Men and Oral Health: A Review of Sex and Gender Differences

Oral cavity and oropharyngeal cancers in Texas: examining incidence rates in dental health professional shortage areas

PURPOSE

Oral cavity (OC) and oropharyngeal (OP) cancer rates have increased annually rising in the U.S. and Texas. Dental providers could play a key role in lowering OC/OP cancer rates through prevention and screening, but Texas faces a significant shortage of dental health professionals, affecting access to dental care, including OC/OP cancer prevention and early detection. This study aims to explore the link between OC/OP cancer rates and these dental shortage areas in Texas.

METHODS

We analyzed OC/OP cancer incidence in Texas using SEER-Medicare data for patients aged 65 and over from 2012 to 2017. Rates per 100,000 were stratified by age, gender, and dental health provider shortage area (DHPSA) status (yes/no). Zero-Inflated Poisson Regression models were used to adjust for patient characteristics in studying cancer incidence, Late-stage diagnoses were assessed using logistic regression.

RESULTS

The incidence rate was 27.3 per 100,000 people in Texas. DHPSA counties had lower incidence rates (24.3 per 100,000) compared to non-DHPSA counties (29.8 per 100,000; p = 0.0423). Among patients with OC/OP diagnoses, those living in a DHPSA county had lower odds of advanced stage diagnoses (aOR: 0.79; CI: 0.64-0.96) than those in non-DHPSA counties.

CONCLUSION

The findings highlight the complex link between dental providers and OC/OP cancer diagnoses, noting differences in indicators of need based on DHPSA location. Limited local dental services may lead to underreported cancer cases. Further research on dental service usage could improve OC/OP outcomes by prioritizing interventions from dental professionals.

Education, Tooth Loss, and Dental Visits: Evidence from Schooling Reforms

Numerous studies have shown that education correlates with tooth loss and dental services use, but whether expanding educational opportunities would reduce tooth loss and improve dental attendance remains unclear given that prior studies lacked a study design to assess causality. We leveraged a policy reform, raising the school leaving age, as an instrumental variable (IV) to estimate the effect of education on edentulism and dental visits in the United States using the repeated cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS; N = 463,878). We additionally examined the effect of education on dental visits using longitudinal data from the Survey of Health, Aging and Retirement in Europe (SHARE; N = 69,929). Applying IV probit models, we found 1 extra year of schooling reduced edentulism likelihood by 2.9 percentage points (95% confidence interval [CI]: -0.041; -0.017) and increased dental visit likelihood by 1.2 percentage points (95% CI: 0.01; 0.024) in the United States, with similar effects on dental visits in Europe. Estimates were robust to different model specifications and plausible amounts of imperfect exogeneity. Negative control analysis supported the validity of our findings. This study provides consistent evidence that extended schooling reduces edentulism risk and increases regular dental attendance.

Association between prediabetes and periodontitis: a meta-analysis of observational studies with multivariate analysis

BACKGROUND

Growing evidence suggests that prediabetes may increase the risk of periodontitis, though the extent of this association remains unclear. To provide a clearer understanding, this meta-analysis focused on observational studies that utilized multivariate analyses to adjust for key confounding factors.

MATERIAL AND METHODS

A comprehensive search of PubMed, Embase, and Web of Science was conducted to identify observational studies assessing the relationship between prediabetes and periodontitis. Only studies that utilized multivariate analyses were included to minimize confounding bias. The quality of the studies was evaluated with the Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model, with heterogeneity assessed by the I² statistic.

RESULTS

Ten observational studies with 38,727 participants were included. Overall, individuals with prediabetes had a significantly higher risk of periodontitis compared to normoglycemic individuals (OR: 1.27, 95% CI: 1.09 to 1.48, p < 0.001) with moderate heterogeneity (I² = 53%). Subgroup analyses revealed a stronger association in studies where the proportion of men was < 45% compared to those ≥ 45% (OR: 1.75 vs. 1.15, p for subgroup difference = 0.01). Studies with lower quality (NOS score = 7) showed a stronger association compared to higher-quality studies (NOS score = 8 or 9, p for subgroup difference = 0.003).

CONCLUSION

This meta-analysis found that prediabetes may be independently associated with an increased risk of periodontitis. Further research is needed to explore the mechanisms underlying this association and potential sex-specific effects.

Acceptance of potential risks in adult orthodontic patients and the influence of personality traits

OBJECTIVES

To determine acceptance of potential risks in orthodontic treatment and whether it could be affected by personality traits of patients.

MATERIALS AND METHODS

Two hundred sixty-one adult participants consulting for orthodontic treatment were involved in this cross-sectional study. Acceptance of 18 orthodontic risks was investigated with a structured questionnaire. Personality traits of included patients were assessed with a validated Chinese version of the Big Five Inventory. Statistical analyses were performed as appropriate, and potential correlations were identified using multivariate binary logistic regression analysis.

RESULTS

Acceptability of the investigated orthodontic risks ranged from 47.1% to 87.0%, with periodontitis being the least accepted. Length of treatment (P = .015) and relapse (P = .007) were more unacceptable to older patients. Female participants showed less tolerance to periodontitis (P = .017) than male counterparts. Among the five dimensions of personality traits, conscientiousness was significantly associated with acceptance of tooth extraction and associated risks (odds ratio [OR] = 1.131, P = .002), problems eating (OR = 1.182, P < .001), problems speaking (OR = 1.111, P = .022), and appliance breakage (OR = 1.109, P = .008), while openness was a significant predictor to the acceptance of length of treatment (OR = 1.090, P = .044).

CONCLUSIONS

Among patients seeking orthodontic treatment, periodontitis was the least accepted risk. A significant association was found between the acceptance of certain orthodontic risks and personality traits, especially conscientiousness and openness.

Oral health effects of non-combustible nicotine products: protocol for a systematic review and network meta-analysis

BACKGROUND

Tobacco use is a global issue, and non-combustible nicotine products (NCNPs) like electronic nicotine delivery systems, nicotine pouches, snus, and nicotine replacement therapies offer potential risk/harm reduction for smokers unable or unwilling to quit. Although NCNPs are less harmful than tobacco smoking, their impact on oral health remains unclear. A systematic review and network meta-analysis will be conducted to answer the research question: What are the oral signs and symptoms associated with NCNPs as both monotherapies and combination therapies compared to each other, placebo, standard care, no drug treatment, and combustible cigarette smoking?

METHODS

We will search PubMed and Scopus databases, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to August 2024. This review will focus on randomized controlled trials (RCTs) with a minimum follow-up period of 1 month, comparing any NCNPs versus placebo, standard care, no drug treatment, combustible cigarette smoking or to each other in adult smokers. Our primary outcomes will be the number of participants reporting any oral side effect, aphthous ulcers, dry mouth and mouth irritation. Studies will be excluded if they involve: non-smokers, pregnant women, individuals with mental health or neurological disorders, participants consuming alcohol or other substances. Data will be analyzed using a network meta-analysis framework, estimating odds ratios with 95% confidence intervals. Risk of bias will be determined using the Cochrane risk of bias tool-version 2.0 for included RCTs and the Confidence In Network Meta-Analysis tool will be employed to assess the confidence of evidence contributing to each network estimate.

DISCUSSION

Our findings will provide critical insights into the oral health implications of NCNPs, informing clinical and public health decisions. Results are expected by May 2025 and will be disseminated through publications and presentations to guide tobacco harm reduction strategies.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42024565118.

India's oral health outlook: challenges, economic impact and need for preventative strategies

Objective

This review explores the economic and behavioral dimensions of oral health in India, emphasizing the economic burden, treatment-seeking behaviors, and policy-level interventions needed to improve oral health outcomes.

Methods

A mixed-method approach was employed, integrating primary data from the Oral Health Observatory (OHO) project (2016-2020) and a systematic review of secondary literature. The OHO project surveyed dental clinic patients using mobile app questionnaires, focusing on oral health behaviors, barriers, and outcomes. Secondary data were analyzed from PubMed, MEDLINE, and Embase databases to assess the economic implications of oral health care in India.

Results

The OHO data revealed a steady decline in routine dental visits after the age of 35-44 years, while emergency visits persisted across age groups. Gender disparities were observed, with men reporting higher dissatisfaction, greater oral pain, and work disruptions compared to women. Only 44.7% of participants brushed twice daily, and 36.7% brushed before bed. Secondary findings reveal that untreated oral diseases have a higher economic impact than preventive measures. This highlights the need for consumer awareness, strategic policies, and sustainable healthcare frameworks.

Conclusion

India faces significant challenges in oral health due to low awareness, insufficient infrastructure, and economic barriers. Strengthening preventive strategies, increasing public-private partnerships, and integrating oral health education into primary care can dramatically reduce costs and improve population outcomes. A shift from reactive to preventive care is essential for ensuring equitable and sustainable oral health solutions.

Managing Fear and Anxiety in Patients Undergoing Dental Hygiene Visits with Guided Biofilm Therapy: Analysis of Psychological and Physiological Differences Between Women and Men-A Conceptual and Multivariate Regression Model

Background: Dental anxiety is a significant barrier to dental care, leading to avoidance behaviors and compromised oral health. This study aimed to analyze fear and anxiety during dental hygiene visits with Guided Biofilm Therapy (GBT), focusing on gender differences in psychological and physiological responses to develop a more personalized approach to dental care. Methods: A total of 247 patients participated in this study. Psychological assessments included the Modified Dental Anxiety Scale (MDAS) and the State-Trait Anxiety Inventory (STAI X2), while physiological responses were measured through heart rate monitoring before and after procedures. Multivariate regression analysis was conducted to identify predictors of anxiety levels. Results: Multivariate regression analysis identified gender, sensory sensitivity (e.g., absence of tools in the field of view), past traumatic dental experiences, and individual preferences for anxiety reduction as significant predictors of anxiety levels. Gender differences were also observed in anxiety management strategies, with women more frequently preferring the elimination of sensory triggers and direct communication with dental professionals. Conclusions: The findings highlight the importance of personalized anxiety management protocols in dentistry. Tailored communication strategies, optimized clinical environments, and individualized pre- and post-procedure care plans can enhance patient experience and treatment acceptance. Implementing such patient-centered, data-driven approaches aligns with the broader principles of precision medicine in dental care.

