Dental Tribune South Asia No. 9, 2023

The oral-gut microbiota axis: the harbinger of autoimmue diseases / News

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The World‘s Dental Newspaper
South Asia Edition
Published in India

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SLEEP APNEA

Sleep apnea and role of dentists

Vol. 1, No. 9

SWASTH DAANT PRO

ITI 2024

Dental camp organized using
AI-based app ‘Swasth Daant Pro‘

ITI World Symposium 2024: More than
50 speakers, exclusive clinical case footage and real patient stories

Page 05

Page 07

Page 03

The oral-gut microbiota axis: the harbinger
of autoimmue diseases
For example, mouth–to–gut
transmission was higher in rheumatoid arthritis patients.
Generally, dental procedures
and periodontitis permit the
spread of salivary microbiome,
oral bacteria, and periodontal
pathogens such as P. gingivalis, F.
nucleatum, and A. actinomycetecomitans into the bloodstream. In
the immune cell migration route,
intracellular oral bacteria can exist
within the immune cells such as
dendritic cells and macrophages,
thus facilitating easy dissemination from oral to gut mucosa. Additionally, the immune cells acquired from the oral draining
lymph nodes can spread to the gut
and the other lymphoid tissues.
For example, oral pathobiontreactive T helper 17 (Th17) cells,
after activating with gut tropism,
migrate to the inflamed gut
(Fig. 1). 3

Microbiome in human gastrointestinal tract. (Image: Canva)
By Dr Geetpriya Kaur
In recent decades, we have
recognise the vital role of microbiota in health and disease. The
human gut and oral microbiota,
the body’s largest microbial communities, are closely connected
due to the mouth’s position as the
start of the digestive system. Compelling new evidence reveals complex links between these two microbiota. This interaction could
significantly impact the development of systemic diseases includ-

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ing autoimmune diseases and certain cancers.
Autoimmune diseases occur
when the immune system loses
the ability to differentiate between
its cells as well as foreign invaders
and mistakenly attacks healthy
cells. So far, more than eighty autoimmune diseases have been
identified, affecting various parts
of the human body.1
Furthermore, they are characterise by an immune response to
self–antigens such as autoantibody-producing B cells, autoreactive T cells, and proinflammatory
cytokines.1
Recent studies reveal that oral
and gut microbiota dysbiosis have
a pivotal role in the initiation and
progression of a broad spectrum
of autoimmune diseases.1,2 The microbiota dysbiosis disrupts the homeostasis between the host and
commensal, accompanied by ab-

normal immune response leading
to autoimmune diseases. The oral
cavity is anatomically connected
with the gastrointestinal tract
(GIT), which harbors the largest
and most diverse microbiota.
There is approximately 45% similarity between the fecal and oral
microbiota suggesting ectopic
colonization of oral bacteria in GIT,
by escaping the inhibition of gastric acid.1
The three routes through
which oral microbiota affects the
gut microbiota are enteral, hematogenous, and immune cell migration routes. Still, there is controversy about whether oral microbiota can colonize the gut through
the enteral route. 3 Recent research
suggested that there was no confirmation of the colonization of
oral bacteria in the distal gut of
healthy adults. In contrast, some
researchers indicated that at least
one in three oral microbiotas can
sustain in a healthy adult gut.

Fig. 1: The three routes through which oral microbial flora
influences gut microbiota. [3]

[2] =>

NEWS

Dental Tribune South Asia Edition | 09/2023

The interplay between oralgut axis and autoimmune diseases:
The role of the oral–gut axis
has been recently proposed in various autoimmune diseases. The
major trigger mechanisms for the
occurrence of autoimmune diseases are microbial translocation,
molecular mimicry, and autoantigen overproduction.1
The following autoimmune
diseases are caused by oral–gut
microbiota dysbiosis:
Rheumatoid arthritis (RA) is a
chronic progressive autoimmune
disease characterise by synovial
inflammation and gradual degradation of articular cartilage and
bone. Autoantibodies to citrullinated proteins are one of the diagnostic criteria for RA. Citrullinated
proteins are developed from posttranslational arginine modification
and catalyzed by peptidyl arginine
deiminases (PADs). The oral bacterium P. gingivalis is responsible for
protein citrullination which further
increases anti-citrullinated peptide antibodies (ACPAs). In RA patients, Anti-Pg-LPS IgG antibody
levels were inversely associated
with the patient’s disease activity;
the serum LPS-binding protein
levels were linked with disease
biomarker concentrations. Thus,
these findings indicated that certain proteins from oral and gut mi-

