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Purpose: To evaluate the clinical survival and impact on oral health--related quality of life (OHRQoL) of immediate loading of implant-supported full-arch CAD/CAM--milled PMMA interim restorations. Materials and Methods: This was a practice-based prospective cohort study performed in a Portuguese dental clinic. Eleven patients received a total of 17 CAD/CAM fully implant-supported, screw-retained, full-arch restorations with milled PMMA and were followed up for 1 year. The primary outcome was prosthesis survival, determined with a modification of the California Dental Association score and a Kaplan-Meier survival function analysis. The secondary outcome was the patient quality of life, as defined by application of the OHIP-14-PT questionnaire and standardized effect size variation between two visits. Significance was set at 5%. Results: Survival probability at 12 months was 76%, complete fracture of the prosthesis occurred in 17.6% of the cases, and small fractures without lab involvement occurred in 5.9% of cases. There was a significant improvement in OHRQoL between visit 1 and visit 4. The mean difference and effect size for total OHIP-14-PT score were -32.91 ± 3.68 and 3.66 (95% CI -1.83 to -5.80) respectively (P < .001* Wilcoxon matched paired rank test). Conclusions: Fullarch implant-supported CAD/CAM--milled PMMA interim prosthesis seem to be a viable approach with good survival rate and great impact on patient OHRQoL. [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]

INTRODUCTION: The goal of our research programme is to develop culturally appropriate patient-specific interventions for primary and secondary prevention of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) among people living with HIV (PLWH); PLWH are at a higher risk for OPC than the general population and, as with many cancers, there are disparities in OPC health outcomes by race and ethnicity. Our study incorporates an anti-racist research framework that proposes considering racism as a foundational sociocultural system that causes ill health. We expand the framework to include biases due to gender, sexual orientation, HIV status and membership in other non-dominant groups. Our research programme focuses on HPV-related OPC among people living with PLWH, and on how intersecting identities may impact an individuals experience with oral health, obtaining regular and appropriate oral healthcare, knowledge and perceptions of oral HPV infection, risk factors for OPC and HPV vaccination. METHODS AND ANALYSIS: We will follow a grounded theory (GT) qualitative research methodology using focus group discussions (FGDs) to collect data. We will invite PLWH with intersecting identities to participate in one of 12-18 FGDs with 5-8 participants per group. Focus groups will be formed based on self-reported domains, including race, ethnicity, gender identity, sexual orientation and other identities that could impact oral health, such as smoking status, experience with homelessness or experience with drug use disorders. We do not know which aspects of intersecting identities are most salient to accessing oral healthcare. Using FGDs will allow us to gain this knowledge in a setting where participants can build on and reinforce shared understandings about oral healthcare. Following our GT methodology, analysis will occur concurrently with data collection, and emerging concepts or theories may result in changes to focus group guide questions. Initial focus group questions will be organised around our main objectives: (1) to identify individual, interpersonal and structural health equity factors that serve as barriers or facilitators to oral health status and care; (2) to explore knowledge and perceptions about causes, risk factors, prevention and screening for oral or OPC and (3) to elicit recommendations for improving access to regular and appropriate oral healthcare and suggestions on engaging PLWH from diverse identity groups in prevention interventions. ETHICS AND DISSEMINATION: All methods and procedures were approved by the University of California, San Francisco, Institutional Review Board (approval number: 23-39307) and are in accordance with the Declaration of Helsinki of 1975, as revised in 2000. Participants are required to provide informed consent. The results of this study will be presented at scholarly meetings and published in peer-reviewed journals. In addition, a lay summary of results will be created and distributed to our participants and community through our website and social media. TRIAL REGISTRATION NUMBER: NCT06055868.

Background: Platelet-rich fibrin (PRF) is used to prepare "sticky bone" by combining it with bone graft material. The present study investigated the ability of different bone grafts to absorb growth factors from the PRF and release them over time. Materials and Methods: Human blood was collected from 10 healthy volunteers for liquid PRF preparation. Bovine bone, allograft (mineralized and demineralized), and synthetic bone were each mixed with the PRF to prepare a sticky bone. All sticky bone samples were incubated for up to 4 days. The absorption and release pattern kinetics of two selective growth factors within the PRF--platelet-derived growth factor (PDGF) and bone morphogenetic protein-2 (BMP-2)--were quantified with immunofluorescence staining and enzyme-linked immunoassay (ELISA) testing. Results: All bone graft materials adsorbed the examined growth factors from the PRF. ß-TCP showed the highest adsorption levels, followed by the xenograft, and the allografts showed the lowest adsorption levels. Furthermore, PDGF showed a fast-release pattern from the grafts, whereas BMP-2 was released at a later stage. Similar to the adsorption pattern, the ß-TCP and xenograft were better able to sustain the release of the PRF growth factors from the graft than the allografts. Conclusions: The adsorption of PDGF and BMP-2 differ between graft materials, with superior results for ß-TCP, followed by xenograft, then allograft materials. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of planning interventions on self-reported changes in parents supervised oral health-related behaviors (OHRBs) and associated clinical oral health parameters for primary school-age children. Method and materials: In total, 110 parent–child pairs (children aged 3 to 8 years) were randomly assigned to either of the two groups. In the “action planning” group, parent participants of the pair were asked to make an “action plan” using the “how, when, where” format for their child OHRBs. In the “implementation intention” group, parents were asked to form an “if-then plan” to improve OHRBs for their child. Self-reported changes on target OHRBs, change in plaque scores, change in plaque stagnation areas, and change in caries status of tooth surfaces were observed at 2, 8, and 12 weeks. Results: Overall OHRBs scores changed significantly from baseline to 12 weeks for both interventions. The scores were significantly better with “if-then” planning than “action planning” (z = 4, P < .001) at 12 weeks. Plaque scores also changed significantly from baseline to 12 weeks for both interventions, and improved significantly more with “if-then” planning (16.20 ± 5.24) than “action planning” (50.66 ± 11.24) at 12 weeks. The number of plaque stagnation areas also changed significantly from baseline to 12 weeks for both interventions, and improved significantly more with “if-then” planning at 12 weeks (12.80 ± 5.33) than “action planning” (42.76 ± 10.34) (t = −11.55, P < .001). There was significant change in the caries status of sound tooth surfaces with “action planning” at 12 weeks (z = 116.50, P = .023). There were no new caries lesions reported with “if-then” planning at 12 weeks. Conclusion: The study observed significant improvement in OHRBs and associated oral health parameters with planning interventions, preferring “if-then” planning over “action planning.” It also elicited significant barriers to behaviors in action. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovary syndrome (PCOS) is widely reported among young females, and anti-androgens are used for treating hirsutism and acne in these patients. The protective effects of myo-inositol, oral contraceptives, and insulin sensitizers have been reported on the periodontium and high-sensitivity C-reactive protein (hsCRP) levels in PCOS females. However, cyproterone acetate/ethinyl estradiol (CPA/EE) has not yet been studied. This cross-sectional study explores the periodontal status and systemic inflammation in PCOS women on CPA/EE drug combination compared to females not on medication. Method and materials: A total of 150 participants were enrolled into three groups: 50 newly diagnosed PCOS females not on medication (N-PCOS); 50 PCOS females consuming CPA/EE combination for the last 6 months (PCOS+CPA/EE); and 50 systemically healthy females (control group). Anthropometric, biochemical, periodontal parameters, and health-related quality of life questionnaires were recorded. Results: N-PCOS and PCOS+CPA/EE groups showed a nonsignificant difference in hsCRP levels, Gingival Index, bleeding on probing, waist circumference, and waist-hip ratio (P > .05). Gingival thickness and keratinized tissue width were significantly greater in the PCOS+CPA/EE than the N-PCOS group (P = .05); however, these were comparable with the control group (P > .05). Regression analysis showed significant association of bleeding on probing with Gingival Index, clinical attachment level, and hsCRP (P = .05). Conclusions: CPA/EE combination does not influence the periodontal and systemic inflammatory status in PCOS females, as similar levels of local and systemic inflammation were observed in CPA/EE consumers compared with PCOS females not on medication. However, it might play a role in increasing gingival thickness and keratinized tissue width in these patients. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to analyze and compare the differences in chewing efficiency among patients with different vertical skeletal types of Angle Class I and Angle Class II malocclusions, to provide reference for orthodontic clinical practice. Method and materials: Sample size estimation revealed a minimum of 53 for each class. Thus, a total of 108 patients with Angle Class I and Angle Class II malocclusions were selected. Lateral skull radiographs were taken, and head measurements were analyzed via geometric tracing software. Chewing efficiency was measured using the gravimetric method to compare between the two groups. The vertical skeletal pattern was classified via Steiner analysis. Results: Significant statistical differences in chewing efficiency were observed between patients presenting with Angle Class I and Angle Class II malocclusions (P<.05). Additionally, significant differences in chewing efficiency were observed among patients with different vertical skeletal patterns (P<.05). Furthermore, a statistically significant difference in chewing efficiency was found between men and women (P<.05). Conclusions: Patients with Angle Class I malocclusions exhibited significantly higher chewing efficiency compared to those with Angle Class II malocclusions. Among patients with different vertical facial types, the chewing efficiency followed theorderof low angle> normal angle> high angle. Moreover, men demonstrated a higher chewing efficiency than women. [ABSTRACT FROM AUTHOR]

