WHO's global oral health status report 2022: Actions, discussion and implementation

How and why do health system factors influence general dentists' participation in publicly funded, contracted primary dental care services: A realist review

OBJECTIVES

To identify health system contexts and mechanisms influencing general dental practitioners' (GDPs) participation in state funded, contracted primary oral healthcare.

METHODS

Peer-reviewed articles and other sources were identified via EMBASE, Medline (OVID), Web of Science and Google Scholar databases, grey literature search, citation tracking and expert recommendations. Studies meeting the inclusion criteria were assessed for rigour, relevance and richness, and coded to identify data relating to contexts, mechanisms and outcomes. Inductive and deductive coding was used to generate context-mechanism-outcome configurations (CMOCs) and develop the final programme theory.

RESULTS

Database searching identified 1,844 articles of which 29 were included. A further 33 sources were identified through adjunctive searches. Analysis identified key systems contexts influencing GDP participation. These include system emphasis on treatment over prevention, low priority for oral healthcare, funding constraints, and change implementation with minimal clinician consensus. At operational level, contracts can restrict GDP decision-making and ability to deliver high quality and holistic patient care. Key underlying mechanisms were feelings of ceded clinical and entrepreneurial control, stress and demoralisation, mistrust of the system and feeling undervalued.

CONCLUSIONS

The factors influencing GDP participation in state-funded, contracted dental care over private dental care are complex. The findings presented in this review have the potential to act as a good place to start leveraging health system change including better GDP engagement and increase participation in publicly funded systems.

Association between serum homocysteine concentration level and tooth loss: a cross-sectional study from NHANES 2003-2006

INTRODUCTION

This cross-sectional study aimed to investigate the associations between serum homocysteine levels and missing teeth, as well as to explore the threshold effect of serum homocysteine levels on the number of missing teeth.

MATERIALS AND METHODS

This study involved 4746 participants (aged ≥ 40 years) from NHANES data 2003-2006. Negative binomial regression was used to assess the association between serum homocysteine levels and tooth loss. Non-linear and dose-response relationships were analyzed using smooth curve fitting and threshold effect analysis. In addition, we supplemented the relationship between serum homocysteine levels and tooth loss and conducted subgroup analysis to determine the impact of covariates on the relationship between serum homocysteine levels and tooth loss.

RESULTS

In a fully adjusted negative binomial regression model, higher levels of serum Hcy concentration in the Q2-Q4(Q2: IRR = 1.46, 95%CI (1.67,1.79)); Q3: IRR = 1.42, 95%CI (1.36,1.48); Q4: IRR = 1.47,95%CI (1.01,1.78)) groups increased the likelihood of tooth loss compared with quartile Q1 (low level of serum homocysteine). Threshold effect analysis revealed that the log2-transformed Hcy infection point was at 2.95 μmol/L.

CONCLUSION

The likelihood of tooth loss increased by 47% for each unit increase in serum homocysteine level. There was a non-linear positive correlation between serum homocysteine and tooth loss, with a threshold effect of approximately log2(Hcy) = 2.95 μmol/L. This link emphasizes the importance of maintaining appropriate homocysteine levels to prevent oral health problems.

Effect of the Darolac® (Oralis SB®) Probiotic Formulation on Oral Health: A Narrative Review

Gingivitis and periodontitis are prevalent periodontal conditions associated with dysbiosis of the oral cavity, which leads to inflammation and bleeding of gums, loss of tooth attachment, and degradation of the underlying bone structure. The standard adjunctive treatment for periodontal conditions, chlorhexidine mouthwash, is effective but is associated with several side effects. Probiotics have been explored as an alternative solution that promotes oral health by restoring homeostasis in the oral cavity. This review presents a summary of clinical trials using the Darolac® (Oralis SB®) probiotic formulation (Lactobacillus acidophilus Rosell®-52, Lactobacillus rhamnosus Rosell®-11, Bifidobacterium longum Rosell®-175 and Saccharomyces boulardii CNCM I-1079) as a mouthwash to support the maintenance of oral health or the restoration of its balance. In reviewed studies, Darolac® is compared to a placebo or other common solutions for periodontal conditions, including chlorhexidine mouthwash. Studies show that Darolac® is as effective or even superior to other available solutions, which supports its use as an effective adjuvant to oral health. The effects of Darolac® on the reduction in oral pathogens and markers of oral dysbiosis are reviewed, and the association between periodontitis, inflammation, and systemic diseases, as well as their implications and the use of probiotics in the periodontal field, are discussed.

Oral health surveys of traditional peoples and communities in Brazil: a scope review

OBJECTIVE

The objective of this review was to map the available evidence on oral health surveys of traditional peoples and communities (TPC) in Brazil, addressing the question, 'What evidence is available on oral health surveys of traditional peoples and communities in Brazil?'.

DESIGN

Scoping review according to the Scoping Review extension for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

DATA SOURCES

MEDLINE/PubMed, Scopus, Web of Science, Embase and Latin American and Caribbean Literature in Health Sciences were searched up until June 2023.

ELIGIBILITY CRITERIA

Studies involving individuals from indigenous groups, quilombolas, riverside communities and Romani communities, all included in TPC in Brazil, were included without any age restrictions.

DATA EXTRACTION AND SYNTHESIS

Data were extracted by two independent reviewers, and studies were categorised considering the author and year of publication, the traditional group, study type, geographical location, age group, sample size, data collection method and the main oral health condition assessed.

RESULTS

After the searches, 39 studies were included in the review, and 2 studies were manually added. The studies included in the review were published between the years 1968 and 2023. Of the total, 31 studies investigated the oral health condition of indigenous peoples, 7 were studies on quilombola communities and 3 studies focused on riverside communities. No studies on Romani people were found in the search. The majority of studies were located in the Northeast region (n=12) of the country, with dental caries being the main oral health issue assessed (n=13) through clinical examinations (n=25), with a high prevalence observed among TPC (n=11).

CONCLUSION

This review reveals that in Brazil, studies on the oral health of TPC are ongoing, although they occur in an isolated and independent manner, indicating a considerably high prevalence of oral health problems in these communities.

New Advances in Periodontal Functional Materials Based on Antibacterial, Anti-Inflammatory, and Tissue Regeneration Strategies

With the global population aging, awareness of oral health is rising. Periodontitis, a widespread bacterial infectious disease, is gaining attention. Current novel biomaterials address key clinical issues like bacterial infection, gum inflammation, tooth loosening, and loss, focusing on antibacterial, anti-inflammatory, and tissue regeneration properties. However, strategies that integrate the advantages of these biomaterials to achieve synergistic therapeutic effects by clearing oral biofilms, inhibiting inflammation activation, and restoring periodontal soft and hard tissue functions remain very limited. Recent studies highlight the link between periodontitis and systemic diseases, underscoring the complexity of the periodontal disease. There is an urgent need to find comprehensive treatment plans that address clinical requirements. Whether by integrating new biomaterials to enhance existing periodontal treatments or by developing novel approaches to replace traditional therapies, these efforts will drive advancements in periodontitis treatment. Therefore, this review compares novel biomaterials with traditional treatments. It highlights the design concepts and mechanisms of these functional materials, focusing on their antibacterial, anti-inflammatory, and tissue regeneration properties, and discusses the importance of developing comprehensive treatment strategies. This review aims to provide guidance for emerging periodontitis research and to promote the development of precise and efficient treatment strategies.

Extracellular Release of a Disintegrin and Metalloproteinase Correlates With Periodontal Disease Severity

AIM

Periodontal disease is driven by oral pathogens, including Porphyromonas gingivalis, and the release of inflammatory cytokines. These cytokines (e.g., TNF) or their receptors (e.g., IL-1R) are substrates of a disintegrin and metalloproteinases (ADAMs). In this study, we aimed to determine the effects of ADAMs on periodontal disease phenotypes.

MATERIALS AND METHODS

Western blot and FRET-based activity measurements of the gingival crevicular fluid (GCF) of patients were compared with those of infected (P. gingivalis) or cytokine-stimulated oral keratinocytes and primary human neutrophils, respectively. This was accompanied by an analysis of the released extracellular vesicles and MMP9 activity.

RESULTS

In the GCF of patients, ADAM8 protein expression and activity were correlated with disease stage, whereas ADAM10 protein expression was inversely correlated with disease stage. Infection and the resulting cytokine release orchestrated the release of soluble ADAM8 by oral keratinocytes and primary neutrophils as soluble ectodomain and on exosomes, respectively. Furthermore, ADAM8 regulated the release of ADAM10 and MMP9.

CONCLUSION

Dysregulation of cell-associated and extracellular ADAM proteolytic activity may be an essential regulatory element in the progression of periodontal disease driven by ADAM8. The influence of ADAM8 on disease onset and the evaluation of targeting ADAM8 as a potential and novel local treatment option should be addressed in future translational in vivo studies.

Optimizing mHealth Interventions for Children's Oral Hygiene: A Factorial Trial

Behavioral interventions can improve children's oral hygiene practices. The multiphase optimization strategy (MOST) offers a framework to prepare, optimize, and evaluate behavioral interventions. This optimization trial tested 3 intervention components-brief motivational interviewing (MI), storytelling videos (STVs), and oral health promotion messages (OHPMs)-in enhancing mother's self-reported brushing of their preschool children's teeth. A total of 128 mothers with children <5 y old were included in a 23 factorial trial. The primary outcome was children's plaque accumulation, assessed using the modified Plaque Index of Silness and Löe, with scores ranging from 0 to 3. The secondary outcome was mothers' self-reported frequency of brushing their children's teeth, categorized as at least once daily or less than once daily. Mothers were randomized to 8 experimental conditions based on combinations of on-off levels of the 3 components. Linear regression and generalized linear regression with logit link function were used to assess the impact of the components and their interactions on plaque score and daily toothbrushing after 3 mo. Multiple imputation was used for missing values. The principle of effect hierarchy guided the selection of components for inclusion in the optimized package, giving priority to main effects and 2-way over 3-way interactions. Plaque was reduced from mean = 1.8 at baseline to mean = 1.5 and daily toothbrushing increased from 50.8% to 69.5% after 3 mo. MI led to non-significantly less plaque and non-significantly more daily toothbrushing. Combining OHPMs and STVs together without MI canceled each other. Neither the main effects nor the 2- or 3-way interactions significantly affected the 2 outcomes. Individual or combined components did not significantly reduce plaque or increase daily toothbrushing. MI had the greatest promise for behavior change, and the m-oral health components need modification before they can be combined with MI in a health promotion package.