The association between predisposing, enabling and need factors and oral health care utilization among U.S. working age adults

BACKGROUND

Irregular dental visits due to cost-related delays contribute to poor oral health outcomes, dental needs, and emergency service utilization across the life course. The study investigated how predisposing, enabling, and needs factors are associated with cost-related delays in oral health care and postponed dental visits.

METHODS

Using secondary data from the 2022 National Health Interview Survey for United States (U.S.) adults aged 18-64 years, the study conducted descriptive, bivariate, and multivariate data analyses. Separate multivariable logistic regressions were used to model cost-related delayed oral health care and postponed dental visits (no dental visit in the past 12 months) as a function of predisposing, enabling, and need factors (n = 17,513). Predictor variables included race, education, smoking status, age, gender and employment status (Predisposing factors), family income as a percentage of the Federal Poverty Level (FPL) and Health Service Deficit (HSD) variables (no health insurance, no usual medical primary care provider, > 12 months of last medical exam and delayed medical care due to cost) (Enabling factors), difficulty engaging in social activities and the presence of > 1 comorbidity (Need factors).

RESULTS

The prevalence of cost-related delayed oral health care was 20.2%, and that of postponed dental visits was 36.4%. Strong predictors for cost-related delayed oral health care emerged from predisposing factors (smoking OR = 1.47, 95% CI, 1.33, 1.62), enabling factors (no health insurance OR = 2.96, 95% CI, 2.56, 3.42), and need factors (difficulty engaging in social activity OR = 1.59, 95% CI, 1.34, 1.88) at p < 0.001. Enabling factors were the strongest predictors of postponed dental visits. The odds decreased with higher family income [> 400% FPL vs. < 100% FPL (OR, 0.50; 95% CI, 0.43, 0.58)], whereas the odds increased by 68%, 64%, 130%, and 57% for persons with no health insurance, no usual primary care provider, > 12 months of last medical exam, and delayed medical care due to cost, respectively.

CONCLUSIONS

Individual factors, including smoking, lack of health insurance, and difficulty engaging in social activity, were independently associated with cost-related delayed oral health care, and the strong links between postponed dental visits and HSDs provide a clear opportunity for advocating for medical and dental integration for patient-centered care.

Oral health-related quality of life in patients with type II diabetes mellitus: a systematic review and meta-analysis

BACKGROUND

Our study aimed to comprehensively assess the impact of type II diabetes mellitus (T2DM) on oral health-related quality of life (OHRQoL) based on results from the Oral Health Impact Profile (OHIP-14) questionnaire. A secondary objective was to explore how the potential correlation between the OHIP-14 score and T2DM was affected by demographic and clinical characteristics.

METHODS

We systematically searched the Medline, EMBASE, CINAHL and Scopus databases on January 24, 2024, for evidence starting from database inception. Studies included in the analysis assessed OHRQoL in T2DM patients. We searched trials both with or without comparisons to healthy controls and presenting OHIP-14 results as a severity of impact, namely, the mean OHIP-14 total score. To assess the difference between diabetic and non-diabetic subjects, we calculated weighted mean differences (WMD) with 95% confidence intervals (CI). A meta-analysis of each summary measure was conducted provided that this outcome was evaluated in at least two studies so that model was selected on the basis of heterogeneity assessment. The quality of the included studies was assessed using the tool developed by The National Heart, Lung, and Blood Institute (NHLBI).

RESULTS

Seven studies fulfilled the inclusion criteria (1,457 patients diagnosed with diabetes mellitus and 216 healthy controls). In patients with T2DM, the mean OHIP-14 total score was approximately 2.7 points higher (an indication of greater oral problems) than in healthy persons; WMD = 2.68 (95% CI: 0.47-4.89); p = 0.0176. Significant differences between diabetic and non-diabetic subjects were also observed for almost all domains of the OHIP-14, except handicap. The calculated average OHIP-14 total score was 12.06 (95% CI: 4.93-19.19), which indicated a slight effect on OHRQoL. Age and sex did not appear to be relevant for assessing the impact of diabetes mellitus on OHRQoL.

CONCLUSIONS

Our findings confirm that OHRQoL in patients with T2DM is significantly lower and may be influenced by functional problems in addition to various physical and psychological limitations. However, the available data are of low quality and a lack of evidence from high-quality studies with matched control groups exists.

CLINICAL TRIAL NUMBER

Not applicable.

Global and Regional Patterns in Edentulism (1990-2021) With Predictions to 2040

AIMS

Edentulism's impact on overall well-being is widely recognized, but there is limited information on regional and sex disparities in its global burden. This study aims to fill this gap by providing an updated picture of edentulism's burden by region and sex and predicting its global trend for the next 2 decades.

METHODS

This study analyzed and reported Global Burden of Disease (GBD) data on the prevalence, incidence, and disability adjusted life years (DALYs) of edentulism, with a breakdown by sex and sociodemographic index (SDI). Epidemiological trends from 1990 to 2021 were characterized using Joinpoint regression analysis. An Autoregressive Integrated Moving Average (ARIMA) model was used to forecast edentulism prevalence trends from 2022 to 2040.

RESULTS

A double increase was found in the number of people with edentulism during the last 30 years. A decrease in the incidence rate of edentulism was found in younger age groups, and a shift in the peak age of prevalence from 70-74 in 1990 to 75-79 in 2021. Females had a higher prevalence rate of edentulism than males globally, with a disproportionate burden in regions of high SDI countries. The global prevalence rate is projected to increase to 5,004 individuals per 100,000 in 2040.

CONCLUSION

These results indicate that edentulism continues to be a significant global public health concern, particularly as its prevalence is expected to rise with the aging population.

CLINICAL RELEVANCE

Public and clinical preventative measures against edentulism is imperative for the welling being of the population, especially in female group.

Evaluating the Effect of Sex on Mortality Risks in Medieval Ireland

OBJECTIVES

This study evaluates the effect of sex on mortality risks in medieval Ireland to advance our understanding of the social, biological, and environmental factors that were deleterious to female health and survival in the past.

MATERIALS AND METHODS

Data on age-at-death and sex was collected on 335 skeletonized individuals from 10 archaeological sites dating to the early medieval (500-1150 ce) and late medieval (1150-1550 ce) periods in Ireland. Transition analysis (TA2) was used to estimate age-at-death for all individuals with visibly fused pelvic and long bone epiphyses. For all other individuals, age-at-death was estimated using dental development and epiphyseal fusion. Morphological traits of the pelvis and cranium and metric measurements were used to estimate sex. A Gompertz-Makeham hazards model with a proportional hazards specification was used to examine the effect of the sex covariate on mortality risks.

RESULTS

The Gompertz-Makeham hazards model failed to reveal an effect of sex on mortality risks in this context. No significant temporal variation in the effect of sex on the model was observed across sites.

CONCLUSIONS

The results failed to find an effect of the sex covariate on the mortality profile using hazards analysis. However, the similar mortality profiles observed between medieval Irish males and females could reflect cultural barriers and/or differential environmental exposures that counteracted the innate female survival advantage observed today.

Frequency, socio-economic characteristics, and risk factors of oral cavity parasites in diabetes mellitus patients from Lorestan Province, Iran; a case-control study

Background

Numerous studies identify diabetes mellitus (DM) as one of the most significant risk factors for the development of periodontal diseases (gum diseases). Individuals with diabetes experience gingival destruction more rapidly and severely due to the accumulation of microbial plaque in the mouth. Entamoeba gingivalis and Trichomonas tenax are parasites commonly found in the human oral cavity. This study aims to determine, the frequency, socio-economic characteristics, and risk factors of E. gingivalis and T.tenax in DM patients from Lorestan Province, Iran as a case-control study.

Methods

The current case-control study involved 500 DM patients who were referred to health centers in Lorestan province, Iran between December 2022 and June 2024. Furthermore, a control group comprising 500 healthy persons without DM (non-DM) who were referred to health centers during the same study period was incorporated into the research. The prevalence of parasites in the oral cavity was determined using microscopic analysis and conventional polymerase chain reaction (PCR) techniques. A questionnaire was administered to collect demographic information, including age, gender, place of residence, education level, occupation, monthly income, tooth brushing practices, and mouthwash usage.

Results

Out of a total of 500 DM patients, 136 (27.2%) and 146 (29.2%) patients had the oral cavity parasites (E. gingivalis and T. tenax) by microscopic and PCR analysis, respectively. While, in non-DM, 61 (12.2%) and 65 (13.0%) tested positive for parasites using microscopic and PCR methods, respectively (P<0.001). Among several factors, income (P = 0.001, OR = 5.491, 95% CI: 4.089 to 9.723), place of residence (P = 0.006, OR = 1.982, 95% CI: 1.222), education (P = 0.002, OR = 3.577 (1.618, 5.907)), and use mouthwash demonstrated a significant protective effect on the oral cavity parasites.

Conclusion

This research for the first time in Iran highlighted a considerable prevalence of oral cavity parasites in DM patients in Lorestan province, Western Iran. Dental professionals should maintain a heightened awareness of these risk factors to effectively identify and address oral health challenges within this population, thereby reducing the incidence of oral diseases and infections.

