Erosive tooth wear and use of psychoactive substances among Finnish prisoners

Oral health services in prison settings: A global scoping review of availability, accessibility, and model of delivery

This review aimed at evaluating the state of availability, accessibility and model of delivery of oral health services in prisons, globally. Five databases of peer-reviewed literature and potential sources of grey literature were systematically searched. Inclusion criteria encompassed oral health papers related to prisons globally, with exclusion of certain article types. Selection involved independent evaluations by two researchers, followed by quality assessment. Data on the availability of oral health interventions in prisons came from 18 countries, while information on the model of delivery of the services is scarce. In addition, two sets of individual and organizational barriers toward oral health service uptake in prisons were revealed and discussed in the text. Lack of oral health services in prisons affects people living in prisons and jeopardizes their reintegration. Urgent and concrete international actions are required to ensure the availability, accessibility, and quality of oral health services among people living in prisons.

Prevalence of erosive tooth wear in risk group patients: systematic review

OBJECTIVE

This systematic review investigates the prevalence of erosive tooth wear (ETW) in individuals classified as risk groups (gastroesophageal reflux disease, eating disorders, special diets, acidic beverage, drugs and alcohol, legal drugs and medications, and occupational or sports).

MATERIALS AND METHODS

The research was conducted in nine databases (PubMed/MEDLINE, Embase, Cochrane Library, LILACS/BVS, SciELO, Scopus, Science Direct, Open Grey, and Web of Science) up to April 2024 (PROSPERO CRD42021270150), along with a manual search of grey literature. Observational studies involving children and adults from these previously mentioned risk groups, which provided data on ETW prevalence, were included without date or language restrictions. The methodological quality of studies was evaluated using the Joanna Briggs Institute's Prevalence Data Critical Appraisal Tool. General and subgroup data were meta-analyzed using a random-effects model.

RESULTS

Overall, 4403 studies were retrieved, out of which 148 met the inclusion criteria. Each risk group showed higher prevalences of ETW in these patients in general and subgroup analysis; although subgroup analysis was not possible for all risk groups due to the heterogeneity of the indices found.

CONCLUSIONS

The Legal drugs and Medications risk group showed lower overall prevalence values (30%), while the Drugs and Alcohol risk group obtained higher values (67%). Prevalence rates for other groups were: Gastroesophageal reflux disease (54.1%), Eating Disorders (65%), Special Diets (65.9%), Acidic Beverages (40%), Occupational and Sports (51%).

CLINICAL RELEVANCE

This systematic review highlights that risk groups are indeed at significant risk for the development of ETW and greater preventive care and dental monitoring are needed.

Analysis of the pH levels in energy and pre-workout beverages and frequency of consumption: a cross-sectional study

BACKGROUND

Erosive tooth wear is an increasingly common pathology in the youth population. It refers to the chronic, localized, painless loss of dental hard tissues caused by non-bacterial acids, often originating from external sources like acidic beverages. Energy drink consumption is on the rise, frequently preceding physical exercise to enhance perceived energy levels. However, there are other types of beverages that also provide energy, such as pre-workout drinks, classified as sports drinks. The main objective of this research study has been conducted with the purpose of analyzing the pH of energy drinks and pre-workout beverages, and studying the frequency of consumption of such beverages in amateur athletes who practice sports.

METHODS

A total of 67 beverages were examined, comprising 43 energy drinks and 24 sports supplementation beverages, also known as pre-workout or pre-training beverages. The participants were given a survey to complete. They were asked to respond whether they consumed any type of pre-workout or energy drink, and they were also asked about the timing of consumption.

RESULTS

The findings indicated an average pH of 3.3 among the studied beverages, indicating a pH below the critical threshold. Out of the 113 participants, 51% reported taking some form of supplementation.

CONCLUSIONS

Consequently, it was concluded that most of the analyzed beverages recorded pH values low enough to classify them as erosive, posing a threat to enamel surface. When analyzing the frequency of consumption of energy drinks and pre-workout beverages in amateur athletes, we observed that most participants aged 29 years or younger took supplements 3 to 5 times a week, while the older age groups more frequently took supplements 1 to 2 times a week.

Hard drugs use and tooth wear: a scoping review

OBJECTIVES

This study aims to map evidence on the relationship between hard drug use and dental wear. The scoping review is guided by the question: What is the relationship between hard drug consumption and dental wear?

MATERIALS AND METHODS

Adhering to PRISMA-ScR guidelines, searches were conducted across PubMed, Embase, and four databases in March 2024. Inclusion criteria included studies investigating the association between hard drug use and dental wear, regardless of publication date or language. Data were presented through narrative exposition, tables, and a conceptual framework.

RESULTS

Twenty-eight studies (four case-control, three cross-sectional, five case reports, and sixteen literature reviews) were included. Among case-control studies, 75% observed an association between drug use and dental erosion; however, no cross-sectional studies demonstrated this association. Despite questionable quality, reviews established connections between drug use and dental erosion. Studies aimed to elucidate potential causes for dental erosion.

CONCLUSIONS

Analysis suggests a potential link between hard drug use and dental wear, though indirect. Factors like bruxism and reduced salivary pH may contribute to dental wear among drug users. Further investigation through primary studies exploring this relationship is necessary.

