1
|
Ilango P, Mahendra J, Mahendra L, Cherian SM, Suresh V, Mahalingam A, Khanna VV, Vummidi AV, Thanigaimalai A, Dave PH. Evidence linking the association of periodontal viruses and pentraxins in periodontitis patients with coronary artery disease. J Periodontol 2024; 95:325-336. [PMID: 37483128 DOI: 10.1002/jper.23-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/24/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Although there is ample evidence in the literature supporting a significant positive association between key periodontal pathogens and established inflammatory markers of periodontitis and coronary artery disease (CAD), their exact role remain unclear. Especially, the role of viruses in the etiology and specific biomarkers have not been validated. Thus, the current study aims to evaluate the role of periodontal viruses such as Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV), as well as the inflammatory marker pentraxin-3 (PTX3), and to analyze their association with CAD. METHODS The study included 240 patients divided into four groups of 60 patients each: nonperiodontitis + noncardiac (NP+NC) group, periodontitis + noncardiac patients (P+NC) group, nonperiodontitis + cardiac patients (NP+C) group, and periodontitis + cardiac (P+C) group. The cardiac surgery group (C-S) was a subgroup of NP+C and P+C. It consisted of 60 patients from the abovementioned two cardiac groups in whom coronary artery bypass graft (CABG) was indicated. Demographic variables, cardiac parameters, and periodontal parameters were recorded. The viruses (EBV, CMV, and HSV) and the inflammatory marker PTX3 were evaluated in the subgingival plaque samples of all the four groups and atheromatous plaque samples of the C-S using reverse transcriptase-polymerase chain reaction (RT-PCR) and quantitative polymerase chain reaction (qPCR), respectively, and were compared between the groups. The results were obtained and statistically analyzed. RESULTS The demographic variables did not differ significantly between the groups, except for age. Systolic blood pressure, diastolic blood pressure, low-density lipoprotein, and random blood sugar were significantly higher in NP+C and P+C, whereas high-density lipoprotein was significantly lower (p ≤ 0.05) in the same. Plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were significantly higher (p ≤ 0.05) in P+NC and P+C. PTX were significantly elevated in P+C among the four groups. On evaluating the subgingival plaque samples, EBV and CMV were significantly higher in the two periodontitis groups P+NC and P+C (p = 0.000). HSV was significantly higher in the two cardiac groups (NP+C and P+C) (p ≤ 0.05). Cardiac EBV and CMV were significantly elevated in the P+C group with a p value of 0.004 and 0.033, respectively. Cardiac HSV was found in the NP+C group with statistical insignificance (p = 0.410) between the groups. On correlation, oral PTX were significantly associated with bleeding index (BI), PPD, and CAL (p = 0.000). Similarly, cardiac PTX showed significant association with PI, BI, PPD, and CAL (p = 0.000). Oral and cardiac PTX also showed significant correlation with each other. Multiple logistic regression analysis revealed a significant association between CAL and oral EBV (p ≤ 0.05). Similarly, cardiac EBV showed a significant association with CAL and oral EBV (p ≤ 0.05). Multiple logistic regression analysis also revealed that both cardiac and oral PTX showed a significant association only with oral EBV, CMV, and HSV. CONCLUSION The results of the current study suggest that the clinical severity of periodontitis (CAL), etiology of periodontitis (EBV and CMV), and inflammatory marker of periodontitis (PTX3) were found to be significantly elevated in CAD. These findings suggests that periodontal diseases may be a risk factor that could influence the progression of CAD.
Collapse
Affiliation(s)
- Paavai Ilango
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Little Mahendra
- Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Sanjay M Cherian
- Department of Cardiac Surgery, Frontier Lifeline Hospital, Chennai, India
| | - Vasugi Suresh
- Department of Physiology, Indira Medical College and Hospital, Chennai, India
| | - Arulpari Mahalingam
- Department of Pedodontics, Thai Moogambigai Dental College & Hospital, Chennai, India
| | - V Vinoth Khanna
- Department of Animal Biotechnology, Madras Veterinary College, Vepery, Chennai, India
| | - Ayswarya V Vummidi
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Abirami Thanigaimalai
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Pavithra H Dave
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India
| |
Collapse
|
2
|
Fisher J, Berman R, Buse K, Doll B, Glick M, Metzl J, Touger-Decker R. Achieving Oral Health for All through Public Health Approaches, Interprofessional, and Transdisciplinary Education. NAM Perspect 2023; 2023:202302b. [PMID: 37273458 PMCID: PMC10238101 DOI: 10.31478/202302b] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Affiliation(s)
| | | | - Kent Buse
- George Institute for Global Health, Imperial College London
| | | | | | | | | |
Collapse
|
3
|
Bangera MK, Kotian R, Madhyastha P. Effects of silver nanoparticle-based antimicrobial formulations on the properties of denture polymer: A systematic review and meta-analysis of in vitro studies. J Prosthet Dent 2023; 129:310-321. [PMID: 34176655 DOI: 10.1016/j.prosdent.2021.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM Denture stomatitis and other oral infections are prevalent in denture wearers and can be treated effectively with an antimicrobial agent such as a silver nanoparticle-based polymer. However, the physical properties of the denture should not be adversely affected by the addition. PURPOSE The purpose of this systematic review and meta-analysis of in vitro studies was to analyze the effects of a silver nanoparticle-based antimicrobial resin on the properties of polymethyl methacrylate(PMMA)-based denture resin. MATERIAL AND METHODS Full-length English language articles reporting silver nanoparticle-based PMMA resin were included in the review, with no limitation on the year till May 2020. Scopus, Web of Sciences, and PubMed databases were accessed for the literature survey. The review was formulated based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and used the Consolidated Standards of Reporting Trials (CONSORT) guidelines and risk of bias Cochrane tool for quality assessment. A meta-analysis of flexural strength was performed by using a random-effects model at a 95% confidence interval. The other properties were analyzed descriptively. RESULTS Silver nanoparticle reinforcement caused considerable differences in the inherent physical material properties of PMMA. CONCLUSIONS An antimicrobial polymer nanocomposite formulation can either negatively affect or bring no improvement to the physical properties of denture resin.
Collapse
Affiliation(s)
- Madhu Keshava Bangera
- PhD Research Scholar, Department of Dental Materials, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ravindra Kotian
- Professor, Department of Dental Materials, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Prashanthi Madhyastha
- Professor and Head, Department of Dental Materials, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
4
|
Zhou T, Xu W, Wang Q, Jiang C, Li H, Chao Y, Sun Y, A L. The effect of the "Oral-Gut" axis on periodontitis in inflammatory bowel disease: A review of microbe and immune mechanism associations. Front Cell Infect Microbiol 2023; 13:1132420. [PMID: 36923589 PMCID: PMC10008960 DOI: 10.3389/fcimb.2023.1132420] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 01/31/2023] [Indexed: 03/02/2023] Open
Abstract
Periodontitis and inflammatory bowel diseases (IBD) are inflammatory diseases of the gastrointestinal tract that share common features of microbial-induced ecological dysregulation and host immune inflammatory response. The close relationship between periodontitis and IBD is characterized by a higher prevalence of IBD in patients with periodontitis and a higher prevalence and severity of periodontitis in patients with IBD, indicating that periodontitis and IBD are different from the traditional independent diseases and form an "Oral-Gut" axis between the two, which affect each other and thus form a vicious circle. However, the specific mechanisms leading to the association between the two are not fully understood. In this article, we describe the interconnection between periodontitis and IBD in terms of microbial pathogenesis and immune dysregulation, including the ectopic colonization of the gut by pathogenic bacteria associated with periodontitis that promotes inflammation in the gut by activating the host immune response, and the alteration of the oral microbiota due to IBD that affects the periodontal inflammatory response. Among the microbial factors, pathogenic bacteria such as Klebsiella, Porphyromonas gingivalis and Fusobacterium nucleatum may act as the microbial bridge between periodontitis and IBD, while among the immune mechanisms, Th17 cell responses and the secreted pro-inflammatory factors IL-1β, IL-6 and TNF-α play a key role in the development of both diseases. This suggests that in future studies, we can look for targets in the "Oral-Gut" axis to control and intervene in periodontal inflammation by regulating periodontal or intestinal flora through immunological methods.