Painless cost control as a central strategy for universal oral health coverage: A critical review with policy guide

AIM

This study aimed to critically review the methods used to control the significantly increasing costs of dental care.

METHODS

Through a comprehensive search of the available literature, the cost control (CC) mechanisms for health services were identified from a healthcare system perspective. The probable applicability of each CC method was evaluated mainly based on its potential contribution to oral health promotion. Each mechanism was then classified and discussed under any of the two headings of financing and service provision. An operational guide was finally presented for policy-making in each of the three main models of healthcare systems, including National Health Services, social/public health insurance and private insurance.

RESULTS

From a total of 142 articles/reports retrieved in PubMed, 73 in Scopus and 791 in Google Scholar, 35 were included in the final review after eliminating the duplicates and screening process. Totally ten mechanisms were identified for CC of dental care. Seven were discussed under the financing function, including cost sharing, preauthorization, mixed payment method and an evidence-based approach to benefit package definition, among others. Three further methods were classified under the service provision function, including workforce skill mix with emphasis on primary oral healthcare providers, development of primary healthcare (PHC) network and an appropriate use of tele-dentistry.

CONCLUSION

Painless control of dental expenditures requires a smart integration of prevention into the CC plans. The suggested policy guide emphasizes organizational factors; particularly including the development of PHC-based networks with midlevel providers (desirably extended-duty dental hygienists) as the frontline oral healthcare providers.

Unveiling the Etiopathogenic Role of Epstein-Barr Virus in Periodontitis

Periodontitis, a prevalent and costly oral disease, remains incompletely understood in its etiopathogenesis. The conventional model attributes it to pathogenic bacteria, but emerging evidence suggests dysbiosis involving bacteria, herpesviruses, and an exaggerated host immune response. Among herpesviruses, Epstein-Barr virus (EBV) closely links to severe periodontitis, yet the mechanisms underlying EBV-related pathogenesis remain elusive. This study examined the presence, methylation patterns, and infection states of EBV in gingival tissues from healthy patients and those with periodontitis. It also assessed gene expression differences associated with EBV through whole-genome transcriptomic profiling in healthy and periodontitis-affected tissues. EBV DNA was found at similar frequencies in healthy and periodontitis tissues, suggesting common EBV infection even before disease manifestation. In healthy tissues, mostly unmethylated EBV genomes indicated lytic infection in gums, consistent with the literature on lytic EBV spread in epithelia and continual significant virus release in the saliva of healthy carriers. Conversely, EBV DNA in periodontitis tissues showed both methylated and unmethylated patterns, suggesting a mix of latent and lytic genomes. This indicates the coexistence of latent EBV in B-cells and lytic EBV in plasma cells (PCs), linking EBV presence with both cell types in periodontitis. Whole-genome transcriptomic analysis revealed distinct expression profiles in EBV-positive periodontitis tissues, with upregulated genes associated with inflammatory/immune responses and B-cell and PC markers, while downregulated genes were related to epithelial structure and organization. The EBV-positive periodontitis signature differed distinctly from that of EBV-positive healthy gums, eliciting only a typical viral-induced immune response. These findings provide new insights into EBV physiopathology in the gum, notably assigning a direct etiopathogenetic contribution to EBV in periodontitis. The results suggest a model where EBV can commonly, and apparently asymptomatically, spread in healthy gingiva but may also aggravate inflammation in the context of gum dysbiosis, involving infiltration of B-cells and PCs and loss of epithelial integrity.

Global burden and trends of severe periodontitis among women of childbearing age, 1990-2021

BACKGROUND

The global burden and trend of severe periodontitis, as well as its association with sociodemographic development, among women of childbearing age (WCBA) have been unclear so far. This study aims to assess the epidemiological pattern of severe periodontitis in WCBA from 1990 to 2021 and provide projections through 2040.

METHODS

Data on the incidence, prevalence, and disability-adjusted life years (DALYs) of severe periodontitis among WCBA from 1990 to 2021 were retrieved from the Global Burden of Disease (GBD) study 2021. The Bayesian age-period-cohort model was run to project the age-standardized incidence rate (ASIR) through 2040.

RESULTS

In 2021, an estimated 26,315,786 incident cases, 257,234,399 prevalent cases, and 1,680,425 DALYs were reported globally. From 1990 to 2021, a consistent annual increase in the age-standardized rate of severe periodontitis was observed, and the ASIR is projected to continue to rise until 2040. Additionally, the burden of severe periodontitis demonstrated a downward trend with increasing sociodemographic development. In 2021, age-specific rates of severe periodontitis increased with age, with the most significant changes occurring in younger age groups.

CONCLUSION

The rising global burden of severe periodontitis, along with regional and age variations, highlights the urgent need for innovative prevention and healthcare strategies to reduce this burden among WCBA globally.

PLAIN LANGUAGE SUMMARY

Women of childbearing age (WCBA) represent nearly a quarter of the global population, yet there is a significant gap in consistent global and regional surveillance data on severe periodontitis in this group. Our study revealed that severe periodontitis among WCBA poses a substantial public health challenge worldwide. From 1990 to 2021, the age-standardized rate of severe periodontitis increased globally, with the most significant rise observed in regions with middle socioeconomic development. This condition disproportionately affects women in their prime years, with the fastest growth seen among younger WCBA. It is essential that healthcare providers recognize the gender disparities and societal factors related to socioeconomic development that contribute to the risk of severe periodontitis in this population. To address this issue effectively, it is crucial to develop region- and age-specific prevention strategies, as well as targeted healthcare interventions.

Near-infrared light reflection for the early detection of proximal caries in posterior teeth: an in vivo study

BACKGROUND

The purpose of this study was to evaluate the validity of near-infrared light reflection for detecting different depths of proximal caries in posterior teeth and to compare it with commonly used clinical oral examinations and bitewing radiography images.

METHODS

Twenty-six patients with a total of 516 proximal surfaces were included in this study. The ground truth of the proximal caries was determined through a consensus reached by two experienced dentists after an intraoral examination assisted by bitewing radiographs. Two general dentists assessed the condition of proximal caries on posterior teeth on near-infrared light reflection images. Accuracy, sensitivity, and specificity were evaluated to determine the diagnostic efficacy of near-infrared light reflection for detecting proximal caries in posterior teeth.

RESULTS

For posterior teeth, the accuracy of near-infrared light reflection was 0.78, with a sensitivity of 0.44 and a specificity of 0.83. Cohen's kappa showed poor consistency between the two diagnostic methods, near-infrared light reflection and bitewing radiography.

CONCLUSION

Near-infrared light reflection is an effective clinical tool for detecting proximal caries in posterior teeth, yet this method does not demonstrate superiority over traditional methods such as bitewing radiography.

TRIAL REGISTRATION

The clinical trial was registered with the China Clinical Trial Registry ( https://www.chictr.org.cn/ ) on 18 August 2023 under the trial number ChiCTR2300074877.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Oral health promotion: a qualitative study to explore perspectives of kindergarten nurses at Qatar

BACKGROUND

The oral health of preschool children remains a concern globally. Kindergarten and school nurses can improve oral health by reducing the incidence of Early Childhood Caries (ECC) among children. This study aimed to explore the perceptions of kindergarten nurses about a proposed oral health promotion program to be implemented in primary health centres and kindergartens.

METHODS

The qualitative research used in-depth interviews of 12 kindergarten nurses who were audio-recorded and transcribed verbatim. Qualitative data analysis software was used (NVivo9 MANUF). Four major themes emerged and were analysed to explore contextual patterns within the data.

RESULTS

The major themes included participants acknowledged the high prevalence of caries in children and identified several causes within the local context, including parental practices, poor dietary habits, the impact of cultural lack of oral health knowledge and limitations in the healthcare system. However, the study results' themes also revealed complex barriers and enablers regarding the implementation of the program highlighting interpersonal, structural, systemic, and social elements.

CONCLUSION

Kindergarten nurses maintained an affirmative attitude towards oral health promotion programs and were enthusiastic about initiating and supporting these programs. This qualitative study brought out critical socio-biological-cultural factors that influence the oral health promotion of preschool children.

A multi-modal dental dataset for semi-supervised deep learning image segmentation

In response to the increasing prevalence of dental diseases, dental health, a vital aspect of human well-being, warrants greater attention. Panoramic X-ray images (PXI) and Cone Beam Computed Tomography (CBCT) are key tools for dentists in diagnosing and treating dental conditions. Additionally, deep learning for tooth segmentation can focus on relevant treatment information and localize lesions. However, the scarcity of publicly available PXI and CBCT datasets hampers their use in tooth segmentation tasks. Therefore, this paper presents a multimodal dataset for Semi-supervised Tooth Segmentation (STS-Tooth) in dental PXI and CBCT, named STS-2D-Tooth and STS-3D-Tooth. STS-2D-Tooth includes 4,000 images and 900 masks, categorized by age into children and adults. Moreover, we have collected CBCTs providing more detailed and three-dimensional information, resulting in the STS-3D-Tooth dataset comprising 148,400 unlabeled scans and 8,800 masks. To our knowledge, this is the first multimodal dataset combining dental PXI and CBCT, and it is the largest tooth segmentation dataset, a significant step forward for the advancement of tooth segmentation.