CLINICAL RELEVANCE

Dentists should focus not only on clinical characteristics of dental wear but also on mediating factors such as bruxism and decreased salivary pH associated with drug use. This holistic approach allows for a deeper understanding of dental wear mechanisms, enabling targeted preventive and therapeutic interventions.

Risk factors of tooth wear in permanent dentition: A scoping review

BACKGROUND

Tooth wear (TW) prevalence is high and increasing and has important consequences on the patient's quality of life. Knowledge of risk factors is crucial to promote diagnosis, prevention strategies and timely interceptive treatment. Many studies have identified TW risk factors.

OBJECTIVE

This scoping review aims to map and describe suspected available factors associated with TW in permanent dentition based on quantitative measurement.

METHODS

The scoping review was conducted using the PRISMA extension of the Scoping Reviews checklist. The search was conducted in October 2022 from the Medline® (PubMed® interface) and Scopus® databases. Two independent reviewers selected and characterised the studies.

RESULTS

2702 articles were identified for assessment of titles and abstracts, and 273 articles were included in the review. The results show a need to standardise TW measurement indices and the study design. The included studies highlighted various factors, classified into nine domains: sociodemographic factors, medical history, drinking habits, eating habits, oral hygiene habits, dental factors, bruxism and temporomandibular disorders, behavioural factors, and stress. Results related to chemical TW (erosion) risk factors underline the importance of eating disorders, gastroesophageal reflux and lifestyle, particularly drinking and eating behaviours, which supports developing public health information campaigns and interventions. Besides chemical, this review identifies evidence of several mechanical TW risk factors, such as toothbrushing and bruxism; the influence of this last factor needs to be further explored.

CONCLUSIONS

TW management and prevention require a multidisciplinary approach. Dentists are in the first line to detect associated diseases such as reflux or eating disorders. Consequently, practitioners' information and guideline diffusion should be promoted, and a TW risk factors checklist (the ToWeR checklist) is proposed to help diagnostic approaches.

Tobacco Use Among People Incarcerated in Western Europe: A Systematic Review and Meta-analysis

Background

Evidence suggests that the prevalence of tobacco use has declined significantly in the general population but still remains high among people incarcerated in high-income countries. Tobacco use is the second leading risk factor of mortality and morbidity worldwide. The objective of this study is to synthesize evidence on the prevalence of smoking among people incarcerated in Western European countries.

Methods

We searched the PubMed database for articles published between June 2010 and June 2020, website of international organizations and hand-searching references. One author reviewed studies that met pre-defined inclusion criteria, and this was cross-validated by a second reviewer, following the MOOSE guidelines. The Meta prop command of Stata (V16) was used for pooling smoking prevalence estimates. Random effects modelling, heterogeneity with subgroup analysis and publication bias was assessed.

Results

Out the 236 identified articles, 25 with full texts were eligible, and 16 were finally included in this study. The overall pooled estimate of smoking prevalence was 72.3%, 95% CI (54.8–84.7), and high heterogeneity (I2 = 99.73%). Females had a pooled prevalence 44.1% (95% CI 9.4–82.6) while males 83.3% (95% CI 72.0–92.1). The total number of prisoners combined in this study was 16,435 (ranging from 31-21,451) with age ranging from 24-43 years.

Conclusion

A relatively high smoking rate was observed among incarcerated people - higher among the male population. The study findings are useful for informing policy-makers of the existing burden of smoking in special vulnerable populations across Western Europe-and the need for comprehensive tobacco control policies in different population settings.

Infrared Spectroscopic Analysis of the Inorganic Components from Teeth Exposed to Psychotherapeutic Drugs

Teeth are unique and complex anatomical organs that can provide relevant data about a person's health, and play an important role in forensic medicine. Teeth are exposed to food, drinks, and the microbiota of the oral cavity; therefore, they have developed a high resistance to localized demineralization. Nevertheless, the continuous demineralization–remineralization cycle present in the oral environment can be influenced by stress, medication, mineralization agents, and other factors such as individual habits, especially diet. In this study, based on attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) spectra from tooth samples of 36 patients, several parameters were estimated: the crystallinity index (CI), the phosphate/amide I ratio, and the carbonate/phosphate ratio. In addition, in eight representative samples (six of the root of the tooth and two of the enamel area of the crown), additional characterization by X-ray powder diffraction (XRPD), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) was conducted. From the FTIR data, it was observed that the highest CI values were found in patients who smoked. Further, in both root and crown samples, the intensity of the absorption band corresponding to PO43- increased in patients undergoing treatment with psychotherapeutic drugs. On the other hand, the intensity of the absorption band of the amide I group decreased with medical treatment and with the patient's biological age. Moreover, it was found that the remineralization process was more active in enamel than in the root due to direct contact with saliva. Regarding the results obtained from the X-ray powder diffractograms, exposure to psychotherapeutic drugs affected the definition of the peaks corresponding to hydroxyapatite, both in the crown and root samples. Concerning SEM results, qualitative differences in the stratification process in demineralized surfaces were observed, and EDS analyses showed some differences in the Ca/P ratio between pathological samples and control ones, but without clear patterns. The above techniques, in particular ATR-FTIR, showed promise for the investigation of the effect of changes produced in the hydroxyapatite structure in teeth and, consequently, to determine possible strategies in the diagnostic protocol.