Impact of removable dentures on oral health-related quality of life among elderly adults in Taiwan

Evaluation of factors associated with fear and anxiety in the orthodontic treatment of adult patients

Background

Despite the technological advances made in dentistry, anxiety and fear of pain due to dental treatment are still common. Most patients in a dental clinic suffer some symptoms of anxiety, which can appear at different times. The objective is to know the degree of anxiety and the factors associated with this anxiety during orthodontic treatment.

Material and Methods

180 adult patients who started orthodontic treatment were selected and a questionnaire was administered at the beginning and after six months of treatment. The SDAI anxiety scale was used to determine the degree of anxiety and its own questionnaire to determine its relationship with the different factors of orthodontic treatment.

Results

When performing descriptive and inferential statistics, it is obtained that 72% of patients at the beginning of orthodontic treatment present a certain degree of anxiety. Through individual logistic regression using anxiety as a response and each of the demographic variables at six months as predictors, it is obtained that gender(OR=3.15) and occupation(OR=3.11) are the two significant predictors (P<0, 05). Using Fisher's exact test of independence, the additional questions are related to the demographic variables and anxiety, obtaining a value of P<0.05 in 27(of 114) non-independent relationships between the additional questions and the demographic/anxiety variables.

Conclusions

38%of patients who begin orthodontic treatment have high anxiety, but after 6 months this anxiety drops to 22%. Women and patients with active work are the most likely to present more anxiety at 6 months. The biggest concerns at the beginning of treatment are: Changes in appearance(Q15),Eating(Q18),Appliance loss(Q19),Hygiene(Q24),Tooth loss(Q25),Extend treatment(Q26),Expectations(Q27) and Retention(Q28).Of these eight, only three continue to worry patients after six months: appliances loss(Q19),Hygiene(Q24) and Tooth Loss(Q25).At the beginning of treatment there are two questions that do not worry: Enter alone(Q10) and take medications(Q21).Four more are added after six months: Embarrassment(Q16),Getting used to it(Q17),Periodic visits(Q22) and Emergencies(Q23). Key words:SDAI scale, Dental anxiety, Adults, Orthodontic treatment.

The role of visual aids in the clinical success of posterior restorations: Randomized controlled clinical trial

Objective

This clinical study aimed to assess the impact of utilizing loupes and dental operating microscopes (DOM) with varying magnifications on the success of class II direct composite restorations.

Methods

A total of 130 class II, moderately deep caries teeth from 85 patients were randomly assigned to four groups: naked eye, ×3 loupe, ×5 loupe, and ×8.5 DOM. Cavities were restored with or without magnification. The restorations were evaluated according to World Dental Federation criteria at 1, 6, and 12-month intervals by previously calibrated evaluators. Cochran's Q test was used to compare paired scores across three or more time points within groups, while the Friedman test was employed to compare scores at three or more time points. Multiple comparisons were adjusted using the Bonferroni correction. The significance level was set at p < 0.05.

Results

Statistical analysis revealed no significant differences among the groups at the 1-, 6-, and 12-month follow-up periods (p > 0.05). Although not statistically significant, the magnified groups exhibited higher scores in aesthetic anatomical form, proximal form, postoperative sensitivity, periodontal response, and adjacent mucosalcriteria compared to the naked eye group.

Conclusion

Although no statistically significant difference was observed at the 12-month follow-up between restorations performed with and without magnification, the groups using magnification showed higher scores.

Microbiota transplantation

Microbiota refers to a collection of living microorganisms, including bacteria, yeasts, and viruses, that coexist in various sites of the human body. Microbiota can perform multiple functions in the body, which have an essential effect on human health and homeostasis. For example, the microbiota can digest polysaccharides, produce vitamins, modulate the immune system, and protect the body against pathogens. Various factors can occasionally alter the microbiota population in the human body, a condition known as dysbiosis. Dysbiosis can disrupt the homeostasis of a person's body and cause disease. Recent years have witnessed efforts to restore the microbiota population of an individual's body to its original state and eradicate dysbiosis through microbiota transplantation. The noteworthy point is that different methods such as fecal microbiota transplantation, vaginal microbiota transplantation (VMT), skin microbiota transplantation (SMT), oral microbiota transplantation (OMT), washed microbiota transplantation (WMT), and sinonasal microbiota transplantation (SiMT) are used for microbiota transplantation (MT). According to the results of studies and the usefulness of MT in improving a person's health, the purpose of this study is to investigate different methods of MT to eliminate dysbiosis.

Traumatic Dental Injuries' Prevalence across Diverse Healthcare Settings: A Systematic Review and Meta-Analysis

Introduction

Traumatic dental injuries (TDI) are a global public health concern, impacting individuals of various age groups. This systematic review aimed to consolidate current evidence on TDI prevalence, providing insights for improved management and prevention strategies.

Methods

A comprehensive search was conducted across PubMed/MEDLINE, Embase, and Scopus databases for studies published between January 1, 2000, and July 1, 2024. Studies reporting on the prevalence of TDI in various populations were included. We followed PRISMA guidelines in the review process. Descriptive statistics were used to summarize study characteristics, and a random-effects model was applied in the meta-analysis using STATA version 14 to pool prevalence rates, while accounting for inter-study variability. Begg's and Egger's tests were conducted to assess publication bias.

Results

The review included data of 151,205 patients from 30 studies across diverse healthcare settings. The prevalence rates varied significantly across studies, ranging from as low as 1.88% to as high as 86.98%. The overall pooled prevalence of TDI, calculated using a random effects model, was 19.48% (95% CI: 11.21% to 27.74%), indicating substantial heterogeneity among the studies (I-squared = 100.0%, p < 0.001). The prevalence varied significantly across different healthcare settings and demographic groups. No evidence of publication bias was found (p > 0.05).

Conclusions

This systematic review underscores the high prevalence of TDI and highlights the need for targeted preventive strategies and evidence-based interventions in dental trauma care.

Impact of Denture Use on Oral Health-Related Quality of Life in Yemeni Patients: A Cross-Sectional Analysis

BACKGROUND We used the 14-item Oral Health Impact Profile-14 (OHIP-14) questionnaire to evaluate the association between sociodemographic variables and oral health-related quality of life in 241 wearers of removable partial or complete dentures attending a single center in Yemen. MATERIAL AND METHODS A total of 241 partial dentures (PD) and complete dentures (CD) wearers were enrolled from the Department of Prosthodontics at the Faculty of Dentistry, Sana'a University, and the University of Science and Technology. Data were collected before the commencement of denture wearing and after 3-6 months of denture use. The questionnaire consisted of sociodemographic information and denture type, and another for the OHIP to assess oral health-related quality of life (OHRQoL), oral health impact profile scale comprises 7 subscales, each evaluating different aspects of oral health and functionality. Descriptive statistics were calculated for participants. Independent t tests were performed to compare different patient groups, focusing on PD and CD wearers. Paired-sample t tests were used to examine changes within patient groups before and after removable denture use. RESULTS Among all participants, 67.6% were male, wearers of CDs were 74.6% male, PDs were 58.3%, and was consistent for CD (71.0%) and PD (72.8%) wearers. The wearing prostheses significantly impacted the OHRQoL of patients using both PDs and CDs (P<0.01). Among CD wearers, 4 of these subscales (3-6) were statistically significant, but the handicaps subscale showed evident reductions in physical pain after treatment among PD wearers. CONCLUSIONS Wearing dentures positively affects the OHRQoL of patients, influencing various aspects of their health, including functional, physical, psychological, and social well-being.

Comparison of Dental Caries Risk Assessment Using CaRisk- A Simple Mobile Based Application and WHO deft, DMFT Scores: A Cross Sectional Study

Statement of the Problem

It is essential to address caries risk at an early stage for the prevention of dental caries. Mobile application CaRisk is designed in a particular way to self-assess the dental caries risk by the individual's themselves.

Purpose

The current study aimed to assess the dental caries risk among age groups 5-6 and 35-44 using self-assessment caries risk mobile application CaRisk and compare it with the deft and DMFT values.

Materials and Method

This cross-sectional study was conducted in Chennai, India; to evaluate the risk of dental caries in children aged 5 to 6 and adults aged 35 to 44. The scores of the mobile application CaRisk and the decayed- extracted- filled teeth (deft)/ decayed-missing-filled-teeth (DMFT) caries risk assessment were evaluated. Descriptive statistics were performed. The risk category was determined by frequency. Chi-square analysis was done to determine whether the DMFT scores and the CaRisk mobile app were associated. The correlation was performed between the CaRisk mobile application and DMFT scores.

Results

Association was found between the caries risk assessment score of the mobile application CaRisk and the DMFT and deft scores of the adults and children for both the age groups 5-6 and 35-44 years respectively and it indicates that it was found to be statistically significant. Pearson's correlation was performed to assess the strength of association and R-values obtained for the age group 5-6 and 35-44 years respectively, which was statistically significant (0.892 and 0.840).

Conclusion

This CaRisk mobile application scores correlate with the deft and DMFT scores and it is an effective self-diagnosis tool for assessing dental caries risk assessment. Further, it is suggested that the mobile application CaRisk should be tested among a huge population.

