Oral Health: The First Step to Well-Being

Potent Oral Health Benefits and Teeth Bleaching Effects of Latilactobacillus sakei THY-B1 Isolated from Broccoli

The study aims to examine the rising social interest in optimizing oral health and teeth bleaching outcomes using lactic acid bacteria, driven by the increasing demand for sustaining a healthy diet and social relationships in later life. This in vitro study evaluates the antibacterial activity of selected LAB via disc diffusion and microdilution methods. Plaque formation and dental caries prevention were assessed using violet biofilm staining, scanning electron microscopy, acid production assays, glycosyltransferase, and enzymatic assays. Teeth bleaching effects were tested by treating black tea-stained artificial teeth with Lactobacillus sakei THY-B1 (L. sakei THY-B1) supernatant for two weeks. L. sakei THY-B1 effectively inhibited biofilm formation at 1.56 mg/mL for S. mutans by disrupting cell walls, reducing acid production, and inhibiting glucosyltransferase activity through the generation of hydrogen peroxide (H2O2 produced at 64.25 μM concentration per 1 g/mL CFS) and organic acids. The CFS of THY-B1 significantly reduced inflammatory markers, decreasing NO production by 22.4 % and suppressing key cytokines (IL-6, IL-1β, TNF-α) by 27.1 - 52.6 % in PDLF cells. Additionally, the treatment inhibited collagen-degrading MMPs (MMP-3/-8/-9/-13) by up to 44.9 %, suggesting protective effects against periodontal tissue damage. At its minimum inhibitory concentration, L. sakei THY-B1 demonstrated a superior bleaching effect compared to 3 % commercial H2O2, with a whiteness index 105.06 % higher than H2O2 after the first week of treatment. These findings suggest that L. sakei THY-B1 is a promising probiotic for oral health, offering both therapeutic advantages in managing oral pathogens and aesthetic bleaching benefits in teeth whitening. The promising results of L. sakei THY-B1 suggest its potential for integration into dental care protocols. This probiotic could enhance caries prevention and serve as a natural alternative for tooth bleaching, aligning with the growing patient preference for multifaceted and biocompatible therapeutic options.

Knowledge and perception of specialties of dentistry among undergraduatein the Northeast China

BACKGROUND

Oral diseases are among the most prevalent non-communicable diseases globally. Due to their lifestyle choices and dietary habits, college students often exhibit poor oral health and are at a higher risk of developing oral diseases. Enhancing their understanding of oral health and increasing their awareness of the dental profession can foster better oral health practices and encourage preventive measures against oral diseases.

METHODS

This cross-sectional study gathered 560 valid responses from undergraduate students divided into three groups: stomatology students, non-dental medical students, and non-medical students. A specifically designed questionnaire assessed the participants' knowledge and attitudes towards dental specialties. Statistical analyses, including Welch's Test and Levene's Test, were performed using SPSS Version 26.0 to examine differences based on gender and undergraduate major.

RESULTS

Analysis of the 560 valid questionnaires revealed that female participants had significantly higher knowledge scores than their male counterparts (p < 0.05). Conversely, males demonstrated more favorable attitudes towards dental specialties (p < 0.05). Stomatology students scored higher than students from both other medical and non-medical major in knowledge and attitude assessments (p < 0.05), reflecting a more profound understanding and identification with their field. These results underscore the significant impact of gender and academic background on students' perceptions of dental specialties.

CONCLUSIONS

A concerning number of medical and non-medical students, including some dental students, exhibit limited awareness of oral health issues and the various dental specialties. It is imperative to implement educational reforms targeting medical students to enhance their understanding of dental specialties. This improvement will enable them to accurately identify oral diseases and make appropriate referrals, ultimately reducing patient suffering in their future medical practice.

Investigating the link between oral health conditions and systemic diseases: A cross-sectional analysis

This study investigates the association between oral health issues, specifically periodontitis and dental caries, and systemic health conditions such as diabetes and hypertension. The goal is to determine the strength of these associations using statistical analysis. We conducted a cross-sectional study utilizing the National Health and Nutrition Examination Survey (NHANES) data from 2017-2020, focusing on 13,772 adults with complete data on oral and systemic health variables. Oral health indicators were periodontitis and dental caries, while systemic health variables included diabetes and hypertension. The statistical analysis involved Cramer's V to assess the strength of associations between these health conditions. The study found statistically significant associations between oral and systemic health conditions. There was a moderate association between periodontitis and diabetes (Cramer's V = 0.14) and a moderate association between dental caries and hypertension (Cramer's V = 0.12). The results underscore the interconnected nature of oral and systemic health, suggesting that poor oral health can be an indicator of broader health issues. These associations could guide integrated health care strategies, emphasizing the need for dental health evaluations in patients with diabetes and hypertension.

Association Between Cognitive Impairment and Poor Oral Function in Community-Dwelling Older People: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

The population of Japan has a high life expectancy, but there is room for improvement in terms of the country's healthy life expectancy. The long period of care dependency among Japan's elderly is also a major economic health challenge. Dementia is a major factor in the need for care, and its prevention is a crucial and urgent challenge. There are recent reports of a possible association between changes in oral function and cognitive impairment, but the details of this association remain unclear. To clarify the relationship between poor oral function and cognitive impairment, we conducted an exploratory investigation using a cognitive function assessment (Mini-Cog) administered in a large-scale study and its relevance to oral function.

METHODS

The study population was 678 community-dwelling individuals aged ≥65 years living in Tarumizu city, Japan, in 2019. Cognitive function was assessed using the Mini-Cog test, and the oral survey was a modification of the content of the Oral Hypofunction Examination as defined by the Japanese Society of Gerodontology.

RESULTS

The participants' median age was 73 years. The oral function results revealed median scores below the oral hypofunction criterion for occlusal force, tongue pressure, oral diadochokinesis, and swallowing function. The results of a binomial logistic regression analysis indicated that tongue-lip motor function was independently associated with oral function in relation to cognitive impairment.

CONCLUSIONS

The oral function associated with cognitive impairment in this study was tongue-lip motor function. Aiming to improve this function may prevent the exacerbation of cognitive impairment.

A Case of Severe Early Childhood Caries Occurring in a Childhood Cancer Patient

BACKGROUND/OBJECTIVES

Childhood cancer is the leading cause of death among children, although medical advances are improving the prognosis. During cancer treatment, nausea or vomiting may occur and eating habits may become irregular; therefore, it is important to prevent the development of oral diseases. We encountered a childhood cancer patient with rapidly progressive multiple dental caries, and this report describes the progress.

METHODS

A boy aged 2 years 9 months was referred for perioperative oral management. No caries were detected in the oral cavity at the initial visit.

RESULTS

As the patient had difficulty eating because of nausea and vomiting during cancer treatment, he began to consume probiotic drinks frequently. At 8-month follow-up, dental caries localized to the primary molars was detected. However, caries had occurred in all erupted teeth by 9 months later, confirming the diagnosis of severe early childhood caries. Dental treatment and long-term oral management contributed to good oral health except for dental abnormalities caused by chemotherapy.

CONCLUSIONS

Childhood cancer patients, particularly at an early age, are at risk of rapid deterioration of oral disease even over a short time period. It is important to cooperate with medical or dental professionals from other hospitals to provide dietary and oral health instruction and continue long-term oral management to improve patients' quality of life.

Development and Validation of the "Basic Oral Health Assessment Tool" (BOHAT) for Nondental Health Care Professionals to Use With the Indian Adult Population: Protocol for a Mixed Methods Study

BACKGROUND

Oral health is a significant indicator of general health, well-being, and quality of life. The prevention of oral health problems requires periodic inspection of the oral cavity. Routine oral health examinations at the individual level appears to be one way to deliver quality oral health care but are too often missed as an opportunity for improved oral health in the nondental health care setting in India. This is because of limited training and inaccessible or lack of specialized oral health assessment tools.

OBJECTIVE

This study will focus on the development, validation, and implementation of the Basic Oral Health Assessment Tool (BOHAT) to improve the oral health assessment capabilities of nondental health care professionals and thus contribute to improved overall health outcomes of the Indian adult population.

METHODS

This study will be a mixed methods, multistage study conducted in 3 stages. The study will be conducted with 708 nondental health care professionals in 33 Primary Health Centers (PHCs) of Mangalore Taluk, Karnataka. Ethical approval was sought from the institutional ethics committee of Manipal College of Dental Sciences Mangalore. Informed consent will be obtained from every participant prior to the study. A literature review and qualitative interviews will be used for item and domain generation with respect to BOHAT, and an expert panel review and pilot testing will be used to refine the items and domains. Finally, statistical analyses will be conducted to validate the reliability and consistency. The second phase will involve capacity building and user experience exploration through comprehensive training for nondental health professionals using audio and visual aids, with hands-on learning methodologies including relevant feedback processes in the form of focus group discussions. The third stage will check the effectiveness of BOHAT regarding the changes in knowledge, attitudes, and practices through pre- and posttraining questionnaires, which will then be followed by a retention analysis 3 months later.

RESULTS

As of January 20, 2025, the study is in its preliminary phase: "Substage A: Item and Domain Development." We have received institutional ethics committee and Institutional Protocol Approval Committee approval for the study. Data collection procedures have not started yet. The study is progressing as per the planned timeline.