crobiota can affect disease activity
in RA patients. 3

the gut microbiota after oral gavage of P.gingivalis. 3

Inflammatory bowel disease
(IBD) is a group of chronic relapsing inflammatory conditions of the
GIT, which comprises two clinical
types–ulcerative colitis (UC) and
Crohn’s disease (CD). The main etiological causes involved in IBD
progression are environmental
and genetic factors. Oral microbiota contains an abundance of Enterobacteriaceae as compared
with other mucosal sites. Klebsiella, an oral Enterobacteriaceae
species, can ectopically colonize
and sustain in the colon and cecum
and thus induce gut inflammation
in a genetically susceptible patient. Additionally, they also promote T helper 1 (Th1) cells during
gut colonization. 3

Systemic lupus erythematosus (SLE) is a chronic autoimmune
disease of unknown etiology that
affects the connective tissue of
multiple organs resulting in tissue
damage and extensive inflammation. Primary Sjogren Syndrome
(pSS) is an autoimmune condition
caused by lymphocytic infiltration
of lacrimal and salivary glands, resulting in dry eyes and mouth.
Moreover, pSS and SLE share common epidemiological, clinical,
pathogenic, and etiological features. Lower diversity in gut microbiota composition was observed
in pSS and SLE patients while a reduced Firmicutes/Bacteroidetes
ratio was present in SLE patients.
However, a diversity of microbiota
composition was observed in SLE
and pSS patients. A study revealed
that SLE is linked with increased
alpha diversity in both buccal
swabs and oral washings than in
pSS patients.4

Type 1 diabetes mellitus
(T1DM) is characterized by insufficient secretion of insulin by the
pancreas. Recent data stated that
oral microbiota can induce gut
dysbiosis and gradual insulin resistance. The main mechanisms for
increased insulin resistance are
gut dysbiosis, increased gut permeability, systemic inflammation,
and metabolic derangement. Another study reported that Turibacter, a butyrate-producing bacterial population was reduced in

Conclusion
Recent evidence suggests that
the oral-gut microbiota axis plays
a pivotal role in the pathogenesis
of several autoimmune diseases
such as RA, IBD, T1DM, SLE, and
pSS. Moreover, the oral microbiota
can influence the gut microbial

population through enteral, hematogenous, and immune cell migration routes. The multifactorial
causative pathways utilized by
oral–gut microbiota dysbiosis for
initiating autoimmune diseases
are microbial translocation, molecular mimicry, and autoantigen
overproduction. Hence, more research is needed to validate these
findings and explore the efficacy
of oral and gut microbiota-based
targeted therapies for the treatment of autoimmune diseases.

study” and concluded that patients with lymph node metastasis
had higher cathepsin D(CD) expression and that increasing tumor
size seemed to correlate with
higher CD expression. Thus, based
on the active potential of CD in
regulating the prognosis of oral
squamous cell carcinoma (OSCC),
the design and synthesis of specific CD inhibitors can have significant research and therapeutic
consequences.

About
Dr Geetpriya Kaur is a successful oral pathologist, running a
dental diagnostic center for the
past nine years. She taught oral
pathology courses as a Professor
at the Department of Oral Pathology and Microbiology at the Institute of Dental Studies and Technologies in India. She has also
worked as an assistant editor with
the Journal of Clinical and Diagnostic Research and has many national and international publications to her credit. Additionally,
she has peer–reviewed articles in
national and international journals.

The list of references can be
obtained from the publisher
upon request.

Her master’s thesis looked into
“Detection of oral squamous cell
carcinoma metastasis with cathepsin D: An immunohistochemical
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NEWS