Preventive effects of taxifolin on dental caries in vitro and in vivo

OBJECTIVES

The present study aimed to explore the inhibitory effect of taxifolin (TAX) on Streptococcus mutans (S. mutans) in vitro and evaluated the anti-caries efficacy of TAX in vivo.

DESIGN

The anti-microbial and anti-biofilm properties of TAX were examined on the S. mutans, and the results were preliminarily verified by quantitative real-time PCR. Polarized light microscopy and transverse microradiography were used to detect the effect of TAX on inhibiting enamel demineralization. The effect of TAX on the remineralization of demineralized enamel was analyzed by a microhardness tester, atomic force microscope, and transverse microradiography. The rat dental caries model was constructed to explore the anti-caries effect of TAX in vivo.

RESULTS

The minimum inhibitory concentration of TAX against S. mutans was 1 mg/mL. The 1 mg/mL TAX impeded the biofilm formation, destroyed the biofilm structure, and effectively prevented enamel demineralization caused by S. mutans. Both the 0.5 mg/mL and 1 mg/mL TAX-treated groups exhibited a higher percentage of surface microhardness recovery, along with lower surface roughness, mineral loss, and lesion depth. Additionally, 1 mg/mL TAX demonstrated the ability to inhibit the initiation and progression of caries in rats, while also proving to be biologically safe.

CONCLUSIONS

TAX had a significant inhibitory effect on S. mutans, could inhibit enamel demineralization and promote remineralization of demineralized enamel, and showed a promising anti-caries effect in vivo.

Prevalence and associated factors of self-reported oral health problems among adults in the Fanteakwa districts in Ghana

BACKGROUND

There is a paucity of data on oral health problems among the residents of Fanteakwa districts (South and North) in the Eastern region of Ghana. Therefore, this study assessed the prevalence and factors associated with self-reported oral health problems in the Fanteakwa districts of Ghana.

METHODS

This community-based cross-sectional study targeted residents of the towns of the Fanteakwa districts, who have not had any dental care visit in the past six months preceding the study. The participants were enrolled from July - October, 2023. Socio-demographic study variables collected were sex, age, educational level, income level, ethnicity, area of residence, household size and frequency of brushing teeth in a day. Whereas the self-reported oral health problems were tooth ache, swollen gum, bleeding gum, sensitive tooth/teeth, hole in tooth/teeth, discoloured tooth/teeth and mouth odour. The chi-square statistical test was used to test the association between the presence of oral health problem(s) and other independent variables. Whereas, Modified Poisson regression was used to test the relationships among the variables.

RESULTS

In total, 400 community members were interviewed. The mean age of respondents was 31 years (SD ± 12.4, Min = 19, Max = 81). The majority were females (55.2%) and more than 96% had some form of formal education. The Akan ethnic group accounted for as much as 47% of the respondents. The overall prevalence of self-reported oral health problems was 58.5% (95% CI 53.5% - 63.4%). The commonly reported oral health problems were toothache (51.7%), swollen gum (38.5%), difficulty in chewing (33.3%), bleeding gum (32.1%), and mobile teeth (17.1%). About 98% (229/234) of the study participants who self-reported oral health problems, reported up to four different problems. Self-reported oral health problems associated with participants' age (χ2 = 7.2, p = 0.027), income level (χ2 = 19.3, p < 0.001), ethnicity (χ2 = 21.2, p < 0.001), area of residence (χ2 = 26.9, p < 0.001), religious affiliation (χ2 = 15.7, p < 0.001) and frequency of brushing teeth in a day (χ2 = 6.85, p < 0.032). Despite the observed relationships, Modified Poisson regression identified that compared to the rural dwellers, the urban dwellers had lower odds of self-reporting oral health problems (aOR = 0.718, p = 0.032, CI: 0.531-0.971), after controlling for age and frequency of teeth brushing in a day.

CONCLUSION

High rate of self-reported oral health problems was observed in the study site. Participants from rural residence were disproportionately affected. Therefore, local health authorities are encouraged to leverage on the identified risk groups for enhanced oral health education towards reduction in the reported oral health problems.

Management of antithrombotic therapy in patients undergoing dental procedures

A growing number of patients receiving antithrombotic therapy require dental procedures. Dental interventions in these patients can be challenging, as the risk of bleeding from the continuation of antithrombotic therapy needs to be weighed against the thromboembolic risk associated with drug interruption or de-escalation. Most minor dental procedures, including simple dental cleaning and filling, pose minimal bleeding risk, and antiplatelet or anticoagulation therapy can be continued without interruption. Local hemostatic measures, such as tranexamic mouthwash, can be used, as needed, to reduce bleeding events following these interventions. Managing antithrombotic therapy during more invasive dental interventions and oral surgeries with a higher risk of perioperative bleeding necessitates the consideration of specific factors influencing the bleeding risk and thromboembolism. In patients receiving antithrombotic therapy for primary prevention, temporary interruption is reasonable. In others, the decisions may be more complex and more nuanced. In this article, we review the current evidence for managing patients receiving oral antiplatelet or anticoagulant drugs scheduled for various dental procedures and present a practical approach for the periprocedural management of antithrombotic treatments.

Implications of type 1 diabetes mellitus in the etiology and clinic of dento-maxillary anomalies - questionnaire-based evaluation of the dentists' opinion

Background and aims

Type 1 diabetes is one of the most common chronic childhood diseases, which can be diagnosed at any age, with implications on the general development, but also on the craniofacial structure. It is widely speculated that diabetes occurs when inherited genetic characteristics are triggered by environmental factors. Oral pathology is complex and it includes a series of clinical entities: dental caries, periodontal disease, dento-maxillary anomalies, diseases of the oral mucosa, which implies a significant responsibility for the doctor, but also for society. This study aims to highlight the association of dento-maxillary anomalies with juvenile diabetes, starting from its increased prevalence among children and adolescents, the oral manifestations of diabetes mellitus and its influence on the oral microbiome, the increased incidence of periodontal and dental diseases, by means of a questionnaire.

Method

A cross-sectional study was carried out on a number of 60 dentists, between 01.01.2023 and 01.03.2024, using a questionnaire with 14 items, which was distributed by e-mail and social networks to dentists of different specialties, from various university. Before completing the questionnaire, the doctors were informed about the purpose of the study and that their answers were anonymous and did not imply any responsibility.

Results

Our results indicated awareness of the association between oral health, the presence of dento-maxillary anomalies and the pathology of type 1 diabetes, among dentists of different specialties. The most frequent changes that occur in the oral cavity in the examined patients are represented by carious lesions, reported by 21 examiners (35.00%), of which 18 (39.13%) are female, aged between 25-35 years.Among the reported dentomaxillary anomalies, those of Angle class II were the most frequent - 17 examiners (28.33%), of which 12 (26.09%) are female reported the presence of these anomalies. The presence of Angle class I anomalies was reported by 13 examiners (21.67%) of which 9 (19.57%) are female, while 6 examiners (10.00%) reported the presence of Angle class III anomalies.

Conclusions

The evaluation of modern therapeutic methods through questionnaires distributed online represents a feedback of the tested activity and shows that most doctors know the correlations between diabetes and oro-dental diseases and have an obvious healthy attitude. The possible association between oral diseases and the presence of type 1 diabetes was reported by most of the dentists interviewed, however the information on the correlations between oral health and the presence of type 1 diabetes in children was not sufficiently explored by dentists. The dentist must know the clinical particularities of diabetes mellitus and its implications on the oral status, in order to be able to intervene effectively in reducing the oral and systemic complications of diabetes.

Optimization of Cellulose Derivative-, PVA-, and PVP-Based Films with Reynoutria japonica Extract to Improve Periodontal Disease Treatment

The aim of this study was to develop and optimize polymeric films based on cellulose derivatives-hydroxypropylmethylcellulose (HPMC), methylcellulose (MC), and sodium carboxymethylcellulose (NaCMC)-as well as pullulan, polyvinyl alcohol (PVA), polyvinylpyrrolidone (PVP), and glycerol (GLY) as plasticizer incorporating Reynoutria japonica extract for potential use in periodontal and gum disease treatment. Over 80 formulations were fabricated using the solvent-casting method, 6 of which were selected for further investigation based on their mechanical properties, mucoadhesion, and disintegration profiles, including three placebo films (OP1 (PVA/PVP/MC400CP/NaCMC/GLY), OP2 (PVA/PVP/MCA15C/NaCMC/GLY), and OP3 (PVA/PVP/HPMC/NaCMC/GLY)) and three films containing R. japonica extract (OW1, OW2, and OW3). The films demonstrated uniform structural characteristics, with the formulations containing PVA with a high hydrolysis degree (98-99%) and methylcellulose derivatives showing prolonged dissolution times due to physical cross-linking, while the inclusion of NaCMC reduced dissolution time without compromising mucoadhesiveness. The study also described the release kinetics of resveratrol and piceid from the OW2 films using three semi-empirical models: the Korsmeyer-Peppas model, a first-order kinetic model, and a multidimensional approach. The multidimensional model demonstrated a strong fit, with a correlation coefficient (R2) of 0.909 for resveratrol, compared to 0.894 and 0.908 for the Korsmeyer-Peppas and first-order models, respectively. For piceid, the multidimensional model showed a correlation coefficient (R2) of 0.958, outperforming the Korsmeyer-Peppas (0.823) and first-order models (0.932). The active compounds released in sustained-release tests, including resveratrol and piceid, suggest that these films could provide an extended therapeutic effect.

