Is there a relationship of negative oral health beliefs with dental fear and anxiety regarding diverse dental patient groups? A systematic review and meta-analysis

Alterations in salivary profile in individuals with dental caries and/or obesity: A systematic review and meta-analysis

OBJECTIVES

To investigate current evidence on the association of salivary profile with dental caries and obesity.

DATA/SOURCES

A comprehensive search was conducted on PubMed, Web of Science, Embase, ProQuest Medical Database, ProQuest Sci-Tech Premium, and Cochrane Library up to June 2024. Observational studies comparing salivary profiles in individuals with dental caries and/or obesity were included. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was utilised to estimate the overall weighted or standardised mean differences (WMD or SMD).

STUDY SELECTION

Fifty studies were included, comprising 47 cross-sectional studies and three longitudinal studies with only baseline data extracted. Meta-analysis demonstrated that individuals with caries had higher total antioxidant capacity (SMD: 1.78, P<0.001) and elevated levels of interleukin-6 (SMD: 3.41, P=0.004) and tumour necrosis factor-α (SMD: 0.61, P=0.005) in unstimulated whole saliva (UWS) compared to caries-free controls. Individuals with overweight/obesity, when compared to normal-weight counterparts, showed decreased UWS pH (WMD: -0.14, P=0.009), unstimulated and stimulated salivary flow rates (WMD: -0.09 mL/min, P=0.001 and WMD: -0.35 mL/min, P<0.001, respectively), phosphorus/phosphate levels in stimulated whole saliva (SWS) (SMD: -0.36, P=0.004), and peroxidase levels in both UWS (SMD: -1.56, P<0.001) and SWS (SMD: -1.10, P<0.001). Additionally, they exhibited higher salivary levels of mutans streptococci (SMD: 0.47, P<0.001), secretory immunoglobulin A (WMD: 14.51 μg/mL, P=0.020), and total antioxidant capacity in UWS (SMD: 0.67, P<0.001).

CONCLUSION

Although individuals with dental caries and/or obesity have altered salivary profiles, the quality of evidence remains low. Further high-quality studies are required to investigate the triadic associations in depth.

CLINICAL SIGNIFICANCE

Monitoring salivary parameters and biomarkers could serve as a relatively simple and non-invasive method for identifying, predicting, controlling, and monitoring individuals at high risk of dental caries and obesity. This knowledge can inform the development of tailored oral health promotion programs for individuals with obesity.

Salivary and gingival crevicular fluid biomarkers of periodontal health and/or obesity among children and adolescents: A systematic review and meta-analysis

Objectives

To investigate the association of salivary and gingival crevicular fluid (GCF) biomarkers with periodontal status and obesity in children and adolescents.

Data/sources

A literature search up to July 2023 was conducted through PubMed, Web of Science, Embase, ProQuest Medical Database, ProQuest SciTech Premium Collection, and the Cochrane Library. Observational studies comparing salivary and GCF biomarkers in children and adolescents with compromised periodontal status and/or obesity were included for data extraction. A meta-analysis was performed to estimate the overall standardised mean difference.

Study selection

Fifteen observational studies met the inclusion criteria and were included in this systematic review. Meta-analysis was only applicable in synthesising the dyadic relationship between GCF biomarkers and obesity. The results demonstrated that children and adolescents with obesity had significantly higher GCF levels of tumour necrosis factor-alpha (SMD:0.56; 95% CI:0.07, 1.04), adiponectin (SMD:0.33; 95% CI:0.06, 0.60), leptin (SMD:0.52; 95% CI:0.15, 0.90), and interleukin-1 beta (SMD:0.71; 95% CI:0.44, 0.99) than those with normal weight.

Conclusion

To date, no study has well addressed the triadic association between salivary or GCF biomarkers, periodontal status, and obesity among children and adolescents. Further in-depth, high-quality studies are required to investigate these associations.

Clinical significance

Periodontal disease and obesity are growing public health crises worldwide. Their relationship has been intensively studied. Investigating the salivary or GCF biomarkers alterations could help better understand the relationship between periodontal disease and obesity, which would assist in tailoring future oral health promotion programs.

Effectiveness of a smartphone application on dental anxiety in adolescents: A randomized controlled trial

BACKGROUND

Dental anxiety is a common issue among adolescents. Despite the use of smartphones being an important part of their daily lives, only a few digital-based interventions for dental anxiety have been tested in randomized controlled trials (RCT).

