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Background: The purpose of the present study was to evaluate the use of a free online continuing education (CE) course that sought to address barriers of capability by training dental team members in the specific recommendations of the American Dental Association (ADA)-endorsed adult guideline for the pharmacologic management of acute dental pain, shared decision-making, and the adoption of the guideline into practice. Methods: In 2022 and 2023, dentists completed an online, asynchronous CE course on the guideline-concordant pharmacologic management of acute dental pain. They completed 11-item knowledge tests before and after completing the course. Total scores on the pre- and post-tests were compared using a t-test. Results: The mean score increased from 7.68 (SD = 1.08) on the pretest to 8.79 (SD = 1.35) on the post-test (t(4468) = -27.34, p <.01), indicating that dentists gained knowledge from the CE course. Conclusions: We found that the CE course increased knowledge with respect to the guideline recommendations and shared decision-making but not epidemiology or incorporating a guideline into practice. Future studies should evaluate whether the CE course increased guideline-concordant prescribing. [ABSTRACT FROM AUTHOR]

Background/Objectives: Odontogenic sinusitis (ODS) is the most common cause of unilateral maxillary sinus opacification. Initial treatment consists of intranasal steroids and antimicrobial therapy. In case of persistence of the disease, endoscopic sinus surgery (ESS) is advised. It is still not clear what extension of ESS is required and whether frontal sinusotomy or ethmoidectomy is justified in ODS with frontal sinus involvement. Methods: Adult patients presented with uncomplicated recalcitrant bacterial ODS due to endodontic-related dental pathology were evaluated by an otolaryngologist and a dentist and scheduled for ESS. Sinus CT scan demonstrated opacification of maxillary sinus and partial or complete opacification of extramaxillary sinuses ipsilateral to the side of ODS. Patients were undergoing either maxillary antrostomy, antroethmoidectomy, or antroethmofrontostomy. Preoperative and postoperative evaluations were done with nasal endoscopy, dental examination, subjective and radiological symptoms. Results: The study group consisted of 30 patients. Statistically significant decreases in values after surgery were found for SNOT-22, OHIP-14, Lund–Mackay, Lund–Kennedy, and Zinreich scale. Tooth pain was present in 40% cases during the first visit and in 10% during the follow-up visit. Foul smell was initially reported by 73.3% and by one patient during follow-up visit (3.3%). Significantly longer total recovery time and more crusting was marked for antroethmofrontostomy when compared to maxillary antrostomy. Conclusions: ESS resolved ODS with ethmoid and frontal involvement in almost every case. Minimal surgery led to improved overall clinical success in the same way as antroethmofrontostomy without risking the frontal recess scarring and stenosis. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Frequent consumption of fermented carbohydrates and bottle feeding contribute to the development of early childhood caries (ECC). There are no substantial findings on the effects of breastfeeding patterns on oral health conditions in children in the United States. We aimed to assess the nexus between exclusive breastfeeding during the first 6 months and oral health disorders, namely toothache, decayed teeth, or unfilled cavities in early childhood. Materials and Methods: Design: Cross-sectional epidemiologic design of nationally representative data collected via telephone surveys in the United States was utilized. Setting: National Survey of Children's Health, 2012 Participants: Population-based random sample of parents/guardians of 24,655 children aged 6 months to 5 years. Main Outcome and Measure: The primary outcome was the presence of oral health disorders (OHD) in children, defined as the parent-reported occurrence of one or more of the following conditions in the past 12 months: toothache, decayed teeth, or an unfilled cavity. This was assessed through a single composite question in the survey, asking parents/guardians if their child had experienced any of these specific oral health issues within the previous year with a binary (yes/no) response option. Results: Among 24,655 children aged 6 months to 5 years, 2392 (9.7%) had experienced an oral health disorder (OHD) in the previous 12 months. In unadjusted analysis, children exclusively breastfed for 6 months were 28% less likely to present with OHD compared to never-breastfed children (OR = 0.72, 95% CI, 0.52–0.98). However, after adjusting for key factors, including maternal health and race/ethnicity, this association was no longer statistically significant (aOR = 1.11, 95% CI 0.79–1.57). Significant predictors of OHD included maternal health (aOR for fair/poor vs. excellent/very good maternal health = 1.79, 95% CI 1.08–2.69) and race/ethnicity, with a higher prevalence among non-Hispanic Black (12.9%) and multi-racial children (12.6%) compared to non-Hispanic White children (7.7%). Conclusions and Relevance: While exclusive breastfeeding for the first six months of life was not found to be a significant predictor of pediatric oral health outcomes after adjustment, maternal health and race/ethnicity were significant determinants of oral health disorders. These findings underscore the importance of comprehensive healthcare approaches that consider maternal well-being and socio-demographic factors. Future research should explore interventions targeting these factors to improve pediatric oral health outcomes. [ABSTRACT FROM AUTHOR]

Background: Oral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers' experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes. Methods: Healthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data. Results: Themes generated in the analysis were: A structured process promotes communication and awareness and stresses the importance of oral health; Oral care for frail older adults is challenging and triggers ethical dilemmas; Unclear responsibilities, roles and routines in the organization put oral health at risk; Differences in experience and competence among healthcare staff call for educational efforts. Conclusions: The structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents' reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement. [ABSTRACT FROM AUTHOR]

Introduction: Many patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems. Methods: The sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant's permission, no note-taking was done during the interviews, which allowed for greater focus on the participants' conversation. The obtained data was analyzed using the content analysis. Results: A total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient's perceptions of general practitioner(GP) and dental practitioner's scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs. Conclusion: Most participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient's consult behaviors regarding dental problems. [ABSTRACT FROM AUTHOR]