Assessment of Oral Health Conditions Among Physically Disabled Patients in Saudi Arabia

OBJECTIVES

This study was undertaken to assess the oral health status among physically disabled Saudi patients.

METHODS

Recruitment took place in the Armed Forces Centre for Health Rehabilitation in Taif, Saudi Arabia. 124 patients living with a physical disability were enrolled and divided into three groups: hemiplegia, paraplegia and quadriplegia. Data was collected on demographics and different oral indices, including the Decayed Missing Filled Teeth (DMFT) index, the Mean Decayed Teeth score, the Community Periodontal Index (CPI), the Community Periodontal Index of Treatment Needs (CPITN), and the Simplified Oral Hygiene Index (OHI-S).

RESULTS

High DMFT was observed among the hemiplegia group (mean = 22.61; P-value = .008) with no difference in the Mean Decayed Teeth. All groups showed signs of gingivitis in the form of gingival bleeding. The most compromised periodontal health in the form of pockets 6 mm or deeper was found in the hemiplegia group (53.7%; P-value = .001). This was also reflected in the CPITN (39.0%; P-value = .001), indicating the need for complex treatments in the same group. Regarding oral hygiene, all groups showed a "fair" oral hygiene condition (OHI-S < 3.0), with significantly poorer hygiene (mean = 2.49; P-value = .042) and greater debris accumulation (mean = 1.52; P-value = .024) among the quadriplegia group. In the regression analysis, both age and gender had significant effects on some indices, while disability type showed borderline effects.

CONCLUSION

The findings indicate poor oral health in these individuals, mainly due to physical limitations, hindering effective self-care practices.

CLINICAL SIGNIFICANCE

Oral health is a critical aspect in people with physical disabilities, as it is intrinsically linked to overall health and well-being. Recognizing the clinical importance of oral health among physically disabled patients is essential to improve access and affordability of dental care for this vulnerable group of the population.

Systematic review and meta-analysis on prevalence and risk factors for gingival recession

OBJECTIVES

Gingival recession is a common mucogingival condition. The aim of this systematic review and meta-analysis was to assess the prevalence of gingival recession and identify associated risk factors in the general population.

STUDY SELECTION

Observational studies reporting prevalence and risk factors for gingival recession published since 2000 were included. Methodological quality was assessed using the modified Newcastle-Ottawa scale for cross-sectional studies. Random-effect meta-analyses were conducted for the prevalence (%) of gingival recession at different cut-off scores (≥1 mm, ≥3 mm, and ≥5 mm) and odds ratios (OR) of identified risk factors.

SOURCES

MEDLINE, Embase, Scopus, and Web of Science were systematically searched in November 2024. Additionally, a hand search was performed. The study was registered in PROSPERO (CRD42024516816).

DATA

21 sources, reporting on 22 studies were included in this systematic review. Most of the included studies represented a low risk of bias. Overall, estimated prevalence of gingival recession was 81.1 % (95 %-CI: 73.9-86.7) for ≥1 mm, 48.4 % (95 %-CI: 39.7-57.2) for ≥3 mm, and 16.2 % (95 %-CI: 9.1-27.4) for ≥5 mm. Risk factors were structured into domains. Meta-analyses revealed male gender (padj.<0.001; OR=1.52, 95 %-CI: 1.36-1.69), smoking (padj.=0.003; OR=1.84, 95 %-CI: 1.33-2.53), alcohol consumption (padj.<0.001; OR=2.04, 95 %-CI: 1.51-2.75), dental plaque (padj.<0.001; OR=4.26, 95 %-CI: 2.91-6.24), presence of a high frenulum (padj.<0.001; OR=4.58, 95 %-CI: 2.58-8.11), occlusal trauma (padj.=0.003; OR=3.20, 95 %-CI: 1.74-5.87), periodontitis (padj.<0.001; OR=9.90, 95 %-CI: 4.15-23.60), and history of periodontal treatment (padj.<0.001; OR=1.86, 95 %-CI: 1.33-2.58) to be significantly associated with gingival recession.

CONCLUSIONS

Observational studies indicated that gingival recession is a highly prevalent condition associated with a variety of risk factors.

CLINICAL SIGNIFICANCE

Gingival recession is associated with periodontal conditions like periodontitis, high frenulum, and modifiable factors such as smoking, alcohol consumption, and occlusal trauma. Clinicians should primarily focus on identifying these risk factors and implementing preventive strategies.

Determinants of the number of dental visits in the general adult population in Germany during the COVID-19 pandemic

BACKGROUND

Oral health is essential to general health and well-being. The utilization of oral health care services represents an important factor in reducing oral health morbidities. In order to understand the disparities in the frequency of dental visits, it is necessary to identify determinants that influence the use of those services. The aim of the current study was to investigate the determinants of the number of dental visits in Germany during the COVID-19 pandemic.

METHODS

We used data from the general adult population in Germany with n = 2,807 individuals in the analytical sample. Average age was 46.5 years (SD: 15.2 years, range 18 to 74 years) and 48.2% of the individuals were female. The number of dental visits in the preceding 12 months served as outcome measure. Grounded on the extended Andersen model, various determinants were included in regression analysis. Multiple negative binomial regressions were used.

RESULTS

Negative binomial regressions showed that a higher number of dental visits was significantly associated with personality-related (higher conscientiousness, IRR: 1.09, 95% CI: 1.03-1.15; higher neuroticism, IRR: 1.06, 95% CI: 1.00-1.12) and psychosocial factors (higher loneliness, IRR: 1.12, 95% CI: 1.02-1.22). In contrast, only very few predisposing characteristics, and none of the enabling resources and need factors were significantly associated with the outcome measure.

CONCLUSIONS

This study particularly emphasized the importance of personality-related factors and psychosocial factors (in terms of loneliness) for the number of dental visits during the pandemic. These factors, often overlooked in prior research, deserve further attention in upcoming studies dealing with the number of dental visits.

High prevalence of oral cavity parasites and its related risk factors in Iranian children with stomatitis; A case-control study

OBJECTIVE

This study for the first time seeks to assess the prevalence, socio-economic characteristics, and risk factors associated with oral cavity parasites (Entamoeba gingivalis (Eg) and Trichomonas tenax (Tt)) in children with stomatitis in Lorestan province, Western Iran.

DESIGN

The present case-control study encompassed a group of 215 children with stomatitis (ST) and 215 children without stomatitis (non-ST) who were referred to healthcare facilities in Lorestan province, Iran, between December 2024 and January 2025. Samples were collected from participants and were analyzed under a light microscope.

RESULTS

The overall prevalence of oral parasites in children with ST was determined to be 59 (27.4 %) and 64 (29.8 %) using microscopic examination and PCR techniques, respectively. Among the positive cases, 48 (75.0 %) of the children were found to be positive for Eg, while 16 (25.0 %) tested positive for Tt. The likelihood of encountering oral cavity parasites among ST participants is markedly higher compared to that of the non-ST group (p < 0.001, OR=2.180; CI= 1.369-3.471). In the multivariate analysis, several factors were found to be significantly associated with parasitic infection, including male gender (p = 0.024, OR= 2.173, 95 % CI: 1.107-4.265), high parental education (p = 0.007, OR= 3.138, 95 % CI:1.373-7.170), living in urban regions (p = 0.000, OR=0.259, 95 % CI: 0.123-0.546), and the use of mouthwash (p = 0.000).

CONCLUSION

The research revealed a significant occurrence of oral cavity parasites among children with stomatitis in Lorestan province, Western Iran. Consequently, pediatric dental practitioners should maintain a heightened awareness of these risk factors for reducing the prevalence of oral infections in children.

The Perception of Illness in People with Advanced Chronic Kidney Disease

Background/objectives: Chronic kidney disease (CKD) has become an important public health issue; however, there are few investigations regarding the perception of CKD in its advanced stages. Personalized medicine approaches, which take into account knowledge of the disease, symptoms and treatment responses, can improve the perception of the disease and help control the progression of CKD. This study aimed to describe illness perception in people with advanced CKD in primary healthcare settings. Methods: A cross-sectional and multicenter descriptive study was conducted amongst a sample of 189 people over 18 years of age with advanced CKD and a glomerular filtration rate between 15 and 29 mL/min/1.73 m2 in three community health centers, including rural and urban areas, during 2023. Data on sociodemographic and clinical variables were collected through an ad hoc questionnaire and those on the perception of disease through the Brief Illness Perception Questionnaire. Nurses at the centers collected data from the study. Results: The mean age was 79.7, and all participants suffered from another chronic condition in addition to CKD. The mean total score for perception of the disease was 44.02 points, and the dimensions of the duration of treatment control and understanding had the highest evaluations. Men had a greater perception in the dimensions of concern (p = 0.023) and understanding (p = 0.006). The dimension of consequences showed a correlation with identity (Spearman's Rho 0.688; p = 0.001), and concern about the disease was associated with emotional response (Spearman's Rho 0.689; p < 0.001). A higher number of hospital admissions was associated with a higher score on the questionnaire (B = 4.93; p < 0.001; CI: 3.01-6.84) in a multiple linear regression. Conclusions: Participants in this study with advanced CKD had low illness perception; women expressed less concern in understanding their health status. Higher symptom burden was linked to greater illness perception, greater emotional impact, and increased hospital admissions.

Risk Factors and Dental Caries Incidence in Childhood Cancer Survivors

BACKGROUND/OBJECTIVES

Dental caries is believed to be one of the most frequent dental long-term adverse effects of anticancer therapy. It may occur due to numerous chemotherapy-dependent oral symptoms or due to the possible neglection of oral care because of parental involvement in the monitoring of other long-term effects of the therapy. This study aimed to determine the incidence of dental caries and the impact of other risk factors in cancer survivors and age-matched controls.