Collapse
Affiliation(s)
- Tianyu Zhou
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Wenzhou Xu
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
| | - Qiqi Wang
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Cong Jiang
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Hongyan Li
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Yang Chao
- Department of Gastroendoscopy, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yue Sun
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
- *Correspondence: Yue Sun, ; Lan A,
| | - Lan A
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
- *Correspondence: Yue Sun, ; Lan A,
| |
Collapse
|
5
|
Teles F, Collman RG, Mominkhan D, Wang Y. Viruses, periodontitis, and comorbidities. Periodontol 2000 2022; 89:190-206. [PMID: 35244970 DOI: 10.1111/prd.12435] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Seminal studies published in the 1990s and 2000s explored connections between periodontal diseases and systemic conditions, revealing potential contributions of periodontal diseases in the initiation or worsening of systemic conditions. The resulting field of periodontal medicine led to the publication of studies indicating that periodontal diseases can influence the risk of systemic conditions, including adverse pregnancy outcomes, cardiovascular and respiratory diseases, as well as Alzheimer disease and cancers. In general, these studies hypothesized that the periodontal bacterial insult and/or the associated proinflammatory cascade could contribute to the pathogenesis of these systemic diseases. While investigations of the biological basis of the connections between periodontal diseases and systemic conditions generally emphasized the bacteriome, it is also biologically plausible, under an analogous hypothesis, that other types of organisms may have a similar role. Human viruses would be logical "suspects" in this role, given their ubiquity in the oral cavity, association with periodontal diseases, and ability to elicit strong inflammatory response, compromise immune responses, and synergize with bacteria in favor of a more pathogenic microbial consortium. In this review, the current knowledge of the role of viruses in connecting periodontal diseases and systemic conditions is examined. We will also delve into the mechanistic basis for such connections and highlight the importance of those relationships in the management and treatment of patients.
Collapse
Affiliation(s)
- Flavia Teles
- Department of Basic and Translational Sciences, School of Dental Medicine, Center for Innovation & Precision Dentistry, School of Dental Medicine & School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ronald G Collman
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Dana Mominkhan
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yu Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
6
|
Ratanajanchai M, Kanchanavasita W, Suputtamongkol K, Wonglamsam A, Thamapipol S, Sae-Khow O. Heat-cured poly(methyl methacrylate) resin incorporated with different food preservatives as an anti-microbial denture base material. J Dent Sci 2021; 16:706-712. [PMID: 33854722 PMCID: PMC8025184 DOI: 10.1016/j.jds.2020.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/12/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND/PURPOSE The colonization of microorganisms onto denture bases is one common problem that can contribute to oral diseases. Herein, three food preservatives, including zinc oxide, potassium sorbate, and sodium metabisulfite were introduced as anti-microbial additives into a heat-polymerized poly(methyl methacrylate) (PMMA). MATERIALS AND METHODS Relative microbial reductions of the modified PMMA resins against Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans were evaluated. The in vitro cytotoxicity of the materials was measured against mouse fibroblast L929 cells. A three-point flexural test was performed to determine a flexural strength and modulus properties of the materials. RESULTS The incorporation of all preservative agents into the material diminished the microbial growth of three microbial species. The PMMA resin combined with sodium metabisulfite exhibited the greatest anti-microbial activity that reduced almost all bacterial cells and about 40% of C. albicans. All modified resins showed no significant cytotoxicity against L929 cells. The addition of food preservatives did not significantly alter the flexural strength of the PMMA resin (∼84-92 MPa). However, the flexural modulus of the PMMA incorporated with food preservatives (∼2,024-2,144 MPa) was significantly lower than the unmodified PMMA. CONCLUSION Three food preservatives, especially sodium metabisulfite, could be applied as anti-microbial additives into the denture base resin. The PMMA incorporated with the additives did not show cytotoxicity. Although, the addition of the food preservatives altered the mechanical properties, the materials still provided acceptable flexural properties.
Collapse
Affiliation(s)
- Montri Ratanajanchai
- Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Kallaya Suputtamongkol
- Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Amonrat Wonglamsam
- Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | | |
Collapse
|
7
|
Gao SS, Chu CH, Young FYF. Oral Health and Care for Elderly People with Alzheimer's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165713. [PMID: 32784777 PMCID: PMC7460333 DOI: 10.3390/ijerph17165713] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/29/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023]
Abstract
Dementia is one of the main causes of disability among elderly people. It is a progressive neurodegenerative disease that affects elderly people’s ability to perform daily living activities. Alzheimer’s disease is the main subtype of dementia and causes declining memory, reasoning, and communication skills. They also have behavioural and psychological symptoms, such as depression and aggression. It is essential for them to maintain good oral health, as oral health is an important and integral part of their general health. Neglecting oral health allows dental diseases to develop, and these diseases are difficult and costly to treat. However, dental diseases can be treated with ambulatory care rather than hospitalisation and emergency care. Elderly people should establish daily oral hygiene care routines during the early stages of Alzheimer’s disease. They should have regular dental examinations and early minimal interventions to prevent the need for extensive and complicated procedures. Maintaining oral health becomes challenging, however, when Alzheimer’s disease progresses to the middle and late stages. Because elderly people might forget or lose interest in keeping their teeth healthy, caretakers and community health workers may need to take over this task. Dentists should provide guidance on the maintenance of oral health, as the techniques used to provide this support vary depending on the elderly people concerned. The purpose of this paper is to provide an overview of oral health and the importance of oral care for elderly people with Alzheimer’s disease. The paper also discusses appropriate dental interventions and techniques for maintaining good oral health and helping people with Alzheimer’s to enjoy a satisfactory quality of life.
Collapse
Affiliation(s)
- Sherry Shiqian Gao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China;
- Correspondence: ; Tel.: +852-2859-0439
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China;
| | - Fanny Yuk Fun Young
- Department of Business Administration, Hong Kong Shue Yan University, Hong Kong 999077, China;
| |
Collapse
|
8
|
Chalittikul W, Kassim S, Sabbah W. The association between number of teeth and physical function limitation among older adults in the USA. Gerodontology 2020; 37:389-394. [PMID: 32710496 DOI: 10.1111/ger.12489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/17/2020] [Accepted: 07/05/2020] [Indexed: 12/13/2022]
Abstract
AIM To examine the association between the number of teeth and physical function limitation (PFL), as an indicator of frailty, among older adults in the USA. BACKGROUND Physical function limitation is common among the elderly and potentially associated with oral health, particularly the number of extracted teeth. MATERIALS AND METHODS Data from the Behavioral Risk Factor Surveillance System 2014 (BRFSS, 2014), a cross-sectional national interview survey of US population, were analyzed. The number of participating older adults aged 65 and over was 158 962. The association between PFL, outcome and number of extracted teeth, demographic data, socio-economic status, smoking, general health, comorbidity conditions and body mass index (BMI) was assessed using logistic regression analyses. RESULTS The prevalence of PFL was 28%. In the fully adjusted model, the number of extracted teeth had a significant association with PFL: edentulous older adults had higher odds for PFL, (odds ratio [OR]:1.36; 95%CI: 1.22, 1.52). Similarly, those who lost 6 teeth or more but not all were likely to have PFL (OR 1.35: 95% CI: 1.23, 1.48). CONCLUSIONS There was a significant association between the number of extracted teeth and PFL among US older adults aged 65 and more, based on the data from BRFSS 2014. The findings indicate that losing teeth may be a potential risk for PFL.