Possibilities of Application of Cold Atmospheric Pressure Plasmas in Dentistry—A Narrative Review

According to the World Human Organization (WHO), dental and periodontal diseases are common among the human population. Traditional dentistry offers a wide range of methods for treating oral diseases and performing esthetic procedures. In contrast, cold atmospheric pressure plasma (CAPP) has been found to be a promising technology in multiple fields, particularly in medical sciences such as dentistry. In this study, CAPP might be a promising adjunct to conventional dental treatments. A substantial number of studies have confirmed the effectiveness of both direct and indirect CAPP applications in dentistry. Because CAPP technology is fast, inexpensive, and noninvasive, we aim to review recent literature focused on the application of this methodology in dentistry.

Tooth point cloud resampling method based on divergence index and improved euclidean clustering rule

Objective.In endodontic therapy, 3D cone-beam computerized tomography (CBCT) and oral scan fusion models allow exact root canal channels and guidance. However, the point cloud model from CBCT has few data points and poor model features, limiting 3D fusion with oral scan data. Our aim to build a sub-regional point cloud resampling method and evaluate the precision of merging it with three-dimensional oral scan data.Approach.Two molars and four incisors were resampled for this investigation. Based on point cloud density and curvature, the rebuilt model was separated into the crown and cervical cavities. Using crown surface morphology, Divergence index (DI) was employed to determine resampling points based on point dispersion. Improved Euclidean clustering rule (IECR) downsamples each point using its weight and joins the two halves using Iterative nearest neighbor to create a complete resampled point cloud. After aligning with the oral scanning model, the maximum error, maximum distance, average distance, and other characteristics are calculated to assess resampling. Additionally, a cross-entropy kernel-based point cloud reconstruction depth selection method is given to determine the appropriate reconstruction depth.Main results.Applying the DI-IECR technique reduces the average distance between the resampled tooth point cloud and the point cloud generated by the dental scanner by around 20%. The maximum error remains same to that of the widely used method. This study also demonstrates that the use of the DI-IECR approach guarantees the complete representation of the coronal characteristics of the resampled reconstructed 3D model, rather than excessively focusing processing resources on pertinent but insignificant areas.Significance.Point cloud data and crown features are balanced using DI-IECR. When registered with the oral scan model, CBCT-generated point clouds are more accurate and timely, making them a better intraoperative navigation model.

May family routines impact oral health in American children?

Objectives

The present study aimed to assess the association between family routines and dental caries and self-rated oral health status.

Methods

Data from the 2020-2021 National Survey of Children's Health (NSCH) completed at United States were used. Our outcome variables were self-reported dental caries (yes/no) and poor oral health condition (yes/no). Our independent variables were related to family routines: (1) Going to bed at the same time (yes/no); (2) Days having dinner together (0-7days); (3) Hours spent in front of the TV, computer, cell phone or other electronic devices (screen time); and (4) adequate sleep (yes/no). We used socioeconomic factors, health insurance coverage, family structure and neighborhood characteristics as covariates. Univariate and multiple logistic regression were used to analyze the data.

Results

For the dental caries outcome, children with regular bedtimes (AOR = 0.68, 95% CI: 0.58-0.79), more frequent family dinners (AOR = 0.90, 95% CI: 0.85-0.96), and supportive neighborhoods (AOR = 0.88, 95% CI: 0.78-0.99) were less likely to report dental caries. Increased screen time (AOR = 1.10, 95% CI: 1.04-1.15) was associated with higher self-reported dental caries. For oral health status, children with regular bedtimes, (AOR = 0.60, 95% CI: 0.48-0.75), supportive neighborhoods (AOR = 0.81, 95% CI: 0.68-0.97), and with more neighborhood amenities (AOR = 0.92, 95% CI: 0.88-1.00) reported better health. More screen time (AOR = 1.11, 95% CI: 1.02-1.21) and poor neighborhood conditions (AOR = 1.13, 95% CI: 1.02-1.26) correlated with poor oral health.

Conclusions

Findings from this study indicate that family routines play a significant role in children's oral health. Future research should focus on interdisciplinary family- and community-level interventions that are tailored to support healthy habits and address the needs of families.

Global research on oral cancer: A bibliometric analysis based on 82 highly cited publications from 2014 to 2024

OBJECTIVE

Oral cancer refers to a group of malignancies. The disease's complexity requires a multidisciplinary approach, encompassing oncology, dentistry, epidemiology, molecular biology, and other fields. Given this multifaceted nature, bibliometrics has emerged as a crucial tool to navigate the vast array of academic literature surrounding oral cancer.

METHOD

82 highly cited publications on oral cancer were collected based on the Web of Science Core Collection. For bibliometric visualization and analysis, VOSviewer and R software (4.3.0 version) were used to explore publication trends, collaboration networks, core journals, research hotspots and authors in the field of oral cancer.

RESULTS

This study analyzed 82 publications published over the past 11 years, including 46 published in the United States, 17 in China, 17 in UK, 12 in Canada and 10 in India. Quynh-Thu Le had the most publications (4 publications). Burtness B was the most cited author with 1,926 citations. University of Texas MD Anderson Cancer Center was the most active institution by contributing 7 publications. The most productive journal was journal of clinical oncology. Cluster Analysis of Co-occurrence Keywords revealed that top 10 highest number of core words were squamous-cell carcinoma, cancer, human-papillomavirus, survival, united-states, oropharyngeal cancer, risk, epidemiology, head and risk-factors.

CONCLUSION

Over the past 11 years, studies of oral cancer are increasingly. This bibliometric study may aid researchers in the understanding of the knowledge base and research frontiers associated with oral cancer. Emerging hotspots for research can be used as the subjects of future studies.

Cathepsin K-Positive Cell Lineage Promotes In Situ Dentin Formation Controlled by Nociceptive Sonic Hedgehog

Oral diseases affect nearly half of the global population throughout their lifetime causing pain, as estimated by the World Health Organization. Preservation of vital pulp is the therapeutic core as well as a challenge to protect natural teeth. Current bottleneck lies in that the regenerative capacity of injured pulp is undetermined. In this study, we identified a lifelong lineage that is labelled by cathepsin K (Ctsk) contributing to the physiological, reactionary and reparative odontogenesis of mouse molars. Ctsk+ cell-mediated dentin formation is regulated by nociceptive nerve-derived Sonic Hedgehog (Shh), especially rapidly responsive to acute injury. Notably, exogenous Shh protein to the injury pulp can preserve Ctsk+ cell capacity of odontogenesis for the nearby crown pulp and even remote root apex growth, alleviating conventionally developmental arrest in youth pulpitis. Exposed to chronical attrition, aged pulp Ctsk+ cells still hold the capacity to respond to acute stimuli and promote reparative odontogenesis, also enhanced by exogenous Shh capping. Therefore, Ctsk+ cells may be one of the lineages for accelerating precision medicine for efficient pulp treatment across ages. Shh application can be a candidate for vital pulp preservation and pulp injury repair by promoting regenerative odontogenesis to a certain extent from young adults to older individuals.

Physicochemical Properties of Curen® Filaments Versus Nylon Filaments in Toothbrush Bristles: An In Vitro Study

Background Toothbrush manufacturers commonly use bristle materials such as nylon, polybutylene terephthalate, polypropylene, polyethylene terephthalate, boar hair, bamboo, carbon fiber, silicone, polylactic acid, or their modifications such as Curen®. Nylon filaments have long been demonstrated to be durable and are widely used, but not much is known regarding the performance of Curen® filaments compared to nylon filaments. This in vitro study compared the stiffness, abrasion potential, abrasion resistance, and bristle surface changes of Curen® and nylon filaments. Methodology Ten specimens (five dry and five wet) each of Curaprox CS5460 toothbrushes featuring Curen® filaments and those with nylon filaments were subjected to tensile strength and force-displacement analyses. Brushing simulation (1,000, 2,000, 3,000, and 5,000 cycles) was conducted using six freshly extracted central incisors (three specimens each for the Curen® and nylon filament groups). Pre- and post-brushing simulation parameters included filament abrasion potential (atomic force microscopy of extracted tooth surface), filament abrasion resistance (field emission scanning electron microscopy), and bristle surface changes (stereomicroscopy and micro- and nano-computed tomography). Results Curen® filaments exhibited lower tensile strengths (41.69 MPa [dry] and 35.18 MPa [wet]) than nylon filaments (321.56 MPa [dry] and 325.44 MPa [wet]), indicating that Curen® filaments have lower abrasion potential (87% [dry] and 89% [wet]) and cause less mechanical wear of enamel, thereby resulting in a gentler cleaning experience compared to nylon filaments. Furthermore, the enamel surface roughness in the crown region decreased by 19.4% with the use of the Curen® filaments, whereas it increased by 92.3% with the use of nylon filaments, indicating that Curen® filaments are 72.84% less abrasive to enamel than nylon filaments. After 5,000 cycles of brushing simulation, Curen® filaments showed 30% less splaying than nylon filaments, highlighting the longevity of Curen® filaments up to six months of tooth brushing, which is twice the longevity of nylon filaments. There was a minimal decrease in height (12.0 mm to 11.95 mm, -0.4% change), an increase in top diameter (2.157 mm to 2.390 mm, 10.8% change), and a rise in base diameter (1.784 mm to 2.035 mm, 14% change) in the Curen® filaments group. Taken together, these results indicate that Curen® filaments are superior to nylon filaments as teeth-cleansing agents. Conclusion The findings of this in vitro analysis demonstrate the lower tensile strength and lesser abrasion potential of Curen® filaments when compared with nylon filaments. Thus, Curen® filaments cause fewer microscratches and abrasion of enamel when compared with nylon filaments, occurring due to day-to-day mechanical wear because of improper brushing technique. Furthermore, the lower tensile strength of Curen® filaments provides greater flexibility, facilitating more effective cleaning of hard-to-reach areas compared to nylon filaments. Additionally, the lesser splaying of Curen® filaments highlights their longevity, demonstrating that Curen® filaments last twice as long as nylon filaments under regular brushing conditions. Based on these advantages, toothbrushes with Curen® filaments should be a preferred choice over nylon filaments.

