The Role of the Dental Team in the Prevention of Systemic Disease: the Importance of Considering Oral Health As Part of Overall Health

Oral Health Implications of Obstructive Sleep Apnea: A Literature Review

BACKGROUND

Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. While the systemic implications of OSA are well documented, the dental consequences are less frequently discussed yet equally significant. This review aims to elucidate the oral health impacts of OSA, emphasizing the importance of interdisciplinary care.

METHODS

A comprehensive literature search was conducted across several databases to identify studies examining the relationship between OSA and various oral health parameters. The review included observational studies, clinical trials, and systematic reviews published in English up to January 2024.

RESULTS

OSA was significantly associated with heightened risks of bruxism, dry mouth, periodontal disease, temporomandibular joint disorders, palatal and dental changes, and alterations in taste sensation. Mouth breathing associated with OSA was a critical factor in exacerbating xerostomia and dental caries. Furthermore, the systemic inflammation induced by OSA appeared to correlate with the severity of periodontal disease. Patients using oral appliance therapy for OSA also showed notable changes in dental occlusion and required ongoing dental monitoring.

CONCLUSIONS

The findings underscore the bidirectional relationship between OSA and oral health, highlighting the need for dental professionals to be integral participants in the management of OSA. Early dental evaluation and intervention can contribute to the overall health and quality of life of individuals with OSA. The review advocates for the development of clinical guidelines to facilitate the early identification and management of OSA-related oral health issues within dental practice and encourages a collaborative approach to patient care.

Current situation, future vision and enablers of nursing home oral healthcare in Singapore: Dentists' perspectives

OBJECTIVES

To address the following research questions: (i) What is the current situation and future vision on oral healthcare service in nursing homes (NHs) in Singapore? (ii) What are the enablers to achieve the future vision? (iii) How do views differ between dentists with and without clinical experiences in NHs?

BACKGROUND

Oral healthcare services in NHs need to reflect the perspectives of a diverse range of stakeholders and establish shared goals, however there is scarce evidence of in-depth dentists' insights.

MATERIAL AND METHODS

Dentists were purposively recruited. Focus group discussions with 4-5 participants each were conducted via teleconferencing. Data were analysed thematically.

RESULTS

The participants (n = 19, median 36.0 years) recognised the need of comprehensive reform of the oral healthcare paradigm in NHs: symptomatic care to preventive care, disease-oriented care to person-centred care and more active collaborative care. Overall, five domains of enabling factors emerged: (1) to improve general system of oral healthcare in NHs, (2) to increase the number of dentists engaging in NHs, (3) to improve the quality of dental practice, (4) to improve the quality of daily oral care and (5) to promote seniors' cooperative attitude to oral healthcare. There was a noticeable difference in the perception on how to encourage dentists to serve in NHs.

CONCLUSION

There is a need for a comprehensive reform of the oral healthcare paradigm for seniors in NHs in Singapore. A multi-tiered strategy using both top-down and bottom-up approaches is required.

Willingness for Medical Screening in a Dental Setting-A Pilot Questionnaire Study

An important way to manage noncommunicable diseases (NCDs) is to focus on prevention, early detection, and reducing associated risk factors. Risk factors can be detected with simple general health checks, which can also be performed in dental clinics. The purpose of this study was to investigate participants' willingness to participate in general health checks at the dentist, in particular the difference in opinion between medical patients and random healthy dental attendees. A total of 100 medical patients from an outpatient internal medicine clinic and 100 dental clinic attendees were included (total of 200 participants). The participants were asked for their opinion using six closed-ended questions. Overall, 91.0% of participants were receptive to information about the risk of diabetes mellitus (DM) and cardiovascular diseases (CVD). The majority (80-90%) was receptive to screening for DM and CVD risk, such as weight and height measurements, blood pressure measurement, saliva testing for CVD and to measure glucose and cholesterol via finger stick. No significant differences were found in the frequencies of the responses between the different groups based on health status, age, sex, or cultural background. This study shows that most participants are willing to undergo medical screening at the dentist for early detection and/or prevention of common NCDs.

