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Purpose Prior to radiotherapy combined with chemotherapy (CRT) or biotherapy (BRT) for oropharyngeal squamous cell carcinoma (OPSCC), teeth with poor prognosis that pose a risk for post-RT osteoradionecrosis (ORN) are removed. The effect of tooth loss on body weight loss and tube feeding (TF) dependency during CRT/BRT is unknown. This study aimed to evaluate the effect of incomplete dentition, tooth extractions prior to CRT/BRT, and the subsequent loss of functional units on (1) weight loss during CRT/BRT and (2) the need for TF during CRT/BRT for OPSCC. Methods OPSCC patients treated with CRT/BRT between 2013 and 2016 were included in this retrospective cohort study. Dental status was determined during the dental assessment at first visit and after tooth extractions prior to the start of CRT/BRT. Weight loss during CRT/BRT was scored dichotomously, comparing weight loss > 5% to stable or increased weight. Potential factors associated with weight loss were identified, including patient, tumor, and treatment characteristics. Results Seventy-seven OPSCC patients were included. Forty patients (52%) experienced weight loss > 5% during CRT/BRT. Extractions were performed in 66% of the OPSCC patients. The mean number of extracted teeth was 4.1 ± 5.6 per patient. Tooth extractions prior to CRT/BRT were associated with weight loss > 5% during CRT/BRT (HR 1.130 (95% CI 1.011–1.262), p = 0.031). None of the dental status-related parameters showed any significant associative value for TF during CRT/BRT. Conclusions Pre-CRT/BRT tooth extractions intended to reduce the risk of ORN, are a risk factor for weight loss during CRT/BRT for OPSCC. Trial registration number This study was approved by the medical ethics committee of the MUMC + (METC 2020–1589) on July 28, 2020.

Objective This paper describes and reports the patient-specific characteristics of an urgent dental care clinic for COVID-19 infected, suspected, exposed or quarantined patients from March to December 2020 in the Hospital District of Helsinki and Uusimaa, Finland. Material and methods The triage and the treatment protocol were established based on the scientific data. Patient files were evaluated from the hospital district's electronic medical record system. IBM SPSS software was used for statistical analysis. Results There were 1114 consultations and 257 visits at the clinic. Most of the patients were generally healthy with mean age of 35, had toothache and were suspected to be SARS-CoV-2 positive. Seventeen of the patients received positive tests for COVID-19 infection. The main treatment was tooth extraction, mostly due to caries. Statistically significant differences between COVID-19 infected and other patients occurred in age (45 vs 34 years-of-age, p = .009) and number of teeth (25 vs 28, p = .031). No SARS-CoV-2 infection transmission chains were traced to the clinic. Conclusion During the challenging pandemic time, patients were carefully screened by specialists in clinical dentistry and treated safely and effectively. Patient-specific characteristics revealed no differences between COVID-19 infected and other patients in terms of symptoms or treatment needs.

Introduction: Dental follow-up in prenatal care represents a unique strategy with interdisciplinary action for the prevention of injuries in pregnant women and complications during childbirth. Objective: To identify the interdisciplinarity in prenatal dental care from the nurses’ perspective. Methodology: This will be a qualitative approach study with based on the Gadamer and Habermas's hermeneutics-dialectic in six primary health care units in a metropolis in Northeast Brazil, with six nurses through in-depth interviews in 2018. The organization of the data occurred through Minayo´s thematic analysis. Results: After the thematic analysis, the categories of “The interdisciplinary care of the doctor, dentist, and nurse” and “Nurse referral during prenatal dental care” were evidenced. There are implications for the development of interdisciplinary practices in prenatal dental care such as weaknesses in the continuity of care, communication, and the team’s interaction. Conclusion: There is a need to expand the comprehensiveness for the quality in the development of healthcare for pregnant women and the reduction of maternal and neonatal complications in populations of Brazilian women. Introducción: El seguimiento odontológico en el control prenatal representa una estrategia única con acción interdisciplinaria para la prevención de lesiones en la gestante y complicaciones durante el parto. Objetivo: Identificar la interdisciplinariedad en la atención odontológica prenatal desde la perspectiva de las personas profesionales de enfermería. Metodología: Estudio con un enfoque cualitativo basado en la hermenéutica-dialéctica de Gadamer y Habermas en seis unidades básicas de salud de una metrópolis del Nordeste de Brasil, con seis profesionales de enfermería, a través de entrevistas en profundidad en 2018. La organización de los datos se realizó mediante el análisis temático de Minayo. Resultados: A partir del análisis temático, surgieron las categorías “El cuidado interdisciplinario de la persona profesional en medicina, odontología y enfermería” y “Remisión de enfermería durante el prenatal odontológico”. Existen implicaciones para el desarrollo de prácticas interdisciplinarias en el prenatal odontológico, como debilidades en la continuidad del cuidado, comunicación e interacción en el equipo. Conclusión: Existe la necesidad de ampliar la integralidad para la calidad en el desarrollo de la atención de la salud de la mujer embarazada y la reducción de las complicaciones maternas y neonatales en las poblaciones de mujeres brasileñas. Introdução: O acompanhamento odontológico no pré-natal representa estratégia singular com atuação interdisciplinar na prevenção de agravos à gestante e complicações no parto. Objetivo: Identificar a interdisciplinaridade no acompanhamento odontológico no pré-natal na perspectiva do enfermeiro. Metodologia: Estudo com abordagem qualitativa fundamentado na Hermenêutica-dialética de Gadamer e Habermas em seis Unidades de Atenção Primária à Saúde de uma metrópole do Nordeste do Brasil, com seis enfermeiros por meio de entrevistas em profundidade no ano de 2018. A organização dos dados ocorreu através da análise temática de Minayo. Resultados: Evidenciaram-se após análise temática as categorias, “O cuidado interdisciplinar do médico, odontólogo e enfermeiro” e “Encaminhamento do enfermeiro durante o acompanhamento odontológico no pré-natal”. Há implicações para o desenvolvimento de práticas interdisciplinares no acompanhamento odontológico no pré-natal, como fragilidades na continuidade do cuidado, na comunicação e interação na equipe. Conclusão: Há necessidade de ampliar a integralidade para qualidade no desenvolvimento de cuidados em saúde à gestante e diminuição de complicações maternas e neonatais em populações de mulheres brasileiras.

