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Dodds MWJ, Haddou MB, Day JEL. The effect of gum chewing on xerostomia and salivary flow rate in elderly and medically compromised subjects: a systematic review and meta-analysis. BMC Oral Health 2023; 23:406. [PMID: 37340436 DOI: 10.1186/s12903-023-03084-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/26/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Xerostomia negatively affects quality of life. Symptoms include oral dryness; thirst; difficulty speaking, chewing, and swallowing food; oral discomfort; mouth soft tissue soreness and infections; and rampant tooth decay. The objective of this systematic review and meta-analysis was to investigate if gum chewing is an intervention that results in objective improvements in salivary flow rates and subjective relief from xerostomia. METHOD We searched electronic databases including Medline, Scopus, Web of Science, Embase, Cochrane Library (CDSR and Central), Google Scholar and the citations of review papers (last searched 31/03/23). The study populations included: 1) elderly people with xerostomia (> 60 years old, any gender, and severity of xerostomia), and 2) medically compromised people with xerostomia. The intervention of interest was gum chewing. Comparisons included gum chewing vs. no gum chewing. The outcomes included salivary flow rate, self-reported xerostomia, and thirst. All settings and study designs were included. We conducted a meta-analysis on studies where measurements of unstimulated whole salivary flow rate for both a gum chewing, and no gum chewing intervention (daily chewing of gum for two weeks or longer) were reported. We assessed risk of bias using Cochrane's RoB 2 and ROBINS-I tools. RESULTS Nine thousand six hundred and two studies were screened and 0.26% (n = 25) met the inclusion criteria for the systematic review. Two of the 25 papers had a high overall risk of bias. Of the 25 papers selected for the systematic review, six met the criteria to be included in the meta-analysis which confirmed a significant overall effect of gum on saliva flow outcomes compared to control (SMD = 0.44, 95% CI: 0.22-0.66; p = 0.00008; I2 = 46.53%). CONCLUSIONS Chewing gum can increase unstimulated salivary flow rate in elderly and medically compromised people with xerostomia. Increasing the number of days over which gum is chewed increases the improvement in the rate of salivation. Gum chewing is linked with improvements in self-reported levels of xerostomia (although it is noted that no significant effects were detected in five of the studies reviewed). Future studies should eliminate sources of bias, standardise methods to measure salivary flow rate, and use a common instrument to measure subjective relief from xerostomia. STUDY REGISTRATION PROSPERO CRD42021254485.
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Affiliation(s)
| | | | - Jon E L Day
- Cerebrus Associates, The White House, 2 Meadrow, Godalming, GU7 3HN, Surrey, UK
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Yeung CYY, Chu CH, Yu OY. A concise review of chewing gum as an anti-cariogenic agent. FRONTIERS IN ORAL HEALTH 2023; 4:1213523. [PMID: 37383517 PMCID: PMC10299855 DOI: 10.3389/froh.2023.1213523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/25/2023] [Indexed: 06/30/2023] Open
Abstract
Chewing gum has been endorsed as a caries preventive agent by the FDI World Dental Federation, the American Dental Association, and the European Food Safety Authority. This review discusses the mechanism and provides an update of the use of chewing gum for caries prevention. Chewing gum typically consists of a water-insoluble gum base, water-soluble added ingredients, and active ingredients. It can be classified as sugar-containing or sugar-free, as well as nonmedicated or medicated. Chewing gum prevents dental caries through a range of mechanisms, including the clearance of the oral cavity, neutralization of oral acidity, inhibition of cariogenic bacterial growth, remineralization of enamel, and reduction of appetite. Recent clinical studies have evaluated the efficacy of sugar-free chewing gum for caries prevention, with most demonstrating positive results, although some studies have reported contradictory outcomes. To achieve optimal caries prevention, it is generally recommended that individuals chew sugar-free gum for five minutes after meals, three times daily.
