with characteristics of the most negative memory. Spearman's correlation between the DFS and the PCL-C was also statistically significant, r (150) =0.365, indicating that dental fear is indeed associated with symptoms of PTSD.

Conclusion: There is a significant association between the characteristics of the most negative experiences of dental treatment and increased dental fear in young adults, while positive experiences did not show the inverse relationship with dental fear.

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2020

M. Kumari, Patthi, B., Chandrashekar Janakiram, Singla, A., Malhi, R., and Rajeev, A., “Oral health-related quality of life in well-controlled diabetic patients of Modinagar city: A cross-sectional study”, Journal of Indian Association of Public Health Dentistry, vol. 18, p. 54, 2020.[Abstract]


Background: Diabetes mellitus is a chronic metabolic disease, which is characterized by elevated levels of glucose in the blood. According to the International Diabetes Federation, around 366 million people are currently estimated to have diabetes. Aim: The aim of the study was to find out the association of oral health-related quality of life (OHRQoL) with diabetes among controlled diabetic patients of Modinagar city. Materials and Methods: This cross-sectional study with a sample of 163 respondents was conducted in a private hospital in Modinagar city, to assess the OHRQoL in a well-controlled diabetic patient. OHRQoL was estimated by the oral health impact profile-20 questionnaire. In addition, general health questionnaire (GHQ) – a 12-item questionnaire was included in this study to distinguish the impact of diabetes on general health of the patient. The analysis was performed using Statistical Package for the Social Sciences 21.0 (SPSS Inc., Chicago, IL, USA). Logistic regression was used to determine the association between OHRQoL and diabetes. Correlation between OHQoRL and GHQ was analyzed using Spearman's rho. P < 0.05 was considered statistically significant. Results: The study results showed that 93 patients (57.4%) had good and 69 patients (42.5%) had low OHRQoL. The study also found out a statistically significant association of OHRQoL with diabetes in case of age of the participants (2.375 [1.094–2.528], P = 0.029**), educational level (0.511 [0.268–0.974], P = 0.041**), and frequency of toothbrushing (0.446 [0.208–0.957], P = 0.038**), whereas its association with smoking status (0.527 [0.235–1.182]), duration of disease (0.757 [0.343–1.671]), and mouth dryness (0.692 [0.316–1.513]) was statistically nonsignificant. There was a highly significant correlation between the OHRQoL and general health of the participants (Spearman's rho [r (162) =0.996], whereP < 0.05). Conclusion: There is a good correlation between OHRQoL and general health among controlled diabetic patients. The association between diabetes and OHRQoL is confined only to some of the variables. The study findings emphasize the importance of oral health in maintaining the overall health of diabetic patients.

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2020

Chandrashekar Janakiram, Dr. R. Venkitachalam, Fontelo, P., Iafolla, T. J., and Dye, B. A., “Effectiveness of herbal oral care products in reducing dental plaque & gingivitis - a systematic review and meta-analysis.”, BMC Complement Med Ther, vol. 20, no. 1, p. 43, 2020.[Abstract]


BACKGROUND: Despite the large number of trials conducted using herbal oral care products for the reduction of dental plaque or gingivitis, results are conflicting and inconclusive.

OBJECTIVE: To assess the effectiveness of herbal oral care products compared to conventional products in reducing dental plaque and gingivitis adults.

METHODS: We searched the following databases for Randomised controlled trials (RCTs): MEDLINE Ovid, EMBASE Ovid etc. which yielded 493 trails. Of which 24 RCTs comparing herbal toothpaste or mouth rinse with over the counter toothpaste or mouth rinse in adults aged 18 to 65 years were included. Two authors extracted information and assessed the methodological quality of the included studies using Risk of Bias. Meta-analyses using the random-effects model were conducted for four outcomes for tooth paste and mouth rinse respectively. Mean difference (MD) or standardized mean difference (SMD) were used to estimate the effect, with 95% confidence intervals.

RESULTS: A total of 1597 adults participated in 24 RCT studies. These were classified as herbal toothpaste (HTP) (15 trials, 899 participants) and herbal mouth rinse (HMR) (9 trials, 698 participants) compared with non-herbal toothpaste (NHTP) or non-herbal mouth rinse (NHMR). We found that HTP was superior over NHTP (SMD 1.95, 95% CI (0.97-2.93)) in plaque reduction. The long-term use of NHMR was superior in reduction of dental plaque over HMR (SMD -2.61, 95% (CI 4.42-0.80)). From subgroup analysis it showed that HTP was not superior over fluoride toothpaste (SMD 0.99, 95% CI (0.14-2.13)) in reducing dental plaque. However, HTP was favoured over non-fluoride toothpaste (SMD 4.64, 95% CI (2.23-7.05)).

CONCLUSION: For short-term reduction in dental plaque, current evidence suggests that HTP is as effective as compared to NHTP; however, evidence is from low quality studies.

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2020

Radhu Raj, Thankappan, K., Chandrashekar Janakiram, Iyer, S., and Anil Mathew, “Etiopathogenesis of Trismus in Patients With Head and Neck Cancer: An Exploratory Literature Review”, Craniomaxillofacial Trauma & Reconstruction, p. 1943387520917518, 2020.[Abstract]


Trismus refers to a person’s inability to normally open his or her mouth. Trismus can occur as a symptom due to tumor ingrowth or it can occur postsurgical following the treatment for head and neck cancer. Radiation-induced trismus is also a relatively common oral complication. This review aimed at reviewing the etiopathogenesis of trismus in patients with head and neck cancer. Of the 16 publications included after final screening, of which one was a nonrandomized control trial, one a randomized control trial, 6 prospective cohort studies, and 8 retrospective cohort studies. Among them, 6 articles addressed the possible mechanism for trismus related to tumor ingrowth, 8 articles suggested the likely reason for trismus in patients who had undergone radiation therapy and 2 articles addressed the postsurgical cause for trismus. This review highlights the possible involvement of infratemporal fossa as a predetermining factor for developing trismus related to tumor extension. The molecular mechanism of radiation-induced fibrosis is well studied in the literature.

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2020

Vineetha Karuveettil, S Kumar, V., Chandrashekar Janakiram, and Joseph, J., “Effectiveness of a curriculum-based educational intervention on oral health behavior and dental caries experience among Indian schoolchildren.”, J Educ Health Promot, vol. 9, p. 90, 2020.[Abstract]


BACKGROUND: The high incidence of dental diseases among Indian children can be attributed to low awareness regarding the oral health maintenance. The school health curriculum in India is deficient of an oral health component, and there are no organized oral health programs for schoolchildren existing at present. Therefore, the present study was conducted to assess the effectiveness of an oral health curriculum in improving the oral health behavior and dental caries experience in schoolchildren.

METHODS: A nonrandomized trial with pretest/posttest design was conducted among 600 schoolchildren. Two intervention arms were designed with one group receiving health education from a dental health professional and other from a school teacher. The oral health curriculum was customized for three sections of different age groups (lower primary [LP], upper primary [UP], high school [HS]) and implemented for a period of 1 year. Oral health behaviors were recorded using a Knowledge, Attitude and Practice (KAP) questionnaire and were evaluated at baseline, 6 months, and 1 year of the educational intervention. Dental caries experience was measured Pre and Post - intervention using deft and decayed, missing, and filled teeth indices. Descriptive statistics were calculated for continuous data, and the change in KAP scores and dental caries experience was analyzed using the repeated measures of ANOVA, independent -tests, and paired -tests.

RESULTS: There were significant improvements in KAP regarding oral health among Indian schoolchildren. Significant reductions in decayed primary teeth were observed in LP and UP schoolchildren post-intervention. However, there was no significant difference in primary outcome between the two intervention arms.

CONCLUSIONS: A curriculum-based health education intervention customized for different age groups was found to be effective in improving oral health behavior and dental caries experience among Indian schoolchildren.

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2020

V. Ramanarayanan, Chandrashekar Janakiram, Joseph, J., and Krishnakumar, K., “Oral health care system analysis: A case study from India.”, J Family Med Prim Care, vol. 9, no. 4, pp. 1950-1957, 2020.[Abstract]


Objectives: The health system of Kerala, India has won many accolades in having health indicators comparable to developed countries. But oral health has not received its due importance at the policy level. With the burden of oral diseases on the rise in the state, a critical introspection of the existing system is warranted. The objective of this review was to assess the oral health care system in Kerala to provide policy solutions.

Methods: This study adopted a mixed methodological approach that gathered information from the primary and secondary sources, which included health facility surveys, key informant interviews, review of published literature, and websites of governmental and non-governmental bodies. The WHO framework of health system building blocks was adapted for the assessment.

Results: A review of epidemiological studies conducted in Kerala suggests that the prevalence of oral diseases is high with the prevalence of dental caries at the age of 12 years ranging from 37-69%. The state has a dentist population ratio of 1:2200 which is well within the prescribed ratio by WHO (1:7500). Only 2% of dentists in Kerala work with government sector catering to 0.6 million of the approximately 33.4 million population. This point to the absence of oral care in first contact levels like primary health centers. Service delivery is chiefly through the private sector and payment for dental care is predominantly through out-of-pocket expenditure.

Conclusion: Despite having the best health indicators, the oral health system of Kerala is deficient in many aspects. Reorientation of oral health services is required to combat the burden of diseases.

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2019

S. SK, Chandrashekar Janakiram, Anil Mathew, Subash, P., and Nair, P., “Efficacy of Occlusal Splints in Managing Temporomandibular Disorders”, Indian Journal of Public Health Research and Development, vol. 10, no. 12, pp. 464-476, 2019.

2019

I. Sabu, SK, S., Anil Mathew, S, P., and Chandrashekar Janakiram, “Efficacy of Occlusal Splints Fabricated in Different Temporomandibular Positions for Treatment in Temporomandibular Disorder Patients”, Indian Journal of Public Health Research and Development , vol. 10, no. 12, pp. 470-476, 2019.

2019

Chandrashekar Janakiram, Chalmers, N. I., Fontelo, P., Huser, V., Mitnik, G. Lopez, Iafolla, T. J., Brow, A. R., and Dye, B. A., “Sex and race or ethnicity disparities in opioid prescriptions for dental diagnoses among patients receiving Medicaid.”, J Am Dent Assoc, vol. 150, no. 10, pp. e135-e144, 2019.[Abstract]


BACKGROUND: The objective of this study was to identify specific factors (sex, race or ethnicity, and health care provider type) associated with patient receipt of an opioid prescription after a dental diagnosis.

METHODS: The authors used Medicaid claims dated from January 1, 2013, through September 30, 2015, for 13 U.S. states in this study. The authors identified oral health-related conditions by using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes 520.0 through 529.9.

