Search

Objectives: Although early-life dental care is crucial for preventing early childhood caries and has numerous benefits, the utilization rate of such care remains remarkably low worldwide, especially in families of low socioeconomic status. The aim of this study was to systematically review the scientific evidence relating to the effectiveness of interventions on improving early-life dental care utilization of very young children. Method and materials: Scientific evidence relating to these positive changes was reviewed, with seven randomized controlled trials after qualitative evaluation. Interventions assessed included prenatal oral health promotion, motivational interviewing, intra-oral camera use alongside social work consultations to aid in decreasing barriers to care, monetary incentives for tooth brushing, fluoride varnish applications, and probiotic usage. Results: The intervention was significantly effective in reducing the incidence of dental caries among children, especially in caries risk. Caries reduction was significant when oral health information was provided at frequent intervals prena-tally. Caries increment was also reduced when probiotics were introduced when administered daily. Interventions that attempted to increase parental involvement in oral health care by increasing motivation and decreasing barriers had inconclusive results within the study groups. Conclusions: Considering high rates of early childhood caries, early establishment and preservation of a dental home should be a focus in public health measures. Continuous monitoring and parental involvement are key components to maintaining healthy oral conditions. Future studies could explore and test various innovative strategies that utilize technological platforms to engage with parents and promote early-life dental care utilization among the underserved population. [ABSTRACT FROM AUTHOR]

Numerous surgical techniques have been developed as effective means to facilitate orthodontic treatment, but they may cause significant postoperative discomfort. Piezocision was established as a flapless and minimally invasive technique to accelerate orthodontic tooth movement by combining small vertical incisions and piezoelectric corticotomies. Computed tomography is combined with the Piezocision technique to fabricate CAD/CAM surgical guides to prevent iatrogenic damage. A method to combine computer-assisted dynamic navigation with Piezocision is introduced here. CBCT was combined with motion-tracking technology to allow real-time tracing of the piezoelectric instruments during the surgical procedure. This technique delivers the location of the piezoelectric knife in regard to roots and important anatomical structures to increase the safety and accuracy during corticotimies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the degrees of dependence and presence of bacterial plaque in children with autism spectrum disorder (ASD) and the quality of life of children and their caregivers. Method and materials: This was a cross-sectional observational study. This study included 119 individuals with ASD and their caregivers. Data were collected through a sociodemographic questionnaire, WHOQOL-Bref, and Burden interview to measure quality of life and caregiver burden, respectively. The Autoquestionnaire Qualité de Vie Enfant Imagé questionnaire, adapted in game format, was applied to verify quality of life in children with ASD. An oral clinical examination evaluated the visible plaque index. The collected data were tabulated and organized for statistical analysis with a significance level of 5%. Results: It was observed that 52% of the children had a severity of ASD level 1; 70% were dependent for general activities, and 65% were dependent for oral hygiene. Of the 77 children who thoroughly answered the questionnaire about their quality of life, 64.9% had good quality of life, and 35.1% had scores below 48, that is, low quality of life. In general, the caregivers generally presented quality of life with a rate of 60.95 (good) points on the scale. It was observed that gingival bleeding greater than 30% is two (ASD 2 + ASD 3) to three (ASD 3) times more likely to occur in patients who have higher levels of ASD (P < .004). Conclusion: It was concluded that the quality of life of individuals with ASD was good, that most children are dependent for their daily activities and oral hygiene, and that they showed reasonable plaque control. On the other hand, the caregivers presented low quality of life and moderate burden. [ABSTRACT FROM AUTHOR]

Peri-implant diseases are defined as bacterial plaque-induced inflammatory conditions affecting implant-surrounding tissues and are classified as peri-implant mucositis and peri-implantitis. Peri-implant mucositis is characterized by an inflammatory lesion that resides in the soft tissue compartment, whereas at peri-implantitis sites the lesions also feature progressive loss of implant-supporting bone. Inflammation resolution and disease progression arrestment are the main therapeutic endpoints of the treatment of peri-implant diseases. The present position paper displays the current evidence and clinical recommendations of the European Association for Osseointegration for the treatment of peri-implant diseases. Mechanical biofilm removal along with the reinforcement of patient-administered oral hygiene is considered the standard treatment for managing peri-implant mucositis. It is recommended to assess the outcomes of peri-implant mucositis treatment 2 to 3 months after therapy, and repeated intervention should be considered in the absence of treatment success. Peri-implantitis treatment should follow a stepwise treatment approach, starting with nonsurgical treatment followed by surgical intervention, if that is not sufficient. Surgical peri-implantitis therapies include nonreconstructive, reconstructive, and combined treatment modalities. Implantoplasty may be advocated for the treatment of supracrestal peri-implant defects, whereas reconstructive therapy is indicated at peri-implantitis sites featuring intraosseous defects with a depth ≥ 3 mm. Adjunctive reconstructive measures may be beneficial in enhancing radiographic defect fill and maintaining postoperative soft tissue levels, which may have a great impact in esthetic cases. The adjunctive use of systemic antibiotics during surgical therapy does not seem to improve the clinical outcomes. Regular supportive peri-implant therapy with biofilm removal should be an integral part of the treatment protocol for peri-implant diseases. In the presence of advanced bone loss around implants that do not play a strategic role in masticatory function, implant removal may be considered immediately. [ABSTRACT FROM AUTHOR]

Purpose: To describe the use of digital technology to surgically guide the shell technique using allogenic cortical plates for a fully guided bone augmentation procedure. Materials and Methods: A total of 10 patients who required bone augmentation for implant placement were included in this study. Allogenic cortical plates were planned using CAD/CAM to have identical thickness to the original cortical plates, then were digitally positioned and shaped to outline the bone defect according to the existing anatomical details. A cutting pattern and a surgical template were manufactured according to the digitally preplanned bone graft and the intraoral setting. Results: A total of 12 horizontal bone grafting procedures were performed using the shell technique with allogenic cortical plates. All grafting procedures were deemed successful and allowed for ideal 3D implant positioning. Of the 12 bone grafting procedures, which used a surgical template to position the cortical plate, 3 required an adjustment to reposition the plate to a more ideal position. Conclusions: Digital technology was used to create a surgical template to guide the shell bone grafting technique with allogenic cortical plates. All surgical templates offered a fixed support to hold the cortical allogenic plate in the preplanned position, offering a predictable, simplified, and accurate guided bone grafting procedure. Further studies on a larger population of patients are necessary to assess those results and to verify the treatment approach described in this study. [ABSTRACT FROM AUTHOR]