Oral hygiene predicts lower life satisfaction and subjective health: experience of post-Soviet countries

Oral diseases are among the most common non-communicable diseases around the globe and become a public health challenge that considerably impact general health and well-being in all ages across the lifespan. Oral health is an integral part of general health, where poor oral health and other lifestyle-related chronic diseases have a common risk factor background. The underlying causes of oral health inequalities are often complex and related to country-specific historical, economic, cultural, social, or political factors. For more than a decade, data from the Health Behavior in School-aged Children (HBSC) survey showed that tooth brushing rates are very low in post-Soviet countries. The general aim of our study was to focus on a more detailed profile of schoolchildren from post-Soviet countries, who have poor habits of teeth brushing, in terms of their family, social support, physical activity, nutrition, and other health-related behaviors. Data for this study was extrapolated from the Health Behavior in School-aged Children study, a World Health Organization collaborative cross-national study, conducted every 4 years since 1983/1984. For this study, the post-Soviet countries from Eastern Europe and Central Asia were selected: Armenia, Azerbaijan, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Moldova, Tajikistan, Ukraine, and Uzbekistan. Data from all countries (some exceptions for Kyrgyzstan, Tajikistan, and Uzbekistan) were collected within 2017-2018 HBSC study, following international research protocol. The sample consisted of 44,760 schoolchildren, aged 11, 13, and 15 years from 12 countries. Irregular tooth brushing is more common among boys, elder adolescents, and schoolchildren from less affluent families. Low own health measures, low life satisfaction, low physical activity, and low FAS relate to poorer adolescent dental hygiene in post-Soviet countries. Adolescents characterized by irregular tooth brushing were more likely to assess their health as fair or poor rather than excellent or good (OR = 1.22), and also had greater odds of reporting low life satisfaction (OR = 1.36). Individual mental health complaints-feeling low, being irritable, being nervous, and having sleep difficulties-were assessed as a possible outcome of irregular tooth brushing. However, irregular tooth brushing was not associated with poorer mental health outcomes (p > 0.05).    Conclusions: Oral hygiene in post-Soviet countries is still a major public health challenge and have to be addressed properly. What is Known: • Oral health strongly affects the overall health of children and adolescents in the future. • Oral diseases often share common determinants and risk factors with other chronic diseases. • The underlying causes of oral health inequalities are often complex and related to country-specific historical, economic, cultural, social, or political factors. What is New: • Irregular tooth brushing was more common among adolescents with low life satisfaction and poor or fair health as well as in less affluent families. • Irregular tooth brushing was not found to be associated with poorer mental health among post-Soviet countries adolescents.

Associations between insomnia symptoms and self-reported oral health in 59370 adults

OBJECTIVES

The associations between insomnia symptoms and oral health have not been studied. We examined the relationships between insomnia symptoms and oral health in a large representative sample of the middle-aged and older adult Indian population.

METHODS

59,370 Indian adults aged ≥ 45 years were included in this study. Multivariable logistic regression was conducted to evaluate the associations of insomnia symptoms with tooth loss, dental cavities, and periodontal disease in the whole sample and within different age subgroups.

RESULTS

Individuals reporting insomnia symptoms were more likely to show higher prevalence rates of tooth loss (8.4%), dental cavities (22.6%), and periodontal disease (20.9%) than those without insomnia symptoms. Multivariable logistic regression analyses revealed that there were significant associations of insomnia symptoms with tooth loss (OR: 1.20, CI: 1.12-1.29), dental cavity (OR: 1.15, CI: 1.10-1.21), and periodontal disease (OR: 1.70, CI: 1.61-1.78) independent of potential cofounders. A significant moderation effect by age was observed between insomnia symptoms and oral health conditions.

CONCLUSIONS

Insomnia symptoms were associated with higher prevalence rates of tooth loss, dental cavities, and periodontal disease among middle-aged and elderly adults in India. These associations varied across different age groups. In the management of oral health, the potential adverse impact of insomnia symptoms should be closely monitored.

Plasma Rich in Growth Factors Compared to Xenogenic Bone Graft in Treatment of Periodontal Intra-Osseous Defects-A Prospective, Comparative Clinical Study

BACKGROUND

Periodontal intra-bony defects are challenging conditions in dental practice, often requiring regenerative approaches for successful treatment. This clinical study aimed to compare the effectiveness of plasma rich in growth factors (PRGF) versus xenogenic bone graft (BXG) in addressing intra-bony defects.

METHODS

Forty patients aged between 30 and 50 years presenting with generalized periodontitis were included. The study assessed various parameters, including relative attachment level (RAL); probing pocket depth (PPD); gingival marginal level (GML); intra-bony defect depth (IBDD) at baseline, 3, and 6 months; and level of pain, post-operative bleeding, and swelling, as patient-reported outcomes during the first seven days post operation.

RESULTS

The results revealed that both PRGF and BXG treatments led to significant reductions in IBDD over the 6-month study period. PRGF demonstrated significant advantages in GML enhancement and post-operative pain management during the initial post-treatment days. However, BXG showed a significantly greater reduction in IBDD compared to PRGF. Post-operative bleeding and swelling levels were comparable between the two treatments.

CONCLUSIONS

These findings underscore the efficacy of both PRGF and BXG in periodontal regeneration, with treatment decisions guided by patient-specific factors and clinical goals.

Eco-friendly synthesis of betanin-conjugated zinc oxide nanoparticles: antimicrobial efficacy and apoptotic pathway activation in oral cancer cells

BACKGROUND

Phytochemical-based synthesis of nanoparticles (NPs) is an eco-friendly approach with various biomedical applications. Betanin, a natural pigment in beetroot, has antioxidant, anti-inflammatory, and antimicrobial properties. When conjugated with zinc oxide nanoparticles (ZnO NPs), these properties are enhanced. This study aimed to synthesize betanin-ZnO nanoparticles (BE-ZnO-NPs) and evaluate their biological potential.

METHODS

BE-ZnO-NPs were synthesized and characterized using UV-Visible spectroscopy, FTIR, FE-SEM, HR-TEM, EDX, XRD, DLS, and zeta potential analysis. In silico studies assessed interactions with oral pathogen proteins, and antibacterial activity was tested against Enterococcus faecalis, Candida albicans, Staphylococcus aureus and Streptococcus mutans. Antioxidant potential and cytotoxicity on KB cells were evaluated through scavenging assays, MTT assay, and qRT-PCR.

RESULTS

Betanin synthesized ZnO NPs UV-Vis results showed surface plasmon resonance at 388 nm, and FTIR confirmed betanin role as a capping agent. FE-SEM and TEM revealed particles of 37 nm. EDX confirmed zinc content, and XRD showed a hexagonal structure. Zeta potential was - 3.3 mV, and DLS indicated a size of 38.73 nm. In silico analysis showed strong binding to E. faecalis (- 8.0 Kcal/mol). BE-ZnO-NPs demonstrated antibacterial activity at 100 µg/mL, with inhibition zones of 18 ± 0.14 mm for E. faecalis and 14 ± 0.18 mm for S. mutans. In contrast, BE demonstrated antibacterial activity at 100 µg/mL, with zone of inhibition of 10.6 ± 0.14 mm for E. faecalisand 11.4 ± 0.18 mm for S. mutans.Antioxidant assays revealed dose-dependent scavenging activity. Cytotoxicity showed an IC50 of 24.29 µg/mL, with qRT-PCR indicating apoptosis through the BCL2/BAX/P53 pathway.

CONCLUSIONS

BE-ZnO-NPs exhibited significant antibacterial and antioxidant activities and demonstrated the ability to induce apoptosis in oral cancer cells via the BCL-2/BAX/P53 signalling pathway. These findings highlight the potential of BE-ZnO-NPs as promising antimicrobial agents for tooth infections and as therapeutic agents for oral tumour treatment.

Research and Application of Deep Learning Models with Multi-Scale Feature Fusion for Lesion Segmentation in Oral Mucosal Diseases

Given the complexity of oral mucosal disease diagnosis and the limitations in the precision of traditional object detection methods, this study aims to develop a high-accuracy artificial intelligence-assisted diagnostic approach based on the SegFormer semantic segmentation model. This method is designed to automatically segment lesion areas in white-light images of oral mucosal diseases, providing objective and quantifiable evidence for clinical diagnosis. This study utilized a dataset of oral mucosal diseases provided by the Affiliated Stomatological Hospital of Zhejiang University School of Medicine, comprising 838 high-resolution images of three diseases: oral lichen planus, oral leukoplakia, and oral submucous fibrosis. These images were annotated at the pixel level by oral specialists using Labelme software (v5.5.0) to construct a semantic segmentation dataset. This study designed a SegFormer model based on the Transformer architecture, employed cross-validation to divide training and testing sets, and compared SegFormer models of different capacities with classical segmentation models such as UNet and DeepLabV3. Quantitative metrics including the Dice coefficient and mIoU were evaluated, and a qualitative visual analysis of the segmentation results was performed to comprehensively assess model performance. The SegFormer-B2 model achieved optimal performance on the test set, with a Dice coefficient of 0.710 and mIoU of 0.786, significantly outperforming other comparative algorithms. The visual results demonstrate that this model could accurately segment the lesion areas of three common oral mucosal diseases. The SegFormer model proposed in this study effectively achieves the precise automatic segmentation of three common oral mucosal diseases, providing a reliable auxiliary tool for clinical diagnosis. It shows promising prospects in improving the efficiency and accuracy of oral mucosal disease diagnosis and has potential clinical application value.