Background/aim: The aim of this study was to assess the reliability and validity of Turkish version of the Xerostomia Inventory XI in patients with primary Sjogren's syndrome (pSS). Materials and methods: A cross-sectional survey study design and analysis were used to assess the reliability and validity of the Xerostomia Inventory XI. A total of 69 patients with pSS (5 males, 64 females; mean age = 54.81 +/- 8.77 years) were included. The Xerostomia Inventory XI (TR) was applied twice at an interval of 15 days. The test-retest reliability was assessed with the intraclass correlation coefficient (ICC), and the internal consistency of multiitem subscales by calculating Cronbach's alpha values. The correlations between ESSPRI, basal and stimulated salivary flow (BSF-SSF), Oral Health Impact Profile-14 (OHIP-14) and Oral Health-Related Quality of Life-UK (OHRQoL-UK) Questionnaire were evaluated to determine the construct validity. Results: The ICC value for test/retest reliability of the Xerostomia Inventory XI (TR) was 0.993. The internal consistency was 0.869. There were low to high correlations between Xerostomia Inventory XI (TR) and ESSPRI, BSF, SSF, OHIR-14 total and OHRQoL-UK total. Conclusion: The Turkish version of the Xerostomia Inventory XI was found to be clinically valid and reliable to be used in clinical evaluations and rehabilitation interventions in patients with pSS.

Objective:To explore the relationships between dental problems and underweight status among rural women in Burkina Faso by using nationally representative data.Design:This was a cross-sectional secondary study of primary data obtained by the 2013 WHO Stepwise Approach to Surveillance survey conducted in Burkina Faso. Descriptive and analytical analyses were performed using Student’s t test, ANOVA, the χ2 test, Fisher’s exact test and logistic regression.Setting:All thirteen Burkinabè regions were categorised using quartiles of urbanisation rates.Participants:The participants were 1730 rural women aged 25–64 years.Results:The prevalence of underweight was 16·0 %, and 24·1 % of participants experienced dental problems during the 12-month period. The women with dental problems were more frequently underweight (19·9 % and 14·7 %; P < 0·05) and had a lower mean BMI (21·1 ± 3·2 and 21·6 ± 3·7 kg/m2, P < 0·01) than those without dental problems. More risk factors for underweight were observed in less urbanised regions among elderly individuals (> 49 years old) and smokeless tobacco users. Age > 49 years, professions with inconsistent income, a lack of education, smokeless tobacco use and low BMI were factors that were significantly associated with dental problems, while residency in a low-urbanisation area was a protective factor.Conclusion:The prevalence of underweight in rural Burkinabè women is among the highest in sub-Saharan Africa, and women with dental problems are more frequently affected than those without dental problems. Public health measures for the prevention of these disorders should specifically target women aged over 49 years and smokeless tobacco users.

Background Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design. Methods This prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures. Results At baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures. Conclusions It was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants).

Aim: To investigate the association between periodontitis and edentulism with cardiovascular disease (CVD) and all-cause mortality. Methods: Baseline data of 506 subjects including 256 angiographically verified coronary artery disease patients and 250 matched participants in cardiovascular health from the Kuopio Oral Health and Heart study were collected from 1995–1996. Mortality data were accrued until May 31, 2015, and related to baseline periodontal health and edentulism, assessed as exposure and collected by means of clinical and radiographic examination by a single examiner. Cox proportional hazards regression models were fit using covariates such as age, gender, smoking, BMI, and education. The final sample size for the periodontitis models ranged from 358 to 376, while the edentate models included 413 to 503 subjects for CVD and all-cause mortality, respectively with no missing values in the predictor, confounders, and outcome. Results: The strongest association was found between edentulism and CVD and allcause mortality (HR: 1.9 CVD, HR: 1.6all-cause; p< .01). Conclusions: Edentulism considered as a poor oral health marker was associated strongly with CVD mortality while periodontitis was not.

Objectives: The aim of this study was to validate an active matrix metalloproteinase (MMP-8) point-of-care diagnostic tool in COVID-19 patients with periodontal disease. Subjects, Materials, and Methods: Seventy-two COVID-19-positive and 30 COVID-19-negative subjects were enrolled in the study. Demographic data were recorded, periodontal examination carried out, and chairside tests run for evaluating the expression of active MMP-8 (aMMP-8) in the site with maximum periodontal breakdown via gingival crevicular fluid sampling as well as via a mouth rinse-based kit for general disease activity. In COVID-19-positive patients, the kits were run again once the patients turned COVID-19 negative. Results: The overall (n = 102) sensitivity/specificity of the mouthrinse-based kits to detect periodontal disease was 79.41%136.76% and that of site-specific kits was 64.71%/55.88% while adjusting for age, gender, and smoking status increased the sensitivity and specificity (82.35%/76.47% and 73.53%/88.24, respectively). Receiver operating characteristic (ROC) analysis for the adjusted model revealed very good area under the ROC curve 0.746-0.869 (p < .001) and 0.740-0.872 (p < .001) (the aMMP-8 mouth rinse and site-specific kits, respectively). No statistically significant difference was observed in the distribution of results of aMMP-8 mouth rinse test (p = .302) and aMMP-8 site-specific test (p = .189) once the subjects recovered from COVID-19. Conclusions: The findings of the present study support the aMMP-8 point-of-care testing (PoCT) kits as screening tools for periodontitis in COVID-19 patients. The overall screening accuracy can be further increased by utilizing adjunctively risk factors of periodontitis. The reported noninvasive, user-friendly, and objective PoCT diagnostic methodology may provide a way of stratifying risk groups, deciding upon referrals, and in the institution of diligent oral hygiene regimens.

