Quality of life related to oral health and its impact in adults

Disparities of Delayed Dental Visits and Severe Tooth Loss Among Older Native Hawaiians and Other Pacific Islanders in Hawai'i: A Cross-Sectional Study of Behavioral Risk Factor Surveillance System Data from 2012 to 2020

Oral health is a major health concern in the US and globally, particularly among communities of color and low-income/low-education groups. General health disparities have been reported among Native Hawaiians (NHs) and Other Pacific Islanders (OPIs), although less is known about the specific racial/ethnic and socioeconomic trends that are relevant to oral health disparities for NHOPIs. We examined delayed dental visits and severe tooth loss among older NHOPI adults in relation to sociodemographic factors and community level disparities using five waves of data from the Hawai'i Behavioral Risk Factor Surveillance System collected between 2012 and 2020. Weighted Poisson regression was used to estimate the unadjusted and adjusted prevalence ratio of delayed dental service utilization and severe tooth loss. Relative to other racial/ethnic groups, older NHs had higher rates of delayed dental service utilization and severe tooth loss after adjusting for sociodemographic factors, and disparities were also found in rural communities.Awareness of the unique challenges and inequities faced by older Indigenous and racially/ethnically marginalized populations is critical for policymakers to develop strategies to achieve health equity.

Oral Health-Related Quality of Life in Children at a Pediatric Emergency Dental Service During the Start of COVID-19

Background/Objectives: Oral health-related quality of life (OHRQoL) has become increasingly significant in dentistry. By incorporating patient perspectives through questionnaires alongside objective diagnoses, the understanding of diseases is enhanced. This study examines OHRQoL during the early COVID-19 pandemic in children aged 0-10 who visited the Emergency unit of Pediatric Dentistry at the Medical University of Vienna from March to May 2020, focusing on the impact of COVID-19 restrictions on various social and health aspects. The study aimed to assess OHRQoL in children during the early weeks of the COVID-19 pandemic and correlate it with other health and social conditions. Materials and Methods: Children (up to 10 years) and their parents visiting the Emergency Unit of the department completed OHRQoL questionnaires. In children aged 0-6, their parents answered the Early Childhood Oral Health Impact Scale questionnaire (ECOHIS), while 7-10-year-olds completed the Child Perception Questionnaire (CPQ) by themselves. Summary scores and associations between oral and general health subdomains were analyzed. Results: Both the ECOHIS and CPQ groups showed high general summary scores, indicating decreased OHRQoL (ECOHIS 12.22 [±8.68] and CPQ 18.36 [±12.35]). The highest scores were in the "oral symptoms" domain, mainly due to "toothache". Significant correlations were observed between "general health" and "oral health" with the "family section" in the ECOHIS group and between "oral health" and "oral symptoms" with "emotional well-being" in the CPQ group. Conclusions: During the pandemic, both age groups experienced decreased OHRQoL. Family background influenced oral health (ECOHIS), while oral symptoms and emotional well-being correlated with oral health (CPQ). Further research is needed to understand pandemic-related factors affecting OHRQoL and develop preventive strategies.

The association between predisposing, enabling and need factors and oral health care utilization among U.S. working age adults

BACKGROUND

Irregular dental visits due to cost-related delays contribute to poor oral health outcomes, dental needs, and emergency service utilization across the life course. The study investigated how predisposing, enabling, and needs factors are associated with cost-related delays in oral health care and postponed dental visits.

METHODS

Using secondary data from the 2022 National Health Interview Survey for United States (U.S.) adults aged 18-64 years, the study conducted descriptive, bivariate, and multivariate data analyses. Separate multivariable logistic regressions were used to model cost-related delayed oral health care and postponed dental visits (no dental visit in the past 12 months) as a function of predisposing, enabling, and need factors (n = 17,513). Predictor variables included race, education, smoking status, age, gender and employment status (Predisposing factors), family income as a percentage of the Federal Poverty Level (FPL) and Health Service Deficit (HSD) variables (no health insurance, no usual medical primary care provider, > 12 months of last medical exam and delayed medical care due to cost) (Enabling factors), difficulty engaging in social activities and the presence of > 1 comorbidity (Need factors).

RESULTS

The prevalence of cost-related delayed oral health care was 20.2%, and that of postponed dental visits was 36.4%. Strong predictors for cost-related delayed oral health care emerged from predisposing factors (smoking OR = 1.47, 95% CI, 1.33, 1.62), enabling factors (no health insurance OR = 2.96, 95% CI, 2.56, 3.42), and need factors (difficulty engaging in social activity OR = 1.59, 95% CI, 1.34, 1.88) at p < 0.001. Enabling factors were the strongest predictors of postponed dental visits. The odds decreased with higher family income [> 400% FPL vs. < 100% FPL (OR, 0.50; 95% CI, 0.43, 0.58)], whereas the odds increased by 68%, 64%, 130%, and 57% for persons with no health insurance, no usual primary care provider, > 12 months of last medical exam, and delayed medical care due to cost, respectively.

CONCLUSIONS

Individual factors, including smoking, lack of health insurance, and difficulty engaging in social activity, were independently associated with cost-related delayed oral health care, and the strong links between postponed dental visits and HSDs provide a clear opportunity for advocating for medical and dental integration for patient-centered care.

Impact of educational video intervention to improve oral health knowledge and beliefs among physicians and nurses

BACKGROUND

The most prevalent dental diseases have adverse effects on an individual's general health. To address this public health crisis and oral health disparity, collaborative efforts of health professionals are critical for dental disease prevention and optimal oral health. This study evaluated the effect of an educational video intervention on oral health knowledge, beliefs, and practices of physicians and nurses.

METHODS

This pre-post interventional study evaluated the immediate effects of a video-based oral health educational intervention given to nurses and physicians in Saudi Arabia. A self-administered questionnaire was distributed to participants to assess their oral health (OH) knowledge, beliefs, and practices of OH care. The study participants (physicians and nurses) were randomly exposed to two intervention groups (video or brochure) after which they responded to a post interventional survey. Means of knowledge and beliefs scores were calculated before and after the intervention. Logistic regression was applied to investigate the factors associated with good knowledge and beliefs after the educational intervention.

RESULTS

A total of 213 healthcare providers of whom 56% were physicians participated in this study. Knowledge of OH improved significantly (p < 0.001) after the intervention and was higher among females compared to males (16.86 to 19.54). The physicians showed more improvement post intervention compared to nurses (19.76 vs. 19.30, respectively) (p < 0.001). The overall belief scores for providing OH education did not change significantly post intervention (p = 0.545). Providing OH care to the patients and conducting an OH screening increased moderately after the intervention (44.6-55.4% and 44.6-55.4%, respectively).

CONCLUSION

The video-based intervention was effective in improving the physicians' and nurses' knowledge, beliefs, and likelihood to incorporate OH care in their current practices. Males, Saudis, working in academia and more work experience were significantly associated with greater odds of having good knowledge after the intervention regardless of its type.

CLINICAL TRIAL NUMBER

Not Applicable.

Relationship Between Fear of Childbirth and Oral Health-Related Quality of Life in Pregnant Women: The Mediating Effect of Pregnancy Anxiety

BACKGROUND

Psychosocial health affects oral health-related quality of life. Pregnancy, as a special time for women, produces significant psychological changes. However, the relationship between mental health during pregnancy and oral health-related quality of life is unclear.

OBJECTIVE

The study aims to explore the association between fear of childbirth and investigate the mediating effect of pregnancy anxiety.

METHODS

Using a cross-sectional design, 478 pregnant women were recruited and evaluated using the Fear of Birth Scale, the Pregnancy-Related Anxiety Questionnaire and the Oral Health Impact Profile-14. Multiple linear regressions were performed to evaluate the relationship between fear of childbirth and oral health-related quality of life. PROCESS software was applied to assess the mediating effect of pregnancy anxiety.

RESULTS

Both fear of childbirth and pregnancy anxiety were negative correlation with oral health-related quality. Pregnancy anxiety mediated 40% of the association between fear of childbirth and oral health-related quality of life (β = 0.072, SE = 0.030, 95% CI [0.015, 0.131]).

CONCLUSIONS

Pregnancy anxiety mediates the relationship between fear of childbirth and oral health-related quality of life in pregnant women. To improve the oral health-related quality of life among pregnant women, relevant healthcare workers should actively help pregnant women to improve psychological health.

The association between oral health and risk behaviours of university students

BACKGROUND

Young adults are exposed to a variety of risk-related behaviours such as alcohol, smoking, and changes in dietary habits, which may result in unknown outcomes in their oral health. There is limited evidence on whether different risk behaviours are associated with oral health behaviours in the university student population. This study gathers data on the behaviours of students in their first year of university, which will inform the future development of oral health behaviour change interventions for this population.

METHOD

This longitudinal quantitative survey involved 205 first-year students aged 18-24 at the University of Manchester. Students completed online questionnaires at baseline and again at a 6-month follow-up interval, providing information regarding self-reported oral health status, hygiene routines, and risk behaviours (e.g., diet, smoking, alcohol).

RESULTS

The findings showed associations between oral health behaviours with risk behaviours, including links with oral care routines, bleeding gums, brushing frequency, with exercise, vaping, and unhealthy food and drink intake. Significant changes over the two-time points were also observed, including the worsening of the self-reported condition of the teeth (p < 0.001), a reduction in the self-reported condition of the gums (p = 0.004), a decrease in brushing frequency (p = 0.003), fewer regular dental visits (p = 0.013), more students intending to visit their previous dentist rather than finding a new dentist at university (p = 0.026), and greater consumption of unhealthy non-alcoholic drinks (p = 0.003). Positive changes over time included reduced frequency and units of alcohol consumption (p = 0.030 and p = 0.001), fewer instances of binge drinking (p = 0.014), and less frequent consumption of unhealthy foods (p = 0.034).

