Attitudes and lifestyle factors in relation to oral health and dental care in Sweden: a cross-sectional study

Association between periodontitis and dental caries: a systematic review and meta-analysis

OBJECTIVES

Recent evidence suggested a link between periodontitis (PD) and dental caries, but the trends and nature of this association remained unclear. The overall aim of this study was to critically assess the correlation of two disorders.

METHODS

A comprehensive search was conducted within the PUBMED and EMBASE databases including grey literatures up to July 5th, 2023. The Newcastle-Ottawa scale was used to qualitatively evaluate the risk of bias.

RESULTS

Overall, 18 studies were included. In terms of caries risk in PD patients, the prevalence of caries was increased by PD (OR = 1.57, 95%CI:1.20-2.07), both in crown (OR = 1.03, 95%CI:1.01-1.05) and root caries (OR = 2.10, 95%CI:1.03-4.29). Odds of caries were also raised by PD severity (OR moderate = 1.38, 95%CI:1.15-1.66; OR severe = 2.14, 95%CI:1.74-2.64). Besides, patients with PD exhibited a higher mean number of decayed, missing and filled teeth (DMFT) and decayed and filled root teeth (DFR) [weighted mean difference (WMD)DMFT = 0.87, 95%CI: -0.03-1.76; WMDDFR = 1.13, 95%CI: 0.48-1.78]. Likewise, patients with caries had an elevated risk of PD (OR = 1.79, 95%CI:1.36-2.35). However, Streptococcus mutans, one of the main pathogens of caries, was negatively correlated with several main pathogens of periodontitis.

CONCLUSIONS

This study indicated a positive correlation between dental caries and periodontitis clinically, while the two disease-associated pathogens were antagonistic.

CLINICAL RELEVANCE

Further research, including clinical cohort studies and mechanisms of pathogens interaction is needed on this link for better prevention and treatment of PD and caries. In addition, innovative prevention strategies need to be developed and incorporated in dental practices to prevent these two highly prevalent oral diseases.

Health behaviors and tooth retention among older adults in China: findings from the 4th Chinese national oral health survey

Background

This study aimed to examine the association between oral health behaviors and tooth retention among Chinese older adults.

Methods

Data were used from the 4th Chinese National Oral Health Survey, a nationally representative sample. The sample included 9054 older adults aged 55 to 74. Control variables and oral health behaviors were measured through a questionnaire interview, and the number of remaining teeth and periodontal health were obtained from an oral health examination. A chi-square test was used for univariate analysis. Multivariate Logistic regression was used to explore the association between health behaviors and the number of remaining teeth.

Results

The average number of remaining teeth in the sample was 24.4 ± 7.7. There was a higher proportion of older adults living in urban areas with 20 or more teeth than those living in rural areas (83.2% vs. 79.4%, P < 0.001); and a higher proportion of individuals with high education levels with 20 or more teeth compared to those with low education levels (P < 0.001). Logistic regression models showed that older adults who used toothpicks `(OR = 3.37, 95% CI 2.94–3.85), dental floss (OR = 1.93, 95% CI 1.05–3.53), toothpaste (OR = 3.89, 95% CI 3.14–4.83); and never smoked (OR = 1.43 95% CI 1.20–1.70) were more likely to retain 20 or more natural teeth; whereas older adults who had a dental visit were less likely to retain 20 or more natural teeth (OR = 0.45, 95% CI 0.39–052).

Conclusion

Good oral hygiene practices, never smoking, and regular dental visits focusing on prevention are significantly associated with teeth retention. It is critical to promote a healthy lifestyle and improve prevention-oriented oral health care systems.

Self-perception of periodontal health and pain experience during periodontal examination in 14- to 15-year-old Danish adolescents

OBJECTIVE

To evaluate different aspects of periodontal examination among Danish adolescents.

MATERIALS AND METHODS

In all, 521 Danish adolescents underwent a periodontal examination and answered a questionnaire concerning their self-perception of periodontal health (PH). Furthermore, 107 participants reported their pain experience during periodontal examination using a visual analog scale. The self-perception of PH and the pain experience were correlated with plaque score (PS), bleeding on probing (BOP), probing pocket depth (PPD), and interdental clinical attachment loss (CAL).

RESULTS

Good PH was reported by 424 (81%) of the participants. However, the association between PH and PS, BOP, PPD, and CAL was small (sensitivity: 7.7, 7.8, 12.0, and 0.0%, respectively). Only 57 (11%) of the participants reported bleeding gums (BG) during tooth brushing, but the correlation with BOP showed a sensitivity of 11.7%. The specificity of both self-perception of PH and BG was high. Sixty-seven (66.6%) of the participants experienced 'mild pain' during periodontal examination. There were no differences in periodontal outcomes between the pain groups (p > .05).

CONCLUSIONS

The adolescents showed a poor ability to identify themselves as having poor PH and BG, and 67 (66.6%) of the adolescents experienced mild pain during periodontal examination. The findings emphasize the need for dental staff to monitor the PH of Danish adolescents and advise them as necessary.