Background/Aim: The aim of this study was to assess of the internal coherence of Bosnian translated version of the Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-B&H), and evaluated the validity of this version. Material and Methods: OHIP-EDENT-B&H questionnaires were completed by 117 edentulous patients and specialists of prosthodontics in health institutions of central Bosnia. Results: Test-retesting analysis showed strong correlations, r ranging from 0.46 to 0.58, respecting complete dentures, with Kappa= 0.68, that indicated reliability of the questionnaire. The lowest reliability was obtained for Psychological disability (n= 117, a= 0.636) and the highest was obtained for Social disability (a= 0.859). The reliability of the summary scores for OHIP-EDENT-B&H was good (a= 0.907). Content validity for the test group-retest group did not expose significant differences between the groups tested. Conclusions: The OHIPEDENT-B&H instrument for verifying of oral-health-related quality of life in edentulous patients demonstrated good reliability and validity in Bosnian patients.

Objective: The aim of the study was to propose an efficient chairside clinical strategy for the identification of undiagnosed hyperglycaemia in periodontal clinics. Material and methods: Alpha chairside system was used for assessment of glycated hemoglobin 1c (HbA1c) and active Matrix Metalloproteinase-8 levels (aMMP-8) were analyzed by immunotest in patients (n = 150) who fulfilled the criteria for screening of the Centers for Disease Control and Prevention. Full-mouth periodontal parameters were assessed and various data such as Body Mass Index (BMI), smoking and education were recorded. Results: Thirty-one patients out of 150 tested were found with unknown hyperglycaemia (20.7%). Regarding sex, education, parent with diabetes, normal BMI, smoking, age >= 45 years and prior testing for diabetes, no differences were observed between subjects displaying HbA1c = 5.7% (Pearson's Chi-square test, p > .05). Subgroups differed regarding BMI (kg/m(2)), tooth count, percentages of 4 and 5 mm pockets (Mann-Whitney and z-test, p = 5.7 was tested by Receiving Operator Characteristic curves and Areas Under the Curve (AUC) for the following: age >= 45 years and BMI (AUC 0.651, p = .010), the above and aMMP-8 (AUC 0.660, p = .006), age >= 45 years, BMI and Stage of Periodontitis (AUC 0.711, p = 45 years, BMI, aMMP-8 and stage of periodontitis (AUC 0.713, p

OBJECTIVE: We aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan. BACKGROUND: Few studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan. METHODS: The participants of this cross-sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima-media thickness ≥1.1 mm or confirmation of atheromatous plaque. RESULTS: Of 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03-4.49). Regarding BL-max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65-2.30), 0.65 (0.32-1.35), and 1.57 (0.81-3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61-10.1) and 4.26 (1.01-17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10-19 and 1-9 teeth were 1.77 (1.004-3.12) and 0.96 (0.52-1.80), respectively. CONCLUSION: The absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan. ispartof: JOURNAL OF PERIODONTAL RESEARCH vol:57 issue:3 pages:615-622 ispartof: location:United States status: published

Background and Aims: Eating disorders (ED) are an important public health problem for adolescents due to changing eating attitudes. Using the Eating Attitude Test (EAT-26) with a sample of Turkish adolescents aged 9-15 years, this study evaluated the behavioral risk of ED and its association with dental caries, age, body mass index (BMI), and gender. Subjects and Methods: The EAT-26 scoring system was used, and variables examined included demographic, familial, sociocultural, social, and clinical features. Data were analyzed using SPSS (R) Statistics for Windows, version 20.0. (IBM, New York, NY, USA). Results: A total of 112 adolescents, 46 (41.1%) boys, and 66 (58.9%) girls (mean age 11.46 +/- 1.91 years), were evaluated. EAT-26 mean scores were 16.0 (10.0-21.0) for girls and 14.0 (12.0-23.0) for boys (Mann Whitney U test; P = 0.509). There was no statistically significant difference between the mean BMI scores and the mean EAT-26 scores for girls and boys (Mann Whitney U test) (P = 0.509) (P = 0.636). The mean DMFT decay -missing -filled and total) was higher in EAT-26 > 20 than in EAT-26 < 20, and the difference was statistically significant (Mann Whitney U test; P = 0.008). BMI was not correlated with EAT-26 (Spearman rank correlation test, r =-0.013, P = 0.156), but there was a statistically significant positive correlation between the development of caries and age (Spearman rank correlation test, r = 0.405, P < 0.05). Conclusion: Early diagnosis of ED is crucial because it primarily starts during childhood and adolescence. It is responsible for the dft of the deciduous teeth. BMI is related to decay,missed,filled,total (DMFT), decay, filled, total (dft), and age in adolescents aged 9-15 years. Furthermore, we searched subgroups of EAT-26 for dental caries. Dieting score may be a significant factor for dental caries for ED. However, observing ability is an important factor for dentists because they can inform parents and provide information on preventing ED.

