The Relationship between Age, Gender, BMI, Diet, Salivary pH and Periodontal Pathogenic Bacteria in Children and Adolescents: A Cross-Sectional Study

Impact of Marital Status, Education, and Family Size on Parental Behaviors Toward Early Childhood Caries in Romania

Background and Objectives: This study aimed to examine the influence of socio-demographic factors (marital status, number of children, and education level) on the knowledge, attitudes, and practices (KAP) concerning Early Childhood Caries (ECC) prevention among parents in Bihor, Romania. This research seeks to address the lack of regional data on the influence of socio-demographic factors, such as marital status, number of children, and education level, on parental knowledge, attitudes, and practices regarding ECC prevention. These insights are essential for developing targeted public health interventions in Romania. Materials and Methods: Conducted from March to September 2024, this cross-sectional study utilized a KAP questionnaire distributed online to parents of children under six. The survey was adapted to local contexts and included sections on demographic data and ECC-specific knowledge, attitudes, and practices. Statistical analyses, including Chi-square tests, were performed to evaluate the relationship between socio-demographic factors and KAP outcomes, ensuring robust data interpretation under ethical standards set by the Declaration of Helsinki. Results: Of the 798 respondents who accessed the questionnaire, 419 completed it, resulting in a completion rate of 52.5%. The participants had a mean age of 33.8 years. In terms of gender distribution, 348 (83.1%) were female and 71 (16.9%) were male. Higher educational levels were strongly correlated with better ECC knowledge and preventive practices; parents with university degrees demonstrated significantly better understanding and engagement in ECC prevention (p < 0.05). Married parents participated more actively in ECC prevention than unmarried ones, with 61.1% adhering to recommended practices compared to significantly lower rates among unmarried parents (p = 0.020). While this difference was statistically significant, the lower representation of unmarried parents in the sample should be considered when interpreting this finding. Families with fewer children showed more effective ECC preventive practices (p = 0.001). Conclusions: The study suggests that higher education and smaller family sizes are associated with better ECC prevention behaviors, emphasizing the need for targeted public health interventions. These could include parental education campaigns on ECC prevention, community-based oral health workshops, subsidized fluoride programs, and increased accessibility to pediatric dental services for underprivileged families.

Beyond BMI: Exploring Adolescent Lifestyle and Health Behaviours in Transylvania, Romania

BACKGROUND/OBJECTIVES

This study aimed to investigate the lifestyle and the behavioral factors that influence the nutritional status of adolescents from Transylvania, Romania.

METHODS

The Global School-Based Student Health Survey (GSHS) was used to collect data from 900 adolescents between 11 and 18 years old from the Transylvania region, Romania. This study assessed nutritional status by calculating BMI indicators adjusted to Z-Score, cut-off points according to the World Health Organization (WHO), using self-reported weight and height; perceived health status; food vulnerability; physical activity; addictive behaviors (cigarette, alcohol and drug consumption); number of hours spent in front of the computer/phone; hand and oral hygiene; sitting time/day; and sleep. Multivariate logistic regression was used to establish the lifestyle factors that influenced nutritional status.

RESULTS

The results showed that 8.7% (n = 78) of girls and 15.2% (n = 137) boys were overweight and obese. In total, 75% of the respondents were engaged in sedentary behaviors, and 65.8% (n = 592) had more than 2 h/day of screen exposure, considering that 98.7% of the study population had a mobile phone. The Romanian adolescents had poor dietary behaviors: over 80% of them did not meet the recommended amount of vegetable and fruit intake per day. Increased BMI was associated with higher-strength physical exercise and with being a boy.

CONCLUSIONS

While some positive trends are evident, such as good oral and hand hygiene and low prevalence of smoking and drug use, significant challenges remain in areas like nutrition, physical activity, alcohol consumption and screen time.

Does Fusobacterium in Colorectal Cancer Sites Originate From the Oral Cavity? A Pilot Study

OBJECTIVES

Fusobacterium can contribute to oral diseases, but also pose as a systemic risk factor. This genus, and especially F. nucleatum, can be found in colorectal cancer (CRC) tissue and is involved in multiple aspects of this type of cancer. Previous studies indicated a possible oral origin of these bacteria; however, stronger evidence is needed to reach a definitive conclusion. This pilot study aimed to establish a method to successfully compare, at the strain level, fusobacteria from the oral cavity and CRC resection material for future cohort studies of CRC patients.