Recent advances in nanomaterial-based biosensor for periodontitis detection

Periodontitis, a chronic inflammatory condition caused by bacteria, often causes gradual destruction of the components that support teeth, such as the alveolar bone, cementum, periodontal ligament, and gingiva. This ultimately results in teeth becoming loose and eventually falling out. Timely identification has a crucial role in preventing and controlling its progression. Clinical measures are used to diagnose periodontitis. However, now, there is a hunt for alternative diagnostic and monitoring methods due to the progress of technology. Various biomarkers have been assessed using multiple bodily fluids as sample sources. Furthermore, conventional periodontal categorization factors do not provide significant insights into the present disease activity, severity and amount of tissue damage, future development, and responsiveness to treatment. In recent times, there has been a growing utilization of nanoparticle (NP)-based detection strategies to create quick and efficient detection assays. Every single one of these platforms leverages the distinct characteristics of NPs to identify periodontitis. Plasmonic NPs include metal NPs, quantum dots (QDs), carbon base NPs, and nanozymes, exceptionally potent light absorbers and scatterers. These find application in labeling, surface-enhanced spectroscopy, and color-changing sensors. Fluorescent NPs function as photostable and sensitive instruments capable of labeling various biological targets. This article presents a comprehensive summary of the latest developments in the effective utilization of various NPs to detect periodontitis.

Characterization of pathogenic microbiome on removable prostheses with different levels of cleanliness using 2bRAD-M metagenomic sequencing

Background

The microbiomes on the surface of unclean removable prostheses are complex and yet largely underexplored using metagenomic sequencing technology.

Objectives

To characterize the microbiome of removable prostheses with different levels of cleanliness using Type IIB Restriction-site Associated DNA for Microbiome (2bRAD-M) sequencing and compare the Microbial Index of Pathogenic Bacteria (MIP) between clean and unclean prostheses.

Materials and Methods

Ninety-seven removable prostheses were classified into 'clean' and 'unclean' groups. All prosthesis plaque samples underwent 2bRAD metagenomic sequencing to characterize the species-resolved microbial composition. MIPs for clean and unclean prostheses were calculated based on the sum of the relative abundance of pathogenic bacteria in a microbiome using a reference database that contains opportunistic pathogenic bacteria and disease-associated information.

Results

Beta diversity analyses based on Jaccard qualitative and Bray-Curtis quantitative distance matrices identified significant differences between the two groups (p < 0.05). There was a significant enrichment of many pathogenic bacteria in the unclean prosthesis group. The MIP for unclean prostheses (0.47 ± 0.25) was significantly higher than for clean prostheses (0.37 ± 0.29), p = 0.029.

Conclusions

The microbial community of plaque samples from 'unclean' prostheses demonstrated compositional differences compared with 'clean' prostheses. In addition, the pathogenic microbiome in the 'unclean' versus 'clean' group differed.

Oral Health-related Quality of Life Among Denture Stomatitis Patients with Implant Overdenture Treated with Photodynamic Therapy

PURPOSE

This study aimed to assess the impact of photodynamic therapy (PDT) on the oral health-related quality of life (OHRQoL) among denture stomatitis patients with implant overdenture prostheses (IODs).

MATERIALS AND METHODS

The patients were recruited from a specialist dental practice according to selection criteria. The Candida spp. were identified and confirmed by the microbiological culture technique. Candida counts were estimated as colony-forming units (CFU/ml) at baseline, 15, 30, and 60 days. PDT was carried out twice a week with 72 h intervals for a period of 4 weeks. A structured questionnaire was used for data collection. It included the demographic details of the patients, including age, gender, education, marital and socioeconomic status (SES), oral habits, and smoking status. In addition, the Oral Health Impact Profile-EDENT (OHIP-EDENT) scale was added to assess the OHRQoL of all patients before and after PDT treatment. The data were analysed using descriptive statistics, the t-test and the Shapiro-Wilk test; statistical signifcance was set at p < 0.05.

RESULTS

At baseline, the overall mean Candida CFU/ml were quite high in the implant overdenture (IODs) samples, 37.12 ± 15.8, as compared to palatal mucosa samples with 5.1 ± 2.3. After PDT treatment, a statistically significant reduction was noted in the mean Candida CFU/ml on both surfaces at all follow-up visits. It was observed that all domains of OHIP-EDENT except for physical disability and handicap showed statistically significant improvement in mean scores after PDT treatment. FL, P1, P2, D2, and D3 had statistically significant mean score improvements of 2.2, 3.1, 2.2, 1.4, and 0.7, respectively. Furthermore, after PDT treatment, the total OHIP-EDENT score showed a statistically significant improvement of 11.6.

CONCLUSION

PDT treatment has a positive impact on the OHRQoL for patients with denture stomatitis. It can be used as an effective treatment option for the treatment of denture stomatitis in IOD patients.

Oral health in cancer palliative care: cross-sectional study

OBJECTIVES

Patients on anticancer therapy attending palliative care services often have oral health problems, but not enough is known in this regard (in India). This cross-sectional study aimed to elucidate this issue.

METHODS

Participants were 98 patients with metastatic cancer (52 males, 46 females) who attended the palliative care clinic and were assessed by a multidisciplinary team consisting of dental health professionals working alongside the palliative care team, between August 2021 and October 2022. Their demographic and medical details were collected from the charts. Details about oral health were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events for dysphagia and xerostomia, Dental Caries Decayed, Missing, and Filled Teeth (DMFT) index, and the WHO Mucositis scale. Quality of life was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Module for Oral Health (EORTC QLQ-OH15).

RESULTS

Patients had an average age of 58 years, with 46.9% having an Eastern Cooperative Oncology Group score of 1, and 61 (64.9%) receiving anticancer treatment along with palliative care. Dental issues were prevalent, with 39.5% classified as DMFT score grade 2. Subgroup analysis showed higher mean DMFT scores in head/neck cancers, particularly in those receiving radiation therapy (2.3) versus without (1.7), and older age (p<0.05).

CONCLUSION

Patients with cancer on anticancer treatment attending a palliative care clinic, especially those with head/neck cancers and older age, had poor oral health. Further prospective research with a dentist on the team is warranted to assess its impact.

Is Parental Rating of Child's Oral Health Associated with Caries Experience in Children? A Cross-Sectional Study

Aim

The Parents' view to the oral health of their children is a significant factor that can impact oral health practices and behaviors. The aim of this research was to investigate how parental assessment of their child's oral health associates with caries experience in children receiving dental treatment at the hospital of Taibah University Dental College.

Materials and Methods

This cross-sectional study enrolled 127 children who underwent dental treatment at Taibah University Dental College and Hospital during 2020-2021. Dental caries experience was assessed using the dmft/DMFT index, and parental rating of oral health was obtained through a questionnaire. Three logistic regression models were used to assess the correlation between dental caries experience and parental rating of oral health while controlling for sociodemographic and behavioral factors.

Results

Most parents rated the oral health of their child as good (60.4%), followed by excellent (18.8%) and very good (15.6%). The mean dmft/DMFT score was 3.47 ± 3.46, with 43.8% of children having high/very high dental caries experience. Logistic regression analysis showed that children whose parents rated their oral health as poor were more likely to have high/very high dental caries experience compared to those rated as excellent/very good/good/fair (adjusted odds ratio = 4.45, 95% confidence interval 1.23-16.07).

Conclusion

This study suggests a link between parental assessment of their child's oral health and an elevated prevalence of dental caries in children. The study found that children whose parents rated their oral health as suboptimal had higher odds of having high dental caries experience. These findings emphasize the significance of parental perception of their child's oral health and suggest a necessity for customized interventions to enhance parental knowledge and practices concerning children's oral health.

Effects of oral health-related quality of life on total mortality: a prospective cohort study

BACKGROUND

The effects of oral health on mortality have been reported; however, the association between mortality and Oral Health-Related Quality of Life (OHQOL) is unknown. We investigated the effect of OHQOL on total mortality in a cohort consisting of dentists.

METHODS

In this cohort study, we analyzed data from the Longitudinal Evaluation of Multi-phasic, Odonatological and Nutritional Associations in Dentists study. We conducted a baseline survey of general and oral health factors. We called for 31,178 participants and collected responses from 10,256 participants. We followed up with 10,114 participants (mean age ± standard deviation, 52.4 ± 12.1 years; females, 8.9%) for 7.7 years, until March 2014, to determine the average total mortality. OHQOL was assessed using the General Oral Health Assessment Index (GOHAI). The total score was divided into quartiles (Q1 ≤ 51.6, Q2 = 51.7-56.7, Q3 = 56.8-59.9, and Q4 = 60.0), with higher GOHAI scores indicating better OHQOL (score range, 12-60). The association between OHQOL and total mortality was analyzed using the Cox proportional hazards model.