Objectives: Inflammatory disorders including periodontitis have been investigated for their impact on systemic inflammation and bone health. The present study was conducted with an aim to evaluate impact of control of periodontal inflammation through subgingival instrumentation on serum interleukin 6 and serum C-terminal telopeptide of type I collagen (CTX) in premenopausal females with stage II and III periodontitis. Method and materials: In this single-arm prospective study, periodontal parameters, serum interleukin 6, serum CTX, and hematologic parameters (total leukocyte count, differential leukocyte count, platelet count, mean platelet volume, and platelet distribution width) were assessed at baseline. Subgingival instrumentation was done, and oral hygiene instructions were given. At week 4, professional plaque control was performed, and oral hygiene instructions were reinforced. Serum and hematologic parameters were reassessed at 8 weeks after subgingival instrumentation, in individuals meeting the clinical endpoints (ie, bleeding on probing < 10%). Results: There was significant reduction in serum interleukin 6 of 0.168 ± 0.164 pg/mL (P = .000), and serum CTX of 17.459 ± 4.363 pg/mL (P = .000) at 8 weeks after subgingival instrumentation. There was significant decrease in eosinophil count (P = .018) and mean platelet volume (P = .016) at 8 weeks after subgingival instrumentation; however, no significant change was found in other hematologic parameters. Conclusion: Following subgingival instrumentation, biomarkers of both systemic inflammation (interleukin 6) and bone turnover (CTX) were observed to reduce significantly. This finding hints towards a positive impact of periodontal intervention on bone health. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT). Materials and Methods: Three electronic databases were searched from 2003. The reference lists of the included articles and relevant reviews were also manually searched. Randomised controlled trials reporting the clinical outcomes of the topical use of TTO as an adjunct to daily oral hygiene or scaling and root planing (SRP) were included. Regarding the use of TTO as an adjunctive to daily oral hygiene, the primary outcome was plaque index (PI) reduction. Regarding the use of TTO as an adjunctive to SRP, probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were the primary outcomes. The secondary outcomes were adverse events. Results: Eleven studies were included for qualitative analysis, 9 studies were included for quantitative analysis, and 6 studies were included to examine the application of TTO mouthwash as an adjunctive to daily oral hygiene. In addition, three studies were included to analyse the subgingival use of TTO adjunctive to SRP at selected sites. The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo. The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group. For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment. However, an unpleasant taste was reported in three out of four studies. Conclusion: There is a lack of strong evidence to support the beneficial effects of TTO. Studies with larger sample sizes and standardised evaluation criteria are needed to further demonstrate the clinical relevance of TTO. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effectiveness of an interproximal brush, a water flosser, and dental floss in removing plaque and reducing inflammation around implant-supported crowns. Materials and Methods: A randomised controlled trial was conducted involving 45 participants with implant-supported single crowns. The participants were randomly assigned to three groups: interproximal brush, water flosser, and dental floss. Plaque index scores, gingival index scores, and interleukin-6 (IL-6) levels were assessed at baseline and after a two-week period. Statistical analysis was performed to compare the outcomes among the groups. Results: Following the second visit, improvements in plaque control were observed across all three interdental cleaning methods. The water flosser demonstrated a slight reduction in IL-6 levels (60.17 ± 3.07 vs 58.79 ± 4.04) compared to the initial visit, although this decrease was not statistically significant. Conversely, both the interdental brush and dental floss exhibited a slight increase in IL-6 levels at the second visit (60.73 ± 2.93 and 55.7 ± 10.64, respectively) compared to the mean at the first visit (58.38 ± 3.24 and 54.6 ± 2.22, respectively). Among the groups, only the interproximal brush demonstrated a statistically significant difference in IL-6 levels (p=0.008), while no statistically significant differences were observed in the dental floss and water flosser groups. Conclusion: Within the study’s limitations, our findings suggest that all three methods of interdental cleaning effectively improve plaque control and reduce gingival inflammation. However, using a water flosser appears to reduce inflammation more effectively, highlighting its potential advantage over the other two methods. Further research is needed to evaluate the long-term efficacy and impact of these methods on implant survival. [ABSTRACT FROM AUTHOR]

Background: The main aim of this cluster randomised controlled trial is to explore the feasibility of a school-based brushing program utilising a smart, connected brush in children. Methods: Students aged 8 to 11 years in 6 primary schools across Manchester, UK were approached for this study. All children received a smart, connected toothbrush which captured information on coverage, duration and frequency of brushing. Teachers had access to class-level digital dashboards summarising brushing habits to set challenges for the students. Additionally, children in schools randomised to the toothbrush plus text messaging trial arm received text message support (delivered to their parents' mobile phones). Outcomes included: (a) consent rate, (b) recruitment rate recorded as the number of participants who completed at least one of the study surveys post-consents, and (c) acceptability of the interventions on schools and parents through a mixed methods approach. Results: Average age of parents was 39.8 years (SD5.94) while the average age of children was 9.7 years (SD1.56). Most parents and children came from households in the most deprived decile based on their Index of Multiple Deprivation (IMD) scores with 77 households (52.4%) scoring 1 (most deprived). Out of 753 eligible participants across all 6 schools, 409 were consented (54.3% consent rate) with 148 participants completing baseline measurements (36.8%). During the study, there was only 1 drop out. In terms of acceptability, parents found the study very enjoyable (average score of 8.9/10), and found the brush and app easy to use (average score of 8.7/10). Those parents who additionally received the text messages found them easy to understand and useful (average score of 8.9/10). In total, 91.6% of parents would recommend the brush and the intervention to family and friends. Three key facilitators ((a) enhancing children's self-reliance, (b) increased engagement through the use of visual cues and (c) increased motivation (due to gamification) potentially supported children's engagement with the brush and app. Conclusions: Low dropout rates and very positive feedback highlight the potential of this intervention. Future studies should consider how to quantify changes in children's oral health, address loss of questionnaire completion and harness the opportunities this study provided. Trial registration: The study was registered at ISRCTN registration number ISRCTN77803149 on the 28th December 2023. [ABSTRACT FROM AUTHOR]