Collapse
Affiliation(s)
- Warut Chalittikul
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Saba Kassim
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| |
Collapse
|
9
|
Binns R, Li W, Wu CD, Campbell S, Knoernschild K, Yang B. Effect of Ultraviolet Radiation on
Candida albicans Biofilm
on Poly(methylmethacrylate) Resin. J Prosthodont 2020; 29:686-692. [DOI: 10.1111/jopr.13180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 01/05/2023] Open
Affiliation(s)
- Randold Binns
- Department of Restorative Dentistry College of Dentistry, UIC Chicago IL
| | - Wei Li
- Department of Pediatric Dentistry College of Dentistry, UIC Chicago IL
| | - Christine D. Wu
- Department of Pediatric Dentistry College of Dentistry, UIC Chicago IL
| | - Stephen Campbell
- Department of Restorative Dentistry College of Dentistry, UIC Chicago IL
| | - Kent Knoernschild
- Department of Restorative Dentistry College of Dentistry, UIC Chicago IL
| | - Bin Yang
- Department of Restorative Dentistry College of Dentistry, UIC Chicago IL
| |
Collapse
|
10
|
Hoben M, Yoon MN, Lu L, Estabrooks CA. If we cannot measure it, we cannot improve it: Understanding measurement problems in routine oral/dental assessments in Canadian nursing homes-Part I. Gerodontology 2019; 37:153-163. [PMID: 31774205 DOI: 10.1111/ger.12449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/26/2019] [Accepted: 10/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items collected by nursing home (NH) care staff to (a) assessments collected by trained research assistants (RAs) and (b) "gold standard" clinical assessments by dental hygienists (DHs). BACKGROUND Routine collection of RAI oral/dental items is mandatory in most Canadian NHs. However, the performance of these items is less than optimal and oral/dental problems are severely under-reported. Accurate assessment is a prerequisite for preventing, detecting and treating oral health problems. Not knowing the reasons for performance problems is a barrier to improving performance of the RAI oral/dental items. MATERIALS AND METHODS We included 103 NH residents from 4 NHs in Edmonton, Alberta, Canada. Using Kappa statistics, we compared the agreement of residents' last (no older than 90 days) RAI assessment with RAI assessments completed by trained RAs and "gold standard" clinical assessments by DHs. We also assessed the inter-rater reliability (IRR) of RA and DH assessments. RESULTS Care staff assessments had poor agreement with RA and DH assessments (Kappa < 0.2 for most items). RAs and DHs identified more oral/dental problems than care staff. However, IRR of RA assessments was low (Kappa < 0.7 for 7/9 items). IRR of DH assessments was acceptable (Kappa > 0.7) for most items. CONCLUSIONS The quality of RAI oral/dental assessments can be improved by better training care staff and ensuring appropriate time to do the assessments. However, remaining problems-even with trained RAs-suggest that rewording some of the items or supplementing them by more robust tools may be required.
Collapse
Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Minn N Yoon
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lily Lu
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | |
Collapse
|
11
|
Kheirmand Parizi M, Akbari H, Malek-Mohamadi M, Kheirmand Parizi M, Kakoei S. Association of salivary levels of immunoglobulin-a and amylase with oral-dental manifestations in patients with controlled and non-controlled type 2 diabetes. BMC Oral Health 2019; 19:175. [PMID: 31387562 PMCID: PMC6685263 DOI: 10.1186/s12903-019-0868-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/29/2019] [Indexed: 01/10/2023] Open
Abstract
Background Oral health is related to general health and one of the most prevalent chronic diseases is diabetes mellitus. Diabetes can have adverse effects on oral health and vice versa. Saliva analysis can be used as a non-invasive method to obtain information about diseases status like diabetes. The aim of present study was to evaluate the salivary immunoglobulin-A (s-IgA) and salivary amylase levels and their associations with oral-dental manifestations in patients with controlled and non-controlled type 2 diabetes. Methods This case-control study was carried out on 90 subjects who referred to the Diabetes Center of Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran. Participants were divided into three groups: 1) uncontrolled diabetic patients (n = 30); 2) controlled diabetic patients (n = 30); and 3) healthy individuals (n = 30). Unstimulated salivary levels of I-A and amylase were measured. All participants underwent a dental and periodontal examination to explore the oral and dental manifestations. T-test, chi-square and ANOVA tests were used for data analysis in SPSS 18. Results Significant higher level of s-IgA was found in uncontrolled diabetic patients compared to controlled diabetic (P ≤ 0.0001) and the control group (P = 0.004). Moreover, the mean levels of s-amylase in uncontrolled patients was significantly higher compared to controlled diabetic (P = 0.01) and the control group (P ≤ 0.0001). Uncontrolled diabetic patients with oral candidiasis, erythematous candidiasis, abscesses, or xerostomia had higher s-IgA levels compared to the controlled diabetic participants. Moreover, uncontrolled diabetic patients with oral candidiasis or erythematous candidiasis showed a significant higher levels of s-amylase compared to controlled diabetic patients. Also, significant positive correlations were found between s-IgA and DMFT and s-IgA and PDI (r = 0.444, P = 0.014 and r = 0.386, P = 0.035, respectively). Conclusion In conclusion, higher s-amylase and s-IgA concentrations may reflect oral-dental manifestations in T2DM. Moreover, the current findings suggest that s-amylase and s-IgA may serve as a complementary and alternative fluid in screening for diabetes mellitus.
Collapse
Affiliation(s)
- Marjan Kheirmand Parizi
- Dentist, Student Research Committee, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamed Akbari
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.,Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahsa Malek-Mohamadi
- Community Oral Health Department, School of dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shahla Kakoei
- Oral and Dental Diseases Research Center, Dental School, Kerman University of Medical Sciences, Kerman, Iran. .,Department of Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
| |
Collapse
|
12
|
Yoon HY, Shim SS, Kim SJ, Lee JH, Chang JH, Lee SH, Ryu YJ. Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia. J Am Med Dir Assoc 2019; 20:1098-1104.e4. [PMID: 31080159 DOI: 10.1016/j.jamda.2019.03.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Aspiration pneumonia is a leading cause of death among older patients; however, little is known about the long-term mortality in aspiration pneumonia. The purpose of this study was to evaluate long-term mortality and its associated factors in patients with aspiration pneumonia. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS In total, 550 patients with aspiration pneumonia (median age: 78.0 years, 66.4% male) with compatible clinical symptoms and chest computed tomography images were enrolled at a single tertiary center from 2006 to 2016. MEASURES The 1-, 3-, and 5-year mortality rates were evaluated for all patients. The prognostic factors for 1-year and 5-year mortality were also evaluated using Cox proportional hazard models. RESULTS A total of 441 (80.2%) patients died during a median follow-up of 50.7 weeks. The 1-, 3-, and 5-year mortality rates were 49.0%, 67.1%, and 76.9%, respectively. Multivariate analysis identified 5 risk factors for 1-year mortality of male sex [hazard ratio (HR) 1.533, P = .003], low body mass index (HR 0.934, P = .002), hypoalbuminemia, anemia (0.973, P = .032), and mechanical ventilation (HR 2.052, P < .001), which were also independent prognostic factors for 5-year mortality. During the follow-up period, 133 (24.2%) patients experienced recurrent aspiration pneumonia. However, Kaplan-Meier analysis showed no significant differences in survival curves between patients with single and recurrent aspiration pneumonia (P = .371). CONCLUSIONS/IMPLICATIONS Long-term prognosis of aspiration pneumonia was poor as a result of underlying morbidity instead of the aspiration pneumonia itself. Our findings suggest that prognostic indices for patients with aspiration pneumonia including the patient's underlying conditions should be devised.
Collapse
Affiliation(s)
- Hee-Young Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Sung Shine Shim
- Department of Radiology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Soo Jung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jin Hwa Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jung Hyun Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Su Hwan Lee
- Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Yon Ju Ryu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
| |
Collapse
|
13
|
Almusawi MA, Gosadi I, Abidia R, Almasawi M, Khan HA. Potential risk factors for dental caries in Type 2 diabetic patients. Int J Dent Hyg 2018; 16:467-475. [PMID: 29749033 DOI: 10.1111/idh.12346] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diabetic patients are known to be at higher risk for dental caries. However, the role of potential risk factors such as blood glucose, salivary glucose and glycaemic control in the occurrence of dental caries in type 2 diabetes (T2D) is not clearly understood so far, and therefore, it was evaluated in this study. MATERIALS AND METHODS This cross-sectional study was conducted on 100 T2D patients from Saudi Arabia. The caries risk assessment was evaluated using the guidelines of Caries Management by Risk Assessment (CAMBRA). Cariogenic bacteria load in saliva was determined by a chair-side test kit. The levels of fasting blood glucose (FBG), salivary glucose and HbA1c were analysed. RESULTS Majority of the patients had dental caries (84%), exposed root surfaces (92%) and heavy plaque (73%), whereas 66% of patients suffered from xerostomia. The frequency of patients with high counts of Streptococcus mutans and Lactobacilli (LB) were 78% and 42%, respectively. There were significant associations between dental caries risk and FBG, HbA1c and salivary glucose. After categorizing the patients into 3 categories of glycaemic control, we observed a significant association between glycaemic control and dental caries risk. CONCLUSION Type 2 diabetes patients are at high risk for dental caries, which is directly associated with FBG, HbA1c and salivary glucose. This is the first study measuring dental caries and its risk factors in T2D patients from Saudi Arabia.