CONCLUSIONS

The BOHAT study holds considerable potential to promote oral health care through collaborative and interdisciplinary approaches. It will facilitate early diagnosis, timely referrals, and comprehensive care by integrating assessment actions for oral health into routine practices of nondental primary health care professionals.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/63480.

A scoping review of factors that affect unmet dental service needs among people living with HIV/AIDS

BACKGROUND

There was an inequality in utilizing oral and dental healthcare utilization. Although people living with HIV need more oral and dental services they receive less and they have many unmet needs about their teeth health. Therefore, the present study aimed to find the factors related to unmet dental service needs (UDSN) among people living with HIV/AIDS (PLWHA) through a scoping review study.

METHODS

This scoping review was done based on the Arksey and O'Malley framework. PubMed, Scopus, Web of Science, Embase, and Proquest were searched for finding the relevant studies. After searching the mentioned databases, 10,431 papers were retrieved. All papers were screened and finally, 20 papers were included for synthesis.

RESULTS

The results showed UDSN ranged between 17-90.4% which in most studies was reported more than 50%. Reported related factors were classified into demographic, access, Health Conditions Exacerbating Dental Needs (HCEDN), health care provider, and patient status categories. The results also show that there is a high prevalence of HCEDN among PLWHA, such as untreated dental caries, dry mouth, enamel hypoplasia, and ulcers.

DISCUSSION

The results provide valuable information for improving access and UDSN among PLWHA. The results suggest the need for further research to explore the causal relationships between these factors and unmet need of dental service, and to evaluate the effectiveness of interventions that aim to overcome the barriers and enhance the facilitators of unmet dental service need among this population.

Factors associated with the use of dental services in older adults in Peru

BACKGROUND

The use of dental services by older adults in Peru faces various challenges that impact both their oral and overall health. Several factors play a crucial role in obtaining adequate dental care.

AIMS

To evaluate the factors associated with the use of dental services in older adults in Peru.

METHODS

This study was an observational, analytical, and cross-sectional investigation that utilized data from multiple years (2018-2022) of the Demographic and Family Health Survey (ENDES, by its Spanish acronym). The use of dental services was assessed through a specific survey question and analyzed in association with various socio-demographic variables, employing both descriptive and analytical statistical methods.

RESULTS

In the multivariable analysis, the likelihood of not utilizing dental services was higher among men aPR: 1.53 (95% CI: 1.45-1.61), those without health insurance aPR: 1.44 (95% CI: 1.36-1.53), those who self-identified as other races aPR: 1.22 (95% CI: 1.13-1.33), Afro-descendants aPR: 1.10 (95% CI: 1.01-1.19), whites aPR: 1.12 (95% CI: 1.01-1.25) according to education level, those with a physical limitation aPR: 1.24 (95% CI: 1.15-1.33), and increased as they were poorer; it was lower among the rich but more pronounced among the middle-income, poor, and very poor, adjusted for five variables.

CONCLUSION

It was reported that 15% of older adults did not use dental services, and this was associated with significant socio-demographic variables.

Developing and delivering a digital educational tool with an oral health focus

The delivery of oral health care has been identified as an important part of holistic patient care. Many patients may neglect their own oral health, oral hygiene and self-care when they are hospitalised due to feeling unwell. The Royal Wolverhampton NHS Trust nursing quality team endeavoured to change their Trust's culture relating to oral health management for all adult inpatients. To facilitate ongoing action relating to oral hygiene and health education and training, a bespoke, mandatory digital learning package was designed, developed and delivered to relevant clinical staff at the Trust.

Air Pollution and Oral Health: An Overall Insight From Genetic Causality

BACKGROUND

A growing body of epidemiological data consistently links air pollution to various adverse health outcomes. However, the potential connection between air pollution and the risk of oral diseases remains underexplored.

METHODS

This study utilized a two-sample Mendelian randomization approach to assess the causal relationship between air pollution and oral diseases. Six categories of air pollution were considered as exposures: nitrogen oxides (NOx), nitrogen dioxide (NO2), particulate matter (PM2.5, PM2.5-10, PM10), and PM2.5 absorbance. The outcomes included 18 oral health-related diseases drawn from the Finngen R10 dataset, the Gene-Lifestyle Interactions in Dental Endpoints consortium, and the Oncoarray oral cavity and oropharyngeal cancer consortium. Sensitivity analyses were performed to validate the primary inverse-variance weighted estimates using methods such as weighted median, weighted mode, and MR Egger.

RESULTS

The inverse-variance weighted analysis demonstrated a detrimental effect of air pollution on multiple oral health conditions, yielding 5 positive associations including PM2.5 with oral leukoplakia, gingivitis and periodontitis; PM2.5-10 with pulp and periapical diseases, and NO2 with gingivitis and periodontitis, and oral cavity, salivary glands and jaws diseases. Sensitivity tests showed no evidence of heterogeneity or pleiotropy, affirming the robustness of the findings.

CONCLUSION

This study highlights the detrimental impact of air pollution on oral health, emphasizing the need for further research into the underlying mechanisms and interactions. These findings reinforce the importance of implementing environmental interventions to mitigate the associated risks for oral health.

Mediterranean diet and dementia: MRI marker evidence from meta-analysis

BACKGROUND

Dementia is a growing public health concern with limited effective treatments. Diet may be a modifiable factor that significantly impacts brain health. Mediterranean diet (MeDi) has been suggested to be associated with brain Magnetic Resonance Imaging (MRI) markers related to dementia, but the existing evidence is inconsistent.

OBJECTIVES

This systematic review and meta-analysis aimed to quantify the association between MeDi and dementia-related MRI markers.

METHODS

A systematic search was conducted on PubMed, Embase, and Web of Science up to September 2024. Two reviewers worked in parallel to select studies and extract data. We considered epidemiologic studies that reported beta coefficients (β) with 95% confidence intervals (CIs) for MRI markers related to MeDi. Separate meta-analyses were performed for cross-sectional and longitudinal studies.

RESULTS

A total of 20 relevant studies involving 44,893 individuals were included in the analysis. Thirteen cross-sectional studies included a total of 42,955 participants. A meta-analysis of cross-sectional studies revealed significant associations between MeDi and white matter hyperintensity (WMH) (β = - 0.03, 95% CI = - 0.05- - 0.01, P = 0.02). However, there were no significant associations found between MeDi and total brain volume (TBV) (β = - 0.03, 95% CI = - 0.20-0.13, P = 0.71), gray matter volume (GMV) (β = 0.26, 95% CI = - 0.19-0.71, P = 0.26), white matter volume (WMV) (β = - 0.09, 95% CI = - 0.40-0.22, P = 0.58), or hippocampal volume (HCV) (β = - 1.02, 95% CI = - 7.74-9.79, P = 0.82). In the longitudinal analysis, seven prospective studies with an average follow-up period ranging from 1.5 to 9 years and involving 1,938 participants. The combined effect size of MeDi showed no significant association with TBV or GMV.

CONCLUSION

Adherence to MeDi may be associated with reduced WMH in older adults. This suggests that MeDi may affect brain health and highlights the need for further research into its role as a modifiable lifestyle factor that might potentially modify the risk of dementia.

Oral Health and Quality of Life in Type 2 Diabetic Patients: Key Findings from a Romanian Study

Background: Diabetes mellitus is associated with various oral health complications that can negatively impact quality of life. Despite evidence of the relationship between diabetes and oral health issues, limited research exists on the perceptions, behaviors, and oral health-related quality of life (OHRQoL) of diabetic patients in Romania. This study aims to evaluate self-reported oral health, knowledge, behaviors, and OHRQoL among diabetic patients in western Romania. Methods: A cross-sectional study was conducted in early 2024 at Pius Brinzeu County Emergency Hospital, Timisoara, involving 121 patients with type 2 diabetes. Data were collected using self-administered questionnaires that assessed oral health status, behaviors, and OHRQoL, with the OHIP-14 instrument employed for quality-of-life measurement. Statistical analyses included descriptive statistics, multiple linear regression, and correlation analyses to identify the predictors of oral health knowledge and OHRQoL. Results: Participants (mean age: 63.24 years; 52.1% female; 60.5% urban residents) reported significant oral health challenges. Over half (56.2%) did not visit a dentist regularly, with financial constraints identified as the primary barrier (23.5%). Oral hygiene practices were suboptimal: only 38.0% brushed twice daily, while 78.5% used fluoride toothpaste. Auxiliary hygiene tools, such as mouthwash and toothpicks, were rarely used (13.22% and 11.57%, respectively). Regression analyses identified the significant predictors of oral health knowledge, including tooth mobility (β = 0.33, p < 0.01) and brushing frequency (β = -0.18, p < 0.05). The mean OHIP-14 score (0.55) indicated a moderate impact on OHRQoL, with domains such as psychological discomfort and social disability revealing nuanced challenges. Conclusions: Diabetic patients in Romania face oral health challenges and care barriers, emphasizing the need for preventive strategies, oral health education, and integrated diabetes care. Addressing these gaps can improve oral health outcomes and overall quality of life in this vulnerable population.