CONCLUSION

The findings highlighted the complex relationship between oral health and risk behaviours in this demographic. Poorer oral health behaviours were linked to engagement in risk behaviours. Thus, oral health behaviours should be targeted alongside other risk behaviours, and tailored interventions should be developed to improve behaviours among university students.

The Role and Advancement of Liposomes for Oral Diseases Therapy

As many as 48.0% of the global population suffers from disabilities caused by oral conditions. These conditions encompass dental caries, periodontal diseases, oral cancers, and other pathologies affecting the hard and soft tissues of the oral and maxillofacial regions. Topical drug treatments in the oral cavity are often ineffective due to the short contact time, which prevents the drug from reaching optimal concentrations necessary for therapeutic effect. Conventional liposomes have several limitations, including low stability, challenges in long-term storage, and rapid clearance by the reticuloendothelial system (RES). These factors significantly reduce their effectiveness in maintaining sustained drug delivery and achieving desired therapeutic outcomes. To overcome these challenges, advanced drug delivery systems have been developed. Among these systems, liposomes have been extensively explored as nanocarriers in targeted drug delivery systems, particularly in mucosal drug delivery, due to their biocompatibility and degradability, making them promising agents for the treatment of oral diseases. To address these issues, extensive research has been conducted to modify the surface of liposomes, optimizing their efficacy, and understanding their mechanisms of action. This review article discusses the role and recent advancements of liposomes in the treatment of oral diseases, highlighting their potential to revolutionize oral health care through improved drug delivery and therapeutic outcomes.

Knowledge, Attitudes, and Practices of Occupational Therapists in Promoting Oral Health: A Protocol for Mixed-Methods Systematic Review

BACKGROUND/OBJECTIVES

Poor oral health is a significant global public health concern that adversely affects an individuals' overall health and general well-being. Occupational therapists are well-suited to promote oral health by supporting activities of daily living (ADLs), thereby improving clients' oral health outcomes. However, there is limited evidence on the knowledge, attitudes, and practices (KAPs) of occupational therapists regarding oral health, as well as the barriers and facilitators they face in delivering oral healthcare.

METHODS

This paper outlines a protocol for a mixed-methods systematic review aimed at synthesizing the current evidence on the KAPs of occupational therapists related to oral health, as well as the barriers and facilitators they encounter in promoting it. The upcoming systematic review will follow the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration. The review will include quantitative, qualitative, and mixed-methods studies that report on KAP, barriers, and facilitators associated with occupational therapists' involvement in oral healthcare. A comprehensive search will be conducted across multiple databases, including MEDLINE (Ovid), CINAHL (EBSCO), SCOPUS, EMBASE (Ovid), and OTseeker to identify relevant studies. Two reviewers will independently screen the studies for eligibility, assess their methodological quality, and extract key data for synthesis. The protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with PROSPERO (CRD42024522136).

RESULTS

The findings from the planned systematic review are expected to provide valuable insights into the role of occupational therapists in promoting oral health, addressing barriers and facilitators, and shaping policies, training programs, and clinical practices.

CONCLUSIONS

Ultimately, these findings aim to enhance the integration of oral health into occupational therapy and improve client outcomes.

Evaluation of the effect of dental caries, oral hygiene, and treatment need on oral health-related quality of life among Turkish orphan children and adolescents

BACKGROUND

The oral and dental health and related quality of life of orphan children and adolescents-who are considered a vulnerable population-are critical for both individual and public health.

OBJECTIVES

This study aimed to investigate the status of the dental caries, oral hygiene, and dental treatment needs among a group of Turkish male orphan children and adolescents, as well as their impact on oral health-related quality of life.

METHODS

A total of 112 orphan children and adolescents aged between 9 and 17 years living in a residential care facility in Istanbul, Türkiye, were involved in this cross-sectional study. A comprehensive examination was conducted on each individual, encompassing the assessment of dental caries using the decayed, missing, and filled teeth (DMFT/dft) index, oral hygiene using the debris (DI-S), calculus (CI-S), and simplified oral hygiene (OHI-S) indices, and dental treatment need using the treatment need index (TNI). Oral health-related quality of life was evaluated using the validated Turkish version of the Child Oral Health Impact Profile-Short Form (COHIP-SF-19). The relationship between oral health-related quality of life and explanatory variables was evaluated using a multivariable linear regression model.

RESULTS

The mean age of the participants was 12 ± 1.79 years. The mean DMFT score was 4.57 ± 3.42, and the mean OHI-S score was 1.4 ± 0.52. Participants had a mean COHIP-SF-19 score of 57.79 ± 14.11, with 25% requiring at least one tooth to undergo radical treatment. Multivariable linear regression analysis indicated that the DMFT score (p = 0.009) and the need for radical treatment (TNI code 6) (p < 0.001) had a statistically significant impact on oral health-related quality of life among orphan children and adolescents aged 13-17.

CONCLUSIONS

This study underscores that dental caries and the need for radical treatment significantly impact the oral health-related quality of life of orphan children and adolescents.

Evaluating the Effectiveness of Patient-Centered Standardized Prophylaxis Processes in Enhancing Patient Satisfaction and Return Intentions

This study aimed to evaluate the effectiveness of a patient-centered standardized prophylaxis process in improving patient satisfaction and intentions to return to dental clinics. Conducted in a first-tier city in China from 9 June to 26 July 2023, the cross-sectional survey included 826 patients from 38 dental clinics. Among the respondents, 438 received standardized prophylaxis services, while 388 were in the non-standardized group, with a mean age of 38.2 ± 12.1 years and 50.24% male participation. The results revealed that patients in the standardized prophylaxis group reported significantly higher satisfaction scores (average 4.74 vs. 3.34, p < 0.0001) and greater intentions to return (average 4.77 vs. 4.10, p < 0.0001) compared to those receiving non-standardized care. The ordinal logistic regression analysis identified patient satisfaction as a strong predictor of return intention, with an odds ratio of 24.487, while the standardized service group had an odds ratio of 16.063, indicating a substantial positive effect on satisfaction. Age was also found to significantly affect return intention, reflected in an odds ratio of 0.969. Furthermore, the model showed strong predictive accuracy, which was supported by a Somers' D value of 0.806. Additionally, an impressive 89.9% of the observations were correctly ordered, which strengthens the reliability of the findings. These outcomes highlight the significant contribution of patient-centered, standardized practices to the satisfaction of the patients as well as the development of their desire to return for follow-up care. However, the findings should be interpreted with caution due to the study's cross-sectional nature, which limits causal inferences, and the specific demographic characteristics that may affect the general applicability of the results. Further research is needed to explore these dynamics across diverse populations and settings.

Engagement and access to support for oral health, substance use, smoking and diet by people with severe and multiple disadvantage: A qualitative study

BACKGROUND

Severe and multiple disadvantage (SMD) is the combined effect of experiencing homelessness, substance use and repeat offending. People experiencing SMD have high burden of physical and mental health issues. Oral health is one of the most common health problems in people experiencing SMD which interacts with substance use, smoking, and unhealthy diet to create a cycle of harm and disadvantage. However, burden of these conditions is worsened by poor access to health services. This study aimed to identify pathways to improve engagement and access to health interventions, for oral health, substance and alcohol use, smoking and diet.

METHODS

Using a qualitative methodology, interviews/focus groups were conducted with: (a) people experiencing SMD in Newcastle Upon Tyne/Gateshead; and (b) frontline staff, volunteer workers, policy makers and commissioners from London, Plymouth and Newcastle Upon Tyne/Gateshead. Data was analysed iteratively using thematic analysis.

RESULTS

Twenty-eight people experiencing SMD (age range: 27-65 years; 21% females) and 78 service providers (age range: 28-72 years, 63% females) were interviewed or included in focus groups. Data were organized into two overarching factors: barriers to accessing health interventions and improving access to health interventions. Barriers included: wider disadvantages of people experiencing SMD leading to low priority for support for oral health and associated health behaviours, psychosocial factors, waiting period and physical space. Factors that improved access to interventions included: positive relationships between service provider and person experiencing SMD, including a support worker, location of services and outreach services.

CONCLUSIONS

The findings suggest the need for flexibility in offering services for oral health and related health behaviours for people experiencing SMD. Training health care providers and co-developing services with people with lived experience of SMD can help prevent (re)stigmatization. Systems-based approach to address factors on an environmental, organizational, inter-personal and individual level is needed. The results from this study could be extrapolated to other health intervention such as vaccinations and sexual and reproductive health.

Post-COVID-19 Trends in Dental Emergencies: A Two-Year Retrospective Study from Romania

Background/Objectives: Dental emergencies significantly impact public oral health, particularly in the post-COVID-19 context. This study aimed to analyze the patterns of dental emergencies presenting to the Emergency Dental Service in Bihor, Romania, during the years 2022 and 2023, focusing on demographic characteristics and the frequency of diagnoses. Methods: A retrospective analysis of medical records from the Emergency Dental Service at Oradea County Emergency Clinical Hospital was conducted. Inclusion criteria encompassed patients presenting with dental emergencies during the specified period. Data regarding demographics, diagnoses, and living environments were collected and statistically analyzed. Results: A total of 4769 patients were analyzed, with acute pulpitis (39.2%, n = 1869) and acute apical periodontitis (37.5%, n = 1788) identified as the most common diagnoses. The study population included 52.3% males and 47.7% females, with a larger proportion residing in urban areas (58.0%) compared with rural areas (42.0%). Significant age-related patterns were evident: pulpitis was more common among patients aged 10-39 years, trauma was associated with patients aged 0-9 years, and gingival infections were prevalent in the 70-79 age group. Diagnoses also varied by dentition type, with abscesses, caries, trauma, and rhizolysis occurring more frequently in deciduous teeth, while pulpitis and post-extraction alveolitis were predominant in permanent teeth. However, no statistically significant differences were found in diagnosis frequency between genders or between rural and urban patients, indicating equitable access to emergency services across environments. Conclusions: The findings underscore the need for targeted interventions in pediatric populations to address early childhood caries, which remains a significant burden. Enhanced public health strategies and preventive education are essential to mitigate the prevalence of dental emergencies, particularly in the aftermath of the COVID-19 pandemic.

