The term “primary intraosseous squamous cell carcinoma” was introduced in 2005 by the World Health Organization with three subcategories. Squamous cell carcinoma arising from the lining of an odontogenic cyst is one important rare subcategory of such lesions with an incidence of 0.01 to 0.02%. Furthermore, the appearance of such malignancy in an odontogenic tumor such as keratocystic odontogenic tumor is considered extremely rare. In this case report we report a case of a 50-year-old Sri Lankan woman who complained of pain and increase in the size of a swelling at the anterior mandible, which had been present for over 1 year. The increase was significant for 1 month with accompanying numbness of the left half of her lip. Cone beam computed tomography results revealed an irregular radiolucent lesion involving most of her mandible and, except in the anterior part, very little buccolingual expansion was seen that suggested a keratocystic odontogenic tumor. An excision biopsy of the cyst lining confirmed a squamous cell carcinoma arising from a preexisting keratocystic odontogenic tumor. Even though primary intraosseous squamous cell carcinoma arising from a keratocystic odontogenic tumor is considered to be very rare, the present case is comparable to most of the aspects cited in the literature. The current case emphasizes the importance of careful investigation of swellings present in the mandible. Clinicians as well as patients should be aware and detect these changes to avoid being clinically negligent.

Sense of Coherence (SOC) is the central construct of the health model of Salutogenesis, which has been identified as an effective approach for health promotion in adolescence as it focuses on pathways and mechanisms leading to health rather than disease and addresses the “upstream” social determinants of health. Antonovsky developed the SOC-13 item questionnaire to assess sense of coherence with the three dimensions, comprehensibility, manageability and meaningfulness in English-speaking populations. This study was conducted to assess the validity and reliability of Antonovsky’s SOC-13 item questionnaire for use among Sinhala-speaking adolescents in Sri Lanka. The cultural adaptation process included the establishment of item, conceptual, operational, and semantic equivalence of the questionnaire. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used to determine construct validity. Data from a sample of 400, Sinhala speaking 15-year-old students attending Sinhala medium government schools in Kandy district were used for this purpose. The reliability was assessed using internal consistency and testretest reliability. The culturally adapted ‘Sinhala version of the Adolescence Sense of Coherence questionnaire produced a single-factor solution with 5- items that accounted for 40.8% of the total variance of the scale. These 5 items included at least one item from the three different dimensions of the original questionnaire namely comprehensibility, manageability, and meaningfulness. The model fitted adequately with a single factor solution (c2 = 5.65; p=0.32, CFI=0.99, RMSEA=0.026) when assessed with CFA. The reliability of the questionnaire assessed through internal consistency (Cronbach alpha=0.63) and test-retest reliability (Spearman r correlation coefficient=0.65) were moderate. The Sinhala version of the adolescents’ sense of coherence questionnaire is a valid and reliable instrument to measure the construct sense of coherence in 15-year-old Sinhalaspeaking students in Sri Lanka.

Background: The COVID-19 (SARS-CoV-2) infection has been reported to affect the physical and mental well-being of individuals due to its pathophysiology and associated strict control measures. Aims: To explore the psychological morbidity and associated factors among the recently diagnosed SARS-CoV-2 infected individuals in Central Province, Sri Lanka. Methods: A descriptive cross-sectional study was conducted among residents of the intermediate care centres (ICC) for COVID-19 infected patients in the Central Province, Sri Lanka from 06/05/2021 to 04/08/2021. The participants completed a questionnaire on sociodemographic details and were screened for symptoms of depression and anxiety using the Patient Health Questionnaire- 9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7). Results: Of the 419 participants, 18.6% and 11.2% met cutoffs for depression and anxiety respectively. None of the participants reported self-harm following the diagnosis of COVID-19 infection, but 4.5% reported having experienced suicidal ideas. On bivariate analysis, female sex (P=0.002), being older than 35 years (P=0.04) and the presence of non-communicable diseases in the participant (P=0.04) were significantly associated with symptoms of depression. Conclusions: The findings of this study indicate that a proportion of people diagnosed with acute COVID-19 infection experience psychological symptoms. This indicates the need for increased awareness about mental health issues associated with COVID-19 and the provision of appropriate psychological support for individuals at risk.

Background/Objectives: This study aimed to assess whether income was associated with dental caries experience and dental care levels among 12-year-old children in two contrasting economic contexts, Sri Lanka (lower-middle-income) and Wales (high-income), regardless of national income status. Methods: An ecological study design was used with published data. For Sri Lanka, the income parameters used included household income, mean per capita income, and the Gini coefficient. For Wales, the Welsh Index of Multiple Deprivation was used. Dental caries was assessed using the DMFT index and its components (DT, MT, FT), while dental care was assessed using the care index, restorative index, and treatment index. Pearson correlations were used to explore associations between income measures and both caries experience and dental care indices across districts in Sri Lanka and unitary authorities in Wales. Results: The mean DMFT for 12-year-old children was 0.6 in both Sri Lanka and Wales, with caries prevalence of 30.4% and 29.6%, respectively. In Sri Lanka, both mean household income and per capita income showed moderate, statistically significant positive correlations with DMFT (r = 0.47, p = 0.01). Income inequality, measured by the Gini coefficient, was positively associated with caries experience (r = 0.42, p = 0.03). In Wales, higher deprivation (lower income) was moderately associated with increased DMFT, in areas within the 20% (r = 0.54, p < 0.01), 30% (r = 0.53, p < 0.01), and 50% (r = 0.61, p < 0.01) deprived quintiles. The dental care indices showed no clear association with income in either of the countries. Conclusions: Income-related disparities in dental caries were evident in both countries. Prevention strategies should focus on higher-income groups in Sri Lanka and on deprived populations in Wales. However, as this was an ecological study, the results are subject to ecological fallacy and should therefore be interpreted with caution.

The ‘Designed to Smile’ (D2S) programme in Wales emphasizes the importance of evidence-based practice in public health. Continuous monitoring, evaluation, and adaptation based on research have made D2S a sustainable model for child oral health care, with a significant reduction in dental decay rates in Wales since its inception. Cost-effectiveness studies, such as those comparing fissure sealants and fluoride varnish, have informed strategic shifts in resource allocation within D2S. The programme now emphasizes preventive measures such as oral health education, supervised tooth brushing, and fluoride varnish application, particularly targeting deprived areas based on the Welsh Index of Multiple Deprivation. Skill mix models in D2S, incorporating dental professionals and non-dental health workers, have enhanced programme delivery, particularly in early years’ interventions. Monitoring and evaluation mechanisms in D2S include both quantitative and qualitative assessments, providing comprehensive insights into programme effectiveness. Community engagement is integral to D2S, with efforts to involve parents, guardians, teachers, and health professionals in promoting oral health. The D2S team makes efforts to align with global health and environmental goals through practices like reducing plastic waste and decarbonization. The strategies and structure of the D2S child oral health care programme in Wales provide insights that could be valuable in facing existing challenges in oral health programmes for children in Sri Lanka.