Relationship between three body obesity indicators, WWI, BMI, WtHR, and periodontitis

Many scholars have studied the relationship between obesity and periodontitis. The relationship between different obesity indicators and periodontitis seems to vary. In this study, we would like to explore the relationship between three commonly used obesity indicators, WWI (weight-adjusted-waist index), BMI (body mass index), WtHR (waist-to-height ratio), and periodontitis, and try to find the most clinically valuable indicators. The NHANES 2009-2014 provided the data for this study. 10,289, 10,600 and 10,290 participants were included to explore the relationship between WWI, BMI, WtHR and periodontitis respectively. Multiple logistic regression, smooth curve fitting, threshold effects analysis, and subgroup analysis were used to explore their relationships. WWI and periodontitis positively correlated in model III (OR = 1.35; 95% CI, 1.26-1.45, p < 0.001). This result persisted after the quartile for WWI was created. Furthermore, in smooth curve fitting, the relationship between WWI and periodontitis with an inflection point of 12.68 was observed. In the fully adjusted model, WtHR also showed a positive correlation with periodontitis (OR = 2.94; 95% CI, 1.57-5.50, p < 0.001). However, BMI did not express a significant association with periodontitis either as a continuous or categorical variable. This cross-sectional study exposed a positive correlation between WWI, WtHR and periodontitis and this positive correlation showed an age difference.

Impact of Paper Information Leaflets on Dental Anxiety and Well-Being in Czech Patients: A Randomized Clinical Trial

Aim

Dental anxiety and well-being significantly influence patients' oral health and quality of life. This study investigated whether providing paper information leaflets (PILs) before performing dental procedures improved psychological well-being and reduced anxiety in Czech patients.

Materials and Methods

This parallel-group, single-blind randomized, prospective clinical trial was conducted at a private dental clinic in the Czech Republic in 2020. A total of 167 adult patients were randomly assigned to either the experimental group (n = 82), receiving both verbal information and a PIL, or the control group (n = 85), receiving only verbal information before their dental procedure (fillings, endodontic treatment, prosthetic restorations, or extractions). Pre- and post-procedure psychological well-being and anxiety were assessed using study-specific questionnaires. Data analysis was conducted in R using RStudio, with a significance level set at P < 0.05. Between-group differences were assessed while controlling for gender and education. Linear regression was used to analyze pre-procedure anxiety, and logistic regression was used to analyze post-procedure well-being outcomes (reporting "everything was fine," "unpleasant mouth sensations," and "quick adjustment"). The Benjamini-Hochberg correction was applied to control for multiple comparisons. Sensitivity analysis used the "best-worst and worst-best case" method to evaluate nonrandom missing data. Power analysis determined a minimum of 64 participants per group for a two-tailed t test.

Results

Baseline anxiety levels, measured on a 1-6 scale, were similar between the PIL group (mean 4.26, SD 1.11) and the control group (mean 4.36, SD 1.17; β = -0.11, P = 0.54). Post-procedure, while fewer patients in the PIL group reported that "everything was fine" (28/82 vs. 39/85), this difference was not statistically significant after correction for multiple comparisons (uncorrected P = 0.038, α FDR = 0.01). No significant differences were found between groups regarding "unpleasant mouth sensations" (P = 0.84) or "quick adjustment" (P = 0.52).

Conclusion

Providing PILs in addition to verbal information did not significantly impact pre-procedure anxiety or post-procedure well-being in this sample of Czech dental patients. These findings indicate that verbal communication alone may be sufficient for managing patient anxiety and promoting well-being in this context. Further research using validated instruments and exploring different communication strategies is warranted.

Interprofessional Learning and Oral Health-Related Attitudes and Knowledge Among Nursing Students at a University in Sweden-An Exploratory Study

AIM

To evaluate an interprofessional learning (IPL) session involving dental hygiene students and nursing students and to investigate the nursing students' oral health-related knowledge and attitudes.

MATERIAL AND METHOD

First, a questionnaire about knowledge and attitudes regarding oral health was answered by 84 nursing students. After an IPL session, including dental hygiene students and nursing students, both groups completed an evaluation questionnaire.

RESULTS

Both student groups stated that the IPL had led to an increased understanding of each other's professional roles and the importance of collaboration. Among the nursing students, 67.9% rated their knowledge about oral health as good/fairly good. Only 15.5% rated their knowledge about gum diseases as good/fairly good and 44% their knowledge about caries as good/fairly good. Additionally, 48.8% fully agreed/agreed that they felt secure performing oral care on care recipients. The nursing students had received little or no oral health-related education.

CONCLUSION

For nursing students, the IPL has led to an increased understanding of how oral diseases can be detected, prevented and treated. For the dental hygiene students, the IPL session has led to an improved capability to discuss oral health and oral care with another profession and to a better understanding of the nurse's role regarding oral healthcare. Both student groups have increased their awareness of the importance of future interprofessional collaboration. IPL about oral health and oral care should be integrated more broadly into dental hygiene and nursing education.

Analysis of Oral Health-Related Quality of Life in Elderly Romanian Edentulous Patients: Implant-Supported Versus Conventional Complete Dentures

Background/Objectives: The integration of quality of life (QoL) assessments into dental health evaluations acknowledges the profound impact of oral health on overall well-being. This study aims to compare the impact of implant-supported complete dentures versus conventional complete dentures on oral health-related quality of life (OHRQoL) in elderly Romanian edentulous patients. Methods: This longitudinal study involved 93 initially recruited edentulous patients, with 52 completing the study over an 18-month period. Data collection utilized the OHIP-5 questionnaire, assessing the OHRQoL at baseline with conventional dentures and three months post-implant-supported denture placement. Ethical approval was secured from the Faculty of Medicine and Pharmacy University of Oradea, adhering to the Helsinki Declaration principles. A statistical analysis was conducted using SPSS version 25 and included non-parametric tests for score comparisons and Fisher's exact test for categorical data. Results: The comparative analysis of the questionnaire responses revealed significant improvements in all five OHRQoL dimensions post-treatment with implant-supported dentures. For instance, the proportion of patients reporting "never" experiencing difficulty chewing any foods increased from 1.9% at baseline to 57.7% post-treatment. Similarly, those reporting "never" experiencing painful aching rose from 3.8% to 76.9%. There was also a notable reduction in discomfort regarding the appearance of mouth, dentures, or jaws from 3.8% reporting "never" at baseline to 75% post-treatment. The improvements in sense of taste and difficulty in performing usual activities saw comparable increases. Conclusions: The findings support the hypothesis that implant-supported complete dentures significantly enhance OHRQoL among elderly edentulous patients compared to conventional dentures, with improvements noted in mastication ability, pain reduction, aesthetics, taste perception, and activity performance. These results underscore the value of prosthetic interventions in dental care to substantially improve patients' OHRQoL.

Oral Health Literacy and Patient Education Practices Among Non-Dental Professionals in Chongqing, China: A Cross-Sectional Study

BACKGROUND Preventing oral diseases is a critical aim in maintaining general health. Non-dental professionals (NDPs) should understand oral health-related knowledge to help patients maintain oral and general health. We investigated the oral health knowledge, behaviors, and attitudes of NDPs regarding patient education and intersectoral collaborations for oral health. MATERIAL AND METHODS For this cross-sectional study, a web-based questionnaire of 36 questions was designed to collect characteristics, oral health knowledge, behaviors, and attitudes of spreading oral health knowledge. A total of 406 NDPs, including 166 doctors and 240 nurses, at 3 randomly selected hospitals in Chongqing, China, were included. Data were collected electronically and statistically analyzed using the chi-square test. RESULTS Only 35.96% and 39.41% of respondents disagreed with "extraction can cause loosening of adjacent tooth" and "tooth loss is a natural part of aging", respectively. Of the respondents, 92.12% were aware of oral healthcare needs before pregnancy; 67.48% agreed with cleaning the gums before the eruption of children's teeth; only 57.14% and 56.16% knew the start time of dental cleaning for children and the relatively safe period of dental treatment for pregnant women, respectively; 73.40% of respondents were interested in oral health knowledge, and they mainly consulted dental professionals; 95.56% agreed with intersectoral collaborations for oral health; and 68.47% thought to conduct oral health education in the future. CONCLUSIONS NDPs knew about common oral health knowledge; however, the oral healthcare knowledge for special groups was insufficient. NDPs should improve their ability to educate the public on oral health and establish intersectoral collaborations.

Refraining from seeking dental care among the Sámi in Sweden: a cross-sectional study

BACKGROUND

While equity in health care is the core of the Swedish health system, social inequalities in accessing health care, particularly regarding dental care, exist. There is however no information on how the Sámi population is affected. This study aimed to assess the prevalence and risk factors for refraining from seeking dental care among the Sámi in Sweden.

METHODS

A Sámi sample was constructed from three pre-existing registers. Among the 9,249 invitations for individuals aged 18-84 years old, 3,779 answered the survey during February-May 2021. We first calculated frequencies and proportions of the independent variables in terms of socio-economic, socio-demographic, and cultural-related factors as well as the outcome, refraining from dental care. Then, we summarized the magnitude of the association between the independent variables and self-reported refrain from dental care with the prevalence difference (PD) using the 95% confidence interval (95% CI) for inferential purposes.

