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Ewa Rodakowska,1 Magdalena Wilczyńska-Borawska,2 Justyna Fryc,3 Joanna Baginska,4 Beata Naumnik5 1Department of Restorative Dentistry, Medical University of Bialystok, Bialystok, Poland; 2Department of Social and Preventive Dentistry, Medical University of Bialystok, Bialystok, Poland; 3Faculty of Medicine, Medical University of Bialystok, Bialystok, Poland; 4Department of Dentistry Propaedeutics, Medical University of Bialystok, Bialystok, Poland; 5I Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland Aims: The aims of the study were to determine oral health-related quality of life (OHRQoL) in chronic hemodialysis (HD) patients and to estimate which scale describing OHRQoL, Oral Health Impact Profile (OHIP-14) or Geriatric/General Oral Health Assessment Index (GOHAI), was more useful in this particular group. Methods: This was a cross-sectional study conducted by means of a census survey. The Polish versions of OHIP-14 and GOHAI were used to assess OHRQoL. The oral examination included decayed, missing and filled teeth (DMF-T) Index; Oral Hygiene Index simplified; Plaque Index and Gingival Index. In the statistical analysis, the Kruskal–Wallis test, Mann–Whitney U test, Pearson’s χ2 test and Spearman’s rank correlation coefficients were used as appropriate. Results: The final sample consisted of 72 patients (mean age 63.2±15.2years). The mean duration of HD treatment was 43.8months. The mean number of teeth was 10.9. The majority of participants (81.9%) were dentate; only 22.2% of the respondents had >20 teeth. Among the dentate subjects, 44.1% wore removable dental prostheses (60.7% women). The most prevalent items for GOHAI (mean 14.71; SD 7.21) were uncomfortable to swallow, discomfort when eating and unhappy with appearance. The most prevalent items for OHIP-14 (mean 8.87; SD 10.95) were uncomfortable to eat foods, and diet has been unsatisfactory. The internal reliability (Cronbach’s alpha) was 0.637 for GOHAI and 0.918 for OHIP-14. Chewing problems were significantly related to GOHAI (p=0.001) and OHIP-14 (p

Due to the progress in medicine and healthcare as well as the socioeconomic development in industrialised countries we have to deal with the flood of lifestyle diseases. The treatment of such diseases and in particular of complications thereof is the greatest economic burden on contemporary healthcare funding systems. Numerous studies prove the existence of interrelationships and cause-and-effect relationships among oral diseases and systemic illnesses. An analysis of risk factors for the occurrence of numerous systemic illnesses with a society-wide range has shown that the maintenance of oral health is one of essential elements which may considerably influence the modification of treatment outcomes for other general diseases.

Background The frequency of dental trauma in schools is secondary only to accidents at home. The aim of this study was to evaluate the knowledge of first aid in the avulsion of permanent teeth presented by Polish school nurses from different areas. Methods A cross-sectional study with the use of a structured self-administrative questionnaire was conducted in 2014 on school nurses working in randomly selected Polish provinces. The instrument consisted of demographic questions, questions referring to nurses’ experience and training in dental trauma and questions checking knowledge of first-aid in the avulsion of permanent teeth. The maximum number of points to be scored was eight. Data were analyzed with the Kruskal-Wallis, the Mann–Whitney U and Chi2 tests with the level of statistical significance at p

– Aim: The purpose of this study was to evaluate the knowledge of first aid in tooth avulsion among nurses working at schools in Bialystok, Poland. A part of this population attended a lecture on the management of dental trauma 2 years before. Methods: The survey was conducted in September 2010 and covered 50 (96.15%) school nurses from Bialystok. Thirty-eight of them attended the dental trauma lecture conducted 2 years before the survey. They were asked to fill in an anonymous questionnaire consisting of 20 closed questions referring to demographic data, previous dental trauma experience, and training. Seven questions referred directly to the knowledge of management of dental avulsion and on that basis, the level of nurses’ knowledge was evaluated. The data were analyzed statistically using the Mann–Withney U-test with P