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Crowe-White KM, Jung SE, Bragg A, Senkus KE. Functional sugar-free chewing gum infused with spices bolsters antioxidant capacity and phenolic content of saliva. Sci Rep 2023; 13:4802. [PMID: 36959196 PMCID: PMC10036468 DOI: 10.1038/s41598-023-30931-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 03/03/2023] [Indexed: 03/25/2023] Open
Abstract
Oral and vascular diseases are seemingly disparate conditions, yet individuals with poor oral health are at increased risk for cardiovascular events. Spice-derived bioactive polyphenols with antioxidant functionality may attenuate mechanisms linking the diseases, namely oxidative stress and inflammation. Acknowledging that novel approaches to increase antioxidant intake are warranted, the purpose of this study was to evaluate the influence of two functional sugar-free gums infused with spices on antioxidant capacity and phenolic content of saliva using the oxygen radical absorbance capacity and Folin-Ciocalteu assays, respectively. Unstimulated followed by stimulated saliva was collected according to a validated method across a prescribed five minute chewing period. Both gums significantly increased hydrophilic, lipophilic, and total antioxidant capacity of saliva (p < 0.05) yet to varying extents. Phenolic content of saliva was significantly higher (p < 0.001) post-chew for both gums. Results suggest spices infused into sugar-free chewing gum bolster the antioxidant capacity of saliva, thereby promoting oral health. Research evaluating the sublingual absorption of spice-derived antioxidants in functional gums and their influence on systemic oxidative stress is warranted.
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Affiliation(s)
- Kristi M Crowe-White
- Department of Human Nutrition, The University of Alabama, 401 Russell Hall, Box 870311, Tuscaloosa, AL, 35487, USA.
| | - Seung Eun Jung
- Department of Human Nutrition, The University of Alabama, 401 Russell Hall, Box 870311, Tuscaloosa, AL, 35487, USA
| | - Anna Bragg
- Department of Human Nutrition, The University of Alabama, 401 Russell Hall, Box 870311, Tuscaloosa, AL, 35487, USA
| | - Katelyn E Senkus
- Department of Human Nutrition, The University of Alabama, 401 Russell Hall, Box 870311, Tuscaloosa, AL, 35487, USA
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Nasseripour M, Newton JT, Warburton F, Awojobi O, Di Giorgio S, Gallagher JE, Banerjee A. A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity. FRONTIERS IN ORAL HEALTH 2022; 3:845921. [PMID: 35434703 PMCID: PMC9006880 DOI: 10.3389/froh.2022.845921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background The aim of this systematic review of published literature was to answer the research question, “What is the difference in the level of plaque quantity, in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG, who do not chew gum, or who use alternatives such as probiotics or fluoride varnish?”. Methods The systematic review [registered on PROSPERO 2018 (CRD42018094676)] included studies on adults and children with chewing of SFG as the main intervention, where “sugar” referred to monosaccharides and disaccharides. Included studies were in English and corresponded to primary research published between 1946 and 2020. The search conducted spanned all relevant databases using both Medical Subject Headings (MESH) and free text with combinations of “chewing gum,” “sugar-free,” “caries,” “xerostomia,” “periodontal disease.” Results Eight articles included plaque quantity as part of their outcomes. Meta-analysis showed that SFG significantly reduced plaque quantity (effect size−0.778; 95% CI−1.167 to−0.39). The correlation between the baseline and the end of study data was assumed to be 0.95 for the control and 0.65 for the SFG group. A sensitivity analysis was conducted with the pre- to post-test correlation, set at 0.95 for the SFG group. This gave an effect size of−1.098 (95% CI−1.539 to−0.656) with I2 = 89.73%. When looking more specifically at xylitol gum, the results of the meta-analysis showed that it significantly reduced plaque quantity (effect size−0.743; 95% CI−1.148 to−0.338). There was a high degree of heterogeneity between studies with I2 = 86.0%. Conclusion There is some evidence that chewing sugar-free gum, in particular xylitol SFG, reduces the quantity of plaque in the oral cavity in comparison to non SFG chewing or no chewing controls. Further research with improved design, lengthier timeframes and higher number of participants should be considered. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=94676.