Changes in Oral Health-Related Quality of Life after (non-)restorative treatment of tooth wear in adult patients: A systematic review

OBJECTIVE

Literature was systematically reviewed to determine the impact of tooth wear management on the Oral Health Related Quality of Life (OHRQoL) amongst adult patients with tooth wear.

DATA

A protocol was developed, a priori (PROSPERO CRD42022343108) following the PRISMA guidelines. To assess risk of bias and certainty of evidence the RoB2-tool, JBI-tool, and GRADE were used.

SOURCES

PubMed, Scopus, Cochrane Library, Embase and Web of Science were searched. The first search took place on 21.10.2022, subsequently updated in May 2024.

STUDY SELECTION

Inclusion criteria were RCT's, quasi-RCT's, prospective- or retrospective-studies with adult patients with moderate to severe tooth wear, treated restoratively and/or with counseling and monitoring that were also assessed for OHRQoL during at least two time points. Exclusion criteria were, studies with children, OHRQoL only measured once, narrative and systematic reviews, conference abstracts, technical reports, consensus papers, and any other type of non-clinical study.

RESULTS

Six papers were included in this review. Overall, qualitative analysis revealed an increase in OHRQoL after restorative treatment, and no change in OHRQoL after one year of counseling and monitoring. Some studies showed a slightly negative effect on esthetics in the years post-treatment, and some of the dimensions of the Oral Health Impact Profile (OHIP) did not change or demonstrated minor change only. For the RCT's, blinding of participants and operators was not possible, as the participants had an awareness of the treatment. For the non-RCT's, the primary issue was the lack of control, with a general high risk of bias.

CONCLUSION

The provision of restorative treatment in patients with moderate to severe tooth wear frequently results in a positive impact on OHRQoL. Further research is required to substantiate the importance of OHRQoL for the treatment of (tooth wear) patients.

CLINICAL SIGNIFICANCE

The outcomes may help dentists and researchers better understand the advantages of using PROMS in their clinical work or research as valuable outcomes.

Pain, Function and Quality of Life in Temporomandibular Disorder Patients With Different Disc Positions

BACKGROUND

Whether pain, jaw function and quality of life are correlated with disc positions is controversial, and similar studies evaluating disc positions by magnetic resonance imaging (MRI) are very limited.

OBJECTIVE

This study evaluated the pain, mandibular function and quality of life of the temporomandibular disorders (TMDs) patients with different disc positions according to MRI, and the relationship among them.

METHODS

Three hundred and thirty-five participants were included. Patients completed questionnaires included the Numeric Rating Scale (NRS), Jaw Functional Limitation Scale 8-item (JFLS-8), the Generalised Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire 9-item (PHQ-9) and Oral Health Impact Profile for TMD (OHIP-TMD). MRI was conducted to evaluate these diagnoses, resulting in the identification of three distinct categories: normal positioning (NP), disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR).

RESULTS

Participants had the mean age of 28.55 ± 11.10 years (80.90% women). DDwR and DDwoR had a higher percentage of females compared with NP. Significant differences existed among patients in all questionnaires. The DDwoR group had significantly the highest pain, functional limitation and the worst quality of life. Moreover, they experienced the most difficulties in chewing tough foods, yawning, experiencing pain and psychological discomfort. Moreover, the multivariate regression showed that age, female gender, diagnosis as DDwoR, GAD-7 and PHQ-9 were significantly linked to higher functional limitation. Worse quality of life was associated with age, diagnosis as DDwoR, GAD-7 and PHQ-9.

CONCLUSIONS

Among patients with different disc positions, DDwoR showed the highest pain, functional limitation and the worst quality of life. Also, NP showed a proportion of chronic pain. Physical pain, psychological discomfort and chewing tough food were regarded as the most impaired. Women who experience anxiety and depression tended to have a higher propotion of dysfunction and a lower quality of life.

Association Between Oral Health Status and Oral Health-Related Quality of Life in Individuals With Thyroid Dysfunction: A Cross-Sectional Study

Background and aim Any alterations in the hormonal regulation system such as thyroid dysfunction may have an impact on oral health status, which in turn may affect their oral health-related quality of life (OHRQoL). The objective of this study was to determine the association of thyroid dysfunction on oral health status and OHRQoL of subjects with thyroid dysfunction. Materials and methods A cross-sectional study was conducted among 150 subjects with thyroid dysfunction and 150 subjects without thyroid dysfunction aged 18-60 years from a government hospital in Bangalore city. Subjects with or without thyroid dysfunction aged 18-60 years were included in the study. Subjects who had other systemic conditions, who were pregnant or lactating, who had tobacco chewing or smoking habits, and who had undergone periodontal therapy in the past six months were excluded. OHRQoL was assessed using a pre-validated Oral Health Impact Profile-14 (OHIP-14) questionnaire. Oral health examination was done using the WHO Oral Health Assessment Form for Adults, 2013. Descriptive and inferential statistics were performed. Results The mean age of the subjects with and without thyroid dysfunction was 43.01±10.9 and 42±9.8, respectively, with female predominance. Most of them had a socioeconomic status of less than the lower middle class. Subjects with thyroid dysfunction showed a higher proportion of dental caries, root caries, gingival bleeding, periodontal pocket, and loss of attachment as compared to the subjects without thyroid dysfunction (p<0.05). Subjects with hyperthyroidism showed poor periodontal condition and a higher proportion of dental caries experience as compared to subjects with hypothyroidism (p>0.05). Oral health indicators showed a significant positive correlation with OHRQoL among subjects with or without thyroid dysfunction. Conclusion There was an association between oral health status and OHRQoL among subjects with thyroid dysfunction when compared to subjects without thyroid dysfunction. Therefore, it is necessary to inform individuals with thyroid dysfunction about the importance of preventive oral care.

LMCD-OR: a large-scale, multilevel categorized diagnostic dataset for oral radiography

In recent years, digital dentistry has increasingly utilized advanced image analysis techniques, such as image classification and disease diagnosis, to improve clinical outcomes. Despite these advances, the lack of comprehensive benchmark datasets is a significant barrier. To address this gap, our research team develop LMCD-OR, a substantial collection of oral radiograph images designed to support extensive artificial intelligence (AI)-driven diagnostics. LMCD-OR comprises 3,818 digital imaging and communications in medicine (DICOM) oral X-ray images from local medical institutions that are meticulously annotated to provide broad category information for both primary dental outpatient services and detailed secondary disease diagnoses. This dataset is engineered to train and validate multiclassification models to improve the precision and scope of oral disease diagnostics. To ensure robust dataset validation, we employ four cutting-edge visual neural network classification models as benchmarks. These models are tested against rigorous performance metrics, demonstrating the ability of the dataset to support advanced image classification and disease diagnosis tasks. LMCD-OR is publicly available at http://dentaldataset.zeroacademy.net .

Conceptualising a theoretical framework for planning and evaluating workplace oral health promotion programs

ISSUED ADDRESSED

Workplaces have considerable potential for enhancing personal resources and providing a supportive working environment for staff health, including oral health and well-being. To date, assessments of workplace oral health promotion (WOHP) activities have observed benefits ranging from self-reported oral health to clinical parameters. However, previous WOHP actions were not based on a theoretical framework and did not consider the working environment as part of the planning and evaluation process.

METHODS

This article used evidence-based health promotion theoretical frameworks, and associated facilitators and barriers, in constructing an integrated and theoretically robust approach to planning and evaluating oral health promotion activities in the workplace.

RESULTS

The PRECEDE-PROCEED Model for planning and evaluation, the reach effectiveness adoption implementation maintenance, and the Salutogenic Model of Health were chosen to complement each other in the planning and evaluation process, based on their different features and the applicability of those features to the workplace setting. Because of the limited literature in this area, the current article also used evidence from oral health promotion in other settings (including schools and the community) and general health promotion in the workplace to construct a theoretical framework for planning and evaluating WOHP activities.

CONCLUSIONS

The theoretical framework developed could assist in planning or improving existing workplace health promotion programs that focus on or incorporate oral health elements. SO WHAT?: Future research on applying and adapting the proposed framework is required.