RESULTS

We documented 460 deaths. Males with low GOHAI scores possessed a remarkably high risk of total mortality. The multivariate adjusted-hazard ratios (aHRs), were 1.93 (95% confidence interval [CI], 1.07 - 3.48) for Q1, 1.69 (95% CI, 0.90 - 3.17) for Q2, and 0.65 (95% CI, 0.29 - 1.46) for Q3, relative to Q4 (trend p = 0.001). The aHRs in the multivariate model with all background variables were 1.69 (95% CI, 1.15-2.46) for Q1, 1.53 (95% CI, 1.04-2.27) for Q2, and 1.09 (95% CI, 0.71-1.70) for Q3, relative to Q4 (trend p = 0.001). In females, there was no significant association between the quartiles, in both the multivariate-adjusted model (trend p = 0.52) and multivariate-adjusted model with all background variables (trend p = 0.79).

CONCLUSIONS

A lower OHQOL indicated an increased risk of total mortality in dentists. OHQOL may be used as an indicator for selecting treatment plans and personalized care interventions, thus contributing to increased healthy life expectancy.

TRIAL REGISTRATION

Aichi Cancer Center, Nagoya University Graduate School of Medicine, and Hiroshima University (Approval numbers: 33, 632-3, 8-21, and E2019-1603).

Comparison of the Shear Bond Strength of Orthodontic Composites Containing Silver and Amorphous Tricalcium Phosphate Nanoparticles: an ex vivo Study

Statement of the Problem

It is important to use orthodontic composites with favorable properties, which are easily removed after the end of the treatment but not easily debonded during treatment. Nanoparticles have drawn attention for their antibacterial properties when added to composite resins. However, the effect of addition of nanoparticle on shear bond strength is not broadly discussed.

Purpose

The present study was designed to compare the shear bond strength of orthodontic brackets bonded by orthodontic composite containing silver nanoparticles with orthodontic composite containing amorphous tricalcium phosphate nanoparticles.

Materials and Method

In this ex vivo study, 36 sound extracted human premolars were used and randomly divided into three groups. The brackets were bonded in the first group by composite without nanoparticles, in the second group by composite containing 3% amorphous tricalcium phosphate nanoparticles and in the third group by composite containing 0.3% silver nanoparticles at the buccal surface of the teeth. The shear bond strengths of the samples were measured 24 hours after preparation by a universal testing machine. Data were analyzed using SPSS 21 software through one-way ANOVA and Tamhane's T2 multiple comparison tests. pValues under 0.05 were considered significant.

Results

There was no significant difference between the mean shear bond strength of composite containing amorphous tricalcium phosphate nanoparticles with composite without nanoparticles (p= 0.142). However, the mean shear bond strength in the composite containing silver nanoparticles was significantly lower than the other two groups (p< 0.001).

Conclusion

According to the results of this study, the addition of amorphous tricalcium phosphate nanoparticles to orthodontic composite does not significantly decrease the shear bond strength while silver nanoparticles reduce the shear bond strength of orthodontic composite.

3D assessment of alveolar bone alterations in orthodontic movement among Indians

Apical root resorption, which is characterised as a biological or abnormal phenomenon that shortens the length of the root apex, is additional typical iatrogenic impact of orthodontic tooth movement that may jeopardise the effectiveness of treatment and tooth lifespan. The main goals of the current retrospective investigation were to assess the dimensions of alveolar bone alterations that come along with orthodontic movement and to look into the frequency and extent of resorption of root in maxillary incisors across categories that were similarly managed with clear aligners (OCA) and fixed appliances (OFA) using CBCT. The study included 50 subjects who were divided into two categories with 25 study subjects in each category. Category OFA: Subjects receiving OFA (n=25). A CBCT scan was used to get three-dimensional pictures at the beginning of therapy as well as at the end of therapy. The overall resorption of root at apical region in OFA group was 0.63±0.21 mm. The overall resorption of root at apical region in OCA group was 0.32 ±0.36 mm. The difference in observation was statistically significant (p= 0.000) with reduced resorption of root at apical region in clear aligners. It was concluded that the decrease in thickness of alveolar bone was greater in orthodontic fixed appliances group as compared to clear aligners. The resorption of root at apical region was lesser in clear aligners group as compared to fixed appliances.

COVID-19 and the Latinx Community: "Promotoras Represent a Community in Pain"

COVID-19 has disproportionately affected the Latinx community, leading to heightened economic instability and increased mortality/morbidity. Frontline community health workers (promotoras) have played an integral role in serving low-income Latinx immigrant communities, disseminating health information to this vulnerable community while also facing heightened risks to their own health and wellbeing. This study explores the impact of the pandemic on Latinx communities and the promotoras that serve them, examining how the stresses and inequities the pandemic wrought might be mitigated. Promotoras (N = 15, all female) were recruited from a local health agency in Santa Ana, CA and completed a semi-structured interview about their experiences during COVID-19. Qualitative analyses demonstrated that the pandemic substantially affected the daily lives both of community members, via economic challenges, limited access to reliable pandemic-related information, and psychological and social stress, and of promotoras, via changes to the nature of their work and psychological and social stress. Promotoras perceived that these harms might be mitigated by providing for economic and material needs in the community, and that promotoras can be fortified to continue serving the community through self-care and psychosocial healing practices. According to promotoras, the Latinx community needs economic and material resources to overcome COVID-19 related stressors. Additionally, promotoras may benefit from programming to preserve mental and physical health in the wake of new stressors. Lending greater support to promotoras within the agencies in which they are nested may enable them to be more successful in fulfilling their mission and sustaining their own health.

Experiences of discrimination and oral health-related quality of life among foreign-born older Chinese Americans: Does resilience play a mediating role?

OBJECTIVES

It is well-established that racial discrimination influences quality of life, but there is scarce evidence about how racial discrimination affects oral health-related quality of life (OHRQoL). Furthermore, the pathways linking racial discrimination and OHRQoL remain unknown. Guided by the integrative framework of immigration, ageing, and oral health, psychosocial stressors and resources exert influences on OHRQoL. In addition, according to the compensatory model of resilience, resilient resources could counteract risk exposures to stressors given specific outcomes. Hence, this study examined the relationship between experiences of discrimination and OHRQoL and investigated resilience as a mediator in such a relationship among older Chinese immigrants.

METHODS

Data came from the Population Study of Chinese Elderly in Chicago collected between 2017 and 2019. The working sample included 3054 foreign-born older Chinese Americans aged 60 years or older. OHRQoL was measured by seven items from the Geriatric Oral Health Assessment Index. Experiences of discrimination (yes or no) were measured by the 9-item Experiences of Discrimination instrument. Resilience was measured by the 10-item Connor Davidson Resilience Scale. Mediation analysis was conducted to examine the direct and indirect pathways towards OHRQoL.

RESULTS

Experiences of discrimination were directly associated with poorer OHRQoL (b = -0.98, P < .05). Resilience partially mediated the relationship between discrimination experiences and OHRQoL. Specifically, discrimination experiences were associated with weaker resilience (b = -1.58, P < .05), and weaker resilience was associated with poorer OHRQoL (b = 0.06, P < .05).

CONCLUSIONS

Findings illustrate the importance of studying racial discrimination and resilience in OHRQoL. Interventions need to consider individuals' discrimination experiences and stress coping abilities to promote OHRQoL.

Comparing knowledge and opinions of medical and dental students in the field of pediatric anesthesia

Background and Purpose

Dental treatment under general anesthesia (GA) is one of the common treatment methods today for dental treatment in children, so dentists' point of view in this field is very important. Therefore, the purpose of this study was evaluation the awareness and attitude of pediatric dentists and final-year dental students about dental treatment for children under GA.

Methods

To conduct this study, 150 people, including 75 general dentists (GD) and 75 final-year dental students (FYDS), were randomly selected in Tehran. In this study, a researcher-made questionnaire containing 15 questions (7 awareness questions and 8 attitude questions) was used to evaluate the awareness and attitude of the participants. After extracting the raw results, statistical analysis of the results was done using SPSS-Ver. 22 software.

Results

60% of the participants (90 people) were men and the remaining 40% (60 people) were women. The results showed that the level of awareness of male dentists was significantly higher than that of female dentists (P = 0.015). In addition, although the awareness level of FYDS was lower than GD, this difference was not statistically significant (P = 0.130). The average level of awareness among different age groups had a significant difference (P = 0.009), so the age group of 36-45 years compared to the younger age groups (25-35 years) and the older age groups (36-45 and 55 -46 years), had a higher level of awareness.

Conclusion

According to the findings, it can be concluded that it is necessary to use appropriate educational methods to improve the level of awareness and attitude of children's dentists.

Impact of unilateral removable partial dentures versus removable partial dentures with major connector on oral health-related quality of life of elder patients: a clinical study

OBJECTIVE

This study aimed to establish the survival rate of unilateral removable partial dentures (u-RPD) comparative with bilateral RPD (bi-RPD) with major connector in elder patients, as well as to determine both their treatment satisfaction and oral health.