Dentists are well-positioned to discuss oral health issues related to Human Papillomavirus (HPV) and recommend the HPV vaccine to their patients, mainly because the HPV virus causes oropharyngeal cancers.. We assessed Los Angeles (LA) County dentists opinions on discussing HPV-related oral health issues and recommending the HPV vaccine to their patients. We tested if opinions differed between dentists whose primary patient population was only adults versus children and adults. We mailed a 19-item survey to 2000 randomly sampled LA County dentists for this cross-sectional study. The primary outcome variable was a summary opinion score of 7 opinion statements. We ran descriptive, bivariate comparisons and adjusted linear regression models. Overall, 261 dentists completed the survey. A majority (58.5%) worried they would lose patients if they recommended the vaccine; 49% thought dentists were not appropriate to educate, counsel, or advise on HPV-related issues; 42% were concerned about the safety of the vaccine; and 40% did not feel comfortable recommending the vaccine. The mean summary opinion score was 21.4 ± 5.4 for the total sample. Regression analysis showed no differences in opinions between dentists whose primary patient population was only adults versus children and adults (Coefficient = 0.146, p = 0.83). Overall, the responding dentists were not very favorable about discussing oral health-related HPV issues and recommending the HPV vaccine to their patients. Additionally, the overall opinions were similar between dentists whose primary patient population was only adults versus children and adults.

Objectives: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5,000 individuals was fluoridated. In 2014, CWF in Israel stopped. Method and materials: Data on 12-year-old children from all areas in Israel from the national cross-sectional epidemiological survey conducted in 2011 to 2012 were stratified by city water fluoridation and by city and school socioeconomic status. Two dependent variables were defined: (1) DMFT index of caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov classification of fluorosis. Results: Data from 2,181 12-year-olds were analyzed. The average DMFT was 1.17 ± 1.72, and 49% were caries-free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs 0.98 in fluoridated cities) and there were more caries-free children in fluoridated cities (56.4% vs 40.6% in nonfluoridated). DMFT was higher in cities with lower socioeconomic status than high socioeconomic status (1.29 vs 1.05, respectively, P < .001) and there were fewer caries-free children in low socioeconomic status cities (44.5% vs 53.0% in high socioeconomic status cities, P < .0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in the Thylstrup-Fejerskov index), had questionable to mild fluorosis (9.3%). Conclusions: CWF is a cheap, simple method of dental health protection that reaches all socioeconomic levels, and cessation of water fluoridation reduced the health of Israel's children. Clinical significance: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities. [ABSTRACT FROM AUTHOR]

Purpose: When carrying out prosthetic rehabilitation of edentulous and partially edentulous patients, great attention is paid to the personal attitude of the patients, their satisfaction with oral health and psychosocial interaction due to tooth loss, as well as the treatment of the resulting disorders. This attention has led to the development of various instruments for examining the quality of life related to oral health. The aim of this study was to develop and validate a reliable instrument in the Serbian language suitable for measuring oral health-related quality of life in patients who have been rehabilitated with complete or partial dentures. Мaterials and Methods: The study was unicentric and cross-sectional, and assessed the reliability and validity of a newly developed instrument for measuring the oral health-related quality of life in denture wearers (OHRQoL-DW). It was conducted on a sample of 200 adults from Serbia, wearers of various types of dentures, with a mean age 66.9 ± 10.3 years and male/female ratio of 86/114 (43%/57%). Results: The definitive version of the OHRQoL-DW scale with 28 items showed very good reliability, with Cronbach’s alpha = 0.938. Good temporal stability of the questionnaire was demonstrated, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis revealed four domains of oral health-related quality of life in denture wearers: physical, psychosocial, environmental and aesthetic. Conclusions: The OHRQoL-DW scale is a reliable and valid generic instrument for measuring the oral health-related quality of life in patients wearing dentures, which is one of the most important outcomes of oral health in prosthetic treatment. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the usefulness of a newly developed oral simulator for nursing students’ oral assessment education on oral diseases and symptoms. Materials and Methods: The participants were first-year students (n=105) at a nursing school in Japan. Ten identical oral simulators with angular cheilitis, missing teeth, dental caries, calculus, periodontitis, hypoglossal induration, food debris, and crust formation were created by a team of dentists. After a 45-minute lecture programme for oral assessment performance with the Oral Health Assessment Tool (OHAT), the ability test with the simulators and the OHAT as well as test feedback were conducted in a 30-minute practical programme. To evaluate the effectiveness of the programmes, questionnaires and ability tests with slides of oral images were conducted at baseline and after the programme. Results: Ninety-nine students (94.3%) participated in this study. The results of the ability test with the simulators and the OHAT in the practical programme showed that the correct answer rates of assessing tongue, gingiva, present teeth, and oral pain were less than 40%. Their levels of confidence, perception, and oral assessment performance were statistically significantly higher after the programmes than they were at baseline. Their level of confidence in assessing the need for dental referral had the largest increase in scores compared to the lowest scores at baseline in the nine post-programme assessment categories. Conclusions: This study identified several problems with nursing students’ oral assessment skills and improvements of their oral assessment confidence, perceptions and performance. [ABSTRACT FROM AUTHOR]

Purpose: Environmental factors modulate oral-health-related quality of life (OHRQoL). The aim of this study was to analyse sociodemographic and behavioural factors affecting the OHRQoL in Spanish adolescents, by using the Child-OIDP (Child-Oral Impacts on Daily Performances) index. Materials and Methods: A cross-sectional study was conducted in 337 adolescent schoolchildren aged 13–15 years. A questionnaire on sociodemographic, behavioural and oral self-perception factors was administered with the Child-OIDP questionnaire. Descriptive statistics, Kruskal-Wallis and Mann-Whitney U-tests, as well as a regression model were used in the data analysis. Results: The overall mean Child-OIDP index was 3.28±6.55. It was statistically significantly higher in females than in males (p < 0.001). Mothers having a managerial job showed statistical association with worse OHRQoL (p < 0.001). Caries experience and history of dental trauma were not associated with the oral-health-related quality of life (p > 0.05). Halitosis statistically significantly affected the activities of daily living (p < 0.001). Perceived dental problems, dental treatment needs, self-assessment of oral health status and satisfaction with oral health were associated with the impact index (p < 0.05). Conclusion: Mothers who were managers, female sex, presence of halitosis, and perceived dental treatment needs were the most important predictors of the impact index, while dietary habits, oral hygiene, and dental visits did not affect it. Knowledge of these factors will help dental professionals to apply adequate preventive and therapeutic measures. [ABSTRACT FROM AUTHOR]

