Caries Experience before and after COVID-19 Restrictions: An Observational Study

Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the suspension of several clinical practices globally, including dentistry. This study investigates the impact of these restrictions on dental caries experience. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University's dental hospital in the Lisbon Metropolitan Area from June 2019 to June 2021. The study involved 3380 participants who were divided into two cohorts: after and before COVID-19 restrictions. Data collection included a questionnaire, full-mouth clinical examinations, and radiographs (panoramic X-rays, bitewings). Results: Before the COVID-19 restrictions, the prevalence of dental caries was 91.8%, with an average DMFT (decayed, missing, and filled teeth) index of 12.13. Post-restrictions, the prevalence decreased to 84.5%, with a DMFT index of 10.99. There was an increase in missing teeth and a decrease in decayed and filled teeth. Additionally, the frequency of toothbrushing declined among participants. Conclusions: The COVID-19 pandemic restrictions have significantly impacted dental caries experiences and oral health, highlighting a decrease in dental caries, but also a concerning reduction in oral hygiene practices. These results emphasize the importance of customized dental healthcare during public health emergencies to reduce impacts and maintain oral health.

Do sociodemographic factors influence the levels of health and oral literacy? A cross-sectional study

BACKGROUND

Oral health literacy has gained importance in dental literature, and its relationship with oral health status and association with health status (HL) has been reported. Then, an association between the levels of HL and OHL could be expected. This study aimed to assess the levels of HL and OHL according to sociodemographic factors and to explore a possible association between HL and OHL.

METHODS

The European Health Literacy Survey and Oral Health Literacy Adults Questionnaire were applied to a convenience sample from Portuguese individuals. Also, sociodemographic factors such as sex, age, schooling level of the participants and their parents, and if the participants were professionals or students of the health field were assessed. To analyze the data, the Kruskal-Wallis and Mann-Whitney U tests were used to compared sociodemographic variables and the levels of literacy in general and oral health. The Spearman correlation test assessed the correlation between the levels of HL and OHL.

RESULTS

HL results showed that 45.1% of the volunteers were considered in a "problematic level" and 10.3% in "excellent level". However, 75% presented an adequate level of OHL. Regarding the levels of HL in each sociodemographic variable, significant higher levels of "excellent level" were found in health professionals and students when compared with participants not related to health area (p < 0.001). Comparisons between the levels of OHL in each sociodemographic variable showed, significant differences regarding sex (p < 0.05), age (p < 0.001), levels of schooling of the participants and their parents (p < 0.009 and p < 0.001) and relationship with health field. (p < 0.001). A significant positive - weak correlation was found between HL and OHL (p < 0.001).

CONCLUSIONS

HL and OHL levels are associated and could be influenced by sociodemographic factors.

Caries Experience and Risk Indicators in a Portuguese Population: A Cross-Sectional Study

Oral health surveys are essential for assessing the dental caries experience and to influence national policies. This retrospective cross-sectional study aims to analyze dental caries experience for which dental treatment was sought in a reference university dental hospital at the Lisbon Metropolitan Area between January 2016 and March 2020. Full-mouth examination, and sociodemographic, behavior, and medical information were included. Descriptive analyses and logistic regression analysis were applied to ascertain risk indicators associated with dental caries experience. A final sample of 9349 participants (5592 females/3757 males) were included, aged 18 to 99 years old. In this population, caries experience was 91.1%, higher in female participants. Age (OR = 1.01, 95% CI [1.00-1.02], occupation (OR = 2.94, 95% CI [2.37-3.65], OR = 3.35, 95% CI [2.40-4.67], OR = 2.55, 95% CI [1.66-3.91], for employed, unemployed, and retired, respectively), overweight (OR = 1.52, 95% CI [1.18-1.96]), reporting to have never visited a dentist (OR = 0.38, 95% CI [0.23-0.64], and self-reported week teeth status (OR = 2.14, 95% CI [1.40-3.28]) were identified as risk indicators for the presence of dental caries, according to adjusted multivariable logistic analyses. These results highlight a substantial rate of dental experience in a Portuguese cohort and will pave the way for future tailored oral public health programs in Portugal.

Efficacy of Botulinum Toxin Type-A I in the Improvement of Mandibular Motion and Muscle Sensibility in Myofascial Pain TMD Subjects: A Randomized Controlled Trial

This study assessed the effects of botulinum toxin type A (BoNT-A) in mandibular range of motion and muscle tenderness to palpation in persistent myofascial pain (MFP) patients (ReBEC RBR-2d4vvv). Eighty consecutive female subjects with persistent MFP, were randomly divided into four groups (n = 20): three BoNT-A groups with different doses and a saline solution group (placebo control group). Treatments were injected bilaterally in the masseter and anterior temporalis muscle in a single session. Clinical measurements of mandibular movements included: pain-free opening, maximum unassisted and assisted opening, and right and left lateral excursions. Palpation tests were performed bilaterally in the masseter and temporalis muscle. Follow-up occurred 28 and 180 days after treatment. For the statistical analysis the Mann–Whitney U-test with Bonferroni correction was used for groups comparisons. Regardless of dose, all parameters of mandibular range of motion significantly improved after 180 days in all BoNT-A groups, compared with the control group. Palpation pain over the masseter and temporalis muscles were significantly reduced in all BoNT-A groups regardless of dose, compared with the control group, after 28 and 180 days of treatment. Independent of doses, BoNT-A improved mandibular range of motion and muscle tenderness to palpation in persistent MFP patients.