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Affiliation(s)
- Melanie Nasseripour
- Centre for Dental Education, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, United Kingdom
- *Correspondence: Melanie Nasseripour
| | - Jonathon Timothy Newton
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, United Kingdom
| | - Fiona Warburton
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, United Kingdom
| | - Oluwatunmise Awojobi
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, United Kingdom
| | - Sonya Di Giorgio
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, United Kingdom
| | - Jennifer Elizabeth Gallagher
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, United Kingdom
| | - Avijit Banerjee
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, United Kingdom
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Antiplaque and antigingivitis efficacy of medicated and non-medicated sugar-free chewing gum as adjuncts to toothbrushing: systematic review and network meta-analysis. Clin Oral Investig 2022; 26:1155-1172. [DOI: 10.1007/s00784-021-04264-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/26/2021] [Indexed: 12/28/2022]
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Elmokanen M, Ezzat M, Ibrahim A, Shaalan O. Effect of dissolving xylitol chewable tablets versus xylitol chewing gum on bacterial count and salivary pH in geriatric bedridden patients: A randomized clinical trial. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_205_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Söderling E, Pienihäkkinen K. Effects of xylitol chewing gum and candies on the accumulation of dental plaque: a systematic review. Clin Oral Investig 2021; 26:119-129. [PMID: 34677696 PMCID: PMC8791908 DOI: 10.1007/s00784-021-04225-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022]
Abstract
Objectives A systematic review of published data was conducted with the aim of assessing the effects of xylitol consumption on the amount of dental plaque. Materials and methods Electronic and hand searches were performed to find clinical studies concerning the effects of xylitol chewing gum or candies on dental plaque. Prospective randomized controlled clinical trials published between 1971 and 2020 conducted in healthy subjects were included in the review. Results The initial search identified 424 xylitol articles. After applying inclusion and exclusion criteria, altogether 14 articles (16 studies) were reviewed. The review identified 12 of the total of 14 xylitol chewing gum studies as having fair or high quality. In 13 of the 14 chewing gum studies, xylitol gum decreased plaque accumulation. In six studies, xylitol gum chewing decreased plaque compared to sorbitol gum, and in three studies compared to gum base/no gum. In three fair-quality studies conducted with xylitol candies, plaque accumulation did not change. Conclusions Habitual xylitol gum chewing appears to show plaque-reducing effects that differ from those of sorbitol gum. This suggests specific effects for xylitol on plaque accumulation. Xylitol candies appear not to decrease plaque. The heterogeneity of the studies warrants further research. Clinical relevance Habitual xylitol gum chewing is likely to decrease plaque.
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Affiliation(s)
- Eva Söderling
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland.
| | - Kaisu Pienihäkkinen
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
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Nasseripour M, Newton JT, Warburton F, Awojobi O, Di Giorgio S, Gallagher JE, Banerjee A. A systematic review and meta-analysis of the role of sugar-free chewing gum on Streptococcus mutans. BMC Oral Health 2021; 21:217. [PMID: 33926448 PMCID: PMC8082871 DOI: 10.1186/s12903-021-01517-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/15/2021] [Indexed: 11/22/2022] Open
Abstract
Background Preventive strategies targeting Streptococcus mutans may be effective in reducing the global burden of caries. The aim of the current systematic review of published literature was to determine the difference in level of Streptococcus mutans in adults and children who chew sugar-free gum (SFG), compared with those who did not chew gum, who chewed a control gum or received alternatives such as probiotics or fluoride varnish.
Methods Systematic review (PROSPERO registration No. CRD42018094676) of controlled trials with adult and child participants where chewing of SFG was the main intervention. Databases searched (1 Jan 1946 to 31 August 2020): MEDLINE, EMBASE, PsycINFO, Scopus, Web of Science, Allied and Complimentary Medicine Database, Cochrane Central Register of Controlled Trials (CENTRAL), Open Grey, PROSPERO and the Cochrane library of systematic reviews. ‘Search terms included Medical Subject Headings, and free text to cover the following range of constructs: chewing gum, sugar free, oral health, caries, xerostomia, periodontal disease. Data extraction and Risk of Bias assessment was undertaken by three researchers using a modified version of the Cochrane RoB tool (version 1). Data synthesis was conducted using meta-analysis in STATA. Results Thirteen studies of SFG with micro-organisms as outcomes were identified. The use of SFG significantly reduced the load of Streptococcus mutans (effect size − 0.42; 95% CI − 0.60 to − 0.25) compared to all controls. In seven of the 13 studies the confidence intervals of the effect size estimate included zero, suggesting no effect of the intervention. Twelve trials used xylitol gum only as the basis of the intervention; xylitol gum significantly reduced the load of Streptococcus mutans (effect size − 0.46; 95% CI − 0.64 to − 0.28) in comparison to all controls. There was a moderate level of heterogeneity across the included studies. No adverse effects were recorded. Conclusion Chewing SFG reduces the load of Streptococcus mutans in the oral cavity in comparison to non-chewing controls. Considering the degree of variability in the effect and the moderate quality of the trials included, there is a need for future research exploring the use SFG as a preventive measure for reducing the cariogenic oral bacterial load. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01517-z.