RESULTS: During the 2013 through 2015 study period, among the more than 1,008,400 Medicaid patients with a dental diagnosis, 19.8% filled an opioid prescription within 14 days of diagnosis. Female patients were 50% more likely to receive an opioid prescription for pain management of a dental condition than were men (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.49 to 1.52). Non-Hispanic whites and African Americans were approximately twice as likely to receive opioids than were Hispanics (OR, 2.12; 95% CI, 2.05 to 2.19; OR, 1.90; 95% CI, 1.84 to 1.96, respectively). Patients receiving oral health care in an emergency department were more than 7 times more likely to receive an opioid prescription than were patients treated in a dental office (OR, 7.28; 95% CI, 7.13 to 7.43). Patients with a dental condition diagnosed were more than 4 times as likely to receive an opioid from a nurse practitioner as from a dentist (OR, 4.31; 95% CI, 4.19 to 4.44). Opioid use was substantially higher among African American female patients (OR, 2.02; 95% CI, 1.93 to 2.10) and non-Hispanic white female patients (OR, 2.16; 95% CI, 2.07 to 2.24) than among Hispanic female patients.

CONCLUSIONS: Opioid prescribing patterns differ depending on patient race or ethnicity, sex, and health care provider source in patients with a dental diagnosis in the United States.

PRACTICAL IMPLICATIONS: Dentists are providing substantially fewer opioid prescriptions compared with their medical colleagues for pain treatment after a dental diagnosis in the Medicaid population. When considering pain management for dental and related conditions, dentists should continue with conservative prescribing practices as recommended.

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2019

Chandrashekar Janakiram, Taha, F., Joseph, J., and Dr. R. Venkitachalam, “Assessment of Common Risk Factors Between Oral Diseases and Non-communicable Diseases in a Hospital-based Population in Kerala, India-A Cross-sectional Study”, Journal of Clinical and Diagnostic Research, vol. 13, pp. 16-20, 2019.[Abstract]


Introduction: Non-Communicable Diseases (NCDs) have assumed epidemic proportions around the world. Oral diseases also pose tremendous physical and emotional burden on the people. Both these conditions (NCDs and oral diseases), are largely caused by a cluster of risk factors like tobacco, unhealthy diet, physical inactivity and harmful use of alcohol (to name a few!). Aim: The objective of the study was to assess the common risk factors between Non- Communicable diseases (cardiovascular diseases, pulmonary diseases, diabetes mellitus type 2 and stroke); and oral diseases. Materials and Methods: A cross-sectional study was conducted with a sample of 280 patients in four NCDs groups like cardiovascular diseases, pulmonary diseases, diabetes mellitus type 2 and stroke. The risk factors for each of NCDs disease were assessed by their medical records, interview of the Physician and patients. In the same patients, oral disease risk factors were assessed and enumerated by clinical examination and a validated clinical questionnaire. Descriptive statistics were used with the demographic data. Cohen’s Kappa was used to assess the degree of agreement for the risk factor to be common to both the NCDs and oral diseases. Results: History of smoking was the most common risk factor between dental caries and diabetes mellitus type 2 (agreement of 15%).Cardiac valve abnormalities were a common risk factor between dental caries and stroke with a 31% degree of agreement. Diabetes as a common risk factor between dental caries and MI had a degree of agreement of 44%.Asthma and oral diseases (dental caries and periodontal diseases) had obesity, history of smoking and positive family history as common risk factors. Conclusion: Smoking is the most common risk factor across the oral diseases and all the six NCDs included in the study followed by family history, obesity, hypercholesterolemia, high blood pressure, diabetes and excessive alcoholism. Thus, oral disease prevention programs can be integrated with the NCD prevention programs.

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2019

M. Anil, Chandrashekar Janakiram, Sanjeevan, V., Arun, K., Joseph, J., Raj, S., and Mohan, S., “Reaching the Unreached-A Retrospection of the Nine Year long Oral Rehabilitative Program in the Tribal Hamlets of Kerala”, Indian Journal of Public Health Research & Development, vol. 10, p. 81, 2019.

2019

Chandrashekar Janakiram, Fontelo, P., Huser, V., Chalmers, N. I., Mitnik, G. Lopez, Brow, A. R., Iafolla, T. J., and Dye, B. A., “Opioid Prescriptions for Acute and Chronic Pain Management Among Medicaid Beneficiaries”, American Journal of Preventive MedicineAmerican Journal of Preventive Medicine, vol. 57, no. 3, pp. 365 - 373, 2019.[Abstract]


IntroductionMillions of Americans are affected by acute or chronic pain every year. This study investigates opioid prescription patterns for acute and chronic pain management among U.S. Medicaid patients.IntroductionMillions of Americans are affected by acute or chronic pain every year. This study investigates opioid prescription patterns for acute and chronic pain management among U.S. Medicaid patients.

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2019

P. Basavaraj, Chandrashekar Janakiram, Rai, M., Singla, A., Malhi, R., and Rajeev, A., “Risk of Having Myocardial Infarction in Periodontal Disease Patients: A Systematic Review”, vol. 17, 2019.[Abstract]


Introduction: Periodontal disease is a common inflammatory disease of the teeth. There is mounting evidence that poor dental health, especially the occurrence of periodontal disease, increases the probability of the occurrence of cardiovascular disease (CVD) which, in turn, is the leading cause of mortality and morbidity throughout the world. Objectives: The study objective was to systematically review the literature and check the risk factors of myocardial infarction (MI) in periodontal disease patients. Materials and Methods: A literature published in PubMed/ Medline, PubMed Central, Scopus, Complementary index, Ebscohost, SciELO, Open DOAR, Science Citation Index, and Web of Science was evaluated. Cross‑sectional studies assessing the prevalence of periodontal disease among MI patients searched above were included. The methodological quality was assessed using a 10‑item ordinal scale for cross‑sectional studies. Two authors extracted the information and assessed the methodological quality of the included studies. The search was performed from 1990 till date for all the mentioned databases. There was no lower limit for the analyzed time frame and no language restrictions. The primary outcome measure was the proportion of MI in periodontal disease patients of each study. Results: Out of the total 46 titles appeared, 11 articles fulfilled the criteria and were selected for the review; most of the literature showed an association between MI and periodontal disease. There is a statistically significant increase in MI in periodontal disease patients. CVDs are associated with an increased incidence of periodontal disease, but the association is weak when adjusted with other potential cofounders. The lack of good‑quality studies is a major limitation to assess the association between MI and periodontal diseases. Conclusion: Periodontal disease is mostly associated with MI and CVD. The association between periodontal disease and CVD may be confounded by other cofactors such as age, diabetes mellitus, and smoking. However, the association remains weak, and the quality of study is low.

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2019

Chandrashekar Janakiram, Sanjeevan, V., and Joseph, J., “Intergenerational Transfer of Tobacco Use Behaviour from Parent to Child: A Case Control Study.”, Asian Pac J Cancer Prev, vol. 20, no. 10, pp. 3029-3035, 2019.[Abstract]


BACKGROUND: Parental influence may be a strong modifiable risk factor in the initiation of Tobacco habits among young adults. Parenting style may modify the risk of initiation of Tobacco use.

OBJECTIVE: To examine the intergenerational transfer of Tobacco habits amongst the urban and tribal populations in Kerala.

METHODOLOGY: A hospital based unmatched case control study was undertaken in urban and tribal health centres in Kerala, India. 239 cases (19-30 years of age using any form of Tobacco, 64.10% males) and 256 controls (35.90% males) were enrolled. Parental Tobacco exposure ascertainment was done by conducting in depth interviews using a validated structured questionnaire, parent bonding instrument and life grid technique. Multiple logistic regressions were performed.

RESULTS: The odds of a case initiating the habit of Tobacco use was nearly four times more when the parent was a Tobacco user [adjusted OR 4.26 (95% CI 2.39 - 7.58)] as opposed to controls. Among other covariates examined, low parental bonding with subject (especially father- warmth/care) was a strong risk factor for Tobacco usage [OR 2.17 (95% 1.11 - 4.23)]. The cases had nearly four times the probability of Tobacco uptake compared to controls if the mothers had no formal schooling [adjusted OR of 3.93 (95% CI, 2.12 - 7.26)].

CONCLUSION: Parental use of Tobacco influences the uptake of Tobacco habits in their children, with the father's parenting (low paternal warmth) being a strong risk factor.

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2019

H. Padamadan Joseph, Dr. R. Venkitachalam, Joseph, J., and Chandrashekar Janakiram, “Health Promoting Schools in Kerala, India.”, Indian J Community Med, vol. 44, no. Suppl 1, pp. S38-S41, 2019.[Abstract]


Introduction: Health promoting school (HPS) is a holistic concept where health and learning coexist. The objective of this study was to assess the health promoting standards of schools in Kerala.

Methodology: A cross-sectional study was designed in Kerala, India, with schools in Kerala as a study unit. A questionnaire which consisted of 37 items across eight domains of the HPS concept was developed and validated. The schools were then graded into compliant and not compliant categories based on scores obtained. Bivariate and multivariate analysis was also done.

Results: Of 120 schools, 90.8% were compliant toward health education domain and only 8.3% were compliant with nutrition services. Majority of schools showed compliance with the other six domains. Average overall scores were 153 (58.8%) with the equal number of schools in both compliant and not compliant categories. There was a significant association between health education and physical education domain with respect to the type of school, i.e., privately managed had six times more chances of being compliant toward health education domain compared to government schools (odds ratio [OR] 6.05; 95% confidence interval [CI] 1.10-33.29). Hence, also private schools had two times more chance of being compliant toward physical education compared to government schools (OR 2.52; 95% CI 1.0 - 4.32). Physical education domain showed a significant association with respect to geographic region, i.e., the schools in North Kerala were found to be three times more compliant compared to South Kerala (OR 3.48; 95% CI 1.05-11.53).

Conclusions: Despite the good health and social indicators in Kerala, there is a deficiency in schools promoting health of children. A coordinated effort by the government and the education system can convert existing schools into health promoting.

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2019

Dr. R. Venkitachalam, Chandrashekar Janakiram, Vinita, S., Joseph, J., Antony, B., Varghese, N., Vineetha Karuveettil, Joseph, H., and Yeturu, S., “Community Health Diagnosis in a Tribal Hamlet-A Case Study from India”, Indian Journal of Public Health Research & Development, vol. 10, p. 123, 2019.[Abstract]


Community Health Diagnosis in a Tribal Hamlet–A Case Study from IndiaVenkitachalam Ramanarayanan1, Chandrashekar Janakiram2, Vinita Sanjeevan3, Joe Joseph4, Bobby Antony5, Naveen Varghese6, Vineetha K6, Heljo Joseph6, Sravan Kumar Yeturu71Assistant Professor, 2Professor, 3Postgraduate Student, 4Professor and Head of Department, Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS, Kochi, 5Senior Lecturer, Department of Public Health Dentistry, Royal Dental College, Chalissery PO, Palakkad; 6Postgraduate Student, 7Assistant Professor, Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS, Kochi, Kerala, IndiaABSTRACTThis is an account of a Community Health Diagnosis program conducted in a tribal hamlet in Kerala, More »»

2019

V. Sanjeevan, Chandrashekar Janakiram, and Joseph, J., “Effectiveness of School-based Dental Screening in Increasing Dental Care Utilization: A Systematic Review and Meta-Analysis”, Indian J Dent Res, vol. 30, no. 1, pp. 117-124, 2019.[Abstract]


Background: School based dental screening has been a popular public health intervention. However, literature provides contrasting evidence regarding effectiveness of such programs on the utilization of dental services.