Evidence has been emerging that hepatocyte growth factor (HGF) - a pluripotential regenerative cytokine - is a key factor in the pathogenesis and progression of periodontal disease, mostly through its over-stimulation of gingival epithelial cell growth and impairment of the regeneration of collagenous structures. We measured the levels of immunoreactive HGF in unstimulated whole mixed saliva from 26 patients referred for treatment of periodontal disease, and from 20 healthy subjects. HGF was detected in all saliva samples from the patients, the concentration ranging from 0.06 to 5.38 ng/ml, with a mean concentration of 1.87 +/- 1.32 ng/ml. In healthy individuals, the median salivary HGF level was 0.68 ng/ml (range: 0 - 7.33 ng/ml), being almost 3-fold lower (P < 0.0001) than that in the patients. Periodontal parameters in the patients were: gingival index (GI) 2.0 (0 - 2.8), papillary bleeding index (PBI) 2.2 (0 - 3.2), plaque index (PI) 2.0 (0 - 3.0), probing depth (PD) 3.0 (1.8 - 5.9) mm, and loss of clinical attachment level (CAL) 4.7 (1.1 - 10.6) mm. We found that the salivary HGF level was positively correlated with GI (P = 0.004), PBI (P = 0.046) and PI (P = 0.001), but not with PD (P = 0.351), CAL loss (P = 0.172), number of teeth (P = 0.279) or patient age (P = 0.362). Our findings suggest that salivary HGF concentration may be a novel marker of symptomatic periodontal disease, and that it warrants further validation.

Purpose The purpose of this study was to evaluate the prevalence and experience of clinical consequences of untreated dental caries in primary dentition in 5 and 7 year-old children from north-east Poland and to find whether there is a correlation between dmft and pufa indices. Material/Methods Two hundred fifteen children aged 5 and 7 years living in the Podlaskie region were examined in the course of the Polish National Oral Health Survey 2011. Caries prevalence and experience in primary dentition was evaluated according to WHO criteria (dmft index). The clinical consequences of untreated dental caries were assessed by pufa index. Results The dmft index was 5.56±4.45 in 5-years-old children and 6.69±3.14 in 7-years-olds. The prevalence/experience of pufa index was 43.4%/2.20±3.43 and 72.4%/2.44±2.22, respectively. Children living in rural areas presented a worse dental condition. A statistical analysis revealed a strong relation between dmft and pufa in both age groups. Conclusion The present study revealed negligence in the dental treatment of children from north-east Poland resulting in the high prevalence and experience of the pufa index in primary dentition. This index is a valuable measurement tool to record the clinical consequences of untreated dental caries.

Dental caries is still a social problem in many countries, including Poland. Through epidemiological studies conducted in index groups among children and adults, it is possible to monitor its progress and take appropriate action. The Podlaskie region is an area where the severity of dental caries in children has been the highest in the country for a few years, both in urban and rural settings.Evaluation and comparison of indicators of the progress of caries--Decayed Missing Filled Teeth (DMFT)--in 12-year-olds from the urban and rural areas of north-eastern Poland, measured between 2003-2010.In 2003 and 2010, respectively, 445 children were examined: in 2003--188: 101 boys, 87 girls; 98 from urban areas, 90 from rural areas, and in 2010--257 adolescents: 134 boys, 123 girls; 157 from urban areas and 70 from rural areas. The study protocol was strictly subordinated to the WHO study monitor guidelines. DMFT indices were evaluated in particular years. The distribution of their individual components was then compared and analyzed. The outcomes resulting from the place of residence and gender of the adolescents were taken into account. In the statistical analysis, Shapiro-Wilk test and Mann-Whitney U test were used.In 2003, the mean value of DMFT was 4.76, and in 2010 it decreased to 3.36 (p0.0001). In 2003, DMFT was 4.42 in the rural areas, and after 7 years it has risen to 4.77. There was a significant decrease in the value of the index (from 5.08 to 2.82, p0.0001) in the urban areas. No significant differences based on gender were observed between these years.The values of caries intensity among 12-year-olds from the Podlaskie region, both in rural and urban areas, are still high. Among children from the rural areas, dental caries progression is more visible and has not improved during the years 2003-2010. These findings should lead to the development of programmes for the inhabitants of rural areas.

The objective of this study was to assess the experience and attitudes of paramedics with regard to first aid in dental avulsion.An anonymous, voluntary, 11-item survey was conducted in three randomly selected emergency medical service (EMS) stations in the Province of Podlasie. We analyzed what the respondents know about procedures in dental avulsion. We were also interested in the impact of professional and personal experience on the ability to take proper action in the case of avulsed/injured teeth. The use of teeth protectors during intubation was another aspect of our study. Data were statistically analyzed with the chi2 test.The study revealed that paramedics in EMS stations are not trained to provide first aid in dental avulsion. Avulsed teeth were usually not taken from the scene of the accident. We also found that previous experience with dental avulsion did not necessarily help to undertake proper action. However, we found that more than 95% of the respondents would act properly when not on duty. Paramedics do not use any teeth protectors to avoid accidental tooth injuries during intubation.We found that paramedics in the Province of Podlasie, Poland, need specialist training courses introducing them to principles of first aid in dental avulsion. Ambulances should carry equipment for the transport of avulsed teeth.