Introduction: Headache is an illness with high prevalence and adverse effects on quality of life. As oral or dental problems such as pain can trigger or aggravate it, we aimed to investigate and compare oral and dental health status in patients affected with chronic headaches and healthy individuals. Methods: The present case-control study included 60 patients with chronic headaches (case) and 60 healthy individuals (control) in Rasht, Iran. The demographic characteristics and clinical examinations, including decayed/missing/filled teeth (DMF-T) and community periodontal index of treatment needs (CPITN) indices, as well as bruxism, frequency of tooth brushing and flossing, and maxillary and mandibular tooth wear were recorded in a checklist. Data analysis was performed using the IBM SPSS version 28 at a significance level of 0.05. Results: The case group consisted of 25 men (41.7%) and 35 women (58.3%) with an average age of 32.55 ± 6.62 years, while the control group had 27 men (45%) and 33 women (55%) with an average age of 30.95 ± 6.33 years. The study groups were not significantly different in bruxism, frequency of tooth brushing and flossing, DMFT, CPTIN, and maxillary and mandibular tooth wear. Conclusion: It seems that chronic headaches do not significantly affect the oral and dental health of the sufferers. Moreover, it appears that these patients are well aware of the role of oral and dental hygiene in triggering or aggravating the episodes of headaches. [ABSTRACT FROM AUTHOR]

Background: Migraine is one of the most common primary headaches worldwide, while toothache is the most common pain in the orofacial region. The association of migraine pain, and oral pain is unknown. This study aims to investigate the association between migraine and dental and gingival pain with the presence of allodynia. Methods: A questionnaire comprising demographic data with the ID-Migraine (IDM) tool, an Allodynia Symptom Checklist (ASC), and inquiries about pain and sensitivity in the teeth and gums during migraine attacks was administered to the participants and 762 responded the survey. The study classified participants based on the ASC, and the relationship between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks was analyzed. The statistical analyses utilized Chi-square tests and the Fisher-Exact test. Results: Among 762 migraine patients, 430 (56.44%) were classified as allodynia (+), while 332 (43.56%) were classified as allodynia (−) (p < 0.001). Additionally, 285 participants (37.5%) reported experiencing pain and sensitivity in the teeth and gums during migraine attacks, with a significant relationship observed between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks (p < 0.001). Conclusion: The findings of this study have important clinical implications. For migraine patients who are non-allodynic, the presence of pain and sensitivity in their teeth and gums during migraine attacks may indicate underlying dental diseases or the need for dental treatment especially root canal treatment. However, for allodynic patients, such symptoms may not necessarily indicate the presence of dental diseases or the need for dental treatment especially root canal treatment. These results underscore the significance of considering the presence of allodynia in the assessment and management of oral symptoms during migraine attacks. [ABSTRACT FROM AUTHOR]

Background • Acute pulpitis poses a significant clinical challenge. Traditional root canal treatment has been a standard approach, and the incorporation of adjunctive therapies, such as eugenol cement, presents a potential avenue for enhanced efficacy and reduced complications. Objective • This study aimed to assess the clinical efficacy of root canal treatment combined with eugenol cement for acute pulpitis and its impact on inflammatory factor levels. Design • The study employed a parallel, randomized, controlled, experimental design. Setting • The research was conducted at Suzhou Ninth People’s Hospital. Participants • A total of 92 patients diagnosed with acute pulpitis and seeking treatment at our hospital between August 2020 and November 2021 were included in the study. Interventions • Participants were randomly assigned to two groups with 46 patients in each group: the control group receiving traditional root canal treatment and the experimental group receiving root canal treatment combined with eugenol cement. Primary Outcome Measures • The primary outcomes assessed included (1) treatment efficiency, (2) masticatory function, (3) complications, and levels of inflammatory factors. Results • In the study, root canal treatment combined with eugenol cement showed superior efficacy (95.7% vs. 76.1%, P < .05) compared to root canal treatment alone. After one month, both groups exhibited reduced bleeding and gingival indices, with a more significant reduction in the experimental group (P < .05). The combined treatment significantly improved masticatory efficiency and occlusal strength (P < .05). The experimental group had a lower complication rate (6.5% vs. 26.1%, P < .05) and reduced inflammatory markers (IL-6, IL-8, TNF-α, LTB4) compared to the control group (P < .05). Conclusions • Root canal treatment plus eugenol cement enhances masticatory function, reduces complications and inflammatory response in patients with acute pulpitis, alleviates dental pain and looseness, and mitigates inflammatory responses with fewer adverse effects. [ABSTRACT FROM AUTHOR]

Introduction: Dental local anaesthesia serves several purposes, the most common of which is to minimise pain during dental procedures, thereby improving patient comfort and facilitating treatment. It can also have therapeutic effects, such as temporarily relieving pulpitis pain. Patients often experience anxiety before and after receiving local anaesthesia. Aim: To evaluate the perceptions and attitudes of patients receiving local anaesthesia through a self-administered questionnaire. Materials and Methods: This cross-sectional study was conducted among 398 patients, including 218 males and 180 females, between August 2022 and October 2022, who underwent dental extractions at a dental hospital in Chengalpattu district, Tamil Nadu, India. A 15-item questionnaire was administered to the patients. The questionnaire comprised three domains: the first domain included questions before the administration of local anaesthesia, the second domain included questions during the administration of local anaesthesia, and the third domain included questions after the administration of local anaesthesia. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software. Results: Of the participants, 126 (40.20%) were between 46 and 60 years of age. Males constituted 218 (54.8%) and females constituted 180 (45.2%) of the sample. Additionally, 76.38% of the patients were unaware of the preinjection topical anaesthesia. Moreover, 70.35% of patients experienced anxiety before the administration of local anaesthesia. During the administration of local anaesthesia, 300 (75.4%) of patients reported experiencing moderate pain. Many patients exhibited physical manifestations of fear, including sweating in 92 (23.12%), light-headedness in 102 (25.63%), and palpitations after the administration of local anaesthesia in 190 (47.74%). Conclusion: Anxiety was more prevalent among patients prior to the administration of local anaesthesia. Patients were more anxious about the fear of the injection rather than the fear of the extraction itself. The outcomes of anaesthesia may be significantly improved by educating patients about dental treatment processes. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Women with vulvovaginal or genital pain more commonly experience interstitial cystitis/bladder pain syndrome (IC/BPS) and urinary tract infections. However, the relationship between genital pain and bladder health is lacking. Methods: Women in the Prevention of Lower Urinary Tract Symptoms Consortium's RISE FOR HEALTH population-based study answered questions about bladder health globally, and across nine bladder health domains of holding, efficacy, social–occupation, physical activity, intimacy, travel, emotion, perception, and freedom. Bladder function was assessed across six indices including urinary frequency, sensation, continence, comfort, emptying, and dysbiosis (e.g., urinary tract infections). Participants were grouped by no pain beyond transitory events (i.e., minor headaches, toothaches, or sprains), nongenital-related pain only, and any genital pain using a validated pain diagram. Mean adjusted scores and indices were compared using general linear modelling. Results: Of 1,973 eligible women, 250 (12.7%) reported genital pain, 609 (30.9%) reported nongenital pain only, and 1,114 (56.5%) reported no pain. Women with any genital pain had lower (worse) adjusted mean scores across all bladder health scales (BHS; BHS global adjusted mean 47.5; 95% CI 40.8–54.1), compared with those with nongenital pain only (53.7; 95% CI 47.6–59.8), and no pain (59.3; 95% CI 53.3–65.4). Similarly, adjusted mean total Bladder Functional Index scores were lower for those with genital pain (63.1; 95% CI 58.4–67.9) compared with nongenital pain (72.1; 95% CI 67.7–76.5) and no pain (77.4; 95% CI 73.0–81.8). Conclusions: Heightened awareness of the relationship between genital pain and bladder health should prompt clinicians caring for women with genital pain to assess bladder health and function. [ABSTRACT FROM AUTHOR]