AIM

The aim of this study was to evaluate a new smartphone application (App) named FALE, which was designed to demonstrate interest from the dentist to adolescent and to reduce dental anxiety.

DESIGN

This is a RCT in which 184 adolescents aged 10-19 years were randomly allocated into the intervention group (IG) or the control group (CG). The intervention was applied in the waiting room before the consultation at a dental clinic. The IG answered the FALE, which contained 14 questions-of which the first and last questions addressed anxiety, whereas the CG answered the question about anxiety twice with an interval between them.

RESULTS

There was a significant difference in the distribution of anxiety rating frequencies before and after the intervention period in both groups. For the IG, there was a reduction in anxiety after the intervention of 16.29%, and, in the CG, a reduction of 2.2% (p < .001).

CONCLUSION

The FALE App effectively reduced dental anxiety before the appointment.

Qualitative Evaluation of YouTube Videos on Dental Fear, Anxiety and Phobia

The aim of this study was to review the health information of dental fear-, dental anxiety-, and dental phobia-related videos on YouTube. The 100 most widely viewed videos for the keywords "dental fear", "dental anxiety", and "dental phobia" were chosen for evaluation. Out of the 300 videos, 145 videos met the inclusion criteria and were analyzed. It was found that most of them were produced by the professions, with a dentist delivering the key messages or with patients giving testimonials. Many etiological factors and symptoms were described. Many pharmacological and non-pharmacological interventions were recommended to the audience, such as sedation and distraction, respectively. However, there was a lack of information on the definition or diagnostic criteria of dental fear, dental anxiety, and dental phobia. Videos with high views had a higher ratio of misleading information. Videos with a dentist being the informant had a similar ratio of misleading information compared to other videos. Without adequate information on how to diagnose, it would be very difficult for the audience to determine if the video content was relevant or useful. The dental profession can work together with psychologists or psychiatrists to produce authoritative videos with accurate content.

Unraveling the signs and symptoms of oral conditions that affect daily life activities and oral health-related quality of life

OBJECTIVES

Since oral conditions negatively affect oral health-related quality of life (OHRQoL), this study evaluated which oral clinical condition, signs, and symptoms are associated with the impact on OHRQoL, its domains, and specific daily life activities among adults.

MATERIALS AND METHODS

Data from a probabilistic sample of adults (35-44 years old) was used. The Oral Impacts on Daily Performance (OIDP) was used to evaluate OHRQoL, its domains (physical, psychological, and social), and nine daily life activities. Signs and symptoms of oral diseases (dental caries, periodontal disease, need for dental prothesis, and tooth loss) and oral self-perception were considered. Descriptive, bivariate, and multi-level analyses were conducted.

RESULTS

A total of 5,834 adults were included, of which 52.9% had some negative impact of oral conditions on OHRQoL. Difficulty in eating was the most affected daily life activity. For multiple models, dental caries lesions (cavities), filled teeth with caries, gingival bleeding, periodontal pocket, dental pain, need for upper or lower dental prosthesis, and oral health self-perception were associated (p < 0.05) with overall OHRQoL or at least one of its domains. The impact on daily life activities of each individual was associated with at least one oral condition. Dental caries lesions (cavity) and dental pain were associated (p < 0.05) with the impact on most daily life activities evaluated.

CONCLUSIONS

Different signs and symptoms of prevalent oral diseases are associated with the impact on specific daily life activities among adults, which may compromise the OHRQoL.

CLINICAL RELEVANCE

Knowledge of how signs, symptoms, and oral conditions affect OHRQoL and daily life activities can provide essential information for clinicians to establish proper disease management and preventive strategies focusing on improving patients' lives.

Variations in temporal trends in non-traumatic dental condition related emergencies

OBJECTIVE

The objective of the study was to investigate temporal trends in non-traumatic dental condition (NTDC) related emergency visits at Emergency Department (ED), urgent care (UC), and at a Federally Qualified Health Center (FQHC) that providing dental services to a mid-sized rural community.

METHODS

Temporal trends over a 9-year period (2008-2016) in NTDC rates at ED, UC, FQHC and in a region around the FQHC were determined. Statistically significant changes (α = 0.05) in the proportion of NTDC visits between FQHC and UC across each of the time points were investigated.

RESULTS

Proportion of NTDC ED visits was relatively stable over the study period; whereas those at FQHC exceeded those at UC site beginning 2012 and were significantly (α = 0.05) higher than that of UC subsequently (2015-2016).

