Search

Background: Dental caries remains one of the most prevalent diseases worldwide, affecting 29.4% of the global population. Despite numerous efforts to diagnose, predict, and prevent dental caries, the incidence continues to rise. Salivary biomarkers provide a non-invasive means for early detection of various oral conditions. C-reactive protein (CRP) is a key marker, elevated in both oral and general inflammatory conditions such as diabetes, periodontitis and oral squamous cell carcinoma. Considering the emerging connection between oral and systemic health, it is worth exploring the various factors associated with this widespread disease. This study investigates the association between CRP levels and dental caries in the United States population, utilizing data from the National Health and Nutrition Examination Survey (NHANES). Methods: The study analyzed data from the 2015–2018 NHANES cycles, focusing on a nationally representative sample of individuals aged 30 years and above. Weighted multivariable negative binomial and logistic regression analyses were employed to explore the relationship between dental caries and CRP levels, adjusting for age, gender, race, education level, diabetes status, and gum disease. Results: The results of the negative binomial regression analysis demonstrated a positive association between higher CRP levels and an increased mean number of dental caries (Adjusted Mean Ratio [AMR] = 1.7; 95% CI: 1.3 – 2; P: < 0.001). The logistic regression analysis showed that individuals with higher CRP levels have a 50% increase in the odds of developing dental caries (AOR: 1.5, CI: 1.2 – 1.9; P: < 0.01). Conclusion: The results of this cross-sectional study of the U.S. population highlight the positive association between high CRP levels and increased dental caries. These findings contribute to the growing body of evidence supporting the integration of oral and systemic health care. Further research is necessary to deepen our understanding of the mechanistic relationship between CRP levels and dental caries. [ABSTRACT FROM AUTHOR]

SARS-CoV-2, a severe respiratory disease primarily targeting the lungs, was the leading cause of death worldwide during the pandemic. Understanding the interplay between the oral microbiome and inflammatory cytokines during acute infection is crucial for elucidating host immune responses. This study aimed to explore the relationship between the oral microbiome and cytokines in COVID-19 patients, particularly those with and without sputum production. Saliva and blood samples from 50 COVID-19 patients were subjected to 16S ribosomal RNA gene sequencing for oral microbiome analysis, and 65 saliva and serum cytokines were assessed using Luminex multiplex analysis. The Mann-Whitney test was used to compare cytokine levels between individuals with and without sputum production. Logistic regression machine learning models were employed to evaluate the predictive capability of oral microbiome, salivary, and blood biomarkers for sputum production. Significant differences were observed in the membership (Jaccard dissimilarity: p = 0.016) and abundance (PhILR dissimilarity: p = 0.048; metagenomeSeq) of salivary microbial communities between patients with and without sputum production. Seven bacterial genera, including Prevotella, Streptococcus, Actinomyces, Atopobium, Filifactor, Leptotrichia, and Selenomonas, were more prevalent in patients with sputum production (p<0.05, Fisher's exact test). Nine genera, including Prevotella, Megasphaera, Stomatobaculum, Selenomonas, Leptotrichia, Veillonella, Actinomyces, Atopobium, and Corynebacteria, were significantly more abundant in the sputum-producing group, while Lachnoanaerobaculum was more prevalent in the non-sputum-producing group (p<0.05, ANCOM-BC). Positive correlations were found between salivary IFN-gamma and Eotaxin2/CCL24 with sputum production, while negative correlations were noted with serum MCP3/CCL7, MIG/CXCL9, IL1 beta, and SCF (p<0.05, Mann-Whitney test). The machine learning model using only oral bacteria input outperformed the model that included all data: blood and saliva biomarkers, as well as clinical and demographic variables, in predicting sputum production in COVID-19 subjects. The performance metrics were as follows, comparing the model with only bacteria input versus the model with all input variables: precision (95% vs. 75%), recall (100% vs. 50%), F1-score (98% vs. 60%), and accuracy (82% vs. 66%). [ABSTRACT FROM AUTHOR]