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Affiliation(s)
- Melanie Nasseripour
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 26, Guy's Dental Hospital, Great Maze Pond, London, SE1 9RT, UK.
| | - Jonathon Timothy Newton
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 26, Guy's Dental Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Fiona Warburton
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 26, Guy's Dental Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Oluwatunmise Awojobi
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 26, Guy's Dental Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Sonya Di Giorgio
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 26, Guy's Dental Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Jennifer Elizabeth Gallagher
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 26, Guy's Dental Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Avijit Banerjee
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 26, Guy's Dental Hospital, Great Maze Pond, London, SE1 9RT, UK
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Ruiz Núñez MDR, da Luz Raulino M, Goulart Castro R, Schaefer Ferreira de Mello AL. Dental plaque control strategies for the elderly population: A scoping review. Int J Dent Hyg 2021; 20:167-181. [PMID: 33829631 DOI: 10.1111/idh.12497] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 03/23/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To review the scientific literature and identify dental plaque control strategies focussed on elderly people that improve plaque indices. DESIGN Scoping review (Joanna Briggs protocol). DATA SOURCES Individual search strategies developed for six databases. The selection of the manuscripts in two phases: title and abstract review, and complete review. ELIGIBILITY CRITERIA Studies on interventions for plaque control in elderly people (60y+). Epidemiological studies and those focussed on caregivers, health professionals and periodontal maintenance therapies were excluded. RESULTS The initial search yielded 2803 studies, 26 were included. The results were classified into: exclusively chemical (10), educational (9), exclusively mechanical (6), and combined mechanical and chemical (1). The studies reported different types of interventions: sugarless chewing gum, chlorhexidine (CHX) in different preparations and concentrations, mouthwash based on essential oils, stannous/sodium fluoride dentifrice and lactoferrin/lactoperoxidase tablets. Additionally, conventional and alternative toothbrushes and professional brushing were tested. Educational interventions included oral hygiene guidance, verbal information, and demonstrations of dental and denture cleaning procedures, and lifestyle changes. Many studies have reported strategies that improve dental plaque indices but without statistical significance when compared to control groups. Promising results were found with the use of CHX, sugarless chewing gum, professional brushing and educational strategies with demonstration, but the results were not long-lasting. CONCLUSION The literature reports that mechanical, chemical and educational strategies have some efficacy in dental plaque control in the elderly population. The results should be viewed with caution, considering the type of intervention (isolated or combined) and the maintenance of the results obtained.