The dental pulp is a highly innervated tissue transmitting pain‐related sensations in the tooth. Consequently, understanding the intricacies of its innervation mechanism in odontogenesis is crucial for gaining insights into dental pain and developing dental pain‐modulating agents. This study examined neuroregulatory molecules such as neurotrophic factors (nerve growth factor [NGF], brain‐derived neurotrophic factor [BDNF], neurotrophin‐4 [NTF‐4], and neurturin [NRTN]) and neuroinhibitory factors (slit2, ephrin isoforms and netrin‐1) in developing rat teeth with follicles. NGF, BDNF and NRTN transcriptions showed time‐dependent upregulation, particularly during the root formation stage. In contrast, NTF‐4 mRNA was highly expressed at the cap stage, but became downregulated over time. Slit2 and ephrin‐B2 expression was distinct at the cap stage and then downregulated in a time‐dependent manner. Ephrin‐A5 and netrin‐1 expression did not significantly change. Immunofluorescence analysis revealed a robust expression of both ephrin‐B2 and slit2 in the outer and inner dental epithelia of the enamel organ, a non‐neurogenic tissue, during the cap stage of 3rd molar germs. In contrast, BDNF was predominantly localized in dental papilla cells and odontoblasts during the root formation stage. These results suggest that neuroregulatory molecules, such as BDNF, slit2 and ephrin‐B2, may be important in identifying therapeutic targets for modulating dental pulp pain. [ABSTRACT FROM AUTHOR]

This article delves into the intricate relationship between oral health, quality of life, and behavioral characteristics in individuals with autism spectrum disorder (ASD). Background/Objectives: Autism has been associated with various challenges, and this study seeks to elucidate the impact of ASD on oral health outcomes and overall well-being. The research focuses on assessing overall oral health by evaluating various parameters, such as the condition of lips, tongue, gums and tissues, natural teeth, dentures, oral hygiene, and dental pain in individuals with ASD. Additionally, the study explores the influence of age, sex, and certain variables, like basic daily living skills on oral health practices, aiming to identify potential correlations between these factors and oral health outcomes. Methods: We employed standardized instruments to quantitatively measure and analyze the impact of oral health status on the overall quality of life experienced by individuals with ASD. Results: The study found a statistically significant positive association between oral health, measured by the Oral Health Assessment Tool (OHAT), and quality of life, as indicated by EuroQol 5-Dimensions Youth version (EQ-5D-Y) total scores (β = 0.13045, p = 0.00271). This suggests that better oral health is linked to higher quality of life. When adjusting for age and sex in a multiple linear regression model, the association remained significant but with a slightly reduced effect size (β = 0.10536, p = 0.0167). Age also showed a marginally significant positive association with quality-of-life scores. ANOVA results indicated that participants with advanced oral health status reported significantly higher quality-of-life scores than those with poorer oral health (p = 0.00246). The study also found that intelligence quotient (IQ) does not substantially influence dental health status, while the "Autonomy" subscale of the EQ-5D-Y is positively related to the OHAT. Conclusions: Unhealthy oral conditions significantly impact the overall quality of life in individuals with ASD. Therefore, it is crucial to include regular dental assessments and treatments in therapeutic protocols for patients with ASD. [ABSTRACT FROM AUTHOR]

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Revitalization has emerged as an innovative treatment approach for immature permanent teeth with necrotic pulp. This article presents a comprehensive analysis of revitalization, focusing on its principles, clinical protocols and outcomes. The article highlights the importance of thorough diagnosis and assessment of the pulp and peri-apical condition to determine the suitability of revitalization. Various factors influencing the success of revitalization, such as the use of scaffolds, growth factors and stem cells, are discussed. Additionally, a case that was treated with a PRP scaffold is also presented. Overall, revitalization shows promise in promoting pulp regeneration and improving treatment outcomes in selected cases of pulp necrosis. CPD/Clinical Relevance: To introduce research-based knowledge to GDPs about the procedure and prognosis of tooth revitalization. [ABSTRACT FROM AUTHOR]

The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a fixed mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients. [ABSTRACT FROM AUTHOR]

Background and aim: Self‐medication is a common practice worldwide, and its prevalence ranges between 20% and 80% among patients suffering from dental pain. The socioeconomic status of an individual plays a key role in self‐medication practice, especially sex and education level. This study aims to investigate the extent of self‐medication practice for toothache due to dental caries among adults in Dar es Salaam, Tanzania. Methods: This was an analytical cross‐sectional study carried out over 6 months. It included adult patients presenting with toothache in public dental clinics. A questionnaire captured information on demography, self‐medication practice, the substance used for self‐medication, duration of self‐medication, and reason for self‐medication. Univariate analysis was carried out to assess factors associated with self‐care remedies. The probability level of α < 0.05 was selected for statistical significance. Results: A total of 420 participants took part in this survey with a majority (54.3%) being females. The ages of the participants ranged between 18 years and 79 years, with a mean age of 33.37 (SD = 12.64) years. Nearly all (98.5%) participants used some sort of self‐prescribed remedies for managing toothache before attending a dental clinic for appropriate treatment. The sociodemographic status of the participants did not influence the practice of self‐medication. Conclusion: About 98% of patients suffering from toothache in Tanzania practice self‐medication, and it cuts across all social strata of the adult dental population Patient or Public Contribution: Patients with toothache secondary to dental caries participated in the pilot study and were consulted on the suitability of the study tool. [ABSTRACT FROM AUTHOR]