METHODS

This cross-sectional study was conducted on 40 cancer survivors and 80 peers divided into three age groups. Indices such as dmft/s, DMFT/S, ft/s, FT/S, Plaque Index (PI), and Gingival Index (GI) were calculated to compare the study participants. The sum of dmft and DMFT was used to assess the possible impact of socioeconomic, oral hygiene, and dietary factors.

RESULTS

Caries frequency was found to be lower in cancer survivors (92.50%) than in controls (97.50%). No statistically significant differences were found between the study groups within all the caries indices examined. Strong positive correlations with PI and cariogenic diet in the youngest survivors and with PI in middle-aged survivors were observed. Strong negative correlations in middle-aged children were noticed in terms of father's education in survivors and mother's education in controls.

CONCLUSIONS

The study findings suggest that there is no relationship between chemotherapy and dental caries in long-term cancer survivors. Careful dental care still remains a major contributor to maintaining oral health.

Establishment of a Mandarin Chinese Version of the Oral Frailty Index-8 and Exploration of the Association Between Oral Frailty and Sarcopenia

Objective: The aim of our study was to introduce a Mandarin Chinese version of the oral frailty assessment and explore the relationship between oral frailty and sarcopenia. A total of 409 elders (171 male, 238 female) participated in surveys using the Mandarin Chinese version of the Oral Frailty Index-8 (OFI-8) in Kaohsiung, Taiwan. Method: The translation of the Mandarin Chinese version of OFI-8 adhered to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) reporting guidelines. The eight-item questionnaire assessed tooth status, oral function, and other subjective measures. Additionally, sarcopenia was evaluated using the SARC-F questionnaire. Result: Among the participants, 195 participants were classified as non-oral frailty and 214 participants were oral frailty. Significant differences were observed in age, gender, body mass index (BMI), education level, and scores on the SARC-F questionnaire between the non-oral frailty and oral frailty populations. In logistic regression model, oral frailty showed a significant and positive association with the SARC-F score (adjusted odds ratio 2.130, 95% confidence interval 1.580-2.872, p-value < 0.001), even after adjusting for age, gender, BMI, and education level. Conclusion: This study has developed a valuable Mandarin Chinese version of the oral frailty screening questionnaire, the OFI-8. Oral frailty is significantly and positively associated with a higher risk of sarcopenia, particularly among the elderly, males, and those with lower education levels. This measure proves to be practical for assessing oral health status in the Chinese community, promoting oral frailty research within the Mandarin Chinese population, and addressing the challenges associated with defining oral frailty in future studies.

Development of new bilingual oral health behavior social support (OHBSS) scales in English and Spanish

This paper describes the simultaneous co-development of Oral Health Behavior Social Support (OHBSS) scales in English and Spanish. OHBSS scales assess social support for toothbrushing, flossing, and dental care utilization, which are targets for interpersonal-level interventions to promote oral health among Hispanic/Latino adults. The focus was on Mexican-origin adults, who comprise the largest United States Hispanic/Latino subgroup and experience a high oral disease burden. All participants self-identified as Mexican-origin adults (ages 21-40 years old), living along the California-Arizona-Mexico border. Independent samples were recruited for each study partnering with Federally Qualified Health Centers. First, we conducted semi-structured interviews about social support for oral health behaviors in August to November 2018 (Study 1, N = 72). Interviews were audio recorded, transcribed (in original language, Spanish or English), and qualitative data were coded and analyzed in Dedoose following three topical codebooks; excerpts were used to co-create the large bilingual item data bank (OHBSSv1). The item bank was pre-tested via 39 cognitive interviews between December 2019 to March 2020, reviewed by an expert panel with several bilingual members, reduced to 107 Spanish/109 English items (OHBSSv2), then pilot tested in January to December 2021 (Study 2, N = 309). Pilot survey data were analyzed through Exploratory Factor Analysis and Horn's parallel analysis, overall and by language, to examine response patterns and inform item selection (OHBSSv3). The scales queried social support for toothbrushing, flossing, and dental care utilization across 39 items from three sources (family, health providers, others/friends), plus up to nine optional dental care-related items (Study 3, conducted April 2022 to February 2023, N = 502). Confirmatory Factor Analysis (CFA) assessed model fit, overall and by language (multiple group CFA). Final OHBSS scales include 37 items, plus seven optional items. Acceptable model fit for three-factor structures for each oral health behavior was found, providing evidence of the scales' construct validity. Cronbach's alphas and McDonald's omegas were tabulated; all were above 0.95, overall and by language, supporting scales' internal consistency.

Association between oral health and physio-cognitive decline syndrome of older adults in China and its sex differences: a cross-sectional study

BACKGROUND

Physio-Cognitive Decline Syndrome (PCDs) is characterized by the coexistence of MIND (mobility impairment, no disability) and CIND (cognitive impairment, no dementia), which predicts dementia risk. Deteriorating oral health can contribute to malnutrition, cognitive decline, and physical frailty, all of which may exacerbate PCDs symptoms. This study investigates the association between oral health and PCDs, exploring sex differences in this relationship.

METHOD

A cross-sectional analysis of the baseline data from the Nanjing Brain Health Cohort included 252 participants aged 60 and older, assessing physical mobility (6-meter walk test, grip strength), cognitive function (MoCA), and oral health (natural teeth count, denture use, tongue and lip motor function, masticatory and swallowing ability, Oral Frailty Index). Logistic regression models were used to examine associations between oral health and PCDs.

RESULTS

Among participants, 15.5% were classified as having PCDs. The odds of having PCDs were lower with a higher number of teeth (OR = 0.939, 95% CI: 0.890-0.991, p = 0.021), while impaired tongue and lip motor function increased the odds of PCDs (OR = 3.811, 95% CI: 1.059-13.717, p = 0.041). In females, the odds of MIND and CIND were lower with a greater number of teeth and denture use. For males, the odds of PCDs were higher with oral frailty (OR = 5.202, 95% CI: 1.429-18.940, p = 0.012).

CONCLUSIONS

Findings underscore the significant association between oral health and the odds of PCDs among older adults, with sex-specific effects. For women, maintaining natural teeth and proper denture use are associated with lower odds of MIND and CIND, while for men, oral frailty is linked to higher odds of PCDs. Healthcare providers should consider oral health and incorporate sex-specific strategies.

Factors Influencing the Choice of Conservative and Surgical Procedures in Dental Patients from Poland: A Single-Center Retrospective Analysis

Background/Objectives: Oral health behaviors can be shaped by various factors, both global (such as the COVID-19 pandemic) and individual (e.g., gender, age). This retrospective study aims to assess the factors influencing the choice between conservative and surgical dental procedures among patients based on the example of the university specialized center in Poznan. Methods: We explored the patient dataset from the University Center of Dentistry and Specialized Medicine (Poznan, Poland), covering the period from 1 January 2017 to 31 December 2023. A total of 182,654 medical records were analyzed, focusing on procedures such as restorations, endodontic interventions, and extractions. Multivariate logistic regression and multidimensional correspondence analyses were employed to assess the impact of demographic factors (age and gender) and tooth-specific characteristics on clinical decisions. Results: Females, particularly younger, were more likely to choose restorative procedures, while males, especially those over 50, predominantly underwent surgical procedures. Endodontic treatments were most common in males aged 18-30, primarily for maxillary anterior teeth and premolars. Molar extractions, especially in the mandible, were the most frequent surgical procedure. Maxillary teeth, particularly canines and premolars, were more likely to be treated conservatively. Conclusions: Economic factors, limited treatment access, and variations in patient preference influenced the observed patterns. Despite a national trend toward increased conservative treatments, disparities persisted based on age, gender, and tooth type. These findings emphasize the need for targeted prevention strategies and equitable access to advanced dental care.

Oral Health and Hygiene Practices from Baramulla District, Jammu and Kashmir, India: A Questionnaire-Based Cross-Sectional Observational Survey

Background/Objectives: Oral hygiene practices are important for good oral health and overall well-being. In this study, we surveyed people across age groups and genders to understand the oral hygiene practices of Baramulla district of the Union Territory of Jammu and Kashmir. Methods: 488 participants-229 males and 259 females-were randomly interviewed through a structured 20-item questionnaire. A chi-square test was used to analyze the age and gender-specific associations in oral hygiene behaviors. Results: The study revealed that majority of participants brushed their teeth only once a day instead of the recommended twice a day; only young cohorts showed relatively higher practice of brushing twice daily. A significantly higher proportion of males (11.69%) rarely brushed their teeth compared to females (4.28%). Tongue cleaning was poorly reported across age and genders and more than 60% of respondents did not clean their tongue at all. Almost 75% and above had made dental visits at least once. However, the visits were made primarily in cases of pain and sensitivity, indicating negligence, financial issues, or a general lack of awareness. The younger cohorts reported eating fast food more frequently, indicating risk groups. The majority of male respondents (45.88%) reported fair oral health whereas the majority of female respondents (35.29%) reported poor overall oral health. Conclusions: Our results show that oral hygiene practices need more improvement, and the attitude and knowledge of the residents need to be ameliorated through oral health education policy interventions.

Weight Loss and Number of Present Teeth in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study in Niigata

BACKGROUND AND OBJECTIVES

Weight loss is a critical health issue among the older population. This study aimed to explore the association between weight loss and oral health in older adults.

METHODS

We used cross-sectional data from the Uonuma Chronic Kidney Disease Cohort Study. The binary logistic regression models were fitted to estimate the relationship between weight loss and independent variables including the number of teeth present.

