Associations Between Oral Health Status, Perceived Stress, and Neuropsychiatric Symptoms Among Community Individuals With Alzheimer's Disease: A Mediation Analysis

Community individuals with Alzheimer's disease (AD) experience oral disease alongside neuropsychiatric symptoms (NPS) with disease progression. Despite growing evidence for the link between oral health and cognitive status, few studies have investigated the associations between oral health and NPS, especially based on individuals' experience of AD. The primary aim of this study was to examine (a) the difference in oral health-related stressors among individuals with AD, mild cognitive impairment (MCI), and subjective cognitive decline (SCD); and (b) the associations of these stressors with NPS under the framework of the stress process model (SPM). A cross-sectional study was conducted among individuals diagnosed with AD (n = 35), MCI (n = 36) or SCD (n = 35), matched for age, sex education, and body mass index (BMI). Multiple regression and mediation model analyses were performed to explore predictors and their relationships with NPS based on the SPM. Data collection comprised four sections: (a) individual context; (b) oral health-related stressors, including dental caries, periodontal status, oral hygiene, the geriatric oral health assessment index (GOHAI), oral salivary microbiota, pro-inflammatory cytokines, and oral health behavior; (c) subjective stressors (i.e., perceived stress [PS]); and (d) NPS. Decayed, missing, and filled teeth (DMFT), missing teeth (MT), loss of attachment (LoA), plaque index (PLI), PS, oral health behavior, GOHAI, pro-inflammatory cytokines, and salivary bacterial composition were significantly different among the three groups; these parameters were poorer in the AD group than SCD and/or MCI group. LoA, PLI, PS, and pain or discomfort in the GOHAI were directly associated with NPS. PLI, LoA, and psychosocial function in the GOHAI indirectly affected NPS, and this relationship was mediated by PS. Individuals with AD reported greater oral health-related stressors. This study identifies direct and indirect associations linking oral health-related stressors and PS with NPS in individuals with AD. Our findings suggest that targeted dental care and oral-related stressor control may be valuable for managing NPS.

Estratégias para o condicionamento comportamental em pacientes com transtorno do espectro autista durante o atendimento odontológico

Transtorno do Espectro Autista (TEA) é um distúrbio do neurodesenvolvimento com etiologia indefinida e graus variados de severidade. Caracterizado por déficits na comunicação e na interação social, além de padrões restritivos de comportamento. O atendimento odontológico desses pacientes é desafiador, pois suas manifestações clínicas são complexas e variadas. Isso ocorre porque o ambiente odontológico e, o próprio atendimento, apresentam potenciais gatilhos para alterações comportamentais nos portadores de TEA, visto que eles possuem uma maior sensibilidade aos estímulos presentes no consultório. Este estudo trata-se de uma revisão de literatura cujo objetivo é identificar as estratégias de manejo comportamental empregadas pelo dentista frente aos desafios encontrados no paciente autista. Foi realizado um levantamento bibliográfico de artigos indexados nas bases eletrônicas PUBMED, SCIELO e BVS, utilizando os descritores “autism spectrum disorder”, “autism”, “oral health”, “behavior” e “dental care”. Foram selecionados artigos encontrados na íntegra considerando os últimos 10 anos, excluindo aqueles que não traziam um bom embasamento sobre o tema. O manejo odontológico do paciente com TEA requer individualização e a compreensão do seu comportamento, englobando diferentes técnicas como: dizer-mostrar-fazer, sessões curtas, eliminação de estímulos sensoriais estressantes, controle de voz, modelação, além das abordagens educacionais PECS, ABA e TEACCH. Conclui-se que, apesar dos desafios, um tratamento odontológico de qualidade pode ser realizado com o uso de abordagens personalizadas, para isso, é necessário que o Cirurgião-Dentista conheça esses recursos e domine a técnica.

Development and Validation of Perceived Oral Health Benefits on Yoga Scale (POBYS)

Objective: Sustained practice of Yoga leads to self-awareness, physical strength and high sense of energy. Yoga stimulates antioxidant levels in the body and reduces likelihood of dental disorders. No research has been undertaken connecting perception on yoga and oral health behaviors. The present study is an attempt to develop a psychometric scale entitled Perceived Benefits on Yoga Scale (PBYS) to measure individuals’ perception on Yoga in relation to oral health behaviors. Material and methods: The psychometric tool was developed based on the concepts of Health Benefit Model (HBM). Among the four components of the model, the present study considered “perceived benefits” component. A total of 206 individuals participated in the study. To analyze the scale theoretically, face and content validity were assessed. Reliability of the scale was tested using Cronbach’s alpha and Spearman-Brown coefficient. Using exploratory and confirmatory factor analysis, construct validity was tested. Cronbach alpha and Spearman- Brown coefficient were applied to test the reliability of scale. Results: There were six items in the final scale, with a Spearman- Brown coefficient of 0.92 and Cronbach’s alpha of 0.91. Statistically significant (p < 0.001) positive correlation was found between POBYS scores and Yoga Self-Efficacy Scale (YSES). Validity of scale is within accepted range as indicated by Goodness of Fit indices. Conclusion: POBYS is a reliable and valid measure of perception on yoga outcomes with specific reference to oral health behavior. Keywords Yoga; Health belief model; Oral health behavior; Scale development; Confirmatory factor analysis.