MATERIAL AND METHODS

In a first cohort of eight periodontitis patients, gingival crevicular fluid and saliva were collected. Fusobacterium was isolated on two different media. In a second cohort, saliva and CRC resection material were collected from ten CRC patients. These samples were used for screening of Fusobacterium with culturing, 16S rRNA gene profiling and a PCR-based approach.

RESULTS

In the first cohort, different Fusobacterium species were identified in GCF and saliva samples. However, as the total yield of Fusobacterium seemed slightly higher in saliva samples, it was therefore preferred for subsequent sample collection. Thus, in the second cohort, patient-matched saliva and CRC resection material were screened for Fusobacterium and this showed that nine patients were culture-positive in the saliva samples; however, no Fusobacterium could be isolated from the resection material. On the other hand, 16S rRNA gene profiling of the resection material indicated that eight CRC patients were positive for Fusobacterium. All eight of these patients carried Fusobacterium in their saliva, indicated by both marker gene PCR and culture-based screening.

CONCLUSIONS

These pilot results are compatible with data from previous studies, indicating a possible link between oral and CRC-associated Fusobacterium, and a more in-depth analysis of specific strains and their characteristics in a larger cohort is justified.

TRIAL REGISTRATION

The protocol was registered at clinicaltrials.gov (NCT05945082).

Oral Health and Caries Prevention: How Tongue Hygiene Helps Maintain Balance of Microbiota and Overall Health in Pediatric Patients

BACKGROUND/OBJECTIVES

The tongue harbors about two-thirds of the microorganisms present in the mouth; the stable bacterial population consists mainly of aerobic and facultative anaerobic streptococci. These bacterial colonies, found more frequently on the tongue than on the outside of the hard part of the dental enamel in children younger than 18 months, suggest that the tongue is a potential bacterial reservoir. The aim of this review is to examine the scientific literature to clarify whether the mechanical removal of bacterial biofilm on the tongue can have a positive effect on caries prevention, with the reduction in colony-forming unit (CFU) of salivary streptococcus and the whole-mouth plaque index (FMPS).

METHODS

An open literature search was conducted by using PubMed (MEDLINE), Cochrane Library and Google Scholar. The most studied age range was 9 to 12 years, with groups of children with no caries and groups with a minimum number of two teeth that were reconstructed, decayed and/or missing (DMFS/dmfs > 2) who experienced different tongue hygiene methods for the first time.

RESULTS

Four randomized trials met the search criteria and were included in this review.

CONCLUSIONS

The results obtained suggest that specific tongue hygiene protocols, combined with a healthy diet and lifestyle, could be considered the gold standard to enable more effective primary prevention and improve the health of pediatric patients. This review improves the understanding of the impact of tongue hygiene in controlling the bacteria responsible for the onset of carious disease and its systemic correlates; however, further research with more data is needed to further confirm the findings of this research.

Real-Time PCR Method as Diagnostic Tool for Detection of Periodontal Pathogens in Patients with Periodontitis

The most common type of periodontal disease is chronic periodontitis, an inflammatory condition caused by pathogenic bacteria in subgingival plaque. The aim of our study was the development of a real-time PCR test as a diagnostic tool for the detection and differentiation of five periodontopathogenic bacteria, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, and Treponema denticola, in patients with periodontitis. We compared the results of our in-house method with the micro-IDent® semiquantitative commercially available test based on the PCR hybridization method. DNA was isolated from subgingival plaque samples taken from 50 patients and then analyzed by both methods. Comparing the results of the two methods, they show a specificity of 100% for all bacteria. The sensitivity for A. actinomycetemcomitans was 97.5%, for P. gingivalis 96.88%, and for P. intermedia 95.24%. The sensitivity for Tannerella forsythia and T. denticola was 100%. The Spearman correlation factor of two different measurements was 0.976 for A. actinomycetemcomitans, 0.967 for P. gingivalis, 0.949 for P. intermedia, 0.966 for Tannerella forsythia, and 0.917 for T. denticola. In conclusion, the in-house real-time PCR method developed in our laboratory can provide information about relative amount of five bacterial species present in subgingival plaque in patients with periodontitis. It is likely that such a test could be used in dental diagnostics in assessing the efficacy of any treatment to reduce the bacterial burden.