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Affiliation(s)
| | | | - Renata Goulart Castro
- Post-Graduation Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
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Interventions to improve oral health of older people: A scoping review. J Dent 2020; 101:103451. [PMID: 32810577 DOI: 10.1016/j.jdent.2020.103451] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/06/2020] [Accepted: 08/12/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES A range of interventions have been tested to improve oral health of older people. We performed a scoping review to map interventions' aims, outcome measures and findings, and to locate them on different levels of care. DATA We systematically screened for (1) controlled studies on (2) people over 65 years of age, (3) comparing at least two interventions to improve oral health. Interventions were summarized according to their aims and the employed intervention type, mapped on their level of action, and classified as primary/secondary/tertiary prevention. SOURCES Studies retrieved via MEDLINE, EMBASE, CINAHL. STUDY SELECTION Eighty-one studies (published 1997-2019, conducted mainly in high-income countries) were included. Sample sizes varied (n = 24-1987). Follow-up was 0.25-60 months. Most studies (64/81) found a statistically significant benefit of the intervention. A total of 13 different aims were identified, and a range of intervention types employed (e.g. educational interventions, professional oral healthcare, restorative treatment, fluoride application and, generally, dentifrices, mouthwashes, chewing gums/food supplements). Most studies were located on the carer/patient level (56/81 studies) or the system/policy-maker level (44/81). The majority of studies aimed for primary prevention (64/81). CONCLUSIONS Oral health improvement interventions are widely studied. However, study aims, methods and outcome measures are highly heterogeneous, which limits the ability for robust conclusions. Current research focusses on primary prevention on the level of patients/carers or system/policy-maker level. Future studies may want to consider interventions on dentists' level focussing on secondary prevention. These studies should rely on a core set of comprehensive, standardized set of outcome measures. CLINICAL SIGNIFICANCE While specific interventions seem efficacious to improve older people's oral health, the current body of evidence is neither comprehensive (significant gaps exists in relevant levels of the care process) nor comparable enough to draw robust conclusions.
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Newton JT, Awojobi O, Nasseripour M, Warburton F, Di Giorgio S, Gallagher JE, Banerjee A. A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum in Dental Caries. JDR Clin Trans Res 2019; 5:214-223. [PMID: 31743654 DOI: 10.1177/2380084419887178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To determine the difference in level of dental caries in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG or use alternatives such as lozenges, candies, rinses, tablets, and other nonchewing controls. METHODS Systematic review of published literature. RESULTS Twelve studies of interventions of SFG for dental caries outcomes were included. SFGs were found to significantly reduce caries increment, giving a preventative fraction (PF) of 28% (95% CI, 7% to 48%). Including the 8 trials that used xylitol gum only as the basis of the intervention, the PF was 33% (95% CI, 4% to 61%). No adverse effects were recorded. There was a high level of heterogeneity among the trials included. CONCLUSION The findings of this review provide tentative evidence that chewing SFG reduces caries increment in comparison to nonchewing controls. However, there is a considerable degree of variability in the effect and the trials included were generally of moderate quality. There is a need for future research to explore the acceptability and feasibility of the use of SFG as a public health intervention (PROSPERO 2018 CRD42018094676). KNOWLEDGE TRANSFER STATEMENT The results of this study can be used by clinicians when deciding how best to implement dental caries prevention regimes for their patients. With consideration of cost and patient preference, this information could help to develop national policy directives on caries prevention and dictate the direction of future clinical research.
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Affiliation(s)
- J T Newton
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - O Awojobi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - M Nasseripour
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - F Warburton
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - S Di Giorgio
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - J E Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - A Banerjee
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
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Martini D, Galli C, Guareschi C, Angelino D, Bedogni G, Biasini B, Zavaroni I, Pruneti C, Ventura M, Galli D, Mirandola P, Vitale M, Dei Cas A, Bonadonna RC, Passeri G, Del Rio D. Claimed effects, outcome variables and methods of measurement for health claims on foods proposed under Regulation (EC) 1924/2006 in the area of oral health. NFS JOURNAL 2018. [DOI: 10.1016/j.nfs.2017.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Deutsch A, Siegel E, Cations M, Wright C, Naganathan V, Brodaty H. A pilot study on the feasibility of training nurses to formulate multicomponent oral health interventions in a residential aged care facility. Gerodontology 2017; 34:469-478. [PMID: 28836301 DOI: 10.1111/ger.12295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This 10 weeks feasibility study investigated whether residential care nurses with 12 hours advanced oral health training in assessments and saliva testing could formulate, implement and monitor individualised oral care plans of early dementia residents. METHOD Four trained lead advocate nurses using SXI-D, OHIP14, oral health assessment tool (OHAT) assessments and a modified saliva test formulated nurse scheduled comprehensive oral care plans (NSCOCPs) by selecting and scheduling preventive products and procedures multiple times throughout the day to alkalise the mouth of 8 residents as an adjunct to assisted brushing and high-fluoride toothpaste. RESULTS Nurse assessments, saliva tests and care plans were validated against oral health therapist (OHT) findings. Care plan agreement between Nurse and OHT intervention selection and scheduling was high (75%-88%). Untrained nurse compliance was very high, 86%-99% for the 4930 scheduled interventions. Untrained nurses delivered multiple scheduled interventions by following NSCOCPs despite initially not understanding the reason for each of 9 interventions categories. NSCOCPs could track and monitor whether a recommended intervention had been completed by general nursing staff over 3 nursing shifts. CONCLUSION The role of nurses may have to be expanded beyond traditional roles to meet the growth and changes in oral health needs in residential facilities. Intensive training of a few lead advocate nurses to assess risk and formulate individualised NSCOCPs provides a method to transfer knowledge to untrained staff and deliver multicomponent preventive interventions soon after entry into residential care where timely visits by dental professionals to examine residents and prescribe preventive interventions are infrequent or unlikely.
