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The purpose of this follow-up Delphi survey was to have an expert panel of 31 academic geriatric physicians, geriatric nurses, and medical directors of nursing homes evaluate the original timeline set to avoid oral neglect of nursing home residents. The Oral Neglect in Institutionalized Elderly (ONiIE) timelines defined oral neglect as having occurred when >7 days for acute oral diseases/conditions or >34 days for chronic oral disease/conditions had passed between initial diagnosis and offering access to dental care to the long-term care (LTC) nursing home resident. The results of this follow-up Delphi survey validated those originally defined ONiIE timelines as 90% of this panel agreed with the original timelines. This ONiIE definition adds a broad-based validation for the ONiIE timelines for setting an oral health standard of care for institutionalized elderly residents of nursing homes and should now be used to protect the vulnerable elderly residing in LTC nursing homes.

Background: Updated information on oral health status could be used to monitor oral disease patterns, as widespread variations in oral health outcomes within and between different countries are reported. Aim: The objective was to examine the status of oral and systemic health and their association with demographic characteristics of the population attending a public dental center. Methods: A cross-sectional secondary analysis of the patients’ record was conducted during June 2017 attending the dental center of Madina Teaching hospital Faisalabad, Pakistan. Study variables were analyzed using the t test and the c2 test with a significance level of P ≤ .050. Results: The mean age of the study sample was 31.9 ± 14.5 years; 56% were females; 48% had primary or higher education; 9% were hypertensive; 5% had hepatitis; and 5% diabetes mellitus; 52% were with poor oral hygiene, 68% had dental caries, 84% had no fillings, 27% had tooth loss, and 99% functional dentition; 74% patients had calculus, 67% had gingivitis, and 5% had periodontitis. Age was the strongest risk indicator. Dental caries, tooth loss, poor oral hygiene, gingivitis, periodontitis, and tooth mobility were significantly associated with diabetes mellitus; tooth loss and tooth mobility were associated with cardiac disease; tooth loss, periodontitis, and tooth mobility were associated with hypertension, whereas tooth loss and calculus were associated with hepatitis. Higher age and lower income were positively associated with poor oral hygiene. Conclusion: Age and gender remain to be the strongest predictors for both oral and systemic conditions. Poor oral health and tooth loss showed a strong relationship with chronic systemic conditions.

Background: Proper knowledge and awareness regarding electric toothbrushes may decrease the incidence of caries and indirectly reduce the burden of oral disease on the developing economy by preventing plaque-related disease on a population level. Aims and objectives: The aim of this study was to assess the knowledge and attitude toward electric toothbrush use among dentist in Saudi Arabia. Materials and methods: An analytical cross-sectional study was conducted among 417 dentists in Saudi Arabia. For this study, an interview-type questionnaire comprising 14 questions was designed. These questions were asked from different dentists randomly through a telephonic survey. The first part of the questionnaire was related to the basic demographic details of the dentists, that is, gender, age, type of practice, dental education, specialty, and experience, whereas the second part of the questionnaire was designed to extract the experience, attitude, and opinion of the dentists regarding electric toothbrushes. The data were compiled and analyzed using Statistical Product and Service Solutions, version 20 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were employed to calculate means and percentages for demographic data. Results: Among the dental participants, 171 (41.0%) were general practitioners, 163 (39.0%) were specialist, 23 (5.6%) were postgraduate students, and 60 (14.4%) were graduate dentists. A total of 271 (65%) respondents believed better patient compliance to be the main benefit of the electric toothbrush, whereas 325 (77.9%) respondents believed that poor patient compliance was the reason for patient’s poor plaque control. Similarly, 319 (76.5%) dentists endorsed patients with manual dexterity issues. Those dentists primarily recommended electric toothbrushes to patients with medical problems. Conclusions: Knowledge of dentists in Saudi Arabia is adequate regarding electric toothbrushes; efforts should be made to improve knowledge and awareness on the use of powered toothbrushes at the patients’ level.