Objectives: To create optimal oral and overall community health, dental public health (DPH) specialists must be competent and appropriately skilled to deal with contemporary and emergent public health issues. This study aims to evaluate the current job market demands related to the DPH profession and suggest contemporary skills and qualities that would enable DPH professionals to address emerging issues more effectively in their field. Methods: A multimethod qualitative study was conducted involving two distinct groups: employers and potential employees. Interviews of stakeholders (employers) representing different job market domains, and a survey was administered to recent DPH residency graduates (employees). Qualitative analysis was applied to the data collected. Results: Employers identified the following skills as crucial for future DPH employees: proficiency in care delivery systems, health informatics, clinical training, leadership, and professional and grant writing skills. Many employers assumed the presence of a clinical component in the residency program. DPH residency graduates emphasized that the most significant barrier to securing positions is the lack of clinical experience within the residency program. Conclusions: This research highlights skills currently valued by the DPH job market and proposes that DPH specialty training may consider revising its curriculum to include these skills. Implementing such updates would ensure that graduates are well equipped and competitive, thus significantly contributing to the broader objective of attaining optimal oral health and overall well‐being of the community. [ABSTRACT FROM AUTHOR]

The Collaborative Open Research Initiative Study (CORIS) is an inclusive and innovative international research project that welcomes contributors from across the globe. CORIS fosters a democratic and collaborative approach, shaping research actively and offering publication opportunities for newcomers in health professions education. In this protocol, we describe the aims and approach of CORIS, which is designed as an annual cross-sectional, web-based survey that seeks to explore critical topics in health professions education. The target population comprises faculty and staff in accredited, degree-granting medical, dental, nursing, pharmacy, and public health schools at undergraduate and postgraduate levels across 16 countries (n=14400). Collaborators within CORIS will actively engage in survey design, question formulation, and the entire research process. The first iteration, CORIS-1, scheduled for 2024, covers themes such as post-COVID-19 patient care, epidemic preparedness, burnout, artificial intelligence, remote learning, conflict's impact on mental health, substance use, and workplace discrimination. Data will be collected on the Chisquares™ survey platform, and results, codebook, questionnaire, and methods report will be publicly accessible. No sensitive data or identifying information will be collected. CORIS-1 fosters diversity by letting contributors suggest survey questions, aiming to provide novel data, identify gaps, and influence health education policies. It provides an opportunity for early-stage researchers to engage in the research process from start to finish and to obtain publications. Contributors must meet ICMJE authorship criteria. Collaborators can also explore the collected data for their independent projects. CORIS redefines research, fostering open collaboration and meaningful contributions. Diverse perspectives and collaborators' contributions are expected to enhance the research process. Graduate students working on theses or dissertations can propose questions in CORIS-1, and early career professionals can also enroll as collaborators to gain a comprehensive understanding of the research process from start to finish. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed to explore the oral and emotional health challenges experienced by a sample of refugees in Massachusetts across different stages of resettlement using a mixed methods approach. Methods: We collaborated with two Federally Qualified Health Centers to identify and recruit participants for either surveys (n = 69) or semi-structured interviews (n = 12). Data collection was conducted in 2018. We performed descriptive statistics using STATA 14, and analyzed the interviews using qualitative methods. Results: Overall, cost and lack of structure were the largest barriers identified for accessing dental care in participants' home and host countries. In the US, participants reported receiving state-provided public health insurance, but still experienced disrupted access to dental care due to coverage limitations. We identified several mental health risk factors that may affect participants' oral health, including trauma, depression, and sleeping problems. Despite these challenges, participants also identified areas of resilience and adaptability in both attitude and actions. Conclusions: The themes identified in our study suggest that refugees have attitudes, beliefs, and experiences that contribute to their perspectives on oral health care. While some of the reported barriers to access dental care were attitudinal, others were structural. Access to dental care in the US was reported to be structured and available, but with limited coverage issues. This paper underscores the oral and emotional health aspects of refugees for future considerations and planning of appropriate, affordable and cost-effective policies in the global health care systems. [ABSTRACT FROM AUTHOR]