Diet and Oral Health: An Investigation Into the Impact of Pakistani Dietary Habits on Oral Disease Prevalence

Background Dietary habits play a significant role in the rising prevalence of oral health disorders, such as dental caries and periodontal diseases, particularly in regions like Pakistan with distinct dietary customs. Objective The primary objective of this research was to investigate the impact of Asian food on the prevalence of oral diseases, with a focus on identifying specific dietary factors that contribute to oral health issues. Methodology A cross-sectional study was carried out in Lahore between February and July 2024. The sample consisted of 384 adults aged 18 and above, selected based on specific inclusion and exclusion criteria. Data were collected through structured questionnaires assessing dietary habits and clinical examinations to diagnose oral diseases. Statistical analyses (SPSS version 26: (IBM Corp., Armonk, NY, USA), including correlation, regression, and Chi-Square, were used to evaluate the relationships between dietary patterns and oral health indicators. Results The study revealed significant correlations between dietary habits and oral disease prevalence. Among the 384 patients, 287 (74.74%) patients reported high sugar consumption, with a mean frequency of 3.26 times per week, correlating strongly with oral diseases (r=0.45, p<0.01). This group exhibited 179 patients (46.60%) with dental caries and 153 patients (39.58%) with periodontal conditions. Additionally, 262 patients (68.32%) with high carbohydrate intake, averaging 4.14 times per week, showed a moderate positive correlation with oral disease prevalence (r=0.32, p<0.05). Conversely, 193 patients (50.26%) who consumed fruits and vegetables with a mean frequency of 2.51 times per week demonstrated a significant negative correlation with oral disease prevalence (r=-0.40, p<0.01), indicating a protective effect. High sugar intake was associated with greater severity of oral diseases, with mean severity scores of 3.12 for dental caries and 3.20 for periodontal conditions. Conclusion The results show that although consuming more fruits and vegetables has a preventive effect, traditional Pakistani dietary practices, particularly excessive sugar and carbohydrate consumption, are associated with an increased incidence of oral illness.

Dental tissues of sickle cell anemia and its impact on the quality of life related to oral health

OBJECTIVE

The aim of this study was to determine the association between dental tissues and sickle cell anemia (SCA) and how it impacts the quality of life related to oral health.

MATERIALS AND METHODS

It was a cohort study of 154 Congolese participants with and without SCA conducted in the dental service of SCA at the Yolo Center, Kinshasa, aged at least 6 years and without a history of clinically severe conditions (hospitalization and blood transfusion), who were regularly monitored. The inclusion criteria were the diagnosis confirmation of SCA at the health service in a period of at least 6 months before enrollment in this study. Dental tissues were assessed by a clinical examination using a dental mirror and probe. The index of Decayed-Missing-Filled Teeth (DMFT) was used to assess the dental state of the participants. For Oral Health-related Quality of Life (OHrQoL), the Congolese versions of the perception questionnaires, modified from the Oral Health Impacts Profile (OHIP-23), were used for participants. Each question had to be answered by yes or no, depending on whether the participant was satisfied (outcome = 1) or dissatisfied (outcome = 0) about an oral health-related quality of life.

RESULTS

Of the 154 participants, aged from 6 to 64 years, with a mean age of 19.5 ± 7 (SD) years, 96 presented with SCA and only 68 were correctly followed; 102 did not present SCA and only 86 were correctly followed. The DMFT and dmft indexes were higher in the SCA group, being 2.9 and 2.5, respectively. The difference between the SCA group and the control group was significant for decayed teeth, missing teeth, filled teeth and no caries. Of the different dimensions of quality of life that were compared between the SCA group and control group, 15 of 23 items were statistically significant.

CONCLUSION

The present study strongly confirmed an association between dental caries and missing teeth with sickle cell anemia. Secondly, the quality of life for SCA participants seems to be poor, compared to the control group.

Oral health-related quality of life and its association with sense of coherence and social support among Yemeni immigrants in Malaysia

Oral health problems prove to be a significant public health issue due to their high prevalence and their impacts on people's self-confidence and basic physical functions such as talking, chewing and smiling, all of which affect an individual's social role. For that, this study aims to determine oral health-related quality of life (OHRQoL) and its association with a sense of coherence (SOC) and perceived social support among Yemeni adults residing in Malaysia. Data was collected from 223 Yemeni adults residing in Malaysia for over a year. The data collection instruments used were: a short version of the sense of coherence Scale (SOC-13), a new short version of the oral health impact profile (OHIP-5) questionnaire, the multidimensional scale of perceived social support (MSPSS), and a questionnaire containing socio-demographic and oral health behaviours information. Simple and adjusted binary logistic regression analyses with the level of significance p < 0.05 were used to determine the association between the independent factors and OHRQoL. Negative impacts on quality of life due to oral health issues were reported by (57.8%) of the participants, and a statistically significant association between SOC and OHRQoL was found; participants with weak SOC were more likely to have a negative impact on their OHRQol than individuals with strong SOC (AOR = 2.8, 95% CI 1.4-5.5). Additionally, self-assessment of oral health as poor (AOR = 4.6, 95% CI 1.5-14.1) were also associated with a negative impact OHRQoL. On the other hand, this study found that a longer period since the last dentist visit was a protective factor against negative impacts on quality of life (p < 0.05). In terms of perceived social support, no association was found between any categories of perceived social support and OHRQoL. In Conclusion, sense of coherence showed a statistically significant association with OHRQoL, emphasizing psychological factors' potential role in oral health. The findings support the hypothesis that SOC is a psychosocial determinant that could act as a protective factor against negative impact on OHRQoL.

Novel Insights into Amlodipine-Induced Gingival Enlargement: A Clinical and Molecular Perspective

This study aimed to identify risk factors for amlodipine-induced gingival enlargement, assess quality of life, and analyze gingival tissue. This cross-sectional study involved hypertensive patients on amlodipine, divided into groups with and without gingival enlargement. Assessments included sociodemographic data, clinical evaluations, and clinical parameters. Quality of life was assessed using OHIP-14 and WB-HRQoL scales. Gingival tissue samples were analyzed for oxidative status and key molecules using RT-PCR and colorimetric assays. The study included 32 patients with no significant sociodemographic differences between groups (p > 0.05). Patients with gingival enlargement had higher systolic blood pressure (139.63 ± 10.743 vs. 128.38 ± 7.249, p = 0.028) and higher OHIP-14 scores. The RT-PCR analysis showed significant differences in IL-6, TNF-α, IL-33, ST2, TGF-β1, FGF-2, CTGF, VEGF-D, and KGF expression. IL-6, TNF-α, ST2, and FGF-2 expression levels were lower in patients taking amlodipine, with and without gingival enlargement. TGF-β1 and CTGF expression levels were highest in patients with amlodipine-induced gingival enlargement. SOD activity was also highest in these patients, whereas MDA levels were higher in patients with gingival enlargement without amlodipine. Our study highlights the impact of amlodipine-induced gingival enlargement on oral health and quality of life, emphasizing fibrosis and oxidative stress, and suggests the need for integrated healthcare approaches and further research.

Impact of dental caries and Self-perceived oral health on daily lives of children and mothers in rural Egypt: a household survey

BACKGROUND

The present study assessed the impact of oral health on the daily lives of children and mothers living in a rural area in Northwestern Egypt.

METHODS

A cross-sectional household survey including children between 6 and 12 years old and their mothers was conducted in rural Egypt, 2019-2020. Data were collected using clinical examination and interview-based questionnaires of children and mothers. Three binary logistic regression models were used to assess the relationship between the dependent variables (oral health impact (yes, no) on avoiding smiling, chewing problems, and missing school (children) and avoiding social events (mothers)), and the explanatory variables: oral health (clinically-assessed caries experience and self-reported oral health) controlling for sociodemographic profile (child age and sex, mother's education), daily toothbrushing and village of residence.

RESULTS

A total of 211 households with 355 children and 211 mothers were included (91.5% response rate). About 54% of the children were girls, mean (SD) age = 8.7 (2.05) years and 82.3% did not brush their teeth daily. Mother's mean (SD) age was 31.70 (5.45) years. Because of dental problems, 31.3% of children reported chewing difficulties, 31% avoided smiling compared to 76.3% and 43.6% of mothers. Also, 30.4% of children missed school and 76.8% of mothers reported reduced participation in social activities. In children, the number of decayed anterior teeth was associated with significantly higher odds of avoiding smiling (AOR = 1.22, 95%CI: 1.03, 1.44). In mothers, a greater number of posterior missing teeth was associated with significantly higher odds of chewing difficulties (AOR = 1.21, 95%CI: 1.01, 1.45), and a greater number of all missing teeth was associated with significantly higher odds of reduced participation in social events (AOR = 1.30, 95%CI: 1.30, 1.57). Good/ very good reported oral health in children and mothers was associated with lower odds of avoiding smiling and chewing problems (p < 0.05).

CONCLUSION

Decayed anterior teeth in children have a negative impact on smiling whereas missing teeth in mothers affect the ability to chew food and socialize. The psychological, functional, and social impacts of caries in this rural setting needs to be mitigated by improving oral health literacy and access to care.

Standardization of Dental Vulnerability Scale scores (EVO-BR)

BACKGROUND

Dental Vulnerability Scale (EVO-BR) is an instrument developed to help identifying oral health-vulnerable individuals. This scale comprises 15 items distributed into 4 dimensions. It is the first instrument with the potential to guide clinical and managerial decisions in the oral health field. The aim is to validate a score to enable using EVO-BR in Primary Health Care (PHC).

METHOD

The investigated sample included PHC users in five Brazilian regions. Data were collected at two different stages: in 2019 (São Paulo) and in 2022 (Minas Gerais, Mato Grosso, Roraima, Pernambuco e Paraná). Exploratory descriptive study of this scale scores was carried out to create classification ranges. Subsequently, discriminant analysis was performed to assess the accuracy of the established classification. Boosting regression was carried out to check items' weight for the instrument score.

RESULTS

EVO-BR score ranged from 0 (highest vulnerability) to 15 (lowest vulnerability). Four (4) classification configurations were tested. Score equal to 12 points was the one presenting the best classification of the assessed individuals (100% were correctly classified). Boosting regression has evidenced that items 1 and 2 (Overall health domain) and 14 and 15 (Health Services domain) had the strongest influence on this instrument's score.

CONCLUSION

The process to standardize the EVO-BR score and, consequently, to develop assessment ranges, is an important step in the fight against health inequalities, since it provides a tool to help planning actions and interventions aimed at meeting specific needs of the population in the Primary Health Care context.