Background: Dental caries is the most common chronic childhood disease. The recommended age for the first dental visit (FDV) is 1 year, yet a minority of children visit before the age of 3 years. Aim: The aim of the study was to estimate the patterns of and predictors for dental visits among a sample of children. Design: Parents of children between the ages of 6 months and 18 years, who attended the paediatric dentistry clinics and the well‐baby clinics, were recruited. A validated questionnaire was used to collect data. Logistic regression was utilized to assess the predictors of ever visiting a dentist. Results: The mean age at FDV was 5.8 ± 2.1 years. Parents' belief of not needing to see a dentist was the most common barrier to visiting a dentist (33%). Among the reasons for FDV, caries and pain were the most common (45% and 20%, respectively). Predictors of ever visiting a dentist were children who are not an only child and children of parents who visited a dentist themselves. Conclusion: Children visited the dentist at an age older than that recommended, and the reasons for FDV were mainly caries and its consequences. [ABSTRACT FROM AUTHOR]

Dentistry has been one of the oldest branches of knowledge in the field of medicine. This medical discipline has undergone various changes throughout different historical periods. During the Safavid period (1135-907 AH), practitioners showed a keen interest in dentistry, and numerous medical texts were written in this field, serving as valuable sources of information about the medical conditions of that era. It appears that dentistry in the Safavid era did not experience significant transformation compared to previous periods and largely imitated the achievements of earlier practitioners. The primary topics of focus in Safavid dentistry included the treatment of toothaches, prevention of dental diseases, polishing and whitening of teeth, management of gum diseases, and pediatric dentistry. The most notable remedies prescribed by the medical community of the Safavid era for treating various dental ailments involved the use of Sanun, a concoction made from several herbal ingredients believed to alleviate or cure dental diseases. The main resource for this research was the medical texts from the Safavid era.

Abstract Introduction Headache is an illness with high prevalence and adverse effects on quality of life. As oral or dental problems such as pain can trigger or aggravate it, we aimed to investigate and compare oral and dental health status in patients affected with chronic headaches and healthy individuals. Methods The present case-control study included 60 patients with chronic headaches (case) and 60 healthy individuals (control) in Rasht, Iran. The demographic characteristics and clinical examinations, including decayed/missing/filled teeth (DMF-T) and community periodontal index of treatment needs (CPITN) indices, as well as bruxism, frequency of tooth brushing and flossing, and maxillary and mandibular tooth wear were recorded in a checklist. Data analysis was performed using the IBM SPSS version 28 at a significance level of 0.05. Results The case group consisted of 25 men (41.7%) and 35 women (58.3%) with an average age of 32.55 ± 6.62 years, while the control group had 27 men (45%) and 33 women (55%) with an average age of 30.95 ± 6.33 years. The study groups were not significantly different in bruxism, frequency of tooth brushing and flossing, DMFT, CPTIN, and maxillary and mandibular tooth wear. Conclusion It seems that chronic headaches do not significantly affect the oral and dental health of the sufferers. Moreover, it appears that these patients are well aware of the role of oral and dental hygiene in triggering or aggravating the episodes of headaches.

Yuping Zhu,1 Xunfu Lai,1 Mengting Wang,2 Xin Tang,1 Tianyi Wan,3 Bin Li,1 Xiaoming Liu,1 Jialin Wu,1 Lei He,1 Yulin He1 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China; 2Department of Radiology, Yichang Central People’s Hospital, Yichang, People’s Republic of China; 3Department of Radiology, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of ChinaCorrespondence: Yulin He, Department of Radiology, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel +86 0791 8869 3802, Email ndyfy02171@ncu.edu.cnObjective: To separate the resting-state network of patients with dental pain using independent component analysis (ICA) and analyze abnormal changes in functional connectivity within as well as between the networks.Patients and Methods: Twenty-three patients with dental pain and 30 healthy controls participated in this study. We extracted the resting-state functional network components of both using ICA. Functional connectivity differences within 14 resting-state brain networks were analyzed at the voxel level. Directional interactions between networks were analyzed using Granger causality analysis. Subsequently, functional connectivity values and causal coefficients were assessed for correlations with clinical parameters.Results: Compared to healthy controls, we found enhanced functional connectivity in the left superior temporal gyrus of anterior protrusion network and the right Rolandic operculum of auditory network in patients with dental pain (p< 0.01 and cluster-level p< 0.05, Gaussian random field corrected). In contrast, functional connectivity of the right precuneus in the precuneus network was reduced, and were significantly as well as negatively correlated to those of the Visual Analogue Scale (r=− 4.93, p=0.017), Hamilton Anxiety Scale (r=− 0.46, p=0.027), and Hamilton Depression Scale (r=− 0.563, p< 0.01), using the Spearman correlation analysis. Regarding the causal relationship between resting-state brain networks, we found increased connectivity from the language network to the precuneus in patients with dental pain (p< 0.05, false discovery rate corrected). However, the increase in causal coefficients from the verbal network to the precuneus network was independent of clinical parameters.Conclusion: Patients with toothache exhibited abnormal functional changes in cognitive-emotion-related brain networks, such as the salience, auditory, and precuneus networks, thereby offering a new imaging basis for understanding central neural mechanisms in dental pain patients.Keywords: toothache, independent component analysis, resting-state networks, Granger causality