RESULTS

Overall, 17.5% of the participants refrained from seeking dental care despite self-reported need in the last three months, with almost the same proportion between men and women. Among the socio-demographic factors, being in the 30-44 years group (PD = 8.0; 95% CI: 3.59, 12.48), in the 45-64 group (PD = 7.3; 95% CI: 2.96, 11.61) and in the 65-84 group (PD = 5.4; 95% CI: 0.92, 9.78) as well as being divorced/widow-er (PD = 6.7; 95% CI: 2.73, 10.70) and unmarried (PD = 3.1; 95% CI: 0.23, 6.04) were statistically significantly associated with refraining from seeking dental care. Among the socio-economic variables, those in the middle-income quintile (PD = 5.3; 95% CI: 1.28, 9.35), in the poor (PD = 8.1; 95% CI: 3.64, 12.51) and poorest (PD = 8.0 95% CI: 3.48, 12.50) quintiles, and especially those experiencing economic stress once (PD = 9.2; 95% CI: 2.93, 15.48) and several times (PD = 26.5; 95% CI: 19.50, 33.43), were strongly associated with refraining.

CONCLUSIONS

Approximately one in six of the Sámi participating in this study refrained from seeking dental care despite self-reported need in the last three months. Those who experienced economic difficulties were the most affected group. To achieve equity in dental health care in Sweden, policies removing economic barriers to access dental health care should be implemented.

The Protective Role Antioxidant of Vitamin C in the Prevention of oral Disease: A Scoping Review of Current Literature

This review meticulously examined the connection between vitamin C and periodontal disease, as well as the potential of vitamin C to prevent this condition. To gather relevant data, comprehensive electronic searches were conducted across various databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, focusing on studies that explored the relationship between vitamin C and periodontal disease in individuals aged between 18 and above. From an initial pool of 421 articles, 14 were ultimately chosen for detailed analysis. This selection encompassed seven cross-sectional studies, two case-control studies, two cohort studies, and three randomized controlled trials. The analysis of these studies revealed a consistent negative association between vitamin C intake, as well as its levels in the blood, and the incidence of periodontal disease across all seven cross-sectional studies. This indicates that higher vitamin C intake and blood levels are linked to a decreased risk of developing periodontal disease. In the two case-control studies, individuals suffering from periodontitis were found to have both a lower intake of vitamin C and reduced levels of vitamin C in their blood compared to those without the disease, further underscoring the potential protective role of vitamin C against periodontal disease. The progression of periodontal disease was observed to be more rapid in patients with lower dietary intake or blood levels of vitamin C compared to controls. Regarding the effects of vitamin C administration as an intervention, there was an improvement noted in gingival bleeding among patients with gingivitis; however, no significant benefits were observed in cases of periodontitis, specifically concerning alveolar bone absorption. Through the meticulous examination of available studies, this systematic review underscores the notion that adequate vitamin C intake and maintaining sufficient levels of vitamin C in the blood can contribute significantly to reducing the risk of periodontal disease.

Caregiver Perception of the Oral-Health-Related Quality of Life of Children with Special Needs: An Exploratory Study

BACKGROUND

Compared to the general population, individuals with special needs tend to have worse oral health, potentially diminishing their quality of life. This study aimed to evaluate the perception of parents and caregivers regarding the effect of oral health on the quality of life of individuals with special needs who received dental treatment under general anaesthesia, as well as the impact on their and their families' quality of life.

MATERIALS AND METHODS

This cross-sectional study involved participants with special needs who had undergone a dental treatment under general anaesthesia. Before the intervention, an oral examination was conducted to count the number of teeth affected by caries. Parents or caregivers filled out a specially designed questionnaire that included sociodemographic information, details about the children's oral hygiene and dietary habits, and questionnaires on the impact of their child's oral health on their quality of life (P-CPQ) and the influence of the oral health of children with psychophysical difficulties on the family (FIS). The data collected were analysed both descriptively and using the chi-square test, Fisher's exact test, Kruskal-Wallis test, and Spearman's correlation analysis. The level of significance was set at p ≤ 0.05.

RESULTS

This study involved 42 children (24 females and 18 males) with an average age of 21.14 ± 8.34 years. The average number of carious teeth per participant was 9.74 ± 5.63. About 66% of respondents reported that their children performed oral hygiene with their help, while 9.5% of them did not do so at all. Individuals with a higher number of caries had statistically significantly higher scores on the emotional well-being (p = 0.004) and social well-being (p = 0.033) subscales of P-CPQ, as well as on the parental emotions subscale of FIS (p = 0.020). Also, there was a difference in the number of carious teeth in participants due to unhealthy habits (drinking sweetened beverages, p = 0.030) and due to comforting with food (p = 0.004).

CONCLUSION

The increase in the number of carious teeth in individuals with special needs has been associated with the quality of life of their families. To address this, it is crucial to promote the prevention of oral health issues by educating individuals with special needs and their caregivers on proper oral hygiene techniques and diets tailored to their specific requirements.

The Association between Dental Caries, Periodontal Status, and Sleep Patterns in Children

Aim and background

Sleep quality has a significant impact on children's overall health and is associated with oral diseases. This study aimed to investigate the relationship between dental caries, periodontal status, and sleep patterns in 8-12-year-old children.

Materials and methods

This cross-sectional study was conducted on 120 children aged 8-12 years. The children's sleep habits questionnaire (CSHQ) was employed to evaluate sleep status. Another questionnaire was used to collect data on lifestyle habits. Dental caries status was evaluated using the decayed, missing, and filled teeth (DMFT) and International Caries Detection and Assessment System (ICDAS) indices. Periodontal status was assessed through the plaque index (PI), probing depth (PD), gingival index (GI), and periodontal screening and recording (PSR). The association between oral health and sleep patterns was evaluated using Spearman's coefficient correlation, independent t-test, and the Chi-squared test.

Results

The ICDAS mean was significantly higher in children with improper sleep patterns (p = 0.032). However, there was no statistically significant relationship between DMFT and sleep patterns (p = 0.346). The GI, PD, and PSR mean were significantly higher in the inappropriate sleep pattern group. There was a significant relationship between children's sleep patterns and GI, PD, and PSR indices (p = 0.033, p = 0.020, p = 0.028, respectively). However, there was no significant association between PI and sleep patterns (p = 0.277).

Conclusion

Children's sleep patterns were associated with dental caries and periodontal status. Adequate sleep is required to prevent oral diseases such as dental caries and periodontal diseases.

Clinical significance

According to this study, it is recommended that children should be encouraged to get adequate sleep by their parents and dentists.

How to cite this article

Mehdipour A, Abbasi R, Keykha E, et al. The Association between Dental Caries, Periodontal Status, and Sleep Patterns in Children. Int J Clin Pediatr Dent 2024;17(8):925-932.

New Perspectives about Relevant Natural Compounds for Current Dentistry Research

Natural compounds have been used since the earliest civilizations and remain, to this day, a safer alternative for treating various dental problems. These present antimicrobial, anti-inflammatory, antioxidant, analgesic, and antimutagenic effects, making them useful in the prophylactic and curative treatment of various oral diseases such as infections, gingivitis, periodontitis, and even cancer. Due to the high incidence of unpleasant adverse reactions to synthetic compounds, natural products tend to gradually replace conventional treatment, as they can be just as potent and cause fewer, milder adverse effects. Researchers use several methods to measure the effectiveness and safety profile of these compounds, and employing standard techniques also contributes to progress across all medical disciplines.

Oral health inequalities in immigrant populations worldwide: a scoping review of dental caries and periodontal disease prevalence

BACKGROUND

Inequalities in immigrants' oral health are often masked in population-level data. Therefore, this paper was planned to assess the prevalence data on oral health diseases, namely dental caries, and periodontitis, among immigrants worldwide.

METHODS

Following a systematic search in Scopus, Embase, and PubMed for studies published between 2011 and 2023, 1342 records were identified. Following title and abstract screening, 76 studies remained for full-text eligibility-screening based on predefined inclusion criteria. Thirty-two studies were included in the review.

RESULTS

Dental caries figures were higher in immigrant populations compared to the local population, regardless of host countries, age, gender, or nationality. In children, the overall mean and standard deviation (SD) for decayed, missing, and filled teeth in the primary dentition (d3mft) was 3.63(2.47), and for D3MFT (permanent dentition), it was 1.7(1.2). Upon comparing overall mean caries counts in children and adults with their control groups in the included studies, untreated dental caries (D3T and d3t) constituted the dominant share of caries experience (D3MFT and d3mft) in immigrant children. For the local population, the highest proportion of caries experience was attributed to filled teeth (FT and ft). Dentin caries prevalence among immigrants ranged from 22% to 88.7% in the primary dentition and 5.6% to 90.9% in the permanent dentition. Gingivitis ranged from 5.1% to 100%. Oral health varied greatly between studies. Regarding oral health accessibility, 52% to 88% of immigrant children had never been to a dentist, suggesting a very limited level of accessibility to dental health services.

CONCLUSION

It is imperative to develop interventions and policies that have been customized to address the oral health disparities experienced by immigrant populations. Additionally, host countries should actively implement measures aimed at enhancing the accessibility of oral health care services for these individuals. The utilization of available data is crucial in establishing a hierarchy of objectives aimed at enhancing the oral health of immigrant populations.

TRIAL REGISTRATION

The Scoping review protocol was registered at OSF Registries with registration number ( https://doi.org/10.17605/OSF.IO/MYXS4 ).