Summary Background Severe malocclusions appear in up to 20 per cent of the population. Many neuropsychiatric diseases are likely to have a neurodevelopmental, partially genetic background with their origins as early as fetal life. However, the possible relationship between neurodevelopmental disorders and severe malocclusions is unclear. The aim of this study was in a population-based setting (270 000 inhabitants) to investigate whether patients with severe malocclusions have more mental and behavioural disorders and growth or speech problems than controls without severe malocclusion. Material and Methods The study group consisted of patients from the Espoo Health Care Center, Finland, born in year 2000, who were retrospectively screened for their medical and dental records, including their possible mental and behavioural disorders (i.e. attention deficit hyperactivity disorder, Asperger’s syndrome, autism, mood disorder, or broadly defined behavioural abnormalities, learning problems, mental disorders, sleep disturbances, anxiety symptoms, depressive symptoms, and eating-related symptoms) and their need of orthodontic treatment according to the Treatment Priority Index (TPI). The study group consisted of a severe malocclusion group (n =1008; TPI 8–10) and a control group (n = 1068) with no severe malocclusion (TPI 0–7). Results Patients with severe mandibular retrognatia (P < 0.000), lip incompetence (P = 0.006), or neurodevelopmental disorders (mental and behavioural; P = 0.002) were found to have significantly more speech problems than the controls. The patients with severe malocclusions were leaner, that is, body mass index (kg/m2) 25, overweight) than controls (P = 0.003), and underweight patients had a significant association with retrognathic maxilla (P < 0.000) compared to normal or overweight patients. No significant relationship between neurodevelopmental disorders and severe malocclusions, that is, retrognatia of maxilla, hypodontia, and severe dental crowding was observed. Conclusion Our results indicate that patients with severe mandibular retrognatia, lip incompetence, or neurodevelopmental disorders were found to have significantly more speech problems than controls. During orthodontic treatment of patients with severe malocclusion, special attention should be paid to patients with severe mandibular retrognatia, lip incompetence, and speech problems to detect signs of possible neurodevelopmental disorders and record if potential follow-up measures are in place.

The main aim of this cross-sectional study was to examine the prevalence of dental fear among Finnish conscripts. Other aims were to study the association between dental fear and cariological status as well as their self-reported, dentition-related well-being. The study material consisted of 13,564 men and 255 women conscripts who underwent oral examinations. Of those, 8713 responded to a computer-based questionnaire. The mean number of decayed teeth (DT) was used in analyses for cariological status. Self-reported dental fear, dentition-related well-being and regular check-ups were analysed. Data were analysed with cross tables, Pearson Chi-Square tests, Fisher’s exact test and binary logistic regressive analysis. High dental fear or finding dental visits very scary was associated with DT > 2 both among women (14.6%, when DT = 0; 33.3%, when DT > 2) and men conscripts (2.3% and 10.8%, respectively). In addition, those reporting that dental health had a negative impact on their well-being and had no regular check-ups were more likely to need cariological treatment than the rest. A high education level, both one’s own and parental, was a protective factor for restorative treatment need in male conscripts. The findings of this study support the concept of a vicious cycle of dental fear and dental caries. A preventive, interactive way of work by dental teams would most likely be beneficial for dental health, avoiding the development of dental fear, and dentition-related well-being.

Objective: Osteonecrosis of the jawbone, especially when associated with osteomyelitis, is a debilitating condition predominantly affecting patients treated for osteoporosis, cancer with bone metastases, and rheumatoid arthritis. Oral pathologies may significantly alter the patients' quality of life and sense of health. Surgery including complete debridement of the necrotic bone followed by packing the dead space with antiseptic agents and meticulous repair of the overlying mucosa is gaining popularity on conservative treatment options. Materials and Methods: In this before and after study 11 patients referred to our clinic between 2018 and 2020 with a diagnosis of maxillary or mandibular osteonecrosis with complete preoperative and postoperative analyses available were included. The patients were assessed with General Oral Health Assessment (GOHA) index preoperatively and postoperatively. These scores were compared with each other to exhibit the effect of our surgical strategy, which also outlined. The effects of patients' demographic and medical backgrounds on the quality of life were also investigated. Results: Neither demographic, nor medical backgrounds of the patients were not found to significantly alter the GOHA index scores of the patients (p>0.05). However, surgical treatment was found to significantly improve the scores (preoperative mean: 38.87, +/- 6.44; postoperative mean: 31.0, +/- 8.28; p

Objectives This study analysed if children of families in need of dental interventions can be identified by using the caries status of the first-born child as a predictor for caries in younger siblings of the same family. Material and methods All children aged 4 to 15 years, i.e. 13,596 children, visiting a compulsory school in the canton of Basel-Stadt, Switzerland, during the school year 2017/2018 were analysed. Total caries experience and untreated carious lesions at time of examination were recorded as well as a subset of socioeconomic factors such as gender, age, nationality, birth order and the family’s place of residence. Results A total of 6738 schoolchildren who had at least one sibling of school age could be included. Differences in caries experience and the presence of active carious lesions were found for age, nationality and place of residence but not for gender or birth order. Younger siblings had odds of having a history of caries 3.7 times higher (95% confidence interval: 3.0–4.4) and odds of having active carious lesions 3.5 times higher (95% confidence interval: 2.6–4.7) if the eldest child in the family already had caries. Conclusion Caries could be shown to be family-dependent. Younger siblings had a more than three-fold higher risk for caries if the first-born child already had carious lesions. Clinical relevance Based on these results, the caries status of the first-born child could be used as a potential indicator to detect vulnerable families and to initiate targeted preventive measures.

Objective: The aim was to evaluate the association of behavioural and socioeconomic factors with the occurrence of periodontal disease and dental caries, paying special attention to the simultaneous occurrence of these diseases. Materials and methods: The study population consisted of 5255 dentate persons aged >= 30 years from a nationally representative survey. Caries and probing pocket depth were recorded by tooth and calculated in relation to the number of existing teeth. The groups were: non-affected (A), the two most affected quintiles for periodontal disease with little or no dental caries (B), the two most affected quintiles for dental caries with little or no periodontal disease (C) and the two most affected quintiles for both periodontal disease and dental caries (D). Presence of dental plaque was determined, and behavioural and socioeconomic factors were established. Results: Dental plaque, smoking, lack of regular dental check-ups, older age and a basic level of education were strongly associated with the simultaneous occurrence of periodontal disease and dental caries. Conclusions: There are many behavioural and socioeconomic factors that associate with the occurrence of both periodontal disease and dental caries. These factors also increase the risk of individuals having these diseases simultaneously.