Collapse
Affiliation(s)
- M A Almusawi
- Department of Family and Community Medicine, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - I Gosadi
- Department of Family and Community Medicine, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - R Abidia
- College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - M Almasawi
- Dr. Abdulaziz Al Ajaji Dental Polyclinics, Riyadh, Saudi Arabia
| | - H A Khan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
14
|
Harnagea H. [Interprofessional collaboration in geriatric primary oral healthcare in Québec – Implementation landmarks]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2018; 30:383-388. [PMID: 30541267 DOI: 10.3917/spub.183.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Accelerated ageing of the population results in an ever-increasing number of functionally dependent elderly persons. Even healthy older people experience self-care deficits due to decreased mobility, endurance and sensory loss. Residents in long-term care centres depend on caregivers for the majority of their activities of daily living.Dental services for functionally dependent seniors generally remain inadequate. Several factors may explain this situation, including the absence of government guidelines and the lack of initial and continuing training of both dental and non-dental personnel.Based on a review of the scientific literature published between 1970-2016, four strategies were identified to improve this problem:Promoting, supporting and formalizing interprofessional collaboration.Building a common vision for oral health.Developing complementary and shared professional and relational skills.Redefining the roles and responsibilities of primary care practitioners.These strategies could be considered in the process of implementing a dental service adapted to the needs of this population group.
Collapse
|
15
|
Gap Analysis of Older Adults With Type 2 Diabetes Receiving Nonsurgical Periodontal Therapy. J Evid Based Dent Pract 2017; 17:335-349. [DOI: 10.1016/j.jebdp.2017.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/11/2017] [Accepted: 05/11/2017] [Indexed: 01/16/2023]
|
16
|
Huang ST, Chiou CC, Liu HY. Risk factors of aspiration pneumonia related to improper oral hygiene behavior in community dysphagia persons with nasogastric tube feeding. J Dent Sci 2017; 12:375-381. [PMID: 30895078 PMCID: PMC6395351 DOI: 10.1016/j.jds.2017.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/04/2017] [Indexed: 11/30/2022] Open
Abstract
Background/purpose Aspiration pneumonia (AsP) was reported to be closely related to poor oral hygiene. This study aimed to investigate the association between caregivers' oral hygiene behavior with AsP in the community dysphagia persons with nasogastric tube feeding (DPNgTF). Materials and methods A cross-sectional study was conducted on 128 DPNgTF and their corresponding caregivers. A self-reported structuralized questionnaire was used to measure the oral care behavior of caregivers. All data analyses were performed using the SPSS. The Chi-square was used for comparison of nonparametric data. Fisher's exact test was used when the expected frequency of any cell in the table was less than five. A p value <0.05 was considered statistically significant. Results Fifty-five DPNgTF had developed AsP (43.0%) and they had statistically significantly halitosis (adjusted OR = 4.46; 95%CI = 2.01–9.93), deposition of oropharyngeal secretion (OR = 4.39; 95%CI = 1.99–9.66), dry mouth (OR = 4.23; 95%CI = 1.81–9.85) and closing mouth and not allow to brush (adjusted OR = 2.83; 95%CI = 1.28–6.27). The poor oral hygiene status of DPNgTF was significantly correlated with the occurrence of AsP. The caregivers' oral care to DPNgTF after getting up (OR = 14.09; 95%CI = 2.92–68.08) and using sponge stick to care (OR = 3.29; 95%CI = 1.26–8.55) were the risk factors of AsP. Conclusion The implemented oral care after getting up only, using sponge stick has a higher risk compared to the implemented oral care prior to sleeping, using toothbrush. The importance of implementing oral care prior to sleeping by using toothbrush should be reinforced in DPNgTF. Guidelines of oral care and education courses for caregivers during the process in their career training are needed.
Collapse
Affiliation(s)
- Shun-Te Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Special Care Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chi-Chen Chiou
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Chi-Mei Medical Center, Tainan, Taiwan
| | - Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
17
|
Hoben M, Kent A, Kobagi N, Huynh KT, Clarke A, Yoon MN. Effective strategies to motivate nursing home residents in oral care and to prevent or reduce responsive behaviors to oral care: A systematic review. PLoS One 2017; 12:e0178913. [PMID: 28609476 PMCID: PMC5469468 DOI: 10.1371/journal.pone.0178913] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/09/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Poor oral health has been a persistent problem in nursing home residents for decades, with severe consequences for residents and the health care system. Two major barriers to providing appropriate oral care are residents' responsive behaviors to oral care and residents' lack of ability or motivation to perform oral care on their own. OBJECTIVES To evaluate the effectiveness of strategies that nursing home care providers can apply to either prevent/overcome residents' responsive behaviors to oral care, or enable/motivate residents to perform their own oral care. MATERIALS AND METHODS We searched the databases Medline, EMBASE, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science for intervention studies assessing the effectiveness of eligible strategies. Two reviewers independently (a) screened titles, abstracts and retrieved full-texts; (b) searched key journal contents, key author publications, and reference lists of all included studies; and (c) assessed methodological quality of included studies. Discrepancies at any stage were resolved by consensus. We conducted a narrative synthesis of study results. RESULTS We included three one-group pre-test, post-test studies, and one cross-sectional study. Methodological quality was low (n = 3) and low moderate (n = 1). Two studies assessed strategies to enable/motivate nursing home residents to perform their own oral care, and to studies assessed strategies to prevent or overcome responsive behaviors to oral care. All studies reported improvements of at least some of the outcomes measured, but interpretation is limited due to methodological problems. CONCLUSIONS Potentially promising strategies are available that nursing home care providers can apply to prevent/overcome residents' responsive behaviors to oral care or to enable/motivate residents to perform their own oral care. However, studies assessing these strategies have a high risk for bias. To overcome oral health problems in nursing homes, care providers will need practical strategies whose effectiveness was assessed in robust studies.
Collapse
Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Kobagi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Kha Tu Huynh
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Alix Clarke
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Minn N. Yoon
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
18
|
Hoben M, Clarke A, Huynh KT, Kobagi N, Kent A, Hu H, Pereira RAC, Xiong T, Yu K, Xiang H, Yoon MN. Barriers and facilitators in providing oral care to nursing home residents, from the perspective of care aides: A systematic review and meta-analysis. Int J Nurs Stud 2017; 73:34-51. [PMID: 28531550 DOI: 10.1016/j.ijnurstu.2017.05.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 04/30/2017] [Accepted: 05/08/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Oral health of nursing home residents is generally poor, with severe consequences for residents' general health and quality of life and for the health care system. Care aides in nursing homes provide up to 80% of direct care (including oral care) to residents, but providing oral care is often challenging. Interventions to improve oral care must tailor to identified barriers and facilitators to be effective. This review identifies and synthesizes the evidence on barriers and facilitators care aides perceive in providing oral care to nursing home residents. METHODS We systematically searched the databases MEDLINE, Embase, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We also searched by hand the contents of key journals, publications of key authors, and reference lists of all studies included. We included qualitative and quantitative research studies that assess barriers and facilitators, as perceived by care aides, to providing oral care to nursing home residents. We conducted a thematic analysis of barriers and facilitators, extracted prevalence of care aides reporting certain barriers and facilitators from studies reporting quantitative data, and conducted random-effects meta-analyses of prevalence. RESULTS We included 45 references that represent 41 unique studies: 15 cross-sectional studies, 13 qualitative studies, 7 mixed methods studies, 3 one-group pre-post studies, and 3 randomized controlled trials. Methodological quality was generally weak. We identified barriers and facilitators related to residents, their family members, care providers, organization of care services, and social interactions. Pooled estimates (95% confidence intervals) of barriers were: residents resisting care=45% (15%-77%); care providers' lack of knowledge, education or training in providing oral care=24% (7%-47%); general difficulties in providing oral care=26% (19%-33%); lack of time=31% (17%-47%); general dislike of oral care=19% (8%-33%); and lack of staff=22% (13%-31%). CONCLUSIONS We found a lack of robust evidence on barriers and facilitators that care aides perceive in providing oral care to nursing home residents, suggesting a need for robust research studies in this area. Effective strategies to overcome barriers and to increase facilitators in providing oral care are one of the most critical research gaps in the area of improving oral care for nursing home residents. Strategies to prevent or manage residents' responsive behaviors and to improve care aides' oral care knowledge are especially needed.