Bactericidal, virucidal, and fungicidal activity of ozone is generally known and has been exploited for years in industry and medicine. Ozone therapy became an inherent element of the treatment of infection in such fields as surgery, dermatology, cosmetics, and dentistry. Ozone is a gas, so it penetrates very well even into such tissues and spaces that are not easily accessible. Thanks to the property of deep penetration and long ozone presence in tissues after treatment, a long-lasting bactericidal effect is achieved. The action of oxygen radicals is, however, not neutral for the human organism, therefore the use of an appropriate procedure and therapy algorithms is essential.We decided to confirm the effect of antibacterial activity of ozone applied by means of the Ozonytron device (made by Biozonix) on model strains of Streptococcus salivarius, pneumonia, pyogenes, and agalactiae, Enterococcus faecalis, Staphylococcus aureus and epidermidis, using two application patterns developed by us.We found a statistically significant difference in the size of zones of inhibited bacterial growth on all media depending on the time of action of ozone. In the present paper, the bactericidal activity of ozone in relation to bacterial strains that are most frequently isolated from the oral cavity was confirmed. What is more, two models of application of the gas on the infected medium were compared.Research on the use of ozone in combatting bacteria typical for dental diseases has shown that the gas has an oxidizing effect on these bacteria and is bactericidal.

Hepatocyte growth factor (HGF), endogenous cytokine with pleiotropic repairing and regeneration properties in relation to most tissues and organs, contributes to the progression of periodontal disease (PD). Furthermore, PD is a significant health problem in patients with chronic renal failure (CRF). The role of HGF in the development of PD in this specific population was not a subject of research so far.The following groups were enrolled in the study: (1) 26 chronic hemodialysis (HD) subjects, (2) 26 patients treated by continuous ambulatory peritoneal dialysis (CAPD), (3) 28 predialysis CRF patients, (4) 26 subjects with advanced PD (without coexisting diseases), and (5) 20 healthy subjects without PDs. HGF level in saliva was measured using the immunoenzymatic method. Gingival index, papillary bleeding index, plaque index, and the loss of clinical attachment level were evaluated.The HGF level in saliva of HD patients was twice higher than in that of subjects with healthy periodontium. Direct relationships between proper HGF level in saliva and the indices GI, PBI, and PI in CAPD-treated patients and with more severe PD were shown. It was found that PD is most advanced in HD patients, moderately in CAPD-treated patients and to the smallest extent in predialysis CRF patients.The HGF level in mixed saliva is the index of PD progression in subjects without renal failure and in CAPD-treated patients. PD is common in renal failure patients and is a significant problem concerning general health status.

The course and treatment of chronic kidney disease (CKD) is adversely affected by numerous metabolic disarrangements, comorbid states and general diseases, i.e. hyperphosphatemia and metabolic bone disease, chronic inflammation, accelerated atherosclerosis (partly of infectious etiology) and devastating cardiovascular disease. Furthermore, CKD patients are usually afflicted by multiple oral abnormalities, including troublesome oral dryness and the very aggressive form of periodontal disease. The use of chitosan-containing chewing gum in CKD subjects seems to offer a novel therapeutic approach of interdisciplinary importance: the chitosan binds salivary phosphates and, when swallowed, likely phosphates in the alimentary tract, thus beneficially lowering blood phosphate levels, while the gum itself increases impaired salivary flow and has a potent oral antimicrobial activity. Thus, it effectively improves general oral hygiene and prevents progression of periodontal disease being (besides of hyperphosphatemia) one of the established causes of atherosclerosis development/progression. The undemanding maneuver of chewing the chitosan-containing, phosphate-binding gum has a potential to diminish excessive morbidity in CKD patients.

Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of knowledge of medical staff concerning tooth avulsion is unsatisfactory and that it could be improved by educational activities. This article attempts to give short algorithms of first-aid management of avulsed tooth.