Objectives: We designed this review to understand the differences in dental attendance rates of children below 15 years of age, receiving a school based dental screening versus those not receiving it.

Material and Methods: The standard methodological procedures prescribed by The Cochrane Collaboration for Systematic review and meta-analysis was employed. An electronic (MEDLINE via PUBMED, Cochrane trial registry, and Google scholar) and a manual search (2016) were made to identify studies.

Results: Five studies met the inclusion criteria, covering a population of 28208 school children of which 21447 were included in the meta-analysis. The review concludes that school based dental screening marginally increases the dental attendance by 16 percent as opposed to a non-screening group (RR 1.16 (95% CI 1.11, 1.21). The quality of evidence was found to be low.

Conclusions: There is evidence of marginally increased dental attendance rate of 16 % following screening. As the quality of evidence was found to be low, the results of this review may be used with caution.

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2018

V. Naveen Jacob, Dr. R. Venkitachalam, Chandrashekar Janakiram, and Joe, J., “Assessment of Quality of Prescription Writing among Dental and Medical Students and Practitioners in Kerala.”, J Nat Sci Biol Med, vol. 9, no. 1, pp. 27-33, 2018.[Abstract]


Background: The medical prescription is a valid and legal document. Prescriptions can also be used as a measure of the quality of medical education, observance of the laws and regulations, and sociocultural beliefs.

Aims: To assess the quality of prescription written by dental and medical students and practitioners.

Settings and Design: A cross-sectional study was conducted in three dental and two medical colleges in Kerala covering 345 participants (dental - 235 and medical - 110).

Materials and Methods: Simulation exercise was conducted for drafting a model prescription based on a given clinical condition. The variables were identified based on the model prescription format by the Medical Council of India and were classified into four domains. Points were assigned for each variable.

Statistical Analysis Used: Analysis was performed using descriptive statistics and Mann-Whitney U-test.

Results and Conclusion: The total scores were found to be higher among dental fraternity (10.93 ± 2.88) to medical (10.81 ± 2.55). The medical house surgeons and postgraduates fared better in the doctor identification domain. Among the dental professionals, there was a significant difference among the undergraduates (mean score = 1.91) and postgraduates (mean score = 1.60) in the doctor identification domain. However, among the medical professionals, in the patient identification domain, house surgeons had a significantly higher score compared to postgraduates. There were no significant differences in quality of prescription writing among medical and dental professionals.

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2018

V. Kumar, Vineetha Karuveettil, Joseph, J., Yeturu, S., Rakesh, P. S., and Chandrashekar Janakiram, “Association of Dental Caries and Oral Health Impact Profile in 12-Year-Old School Children: A Cross-Sectional Study”, JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, vol. 12, 2018.[Abstract]


Introduction: The healthcare today is undergoing a paradigm shift from biomedical to biopsychosocial approaches. This holds true for dentistry as well, as the ultimate goal of oral health does not mean the mere absence of disease, rather the patients mental and social well-being. Oral health status in children is traditionally assessed by oral examination. But with the emergence of psychosocial factors affecting oral health and vice-versa, it is necessary to assess the subjective component of oral health in order to get a complete picture. Oral health related quality of life questionnaire can be used as a tool for the assessment of the impact of oral health on various dimensions of subjective well-being. Aim: To determine the association between dental caries and oral health impact profile among 12-year-old school children in Ernakulam. Materials and Methods: A cross-sectional study was conducted in 2017 on a representative sample of 281 school children aged 12 years from Ernakulam district. The data regarding caries experience were collected through oral examination using DMFT and deft indices. Oral health related quality of life was evaluated using a self-administered Child Oral Health Impact Profile questionnaire (COHIP). Descriptive statistics were computed for continuous data, whereas for categorical data, the respective frequencies were taken. Pearson’s correlation was used to test the correlation between each domain of questionnaire and decay (D) component of DMFT. Results: The mean COHIP score obtained for this population was 101.58±15.66. The prevalence of dental caries in this population was found to be 71.5%. The mean DMFT and deft scores did not have any significant correlation with the domains of the COHIP questionnaire. The association between the domain school environment and decay component (D) of DMFT was found to be significant (p-value – 0.024). Conclusion: The results are conclusive that dental caries has a negative impact on the oral health related quality of life, thereby leading to loss of school hours and adversely affecting the student’s academic performance. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved.

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2018

Chandrashekar Janakiram, Dr. R. Venkitachalam, J, J., S, V., and JV, N., “Comparison of antiplaque efficacy of toothpaste and toothpowder in young adults: A randomized controlled single blinded equivalence trial”, Journal of International Academy of Periodontology , vol. 20, 4 vol., pp. 116-122, 2018.

2018

Chandrashekar Janakiram, Antony, B., Joseph, J., and Dr. R. Venkitachalam, “Prevalence of Dental Caries in India among the WHO Index Age Groups: A Meta-Analysis”, JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, vol. 12, 2018.[Abstract]


Introduction: Dental caries is widely prevalent globally but the distribution and severity of dental caries varies across countries and regions. In the absence of surveillance or real time monitoring of dental caries in India, there exist a need to assess the prevalence in the country for planning and implementation of oral health programs. Aim: To assess the combined prevalence and mean DMFT of dental caries in India among the WHO index age groups (5, 12, 15, 35-44 and 65-74 years). Materials and Methods: Epidemiological/point prevalence studies conducted (among index age groups) in various parts of India from January 2000 to April 2016 were retrieved from Pubmed central database using ‘Dental caries’ AND ‘India’ as MeSH terms and information from the only National Oral Health Survey and Fluoride Mapping (2002-2003) in India were used. The combined mean deft/DMFT and pooled prevalence of the dental caries was assessed region wise for each age group. Results: The mean deft/DMFT was 2.36, 1.95, 3.31 and 7.01 among 5, 12, 15 and 65-74 years respectively. The SiC index shows steady increase from 3.36 to 8.11 across the groups. The mean prevalence of dental caries is almost similar at 5 years and 12 years at 49% while it shows steady increase from 15 years (60%) to 35-44 years (78%) and peaks at 65-74 year group (84%). In the Eastern and Western regions of India, the 15 year old had higher caries prevalence and mean DMFT compared to the 12-year-old. Across India, the 60-74-year-old had the highest DMFT of 7.01. In North and South India, 65-74-year-old had the highest caries prevalence of 84% and 85% respectively. Conclusion: Irrespective of age groups, the prevalence of dental caries was found to be high and varied across India. This data could help health policy makers to tailor region specific oral health interventions. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved.

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2018

Chandrashekar Janakiram, Taha, F., and Joe, J., “The Efficacy of Plaque Control by Various Toothbrushing Techniques-A Systematic Review and Meta-Analysis”, Journal of Clinical and Diagnostic Research, vol. 12, 2018.[Abstract]


Introduction: Efficient removal of dental plaque plays a key role in the maintenance of oral health. Dental Plaque is responsible for the occurrence of dental caries and periodontal diseases. Aim: To compare the various toothbrushing methods in effective removal of plaque. Materials and Methods: Systematic review with meta-analysis methodology developed by Cochrane Corporation was used in this review. Computerised searches Medline, the Cochrane Register of Controlled Trials and the Google Scholar for randomised controlled trials were searched up to May 2017 to identify appropriate studies. Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate. A meta-analysis was attempted on two trials. The test group was using ‘modified Bass technique’ and the control group was using ‘horizontal scrub technique’ in both the selected trials. Standard Mean Deviation (SMD) was calculated using random-effects models. Results: In total, 664 unique papers were found, of which seven met the eligibility criteria. The meta-analysis of two studies showed that the modified Bass technique provided significantly better plaque control (SMD=-1.22, p

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2018

Chandrashekar Janakiram, Antony, B., and Joseph, J., “Association of Undernutrition and Early Childhood Dental Caries.”, Indian Pediatr, vol. 55, no. 8, pp. 683-685, 2018.[Abstract]


OBJECTIVE: To determine the association between early childhood caries and nutritional status in preschool children.

METHODS: Cross-sectional study among preschool children (N=550, age 8-60 mo) were selected in tribal, rural and urban health care units of Kerala. An oral examination for early childhood caries status was done using Deft index. The anthropometric measurements were recorded. Multiple logistic regression with other covariates was used to determine the association between the early childhood caries and nutritional status.

RESULTS: The mean (SD) Deft scores were 0.93 (1.73), 2.22 (2.92) and 3.40 (3.23) for children with normal nutritional status, borderline undernutrition and undernutrition, respectively. Children with borderline undernutrition (adjusted OR 2.05, 95% CI 1.20, 3.49) or undernutrition (adjusted OR 3.46, 95% CI 1.93, 6.29) had higher odds of dental caries in comparison to those with normal nutritional status.

CONCLUSION: Undernutrition is associated with early childhood caries among preschool children.

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2018

V. Mehta, Shetiya, S. Hegde, Kakodkar, P., Chandrashekar Janakiram, and Rizwan, S. Abdulkader, “Efficacy of herbal dentifrice on the prevention of plaque and gingivitis as compared to conventional dentifrice: A systematic review and meta-analysis.”, J Indian Soc Periodontol, vol. 22, no. 5, pp. 379-389, 2018.[Abstract]


Objective: The aim of this study was to review literature on the effects of herbal dentifrice compared to conventional dentifrice on plaque and gingival inflammation.

Materials and Methods: MEDLINE, Cochrane Central Register of Controlled Trials, and major journals were explored for studies up to September 30, 2017. A comprehensive search was designed and the articles were independently screened for eligibility by two reviewers. Randomized controlled clinical trials, in which oral prophylaxis was undertaken before the intervention was introduced into the oral cavity using toothbrush were included. Where appropriate, a meta-analysis (MA) was performed and standardized mean differences (SMDs) were calculated.

Results: Ten articles out of 1378 titles were found to meet the eligibility criteria. A MA showed that for plaque intervention the SMD was 2.14; 95% confidence interval (CI): 0.88-3.41, = 0.0009; test for heterogeneity: < 0.00001, = 96% in favor of conventional dentifrice; and for gingival inflammation, the SMD was 1.37; 95% CI: 0.49-2.26, = 0.002; test for heterogeneity: < 0.00001, = 94% which also was in favor of conventional dentifrice. Subgroup analysis for plaque intervention and gingival inflammation in case of long-term (more than 4 weeks and up to 6 months) and short-term effects (minimum of 4 weeks) of herbal dentifrice showed no difference when compared to conventional dentifrice.

Conclusion: Currently, there is no high-quality evidence to support or abnegate the anti-plaque and anti-gingivitis effects of the herbal dentifrice.