Background: To determine whether patients who had undergone tonsillectomy would have higher risks of postoperative periodontitis.Methods: Data were collected from the Taiwan Longitudinal Health Insurance Dataset from 1999 to 2013, a population-based cohort study consisting of cases of newly-onset sleep apnoea, chronic diseases of tonsils and adenoids, peritonsillar abscess, and periodontal diseases. A total of 1482 tonsillectomy cases and 14,796 non-tonsillectomy controls were selected. Propensity score matching37 between the tonsillectomy group and the non-tonsillectomy group was conducted to exclude the confounding effect resulting from indications of tonsillectomy. Cox proportional hazard model and subgroup analyses were conducted to identify subpopulations at risk of tonsillectomy-associated periodontitis, and a sub-outcome analysis was applied to identify the subtype of tonsillectomy-associated periodontitis.Results: A total of 648 patients who had undergone tonsillectomy and 648 out of 6509 propensity score-matched controls were retrieved, among which 230 cases in the tonsillectomy group were associated with post-surgical periodontitis (adjusted HR = 1.31, 95% CI = 1.08 to 1.59). The association persisted in a subpopulation of patients with periodontitis who received mechanical and surgical treatments for periodontitis (adjusted HR = 1.33, 95% CI = 1.09 to 1.63). The incidence of periodontitis was significantly high in the individuals who underwent tonsillectomy and was particularly high in those that were below 12 years of age (HR = 1.58, 95% CI = 1.10 to 2.27). The risk of periodontitis increased 4 years after tonsillectomy (HR = 1.82; 95% CI = 1.29 to 2.59). The majority of post-tonsillectomy periodontitis was aggressive and acute periodontitis (HR = 1.37; 95% CI = 1.10 to 1.71).Conclusions: Tonsillectomy performed in pediatric patients of < 12 years old, increased the risk of developing periodontitis. Aggressive and acute periodontitis as a long-term, postoperative adverse event took place at 4 years or longer after tonsillectomy. [ABSTRACT FROM AUTHOR]

Background: Poor sleep behavior appears to have adverse effects on health by metabolic disruption and immunity suppression. Sleep disturbance is strongly associated with diabetes, cardiovascular diseases, and some cancers. This study aimed to evaluate the association between sleep duration and periodontal disease in a national US population study in a National Health and Nutrition Examination Survey (NHANES).Methods: The data were collected from individuals aged ≥30 years and included 3,624 participants in the United States NHANES 2013 to 2014. A weighted multivariable logistic regression modeling quantified the association between sleep and severe periodontal disease. We tested for diabetes as an effect modifier, adjusting for potential confounders such as smoking status, sex, age, education level, and dental visit.Results: Individuals who sleep >7 hours/night with no trouble sleeping are 40% less likely to have severe periodontal disease (odds ratio [OR] = 0.6, P < 0.05), adjusting for age, sex, smoking status, FPL, education level, and dental visit. Additionally, diabetes was a significant positive effect modifier of the relationship between sleep and severe periodontal disease (OR = 4.8, P < 0.05).Conclusions: Findings of this cross-sectional representative study of an adult US population revealed a statistically significant association between sleep duration and severe periodontitis. In this study, individuals who slept >7 hours/night were less likely to exhibit severe periodontal disease. It also seems that this relationship was stronger among individuals with diabetes compared with individuals without diabetes. [ABSTRACT FROM AUTHOR]