METHODS

The study sample included 17 patients treated with u-RPD and 17 patients treated with bi-RPD with a major connector. The patients were followed over five years with recalls every 6 months. A 5- points Likert scale was used to determine the satisfaction of the patients. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to evaluate their oral health after each type of administrated treatment. The local oral examined aspects included the maintenance of the abutment teeth periodontal health, the fractures of the removable dentures, the fractures of the connectors, the chipping of the aesthetic material. Kaplan-Meier survival analysis was conducted to evaluate the performance of the two treatments.

RESULTS

The mean survival time in years was 4.882 ± 0.114, 95% CI (4.659; 5.106) and 4.882 ± 0.078, 95% CI (4.729; 5.036), for the u-RPD and the bi-RPD, respectively. The five-year survival rates for the two dentures were 94.1% for u-RPD vs. 88.2% for bi-RPD with a major connector, without a statistically significant difference between them (Log-rank test χ2(1) = 0.301, p = 0.584). The patients receiving u-RPD presented significantly higher satisfaction scores compared to the patients receiving bi-RPD, 4.88 ± 0.48 vs. 4.41 ± 0.62, Mann-Whitney U test, p = 0.026.

CONCLUSION

Patients receiving u-RPD presented higher levels of treatment satisfaction and better oral health than patients receiving bi-RPD. The survival rates of the treatments u-RPD and bi-RPD were similar.

Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly

Aim: To evaluate the impact of xerostomia, edentulism, use of dental prosthesis, and presence of chronic diseases on quality of life in relation to oral health in institutionalized elderly individuals. Methods: This is a cross-sectional study. A questionnaire was administered containing the following instruments: Oral Health Impact Profile (OHIP-14), which measures the quality of life related to oral health; the Summated Xerostomia Inventory questionnaire (SXI-PL) for evaluation of xerostomia, sociodemographic data, clinical description, and patient-reported factors was assessed (edentulism, use of dental prostheses, and chronic diseases). Results: Most elderly individuals did not have any teeth in their mouths and used dental prosthesis. The impact on quality of life, considering the mean of the OHIP-14 scores, was positive in 58.3% of the elderly. Those who used a dental prosthesis were three times more likely to have their oral health negatively impacted (OR=3.09; 95%CI =1.17 8.11), compared to those who did not use, and individuals with xerostomia were more likely to have their oral health negatively impacted (OR=1.57; 95%CI=1.25-1.98) compared to those without xerostomia. There was no difference in the quality of life of individuals with and without chronic diseases. Conclusions: The feeling of dry mouth and use of dental prostheses negatively impacted the quality of life in relation to oral health of the elderly.

The effect of periapical lesion size on the success rate of different endodontic treatments: a systematic review and meta-analysis

INTRODUCTION

This systematic review evaluated the effect of periapical lesion (PL) size on the success rate of different endodontic treatments, including root canal treatment (RCT), non-surgical retreatment (NSR), and apical surgery (AS).

METHODS

Cohorts and randomized controlled trials investigating the outcomes of endodontic treatment of permanent teeth with PL and its size were identified electronically through Web of Science, MEDLINE, Scopus, and Embase databases. Two reviewers independently conducted the study selection, data extraction, and critical appraisal process. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale and the 11-item Critical Appraisal Skills Program checklist for randomized controlled trials. The success rates of the endodontic treatments (small lesions and large lesions) were estimated using the rate ratios (RRs) with an associated 95% confidence interval (CI).

RESULTS

Out of 44 included studies, 42 were cohort, and 2 were randomized controlled trials. Thirty-two studies had poor quality. For the meta-analysis, five studies in RCT, 4 in NSR, and 3 in AS were considered. The RR of the endodontic treatment success in PLs was 1.04 in RCT (95% CI, 0.99-1.07), 1.11 in NSR (95% CI, 0.99-1.24), and 1.06 in AS (95% CI, 0.97-1.16). Only sub-group analysis of long-term follow-up of RCT showed a significantly higher success rate in small lesions than in large lesions.

CONCLUSIONS

Considering the quality of studies and variation in outcomes and size classification, our meta-analysis demonstrated that the PL size had no significant effect on the success rate of different endodontic treatments.

Clinical attachment loss in the use of adjunctive antimicrobial photodynamic therapy in Stages II-IV Grade C molar-incisor periodontitis: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial photodynamic therapy (aPDT) in non-surgical management of stage II-IV grade C molar-incisor pattern Periodontitis. This review protocol was conducted in accordance with PRISMA statements and is registered in PROSPERO (CRD42022321211). An electronic and manual search was conducted for relevant articles comparing the efficacy of aPDT versus scaling and root planning (SRP) alone or with amoxicillin/metronidazole (AMX/MET) published up until December 2021. The mean clinical attachment loss (CAL), probing depth (PD) reduction, and bleeding on probing (BOP) with a 95% confidence interval (CI) were pooled and compared between the two groups with CAL < and > 7 mm using a random-effect model after 3 and 6 months. To assess the heterogeneity of the findings, the I2 test was applied and Publication bias was evaluated by visual examination of the funnel plot symmetry. Analysis of 9 studies indicated a significant difference in clinical attachment gain in patients with CAL > 7 mm between the aPDT group and the SRP alone (mean difference=0.92, 95% CI=0.01-1.84, P=0.05) and SRP + AMX/MET (mean difference=0.91, 95% CI=-0.14-1.68, P=0.02) control groups. However, this difference was not significant in patients with CAL < 7 mm. Despite the limitations of the included studies, aPDT can be suggested for the improvement of clinical parameters in grade C molar-incisor pattern Periodontitis with CAL > 7 mm. However, its application in milder cases requires further investigation.

Ill Effects and Complications Associated to Removable Dentures With Improper Use and Poor Oral Hygiene: A Systematic Review

The importance of oral care and its relationship with an individual's well-being has been identified over the past few decades. As there is a drastic increase in the aging population, so did the use of removable dentures more than ever before. The use of dentures among the elderly provides functional advantages and esthetic benefits. However, improper use and poor oral hygiene with removable dentures come with complications, including denture stomatitis, ulcerations, pneumonia, and many more. The study aims to determine the complications associated with inappropriate use and poor oral care and bring forth evidence-based dentist-recommended guidelines for denture maintenance. Articles were systematically screened in PubMed/Medline (Medical Literature Analysis and Retrieval System Online), PubMed Central (PMC), and Cochrane Library using keywords. Medical Subject Heading (MeSH) was also utilized to identify relevant articles. Inclusion and exclusion criteria were applied, duplicate articles were discarded, and then the articles were reviewed by title and abstract screening. The remaining articles went through a detailed full-text review. A quality appraisal check was conducted for each unique type of research publication, after which a total of 22 articles were finalized. In this study, we have seen pathological biofilm formation on dentures, life-threatening pneumonia, denture stomatitis, and accidental ingestion/aspiration of dentures amongst the elderly population. The study also identified members with low literacy rates, minorities, and low-income families seem to be at higher risk of poor oral care and denture hygiene. We identified that most of these complications could be prevented with proper guidance and education. In the future, a further detailed study is important as no clear consensus exists in terms of best practices of denture cleaning methods. In addition, measures should be initiated to encourage regular dentist appointments and increase accessibility among members of low socioeconomic status and minorities.

Evaluation of Sublingual Varices Prevalence and Its Respective Factors in Two Iranian Nursing Homes in 2019

Introduction

Sublingual varices (SLVs) are among the most prevalent oral lesions, which develop with aging. We aimed to find the prevalence of SLVs among seniors in two nursing homes and evaluate the possible linked factors.

Materials and Methods

This descriptive cross-sectional study was carried out at Kahrizak Alborz and razy allah razi Al-Waledain nursing homes in 2019. The list of all seniors over 60 years old was prepared then; after explaining the aim of the study and obtaining their consent, a well-trained senior dentistry student examined them for the presence of SLVs. At the same time, factors, including age, gender, smoking, oral prosthesis, leg varices, high blood pressure, and literacy level, were recorded. The role of each feature was analyzed by Chi-square test using SPSS (version 22; SPSS Inc., Chicago, IL, USA).

Results

The study performed on 478 nursing home residents showed an SLVs' prevalence of 56.7% (95% confidence interval (CI): 52.3-60). SLVs were significantly correlated with gender (P<0.001), age P<0.01), smoking status (P<0.001), complete denture usage (P<0.01), and leg varicosity status (P<0.0001).

Conclusions

It appears that SLVs are highly prevalent in senior adults. Therefore, clinicians should be aware of the possible presence of SLVs and avoid unnecessary interventions.

Readiness for Interprofessional Learning Among First Year Medical and Dental Students in Nepal

Introduction

Health professional education curricula in Nepal do not include interprofessional education (IPE). Though a previous study conducted in Nepal identified positive attitudes among medical and nursing students, so far there are no studies assessing the health professional students' readiness toward IPE. The aim of the study was to assess the readiness for IPE among medical and dental students.

