Alagille Syndrome: A case report of a rare oral and multisystem manifestation

Alagille syndrome is an inherited multisystem disorder of autosomal dominant transmission. Its prevalence is estimated at 1 per 70,000 to 100,000 live births. We report the case of a young patient suffering from Alagille syndrome who consulted the center of diagnosis and dental treatment of Rabat - MOROCCO (CCTD). The general manifestations are facial dysmorphia, hepatic, cardiac, and ocular disorders. Hepatic cholestasis causes oral repercussions such as a yellow oral mucosa, hypomineralization of the teeth, and a high tendency to dental caries. The management of such a patient requires the knowledge of the general health of the patient, therefore collaboration with the attending physicians, the establishment of rigorous oral hygiene, personalized prophylaxis with a consequent contribution of fluorine.

Factors Involved in the Perception of Enamel Dyschromic Lesions—A Questionnaire-Based Study

Dyschromic lesions (DLs) of tooth enamel are common disorders, with multiple etiologies and various clinical forms, that raise public health concerns. This study aimed to determine the factors that influence the perception of DLs and to assess the perceived need for dental treatment in various clinical cases. A paper-based questionnaire with attached images of frontal teeth exhibiting different DLs was distributed to patients, dental students, and dentists. A total of 383 volunteers participated in this study, and their answers were statistically described and analyzed. This study found that in cases with multiple, well-demarcated areas of opacities associated with diffuse opacities on neighboring teeth, most respondents noticed and reported only the most severe lesions, disregarding the minor ones. The contrast of the lesion with the color of the substrate influenced the overall perception and a significant correlation between these two variables was found. However, the color of the DLs did not significantly impact the overall perception of the lesions. A higher overall perception of DLs was significantly correlated with a favorable opinion regarding the need for treatment. Furthermore, gender and medical background were significantly associated with the overall perception of DLs.

The Trend of Dental Check-Up And Incidence of Dental Complications Following The Use of Bone Modifying Agents In Patients With Metastatic Breast And Prostate Cancer: Analysis of Data From The Korean National Health Insurance Service

Purpose: Bone-modifying agents (BMAs) are key components in the management of cancer patients with bone metastasis. Despite their clinical benefits, the use of BMAs is associated with adverse dental events including medication-related osteonecrosis of the jaw (MRONJ). This study investigated the rate of preoperative dental surveillance to reduce the incidence of adverse dental events including MRONJ after BMA treatment in patients with bone metastasis from breast and prostate cancer. Methods: Data, including age, cancer diagnosis, administered BMAs, and adverse dental events during cancer treatment, of patients with bone metastasis from breast and prostate cancer who received at least one infusion of BMA between 2007 and 2019 were extracted from the Korean National Health Insurance Service (KNHIS) dataset. Results: Of the 15357 patients who received BMAs, 1706 patients (11.1%) underwent dental check-ups before BMA treatment. The proportion of patients receiving dental check-ups increased from 4.4% in 2007 to 16.7% in 2019. Referral for dental check-up was more frequent in clinics and primary hospitals than in tertiary hospitals, and from the departments of internal medicine and urology than from the department of general surgery, regardless of the patient's health insurance status. After BMA treatment, 3328 patients (21.6%) developed adverse dental events, including tooth extraction (73.0%), abscess (16.9%), acute periodontitis (5.3%), acute pericoronitis (2.6%), and MRONJ (2.2% of 3328, 0.5% of 15357). Conclusions: Considering the long treatment period in patients with metastatic cancer, coordination between dentists and oncologists is necessary to ensure appropriate dental treatment before the initiation of BMAs.

Delaying Intraoral Radiographs during the COVID-19 Pandemic: A Conundrum

Background. The COVID-19 pandemic has made dentists very assiduous about cross-infection during dental treatment, thereby delaying dental radiographs for treatment. However, patients needing dental emergency treatment in the ongoing pandemic require relevant intra/extraoral dental radiography for adequate diagnosis and treatment planning. Methods. This article is aimed at adding to the hot debate: Is delay for intraoral radiographs justified or a possible proxy? As a narrative review, it provides an insight into the reasons for delaying intra-oral dental radiographs during in the pandemic and options of the nontraditional radiographic techniques available until the pandemic subsides. Discussion and Conclusion. Cross-contamination concerns through respiratory droplets grow while using intraoral film holders that stimulate gag reflex, coughing, saliva secretion, and if proper disinfection protocols are not applied. Since the patients’ acquiring emergency dental treatment cannot be neglected, the return-to-work guidelines by the health regulatory bodies urge to prioritize extraoral radiographic imaging techniques to curb the infection, offering the best diagnostic efficacy. The dental professionals can consider cone-beam computed tomography (CBCT) scans and sectional dental panoramic radiographs (SDPRs), followed by a risk assessment for COVID-19, a safer modality in reducing cross-contamination and assuring an innocuous environment for both patient and coworkers.

Ecological Study on the Oral Health of Romanian Intellectually Challenged Athletes

This study aimed to give an image of the oral health status and treatment needs of intellectually challenged athletes taking part in Special Olympics—Special Smiles (SO-SS) events organized in Romania during 2011–2019 and to find potential associations with socio-economic factors. An observational ecological retrospective study was conducted, and 1860 oral examinations were performed on participants aged 8 to 30 years in nine SS-SO events. Oral examination was performed under field conditions. Percentage of caries-free subjects, mean DMF-T index and its components (D = decayed; M = missing; F = filled; T = teeth), restoration index RI = [F/(F + D) × 100]%, and Plaque Index were calculated for each of the nine groups. Caries-free subjects ranged between 5.90% and 21.70%. DMF-T ranged from 4.27 to 7.71. Higher values for “F” component (range 0.66–1.69) and RI (range 13.02–27.74%) were found in events held in cities from regions with higher reported Gross Domestic Product. Sealants were present in 0 to 8.4% of the subjects. In areas with lower numbers of inhabitants per dentist, more sealants were found (p < 0.001). Romanian SO athletes exhibited relatively poor oral health, limited access to dental treatment, and low level of prevention. Targeted prevention and treatment programs adjusted to specific conditions in each geo-economic region are needed.