Objective: Inadequate sleep contributes to several adverse systemic health outcomes due to hormonal and metabolic disorders. The purpose of this study was to determine the effect of bedtime on the development of dental caries and the relationship with salivary ghrelin and leptin in a prospective cohort study of Kuwaiti children. Methods: Data were collected from 5456 10‐year‐old children in 2012 and repeated in 2014. We selected children from 138 middle schools representing the six governorates of Kuwait. We derived data from oral examinations, self‐reported sleep interviews, body and weight measurements, and chemical analysis of whole saliva samples. Leptin and ghrelin were determined by salivary assay in a subset of 744. Two separate analyses were performed. a) Using the entire longitudinal data set (n = 5456), multilevel random intercept analysis was conducted to assess the relationship between reported bedtime and dental caries. b) Using data from a subset of the original sample (n = 744), multiple linear regression analysis was conducted to determine the relationship between dental caries and salivary ghrelin and leptin. The outcome variable was the development of dental caries in children. The independent explanatory variables and confounders were bedtime, sleep duration, salivary ghrelin and leptin; confounders assessed were gingivitis, sex, age and governorate (school location). Results: With every additional hour past 8 pm for bedtime, there was a 20% increase in dental caries incidence over two years (B = 0.2, P =.01), adjusting for age, gender, gingivitis and governorate. There was a significant difference in the magnitude of dental caries between the six governorates of Kuwait. Lower levels of salivary leptin and higher levels of salivary ghrelin were associated with increased dental caries, and sleep duration was an effect modifier that negatively affected the relationship between leptin and dental caries (B = −0.09, P <.05) and positively affects the relationship between ghrelin and dental caries (B = 0.07, P <.05). Additionally, there was a significant clustering effect within schools in this cohort. Conclusion: In a cohort study of Kuwaiti children, late bedtime was associated with increased dental caries incidence. Additionally, dental caries experience increased with higher levels of salivary ghrelin and lower levels of salivary leptin, and sleep duration mediates the relationship between these two biomarkers and dental caries. [ABSTRACT FROM AUTHOR]

The aims of this study were to qualitatively assess dental public health (DPH) residents' perspectives on teaching methods for DPH competencies and to develop and implement a case‐based simulation to address those competencies, constructed on the basis of the qualitative assessment. Focus group discussions were conducted with 18 DPH residents enrolled in two university‐based DPH programs. Topic areas discussed in the two focus groups were perceived value of DPH competencies, ways to acquire new DPH skills/abilities, and additional skills/abilities needed by DPH residents. The focus groups' responses showed that the residents felt competent in the analytical thinking competencies such as research methodology and critiquing literature. They emphasized the importance of learning leadership skills and reported feeling somewhat uncertain about their mastery of the policy and advocacy and system evaluation competencies. Of the two distinct categories of DPH skills and competencies— analytical/critical thinking and practical competencies—these residents reported that a greater proportion of time needed to be devoted to integrating the practical competencies into their education. Based on the residents' feedback, the authors developed a structured seminar series taking a case‐based approach to simulate real‐world DPH problems, using real and semi‐hypothetical planning projects to meet the residents' perceived needs and covering gaps between didactic learning and practice. [ABSTRACT FROM AUTHOR]