Dental Tribune South Asia Edition | 09/2023

Sleep apnea and role of dentists

Dentists are playing an increasingly bigger role in the management of sleep-related disorders.
(Image: Canva)
By Dr Satabdi Saha
Dentists’ role in sleep disorders has grown, particularly in the
collaborative care of individuals
experiencing mild to moderate
obstructive sleep apnea (OSA).
With the scope of dentistry growing beyond treating only oral
health conditions, practicing dental professionals are now facing a
distinct prospect of engaging with
patients across various stages of
OSA. Dentists can help in identifying the presence of a sleep-related
disorder, timely referral to sleep
medicine physicians for a comprehensive evaluation, and take part
in its therapeutic management.
Acknowledging this expanding role of dentists in OSA, the
American Academy of Sleep Medicine (AASM) and the American
Academy of Dental Sleep Medicine (AADSM) [1] strongly recommend a team effort by qualified
dentists and sleep physicians to
treat OSA patients in the best possible way. Despite such a key inclusive role of dentists in this field, we
lack enough information and
awareness to tackle OSA cases in
dental chairs. This article focuses
on the disease’s pathophysiology,
its serious health consequences,
and how dentists can act firsthand in its diagnosis and management.
Interpreting the global evidence on the disease burden:
Patients undergo disrupted
sleep and uneven breathing patterns due to these respiratory episodes. This depletes distinct
stages of both non-REM and REM
sleep. The effects of OSA extend
beyond the sleep cycle. It involves
repeated blockages in the upper
airway, lowering blood oxygen
levels, and increasing carbon dioxide. Research indicates that untreated OSA can cause various issues. These include headaches,
worsened epilepsy, asthma exacerbations, hypertension, irregular
heartbeats, depression, strokes,

chest pain, atrial fibrillation, increased motor vehicle accidents,
and congestive heart failure. 2
Healthy individuals spend
one-third of their lives sleeping. 3
So, disruptions in sleep quality can
create havoc in all aspects of our
daily lives. Regarded as a global
health issue, OSA prevalence has
been rising over the last 20 years.
Research reveals that the OSA
prevalence increases with age and
weight gain.4
Classification of sleep apnea:
Apnea is a full blockage of airways for at least 10 seconds, accompanied by a 2 to 4% decline in
arterial oxygen saturation. Sleep
apnea is categorised into central,
obstructive, or mixed types, with
varying degrees of severity. 2
Central sleep apnea (CSA) is
linked to a problem in the central
nervous system, causing the chest
muscles to not function and resulting in reduced lung oxygen intake.
OSA is a partial or total obstruction of the upper airway
during non-REM or REM sleep.
Considered the most prevalent
form of sleep apnea, OSA disrupts
regular sleep patterns. When OSA
leads to excessive daytime sleepiness, it’s referred to as obstructive
sleep apnea syndrome (OSAS).
If both central and obstructive
apneas are present in a patient, it’s
termed mixed sleep apnea.
OSA has three categories,
based on the apnea-hypopnea
index (AHI). The average number
of apneas and hypopneas per hour
of sleep is taken into account.
• Mild OSA (5 to 15 events per
hour)
• Moderate OSA (15 to 30 events
per hour)
• Severe OSA (more than 30
events per hour)
Understanding the underlying
pathology of OSA:
OSA is a complex sleep disorder with a multifaceted pathophysiology. It revolves around
upper airway dynamics, neural

control, and the interplay of anatomical and physiological factors.
This results in diverse causes for
OSA. Here is a list of the major
ones.
1. Anatomical variations: To get a
hold of the basic OSA etiology,
we need to look into the anatomy of the upper respiratory
tract first. Individuals with OSA
are more likely to have a constricted or collapsed upper airway. Obesity, which causes
greater fat deposits around the
neck and throat, or physical
traits such as a wide tongue,
tonsils, or a sunken jaw (micrognathia) can all contribute
to this.
2. Predisposing factors: Retrognathia, high-arched palate,
nasal septal deviation, longer
anterior facial height, steeper
anterior cranial base, inferiorly
displaced hyoid bone, long soft
palate, tumors, and reduced
posterior airway space can all
contribute to OSA. Chronic
smokers and alcoholics are also
at a high risk of suffering from
OSA.
3. Dysfunction of neural control:
The central nervous system
regulates the muscles involved
in breathing. Evidence confirms
changes in the brain regulatory
processes in OSA, resulting in
insufficient activation of upper
airway dilator muscles during
sleep. This malfunction increases the likelihood of airway
collapse.
4. Infections: Allergic rhinitis and
recurrent asthma lead to an inflamed airway- and raise the
risk of airway collapse.
5. Diminished
muscle
tone:
During sleep, there is a physiological reduction in muscle
tone across the body. In individuals with OSA, the muscles
responsible for opening the
upper airway experience an excessive degree of relaxation.
This heightened relaxation
contributes to the collapse of
the airway walls, resulting in
airflow obstruction.