Purpose: The relationship between the number of chronic diseases and oral health problems is unclear. We sought to determine whether the number of chronic diseases and multimorbidity have an association with oral health problems in Korean adults. Materials and Methods: Data from 23,246 adults aged ≥ 19 years, who participated in the Korea National Health and Nutrition Examination Survey from 2016 to 2019, were considered for our analyses. Participants with either masticatory or speech problems were defined as the oral health problems group. Individuals who reported having had dental treatment in the last year were defined as the dental treatment group. We used multivariable logistic regression analyses to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: The proportions of oral health problems and dental treatment were higher in participants with multimorbidity than in those without multimorbidity (all p < 0.001). Moreover, ORs of oral health problems demonstrated a tendency to increase with the number of chronic diseases, even after adjustment (p for trend < 0.001). Compared to the participants without multimorbidity, the risk of having oral health problems increased by 25% (OR: 1.25, 95% CI: 1.12–1.39), and that of receiving dental treatment increased by 23% (OR: 1.23, 95% CI: 1.13–1.34) in patients with multimorbidity. Conclusion: The risk of oral health problems and dental treatment increased in association with the number of chronic diseases in Korean adults. The authors emphasise the risks and importance of oral health in a large population affected by multiple chronic diseases. [ABSTRACT FROM AUTHOR]

Purpose: To examine the relationship between socioeconomic inequalities and oral health among adults in the Guangxi province of China. Materials and Methods: The present work was designed as a cross-sectional study, and comprises a secondary analysis of the Fourth National Oral Health Survey from 2015–2016. A multistage cluster sampling method was adopted for this survey, conducted in three urban and three rural districts Guangxi province. Dental examinations were conducted to determine oral health indicators: decayed teeth (DT), clinical attachment loss (CAL) and missing teeth (MT). The outcome measures were DT, CAL and MT. A structured questionnaire was used to collect data on demographic characteristics and socioeconomic status (SES). Multiple logistic regression models were used to analyse the relationship between SES and oral health by adjusting covariates. Results: The sample consisted of 651 participants aged 35–74 years. Logisitic analysis showed a statistically significant association between SES and oral health indicators. In the fully adjusted model, participants with primary education were more likely to suffer more DT (OR = 2.67, 95% CI: 1.17–6.10), teeth with CAL ≥ 4 mm (OR = 2.15, 95% CI: 1.25–3.67) and MT (OR = 3.04, 95% CI: 1.65–5.60) compared to the higher education group. Participants with secondary education exhibited a higher likelihood of experiencing increased MT compared to those in the higher education group in the fully adjusted model (OR = 3.21, 95% CI: 1.78–5.76). Household income was associated with DT and MT in the unadjusted model only. Conclusions: There was strong relationship between SES and oral health of adults. The survey suggested a relationship between low educational attainment and oral health. [ABSTRACT FROM AUTHOR]

Purpose: To identify the relationship between periodontal health knowledge and oral health-related quality of life among Caribbean adults. Materials and Methods: A cross-sectional study was conducted in a representative sample from 3 Caribbean cities (weighted N = 1805). Participants completed a questionnaire on oral health knowledge, hygiene habits, and other practices, as well as the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The associations between knowledge and habits and OHIP-14 score and its tertiles were evaluated using negative binomial and multinomial logistic regression models, respectively, adjusting for confounders. Odds ratios and regression coefficients were reported. Results: Participants reporting none, little, and adequate knowledge about gum health had higher odds of being in the worst tertile for OHRQoL, compared to those reporting “good knowledge” (ORnone vs good = 2.38, 95% CI: 1.59– 3.54; ORlittle vs good = 1.82, 95% CI: 1.19–2.78; ORadequate vs good = 1.68, 95% CI: 1.11–2.57). Participants reporting toothbrushing ≥ twice/day were less likely to be in the worst tertile for OHRQoL, compared to those brushing less often (OR = 0.67, 95% CI: 0.48–0.92). Self-reported gum bleeding was associated with double the odds of being in the worse tertile (OR = 2.03, 95% CI: 1.60–2.58). Conclusion: According to the findings of this study, periodontal health knowledge is associated with reduced OHRQoL in Caribbean Adults. In addition, the frequency of brushing and the self-reported gum bleeding was related to a worse quality of life (QoL) level. [ABSTRACT FROM AUTHOR]

Purpose: To describe the use of work process modelling to optimise the organisation of the demand for oral health treatment in primary care units in Brazil. Materials and Methods: The oral health care routine was at first described as the “AS IS” model, which was evaluated by the oral team professionals, rearranged, and further described as the “TO BE” model described using a business process management modelling tool. The significant increase in the demand of patients due to restrictions offered by the dental service in addition to non-urgent treatments being avoided by patients during COVID-19 pandemic was also considered. Results: Structuring the work processes in a visual way using modelling tools was useful to picture the entire treatment process and adjust when needed. The use of the managerial tool was useful to understand and reorganise the workflow of organising the demand and ultimately improve the efficiency of the resources. The use of such managerial tools helped oral health professionals to efficiently rearrange their tasks and set priorities to meet their needs. Conclusions: With the use of management tools, each unit can readjust its structures and ways of working, aiming to improve the quality of public health care services provided to patients. [ABSTRACT FROM AUTHOR]

Bariatric dentistry is the branch of dental medicine focused on preventive and comprehensive oral health care of overweight or obese patients. Obesity is an increasing US and international health problem and is a condition characterized by abnormal or excessive fat accumulation in the adipose tissue and is categorized by body mass index (BMI) according to the World Health Organization (WHO). With the increase of morbid obesity worldwide and the unfavorable effect on the overall health and life expectancy, it is necessary that proper accommodations are made for accessible dental care of this vulnerable population of patients. The following case report details the emergency and the subsequent elective dental treatment of a patient with a morbid obesity and demonstrates the importance of necessary equipment, a multidisciplinary approach, and broad networking communication needed to treat bariatric patients. The aim of the present case report was to bring awareness and start professional discussions on the importance of dental practitioners in the community and dental academic programs working together to assure access for primary oral health for bariatric patients. [ABSTRACT FROM AUTHOR]

Radiation therapy (RT) plays a crucial role in the treatment of head and neck cancers (HNCs). This paper emphasizes the importance of effective communication and collaboration between radiation oncologists and dental specialists in the HNC care pathway. It also provides an overview of the role of RT in HNC treatment and illustrates the interdisciplinary collaboration between these teams to optimize patient care, expedite treatment, and prevent post-treatment oral complications. The methods utilized include a thorough analysis of existing research articles, case reports, and clinical guidelines, with terms such as dental management, oral oncology, head and neck cancer, and radiotherapy included for this review. The findings underscore the significance of the early involvement of dental specialists in the treatment planning phase to assess and prepare patients for RT, including strategies such as prophylactic tooth extraction to mitigate potential oral complications. Furthermore, post-treatment oral health follow-up and management by dental specialists are crucial in minimizing the incidence and severity of RT-induced oral sequelae. In conclusion, these proactive measures help minimize dental and oral complications before, during, and after treatment.