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2018

Chandrashekar Janakiram, Sanjeevan, V., Br, R., Joseph, J., Stauf, N., and Benzian, H., “Political priority of oral health in India: analysis of the reasons for neglect.”, J Public Health Dent, vol. 78, no. 2, pp. 144-153, 2018.[Abstract]


<p><b>OBJECTIVES: </b>To examine the political priority of oral health in India and to understand the underlying reasons for the political support oral health receives.</p><p><b>METHODS: </b>The analysis is based on the political power framework developed by Shiffman and Smith and modified by Benzian et al. to examine the factors that contribute to the political priority of oral health in India. The framework comprises four main analysis categories, further subdivided into 11 dimensions. Based on the set of criteria, each dimension was analyzed and rated by assigning a score to assess to what extend the criteria were met.</p><p><b>RESULTS: </b>There is a good understanding on what defines an oral health problem, however, there is no consolidated and comprehensive approach to address oral diseases. Despite India's efforts to improve oral health-related research, its poor utilization in terms of public health and population-based approaches is apparent. The absence of a national surveillance system for oral health masks the severity and extent of the oral disease burden and limits the basis for advocacy on improving oral health to health decision makers. The fragmentation of actors and institutions and the absence of leaders uniting various actors in oral public health impede changes toward improving the oral health status of the population.</p><p><b>CONCLUSIONS: </b>Limited accessibility to oral health care, poor portrayals of the severity and extent of the burden, and inertia to address-related challenges are important factors contributing to the low political priority of oral health.</p>

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2017

S. SK, Anil Mathew, and Chandrashekar Janakiram, “Temporomandibular disorders in Edentulous”, Journal of Prosthetic and Implant Dentistry , vol. 1, no. 1, pp. 44-51, 2017.

2017

Anil Mathew, Chandrashekar Janakiram, Radhu Raj, and P., D., “Trismus: Aetiology and Management”, Journal of Prosthetic and Implant Dentistry , vol. 1, no. 1, pp. 52-58, 2017.

2017

Chandrashekar Janakiram, Joseph, J., and Antony, B., “Career Satisfaction Among Dental Public Health Specialists in India - A Cross-sectional Survey.”, J Clin Diagn Res, vol. 11, no. 1, pp. ZC97-ZC101, 2017.[Abstract]


INTRODUCTION: The satisfaction in career is an important indicator for the growth of the discipline and the profession. An empirical investigation of satisfaction in career and amendments needed in course and profession may help in growth of discipline.

AIM: To assess career satisfaction among Dental Public Health (DPH) specialists working in India and analyze their perspective on changes required in the profession.

MATERIALS AND METHODS: Questionnaire for this cross-sectional survey was adapted from Minnesota Job Satisfaction Survey which included 40 enquiries to understand the reasons for choosing public health dentistry as career, competencies of public health dentists, satisfaction as a public health dentist and changes required in the profession. The questions were both open and closed end type. Updated electronic mail details of all registered public health dentists were collected from the head office of Indian Association of Public Health Dentistry. Each participant was contacted by electronic mail and consent to participate were sought. Reminders were e-mailed thrice during three months. A total of 580 participants were contacted. A total of 183 responses were received, among which 179 consented.

RESULTS: Nearly half of the respondents felt they are yet to achieve the accomplishment from the present career as public health dentist. Only 46.9% felt that there is advancement in the profession as career. Nearly three-fourth of respondents could not attain recognition as a public health dentist. A 45.8% of respondents were of the opinion that career in public health dentistry would provide them a steady employment and 53.1% of public health dentists would envision as satisfied in their career in next 10 years. Nearly 85% felt public health dentistry training needs a major course correction.

CONCLUSION: There has been some reservation or skepticism about the future of the specialty as the jobs are in declining stage. This information provides insight about success and failures of public health dentistry as profession which would be needed for planning the dental manpower.

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2017

Chandrashekar Janakiram, Basapathy, R., Farheen, T., Dr. R. Venkitachalam, AKALGUD, H., and Kadanakuppe, S., “Equity in Oral Healthcare in India: A Review on Health System Analysis”, Economic and political weekly, vol. 52, p. 82, 2017.[Abstract]


Oral health is a critical but overlooked component of overall health and well-being. Although there have been impressive advances in both dental technology and in our scientific understanding of oral diseases, significant disparities in both the prevalence of dental disease and access to dental care among population subgroups remain. This paper attempts to elaborate on the nature of oral health equity in India by exploring the process and trajectories of oral health inequity.

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2017

D. C Kumar, Joseph, J., Chandrashekar Janakiram, and Gopinath, M., “Health-related quality of life and the perceived palliative care needs among oral cancer patients”, Journal of Indian Association of Public Health Dentistry, vol. 15, no. 4, pp. 327 - 333, 2017.[Abstract]


Introduction: Survival rate is the only outcome measure for cancer management which fails to recognize the impact of on health-related quality of life (HRQoL). Optimizing QoL before a timely, dignified, and peaceful death is the primary aim of good palliative care. Aim: The aim of this study is to assess the HRQoL of oral cancer patients and explore whether there is a need for professional palliative services to focus on social, psychological, and spiritual well-being. Materials and Methods: A mixed methodological approach was adopted. A validated closed-ended questionnaire was used to assess the HRQoL, and in-depth interviews were conducted to assess the palliative care needs. The study encompassed of 876 participants, among which 317 consented for administration of questionnaire and 12 participants consented for interview. Karl Pearson's coefficient test was used to find the association between the well-being score and demographic factors. Results: The general well-being of these patients was compromised. Elderly participants experienced bad (31%) general well-being. Semi-skilled (7%) and unskilled workers (5%) experienced bad general well-being while unemployed (13%) and retired (13%) experienced good general well-being in majority. Conclusions: HRQoLs are low in oral cancer patients, and early referral for palliative care might increase the QoL.

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2017

S. V., Chandrashekar Janakiram, Joseph, J., S.K., Y., and Dr. R. Venkitachalam, “Letter to the editor: ‘Long-term effectiveness of school-based children oral hygiene program on oral health after 10-year follow-up’ by Lai et al. (2016)”, Community Dentistry and Oral Epidemiology, vol. 45, pp. 189-190, 2017.[Abstract]


‘Long-term effectiveness of school-based children oral hygiene program on oral health after 10-year follow-up

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2017

Chandrashekar Janakiram, Kumar, C. V. Deepan, and Joseph, J., “Xylitol in preventing dental caries: A systematic review and meta-analyses”, Journal of Natural Science, Biology and Medicine, vol. 8, pp. 16-21, 2017.[Abstract]


Xylitol is a sugar alcohol having the properties that reduce levels of mutans streptococci (MS) in the plaque and saliva. To assess the role of xylitol in preventing dental caries. Systematic review and meta-analysis developed by Cochrane cooperation were adapted. Electronic search was carried out in PubMed through the period up to 2014. Included clinical studies were done on (1) humans (2) participants include both individuals and as pairs (mother-child) (3) participants using orthodontic appliances (4) xylitol dispensed in any form (5) compare the effect of xylitol on dental caries and on other phenotype that determines the preventive effect on dental caries, such as decayed, missing, and filled (DMF/dmf) and salivary or plaque MS level. Twenty articles of the 477 articles initially identified. Among 20 studies indexed, 16 articles were accessed, systematically reviewed, and the meta-analysis was carried out. The evaluation of quality of the studies was done using risk of bias assessment tool. The quality of the studies was high risk and unclear risk for six and five trials. The meta-analysis shows a reduction in DMF/dmf with the standard mean (SM) of -1.09 (95% confidence interval [95% CI], -1.34, -0.83) comparing xylitol to all controls. The effect of DMF/dmf reduction by xylitol to fluoride varnish was with the SM of -1.87 (95% CI, -2.89, -0.84). The subgroup analysis, there was a reduction in MS count with SM of 0.30 (95% CI, 0.05, 0.56) when compared with all other caries preventive strategies; however, it was insignificant. Xylitol was found to be an effective strategy as self-applied caries preventive agent. © 2017 Journal of Natural Science, Biology and Medicine.

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2016

Chandrashekar Janakiram, J., J., S., V., F., T., C.V., D. Kumar, Dr. R. Venkitachalam, B., A., V., S., and J., V. N., “Prevalence and Dependency of Tobacco Use in an Indigenous Population of Kerala, India”, Journal of Oral Hygiene & Health, vol. 4, pp. 1-4, 2016.[Abstract]


Background: Kerala has a large number of tribal communities where the prevalence of tobacco related oral mucosal lesions is alarmingly high. This coupled with ignorance regarding harmful effects of tobacco use is an emerging public health problem. Purpose: To find out dependency of tobacco use in an indigenous population of Wayanad, India.
Methods: A cross- sectional study was designed in the tribal colonies of Kalpetta, Kerala. A multi-stage cluster sampling design was adopted to select the indigenous people living in colonies. A structured close-ended interview was conducted using a 27-item questionnaire, modified and adapted from the National Institute for Mental Health and Neurosciences, India (NIMHANS). The questionnaire consisted of five domains. To assess the dependency of tobacco habit, Fagerstrom Nicotine Dependency Scale for both smoking and smokeless forms of tobacco were used.
Results: Of the 103 responses obtained, 41.7% were males. Participants were in the age group of 14-70 years with a mean age of 43 years. Almost half of the respondents cleaned their teeth twice daily. About 53% of people cleaned their teeth using fingers. Toothpowder and rice husks were the commonly used materials for cleaning teeth (64%) followed by toothpaste (35.9%). It was observed that the prevalence of tobacco use in this population was 73.8%. Majority of the respondents (92%) used smokeless forms of tobacco. The mean scores of nicotine dependency for smoked tobacco was 3.85 (± 2.7) and that for smokeless form was 4.61 (± 2.17). Both these scores denote moderate dependency of tobacco use. The average age of onset of tobacco use was 16.41 years for smoked and 17.53 years for smokeless forms.
Conclusions: The prevalence of tobacco consumption was found to be high among both males and females in the tribal population. Majority of them consumed different forms of smokeless tobacco

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2016

Chandrashekar Janakiram, Joseph, J., and Varaghese, N., “Healthier Choice Symbols in Cariogenic Foods”, Oral Health and Dentistry, vol. 1, pp. 4-7, 2016.[Abstract]


The main objective of the commentary is highlighting the importance of incorporating healthier choice symbols in cariogenic foods in India. By providing healthier choices or symbols to the food, consumers could be aware of the consequences of consuming such foods and they have the right to know about it. The Healthier Choice Symbols (HCS) on packaged food products indicates that there are healthier options, and this helps consumers to make informed food choices. Since dental caries are almost omnipresent among children and they are most vulnerable to Candy Culture, warnings, symbols, index should be provided in front of packs of cariogenic foods to prevent caries. Health claims and nutritional claims can also be provided on the cariogenic foods. Cariogenic food causes dental caries but no information is available to the consumer, and cannot make a choice, like in Gluten free foods, symbols warning are provided. Thus nutrition labelling provides point-of-sale information to help consumers make informed food choices. The warnings can be Cariogenic Potential of the foods and there should be cariogenicity testing of the products using a appropriate index to scale like those used in xylitilol based chewing gums using the Stephens Curve. This commentary discuss about need of the health choice symbols in the food which may cause the dental caries and an important public health measure for health promotion.

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2016

N. Varghese, Chandrashekar Janakiram, and Joseph, J., “Healthier choice symbol for cariogenic foods”, Dental Poster journal, vol. 1, no. 1, 2016.

2016

Dr. R. Venkitachalam, Mohamed, S., Chandrashekar Janakiram, and Joseph, J., “Redefining Public Health Dentistry in India: Bicycle model- The way forward”, Dental Poster journal , vol. 5, 5 vol., no. 2, 2016.

