Periodontal disease in preoperative patients with digestive cancer: a retrospective, single-institution experience in Fukui, Japan

Dental decision-making for persons with dementia: A systematic narrative review

Dental decision-making represents the establishment of a common understanding between the dental professional and the recipient of the intervention, which determines oral healthcare and dental treatment policies. Dental decision-making for persons with dementia can be challenging, and there have been no systematic reviews on this topic. Therefore, this systematic narrative review aimed to identify the current state of dental decision-making in persons with dementia. Literature search was performed using PubMed, Web of Science, Cochrane Library, CINAHL, and Google Scholar databases. Through the process of research selection, 7 articles with a high risk of bias were included in this study. This review clarified that there is limited information on the dental decision-making processes for persons with dementia. In conclusion, although this may be difficult due to different medical and socioeconomic conditions, the dilemma between the need to establish evidence for dental decision-making and medical ethics that prioritize a patient-centered position should be discussed globally in the future.

Comparative analysis of subgingival microbiota in patients with mild, moderate, and severe chronic periodontitis

In this study, we explored the suspected pathogens of chronic periodontitis at different stages of occurrence and development. We collected 100 gingival crevicular fluid samples, 27, 27, and 26 from patients with mild, moderate, and severe chronic periodontitis, respectively, and 20 from healthy individuals. Pathogens were detected using a 16S rRNA metagenomic approach. Quantitative Insights in Microbial Ecology, Mothur, and other software were used to analyze the original data, draw relative abundance histograms and heat maps, and calculate flora abundance and diversity indexes. We identified 429 operational taxonomic units, covering 13 phyla, 20 classes, 32 orders, 66 families, and 123 genera from the four groups of samples. Each group showed microbial diversity, and the number of new species of bacterial flora in the gingival crevicular fluid samples gradually increased from the healthy to the severe chronic periodontitis group. There was a significant difference in the relative abundance of the core flora at the phylum, class, order, family, and genus classification levels. Our data indicated a certain correlation between the changes in the subgingival microbial structure and the occurrence and development of chronic periodontitis, which might be able to provide a reference for the diagnosis, treatment and prevention of chronic periodontitis.

Impact of oral health management on mental health and psychological disease: a scoping review

OBJECTIVE

The relationship between oral and mental health has been controversial. Few studies have assessed the direct effects of oral health management on mental health and psychological disease. Using evidence from the last 5 years, this scoping review aimed to map and discuss recent progress in understanding this relationship.

METHODS

Electronic literature searches were performed using PubMed, Web of Science, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature databases. An additional manual search was performed using Google Scholar databases. Studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow diagram.

RESULTS

An eligibility review process identified three randomized controlled trials for inclusion in this review. The oral health interventions and participants' target age, mental health status, and psychological diseases varied across these studies. The only study that reported an improvement included psychosocial support integrated with educational components of oral health as the intervention. The remaining two studies detected no significant impact of oral health interventions on mental health and psychological disease.

CONCLUSIONS

Evidence of the impact of oral health management on mental health and psychological disease is insufficient in studies published between 2017 and 2021.

Effect of the COVID-19 pandemic on the oral health and nutritional status of Japanese older adults who underwent total hip or knee arthroplasty: A 3-year single-institution retrospective cohort study

The coronavirus disease 2019 (COVID-19) pandemic affected the physical and mental health, socioeconomic status, and community behavior of people worldwide. The aim of this retrospective cohort study was to analyze the impact of the COVID-19 pandemic on the oral health and nutritional status of Japanese older adults based on the results of preoperative assessment in patients who underwent total hip or knee arthroplasty under general anesthesia. This study included older adults (≧65 years) who underwent total hip or knee arthroplasty in whom orthopantomography was performed for preoperative oral health assessment, during January 2019 to December 2021. Gender, age, number of family members living together, number of teeth, body mass index, and serum total protein and serum albumin levels were collected for analysis of this study. A total of 201 patients aged 65 to 89 years participated in the study. While the COVID-19 pandemic has had no impact on the oral health status, there has been a drop in serum albumin level from the results of multivariable-adjusted regression analysis considering age, gender, number of family members, and time. The COVID-19 pandemic has affected the serum albumin level of Japanese orthopedic patients aged 65 years or older.

The Need for Oral Hygiene Care and Periodontal Status among Hospitalized Gastric Cancer Patients

Poor oral hygiene leads to the accumulation of dental plaque, thus contributing to the initiation of periodontal disease (PD). Local infections can lead to systemic inflammatory responses, which are essential mediators for the evolution of systemic conditions or cancer tumorigenesis. Often, patients hospitalized with life-threatening and incapacitating disorders such as gastric cancer (GC) might lose interest in keeping their mouth healthy. This study evaluates oral hygiene, periodontal status, and the need for oral care and medical personnel to assist in achieving it in patients hospitalized with GC. This study was carried out on 25 patients with a diagnosis of GC, divided into two groups (GP—14 patients from the Gastroenterology Department, and SP—11 patients from the 1st Department of Surgery). Patients were examined on the day of admission (T0), the day of the medical procedure of endoscopy or surgery (T1), and the day of discharge (T2), recording the number of absent teeth, dental plaque (PI), bleeding on probing (BOP), probing depths (PPD), frequency of toothbrushing, and if the oral hygiene had been self-performed or assisted. Data were subjected to statistical analysis. Our results showed that, in both the GP and the SP group, there were strong and statistically significant correlations between PI and BOP measured on the last day of hospitalization and the period of hospitalization after the medical procedure. Longer hospital stays and the presence of surgery were risk factors for changing toothbrushing frequency. Results also highlight the need for a dentist to diagnose and eventually treat periodontal disease before and after hospitalization, and for a trained nurse who should help take care of the patient’s oral hygiene during hospitalization.