Objective: Xerostomia (or oral dryness) is most commonly caused by medications that affect saliva secretion, and is often accompanied by symptoms of orofacial pain. Medication-induced xerostomia may or may not be associated with objectively de-monstrable hyposalivation. The present study attempted to systematically identify an association between medication-induced xerostomia and orofacial pain. Method and materials: A systematic search was conducted using the following databases: WoS, PubMed, SCOPUS, and MEDLINE. The search terms used were: xerostomia OR "dry mouth" AND medication AND ("oral pain" OR "orofacial pain" OR "craniofacial pain" OR "burning mouth" OR "glossodynia") NOT Sjogren's NOT cancer. Inclusion criteria were medication-induced xerostomia and reported symptoms of orofacial pain. Four researchers performed the selection process and quality assessment and two researchers conducted data extraction. Results: Seven studies with a total of 1,029 patients were included. These studies were conducted between 2009 and 2022 and consisted of cross-sectional studies, case-control studies, and one randomized crossover trial. The studies consisted of a total of 1,029 participants. All studies included male and female participants whose mean ages ranged from 43 to lOOyears. Conclusions: A positive association was found between medication-induced xerostomia and orofacial pain. No associations were found between salivary flow measurements (hyposalivation) and medication use. Future research should focus on saliva flow measurements, standardized assessment of medication-induced xerostomia, as well as the inclusion of accompanying orofacial pain diagnosis in the medical history to allow for higher level of evidence in establishing reliable predictors of medication- induced oral health damage to facilitate clinical prevention and management. [ABSTRACT FROM AUTHOR]

Abstract: Dental data can reveal evidence for a past population's oral health, nutrition, and certain cultural activities. This study aims to explore oral health and dental attrition during the late Bronze Age in order to explore health outcomes in different subgroups as well as aspects of foodways and changes in subsistence strategies during the second millennium BCE in northwest China. To do this, the skeletal remains of adult individuals associated with the Siwa material culture (1400–1100 BC) from the Mogou site (n = 28) were macroscopically assessed and compared with previously published data derived from a subsample of individuals associated with Qijia period material culture complex (1750–1400 BC) from the same site. The results show that the Siwa‐period population experienced a high frequency of carious lesions and antemortem tooth loss associated with advanced attrition (of both molars and nonmolar teeth), which did not vary significantly by sex. Females had a higher prevalence of carious lesions and antemortem tooth loss than did males, while males had a higher prevalence of dental calculus. These male/female health outcomes are also attested during the earlier Qijia period at the Mogou site. The Siwa period differs from the Qijia in that females experienced slightly worse attrition than their predecessors. Overall, oral health does not diverge significantly between the Qijia and Siwa periods, suggesting that the factors that contributed to oral health including dietary practices may have persisted diachronically for individuals buried at this site.

Background: Early childhood caries (ECC) is a significant oral health issue affecting children under six years old. This study aimed to determine the prevalence and distribution of ECC in Nigeria through a systematic review and meta-analysis. Methods: A systematic search was conducted across multiple databases for studies on ECC prevalence in Nigeria. The Joanna Briggs Institute (JBI) checklist was used to assess study quality. A random-effects model was employed to calculate pooled prevalence estimates and mean dmft scores. Subgroup analyses and meta-regression were performed to explore sources of heterogeneity. Results: Twenty-three studies met the inclusion criteria, comprising 7,362 participants. The pooled ECC prevalence in Nigeria was 17% (95% CI 11–24%), with significant heterogeneity (I2 = 97%). Subgroup analyses revealed variations across geopolitical zones and study settings. The pooled mean dmft score was 0.44 (95% CI 0.24–0.74). Age group and gender showed minimal impact on ECC prevalence. Conclusion: With a 17% prevalence rate, ECC remains a significant public health concern in Nigeria. The study highlights the need for targeted interventions, standardized national surveys, and further research into region-specific risk factors to address ECC effectively. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Within Aotearoa | New Zealand, rates of largely preventable severe caries and dental hospitalisations among children are increasing and inequalities exist. However, little population‐based empirical evidence exists describing this oral health burden among children with neurodevelopmental disabilities (NDDs). This study aimed to estimate and compare the rates of dental hospital admissions in a near‐national population of children aged ≤ 14 years with attention‐deficit hyperactivity disorder, autism, intellectual disability or any NDD after accounting for key confounding variables. Caries status for these children was derived from an oral health screening at 4 years and also examined.The cohort were children who had their B4 School Check (B4SC) national health screening assessment undertaken between 1 January 2011 and 31 December 2018 and followed until 1 January 2020 (the study end date). Linked administrative databases, which include NDD indication and dental hospital records, were utilised. Dental hospital admissions were assessed using unadjusted and adjusted Cox proportional hazard regression models treating NDD as a discrete time‐varying covariate. Caries status at 4 years of age was investigated cross‐sectionally and the area under the receiver operating characteristic curve used to assess predictive accuracy.The eligible sample included 433 569 children (48.6% female) with a mean age of 9.3 years at the study end date. Overall, 16 359 (3.8%) children had at least one NDD indication and 38 574 (8.9%) had at least one dental hospitalisation. In adjusted analyses, the hazard ratio of dental hospitalisation admissions was 3.40 (95% CI: 3.22–3.60) for children indicated with any NDD compared to their non‐NDD counterparts. At 4 years of age B4SC screening, 465 (17.6%) children out of 2640 indicated with any NDD had visible caries compared to 61 026 (14.3%) from 427 254 children without NDD indication (prevalence ratio = 1.24 [95% CI: 1.14–1.35]). However, the area under the receiver operating characteristic curve for this association was 0.52 (95% CI: 0.51–0.52), suggesting negligible predictive capacity.Children with NDDs in Aotearoa, New Zealand suffer from substantial oral health inequities. Targeted preventive strategies and adaptation to primary oral health services are needed to meet the needs of neurodiverse children and redress this substantial inequity. However, targeting children with NDDs at the B4SC is unlikely to mitigate these oral health inequities. [ABSTRACT FROM AUTHOR]

Background: Regular dental l check-ups and good oral hygiene are challenging for nursing home residents, resulting in poor oral health. The interRAI instrument for Long-Term Care Facilities (LTCF) enables caregivers to evaluate residents' health, including oral health, and to integrate oral care into general care planning. Because the current oral heal1th section in the interRAI instruments does not accurately identify residents who need help with daily oral care or dental referral, the interRAI Oral Health Section (OHS-interRAI) was developed. The OHS-interRAI differs from the current section by including more items, response options and guidelines, photographs, instruction videos, and Collaborative Action Points to alert caregivers when oral care is needed. This study describes and compares residents' oral health status assessed by caregivers using the current section and the OHS-interRAI. Methods: This cross-sectional study includes baseline data of adults aged 65 years or older in Flemish and Dutch nursing homes, collected by professional caregivers (e.g., nurses, nurse aids, therapists). Assessments with the current section dated from October 2016 to January 2023, and with the OHS-interRAI from October 2020 to January 2023. Results: InterRAI assessments of 12,476 residents from 158 nursing homes with the current section were compared with those of 1212 residents from 37 nursing homes with the OHS-interRAI. The OHS-interRAI assessments showed more missing data. A higher proportion of oral health problems was detected with the OHS-interRAI compared to the current section for chewing function (13.7% vs. 6.8%), dry mouth (9.8% vs. 7.6%), teeth (22.1% vs. 16.6%),and gums (7.8% vs. 3.1%). There was no significant difference in the proportion of residents with discomfort or pain in the mouth. Conclusions: More missing OHS-interRAI data may be attributed to regulatory decisions on using the interRAI LTCF instrument. Caregivers identified more oral health problems with the OHS-interRAI, which may be due to its additional features, such as photographs and extensive instructions. The Collaborative Action Points included in the OHS-interRAI support continuity of care and enable integration of oral care into general care. Further research is needed to evaluate whether the OHS-interRAI accurately identifies residents who need help with daily oral hygiene or dental referral. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint dysfunction (TMD) is a multifactorial and complex problem. The underlying causes of the symptoms and related factors of TMD should be specifically identified. This study aimed to examine factors in the relationship between TMD severity and compare cases regarding TMD severity in university students. Methods: The participants were evaluated with the Visual Analog Scale (VAS) for jaw and neck pain severity. TMD severity was assessed with the Fonseca Anamnestic Index (FAI), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), oral habits with the Oral Behavior Checklist (OBC), and depression and anxiety status with the Hospital Anxiety and Depression Scale (HADS). In addition, mandibular movements were also evaluated. Results: A total of 51 individuals (39 female, 12 male; mean age: 21.9 ± 3.8) were included in the study. There was a positive moderate correlation between FAI and OBC (r = 0.560, p < 0.01). PSQI (r = 0,373), VAS-jaw pain (r = 0,374, p < 0.05), VAS-neck pain (r = 0,437, p < 0.05) and HADS-D (r = 0,392, p < 0.05) were moderately associated with FAI. There was also a low correlation between FAI and HADS-A (r = 0.346, p < 0.05). A statistically significant predictive correlation was found between VAS-Neck pain and OBC with FAI (p < 0.05). Conclusions: This study's results show that jaw and neck pain, sleep habits, oral habits, and anxiety-depression levels are associated with TMD severity. This association highlights the need to consider these factors in assessing and treating TMD. [ABSTRACT FROM AUTHOR]