6. Heightened sympathetic stimulation: In OSA, there is escalated activity within the sympathetic nervous system. This
heightened activation is a consequence of the repetitive occurrences of low oxygen levels
(hypoxia) and elevated carbon
dioxide levels (hypercapnia)
during periods of airway obstruction.
AASM - AADSM clinical practice guidelines for stepwise treatment approach for OSA
• Sleep physicians should consider prescribing oral appliances for adult obstructive
sleep apnea patients intolerant
of CPAP or preferring alternate
therapy.
• When a sleep physician prescribes oral appliance therapy,
AASM & AADSM recommend
qualified dentists craft custom,
titratable appliances, as they
outperform non-custom devices by reducing AHI, arousal
index, and oxygen desaturation while improving oxygen
saturation.
• Qualified dentists must oversee oral appliance therapy,
monitoring for dental side effects and occlusal changes to
enhance patient experience
and treatment outcome.
• Both dentists and sleep physicians should instruct adult patients using oral appliances to
schedule regular follow-up visits.
• These 2015 guidelines serve as
a roadmap for OSA, elevating
professional knowledge, patient outcomes, and healthcare
cost-efficiency.
Current approaches for managing the disease in the dental
chair:
Treatment options for adult
OSA vary based on severity, patient preferences, health status,
and the healthcare team’s expertise.
1. Lifestyle modifications: For mild
cases, lifestyle changes like

weight loss, positional therapy,
and avoiding alcohol before
sleep can help.
2. Oral appliances: Recommend
oral appliances if conservative
measures fail and patients seek
further treatment. These devices adjust the jaw and tongue
position to maintain the airway,
beneficial for mild to moderate
cases. Research shows they improve sleep and quality of life.
3. Continuous positive airway
pressure (CPAP): CPAP therapy
involves wearing a mask that
delivers a continuous flow of air
to keep the airway open during
sleep. This is a commonly prescribed treatment for severe
OSA.
4. Surgery: Consider surgery like
uvulopalatophar yngoplast y
(UPPP), genioglossus advancement (GA), or maxillomandibular advancement (MMA) for
major anatomical adjustments
or when other treatments are
ineffective.
The way ahead:
The scope of oral appliances in
OSA is expanding, but specialized
dental sleep medicine training is
rare. Not all dentists can competently treat OSA or apply evidence-based
practices.4
The
AADSM has addressed this
through training programs. More
dentists need expertise in managing OSA patients. Thus, making
sleep-related disorders a part of
the UG curriculum is the need of
the hour.5 With growing evidence
of OSA’s complex nature and collaborative treatment, the dental
fraternity must step up to fill this
long-existing gap.
However, further development
and evidence-based clinical validation of haptic VR dental trainers
are needed to improve engagement and learning outcomes for
more dental students around the
world. I am convinced that, as the
technology continues to advance,
it is likely that dental educators will
see even more innovative and exciting dental applications of haptic
VR technology in the coming
years.
The list of references can be
obtained from the publisher
upon request.

[4] =>

NEWS

Dental Tribune South Asia Edition | 09/2022

Dental camp organised using
AI-based app Swasth Daant Pro

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AI-based apps like Swasth Daant Pro that patients can use on their mobile devices will make the dentists’ job easier in dental camps.
(Image: Canva)

By Dr Rajeev Chitguppi
An oral health camp was organized by Muskan in collaboration
with ASI (Archaeological Survey of
India, Chandigarh Circle) and
Aadesh Dental College (Bathinda-Bucho-Adesh University) on
12- 13 August in Bathinda, Punjab.
Muskan is a company of enthusiasts, from dentists to engineers, trying to integrate human-centric Artificial Intelligence
(AI) in dentistry to bring about significant positive changes in dental
care. They have leveraged the latest innovations from MIT, Harvard
School of Dental Science, and
many others.
Muskan has three
ting-edge products:

cut-

AI-driven oral cancer screening: The AI enginea leverages clinical and non-clinical data to conduct non-invasive and highly accurate oral cancer screenings.
Early detection is crucial, and this
product can aid in identifying potential risks, enabling timely intervention, and ensuring the best
possible care for your patients.
AI-powered oral health wellness: This AI-powered app can be
used by dentists to actively promote oral health among their patients. The platform encourages
good oral hygiene practices while
fostering a strong patient-dentist
relationship, leading to improved
patient engagement and satisfaction.