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Affiliation(s)
- Alan Deutsch
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Emma Siegel
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Monica Cations
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, University of Sydney, Concord, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
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Conscious sedation: is this provision equitable? Analysis of sedation services provided within primary dental care in England, 2012-2014. BDJ Open 2016; 2:16002. [PMID: 29607063 PMCID: PMC5842861 DOI: 10.1038/bdjopen.2016.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 12/04/2015] [Accepted: 12/08/2015] [Indexed: 11/22/2022] Open
Abstract
Aim: Patients receiving primary dental care may occasionally require conscious sedation as an adjunct to care. It is one of a range of options to support anxious patients or those undergoing difficult procedures. The aim of this study was to examine patterns of conscious sedation within primary dental care in relation to patient demography, deprivation status, geography (local authority, region) and type of care (Band) within England to examine equity in distribution of service provision. Materials and Methods: Descriptive analysis of cross-sectional primary dental care data, obtained from national claims held by the National Health Service (NHS) Business Services Authority, on patients who had received one or more courses of care involving sedation. Results: Just under 137,000 episodes of care involving sedation are provided for over 120,000 patients per year, the majority of which are for adults. Four out of ten (41%) patients were children, with 6–12-year-olds forming the largest group; 6% were aged under six years. Eleven per cent of patients had more than one course of care involving sedation, with adults aged 25–34 years having the highest rate: 1.17 (s.d.: 0.887) in 2012/2013 and 1.16 (s.d.: 0.724) in 2013/2014. There was a clear social gradient, whereby the most deprived quintile had the highest volume of patients that had received sedation at least once in primary dental care in both years (31.5%). Whilst there was a clear social gradient amongst children and young adults who received sedation, the gradient flattened among middle-aged and was flat amongst older adults. The majority of courses of care involving sedation were associated with Band 2 claims for care (88.6% in 2012/2013; 88.8 in 2013/2014). Whilst one or more patients in all higher tier local authorities received care involving sedation, there were marked geographic inequalities. Discussion: Patients receive sedation in support of NHS primary dental care across the life course and social spectrum. Whilst the pattern of uptake of care parallels the social gradient in younger age groups overall, there are clear geographical inequalities in provision. As sedation is only one of a series of adjuncts to care which may be provided across different sectors of the health system, a wider systems analysis should be undertaken as the findings raise important issues about equitable access to appropriate care. Furthermore, there should be a greater emphasis on prevention to reduce the need for care. The implications for child oral health, access and quality are discussed.
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Matthews F. The use of sugar free chewing gum as a supplement in the prevention of dental caries. Narrative Review. JOURNAL OF ORAL RESEARCH 2015. [DOI: 10.17126/joralres.2015.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hashiba T, Takeuchi K, Shimazaki Y, Takeshita T, Yamashita Y. Chewing Xylitol Gum Improves Self-Rated and Objective Indicators of Oral Health Status under Conditions Interrupting Regular Oral Hygiene. TOHOKU J EXP MED 2015; 235:39-46. [DOI: 10.1620/tjem.235.39] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Takafumi Hashiba
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
| | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
| | - Yoshihiro Shimazaki
- Department of Hygiene and Oral Health, School of Dentistry, Aichi Gakuin University
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
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