Methods

The present cross-sectional study explored the readiness of conveniently selected first-year medical and dental students towards IPE and compared readiness among subgroups of respondents. The readiness was assessed through an online survey using the standard Readiness for Interprofessional Learning Scale (RIPLS) during June 2021. The nineteen questions in RIPLS were categorized under four domains: teamwork and collaboration (items 1-9), negative professional identity (items 10-12), positive professional identity (items 13-16), and roles and responsibilities (items 17-19). The individual statements were scored and assessed as per the study objectives. The scores were not normally distributed, so non-parametric tests (Mann-Whitney U-test and Kruskal Wallis test) were used.

Results

A total of 83 students (69 medical and 14 dental) students responded. The median total score was 75, IQR 6 with the maximum score being 95. The median (IQR) scores for the domains teamwork and collaboration were 38 (IQR 3), negative professional identity 11 (IQR 2), positive professional identity 16 (IQR 3), roles and responsibilities 10 (3). The scores were different between students aged 20 years and below = 37, and above 20 years = 38; (p =< 0.001) in the negative professional identity domain and the total score (p = 0.001). The scores were also different among those with and without previous learning exposure with other discipline students in the same class (p = 0.046). A high median score of 5 was achieved for 8 out of 19 statements in the questionnaire.

Conclusion

The findings showed a high level of readiness for IPE among student respondents. Study findings can be considered as a positive factor for implementing IPE sessions.

Analysis of the sagittal root angle and its correlation with hard and soft tissue indices in anterior teeth for immediate implant evaluation: a retrospective study

BACKGROUND

To assess the root angle characteristics of maxillary incisors, and to analyze the relationship between the root angle and other implant-related anatomical indices to use the sagittal root angle as an index for immediate implant evaluation and design.

METHODS

A random sample consisting of 400 cone-beam computed tomography (CBCT) images and 65 maxillary plaster models were selected for the present study. CBCT and stereolithography (STL) scan images were imported as DICOM files into coDiagnostiX software for matching the hard and soft tissue. The angle between the long axis of the anterior tooth and the corresponding alveolar bone and implant-related hard and soft tissue indices were measured in the sagittal section. Descriptive statistics, frequency analysis, multi-level comparisons, and correlation analyses were performed.

RESULTS

The average sagittal root angles were 15° at the central incisor and 19° at the lateral incisor. The root angle in males was significantly larger than that in females, and increased with age. The largest angle, 22.35°, was found in the lateral incisors of the oldest (> 50 years old) male group. The root angle was found to correlate with coronal buccal bone thickness, coronal palatal bone thickness, apical buccal bone thickness, palatal bone thickness, and the below apex bone thickness.

CONCLUSIONS

The sagittal root angle could reflect the distribution of other implant-related anatomical indices, which may provide additional reference for the evaluation of immediate implant placement.

Determining the factors associated with oral health-related quality of life in Chinese elders: Findings from the fourth national survey

OBJECTIVE

The purpose of this study was to assess the associations between the self-reported oral health-related quality of life (OHRQoL) of older Chinese people and their socio-economic status and oral health using data collected in the 4th National Oral Health Survey.

METHODS

After multistage stratified cluster sampling, 4332 adults aged 65-74 years participated in the study. After a clinical examination, the participants completed a structured questionnaire. A Mandarin version of the General Oral Health Assessment Index (GOHAI) was included in the questionnaire. Clinical examinations were carried out using the criteria recommended by the World Health Organization. Multivariate analysis was used to evaluate the associations of the clinical and socio-demographic variables with the GOHAI scores of the participants.

RESULTS

The weighted mean (SE) GOHAI score was 51.6 (0.0). Female sex and having more than 10 missing teeth, unrestored tooth spaces, more than 10 decayed teeth and a periodontal pocket ≥6 mm were negatively associated with the GOHAI score, while having a higher education level and living in the Eastern region of China were positively associated with the GOHAI score.

CONCLUSION

After adjustment for confounders, the OHRQoL of older Chinese individuals was mainly affected by untreated dental caries and the loss of teeth. Older Chinese individuals who were male, had a higher education level, were from the Eastern region, had no unrestored tooth spaces or deep periodontal pockets and had fewer decayed or missing teeth had higher GOHAI scores, indicating better OHRQoL.

Analysis of the relevant factors associated with oral health-related quality of life in elderly denture wearers

PURPOSE

The purpose of the present study was to explore the factors related to oral health-related quality of life (OHRQoL) in elderly patients who underwent prosthetic treatment with removable dentures through several objective and subjective examinations and to analyze their interrelationships.

METHODS

The current study involved 78 denture wearers, aged 65 years or above, who underwent treatment at the clinic of prosthodontics and undertook routine checkups. The present study used eight age-matched patients with healthy dentition as controls. The following items were evaluated: OHRQoL (Oral Health Impact Profile), main occluding area, maximal occlusal force, masticatory performance, and masticatory ability. Spearman's rank correlation coefficient was used to assess the correlation between the OHIP score and each item and multiple linear regression analysis with the backward elimination method was used to analyze the factors affecting the OHIP score (α = 0.05).

RESULTS

The OHIP summary score was significantly correlated with the number of occlusal supports, number of remaining teeth, maximal occlusal force, and the masticatory ability score. The multiple regression analysis revealed that the number of occlusal supports, the number of remaining upper teeth, whether the upper main occluding area was the remaining tooth or not, and the masticatory ability score were the significant independent variables that affected the OHIP summary scores.

CONCLUSIONS

The present study verified the relationship between the OHRQoL and the occlusion of remaining teeth or the items derived from the main occluding areas. The current results suggest that retaining the maxillary first molar is a key factor in the OHRQoL.

Factors Affecting Masticatory Satisfaction in Patients with Removable Partial Dentures

(1) Background: The degree of satisfaction with dental treatment varies among patients, and the discrepancy may exist between the patient's subjective evaluation and the objective assessment. Further, the optimal methods for increasing patient satisfaction with mastication remain unclear. This study aimed to identify factors affecting masticatory satisfaction in patients with removable partial dentures. (2) Methods: A total of 132 participants (71.0 ± 9.0 years) were included. Masticatory satisfaction was assessed on a visual analog scale. An oral health survey was conducted to assess the number of functional teeth, missing tooth classification: Kennedy classification, occlusal support: Eichner classification, and removable partial dentures wearing jaw. Objective masticatory performance was assessed using gummy jelly, while subjective masticatory ability was assessed using food acceptance status and oral health-related quality of life. The associations of these factors with masticatory satisfaction were assessed. (3) Results: Masticatory satisfaction among removable partial denture wearers was not significantly associated with gender, age, denture wearing jaw, Kennedy classification, and occlusal support. The degree of masticatory satisfaction was significantly greater with higher levels of masticatory function: masticatory performance, food acceptance score, and OHIP-14 score. The OHIP-14 score was the only significant explanatory variable for masticatory satisfaction in the multiple regression analysis; the strongest associations were with the "psychological discomfort" and "physical disability" subscales (p = 0.02 and p = 0.005, respectively). (4) Conclusions: Masticatory satisfaction among removable partial denture wearers was strongly associated with oral health-related quality of life, in which the ability to eat meals comfortably with removable partial dentures is the most important determinant of masticatory satisfaction.

The impacts of oral health-related quality of life of elderly people living at home: a cross-sectional study

The scope was to verify the impact of oral and sociodemographic conditions, the dental treatment needs and dental pain, on the quality of life of the elderly. This cross-sectional study was conducted in 15 primary health care areas. A backward multivariate linear regression model was used (p<0.05) with oral health related-quality of life as dependent variable. There were 335 elderly people with predominance of women (56.72%) and aged up to 74 years (59.40%). Those who had up to 8 years of education predominated (87.46%), and those who were still working were the minority (13.43%). Multivariate linear regression (p<0.05) showed association with missing teeth (β=0,12; IC 0,00:0,04; p<0,04) and dental prosthesis needs (β=0,14; IC 0,13:0,81; p<0,01), women (β=0,18; IC 0,23:0,85; p<0,01), less aged (β=-0,12; IC -0,05:0,00; p<0,02), not working (β=-0,15; IC -1,09:-0,20; p<0,01), with dental care need (β=0,24; IC 0,25:0,63; p<0,01) and dental pain (β=0,14; IC 0,10:0,64; p<0,01). Missing teeth, sociodemographic conditions, dental treatment needs and dental pain might impact oral health-related quality of life of elders.

Replication of GWAS significant loci in a sub-Saharan African Cohort with early childhood caries: a pilot study

BACKGROUND

Early childhood caries (ECC) is a rapidly progressing form of dental infection and a significant public health problem, especially among socially and economically disadvantaged populations. This study aimed to assess the risk factors for ECC among a cohort of Sub-Saharan African children and to determine the role of genetics in the etiology of ECC.

METHODS

A sample of 691 children (338 with ECC, 353 without ECC, age < 6 years) was recruited from schools in Lagos, Nigeria. Socio-demographic, dental services utilization and infant dietary data were obtained with interviewer-administered questionnaire. Oral examination was conducted using the WHO oral health diagnostic criteria. Saliva samples were collected from the children for genetic analysis. Single nucleotide polymorphisms were selected from previous study for genotyping. Genetic association analyses to investigate the role of genetics in the etiology of ECC was done. Bivariate comparisons and Multivariate logistic regression analyses were conducted to assess associations between ECC and predictor variables, p < 0.05.

