Assessment of dental anodontia among Ferdinand I Military Technical Academy students in Romania

Background / Aim. Data regarding tooth absence among Romania military personnel are lacking. The purpose of this study was to determine the prevalence of dental anomalies among military students at a military technical academy in Bucharest, Romania. Methods. A cohort of 318 military students enrolled the study. Each participant underwent an extensive evaluation of their oro-dental health status based on guidelines of the EGOHID II (European Global Oral Health Indicators Development II Project). Results. Anodontia was discovered in 6/318 participants (prevalence rate, 1.9%), namely 4 women (prevalence among women, 4.6%) and 2 men (prevalence among men, 0.87%). Five of the six patients were previously undiagnosed. The most commonly affected teeth were second premolars (n = 8), followed by first premolars (n = 4) and second permanent molars (n = 2). Premolar anodontia was equally common in the maxilla and the mandible; both instances of molar anodontia were in the mandible. None of the participants with anodontia had remaining temporary teeth. A brief overview of the case of two of the presently diagnosed patients, who presented with inferior bilateral second molar anodontia and quadruple canine inclusion and a quadruple second premolar anodontia, is included. Conclusion. Military students in Romania would benefit from systematic dental evaluation and long-term monitoring prior to the enrollment the Military Academy.

The Impact of Periodontal Disease on Hospital Admission and Mortality During COVID-19 Pandemic

Introduction: COVID-19 has had a huge impact on society and healthcare and it has been suggested that people with periodontal disease are at risk of having worse outcomes from the disease. The aim of this study was to quantify the impact of periodontal disease on hospital admission and mortality during the COVID-19 pandemic.Materials and Methods: The study extracted UK Biobank participants who had taken a COVID-19 test between March and June 2020 (n = 13,253), of which 1,616 were COVID-19 positive (12%) and 11,637 were COVID-19 negative (88%). Self-reported oral health indicators of painful or bleeding gums and loose teeth were used as surrogates for periodontal disease, participants who did not report any of the aforementioned indicators were used as controls. Multivariable logistic regressions were used to obtain crude and adjusted odds ratios of COVID-19 infection, subsequent hospital admission and mortality adjusted for demographics, BMI, biomarkers, lifestyle and co-morbidities.Results: Painful gums, bleeding gums and loose teeth were reported in 2.7, 11.2 and 3.3% of participants with COVID-19 infection, respectively. Risk of COVID-19 infection in participants with painful or bleeding gums and loose teeth compared to controls was not increased (odds ratio [OR]: 1.10, 95% CI: 0.72–1.69; OR: 1.15, 95% CI: 0.84–1.59). COVID-19 positive participants with painful or bleeding gums had a higher risk of mortality (OR: 1.71, 95% CI: 1.05–2.72) but not hospital admission (OR: 0.90, 95% CI: 0.59–1.37). Participants with loose teeth did not show higher risk of hospital admission or mortality compared to the control group (OR = 1.55, 95% CI: 0.87–2.77; OR: 1.85; 95% CI: 0.92–2.72).Conclusion: There was insufficient evidence to link periodontal disease with an increased risk of COVID-19 infection. However, amongst the COVID-19 positive, there was significantly higher mortality for participants with periodontal disease. Utilization of linked dental and hospital patient records would improve the understanding of the impact of periodontal disease on COVID-19 related outcomes.

APPLICATION OF OBJECTIVE AND SUBJECTIVE EVALUATION METHODS FOR MASTICATORY FUNCTION IN PATIENTS WITH MANDIBULAR OVERDENTURES