Impact of Pregestational Obesity on the Oral Health-Related Quality of Life in Brazilian Pregnant Women: A Cohort Study

The oral health-related quality of life of pregnant women and its effects on health conditions are important topics to be investigated in scientific research. The objective of this study was to evaluate the impact of pre-pregnancy obesity on oral health-related quality of life (OHRQoL) in pregnant women. A prospective cohort study was carried out with 93 pregnant women who were evaluated in the 2nd trimester of pregnancy (T1) and after delivery (T2). The following were analyzed: dental caries (DMFT), OHRQoL (OHIP-14), anthropometric data (BMI), socioeconomic, demographic, oral hygiene behavioral habits and the use of dental services. Unadjusted and adjusted Poisson regression analyses were performed to determine the impact of predictors on OHRQoL. The results of the adjusted analysis showed lower education relative risk (RR) (1.37; 95%CI 1.02-1.83; <0.00), low income (RR 2.19; 95%CI 1.63-2.93; <0.00) and higher BMI pre-pregnancy (RR 1.03; 95% CI 1.01-1.04; <0.00) were associated with worse OHRQoL in postpartum pregnant women. Flossing was a predictor of better OHRQoL at T2 (RR 0.73; 95%CI 0.57-0.93; <0.01). Higher BMI, low education, low income and inadequate oral hygiene habits were predictors of worse OHRQOL of pregnant women after the birth of the baby.

Parents' Knowledge and Awareness About the Importance of Primary Teeth and Space Maintainers in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Primary teeth are important for eating, speaking, and esthetics, as well as for guiding the eruption and maintaining the space for the permanent teeth. The best space maintainers (SM) for permanent dentition are the natural primary teeth. The aim of this study was to assess parents' knowledge and awareness of the importance of primary teeth and SM in Saudi Arabia.

METHOD

This cross-sectional study invited parents who were living in Saudi Arabia via different social media platforms to complete a validated questionnaire. The data collected included demographic characteristics, questions about parents' knowledge of their children's oral hygiene, and the importance of primary teeth, as well as questions about knowledge of SM.

RESULTS

A total of 392 participants completed the questionnaire. Dental problems and pain were the most common reasons for visiting the pediatric dentist (n=260; 66.3%). With respect to the age at which the first primary tooth erupted, more than half of the parents (n=270; 68.9%) knew the correct age. Only 43.3% (n=168) of the parents had received any information about SM and only 39.5% (n=155) of them knew their purpose.

CONCLUSION

Most parents agree that treating primary teeth is important for their children's oral health and development. However, most are unaware of an SM's purpose. We recommend that dentists discuss SM's importance with parents actively after extracting their child's teeth. This will help increase parents' awareness and understanding of SM and encourage them to be more informed about this dental treatment option.

Evaluation of oral health among people with multimorbidity in the marginalized population of Karachi, Pakistan: A multicenter cross-sectional study

Background

Oral health is linked to physical and mental well-being. Oral disease is common among poor and socioeconomically disadvantaged people in developing and industrialized countries.

Objectives

This study assessed the oral health disease burden among people with multimorbidity in marginalized populations.

Methods

This cross-sectional study was conducted across 16 locations in the slums of Karachi, Pakistan, to assess oral health disease problems among adults aged 18 to 70 with comorbidity or multimorbidity. The questionnaire covered the socioethnic, demographic, and disease status of people with oral health status. Data analyses were performed using SAS version 9.4.

Results

Of the 16 designated slum locations, 870 individuals were considered for oral health screening. Gingivitis was highly prevalent, 29% among slum dwellers with multimorbidity of diabetes, hepatitis, and hypertension. Dandasa was widely used as a tooth-cleansing agent in 35% of the study population. By contrast, 45.4% of people showed unsatisfactory oral hygiene conditions. Pathan ethnicity showed the highest prevalence (i.e., 29.8% of dental problems with disease multimorbidity in 26.8% of Baldia Town residents of Karachi). Of the 870 individuals, the highest frequency of dental problems was found in the age group of 18-38 years (28-42.9%) and among female participants (53.8%).

Conclusion

There is an urgent need for the global enhancement of public health programs, specifically focusing on implementing effective strategies to prevent oral illnesses, promote oral health, and address other chronic diseases in basic healthcare settings. Enhancing oral health poses significant difficulties, especially in less developed nations.

Territorial Disparities in Dental Care for Disabled Persons and Oral Health-Related Indicators: A Population-Level Approach in Brazil's Public Healthcare System from 2014 to 2023

This study evaluated territorial disparities in dental care for disabled persons in Brazil's public healthcare system from 2014 to 2023. The person-year incidence of outpatient dental procedures carried out by special care dentistry specialists and hospitalizations for dental procedures for disabled persons were compared across different regions and against the national estimate. In addition, productivity was correlated with oral health-related indicators. The significance level was set at 5%. The northern region exhibited the highest outpatient productivity, while the southern region showed lower productivity compared to the national estimate (both p-value < 0.05). This pattern was reversed in inpatient productivity (both p-value < 0.05), with the northeastern and central-western regions also below average (both p-value < 0.05). There were no significant correlations between the indicators and inpatient productivity, but outpatient productivity was positively correlated with the proportions of inhabitants who self-rated their general and oral health as "poor" or "very poor", who have never visited a dentist, and who visited a dentist for tooth extraction (all p-values < 0.05). Territorial disparities in dental care for disabled persons were observed within Brazil's public healthcare system, and they were correlated with unfavorable oral health-related indicators at the population level.

The antecedents of oral care in nursing facilities - a qualitative interview study among supervisor nurses

OBJECTIVES

This qualitative study describes the views of supervisor nurses related to antecedents of oral care in Finnish nursing facilities.

METHODS

In the six largest cities in Finland, 19 supervisor nurses were interviewed and asked five semi-structured questions related to the antecedents of oral care in the units. The interviews were analyzed using inductive content analysis.

RESULTS

Qualitative content analysis revealed five main categories: awareness of nurses (3 categories, 9 subcategories), attitude and motivation (3 categories, 10 subcategories), supporting quality of life and health (4 categories, 11 subcategories), the meaning of oral health in the unit (3 categories, 10 subcategories), and the role of the supervisor nurse in oral health care (4 categories, 14 subcategories). The awareness of nurses regarding oral health was in most cases good. Nurses' attitudes towards oral health and their motivation to oral care vary but were mostly good. Nurses were aware that oral care enhances the quality of life. The role of the supervisor nurse in organizing oral care was crucial.

CONCLUSIONS

The performed analysis identified five main categories to describe antecedents for oral care in Finnish nursing facilities. The categories that needed to be improved were knowledge and attitude, and motivation related to oral care.

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.

Development and validation of a nomogram for predicting depressive symptoms in dentistry patients: A cross-sectional study

Depressive symptoms are frequently occur among dentistry patients, many of whom struggle with dental anxiety and poor oral conditions. Identifying the factors that influence these symptoms can enable dentists to recognize and address mental health concerns more effectively. This study aimed to investigate the factors associated with depressive symptoms in dentistry patients and develop a clinical tool, a nomogram, to assist dentists in predicting these symptoms. Methods: After exclusion of ineligible participants, a total of 1355 patients from the dentistry department were included. The patients were randomly assigned to training and validation sets at a 2:1 ratio. The LASSO regression method was initially employed to select highly influrtial features. This was followed by the application of a multi-factor logistic regression to determine independent factors and construct a nomogram. And it was evaluated by 4 methods and 2 indicators. The nomograms were formulated based on questionnaire data collected from dentistry patients. Nomogram2 incorporated factors such as medical burden, personality traits (extraversion, conscientiousness, and emotional stability), life purpose, and life satisfaction. In the training set, Nomogram2 exhibited a Concordance index (C-index) of 0.805 and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.805 (95% CI: 0.775-0.835). In the validation set, Nomogram2 demonstrated an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.810 (0.768-0.851) and a Concordance index (C-index) of 0.810. Similarly, Nomogram1 achieved an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.816 (0.788-0.845) and a Concordance index (C-index) of 0.816 in the training set, and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.824 (95% CI: 0.784-0.864) and a Concordance index (C-index) of 0.824 in the validation set. Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) indicated that Nomogram1, which included oral-related factors (oral health and dental anxiety), outperformed Nomogram2. We developed a nomogram to predict depressive symptoms in dentistry patients. Importantly, this nomogram can serve as a valuable psychometric tool for dentists, facilitating the assessment of their patients' mental health and enabling more tailored treatment plans.

Comparison of the Early Childhood Oral Health Impact Scale (ECOHIS-4D) and Child Health Utility Index (CHU-9D) in children with oral diseases

OBJECTIVE

Accurate assessment of child oral health is important for guiding economic evaluations and informing healthcare decision-making. Early Childhood Oral Health Impact Scale (ECOHIS-4D) is a preference-based instrument that measures the oral health-related quality of life of young children. The aim of this study was to compare the utility scores of ECOHIS-4D and Child Health Utility Index (CHU-9D), against an oral health indicator to evaluate which utility score corresponds better with the oral health indicator.

METHOD

The ECOHIS-4D and CHU-9D were applied to 314 parent/child dyads from preschools in a primary healthcare setting in Perth, Western Australia. Four parameters were used to assess which instrument corresponds better with the oral health indicator (decayed, missing and filled teeth score-dmft score): (i) discrimination, the ability to discriminate between different clinical severity groups, (ii) external responsiveness, how much the utility values relate to the changes in dmft scores, (iii) correlation, the association between the two instruments and the related dimensions and (iv) differences in the utility values across the two instruments.