Background Stroke is a major cause of disability and mortality. Poorer outcome after stroke is associated with concomitant inflammatory and infectious disease. Periodontitis is a chronic inflammatory disease of the dental supporting structures and is a prominent risk factor for many systemic disorders, including cardiovascular disease and stroke. While epidemiological studies suggest that periodontitis increases the likelihood of stroke, its impact on stroke severity is poorly understood. Here, we sought to determine the contribution of periodontitis to acute stroke pathology. Methods We characterized a murine ligature model of periodontitis for inflammatory responses that could potentially impact stroke outcome. We applied this model and then subjected mice to either transient or permanent middle cerebral artery occlusion. We also enhanced the periodontitis model with repeated intravenous administration of a periodontal-specific lipopolysaccharide to better mimic the clinical condition. Results Ligature-induced periodontitis caused bone loss, bacterial growth, and increased local inflammatory cell trafficking. Systemically, periodontitis increased circulating levels of pro-inflammatory cytokines, and primed bone marrow monocytes to produce elevated tumour necrosis factor-alpha (TNFα). Despite these changes, periodontitis alone or in tandem with repeated lipopolysaccharide challenge did not alter infarct volume, blood–brain barrier breakdown, or systemic inflammation after experimental stroke. Conclusions Our data show that despite elevated systemic inflammation in periodontitis, oral inflammatory disease does not impact acute stroke pathology in terms of severity, determined primarily by infarct volume. This indicates that, at least in this experimental paradigm, periodontitis alone does not alter acute outcome after cerebral ischemia.

The purpose of this study was to evaluate the associations between interdental cleaning behavior and the prevalence of caries and periodontal disease and numbers of missing teeth, with data from the National Health and Nutrition Examination Survey (2011 to 2012 and 2013 to 2014). Analysis included the following parameters: interproximal clinical attachment level (iCAL) ≥3 mm, interproximal probing depth (iPD) ≥4 mm, number of coronal and interproximal caries, number of missing teeth, ≥1 surfaces with coronal caries, and periodontal profile classes (PPCs). Chi-square was used for bivariate associations. Associations of interdental cleaning with outcomes were assessed with multiple linear regression and generalized logit regression, adjusting for age, race, sex, diabetes, smoking, education, dental visits, and sugar consumption. Nonusers had a significantly higher percentage of sites with iCAL ≥3 mm and iPD ≥4 mm as compared with individuals who used interdental cleaning devices ( P < 0.0001). Individuals with a higher frequency of cleaning (4 to 7×/wk) had a significantly lower extent of sites with iCAL ≥3 mm as compared with lower-frequency cleaning (1 to 3×/wk; P ≤ 0.05). Interdental cleaning users showed lower numbers of coronal caries, interproximal coronal caries, and missing teeth as compared with nonusers ( P < 0.0001). Nonusers had 1.73-times (95% confidence interval, 1.53 to 1.94) higher odds for having ≥1 surfaces of coronal caries as compared with interdental cleaning users, regardless of the weekly frequency. Individuals were less likely to be in diseased PPCs if they were interdental cleaning users. Low-frequency cleaners (1 to 3×/wk) had significantly greater odds (1.43; 95% confidence interval, 1.08 to 1.88) to have severe disease (PPC-G) versus health (PPC-A) than were high-frequency cleaners (4 to 7×/wk). Interdental cleaning users showed lower levels of periodontal disease and caries and lower numbers of missing teeth. Higher frequency of interdental cleaning was correlated with increased periodontal health. Individuals with severe periodontal disease could show additional oral health benefits by increasing cleaning frequency. The data support the use of interdental cleaning devices as an oral hygiene behavior for promoting health.