Development of an innovative eugenol and borax-based orodispersible film for enhanced treatment of mouth ulcers

Orodispersible films (ODFs) have emerged as an advanced and patient-friendly delivery system due to ease of administration, improved patient compliance, quick release and taste-masking of active pharmaceutical ingredients. This research reports the preparation of the ODF containing eugenol and borax (EB-ODF) by a solvent casting technique for treating mouth ulcers. The EB-ODF consisted of vinyl pyrrolidone/vinyl acetate copolymer (Kollidon® VA64, VA64) and hydroxypropyl methylcellulose (HPMC-K250) as the film formers where eugenol and borax were loaded. The thickness of the EB-ODF obtained was 0.119 ± 0.001 mm and the tensile strength was 13.1 ± 1.1 N/mm2 (p > 0.05). The prepared films disintegrated in the oral cavity within 30 s and over 90% of the eugenol was released from the film in the first 5 min. Furthermore, the combined application of eugenol and borax, loaded in EB-ODF, displayed notable synergetic antibacterial property against both gram-negative and gram-positive bacteria. In an in-vivo study on a rat model with chemical burn-induced oral ulcers, the EB-ODF treatment group had a 100% reduction in ulcer area (p > 0.05) after 10 days of treatment and demonstrated a 38.7% higher reduction in oral ulcer area compared to the Dingpeng Cream treatment group (p < 0.0001). The EB-ODF treatment group showed minimal oral irritation, scoring only 1 point and a 65% preference in the taste tests (p < 0.0001). In summary, EB-ODF had successfully overcome the poor palatability of commercially available formulation and provided notable potential for further ulcer treatment product development.

Masticatory function in edentulous patients wearing implant overdentures after graftless maxillary sinus membrane elevation

BACKGROUND

Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials.

OBJECTIVES

This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation.

METHODS

The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction.

RESULTS

Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'.

CONCLUSIONS

Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.

Exploring the Interplay Between Lifestyle Medicine and Oral Health: A Bidirectional Relationship

Lifestyle medicine, characterized by its evidence-based approach, recognizes the profound impact of lifestyle choices on overall health. The six pillars of lifestyle medicine encompass nutrition, physical activity, stress management, sleep, avoidance of risky substances, and social connections. While their significance in promoting general health is well-established, their specific influence on oral health is an area of growing interest. A balanced and nutritious diet contributes to strong teeth and healthy gums, while regular physical activity enhances blood circulation and salivary flow, which is vital for maintaining optimal oral health. Effective stress management techniques can mitigate oral health issues related to anxiety and bruxism. Quality sleep supports oral health, allowing for tissue repair and immune system rejuvenation. Avoiding risky substances like tobacco and excessive alcohol consumption reduces the risk of oral diseases such as periodontitis and oral cancer. Lastly, social connections and supportive networks positively influence oral health by promoting positive oral hygiene behaviors and providing access to dental care resources. Understanding the impact of lifestyle medicine's six pillars on oral health offers valuable insights for healthcare professionals and individuals seeking to improve their oral well-being.

A Holistic Approach for Ethics and Sustainability in the Food Chain: The Gateway to Oral and Systemic Health

Food production is a complex matter, affecting people's lives, organizations' profits, and the well-being of the whole planet, and has multifaceted ethical considerations surrounding its production, distribution, and consumption. This paper addresses the pressing need to confront ethical challenges within the food system, encompassing issues such as environmental sustainability, food security, and individual food choices for better oral and systemic health of all individuals around the globe. From agricultural practices to global trade and food waste, ethical implications are addressed across various domains, highlighting the interconnectedness of ethical decision-making in the food industry. Central themes explored include the ethical dimensions of food production methods, the impact of global trade on food ethics, and the role of individuals in making ethically informed food choices. Additionally, this paper considers the spiritual and physical significance of food, particularly through the lens of oral health as a gateway to holistic well-being. Recognizing the complexity of the food and mouth ecosystem, this paper calls for serious interventions in legislation and economics to promote ethical protocols and techniques for sustainability reasons. It emphasizes the importance of ethical considerations in food safety management systems, regulatory frameworks, and quality standards. Moreover, this paper underlines the need for a comprehensive approach to address ethical dilemmas and moral values inherent in the food industry and oral health policies, adopting the precautionary principle and ethical decision-making frameworks. This article finally aims to serve as a call to action for stakeholders across the food industry and the healthcare sector, to prioritize ethical practices, promote transparency, rearrange economic parameters, and work towards a more sustainable and equitable food system for inner and outer oral and systemic health and human sustainability for all.

Pediatric Oral Health Service Access in Racial/Ethnic Minority Neighborhoods: A Geospatial Analysis in Washington, D.C., USA

Oral health plays a crucial role in overall well-being. One of the goals set by the US Department of Health and Human Service, Healthy People 2030 is to reducing dental caries in children and adolescents. The study aims to investigate the accessibility of pediatric dental care in neighborhoods with mixed-race and predominantly African American populations in the Washington District of Columbia (DC) area. Our objective is to uncover and highlight the disparities that exist in pediatric dental care within these communities. We have specifically examined the geographic and socio-demographic aspects of pediatric dental care facilities, utilizing geospatial tools such as modeling and mapping, as well as data from the clinical database at Howard University College of Dentistry. The detailed analysis of dental care access revealed significant disparities among various Wards in the region. Specifically, Wards 5, 7, and 8 stood out as having both the highest concentrations of African American residents and the lowest availability of pediatric dentistry providers when compared to the more affluent Wards 1, 2, and 3. Howard University College of Dentistry's pediatric dentistry department played a crucial role in providing dental care services to the community. Over the course of the year 2022, they recorded a total of 3,855 visits from residents of the DC area. Notably, a substantial portion of these visits, specifically 1,566 visits, were from individuals residing in Wards 5, 7 and 8. This data underscores the significant demand for pediatric dental services in these underserved communities and highlights the importance of addressing the disparities in access to care.

Factors related to depression in adults with oral health problems in Spain (2017 to 2020)

Background

The need to study the link between gender, depression, and oral health is becoming increasingly evident. This study therefore aimed to determine the prevalence and evolution over time of depression among women and men with oral health problems and to evaluate the association between depression status, lifestyle-related variables health-related variables and use of dental health services in those people.

Methods

We performed a nationwide cross-sectional study on 25,631 adults with oral health problems residing in Spain from the Spanish National Health Survey 2017 and the European Health Survey of Spain 2020, including as the main variable self-reported diagnosis of depression. We analysed independent variables such as lifestyle-related variables, health-related variables, and variables related to dental health services. Sociodemographic characteristics were considered as control variables.

Results

The prevalence of depression among adults with oral health problems in Spain was 7.81% (10.14% for women, 5.39% for men), with a notable decrease from 2017 to 2020 in women. Depressed women had a slightly higher percentage of filled or capped teeth, and had more covers (crowns), bridges or other types of prostheses or dentures, while men had more caries. Women also made more frequent, regular dental visits for check-ups and mouth cleaning, whereas men often needed extractions. Unfavourable associated factors in both genders were: perceiving their health as good, average, poor, or very poor, and having 1-2 and ≥ 3 comorbidities. Conversely, not being a current smoker was related to less likelihood of depression. In women only, not engaging in leisure-time physical activity produced more unfavourable associated factors.

Conclusion

The prevalence of depression among adults with oral health problems in Spain from 2017 to 2020 was 7.81%, but this figure has been steadily decreasing over time. In addition, the favourable and unfavourable associated factors could help us inform health professionals and authorities in order to prevent depression and enhance the care of this population according to gender.

Charting the Future of Oral Health: A Bibliometric Exploration of Quality-of-Life Research in Dentistry

In recent decades, the focus of health research has shifted to the impact of disease or impairment on how people proceed, behave, and experience quality of life. People's lives are affected by oral diseases in various ways. Oral health-related quality of life (OHRQoL) is inextricably linked to general health and well-being, and it has far-reaching consequences for clinical practice and dentistry research. Particularly in Indonesia, increasing attention to OHRQoL is related to several concerning oral conditions, such as the extremely high number of cases of tooth decay and inflammation of dental supportive tissue that inexplicably lowers the population's OHRQoL. To date, there has yet to be a bibliometric study of OHRQoL research in Indonesia. We intend to map the existing scientific literature on OHRQoL research in Indonesia during the last five years and investigate its research gaps. Scopus and the Sinta Database (a national database through Google Scholar) were used to retrieve Indonesian OHRQoL research publications from 2018 to 2023. Bibliographic data were analyzed using SPSS Statistics 25.0 and VOS Viewer 1.6.19. The data demonstrate that the number of OHRQoL-related publications in Indonesia and the number of local writers have increased over time. More of these publications were published in prestigious national journals than foreign ones. The study found that local researchers tended to conduct OHRQoL research on children and older populations, raising the issue of tooth decay or tooth loss. Exploring other subjects, such as dental anxiety, patient satisfaction, chewing performance, aesthetics, and appearance, and other populations (people with oral cancer and other systemic conditions) could broaden the environment of OHRQoL research in Indonesia.