Xerostomia resulting mostly from hyposalivation and alkaline salivary pH is a frequent but often underappreciated symptom in the diseased population of maintenance hemodialysis (HD) patients. We reviewed also other xerostomia-predisposing factors, its specific dental and oral clinical signs and features, as well as plausibly detrimental dialysis-specific pro-atherosclerotic and cardiovascular consequences. In view of increasing multidisciplinary importance of xerostomia, its general, pharmacological and emerging treatment methods were presented. Special attention was paid to the untoward and often neglected pro-xerostomic effects of multiple common medications and substances; they were listed and described in more detail. The combined therapeutic approach of dentists and nephrologists may effectively alleviate xerostomia and support general health condition of maintenance hemodialysis patients.

Kidney transplantation is the best option of treatment for patients with end-stage renal failure. However, following kidney transplantation many stomatological abnormalities are frequently reported. It is mainly due to immunosuppressive therapy and subsequent impaired immune response. There is an increased risk of infections and malignancies. The most frequent findings in the oral cavity include: aphthae, erosions of bacterial, viral and fungal origin, lichen-like or leukoplakia-like changes. The another type of change is gingival hyperplasia and its periodontologial consequences. In this review etiology, clinical symptoms of periodontological changes are described together with algorithm of pre- and posttransplant management of oral healthy is provided.

Renal failure is associated with many abnormalities in the oral and dental health status. The aim of this study was to describe dental treatment procedures in a patient on the waiting list for kidney transplantation.We treated a 46-year-old female with ESRD due to reflux nephropathy who was dialyzed peritoneally for 8 years. She received a cadaveric kidney transplant in 2003. Her immunosuppression consisted of prograf, MMF, and steroids. Creatinine after Tx was 1.58 mg/dL rising to 2 mg/dL 6 months later. Transplant biopsy in 2005 (creatinine 3.5 mg/dL) revealed chronic thrombotic microangiopathy. Four years after Tx she entered the PD program to eliminate odontogenic foci of infection. Pantomography and digital radiography disclosed the presence of three teeth classified as potential centers of inflammation. The methods of treatment were: (1) surgical extraction with filling of the bone defect with BioOss bone substitute material and application of Bio-Gide collagen membrane; (2) extirpation of inflamed pulp under anaesthesia; (3) antiseptic endodontic treatment.Clinical and radiologic examination revealed normal bone healing and normal condition of periapical tissues.Elimination of odontogenic centers of inflammation in patients before kidney transplantation should be the goal of a precisely planned multi-specialist treatment. Prevention of odontogenic inflammation must be started as soon as possible in the pre-dialysis period since periodontal diseases are a significant cause of generalized inflammation accelerating progression of atherosclerosis and its complications.

Background Periodontitis contributes to generalized inflammation and development of systemic diseases, including atherosclerosis and cardiovascular disease. Its extent in maintenance haemodialysis (HD) patients is disputable and not known in continuous ambulatory peritoneal dialysis (CAPD) and pre-dialysis chronic kidney disease (CKD) patients. Methods One hundred and six patients (35 on HD, mean age, 56 years; 33 on CAPD, mean age 51 years; and 38 pre-dialysis CKD stage 2-5, mean age 51 years) from north-eastern Poland were enrolled. Dialysis subjects were recruited from a cohort of 141 HD and 61 CAPD patients. Two control groups comprised 26 generally healthy individuals with advanced periodontitis requiring specialized treatment, and 30 subjects from general population. Gingival index (GI), papillary bleeding index (PBI), plaque index (PI), loss of clinical attachment level (CAL) and community periodontal index of treatment needs (CPITN) were determined according to WHO recommendations. Results Average values of the indices in HD, CAPD, pre-dialysis CKD, advanced periodontitis and general population subjects were as follows: GI-1.37, 0.95, 1, 2 and 1; PBI-1.45, 0, 0, 2.20 and 1; PI-2.05, 1.59, 1, 2 and 1; and CAL loss-5.11, 3.47, 2.50, 4.68 and 1.40 mm, respectively. CPITN, analysed separately as community periodontal index and periodontal treatment needs, further indicated a high severity of periodontitis in all renal failure groups as compared with general population subjects. The disease was most advanced in maintenance HD patients-comparable to the full-symptomatic form of periodontitis; then it was successively diminished in CAPD and pre-dialysis CKD subjects. Conclusions Periodontal disease is prevalent, severe and under recognized in renal failure patients. Prophylaxis and early dental treatment should be intensified in these subjects, and may be of interdisciplinary importance.