Background: Current methods for oral health workforce planning lack responsiveness to dynamic needs, hampering efficiency, equity and sustainability. Effective workforce planning is vital for resilient health care systems and achieving universal health coverage. Given this context, we developed and operationalised a needs-adaptive oral health workforce planning model and explored the potential of various future scenarios. Methods: Using publicly available data, including the Special Eurobarometer 330 Oral Health Survey, we applied the model in a hypothetical context focusing on the Dutch population's dental needs from 2022 to 2050. We compared current and future provider supply and requirement and examined, in addition to a base case scenario, several alternative scenarios. These included epidemiological transition scenarios with different oral health morbidity trajectories, skill-mix scenarios with independent oral hygienists conducting check-ups and multiple dental student intake and training duration (5 instead of 6 years) scenarios. Results: Based on the aforementioned historical data, our model projects that provider requirement will exceed supply for the planning period. If the percentage of people having all natural teeth increases by 10% or 20% in 2032, 34 or 68 additional full-time equivalent (FTE) dentists will be required, respectively, compared to the base case scenario. In the skill-mix scenario, the model indicates that prioritising oral hygienists for check-ups and shifting dentists' focus to primarily complex care could address population needs more efficiently. Among the student intake and training duration scenarios, increasing intake to 375 and, to a lesser extent, reducing training to 5 years is projected to most effectively close the provider gap. Conclusions: The study underscores the importance of understanding oral health morbidity trajectories for effective capacity planning. Due to limited dental epidemiological data, projections carry substantial uncertainty. Currently, demand for FTE dentists seems to exceed supply, though this may vary with epidemiological changes. Skill-mix strategies could offer efficiency gains by redistributing tasks, while adjustments in dental intake and training duration could also help address the requirement-supply gap. Resolving dentistry workforce challenges requires a multifaceted approach, including strengthening oral epidemiology projections, addressing the root causes of dental health issues and prioritising harmonious dental public health and general practice prevention measures. [ABSTRACT FROM AUTHOR]

This study evaluated correlations between poor dental health and craniomandibular morphology for the Radcliffe Infirmary population buried between 1770 and 1855. The Radcliffe Infirmary is situated in Oxford, 90 km northwest of London, in what used to be a rural area. The original report for this population observed high prevalence rates of dental caries, antemortem tooth loss (AMTL), and periodontal disease. Industrial societies are acknowledged to have highly processed foods that not only are detrimental to dental health but also require less mastication. This softening of diet is suggested to be the leading influence on the modern morphology of the skull. By using two‐dimensional geometric morphometrics (GM) and linear measurements of the skull, the Radcliffe population was evaluated for the effects of poor dental health and decreased wear on the masticatory structures. High frequencies of AMTL, periodontal disease, and caries and low amounts of dental wear were observed in this sample population. Caries and AMTL showed weak correlations with skull shape and craniomandibular dimensions according to the results of the morphometric analysis and Kendall's tau. Dental wear correlated with a wide bizygomatic breadth and a long narrow skull shape for the males only. Periodontal disease was the only dental health variable not correlated with shape or size. This study confirmed that the Radcliffe population ate a cariogenic diet and suggests that dental wear and pathology weakly correlates with craniomandibular shape and size. This unpredicted finding may be due to the limitations of two‐dimensional shape analysis, a small sample size, and the sampling strategy. Future research is highly encouraged to better understand the consequences of poor dental health for skull morphology. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Methods Results Conclusions Periodontal disease (PD) screening models based on a self‐reported questionnaire were previously established and externally validated. The aim of the present study is to explore whether the screening models could be modified to improve prediction performance; this methodology is called ‘updating’.Updating the models for ‘total’ and ‘severe’ PD was performed using two datasets. One dataset from a previous study (n = 155) was used to explore the updating, and a second (n = 187, built for the current study) was used to validate whether updating improved performance. Updating was based on different statistical approaches, including model recalibration and revision. Discrimination and calibration were assessed after updating.For ‘total’ PD, the update based on model revision improved its performance. However, still low AUCs were found: 0.64 (0.56–0.73) and 0.61 (0.53–0.69) with corresponding O:E ratios 1.00 (0.80–1.23) and 0.92 (0.75–1.13) in the update and validation cohorts, respectively. For ‘severe’ PD, performance of the original model without update performed still the best; AUCs were 0.72 (0.61–0.83) and 0.75 (0.66–0.84) in the update and validation cohorts, respectively, with corresponding O:E ratios 0.60 (0.38–0.84) and 0.62 (0.42–0.87).The updating methodology did not further improve the performance of the original ‘severe’ PD screening model; it performed satisfactorily in the medical care setting. Despite updating attempts, the screening model for ‘total’ PD remained sub‐optimal. Screening for ‘severe’ PD can now be implemented in the medical care setting. [ABSTRACT FROM AUTHOR]

Background: Oral Health-Related Quality of Life (OHRQoL) is a term that encompasses conditions such as oral health status, living conditions, and function. OHQoL can change with the varying health conditions of the same individual. Many patients cannot afford implants or have anatomical limitations and therefore use traditional removable dentures. There are comparatively few studies investigating OHRQoL and denture satisfaction that include the patients' sociodemographic data, denture satisfaction and related questions. Aim: This study aimed to investigate OHRQoL and patients' satisfaction with three types of dentures: upper and lower complete dentures, upper and lower partial dentures, and upper complete lower partial dentures. Methods: The study was conducted between January 2022 and June 2023, with 150 patients using removable dentures. Patients' age, gender, education level, place of residence, smoking status, reasons for tooth loss and visiting the clinic, type of denture and the duration of denture use were recorded. Oral Health Impact Profile (OHIP-14) and patient satisfaction with dentures as measured on a Visual Analog Scale (VAS) were used to assess patients' satisfactions with OHRQoL and dentures respectively. Descriptive statistics, the Shapiro-Wilk normality test, the Mann-Whitney non‐parametric test and the Kruskal-Wallis test were used. Results: Statistically significant differences were found between gender, prosthetic type, usage duration and OHIP and VAS scores (p < 0.05). Women's OHIP scores were higher than men's, patients using complete dentures had higher scores than those using partial dentures in both jaws, those using dentures for less than 1 year had higher scores than those that had used them for more than 1 year. The analysis revealed no statistically significant differences in OHIP and VAS scores based on age, education level, and place of residence (p > 0.05). Conclusions: Patients may find it easier to adapt to removable partial dentures compared to complete dentures. Therefore, in prosthetic planning, dentists should prioritize preserving existing teeth. Regardless of the type of prosthesis, patients adapt to their prostheses over time, leading to increased satisfaction with prolonged use. Since individuals do not have a habit of visiting the dentist when there is no known problem, dentists should encourage patients to attend regular dental check-ups. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the level of oral health knowledge among teachers in a city of the Brazilian Amazon region (Belem, Pará) and explore the association between teachers' knowledge and their proposed actions in the event of dental trauma accidents within the school environment. The descriptive cross‐sectional study involved 170 elementary teachers from public schools in the Metropolitan Region of Belem, Para State, Brazil. A self‐administered questionnaire with multiple‐choice questions was utilized to assess teachers' oral health knowledge across various domains. The questionnaire comprised seven targeted sections: the first section focused on demographic and professional aspects of the educators, while the remaining six sections addressed the oral health knowledge related to oral health education, dental caries, dental trauma (specifically dental avulsion), periodontal disease, visits to the dentist, and the educator's role in promoting oral health. Data analysis involved descriptive statistics and χ2 tests using Statistical Package for Social Science (SPSS; 20.0 version). Most of the sample were female (92.2%) and around 41–60 years (36.0%). Most teachers had over 5 years of teaching experience (87.0%) and held an undergraduate degree (63.0%). A significant association was found between teaching experience and the choice of storage method for avulsed teeth following dental trauma (p = 0.005). However, the teachers examined in this study exhibited inadequate knowledge concerning the appropriate treatment for cavities and the recommended age for a child's first dental appointment. These findings underscore the crucial role teachers play in promoting oral health among students, particularly in regions characterized by social inequality and limited access to basic sanitation and healthcare services. [ABSTRACT FROM AUTHOR]