Risk factors for dental caries: A case study in peatlands and non-peatlands of West Kalimantan, Indonesia

The prevalence of dental caries in peatlands and non-peatlands in West Kalimantan require preventive acts based on its natural conditions and the behavior of local communities. The objective was to analyse risk factors for dental caries in communities living in peatlands and non-peatlands in West Kalimantan. The research is a causal comparative study with cross-sectional approach. The samples were chosen by purposive sampling technique among adolescents aged 17-27 years, who were domiciled in Pontianak City (peatland) and Bengkayang (non-peatland) all their lives. The results showed that dental caries is significantly correlated with debris in peatlands (rs = 0.289). On non-peatlands, dental caries is correlated with drinking water phosphate (rs = 0.313) and calculus (rs = 0.034). In West Kalimantan, dental caries is significantly correlated with drinking water minerals (fluoride rs = -0.243; phosphate rs = 0.260), drinking water pH (rs = 0.235), behavior (rs = -0.327), and debris (rs = 0.240). The risk factors for dental caries in peatlands and non-peatlands in West Kalimantan are pH and drinking water minerals (fluoride and calcium), debris, calculus, and behavior.

Evaluation of the Impact of Oral Health on the Daily Activities of Users of the National Health System

BACKGROUND

the integration of dentistry services in the Unified Health System in Brazil (SUS) is essential in primary care assistance.

OBJECTIVE

we aimed to develop a tool for improving demand flowby evaluating the impact of oral health on the daily activities of users of the Family Health Unitusing the Oral Impacts of Daily Performance (OIDP)tool.

METHODS

In Barretos, Brazil, a cross-sectional study was conducted at a Family Health Unit (FHU)including patients over 12 years old. Oral health impact was assessed using the Oral Impacts of Daily Performance (OIDP) tool, and family risk was measured with the Coelho-Savassi scale.

RESULTS

430 participants, including 411 adults and 19 young people, were recruited. Of the adults, 31% had an average OIDP score of 16.61. For young people, 53% reported an impact (average OIDP score: 28.61). Family risk (R1) was prevalent in 57.9% of young people and 53.3% of adults. Among adults, different activities were affected by risk: smiling without embarrassment (risk level 2), enjoying contact with people (risk level 3), and performing one's job or social role (risk level 1). Emotional state (R3) had the lowest OIDP score (p = 0.029).

CONCLUSION

implementation of the OIDP scale in clinical practice enhances healthcare planning and ensures better-quality and equitable services, thus emphasizing comprehensive oral healthcare within the SUS.

Association between life's essential 8 and periodontitis: a population-based study

BACKGROUND

The American Heart Association has developed a novel cardiovascular health indicator called Life's Essential 8 (LE8). However, no one has reported using LE8 to assess periodontitis. This study aimed to investigate the association between LE8 and periodontitis in American adults.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014 were used for this investigation. LE8 was the independent variable, and it is divided into three grades: high, moderate, and low. Periodontitis was the dependent variable, and the classification of periodontitis was based on the criteria of Eke in 2012. Multivariable logistic regression models were used to explore the relationship between LE8 and periodontitis.

RESULTS

A total of 9,039 participants with an average age of 52.16 ± 14.21 years were enrolled in this study, of whom 48.29% were male and 51.71% were female. The mean and standard deviation of LE8 was 66.29 ± 14.57, and the prevalence of periodontitis was 50.48% overall. The LE8 score and periodontitis in the fully adjusted logistic regression model showed a negative correlation (OR = 0.98; 95% CI, 0.98-0.99, p < 0.001). This result persisted when Life's Essential 8 was categorized into low, moderate, and high groups. Compared with those in the lowest group, those in the highest LE8 group had a 47% decreased risk of periodontitis (OR = 0.53; 95% CI, 0.46-0.66, P < 0.001).

CONCLUSIONS

This cross-sectional investigation revealed a negative relationship between the LE8 score and the likelihood of periodontitis.

Oral Health Knowledge, Self-Assessed Oral Health Behavior, and Oral Hygiene Practices among the Adult General Population in Croatia

OBJECTIVES

Emphasizing the significance of optimal oral health for enhancing overall well-being, this study aimed to investigate oral health knowledge, self-assessed oral health behaviors, and oral hygiene practices within the Croatian general population.

MATERIALS AND METHODS

A cross-sectional observational study was conducted online, utilizing a questionnaire collecting sociodemographic characteristics and inquiring about respondents' oral health knowledge, self-assessed oral health status, oral hygiene habits, and use of oral hygiene products. Collected data underwent both descriptive and regression analyses to unveil patterns and relationships within the dataset.

RESULTS

The respondents showed a high level of knowledge about oral health (median score 9, IQR 7.00-10.00, maximum possible score 10), with significant factors for higher knowledge being engaged in dental professions; above-average socioeconomic status; and the use of an electric brush, dental floss, and interdental brushes (p ˂ 0.05). Insufficient knowledge, on the other hand, was associated with bleeding gums and daily smoking (p ˂ 0.05). Although 69.4% of respondents considered their oral health to be very good, 32.5% reported tooth decay, and 38.2% reported tooth sensitivity. The majority (62.0%) cited regular check-ups as the reason for their last visit to the dentist, with 74.1% feeling no anxiety or discomfort during these visits. Daily toothbrush use was widespread (97.8%), but only 34.1% and 19.1% of respondents reported using floss and/or interdental brushes daily. A remarkable 69.0% of respondents indicated that low oral health literacy and low prioritization contribute to suboptimal oral health.

CONCLUSIONS

While respondents demonstrated commendable oral health knowledge, the prevalence of reported issues suggests a potential gap between perception and actual oral health status. To address this, targeted educational interventions focusing on comprehensive oral hygiene practices and debunking misconceptions should be prioritized in Croatia.

Quality of Life: determinant of success of head and neck cancer therapy in the battle of survival vs. rehabilitation

BACKGOUND

Surgical treatment for cancers in the oral and maxillofacial region significantly impacts a patient's physical, social, functional, and psychological well-being, which can in-turn affect the Quality of Life (QoL) negatively. The goal of our study was to assess the Quality of Life (QoL) of patients who underwent surgery in our hospital, and we attempted to extrapolate the data which could in the future help improve the QoL of other patients who undergo similar treatments.

METHODS

This was a retrospective study, including patients who have been treated for oral cancer in the last few years in the institute. The standard EORTC Questionnaires QLQ C-30 (version 3.0) and QLQ H and N-35 (version 1.0) were used in this study.

RESULTS

GHS scores were lower in patients with T3 stage tumor than in patients with T1 stage tumor. Patients who underwent surgery along with radiotherapy and those who underwent surgery, radiotherapy, and chemotherapy showed a substantial difference in their GHS and FS ratings when their treatment options were compared. Patients who had undergone surgery, radiation, and chemotherapy had higher scores on the symptom scale and QoL H&N-35 than patients who had just undergone surgery and radiotherapy There was no statistically significant difference in the scores, pertaining to the location, age, gender and stage of the tumor but when the comparison was made on the basis of treatment modality chosen, there was a significant difference in the scores.

CONCLUSIONS

The aim of any treatment is to improve the Quality of Life. The EORTC questionnaires QLQ 30 and QLQ H and N-35 proved to be very appropriate instruments to evaluate QoL in patients with oral cancer. Assessment of QoL should always receive adequate attention in treatment planning and rehabilitation. Choice of treatment modality plays a significant role in QoL of patients treated for oral cancer. Henceforth, any treatment modality should be selected not only with a curative intent but also with the goal of improving the Quality of Life as this ultimately decides the success of the therapy from the patient's perspective.

Interprofessional survey on knowledge and attitudes of midwives regarding oral health, in France

INTRODUCTION

Oral health is essential for psychosocial well-being and general health. For expectant mothers, pregnancy increases the risk of oral diseases and has a subsequent impact on the oral health of a child once born. Midwives are in charge of pregnancy monitoring, childbirth and newborns' first days of life. They could have an important role in prevention. However, limited studies evaluating the knowledge, attitudes and practices on oral health among midwives have been conducted in Europe.

METHODS

We performed a cross-sectional study using a self-administered questionnaire. Two local midwifery associations sent out the questionnaire by email and social media networks to all registered midwives and practicing in the department of Herault (n=613), between April and May 2022. Statistical analyses on quantitative data and descriptive analyses of qualitative free-text responses were performed.

RESULTS

In total, 167 midwives were included. We found a lack of knowledge on many oral health topics and this was stated as the main reason that only 29% of midwives provided oral health information to their patients. Only 30% of the midwives had a training module on oral health during their initial training, and less than half of them considered the training adequate. To improve their lack of knowledge, participants expressed a preference for digital communication methods for themselves; however, they favored in-person interaction for public interventions.

CONCLUSIONS

This study showed a lack of training and knowledge about oral health among midwives and a lack of oral health discussion with expectant mothers who are a high-risk population for oral diseases.

Providing potential solutions by using FT-IR spectroscopy for biofluid analysis: Clinical impact of optical screening and diagnostic tests

BACKGROUND

Currently, the potential of FT-IR spectroscopy for rapid diagnosis of many pathologies has been demonstrated by numerous research studies including those targeting COVID-19 detection. However, the number of clinicians aware of this potential and who are willing to use spectroscopy in their clinics and hospitals is still negligible. In addition, lack of awareness creates a huge gap between clinicians and researchers involved in clinical translation of current FT-IR technology hence hindering initiatives to bring basic and applied research together for the direct benefit of patients.