Appropriate chewing function is an important indicator of oral health, and masticatory efficiency assessment is one of the most objective methods of prosthetic treatment quality control. In the globe dental practice, static and dynamic chewing tests are still considered to be the main methods of masticatory function assessment. Thus, there is an extension of functionally-oriented clinical investigations base, which actualizes the importance of this work. The aim of the work was to evaluate the masticatory function of patients that use mandibular overdentures by studying the results of physiological masticatory test and self-assessment indicators of dental health associated with the use of dentures. Materials and methods. The clinical trials were carried out in two stages. At the first stage upon informed consent an examination of 20 student volunteers aged 18-22 years (control group -I) and 36 patients -17 women, 19 men (aged 57-76 years) with complete mandibular removable dentures (comparison group -II) was proceeded. Patients of the group I underwent physiological masticatory test with agar-agar samples formed according to UMSA method, patients of group II- masticatory test procedure and interview survey. The second stage was performed by the group III–42 persons –23 women, 19 men (aged 56-89 years) at 1, 6 and 12 months after mandibular dental arch restoration with complete removable overdentures, fixed by spherical attachments. Chewing efficiency was determined using masticatory physiological test and problem-oriented questionnaires. Video registration by Nikon Digital Camera D3200 was used to determine chewing time, number of movements and peculiarities of the mastication process. All patients of groups II and III in personal interview survey answered 6 questions about indicators of oral health connected with the use of dentures. Questions were formed according to European Oral Health Indicators (2005). Statistical data analysis was performed by standard statistics variation methods with Statistica 6.0 Program use. Results and discussion. All the parameters of physiological masticatory test: duration of chewing, group I 25,3±2,8 sec. group II 67,3±3,7 sec., group III 60.5±3.5 sec, number of chewing movements in group I was 58.3±4,8, in group II − 82.3±6.3, in group III − 68.8±3,4, samples mass loss: group I − ≤0,13(4,3%), group II − ≤0,21(7,0%), group III − ≤0,18(5,9%). Diminution Index obtained: group I − 1.85±0.5, group II – 3.33±0.7, group III – 2.48±0.5). Masticatory efficiency level in patients of the group III prevailed over group II by the respective parameters. Masticatory test video registration data analysis showed that the patients of group I diminished test samples with bilateral chewing pattern, as the majority of group II patients, while patients in group II employed combined— uni- and bilateral chewing pattern. According to the average values of the expression of all oral health-related questionnaire indicators: chewing difficulties - 2.67 ± 1.35 vs 0.50 ± 0.20*; excessive bite closure efforts - 1.19 ± 0.65 vs 0.57 ± 0.30*; limited food consumption 2.83 ± 1.35 vs 0.59 ± 0.30*; oral lesions 2.39 ± 1.20 vs 0.56 ± 0.30*; difficulty non-chewing movements 2.14 ± 1.05 vs 0.51 ± 0.30*; uncertainty about reaching treatment goals 2.06 ± 1.10 vs 0.66 ± 0.30*. A statistically significant (p <0.05) difference in favor of group III was clearly demonstrated. Conclusions The results of physiological masticatory test and patients interview survey indicated favorable adaptation process to mandibular overdentures with reestablished masticatory function restoration during 12 months of use. Masticatory efficiency and oral health indicators, connected with dental prostheses usage proved the appropriate quality level of prosthetic treatment in mandibular single remaining teeth-attended patients, using dentures fixed by spherical attachments.

Oral Health and Cardiovascular Disease: Mapping Clinical Heterogeneity and Methodological Gaps

Background: Numerous studies have examined the associations between poor oral health and the incidence of cardiovascular disease (CVD) over the past 25 y. This long history of research has resulted in a broad and heterogenous epidemiological field whose implications are difficult to understand and whose methodological gaps are hard to track. Objectives: This systematic mapping review aims to systematically map clinical heterogeneity and methodological gaps in assessing the relationship between poor oral health and CVD outcomes. Methods: Medline, Embase, and Cochrane Library were searched to identify longitudinal studies that examined the relationship between any oral health indicator and CVD outcomes. Each database was searched from its inception date and June 27, 2018. Extracted data assess the clinical heterogeneity (participants’ characteristics, exposure and outcome measures, length of follow-up) and methodological gaps (availability of randomized controlled trials, utilization of time-varying exposures, propensity methods, mediation analysis, and competing risks analysis). Results: Eighty-five studies met the inclusion criteria. Clinical heterogeneity is evident in participants’ characteristics (age, clinical status, and occupation) and in the definitions of oral health indicators and CVD outcomes. More important, a significant proportion of studies reported unclear definitions for CVD outcomes. The search strategy did not reveal any randomized controlled trials. Time-varying exposures, propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. Conclusion: There is a need for a universally accepted conceptual framework on the association between oral health and CVD to derive more consistent definitions for oral health and CVD outcomes that are aligned with the investigated research questions. There is also a need to use emerging research methods to maximize the impact of research in this area. Knowledge Transfer Statement: Clinical heterogeneity is evident in the definitions of oral health indicators and cardiovascular disease outcomes. Propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. The identified clinical heterogeneity and methodological gaps interfere with summarizing existing evidence and understanding their practical implications. Advancing the current understanding of the associations between oral health and cardiovascular disease goes hand in hand with minimizing clinical heterogeneity and closing the identified methodological gaps.

Nutrition and oral health in early childhood: associations with formal and informal childcare

Objective: To examine associations between childcare type and nutrition and oral health indicators. Design: Cross-sectional data extracted from a longitudinal birth cohort. Parent-completed FFQ and questions regarding oral health and childcare use. The associations between childcare type, classified into four groups: parent care only (PCO), formal childcare only (FCO), informal childcare only (ICO) or combination of care (F&I), and nutrition and oral health indicators were examined. Setting: Home and childcare. Participants: Families with children aged 3 years (n 273) and 4 years (n 249) in Victoria, Australia. Results: No associations were observed between childcare type and core food/beverage consumption or oral health indicators. For discretionary beverages, compared with children receiving PCO at age 3 years, children in FCO or F&I were less likely to frequently consume fruit juice/drinks (FCO: adjusted OR (AOR) 0·41, 95 % CI 0·17, 0·96, P = 0·04; F&I: AOR 0·32, 95 % CI 0·14, 0·74, P = 0·008). At age 4 years, children receiving FCO or ICO were less likely to consume sweet beverages frequently compared with children receiving PCO: fruit juice/drink (ICO: AOR 0·42, 95 % CI 0·19, 0·94, P = 0·03; FCO: AOR 0·35, 95 % CI 0·14, 0·88, P = 0·03) and soft drink (ICO: AOR 0·23, 95 % CI 0·07, 0·74, P = 0·01; FCO: AOR 0·14, 95 % CI 0·03, 0·76, P = 0·02). Conclusions: Associations between childcare type and discretionary beverage intake were observed. Investigation into knowledge, attitudes and activities in formal and informal childcare settings is required to explore different health promotion practices that may influence nutrition and oral health.