Working characteristics for practicing dental hygienists in two countries in different hemispheres

OBJECTIVES

The study aimed to collect and compare practice characteristics for dental hygienists (DHs) in New Zealand (NZ) and Sweden.

METHODS

Dental hygienists from NZ and Sweden were invited to participate in an anonymous online survey focusing on their working practices. An email, with a link to the online survey and a participant information sheet, was sent to DHs registered with their professional association in their respective country. Frequency analyses and cross-tabulations were conducted using Chi-square and Fisher's Exact tests to investigate possible statistical associations to allow for comparisons between the countries.

RESULTS

DH is a female-dominated workforce with equal distribution of gender in both countries. The majority of DHs in NZ worked in private practice while Swedish DHs mostly worked in the public sector. NZ participants were younger and with a more recent qualification than their Swedish counterparts. The highest degree of education was a PhD for DHs working in Sweden, compared with a Masters' Degree for NZ participants. The majority of participants from both countries treated patients 65 years of age or older, with the most common medical conditions being cardiovascular disease and diabetes mellitus. The most common dental condition observed/treated was periodontal disease. Over 60% agreed to have an understanding of information technology (IT). The most used technical equipment was digital radiology, followed by other diagnostic tools.

CONCLUSION

Findings confirm previous international data on demographical uptake for the DH workforce in NZ and Sweden. A coherence was seen in patient characteristics, DHs attitudes towards information technology and use of technical equipment.

The Incidence of Dental Fracturing in Electroconvulsive Therapy in Sweden

OBJECTIVES

One adverse effect of electroconvulsive therapy (ECT) is dental fracture; thus, a bite guard and muscle relaxants are used to prevent it. Earlier research reported varying rates of dental fracture, but there is no large-scale study on the incidence of dental fracture during ECT. This study aimed to examine the incidence of dental fracture during ECT and to investigate whether the incidence differs between different sexes, age groups, diagnosis groups, electrode placements, or number of treatment sessions.

METHODS

This register-based study used data from the Swedish national quality register for ECT. All hospitals offering ECT report to this register, and the coverage ratio is about 90%. All registered patients who started an ECT series between January 2012 and January 2019 were included in this study, with the data representing 16,681 individuals, 38,862 series, and 254,906 sessions.

RESULTS

Forty-six dental fractures were identified, giving an incidence of dental fracture of 0.2% per series, 0.02% per session, and 0.3% per individual. We did not find any significant associations between dental fracture rates and male or female populations, age, or different diagnosis groups, nor was there any significant difference between dental fracture rates and electrode placement. The mean number of treatments was significantly higher in the dental fracture group than in patients without dental fracture.

CONCLUSIONS

There is a minimal risk of dental fracture during ECT. Our findings, together with those of other studies, provide further motivation for the use of a bite guard and muscle relaxant.

Relationship between oral health behaviour and handgrip strength: a cross-sectional study with 7589 Korean adults

Objective: This cross-sectional study investigated the relationship between handgrip strength and oral health behaviours among Koreans.Methods: The data of 7589 individuals (3384 men and 4205 women) aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2015 were analyzed. Oral health behaviour was assessed based on the number of daily toothbrushing sessions and the use of secondary oral-care products. The association between oral-health behaviour and handgrip strength was investigated adjusting for confounders. Multivariable logistic regression analysis was performed (α = 0.05).Results: The proportion of participants diagnosed with sarcopenia was significantly higher in the group with poor oral-health behaviours. After adjusting for confounders including age, the adjusted odds ratios and 95% confidence intervals of female participants with low handgrip strength in groups toothbrushing thrice or more per day, twice per day, and once or less per day were 1 (reference), 1.18 (0.99-1.4), and 1.24 (0.89-1.71), respectively. There were significantly more participants with low handgrip strength in the group that did not use secondary oral products for both sexes.Conclusions: Oral health behaviour is associated with handgrip strength among adults. Poor oral self-care habits may constitute a risk indicator for low muscle strength.

Study of Periodontal Health in Almada-Seixal (SoPHiAS): a cross-sectional study in the Lisbon Metropolitan Area

This study aimed to describe the prevalence and extent of periodontal diseases among adults in the southern region of the Lisbon Metropolitan Area. This population-based cross-sectional study included 1,064 randomized participants (aged 18 to 95 years, 617 females/447 males). Sociodemographic, behaviours and medical information were recorded. Periodontal conditions were assessed with a full-mouth circumferential periodontal examination. It was used the American Association of Periodontology/European Federation of Periodontology 2017 case definitions. A logistic regression analysis was applied to ascertain hypothetical risk factors towards periodontitis. The prevalence of periodontitis was 59.9%, with 24.0% and 22.2% of the participants exhibiting severe and moderate periodontitis, respectively. The risk of periodontitis significantly increased with age (OR = 1.05, 95% CI: 1.04-1.06), for active and former smokers (OR = 3.76 and OR = 2.11, respectively), with lower education levels (OR = 2.08, OR = 1.86, for middle and elementary education, respectively) and with diabetes mellitus (OR = 1.53). This study confirms a high burden of periodontitis in the target (Portuguese) sub-population. The findings provide a comprehensive understanding that will empower appropriate national public oral health programmes and population-based preventive actions.