METHODS

Knowledge and medical training on FT-IR on the side of clinicians should be one of the first steps to be able to integrate it into the list of complementary exams which may be requested by health professionals. Countless FT-IR applications could have a life-changing impact on patients' lives, especially screening and diagnostic tests involving biofluids such as blood, saliva and urine which are routinely non-invasively or minimally-invasively.

RESULTS

Blood may be the most difficult to obtain by the invasive method of collection, but much can be evaluated in its components, and areas such as hematology, infectiology, oncology and endocrinology can be directly benefited. Urine with a relatively simple collection method can provide pertinent information from the entire urinary system, including the actual condition of the kidneys. Saliva collection can be simpler for the patient and can provide information on diseases affecting the mouth and digestive system and can be used to diagnose diseases such as oral cancer in its early-stages. An unavoidable second step is the active involvement of industries to design robust and portable instruments for specific purposes, as the medical community requires user-friendly instruments of advanced computational algorithms. A third step resides in the legal situation involving the global use of the technique as a new diagnostic modality.

CONCLUSIONS

It is important to note that decentralized funds for variety of technologies hinders the training of clinical and medical professionals for the use of newly arising technologies and affect the engagement of these professionals with technology developers. As a result of decentralized funding, research efforts are spread out over a range of technologies which take a long time to get validated and translated to the clinic. Partnership over similar groups of technologies and efforts to test the same technologies while overcoming barriers posed to technology validation in different areas around the globe may benefit the clinical/medical, research and industry community globally.

Interprofessional Survey on Knowledge and Attitudes on Oral Health among Nurses in France

PURPOSE

Healthcare professionals (HCPs) play a key role in improving the health literacy of patients. Since oral health is an essential part of overall health, the objective of this study was to assess the knowledge and attitudes about oral health among registered nurses.

MATERIALS AND METHODS

A four-component questionnaire was used to assess the oral health training, oral health knowledge and attitudes of registered nurses. Participants were recruited from the city of Montpellier, France, and the surrounding area between May and June 2022 via e-mail and social media.

RESULTS

In total, 416 responses were included in our study. Only 35.8% of nurses reported that they had received specific training on oral health and 24.3% had never advised patients to consult a dentist. Participants demonstrated good overall knowledge, but stated there were weaknesses in a variety of areas, such as oral health in children. The nurses proposed methods to improve understanding of the importance of oral health, namely by setting up training courses and better interdisciplinary collaboration.

CONCLUSION

Our study showed that some aspects of oral health are not well understood by nurses. Initial training should be improved and supplemental training should be offered to improve the knowledge, attitude and practices of nurses in order to improve patient care.

Prevalence of Aphthous Stomatitis: A Cross-Sectional Epidemiological Study

Introduction Recurrent aphthous stomatitis (RAS) is a common ulcer of idiopathic etiology but is recurrent, causing painful ulcers in the non-keratinized mucosa. The disease is commonly seen in people aged 10-40 years. The etiology of RAS has yet to be well established, but several risk factors that lead to the development of RAS have been proven in the literature. With an unknown etiology, developing a definitive cure and maintaining disease remission remains challenging. An epidemiological survey will shed some light on the disease's prevalence, which could provide insights into disease management. This study aimed to study the prevalence of aphthous stomatitis among the patients visiting the dental outpatient services of a dental college in South India. The objectives were to discover the different subtypes of aphthous stomatitis and the age predominance of the type of ulcer. Materials and methods The data was collected from the case records of Saveetha Dental College and Hospitals, Chennai, India, dated from June 2019 to June 2023. The age and gender of the patients with RAS were recorded. The details collected were systematically arranged in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and further analyzed using IBM SPSS Statistics for Windows, Version 24.0 (Released 2016; IBM Corp., Armonk, New York, United States) and chi-square tests were run to check for statistical significance. Results A total of 1,44,056 patients visited the Dental OPD during the study period. Of these, 1115 patients had RAS. When the data was analyzed, there was a three-fold increase in the occurrence of RAS during the coronavirus disease 2019 (COVID-19) pandemic, which was statistically significant (p=0.043). The most commonly affected age group was 26-40 years. Among the clinical variants of RAS, it was found that 82.5% of RAS patients had a minor variant of aphthous stomatitis. Conclusion This study shows the prevalence of different types of aphthous stomatitis, wherein we noticed that the minor clinical variant was the most common, followed by the major variant. The lesions were more commonly seen in women. However, the age group most commonly affected was 26-40 years.

Managing Dental Phobia in Children with the Use of Virtual Reality: A Systematic Review of the Current Literature

BACKGROUND

It is common today to encounter anxiety in patients facing dental treatment. Virtual reality (VR) is presented as a high-performing and innovative procedure because it can distract patients undergoing dental procedures or prepare them for such treatments. In addition, this meta-analysis has gathered evidence on VR and its ability to reduce dental anxiety in pediatric patients undergoing different treatments.

METHODS

The major Scopus, PubMed, EMBASE and Web of Science databases were searched for scientific articles published up to 2023. Studies in which VR was used for children and adults as a measure against anxiety during dental treatments were included. VR was defined as a three-dimensional place where patients experience a sense of immersion as they find themselves in attractive and interactive environments that detach them from reality. Anxiety and pain were examined and measured during dental treatments in which VR was used by comparing them with standard care situations.

RESULTS

Twenty-five studies were identified, of which eleven met the inclusion criteria. The effect of VR was studied mainly in the pediatric population as a distractive method. Only two studies (not significant) on an adult population were considered.

CONCLUSIONS

this review shows that VR is an excellent distraction method that is effective in reducing anxiety before dental treatment; however, due to the few studies in this area, further research on VR as a tool to prepare patients for dental treatment is needed.

Phyllanthus emblica fruits: a polyphenol-rich fruit with potential benefits for oral management

The fruit of Phyllanthus emblica Linn., which mainly grows in tropical and subtropical regions, is well-known for its medicine and food homology properties. It has a distinctive flavor, great nutritional content, and potent antioxidant, anti-inflammatory, anti-cancer and immunoregulatory effects. According to an increasing amount of scientific and clinical evidence, this fruit shows significant potential for application and development in the field of oral health management. Through the supplementation of vitamins, superoxide dismutase (SOD) and other nutrients reduce virulence expression of various oral pathogens, prevent tissue and mucosal damage caused by oxidative stress, etc. Phyllanthus emblica fruit can promote saliva secretion, regulate the balance of the oral microecology, prevent and treat oral cancer early, promote alveolar bone remodeling and aid mucosal wound healing. Thus, it plays a specific role in the prevention and treatment of common oral disorders, producing surprising results. For instance, enhancing the effectiveness of scaling and root planing in the treatment of periodontitis, relieving mucosal inflammation caused by radiotherapy for oral cancer, and regulating the blood glucose metabolism to alleviate oral discomfort. Herein, we systematically review the latest research on the use of Phyllanthus emblica fruit in the management of oral health and examine the challenges and future research directions based on its chemical composition and characteristics.

Levofloxacin HCl-Loaded Eudragit L-Based Solvent Exchange-Induced In Situ Forming Gel Using Monopropylene Glycol as a Solvent for Periodontitis Treatment

Solvent exchange-induced in situ forming gel (ISG) is currently an appealing dosage form for periodontitis treatment via localized injection into the periodontal pocket. This study aims to apply Eudragit L and Eudragit S as matrix components of ISG by using monopropylene glycol as a solvent for loading levofloxacin HCl for periodontitis treatment. The influence of Eudragit concentration was investigated in terms of apparent viscosity, rheological behavior, injectability, gel-forming behavior, and mechanical properties. Eudragit L-based formulation presented less viscosity, was easier to inject, and could form more gel than Eudragit S-based ISG. Levofloxacin HCl-loading diminished the viscosity of Eudragit L-based formulation but did not significantly change the gel formation ability. Higher polymer loading increased viscosity, force-work of injectability, and hardness. SEM photographs and µCT images revealed their scaffold formation, which had a denser topographic structure and less porosity attained owing to higher polymer loading and less in vitro degradation. By tracking with fluorescence dyes, the interface interaction study revealed crucial information such as solvent movement ability and matrix formation of ISG. They prolonged the drug release for 14 days with fickian drug diffusion kinetics and increased the release amount above the MIC against test microbes. The 1% levofloxacin HCl and 15% Eudragit L dissolved in monopropylene glycol (LLM15) was a promising ISG because of its appropriate viscosity (3674.54 ± 188.03 cP) with Newtonian flow, acceptable gel formation and injectability (21.08 ± 1.38 N), hardness (33.81 ± 2.3 N) and prolonged drug release with efficient antimicrobial activities against S. aureus (ATCC 6538, 6532, and 25923), methicillin-resistant S. aureus (MRSA) (S. aureus ATCC 4430), E. coli ATCC 8739, C. albicans ATCC 10231, P. gingivalis ATCC 33277, and A. actinomycetemcomitans ATCC 29522; thus, it is the potential ISG formulation for periodontitis treatment by localized periodontal pocket injection.

Oral health equity for rural communities: where are we now and where can we go from here?