Public health research in dentistry has used geographic information systems since the 1960s. Since then, the methods used in the field have matured, moving beyond simple spatial associations to the use of complex spatial statistics and, on occasions, simulation modelling. Many analyses are often descriptive in nature; however, and the use of more advanced spatial simulation methods within dental public health remains rare, despite the potential they offer the field. This review introduces a new approach to geographical analysis of oral health outcomes in neighbourhoods and small area geographies through two novel simulation methods-spatial microsimulation and agent-based modelling. Spatial microsimulation is a population synthesis technique, used to combine survey data with Census population totals to create representative individual-level population datasets, allowing for the use of individual-level data previously unavailable at small spatial scales. Agent-based models are computer simulations capable of capturing interactions and feedback mechanisms, both of which are key to understanding health outcomes. Due to these dynamic and interactive processes, the method has an advantage over traditional statistical techniques such as regression analysis, which often isolate elements from each other when testing for statistical significance. This article discusses the current state of spatial analysis within the dental public health field, before reviewing each of the methods, their applications, as well as their advantages and limitations. Directions and topics for future research are also discussed, before addressing the potential to combine the two methods in order to further utilize their advantages. Overall, this review highlights the promise these methods offer, not just for making methodological advances, but also for adding to our ability to test and better understand theoretical concepts and pathways.

Funding Information: Funding: This research is part of a TUTL-project awarded to T.P. and funded by Aalto University (https://www.aalto.fi/en, accessed on 29 April 2021) and Tekes (https://www.businessfinland.fi/en, accessed on 29 April 2021; grant number 4364/31/2016). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Aim: This study aimed to determine the feasibility and first efficacy of indocyanine green (ICG)-assisted antimicrobial photodynamictherapy (aPDT) as activated using LED light to the dental plaque. Methods: Fifteen healthy adults were assigned to this four-day randomized study. After rinsing with ICG, 100 J/cm2 of 810 nm LED light was applied to the aPDT-treatment area. Plaque area and gingival crevicular fluid (GCF) matrix metalloproteinase-8 (MMP-8) were measured, and plaque bacteriomes before and after the study were analyzed using 16S rRNA sequencing. Results: aPDT administration was preformed successfully and plaque-specifically with the combination of ICG and the applicator. Total plaque area and endpoint MMP-8 levels were reduced on the aPDT-treatment side. aPDT reduced Streptococcus, Acinetobacteria, Capnocytophaga, and Rothia bacteria species in plaques. Conclusion: ICG-assisted aPDT reduces plaque forming bacteria and exerts anti-inflammatory and anti-proteolytic effects.

Bruxism is a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. It can occur during sleep, indicated as sleep bruxism, or during wakefulness, indicated as awake bruxism. Exogenous risk indicators of sleep bruxism and/or awake bruxism are, among others, medications and addictive substances, whereas also several medications seem to have the potential to attenuate sleep bruxism and/or awake bruxism. The objective of this study was to present a narrative literature on medications and addictive substances potentially inducing or aggravating sleep bruxism and/or awake bruxism and on medications potentially attenuating sleep bruxism and/or awake bruxism. Literature reviews reporting evidence or indications for sleep bruxism and/or awake bruxism as an adverse effect of several (classes of) medications as well as some addictive substances and literature reviews on medications potentially attenuating sleep bruxism and/or awake bruxism were used as starting point and guidelines to describe the topics mentioned. Additionally, two literature searches were established on PubMed. Three types of bruxism were distinguished: sleep bruxism, awake bruxism and non-specified bruxism. Generally, there are insufficient evidence-based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism. There are insufficient evidence-based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism.

Background Despite the interdependence of general and periodontal health, there is paucity of national representative data on the prevalence of periodontal diseases and their associated risk factors in Egyptian population. This cross-sectional study, thus, aimed to assess the prevalence of periodontitis and tooth loss among Egyptian adults and investigate the association between potential risk factors and periodontal diseases. Methods A total of 5,954 adults aged ≥ 20 years were included in this study as a subsample from Egypt’s national oral health survey. Periodontitis was diagnosed with Community Periodontal Index ‘CPI’ scores ≥3 and tooth loss not due to caries was included in the analysis. Socio-demographic data and information on behavioral factors and history of diabetes were gathered in a face-to-face interview. Logistic regression was done to interpret the impact of potential predictors on the incidence of the two selected outcome variables. Results The overall prevalence of periodontitis was 26% and regression analysis revealed that higher odds of periodontitis existed among illiterate participants (OR = 1.74; 95% CI: 1.40–2.17), smokers (OR = 1.93; 95% CI: 1.69–2.20) and rural residents (OR = 1.16; 95% CI: 1.03–1.30). On the other hand, old age, frequency of dental attendance and history of diabetes were the main predictive factors for tooth loss. Conclusions Among Egyptian adults, periodontal diseases were strongly associated with a multitude of modifiable and non-modifiable risk factors and inequalities in distribution of periodontal treatment needs were determined mainly by age, gender, level of education and residency location.