Collapse
Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Alix Clarke
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Kha Tu Huynh
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Nadia Kobagi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Huimin Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | | | - Tianyuan Xiong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Kexin Yu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Hongjin Xiang
- Ultrasound Department, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
| | - Minn N Yoon
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
19
|
Lin PY, Chiang YC, Chou YJ, Chang HJ, Chi LY. Association of Unfinished Root Canal Treatments with the Risk of Pneumonia Hospitalization. J Endod 2017; 43:29-35. [DOI: 10.1016/j.joen.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 10/03/2016] [Accepted: 10/03/2016] [Indexed: 11/27/2022]
|
20
|
Bachkati KH, Mortensen EL, Brønnum-Hansen H, Holm-Pedersen P. Midlife Cognitive Ability, Education, and Tooth Loss in Older Danes. J Am Geriatr Soc 2016; 65:194-199. [PMID: 28111753 DOI: 10.1111/jgs.14513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the possible influence of cognitive ability and education at age 50 or 60 on number of teeth at age 70. SETTING Community-dwelling population in Copenhagen, Denmark. PARTICIPANTS Men and women born in 1914 (N = 302). MEASUREMENTS Cognitive ability was assessed using the Wechsler Adult Intelligence Scale at age 50 or 60. A global cognitive ability measure was used as a continuous measure and according to tertile. Information on education was gathered using a questionnaire at age 50 or 60. A clinical oral examination took place at age 70, and oral health was measured according to number of teeth (<6 vs ≥6). Baseline covariates were smoking, alcohol, sex, and income. RESULTS Logistic regression analyses revealed that greater cognitive ability and educational attainment had a protective effect against risk of tooth loss. The associations were significant and persisted after adjusting for confounders and a two-way interaction between cognitive ability and education. CONCLUSION Higher education level and cognitive ability measured at age 50 or 60 were associated with having more teeth at age 70. Whether these findings are due to the interaction of these factors with oral health, related socioeconomic factors, or other factors remains to be studied.
Collapse
Affiliation(s)
- Kristine Harrsen Bachkati
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Erik Lykke Mortensen
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark.,Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Brønnum-Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | |
Collapse
|
21
|
Hoben M, Poss JW, Norton PG, Estabrooks CA. Oral/dental items in the resident assessment instrument - minimum Data Set 2.0 lack validity: results of a retrospective, longitudinal validation study. Popul Health Metr 2016; 14:36. [PMID: 27785121 PMCID: PMC5073836 DOI: 10.1186/s12963-016-0108-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 10/10/2016] [Indexed: 01/13/2023] Open
Abstract
Background Oral health in nursing home residents is poor. Robust, mandated assessment tools such as the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) 2.0 are key to monitoring and improving quality of oral health care in nursing homes. However, psychometric properties of RAI-MDS 2.0 oral/dental items have been challenged and criterion validity of these items has never been assessed. Methods We used 73,829 RAI-MDS 2.0 records (13,118 residents), collected in a stratified random sample of 30 urban nursing homes in Western Canada (2007–2012). We derived a subsample of all residents (n = 2,711) with an admission and two or more subsequent annual assessments. Using Generalized Estimating Equations, adjusted for known covariates of nursing home residents’ oral health, we assessed the association of oral/dental problems with time, dentate status, dementia, debris, and daily cleaning. Results Prevalence of oral/dental problems fluctuated (4.8 %–5.6 %) with no significant differences across time. This range of prevalence is substantially smaller than the ones reported by studies using clinical assessments by dental professionals. Denture wearers were less likely than dentate residents to have oral/dental problems (adjusted odds ratio [OR] = 0.458, 95 % confidence interval [CI]: 0.308, 0.680). Residents lacking teeth and not wearing dentures had higher odds than dentate residents of oral/dental problems (adjusted OR = 2.718, 95 % CI: 1.845, 4.003). Oral/dental problems were more prevalent in persons with debris (OR = 2.187, 95 % CI: 1.565, 3.057). Of the other variables assessed, only age at assessment was significantly associated with oral/dental problems. Conclusions Robust, reliable RAI-MDS 2.0 oral health indicators are vital to monitoring and improving oral health related quality and safety in nursing homes. However, severe underdetection of oral/dental problems and lack of association of well-known oral health predictors with oral/dental problems suggest validity problems. Lacking teeth and not wearing dentures should be considered an indicator for urgent oral/dental treatment needs. Electronic supplementary material The online version of this article (doi:10.1186/s12963-016-0108-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Matthias Hoben
- Knowledge Utilization Studies Program (KUSP), Faculty of Nursing, University of Alberta, 5-006 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Jeffrey W Poss
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON Canada
| | - Peter G Norton
- Department of Family Medicine, University of Calgary, Calgary, AB Canada
| | - Carole A Estabrooks
- Knowledge Utilization Studies Program (KUSP), Faculty of Nursing, University of Alberta, 5-006 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| |
Collapse
|
22
|
Gelato MC, Schoenfeld E, Hou W, Michalowicz B, Seaquist E, Oates T, Tripathy D, Engebretson S, Hyman L. Changes in diabetes medications in the Diabetes and Periodontal Therapy Trial and their effect on hemoglobin A1c (HbA1c). Contemp Clin Trials 2016; 50:21-7. [PMID: 27417981 DOI: 10.1016/j.cct.2016.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/16/2016] [Accepted: 07/10/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Evaluate the effect of medications and medication changes during the Diabetes and Periodontal Therapy Trial (DPTT) on the primary study outcome, namely, change in hemoglobin A1c (HbA1c) at 6months following baseline. METHODS The DPTT set strict criteria for changes in diabetes medications. Medication change was defined as: change in dose of any 1 oral hypoglycemic agent by more than two-fold, change in dose of insulin of >10% and/or addition or subtraction of an oral hypoglycemic agent, insulin or non-insulin injectable agents. Comparisons between the treatment (non- surgical periodontal therapy) and control (no therapy) groups used t-tests for continuous variables and chi-square tests for categorical variables, including DPTT defined diabetes medication changes between baseline (BL) and 3month visits and 3- and 6-month visits. Changes in HbA1c were compared across the four medication change categories using ANOVA models, overall and for each treatment group separately. RESULTS Baseline medication use was similar between the treatment groups (p>0.40), as were medication changes between BL- 3month visits and 3 and 6month visits (p=0.58). Participants with higher BL HbA1c (>8%) and those taking insulin at BL were more likely to have a change in medication (p=0.03). CONCLUSIONS The DPTT had the most rigorous definition of medication changes and medication monitoring of any trial in this field to date. The absence of a significant difference in medication changes between treatment groups may suggest that such changes did not play a role in the negative outcome of the DPTT.
Collapse
Affiliation(s)
- Marie C Gelato
- Division of Endocrinology, Stony Brook Medicine, HSC T16-027i, Stony Brook, New York 11794-8154, United States.