Objective: Dentin hypersensitivity (DH) is a common oral disease with approximately 41.9% prevalence. Reconstruction of dental hard tissues is the preferred treatment for relieving DH. Here, we applied biomineralization method using oligopeptide simulating cementum protein 1 (CEMP1) to regenerate hard tissues on demineralized dentin. Methods: The self-assembly and biomineralization property of the oligopeptide were detected by scanning electron microscopy (SEM), circular dichroism spectroscopy, and transmission electron microscopy. Oligopeptide’s binding capacity to demineralized dentin was evaluated by SEM and attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). Remineralization was characterized using SEM, ATR-FTIR, X-ray diffraction, and nanoindentation. Oligopeptide’s biocompatibility was evaluated using periodontal ligament cells. Results: Oligopeptides self-assembled into nano-matrix and templated mineral precursor formation within 24 h. Moreover, oligopeptide nano-matrix bound firmly on demineralized dentin and resisted water rinsing. Then, bound nano-matrix served as a template to initiate nucleation and transformation of hydroxyapatite on demineralized dentin. After 96 h, oligopeptide nano-matrix regenerated an enamel-like tissue layer with a thickness of 15.35 μm, and regenerated crystals occluded dentin tubules with a depth of 31.27 μm. Furthermore, the oligopeptide nano-matrix had good biocompatibility when co-cultured with periodontal ligament cells. Conclusions: This biomimetic oligopeptide simulating CEMP1 effectively induced remineralization and reconstructed hard tissues on demineralized dentin, providing a potential biomaterial for DH treatment.

As the UK population ages and older people retain their natural teeth for longer, the complexity of the oral health needs in older people is becoming more challenging. Older patients are often registered with a GP and will increasingly be likely to require dental care. Older people in particular may benefit from dental care but may not have a dentist or perceive any risk of oral disease. This article therefore provides practical insight into the oral health management of older people to assist in addressing their oral health needs.

Dental caries is the most common of all chronic childhood diseases. Parenting practices can either contribute to or protect against the formation of dental caries in children. Because children rely on parents and caregivers for oral disease prevention and treatment, parents and caregivers must be motivated to use oral disease prevention behaviors that are based on accurate information. A survey was administered to 582 WIC recipients in rural southern Illinois to assess mothers’ knowledge, opinions, and behaviors related to oral health. Deficits existed in mothers’ ability to identify drinks, foods, and behaviors that contribute to or protect against dental caries development. Nevertheless, most believed that they did not need additional oral health education in order to take good care of their children’s teeth. Many women reported having untreated caries in their own mouth, failed to have annual professional dental cleanings, and did not have a dental home. A multidisciplinary approach to early intervention is needed to promote oral wellness in one of the most vulnerable populations. WIC staff are positioned to share responsibility in children’s oral health through consistent and effective nutrition and oral health counseling.

The next century will see phenomenal changes especially and, most importantly, in patient empowerment, in the improvement of health in the disadvantaged, and in the harmonisation of standards of healthcare throughout the world. Advances in the dental sciences will facilitate these improvements but the major changes surely will be largely stimulated and motivated by the information revolution and the advances in molecular and materials sciences. The identification, and protection against disease, of patients who, because of a genetic predisposition, are at particular risk of disease is likely to become possible. Simple, sensitive, effective, non-invasive and safe diagnostic procedures will become available, as will chairside diagnostic test kits that would identify specific microorganisms causal of oral disease. The advances in digital imaging will be taken further and linked to record-keeping. Specific safe agents targeted at responsible microorganisms will be devised, and systems to deliver therapeutic agents effectively and prevent tissue damage simply will be perfected. Painless, minimally-invasive techniques for the removal of diseased oral tissues will become available, as will biocompatible materials for replacement of lost oral tissues.

