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Ono Y, Chou YC, Chien WC, Sun CA. Association between severity of dental caries and the risk of stroke. Oral Dis 2024; 30:3413-3421. [PMID: 37864387 DOI: 10.1111/odi.14756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/01/2023] [Accepted: 09/19/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVE The relationship between dental caries and stroke remains inconclusive. The aim of this study is to investigate whether different severities of dental caries affect the risk of stroke. METHODS This retrospective cohort study was conducted using the 2000-2013 Taiwan National Health Insurance Database. We selected 23,662 patients with advanced/severe dental caries and 23,662 patients with incipient/moderate dental caries between 2000 and 2006. These patients were followed to the occurrence of stroke or to the end of the study in 2013. Hazard ratios (HRs) and 95% confidence intervals (CIs) derived from the Cox proportional hazards models were calculated to assess the association between severity of dental caries and the risk of stroke. RESULTS The advanced/severe dental caries group had a significantly higher risk of stroke compared with incipient/moderate dental caries group (adjusted HR, 1.16; 95% CI, 1.03-1.31). Stratified analyses showed that advanced/severe dental caries was positively associated with the risk of ischemic stroke in patients aged ≥40 years and with the risk of hemorrhagic stroke in patients aged <40 years. CONCLUSION There is a severity-dependent association between dental caries and stroke in an Asian population.
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Affiliation(s)
- Yukiko Ono
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense medical Center, Taipei City, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
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Lee J, Park HM, Kim YW. Comparative Analysis of Plaque Removal and Wear between Electric-Mechanical and Bioelectric Toothbrushes. Bioengineering (Basel) 2024; 11:474. [PMID: 38790341 PMCID: PMC11117528 DOI: 10.3390/bioengineering11050474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/28/2024] [Accepted: 05/01/2024] [Indexed: 05/26/2024] Open
Abstract
Effective oral care is important for maintaining a high quality of life. Therefore, plaque control can prevent the development and recurrence of periodontitis. Brushing with a toothbrush and toothpaste is a common way to remove plaque; however, excessive brushing or brushing with abrasive toothpaste can cause wear and tear on the dental crown. Hence, we aimed to quantitatively compare the plaque-removal efficiency and tooth wear of toothbrushes using the bioelectric effect (BE) with those of electric-mechanical toothbrushes. To generate the BE signal, an electronic circuit was developed and embedded in a toothbrush. Further, typodonts were coated with cultured artificial plaques and placed in a brushing simulator. A toothpaste slurry was applied, and the typodonts were eluted with tap water after brushing. The plaques of the typodonts were captured, and the images were quantified. For the tooth wear experiment, polymethyl methacrylate disk resin blocks were brushed twice a day, and the thickness of the samples was measured. Subsequently, statistical differences between the experimental toothbrushes and typical toothbrushes were analyzed. The BE toothbrush had a higher plaque-removal efficiency and could minimize tooth wear. This study suggests that the application of BE may be a new solution for oral care.