Natural Bioactive Compounds in the Management of Oral Diseases in Nephropathic Patients

Among the chronic non-communicable degenerative diseases (CDNCDs), chronic kidney disease (CKD) represents a global public health problem. Recent studies demonstrate a mutual cause-effect relationship between CKD and oral diseases, in which the presence of one induces the onset and faster progression of the other. In particular, the oral cavity alterations more frequent in CKD patients are: chronic periodontitis diseases, bone lesions, oral infections, and oral cancer lesions. Currently, a standardized therapy for the treatment of oral diseases is lacking. For this reason, natural bioactive compounds (NBCs), characterized by several health effects, such as antioxidant, antimicrobial, anti-inflammatory and anti-cancer actions, represent a new possible adjuvant therapy in the management of these pathological conditions. Among NBCs, polyphenols play a leading role due to positive modulation of oral microbiota, preventing and correcting oral dysbiosis. Moreover, these compounds exert anti-inflammatory effects, such as inhibiting the production of pro-inflammatory cytokines and the expression of cycloxigenase-2. In this light, the formulation of a new mouthwash/gel/gingival paste, with a high content of polyphenols in association with NBCs characterized by antimicrobial action, could represent a future therapy of oral disease in CKD patients.

What influences the provision and reception of oral health education? A narrative review of the literature

OBJECTIVES

Most common diseases of the mouth are preventable through behavioural changes, oral hygiene routines and regular professional care. Research suggests dental professionals may prioritize clinical experience, personal values and preferences over evidence when delivering such interventions. Research also suggests variable rates of patient behaviour change following oral health education (OHE) interactions. This review explores the literature to answer the question: what factors influence the provision and reception of OHE messages and the wider OHE process?

METHODS

A structured search of literature was carried out with databases covering a range of academic disciplines (healthcare sciences, social sciences, education). Key words/terms were searched to elicit papers published since 1998. Citation mining (relevant citations within papers) and citation tracking (papers citing relevant papers) were also used. Recurring themes within the papers were identified and coded using NVivo12 and presented in a conceptual model.

RESULTS

The studies analysed tended to employ small-scale surveys, larger-scale surveys (some with low response rates), or interview studies of varying sizes. There was also a limited number of review papers. However, several key messages were identified regarding dental professionals' and patients' views on OHE and the factors that influence its provision. Factors that were identified related to the wider social and policy context (macro), community-level factors (meso), the individual practitioner and patient (micro), factors that influenced the nature of OHE interaction and any resulting behaviour change, and how the outcomes of the process influence future OHE interactions for both parties.

CONCLUSIONS

The literature highlighted how factors influence the OHE process before, during and after the educational interaction. The resultant conceptual model acknowledges the influence of wider 'upstream' factors alongside interpersonal and individual influences which should be taken into consideration when developing OHE interventions.

Knowledge, attitudes, and practice behavior of dental hygienists regarding the impact of systemic diseases on oral health

OBJECTIVES

To assess the knowledge levels of dental hygienists in Saudi Arabia regarding the association between systemic and oral disease in addition to evaluating their attitude about integrating this knowledge into clinical practice. Methods: This was a cross-sectional survey using a questionnaire of 102 items among 192 randomly selected dental hygienists practicing in Riyadh, Saudi Arabia by individual interview. The research tool was pilot tested among 12 dental hygienists (8 females and 4 males) to obtain feedback about clarity and objectivity. Results: The response rate was 83%, and the majority of respondents were female (77.5%). The respondents' knowledge about the risk factors of cardiovascular diseases was better than other conditions. The level of education was considered to be a significant predictor in many items related to risk factors. More than the half, rated the evidence linking periodontal disease and diabetes mellitus as strong; however, the knowledge level of oral-systemic evidence was less than expected. A high percentage of the respondents were confident and comfortable managing patients with systemic conditions. Most agreed that dental hygienists must be prepared efficiently to manage medically compromised patients. Conclusion: Dental hygienists in Riyadh, Saudi Arabia have low level of knowledge about the oral-systemic disease relationship. This study suggests that greater emphasis should be placed on this association in current and continuing education programs.