Oral disease is common in patients with cancer and mouth care is an important element of palliative care. Responsibility for provision of this care usually falls to nursing staff. This study aimed to determine the level of mouth care provided by nurses for patients with cancer in Scottish hospices and in the community within Scotland, and to assess the value of a training pack in oral disease and oral care. Fifteen hospices, 52 Macmillan nurses and 112 district nurses were invited to participate. Responses to an initial questionnaire confirmed the important role of nurses in providing mouth care, but highlighted significant deficiencies in training, particularly for district nurses, and a lack of formal protocols in this area. There was little interaction with professional dental staff. Training packs, including clinical photographs and simple mouth care protocols were sent to 15 hospices, 20 Macmillan nurses and 45 district nurses. A follow-up questionnaire six weeks later showed that the packs had been very well received and had resulted in significant changes to mouth care practices of many of the users. However, 34% of the respondents felt that further training would still be beneficial.

Catastrophic hyposalivation significantly increases susceptibility to dental caries in dentate individuals and may cause the expression or exacerbation of other oral diseases/disorders as well. The effect of subcatastrophic hyposalivation on susceptibility to caries or other diseases/disorders is less well understood. The aim of this study (part of a larger study on the prevalence of hyposalivation) was to determine the prevalence and to measure the association of oral pathologic conditions with unstimulated and stimulated whole saliva flow rates. Only 6.3% of all study participants had significantly diminished unstimulated (

The dental diseases of rabbits are unique because of their dental anatomy and physiology. Common problems of Lagomorph dentition are covered in this article including malocclusions, periodontal disease, and their treatment. The anatomy of Lagomorph dentition is reviewed and anesthesia protocols are included.

The pathological sequela of reduced neutrophil function in the oral cavity and the mechanisms behind dysfunction have added to our understanding of infectious diseases. Numerous examples have been given, and the overriding conclusion must be that any impairment of neutrophil function will lead to some degree of increased susceptibility to infection. Perhaps the tissue most sensitive to pathological changes in the oral cavity is the periodontium. In cases of severe neutrophil dysfunction, there is severe periodontal breakdown, but also in cases of "mild" neutrophil dysfunction, where there is no other infection, such as in individuals with LJP, there is severe periodontal breakdown. The molecular basis of neutrophil dysfunction is beginning to be understood in individuals with LJP, LAD, CGD, and AIDS. It is our hope that further research in this area will help to delineate the pathogenesis of these and other oral diseases.

Controlled-release therapeutic systems are designed to deliver a pre-determined amount of drug to a specific anatomical site for an extended period of time. A single controlled-release delivery system no larger than an ordinary tablet or capsule and placed at the desired site of drug action can produce long-term therapeutic effects that previously could only be achieved through multiple administration of conventional dosage forms. Transient spikes in drug concentration seen with multiple dose regimens are eliminated, decreasing the chance of adverse reactions. Because they are effective for an extended period of time, controlled-release therapeutic systems minimize the involvement of the patient in drug administration , a factor which can increase both patient compliance with a prescribed regimen and patient satisfaction with the treatment schedule compared with conventional therapy. Controlled-release technology can be utilized to deliver therapeutic agents ranging in size from small ions to macromolecules. Clinically-proven controlled-release drug delivery systems are currently available with durations of action ranging from several days (e.g., for the prevention and treatment of angina pectoris and motion-induced nausea and the treatment of glaucoma) to one year (e.g. for contraception). A therapeutic system for contraception with a five-year effective lifetime is in clinical trial. Intra-oral controlled-release therapeutic systems are being investigated for the delivery of fluoride and antibiotics. A system for fluoride has reduced experimental dental caries in rats by over 50% and has significantly elevated salivary fluoride concentrations during a six-month trial in adolescents. Tetracycline-containing polymeric fibers can provide site-specific delivery of the antibiotic to periodontal pockets for 10 days or more. An intra-oral controlled-release pellet for tetracycline with a duration of action of one to two weeks is being developed, and additional possibilities exist for the intra-oral use of this versatile technology.

The association of periodontal disease with 12 selected variables, considered to be intrinsic-systemic factors, was examined. A probability sample of 324 subjects, ≥ 20 years old, was studied. The statistical analyses included simple, partial, and multiple correlations, and linear regression.