Periodontitis adversely affects lipoprotein subfractions - results from the cohort study SHIP-TREND: Periodontitis adversely affects lipoprotein subfractions

AIM

We aimed to investigate the medium-term associations of periodontitis and the number of missing teeth with serum lipoproteins and their plasma subfractions using follow-up data from the population-based Study of Health in Pomerania (SHIP-TREND).

METHODS

A total of 2,058 participants with 7-year follow-up data underwent periodontal examinations, serum lipid panel tests, and proton nuclear magnetic resonance (1H-NMR) spectroscopy of plasma lipoproteins and their subfractions. Generalized models with gamma distribution and loglink were used to analyze associations between periodontal variables and lipoproteins and their subfractions, adjusting for confounders using propensity score weighting.

RESULTS

Periodontal variables were consistently associated with elevated follow-up serum levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol levels. When plasma lipoprotein subfractions were evaluated, periodontal variables were associated with elevated levels of triglycerides and cholesterol-enriched apolipoprotein B-containing lipoprotein particles, particularly small dense low-density lipoprotein, very-low-density lipoprotein and intermediate density lipoprotein. In addition, altered high-density lipoprotein particle composition was observed, suggesting potential functional changes.

CONCLUSION

This study provides evidence for causal effects of periodontitis on conventional serum lipids and plasma lipoprotein subfractions. As the underlying biological mechanisms are not fully understood, further research is needed.

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

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

Clinical insights into tooth extraction via torsion method: a biomechanical analysis of the tooth-periodontal ligament complex

Traditionally, extracting single, flat- or curved-rooted teeth through twisting is unfeasible. However, our clinical practice suggests that such teeth can be extracted efficiently through moderate twisting in a minimally invasive manner. Given the lack of studies on biomechanics of the tooth-periodontal ligament (PDL) complex during torsion, which has further constrained its application, we assessed the feasibility of the torsion method for extracting single-rooted teeth and evaluated its minimally invasive potential. Using three-dimensional finite element analysis, we examined the stress distribution of the tooth and PDL during torsion. Then, we examined changes in the optimal torsion angle (OTA) and stress distribution across various anatomical scenarios. During torsion loading, stress concentration was primarily observed on the sing-rooted tooth surface near the alveolar crest, whereas molars at the root furcation. The OTA was found to increase under conditions such as narrowing of root width, decrease in the root apical curvature, change from type I to IV bone, alveolar bone loss, and shortening of root length. Moreover, the clinically validated model demonstrated that 74% of outcomes fell within the standard OTA range. In conclusion, the decrease in PDL area necessitated a larger angle for complete PDL tearing. Single-rooted teeth with root width-to-thickness ratios of ≥0.42 and apical curvatures of ≤30°are suitable for extraction using the torsion method. This study confirms the feasibility of the torsion method for minimally invasive tooth extraction and expands its indications, laying the theoretical foundation and essential insights for its clinical application.

Oral health status and factors associated with oral health of primary school children in Gulu district, northern Uganda

BACKGROUND

Globally, oral diseases remain a major public health problem. However, there is limited information about the oral health status and factors associated with oral disease among children in Uganda. The aim of this study was to examine the oral health status and factors associated with oral health of primary school children in urban and rural areas of the Gulu district of northern Uganda.

METHODS

A comparative cross-sectional study was conducted among 356 school children aged 11-13 years attending six schools located in urban and rural areas. The children received a clinical oral examination and participated in a questionnaire survey that collected information on sociodemographic and oral health knowledge, attitude, and practices. All data were entered and analysed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp statistical software. Logistic regression analyses examined factors associated with dental caries and gingival bleeding.

RESULTS

Of the 356 children (11-13 years) included, the mean age was 12.2 years, 140 (39.3%) were male and 176 (49.4%) were from urban areas. The proportion of school children with dental caries was 33.6% (n = 119), with the mean decayed, missing due to caries, and filled teeth (DMFT) index of 0.81 (25th percentile = 0; 75th percentile = 1.00). There was no significant difference in caries prevalence between rural and urban children (31.6% versus 35.6%, p = 0.33). Of the children involved in the study, 141(39.8%) had gum bleeding. The mean oral knowledge score was 2.85 ± 1.53 (range, 0-7), while the mean attitude, hygiene practice, frequency of sweets consumption, and oral health related impact scores were 4.25 ± 1.23 (range, 1-6), 5.40 ± 1.81 (range, 0-9), 25.66 ± 4.29 (range 9-54) and 2.1 ± 1.65 (range, 0-6), respectively. Using logistic regression analyses, as oral health knowledge score increased the odds of not having dental caries increased (aOR = 1.19, 95% CI 1.02-1.39).

CONCLUSION

The prevalence of dental caries and gum bleeding of primary school children in Gulu district is high. Children lacked knowledge on causes of oral disease, and behaviour towards oral disease prevention. In addition, oral health knowledge scores were significantly associated with dental caries. Oral health education programs in schools should emphasise providing skills-based education.

Exploration of oral hygiene practices, oral health status, and related quality of life of individuals residing in the Rorya district of Tanzania, East Africa

Introduction

Oral health substantially impacts individuals' quality of life, making it an important target for global health interventions. This research describes oral health status, practices, and beliefs within the Rorya district of Tanzania to understand barriers to care.

Methods

To quantify physical oral health status, intraoral examinations were conducted on adults, noting the Decayed Missing and Filled Teeth (DMFT) and Comprehensive Periodontal Inflammatory Burden Index (CPBI). Oral Health-Related Quality of Life (OHRQoL) and semi-structured interviews were conducted to understand oral hygiene behaviors and beliefs. Data was analyzed via two-sample t-tests, Pearson's statistics, and NVIVO.

Results

A purposive sample (n = 139) of participants self-reported to reside in either Burere (n = 32), Nyambogo (n = 52), or Roche (n = 55) were assessed. A two-sample t-test revealed females (n = 67; x¯ = 7.1; SD = 5.4; p < 0.05) have a significantly higher DMFT score than males (n = 72; x¯ = 3.7; SD = 3.9). Moreover, the OHRQoL score of females (n = 67; x¯ = 12.10; SD = 14; p < 0.05) were significantly higher than males (n = 72; x¯ = 10.16; SD = 3). In contrast, males have significantly higher CPBI scores (x¯ = 3.8; SD = 1.5; p=<0.05) than females (x¯ = 3.0; SD = 1.3). Additionally, older age groups presented higher GI and PISA scores, while the younger group (20-30 years) displayed the highest mean DMFT score. The themes that emerged from semi-structured interviews were "pearls of laughter guarded by wisdom teeth," "whispered tales of oral tides and communal echoes," and "tales of the tooth fairy."

Discussion

In this community, proper oral health maintenance techniques are vital yet frequently disregarded, mainly due to disparities in access to resources, reflected in oral health scores. Addressing this is a crucial intervention, presenting an opportunity to uplift overall well-being. Moreover, gender and age disparities in oral health highlight the urgent need for tailored interventions.

Periodontitis: etiology, conventional treatments, and emerging bacteriophage and predatory bacteria therapies

Inflammatory periodontal diseases associated with the accumulation of dental biofilm, such as gingivitis and periodontitis, are very common and pose clinical problems for clinicians and patients. Gingivitis is a mild form of gum disease and when treated quickly and properly is completely reversible. Periodontitis is an advanced and irreversible disease of the periodontium with periods of exacerbations, progressions and remission. Periodontitis is a chronic inflammatory condition that damages the tissues supporting the tooth in its socket, i.e., the gums, periodontal ligaments, root cementum and bone. Periodontal inflammation is most commonly triggered by bacteria present in excessive accumulations of dental plaque (biofilm) on tooth surfaces. This disease is driven by disproportionate host inflammatory immune responses induced by imbalance in the composition of oral bacteria and changes in their metabolic activities. This microbial dysbiosis favors the establishment of inflammatory conditions and ultimately results in the destruction of tooth-supporting tissues. Apart microbial shift and host inflammatory response, environmental factors and genetics are also important in etiology In addition to oral tissues destruction, periodontal diseases can also result in significant systemic complications. Conventional methods of periodontal disease treatment (improving oral hygiene, dental biofilm control, mechanical plaque removal, using local or systemic antimicrobial agents) are not fully effective. All this prompts the search for new methods of therapy. Advanced periodontitis with multiple abscesses is often treated with antibiotics, such as amoxicillin, tetracycline, doxycycline, minocycline, clindamycin, or combined therapy of amoxicillin with metronidazole. However, due to the growing problem of antibiotic resistance, treatment does not always achieve the desired therapeutic effect. This review summarizes pathogenesis, current approaches in treatment, limitations of therapy and the current state of research on the possibility of application of bacteriophages and predatory bacteria to combat bacteria responsible for periodontitis. We present the current landscape of potential applications for alternative therapies for periodontitis based on phages and bacteria, and highlight the gaps in existing knowledge that need to be addressed before clinical trials utilizing these therapeutic strategies can be seriously considered.

Content quality and reliablity of YouTube™ videos as a source of information about good oral hygiene practices in adults

Background

Good oral hygiene is crucial for preventing dental caries and periodontal diseases. However, proper and regular application of oral hygiene practices requires adequate knowledge. In recent years, the internet has become one of the most popular places to find health-related information, necessitating studies that analyze the quality of the content available online. The purpose of the present study was to analyze the content quality and reliability of YouTube™ videos on the topic of adult oral hygiene practices and to guide oral health care professionals who use this platform for patient education.