Status of Healthy Choices, Attitudes and Health Education of Children and Young People in Romania-A Literature Review

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic's overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania.

Psychometric Properties of the Iowa Fluoride Study Oral Health Questionnaire in Mexican Adolescents

BACKGROUND AND OBJECTIVE

The perception of quality of life about health status is subjective; assessment of the impact includes well-being while eating, speaking, smiling, interacting with others, and feeling good about the esthetic appearance of teeth and mouth. The objective of the present study was to cross-culturally adapt and determine the validity and reliability of the Mexican version of the Iowa Fluoride Study Oral Health for adolescents.

MATERIAL AND METHODS

A cross-sectional study was carried out in a sample of 240 Mexican adolescents aged 15 to 19 years. The questionnaire was translated, back-translated, and administered through the Google Forms platform. The cultural adaptation consisted of the evaluation of the grammatical, conceptual, and linguistic equivalences. The evaluation of the utility and acceptability was carried out through an analysis of semantic equivalence. The utility of the questionnaire was also evaluated by analyzing its grammatical readability. Reliability tests, Kaiser-Meyer-Olkin (KMO), factor analysis, and Pearson's correlation were performed.

RESULTS

The mean age of all participants was 16.4±1.4; 65.3% (n=158) were female. Face validity was considered adequate. The wording of the objective and instructions of the questionnaire were improved. The confidentiality assurances were highlighted. The questions were clear, understandable, and pertinent, and they showed adequate syntax. The INFLESZ index corresponds to a "fairly easy" level of readability. In the quantitative validation, the correlation of items was greater than 0.4. The KMO was 0.930 (p=0.001), and Bartlett sphericity was 2466.5 (p=0.001). Through the exploratory factorial analysis, we evaluated the emotional well-being (12 items), social welfare (five items), and oral symptoms (OS) (three items) dimensions. Internal consistency was high (Cronbach's α=0.942).

CONCLUSION

The culturally translated and adapted questionnaire is valid and reliable for use in research on Mexican adolescents.

The Relationship between Dietary Habits and Periodontal Pathogens in a Sample of Romanian Children and Adolescents: A Cross-Sectional Study

The role of diet in shaping oral microbiota and its potential contribution to the development of periodontal pathogens cannot be understated. This study aimed to explore the correlation between dietary habits and the prevalence of 11 periodontal pathogens among children and adolescents in Oradea, Romania. The identification of these pathogens was performed using the micro-IDent test kit, capable of detecting 11 specific periodontal pathogens. Bacterial sampling was conducted from the crevicular fluid in the morning, prior to brushing, followed by the completion of a brief questionnaire by parents. The questionnaire captured various aspects of the children's eating habits, including meal frequency, consumption of sweets, and hydration levels. The collected samples were dispatched to the laboratory for analysis, which provided insights into the abundance of microorganisms. The study encompassed 60 participants aged between 2 and 18 years, with the majority reported by their parents to have regulated meal timings, frequent sugar intake, and adequate hydration. The findings revealed significant associations between certain dietary factors and the presence of specific periodontal pathogens. Notably, the absence of breastfeeding was linked with the detection of Tannerella forsythia and Campylobacter rectus. Furthermore, frequent consumption of sweets corresponded with the presence of Capnocytophaga spp., which was particularly observed in individuals consuming sweets 2-3 times a day. Insufficient age-appropriate hydration showed an association with the prevalence of T. forsythia, Peptostreptococcus micros, and Capnocytophaga spp. In this sample, it became evident that eating habits and diet influenced the presence of several periodontal pathogens. The lack of breastfeeding was predominantly associated with positive results for T. forsythia and C. rectus, while inadequate hydration correlated more frequently with the presence of T. forsythia and P. micros. Moreover, frequent consumption of sweets was linked to the presence of Capnocytophaga spp.