| | - Elinor Schoenfeld
- Department of Preventive Medicine, Stony Brook University, School of Medicine, Stony Brook, NY
| | - Wei Hou
- Department of Preventive Medicine, Stony Brook University, School of Medicine, Stony Brook, NY
| | - Bryan Michalowicz
- Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, MN
| | | | - Thomas Oates
- School of Dentistry, University of Texas at San Antonio, San Antonio, TX
| | - Devjit Tripathy
- Department of Medicine, University of Texas at San Antonio, San Antonio, TX
| | - Steven Engebretson
- Department of Periodontology and Implant Dentistry, New York University, New York, NY
| | - Leslie Hyman
- Department of Preventive Medicine, Stony Brook University, School of Medicine, Stony Brook, NY
| |
Collapse
|
23
|
Effect of Antimicrobial Denture Base Resin on Multi-Species Biofilm Formation. Int J Mol Sci 2016; 17:ijms17071033. [PMID: 27367683 PMCID: PMC4964409 DOI: 10.3390/ijms17071033] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/13/2016] [Accepted: 06/20/2016] [Indexed: 02/05/2023] Open
Abstract
Our aims of the research were to study the antimicrobial effect of dimethylaminododecyl methacrylate (DMADDM) modified denture base resin on multi-species biofilms and the biocompatibility of this modified dental material. Candida albicans (C. albicans), Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis), as well as Actinomyces naeslundii (A. naeslundii) were used for biofilm formation on denture base resin. Colony forming unit (CFU) counts, microbial viability staining, and 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) array were used to evaluate the antimicrobial effect of DMADDM. C. albicans staining and Real-time PCR were used to analyze the morphology and expression of virulence genes of C. albicans in biofilm. Lactate dehydrogenase (LDH) array and Real-time PCR were conducted to examine the results after biofilm co-cultured with epithelial cell. Hematoxylin and eosin (HE) staining followed by histological evaluation were used to study the biocompatibility of this modified material. We found that DMADDM containing groups reduced both biomass and metabolic activity of the biofilm significantly. DMADDM can also inhibit the virulence of C. albicans by means of inhibiting the hyphal development and downregulation of two virulence related genes. DMADDM significantly reduced the cell damage caused by multi-species biofilm according to the LDH activity and reduced the expression of IL-18 gene of the cells simultaneously. The in vivo histological evaluation proved that the addition of DMADDM less than 6.6% in denture material did not increase the inflammatory response (p > 0.05). Therefore, we proposed that the novel denture base resin containing DMADDM may be considered as a new promising therapeutic system against problems caused by microbes on denture base such as denture stomatitis.
Collapse
|
24
|
Zimmerman L. Pulmonary Complications of Endocrine Diseases. MURRAY AND NADEL'S TEXTBOOK OF RESPIRATORY MEDICINE 2016. [PMCID: PMC7152263 DOI: 10.1016/b978-1-4557-3383-5.00095-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
25
|
Relation entre la mastication et la qualité de l'alimentation des aînés de l'Étude longitudinale québécoise sur la nutrition et le vieillissement (NuAge). Can J Aging 2015; 34:561-569. [PMID: 26560637 DOI: 10.1017/s0714980815000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The objective of this study was to assess the relationship between the quality of mastication and dietary intake among community-dwelling older adults (67-84 years). A secondary analysis of data collected upon entry of participants in the NuAge study was effected. Perceived masticatory efficiency (n=1793) was measured using a questionnaire inspired by the Oral Health Impact Profile. Direct assessment of masticatory efficiency was carried out in a subsample (n=94), using a validated clinical test (Swallowing Threshold Test Index, 0-100%). Dietary intake was calculated from three non-consecutive 24h recalls. Mean scores indicate good perceived masticatory efficiency (Men:26.22±0.19/28;Women:25.81±0.21/28), but weak assessed efficiency (Men:60.8% [CI(57.3-64.2)]; Women:61.2% [CI(57.7-64.7)]). Multivariate regression analysis, adjusting for confounding variables (age, sex, schooling, living alone, income, smoking, chronic conditions, functional autonomy), showed that masticatory efficiency (measured or perceived) was not associated with intake of fruits/vegetables, protein, vitamin C or folic acid.
Collapse
|
26
|
Cusson V, Caron C, Gaudreau P, Morais JA, Shatenstein B, Payette H. Assessing Older Adults’ Masticatory Efficiency. J Am Geriatr Soc 2015; 63:1192-6. [DOI: 10.1111/jgs.13443] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Valérie Cusson
- Research Centre on Aging; Health and Social Services Center; University Institute of Geriatrics of Sherbrooke; Sherbrooke Quebec Canada
| | - Christian Caron
- Centre d'Excellence sur le Vieillissement de Québec; Centre Hospitalier de l'Université de Québec; Quebec Quebec Canada
- Faculty of Dental Medicine; Laval University; Quebec Quebec Canada
| | - Pierrette Gaudreau
- Department of Medicine; Centre Hospitalier de l'Université de Montréal Research Center; University of Montreal; Montreal Quebec Canada
| | - José A. Morais
- Faculty of Medicine; McGill University; Montreal Quebec Canada
- Division of Geriatrics; McGill University Health Centre; Montreal Quebec Canada
| | - Bryna Shatenstein
- Department of Nutrition; Centre de Recherche; Institut Universitaire de Gériatrie de Montréal; University of Montreal; Montreal Quebec Canada
| | - Hélène Payette
- Research Centre on Aging; Health and Social Services Center; University Institute of Geriatrics of Sherbrooke; Sherbrooke Quebec Canada
- Department of Community Health Sciences; Faculty of Medicine and Health Sciences; Sherbrooke University; Sherbrooke Quebec Canada
| |
Collapse
|
27
|
El-Rabbany M, Zaghlol N, Bhandari M, Azarpazhooh A. Prophylactic oral health procedures to prevent hospital-acquired and ventilator-associated pneumonia: A systematic review. Int J Nurs Stud 2015; 52:452-64. [DOI: 10.1016/j.ijnurstu.2014.07.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 01/16/2023]
|
28
|
Morse DE, Avlund K, Christensen LB, Fiehn NE, Molbo D, Holmstrup P, Kongstad J, Mortensen EL, Holm-Pedersen P. Smoking and Drinking as Risk Indicators for Tooth Loss in Middle-Aged Danes. J Aging Health 2014; 26:54-71. [DOI: 10.1177/0898264313509278] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objectives: To investigate tobacco and alcohol consumption as risk indicators for missing teeth in late middle-aged Danes. Method: In all, 1,517 Copenhagen Aging and Midlife Biobank (CAMB) participants received a clinical oral examination that included number of teeth. Information on smoking, drinking, and various covariates was obtained using self-administered, structured questionnaires. Descriptive statistics and logistic regression (dependent variable: 6+ vs. <6 missing teeth) were used to investigate smoking and drinking in relation to missing teeth. Results: Current smokers, persons who currently or previously smoked >15 tobacco units/day, and persons who had smoked for 27+ years had elevated mean scores of missing teeth and associated odds ratios (OR) compared with never smokers. Relative to nondrinkers, alcohol consumption was associated with reduced odds of missing 6+ teeth. Discussion: Our findings suggest that smoking is positively associated, while alcoholic beverage consumption is inversely related to tooth loss in middle-aged Danes.
Collapse
Affiliation(s)
| | - Kirsten Avlund
- University of Copenhagen, Denmark
- University of Southern Denmark, Odense, Denmark
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Abstract
UNLABELLED Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists. BACKGROUND Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings. METHODS A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested. CONCLUSION Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias.
Collapse
Affiliation(s)
- Caren M Barnes
- Applied and Clinical Research, Department of Dental Hygiene, Nebraska Center for Materials and Nanoscience, University of Nebraska Medical Center, College of Dentistry, Lincoln, NE 68583-0740, USA.