The use of silicone mouth swabs for soft tissue cleaning in elderly care is significant as it offers a gentle yet effective solution for maintaining oral hygiene, particularly in patients with limited dexterity or cognitive impairments, thereby reducing the risk of oral infections and improving overall health. This study aimed to compare the pseudo-plaque cleaning efficiency of a newly designed silicone mouth swab with that of the existing MouthEze (MC3) under both wet and dry brushing conditions. A new silicone mouth swab was designed with both straight and threaded brushing bristles and a longer head length of 24.0 mm, compared to the MC3, which has only straight bristles and an 18.0 mm head. A pseudo-plaque, created by mixing 6.0 g of Thicken Up Clear food additive with 12.0 ml of water and food coloring, was spread onto a NISSIN dentoform silicone rubber sheet with a thickness of 2.0 mm. The MC3 silicone head (n = 12) and the new silicone head (n = 12) were attached to a V.P.2000 tooth brushing machine, operating at 75 rounds per minute with a force of 2.45 N, and each was used to brush the surface 25 times under both wet (n = 12) and dry (n = 12) conditions. The ImageJ program was used to analyze and quantify the area where the pseudo-plaque was removed after brushing. A two-way analysis of variance (ANOVA) was conducted to assess differences in pseudo-plaque removal between groups. The pseudo-plaque removal per head length of the new silicone mouth swab was significantly higher than that of the MC3 under both wet brushing (72.30 ± 10.21 mm2 vs. 53.69 ± 5.66 mm2, p < 0.05) and dry brushing conditions (66.82 ± 11.29 mm² vs. 53.33 ± 8.54 mm2, p < 0.05). The new silicone mouth swab with both straight and threaded brushing bristles and a longer head length was more effective in pseudo-plaque removal than the swab with only straight bristles and a shorter head. [ABSTRACT FROM AUTHOR]

The delivery of oral health care has been identified as an important part of holistic patient care. Many patients may neglect their own oral health, oral hygiene and self-care when they are hospitalised due to feeling unwell. The Royal Wolverhampton NHS Trust nursing quality team endeavoured to change their Trust's culture relating to oral health management for all adult inpatients. To facilitate ongoing action relating to oral hygiene and health education and training, a bespoke, mandatory digital learning package was designed, developed and delivered to relevant clinical staff at the Trust. [ABSTRACT FROM AUTHOR]

This study aims to investigate the prevalence and association between characteristics, dietary habits, and other factors associated to Helicobacter pylori (H. pylori) infection, as well as the resistance of H. pylori to antibiotics and risk factors in Quanzhou. A minimally invasive string test combined with qPCR was used to investigate the relationship between H. pylori infection and several factors that were evaluated using a survey. Logistic analyses were performed to estimate the risk factors for the prevalence and antibiotic resistance of H. pylori. The H. pylori prevalence amounted to 52.60%, the clarithromycin and levofloxacin resistance rate of H. pylori were 48.92% and 44.59%, respectively. Logistic analyses showed that takeaway food emerged as a protective factor for H. pylori infection, while the consumption of soy products reduced the risk of clarithromycin resistance. Furthermore, high sugar, spicy food, frequent tea drinking, and hyperlipidemia increased the risk of H. pylori infection. Finally, the frequency of oral hygiene had an impact on levofloxacin resistance. The prevalence and resistance rate of H. pylori was found to be high in Quanzhou. Our results also showed that diet, hygiene, and disease prevention awareness play an importance role in H. pylori prevention and treatment. [ABSTRACT FROM AUTHOR]

Objective: The primary goal of this study was to conduct a comprehensive analysis of the comparative effects of chlorhexidine 0.12% and fluoride toothpaste as oral hygiene agents in mechanically ventilated patients, with a specific focus on their impact on oral microorganisms and hygiene. Methods: This single-blinded, randomized clinical trial was conducted at Dr. Wahidin Sudirohusodo General Hospital in Makassar, Indonesia, from April to August 2024. The study population consisted of all patients on mechanical ventilation in the hospital's intensive care unit (ICU) during this period. Participants were randomly assigned into two groups: one received oral care with chlorhexidine 0.12% and the other with fluoride toothpaste. This division allowed for a direct comparison of the effects of each oral hygiene agent on reducing oral microorganism colonies and improving Beck oral assessment scale (BOAS) scores among mechanically ventilated ICU patients. Results: A total of 20 patients participated in this study, evenly divided between the two intervention groups: chlorhexidine 0.12% and fluoride toothpaste. The comparison of oral microorganism colonies before and after the intervention revealed a significant reduction in both groups (p<0.05). However, there was a notably more significant reduction in the chlorhexidine 0.12% group, indicating its superior effectiveness in lowering oral microorganism colonies. This finding has practical implications for oral care in ICU settings, suggesting that chlorhexidine 0.12% may be a more effective choice. Similarly, BOAS scores also showed a more significant decrease in the chlorhexidine group, further supporting its effectiveness as an oral hygiene agent in mechanically ventilated patients. Conclusion: Chlorhexidine 0.12% has proven more effective than fluoride toothpaste as an oral hygiene agent, particularly in mechanically ventilated patients. [ABSTRACT FROM AUTHOR]