RESULTS

The participants included 1656 females and 1625 males. There were 1217 females (73.4%) and 1236 males (76.0%) with normal BMI (18.5 ≤ BMI < 25) in the previous year. Weight loss was determined over a 12-month period. Individuals with normal BMI in previous year, and those with weight loss (≥ 5%) or those whom maintained a stable weight were further analysed. The regression analysis (model 3, fully adjusted) showed that females with 0 and 1-10 teeth present had a higher likelihood of losing weight (OR = 4.07; 95% CI = 1.85-8.93, OR = 2.33; 95% CI = 1.24-4.39) compared with those with 20 or more teeth. Current smokers had a higher likelihood of losing weight (OR = 3.15; 95% CI = 1.01-9.76) than lifelong abstainers. Among males, both current and previous smokers showed a higher likelihood of losing weight (OR = 4.94; 95%CI = 1.76-13.8, OR = 3.35; 95% CI = 1.29-8.68) than those who never smoked.

CONCLUSIONS

This study indicates that the number of teeth and smoking are both linked to weight loss in females. However, in males, the association between the number of teeth and weight loss may be compromised due to the high prevalence of smoking in this group.

Cost of Illness Study on Oral Cancer in Australia

OBJECTIVES

The aim of this study is to estimate the economic burden of oral cancer in Australia from the societal perspective.

METHODS

The population consisted of the prevalence of lip and oral cavity cancer, and other lip, oral cavity, and pharynx cancers for ages 40 years and older. Healthcare costs of oral cancer were estimated using 2019-2020 Australian Disease Expenditure Data. Productivity losses were estimated using disability-adjusted life years, derived from the 2019 Global Burden of Disease Study and 2019 Australian gross domestic product per capita.

RESULTS

The estimated annual healthcare costs for oral cancer in Australia were approximately AUD$113.2 million. Over half of the total healthcare costs (54%) were attributable to public hospital admissions (AUD$61.2 million), followed by private hospital services (28%) and pharmaceutical benefits (8%). The total costs, including healthcare and productivity losses, were around AUD$2.1 billion. The productivity losses due to oral cancer were higher for males compared to females (AUD$1.5 billion versus AUD$0.6 billion).

CONCLUSIONS

The study reveals a significant economic burden of oral cancer for 2019 in Australia at AUD$2.1 billion, largely due to productivity losses and public hospital admissions. This highlights the need for effective screening and prevention programs.

The impact of dental photography in social media platforms on patients' selection of dentists and type of treatment

BACKGROUND

Dental photography has many advantages such as improving professional communication, enhancing patient education, and facilitating treatment acceptance. This study investigated the impact of dental photography through social media on patients' choice of dental care providers.

METHODS

This cross-sectional survey-based study recruited a convenience sample of adult patients attending selected public and private dental facilities in Saudi Arabia. Data was collected using an online self-administered questionnaire. Participants received the link to the questionnaire through social media of their treating dentists.

RESULTS

A total of 552 completed the survey of whom 289 (52.4%) aged 18-25 years, 291 (52.7%) were males, 336 (60.9%) were bachelors, and the majority 448 (81.2%) had a postgraduate degree. Snapchat was the most commonly used social networking application, n = 190 (34.4%). Females reported they were more likely to report that seeing the previous cases affect their choice of a dentist (2.025(1.253-3.274)) and that social media can affect their choice as well (1.787(1.219-2.621)). While those who never visited the dentist were less likely (0.622(0.395-0.978)) to support the use of dental photography and less likely (0.579(0.362-0.926)) to report that social media affect their choice of a dentist. Instagram was found to be a significant platform for selecting a dentist (OR = 1.132, range; 0.608-2.11) (p-0.05).

CONCLUSION

The presence of the dentist in social networking sites and sharing of their pre-post treatment cases can be an effective marketing tool especially among females and Instagram users.

Prediction of oral diseases in care dependent older people

BACKGROUND

A large number of older people depend on others for help with their daily personal care, including oral health care. Nursing home and elder-care staff often face challenges identifying older people, who are exposed to or at an increased risk of oral diseases. Thus, the aim of this study was to identify risk factors that non-dental care staff can use to identify older people at risk of oral diseases and poor oral hygiene.

METHODS

In this cross-sectional study, the oral health and risk factors for poor oral health were determined for 217 care dependent older people living in two nursing homes and a rehabilitation centre or receiving home care in two Danish municipalities. The outcome variables for oral disease i.e. caries, periodontitis, and gingivitis, and oral hygiene, i.e. plaque and calculus, were assessed using standardised oral examinations. Risk factors for oral diseases and poor oral hygiene were assessed based on a questionnaire concerning (1) background information, (2) health status, (3) social support, (4) oral health behaviours, and (5) self-reported oral health. The associations between oral health and risk factors were investigated using logistic regression analyses.

RESULTS

In general, older people with different living arrangements had quite similarly distributed risk factors. The oral examinations showed that 54.5% had oral diseases, and 14.8% had poor oral hygiene. Not seeing a dentist regularly was significantly associated with having oral diseases (Odds Ratio, 2.87; CI, 1.53-5.39) and poor oral hygiene (OR, 4.50; CI, 1.83-11.05). A significant association was found between the presence of an oral disease and adversely affected quality of life (OR, 2.65; CI, 1.42-4.95), especially due to challenges eating (OR, 3.76; CI, 1.64-8.60) and/or smiling and showing teeth (OR, 3.64; CI, 1.27-10.42). A significant association was also found between poor oral hygiene and taking psychotropic drugs (OR, 2.61; CI, 1.08-6.30).

CONCLUSION

Questions regarding the use of the dental care system and oral health problems could be used by nondental care staff in conversations with older people to determine their risk of oral diseases and poor oral hygiene.

Periodontal pathogens and obesity in the context of cardiovascular risks across age groups

Background

Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity among noncommunicable diseases. Over the past decade, there has been a notable increase in the prevalence of CVDs among young individuals. Obesity, a well-known risk factor for CVDs, is also associated with various comorbidities that may contribute to cardiovascular risk. The relationship between periodontal pathogens and CVD risk factors, including obesity, smoking, lipid metabolism disorders, and inflammatory markers, remains underexplored.

Methods

This study examined the relationship between six periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Tannerella forsythia, Prevotella intermedia, and Fusobacterium nucleatum) and CVD risk factors among 189 subjects stratified by age and body mass index (BMI). Body composition was assessed via bioimpedance analysis, and blood samples were analyzed for lipid profiles, glucose, and proinflammatory cytokines. Oral samples were collected for polymerase chain reaction (PCR) analysis to identify periodontal pathogens. Cardiovascular and diabetes risk scores were calculated using the SCORE and FINDRISC scales.

Results

The prevalence of periodontal pathogens in the population was 33.0% for P. gingivalis, 47.8% for P. intermedia, 63.4% for A. actinomycetemcomitans, 46.6% for T. forsythia, 46.6% for T. denticola, and 89.2% for F. nucleatum. Significant age- and BMI-related differences were observed in pathogen prevalence, particularly with P. gingivalis, P. intermedia, and T. denticola. Young obese individuals exhibited a higher prevalence of P. intermedia and T. forsythia. P. gingivalis was found to be associated with hypertension and dyslipidemia, while P. intermedia was linked to hypertension and obesity. T. denticola was associated with obesity, dyslipidemia and smoking, whereas T. forsythia was linked to dyslipidemia alone.

Conclusions

This study highlights the potential connection between periodontal pathogens and risk factors associated with cardiovascular disease, including smoking, elevated BMI, increased adipose tissue, hypertension, and dyslipidemia. Further research is required to determine the causal relationships between oral microbiome dysbiosis, obesity and, systemic diseases and to develop an effective strategy for preventing oral health-related CVD risk factors in young adults.

Sex and Gender Health Education Tenets: An Essential Paradigm for Inclusivity in Dentistry

Sex and gender are essential components of person-centered care. This article presents and discusses four important tenets regarding sex and gender health that should be incorporated into dental education and oral health care to foster inclusivity and improve care for all patients, including a sex and gender-diverse patient population.

Effect of Oral Inflammatory Burden on Size and Stage of Oral Tongue Cancer

OBJECTIVE

Oral tongue squamous cell carcinoma is an aggressive life-threatening disease, the prognosis of which is affected by tumor stage and size. We retrospectively studied whether oral inflammatory burden and established tongue carcinoma etiological factors exert an impact on tumor size and stage.

MATERIALS AND METHODS

Medical records of 183 subjects diagnosed with tongue carcinoma at Helsinki University Hospital were investigated. Data on sex, smoking habits, alcohol consumption, and oral inflammatory burden were assessed by the Periodontal Burden Index, Total Dental Index, and Panorama Tomography Index. In addition, Candida hyphae in histological samples, and tumor size and stage were recorded and analyzed. History of oral potentially malignant disorders was also investigated.

RESULTS

Increased oral inflammatory burden, male sex, and smoking were associated significantly with larger size and advanced stage of cancer, whereas oral Candida hyphae were not associated with size of tongue carcinoma but were associated with female sex.

CONCLUSION

Male sex, oral inflammatory burden, and smoking were more common in patients with a large and advanced stage of tongue carcinoma. Thus, oral and periodontal infections and their pro-inflammatory effects may eventually promote carcinoma growth and advance the stage, especially in males.

Changes in Dental Care Use Following Marital Status Change in the Health and Retirement Study

BACKGROUND AND OBJECTIVES

Previous studies have indicated that married people are generally healthier than unmarried people, with lower mortality rates. Most work in this area has employed cross-sectional data, and few studies have examined change in marital status from married to unmarried as a potential social ecological determinant of dental health behavior. Here, we used longitudinal data to examine change in dental behavior over time following marital status change, and to explore whether self-reported gender may play a modifying role in any behavioral change.