| |
Collapse
|
30
|
van der Putten GJ, De Visschere L, van der Maarel-Wierink C, Vanobbergen J, Schols J. The importance of oral health in (frail) elderly people – a review. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
31
|
Sivakumar I, Arunachalam KS, Sajjan S, Ramaraju AV, Rao B, Kamaraj B. Incorporation of Antimicrobial Macromolecules in Acrylic Denture Base Resins: A Research Composition and Update. J Prosthodont 2013; 23:284-90. [DOI: 10.1111/jopr.12105] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2013] [Indexed: 12/29/2022] Open
Affiliation(s)
- Indumathi Sivakumar
- Department of Prosthodontics and Implantology; Vishnu Dental College; Bhimavaram India
| | | | - Suresh Sajjan
- Department of Prosthodontics and Implantology; Vishnu Dental College; Bhimavaram India
| | | | - Bheemalingeshwara Rao
- Department of Prosthodontics and Implantology; Vishnu Dental College; Bhimavaram India
| | - Bindu Kamaraj
- Department of Prosthodontics; Penang International Dental College; Penang Malaysia
| |
Collapse
|
32
|
Randomized clinical evaluation of a light-cured base material for complete dentures. Clin Oral Investig 2013; 18:1457-65. [DOI: 10.1007/s00784-013-1110-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 09/12/2013] [Indexed: 12/28/2022]
|
33
|
Skorupka W, Zurek K, Kokot T, Nowakowska-Zajdel E, Fatyga E, Niedworok E, Muc-Wierzgoń M. Assessment of oral hygiene in adults. Cent Eur J Public Health 2013; 20:233-6. [PMID: 23285527 DOI: 10.21101/cejph.a3712] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the research was to assess the oral hygiene habits in the elderly group of study population of Southern Poland. METHODS The study was conducted in dental services in two selected cities in Southern Poland. The group of subjects consisted of 664 respondents (272 men, 392 women) aged 65 to 81 years. Oral hygiene was measured with the author's anonymous questionnaire consisting of twenty questions. Questions related to information on personal history and general health, comorbidities, dietary habits, alcohol consumption, smoking, taking drugs and the state of oral hygiene practices as frequency of visits to the dentist and the number of own teeth. RESULTS The majority of the subjects had higher n=240 (36.1%) and secondary n=219 (33%) education and were predominantly n=590 (89%) professionally inactive (retirees or pensioners). No significant differences were found between the groups: women and men. But there were differences in technologies used, the examined men significantly often used computer in comparison with the women's group. In total, 19.6% had own natural teeth only, 45.0% own teeth and dentures, 30.0% dentures only, and 5.4% neither teeth nor dentures. Majority of subjects brush their teeth or dentures only 1-2 times a day (80%) and visit the dentist less than once in 2 years or once a year (75%). Women significantly more often stated use of a toothbrush and taking care of oral hygiene and compared to men, they declared higher number of own teeth. CONCLUSION People aged over 65 neglect hygiene and oral care. Women pay more attention to oral hygiene and they have more own teeth than men. The most frequent cause of oral hygiene neglect in the elderly could be gender, the socio-economic conditions, behaviour habits and lack of sufficient health education. The dentist may need to consult with the patient's GP the development of the appropriate personalised treatment plan for the elderly. Young dentists need to be educated in order to provide appropriate dental care to the elderly.
Collapse
|
34
|
Kimura Y, Ogawa H, Yoshihara A, Yamaga T, Takiguchi T, Wada T, Sakamoto R, Ishimoto Y, Fukutomi E, Chen W, Fujisawa M, Okumiya K, Otsuka K, Miyazaki H, Matsubayashi K. Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly. Geriatr Gerontol Int 2012; 13:718-25. [PMID: 23279752 DOI: 10.1111/ggi.12006] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2012] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly. METHODS The study population consisted of 269 community-dwelling elderly aged ≥ 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11). RESULTS Number of teeth was significantly related to chewing ability (P<0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance (P=0.029) and intellectual activity (P=0.021). There was a significant association between low chewing ability and depression (P<0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE (P=0.022), HDSR (P=0.017) and FAB (P=0.002). The participants with low chewing ability had lower food variety (P<0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability. CONCLUSION Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings.
Collapse
Affiliation(s)
- Yumi Kimura
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
|
36
|
Effectiveness of supervised implementation of an oral health care guideline in care homes; a single-blinded cluster randomized controlled trial. Clin Oral Investig 2012; 17:1143-53. [DOI: 10.1007/s00784-012-0793-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 07/09/2012] [Indexed: 10/28/2022]
|
37
|
Kikutani T, Tamura F, Takahashi Y, Konishi K, Hamada R. A novel rapid oral bacteria detection apparatus for effective oral care to prevent pneumonia. Gerodontology 2011; 29:e560-5. [DOI: 10.1111/j.1741-2358.2011.00517.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
38
|
Li L, Finnegan MB, Özkan S, Kim Y, Lillehoj PB, Ho CM, Lux R, Mito R, Loewy Z, Shi W. In vitro study of biofilm formation and effectiveness of antimicrobial treatment on various dental material surfaces. Mol Oral Microbiol 2011; 25:384-90. [PMID: 21040512 DOI: 10.1111/j.2041-1014.2010.00586.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Elevated proportions of Candida albicans in biofilms formed on dentures are associated with stomatitis whereas Streptococcus mutans accumulation on restorative materials can cause secondary caries. Candida albicans, S. mutans, saliva-derived and C. albicans/saliva-derived mixed biofilms were grown on different materials including acrylic denture, porcelain, hydroxyapatite (HA), and polystyrene. The resulting biomass was analysed by three-dimensional image quantification and assessment of colony-forming units. The efficacy of biofilm treatment with a dissolved denture cleansing tablet (Polident(®)) was also evaluated by colony counting. Biofilms formed on HA exhibited the most striking differences in biomass accumulation: biofilms comprising salivary bacteria accrued the highest total biomass whereas C. albicans biofilm formation was greatly reduced on the HA surface compared with other materials, including the acrylic denture surface. These results substantiate clinical findings that acrylic dentures can comprise a reservoir for C. albicans, which renders patients more susceptible to C. albicans infections and stomatitis. Additionally, treatment efficacy of the same type of biofilms varied significantly depending on the surface. Although single-species biofilms formed on polystyrene surfaces exhibited the highest susceptibility to the treatment, the most surviving cells were recovered from HA surfaces for all types of biofilms tested. This study demonstrates that the nature of a surface influences biofilm characteristics including biomass accumulation and susceptibility to antimicrobial treatments. Such treatments should therefore be evaluated on the surfaces colonized by the target pathogen(s).
Collapse
Affiliation(s)
- L Li
- UCLA School of Dentistry, University of California, Los Angeles, CA 90095-1668, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
van der Maarel-Wierink CD, Vanobbergen JNO, Bronkhorst EM, Schols JMGA, de Baat C. Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc 2011; 12:344-54. [PMID: 21450240 DOI: 10.1016/j.jamda.2010.12.099] [Citation(s) in RCA: 171] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 12/28/2010] [Accepted: 12/28/2010] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors. DESIGN Systematic literature review. SETTING PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligible studies, published in English in the period January 2000 to April 2009. PARTICIPANTS Frail older people. MEASUREMENTS Only publications with regard to hospitalized, institutionalized, or frail home-dwelling people of 60 years and older were eligible. Two authors independently assessed the publications for their methodological quality. Unadjusted and adjusted odds ratios and their corresponding 95% confidence intervals for respective risk factors related to aspiration pneumonia were extracted. The results were evaluated according to the levels of evidence of the Oxford Centre for Evidence-based Medicine. RESULTS A total of 21 publications fulfilled the quality criteria. Evidence level 2a (systematic review with homogeneity of cohort studies) was found for a positive relationship between aspiration pneumonia and age, male gender, lung diseases, dysphagia, and diabetes mellitus; 2b (individual cohort study) for severe dementia, angiotensin I-converting enzyme deletion/deletion genotype, and bad oral health; 3a (systematic review with homogeneity of case-control studies) for malnutrition; 3b (individual case-control study) for Parkinson's disease and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health among the risk factors seems limited. CONCLUSION Thirteen significant risk factors were identified: age, male gender, lung diseases, dysphagia, diabetes mellitus, severe dementia, angiotensin I-converting enzyme deletion/deletion genotype, bad oral health, malnutrition, Parkinson's disease, and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health seems limited.
Collapse
|
40
|
Sibbritt DW, Byles JE, Tavener MA. Older Australian women's use of dentists: A longitudinal analysis over 6 years. Australas J Ageing 2010; 29:14-20. [DOI: 10.1111/j.1741-6612.2010.00396.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
41
|
|
42
|
Abstract
Chronic adult periodontitis is a bacterially induced chronic inflammatory disease that destroys the connective tissue and bone that support teeth. Concepts of the specific mechanisms involved in the disease have evolved with new technologies and knowledge. Histopathologic observations of diseased human tissues were used previously to speculate on the causes of periodontitis and to describe models of pathogenesis. Experimental evidence later emerged to implicate bacterial plaque deposits as the primary factor initiating periodontitis. At the same time, specific bacteria and immunoinflammatory mechanisms were differentially implicated in the disease. In the mid-1990s, early insights about complex diseases, such as periodontitis, led to new conceptual models of the pathogenesis of periodontitis. Those models included the bacterial activation of immunoinflammatory mechanisms, some of which targeted control of the bacterial challenge and others that had adverse effects on bone and connective tissue remodeling. Such models also acknowledged that different environmental and genetic factors modified the clinical phenotype of periodontal disease. However, the models did not capture the dynamic nature of the biochemical processes, i.e., that innate differences among individuals and changes in environmental factors may accelerate biochemical changes or dampen that shift. With emerging genomic, proteomic, and metabolomic data and systems biology tools for interpreting data, it is now possible to begin describing the basic elements of a new model of pathogenesis. Such a model incorporates gene, protein, and metabolite data into dynamic biologic networks that include disease-initiating and -resolving mechanisms. This type of model has a multilevel framework in which the biochemical networks that are regulated by innate and environmental factors can be described and the interrelatedness of networks can be captured. New models in the next few years will be merely frameworks for integrating key knowledge as it becomes available from the "-omics" technologies. However, it is possible to describe some of the key elements of the new models and discuss distinctions between the new and older models. It is hoped that improved conceptual models of pathogenesis will assist in focusing new research and speed the translation of new data into practical applications.