Behavioral interventions can improve children's oral hygiene practices. The multiphase optimization strategy (MOST) offers a framework to prepare, optimize, and evaluate behavioral interventions. This optimization trial tested 3 intervention components—brief motivational interviewing (MI), storytelling videos (STVs), and oral health promotion messages (OHPMs)—in enhancing mother's self-reported brushing of their preschool children's teeth. A total of 128 mothers with children <5 y old were included in a 23 factorial trial. The primary outcome was children's plaque accumulation, assessed using the modified Plaque Index of Silness and Löe, with scores ranging from 0 to 3. The secondary outcome was mothers' self-reported frequency of brushing their children's teeth, categorized as at least once daily or less than once daily. Mothers were randomized to 8 experimental conditions based on combinations of on-off levels of the 3 components. Linear regression and generalized linear regression with logit link function were used to assess the impact of the components and their interactions on plaque score and daily toothbrushing after 3 mo. Multiple imputation was used for missing values. The principle of effect hierarchy guided the selection of components for inclusion in the optimized package, giving priority to main effects and 2-way over 3-way interactions. Plaque was reduced from mean = 1.8 at baseline to mean = 1.5 and daily toothbrushing increased from 50.8% to 69.5% after 3 mo. MI led to non-significantly less plaque and non-significantly more daily toothbrushing. Combining OHPMs and STVs together without MI canceled each other. Neither the main effects nor the 2- or 3-way interactions significantly affected the 2 outcomes. Individual or combined components did not significantly reduce plaque or increase daily toothbrushing. MI had the greatest promise for behavior change, and the m-oral health components need modification before they can be combined with MI in a health promotion package. [ABSTRACT FROM AUTHOR]

Background and objectives: Different methods to simulate plaque in order to test the efficacy of oral cleaning methods have been published. This scoping review aims to provide an overview of the existing models and to highlight their respective benefits and limitations. Material and methods: Following the recommended scoping review methodology the scientific literature was systematically searched electronically (PubMed and Scopus) and by hand search up to July 2024, using combinations of search items related to oral plaque simulation, periodontitis or peri-implantitis. Retrieved study titles and abstracts were screened for possible inclusion. Finally, data from included fulltexts was extracted by two independent reviewers. Nine different characteristics for proper plaque simulation method were defined and each existing method evaluated and rated accordingly, and an overall rating was calculated for each method. Results: Initially, 1787 records were identified. After abstract and title screening and fulltext revision, 25 fulltexts describing 7 different simulation methods, were included. The assessed methods of simulation were ink (12), varnish (5), calcium phosphate (1), calcium carbonate (1), occlusal spray (3), aluminum (1), commercially distributed and prepared artificial plaque (2). Even though some materials achieved good results in the assessment for individual criteria like water solubility, big differences could be found concerning practicability and production time, no simulation method was rated "very good" or even "good" in the overall evaluation. While ink and varnish were considered simulation materials of moderate quality for oral plaque simulation, all other techniques were assessed as weak simulation materials. Conclusion: Among the different published methods for the simulation of mechanical plaque removal, none seems to sufficiently simulate the essential characteristics of oral plaque, while some simulation methods may be useful to feature single properties of plaque in in-vitro studies sufficiently. Nevertheless, advanced models reflecting the diverse features of dental plaque more comprehensively are needed. [ABSTRACT FROM AUTHOR]

Introduction: The global burden of disease study 2016 estimated that oral diseases affected 3.58 billion people with dental caries. Severe tooth loss and total edentulous condition have been reported as one of the leading causes of years lived with disability in some high-income countries. Oral health inadequacies exist among and between different population groups, and social determinants have a strong impact on oral health. The World Health Organization (WHO) defines oral health as "a state of being free from chronic mouth and facial pain, oral infections and sores, periodontal diseases, tooth decay, tooth loss and other disorders and diseases that limit individual capacity in biting, chewing, smiling, speaking and psychosocial well-being." National Oral Health Survey Report 2004 states that caries prevalence in India was 51.9%, 53.8%, and 63.1% at 5, 12, and 15 years, respectively. Literature on-caries research in eastern India is few, and reports related to West Bengal are sparse with respect to the dentition status and treatment needs. Aim: To assess dentition status, treatment needs, and their association with diet and oral hygiene practices among school-going children population of West Bengal. Methods: The survey was carried out after obtaining institutional ethics clearance. The state of West Bengal was divided into three zones, and random sampling method was employed to examine students using the WHO questionnaire and achieve the target sample size of based on the formula N = 4pq/L2 and a sample size of 784 per zone. Results: Significant Caries Index of 2352 respondents has been found to be 5.57 in this study, and the mean DMFT is 2.34. There was need for one surface filling in 384 (34.3%) children from Zone 1, 360 (32.1%) from Zone 2, and 377 (33.6%) from Zone 3. The need for two surface fillings was observed as 200 (32.4%) children from Zone 1, 223 (36.1%) from Zone 2, and 194 (31.4%) children from Zone 3. The association of brushing versus caries prevalence was not statistically significant (P = 0.0601). Conclusion: Caries prevalence was found to be 53.3% in this study. The difference in caries prevalence across the zones is not statistically significant. Toothbrush and paste twice a day is used mostly as oral hygiene aid. [ABSTRACT FROM AUTHOR]

Introduction: Inadequate toothbrushing practice is define as brushing teeth less than two times per day. Inadequate toothbrushing during adolescence can lead to oral health problems and disease burden in adults. Moreover, inadequate practice can lead to low quality of life and inadequate self-esteem. Objective: This study aimed to determine the prevalence of inadequate toothbrushing practice among adolescents aged 13 to 17 years in Malaysia and its association with sociodemographic and other related risky lifestyles. Method: This study was part of a national cross-sectional study, Global School Health Survey 2017. 27,497 students were agreed to participate in this study, with response of 89.2%. A validated self-administered bilingual, comprised of topics related to sociodemographic as well as adolescent health and risky lifestyles; substance use (alcohol, drug, smoking cigarettes), eating patterns, hygiene (inclusive of oral and hand hygiene), mental health status, lack of peer and parental/guardian support, truancy, physical activity, and body mass index (BMI). Analysis was performed using IBM SPSS for Windows version 26.0 involving complex sampling analysis and logistic regression. Results: A total of 12.7% (95% CI: 11.8–13.6) of in-school adolescents had inadequate toothbrushing practices. Higher prevalence of inadequate toothbrushing were found among male, Indian, had ever drug use, had three or more lack of protective factors and had inadequate hand hygiene practices. Adolescents who had inadequate toothbrushing were significantly higher odd among males, Indian ethnic, ever drug use, inadequate hand hygiene practices and adolescents who had three or more lack of peer and parental/guardian support. Conclusion: Approximately 1 out of 10 adolescents had inadequate toothbrushing practices with several factors associated, such as male gender, Indian ethnicity, inadequate hand hygiene, ever drug use and lack of protective factors are identified to be associated. By emphasizing the significance of frequent brushing, we can encourage positive changes and reduce the burden of preventable dental problems on adolescents. [ABSTRACT FROM AUTHOR]