RESULTS

Most participants (81%) were 2-6 years old, and nearly 50% had a dmft score <3. ECOHIS-4D demonstrated a superior ability to differentiate between dmft severity groups and respond to changes in dmft scores. A significant weak correlation was observed between dmft and ECOHIS-4D (-0.26, 95%, CI -0.36 to -0.15) compared to a non-significant very poor correlation between dmft and CHU-9D (0.01, 95% CI -0.12 to 0.10). The utility scores of the two instruments had relatively good agreement towards good health and weak agreement towards poor health.

CONCLUSIONS

ECOHIS-4D, the oral health-specific instrument, is more sensitive in assessing children's oral health-related quality of life than the generic CHU-9D. Thus, ECOHIS-4D is more appropriate for utility estimates in economic evaluations of oral health-related interventions and resource allocation decision-making.

Impact of dental caries on the daily lives of geriatric patients visiting dental hospitals in Rawalpindi, Pakistan

Background

The objectives were to assess the impact of dental caries on the daily living of the geriatric population and determine the factors that influence the relationship between dental health and the daily living of the geriatric population.

Methods

A descriptive cross-sectional study was carried out over six months at Rawalpindi's public and private dental hospitals. Participants aged≥60 years, both male and female, were selected. The calculated sample size was 281. Desired sample from one of the dental hospitals was collected using a non-probability consecutive sampling strategy. Data about sociodemographic characteristics and the DMFT index were collected. Adapted validated tool dental impact on daily living (DIDL) was used to assess the impact of dental health on daily living.

Results

Chi-squared test of association showed a positive association between the DIDL and sociodemographic variables, including age (P=0.001), gender (P=0.001), education (P=0.001), income (P=0.001), occupation (P=0.029), marital status (P=0.001), living arrangement (P=0.001), and history of chronic illnesses (P=0.001). The association between the DMFT index and DIDL also showed statistically significant results (P=0.001). Binary logistic regression analysis indicated that gender (OR=6.98, P=0.005) and the individual's dental health (OR=6.43, P=0.001) were the strongest predictors of the impact experienced in daily life activities. The overall model was statistically significant (χ2=51.24, P=0.001), and the variables were responsible for 32.4% of the variance in the outcome variable.

Conclusion

The study provides strong evidence that sociodemographic factors, DMFT index, gender, and individual dental health significantly contribute to the impact of dental health on daily living. Gender and individual dental health emerge as particularly influential predictors. These findings emphasize the need for targeted interventions and awareness programs, especially for groups with a higher risk of experiencing a significant impact on daily life due to dental issues.

The self-perceived impact of sexual abuse on daily life and general health - an issue to consider in dental care

BACKGROUND/AIM

To analyse, from the perspective of adults with a history of sexual abuse, the impact of the experience on their general health and well-being.

MATERIAL AND METHODS

The participants comprised 12 strategically selected informants (10 women), aged 19-56; all sexually abused during child- and/or adulthood. They were interviewed in-depth and encouraged to describe the impact of the sexual abuse on their daily lives. The consequences of sexual abuse on oral health have previously been reported. The interviews were recorded digitally, transcribed verbatim and analysed according to qualitative content analysis with an inductive approach.

RESULTS

The overall theme illustrating the latent content was Sexual abuse experience-limiting long-term consequences, always present in body and mind. The first category covering the manifest content was 'A lost foothold', with two subcategories: (i) emotional repercussions and (ii) physical health repercussions. The second category was 'The significance of distance to trauma', with two subcategories (i) keeping a distance and tending to escape and (ii) processing the trauma experience-a struggle towards balance.

CONCLUSIONS

A history of sexual abuse cannot be understood in isolation: the long-term repercussions pervade daily life. However, after disclosure of the abuse and processing the trauma, it is possible to ameliorate some of the negative effects. In this context, the dental setting emerges as a potentially important venue for disclosure as almost every person, sooner or later, visits the dentist.

Long-term occlusal tooth wear at the onset of permanent dentition

OBJECTIVES

This study quantified the long-term occlusal wear in the natural posterior teeth and the associations per tooth type within the dentition.

METHODS

The sample included 70 orthodontically treated subjects (52 females and 18 males; median age, 14.3 years), followed for a 12.7-year period. They were consecutively selected with no tooth wear-related criteria. Post-treatment (T1) and follow-up dental casts (T2) were scanned and superimposed through three-dimensional methods. Occlusal wear volume of posterior teeth and tooth wear patterns were investigated through non-parametric statistics and analysis of covariance.

RESULTS

There were no significant differences between contralateral teeth. The average occlusal wear per posterior tooth was 2.3 mm3, with 65.2% of teeth showing values greater than 1 mm3. Males, mandibular teeth, and first molars exhibited slightly greater wear levels than females (median, 2.57 and 2.21 mm3, respectively; p = 0.005), maxillary teeth, and first or second premolars, respectively. In all first premolars and in the mandibular second premolars, the buccal cusps were primarily affected with no other distinct patterns. There were weak to moderate correlations between tooth types, apart from certain strong correlations detected in males.

CONCLUSIONS

Posterior tooth wear was highly prevalent after a 13-year period starting at the onset of permanent dentition. The detected patterns are in accordance with the concept of canine guidance occlusion that is transforming into group synergy through function.

CLINICAL RELEVANCE

The widespread tooth wear occurrence and the high intra- and inter-individual variability underline the need for individual patient monitoring to identify high-risk patients at early stages.

Reliability and validity of cross‑culturally adapted oral health‑related quality‑of‑Life instruments for Brazilian children and adolescents: a systematic review

OBJECTIVE

This systematic review aimed to review the reliability and validity of oral health-related quality of life (OHRQoL) questionnaires for Brazilian children and adolescents. Also, the cross-cultural adaptation was evaluated.

METHODS

This systematic review is registered in PROSPERO (CRD42022300018) and was performed based on the COSMIN guideline. Electronic searches were performed in the PubMed/MEDLINE, Web of Science, Lilacs, BVS (BIREME), Scielo, and Embase databases until March 2023 by two independent reviewers. There was no restriction on time or language. The following studies were included: validation studies and cross-cultural adaptation of OHRQoL instruments into Brazilian Portuguese; studies that evaluated the measurement properties of OHRQoL questionnaires in children and adolescents and that reported at least one of the measurement properties: reliability, internal consistency, error measurement, content validity, construct validity, criterion validity, discriminant validity, and/or convergent validity. The following were excluded: studies of systematic reviews of OHRQoL measures; studies reporting OHRQoL assessment through instruments; construction (development) and validation of a new instrument; questionnaires that had a single item; and validation for Portuguese from Portugal. The cross-cultural adaptation process and psychometrics of the included studies were verified.

RESULTS

6556 articles were identified, and 19 manuscripts were included. All studies were conducted in Brazil, and the age of the participants ranged from 2 to 15.42 years old. Sixteen articles presented the cross-cultural validation steps. Cronbach's alpha of the revised instruments ranged from 0.59 to 0.86.

CONCLUSIONS

It can be concluded that most studies provided information and evidence regarding validity, reliability, translation, and cultural adaptation.

The effect of mass media campaigns on oral health knowledge: A systematic review and meta-analysis

OBJECTIVES

Knowledge and awareness gained from mass media can prepare people for lifestyle changes and impact their health and well-being. Considering the differences in the results of primary studies, we decided to conduct this study to evaluate the effect of mass media campaigns on oral health knowledge as a systematic meta-analysis and review.

METHOD

The databases such as the Web of Sciences (ISI), Scopus, PubMed/Medline, and the Cochrane Library were searched systematically until February 2022. Data pooling was performed using a random effects model. The effect sizes were estimated as odds ratios (ORs) with their 95% confidence intervals (CIs). Additional analyses, including sensitivity, subgroup, and publication bias analyses, were also conducted.

RESULTS

Our meta-analysis comprised a total number of seven articles. The pooled results indicated significant increases in oral health knowledge among included studies (OR = 1.64, 95% CI: 1.20-2.24, p < 0.001). In subgroup analyses, the effects of mass media campaigns on oral health knowledge remained significant for the studies with follow-up of less than 150 weeks (OR = 1.69, 95% CI: 1.49-1.91) and working-age populations (OR = 1.80, 95% CI: 1.40-2.32) compared to other categories.

CONCLUSION

In general, this study showed that mass media campaigns may have positive effects on oral health knowledge, especially in the working-age population; it seems that for improving health knowledge among children, more initiatives are needed. Besides, the effects of these campaigns seem to be time-dependent and higher in shorter follow-up periods.

Oral health-related quality of life among diabetic patients: A cross-sectional controlled study

Introduction

Diabetes is a widespread chronic metabolic condition that has a significant negative influence on a person's sociopsychological, physical, and economic well-being. This study was designed to (1) measure the impact of oral health on quality of life (QoL) using the Oral Health Impact Profile-14 (OHIP-14) in association with other factors (age, gender, years of diabetes, level of education, smoking, presence of other conditions, oral complaints, and glycemic control) and (2) validate the Arabic version of the OHIP-14.

Materials and Methods

Diabetic and healthy participants completed a two-part survey including demographic characteristics OHIP-14 questionnaire.

Results

The sample consisted of 121 patients with type 2 diabetes mellitus and 146 healthy controls. Sociodemographic data, OHIP-14 questionnaires, and glycemic control data were collected. The data were statistically analyzed. The results showed that OHIP-14 was found to have sufficient reliability and validity in measuring life quality. Our study documented the effects of oral health complications on QoL among diabetics compared to controls. The type of diabetes had no effect on life quality. The highest OHIP-14 domain affected was functional limitation, while the lowest one was social handicap.