CONCLUSIONS

NTDCs are preventable dental conditions and the care provided in treating NTDCs in emergency settings is palliative and does not address the underlying conditions resulting in poor outcomes. The results presented elucidate the critical role of FQHCs in significantly reducing NTDC visits. These might be precursors to a potential shift in NTDC care seeking behavior and expected to favorably impact oral health outcomes.

The Meaning and Purpose of Primary Tooth Disposal Rituals: Implications for Pediatric Dental Professionals

Rituals for disposing of exfoliated primary teeth exist in virtually all cultures around the globe, suggesting an important psychological and social function for young children and parents. Despite the importance of these rituals, and the role they may play in children's interactions with dental professionals, the meaning and purpose of primary tooth disposal traditions has not yet received adequate attention in pediatric dentistry. The overarching goal of this perspective was to draw attention to the meaning and purpose of primary tooth disposal rituals and show how, with a greater understanding of these rituals, dental professionals could improve the interactions they have with their young patients. To achieve this goal, we first summarize findings from prior research on how primary tooth disposal rituals are primarily practiced as a rite-of-passage to ease the transition from early to later childhood, to counteract anxiety, trauma, or pain experienced by children of tooth-shedding age, and to honor spiritual or religious beliefs that are thought to protect the child and aid their healthy development. Second, we articulate how, by understanding the significance and diversity of these traditions, practitioners can potentially improve their ability to prevent dental anxiety, increase their cultural competence to engage with increasingly diverse pediatric patient populations, and ensure more timely primary oral care. Finally, we provide a two-pronged approach, centered around the pillars of Education and Communication, to improve overall patient care built on knowledge of these rituals and cultural practices.

The Mediterranean Dietary Pattern and Inflammation in Older Adults: A Systematic Review and Meta-analysis

This systematic review and meta-analysis aimed to explore the association between the Mediterranean dietary pattern and inflammation in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A search of the literature was conducted up to June 2020 in 7 electronic databases, namely PubMed, Embase, Web of Science, Scopus, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and ProQuest. The Joanna Briggs Institute Critical Appraisal Checklists and the Newcastle-Ottawa Scale were used to assess the methodological quality. The overall standardized mean difference (SMD) and 95% CIs were estimated in random-effects meta-analyses. Thirteen studies were identified as having acceptable quality and were included in this systematic review: 3 randomized controlled trials (RCTs), 1 quasi-experimental study, 1 cohort study, and 8 cross-sectional studies. The circulating C-reactive protein (CRP) concentration was the most common inflammation indicator used. Results of the meta-analysis on 5 cross-sectional studies revealed a significant inverse association between the Mediterranean dietary pattern and inflammation as assessed by CRP (SMD = -0.26; 95% CI: -0.41, -0.11; P < 0.001). Other studies that investigated a variety of inflammation indicators other than CRP showed mixed results with regard to the relation between the Mediterranean dietary pattern and inflammation in older adults. Our findings suggest that the Mediterranean dietary pattern may be associated with lower inflammation in older adults. However, more long-term RCTs are required to demonstrate the effects of the Mediterranean dietary pattern on multiple inflammation parameters in older adults. The study has been registered on PROSPERO (#CRD42020140145).

Digital behavior surveillance for monitoring the interests of Google users in amber necklace in different countries

AIM

To determine the interests of Google users in information about amber necklace in distinct countries over time.

DESIGN

This longitudinal retrospective study analyzed the amber necklace-related computational data generated from the activity of Google users from17 countries, by the application of Google Trends. Four search strategies were defined in English, Spanish, Portuguese, and Italian, for retrieving the monthly variation of relative search volume (RSV) between January 2004 and September 2018, including all categories and sources of search. Trends and 12-month predictive interests of users were analyzed by forecasting autoregressive integrated moving average models, while the influences of seasonality were evaluated by generalized additive models. The most popular queries employed for Google users were determined to qualitative analysis. P values < 0.05 were considered significant.

RESULTS

In general, RSV curves were characterized by uptrends in most studied countries over the years, without the influence of monthly or quarterly seasonality. The queries were frequently associated with a desire for additional information, with respect to the definition, usability, and teething symptoms relief promoted by amber jewelries.

CONCLUSIONS

These findings indicate an increasing interest of Google users in amber necklace-related topics in different countries.