Chlorhexidine (CHX) is the most commonly used mouthwash with proven antiplaque and antibacterial activity. The aim is to evaluate the effect of vitamin C (VitC) in CHX mouthwash on plaque accumulation and gingivitis, and to compare it with CHX alone mouthwash and antiseptic phenol-containing mouthwashes. This study conducted as a multicenter, randomized, controlled, double-blind, parallel design clinical study. Sixty patients were included, randomly divided into three groups. 1. Antiseptic phenol agent (P, Phenol), 2. Antiseptic bisbiguanide agent CHX-only (CHX) and 3. Antiseptic bisbiguanide agent CHX + VitC mouthwash (CHX + VitC). The study assessed oral hygiene and periodontal health status, followed by scaling and root planning (SRP) and subsequent polishing. After using the mouthwash for 60 s twice daily along 14 days, patients recalled for evaluation of plaque index (PI), gingival index (GI), bleeding on probing (BOP) and staining. One-way analysis of variance (ANOVA) was used to compare the differences formed between groups and Tukey multiple comparison analysis was used to determine groups that showed the differences. Statistical significance was determined using a p-value threshold of 0.05. There were no significant differences between the groups regarding baseline PI, GI and BOP (p > 0.05). Changes at 14th day in PI, GI and BOP in all groups were similar and no significant differences were observed (p > 0.05). Regarding 'all surfaces', staining density of two mouthwashes containing CHX was significantly higher than that of P mouthwash. CHX, CHX + VitC, and P mouthwashes appeared to exhibit comparable effects as oral hygiene adjuncts to periodontal mechanical treatment, with the exception of staining, which was more noticeable in the CHX groups compared to the P group. Adding vitamin C did not enhance the effects of CHx alone. [ABSTRACT FROM AUTHOR]

Background: Different educational methods play an important role in oral hygiene education programs. This study aims to evaluate the impact of various educational methods on the oral hygiene knowledge of primary school children. Methods: A total of 490 primary school students participated in this cross-sectional study. The students were assigned to one of three groups: a verbal explanation group, an animation group, or a peer-led reels group. Before and after the intervention, the students completed questionnaires assessing their oral hygiene knowledge. Results: A significant increase was observed in the post-educational knowledge levels of the children in three educational methods (p < 0.001). The study found that the main effect of educational methods was statistically significant (p < 0.001). However, effects of gender, and tablet/mobile phone use, respectively, were not statistically significant (p = 0.694, p = 0.641). The animation group (6.73) and the verbal expression group (6.57) had the highest post-training knowledge levels, respectively, while the peer-led reels group had the lowest (5.95) (p < 0.001). Conclusions: All three educational methods are effective in promoting oral hygiene, but due to the accessibility and consumption of information in the current technological era, animation videos may be more useful and suitable for modern education. Trial registration: ID: NCT06569745; Date: 21.08.2024; 'retrospectively registered'. [ABSTRACT FROM AUTHOR]

This empirical study assessed the potential of developing a machine-learning model to identify children and adolescents with poor oral health using only self-reported survey data. Such a model could enable scalable and cost-effective screening and targeted interventions, optimizing limited resources to improve oral health outcomes. To train and test the model, we used data from 2,133 students attending schools in a Portuguese municipality. Poor oral health (the dependent variable) was defined as having a Decayed, Missing, and Filled Teeth index for deciduous teeth (dmft) or permanent teeth (DMFT) above expert-defined thresholds (dmft/DMFT ≥ 3 or 4). The survey provided information about the students' oral health habits, knowledge, beliefs, and food and physical activity habits, which served as independent variables. Logistic regression models with variables selected through low-variance filtering and recursive feature elimination outperformed various others trained with complex machine learning algorithms based on precision@k metric, outperforming also random selection and expert rule-based models in identifying students with poor oral health. The proposed models are inherently explainable, broadly applicable, which given the context, could compensate their lower performance (Area Under the Curve = 0.64—0.70) compared to similar approaches and models. This study is one of the few in oral health care that includes bias auditing of classification models. The audit surfaced potential biases related to demographic factors such as age and social assistance status. Addressing these biases without significantly compromising model performance remains a challenge. The results confirm the feasibility of survey-based machine learning models for identifying individuals with poor oral health, but further validation of this approach and pilot testing in field trials are necessary. [ABSTRACT FROM AUTHOR]

Background: Early childhood caries (ECC) is a highly prevalent oral disease among children worldwide, arising from multiple contributing factors. This study aimed to investigate the sociodemographic and clinical factors associated with ECC in preschool children attending a hospital in Ica, Peru. Methods: This observational cross-sectional study involved 186 children evaluated during two dental health campaigns organised by a hospital in Ica, Peru. Oral examinations were conducted by two trained paediatric dentists, while haemoglobin levels were measured by two nurses. Mothers or caregivers completed questionnaires to provide relevant sociodemographic and behavioural data. Multiple logistic regression analyses were conducted to identify variables significantly associated with ECC (p < 0.05). The maximum likelihood method was used to assess the contribution of demographic, clinical and other factors—such as oral hygiene and cariogenic diet—using odds ratios (ORs) and regression coefficients to indicate the magnitude and direction of their effects. Results: The prevalence of ECC was 76.88%. Among the children, 50.54% were male, with a mean age of 4.44 ± 0.87 years. Most participants had poor oral hygiene (63.98%), while 82.26% of children with anaemia had reduced haemoglobin levels. The mean monthly family income was USD 376.35 ± 168.96. Mothers or caregivers reported brushing their children's teeth twice daily (56.99%) and giving sweets one to two times daily (79.03%). Factors significantly associated with ECC included the child's age (OR = 3.32; 95% CI, 1.68–6.58), haemoglobin level (OR = 0.43; 95% CI, 0.25–0.72), monthly family income (OR = 0.99; 95% CI, 0.9972–0.9998) and mother/caregiver education (OR = 0.13; 95% CI, 0.03–0.52). Additionally, dental brushing frequency (OR = 0.13; 95% CI, 0.02–0.65) and sweet consumption (OR = 4.98; 95% CI, 1.05–23.56) were identified as associated behaviours. Conclusion: The findings demonstrate that ECC is associated with a child's age, monthly family income, mother/caregiver education level, haemoglobin level, brushing frequency and sweet consumption. [ABSTRACT FROM AUTHOR]