Possibilities and challenges in digital personal identification using teledentistry based on integration of telecommunication and dental information: a narrative review

Personal identification using dental evidence is decisive in the case of unidentified bodies because dental features, including decayed, missing and filled teeth, are unique to every individual. This review explored the possibilities and problems associated with personal identification through digital methods by the integration of telecommunications and dentistry, also known as teledentistry. Establishment of a global, objective personal identification method using dental evidence through teledentistry is desirable. However, the review reports that there are various problems that need to be resolved first, in aspects such as changes in dentition over time, technology, individual privacy and ethics. It is suggested that solving such problems and constructing a worldwide dental database for personal identification from dental images, using teledentistry, as part of social services, is a new challenge for researchers in forensic odontology and dentistry.

Subgingival Periopathogens Assessment and Clinical Periodontal Evaluation of Gastric Cancer Patients—A Cross Sectional Pilot Study

Oral microbiota have shown a higher bacterial diversity in patients with cancers of the digestive tract, with higher levels of periopathogens. Recent studies have shown that Fusobacterium links to gastro-intestinal neoplastic tissue and accelerates its progression, as well as worsening patient outcome. The present pilot study was carried out between February and December 2020 to evaluate the possible association between the abundance of some periopathogens (Fusobacterium nucleatum, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola and Tannerella forsythia) in subgingival plaque and periodontal status with characteristics of gastric cancer. The study was performed on a sample of 24 patients with gastric cancer from the 1st Department of Surgery and Department of Gastroenterology within the Clinical County Hospital of Emergency of Craiova, Romania. The patients’ oral cavity was examined, gingival crevicular samples were collected, and signs of periodontal disease were recorded. On the histopathological exam, the differentiation grade and size of the tumour were registered. Our results showed that, from the periopathogens studied, the most abundant bacteria were F. nucleatum followed by T. forsythia in all groups. In our present study, the strong correlation between tumour dimension and all periodontal parameters but also between tumour dimension and F. nucleatum could suggest a positive association between periodontal disease, tumoral growth and periopathogens implication in this process.

Maxillary third molars with horizontal impaction: A cross-sectional study using computed tomography in young Japanese patients

Objective

To examine the anatomical characteristics of impacted maxillary third molars to help predict and prevent possible adverse events during extraction.

Methods

This retrospective study enrolled young Japanese patients that were assessed for third molar extraction. Patients with maxillary third molar impaction presenting with no space between the maxillary second molar and the occlusal surface of the maxillary third molar were analysed using computed tomography data.

Results

In this study, a total of 663 patients aged 20–29 years were examined for third molar extraction and 26 teeth in 23 patients were analysed. The mean ± SD angle between the second and third molar axes was 54.2° ± 7.5° and the mean ± SD length of the maxillary third molar was 16.1 ± 1.9 mm. The maxillary third molars showed close or extensive contact with the maxillary sinus and computed tomography did not show any bone from the maxillary sinus floor. Furthermore, in all patients, the crowns of the third molars were not completely covered by the alveolar bone.

Conclusions

Maxillary third molars with horizontal impaction showed close or extensive contact with the maxillary sinus and their crowns were not completely covered by the alveolar bone.

Has the COVID-19 pandemic influenced the oral health and nutritional status of elderly patients with digestive cancer?: A retrospective study in Fukui, Japan

The coronavirus disease 2019 (COVID-19) pandemic has affected various aspects, including socioeconomic status and health. This retrospective study aimed to investigate the influence of the COVID-19 pandemic on oral health based on the number of teeth that contribute to mastication, and the nutritional status of elderly patients with digestive cancers.The authors defined the before and during COVID-19 periods in this study as January 2019 to December 2019 and January 2020 to December 2020, respectively. Patients with digestive cancer who underwent general, laboratory, and orthopantomograph examinations for preoperative oral health assessment before general anesthesia participated in this study. The authors investigated the following general characteristics: (1) sex, (2) age, and (3) the organ affected by disease and scheduled for surgery under general anesthesia. The authors collected information about (4) the number of teeth that could contribute to mastication as a clinical oral health parameter. The parameters: (5) body mass index, (6) serum total protein levels, and (7) serum albumin levels were used to indicate the nutritional status.A total of 233 elderly patients with digestive cancer participated in this study. There was no significant difference between the age of the patients with digestive cancer. There was also no significant difference in the number of teeth that could contribute to mastication. Additionally, there was no significant difference in nutritional status as indicated by the body mass index, serum total protein levels, and serum albumin levels.This study showed that the COVID-19 pandemic during 2020 did not have a significant influence on the oral health and nutritional status of elderly patients with digestive cancer. However, the influence of COVID-19 on community oral health may become apparent in the future. Thus, dental professionals should continue further research regarding the effects of COVID-19 on oral health.

Importance of postural change for accidental ingestion of dental prostheses: a case report

Accidental ingestion of dental prostheses requires immediate emergency action. The authors report a case of accidental ingestion of a dental prosthesis in a patient with a disorder of consciousness. The accidental ingestion was diagnosed by imaging examination, and the location of the dental prosthesis was explored under general anesthesia according to the preoperative examination images. However, no dental prosthesis was found in the hypopharyngeal region. The operators found a radiopaque region in the nasopharynx that was suspicious of a dental prosthesis by X-ray examination of the head and neck region. According to the X-ray examination, the dental prosthesis was removed from the nasopharynx. The patient’s postoperative course was uneventful. Postural change for cases of accidental ingestion of dental prostheses may be a simple and important lifesaving step in addition to traditional methods.