AI-assisted radiograph interpretation: This AI assistant can accurately analyse radiographs
(bitewings, periapical, and OPGs),
to help dentists make informed
decisions promptly, leading to improved patient outcomes.
Muskan organized a free-ofcharge oral health camp, “Swasth
Muskan, Swasth Bharat,” at the
historical fort Qila Mubarak,
Bathinda on 12-13 August 2023.
A new AI engine-based app
called Swasth Daant Pro was used
to check oral health and generate
a digital report. The camp was
given wide media coverage on social & print media to provide and
create awareness about a digital
AI-based oral healthcare diagnos-

tic and check-up service for patients.
A digital campaign was run a
few days before the event to create awareness, which helped 200300 patients to turn up. Ten dental
interns from Aadesh Dental College participated, and the Gurdwara provided food and helped
with other logistics.

Dental Tribune International GmbH
makes every effort to report clinical
information and manufacturers’ product news accurately but cannot assume responsibility for the validity of
product claims or for typographical
errors. The publisher also does not
assume responsibility for product
names, claims or statements made
by advertisers. Opinions expressed
by authors are their own and may
not reflect those of Dental Tribune
International GmbH

The dental college interns
gave the initial briefing to the patients, followed by oral screening
done on digital devices like mobiles and tabs. Reports generated
were forwarded to the patient’s
mobile devices.
Learnings from this camp
using digital devices and technology:
Patients need to be at ease
about cyber security with respect
to digital media, especially apps
and data privacy. QR Code security
needs to be conveyed to patients.
Patients showed enthusiasm
about the app and wanted to try it
on their own. Language barrier
was an issue initially but the local
student interns and other health
care workers helped communicate.
Further awareness among patients towards oral hygiene needs
to be created through social media
campaigns. This needs a lot of collective effort from all stakeholders.

AI engine-based app called Swasth Daant Pro was used to check oral health and generate a digital report.
(Photo: Muskan)

All rights reserved. © 2023 Dental
Tribune International GmbH. Reproduction in any manner in any language, in whole or in part, without the
prior written permission of Dental
Tribune International GmbH is expressly prohibited.

DENTAL TRIBUNE SOUTH ASIA
EDITION

PUBLISHER
Ruumi J. DARUWALLA
CHIEF EDITOR
Dr. Meera VERMA

CLINICAL EDITOR
Dr. Dilip DESHPANDE

RESEARCH EDITOR
Dr. Shobha DESHPANDE

ASSOCIATE EDITOR
Dr. GN ANANDAKRISHNA
EXECUTIVE EDITOR
Dr. Rajeev CHITGUPPI

ASSISTANT EXECUTIVE EDITOR
Dr. Riddhi D. TELISARA
DESIGNER
Anil LAHANE

PRINTER
Mehernosh MISTRY
Burzin MISTRY
Ampersand, Mumbai, India

[5] =>

NEWS

Dental Tribune South Asia Edition | 09/2023

Precision dentistry and artificial
intelligence: A symbiotic revolution
from acquiring technology to
training staff. Dental practices, especially smaller ones, must carefully evaluate the return on investment to justify these expenses.

The fusion of precision dentistry and artificial intelligence will create a new era of individualised and technologically sophisticated dental
treatments. (Image: Canva)

By Dr Rewant Chauhan &
Dr Saumya Tiwari
Since its inception, dentistry
has progressed beyond traditional
approaches to embrace innovative
technologies that improve accuracy, efficiency, and patient
results.1 As the two groundbreaking technologies, precision dentistry and artificial intelligence (AI),
merge, they create a new era of individualized and technologically
sophisticated dental treatment. It
is a combination of data and algorithms that can provide personalized care for oral health. As rightly
said by Prof. Judea Pearl: “Data do
not understand causes and effects; humans do.”
What is precision dentistry?
Precision dentistry, often synonymous with personalized dentistry, represents a paradigm shift
from the past one-size-fits-all
approach. 2 It involves tailoring
dental treatments to the individual
needs of each patient, taking advantage of the unique genetic
makeup of the patient, oral health
history, and other factors. This approach enables dental professionals to provide highly targeted and
effective interventions, minimising
unnecessary procedures, and
maximizing results.
Predictive diagnostics are essential for precision dentistry.
Dentists can identify potential
problems before they appear clinically using modern imaging and
genetic analysis methods. This
method not only minimises disease progression but also allows
early intervention, resulting in less