RESEARCH DESIGN AND METHODS

Employing panel data from the Health and Retirement Study (1996-2018) to follow all individuals who entered the study in married/partnered status, and using both 2-way fixed effects and group-time average difference-in-difference models, we analyzed the association between any change in marital status and dental care use, compared with individuals who remained married. All analyses were stratified by gender.

RESULTS

Both types of difference-in-difference analyses indicated that both widowhood and divorce were associated with a decrease in dental care use in both genders. Divorced men saw the greatest decrease in dental care use. We found gender had a moderating effect on strength of association in all analyses.

DISCUSSION AND IMPLICATIONS

This research suggests that any change in marital status from married to unmarried has a detrimental effect on dental health behavior for both genders. Future research might investigate other potential barriers to dental care access these populations might face, in order to develop effective interventions.

Influence of gender on periodontal outcomes: A retrospective analysis of eight randomized clinical trials

AIMS

To explore the influence of gender on periodontal treatment outcomes in a dataset of eight RCTs conducted in Brazil, United States, and Germany.

METHODS

Clinical parameters were compared between men and women with stages III/IV grades B/C generalized periodontitis at baseline and 1-year post-therapy, including scaling and root planing with or without antibiotics.

RESULTS

Data from 1042 patients were analyzed. Men presented a tendency towards higher probing depth (p = .07, effect size = 0.11) and clinical attachment level (CAL) than women at baseline (p = .01, effect size = 0.16). Males also presented statistically significantly lower CAL gain at sites with CAL of 4-6 mm at 1-year post-therapy (p = .001, effect size = 0.20). Among patients with Grade B periodontitis who took antibiotics, a higher frequency of women achieved the endpoint for treatment (i.e., ≤4 sites PD ≥5 mm) at 1 year than men (p < .05, effect size = 0.12).

CONCLUSION

Men enrolled in RCTs showed a slightly inferior clinical response to periodontal therapy in a limited number of sub-analyses when compared to women. These small differences did not appear to be clinically relevant. Although gender did not dictate the clinical response to periodontal treatment in this population, our findings suggest that future research should continue to explore this topic.

Effect of the oral examinations in the national health screening program on preventive oral health care and treatments: a 19-year follow-up study

OBJECTIVES

The national health screening (NHS) program in Korea serves as primary prevention by detecting oral diseases early for easier management. Dental scaling helps prevent oral disease and treat early periodontal disease. This study evaluated the effects of national oral examinations (NOE) in NHS on preventive oral hygiene care and dental treatments for a 19-year follow-up study.

METHODS

We conducted a longitudinal observation of Korean adults ≥ 19 years between 2002 and 2003 from the Korean National Health Insurance Service (n = 4,669,107; men = 2,518,704; women = 2,150,403). The independent variable involved tracking the number of people who underwent the NOE recruited between 2002 and 2003 from 2002 to 2013. The dependent variables pertained to the number of dental scaling and the presence or absence of periodontal and dental caries treatments from 2014 to 2020.

RESULTS

Individuals receiving 6 to 7 dental scaling during the follow-up exhibited an adjusted odds ratio (AOR) of 2.91 in the NOE-middle (3-4 times) and 3.30 in the NOE-high (5-6 times) (p < 0.001). The adjusted rate ratios were 1.69 in the NOE-middle and 1.77 in the NOE-high (p < 0.001). The AOR for periodontal treatment was 1.23 in the NOE-middle and NOE-high (p < 0.001).

CONCLUSION

Frequent NOEs lead to undergoing dental scaling and dental treatment, highlighting the importance of encouraging NOE attendance to improve population oral health. Expanding the scope of dental coverage for preventive intervention combined with NOE could help encourage greater participation and promote preventive oral healthcare.

The Relationship Between Dental Anxiety and Oral Health-Related Quality of Life in Patients with Periodontitis

OBJECTIVES

This study aimed to (1) investigate whether dental anxiety (DA) and oral health-related quality of life (OHRQoL) differed between patients diagnosed with periodontitis and individuals with periodontal health, (2) examine associations and correlations between these patient-reported measures, and (3) analyze demographic and clinical parameters.

METHODS

Ninety-six patients diagnosed with periodontitis and age- and sex-matched periodontally healthy controls were included. Participants' demographic characteristics, smoking status, current dental pain, dental pain during the last month, the Modified Corah's Scale (MDAS), and the Oral Health Impact Profile (OHIP-14) were determined.

RESULTS

The mean age of participants was 48.51 years ± 11.41. Patients with periodontitis experienced higher pain in the last month compared to controls (p = 0.003). Patients with periodontitis exhibited significantly higher MDAS total and sub-scores (p < 0.001). Compared to controls, the periodontitis group indicated extreme DA (1.04% vs. 7.79%, p = 0.034). Patients with periodontitis feared having a foreign object in the mouth compared to controls (p = 0.004). The periodontitis group exhibited worse OHIP-14 global and sub-scores (all Ps < 0.001). Positive associations and correlations of MDAS total and sub-scores with OHIP-14 global and domain scores were found for the periodontitis group, but not for controls. Patients with periodontitis who reported "moderate and extreme anxiety" had poorer OHRQoL compared to controls (p = 0.001). The minimal importance difference for this finding indicates a large effect size and a moderate standardized response mean between groups.

CONCLUSIONS

Patients with periodontitis had higher levels of DA and worse OHRQoL compared to controls. Our study highlights the importance of providing a comprehensive approach, including psychosocial well-being, when diagnosing and treating periodontal disease.

Sex Differences in Health-Related Quality of Life in Patients With Head and Neck Cancer-A Prospective Study

OBJECTIVE

To analyse sex differences in health-related quality of life (HRQL) before, during and up to 3 months posttreatment of head and neck cancer, and to examine the importance of salivary secretion rate for HRQL posttreatment.

METHODS

Patients were recruited before starting curative oncologic treatment. Clinical examinations were performed including determination of the stimulated salivary secretion rate. HRQL (EORTC C30 and HN35) was reported at baseline, weeks 2, 4 and 6 during treatment and 3 months after treatment.

RESULTS

A total of 56 men and 19 women were included. During treatment, men reported more problems with pain and sexuality, a higher use of painkillers and need for nutritional support during oncologic treatment, while women reported more problems with weight loss and dry mouth. At 3 months posttreatment, women reported more problems and symptoms than men with the highest scores noted for dry mouth, weight loss and sticky saliva. Patients with hyposalivation (≤ 0.7 mL/min) posttreatment reported more problems and symptoms compared with those with a secretion rate of > 0.7 mL/min, especially regarding dry mouth, sticky saliva and social eating (p < 0.001 for all three).

CONCLUSION

Problems and symptoms during and postoncologic treatment seem to differ between women and men, which must be taken into consideration by healthcare and dental professionals. Patients with hyposalivation posttreatment have more problems and symptoms and are therefore in greater need of supportive care.

Is Poor Self-Rated Health Associated with Higher Caries Experience in Adults? The HUNT4 Oral Health Study

INTRODUCTION

The association between lower socioeconomic status and a higher risk of dental caries is well established, but the independent association between general health status and dental caries on a population level is less investigated. The aim of this study was to assess the association between self-rated general health and caries experience in an adult Norwegian population and to assess if the associations were modified by age and sex.

METHODS

Data were collected as part of the Trøndelag Health Study (HUNT4) conducted 2017-2019 and a randomly selected subsample (20%) were invited for the HUNT4 Oral Health Study. This cross-sectional study included 4,880 dentate participants aged 19-94 years (response rate 67%). Participants underwent clinical and radiographic oral examinations and caries experience was measured by numbers of decayed (DT), missing (MT), and filled teeth (FT), DMFT index. The DT component consisted of primary and secondary caries in dentine, cavitated root caries, and remaining roots. Questionnaires were used to assess self-rated general health and socioeconomic position, denoted by education, household income, and employment status. Associations between self-rated health and caries experience (DMFT) and components (DT, MT, and FT) were assessed using negative binomial regression models. Ratios of means (RMs) with 95% confidence intervals (CI) for the associations were estimated, adjusting for socioeconomic position.

RESULTS

Individuals with poor self-rated general health had a 29% higher mean number of MT (RM: 1.29 [95% CI: 1.13-1.46]), a 22% higher mean number of DT (RM: 1.22 [95% CI: 1.07-1.39]), and a 7% higher mean number of DMFT (RM: 1.07 [95% CI: 1.04-1.11]) than individuals reporting very good health. Age-stratified analyses presented a more pronounced association between self-rated health and caries experience for individuals below the age of 55 years than for those 55 years or older. Similarly, the association was more evident in women, with significantly higher mean values for DMFT, MT, and FT among women reporting poor health.

CONCLUSIONS

The present study demonstrated an independent association between poor self-rated health and a higher burden of caries experience, adjusted for education, income, and employment status. The association was stronger in women and individuals below the age of 55 years. These findings add new evidence in understanding caries inequalities through self-rated health.