Malocclusion is the misalignment of teeth and jaws, affecting oral health and appearance. This study aimed to examine the knowledge, attitude, and practice (KAP) of both adolescents and parents toward malocclusion. This web-based cross-sectional study was conducted at Tianjin between July 2019 and July 2022, enrolled adolescents and their parents. The structural equation model (SEM) was used to analyze the interactions between KAP. A total of 478 adolescents and 380 parents were included. For knowledge, the scores were 6.95 ± 2.69 for adolescents and 7.07 ± 2.90 for parents (possible range, 0–12). For attitude, the scores were 36.96 ± 7.86 for adolescents and 33.26 ± 9.20 for parents (possible range, 13–65). For practice, the scores were 39.88 ± 7.85 for adolescents and 25.75 ± 8.56 for parents (possible range, 11–55). In parents, knowledge, practice, being a service personnel and production personnel, and acquiring knowledge through the Internet were associated with receiving orthodontic treatment. The SEM showed that knowledge directly affected attitudes (β = 0.551, P < 0.001) and practices (β = 1.122, P < 0.001). But attitudes did not affect practices (β=-0.003, P = 0.923). Adolescents and parents demonstrate unsatisfactory levels of knowledge, attitudes, and practices toward malocclusion. Improvements can be made by focusing on enhancing knowledge and encouraging proactive practices. [ABSTRACT FROM AUTHOR]

Objective: Determine relationships between college students' student loan presence and self-rated physical and mental health, major medical problems, mental health conditions, physical, dental, and mental health care visits and delays, and medication use and reductions. Participants: A total of 3,248 undergraduates at two regional public U.S. universities, surveyed Spring 2017. Methods: OLS and Logistic regression. Results: Loan presence was related to significantly worse self-rated physical and mental health and more major medical problems, but not to mental health conditions, or physical or mental health medication use. Respondents with loans were less likely to visit the dentist and more likely to report delaying medical, dental, and mental health care, and reducing medication use to save money. Conclusions: Results provide evidence of health and health care use divides among college students by loan presence. [ABSTRACT FROM AUTHOR]

Smiling is an embodied and complex social act. Smiling is presented as facilitating individual health and wellbeing, but the value placed on smiling raises questions about structural conditions acting on the body. While smiling has been considered sociologically, psychologically and historically, we argue that further exploration of the embodied smile offers fruitful avenues for future research. This article attempts to advance understanding of the smile and its importance by: (I) Bringing together literature on smiling as a social act and smiling as embodied. (II) Systematically identifying key themes, which recognise sociological insights and the relevance of oral health. (III) Pointing to useful directions for future sociological research into smiling. In this article, we review literature on body techniques; impression management and social interaction; gender, race and smiling; and emotional, aesthetic and affective labour. We move on to embodiment, considering the mouth as a body project and in relation to the ageing body, before reflecting on the significance of oral health and dentistry. We highlight future directions for sociological research on smiling, building on eight interrelated and cross‐cutting themes: norms and expectations, aesthetic ideals, self and identity, health and wellbeing, body work, commodification and labour, inclusion and exclusion and resistance. [ABSTRACT FROM AUTHOR]

Introduction: Photodynamic Therapy (PDT) presents a non invasive avenue for treating various infections, including periodontal disease, offering an alternative to mechanical methods like scaling and root planing. Concerns about antibiotic resistance have fueled the exploration of PDT as an antimicrobial therapy. PDT combines low-power lasers with photosensitising drugs to eliminate microorganisms through the generation of cytotoxic reactive oxygen species upon light activation. Aim: To evaluate the scope of PDT and its role in periodontology. Materials and Methods: A comprehensive electronic search was conducted in major medical databases, including Google Scholar, PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Wiley. A total of 43 studies from 2007 to 2023 were selected, focusing on PDT for the treatment of periodontal disease. The review included Randomised Controlled Trials (RCTs), case-control studies, and cohort studies involving human subjects, using Photosensitisers (PSs) or Indocyanine Green (ICG) for subgingival irrigation in chronic periodontitis patients after scaling and root planing, with follow-ups extending over one month. The outcomes measured were Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Plaque Index (PI), and Gingival Index (GI). Results: In present review, after thorough analysis, a total of 21 studies were selected from databases including Google Scholar, PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Wiley. The risk of bias assessment showed high-risk in 1 out of 128 studies (0.59%), low risk in 139 out of 168 studies (82.74%), and unclear risk in 28 out of 168 studies (16.67%). The results indicated significant clinical improvements when PDT was combined with conventional treatments. Conclusion: The PDT in periodontology showcases varied roles, from antimicrobial action to tissue healing and the promotion of periodontal health. Its efficacy as an adjunctive treatment, especially in challenging cases or against resistant microbes, is evident, accentuated by its non invasive nature and minimal adverse effects, making it an appealing option in periodontal care. [ABSTRACT FROM AUTHOR]

The article presents a study which explored the relationship between cognitive function and oral health in home-dwelling Norwegian older adult population. Topics discussed include examinations conducted among participants of the study, assessment of the relationships between cognitive function and the number of decayed teeth, and estimate made on the relationship between cognitive function and the prevalence of severe periodontitis.

In recent years, the use of electronic cigarettes (e-cigs) has increased. However, their long-term effects on oral health and saliva remain poorly understood. Therefore, this study aimed to evaluate the saliva of e-cig users and investigate possible biomarkers. Participants were divided into two groups: the Electronic Cigarette Group (EG)—25 regular and exclusive e-cig users—and Control Group (CG)—25 non-smokers and non-e-cig users, matched in sex and age to the EG. The clinical analysis included the following parameters: age, sex, heart rate, oximetry, capillary blood glucose, carbon monoxide (CO) concentration in exhaled air, and alcohol use disorder identification test (AUDIT). Qualitative and quantitative analyses of saliva included sialometry, viscosity, pH, and cotinine concentrations. Furthermore, the EG and CG salivary metabolomes were compared using gas chromatography coupled with mass spectrometry (GC-MS). Data were analyzed using the Mann–Whitney test. The MetaboAnalyst 6.0 software was used for statistical analysis and biomarker evaluation. The EG showed high means for exhaled CO concentration and AUDIT but lower means for oximetry and salivary viscosity. Furthermore, 10 metabolites (isoleucine, 2-hydroxyglutaric acid, 3-phenyl-lactic acid, linoleic acid, 3-hydroxybutyric acid, 1,6-anhydroglucose, glucuronic acid, valine, stearic acid, and elaidic acid) were abundant in EG but absent in CG. It was concluded that e-cig users had high rates of alcohol consumption and experienced significant impacts on their general health, including increased cotinine and CO concentration in exhaled air, decreased oximetry, and low salivary viscosity. Furthermore, they showed a notable increase in salivary metabolites, especially those related to inflammation, xenobiotic metabolism, and biomass-burning pathways. [ABSTRACT FROM AUTHOR]

Background: This study investigates the clinical characteristics and differences between primary Sjögren's Syndrome (pSS) and secondary Sjögren's Syndrome (sSS) in a cohort of 50 patients. Methods: Conducted across two academic facilities in North-East Romania, the study emphasizes the importance of glandular and extraglandular manifestations, focusing on salivary flow rates, pH levels, and buffer capacity. Patients were diagnosed using the 2016 ACR-EULAR classification criteria, with a detailed examination including salivary tests, biopsies, and antibody presence. Results: The findings highlight significant differences between pSS and sSS, particularly in salivary function, with pSS patients exhibiting more severe glandular dysfunction. The study also notes a higher prevalence of inflammatory joint involvement in sSS patients, often associated with rheumatoid arthritis. Statistical analysis revealed correlations between salivary parameters and disease progression, underscoring the necessity of tailored treatment strategies. The research suggests that lower salivary flow rates and altered pH levels in pSS patients contribute to compromised oral health, including increased dental cavities and periodontal disease. Conclusions: The study's results contribute to a deeper understanding of Sjögren's Syndrome and reinforce the need for multidisciplinary management to address both systemic and oral health complications in these patients. [ABSTRACT FROM AUTHOR]