intrusive and more conservative
therapies.
The rise of AI in dentistry:
AI has become a transformative force in various industries, including dentistry. When applied in
dentistry, AI has the potential to
revolutionise the delivery and
management of dental care.
AI’s applications in dentistry
are broad and varied. One of its
primary functions is diagnostic.
AI-powered imaging analysis
based on deep vision can quickly
and accurately identify oral health
issues from X-rays, computed tomography (CT) scans, and other
images. 3 These systems can detect
caries, periodontal diseases, and
oral cancers at an early stage, allowing timely intervention.
Furthermore, AI helps in treatment planning by analyzing enormous amounts of patient data to
recommend the most suitable
treatment option for a particular
individual. This not only reduces
the burden on dental professionals but also enhances treatment
accuracy and patient satisfaction.
The synergy between precision dentistry and artificial intelligence:
The amalgamation of precision dentistry and AI is where innovation occurs. AI’s ability to analyze and interpret huge datasets
complements precision dentistry’s
focus on individualised care. Together, they create a symbiotic relationship that amplifies the potential for improved patient outcomes.

1. Improved diagnostics
AI algorithms excel in pattern
recognition, making them ideal for
identifying subtle anomalies like
dental caries in dental images and
radiographs.4 that might be missed
by the human eye. This aids in the
early detection of dental issues,
enabling timely intervention and
prevention of disease progression.
2. Personalised treatment
plans
Precision dentistry is based on
the concept of tailoring treatment
to each patient’s unique characteristics. AI improves this by analysing large databases of patient
information to recommend the
most effective treatment plans
based on factors such as genetics,
medical history and lifestyle.
3. Predictive maintenance
Incorporating AI into dental
practice management systems can
lead to more efficient clinical operations. AI algorithms can predict
equipment maintenance needs
and ensure that dental tools are in
optimal working condition. This
predictive maintenance prevents
unexpected breakdowns and minimises disruptions in patient care.
4. Patient engagement
AI-powered gadgets can provide control over oral health. Mobile apps, such as the Oral-B iO
app5 and virtual assistants can
provide individualised oral hygiene advice, track brushing and
flossing habits, and remind patients of impending appointments.6 This level of participation
develops a sense of ownership
and alertness toward oral health.

5. Research and development
AI-driven dentistry research is
accelerating the development of
new materials, treatments, and
technologies. AI accelerates the
process of uncovering innovations
that can transform the future of
dental care by evaluating vast data
sets and modeling treatment results.
Challenges ahead:
Several challenges need to be
addressed as promising as the fusion of precision dentistry and AI.
1. Data privacy and security
The integration of AI requires
access to enormous amounts of
patient data. Ensuring the privacy
and security of such data is paramount. Striking a balance between
data use to improve patient care
and safeguarding patient confidentiality is crucial. (7)
2. Compliance with law and
regulations
Dental practice must navigate
through a maze of regulations
when implementing AI systems.
These systems must comply with
standards set by medical and dental regulatory bodies to ensure patient safety and ethical use following HIPAA laws. (8)
3. Education and training
Dental professionals must be
trained to effectively use AI-powered tools and interpret their outputs. Incorporating AI into dental
curricula and providing continuous training opportunities will be
vital to harnessing its full potential
(9)
.
4. Cost implications
Integrating AI systems can involve significant upfront costs

The road ahead:
Precision dentistry, powered
by AI, promises a paradigm shift in
oral healthcare. As AI technologies
advance, they become more accessible and sophisticated, boosting their incorporation into dentistry. The future offers AI-powered robotic helpers conducting
difficult dental procedures with
exceptional precision and efficiency, as well as treatment programs that are not only individualized but also optimised for longterm success.
Dentistry’s path into precision
and AI-driven care has been nothing short of amazing. It has the potential to reshape oral health outcomes, making dental visits more
comfortable, treatment more effective, and smiling brighter than
ever before. As these two disciplines continue to combine and
communicate, patients and practitioners alike will realise the benefits of this extraordinary symbiotic
relationship.

About
Dr Rewant Chauhan is a dental
professional with a passion for
using technology to improve the
practice of dentistry, especially artificial intelligence and machine
learning. Dr Rewant is well-versed
in a variety of computer platforms,
advanced software packages, digital dentistry workflows and CAD/
CAM software, which he uses to
improve the accuracy and efficiency of dental treatments.
Dr Rewant holds a patent for an AI
model in dentistry.
Dr Saumya is a dentist and
professional content writer with a
strong interest in business and
marketing.
The list of references can be
obtained from the publisher
upon request.