Tunnel Technique and Subepithelial Connective Tissue Graft, With or Without Cross-Linked Hyaluronic Acid, in the Treatment of Multiple Gingival Recessions: Prognostic Parameters for Clinical Treatment Outcomes of Randomized Controlled Trial

Objectives: This study aimed to investigate factors that influence the 12-month outcomes after the treatment of multiple gingival recessions (GRs) with a modified coronally advanced tunnel (MCAT) and a subepithelial connective tissue graft (SCTG), with cross-linked hyaluronic acid (HA, tests) or without (controls). Materials and Methods: Twenty-four patients with 266 GRs were treated. A logistic regression model was set to identify the baseline parameters that could predict the 12-month outcomes. The study protocol was registered at ClinicalTrials.gov (ID No. NCT05045586). Results: The evaluated clinical and esthetic parameters showed marked improvement in both groups without any statistically significant differences between the groups, with the exception of the soft tissue texture (STT). The STT was in favor of the HA group (0.96 versus 0.73, p = 0.0091). The likelihood of an MRC > 85%, of achieving CRC, and of gaining an RES = 10 was the highest for the incisors (reference group) and the lowest for the molars (OR = 0.046, p = 0.005). With each 1 mm increase in the baseline clinical attachment level, the odds of failure (MRC < 85%, not achieving CRC) increased, whereas each 1 mm increase in the baseline keratinized tissue width (KTW) improved the chances of an MRC > 85%, of achieving CRC, and of gaining an RES = 10. The application of HA increased the likelihood of a perfect RES more than twofold (OR = 2.683, p = 0.001). Conclusions: The application of HA improved the 12-month esthetic outcomes after the treatment of GRs with the MCAT technique. The baseline CAL, KTW, and tooth type predicted the 12-month MRC, CRC, and RES. An evaluation of the baseline characteristics of the surgical area might help clinicians develop individualized treatment plans.

Prevalence of dentine hypersensitivity, erosive tooth wear, gingival recession and periodontal health in seven European countries

OBJECTIVES

To determine the prevalence and associated risk indicators for dentine hypersensitivity (DH), erosive tooth wear (ETW), gingival recession (GR), and gingival inflammation (bleeding on probing, BOP), with clinical and questionnaire data from seven European countries.

METHODS

A cross-sectional, observational, seven-European country, epidemiological study in systemically healthy adults. Participants completed a questionnaire regarding oral hygiene, diet and lifestyle factors. A clinical examination, by calibrated examiners, measured DH (Schiff; participant yes/no), ETW (basic erosive tooth wear examination, BEWE), GR (mm), and BOP (yes/no).

RESULTS

3551 participants completed the study, mean age 44 ± 17.4, 43.6 % male, 26.1 % rural dwellers. DH (Schiff ≥ 1) was seen in 75.9 % of participants, ETW (BEWE ≥ 1) in 97.6 %, GR (≥1 mm) in 87.9 %. 65.7 % participants had BOP ≥ 10 % sites, 34.3 % BOP<10 % with probing depths ≤3 mm. DH, ETW, GR and BOP increased markedly during young adult life. Thereafter, GR and ETW continued to increase, DH declined after around age 38-47, and BOP plateaued after age 48. DH was significantly associated with ETW (p < 0.001) and GR (p < 0.01); GR was significantly associated with BOP on lingual surfaces (p = 0.017). There were significant associations between increased full mouth BOP ≥ 10 % and reduced brushing duration and exercise frequency (p < 0.001); increased DH and heartburn (p < 0.001); decreased DH (p < 0.001), ETW (p < 0.001) and BOP ≥ 10 % (p = 0.002) with powered toothbrush use.

CONCLUSIONS

Prevalence of oral conditions assessed was high, greater than in the majority of the GR, DH and ETW literature. Periodontal health was seen in a third of sampled individuals. All these conditions varied markedly by country and age.

CLINICAL SIGNIFICANCE

Oral diseases and conditions were highly prevalent throughout the seven European countries investigated. For the majority, these conditions are eminently preventable and treatable by changing behaviours. Upstream policy changes are needed to address these health challenges, to raise awareness and to empower individuals with oral health education and support.

Women in Dental Clinical and Translational Research

This article presents a summary of the third American Association for Dental, Oral, and Craniofacial Research Meeting within a Meeting, which was held during the 2024 annual meeting in New Orleans, Louisiana. Speakers were challenged to reflect on how women are differentially affected by health and societal issues by factors that go beyond biology. The goal was to promote current research on women's issues that are relevant to dental, oral, and craniofacial scientists.

Caregiving-Related Characteristics and Dental Care Utilization in Informal Caregivers of Persons With Dementia: Is There a Gender Difference?

BACKGROUND AND OBJECTIVES

Dental care utilization is an important, yet understudied aspect of healthcare in informal caregivers of persons with dementia. This study examined how caregiving-related characteristics are associated with dental care utilization among U.S. informal caregivers of persons with dementia and further examined gender differences.

RESEARCH DESIGN AND METHODS

Pooled data came from the Behavioral Risk Factor Surveillance System in 2016, 2018, 2020, and 2022. A nationally representative sample of informal caregivers (n = 3,909) was included. Dental care utilization was "yes" versus "no" within the past year. Caregiving-related characteristics included caregiver role, intensity of care, duration of care, and type of care. Logistic regressions and subgroup analyses were conducted.

RESULTS

In total sample, compared to adult child caregivers, spousal caregivers were 28% less likely to visit a dentist (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.56, 0.94). Caregivers who provided care for more than 20 hr per week were 18% less likely to visit a dentist (OR = 0.82; 95% CI = 0.69, 0.98). In subgroup analyses, intensity of care was a barrier to dental care utilization for female caregivers (OR = 0.78; 95% CI = 0.62, 0.98), whereas caregiver role such as spousal caregiver (OR = 0.59; 95% CI = 0.39, 0.89) or other relative caregiver (OR = 0.70; 95% CI = 0.50, 0.99) was a barrier to dental care utilization for male caregivers.

DISCUSSION AND IMPLICATIONS

The findings highlight the importance of caregiving-related characteristics in dental care utilization and suggest gender-tailored interventions.

Prevalence of dental caries and oral hygiene among specially-abled children

Dental caries (tooth decay) is a common oral health problem among children, significantly impacting their overall well-being and quality of life. Therefore, it is of interest to find the prevalence of dental caries and oral hygiene status in specially-abled children. This cross-sectional study was conducted to assess the prevalence of dental caries and oral hygiene status in 225 specially-abled children. The participants, aged <18 years, were included in the study. The study included children with physical, intellectual and developmental disabilities, ensuring a diverse representation of conditions that may impact oral health. A total of 225 especially abled children participated in the study, with a mean age of 12.5± 3.4 years. The participants included 130 males (57.8%) and 95 females (42.2%). Children with intellectual disabilities exhibited the highest mean DMFT (Decayed, Missing, Filled Teeth) score (4.2 ± 2.3), with 75% of them affected by dental caries. In comparison, children with physical disabilities had a mean DMFT score of 3.6 ± 1.9 and a caries prevalence of 62%. Thus, the prevalence of dental caries and poor oral hygiene status is notably high among specially-abled children, particularly those with intellectual disabilities.

Age and sex differences in the association of dental visits with inadequate oral health and multimorbidity: Findings from the Canadian Longitudinal Study on Aging (CLSA)

BACKGROUND

Dental attendance is important for the prevention, diagnosis, and treatment of oral diseases. In this study, we aimed to assess the extent of the association between dental visits, inadequate oral health, and multimorbidity (MM), and whether this association differs by age and sex.

METHODS

We conducted a cross-sectional analysis of the first follow-up wave (2018) of the Canadian Longitudinal Study on Aging (CLSA). Poor self-reported oral health (SROH), oral health problems, and edentulism were used to indicate inadequate oral health. MM was defined as having 2 or more chronic conditions out of cancer, cardiovascular diseases, chronic respiratory diseases, diabetes, and mental illnesses. Dental visiting was determined as the number of visits to a dental professional within the past 12 months. Covariates included socioeconomic, behavioural factors, and the availability of dental insurance. We constructed multivariable Poisson and logistic regression models with interactions terms and estimated the relative excess risk due to interaction prevalence ratio (RERIPR) to assess the effect measure modification of age and sex on the associations of interest. We conducted sensitivity analyses and estimated E-values for unmeasured confounding.

RESULTS

In this sample (n = 44,815), dental visiting was inversely associated with inadequate oral health and MM in adjusted models, reducing the odds/prevalence of poor SROH (OR 0.41, 95% CI 0.34, 0.51), oral health problems (PR 0.89, 95% CI 0.79, 0.94), edentulism (OR 0.10, 95% CI 0.06, 0.15), and MM (PR 0.86, 95% CI 0.79, 0.92). These associations were stronger in older age and females.

CONCLUSION

Dental visiting may contribute to better oral health and reduced chronic diseases in the middle-aged and older population. Our findings suggest the need for age and sex-specific targeted interventions to optimize oral and overall health.

Men with HIV have increased alveolar bone loss

BACKGROUND

Periodontal health in men with HIV remains understudied, despite suggestions of associations between HIV infection and gingival pocketing, periodontal attachment loss, and gingival inflammation. As antiretroviral therapy (ART) has improved the quality of life for people living with HIV (PLWH), aging-related risk factors and comorbidities, including periodontitis, have emerged. This study aims to assess alveolar bone height, gingival crevicular fluid (GCF) cytokines, and periodontal disease activity in men with and without HIV.

METHODS

Ninety-three men (50 HIV+, 43 HIV-) aged 35-70 years were recruited from Columbia University Irving Medical Center clinics. Periodontal examination, GCF collection, and intraoral radiographs were collected. Statistical analysis was conducted with t-tests for continuous variables and chi-squared tests for categorical variables.

RESULTS

While no significant differences were observed in bleeding on probing, clinical attachment loss and pocket depths, men with HIV exhibited significantly greater alveolar crestal height on radiographs compared to men without HIV (HIV + 3.41+/-1.35 mm, HIV- 2.64+/-1.01 mm; p = 0.004), reflecting greater alveolar bone loss.

CONCLUSIONS

Men living with HIV demonstrate increased alveolar bone loss compared to those without HIV, possibly mediated by elevated IL6 levels. These results underscore the importance of comprehensive oral health management in PLWH and highlight the need for further research understanding the mechanisms linking HIV infection, cytokine dysregulation, and periodontal health.