Administration of Systemic Antibiotics for Dental Treatment in Kosovo Major Dental Clinics: A National Survey

Objective Antibiotics misuse and a high level of antibiotics resistance is observed worldwide, but particularly in developing countries. Kosovo in the last decade is facing challenges regarding antimicrobial resistance. The purpose of the present study was to investigate patterns of antibiotics prescriptions of dentists in Kosovo's major dental clinics. Materials and Methods For Kosovo's prescribing pattern, data collection was obtained from 10 Regional Dental Clinics and a Tertiary Health Center regarding patients who were prescribed antibiotics in the years 2015 to 2019. Data analysis was performed by using descriptive statistics and was processed by using MS Excel. Results Most prescribed antibiotic during the observed period from 2015 to 2019 in Kosovo was amoxicillin, although a drastic increase of amoxicillin with clavulanic acid—as a broad-spectrum antibiotic—is observed. The trend of antibiotics use in tertiary health institutions is in an overall decrease in Kosovo with an exception in the year 2017. Despite this overall decrease, inconsistency in prescribing is observed when the pattern is analyzed for each region separately. The highest number of patients in health care dental clinics received antibiotics for maxilla-related health conditions and the lowest number of them for oncologic ones. Conclusion The patterns of antibiotics prescriptions by dental practitioners in Kosovo during the years 2015 to 2019 are fluctuating. Compared with the global health care standards, the irrational use of antibiotics in dental health care clinics in Kosovo still exist and this issue should be further addressed by respective actors.

Dentistry during COVID-19: patients' knowledge and satisfaction toward health protocols COVID-19 during dental treatment

Background Coronavirus disease 2019 (COVID-19) as an infectious disease primarily spreading through droplet infection in dental treatment. Patient satisfaction is an indicator of healthcare quality service. Quality of healthcare service and patient satisfaction has been affected by the COVID‑19 pandemic. This study aims to assess the knowledge and satisfaction toward health protocols COVID-19 during dental treatment among dental patients. Methods An institutional-based cross-sectional study was conducted on 270 dental patients using a self‑designed questionnaire consisting of knowledge and satisfaction about health protocols COVID-19 during dental treatment through a random sampling technique. Data were imported to SPSS version 21 for analysis. Descriptive and analytical statistics were used to identify the factors associated with their knowledge and satisfaction. A p value < 0.05 was considered statistical significance. Results Totally, 270 dental patients with mean age of 37.6 ± 6.7 years participated in the study. The mean knowledge score was 36.7 ± 3.5, as considerable number of participants were unaware about the risk associated with dental treatment as well as restrictions imposed on dental procedures. About 18% of participants experienced one or other form of dental complaints during the lockdown period. The overall level of patient satisfaction was 44.6%. Conclusion It can be concluded that, public knowledge is to be improved about risk of virus transmission that can be related with dental treatment and also people should be encouraged to use virtual facilities, such as teledentistry, so that no dental emergencies is left untreated during the pandemic time. In addition, the level of satisfaction was in a medium level for dental patients in the study area. Specifically, we deduced from the results that social/physical distancing measures are one of the mechanisms to decrease the fear of exposure to the COVID-19.

A dataset for dental anxiety and psychological distress in 1550 patients visiting dental clinics

Objectives Information was collected to identify anxiety in dental patients visiting a dental clinic using the Dental Anxiety Scale, their level of psychological distress using the Brief Symptom Inventory-18 and identifying a correlation between these groups as well as the gender and age. Data description This data contains a set of 1550 patients’ answers to questionnaires taken before dental treatment in a dental clinic. It is divided into male and female patients as well as according to their age. The level of Dental Anxiety can be interpreted by answers chosen in the Dental Anxiety Scale (DAS) and the level of psychological distress by answers chosen in the Brief Symptom Inventory-18 (BSI-18). This dataset should help to encourage more research in the field of dental anxiety and we hope to see more comparisons with our data in the future or in different regions of the world.

Osteonecrosis development by tooth extraction in zoledronate treated mice is inhibited by active vitamin D analogues, anti-inflammatory agents or antibiotics

Invasive dental treatment such as tooth extraction following treatment with strong anti-bone resorptive agents, including bisphosphonates and denosumab, reportedly promotes osteonecrosis of the jaw (ONJ) at the extraction site, but strategies to prevent ONJ remain unclear. Here we show that in mice, administration of either active vitamin D analogues, antibiotics or anti-inflammatory agents can prevent ONJ development induced by tooth extraction during treatment with the bisphosphonate zoledronate. Specifically, tooth extraction during treatment with zoledronate induced osteonecrosis in mice, but administration of either 1,25(OH)2D3 or ED71, both active vitamin D analogues, significantly antagonized osteonecrosis development, even under continuous zoledronate treatment. 1,25(OH)2D3 or ED71 administration also significantly inhibited osteocyte apoptosis induced by tooth extraction and bisphosphonate treatment. Administration of either active vitamin D analogue significantly inhibited elevation of serum inflammatory cytokine levels in mice in response to injection of lipopolysaccharide, an infection mimetic. Furthermore, administration of either anti-inflammatory or antibiotic reagents significantly blocked ONJ development following tooth extraction and zoledronate treatment. These findings suggest that administration of active vitamin D, anti-inflammatory agents or antibiotics could prevent ONJ development induced by tooth extraction in patients treated with zoledronate.