Collapse
|
43
|
Abstract
Oral health is critical to systemic health and quality of life for the elderly, especially the institutionalized elderly, who are at high risk for oral and nutritional problems. Oral health is an integral component of overall nutritional health, just as nutrition plays a vital role in overall oral health. This article reviews the critical factors in the relationship among oral, nutritional, and systemic health and urges ongoing collaboration of providers of health care to reduce the rate of morbidity and mortality in institutionalized elders.
Collapse
|
44
|
Abstract
BACKGROUND Aspiration pneumonia is a common cause of morbidity and mortality. Several approaches, including bed positioning, dietary changes, and oral hygiene, have been proposed to prevent aspiration pneumonia, yet few data are available on the efficacy of pharmacologic interventions in reducing the rate of aspiration. OBJECTIVE This study was a systematic literature review of the pharmacologic prevention of aspiration pneumonia. METHODS We searched MEDLINE (1996-2006); EMBASE (1974-2006); Cumulative Index to Nursing & Allied Health Literature (CINAHL) (1982-2006); Health Services Technology, Administration, and Research (HealthSTAR) (1975-2006); and the Cochrane Library for relevant articles. References of all included articles were reviewed. Studies were included if they had a prospective, controlled design with a primary outcome of prevention of aspiration pneumonia. Surrogate outcomes that had a direct link to decreasing the incidence of aspiration pneumonia were considered. Selected articles were reviewed independently by 2 authors. RESULTS Of 1108 studies reviewed, 20 were analyzed. Angiotensin-converting enzyme inhibitors may be beneficial in selected patients at high risk for aspiration. Capsaicin may be a low-risk approach to stimulate swallowing and cough reflexes. Amantadine, cabergoline, and theophylline may cause serious adverse events, and their routine use for prevention of aspiration pneumonia is not recommended. Cilostazol should not be used because of the increased risk for bleeding. CONCLUSIONS Limited information is available on benefits and risks to guide an evidence-based approach to the pharmacologic prevention of aspiration pneumonia. Considering the high incidence of aspiration pneumonia in older adults, large randomized clinical trials on the effectiveness of pharmacologic interventions are warranted.
Collapse
|
45
|
Sarin J, Balasubramaniam R, Corcoran AM, Laudenbach JM, Stoopler ET. Reducing the Risk of Aspiration Pneumonia among Elderly Patients in Long-Term Care Facilities through Oral Health Interventions. J Am Med Dir Assoc 2008; 9:128-35. [DOI: 10.1016/j.jamda.2007.10.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 10/02/2007] [Accepted: 10/02/2007] [Indexed: 11/28/2022]
|
46
|
Dye BA, Fisher MA, Yellowitz JA, Fryar CD, Vargas CM. Receipt of dental care, dental status and workforce in U.S. nursing homes: 1997 National Nursing Home Survey. SPECIAL CARE IN DENTISTRY 2007; 27:177-86. [PMID: 17990476 DOI: 10.1111/j.1754-4505.2007.tb00343.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The goal of this paper was to report the prevalence of dental care--a Healthy People 2010 objective--for nursing home residents 65 years and older, and to assess the association between receipt of dental care with other oral status and workforce measures. Data from 7,363 residents aged 65 years and older with information in the 1997 National Nursing Home Survey (NNHS) were used. Overall, 18.2% of elderly nursing home residents had received dental care in the last month. Multivariable modeling found residents were more likely to receive dental care in the past month if they lived in the Northeast (OR=3.32, 95% CI 2.51-4.39); were dentate (OR=1.46, 95% CI 1.26-1.69); had a length of stay 12 months or longer (OR= 1.37, 95% CI 1.17-1.62); or resided in facilities with dental professional services (OR=2.05, 95% CI 1.60-2.62). The results showed that disparities in receipt of dental care existed by region, length of stay, dentate status, and availability of dental services in nursing homes. Additionally, current oral health surveillance measures for nursing homes may have been inadequate.
Collapse
Affiliation(s)
- Bruce A Dye
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Md., USA.
| | | | | | | | | |
Collapse
|
47
|
D'Aiuto F. The new era of 'perio-focal infection'. Oral Dis 2007; 13:507. [PMID: 17944663 DOI: 10.1111/j.1601-0825.2007.01418.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
48
|
Davidson N, Skull S, Calache H, Chesters D, Chalmers J. Equitable access to dental care for an at-risk group: a review of services for Australian refugees. Aust N Z J Public Health 2007. [DOI: 10.1111/j.1753-6405.2007.00014.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
49
|
Andersson K, Nordenram G, Wårdh I, Berglund B. The district nurse's perceptions of elderly patients' oral health: a qualitative interview study. Acta Odontol Scand 2007; 65:177-82. [PMID: 17514521 DOI: 10.1080/00016350701278898] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this qualitative study based on interviews was to explore the perceptions that district nurses have of the oral health of elderly patients. MATERIAL AND METHODS The criterion for inclusion was being a district nurse working in a primary health-care centre in the County of Stockholm. The respondents were asked open-ended questions about their perceptions of oral health and about the impact of oral problems on the general health and well-being of elderly patients. The analyses started at the first interview and proceeded in parallel until no further relevant information could be obtained. Analysis of the open-ended questions was inspired by grounded theory methodology and comprised four stages: native reading, open coding, axial coding, and selective coding. RESULTS The one core category identified, namely indistinct professional duties of the district nurse, formed the central meaning of the district nurse's perceptions of oral health in elderly patients. This related to two other categories labelled 'insights into the district nurse's professional role' and 'obstacles for the district nurse', with sub-categories. CONCLUSION Although the district nurses in this study were aware of the impact of oral health in old age, their attitude was that this was a matter for dentistry.
Collapse
Affiliation(s)
- Kerstin Andersson
- Department of Geriatric Dentistry, Institution of Odontology, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | |
Collapse
|
50
|
Andersson K, Furhoff AK, Nordenram G, Wårdh I. 'Oral health is not my department'. Perceptions of elderly patients' oral health by general medical practitioners in primary health care centres: a qualitative interview study. Scand J Caring Sci 2007; 21:126-33. [PMID: 17428224 DOI: 10.1111/j.1471-6712.2007.00446.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to explore general medical practitioners' (GPs) perceptions of the oral health of their elderly patients. The design was a qualitative study based on individual in-depth interviews with GPs. The criterion for inclusion in the study was that the GP was a specialist in family medicine working in a primary health care centre (PHCC:s) in the county of Stockholm. The participants took part in the study after informed consent. Eleven GPs were interviewed. The interview started with semi-structured questions about the respondents' clinical presentation of their elderly patients', e.g. medication, medical treatment and socioeconomic status. The interview concluded with questions about the respondents' experiences of and perceptions of the oral health of their patients. This process started with the first interview and proceeded with successive interviews until no new relevant information was forthcoming. The initial semi-structured part of the interview guide was analysed for content with special reference to descriptive answers. The final open questions were analysed by a method inspired by grounded theory (GT) and comprised three stages: open coding, axial coding and selective coding. In the GT influenced analysis process, three categories, health perspective, working conditions and cultural differences, each in turn containing subcategories, were identified and labelled. The most significant category, cultural differences, was identified as the core category, explaining the central meaning of the respondents' perceptions of the oral health of their elderly patients. The GPs in this study showed little or no awareness of the oral health of their elderly patients. The interviews disclosed several contributing factors. Barriers to closer integration of oral and general health in the elderly were identified. There existed a cultural gap between the disciplines of dentistry and medicine, which does not enhance and may be detrimental to the overall well-being of elderly patients.
Collapse
Affiliation(s)
- Kerstin Andersson
- Department of Periodontology, Institution of Odontology, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | |
Collapse
|