pH analysis of still and carbonated bottled water: Potential influence on dental erosion

Objective

To assess pH values to characterize bottled water in Portugal, being able to provide information for both patients and clinicians about its erosive potential, as a tool to prevent the ingrowing prevalence of dental erosion and its progression, especially in patients who are at greater risk, such as those with dry mouth syndrome, making the dissemination of this knowledge a fundamental tool for clinical decision.

Materials and Methods

One hundred and five common brands of bottled water (n = 105), commercialized in Portugal, were analyzed. Of these, 73 were smooth water (Group A) and 32 carbonated water (Group B). All pH values were assessed by potentiometric measurement with a calibrated electrode. For each brand, five independent measurements were recorded at 25°C for further calculation of the mean pH value and standard deviation.

Results

Focusing on the mean pH values from Group A, one had a pH mean value lower than 5.2, four between 5.2 and 5.5, thirty‐seven between 5.5 and 6.8, and thirty‐one higher than 6.8. In Group B, ten had a mean pH value lower than 5.2, ten between 5.2 and 5.5, twelve between 5.5 and 6.8, and none above 6.8.

Conclusions

Bottled water, commercialized in Portugal, has different mean pH values, some below the critical threshold of enamel and/or dentin, suggesting that they may have a greater risk of consumption than others, only with respect to the pH parameter of erosive potential. Further investigation concerning this area is needed for wider conclusions.

Sociodemographic factors associated with oral health in 12-year-old adolescents: hygiene behaviours and health appointments. A cross-sectional national study in Portugal

OBJECTIVES

The aim of this study was to characterise the daily oral hygiene behaviours and the frequency of, and reasons for, oral health appointments, among 12-year-old adolescents in Portugal. We also investigated whether there were any associations between these behaviours and sociodemographic factors.

METHODS

We conducted an observational descriptive study based on 1,309 Portuguese adolescents from rural, peri-urban and urban populations. Data were drawn from the III National Prevalence Study of Oral Health Diseases. After descriptive analyses, binary logistic regression models were used.

RESULTS

In this study, 70.6% (n = 924) of adolescents reported that they brushed 'twice a day or more', and this behaviour was associated with all sociodemographic variables. Multivariate analysis revealed that male gender [odds ratio (OR) = 2.124; 95% confidence interval (95% CI): 1.616-2.793], rural residence (OR = 1.647; 95% CI: 1.169-2.321), peri-urban residence (OR = 1.926; 95% CI: 1.319-2.812), low level of maternal educational (OR = 2.139; 95% CI: 1.446-3.164) and father's unemployment (OR = 1.671; 95% CI: 1.127-2.478) were associated with not brushing at least twice a day (P < 0.05). Approximately 94% (n = 1,217) of participants had already visited an oral health professional, and 74.5% (n = 860) did so in the last 12 months.

CONCLUSION

Our results are in agreement with the literature; the oral health behaviours of 12-year-old Portuguese adolescents can be regarded as satisfactory, although there are important variations across different subpopulations. The influence of sociodemographic factors suggests that tailored strategies must be developed for specific subpopulations, at both individual and community levels.

Self-perception of oral health in older adults from an urban population in Lisbon, Portugal

OBJECTIVE

To analyze if the self-perception of oral health in the urban context is associated with sociodemographic factors that interfere in the life quality of oral health.

METHODS

Cross-sectional study with convenience sample of older individuals (65 years old or more) enrolled in the Agrupamento de Centros de Saúde de Lisboa Norte (ACES Lisboa Norte – Health Centers Groupings North Lisbon). The self-perception of oral health and associated life quality was evaluated by the Geriatric Oral Health Assessment Index and the individuals were classified according to sociodemographic characteristics. The internal consistency of the questionnaire was evaluated by Cronbach’s alpha (α). Later, we used binary logistic regression models to characterize the factors associated with the self-perception of oral health, considering the sociodemographic variables and the older adults’ clinical conditions of oral health and establishing the crude and adjusted (to age) odds ratios and their 90% confidence intervals.

RESULTS

A total of 369 older adults participated in this study, with an average age of 74.2 years (SD = 6.75); 62.9% were female. On average, the index was moderated, with tendency to be high: 32.9 (SD = 3.6; 12-36 interval). The Cronbach’s alpha was high: 0.805. Age, marital status, and the last dental appointment were the factors significantly associated with self-perception of oral health.

CONCLUSIONS

The study shows that these individuals have a moderate, with tendency to high, self-perception of oral health. The self-perception of oral health assessment allowed us to identify the main associated sociodemographic factors. This instrument can help guiding planning strategies and oral health promotion directed toward a better life quality for this population group.