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Affiliation(s)
- Jihyun Lee
- Department of Periodontology, Ulsan University Hospital, College of Medicine, University of Ulsan, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Republic of Korea;
| | - Hyun M. Park
- PAIST (ProxiHealthcare Institute for Science and Technology), ProxiHealthcare Inc., Seoul 08507, Republic of Korea
| | - Young Wook Kim
- PAIST (ProxiHealthcare Institute for Science and Technology), ProxiHealthcare Inc., Seoul 08507, Republic of Korea
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Sen S, Logue L, Logue M, Otersen E, Mason E, Moss K, Curtis J, Hicklin D, Nichols C, Rosamond WD, Gottesman RF, Beck J. Dental Caries, Race and Incident Ischemic Stroke, Coronary Heart Disease, and Death. Stroke 2024; 55:40-49. [PMID: 38018831 PMCID: PMC10841981 DOI: 10.1161/strokeaha.123.042528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/19/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Dental caries is a highly prevalent disease worldwide. In the United States, untreated dental caries is present in >1 in 5 adults. The objective of this study was to determine the relationship between dental caries and incident ischemic stroke, coronary heart disease (CHD) events, and death. METHODS The dental cohort (n=6351) of the ARIC study (Atherosclerosis Risk in Communities) was followed for incident ischemic stroke, CHD event, and all-cause mortality. Of all the participants at visit 4 (n=11 656), those who were unable to go through dental examination, or with prevalent ischemic stroke and CHD events, were excluded. The full-mouth dental examination was conducted at visit 4 (1996-1998), assessing dental caries. The dose response of decayed, missing, and filled surfaces due to caries was assessed and related to the outcome. Outcomes were assessed through the end of 2019. Additionally, the effect of regular dental care utilization on dental caries was evaluated. RESULTS Participants with ≥1 dental caries had an increased risk of stroke (adjusted hazard ratio [HR], 1.40 [95% CI, 1.10-1.79]) and death (adjusted HR, 1.13 [95% CI, 1.01-1.26]) but not for CHD events (adjusted HR, 1.13 [95% CI, 0.93-1.37]). The association of dental caries and ischemic incident stroke was significantly higher in the African American population compared with the White subgroup (interaction term P=0.0001). Increasing decayed, missing, and filled surfaces were significantly associated with stroke (adjusted HR, 1.006 [95% CI, 1.001-1.011]) and death (adjusted HR, 1.003 [95% CI, 1.001-1.005]) but not CHD (adjusted HR, 1.002 [95% CI, 1.000-1.005]). Regular dental care utilization lowered (adjusted odds ratio, 0.19 [95% CI, 0.16-0.22]; P<0.001) the chance of caries. CONCLUSIONS Among the cohort, dental caries was independently associated with the risk of ischemic stroke and death, with the effect higher in African American participants. Regular dental care utilization was associated with a lower chance of caries, emphasizing its relevance in the prevention of these events.
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Affiliation(s)
- Souvik Sen
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Lawson Logue
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Makenzie Logue
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Elizabeth Otersen
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Emma Mason
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Kevin Moss
- Division of Comprehensive Oral Health/Periodontology, University of North Carolina, Chapel Hill, NC
| | - James Curtis
- Department of Dentistry, Prisma Health Medical Group, Columbia, SC
| | - David Hicklin
- Department of Dentistry, Prisma Health Medical Group, Columbia, SC
| | - Cynthia Nichols
- Department of Dentistry, Prisma Health Medical Group, Columbia, SC
| | - Wayne D Rosamond
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC
| | - Rebecca F. Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, MD
| | - James Beck
- Division of Comprehensive Oral Health/Periodontology, University of North Carolina, Chapel Hill, NC
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Lee J, Kim YW. Bioelectric device for effective biofilm inflammation management of dental implants. Sci Rep 2023; 13:21372. [PMID: 38049472 PMCID: PMC10695962 DOI: 10.1038/s41598-023-48205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/23/2023] [Indexed: 12/06/2023] Open
Abstract
Dental implant inflammation is primarily caused by oral biofilms, which form within 8 h, particularly at 37 °C, thereby requiring diligent cleaning. Considering the complex management of dental implants, a novel technology based on the bioelectric effect (BE) to combat inflammation has emerged. A BE-integrated toothbrush was developed and clinically tested on patients with dental implants (N = 36). Our findings revealed a significant average plaque index reduction of 67% with BE technology compared with that at baseline (P < 0.05), whereas non-BE did not yield statistical significance even after 4 weeks of use (P > 0.05). The bleeding index demonstrated a 59% average reduction in all surfaces with BE technology (P < 0.05), whereas the non-BE group exhibited no significant change. Substantial reductions in total plaque and bleeding indices suggest that using BE toothbrushes can help effectively remove oral biofilms and treat bleeding symptoms.