AbstractBackgroundMethodsResultsDiscussionConclusionTwo experiments (E1 and E2; N = 44 and N = 52, respectively) investigated the effect of positive (PI) and neutral information (NI) about a dental procedure, and if the delivery of the information by the treatment team (open administration) or unbeknownst to the treatment team (hidden administration), affected pain.Using a mixed design, patients undergoing drilling in a molar were randomized to the NI or PI groups. Before, during, and after treatment, patients reported their pain and stress levels. In E1 the treatment team delivered the information. In E2, an assistant not engaged in the treatment delivered the information.In the PI group in E1, pain was reduced by 50 % compared to the NI group, and the effects of stress on pain were mitigated. These effects were abolished in E2. The dentist reported having displayed positive nonverbal behaviours (e.g. smiling and longer eye contact) in the PI group in E1, but not in E2.Positive information reduced pain only when administrated openly. There was no effect of positive information administrated hidden from the treatment team. As information was similar in both experiments, factors other than the information most likely reduced pain in the PI group in E1.Delivering positive information by the treatment team may generate behavioural cues which generate placebo effects. [ABSTRACT FROM AUTHOR]

Introduction: There is an underuse of pain management strategies in dental care for children, possibly owing to perceived stress and discomfort when treating children, which has also been reported by dental students. The aim of this study was to explore how undergraduate dental students experience and understand pain related to dental treatment in children. Materials and Methods: Interviews were held with 21 Swedish dental students, from 3 dental schools, all in their final 2 years of education. The interviews were transcribed verbatim and analysed according to Grounded Theory. Results: A core category, seeking guidance to avoid pain, was identified and related to 6 conceptual categories. The students used different strategies to manage pain prevention in child dentistry and to become skilled dentists. They described high levels of stress, as well as having high expectations on themselves when treating children. The stress led to a surface learning approach, something the students were not fully aware of. Conclusion: All children should have the right to be ensured optimal pain prevention in dental care. The basis for this is laid during undergraduate education. Thus, pain management in child dentistry is an area in need of special attention in this respect. The academic staff has an important role in supporting their students in their process to gain an identity as professional dentists. To ensure that students incorporate an understanding of the importance of pain prevention when treating children there is a need to create more integration between theory and clinical training in undergraduate education. [ABSTRACT FROM AUTHOR]

Background: Symptomatic irreversible pulpitis often results in heightened reactions to thermal stimuli such as pain evoked by a cold stimulus, and spontaneous odontogenic pain (unprovoked pain). Objective: This study primarily compared the clinical manifestations of odontogenic spontaneous pain and pain provoked by cold stimulus specifically focusing on their sensory discriminative characteristics (intensity, duration and quality) between symptomatic irreversible pulpitis patients with and without referred pain. Methods: Twenty‐three patients with symptomatic irreversible pulpitis with referred pain and 12 patients without referred pain were included in this cross‐sectional study. The following outcomes were assessed: odontogenic spontaneous pain and its descriptors; pain evoked by cold stimulus and qualitative sensory testing before and after local anaesthesia; referred pain location; use of analgesic medication; complementary anaesthesia efficacy. T‐test, chi‐squared and McNemar tests were applied to the data (p <.50). Results: Patients with referred pain presented a greater odontogenic pain intensity (p <.05) when considered the average of the last 24 h. These patients also showed higher pain rating and pain descriptors (p <.05). Intensity and duration of the pain evoked by cold stimulus in the non‐affected contralateral tooth at baseline were higher for patients with referred pain (p <.05). Conclusion: Symptomatic irreversible pulpitis patients with referred pain present greater odontogenic spontaneous pain and a heightened pain sensitivity. Therefore, patients with referred pain seem more complex from a pain severity perspective, supporting the clinical utility of discriminating symptomatic irreversible pulpitis with and without referred pain. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to verify the association between dental pain and severity of dental caries (caries morbidity stages) and the impact on oral health-related quality of life (OHRQoL) in preschool children. Methods: A cross-sectional study with 199 children (2–5 years old) enrolled at preschools in Capão do Leão-RS, Brazil. The self-report of mothers of children with a history of dental pain in the last 6 months and perception of their child's OHRQoL (ECOHIS) were obtained through a structured questionnaire. This questionnaire also collected independent variables. Children's oral examination was performed using the CAST instrument to determine caries morbidity stage. Crude and adjusted Poisson regression analysis was performed. Results: The prevalence of dental pain was 14.57%. The chance of the occurrence of dental pain was higher among children diagnosed in morbidity [Prevalence ratio—PR: 5.29 (95% confidence interval—95% CI 1.91–14.61); p = 0.001] and severe morbidity [RP = 6.12 (95 CI% 2.25–16.64); p < 0.001] stages. Children with dental pain presented higher scores in the total ECOHIS [rate ratio = 7.11 (95% CI 4.55–11.09); p < 0.001] and in all of the domains of this instrument. Furthermore, children with a history of dental trauma [PR = 2.41 (95% CI 1.15–5.04); p < 0.001] and those whose reason for last visit to the dental office was for restorative/endodontic/extraction treatment [PR = 1.29 (95% CI 1.01–6.19); p = 0.049] had a higher prevalence of dental pain. Conclusion: A substantial prevalence of dental pain in the last 6 months and negative impact on children's OHRQoL was identified in this sample. Children diagnosed with carious dentin lesions and abscess and fistula were more likely to have dental pain. [ABSTRACT FROM AUTHOR]

Background: To appreciate dental care utilization in ‌the context of socio-economic inequalities, it is imperative to identify sources of inequalities and evaluate the extent to which dental care utilization is still related to socio-economic status. This study aimed to quantify the influence of contributed determinants on dental care utilization in the context of socio-economic inequalities amongst adults residing in Tehran metropolis. Methods: In this cross-sectional community-based study, a stratified random sample of 1,510 subjects aged over 18 years was investigated by the zero-inflated Poisson analysis to measure the effect of determinants on utilization of dental care, and concentration index as well as the decomposition approach to identify the contributions of deterministic variables to the socio-economic inequality. Data was obtained by employing a phone interview survey. Individuals who were not willing or able to answer the questions in the telephone interview due to hearing or neurological problems did not participate in the interview. Dental care utilization was measured using the number of dental appointments. Results: Gender (male), oral health-related behaviors (such as brushing and dental flossing), experience of toothache, and concern about dental appearance were associated with an increased likelihood of utilizing dental care. Individuals who belonged to advanced age groups and lived alone significantly underutilized dental care. The concentration index equaling 0.05 (SE = 0.05) corroborates a pro-rich inequality. Decomposition analysis demonstrated the impact of oral health-related behaviors (i.e. dental brushing and use of dental flossing), concern about dental appearance, toothache, gender (male), insurance coverage of dental care, and smoking habit on the poor-rich gap in the dental care utilization. Conclusions: The influence of socio-economic inequalities on dental care utilization is discernable along the entire spectrum of socio-economic status. Individuals with lower socio-economic status experience more underutilization of dental care. Community subgroups, particularly the more deprived bracket, require consideration from key stakeholders, including policymakers and health professionals for the enhancement of dental care utilization as revealed by underlying determinants. [ABSTRACT FROM AUTHOR]