Analysis of the Effect of Daily Water Intake on Oral Health: Result from Seven Waves of a Population-Based Panel Study

Proper moisture is an essential condition for maintaining the homeostasis of the body, enhancing immunity, and preventing constipation, and it is an indispensable substance for maintaining human life and health. As the bacteria that cause oral disease are affected by water intake, there is a strong relationship between water intake and oral disease. Therefore, the purpose of this study is to determine the effect of daily water intake on oral disease. The data analyzed were from a seven-year period (2010–2017) from the National Health and Nutrition Survey, conducted annually by the Korea Centers for Disease Control and Prevention. Out of a total of 48,422 people, 134 people in the ‘<1 cup’ group, 27,223 people in the ‘1–4 cups’ group, 14,693 people in the ‘5–7 cups’ group and 6372 people in the ‘>7 cups’ group were selected as subjects. Each time a person drank one less cup of water per day, the prevalence of periodontal disease increased by 1.018 times, the prevalence of dental caries increased by 1.032 times, and the experience of dental caries increased by 1.075 times. Even in Model 2, for which age and gender were adjusted, there was a significant effect. In addition, there was a significant impact in Model 3, which adjusted for oral health behavior, except for permanent caries prevalence. Based on the above results, oral health behavior and state were positive in those who consumed more water per day. Therefore, it is suggested that the government’s active promotion of water intake recommendations and policies should be prepared to include water intake as a component of improving oral health.

Awareness of Oral Hygiene Practices and Periodontal Health In The Rural Area of Peshawar, Khyber Pakhtunkhwa

Aim: To evaluate the oral hygiene-related knowledge, oral hygiene practices, self-efficacy and motivation towards periodontal Health of the rural population of Peshawar, Khyber-Pakhtunkhwa Methodology: Comprehensive structural questionnaire was distributed among 138 people. The questionnaire was based on their oral hygiene related knowledge, practices, and behavior pattern. Results: The results of this study show an acute lack of oral hygiene awareness and limited knowledge of oral hygiene practices in Peshawar Conclusion: There is an immediate need for comprehensive educational programme and health activity to promote oral health. Key words: Oral health, Behavior pattern, motivation

Assessment of the Relationship between Oral Health Behavior, Oral Hygiene, and Gingival Status of Adolescent Tobacco Consumers in Ranchi, Jharkhand: A Comparative Study

Background. Tobacco consumption is very prevalent in India and associated with a number of oral health problems. Good oral health behavior plays a significant role in improving oral hygiene status. Objectives. To assess the relationship between the oral health behavior, oral hygiene, and gingival status of adolescent tobacco consumers (smoke/smokeless form) and to compare it with that of the nonconsumers of tobacco in the same age group, who were selected from the OPD of Dental Institute, RIMS. Methods. This was a cross-sectional study carried out in Ranchi. The study included a total of 400 adolescents who were reported to be consumers of tobacco and 400 adolescents who were nonconsumers of tobacco. The oral health behavior was assessed using HU-DBI. The plaque and gingival scores were assessed using standardized indices. Data were analyzed using the Chi-square test, independent sample t-test, and Pearson’s correlation. The significance level was set at p ≤ 0.05 . Results. The majority of tobacco consumers were found to have poor plaque scores as assessed using the plaque index. As assessed by the gingival index, the majority of the tobacco consumers were found to have a severe form of gingivitis. The mean plaque score (2.38 ± 0.51, p value <0.001) and the mean gingival score (2.6 ± 0.63, p value <0.001) were significantly higher in tobacco consumers. The mean HU-DBI score was significantly higher in non-tobacco consumers (8.3 ± 1.60, p value <0.001). It was observed that the gingival and plaque scores have a significant negative correlation with the HU-DBI score. The majority of tobacco consumers were worried about the staining of teeth and bleeding from gums. A dental visit for a routine preventive check-up was reported to be rare in both groups. Conclusion. The oral hygiene and gingival status were significantly poor in tobacco consumers compared to non-tobacco consumers. As the oral health behavior of the participants improved, the plaque and gingival scores reduced significantly.

The Role of Peer Influence on Oral Health Knowledge and Behaviors among Adolescents

Although many researchers, in different social sciences fields, are being attracted to the new potential promotional phenomenon, the influence of peer connections, the literature in dental public health is very poor. Objective: This article investigates the role of peer influence on individuals’ oral health knowledge and behavior among adolescents. Methods: The purpose of the study was to explore the correlation between secondary school students’ oral health u and knowledge within friendship groups. A valid and reliable questionnaire was developed. A total of 421 students (228 boys and 193 girls) aged between 12-13 years old participated in the study. Ordinal regression analysis was used to identify the correlation between an individual’s oral health knowledge and his/her friends. Results: The results demonstrated a strong relationship between students’ oral health behaviors and their peer connections within their friendship groups at school. Specifically, the tooth brushing frequency of a student had a strong correlation with the similar behavior of his/her friends. Also, investigation of the role of the second level connections (friends of one’s friend with no direct connection) showed a significant correlation in brushing behavior. However, the results revealed no strong correlation of oral health knowledge among friends within their social network. Conclusion: This paper highlighted the importance of the role of peer influence on oral health behavior. Understanding the relationship between oral health behavior and social network would help policymakers for more cost-effective oral health promotion programs among adolescents.