2016

M. Prasad, Patthi, B., Singla, A., Gupta, R., Chandrashekar Janakiram, Kumar, J. Krishna, Vashishtha, V., and Malhi, R., “The Clinical Effectiveness of Post-Brushing Rinsing in Reducing Plaque and Gingivitis: A Systematic Review.”, J Clin Diagn Res, vol. 10, no. 5, pp. ZE01-7, 2016.[Abstract]


INTRODUCTION: Dental plaque is the major etiological factor associated with the development of gingivitis. Hence, maintenance of oral hygiene is very essential.

AIM: To systematically review the literature on the effects of a post toothbrushing rinsing on plaque and parameters of gingival inflammation.

MATERIALS AND METHODS: A literature review was performed in PubMed Central and Cochrane library, embase, google scholar were searched up to February 2015 to identify appropriate studies. The primary outcome measure was plaque and gingival inflammation reduction.

RESULTS: Out of the total 56 titles appeared, 08articles fulfilled the criteria and were selected for the review. One article which was hand searched and one article which was through e-mail was included. A statistically significant reduction in overall plaque and gingivitis was noted when different mouth rinses were compared to the control (p<0.05). It was seen that chlorhexidine is the best antiplaque and antigingivitis agent but due to its side effects after continuous use, was not indicated for long term use. Probiotic was superior to chlorhexidine in terms of reduction of gingival inflammation.

CONCLUSION: There are relatively few studies evaluating the association between post toothbrushing rinsing and gingivitis. A clear effect was observed, indicating that different mouthrinses (chlorhexidine, probiotic, herbal, essential oil mouthrinse) when used as an adjunct to mechanical means of oral hygiene, provides an additional benefit with regard to plaque and gingivitis reduction as compared to a placebo or control.

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2016

R. Gupta, Malhi, R., Patthi, B., Singla, A., Chandrashekar Janakiram, Pandita, V., Kumar, J., and Prasad, M., “Tracking WHO MPOWER in South East Asian region: An opportunity to promote global tobacco control”, Journal of Indian Association of Public Health Dentistry, vol. 14, no. 2, pp. 218 - 223, 2016.[Abstract]


Introduction: Tobacco use is a major public health challenge worldwide and to counter the global tobacco epidemic, the World Health Organization (WHO) developed the WHO Framework Convention on Tobacco Control (WHO FCTC) to provide new legal dimensions for international health cooperation. Further WHO introduced the MPOWER package to monitor the tobacco control programs among the countries to accomplish the FCTC objective. Aim: The aim is to quantify the implementation of MPOWER tobacco control policies in South East Asia Region (SEAR) from the year 2008 to 2015. Materials and Methods: Information was collected from the WHO report on the Global Tobacco epidemic program SEAR from 2008 to 2015 using MPOWER. This assessment was based on the checklist which was designed previously by Iranian and International tobacco control specialists in their study on tobacco control. Results: Various countries of SEAR were ranked by scores and these scores were obtained from each indicator for each activity. Among SEAR region, Thailand got the highest scores and significant positive change was seen from a score of 8 in 2008 to 32 in 2015 where certain countries like Korea and Timore-Leste showed no significant positive change. Conclusion: Tobacco control policies have reduced the tobacco consumption, but still multisectoral efforts are needed toward effective enforcement of the law to bring about a significant decline in the prevalence of tobacco use.

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2016

Chandrashekar Janakiram, Vinita, S., and Joe, J., “Public healther: The true role of public health dentist”, Journal of Indian Association of Public Health Dentistry, vol. 14, no. 2, pp. 241 - 242, 2016.

2016

I. Valsan, Joseph, J., Chandrashekar Janakiram, and Mohamed, S., “Oral Health Status and Treatment Needs of Paniya Tribes in Kerala.”, J Clin Diagn Res, vol. 10, no. 10, pp. ZC12-ZC15, 2016.[Abstract]


INTRODUCTION: The tribal communities of Kerala have been largely left out of the gains of the Kerala model of development.

AIM: The study was aimed to obtain baseline data of oral health status and treatment needs of Paniyas, in Kerala, India.

MATERIALS AND METHODS: A descriptive population based survey of adult Paniya belonging to index age groups of 35-44 years and 65-74 years was conducted. The study population comprised of 420 subjects drawn from three talukas by stratified cluster sampling. Modified version of WHO Oral Health Assessment Form (1997) was used to assess the oral health status.

RESULTS: Caries prevalence was 40%. The mean DMFT in the 35-44 years age group was 1.52±1.95 and in 65-74 age group it was 18.47 ± 13.10. Oral mucosal lesions were seen in 4.52% and 76.9% had periodontal disease. Tooth brushing was reported by 55.5% of the subjects. Paan chewing, with tobacco or without tobacco, habit was reported by 89.3%. Bi-variate analyses between the CPI scores and age groups showed high statistical significance. The maximum mean treatment requirement was for extraction (1.37 ± 4.01) and was observed in 65-74 age groups.

CONCLUSION: The lack of basic oral health care access is important for high oral disease burden in these populations. Efforts are to be done for basic oral health care facility to these marginal populations.

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2016

S. Yeturu, Annapurani, R., Chandrashekar Janakiram, Joseph, J., and Pentapati, K., “Assessment of knowledge and attitudes of fire safety – An institution based study”, Journal of Pharmaceutical Sciences and Research, vol. 8, pp. 1281-1284, 2016.[Abstract]


Introduction: Fire safety is essential component and requirement in building infrastructure plans and provision of fire safety systems is mandatory even in dental care settings. Knowledge regarding the use of these systems in various instances is essential to all health care workers including dentists, dental students and auxiliaries. Aim: To assess the knowledge and attitudes of fire safety among undergraduate, postgraduate dental students and staff in Amrita School of Dentistry and to find any association between education level and knowledge regarding fire safety. Material and Methods: A cross sectional study was conducted by distributing a 20 itemed self-administered questionnaire which consisted of 4 dichotomous responses, 6 rating scale responses, 3 multiple responses and 7 open ended questions. Data was analyzed using SPSS version 16. Results: A total of 270 participated in the study. Nearly half of the participants have a positive attitude towards fire safety and very few participants knew the way to use fire control measures in case of fire accident. Conclusion: There was an appreciably good knowledge about fire safety among dentists and dental students with a positive attitude towards safe practice.

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2016

A. Ga Joseph, Chandrashekar Janakiram, and A., M., “Prosthetic status, needs and oral health related quality of life (OHRQOL) in the elderly population of Aluva, India”, Journal of Clinical and Diagnostic Research, vol. 10, pp. ZC05-ZC09, 2016.[Abstract]


Introduction: Oral Health Related Quality of Life (OHRQOL), being a patient-centred outcome has profound association with the existing prosthetic status and needs. Aim: To assess the association between the prosthetic status and needs with OHRQOL in the elderly population of Aluva, Kochi, Kerala, India. Materials and Methods: A cross-sectional study was conducted among the elderly residing in the municipal wards of Aluva municipality, Kochi, Kerala, India. A total of 539 subjects whose age was 60 years or above were considered for the study. Proforma utilizing a validated structured questionnaire of two sections; the first section noted with demographic details with WHO assessment of prosthetic needs and details regarding loss of teeth and denture wear and the second section consisted of Oral Health Impact Proflie (OHIP)-14 questions to measure the OHRQOL which was prepared in the local language. Type III oral examination (WHO Basic Oral Health Assessment 2013) was carried out on selected elderly subjects from house hold survey at municipal wards and recordings were done by the trained local health worker. ANOVA was used to find out the association between different domains of the OHIP and prosthetic status and need. Results: The prosthetic status was 18.2% and 14.7% and the prosthetic needs 62.7% and 60.3% of the upper and lower jaws respectively for the population. The prosthetic status was found to have no impact on the OHRQOL. However, the prosthetic need was significantly related to various components of OHRQOL of the study population. Of all the domains in OHRQOL, physical pain was the most affected in this population. Conclusion: There is high unmet prosthetic care for non-institutionalised elderly population in Aluva. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.

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2016

Ra Gupta, Malhi, Ra, Patthi, Ba, Singla, Aa, Chandrashekar Janakiram, Pandita, Va, Prasad, Ma, and Kumar, J. Ka, “Experience from classroom teaching to clinical practice regarding shortened dental arch (SDA) concept among dentists – a questionnaire study”, Journal of Clinical and Diagnostic Research, vol. 10, pp. ZC27-ZC32, 2016.[Abstract]


Introduction: Periodontal disease and dental caries are the common oral conditions which cause loss of teeth, mostly molars. This further leads to Shortening of Dental Arch and Shortened Dental Arch (SDA) concept provides the overall requirements of functional dentition at reduced cost without compromising the health. Aim: The aim of the present study was to assess the Knowledge, Attitude and Practices (KAP) towards SDA concept among dentists of Ghaziabad city (Uttar Pradesh, India). Materials and Methods: A cross-sectional study was conducted among 514 dentists working as academicians or clinicians or both. KAP questionnaire consisting of questions related to SDA concept was distributed to them. Data were analyzed using Statistical Package for Social Sciences (SPSS) 18.0 (SPSS Inc., Chicago, IL, USA) and descriptive and analytical tests, including mean, standard deviation, and Chi square test were used. Results: Of the 514 dentists, only 493 dentists responded to the questionnaire, generating the response rate of 95.5%. Only 113 (22.9%) had knowledge about this concept. Clinicians were found to have more knowledge regarding the SDA concept (p&lt;0.05). Also years of experience and level of knowledge among dentists regarding SDA was found to be statistically significant (p&lt;0.05). Conclusion: The study showed lack of knowledge regarding SDA concept among dentists and also only few dentists practice the SDA concept on their patients. If used judiciously the SDA concept can serve as a cost effective and functionally oriented approach in clinical management of patients. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.

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2016

Chandrashekar Janakiram and Porteri, Cb, “Ethical Process Reporting in Indian Dental Journals”, Accountability in Research, vol. 23, pp. 163-177, 2016.[Abstract]


Aim: To study the proportion of articles reporting ethical review board (ERB) approval and informed consent process (ICP) in articles published in dental journals in India. Methods: A descriptive study was designed, and ten Indian dental journals published by different dental specialty professional associations were selected. Among 702 retrieved articles, from 40 issues of the 10 selected journals published in 2008 and 2011, 428 meet the inclusion criteria, and they were analyzed. The entire text of the articles was manually searched for statements for ICP and ERB approval. The data was retrieved independently by two observers using an ad hoc developed template. Results: 10.3% (44) of authors stated ICP, while 9.8 % (42) reported ERB approval in their articles; 6.1% (26) articles reported both the ICP and ERB. There are 21 times more chances that authors who report the ERB will also report ICP in their articles when compared to authors who report either ICP or ERB only (OR 21.3, 95% CI 8.5–52.8). Seven journals stated the ethical process reporting in the instructions for authors. Overall, 15.7% articles declared the conflicts of interests. Conclusions: The low compliance of reporting ethical protection measures in dental research among Indian dental journals is of high concern. © 2016 Taylor & Francis.