This study investigates the impact of nonsurgical periodontal treatment (NSPT) on oral health-related quality of life (OHRQoL) in patients with periodontitis stages (S)2 and S3, and the factors associated with the prediction of patient-reported outcomes. Periodontitis patients (n = 68) with moderately deep periodontal pockets were recruited. Responses to the Oral Health Impact Profile (OHIP)-14 questionnaire and clinical parameters including plaque index, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) were recorded. All patients received supra- and subgingival professional mechanical plaque removal. All clinical parameters and questionnaire responses were recorded again 3 months after NSPT. Clinical parameters and OHIP-14 scores for both stages of periodontitis were significantly improved 3 months after treatment. However, participants with periodontitis S3 had significantly higher total OHIP-14, physical pain, and functional limitation domains scores than periodontitis S2 cases. Baseline CAL, BOP, and the presence of PPD in anterior teeth were positively associated with increased OHIP-14 scores after NSPT. NSPT improved OHRQoL in participants with periodontitis S2 and S3. This was more pronounced in participants having periodontitis S3 than S2. Poorer OHRQoL could be anticipated in people having severe CAL, high BOP, and presence of pockets in the anterior teeth. [ABSTRACT FROM AUTHOR]

Objective: Toothache, often caused by tooth decay, cracks, or sensitivity to temperature, is one of the most distressing types of pain. Medicinal plants have long been used in traditional medicine and ethnobotanical knowledge for treating toothache. This study aims to identify medicinal plants used in Iranian ethnobotanical practices to alleviate toothache. Methodology: In this review, articles were searched using keywords such as medicinal plants, Iran, tooth, toothache, and ethnobotany. Databases including Google Scholar, SID, Magiran, PubMed, and Scopus were utilized for the search. Relevant ethnobotanical articles were reviewed for this study. Results: Medicinal herbs such as Origanum vulgare, Papaver somniferum, Mentha aquatica L., Mentha spicata L., Ferula persica Willd, Glycyrrhiza glabra L., Perovskia abrotanoides Kar., Dianthus caryophyllus, Viola odorata, Astragalus verus, Zingiber officinale, Allium sativum, Thymus danensis are identified as the most effective plants against toothache in traditional medicine. Conclusion: Iran's diverse herbal flora and rich ethnobotanical knowledge offer valuable insights and resources for the treatment of toothache. The findings of this study highlight the importance of incorporating this traditional knowledge into pharmacological research to develop effective anti-toothache, drugs. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare students are becoming increasingly concerned about self-medication (SM), which can have major health repercussions. It affects how future physicians make professional decisions about medications. Such a mindset has an indirect impact on providing their patients with appropriate counselling. The study was planned to investigate the attitude, determinants and different clinical aspects associated with SM of dental pain amongst medical students in Jeddah, Saudi Arabia. Materials and Methods: The present descriptive cross-sectional study was conducted exclusively on the 400 medical students from the 1st year and interns pursuing bachelor’s degrees from various medical colleges in Jeddah, Saudi Arabia. A convenient non-probability sampling technique was employed, and a pre-tested/pre-validated questionnaire was loaded on Google Forms and sent to the medical students of medicine, dentistry, pharmacy and nursing programmes. Qualitative characteristics were assessed using the Chi-square test. The significance level (P value) chosen for the various comparisons was P < 0.05. Results: The results of this study show that 65.5% of students self-medicate. It was significantly more common in women (74.9%), pharmacists (76.9%) and dental students (72.7%). Students who self-medicated less often were in the 1st and 2nd years (49.2% and 57.1%). Toothache was the most common cause for which they self-medicated (79.8%). Conclusion: The results of the present study have shed light on the fact that SM was high amongst medical students in Jeddah. The potential problems associated with self-medication should be highlighted to students to reduce the risk of inappropriate SM, which can seriously harm both students and others to whom they prescribe medication. [ABSTRACT FROM AUTHOR]

Background: Microbiota may be associated with esophageal squamous cell carcinoma (ESCC) development. However, it is not known the predictive value of microbial biomarkers combining epidemiological factors for the early detection of ESCC and precancerous lesions. Methods: A total of 449 specimens (esophageal swabs and saliva) were collected from 349 participants with different esophageal statuses in China to explore and validate ESCC-associated microbial biomarkers from genes level to species level by 16S rRNA sequencing, metagenomic sequencing and real-time quantitative polymerase chain reaction. Results: A bacterial biomarker panel including Actinomyces graevenitzii (A.g_1, A.g_2, A.g_3, A.g_4), Fusobacteria nucleatum (F.n_1, F.n_2, F.n_3), Haemophilus haemolyticus (H.h_1), Porphyromonas gingivalis (P.g_1, P.g_2, P.g_3) and Streptococcus australis (S.a_1) was explored by metagenomic sequencing to early detect the participants in Need group (low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia and ESCC) vs participants without these lesions as the Noneed group. Significant quantitative differences existed for each microbial target in which the detection efficiency rate was higher in saliva than esophageal swab. In saliva, the area under the curve (AUC) based on the microbial biomarkers (A.g_4 ∩ P.g_3 ∩ H.h_1 ∩ S.a_1 ∩ F.n_2) was 0.722 (95% CI 0.621–0.823) in the exploration cohort. Combining epidemiological factors (age, smoking, drinking, intake of high-temperature food and toothache), the AUC improved to 0.869 (95% CI 0.802–0.937) in the exploration cohort, which was validated with AUC of 0.757 (95% CI 0.663–0.852) in the validation cohort. Conclusions: It is feasible to combine microbial biomarkers in saliva and epidemiological factors to early detect ESCC and precancerous lesions in China. [ABSTRACT FROM AUTHOR]