Background: The oral and dental health and related quality of life of orphan children and adolescents—who are considered a vulnerable population—are critical for both individual and public health. Objectives: This study aimed to investigate the status of the dental caries, oral hygiene, and dental treatment needs among a group of Turkish male orphan children and adolescents, as well as their impact on oral health-related quality of life. Methods: A total of 112 orphan children and adolescents aged between 9 and 17 years living in a residential care facility in Istanbul, Türkiye, were involved in this cross-sectional study. A comprehensive examination was conducted on each individual, encompassing the assessment of dental caries using the decayed, missing, and filled teeth (DMFT/dft) index, oral hygiene using the debris (DI-S), calculus (CI-S), and simplified oral hygiene (OHI-S) indices, and dental treatment need using the treatment need index (TNI). Oral health-related quality of life was evaluated using the validated Turkish version of the Child Oral Health Impact Profile-Short Form (COHIP-SF-19). The relationship between oral health-related quality of life and explanatory variables was evaluated using a multivariable linear regression model. Results: The mean age of the participants was 12 ± 1.79 years. The mean DMFT score was 4.57 ± 3.42, and the mean OHI-S score was 1.4 ± 0.52. Participants had a mean COHIP-SF-19 score of 57.79 ± 14.11, with 25% requiring at least one tooth to undergo radical treatment. Multivariable linear regression analysis indicated that the DMFT score (p = 0.009) and the need for radical treatment (TNI code 6) (p < 0.001) had a statistically significant impact on oral health-related quality of life among orphan children and adolescents aged 13–17. Conclusions: This study underscores that dental caries and the need for radical treatment significantly impact the oral health-related quality of life of orphan children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy (CMT) in children can disrupt dental development and calcification, causing long-term dental issues, but good dental care and habits can help improve quality of life. This case report examines permanent dental disturbances in a 7-year, 4-month-old girl undergoing CMT, explores the histology of microdontia, and outlines an oral treatment plan for CMT management. Methods: Clinical examination revealed microdontia and a groove crossing the cervical area (chronological hypoplasia), which were assessed using panoramic radiographs and histological analysis. The patient was monitored for five years, and microdontia was extracted for orthodontic reasons. A tailored treatment plan was implemented to maintain oral health during CMT. Results: Clinical and radiographic findings indicated tooth agenesis, rudimentary form, chronological hypoplasia, and microdontia. Histological analysis showed reduced odontoblast counts, abnormal dentinal tubules, thinner pre-dentin, and interglobular dentin (hypocalcification) surrounded by globular dentin (normal calcification). CMT-related microdontia caused inflammation with dilated blood vessels in the pulp. A high fever during CMT led to a groove in the enamel of all teeth, presenting as chronological hypoplasia. No new dental caries was observed over the follow-up. Conclusions: This report highlights long-term dental disturbances from CMT in permanent dentition and associated histopathological changes. It proposes an oral care protocol for managing these issues. Maintaining oral hygiene and preventing caries during the five-year follow-up reduced CMT side effects and improved the quality of the patient's life. [ABSTRACT FROM AUTHOR]

Background/Objectives: As gingivitis prevalence is closely related to plaque accumulation, effective oral hygiene is mandatory for maintaining healthy gingival tissues. The aim of this study was to evaluate the impact of different toothbrushing methods (a manual toothbrush (group 1 = MTB, the control); an electric toothbrush (group 2 = ETB); and an electric toothbrush with daily visual feedback (group 3 = ETBV)) on the plaque levels and periodontal health in patients after receiving initial periodontal treatment. Methods: A total of 67 patients were initially screened in this study, and 60 patients were randomly allocated into 1 of the 3 groups, with 53 patients completing this study. At baseline, the average probing depth across all groups was 3.60 mm, with an average bleeding on probing (BoP) score of 69,15%. Clinical parameters were assessed at multiple time points over 12 weeks. Results: The plaque levels reduced significantly in all groups: MTB decreased from 65,57% to 33.26%, ETB from 64,17% to 31.49%, and ETBV from 63,04% to 26.25% (p < 0.001 for all groups). Furthermore, a significant improvement for BoP was recorded across all groups: BoP decreased to 25.68% (MTB), 22.32% (ETB), and 23.14% (ETBV) (p < 0.001 for all groups). However, no significant difference in the plaque removal efficacy was observed between manual and electric toothbrushes, irrespective of visual feedback (p > 0.190). A linear mixed model analysis showed a significant overall group effect on the periodontal health parameters (p = 0.041) but no interaction with time (p = 0.965). Conclusions: These findings emphasize the importance of consistent oral hygiene in reducing periodontal disease. Further research is necessary to explore effective strategies for enhancing patient adherence and optimizing health outcomes. [ABSTRACT FROM AUTHOR]

Background: All-cause mortality consisting of several heterogeneous subgroups does not have a well-defined set of risk factors. Despite the well-described role of oral hygiene on mortality, the association between the condition of the existing dentition and mortality remains unclear. Therefore, we embarked on the current study to assess the association of oral hygiene self-care (OHS) with all-cause mortality. Methods: We assessed whether edentulism and the levels of OHS are associated with all-cause mortality in 476 subjects without missing values participating in the KOHH study using proportional hazard models. We designated the edentulous group as OHS0, and poor, fair, and good OHS groups as OHS1, OHS2, and OHS3, respectively. The self-reported OHS was validated against clinical measures of oral inflammation and dental cleanliness, i.e., gingival bleeding and plaque indices. We, then, compared all-cause mortality at three levels of OHS (poor, fair, good) to that of the edentulous group. To test whether the association of OHS to all-cause mortality was mediated by inflammation, we adjusted for CRP. Results: The validity of self-reported OHS was good demonstrating an inverse association with gingival inflammation and plaque index in a dose-response manner. The group with good OHS lived significantly longer, with a 50% lower risk of all-cause mortality. The Hazard ratio (HR) = 0.50 (95% confidence limit: 0.25–0.99), p = 0.045, in a model adjusted for age, smoking, body mass index, and education. Adjusting for CRP attenuated the association of OHS to all-cause mortality slightly, suggesting that this association was mediated, at least in part, by inflammation. In the final model, the poor OHS group exhibited HR = 0.98 (0.51–1.89), p = 0.95. The HR and p-value so close to 1 suggested poor OHS has a similar risk to edentulism. Conclusions: OHS was associated with reduced risk for all-cause mortality: the better OHS, the lower the risk for all-cause mortality. Poor oral hygiene showed a similar risk for all-cause mortality to edentulism. [ABSTRACT FROM AUTHOR]