Methods

A YouTube™ search was performed of the most frequent search term, 'dental hygiene'. A total of 150 videos were screened, and 51 were included in the final study. The characteristics, sources, and content of the videos were analyzed using the Global Quality Score (GQS) and DISCERN reliability indices. The IBM SPSS 25 program was used for statistical analyses.

Results

Most of the included videos were uploaded by oral health care professionals (63%). GQS revealed only 17.6% of the videos were excellent quality whereas 23.5% of them were poor quality. In the content analysis, 62.7% of the videos were deemed moderately useful. Video duration, total content score, and interaction indices were all significantly higher in the useful and very useful groups compared to the slightly useful group (p = 0.020, p < 0.001, p = 0.040). GQS had a positive, low-medium statistically significant correlation with both video duration and total content scores (r = 0.235, r = 0.517; p < 0.05). DISCERN score also had a positive, low-medium statistically significant correlation with total content score (r = 0.500; p < 0.05).

Conclusion

The study concluded that most YouTube™ videos on oral hygiene practices for adults are moderately useful. When using YouTube™ for patient education, oral health care professionals and organizations should be aware of low-quality videos and seek out accurate, useful videos. There is also a need for quality videos with expanded oral health content.

Association between LTF/MMP20/CA6/TAS1R2 polymorphisms and susceptibility to dental caries

OBJECTIVES

The aim was to assess the associations between the LTF, MMP20, CA6, and TAS1R2 polymorphisms and caries in the Zhuang population and explore the underlying mechanism of the impact of lactoferrin on caries susceptibility.

METHODS

A case-control study of 315 adolescents was conducted in Guangxi, China, from May-November 2022. Data were collected through oral examinations and questionnaires. Buccal mucosa cells and DNA samples were collected using the SNPscan technique. Saliva and supragingival plaque samples were taken from 69 subjects with various LTF rs10865941 genotypes. The relationships among the LTF rs10865941 polymorphism, lactoferrin, Streptococcus mutans, and caries were investigated by using the ELISA and qRT-PCR, along with logistic regression analysis.

RESULTS

The genotype distribution of the LTF gene were significantly different between the case and control groups (p = 0.018). The case group had lower C allele and greater T allele frequencies than the control group (p = 0.006). The LTF rs10865941 polymorphism was associated with caries in the codominant, dominant, and additive models (p < 0.05). MMP20 rs1784418, CA6 rs2274328, and TAS1R2 rs35874116 were not significantly different between the two groups (p > 0.05). A greater quantity of S. mutans. in the supragingival plaque was found in the case group (p = 0.03). There were significant differences between the two groups in both the codominant model and the dominant model (p < 0.05).

CONCLUSIONS

The LTF rs10865941 polymorphism may be associated with caries susceptibility in the Zhuang population of China. The LTF rs10865941 T allele may be a potential risk factor for dental caries.

Centrifugal Microfluidic Cell Culture Platform for Physiologically Relevant Virus Infection Studies: A Case Study with HSV-1 Infection of Periodontal Cells

Static well plates remain the gold standard to study viral infections in vitro, but they cannot accurately mimic dynamic viral infections as they occur in the human body. Therefore, we established a dynamic cell culture platform, based on centrifugal microfluidics, to study viral infections in perfusion. To do so, we used human primary periodontal dental ligament (PDL) cells and herpes simplex virus-1 (HSV-1) as a case study. By microscopy, we confirmed that the PDL cells efficiently attached and grew in the chip. Successful dynamic viral infection of perfused PDL cells was monitored using fluorescent imaging and RT-qPCR-based experiments. Remarkably, viral infection in flow resulted in a gradient of HSV-1-infected cells gradually decreasing from the cell culture chamber entrance towards its end. The perfusion of acyclovir in the chip prevented HSV-1 spreading, demonstrating the usefulness of such a platform for monitoring the effects of antiviral drugs. In addition, the innate antiviral response of PDL cells, measured by interferon gene expression, increased significantly over time in conventional static conditions compared to the perfusion model. These results provide evidence suggesting that dynamic viral infections differ from conventional static infections, which highlights the need for more physiologically relevant in vitro models to study viral infections.

Promoting Health Literacy in the Workplace Among Civil Servants: Cross-Sectional Study

Background

In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population.

Objective

This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces.

Methods

A cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed.

Results

A total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores.

Conclusions

Some French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases.

Oral Health and "Modern" Digestive Diseases: Pathophysiologic and Etiologic Factors

In the contemporary era of medicine, exploring the complexity of the human body and its intricate interactions has become a central concern for health researchers. The main purpose of this article is to summarize the current understanding of relevant pathophysiological factors such as chronic inflammation, dysbiosis (microbial imbalance), and metabolic disorders, as well as etiological factors including dietary habits, lifestyle choices, obesity, metabolic syndrome, and genetic predispositions, as well as to emphasize potential avenues for upcoming studies and their medical significance. Additionally, this article aims to assess the potential impact of integrated treatment approaches on patient outcomes, emphasizing the need for interdisciplinary collaboration between gastroenterologists, dentists, and other healthcare professionals to develop comprehensive care plans that address both oral and digestive health issues simultaneously. Among the branches with a significant impact on general well-being are oral cavity health and digestive diseases, which have been the subject of intensive research in recent decades. In this context, analysis of the current state of knowledge on oral cavity disorders in relation to "modern" digestive diseases such as non-alcoholic fatty liver disease (NAFLD), small intestinal bacterial overgrowth (SIBO), inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS) becomes essential for a deeper understanding of the interconnections between oral and digestive health. The temporal overlap or succession, whether preceding or following, of oral manifestations and digestive disorders should be taken seriously by both gastroenterologists and dentists to facilitate early diagnosis and explain to patients the correlation between these two body systems. In summary, this article underscores the importance of understanding the intricate relationship between oral and digestive health, advocating for interdisciplinary approaches to improve patient outcomes and guide future research.

Incorporating basic periodontal screening into antenatal care services provided in Rwanda: A policy brief

Background

Preterm birth, which is child delivery before 37 weeks of pregnancy, is the primary cause of perinatal mortality worldwide. Preterm birth remains a major public health challenge in Rwanda, affecting approximately 13.8% of birth. The World Health Organization estimates that 15 million babies are born prematurely each year. While the association between periodontitis and preterm deliveries is increasingly recognized, little is known about this link in Rwanda. This policy brief aims to bridge this knowledge gap by presenting the findings of a recent study investigating the prevalence of periodontitis among pregnant women in Rwanda and its association with preterm deliveries. This policy brief also aims to inform and guide decision making towards incorporating periodontal screening into the antenatal care package in Rwanda. This has the potential to improve pregnancy outcomes and contribute to improved oral health in the future.

Policy outcome and Implications

Contemporary evidence has shown a six-fold increased risk of preterm delivery for women with periodontitis in Rwanda, with a concerningly high prevalence (60%) among pregnant women. Additionally, nurses working in antenatal clinics displayed insufficient knowledge about gum disease.

Actionable recommendations

The adoption of basic periodontal screening within existing antenatal care packages is recommended. This, coupled with nurse training and public awareness campaigns, can empower women and healthcare professionals to prioritize oral health for better pregnancy outcomes.

Conclusions

Integrating periodontal screening into antenatal care has the potential to significantly reduce preterm deliveries and contribute to a healthier future generation in Rwanda.

Artificial Intelligence in Dental Caries Diagnosis and Detection: An Umbrella Review

BACKGROUND AND AIM

Dental caries is largely preventable, yet an important global health issue. Numerous systematic reviews have summarized the efficacy of artificial intelligence (AI) models for the diagnosis and detection of dental caries. Therefore, this umbrella review aimed to synthesize the results of systematic reviews on the application and effectiveness of AI models in diagnosing and detecting dental caries.

METHODS

MEDLINE/PubMed, IEEE Explore, Embase, and Cochrane Database of Systematic Reviews were searched to retrieve studies. Two authors independently screened the articles based on eligibility criteria and then, appraised the included articles. The findings are summarized in tabulation form and discussed using the narrative method.

RESULT

A total of 1249 entries were identified out of which 7 were finally included. The most often employed AI algorithms were the multilayer perceptron, support vector machine (SVM), and neural networks. The algorithms were built to perform the segmentation, classification, caries detection, diagnosis, and caries prediction from several sources, including periapical radiographs, panoramic radiographs, smartphone images, bitewing radiographs, near-infrared light transillumination images, and so forth. Convoluted neural networks (CNN) demonstrated high sensitivity, specificity, and area under the curve in the caries detection, segmentation, and classification tests. Notably, AI in conjunction with periapical and panoramic radiography images yielded better accuracy in detecting and diagnosing dental caries.

CONCLUSION

AI models, especially convolutional neural network (CNN)-based models, have an enormous amount of potential for accurate, objective dental caries diagnosis and detection. However, ethical considerations and cautious adoption remain critical to its successful integration into routine practice.

Postbiotic mediators derived from Lactobacillus species enhance riboflavin-mediated antimicrobial photodynamic therapy for eradication of Streptococcus mutans planktonic and biofilm growth

BACKGROUND

Streptococcus mutans has been implicated as a primary causative agent of dental caries and one of its important virulence properties is an ability to form biofilm on tooth surfaces. Thus, strategies to prevent and control S. mutans biofilms are requested. The present study aimed to examine the eradication of S. mutans planktonic and biofilm cells using riboflavin (Rib)-mediated antimicrobial photodynamic therapy (aPDT) enhanced by postbiotic mediators derived from Lactobacillus species.