Background and aims. This study aimed at evaluating the etiology and treatment challenges of temporomandibular disorders (TMDs). Methods. 160 subjects with TMDs, 38 males (23.8%) and 122 females (76.3%) were studied. A personalized coefficient was designated, which included the resolution of the main symptom, correction of secondary symptoms, patient collaboration (emotional parameter), treatment duration, and cost. Results. The most frequent cause for consultation was muscle impairment (42.5%), or limitation of mouth opening, followed by joint impairment (23.1%). Muscle pain was noticed, particularly in the masseter (57.5%) and lateral pterygoid muscles (51.9%). Tooth pain or gingival retraction was frequently associated with tooth wear (48.1%) and dental abfraction (31.3%). Remote symptomatology was dominated by otologic symptomatology. Iatrogenic etiology was highest (69.4%), followed by untreated missing teeth (66.9%). Treatment options included muscle relaxation, occlusal balancing (equilibration), kinesitherapy, medication, and swallowing reeducation. Most patients benefited from four to seven different types of therapy, which resulted in a higher cost and a longer and more uncomfortable treatment. The primary symptom was relieved in 82.3% of cases, with recurrence occurring in 15.7%. Conclusion. The treatment of temporomandibular joint dysfunction is time-consuming, demanding, and intricate. Most patients required four to seven different types of therapy, which increased the expense, treatment duration, and suffering. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to analyze the profile and trends of HIV mother‐to‐child transmission (MTCT) in the Brazilian land border strip (LBS). Methods: This was a quantitative, ecological, and cross‐sectional study using secondary data available in the information systems of the Brazilian Ministry of Health. All cases reported in the Notifiable Diseases Information System between 2010 and 2021 were studied. Results: Between 2010 and 2021, 275 children were born infected through MTCT, and 6076 pregnant women were living with HIV in the Brazilian LBS. HIV detection rates in pregnant women increased in all border arcs. The northern arc experienced the highest increase (19.6%), followed by the central arc (11.4%), and the southern arc (6.1%). Despite historically high detection rates, the southern arc exhibited the smallest increase. While MTCT rate decreased by 37.7% in the border area, the central arc showed no statistically significant reduction. In 2021, the average age of pregnant women was 26.2 years, 25.7% had up to 8 years of schooling, and 55.8% identified as non‐white. The majority (92.8%) received antenatal care, and 59.7% were diagnosed with HIV before prenatal care. The use of prophylactic antiretroviral therapy during prenatal care occurred in 69.6% of pregnant women, and infant prophylaxis was provided within first 24 h to 43.6% of live births. Conclusion: The results indicate progress in reducing MTCT cases in Brazilian LBS. Disparities in HIV detection rates may be influenced by differences in testing uptake, despite mandatory testing for all babies. It is crucial to continue implementing strategies to reach these women and ensure equitable access to healthcare services for MTCT prevention. Synopsis: This study shows that there are differences among the different arcs of the Brazilian land border strip regarding progress towards the elimination of mother‐to‐child transmission. [ABSTRACT FROM AUTHOR]

Patients who present with acute or chronic posterior dental pain but cannot identify the tooth from which the pain originates may suffer from a common but often unrecognized condition. The present article introduces a new term for this disorder, ectopic sulcular pain (ESP), derived from its unusual presentation, location, and defining symptom. It is tempting to call ESP an infection, but this has not been confirmed. In ESP, oral examination reveals no visual abnormalities, and there are no evident fractures, caries, periodontitis, attachment loss, traumatic occlusion, or periapical abscesses. This confusing symptomatology often leads to incorrect diagnosis and, consequently, treatment that fails to relieve the patient's pain. This article discusses ESP and reports 13 cases in which the condition was identified via intraligamental or topical application of an anesthetic agent to numb the gingiva. In 12 patients, ESP was successfully treated with meticulous oral hygiene, chlorhexidine rinses, and, in some cases, oral antibiotics. [ABSTRACT FROM AUTHOR]

A detailed and honest social history is vital when piecing together any clinical diagnostic puzzle. This case presentation highlights this, leading to a surprising diagnosis for both patient and clinician. Additionally, access to cone beam computed tomography (CBCT) has vastly widened diagnostic accuracy within the dental field, and this case emphasizes the importance of thorough training to identify, and interpret, incidental findings. CPD/Clinical Relevance: Injuries obtained under the influence of drugs might be missed without in-depth social history and appropriate imaging training. [ABSTRACT FROM AUTHOR]

Background and Aim: Pulpotomy of primary teeth is a common and daily treatment in pediatric dentistry, and by performing this treatment properly and accurately, tooth pain, infection, and extraction can be prevented. Considering the advantages and disadvantages of various pulpotomy treatment methods, it is necessary to evaluate the success rate of these methods (pulpotomy), in an educational environment. Materials and methods: The intended study is a descriptive study. The files in the pediatric department were reviewed by a dental student. Patients, age range three to seven years old were selected from both genders, boys and girls. Through phone calls, patients were asked to present for a follow-up visit. After obtaining consent, and according to the inclusion and exclusion criteria of the study, The examination was performed using a mirror and explorer and the dental unit’s light. Periapical radiography (parallel technique) was used for radiographic evaluation. To reduce the error of interpretation, each radiograph was evaluated by two people (student and supervisor) independently. The results were statistically analyzed by SPSS20 and descriptive chi-square test. Results:35 participated in this study which 90 of their primary molar were treated by formocresol in the last 24 months.43/7% of patients were boy and 56/3% were girl.70/3 % of teeth were treated by stainless steel crown,27/8 % by amalgam and 1 %by composite after pulpotomy procedure. In total,23 cases f all examined teeth had pathological clinical signs, and 66 cased had pathological radiographic signs. Conclusion: Finally,the clinical and radiographic success rate of pulpotomy was estimated respectively 76/9 % and 44%. [ABSTRACT FROM AUTHOR]

ChatGPT is an Artificial Intelligence (AI) language model that can provide health information to patients. This study examined the usefulness and readability of ChatGPT in answering questions about oral health in autism. The results showed that ChatGPT provided comprehensive and useful information, but the readability of the responses was beyond the level of a lay person. While ChatGPT has potential benefits in healthcare, it also has limitations such as ethical/legal issues and the risk of false or misleading information. Oral healthcare professionals should use AI tools sensibly and cross-reference information with reliable sources. [Extracted from the article]