Conclusion

It was concluded that diabetes has a negative effect on life quality. Diabetic patients have unsatisfactory oral health, which affects their QoL. The OHIP-14 is a reliable and valuable instrument to measure life quality.

Oral health-related quality of life among people living with HIV and HIV-negative adults in Kigali, Rwanda: a comparative cross-sectional study

BACKGROUND

Assessing health-related quality of life has become integral to people living with HIV (PLHIV) follow-up. However, there is a lack of data regarding the impact of oral health on quality of life, known as Oral health-related quality of life (OHRQoL) among PLHIV compared to HIV-negative individuals in Rwanda.

AIM

The study aimed to assess OHRQoL among PLHIV compared to HIV-negative counterparts in Kigali, Rwanda.

METHODS

The Oral Health Impact Profile short version (OHIP-14) questionnaire was interviewer-administered to 200 PLHIV and 200 HIV-negative adults (≥ 18 years old) at an HIV clinic of Kigali Teaching Hospital (CHUK). Socio-demographic characteristics, including age, sex, occupation, and socioeconomic status (SES) of participants, were collected using a survey questionnaire. A 4-point Likert scale was used to assess the frequency of oral impacts for all 14 items within 7 domains of the OHIP tool. The descriptive statistics were used to see frequencies and percentages of OHRQoL among PLHIV and HIV-negative persons, respectively. The Chi-square test was used to determine the association of OHRQoL with caries (DMFT) and periodontal disease (CPITN) among PLHIV compared to HIV-negative individuals.

RESULTS

The results revealed a higher prevalence of PLHIV with poor OHRQoL than HIV-negative individuals in 5 domains and almost all items of OHIP-14 except for the OHIP 3 (found it uncomfortable to eat any foods because of problems with teeth or mouth) and OHIP-14 (being totally unable to function because of problems with teeth or mouth). The findings showed statistically significant results (p ≤ 0.05) for the OHIP1 item "trouble pronouncing any word," with a prevalence of 2.5% (n = 11) and 2.25% (n = 9) in PLHIV and HIV-negative, respectively. Also, PLHIV had a significantly higher prevalence, 2.75% (n = 11) for the OHIP 13 item "life not satisfying due to teeth and mouth problems compared to HIV-negative individuals 2% (8) p ≤ 0.05. Moreover, dental caries was significantly associated with poor OHRQoL among PLHIV and HIV-negative adults and for all 14 items of the OHIP tool. Periodontal disease was not significantly associated with OHRQoL among PLHIV and HIV-negative adults.

CONCLUSION

This study revealed poor OHRQoL among PLHIV compared to HIV-negative adults. There is a need for further longitudinal studies to investigate the OHRQoL in Rwanda, especially among PLHIV. It is essential to include oral health care as one of the components of the medical health care programs for PLHIV in Rwanda.

Investigating oral health among US adults with sleep disorder: a cross-sectional study

BACKGROUND

This study aims to investigate the relationship between sleep disorders and oral health outcomes among a representative sample of the United States population.

METHODS

The study sample comprised 6,161 participants who participated in the NHANES 2017-2018, representing a population of 255,939,599. Oral health outcomes were assessed using the Oral Health Questionnaire (OHQ), covering dental pain, periodontal disease, bone loss, emotional perceptions of oral health, and impact on daily life. Sleep disorders were evaluated using questions related to sleep trouble and daytime sleepiness.

RESULTS

Analysis of the NHANES 2017-2018 dataset, revealed notable associations between sleep disorders and oral health outcomes. Individuals with sleep disorders were more likely to report dental pain (19.79% vs. 11.8%), periodontal issues (19.5% vs. 12.25%), and feeling bad or embarrassed about their oral health (21% vs. 12%), compared to those without sleep disorders. Difficulty due to oral health issues was also more prevalent among participants with sleep disorders (32.6% vs. 12.9%). Adjusted models demonstrated that individuals with sleep disorders had a significantly higher likelihood of experiencing oral aches [adjusted odds ratio (aOR) = 1.58 (1.22-2.22)], reporting negative emotions about oral health [aOR = 1.59 (1.06-2.37)], and encountering challenges in school or job performance [aOR = 2.27 (1.47-3.51)], compared to individuals without sleep disorders (refer to Table 3). Other significant covariates affecting oral health outcomes included smoking, income, and education level.

CONCLUSIONS

This study reveals a compelling association between sleep disorders and adverse oral health outcomes in the U.S.

POPULATION

The Development and Evaluation of the Slovenian Version of the Early Childhood Oral Health Impact Scale (ECOHIS-SVN)

Introduction

There has been no valid and reliable instrument available to measure the impact of oral health on the quality of life of Slovenian preschool children. The main aim of this study was to develop and evaluate the validity and reliability of the first Slovenian instrument assessing Oral Health-Related Quality of Life (OHRQoL) preschool children: the ECOHIS-SVN.

Methods

The ECOHIS-SVN was developed using forward-backward translations and with the participation of children aged under six and their parents. The children's teeth were examined, and parents were asked to complete questionnaires, including the ECOHIS-SVN. The internal consistency of ECOHIS-SVN was evaluated through the calculation of Cronbach's alpha (α), test-retest reliability with an intra-class-correlation coefficient (ICC), convergent validity with Spearman's rank correlation (r) and criterion validity with the Mann-Whitney test. The association between the ECOHIS-SVN score and parents' age, educational level, self-reported oral health and OHIP-SVN14 was estimated using multiple linear regression.

Results

In the study, 255 children participated, with a mean age of 4.8 years (±0.8). The ECOHIS-SVN questionnaire was completed by the parents of all 255 children and re-filled by 71 parents. The results of the total ECOHIS-SVN scale include α=0.85, ICC=0.85, and r=0.6-0.75. A statistically significant association was found between the ECOHIS-SVN and parents' age and between the ECOHIS-SVN and parents' OHIP-SVN14 in the whole group and in the subgroup of children with no teeth affected by cavitated caries (dmft=0) (p=0.025, p=0.028), respectively.

Conclusion

ECOHIS-SVN enables further studies to assess the OHRQoL of preschool children in the Slovenian-speaking population.

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.

Knowledge, attitudes, and interest in orthodontic treatment: a cross-sectional study in adults with stage III-IV periodontitis and secondary malocclusions

BACKGROUND

An increasing number of patients with advanced stages of periodontitis are seeking for treatment options. The study aimed to determine interest in orthodontic treatment (OT) and its association with oral health status and knowledge about the disease in adult subjects with stage III-IV periodontitis.

METHODS

96 subjects ≥ 30 years, with stage III-IV periodontitis agreed to fill in a questionnaire and undergo a comprehensive periodontal-orthodontic examination. The questionnaire included 44 questions: demographic, dental, health related habits, self-perceived overall and oral health, knowledge of periodontitis, and attitude toward OT. The statistical analysis was performed using a paired-sample T-test, Receiver Operating Characteristic (ROC) and binary logistic regression analysis (LRA).

RESULTS

Stage IV periodontitis was observed in 32.3% of subjects and Class II malocclusion was most prevalent (53.1%). More than half of subjects were interested in OT. Oral health, knowledge about periodontitis and age were significant predictors for interest in OT.

CONCLUSIONS

Knowledge spread about OT possibilities in advanced stages of periodontitis is very important both for the dental community and older subjects to save natural dentition.

Job shadowing for early undergraduate dental students: Evaluation and validation of educational effectiveness using structural equation modelling

INTRODUCTION

This study aimed to evaluate and validate the educational effectiveness of a job shadowing class as a dental teaching programme for preclinical dental students through a questionnaire that assessed related student perceptions.

MATERIALS AND METHODS

A total of 124 preclinical (second year) dental students at Tokushima University participated in job shadowing placements from 2017 to 2019. Each student observed dental practice or surgery for 1 day in the university hospital. After shadowing, the students were requested to fill out a nine-item questionnaire based on a five-point scale. The first analysis was performed to calculate the correlation for each item. Furthermore, regression analysis for the categorical data was performed to show the relationship between eight questions (Items 1-8) and one question (Item 9: comprehensive evaluation). Next, factor analysis was performed to determine students' perceptions regarding the shadowing class.

RESULTS

Ninety-eight students (response rate: 79%) completed the questionnaire. There was a strong relationship amongst Items 1, 8 and 9 ("interested in dentistry as a job," "learning motivation" and "comprehensive evaluation" respectively) based on the results of the correlation and regression analysis. The factor analysis led to three student perceptions as latent factors, namely, "Interesting," "Self-awareness" and "Future Goal," which had a relatively close inter-factor correlation (0.465-0.772).

CONCLUSION

The finding suggests that job shadowing may increase a students' interest in a dentistry career at an early stage of their education and learning motivation, along with generating self-awareness. This programme may present possible educational effectiveness in dental education.

Is Burning Mouth Syndrome Associated with Extraoral Dryness? A Systematic Review

Burning mouth syndrome (BMS) is characterized by a persistent intraoral burning sensation, often experienced by postmenopausal women. The etiology of BMS remains partially understood, and consequently, treatments remain suboptimal. Extraoral manifestations of BMS, such as extraoral dryness, are less studied. However, it has been suggested that the identification of the frequency and patterns of extraoral dryness and potential underlying mechanisms are essential to optimize treatment strategies and reduce the burden of disease. Therefore, we conducted this systematic review to provide existing evidence about extraoral dryness in BMS. The guidelines for the conduction and reporting of systematic reviews were followed. An electronic search was conducted in four major databases-PubMed, Web of Science, COCHRANE Library, and EBSCOhost-and the grey literature was assessed through Google Scholar. From each included article, information on extraoral dryness in BMS was extracted, and odds ratios were calculated for extraoral dryness among BMS patients compared with non-BMS controls. The findings demonstrated higher odds of the prevalence of extraoral dryness in BMS, which was found to a high degree in the lips, eyes, skin, and genitalia. The pattern of spread and locations of extraoral dryness propose a potential central mechanism. Based on our findings, we encourage the standardization of the assessment, recording, and reporting of the extraoral characteristics of BMS, including extraoral dryness, which can lead to better management strategies and enhance the quality of life of the affected patients.