Background and Objectives Dental care utilization is an important, yet understudied aspect of healthcare in informal caregivers of persons with dementia. This study examined how caregiving-related characteristics are associated with dental care utilization among U.S. informal caregivers of persons with dementia and further examined gender differences. Research Design and Methods Pooled data came from the Behavioral Risk Factor Surveillance System in 2016, 2018, 2020, and 2022. A nationally representative sample of informal caregivers (n = 3,909) was included. Dental care utilization was "yes" versus "no" within the past year. Caregiving-related characteristics included caregiver role, intensity of care, duration of care, and type of care. Logistic regressions and subgroup analyses were conducted. Results In total sample, compared to adult child caregivers, spousal caregivers were 28% less likely to visit a dentist (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.56, 0.94). Caregivers who provided care for more than 20 hr per week were 18% less likely to visit a dentist (OR = 0.82; 95% CI = 0.69, 0.98). In subgroup analyses, intensity of care was a barrier to dental care utilization for female caregivers (OR = 0.78; 95% CI = 0.62, 0.98), whereas caregiver role such as spousal caregiver (OR = 0.59; 95% CI = 0.39, 0.89) or other relative caregiver (OR = 0.70; 95% CI = 0.50, 0.99) was a barrier to dental care utilization for male caregivers. Discussion and Implications The findings highlight the importance of caregiving-related characteristics in dental care utilization and suggest gender-tailored interventions. [ABSTRACT FROM AUTHOR]

The concept of oral frailty was first proposed in Japan in 2014 by the "Joint Working Committee on Oral Frailty," consisting of three academic societies—the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty—to enhance public understanding of oral frailty. Oral frailty is a state between robust oral function (a "healthy mouth") and its decline, characterized by slight declines in oral function, including tooth loss and difficulties in eating and communicating, which increase the risk of impaired oral functional capacity but can be reversed with proper intervention and treatment. Oral frailty can be assessed using the Oral Frailty 5‐item Checklist (OF‐5) without the need for a dental health professional. Oral frailty is defined as having at least two of the following components: (i) fewer teeth, (ii) difficulty chewing, (iii) difficulty swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Approximately 40% of community‐dwelling older adults have oral frailty. Oral frailty is associated with poor dietary variety, social isolation, physical frailty, disability, and mortality. This statement introduces the concept and definition of oral frailty, a new assessment tool (OF‐5), and concept diagrams for healthcare professionals and the general public. These tools aim to promote public awareness and facilitate collaboration between medical and dental healthcare providers. Geriatr Gerontol Int 2024; 24: 1111–1119. [ABSTRACT FROM AUTHOR]

Introduction: Elderly people experience a high level of oral diseases, and such conditions were found to be more prevalent among those living in residential aged care facilities (RACFs). Objectives: This study explored the barriers to providing oral health (OH) care for residents living in private residential aged care facilities (RACF) in Malaysia, from the perspective of the supervisors. Methodology: This was a qualitative study, that involved face-to-face interviews with supervisors in seven private RACFs in Selangor, Malaysia. Interviews were conducted using a semi-structured open-ended questionnaire, audio-recorded for analysis, transcribed verbatim, and subjected to thematic analysis. Results: All seven supervisors agreed on a lack of any structured protocol available to residents or workers to promote OH care for residents. They reported that RACF staff received no formal training in providing OH care for residents, and noted various barriers to the provision of routine OH care, categorised into three main themes: (1) residents' factors (e.g. physical limitations, limited family involvement, uncooperative behaviour), (2) caregivers' factors (e.g. lack of knowledge on the part of caregivers, incompetent caregivers and insufficient comprehensive management in RACFs) and (3) environmental factors (e.g. less involvement from government, difficulty in accessing dental clinics, refusal of dentists to manage patients with complex medical conditions, and poor public awareness). Conclusions: The study concluded with the need for the establishment of an OH training program for RACF staff and a protocol for daily and professional OH care for the residents of private RACFs in Malaysia. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion Palateless overdentures (PLODs) provide advantages of improved taste perception and retention over conventional dentures. We aimed to evaluate 5‐year outcomes of four implant maxillary PLODs.In this prospective observational study, edentulous participants were enrolled. A new conventional maxillary denture was prepared followed by implant placement and insertion of four implant retained maxillary PLOD. Oral health quality of life was assessed using the 49‐item Oral Health Impact Profile (OHIP‐49) at multiple intervals over 5 years along with biological and mechanical outcomes.Nine patients were evaluated at year 5. The mean age was 68 years, and six of the nine patients were males. The cumulative survival rate of implants was 100% while the implant success rate was 86%. Nylon retentive replacement was the most common encountered complication noted approximately four times per patient over 5 years. From a mean OHIP‐49 severity score of 71.2 at baseline, severity scores decreased to 23.9 (p < 0.001) at year 1, denoting a clinically meaningful and statistically significant improvement in oral health quality of life. The lowered OHIP‐49 severity scores remained stable throughout 5 years of follow‐up.Four implant supported maxillary overdenture appears to have good patient perceived, biological and mechanical outcomes over 5 years. Fully powered studies are needed to replicate these findings. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Objectives Methods Results Conclusions Weight loss is a critical health issue among the older population. This study aimed to explore the association between weight loss and oral health in older adults.We used cross‐sectional data from the Uonuma Chronic Kidney Disease Cohort Study. The binary logistic regression models were fitted to estimate the relationship between weight loss and independent variables including the number of teeth present.The participants included 1656 females and 1625 males. There were 1217 females (73.4%) and 1236 males (76.0%) with normal BMI (18.5 ≤ BMI < 25) in the previous year. Weight loss was determined over a 12‐month period. Individuals with normal BMI in previous year, and those with weight loss (≥ 5%) or those whom maintained a stable weight were further analysed. The regression analysis (model 3, fully adjusted) showed that females with 0 and 1–10 teeth present had a higher likelihood of losing weight (OR = 4.07; 95% CI = 1.85–8.93, OR = 2.33; 95% CI = 1.24–4.39) compared with those with 20 or more teeth. Current smokers had a higher likelihood of losing weight (OR = 3.15; 95% CI = 1.01–9.76) than lifelong abstainers. Among males, both current and previous smokers showed a higher likelihood of losing weight (OR = 4.94; 95%CI = 1.76–13.8, OR = 3.35; 95% CI = 1.29–8.68) than those who never smoked.This study indicates that the number of teeth and smoking are both linked to weight loss in females. However, in males, the association between the number of teeth and weight loss may be compromised due to the high prevalence of smoking in this group. [ABSTRACT FROM AUTHOR]

This study investigated the association between prior incarceration length and edentulism among US adults 55 years and older. Analyses explored indirect factors such as wealth, smoking status, mental health, and chronic health conditions that may explain this relationship. In addition, the study analyzed how associations between incarceration and edentulism vary by race and ethnicity. The authors used data from the 2012-2014 Health and Retirement Study (unweighted N = 11,630; weighted N = 72,872,877) to assess the relationship between incarceration duration and edentulism through multivariable logistic regression. The Karlson-Holm-Breen method evaluated indirect effects, and multiplicative interaction terms examined variations by race and ethnicity. Net of control variables analyses showed a positive association between having been incarcerated for more than 1 month and higher odds of edentulism. However, this association was rendered statistically nonsignificant after accounting for wealth, current smoking status, mental health, and chronic disease. Collectively, wealth and smoking explained approximately 60% of the association between prior incarceration length and edentulism. Racial moderation models indicated that longer incarceration times increased edentulism likelihood in non-Hispanic Whites specifically. To the authors' knowledge, this is the first study on the association between prior incarceration length and edentulism among older adults. Study findings indicated the relationship between incarceration and edentulism was explained by higher wealth and current smoking status. These findings highlight the need for adequate access to oral health care services for formerly incarcerated older adults to improve oral health and enhance their overall health and quality of life [ABSTRACT FROM AUTHOR]