Aim Methodology Results Conclusions The European Society of Endodontology outlines best practices for the management of deep caries and the pulp. Despite evidence supporting vital pulp treatments (VPTs) as predictable alternatives to conventional endodontic treatment, studies have shown they are not widely adopted in the UK. This study aimed to explore the barriers to implementation of VPTs by primary care general dental practitioners (GDPs).Qualitative one‐to‐one semi‐structured online interviews were conducted with purposively sampled UK GDPs. Interview transcripts were analysed using reflexive thematic analysis. Recurring themes were iteratively refined as additional transcripts were reviewed.Eleven participants were interviewed. A range of barriers to the provision of VPTs were identified, which aligned with two core themes: ‘Motivational barriers to service provision’ and ‘Educational access & opportunities’. Sub‐themes included lack of access to materials and equipment, deficiencies in knowledge of treatment (including protocols, outcomes and prognosis), lack of confidence (in treatment efficacy and clinical ability), time constraints and public dental service funding and remuneration.This study identifies barriers to the widespread adoption of VPTs among primary care GDPs in public and private settings. Economic constraints, practitioner confidence, time limitations and educational gaps are key challenges. Addressing these may require systemic changes such as policy interventions, education and improved resource allocation. [ABSTRACT FROM AUTHOR]

Introduction: Descending necrotizing mediastinitis is one of the most lethal forms of acute mediastinitis. It originates from an odontogenic or deep neck infection, which descends to the mediastinum through the fascial planes. It is a rare condition, but mortality rates remain high, especially in the presence of comorbidities or predisposing factors. Delay in diagnosis has been shown to be one of the most important factors for the disease outcome. Therefore, early diagnosis and treatment by a multidisciplinary team are of utmost importance. Case series: Four healthy young males with descending necrotizing mediastinitis were treated at our institution. None of them had any comorbidities, but all of them waited between 3 and 4 days before seeking medical help. Upon their arrival at the hospital, in addition to the presence of a severe neck infection, the presence of mediastinitis was also found. Despite the timely surgical treatment of both the source of the infection and the mediastinitis, three of the four cases had a fatal outcome. Conclusion: We believe that the time factor is of greater importance for the outcome of acute descending mediastinitis than the factors of age and presence of accompanying diseases. Proper and rapid treatment by a multidisciplinary team is essential, even for young and healthy people. [ABSTRACT FROM AUTHOR]

Background: Patients presenting with dental pain are common in general practice, despite dental infections being most appropriately managed with dental treatment to address the cause of the infection. Although antibiotics are not appropriate for the management of localised toothache without signs of systemic spread, general practitioners (GPs) often prescribe antibiotics and analgesics for the management of dental pain. The aim of this study was to explore GPs' perceptions and management of dental presentations in Australia. Methods: Twelve semi-structured interviews were conducted with GPs across Victoria, Australia, between October 2022 and January 2023. Data were thematically analysed. Results: The study found that dental pain was the most common presenting complaint for patients attending general practice with a dental problem. Five major themes were identified in this study: knowledge, beliefs about capabilities, emotion, environmental context and resources, and social influences/social professional role and identity. In terms of knowledge and capabilities, GPs would advise patients to seek dental care, as they are aware that antibiotics would not resolve the underlying issue. Challenges for GPs included limited training in oral and dental treatment, as well as emotions, such as patient anxiety and phobia resulting in patients seeking dental care through a GP rather than a dentist. Barriers due to the context, such as access to dental care, long waiting lists within the public dental system and cost, were some of the reasons patients present to general practice rather than a seeing a dentist. Furthermore, issues that influenced GPs' antibiotic prescribing included patients' expectations for antibiotics to treat their dental pain, as well as dentists advising their patients to attend their GP for antibiotics prior to dental treatment. Conclusions: This study identified factors that influenced GPs' management of patients with dental conditions. To address these issues, it is imperative to develop interventions addressing patients' knowledge around oral health, as well as providing improved access to dental care for these patients. Patients with dental pain often seek treatment from general practitioners (GPs), even though the problem often requires dental treatment rather than antibiotics and/or pain relief medications. This study looked at GPs' management of patients with dental problems, and identified barriers as to why patients would see a GP instead of a dentist. Understanding these reasons will help develop interventions to better educate patients in oral health, and provide better access to dental care to patients with oral conditions. [ABSTRACT FROM AUTHOR]

Introduction: Over the past few years, anti-CD20 therapies like rituximab, ocrelizumab or ofatumumab have seen an increase in interest in the treatment of neurological autoimmune disorders such as multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), or resistant forms of generalized myasthenia gravis (MG). They are generally well-tolerated, but recent reports have highlighted severe dental disorders in patients undergoing anti-CD20 therapies. The aim was to describe a series of cases and to compare with the available scientific literature. Methods: We reviewed 6 patient cases with dental disorders during anti-CD20 therapy that were reported to the pharmacovigilance center. A disproportionality analysis was also conducted on Vigibase® for each anti-CD20 and each adverse effect described in the cases. Results: Six cases of dental and gingival conditions in relatively young patients were reported (median age: 40.5 years old [min: 34; max: 79]). Oral conditions were developed in four patients with MS treated with ocrelizumab and in two patients receiving rituximab (one patient with MG and one with NMOSD). The onset of oral conditions ranged from 10 days to 2 years after treatment initiation. Notably, all patients treated with ocrelizumab experienced gingival recession. Various dental pathologies were observed, including tooth loss, dental pain, caries, brittle teeth, dental fractures, dental abscesses, and periodontitis. Analysis of Vigibase® revealed 284 worldwide cases of dental and gingival conditions under ocrelizumab, 386 cases under rituximab, and 80 under ofatumumab. Significant associations were found between these therapies and dental pathologies, particularly tooth abscesses and infections. Conclusion: To our knowledge, this is the first case series reporting dental conditions developed in patients long-term treated with anti-CD20 treatments. This issue, literature data, and Vigilyze® analysis might be considered a safety signal that necessitates being confirmed with more robust data, such as a retrospective study with a control group. Meanwhile, proactive measures are essential like frequent dental checkups and dental hygienic measures to prevent oral health problems associated with anti-CD20 therapies. [ABSTRACT FROM AUTHOR]