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2016

Chandrashekar Janakiram, Dr. R. Venkitachalam, and Joseph, J., “Profile of Institutional Ethics Committees in Dental Teaching Institutions in Kerala, India”, Accountability in Research, vol. 23, pp. 219-229, 2016.[Abstract]


Objectives: To assess the existence, structure, and functioning of Institutional Ethics Committees (IECs) in dental teaching institutions in Kerala. Methodology: A cross-sectional questionnaire-based survey was conducted by personally approaching Heads of Institutions/Ethics Committee (EC) in-charge of all dental colleges (23) in Kerala. The validated questionnaire consisted of two parts. The first part pertained to details of institutions, and the second part assessed the structure and functioning of the IEC. The data obtained was tabulated and analyzed using descriptive statistics. Results: Of the participating 17 colleges, 13 colleges had a functioning IEC. Only four of these IECs were accredited to a central agency. Only one among the 12 colleges completely adhered to recommended structure. Regarding the functioning of IECs, 69% of the IECs had neither a separate application form for ethical review of proposals nor a proforma for its evaluation. On average, more than ten proposals were reviewed in a single EC meeting in 54% of the colleges. Nearly 40% of the IECs had no representation of a lay person. Conclusion: The absence of IEC in four colleges and non-accreditation to a central agency was a matter of concern. Enforced accreditation is the need of the hour to ensure ethical protection to human participants. © 2016 Taylor &amp; Francis.

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2015

S. Sinha Sham Mohammed and Chandrashekar Janakiram, “User’s perception of pictorial warning on tobacco products in Ernakulum”, India Journal of Indian Dental Association , vol. 1, no. 9, pp. 25-32 , 2015.

2015

Chandrashekar Janakiram, “Perceived barriers in accessing dental care among the residents of Modinagar, India with application of DEMATEL method”, Journal of Indian association of Public Health Dentistry, vol. 13, pp. 152-157, 2015.

2015

F. Taha, Chandrashekar Janakiram, and Joseph, J., “Dental infection control practices and public perception–a cross-sectional study”, International of Oral Health, vol. 7, pp. 20-26, 2015.[Abstract]


Background: The aims of this study was to determine the practice of infection control among the dental professionals practicing in private dental clinics in Ernakulam city, and public’s perception of infection control measures. Materials and Methods: This was a cross-sectional study conducted with a sample of 84 private dental clinics and 152 respondents from the general public in Ernakulam city. A 24 item self-administered close-ended questionnaire was used for the dentists and a 13 item semi-structured questionnaire with both open and closed ended questions administered to the general public. Data obtained from both populations were tabulated and analyzed using descriptive statistics and bivariate analyses using Chi-square test (α = 0.05). Results: The final sample consisted of 66 dental clinics. Most of the dentists complied with the use of barrier techniques (gloves and mouth mask) during patient care. Almost half of the dentists had no knowledge of their auxiliaries being vaccinated against hepatitis B. With regard to the general public, 58% of the people had concerns regarding the methods used by the dentists to sterilize dental instruments, yet most of them (77%) did not avoid the dental treatment due to perceived cross infection risk. Conclusion: Results of this study revealed that the level of infection control practices adopted by the private dental clinics in the city was inadequate in a few areas. It was found necessary to educate, raise awareness, and promote continuing dental education aimed at improving dental safety.

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2015

F. Taha and Chandrashekar Janakiram, “Ethics of dental health screening in communities in India”, Journal of Medical Ethics, vol. 1, no. 3, pp. 171-6, 2015.

2015

C. V. Deepan Kumar, Mohamed, S., Chandrashekar Janakiram, and Joseph, J., “Validation of dental impact on daily living questionnaire among tribal population of India”, Contemporary Clinical Dentistry, vol. 6, pp. S235-S241, 2015.[Abstract]


Background: Oral conditions are known to affect various aspects of quality of life. Similarly, the social consequence of the quality of life in the day to day living is also equally important. Several studies have quantified the social consequences of diseases through activity limitations in people's daily living. The instruments which cover a broad spectrum of life are proposed to be compared with the clinical oral hygiene status of people from different social classes. Aim: To assess the validity of dental impact on daily living (DIDL) questionnaire measuring subjective dental problems and their impact in the day to day life among tribes of Wayanad. Study Design: Cross-sectional. Materials and Methods: DIDL questionnaire developed by Leao and Sheiham was used. We recorded the clinical oral health status using decayed, missing, filled, simplified oral hygiene index, and community periodontal index indices, to correlate the subjective findings of dental impact tribe to obtain construct validity of the questionnaire. Analysis: Descriptive statistics and Spearman's correlation using IBM SPSS software version 20. Results: In the study population of 250 participants, the majority of the participants were from the age group between 36 and 50 years (40%) and females were in the majority (64%). The clinical status of the participants was poor in the majority while their perceived impact in their day to day living was found to be relatively satisfied. The study results show the DIDL tool had weak validity in relation to the clinical status with relevance to the social status of Indian tribal population. Conclusion: The study result shows that there was insignificant and weak validity between the DIDL tool and the oral health status among these tribes who were from a low social class. This might be because their priority in life which is different from what a person from high social class. So the dental problem is ignored at the level of individual depending on his/her priority and at the community level by the policy makers.

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2014

S. Mohamed and Chandrashekar Janakiram, “Recurrent Aphthous Ulcers Among Tobacco Users- Hospital Based Study”, Journal of clinical and diagnostic research : JCDR, vol. 8, pp. ZC64-LC66, 2014.[Abstract]


Current evidence shows ambiguous relationship between tobacco use and the occurrence of aphthous. We studied the relationship between the occurrence of recurrent aphthous ulcers and various forms of tobacco usage. A hospital based case control study was carried out in a dental teaching hospital in Cochin, India. One hundred and two outpatient subjects (Males 56.9%) were identified having aphthous ulceration using Natha's diagnostic criteria and were classified as cases. One hundred and eight subjects (Males, 70.4%) with no aphthous ulceration were selected randomly as controls. Exposure ascertainment of tobacco usage was done by structured interview. The adjusted odd ratio was found to be 0.41 (95% CI 0.19-0.87) for tobacco usage and occurrence of aphthous ulceration compared to non tobacco users. The odds ratio of 0.41 for tobacco usage infers that subjects using tobacco were 59% less likely to have aphthous ulcerations compared to nontobacco users. The tobacco consumers have less frequency of aphthous ulceration compared non users.

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2013

S. Mohamed and Chandrashekar Janakiram, “Periodontal status among tobacco users in Karnataka, India.”, Indian journal of public health, vol. 57, pp. 105-108, 2013.[Abstract]


A cross-sectional study was designed to assess the prevalence of periodontal diseases among tobacco and non-tobacco users. A total of 2,156 dentate subjects were selected in the age group of 35-44 years through multi-stage sampling method. A total of 350 and 175 subjects were selected from household survey from each district in rural and urban areas. Subjects were interviewed for the tobacco usage status, followed by clinical assessment of periodontal status. Prevalence of calculus, periodontal pockets of 4-5 mm depth and loss of attachment of 0-3 mm and 4-5 mm was significantly more frequent among current tobacco users. The subject with smoking and chewing tobacco has an odds ratio (OR) 1.6 (95% confidence intervals [CI] 1.14-2.31) and OR 1.7 (95% CI 1.38-2.28) respectively. The findings contribute to the evidence of smoking as a risk factor for periodontal disease.

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2011

Chandrashekar Janakiram, Thankappan, K. R., and Sundaram, K. R., “P2-518 Sorghum consumption modifies the effect of fluoride on dental fluorosis in India”, Journal of Epidemiology & Community Health, vol. 65, pp. A364-A364, 2011.[Abstract]


Background Dental fluorosis is a major public health problem in 17 states of India. Earlier studies reported that sorghum {a type of millet, (jowar)} consumption interacts with fluoride in the body and enhances fluorosis. Objectives This study was carried out to explore the potential association between sorghum consumption and severity of dental fluorosis. Methods A community based case control study was carried out in villages having different fluoride levels (high, medium and low) in drinking water in Davangere, India. 352 school Children (12?15?years, male 58 %) with severe grades of dental fluorosis classified by Thylstrup & Fejerskov Index (scores 4?9) were selected as cases. 428 school children (12?15?years, male 48.8%) with no dental fluorosis were selected randomly from the same area as controls. Exposure ascertainment of jowar consumption was done by 24-h diet recall and food frequency questionnaire. Logistic regression analysis was done using SPSS version 17. Results Children who consumed jowar had 2.67 times more chance of getting severe dental fluorosis compared to those who did not (OR 2.67, CI 1.98 to 3.62). The ORs for jowar consumption and dental fluorosis were 1.59, 3.18 and 3.76 at each stratum, for low, medium and high fluoride villages respectively. The Mantel-Haenszel OR was 2.58 (p value=0.001) which was similar to crude OR. The test of homogeneity (Breslow test) showed p value=0.05. Conclusions Sorghum consumption modifies the effect of fluoride in occurrence of severity of dental fluorosis in this population.

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2011

Chandrashekar Janakiram, Manjunath, B. C., and Unnikrishnan, M., “Addressing tobacco control in dental practice: a survey of dentists' knowledge, attitudes and behaviours in India.”, Oral health & preventive dentistry, vol. 9, pp. 243-249, 2011.[Abstract]


Dental professionals are strategically placed to be the leaders in tobacco prevention and cessation as they provide preventive and therapeutic services to a basically healthy population on a regular basis. The objective of this study was to assess the tobacco cessation knowledge, attitudes and behaviours of dental practitioners in Kochi (Cochin), Kerala, India. A sampling frame of dentists enrolled in the Indian Dental Association (IDA), Kochi (Cochin) branch, practising in Ernakulam city, was obtained from the IDA. The letter describing the rationale for the study contained a 35-item pre-tested questionnaire and was personally delivered along with a stamped envelope. One hundred fourteen dentists returned a usable questionnaire. Data were entered and analysed using SPSS 12. Frequencies were calculated for all variables. Based on the responding dentists' self-reports, 54.6% were not confident in tobacco cessation counselling, 10.6% never asked, 60.9% asked in 50% of their patients about tobacco use and 17.6% of the dentists surveyed were smokers themselves. Participating dentists perceived that they were interested in using tobacco cessation counselling, but were not sure of quitting rates in their patients. The average time spent counselling patients about tobacco cessation was less than 2 minutes. The dentists perceived that lack of formal training leads to less motivation about tobacco counselling and hence infrequently incorporated tobacco cessation into their dental practices. The cessation of tobacco habits among dentists is essential.