Evolving trends in oral cancer burden in Europe: a systematic review

Introduction

Oral cavity cancer (OCC), primarily oral squamous cell carcinoma (OSCC), is a growing concern in Europe, particularly among younger populations. Preventable lifestyle factors and social determinants of health contribute significantly to the disease burden. Limited access to healthcare and delayed diagnoses further complicate treatment and reduce survival rates.

Methods

This systematic literature review adhered to PRISMA guidelines to explore trends in OSCC epidemiology, etiology, diagnosis, treatment, and survival across Europe. A comprehensive search strategy using PubMed, GLOBOCAN data, and the EUROCARE-5 study identified relevant articles focusing on human populations in Europe with a primary interest in OSCC epidemiology. Only peer-reviewed publications in English with full-text access were included.

Results

This study investigated the burden of OSCC across Europe, revealing variations in incidence, mortality, and prognosis. Eastern and Central Europe displayed the highest burden. Males exhibited a significantly higher risk compared to females. Age-related disparities existed in life expectancy and time to achieve favorable outcomes. HPV emerged as a growing risk factor for oropharyngeal cancer. Public health strategies should target modifiable risk factors and improve early detection.

Conclusion

This review reveals concerning disparities in European OSCC. Region, sex, and age all influence burden and prognosis. Future research should focus on controlling risk factors and personalized medicine to optimize treatment. This will lead to a Europe with reduced OSCC incidence and demonstrably better patient outcomes.

Oral Health Status at Age 60 and 72 Years-A Longitudinal Study

OBJECTIVE

This study investigated oral health status in 60-year-old individuals over 12 years.

MATERIALS AND METHODS

Data were obtained from The Swedish National Study on Aging and Care (SNAC). One hundred nineteen 60-year-old individuals (48% females) underwent a clinical and radiographic baseline examination (2001-2003) and follow-up examination in 2013-2015. For statistical analyses, paired t-tests and McNemar's test were performed. Statistical significance was determined at p < 0.05.

RESULTS

At the 12-year follow-up, the mean number of teeth and the proportion of individuals having ≥ 20 teeth decreased (p < 0.001). The mean number of teeth with buccal/lingual and approximal caries lesions increased (p < 0.029 and p < 0.031). Individuals with a distance from the cement-enamel junction to the bone of ≥ 5 mm increased in total (p < 0.002) and in males (p < 0.006). The prevalence of gingivitis increased in total (p < 0.001). The prevalence of periodontitis showed a significant increase in total (p < 0.043) and in females (p < 0.039).

CONCLUSION

The present study indicates that oral health status in 60-year-old individuals deteriorates over 12 years. However, the deteriorations were minor in terms of tooth loss, caries lesions, and changes in periodontal status.

General health status of a sample of patients with periodontitis in a Spanish university dental clinic: A case-control study

Background

During the past years, a bidirectional relationship has been proved between periodontitis and some systemic disorders, such as diabetes mellitus (DM) and cardiovascular diseases (CVDs). The aim of this study was to compare the general health status between patients with and without periodontitis from a Spanish university dental clinic.

Material and Methods

A retrospective observational case-control study was conducted to achieve the research objective. The random sampling was extracted from the patients who attended to the university dental clinic between January 2017 and December 2020.

Results

A total of 2,714 (44.6% males and 55.4% females, 49 [38-60] years old) were included: 1,363 cases (patients with periodontitis; 47.2% males and 52.8% females; 54.6 ± 13.4 years old) and 1,351 controls (patients without periodontitis; 41.9% males and 58.1% females; 44.2 ± 13.4 years old). Patients with periodontitis had lower oral hygiene habits than controls: the 28.9% vs 7.0% (p-value <0.001) brushed their teeth once a day, 94.9% vs 69.6% (p-value <0.001) did not use interproximal cleaning. 31.0% of periodontal patients were smokers vs 21.2% of the control group (p-value <0.001). 51.8% of patients with periodontitis were taking medication vs 31.2% of the controls (p-value <0.001). Regarding their general health status, 8.2% periodontitis patients had DM vs 3.9% of the controls (p-value <0.001) and 21.3% of the cases suffered from high blood pressure (HBP) vs 10.6% (p-value <0.001). In addition, a multivariable regression analysis was performed, where the variables with more strength were age, number of cigarettes and oral hygiene habits.

Conclusions

In the present research, statistically significant differences have observed between patients with and without periodontitis, regarding medication, health problems such as DM, HBP, CVD and cholesterol. Key words:Periodontitis, systemic diseases, health status, university dental clinic.

Inequalities in the use of dental services by people with and without disabilities in Brazil: a National Health Survey

OBJECTIVES

The present cross-sectional study aimed to evaluate if social, racial, and gender inequalities disproportionally affect the use of dental services by people with and without disabilities in Brazil in the year 2013.

MATERIALS AND METHODS

The study used data from the 2013 National Health Survey and the dependent variable was the use of dental services. The outcome was stratified by gender, race, and social variables. Descriptive analysis was represented by absolute and relative frequencies. Two inequality measures were used to investigate the inequalities: the Slope Index of Inequalities (SII) and the Concentration Index of Inequalities (CIX). The SII expresses the absolute difference and the CIX identifies the relative inequality.

RESULTS

Of 145,580 adults evaluated, 7.7% reported disability. The proportion of adults without disabilities who used dental services in the last 12 months was higher (45.2%; 95%CI 44.2-46.1) than adults with disabilities (33.9%; 95%CI 32.0-35.9). There was an absolute difference of 40% points (SII 0.40; CI95% (0.36-0.45) in the use of dental services between poorer and richer people with disabilities. Absolute and relative inequalities were identified in the use of dental services, considering the education of the head of the family and family income, with similar results for people with and without disabilities. High inequality is observed concerning race. Racial minorities (Black, Brown, Yellow, and Indigenous) without disabilities presented a higher use of dental services in the last 12 months than racial minorities with disabilities.

CONCLUSIONS

Our findings demonstrate that social and racial inequities negatively affect individuals with and without disabilities.

CLINICAL RELEVANCE

Inequalities exist in the use of oral health services for people with and without disabilities.

Linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China: a cross-sectional study

BACKGROUND

Depression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China.

METHODS

From November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately.

RESULTS

Based on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (β) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (β = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (β = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (β = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (β = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes.

CONCLUSION

Both the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life.

Gender differences in the association between transitions in depressive symptoms and oral health among older adults with chronic conditions

BACKGROUND

Oral health influences the quality of life of older adults. Further, depression is negatively associated with oral health. However, little is known about this relationship among older adults with chronic health conditions. Additionally, since oral health and depression differ between genders, this study aimed to investigate the effect of transitions in depressive symptoms on oral health among older adults with chronic health conditions by gender.

METHODS

We used data from the Korean Longitudinal Study of Aging (2020-2022). The study sample comprised 2836 older adults (1104 men; 1732 women). We adopted multiple linear regression to examine the association between depressive symptom transitions and oral health by gender.

RESULTS

The new onset depression symptoms were significantly associated with the deterioration of oral health in men (β = -5.4308) and women (β = -4.8328). Our study showed a gender-specific association between new onset depressive symptoms and particular domains of oral health. For men, the association was slightly more negative in psychosocial function (β = -2.1177) while women presented lower GOHAI scores in both the physical function domain (β = -1.8800) and the psychosocial function domain (β = -1.8801).

LIMITATIONS

The data used in this study were self-reported via a survey; thus, self-report bias may be a relevant concern.

CONCLUSION

To prevent deterioration in oral health, depressive symptoms must be detected and addressed early among older adults with chronic conditions. This study underscores the importance of interventions that consider gender differences in the association between depressive symptoms and psychosocial and physical functioning.

Oral health among refugees and asylum seekers utilizing Médecins du Monde clinics in mainland Greece, 2016-2017

BACKGROUND

The oral health of refugees and asylum seekers is understudied. However, oral health has important implications for overall health and wellbeing. This study addresses this gap by characterizing oral health care utilization in Médecins du Monde (MdM) clinics across mainland Greece from 2016 - 2017.

METHODS

A retrospective cross-sectional study design was used to estimate proportional morbidities for caries, extraction, developmental, periodontal disease, preventive, and other oral health outcomes. The association between physical health conditions and consultations of interest - upper respiratory tract infections (URTIs) and reproductive health consultations - and oral health were compared using odds ratios (OR) and 95% confidence intervals (CIs). Oral health outcomes between Afghans and Syrians were compared using odds ratios and 95% CIs.

RESULTS

Caries (39.44%) and extractions (28.99%) were highly prevalent in our study population. The utilization of preventive dental consultations (37.10%) was high, particularly among males. Individuals with at least one upper respiratory tract infection (OR = 1.52; 95% CI: 1.30 - 1.77; Or = 1.90; 95% CI: 1.53 - 2.36) and women and girls with reproductive health consultations (OR = 1.30; 95% CI: 1.03 - 1.66; OR = 2.03; 95% CI: 1.49 - 2.76) were more likely to have any dental or caries specific consultations. The observed patterns in oral health needs differed between Afghans and Syrians, with Afghans more likely to have preventive screenings and less likely to have caries, extractions, or other conditions.

CONCLUSIONS

Displaced populations utilizing MdM dental clinics had high levels of oral health needs, particularly for caries and extractions. The connection between oral and overall health was seen in the study population, and these findings reinforce the public health importance of oral health for improving health and wellbeing of displaced populations. Evidence-informed policy, practice, and programming inclusive of oral health are needed to address both oral and overall health of refugees and asylum seekers in Greece. Future research should investigate not only oral health care needs but also knowledge and beliefs that inform utilization patterns among displaced populations.