Oral health is embedded in overall health and contributes to physical, social and mental wellbeing. Most diseases are preventable, and yet, oral diseases pose a significant public health problem and an economic burden globally. Poor oral health is a risk factor for certain systemic diseases, such as cardiovascular disease, diabetes and lung pathologies. Rural populations are disproportionately affected by oral disease, with higher levels of periodontal disease, caries and the loss of teeth. These issues are worsened by barriers in access to oral healthcare services and minimal promotion of healthy behaviours in rural communities. Certain interventions, including mobile dental clinics, teledentistry, dental outreach camps and educational initiatives, have been successful in addressing rural challenges. Policies and action plans should be considered by public health officials to reduce the disparities in oral health among rural communities, reduce the overall burden of oral health and promote health equity.

The risk of dental restoration-related lead exposure on renal function

OBJECTIVE

To explore the relationship between oral restoration count, blood lead (PbB) level, and renal function as potential heavy metal releases, and the related toxicity of dental restorative materials.

METHODS

A total of 3682 participants from the National Health and Nutrition Examination Survey (January 2017 to March 2020) were included in this cross-sectional analysis. We utilized multivariable linear regression models to investigate the associations between the number of oral restorations and PbB levels or renal function. The mediating effect of PbB on renal function indicators was analyzed using the R mediation package.

RESULTS

Based on the indicators of 3682 participants, we found that the elderly, females, and whites were fit with more oral restoration, which was accompanied by increased PbB levels and decreased renal function. Meanwhile, oral restoration count was positively associated with PbB level (β = 0.023, 95% CI: -0.020 to 0.027), renal function-related urine albumin creatinine ratio (β = 1.541, 95% CI: 0.615-2.468), serum uric acid level (β = 0.012, 95% CI: 0.007 to 0.017), and serum creatinine level, and negatively associated with estimated glomerular filtration rate (eGFR) (β = -0.804, 95% CI: -0.880 to -0.728). Furthermore, the mediation effect test confirmed that PbB played a mediating role in the relationship between restoration count and serum uric acid or eGFR, with mediation effects accounting for 98.0% and 71.0%, respectively.

CONCLUSIONS

Oral restoration negatively affects renal function. Oral restoration-related PbB level is a potential mediating factor.

The Epidemiology of Dental Pathologies in Elderly Patients Admitted to a Tertiary Level Hospital in Oradea, NW Romania: A 5-Year Retrospective Study

Oral diseases can affect the quality of life of all individuals, including elderly people. In elderly people, the associated general diseases can increase the risk of dental pathologies or can impact their treatment. The main aim of this study was to identify elderly patients with dental pathology out of the total number of patients admitted to the Department of Oral and Maxillofacial Surgery at a tertiary-level hospital in North-Western Romania. Another aim was to describe the characteristics of the patients included in this study, as well as to analyze data from patients with dental pathologies. In this retrospective study, the medical records of patients admitted to the Department of Oral and Maxillofacial Surgery at the Bihor County Emergency Hospital between 2016 and 2020 were analyzed, with a focus on patients aged 65 years or more. After applying the exclusion criteria, 721 patients were kept in the study, of which 316 (43.8%) had at least one dental pathology. Most elderly patients with dental pathologies were admitted in 2018 (n = 89). The most common associated systemic diseases were arterial hypertension (n = 268) and ischemic heart disease (n = 233), while the most common dental pathologies were pulpitis (n = 185), chronic apical periodontitis (n = 61) and abscesses (n = 35). Most patients were either healed or had an improved condition at the time of discharge. The great number of dental pathologies, as well as the diversity in dental pathologies, underline the necessity for better preventive programs aimed not only at children, adolescents or young people but at the elderly population as well.

Development of a novel, entirely herbal-based mouthwash effective against common oral bacteria and SARS-CoV-2

BACKGROUND

Parallel to the growth of the oral healthcare market, there is a constantly increasing demand for natural products as well. Many customers prefer products that contain fewer toxic agents, therefore providing an environmentally friendly solution with the benefit of smaller risk to the user. Medieval and early modern medicinal knowledge might be useful when looking for natural, herbal-based components to develop modern products. Along with these considerations we created, tested, and compared an entirely natural mouthwash, named Herba Dei.

METHODS

The manufacturing procedure was standardized, and the created tincture was evaluated by GC/MS analysis for active compounds, experimentally tested in cell-based cytotoxicity, salivary protein integrity, cell-free antioxidant activity, anti-bacterial and anti-viral assays, and compared with three market-leading mouthwashes.

RESULTS

Our tincture did not show significant damage in the cytotoxicity assays to keratinocyte and Vero E6 cells and did not disrupt the low molecular weight salivary proteins. Its radical scavenging capacity surpassed that of two tested, partly natural, and synthetic mouthwashes, while its antibacterial activity was comparable to the tested products, or higher in the bacterial aerobic respiratory assay. The active compounds responsible for the effects include naturally occurring phenylpropanoids, terpenes, and terpenoids. Our mouthwash proved to be effective in vitro in lowering the copy number of SARS-CoV-2 in circumstances mimicking the salivary environment.

CONCLUSIONS

The developed product might be a useful tool to impede the transmission and spread of SARS-CoV-2 in interpersonal contact and aerosol-generating conditions. Our mouthwash can help reduce the oral bacterial flora and has an antioxidant activity that facilitates wound healing and prevents adverse effects of smoke in the oral cavity.

The Importance of Periodic Dental Control in the Oral Health Status of Elderly Patients

The aim of the present study was to evaluate the status of the elderly patient with oral pathology, comparing two groups of elderly patients, from the point of view of presentation for periodic dental control (regular and irregular). In carrying out the study, the following parameters were analyzed: the epidemiological profile of the group of patients; associated chronic diseases; dental hygiene; the accessibility of, and attendance at, dental health services; quality of life; and dental clinical diagnosis. Of the 120 elderly patients included in the study, only 25% present regularly for dental checkups. Increasing age leads to a reduction in the share of patients who regularly present themselves for dental checkups, and patients with higher education and those with higher incomes regularly visit the dentist. Associated chronic diseases are found in both groups; patients with regular checkups have a statistically significantly lower drug consumption for dental pain in the last month compared to those who present irregularly for checkups. A better achievement of dental hygiene is observed in patients who regularly see the dentist. It is alarming that we find patients (10% among those who do not visit the dentist regularly) who do not use a toothbrush and toothpaste, and approximately 40% of the patients enrolled in the study do not know which toothpaste they use. Approximately 40% of the interviewed patients indicate a lack of money as the main reason for attending the dentist only when necessary. Difficult access is mentioned by 10% of the group of patients who regularly visit the dentist and who come from rural areas. The reasons for visiting the dentist are different in the two groups: patients who regularly visit the dentist request caries treatment or prosthetic work, or they present with dental bleeding; patients with irregular checkups especially request emergency services such as toothache treatment, assistance with denture problems, and tooth extractions. When undergoing odontal and endodontic examination, 60% of the respondents who go to the dentist as required suffer from periodontal disease, and 50% of them suffer from class I and II edentation. The results of the study demonstrated that elderly patients who regularly attend periodic dental checkups have better self-reported and dentist-confirmed oral health status.

Research Advances on Hydrogel-Based Materials for Tissue Regeneration and Remineralization in Tooth

Tissue regeneration and remineralization in teeth is a long-term and complex biological process, including the regeneration of pulp and periodontal tissue, and re-mineralization of dentin, cementum and enamel. Suitable materials are needed to provide cell scaffolds, drug carriers or mineralization in this environment. These materials need to regulate the unique odontogenesis process. Hydrogel-based materials are considered good scaffolds for pulp and periodontal tissue repair in the field of tissue engineering due to their inherent biocompatibility and biodegradability, slow release of drugs, simulation of extracellular matrix, and the ability to provide a mineralized template. The excellent properties of hydrogels make them particularly attractive in the research of tissue regeneration and remineralization in teeth. This paper introduces the latest progress of hydrogel-based materials in pulp and periodontal tissue regeneration and hard tissue mineralization and puts forward prospects for their future application. Overall, this review reveals the application of hydrogel-based materials in tissue regeneration and remineralization in teeth.

International Delphi Study to Optimize the Oral Health Section in interRAI

Introduction: The oral health (OH) of care-dependent older people is generally poor. Since caregivers are mainly responsible for older people's daily care, they can be considered important intermediaries to improve their OH by performing regular OH assessments. The interRAI instruments are introduced in 37 countries to assess care needs and facilitate care planning across different health care settings. The oral health section (OHS) within the interRAI instrument used in long-term care facilities was optimized for the Belgian context to identify residents who need assistance with daily oral care and/or need to be referred to a dentist. This Delphi study evaluated whether the OHS is also relevant and useful in other countries and modified the OHS accordingly until an international consensus was reached. Participants were experts in OH for older people. During 2 rounds of online questionnaires, experts rated the content, assessment process, triggering of Clinical Assessment Protocols, and accompanying guidelines and instruction videos of the optimized OHS. Based on the experts' comments and suggestions collected during the first round, the OHS was adjusted and presented to the experts in the second round for re-evaluation. The first and second questionnaires were completed by 48 and 42 oral health experts from 29 and 27 countries where the interRAI instruments are introduced, respectively. Five experts from 5 countries where interRAI is not introduced also participated in both rounds. After the second round, a consensus of over 86% was reached on all criteria. International consensus on the OHS was reached, considering national and cultural differences that may affect OH. The next step in this research is to evaluate the assessment process to identify potential barriers and facilitators to achieving reliable OH assessments internationally. Furthermore, the effect of the OHS at the level of the resident and of the caregivers will be evaluated.