In a longitudinal study of 6,158 Kuwaiti children, we selected 94 for salivary metabolomic analysis who were neither obese (by waist circumference) nor metabolic syndrome (MetS) positive (<3 diagnostic features). Half (43) remained healthy for 2 years. The other half (51) were selected because they became obese and MetS positive 2 years later. In the half becoming obese, metabolomic analysis revealed that the level of salivary N1-Methyl-2-pyridone-5-carboxamide (2PY) had the highest positive association with obesity (p = 0.0003, AUC = 0.72) of 441 salivary biochemicals detected. 2PY is a recognized uremic toxin. Also, 2PY has been identified as a biomarker for uranium uptake. Considering that a relatively recent military conflict with documented uranium contamination of the area suggests that this weight gain could be a toxicological effect of long-time, low-level uranium ingestion. Comparison of salivary 2PY in samples from the USA and Kuwait found that only Kuwait samples were significantly related to obesity. Also, the geographic distribution of both reported soil radioactivity from 238U and measured salivary 2PY was highest in the area where military activity was highest. The prevalence pattern of adult diabetes in Kuwait suggests that a transient diabetogenic factor has been introduced into the Kuwaiti population. Although we did not measure uranium in our study, the presence of a salivary biomarker for uranium consumption suggests potential toxicity related to obesity in children. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to identify lifestyle habits that contribute to night sleep reduction in the Kuwaiti population. Methods. Children were 10 to 12 years old and were approximately equally distributed among 138 elementary schools representing the 6 governorates of Kuwait. In the first phase of the study, data were collected from 8317 children. The same data were collected 2 years later from 6316 of the children from the first phase of the study. Calibrated examiners conducted sleep evaluation, lifestyle habits interviews, and body weight measurements. A multilevel random intercept and slope model was conducted to determine the effect of screen-based activities on the daily night sleep hours at 3 levels: within schools, among children, and over time. The primary dependent variable was the number of daily sleep hours. Independent variables assessed were lifestyle habits including screen-based activity variables including TV and video game use. Results. Screen-based activities were significant factors that reduced daily sleep hours (P < .05). There were statistically significant variations between schools and children over time. Conclusion. Longitudinal analysis of Kuwaiti children revealed that TV and video game use were major risk behaviors contributing to decreased sleep duration with strong clustering effect of the observations within schools across time. [ABSTRACT FROM AUTHOR]

Inadequate sleep has negative effect on health including obesity, diabetes, and cardiovascular diseases. Current evidence showed that delayed night sleep may impair endocrine function, disrupt glucose metabolism and promote abnormal weight gain, irrespective of caloric intake. The aim of this analysis was to investigate the longitudinal relation between bedtime, salivary glucose levels, and waist circumference among Kuwaiti children. Repeated measures data were collected from 6316 children 8-14 years old at two time points: 2012 and 2014. Children were approximately equally distributed among 138 elementary schools representing the six governorates of Kuwait. Trained examiners conducted body weight measurements, sleep evaluation interviews, and collected saliva samples. Mixed-effect multivariate linear regression model was conducted to determine the longitudinal relationship between bedtime and the rate of change in abdominal obesity. Other explanatory variables, mediator, or potential confounders assessed were glucose level (>1.13 mg/dL), systolic blood pressure, fitness, ethnicity, and gender. There was a significant increase of waist circumference with later bedtime over time ( P < 0.05). A higher salivary glucose level (higher than 1.13 mg/dL) was a positive partial mediator in the relation between bedtime and waist circumference. There were statistically significant variations between schools across time ( P < 0.05). Longitudinal analysis of Kuwaiti children revealed that going to bed late increases salivary glucose (and presumably plasma glucose) and predicts abdominal obesity in Kuwaiti children with strong clustering effect within schools over time. [ABSTRACT FROM AUTHOR]

The potential role of the salivary microbiome in human diseases has increasingly been explored. The salivary microbiome has been characterized in several global populations, except the Arabian Gulf region. Hence, in this pilot study, we profiled the salivary microbiome of Kuwaiti adolescents with varied body mass indexes (BMI). The analyses of core microbiome composition showed Firmicutes, Bacteroidota, Proteobacteria, Patescibacteria, Fusobacteriota, Actinobacteriota, and Campylobacterota as the common phylum found in the Kuwaiti adolescent population. We also illustrated a diverse microbial community among the sampled individuals grouped according to their BMI. Notably, the overweight group was found with a higher number of distinct taxa than other groups. As such, the core microbiome composition was found to be significantly different (p-value < 0.001) across different BMI groups. Overall, this pilot investigation outlined the microbial diversity and suggested that changes in salivary microbiome composition in people with obese or overweight BMI might reflect their susceptibility to oral diseases. [ABSTRACT FROM AUTHOR]