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Affiliation(s)
- Jihyun Lee
- Department of Periodontology, Ulsan University Hospital, College of Medicine, University of Ulsan, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
| | - Young Wook Kim
- ProxiHealthcare Advanced Institute for Science and Technology (PAIST), Seoul, Republic of Korea
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Park HM, Ryu S, Jo E, Yoo SK, Kim YW. A Study on the Biofilm Removal Efficacy of a Bioelectric Toothbrush. Bioengineering (Basel) 2023; 10:1184. [PMID: 37892914 PMCID: PMC10604395 DOI: 10.3390/bioengineering10101184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Effective oral care is a critical requirement to maintain a high quality of life. Most oral diseases are caused by plaque (oral biofilm), which is also correlated with systemic diseases. A common method to remove biofilm is brushing teeth with toothpaste. However, 3.5 billion people in the world have oral diseases, meaning that more efficient methods of removing biofilms are needed. We have developed a toothbrush that applies a bioelectric effect (BE) utilizing an electric force for biofilm removal. It demonstrated significantly higher biofilm removal efficiency than non-BE manual toothbrushes. Tests were performed in saline and toothpaste conditions using various pressures. Results showed that the BE toothbrush had a significantly higher biofilm removal efficiency in saline (0.5 N: 215.43 ± 89.92%, 2.5 N: 116.77 ± 47.02%) and in a toothpaste slurry (0.5 N: 104.96 ± 98.93%, 2.5 N: 96.23 ± 35.16%) than non-BE manual toothbrushes. Results also showed that BE toothbrushes were less dependent on toothpaste. This study suggests that the application of BE can be a new solution to plaque problems in oral care.
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Affiliation(s)
- Hyun Mok Park
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
- Graduate Program of Biomedical Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seungjae Ryu
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
| | - Eunah Jo
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
| | - Sun Kook Yoo
- Graduate Program of Biomedical Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Young Wook Kim
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
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Moldvai J, Orsós M, Herczeg E, Uhrin E, Kivovics M, Németh O. Oral health status and its associated factors among post-stroke inpatients: a cross-sectional study in Hungary. BMC Oral Health 2022; 22:234. [PMID: 35701775 PMCID: PMC9195382 DOI: 10.1186/s12903-022-02259-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/30/2022] [Indexed: 11/11/2022] Open
Abstract
Background Post-stroke inpatients are at risk of poor oral health for a number of reasons. The aim of this study was to assess the oral health status of post-stroke patients and also to explore the factors that may influence it. Methods This cross-sectional study was organised at National Institute for Medical Rehabilitation in Hungary. Altogether 410 post-stroke patients were enrolled in the survey. Personal medical history and functional assessment was obtained from the final medical reports of the patients. The clinical examination and data collection were conducted according to the World Health Organization (2013) criteria. Socio-demographic background and behaviours related to oral health were assessed using a questionnaire. The dental status was explained by the number of Decayed, Missing and Filled Teeth (DMFT). The association of socio-demographic factors, stroke and functional assessment with oral health status and behaviour was evaluated. Chi-square test, Fisher’s exact test, Welch test, Mann–Whitney U test, Kruskal–Wallis test, ANOVA model and correlation analysis were used to analyse our data. The level of significance was set at p < 0.05. Results Mean age of stroke patients was 59.21(Standard Deviation [SD] 14.74) years. Mean DMFT score was 20.13 (8.08), including 3.28 (4.24) decayed teeth, 15.02 (10.29) missing teeth and 1.83 (2.94) filled teeth score. Factors that influenced the oral health status were gender, age, occupational status, level of education, type and risk factors for stroke. Significant correlation was found between the Functional Independence Measure and oral health-related behaviours with patients brushing their teeth once a month showing the lowest value. Conclusion According to the results, low socio-demographic and economic status, low level of education and the Functional Independence Measure score, unemployment, the combination of risk factors for stroke and residual dysfunctions are associated with poor oral health status. The data indicate that a series of changes are needed, for special attention and care in oral health for patients who have had a stroke. Based on the findings of this research, a new model of prevention and care can be developed, with an interdisciplinary collaboration, to promote the quality of life of these individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02259-2.
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Affiliation(s)
- Júlia Moldvai
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary.
| | - Mercédesz Orsós
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
| | - Eszter Herczeg
- Department of Rehabilitation Post-Stroke, National Institute for Medical Rehabilitation, Budapest, Hungary
| | - Eszter Uhrin
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
| | - Márton Kivovics
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
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