RESULTS

Of the 338 children with ECC, 64 (18.9%) had Severe-Early Childhood Caries (S-ECC). Children aged 48-59 months comprised the highest proportion of subjects with ECC (165; 48.8%) and S-ECC (24; 37.5%) while female subjects had higher dt (3.13 ± 2.56) and dmft values 3.27 ± 2.64. ECC was significantly more prevalent among children who were breastfed at night ≥ 12 months (OR 3.30; CI 0.39, 4.75), those with no previous dental visit (OR 1.71; CI 0.24, 2.77), those who used sweetened pacifiers (OR 1.85; CI 0.91, 3.79) and those who daily consumed sugar-sweetened drinks/snacks (OR 1.35; CI 0.09, 18.51). A suggestive increased risk for ECC (OR 1.26, p = 0. 0.0397) was observed for the genetic variant rs11239282 on chromosome 10. We also observed a suggestive reduced risk for ECC (OR 0.80, p = 0.03) for the rs131777 on chromosome 22. None of the genetic variants were significant after correction for multiple testing (Bonferroni p value p = 0.004).

CONCLUSIONS

Prolonged night-time breastfeeding, poor utilization of dental services and daily consumption of sugar were risk factors for ECC. Larger sample size is needed to confirm the results of the genetic analysis and to conduct genome wide studies in order to discover new risk loci for ECC.

Oral Health Status and the Impact on Oral Health-Related Quality of Life among the Institutionalized Elderly Population: A Cross-Sectional Study in an Area of Southern Italy

Background: The objectives of this study were to describe the oral health status in the institutionalized geriatric population in an area of southern Italy and to identify the impact of oral health on the Oral Health Related Quality of Life (OHRQoL). Methods: Data were collected from individuals aged ≥60 years in randomly selected Calabrian long-term care facilities. The dental health status was assessed recording the decayed, missing, or filled dental elements due to the carious lesions (DMFT) index, the presence of visible dental plaque, and the gingival condition. The influence of the dental health status on the self-perceived value of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Results: Among the 344 elderly individuals included, 18.4% reported frequent tooth-brushing, and only 39.9% reported the need of dental care. The DMFT index was 26.4. Less than a third of the participants had a GOHAI score of ≤50 which is suggestive of highly compromised OHRQoL. The GOHAI score was significantly better for elderly individuals with no self-perceived need of dental care and with a lower DMFT index. Conclusions: The burden of oral conditions among residents in long-term care facilities was considerable, with a high prevalence of missing teeth and dentures. Strategies targeting care providers are needed.

Do Differences in Cultivable Subgingival Species Exist between Different Periodontitis Stages and Grades?

PURPOSE

To investigate the subgingival microbiological profiles of patients with periodontitis, to determine their stage and grade scores and to evaluate the differences in the microbiota among different stages and grades. Materials and Methods: Sixty-seven (n = 67) periodontitis patients were selected. Periodontitis staging and grading, following the 2018 classification system, were defined. Following a clinical examination, subgingival samples were taken from the deepest periodontal pocket of each quadrant for cultivation, identification and quantification. The prevalence, proportion and counts of nine selected periodontal pathogens were determined, and differences between periodontitis stages III and IV and grades B and C were assessed. Results: All nine cultivable periodontal bacteria were detected, of which the most prevalent was P. intermedia (91.0%) and the least prevalent were E. corrodens (9.0%) and C. ochracea (9.0%). The frequency of detection of the two main target pathogens, A. actinomycetemcomitans and P. gingivalis, was 41.8% and 76.1%, respectively. The prevalence (grade B: 80.6%, grade C: 55.6%, p = 0.035) and total counts (grade B: 19.8 colony forming units - CFU/ml-4 (1.9-52.8); grade C: 4.0 CFU/ml-4 (0.0-26.4); p = 0.022) of F. nucleatum were statistically significantly higher in grade B than in grade C periodontitis patients, whereas the counts of P. gingivalis and A. actinomycetemcomitans were similar between grades and stages. Conclusion: Our study suggests that relevant differences between the various grades of periodontitis exist only in the numbers of F. nucleatum. Prevalence and quantities of other cultivable species between different stages and grades of periodontitis seem to be similar.

Influence of healthy lifestyle behaviors on life satisfaction in the aging population of Thailand: a national population-based survey

BACKGROUND

Understanding the influence of healthy lifestyle behaviors on population-level life satisfaction is few known in the aging population, especially in low- and middle-income countries in Asia. The objective of our study was to analyse the association of lifestyle behaviors with life satisfaction in a nationally-representative sample of older persons in Thailand.

METHODS

The sample was obtained from a baseline phase of a nationally-representative, longitudinal survey of the Thai population. The study employed a multistage sampling technique to recruit study participants age 60 years or older from the five geographic regions of Thailand. In this study, 1460 adults age 60 years or older from 3670 households successfully completed face-to-face interviews by trained staff with a structured questionnaire. Information on self-reported life satisfaction, lifestyle behaviors, and sociodemographic characteristics were collected via survey questionnaire. Life satisfaction was assessed using the Scale with Life Satisfaction (SWLS) [1 to 7] response. Binary logistic regression analysis was used in investigating the association between lifestyle behaviors and life satisfaction.

RESULTS

The median age of the participants was 68.1 (60-93 years). The overall mean life satisfaction score was 24.2 ± 5.6. Regular physical activity (at least 30 min per day) and sufficient fruit and vegetable (FV) intake (at least 400 g per day) were significantly associated with older people's life satisfaction (p ≤ 0.001 and p ≤ 0.10, respectively) after controlling all sociodemographic variables. Participants who had regular physical activity were 1.7 times as likely to be satisfied as those with less physical activity (95% CI 1.284-2.151). Participants with sufficient daily FV intake were 1.3 times as likely to be satisfied with life as those with insufficient daily FV (95% CI 0.994-1.723). Life satisfaction score also differed significantly by sociodemographic characteristics (sex, age, marital status, educational attainment) and presence of chronic disease.

CONCLUSIONS

To improve the life satisfaction of older persons, taking into account sociodemographic characteristics of the population and absence of chronic disease, the need for promotion of healthy lifestyle behaviors, especially regular physical activity and sufficient FV intake, must be recommended.

The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review

BACKGROUND AND OBJECTIVES

The number of people aged 65 years or older is growing substantially. As a result of increased health burden and tooth retention, more oral health problems are expected in this age group. A poor oral health-related quality of life (OHQoL) can compromise a person's psychological state, social relationships, personal beliefs, and physical health. The aim of this systematic review was to identify oral health factors associated with OHQoL in people aged 65 years or older and to give a comprehensive overview of the body of literature for each oral health factor separately.

RESEARCH DESIGN AND METHODS

A comprehensive search was performed in five databases. The following terms were used as index terms or free-text words: "Oral Health," "Quality of Life," "Older People." Two researchers independently assessed studies for eligibility based on predefined criteria.

RESULTS

Of 3,702 references retrieved from the databases, 68 studies were eligible and included (9 randomized clinical trials, 6 cohort studies, and 53 cross-sectional studies). All results were reported descriptively. OHQoL in people aged 65 years or older is positively associated with higher number of teeth, higher number of occluding pairs, implant-retained overdentures, and the shortened dental arch concept and negatively associated with xerostomia, orofacial pain, and poor chewing ability. In the current literature, there is no consensus on the association between edentulism, caries, and periodontal conditions and OHQoL.

DISCUSSION AND IMPLICATIONS

Having a functional dentition (either natural or prosthetic) is important for a good OHQoL, whereas painful or functional complaints are associated with impaired OHQoL.

Longitudinal Follow-up Survey of Effects of Oral Comprehensive Healthcare Measures on Early Childhood Caries

PURPOSE

To assess the effect of oral comprehensive healthcare on the prevalence of early childhood caries in urban areas of China.

MATERIALS AND METHODS

A total of 398 children aged 4-5 years from six different kindergartens in Qingdao were recruited to participate in a 1-year single-blind randomised controlled clinical trial. They were randomly assigned into either an experimental group (187 children) or a control group (211 children). The experimental group received comprehensive oral healthcare including oral health examinations, oral health education for children and their guardians, and local fluoride application and dental treatment, whereas children in the control group only received oral health examinations twice a year. The children's parents finished a comprehensive oral health questionnaire before and after the experiment. After a year, the oral health status of two groups of children was statistically analysed to determine the effect of oral comprehensive healthcare on early childhood caries.

RESULTS

After 1 year, the numbers of decayed teeth (dt), decayed tooth surfaces (ds), filled teeth (ft), and filled tooth surfaces (fs) in the experimental group were significantly lower than the control group (p <0.001). The dmft and dmfs were also significantly different between the two groups (p <0.05). Statistically significant differences were additionally shown in oral hygiene habits and eating habits of both the children and their parents in the two groups compared with 1 year before (all p <0.001).

CONCLUSION

Implementation of comprehensive oral healthcare measures both prevents and reduces early childhood caries.