MATERIALS AND METHODS

Minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of Rib and postbiotic mediators were determined. The antimicrobial and anti-biofilm effects of Rib-mediated aPDT (Rib plus blue light), Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus casei (LC) (aPDT+ LC), and Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus plantarum (LP) (aPDT+ LP) were evaluated. The anti-virulence potential of Rib-mediated aPDT, aPDT+ LC, and aPDT+ LP were assessed by measuring the expression of the gtfB gene using quantitative real-time polymerase chain reaction (qRT-PCR) at the highest concentrations of Rib, LC, and LP, at which the S. mutans had proliferation as the same as in the control (non-treated) group.

RESULTS

According to the results, the MIC doses of LC, LP, and Rib were 64 µg/mL, 128 µg/mL, and 128 µg/mL, respectively, while the MBC values of LC, LP, and Rib were 128 µg/mL, 256 µg/mL, and 256 µg/mL, respectively. Rib-mediated aPDT, aPDT+ LP, and aPDT+ LC showed a significant reduction in Log10 CFU/mL of S. mutans compared to the control group (4.2, 4.9, and 5.2 Log10 CFU/mL, respectively; all P < 0.05). The most destruction of S. mutans biofilms was observed after treatment with aPDT+ LC followed by aPDT+ LP and Rib-mediated aPDT (77.5%, 73.3%, and 67.6%, respectively; all P < 0.05). The concentrations of 31.2 µg/mL, 62.5 µg/mL, and 62.5 µg/mL were considered as the highest concentrations of LC, LP, and Rib, respectively, at which S. mutans replicates as same as the control group and were used for gtfB gene expression assay using qRT-PCR during Rib-mediated aPDT, aPDT+ LP, and aPDT+ LC treatments. Gene expression results revealed that aPDT+ LP and aPDT+ LC could decrease the gene expression level of gtfB by 6.3- and 5.7-fold, respectively (P < 0.05), while only 5.1-fold reduction was observed after Rib-mediated aPDT (P < 0.05).

CONCLUSION

Our findings indicate that aPDT+ LP and aPDT+ LC hold promise for use as a treatment to combat S. mutans planktonic and biofilms growth as well as anti-virulence as a preventive strategy to inhibit biofilms development via reduction of gtfB gene expression.

Athletes' medical preventive behaviors: the case of oral health and ultraendurance trail runners

Ultra-endurance runners are particularly exposed to caries risk factors due to the continuous intake of sugars in liquid or sticky forms during long-distance exercise. The risk of caries increases due to a failure to perform oral hygiene during races. Ultra-endurance runners had good oral health status despite these particularities. Our hypothesis is that high compliance with preventive oral health recommendations (toothbrushing and preventive or regular dental visits) counterbalance the risks associated with their exposure to caries. We aimed to gain a better understanding of preventive dental behaviors in ultra-endurance runners. We then studied the determinants of two major recommendations: (1) visiting a dentist for preventive check-ups and (2) visiting a dentist during the year. 37% of the total sample reported patterns of both preventive dental visits and recent visits. Early visits (ORa = 4.8***), good oral health (ORa = 8.8**) and tooth brushing (ORa = 2.2**) were associated with preventive dental visits, but there was no significant influence of snacking or weekly work hours. The ultra-endurance race frequency was associated with early dental visits despite equal needs. Most risk-control behaviors were associated with each other, indicating that they are all-or-nothing behaviors. Individual prevention strategies implemented at the dental office may not be as effective as they predominantly target individuals who are already aware of and interested in preventive care. Instead, developing targeted primary prevention strategies that are accessible at race venues, such as stands, villages, or food supply points, could be more effective.

Prevalence of Malocclusion and Orthodontic Treatment Need in 9- to 12-Year-Old Schoolchildren in Ulaanbaatar, Mongolia

Background The prevalence of malocclusion in Mongolia is increasing every year. Estimating the need for orthodontic treatment in the population is crucial for planning orthodontic care services and monitoring oral health programs. Therefore, the present study aimed to assess the need for orthodontic treatment among schoolchildren in Ulaanbaatar, Mongolia, using the Index of Orthodontic Treatment Need (IOTN). Methods A total of 656 schoolchildren aged 9-12 years were enrolled from 8 schools located in urban and suburban areas of 6 districts of Ulaanbaatar city. All the children were assessed according to the two components of the IOTN, the Dental Health Component (DHC) and the aesthetic component (AC). Statistical analyses were carried out using IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York, United States). Results The prevalence of malocclusion was 561 (84.5%), consisting of 452 (68%) Angle Class I, 178 (26.8%) Angle Class II, and 34 (5.2%) Angle Class III malocclusion. For the DHC, the moderate need for treatment was 194 (29.3%) and the definite need was 53 (8.1%). For the AC, the moderate need was 148 (22.3%) and the definite need was 45 (6.9%). The association between the DHC and the AC was found to be statistically significant (p<0.001). The most common malocclusions were an increased overjet (maxillary protrusion), a contact point displacement (crowding), and an increased overbite (deep bite). The AC, Angle's molar relationship, an increased overjet, a contact point displacement, and an increased overbite were factors associated with the need for orthodontic treatment. Conclusion Approximately one-third of schoolchildren in Ulaanbaatar, Mongolia, require orthodontic treatment. This finding helps dental practitioners to better understand oral health problems, leading to an improvement in the overall quality of life of children.

Reducing maternal and child oral health disparities in Sub-Saharan Africa through a community-based strategy

Oral conditions disproportionately affect mothers and children in Sub-Saharan Africa, due to biological vulnerabilities, a scarcity of oral health workers, deficient preventive strategies, and gender-based barriers to care. The World Health Organization (WHO) recommends integrating oral health into broader health delivery models, to reduce these disparities. We propose integrating preventive oral healthcare into community-based programs to bridge these gaps. We examine integrating preventive oral healthcare into Western Kenya's Chamas for Change (Chamas) community-based program which aims to reduce maternal and child health disparities. Chamas incorporates women's health and microfinance programs best practices to produce a low-cost, community-driven, sustainable, and culturally acceptable health delivery platform. Our strategy is based on the Maternal and Child Oral Health Framework and uses the WHO Basic Package of Oral Care principles. This framework prioritizes community involvement, cultural sensitivity, regular screenings, and seamless integration into general health sessions. We discuss the strengths, weaknesses, opportunities, and threats to enriching Chamas with oral health promotion activities. It is crucial to assess the effectiveness, sustainability, and acceptability of the proposed strategy through implementation and evaluation. Future studies should investigate the long-term impact of integrated oral health models on community health and oral health disparity reduction in Africa.

Study protocol for a pilot quasi-experimental study on oral health education for nurses and community health workers in Nigeria

Introduction

The primary health care system provides an ideal setting for the integration of oral health into general health care as well as equitable access to oral health care. However, the limited oral health knowledge of primary health care workers necessitates appropriate training before they can participate in health promotion efforts. This pilot training was designed to examine the impact of the Oral Health Education module for Nurses and Community Health Care Workers on their oral health awareness and referral practices.

Methods

This study will utilize a quasi-experimental design (pre-and post with a non-equivalent control group) to assess the impact of a five-day pilot oral health education program on the knowledge and referral practices of Nurses and Community Health Workers in primary health care centers in three states in Nigeria-(Lagos, Oyo, and Kano). The training modules were developed based on the six iterative steps described in the intervention mapping framework - needs assessment, highlighting program objectives and outcomes, selection of theory and mode of intervention, designing program based on theory, designing implementation plans, and developing an evaluation plan. Only the intervention group will participate in the full educational training sessions but both groups will complete the pre-and post-intervention questionnaires.

Discussion

This pilot training combined the standardized training modules from the recently launched "Oral Health Training Course for Community Health Workers in Africa" and a newly developed maternal and child oral health module by our group using an evidence-based approach. To the best of our knowledge, this is the first program to examine the impact of the standardized OpenWHO modules. The success of this training will lay the foundation for developing a sustained channel for providing oral health education at the primary health care level in Nigeria, West Africa, and Africa.

Bioinformatics for Dentistry: A secondary database for the genetics of tooth development

Genes strictly regulate the development of teeth and their surrounding oral structures. Alteration of gene regulation leads to tooth disorders and developmental anomalies in tooth, oral, and facial regions. With the advancement of gene sequencing technology, genomic data is rapidly increasing. However, the large sets of genomic and proteomic data related to tooth development and dental disorders are currently dispersed in many primary databases and literature, making it difficult for users to navigate, extract, study, or analyze. We have curated the scattered genetic data on tooth development and created a knowledgebase called 'Bioinformatics for Dentistry' (https://dentalbioinformatics.com/). This database compiles genomic and proteomic data on human tooth development and developmental anomalies and organizes them according to their roles in different stages of tooth development. The database is built by systemically curating relevant data from the National Library of Medicine (NCBI) GenBank, OMIM: Online Mendelian Inheritance in Man, AlphaFold Protein Structure Database, Reactome pathway knowledgebase, Wiki Pathways, and PubMed. The accuracy of the included data was verified from supporting primary literature. Upon data curation and validation, a simple, easy-to-navigate browser interface was created on WordPress version 6.3.2, with PHP version 8.0. The website is hosted in a cloud hosting service to provide fast and reliable data transfer rate. Plugins are used to ensure the browser's compatibility across different devices. Bioinformatics for Dentistry contains four embedded filters for complex and specific searches and free-text search options for quick and simple searching through the datasets. Bioinformatics for Dentistry is made freely available worldwide, with the hope that this knowledgebase will improve our understanding of the complex genetic regulation of tooth development and will open doors to research initiatives and discoveries. This database will be expanded in the future by incorporating resources and built-in sequence analysis tools, and it will be maintained and updated annually.