[6] =>

NEWS

Dental Tribune South Asia Edition | 09/2023

ITI World Symposium 2024: More than 50
speakers, exclusive clinical case footage and
real patient stories

A large study in children has demonstrated a highly complex microbial interaction in dental plaque. (Image: Evgeniy Kalinovskiy/Shutterstock)

By International Team for
Implantology
SINGAPORE: The International
Team for Implantology (ITI) World
Symposium 2024 will be held in
Singapore from 9 to 11 May next

year. The event will feature more
than 50 world-renowned speakers,
real patient stories and exclusive
clinical procedures, and attendees
can expect cutting-edge insights
into soft tissue management,
guided bone regeneration and
bone augmentation, immediate

implants, peri-implantitis
digital workflows.

and

Speakers who will present at
the world’s largest scientific
implant dentistry event include
Prof. Daniel Buser, Prof. Giovanni
Zucchelli, Dr Istvan Urban, Prof.

Ronald Jung, Prof. Hom-Lay Wang
and Prof. Irena Sailer. Attendees
can expect an engaging experience
with lectures, clinical procedures
and discussions.
With a unique, patient-centred
programme structure, the ITI

World Symposium 2024 aims to
combine practical clinical insights
with the latest scientific findings.
Over three days, attendees will
have the opportunity to follow real
patients’ stories on stage, with
world-class clinicians providing
commentary
on
exclusively
recorded clinical procedures.
Besides the main sessions, the
ITI World Symposium will offer
several parallel sessions on topics
such as regeneration, periodontics
and primary stability. In addition,
attendees can choose from a wide
range of limited attendance
workshops, which will offer
hands-on opportunities to acquire
new skills.
All registrations include full
lunch and coffee break catering,
offering attendees a flavour of
Singapore’s diverse cuisines. An
event app for Apple and Android
phones will be available in order
for attendees to keep up to date
with the fast-paced programme
and all other ITI offerings.

The organisers expect more than 4,000 attendees. (Image: ITI)

Registration for the ITI World
Symposium is now open, and ITI
members as well as early
registrants will benefit from
significant discounts. Over 4,000
dental professionals from around
the world are expected to attend,
making this event an excellent
opportunity to network, share and
learn.

[7] =>

NEWS

Dental Tribune South Asia Edition | 09/2023

Most children with special healthcare needs
have caries and poor oral hygiene-study
hygiene, and the need for tailored
interventions, we can strive for
improved oral health outcomes
and enhance their overall wellbeing,” the authors concluded.
The
study,
titled
“An
assessment of the prevalence of
dental caries, oral hygiene status,
deft index, and oral hygiene habits
among children with special
healthcare needs”, was published
online on 25 July 2023 in the
Cureus Journal of Medical Science.

Researchers studying the oral health of children with disabilities say that tailored interventions are needed in order to improve oral health
outcomes and enhance overall well-being. (Image: Apichatn21/Shutterstock)

By Dental Tribune
International
JODHPUR, India: A study of the
oral health of children with special
healthcare needs in the Jodhpur
district in Rajasthan province has
found a high incidence of caries
and poor levels of oral hygiene.
The prevalence of caries among
the children was 65%, and the
authors say that the findings
emphasise the need for targeted
preventive measures to improve
the oral health of the at-risk group.
Researchers from India, Saudi
Arabia and Canada evaluated the
oral health and hygiene of 124
children aged 4–15 years enrolled
in special schools in the Jodhpur
district. All the children in the
study required special healthcare
support.
Oral examinations showed
that 65% of the group had caries,
varying in severity from mild (40%)
to moderate (20%) and severe
(5%). Poor oral hygiene was
exhibited by 75% of the children.
The group had a mean number of
decayed, missing and filled

primary teeth (dmft) score of 2.8,
and the incidence of caries was
greater among the older pupils.
Mean dmft scores were 2.5 in the
4–7 age group, 2.9 in the 8–11 age
group and 3.2 in the 12–15 age
group.
An assessment of the oral
hygiene habits of the group
showed that 60% of the children
brushed their teeth once daily and
40% brushed their teeth twice
daily. The vast majority (70%)
reported not using fluoride, and
55% said that they did not regularly
use dental floss.
The researchers said: “The
findings emphasise the need for
early intervention and preventive
measures to address dental caries
in this population.” They explained
that
the
group
required
comprehensive oral healthcare
and educational programmes
focusing on proper oral hygiene
practices.
“By addressing the unique
challenges faced by these children,
such as limited access to care,
difficulties in maintaining oral

View details of the programme
on our website and register now.

world-dental-congress.org

WORLD
DENTAL
CONGRESS
SYDNEY 2023
SUN 24 - WED 27 SEPTEMBER
Register now for the premier dental event of 2023.
Enjoy a 4-day scientific programme with leading
speakers from across the globe, a 25,000sqm
exhibition with the latest in dental products and
services, and rich socialising opportunities right
in the heart of Australia’s harbour city.