Impact of Wearing Two Different Types of Partial Dentures on Oral Health-related Quality of Life in Geriatric Diabetic Patients – A Crossover Study

OBJECTIVE: This study aimed to evaluate oral health-related quality of life (OHRQoL) of partially edentulous elderly diabetic patients before and after wearing heat-cured acrylic resin and flexible partial dentures. BACKGROUND: In the past two decades, an increased concern about the effect of oral conditions on a patient’s quality of life leads to the development of a wide range of OHRQoL measurements. There is a necessity for evaluation required for setting the measurements that are recommended to be used for different needs of geriatric patients. MATERIALS AND METHODS: One hundred partially edentulous bilateral free-end saddle diabetic elderly patients have been randomly selected from the outpatient clinics of the Excellence Centre at National Research Centre. Heat-cured acrylic resin partial denture and flexible removable partial dentures were made for all patients. General oral health assessment questionnaire was completed before and after wearing the two types of partial dentures. The criteria of assessment were speech, mastication and associated pain, esthetics and physiological status, and general life satisfaction and practicing daily activity. RESULTS: The results revealed a significant improvement regarding all aspects of OHRQoL after wearing both partial dentures for diabetic elderly patients. More improvement was observed after wearing the flexible one. CONCLUSIONS: Our findings indicated that OHRQoL in diabetic elderly patients was markedly improved by restoring edentulous spaces using flexible partial dentures than using heat-cured acrylic resin partial dentures.

Impact of periodontal disease and chewing ability on the quality of life of the elderly in an affluent community

BACKGROUND/PURPOSE

Improvement of the medical and social environment is an important aspect of government policies in assuring the quality of life (QoL) of older adults. However, few studies have appraised the impact and relationship of QoL with clinical factors among elderly individuals in affluent residential areas.

METHODS

A total of 166 older adults from Chang Gung Health and Culture Village were enrolled. Oral health-related QoL was measured using the Geriatric Oral Health Assessment Index. Self-assessed chewing abilities and demographic characteristics were collected by questionnaire. Physical health was scored by activities of daily living (ADL) and instrumental ADL. Mini nutrition assessment questionnaire was used to evaluate the nutritional intake. Multiple linear regression was used to predict risk factors affecting QoL and to examine whether chewing ability was a mediator of oral health-related QoL.

RESULTS

Poor chewing ability was associated with older age (OR = 1.82 for 76-85 years and 3.58 for 86-95 years), sufficient economic status (OR = 5.55) and removable denture-wearing (OR = 7.52). On the other hand, poor chewing ability (OR = 0.11), removable denture-wearing (OR = 0.48), periodontal disease (OR = 0.38) had lower likelihood of good oral health-related QoL. Mediator analyses showed that chewing ability was a mediator for the association between oral health-related QoL and economic status or removable denture-wearing or having more than 20 teeth. Periodontal disease was an independent factor for oral health-related QoL.

CONCLUSION

Among older adults in an affluent community, periodontal disease is an independent risk factor directly related to oral health-related QoL, whereas chewing ability is a mediator between QoL and removable denture-wearing.

Improvement in oral health related quality of life among the elderly: a randomized controlled trial

Background

The present study was conducted to determine the impact of educational intervention based on adult learning theory on oral health related quality of life of the elderly.

Materials and methods

This study (IRCT20120910010804N13) was performed with 92 elderly patients referred to the dental clinic of Ahvaz Jundishapur University of medical sciences. Participants were randomly divided into experimental and control groups. The data were gathered by a questionnaire with demographic variables, variables of oral health related quality of the elderly, and variables for assessing the effectiveness of adult learning theory. Following pre-test, educational programs were conducted for the interventional group. After 1 month, the questionnaire was again administered to both groups. Next, the results of pre-test and post-test were analyzed using SPSS-23 at a significance level of 0.05.

Results

Educational intervention was significant in terms of overall oral health related quality of life and the overall effectiveness score of adult learning theory (P < 0.001). There was a significant difference between the two groups in terms of the mean change score of three physical, psychosocial, and pain dimensions following the educational intervention (P < 0.001).

Conclusion

Education based on adult learning theory is recommended for improving oral health related quality of life among the elderly.

Trial registration

Iranian Registry of Clinical Trials, IRCT20120910010804N13. Registered on 2018-12-16.

https://www.irct.ir/trial/35239

Impact of surgical orthodontic treatment on quality of life in Chinese young adults with class III malocclusion: a longitudinal study

Background

The quality of life in Class III malocclusion patients are worse than those without the disorder and previous studies have shown that surgical orthodontic treatment has a different effect on these patients compared with mild or moderate malocclusion. This study aimed to investigate the changes in quality of life in patients with Class III malocclusion during surgical orthodontic treatment in Chinese young adults.

Methods

The 14-item Short Form Oral Health Impact Profile (OHIP-14), and the 22-item Orthognathic Quality of Life Questionnaire (OQLQ) were used to assess the effect of surgical orthodontic treatment on the quality of life in 21 patients with Class III malocclusion at pre-treatment (T₀), pre-surgical orthodontic treatment (6 to 8 months, T₁) and post-surgical orthodontic treatment (6 to 8 months after surgery, T₂), and 24 healthy individuals were included as controls. The comparisons in numerical variables between patients and controls were performed using Mann-Whitney U test. The scores of the two questionnaires between T₀, T₁, T₂ and controls (Tc) were compared using generalized estimating equation.

Results

According to OHIP-14 questionnaire, the mean scores in T₀ and T₁ were higher than those in T₂ and Tc (P < 0.001), and a significant decrease was observed after post-surgical orthodontic treatment (P < 0.001), which achieved a level similar to the control group (P > 0.05). As to OQLQ questionnaire, the mean scores of all domains showed a significant increase between T₀ and T₁ except for awareness of dentofacial aesthetics (P > 0.05) and social aspects of dentofacial deformity (P > 0.05), followed by a significant decrease between T₁ and T₂.

Conclusion

Surgical orthodontic treatment may improve quality of life in patients with Class III malocclusion, but pre-surgical orthodontic treatment may have an adverse effect on quality of life.

Understanding oral health care team performance in primary care: A mixed-method study

Objective

This study aims to describe the primary care services carried out by Oral Health Teams (OHTs) in Brazil, and to understand the nuances that lead to different levels of OHT performance.

Material & methods

A mixed-methods study with a sequential explanatory design was developed. In the quantitative phase, secondary data from a national survey (PMAQ-AB) was used to describe the work of 12,403 OHTs. Item response theory (IRT) was applied, to evaluate the psychometric qualities of 20 oral health questions from PMAQ-AB and to identify the performance of OHT. The quantitative results guided the selection of the qualitative sample. An extreme case sampling strategy was used (opposite results). OHTs were selected from Belo Horizonte metropolitan region in Brazil using scores measured by IRT. Data were collected through semi-structured interviews. Data analysis was conducted using deductive and inductive thematic analysis.

Results

Quantitative results showed that there are OHT with high and low performance in Brazil. The IRT analysis showed that items related to prostheses and oral cancer tend to discriminate high-performance OHTs from other OHTs. Qualitative results deepened the understanding of accessing oral health services and found several access barriers, such as the insufficient number of OHTs for the population, and a very long waiting time for dental consultations other than urgency. The qualitative results confirmed that high-performance OHTs tend to emphasize oral cancer surveillance and deliver prostheses in PHC services.

Conclusion

Despite the expansion of oral health in PHC in Brazil in recent years, OHTs still face many challenges such as: access barriers; failures in prevention, early diagnosis and follow-up of oral cancer cases; and insufficient rehabilitation with prostheses.

Oral health-related quality of life in children using the child perception questionnaire CPQ11-14: a review

OBJECTIVES

The Child Perceptions Questionnaire 11-14 (CPQ11-14) is the most common and effective indicator of paediatric oral health-related quality of life. The aim of this review was to verify if CPQ11-14 can be considered a valid instrument for assessing the impact of oral health on the quality of life of adolescents for the paediatric population aged between 11 and 14 years old and which dental conditions mainly affect it.

STUDY DESIGN

A literature research from Pubmed Medline database was adopted to identify the eligible studies among the published articles related to CPQ 11-14 using keyword search strategy. From 170 initial articles, a total of 128 articles were included for the full text reading.

RESULTS

Conditions that mainly interest the oral health-related quality of life are untreated dental caries, dental trauma, increased dental protrusion, wearing orthodontic appliances, and severe periodontal disease.

CONCLUSION

CPQ 11-14 seems to be a solid and valid indicator to measure oral health-related quality of life, because it has been widely tested and validated in several states including developed, developing and underdeveloped countries.

Oral Health-Related Quality of Life among Elderly People with Edentulous Jaws in Hafar Al-Batin Region, Saudi Arabia

Aims and Objectives:

The aims of this study were to determine oral health-related quality of life (OHRQoL) among elderly people aged 65 and above years from Hafar Al-Batin area, Saudi Arabia, by utilizing Arabic version of Geriatric Oral Health Assessment Index (GOHAI-Ar).

