Self-reported dental hygiene, obesity, and systemic inflammation in a pediatric rural community cohort

Dental treatments under sedation-analgesia in patients who are unable to collaborate: a prospective observational study

Background

Excessive fear of dental procedures leads to disruptive behavior during dental examinations and treatments. Dental examinations and treatments of these patients usually require additional techniques, such as sedation. The most commonly used techniques are inhalation of nitrous oxide, infusion of propofol with fentanyl, and premedication and infusion of midazolam.

Methods

A prospective observational epidemiological study was conducted on patients who required sedoanalgesia techniques for dental exploration and procedures. The reasons for the inability of patients to cooperate (excessive fear or intellectual disability), age, sex, weight, systemic pathology, oral pathology, treatment performed, time of intervention, anesthetic technique performed, and occurrence of complications were recorded.

Results

In total, 218 patients were studied. Sixty-five patients came for fear of dental treatment and 153 for presenting with a diagnosis of intellectual disability and not collaborating in the treatment with local anesthesia. The average age of all patients was 30.54 ± 17.30 years. The most frequent oral pathologies found in patients with excessive fear were tartar (6.8%) and wisdom teeth (6.4%), followed by missing teeth (5%). In patients with disabilities, a combination of tartar and cavities appeared most frequently (41.3%), followed by cavities (15.6%). The most frequently used sedoanalgesia technique was the infusion of propofol with fentanyl in both groups of patients, followed by nitrous oxide.

Conclusion

The combination of propofol and fentanyl was the most frequently used alternative in patients who were unable to collaborate because of intellectual disability or carry out longer or more complex treatments. Inhaled nitrous oxide and midazolam were the sedative techniques of choice for simpler oral treatments, such as tartrectomies, shallow obturations, and shorter interventions, or in younger patients.

Is inflammatory potential of the diet related to oral and periodontal health?

Inflammation is among the risks of periodontal diseases. The relationship between the inflammatory load of the diet and inflammation has been shown in previous studies, but the relationship between periodontal diseases and the inflammatory load of the diet is not clear. In this study, it was aimed to examine the relationship between dietary inflammatory index (DII) and periodontal health. Board approved the protocol. Information about the study was given to the patients who met the criteria of the study and agreed to participate in the study. Oral health status was evaluated by measuring the Decayed, Missing, and Filled Teeth (DMFT). Periodontal health status was determined using the plaque index (PI) and gingival index (GI). Twenty-four-hour dietary record was taken for 1 day to calculate the inflammatory load gained from daily diet, and the DII score was used. The study group consisted of 138 participants. DMFT scores were found with median 4.0, and no statistically significant difference was observed between DII quartiles. 65.8% of the participants had absence or small amount of plaque accumulation, while 39.2% had moderate or dense amount of plaque accumulation according to the PI classification. While DII did not differ by PI classification, DII quartile between second and third found a difference according to the GI classification. The new definition of periodontal health has been proposed as the absence of clinically detectable inflammation. It seems that pro-inflammatory properties of the diet and periodontal health are related. But future randomized controlled trials are needed.

Association between dietary inflammatory index and the risk of oral cancer in the southeast of China

BACKGROUND/OBJECTIVES

To evaluate the role of the potential inflammatory effects of diet using the Energy adjusted Dietary Inflammatory Index (E-DII) for oral cancer.

SUBJECTS/METHODS

A case-control study including 295 oral cancer cases and 425 controls from September 2010 to June 2018 was performed in Fujian Province, China. The E-DII was calculated based on the food frequency questionnaire (FFQ) and adjusted by total energy intake. The association between E-DII and the risk of oral cancer was estimated with unconditional logistic regression model.

RESULTS

Compared with E-DII score in the lowest quartile, those with E-DII score in the fourth quartile were at the higher risk of oral cancer (OR = 2.57; 95% CI: 1.54, 4.29, P_trend = 0.013). When analyses were carried out using E-DII as a continuous variable, one-unit increase in E-DII increased the odds of having oral cancer by 3% (95% CI: 1.00, 1.06). Moreover, there was a significant interaction between the E-DII and oral hygiene for oral cancer (P_interaction < 0.001, in those without and with poor hygiene, the OR (95% CI) were 1.96 (0.96, 4.00) and 4.23 (1.83, 9.81), respectively).

CONCLUSIONS

The present study suggests that the higher E-DII score, indicated a pro-inflammatory diet, may be a risk factor for oral cancer in southeast of China. More large samples and prospective studies need to validate our results and explore the prevention strategies of oral cancer via changing dietary habits.

[Relation between body mass index and dental caries among adolescents]

BACKGROUND

Obesity and dental caries are both multifactorial diseases. Their prevalence is increasing among infants and adolescents. Research results on the association between dental caries and obesity are contradictory and the nature of factors involved remains unclear. The aims were to review and summarize the type of the relation between dental caries and obesity among infants and adolescents aged 8 to 18 years old and to identify factors contributing to the clarification of the relationship.