Background Cystic fibrosis (CF) is a life-threatening chronic inflammatory disease in children due to respiratory complications. Saliva could serve as reservoir of bacterial colonization and potentially reflect systemic inflammation. This study investigated whether salivary triggering receptor expressed on myeloid cells 1 (TREM-1), peptidoglycan recognition protein 1 (PGLYRP1), interleukin (IL)-1? and calprotectin are associated with CF or reflect concomitant gingival inflammation. Methods Ten CF (age:3-12yrs) and ten systemically healthy age-and-gender-matched children (C) were enrolled in the study. Individuals with CF underwent routine laboratory determinations. Probing pocket depth (PPD), gingival index (GI), plaque index (PI) and bleeding on probing (BOP) were recorded on fully erupted teeth and saliva samples collected. Salivary TREM-1, PGLYRP1, IL-1? and calprotectin were analysed by ELISA. Results Children with CF had significantly higher BOP scores (P = 0.001) and calprotectin levels (P = 0.017) compared to the C group. TREM-1, PGLYRP1 and IL-1? could not distinguish between CF and SH but showed positive correlation with GI, PI and BOP in both groups. Calprotectin levels positively correlated with procalcitonin (P = 0.014), thrombocyte counts (P = 0.001), mean platelet volume (P = 0.030) and with PGLYRP1 (P = 0.019) and IL-1? (P = 0.013) in CF children. Receiver operating characteristic curve analysis for calprotectin (CFvsC) showed an area under the curve of 0.79 (95% CI 0.58-0.99, P = 0.034). Conclusions CF children presented with higher gingival inflammation scores and salivary calprotectin levels, that correlated with systemic inflammatory markers. Salivary calprotectin levels were not associated with periodontal parameters. Hence, preliminary data demonstrate that salivary calprotectin might have a chairside diagnostic potential for CF in children. This article is protected by copyright. All rights reserved

Objective The dimensions of oral health–related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. Methods Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated. Results For every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering. Conclusion Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.

The aim of this study was to investigate the frequency of consumption of snack products, as well as the association between snacking and restorative treatment need, and associated factors among a healthy Finnish male population. Approximately 8500 conscripts answered a computer-based questionnaire covering their snacking habits and other health behaviours. Restorative treatment need and history (DT, DMFT) were examined by trained and calibrated dentists. Cross-tabulations were used to investigate the associations between snacking habits and the other researched variables, and logistic regression analyses (odds ratio and 95% confidence interval) were used to investigate the variables influencing the restorative treatment need. In the present study, almost one-third of the study group consumed snack products daily, most often fizzy and energy drinks. Only 10% had received a diet counselling. The most common situations involving snacking were at the cinema and while playing computer games. According to Pearson’s Chi square test, snacking was associated with smoking and snuffing and infrequent tooth brushing (p

Objective: To estimate the effect of income at birth on adulthood tooth loss due to dental caries in 539 adults from the 1982 Pelotas birth cohort. Methods: Family income was collected at birth. Tooth loss was clinically assessed when individuals were aged 31. Dental visit and oral hygiene at age 25 were considered mediators. Confounders included maternal skin color, and individual's skin color, sex, and income in adulthood. Marginal structural modeling was used to estimate the controlled direct effect of income at birth on tooth loss due to dental caries that was neither mediated by the use of dental service nor oral hygiene. Results: Forty-three percent of the individuals of low income at birth lost one/two teeth, and 23% lost three or more; among those non-poor, the prevalence was 30% and 14%, respectively. Poor individuals at birth had a 70% higher risk for missing teeth in adulthood than those non-poor. The risk of losing one/two (risk ratio 1.68) and three or more teeth (risk ratio 3.84) was also higher among those of low income at birth. Conclusions: Economic disadvantage at birth had an effect on tooth loss due to dental caries at age 31 not mediated by individual risk factors.

Background: This study aimed to investigate the association between metabolic syndrome (MetS) and periodontitis among young adults, and also to compare results using observed and latent variables for MetS and periodontitis. Methods: Data from the 1982 Pelotas Birth Cohort, Brazil, were used. Metabolic syndrome at the age of 23 years was measured using clinical and biochemical analysis and set as the main exposure. Periodontitis at the age of 31 years was clinically measured and set as the outcome. Confounding variables included sex and maternal education, assessed at birth, family income at 23 years, and smoking status at the age of 23 and 30 years. Factor analyses (exploratory and confirmatory) were performed to define latent variables for MetS and periodontitis. In addition, both conditions were also defined as categorical observed variables. The association between MetS and periodontitis was tested in structural equation models. Results: Two latent periodontal variables were identified: “initial” and “advanced” periodontitis, while one latent variable was identified for MetS. Metabolic syndrome is positively associated with “advanced” (coefficient 0.11; P value < 0.01), but not with “initial” (coefficient -0.01; P value = 0.79) periodontitis. When MetS and periodontitis were set as observed variables in the structural equation models, no association was found irrespective of the criteria used for periodontitis classification. Conclusions: There was a positive association between metabolic syndrome and “advanced” periodontitis, when the multiple dimensions of both diseases were accounted in latent variables. Nevertheless, when MetS and periodontitis were treated as observed variables, no association was detected irrespective of the criteria used for periodontitis classification.

BACKGROUND: Numerous prospective studies have investigated the association between the number of remaining teeth and dementia or cognitive decline. However, no agreement has emerged on the association between tooth loss and cognitive impairment, possibly due to past studies differing in target groups and methodologies. We aimed to investigate the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive impairment in community-dwelling older adults while considering baseline cognitive function. METHODS: This 4-year prospective cohort study followed 140 older adults (69.3% female) without cognitive impairment aged ≥65 years (mean age: 70.9 ± 4.3 years) living in the town of Ohasama, Iwate Prefecture, Japan. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) in baseline and follow-up surveys. Based on a baseline oral examination, the participants were divided into those with 0-9 teeth and those with ≥10 teeth. To investigate the association between tooth loss and cognitive impairment, we applied a multiple logistic regression analysis adjusted for age, sex, hypertension, diabetes, cerebrovascular/cardiovascular disease, hypercholesterolemia, depressive symptoms, body mass index, smoking status, drinking status, duration of education, and baseline MMSE score. RESULTS: In the 4 years after the baseline survey, 27 participants (19.3%) developed cognitive impairment (i.e., MMSE scores of ≤24). Multiple logistic regression analysis indicated that participants with 0-9 teeth were more likely to develop cognitive impairment than those with ≥10 teeth were (odds ratio: 3.31; 95% confidence interval: 1.07-10.2). Age, male gender, and baseline MMSE scores were also significantly associated with cognitive impairment. CONCLUSIONS: Tooth loss was independently associated with the development of cognitive impairment within 4 years among community-dwelling older adults. This finding corroborates the hypothesis that tooth loss may be a predictor or risk factor for cognitive decline. ispartof: BMC ORAL HEALTH vol:18 issue:1 ispartof: location:England status: published