Simple Summary: As companion animals live longer and their owners become more concerned with their quality of life, dental health in dogs is gaining attention. Dental diseases are common in dogs, especially small breeds, but research on this group is limited. This study analyzed tooth extractions in 2201 small- and medium-breed dogs to understand the main causes and patterns. Older dogs and small breeds were the most affected by periodontal disease, which was found to be the leading cause of extractions. Other factors, such as tooth fractures and certain oral diseases, also led to tooth extractions. This research highlights the importance of personalized dental care for dogs, particularly as they age, and suggests the need for further studies on how diet, genetics, and other factors affect their oral health. By improving our understanding of these issues, we can enhance the overall wellbeing of our canine companions. As the life span of companion animals increases and their owners' concern for their quality of life increases, interest in dental diseases has also gained attention. While many studies have explored oral diseases in general, research on small-breed dogs remains limited. Therefore, in this study, we analyzed various diseases that led to tooth extraction in small- and medium-breed dogs. A study involving 2201 client-owned small- and medium-breed dogs was conducted. All dogs were categorized by sex, age, breed, and tooth position. Teeth were classified into untreated, missing, or extracted categories. For extracted teeth, 14 causes were identified. The results revealed that periodontal disease was the primary cause of tooth extractions, particularly in older dogs and small breeds. In addition to periodontal disease, various other diseases that led to tooth extraction were identified. For these other diseases, the number of extracted teeth increased with age, and brachycephalic breeds exhibited higher extraction rates. The study emphasizes the need for personalized oral care and further research into other contributing factors such as diet and genetics to better understand and manage oral health in dogs. It also offers valuable insights into the broader patterns of tooth extraction associated with various dental diseases. [ABSTRACT FROM AUTHOR]

Background: Oral diseases such as caries, gingivitis, and periodontitis are highly prevalent worldwide and often arise from plaque. This study focuses on detecting three plaque stages—new, mature, and over-mature—using state-of-the-art YOLO architectures to enhance early intervention and reduce reliance on manual visual assessments. Methods: We compiled a dataset of 531 RGB images from 177 individuals, captured via multiple mobile devices. Each sample was treated with disclosing gel to highlight plaque types, then preprocessed for lighting and color normalization. YOLOv9, YOLOv10, and YOLOv11, in various scales, were trained to detect plaque categories, and their performance was evaluated using precision, recall, and mean Average Precision (mAP@50). Results: Among the tested models, YOLOv11m achieved the highest mAP@50 (0.713), displaying superior detection of over-mature plaque. Across all YOLO variants, older plaque was generally easier to detect than newer plaque, which can blend with gingival tissue. Applying the O'Leary index indicated that over half of the study population exhibited severe plaque levels. Conclusions: Our findings demonstrate the feasibility of automated plaque detection with advanced YOLO models in varied imaging conditions. This approach offers potential to optimize clinical workflows, support early diagnoses, and mitigate oral health burdens in low-resource communities. [ABSTRACT FROM AUTHOR]

Objective: This study aims to analyze the differences in gingivitis incidence among adolescents and adults using clear aligners for orthodontic correction and to evaluate the effectiveness of prevention strategies on orthodontic outcomes. Methods: This observational study included 120 patients undergoing clear aligner orthodontic treatment from June 2018 to September 2023. Participants were divided into an adolescent group (66 cases) and an adult group (54 cases), each further split into a study group and a control group. The control group patients maintained their daily lifestyle throughout the study period. The study group received personalized oral hygiene education and guidance on self-oral care techniques at each follow-up visit. Routine periodontal treatment and personalized oral hygiene education were provided, and the incidence of gingivitis was evaluated six months post-treatment. Statistical methods, including chi-square tests for categorical data, t-tests for continuous variables, and two-way ANOVA for group comparisons, were employed to ensure the robustness of the results. Results: The incidence of gingivitis was significantly higher in the adolescent group compared to the adult group (P < 0.05). Specifically, within the adolescent group, the study group exhibited a higher gingival index (GI) than the control group (P < 0.05), while the difference in the adult group was not significant. Conclusion: During clear aligner orthodontic treatment, adolescents are more prone to developing gingivitis than adults. Additionally, basic periodontal therapy, as opposed to verbal oral health education alone, can moderately reduce the incidence of gingivitis in clear aligner patients during treatment. [ABSTRACT FROM AUTHOR]

Background: Oral diseases with high prevalence worldwide are recognized as severe health problems. Probiotics are used to prevent oral diseases, including dental caries, oral malodor, periodontitis, and subgingival plaque. In this study, we aimed to confirm the antibacterial effect of probiotics on oral pathogens and to assess their characterization and safety as probiotics. Methods: The antibacterial effects of Lacticaseibacillus rhamnosus MG4706, Lacticaseibacillus paracasei MG4715, and Limosilactobacillus reuteri MG4722 on the growth biofilm formation of Streptococcus mutans, Aggregatibacter actinomycetemcomitans, and Porphyromonas gingivalis were evaluated. We also investigated the production of antibacterial substances (H2O2 and reuterin) by these strains and their ability to adhere to oral epithelial cells. The safety of L. reuteri MG4722 was verified through whole-genome sequencing analysis and antibiotic susceptibility, lactate dehydrogenase activity, hemolytic activity, and bile acid hydrolase activity. The reuterin biosynthesis genes of L. reuteri MG4722 were identified using genomic analysis. Results: L. reuteri MG4722 significantly inhibited the growth of S. mutans, A. actinomycetemcomitans, and P. gingivalis and suppressed the biofilm formation by A. actinomycetemcomitans. In addition, it showed considerable adhesion ability to oral epithelial cells. L. reuteri MG4722 produced H2O2 and reuterin as antibacterial substances, as confirmed by the presence of genes encoding the antibacterial compounds reuterin, reuteran, and reutericyclin. L. reuteri MG4722 showed no hemolysis, bile salt hydrolase activity, antibiotic resistance or toxicity to HT-29 cells, and no antibiotic-resistance genes were identified. Conclusion: L. reuteri MG4722 demonstrated antibacterial effects on oral pathogens by producing antibacterial substances and adhering to oral epithelial cells. These results suggest that L. reuteri MG4722 could be an effective probiotic for oral health. [ABSTRACT FROM AUTHOR]