People with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSDs) are at greater risk of developing temporomandibular disorders (TMDs), perhaps due to the general joint hypermobility. There is, however, no information on how oral health–related quality of life (OHRQoL) is affected in people with hEDS or HSD with TMD. The authors' aim was to assess OHRQoL via the 14-item, short version Oral Health Impact Profile (OHIP-14), as well as associated risk factors in women with TMD symptoms and confirmed hEDS or HSD. A digital questionnaire was sent to members of The Swedish National EDS Association who reported having a confirmed or suspected EDS or HSD diagnosis in the health care system from January through March 2022. Then, a sample of 133 women with confirmed hEDS or HSD and TMD symptoms was constructed, and information on the following variables was collected: TMD symptoms, age, general health, oral health–related factors, comorbid symptoms, and psychological factors. Linear regression analysis was conducted to investigate the association between these variables and the OHIP-14 summary score as the outcome. Most participants reported TMD pain symptoms (93.9%), temporomandibular joint clicking (89.5%), and crepitation (55.6%). The mean (SD) total OHIP-14 summary score was 21.0 (13.2). Oral function had the lowest impact (2.0 [2.4]) and orofacial pain had the highest impact on OHRQoL (3.9 [2.5]). Self-reported bruxism, poor general health, and comorbid symptoms were significantly associated with impaired OHRQoL. Women with confirmed hEDS or HSD and TMD symptoms have a considerably impaired OHRQoL. The multidimensional phenomenon of OHRQoL in this group needs to be considered in management strategies. [ABSTRACT FROM AUTHOR]

Mineral metabolism is critical for proper development of hard tissues of the skeleton and dentition. The dentoalveolar complex includes the following 4 mineralized tissues: enamel, dentin, cementum, and alveolar bone. Developmental processes of these tissues are affected by inherited disorders that disrupt phosphate and pyrophosphate homeostasis, although manifestations are distinct from those in the skeleton. The authors discuss original data from experiments and comparative analyses and review articles describing effects of inherited phosphate and pyrophosphate disorders on dental tissues. A particular emphasis is placed on how new therapeutic approaches for these conditions may affect oral health and dental treatments of affected patients. Disorders of phosphate and pyrophosphate metabolism can lead to reduced mineralization (hypomineralization) or inappropriate (ectopic) calcification of soft tissues. Disruptions in phosphate levels in X-linked hypophosphatemia and hyperphosphatemic familial tumoral calcinosis and disruptions in pyrophosphate levels in hypophosphatasia and generalized arterial calcification of infancy contribute to dental mineralization defects. Traditionally, there have been few options to ameliorate dental health problems arising from these conditions. New antibody and enzyme replacement therapies bring possibilities to improve oral health in affected patients. Research over the past 2 decades has exponentially expanded the understanding of mineral metabolism, and has led to novel treatments for mineralization disorders. Newly implemented and emerging therapeutic strategies affect the dentoalveolar complex and interact with aspects of oral health care that must be considered for dental treatment, clinical trial design, and coordination of multidisciplinary care teams. [ABSTRACT FROM AUTHOR]

Context The impact of unhealthy foods and beverages, namely those high in sugar, salt, and saturated or trans fats, has been studied extensively in relation to weight, body composition, and noncommunicable diseases, but less so in relation to the risk of dental caries. Few previous reviews have examined the evidence from all countries globally. Objective A systematic review was conducted to assess the impact of unhealthy food and beverage consumption on the risk of dental caries in children aged ≤10 years, commissioned by the World Health Organization to inform updated complementary feeding recommendations. Data Sources Systematic searches were conducted in the PubMed, Cochrane, and Embase databases for articles meeting the inclusion criteria dating from January 1971 to March 2022; supplementary searches were undertaken for articles from that period to June 2022. Data Extraction Unhealthy foods and beverages were identified using nutrient- and food-based approaches. Risk of bias was assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). Data Analysis A total of 30 023 unique citations were screened, yielding 37 studies for inclusion. Studies were conducted in high-income (n = 23 [62.2%]) or middle-income countries (n = 14 [37.8%]). Evidence synthesis was performed narratively, stratified by age (0 years to <2 years, 2 years to <5 years, and 5 years to ≤10 years) and exposure (unhealthy foods and unhealthy beverages). The heterogeneity of the exposures and comparators across studies was high. Almost all studies (n = 34) reported positive associations between the consumption of sugar-sweetened beverages or foods high in free sugars and dental caries. However, 67.6% of studies were assessed as having serious risk of bias. Conclusion The evidence indicates that the consumption of unhealthy food and beverages in children ≤10 years appears to increase the risk of dental caries. Further longitudinal studies with high-quality dietary assessments, including studies in low-income countries and children aged >5 years at baseline, are recommended in order to build a more robust evidence base for use in the development of policy recommendations. Systematic Review Registration PROSPERO registration no. CRD42020218109. [ABSTRACT FROM AUTHOR]

Poor oral health has been associated with various systemic diseases (e.g., endocarditis, pneumonia, cardiovascular disease, and diabetes) and decreased quality of life. When enacted in 1965, Medicare excluded coverage for comprehensive dental services. As of 2023, Medicare has allowed coverage of limited dental services inextricably linked to specific medical conditions. Many Medicare Advantage plans (Medicare Part C) offer dental coverage. Yet in 2019, approximately 24 million Medicare beneficiaries (47% of all Medicare enrollees), lacked dental coverage. Seventy-one percent of traditional Medicare enrollees (those not enrolled in a Medicare Advantage Plan) reported that high cost was the primary reason that they did not obtain dental care. The importance of oral health for the older adults has been the main reason that a national interprofessional consortium, which includes several national nursing organizations, has been advocating for legislation to expand Medicare to include dental coverage. The consortium's efforts have been thwarted by fierce opposition from the American Dental Association and many Republican legislators. Given the vital role that nurses and advanced practice nurses play in caring for the nation's older adults and disabled, nursing's voice needs to be strengthened as leaders in advocating for inclusion of dental benefits in traditional Medicare. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort. Materials and Methods: Oral health problems were self‐reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ‐4) in a cross‐sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety. Results: A total of 305,188 participants were included in the cross‐sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73–1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10–1.19), depression (HR: 1.19, 95% CI: 1.13–1.25) and anxiety (HR: 1.13, 95% CI: 1.07–1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16–1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C‐reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow‐up (N = 10,673) were not significant. Conclusions: Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to detect trends and related factors in the functional dentition (FD) in 65- to 74-year-olds in Guangdong, China, while also assessing trends in education and income inequality factors. Materials and methods: Three large-scale cross-sectional National Oral Health Surveys (NOHS), specifically NOHS II in 1995, NOHS III in 2005, and NOHS IV in 2015, were included. Post hoc stratification was weighted for 1038 participants aged 65 to 74years. Retaining teeth ≥ 20 teeth and retaining < 20 teeth was defined as functional dentition (FD) and nonfunctional dentition (NFD), respectively. Logistic regression models were established to assess related factors. Slope index of inequality (SII) and relative index of inequality (RII) were used to analyze inequality. Results: From NOHS II to IV, the FD proportion increased from 42.8 to 71.9%. Years of NOH, with caries, with periodontal pocket, high educational level, high income level, female, and those who had dental visits were associated with FD preservation. The education-related SII decreased from 0.44 to 0.20, and the income-related SII increased from 0.13 to 0.16. Conclusions: The FD proportion among 65- to 74-year-olds improved from 1995 to 2015. Years of NOHS, with caries, with periodontal pocket, high education level, and high income level were associated with higher FD proportion. Female and those who had dental visits were associated lower FD proportion. Social inequalities in FD persisted, especially economic-related inequalities. Public health policy support and respective interventions should be applied to increase FD retention. [ABSTRACT FROM AUTHOR]