Background: Mini dental implant (MDI) overdenture rehabilitation for the edentulous maxilla is a valuable, less invasive and affordable treatment alternative for complete removable dentures (CRD). However, comparative quantification of masticatory performance in different oral conditions are scarce. Purpose: This study compares objective masticatory performance of dentate groups, maxillary CRD and MDI overdentures and subjective masticatory performance in maxillary CRD and MDI overdentures. Materials and Methods: Four groups were defined, age 20+ dentate dental students (DS), age 50+ complete dentate subjects (DP), age 50+ maxillary CRD or MDI overdentures/dentate mandible. Objective masticatory performance was evaluated by measuring circular Variance of Hue (VOH) or the mixture degree of two-color chewing gum (Hue-check View Gum® Test). Additionally, subjective masticatory comparison was investigated in the CRD and MDI groups, with a visual analogue scale (VAS) for different food consistencies and the Oral Health Related Quality of Life (OHRQL) OHIP-14 questionnaire. Results: The mean VOH was 0.11 (SD 0.50, range 0.05–0.27) for the dentate dental 20+ students, 0.13 (SD 0.08, range 0.03–0.31) for the 50+ dentate group (p = 0.774), 0.41 (SD 0.41, range 0.14–0.76) for the CRD group and 0.39 (SD 0.18, range 0.07–0.76) for the MDI group (p = 0.725). Based on the VAS scores, no improvement was found between the CRD and the MDI overdenture group (p &gt, 0.050). The mean OHIP-14 total score was 12.10 (SD 15.87, range 0–56) for CRD, while the MDI group (p = 0.039) saw a significant improvement to 2.85 (SD 2.85, range 0–15). Conclusion: Comparable results in objective masticatory performance were registered in dentate 20+ and 50+ subjects with a remarkable inferior outcome for the CRD and MDI group. Compared to CRD, MDI overdentures revealed no substantial improvement in subjective and objective masticatory performance. However, for MDI a significant increase in OHRQL was apparent.

BACKGROUND: The number of contingent valuation (CV) studies in dental medicine using willingness-to-pay (WTP) methodology has substantially increased in recent years. Missing values due to absent information (i.e., missingness) or false information (i.e., protest zeros) are a common problem in WTP studies. The objective of this study is to evaluate the prevalence of missing values in CV studies in dental medicine, to assess how these have been dealt with, and to suggest recommendations for future research. METHODS: We systematically searched electronic databases (MEDLINE, Web of Science, Cochrane Library, PROSPERO) on 8 June 2021, and hand-searched references of selected reviews. CV studies in clinical dentistry using WTP for valuing a good or service were included. RESULTS: We included 49 WTP studies in our review. Out of these, 19 (38.8%) reported missing values due to absent information, and 28 (57.1%) reported zero values (i.e., WTP valued at zero). Zero values were further classified into true zeros (i.e., representing the underlying preference of the respondent) or protest zeros (i.e., false information as a protest behavior) in only 9 studies. Most studies used a complete case analysis to address missingness while only one study used multiple imputation. CONCLUSIONS: There is uncertainty in the dental literature on how to address missing values and zero values in CV studies. Zero values need to be classified as true zeros versus protest zeros with follow-up questions after the WTP elicitation procedure, and then need to be handled differently. Advanced statistical methods are available to address both missing values due to missingness and due to protest zeros but these are currently underused in dental medicine. Failing to appropriately address missing values in CV studies may lead to biased WTP estimates of dental interventions. ispartof: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH vol:18 issue:14 ispartof: location:Switzerland status: published

Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self‐esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio‐economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. Aim. To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. Methods. One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report. Results & Conclusions. There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc‐γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end‐products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub‐optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases.

ObjectiveThe task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults.MethodsThese recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care.Recommendations for Screening and AssessmentThe task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation).Recommendations for ManagementA comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.

OBJECTIVES: The aim of this study was to learn more about levels of knowledge relating to erosive tooth wear and about the most desirable way of disseminating dental information among young adults.METHODS: The research was a cross-sectional study of 331 young adults (20-25 years old) attending 25 dental care practices. Participants were asked to fill out a questionnaire with questions about their background, knowledge relating to erosive tooth wear and the preferred way of acquiring information about erosive tooth wear.RESULTS: The results showed that there are gaps in the knowledge of young adults about erosive tooth wear. The knowledge score depended on educational level and dental information received in the past. The preferred way of acquiring information was chair side information from an oral health care professional complemented by tailored information in writing.CONCLUSION: There is a lack of knowledge among young adults about erosive tooth wear. They prefer to receive information from the oral health care professionals accompanied by tailored information in writing. Further research should focus on developing this tailored information in line with the advice given by the oral health care professional. This article is protected by copyright. All rights reserved.