Objective: To explore the interventions for change in oral health behaviour that are effective in improving oral health behaviours in 8 to 18-year-old children during oral health promotion. Methods: The Joanna Briggs Institute framework of evidence synthesis for conducting a scoping review was implemented for the methodology. Included studies related to the objective, measured clinical or non-clinical outcomes, were in English, 2011–2023, and were experimental, observational or reviews. PUBMED, Science-Direct, Scopus and Sabinet were systematically searched with predetermined search strings. Studies were selected by appraisal of the title, abstract and full text. Data were extracted using a standardised template and the key questions were addressed via a qualitative analysis. Results: Searches yielded 407 articles from electronic databases. Of these, 290 articles were excluded, and 47 full-text studies were assessed for eligibility, with 23 studies and two systematic reviews finalised for inclusion. In addition, a PEARL search was conducted from the reference lists of other studies. Most studies (91.3%) focused on educating children directly; 8.7% indirectly influenced parents, guardians, and teachers. Interventions focused largely on traditional oral health education presented in diverse forms and via different platforms. Studies differentiated clinical outcomes (indices) from non-clinical outcomes (knowledge, behaviour). All included RCTs were of different quality regarding selection, performance and detection bias. But all studies indicated a low risk of bias in attrition and Reporting bias. Seventeen of the 25 studies (68%) were not based on any behaviour change theory. Conclusions: Oral health interventions based on motivational interviewing and the social cognitive theory have been shown to be to be effective. Interventions could also include practical tooth brushing activities, gamification, audio-visual components, as well as reinforcement and repetition in the longer term. Future oral health promotion in children should be designed to include these elements. There is a need for higher quality studies in this field, with future research being urged to provide detailed intervention descriptions and incorporate longer follow-up periods. [ABSTRACT FROM AUTHOR]

Background: Cleft lip and/or palate is the most common congenital orofacial deformity, affecting 1/800 births. A thorough review of the literature has shown that children with cleft have poorer oral hygiene and dental health than other children, with higher levels of caries in both temporary and permanent teeth and poorer periodontal health. Cleft patients are treated by a multidisciplinary team that aims to provide comprehensive care from pre- or post-natal diagnosis to early adulthood and the end of growth. We aim to assess, through a single-center, prospective, randomized and controlled clinical trial conducted at the Nantes Cleft Centre, the impact of an enhanced dental program on oral hygiene and dental health in cleft patients. Methods: Patients aged 3 to 15 years with unilateral or bilateral cleft lip and/or palate will be offered to participate in this study. After acceptance, patients will be randomly assigned to 2 groups: test group or control group. For the control group, there will be no change in the patient's care, and they will continue to see their surgeon on an annual basis. For the test group, a 30–45-min consultation will be added to the annual check-up. During this visit, patients and their parents will receive oral and written oral hygiene instructions to improve oral hygiene knowledge and brushing technique. If necessary, dental treatment will be provided at the same appointment or at a later date. In addition, patients will be contacted via telemedicine every 2 months to increase motivation, and an additional dental appointment will be scheduled at 6 months. Discussion: This is a single-center study which, if conclusive, could lead to a paradigm shift in the dental care pathway for cleft patients. Trial registration: NCT05867862 submitted 2023–07-05 https://clinicaltrials.gov/study/NCT05867862?locStr=Nantes,%20France&country=France&state=Pays%20de%20la%20Loire&city=Nantes&distance=50&cond=CLEFT%20LIP&rank=1--Trial Sponsor Nantes University Hospital. Trial status: 8th Version date 2023 May 05; recruitment began in June 2023 and will be completed in June 2024. [ABSTRACT FROM AUTHOR]

Background: A large number of older people depend on others for help with their daily personal care, including oral health care. Nursing home and elder-care staff often face challenges identifying older people, who are exposed to or at an increased risk of oral diseases. Thus, the aim of this study was to identify risk factors that non-dental care staff can use to identify older people at risk of oral diseases and poor oral hygiene. Methods: In this cross-sectional study, the oral health and risk factors for poor oral health were determined for 217 care dependent older people living in two nursing homes and a rehabilitation centre or receiving home care in two Danish municipalities. The outcome variables for oral disease i.e. caries, periodontitis, and gingivitis, and oral hygiene, i.e. plaque and calculus, were assessed using standardised oral examinations. Risk factors for oral diseases and poor oral hygiene were assessed based on a questionnaire concerning (1) background information, (2) health status, (3) social support, (4) oral health behaviours, and (5) self-reported oral health. The associations between oral health and risk factors were investigated using logistic regression analyses. Results: In general, older people with different living arrangements had quite similarly distributed risk factors. The oral examinations showed that 54.5% had oral diseases, and 14.8% had poor oral hygiene. Not seeing a dentist regularly was significantly associated with having oral diseases (Odds Ratio, 2.87; CI, 1.53–5.39) and poor oral hygiene (OR, 4.50; CI, 1.83–11.05). A significant association was found between the presence of an oral disease and adversely affected quality of life (OR, 2.65; CI, 1.42–4.95), especially due to challenges eating (OR, 3.76; CI, 1.64–8.60) and/or smiling and showing teeth (OR, 3.64; CI, 1.27–10.42). A significant association was also found between poor oral hygiene and taking psychotropic drugs (OR, 2.61; CI, 1.08–6.30). Conclusion: Questions regarding the use of the dental care system and oral health problems could be used by nondental care staff in conversations with older people to determine their risk of oral diseases and poor oral hygiene. [ABSTRACT FROM AUTHOR]