Materials and Methods:

This was a cross-sectional study undertaken from October 2017 to December 2017. A convenience sampling methodology was employed to select the elderly patients aged ≥65 years attending dental clinics of primary health-care centers in five different regions of the Hafar Al-Batin, Saudi Arabia. OHRQoL of the participants was measured using the Saudi Arabian version of GOHAI-Ar. The oral examinations performed to record a total number of remaining natural teeth, complete and removable partial dentures, and fixed partial dentures. Descriptive and inferential statistics were performed.

Results:

A total of 200 elderly participants (M = 157 and F = 43) having mean age (± standard error [SE]) was 69.26 (±0.34) years, participated in the study. Mean ± SE of GOHAI-Ar was 27.68 ± 0.54, physical function 9.12 ± 0.26, pain and discomfort (6.87 ± 0.18), and psychological discomfort (11.69 ± 0.25). Remaining natural teeth and prosthodontic status significantly correlated with pain and discomfort. The presence of prosthesis was found to influence the psychological function. Gender and prosthodontic statuses were found to have significant correlation with OHRQoL.

Conclusion:

Poor OHRQoL among elderly from Hafar Al-Batin city was found, and presence dental prosthesis showed a positive impact on OHRQoL.

Removable Dentures Treatment Satisfaction of Patients with Type-2 Diabetes

Background and aims: The aim of this study was to find out which was the impact of the treatment with removable dentures on the satisfaction of the type 2 diabetes patients.

Material and method: 50 patients, 27 females (54%) and 23 males (46%) were included in the study. 37 were treated by using a partial removable denture and 13 were receiving a complete denture. Each patient included in the study had answered to a questionnaire after the first year of wearing the dentures and the blood glycemic level and the salivary flux were assessed. Chi-square test was applied to investigate the statistical significance of observed differences in proportions. Kruskal-Wallis test was applied to compare distributions across the groups.

Results The age of the enrolled patients was between 40 and 85 years, with a mean of 64.3 years (standard deviation = 9.77). The mean values of the glucose levels were decreasing proportional with the age of the patients until 85 years and were inconstant for the group 81-90 years. The saliva at 5min was significantly decreasing with the age (p<0.001). The most satisfied patients with the removable dentures were in the group 61-70 years.

Conclusions: The prosthodontic treatment of the type -2 diabetic patients with removable denture should be started after stabilizing the blood glycemic levels and treating the xerostomia, when present.

Socio-demographic factors, dental status and health-related behaviors associated with geriatric oral health-related quality of life in Southwestern China

Background

The aging of Chinese society has increased interest in improving the health-related quality of life (HRQoL) of the elderly, including their oral health-related quality of life (OHRQoL). This study aims to evaluate the OHRQoL of elders living in Sichuan Province (China) and to explore the explanatory factors of their OHRQoL.

Methods

A cross-sectional study conducted in 2016 in the Sichuan Province analyzed data from 744 elders, aged 65 to 74 years (mean age 69.3, 51.3% female). Clinical examinations and questionnaires were completed to collect information on the participants’ socio-demographic characteristics, health-related behaviors, dental status, subjective health conditions and General Oral Health Assessment Index (GOHAI) score.

Results

The mean GOHAI score was 48.23 (SD 7.62), and the median score was 49. After adjustment for age and gender, the multiple linear regression analysis showed that participants who were female, had fair or poor self-rated oral health, decayed, missing and filled teeth (DMFT) score ≥ 20, fair or poor self-rated general health, and ≥ 2 teeth with root caries had worse OHRQoL, and participants who were edentulous had better OHRQoL (F = 29.58, p < 0.001).

Conclusion

The OHRQoL of the elders living in Sichuan Province was relatively good. The explanatory variables were gender; self-rated oral health; DMFT score; self-rated general health; number of natural teeth; and number of teeth with root caries. More attention should be paid to caries status and retention of healthy teeth to improve the OHRQoL of elders in Sichuan Province, preserving a healthy mouth contributes to better OHRQoL.

Health related quality of life and its associated factors among community-dwelling older people in Sri Lanka: A cross-sectional study

BACKGROUND

Population ageing has become a public health issue as it is associated with increased morbidity, institutionalization and death. These may directly affect health-related quality of life (HRQOL) of older people.

PURPOSE

The aim of the study was to investigate HRQOL and its associated factors among community-dwelling older people in Kandy district, Sri Lanka.

METHOD

This cross-sectional survey involved 1300 older people. The Euro 5D-3L, International Physical Activity Questionnaire, body mass index, handgrip strength were used to measure HRQOL, physical activity and nutritional status of older people respectively. Factors associated with health-related quality of life were identified through complex sample logistic regression analysis.

RESULTS

Majority of older people (81.9%) reported poor health-related quality of life. Middle old (aOR: 12.06, 95% CI: 5.76, 25.23), very old (aOR: 174.74, 95% CI: 39.74, 768.38), vegetarian diets (aOR: 2.13, 95% CI: 1.14, 3.96), under-nutrition (aOR: 3.41, 95% CI: 1.65, 7.04) and over-nutrition (aOR: 1.85, 95% CI: 1.04, 3.28) were significantly associated with poor HRQOL. Using dentures (aOR: 0.05, 95% CI: 0.28, 0.90) was found as a protective factor for poor HRQOL.

CONCLUSIONS

HRQOL was poor among community-dwelling older people in Kandy district. Nutrition-related factors need to be further investigated to improve HRQOL among older people.

Impact of Removable Partial Denture on Quality-of-life of Sudanese Adults in Khartoum State

INTRODUCTION

Tooth loss can affect a patient's quality-of-life (QoL), impacting on aspects, such as nutritional intake, psychological status, self-image, and daily engaging in social interaction. The purpose of this study was to assess the oral health-related QoL (OHRQoL) among adult Sudanese patients wearing removable partial dentures (RPDs) by utilizing oral health impact profile-14 (OHIP-14) to assess patient satisfaction with their dentures.

MATERIALS AND METHODS

The study population included 370 adult patients wearing RPDs. Of these, 99 were males and 271 females with the age range of 35 to above 60 years. Self-reported questionnaires were distributed randomly to be completed by the participants from each health sector after having read a consent letter. Two measures interpreting the OHIP-14 scales (sum and prevalence) were utilized for data collection. The relationship of patients' demographic characteristics, general and oral health status, and denture characteristics with their OHRQoL was investigated. The data were processed and analyzed by means of Statistical Package for the Social Sciences (SPSS).

RESULTS

The means of OHIP-14 sum and OHIP-14 prevalence of partial denture wearers were 10.9 + 7.8 and 18.9% respectively. The most problematic aspects of OHIP-14 were functional limitation and psychological disability. On the contrary, the participants had little problem as a handicap and social disability aspects. The self-reported oral health, regular follow-up, denture satisfaction, duration of denture wearing use of the denture while eating, and frequency of denture cleaning positively contribute to oral health-related quality.

CONCLUSION

Loss of teeth and use of RPD significantly affect patients' oral health status and QoL. Patients who are satisfied with their dentures have a better QoL than their unsatisfied counterparts.

Denture Stomatitis: Causes, Cures and Prevention

Removable dentures are worn by 20% of the UK population and two thirds of these individuals have denture stomatitis. Poor oral hygiene is commonplace among this group, as is smoking and xerostomia, which also contribute to the development of denture stomatitis. A complex polymicrobial biofilm is able to proliferate on the surface of denture materials and matures to form visible denture plaque. This denture plaque biofilm stimulates a local inflammatory process that is detectable clinically as erythema, and hyperplasia. Systemically, denture plaque represents a potential risk factor for systemic disease, in particular aspiration pneumonia. Respiratory pathogens have been detected in the denture plaque and overnight denture wear has been linked to an increased risk of aspiration pneumonia. There is a general lack of evidence on the adequate management of denture stomatitis and we present a protocol for use in the primary care setting.

Design and manufacturing of patient-specific orthodontic appliances by computer-aided engineering techniques

Orthodontic treatments are usually performed using fixed brackets or removable oral appliances, which are traditionally made from alginate impressions and wax registrations. Among removable devices, eruption guidance appliances are used for early orthodontic treatments in order to intercept and prevent malocclusion problems. Commercially available eruption guidance appliances, however, are symmetric devices produced using a few standard sizes. For this reason, they are not able to meet all the specific patient's needs since the actual dental anatomies present various geometries and asymmetric conditions. In this article, a computer-aided design-based methodology for the design and manufacturing of a patient-specific eruption guidance appliances is presented. The proposed approach is based on the digitalization of several steps of the overall process: from the digital reconstruction of patients' anatomies to the manufacturing of customized appliances. A finite element model has been developed to evaluate the temporomandibular joint disks stress level caused by using symmetric eruption guidance appliances with different teeth misalignment conditions. The developed model can then be used to guide the design of a patient-specific appliance with the aim at reducing the patient discomfort. At this purpose, two different customization levels are proposed in order to face both arches and single tooth misalignment issues. A low-cost manufacturing process, based on an additive manufacturing technique, is finally presented and discussed.