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Eto F, Nezu T, Nishi H, Aoki S, Tasaka S, Horikoshi S, Yano K, Kawaguchi H, Maruyama H. Oral condition at admission predicts functional outcomes and hospital-acquired pneumonia development among acute ischemic stroke patients. Clin Oral Investig 2024; 28:434. [PMID: 39028492 PMCID: PMC11271429 DOI: 10.1007/s00784-024-05833-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION Oral care is crucial for the prevention of cardiovascular events and pneumonia. However, few studies have evaluated the associations between multidimensional assessments of oral status or functional outcomes and hospital-acquired pneumonia (HAP). METHODS Consecutive patients with acute ischemic stroke (AIS) were retrospectively analyzed. We evaluated the modified oral assessment grade (mOAG) and investigated its association with a modified Rankin scale (mRS) score of 0‒2 (good stroke outcome) and HAP. The mOAG was developed to evaluate 8 categories (lip, tongue, coated tongue, saliva, mucosa, gingiva, preservation, and gargling) on a 4-point scale ranging from 0 to 3. We analyzed the effectiveness of the mOAG score for predicting stroke outcome or HAP using receiver operating characteristic (ROC) curve analysis. RESULTS In total, 247 patients with AIS were analyzed. The area under the ROC curve of the mOAG for predicting poor outcomes was 0.821 (cutoff value: 7), and that for HAP incidence was 0.783 (cutoff value: 8). mOAG (a one-point increase) was associated with poor stroke outcome (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.17‒1.48, P < 0.001) and HAP (OR 1.21, 95% CI 1.07‒1.38, P = 0.003) after adjusting for baseline clinical characteristics, including age and stroke severity. CONCLUSIONS Lower mOAG scores at admission were independently associated with good outcomes and a decreased incidence of HAP. Comprehensive oral assessments are essential for acute stroke patients in clinical settings.
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Affiliation(s)
- Futoshi Eto
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami ward, Hiroshima, 734-8551, Japan
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami ward, Hiroshima, 734-8551, Japan.
| | - Hiromi Nishi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami ward, Hiroshima, 734-8551, Japan
| | - Saki Tasaka
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami ward, Hiroshima, 734-8551, Japan
| | - Susumu Horikoshi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Kanako Yano
- Division of Dental, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroyuki Kawaguchi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami ward, Hiroshima, 734-8551, Japan
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Malik Z, Sohn W, Nanayakkara S, Williams K. Unique dietary and oral hygiene behaviors in a cohort with clinically severe obesity: A cross sectional study. Clin Exp Dent Res 2024; 10:e895. [PMID: 38726729 PMCID: PMC11082831 DOI: 10.1002/cre2.895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/30/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND An association between increased risk of dental caries with increased levels of clinically severe obesity has been reported. Data linking body mass index (BMI) and dietary behaviors, including at-risk dietary factors and oral hygiene habits, are lacking in a cohort with clinically severe obesity. This study aimed to explore the dietary and oral hygiene behaviors in individuals with clinically severe obesity attending a hospital-based obesity service. METHODS Adult patients attending a hospital-based obesity service in Greater Western Sydney with clinically severe obesity were invited to participate in a self-administered survey, which collected data on their nutritional and oral hygiene behaviors. Demographic data (age, gender) and BMI were extracted from the participants' medical records. The primary outcome was the relationship between BMI and frequency of toothbrushing. RESULTS: Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire. The median BMI of the cohort was 49.1 kg/m2 (interquartile range [IQR]: 43.2-57.3 kg/m2) and median age 51 (IQR: 39-63) years. BMI was not significantly correlated with individual oral health behaviors (p > .05). Many participants reported dietary risk behaviors, which have the potential to influence their oral health. CONCLUSIONS While oral health behaviors were not associated with increasing BMI, patients with clinically severe obesity in this study reported unique dietary behaviors and mixed oral hygiene habits that may complicate nutritional and dental management. Awareness of these behaviors among clinicians including dental professionals is required in this cohort.