METHOD

Research of literature was undertaken on electronically databases Scholar Google, Medline, completed by manual searches from reference lists of studies. Review was based on cross sectional studies published between 2010 and 2015.

RESULTS

The results showed that dental caries were associated with high and low body mass index. In addition to the socio-economic, environmental, behavioural, lifestyle factors, the review identified that the choice of instruments used to diagnose the dental caries and the obesity had impact on the results.

CONCLUSION

The present review has identified the impact of the indicators used for measuring obesity and dental caries other than the standard BMI or DMFT respectively. Future research should test if their use will change the conclusions on the association between obesity and dental caries.

Dental anxiety: An understudied problem in youth

Dental anxiety and dental phobia typically emerge during childhood; the associated avoidance of dental care can result in oral health problems and is associated with lower quality of life. In this review, we discuss the definition of dental phobia and dental anxiety and issues related to their differentiation. We then review the literature on dental anxiety and dental phobia, including its prevalence, assessment, and sequalae. Moreover, we provide a synthesis of findings on the etiology and maintenance of dental phobia and propose a comprehensive cognitive behavioral model to guide further study. We also present a systematic qualitative and a quantitative review of the treatment literature, concluding that although we have made strides in learning how to prevent dental anxiety in youth, the methods effective in preventing anxiety may not be equally effective in treating youth with dental phobia. We propose a multidisciplinary approach, including those with expertise in pediatric anxiety as well as pediatric dentistry, is likely required to move forward.

Effectiveness of periodontal treatment on the improvement of inflammatory markers in children

AIM

It is known that atherosclerosis begins in childhood, a behaviour towards oral health care and metabolic control, since an early age, is essential for patients with cardiovascular disease. The aim of this research was to evaluate the effectiveness of periodontal treatment full-mouth scaling and root planning (FMSRP), applied to children without systemic diseases, correlating with periodontal clinical and blood parameters (lipid profile and inflammatory markers).

MATERIALS AND METHODS

The 29 patients were divided into two groups, group 1 (14) - scaling and rot planning (SRP), group 2 (15) - FMSRP and the follow-up was conducted among 180 days.

RESULTS

The results showed a significant improvement in clinical periodontal parameters (p<0.05) in both groups. In the analyzed blood parameters there was a greater evidence, with a significant improvement (p<0.05), in total cholesterol (TC), triglycerides (TGs), fibrinogen (FGN), and interleukin-6 (IL-6) CONCLUSIONS: Thus, we suggest that both periodontal treatments were effective in children without any systemic diseases.

Lipid profiles and inflammatory markers after periodontal treatment in children with congenital heart disease and at risk for atherosclerosis

Due to the biological associations between periodontal and cardiovascular diseases, as well as the fact that atherosclerosis begins in childhood, behavior based on oral health care and metabolic control from an early age is essential for patients with cardiovascular disease. The aim of this research was to examine the effect of full-mouth scaling and root planing on the reduction of periodontal disease in children with congenital heart disease. In this study, treatments were related to clinical periodontal parameters and also to blood ones, such as lipid profile and inflammatory markers. The patients were divided into two groups: group 1 (n=17), scaling and root planing; and group 2 (n=16), full-mouth scaling and root planing. The results showed a significant improvement in clinical periodontal parameters (P<0.05) in both groups. Considering lipid parameters, total cholesterol, triglycerides, and very-low-density lipoprotein parameters showed significant improvement (P<0.05). There was also an improvement in C-reactive protein (ultrasensitive) in the group treated with scaling and root planing (P<0.05). Fibrinogen and interleukin-6 parameters improved (P<0.05) in both groups. We suggest that both periodontal treatments were effective in children with congenital heart disease, though neither demonstrated superiority.

Body mass index and dental caries in children and adolescents: a systematic review of literature published 2004 to 2011

THE OBJECTIVE

The authors undertook an updated systematic review of the relationship between body mass index and dental caries in children and adolescents.

METHOD

The authors searched Medline, ISI, Cochrane, Scopus, Global Health and CINAHL databases and conducted lateral searches from reference lists for papers published from 2004 to 2011, inclusive. All empirical papers that tested associations between body mass index and dental caries in child and adolescent populations (aged 0 to 18 years) were included.

RESULTS

Dental caries is associated with both high and low body mass index.

CONCLUSION

A non-linear association between body mass index and dental caries may account for inconsistent findings in previous research. We recommend future research investigate the nature of the association between body mass index and dental caries in samples that include a full range of body mass index scores, and explore how factors such as socioeconomic status mediate the association between body mass index and dental caries.