A randomized double-blind clinical trial evaluating comparative plaque and gingival health associated with commercially available stannous fluoride-containing dentifrices as compared to a sodium fluoride control dentifrice

BACKGROUND

Gingivitis is a non-specific inflammatory lesion in response to the accumulation of oral biofilm and is a necessary precursor to periodontitis. Enhanced oral hygiene practices, including utilization of a dentifrice that could significantly improve plaque accumulation and gingival inflammation, is desirable to prevent and treat gingivitis and potentially prevent progression to periodontitis. This clinical study aimed to investigate the effect of a new stannous fluoride-containing dentifrice with 2.6% ethylenediamine tetra acetic acid (EDTA) as an anti-tartar agent to reduce plaque index and gingival index over a 3-month study period compared to other commercially-available fluoride-containing dentifrices.

METHODS

This double-blind, randomized controlled clinical study evaluated plaque, gingival inflammation, and sulcular bleeding in patients using one of five commercially available fluoride-containing dentifrices The dentifrices tested contained: 0.454% stannous fluoride and 2.6% EDTA (D1), 0.24% sodium fluoride (C), and 0.454% stannous fluoride (D2-D4). One hundred fifty subjects participated over a 3-month period. Co-primary endpoints were improvements in plaque index (PI) and modified gingival index (mGI) from baseline values. No professional cleaning was performed during the study period.

RESULTS

All subjects in the study demonstrated statistically significant improvements in all measures of oral hygiene over the 3-month study period. Subjects using dentifrice 1 (D1) showed statistically significantly greater reductions in PI, mGI, and modified sulcular bleeding index (mSBI) compared with all other commercially-available dentifrices tested (p < 0.00001).

CONCLUSIONS

A new dentifrice with 0.454% stannous fluoride and 2.6% EDTA demonstrated significant improvements in clinical parameters associated with gingivitis compared to other sodium and stannous fluoride containing dentifrices.

The Impact of Diabetes Mellitus Duration and Complications on Health-Related Quality of Life Among Type 2 Diabetic Patients in Khamis Mushit City, Saudi Arabia

BACKGROUND AND OBJECTIVES

 Diabetes mellitus is one of the most significant public health problems in Saudi Arabia. Therefore, this study aims to investigate the impact of disease duration and disease complications on health-related quality of life among type 2 diabetic patients.

MATERIALS AND METHODS

A cross-sectional study was conducted on 380 adult diabetic type 2 patients at a tertiary hospital in the city of Khamis Mushit in Saudi Arabia. The participants were asked to complete a pre-validated health status questionnaire (SF-36) consisting of 36 questions measuring eight domains of health, with each domain providing a score from 0 to 100. Demographic and clinical variables were collected using a diabetes type 2 specification form designed to be used in conjunction with the health status questionnaire. The clinical data included variables such as duration of diabetes, co-morbidities, and treatment modality. Statistical analysis was conducted using SPSS version 22 (IBM Corp., Armonk, NY, USA), with differences tested using various statistical tests. Spearman correlation was done between the score and continuous variables, such as age and BMI. A p-value less than 0.05 was considered statistically significant.

RESULTS

Most of the participants (40%) were recently diagnosed with diabetes mellitus (less than one year ago) and 29.5% of the participants were diagnosed with diabetes mellitus within one to five years. The percentage of those with complications was 39.2%, which was mainly diabetic foot (43.4%) followed by nephropathy (29.5%). 46.8% of the participants were admitted due to conditions related to diabetes mellitus. Dietary modifications were prescribed in 38.4% of the participants, 19.5% used non-insulin medications only, 22.6% were on insulin, and 19.5% were using oral medications and insulin. The relationship between diabetes mellitus complications and quality of life domains revealed no significant difference in most of the domains except physical function and general health, which were lower with complicated diabetes melitus. Similarly, the relation between diabetes mellitus duration and quality of life domains was also not significant in all domains except physical function, which was low with a duration of more than 10 years.

CONCLUSIONS

Understandably, the complications associated with diabetes melitus resulted in low quality of life - in terms of physical function and general health - due to the organ-dysfunction associated with poor glycaemic control. Similarly, disease duration greater than 10 years resulted in impaired physical functioning.

Oral-Functioning Questionnaires in Patients with Head and Neck Cancer: A Scoping Review

Background: Oral-functioning impairment can negatively affect the quality of life (QoL) of head and neck cancer (HNC) patients after receiving radiotherapy (RT). Assessment of patient-reported oral functioning throughout treatment can improve patient care. This scoping review aims to propose a definition for oral functioning for HNC patients and to map out the available questionnaires measuring patient-reported oral functioning in RT-treated HNC patients. Methods: A literature search in relevant databases was performed. Each questionnaire was scored on the domains validity, reliability, and responsiveness. Furthermore, the items from the questionnaires were analyzed to define the common denominators for oral functioning in HNC patients. Results: Of the 6434 articles assessed, 16 met the inclusion criteria and employed 16 distinct instruments to evaluate QoL. No questionnaire covered all oral-health-related QoL items nor assessed all aspects of validity, reliability, and responsiveness. Chewing, speaking, and swallowing were the common denominators for oral functioning. Conclusions: Based on the included studies, we suggest using the VHNSS 2.0 questionnaire to assess oral functioning in HNC patients. Furthermore, we suggest to more clearly define oral functioning in HNC patients by focusing on masticatory function (chewing and grinding), mouth opening, swallowing, speaking, and salivation.

Trends in dental care utilisation among the elderly using longitudinal data from 14 European countries: A multilevel analysis

BACKGROUND

The use of dental care among older people is low compared to other forms of health care, with significant health consequences. However, the evidence on the extent to which countries' welfare systems and socio-economic factors influence the uptake of dental care by older people is limited. This study aimed to describe trends of dental care utilisation, and to compare use of dental care with other types of healthcare services among the elderly, considering different socio-economic factors and welfare systems in European countries.

METHODS

Multilevel logistic regression analysis was performed using longitudinal data from four waves (between Wave 5 and 8) of the Survey of Health, Ageing and Retirement in Europe database, with a follow-up period of 7 years. The study sample included 20,803 respondents aged 50 years or older from 14 European countries.

RESULTS

The annual dental care attendance was the highest in Scandinavian countries (85.7%), however, improving trends of dental attendance was recognized in Southern and Bismarckian countries (p<0.001). The difference in use of dental care services between socio-economic groups was expanding over time regarding low- and high-income level and residential area. A more marked difference was observed between social groups in dental care utilisation compared to other forms of care. Income level and unemployed status had significant effect on forgoing dental care due to cost and unavailability.

CONCLUSION

The observed differences between socioeconomic groups may highlight the health consequences of the different organization and financing of dental care. The elderly population could benefit from adopting policies aiming to reduce the financial barriers to dental care usage, especially in Southern and Eastern European countries.

Oral health promotion activities in the workplace: a scoping review

There is limited literature and no reviews on oral health promotion activities in the workplace to guide planning and practice. This review summarizes evidence about oral health promotion activities in the workplace (nature and extent), its impact and the factors that facilitate or act as barriers to implementation. Using the PRISMA-ScR guidelines, scientific articles written in English and published in peer-reviewed journals up to April 2021, from six databases (Medline, PubMed, CINAHL, Scopus, EMBASE and Emcare) were screened and selected. The full texts of 95 articles were then considered; 21 articles met the inclusion criteria of using oral health status or oral health predisposing factors as primary outcome after an intervention in the workplace. Almost all included articles took a quantitative approach (n = 18), two used a qualitative design and another used a mixed-method approach. The most common activities were personalized or group oral health education interventions and oral health screenings conducted by a dental professional. Two studies reported the cost-benefit of workplace oral health promotion (WOHP). The literature indicated that WOHP interventions can be successful in achieving improvements in oral health, measured using a range of clinical (plaque accumulation, gingival inflammation, periodontal inflammation) and self-rated oral health indicators. Based on the limited literature available, WOHP may have benefits for employee oral health and employers, and the support of managers and organizations potentially improves the success of programmes. The workplace would appear to be an ideal setting to promote oral health. However, there is limited information to guide oral health promotion planning and implementation, and policy.

The Effects of a Mandibular Overdenture on Edentulous Patients' Quality of Life: A Clinical Study

Edentulous patients' quality of life can be greatly diminished by the use of a badly fitting removable prosthesis, as many aspects of social life become notably impaired. The object of this study was to evaluate if treating these patients with a two implants mandibular overdenture could improve their quality of life as measured with the Italian version of the OHIP-14 (Oral Health Impact Profile). Edentulous patients, in good clinical condition, were selected. Two implants were placed following the recommended guidelines and three months after new mandibular dentures were manufactured, implants were uncovered and connected to the prosthesis using LOCATOR abutments. OHIP-14 was measured at baseline, one month after delivery and one year after delivery. An improvement was observed even after one month (with a mean reduction of 17 points in OHIP) and that improvement appeared to be stable at the one-year follow-up. Mandibular overdentures can improve a patient's quality of life when compared to a tissue-supported removable complete denture, as long as the patient is subjected to an appropriate follow-up as the retentive rings of the attachment can deteriorate even after two years and lose a great deal of retentive capabilities.