Changes in Oral Health Indicators due to Implementation of the National Health Insurance Services Coverage for First Molar Dental Sealant for Children and Adolescents in South Korea

Background: In South Korea, dental sealant was included in the National Health Insurance Services (NHIS) coverage for the first molar for ages 6–14 in December 2009. The second molar was included in 2012, and the age of insurance coverage was extended to under 18 in 2013. This study aimed to verify the effectiveness of an NHIS dental sealant coverage policy for children and adolescents by comparing the changes in first molar oral health indicators before and after policy implementation.Methods: The Korea National Health and Nutrition Examination Survey data were analyzed; the fourth period (2007–2009) provided data for before and the sixth period (2013–2015) provided data for after policy implementation. The proportion of individuals with first-molar sealant, decay-missing-filled first molar permanent teeth, and single crowns in the group aged 11-20 years were calculated. Data were analyzed using chi-square for complex samples and the complex samples general linear model. In addition, complex-sample logistic regression analysis was performed to confirm the association between factors. Results: Compared with non-beneficiaries, among policy beneficiaries, sealant ownership increased by 7.7% (from 27.8 to 35.5, P<0.001), and the number of permanent teeth with sealant per capita increased by approximately 0.4 to 0.8 (P<0.001). The proportion of individuals with decay-missing-filled permanent teeth decreased by 9.1% (from 68.4 to 59.3, P<0.001), and the average decay-missing-filled permanent teeth index per person decreased by approximately 2.0 to 1.5 (P<0.001). The rate of single-crown holders decreased by 2.7% (from 8.7 to 6.0, P>0.05), and the average single-crown index decreased by approximately 0.11 to 0.08 per person(P>0.05). The number of sealants increased with age and household income (P<0.001). The mother’s education level affected sealant experience (P<0.05). The caries rate was higher in females and older respondents (P <0.001).Conclusions: The sealant covered by NHIS contributed to decreasing dental caries in Korea. However, policies that can reduce oral health inequality should also be considered, and a follow-up study is required for long-term sealant maintenance in Korea.

Changes in Oral Health Indicators due to Implementation of the National Health Insurance Services Coverage for First Molar Dental Sealant for Children and Adolescents in South Korea

Background: In South Korea, dental sealant was included in the National Health Insurance Services (NHIS) coverage for the first molar for ages 6–14 in December 2009. The second molar was included in 2012, and the age of insurance coverage was extended to under 18 in 2013. This study aimed to verify the effectiveness of an NHIS dental sealant coverage policy for children and adolescents by comparing the changes in first molar oral health indicators before and after policy implementation. Methods: Korea National Health and Nutrition Examination Survey data were analyzed; the fourth period (2007–2009) provided data for before and the sixth period (2013–2015) provided data for after policy implementation. The proportion of individuals with first-molar sealant, decay-missing-filled first molar permanent teeth, and single crowns in the group aged 11-20 years were calculated. Data were analyzed using chi-square for complex samples and the complex samples general linear model. In addition, complex-sample logistic regression analysis was performed to confirm the association between factors. Results: Compared with non-beneficiaries, among policy beneficiaries, sealant ownership increased by 7.7% (from 27.8 to 35.5, P<0.001), and the number of permanent teeth with sealant per capita increased by approximately 0.4 to 0.8(P<0.001). the proportion of individuals with decay-missing-filled permanent teeth decreased by 9.1% (from 68.4 to 59.3, P <0.001), and the average decay-missing-filled permanent teeth index per person decreased by approximately 2.0 to 1.5( P <0.001). the rate of single-crown holders decreased by 2.7% (from 8.7 to 6.0, P >0.05), and the average single-crown index decreased by approximately 0.11 to 0.08 per person( P >0.05). The number of sealants increased with age and household income ( P <0.001). The mother’s education level affected sealant experience ( P <0.05). The caries rate was higher in females and older respondents ( P <0.001). Conclusions: The sealant covered by NHIS contributed to decreasing dental caries in Korea. However, policies that can reduce oral health inequality should also be considered, and a follow-up study is required for long-term sealant maintenance in Korea.