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2010

Chandrashekar Janakiram, Thankappan, K. Rb, and Sundaram, K. Rc, “Severe dental fluorosis and jowar consumption in Karnataka, India”, Community Dentistry and Oral Epidemiology, vol. 38, pp. 559-567, 2010.[Abstract]


Chandrashekar J, Thankappan KR, Sundaram KR. Severe dental fluorosis and jowar consumption in Karnataka, India. Community Dent Oral Epidemiol 2010; 38: 559-567. Ǎ 2010 John Wiley & Sons A/S Abstract-Introduction: Dental fluorosis is a major public health problem in 17 states of India. Earlier studies have reported that Jowar (a type of millet) consumption interacts with fluoride (F) in the body and enhances fluorosis. We conducted this study to determine the association between jowar consumption and severity of dental fluorosis. Methods: A community based case control study was carried out in villages having different F levels (low, medium, and high) in drinking water in North Karnataka, India. 352 school Children (12-15years, male 58%) with severe dental fluorosis classified by Thylstrup & Fejerskov Index (1988) were selected as cases. 428 school children (12-15years, male 48.8%) with no dental fluorosis were selected randomly from the same area as controls. Exposure ascertainment of jowar consumption was done by 24-h diet recall and food frequency questionnaire. Ion selective electrode method was used to estimate the F level in spot urine samples of subjects and in drinking water. Multiple logistic regression analysis was done using SPSS V. 11.01 Results: Children who consumed jowar had 2.67 times more chance of getting severe dental fluorosis compared to those who did not [Odds Ratio (OR) 2.67, CI 1.98-3.62]. Children from high F level villages (OR 1.91, CI 1.27-2.85) had higher odds of severe dental fluorosis compared to children from medium and low F level villages. Daily jowar consumers (OR 2.14, CI 1.64-3.09) and weekly consumers (OR 1.68, CI 1.31-3.45) had higher risk for dental fluorosis compared to non jowar consumers. Children who started consuming jowar before 8years of age had significantly higher proportion of severe dental fluorosis compared to their counterparts. Urinary F excretion among jowar consumers was significantly lower than non-jowar consumers. Conclusions: Jowar consumption was positively associated with severity of dental fluorosis in this population. © 2010 John Wiley & Sons A/S.

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2009

P. Praveen and Chandrashekar Janakiram, “Relevance of H. Pound'S Formula to Indian Population”, Amrita Journal of Medicine , vol. 5, no. 2, pp. 37-38, 2009.

2008

S. M and Chandrashekar Janakiram, “Dental Waste Management of Private Dental Practitioners in Bangalore City”, International Dental Journal , vol. 58, no. 1, pp. 51-4, 2008.

2004

Chandrashekar Janakiram and Anuradha, K. Palshikar, “Prevalence of dental fluorosis in rural areas of Davangere, India.”, Int Dent J, vol. 54, no. 5, pp. 235-9, 2004.[Abstract]


OBJECTIVES: To assess the prevalence and severity of dental fluorosis and its relationship with fluoride levels in drinking water.

DESIGN: Twelve villages with similar climate, diet, socioeconomic conditions and altitudes were selected from rural areas of Davangere district, Karnataka, India. The fluoride concentration in drinking water was estimated by the Ion Selective Electrode Method. Dean's Index was used to assess the dental fluorosis. Karl-Pearson coefficient for correlation and simple regression analysis were used to evaluate the association between the water fluoride levels and the community fluorosis index (CFI).

RESULTS: The study group consisted of 1,131, 12-15-year-old school children. The fluoride levels in drinking water of selected villages were in the range of 0.22-3.41ppm. A stepwise increase in the prevalence of dental fluorosis with corresponding increase in water fluoride content, 13.2% at 0.22ppm F to 100% at 3.41 ppm F, was found. There was a significant positive linear correlation (r=0.99) between CFI and water fluoride level.

CONCLUSION: Dental fluorosis is a major dental public health problem among children in Davangere district and is related to drinking water with 0.74ppm fluoride or above.

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2002

Chandrashekar Janakiram, “Prevalence of Periodontal Disease in Endemic areas of Davangere District”, Indian Journal of Dental Research, vol. 13, pp. 15-9, 2002.

2000

Chandrashekar Janakiram and Dye, B. A., “Public Health Approaches in Prevention of Periodontal Disease”, Periodontology , 2000.

Publication Type: Conference Proceedings

Year of Publication Title

2019

Chandrashekar Janakiram, Fontelo, P., Tranby, E., Mitnik, G., Huser, V., Brow, A., and Dye, T. Iafolla Br, “Opioid Prescriptions for Dental Diagnosis among Medicaid Beneficiaries with Depression”, 97th General Session of the IADR, held in conjunction with the 48th Annual Meeting of the AADR and the 43rd Annual Meeting of the CADR. Vancouver, BC, Canada, 2019.

2018

Chandrashekar Janakiram, “Opioid Prescriptions for Dental Diagnosis among Medicaid Populations”, 35th Academy Health 2018 Annual research meeting Seattle . National Institute of Dental and Craniofacial Research National Institutes of Health Gender and Racial Disparities, USA, 2018.

2018

Chandrashekar Janakiram, “Opioid Prescriptions for Dental Diagnoses Varies by Provider Type and Patient Characteristics in Medicaid Populations”, 2018 National Oral Health Conference . Louisville, Kentucky, 2018.

2009

A. Keepanasseril, Mathew, A., Chandrashekar Janakiram, and Muddappa, S. C., “Effectiveness of Remote- Interceptive- Preventive Prosthodontic Programme in Rural India”, Journal of Dental Research 2009, vol. 88. Amrita School of Dentistry, Kochi, India, 2009.[Abstract]


Objectives: Rural (71%) India has little access to quality Prosthodontic care. Only treatment available for failing dentition is total extraction and construction of conventional complete dentures. This sets up irreversible residual ridge resorption (RRR) making denture cripples out of many of them. The study aimed at examining the effectiveness of utilizing teledentistry to provide preventive interceptive Prosthodontic treatment (over dentures) by a general dentist at rural sites supervised by prosthodontists at a university hospital.
Methods: A comparative study was carried out in 60 pre-edentulous patients, 30 each at university hospital and a remote rural site. Over dentures were fabricated for all of them by identically pre-trained general dentists. Direct supervision at predetermined intervals was provided to dentist at the hospital. The remote dentists were guided using teledentistry unit of Amrita University. Evaluation was carried out by 3 independent examiners for diagnostic competency, quality of secondary impressions and trial dentures . A post insertion functional assessment by using Functional assessment of Dentures (FAD) criteria also done. Subjective evaluation was determined by completion of Oral Health-Related Impacts on Quality of Life questionnaire before starting treatment and one month post insertion. The data was analyzed using SPSS Version 11.5.

Results: There was no significant difference in scores of evaluating criteria in diagnostic competency, quality of secondary impressions trial dentures and post insertion functional assessment between two groups. Statistically significant improvement in the OHIP domains of functional limitation and physical and psychological disability was seen in both groups.

Conclusion: Preventive and interceptive prosthodontic treatment provided by sufficiently trained general dentist supervised remotely is a viable and cost effective approach .

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2008

Chandrashekar Janakiram, “Jowar consumption predicts the Severity of Dental Fluorosis”, International Academy of Dental Resarch. Toronto, 2008.

2007

Chandrashekar Janakiram and Thankappan, K. R., “Risk of Jowar consumption associated with severity of dental fluorosis in north Karnataka, India”, 39th APACPH conference 22-25, November 2007. Saitama Japan, 2007.

Publication Type: Conference Paper

Year of Publication Title

2018

Chandrashekar Janakiram and Chalmers, N. I., “Gender and Racial Disparities in Opioid Prescriptions for Dental Diagnosis Among Medicaid Populations”, in Podium Presentation 2018 ARM Annual Meeting of Academy Health, USA , 2018, vol. 149, no. 4, pp. 246-255.

2016

Chandrashekar Janakiram, “Assessment of Common risk factors between the oral diseases and NCDs”, in 21st National IAPHD conference Bhubaneshwar, Bhubaneshwar, 2016.

2015

Chandrashekar Janakiram, “Career Satisfaction among Dental Public Health Specialist”, in 20th National Conference of Indian Association of Public Health Dentistry Manipal , Manipal , 2015.

2015

Chandrashekar Janakiram, “Ethical Process reporting in Indian dental journals”, in Clinical Society Meeting at Amrita School of Dentistry, Kochi, 2015.

2014

Chandrashekar Janakiram, “Ethics of dental health screening in communities in India”, in National Bioethics conference in Bangalore India, Bangalore India, 2014.

2012

Chandrashekar Janakiram, “User perception of Pictorial warnings in tobacco products in Ernakulum in India”, in World conference on tobacco or health, Singapore, 2012.

2012

Chandrashekar Janakiram, “Knowledge attitudes and practices of Healthcare ethics among medical and dental postgraduates in Kerala”, in Indian Medical Ethics conference Jaipur India , Jaipur India , 2012.

2009

Chandrashekar Janakiram, “Relationship of Dental Fluorosis and Malnutrition in Kolar India”, in 86th General assembly of International Academy of Dental Research, Miami USA , 2009.

2008

Chandrashekar Janakiram, “Addressing Tobacco Control: Knowledge Attitudes Practices of Dentist in Cochin India”, in National Emerging Issues in Public Health India, Trivandrum, India, 2008.

2008

Chandrashekar Janakiram, “Jowar Consumption Predicts the risk of Dental Fluorosis in India ”, in 85th General Assembly of International Academy of Dental Research , Toronto Canada , 2008.

2006

Chandrashekar Janakiram, “Primary Dental Care or Primary Dental Clinic”, in Second National PG Convention of IAPHD, Bangalore, India, 2006.

2001

Chandrashekar Janakiram, “Prevalence of Dental Fluorosis among 12 to 15 years old school children of Davangere district”, in 7th National Conference of Indian Association of Public Health Dentistry, India, 2001.

2000

Chandrashekar Janakiram, “Prevalence of Periodontal Disease in Endemic areas of Davangere District”, in 6th National Conference of Indian Association of Public Health Dentistry, India, India, 2000.

Submitted Publication - Review Stage

  • Lakshmi Menon, Chandrashekar Janakiram. Common Risk Factor Approach to limit Non-Communicable diseases and Periodontal Disease- The molecular basis NEJM
  • Mallika Venkat, Chandrashekar Janakiram. Mass media coverage in health & oral health-related advertisements: A content analysis in Kerala, India. Journal of Health Communication
  • Chandrashekar Janakiram, Venkitachalam R, Abhishek Mehta. Prevalence of Periodontal disease in India. A systematic review and meta-analysis – IDJ
  • Mallik Venkat, Chandrashekar Janakiram Venkitachalam R. Prevalence of tooth mortality among adults in India: A systematic review and meta-analysis, JIPS
  • Chandrashekar Janakiram, Ramanarayanan V, Induja Devan. Effectiveness of Silver Diamine Fluoride applications for dental caries cessation in tribal Preschool children in India.  BMC Oral Health
  • Venkitachalam Ramanarayanan, Vineetha K, Chandrashekar Janakiram. Dental Public Health: Fallout of the Covid-19 pandemic. JIAPHD
  • Sandhya K N, Chandrashekar Janakiram, Beena Varma. Oral Health status and related quality of life among elderly tribes in India
  • Chandrashekar Janakiram, Parvathy Balachandran. Review on Complementary and Alternative Medicine (CAM) in Oral Health
  • Chandrashekar Janakiram, Naveen Varghese, Joe Joseph. Review on Social Economic status and Oral Diseases in India Journal of Dental and Allied Sciences
  • Manju Vijaya Mohan, Chandrashekar Janakiram. Rapid Prototyping Technology for Silicon Auricular Prosthesis Fabrication: A Pilot Study