Antecedentes y objetivos: La enfermedad de Steinert o distrofia miotónica tipo 1 (DM1),(OMIM 160900) es la miopatía más prevalente en el adulto. Es una enfermedad multisistémica con alteración de prácticamente todos los órganos y tejidos y una variabilidad fenotípica muy amplia, lo que implica que deba ser atendida por diferentes especialistas que dominen las alteraciones más importantes. En los últimos años se ha avanzado de manera exponencial en el conocimiento de la enfermedad y en su manejo. El objetivo de la guía es establecer recomendaciones para el diagnóstico, el pronóstico, el seguimiento y el tratamiento de las diferentes alteraciones de la DM1.Material y métodos: Esta guía de consenso se ha realizado de manera multidisciplinar. Se ha contado con neurólogos, neumólogos, cardiólogos, endocrinólogos, neuropediatras y genetistas que han realizado una revisión sistemática de la literatura. Recomendaciones: Se recomienda realizar un diagnóstico genético con cuantificación precisade tripletes CTG. Los pacientes con DM1 deben seguir control cardiológico y neumológico de por vida. Antes de cualquier cirugía con anestesia general debe realizarse una evaluación respiratoria. Debe monitorizarse la presencia de síntomas de disfagia periódicamente. Debe ofrecerse consejo genético a los pacientes con DM1 y a sus familiares.Conclusión: La DM1 es una enfermedad multisistémica que requiere un seguimiento en unidades especializadas multidisciplinares., Background and objectives: Steinert’s disease or myotonic dystrophy type 1 (MD1), (OMIM160900), is the most prevalent myopathy in adults. It is a multisystemic disorder with dys-function of virtually all organs and tissues and a great phenotypical variability, which impliesthat it has to be addressed by different specialities with experience in the disease. The know-ledge of the disease and its management has changed dramatically in recent years. This guidetries to establish recommendations for the diagnosis, prognosis, follow-up and treatment of thecomplications of MD1.Material and methods: Consensus guide developed through a multidisciplinary approach witha systematic literature review. Neurologists, pulmonologists, cardiologists, endocrinologists, neuropaediatricians and geneticists have participated in the guide. Recommendations: The genetic diagnosis should quantify the number of CTG repetitions. MD1patients need cardiac and respiratory lifetime follow-up. Before any surgery under generalanaesthesia, a respiratory evaluation must be done. Dysphagia must be screened periodically.Genetic counselling must be offered to patients and relatives. Conclusion: MD1 is a multisystemic disease that requires specialised multidisciplinaryfollow-up.

Background. Dental education plays an important role in providing students with the opportunity to develop their evidence-based knowledge and clinical skills regarding patient-specific preventive care and caries management strategies. The aims of this study were to examine the knowledge, attitude, and self-perceived competency towards preventive dentistry among final-year dental students and to investigate their preventive practice for high-caries-risk children. Methods. Data were collected from a convenience sample of 126 dental students using a questionnaire. The IBM SPSS Statistics version 21 was used for data analysis.Results. A total of 126 students completed the questionnaire, and 63% of the respondents were female. Significant gender differences were found in the total Professional Preventive Knowledge Scale (PPKS) (p=0.016) and its subscales of the noncariogenic nutrition (p=0.015), dental hygiene/clinical examination (p<0.001), caries-preventive practice (p=0.02), and the Hiroshima University-Dental Behavioral Inventory (HU-DBI) (p=0.028). Significant differences were observed in the total PPKS (p=0.003) and its subscales of the noncariogenic nutrition (p=0.043) and caries risk management (p=0.006) in terms of self-perceived need to receive education and training. Caries-preventive practice was correlated with the self-perceived competency (r = 0.279;p=0.002), the attitudes (r = 0.394;p<0.001), the total PPKS (r = 0.457;p<0.001) and its all subscales of dental hygiene and clinical examination (r = 0.425;p<0.001), noncariogenic nutrition (r = 0.410;p<0.001), and caries risk management (r = 0.184;p=0.039). The self-perceived competency was positively correlated with the total PPKS (r = 0.192;p=0.031) and its subscale of noncariogenic nutrition (r = 0.259;p=0.003). Greater self-perceived competence, more positive attitudes, and good knowledge regarding preventive dentistry were found to be important predictors of the caries-preventive practice of dental students, explaining 31% of the variance (adjustedR2 = 0.312,p<0.001).Conclusion. 40% of dental students reported educational and training needs regarding the diagnosis, caries-preventive agents, and risk-based treatment plan. These results should be taken into account by the stakeholders in developing the national core curriculum for undergraduate Turkish dental education.

Large socioeconomic inequalities still exist in oral health. It is already known that oral health-related behaviour may contribute to these inequalities, but why people with a lower socioeconomic position behave less healthily is not easily understood. A possible explanation that integrates insights on health behaviour, stress, and financial resources is the pathway of behavioural responses to financial strain. The aim of this study was to assess to what extent financial strain is associated with clinically assessed caries experience in a population-based study of dentate adults, independently of other socioeconomic indicators. Furthermore, the potential mediating pathways of oral health-related behaviours (oral hygiene, dietary habits, preventive dental visits) were explored. Dentate participants, aged 25–44 years, taking part in a survey on oral health and preventive behaviour in the Netherlands in 2013 were clinically examined on – among others – caries experience (DMFS index) and level of oral hygiene (OHI-s index). Financial strain, frequency of tooth brushing, dietary habits, attendance of (preventive) dental visits in the past year, and demographic variables were assessed via questionnaires. Negative binomial hurdle models were used to study the association between financial strain and DMFS and between oral health behavioural indicators and DMFS. Although it was observed that experiencing financial strain did not seem to affect whether there is any caries experience or not, among those having any caries (DMFS >0) suffering from financial strain was associated with a higher caries prevalence, independent of educational level and income. None of the studied potential mediators could explain this association.

Objectives: To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region.Methods: Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2 M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2 M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position.Results: The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3 h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p > 0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support.Conclusions: Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region.Clinical significance: Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. (C) 2016 Elsevier Ltd. All rights reserved.