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Affiliation(s)
- Zanab Malik
- Faculty of Medicine and HealthThe University of Sydney School of DentistrySurry HillsNew South WalesAustralia
- College of Health, Medicine and WellbeingThe University of Newcastle, School of Health Sciences (Oral Health)OurimbahNew South WalesAustralia
| | - Woosung Sohn
- Faculty of Medicine and HealthThe University of Sydney School of DentistrySurry HillsNew South WalesAustralia
| | - Shanika Nanayakkara
- Faculty of Medicine and HealthThe University of Sydney School of DentistrySurry HillsNew South WalesAustralia
| | - Kathryn Williams
- Nepean Blue Mountains Family Metabolic Health Service, Nepean Blue Mountains Local Health DistrictKingswoodNew South WalesAustralia
- Charles Perkins Centre‐NepeanThe University of SydneySydneyNew South WalesAustralia
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Large JF, Madigan C, Graham H, Biddle GJH, Sanders J, Daley AJ. Public and dental teams' views about weight management interventions in dental health settings: Systematic review and meta-analysis. Obes Rev 2024; 25:e13726. [PMID: 38343102 DOI: 10.1111/obr.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 12/05/2023] [Accepted: 01/18/2024] [Indexed: 05/14/2024]
Abstract
Collaborative approaches across healthcare to address obesity are needed but intervention in dental settings is not widely implemented. Here we systematically synthesized the views of both the public and dental teams about delivering weight management interventions in dental settings and identified potential barriers to implementation. A systematic review of five databases from inception to April 3, 2023 was completed. Proportional meta-analyses were performed with quantitative data and thematic analysis of qualitative data. A total of 7851 studies were screened and 33 included in the review. The prevalence of height and weight screening in dental settings varied (4%-87%) with an average of 29% undertaking screening (p = <0.01; 95% CI: 14%-46%). A significant proportion of the public were supportive of weight screening in dental settings (83%; p = <0.01; 95% CI:76%-88%). Significant barriers to providing weight screening and/or intervention included fear of offending patients (57%; 95% CI: 45%-68%) and a lack of time (48%; 95% CI: 30%-66%). Qualitative data revealed further barriers including stigmatizing views of dental teams toward people living with overweight/obesity. Enablers of weight discussion included associating weight with oral health. Overall, whilst some barriers were identified, there is potential for weight management interventions to be used more routinely in dental settings.
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Affiliation(s)
- Jessica F Large
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Claire Madigan
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Henrietta Graham
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Gregory J H Biddle
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - James Sanders
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Amanda J Daley
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
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Correction: Real-world evidence of the impact of obesity on residual teeth in the Japanese population: A cross-sectional study. PLoS One 2023; 18:e0296475. [PMID: 38134009 PMCID: PMC10745160 DOI: 10.1371/journal.pone.0296475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0274465.].
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Malik Z, Sohn W, Nanayakkara S, Williams K. Poor dental service utilization in those with clinically severe obesity: A neglected issue with solutions needed. Clin Obes 2023; 13:e12608. [PMID: 37348852 DOI: 10.1111/cob.12608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/27/2023] [Accepted: 06/03/2023] [Indexed: 06/24/2023]
Abstract
Data linking body mass index (BMI) and dental service utilization with oral and general health, quality of life, wellbeing, and mental health are lacking. Adult patients with clinically severe obesity attending a hospital-based obesity service in Greater Western Sydney were invited to participate in a cross-sectional survey that collected data on dental utilization and visiting patterns, dental anxiety, and oral health-related quality of life (OHRQoL). General health data were obtained from participants' medical records. Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire, and 74 (91.3%) answered additional screening questions related to their general wellbeing and mental health. Of the participants, 50 (61.7%) reported that their last dental visit was more than 1 year ago, 43 (53.1%) visited only as needed and 22 (27.2%) participants reported favourable dental visiting patterns. Twenty-four (29.6%) participants reported high levels of dental anxiety, and low levels of OHRQoL compared with national data. Screening questions suggested low general wellbeing and poor mental health in this patient cohort. Within this group, BMI was not significantly correlated with any of the variables of dental service utilization, dental anxiety, OHRQoL, wellbeing, or mental health (p > .05). There was a negative correlation between dental anxiety and dental utilization (p < .05). Patients with clinically severe obesity reported poor dental utilization, low OHRQoL, and high levels of dental anxiety. This study highlighted the frequency of medical complications, lack of wellbeing, and poor mental health, which were evident in this cohort and may complicate dental management.
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Affiliation(s)
- Zanab Malik
- Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
- School of Health Sciences (Oral Health), College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales, Australia
| | - Woosung Sohn
- Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
| | - Shanika Nanayakkara
- Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
| | - Kathryn Williams
- Nepean Blue Mountains Family Metabolic Health Service, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
- Charles Perkins Centre-Nepean, The University of Sydney, Sydney, New South Wales, Australia
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Obesity. Br Dent J 2022; 233:825-826. [DOI: 10.1038/s41415-022-5268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Holland C. Obesity, oral health and the role of the dental profession. Br Dent J 2022. [DOI: 10.1038/s41415-022-5242-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Largest study of its kind reveals increased risk of tooth loss due to obesity. Br Dent J 2022. [DOI: 10.1038/s41415-022-5169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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