Professional Service

  • Resource Person, Ethics and Legal aspects of clinical Dental Practice IDA Smart city March 1, 2020
  • Resource Person “Scientific Misconduct” Dayananda University on February 1, 2020.
  • Resource Person, “Career in Public Health” Pathfinder 7 Bangalore IAPHD January 24, 2020
  • Resource Person, Workshop on Research Ethics. Annoor Dental College Cochin, India on January 9, 2020
  • Inviter Speaker, ASPIRE 2K19 Research Day - Asan Dental college Chennai, India April 2019.
  • Invited speaker Poster Symposium. ARM Academy Health Conference Seattle, USA.
  • Keynote speaker, Dental Public Health Challenges. 21st National Conference on Indian Association of Public Health Dentistry, 2017, Pune, India.
  • Invited Speaker, Role of IEC in Dental Colleges India - Way Forward. IADR-APR Symposium Savitha University Chennai 2017, India.
  • Resource Person, Research Ethics and Benefit Harm. 3T UNESCO Bioethics Chair program at AIMS Cochin 2017, India.
  • Resource Person, Autonomy, Benefit and Harm, Justice and Equity in clinical care ethics” , 3T UNESCO Bioethics chair program Santhosh University 2016 November, New Delhi, India.
  • Invited Speaker, “ Career Pathways for Dental Graduates” Colgate Professional Enrichment program in Bangalore September 2016, India.
  • Resource Person, “Recent Concepts in Research Ethics” Tuesday Presentation Grand Rounds AIMS 2016
  • Invited Lecture, “Ethical Dentistry and Jurisprudence in Dental care in India” for Government dental surgeons of Kerala in Amrita School of Dentistry on April 2016, India.
  • Invited Lecture, “Oral Health in India – Where does it stand?” KMCT Dental College Calicut India on March 2016.
  • Invited Lecture, “Public Health without borders” at Pathfinder program at Vyedhi Dental college at February 2016, Bangalore, India.
  • Invited Lecture, “Oral Health Rights” Colloquium Speaker at R V Dental College Bangalore 2015, India.
  • Invited Speaker, “Dentist as Public Healther” at Raja Rajeshwari Dental College, India, August 2015 India.
  • Resource Person, “Public Health Dentistry as a Profession in India” at Nellore Post Graduate Convention June 2015 India.
  • Resource Person, “Public Health Ethics” National Bioethics Conference India December 2014 India.
  • Resource Person, “BPOC Past Present Future at 18th National Conference of IAPHD 2013 Lucknow India.
  • Resource Person, “Informed consent Process” in JSS Dental College Mysore India August 2014.
  • Resource Person, “Research Designs” for CDE Program for IAPHD UP Chapter India, February 2014.
  • Invited Speaker, “Public Health Ethics “CDE program for IAPHD Hyderabad Chapter Hyderabad India, 2013.
  • Invited Speaker, “How to frame Research Question “Rungta college of Dental Sciences, India, 2013.
  • Invited Speaker, “Ethics in Clinical Research” DBT Course on clinical research 2009& 2010 Cochin, India.
  • Invited Speaker, “Ethics in Clinical Research” ACBI conference 2009 November Cochin, India.
  • Invited Speaker, “Informed Consent Process” Indian society of Dental Research Chennai India, August 2009.
  • Invited Chair, Session “Current Topics in Oral Epidemiology”86th General assembly of IADR USA, April 2009
  • Invited Lecture, “Research Methodology” workshop Bapuji Dental College India from 2007.
  • Invited Lecture, “Research Methodology” workshop in Peoples Medical College Bhopal India 2007.
  • Invited Lecture, “Curriculum Development for Community Dentistry” National Community Dentistry Teachers Convention at Davangere September 2008 India.
  • Invited Lecture, “Working Towards Community Oral Health” postgraduate conference IAPHD July 2006, India.
  • Invited Lecture, “Study Designs in research” in Dentistry in RV Dental College Bangalore June 2006, India.
  • Invited Lecture, “Bias in Research” in Dentistry in RV Dental College Bangalore India November 2006.

Mentoring

Doctoral Committee – Ph.D. Thesis Advisor

  1. Radhu Raj - Amrita University -2017.
    Assessment of Trismus in Head and Neck Cancer Patients in Indian Population.
  2. Saranya K - Amrita University- 2017
    Prevalence of Temporomandibular disorders in prosthetically rehabilitated and non-rehabilitated edentulous patients in Kerala, India.
  3. Lakshmi P - Amrita University 2019.
    Association of common risk factors between the Non-communicable diseases and periodontal disease in Indian adults - analytical cross-sectional study.
  4. Induja Devan – Amrita University 2019
    Effectiveness of Silver Diamine Fluoride applications for dental caries cessation in tribal preschool children in India

Graduate Student Mentorship – Master’s in Dental Public Health

  1. Parvathy Balachandran – Amrita University -2019
    • Oral Health Status among Tea plantation workers in Idukki Kerala
    • Prevalence of Malocclusion among children in India – Systematic Review
    • Assessment of Cultural competence in Healthcare professionals – Questionnaire validation
  2. Mallika Venkata – Amrita University 2018
    • Association of Obesity and Periodontal Disease among adults in Ernakulum
    • Prevalence of Tooth mortality among Adults in India – Systematic Review
    • Health messages in media  
  3. Naveen Varghese - Amrita University- 2015
    • Comparison of modified Bass, Fones and Normal toothbrushing techniques for efficacy of plaque control in young adults -A randomized controlled trial
    • Prevalence of oral health status in different socioeconomic groups- A Review
    • Assessment of quality of prescription writing among dental and medical students and practitioners on dental and medical colleges in Kerala
  4. Vinita Sanjeevan- Amrita University - 2015
    • Intergenerational transfer of tobacco use behavior from parent to child – A case control study
    • Effectiveness of school based dental screening in improving dental care utilization –A systematic review and meta-analysis
    • Political priority of oral health in India
  5. Bobby Anthony - Amrita University 2014
    • Nutritional status and early childhood caries among preschool children
    • Trends in dental caries in India
    • Career satisfaction among Public Health Dentists in India
  6. Venkitachalam Ramanarayanan- Amrita University 2014
    • Comparison of antiplaque efficacy of a commercially available toothpowder and toothpaste in young adults: A single blind randomized controlled equivalence trial
    • Oral health infrastructure of Kerala
    • Institutional Ethics Committees in Dental Colleges in Kerala
  7. Farheen Taha - Amrita University2013
    • Assessment of common risk factors in Non-communicable diseases and oral diseases
    • Efficacy of plaque control by different tooth brushing techniques in adults: A systematic review
    • Infection control practices and public perception- a cross-sectional study
  8. Deepak Kumar - Amrita University 2013
    • Health related quality of life and palliative care needs in oral cancer patients
    • Xylitol in preventing dental caries: A systematic review and meta-analysis
    • Validation of Dental impact of Daily Living (DIDL) questionnaire among tribes of Kerala
  9. Bindu Bhaskar - Amrita University- 2012
    • Access to dental care among differently abled children in Kochi
    • Need for oral health policy for differently abled children in India
  10. Iris Vaslan- Amrita University - 2012
    • Oral health status and treatment needs among Paniyas tribes in Wayanad. district
    • School dental health program

Graduate Committee

  1. Heljo Joesph- Amrita University-2016
    • Compliance and feasibility of a school-based fluoride mouth rinse program over a combined hand washing program and fluoride mouth rinse program in Kerala
    • Screening of health promoting school concept among schools in Kerala: A cross sectional study.
  2. Vineetha - Amrita University - 2016
    • Effectiveness of an oral health curriculum in improving oral health knowledge among school children in Ernakulam: An intervention study
    • Perceptions of oral health among various sections of society: A qualitative analysis.
    • Association of dental caries and child oral health impact profile among 12-year-old school children in Ernakulam: A cross sectional study.
  3. Vini Mehta – D Y Patil University – 2017
    • Efficacy of Herbal Dentifrice on the Prevention of Plaque and Gingivitis as compared to Conventional Dentifrice – A Systematic Review and Meta-Analysis

External Review – Role

  1. Certification Examiner - Undergraduate 2015 - till date

    Bachelor of Dental Surgery – Public Health Dentistry

    • Rajiv Gandhi University of Health Sciences, Bangalore India
    • NTR University of Health Sciences, Hyderabad, India
    • Amrita University, Cochin India
    • T N MGR Medical University, Chennai India
    • Kerala University of Health Sciences, Thrissur India
  2. Certification Examiner - Graduate 2012- 2017 and 2019- till date

    Master of Dental Surgery- Public Health Dentistry

    • BP Koirala University of Health Sciences Nepal
    • Rajiv Gandhi University of Health Sciences India
    • Kerala University of Health Sciences, Thrissur India
    • NTR University of Health Sciences Hyderabad, India
    • Amrita University Cochin India
  3. Certification- Examiner Doctoral
    • K Pusphanajalli 2016 - Rajiv Gandhi University of Health Sciences, Bangalore, India
    • Dental Health Care Waste Generated among Private Dental Practices in Bengaluru City
    • Neethu Suresh 2017- Sree Chitra Tirunal Institute for Medical Sciences & Technology Trivandrum, India School Oral Health Education for 6-12-year-old children based on PRECEED-PROCEED Model

Teaching Administration

Year Affiliation
2005 - 2012 &
2019 – till date
Chair, Department of Public Health Dentistry Amrita of School of Dentistry
2013 - 2017 Coordinator, Population Studies Amrita School of Dentistry
2015- till date Member of Clinical Ethics Committee, AIMS 
2012 - Present  Member of Dissertation Review Committee, Amrita School of Medicine
2012 - Present  Member of   Ethics Committee, Amrita Institute of Medical Sciences 
2012 - Present  Member of Dissertation Review Committee School of Dentistry
2012 - Present  Member of Postgraduate Program Faculty Dentistry Amrita university
2014 - Present  Secretary, UNESCO Bioethics Chair, Amrita University

Teaching

Undergraduate Courses Taught

  • Social Sciences and health - 1 credit hour
  • Planning for Health program - 1 credit hour
  • Health communication - 2 credit hour
  • Health Care delivery - 2 credit hour
  • Health Administration - 1 credit hour
  • Measurement of Oral diseases & Oral Epidemiology - 2 credit hour
  • Introduction to Public Health - 1 credit hour

Graduate Courses Taught

Department of Public Health Dentistry, Clinical Research and Public Health

  • Research Methods - Course Director
  • Research Integrity - Course Director
  • Epidemiology - Course Director
  • Social Determinants of Health - Course Director
  • Ethics in Clinical Research - Course Director
  • Health Administration - Course Director
  • Flied training – Community Diagnosis - Course Director
  • Public Health Ethics - Course Instructor

Additional Courses Taught

Department of Clinical Research

  • Basic Bioethics Module - Course Director 
  • Advanced Bioethics Module - Course Director 
  • Principles of clinical Research - Course Instructor
  • Research Ethics - Course Instructor

Leadership

  • 2011 - 2017: President of Kerala Chapter Indian Association of Public Health Dentistry, Kochi.
  • 2014:  Chairman, XIX National Conference of Public Health Dentistry, Cochin, Kerala.
  • 2019 - 2021: Executive Member, Indian Association of Public Health Dentistry, India