Oral examinations of 124 children enrolled in special schools in
Jodhpur District in India showed that showed that 65% of the group
had caries. (Image: Shalini S, Sharma S, Anand A, et al., CC BY 4.0, no
changes.)

[8] =>

NEWS

8

Dental Tribune South Asia Edition | 09/2023

Indian dental revamp to make graduate test
mandatory
By Jeremy Booth,
Dental Tribune International
NEW DELHI, India: New regulations for the dental profession in
India will mean that all BDS graduates will have to pass a dental National Exit Test (NExT-Dental) as a
prerequisite for licensure to practise dentistry in India and for admission to postgraduate dental
programmes. The National Dental
Commission Bill 2023 also proposes to replace the Dental Council of India with the National Dental Commission (NDC) as the
country’s top regulatory body for
dental education.
The bill was passed on 8 August in the Rajya Sabha, the upper
house of India’s parliament. It repeals the Dentists Act of 1948 and
aims to make dental education in
the country more affordable and
to improve access to oral healthcare.
According to The Hindu, the
yet to be established NDC will become the top regulator of dental
education in India and will begin
conducting the NExT-Dental examinations within three years of
the bill becoming law. Dr G.C. Rajkumar, head of Vokkaligara
Sangha Dental College and Hospital in Bengaluru, told the newspaper: “If you want to maintain quality of dental education, NExT is the
best option. However, to avoid
last-minute confusion, the government should provide complete
information and enough time for
students before implementing it.”
Holders of dental degrees
gained outside India will be required to pass the examination
before practising dentistry in the
country.
In July, Indian students and
their families demanded the postponement of a similar licensure
examination for medical students,
arguing that the newly introduced
test should not be mandatory for
graduates who began their studies
before the uniformity standard
was imposed.
The National Dental Commission Bill 2023 and what it will
change
The bill amounts to an overhaul of the way in which dental education is organised and governed
in India. Some of the key changes
include:
• the establishment of the NDC,
which will control fees for 50%
of the places in private dental
schools, oversee educational
quality standards, improve access to dental education and
impose uniformity in academic
examinations;

The National Dental Commission Bill 2023 cleared India’s Rajya Sabha on 8 August and will bring major changes for dental education in the
country. (Image: Maneesh Agnihotri/Shutterstock)

Advertisement

• the creation of a state dental
council structure and a dental
advisory council that will be
made up of representatives
from all the Indian states;
• the creation of three autonomous boards to oversee dental
education (Undergraduate and
Postgraduate Dental Education
Board, Dental Assessment and
Rating Board, and Ethics and
Dental Registration Board);
• the creation of an online register of licensed dentists;
• the facilitation of increased collaboration between dental and
other Indian healthcare bodies;
and
• the facilitation of increased participation between the dental
industry and dental education
institutes in order to advance
dental research and innovation.

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[9] =>

SCAN FOR
REGISTRATION
INFORMATION

THE LEADING DENTAL
EXHIBITION AND CONFERENCE
IN ASIA PACIFIC

EARLY BIRD
REGISTRATION
NOW OPEN!

19-21
APRIL 2024
Marina Bay Sands,
Singapore

FIRST WAVE OF SPEAKERS ANNOUNCED

David Alleman

Davey Alleman

Roberto Sorrentino

Andrea Bazzucchi

Taisuke Tsukiboshi

DENTAL HYGIENIST AND THERAPIST FORUM
The 5th edition of the Dental Hygienist and Therapist Forum will bring two
full days of insighful lectures focusing on the learning needs of the dental
hygienist and therapist from across the Asia Pacific.
The Forum will cover a variety of topics from geriatric and digital dentistry
to oral lesions and more. More speakers coming soon!
Kelvin Chua

Presented by:

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[cover] => Dental Tribune South Asia No. 9, 2023

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The oral-gut microbiota axis: the harbinger of autoimmue diseases / News

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