Oral Hygiene Practice among Hospitalized Patients: An Assessment by Dental Hygiene Students

Aim: An epidemiological study was carried out, in hospital wards, with the aim of assessing the oral health status of patients subjected to multiple medical treatments. Material and Methods: The study was conducted at Fondazione IRCCS Policlinico San Matteo (Pavia, Italy). A questionnaire was submitted to patients for the evaluation of oral hygiene devices used; then, a clinical examination was conducted to collect Decayed Missing Filled Teeth (DMFT) index, Plaque Index (PI), and Marginal Gingival Index (MGI) values. Results: Manual toothbrushes were used by a wide range of the sample study (65–100% among hospital wards), together with mouthwash (20–80%); interproximal aids were used by few patients (the lowest recorded value was 33.3%). Conclusion: dental hygienists could be integrated into hospital wards as oral hygiene procedure instructors, for the improvement of the oral health conditions of hospitalized patients.

Association of salivary pH in patients with dental caries and periodontal disease

Background: The aims of the study was to find out the prevalence of dental caries in healthy and periodontal disease and its association with salivary pH.Methods: A total of 80 healthy subjects reporting to the department of periodontology were selected. They were divided into four groups (clinically healthy gingival, chronic generalized gingivitis, chronic generalized periodontitis, and aggressive periodontitis) with 20 subjects in each. Periodontal parameters; decayed, missing, and filled teeth (DMFT) index and salivary pH were recorded. Unstimulated whole saliva was collected according to Navazesh method. The pH of saliva was immediately measrued using a single electrode digital pH meter.Results: Based on statistical test it was seen that caries prevalence and DMFT was found out to be least in aggressive periodontitis group, along with least mean pH value, as compared to the other 3 groups, p<0.05.Conclusions: The low prevalence of caries in aggressive periodontitis can be attributed to the low pH of saliva. Salivary pH plays a vital role in the formation of microbial film, which in turn has a significant role in the pathogenesis of both dental caries and periodontitis.

Dental caries in children with attention deficit/hyperactivity disorder: a meta-analysis

Objectives: To evaluate whether children with attention deficit/hyperactivity disorder (ADHD) are more affected by dental caries than children without ADHD by means of a systematic review and meta-analysis. Design: Electronic searches was performed in four databases (PubMed, Embase, Scopus, and Web of Science) in July 2021. Grey literature search in OpenGrey, a search in Google Scholar, and searches in the reference list of included articles were also conducted. The eligibility criteria were observational studies in which children with ADHD were compared with children without ADHD with respect to the dental caries. Study selection, data extraction, and risk of bias assessment, applying the Joanna Briggs tool were performed by two reviewers independently. Meta-analysis and assessment of heterogeneity among studies were conducted with the meta-package of RStudio using the R programming language (R Core Team, Vienna, Austria). Results of meta-analysis were provided in mean difference (MD), odds ratio (OR), and confidence intervals (CI). For assessment of heterogeneity, Baujat plot and influence analysis plot were obtained. Results: Thirteen studies were included and 10 were incorporated into meta-analyses. The meta-analysis showed that children with ADHD had a higher decayed, missing, and filled teeth (DMFT) index than their peers without ADHD (I²=42%; MD=0.75 [0.38-1.13]). For decayed, missing, and filled surfaces (DMFS) (I²=0; MD=0.39 [-0.02-0.80]) and decayed surfaces (DS/ds) (I²=0%; MD=0.35 [-0.63-1.33]), no difference between groups was observed. In addition, children with ADHD had higher odds of having dental caries than their healthy peers (OR = 3.31 [1.25, 8.73]; I² = 0%). After assessment of heterogeneity among studies, sensitivity analysis was conducted for DMFT. One study was removed and the significant difference between groups remained. Children with ADHD had a significantly higher DMFT index than their peers without ADHD (MD = 0.98 [CI = 0.75, 1.20]; I² = 0%) Risk of bias ranged from low to high. Conclusion: The main shortcoming of the included studies is the high risk of bias regarding the strategies to deal with confounding factors. Within its limitations, this systematic review and meta-analysis demonstrated that children with ADHD were more likely to develop dental caries than their healthy counterparts. Funding: No funding Registration: CRD42021238923

Serum and Saliva 25(OH)D Levels in Relation to Dental Caries in Young Children

Objective: Several studies have reported that low levels of vitamin D (25(OH)D) are associated with an increased risk of dental caries and that optimal levels may offer protection This study aimed to assess the relationship between serum and saliva 25(OH)D levels and caries among young children. Study design: A total of 120 healthy children were recruited; 93 with caries and 27 caries-free. Dental caries status was evaluated using decayed, missing and filled in primary teeth (dmft) index. Blood and unstimulated whole saliva samples were collected. Laboratory analysis was performed using Enzyme-Linked Immunosorbent Assay Kit. Data were analyzed with descriptive statistics, bivariate and Spearman’s rank correlation analysis. Results: There were no significant associations between serum and saliva 25(OH)D levels and caries status (P &gt; 0.05). Levels of 25(OH)D in serum were significantly higher than levels found in saliva (P &lt; 0.05), and a correlation between serum and saliva 25(OH)D levels was observed (P &lt; 0.05). Conclusions: The association between serum and saliva 25(OH)D and dental caries in young children was inconclusive. However, a positive and significant correlation was observed between serum and saliva 25(OH)D levels. Further studies are warranted to investigate the definite relation between 25(OH)D levels and dental caries and using saliva 25(OH)D as a non-invasive alternative method over blood samples.

Oral health status of patients infected with human immunodeficiency virus and related factors, Iran: a cross-sectional study

Background Human immunodeficiency virus (HIV) continues to be a major global issue. HIV-infected patients commonly experience oral health problems. This study aimed to assess oral health status of the patients and its related factors in Shiraz, Iran. Methods In this cross-sectional study, by using simple random sampling, 250 HIV-infected patients were selected from Shiraz Voluntary Counseling and Testing Center in 2019. Patients' decayed, missing, and filled tooth (DMFT) index, plaque index (PI), and community periodontal index (CPI) were determined. Associations between patients' characteristics and the above-mentioned indices were examined by using Pearson correlation, one-way ANOVA, chi-square, and independent sample T test. The effect of possible confounding factors was controlled by using multiple linear regression and logistic models. Results Of the 222 participants, 111 (50%) had 15 or more missing teeth and 79 (35.6%) were edentulous. Their mean (SD) DMFT and PI were 20.71 (10.74) and 1.11 (0.79), respectively. About 40% of them had healthy gingiva. DMFT (p < 0.001), PI (p < 0.001), and CPI (p = 0.002) were significantly worse in men than women. The patients' DMFT and edentulous status were significantly associated with their age (both p < 0.001) and duration of disease (p = 0.001 and p = 0.008, respectively). Unemployed patients had the worst DMFT, PI, and CPI (all p < 0.001) and the highest percentage of edentulous individuals (p = 0.003). All examined indices were significantly worse in cigarette smokers, alcoholics, addicts, and patients with a previous history of imprisonment (all p < 0.001). The odds ratio of being edentulous was 5.74 times in addicted patients than in non-addicted ones (p < 0.001). The odds increased 0.11 with every year that the patients' age increased (p < 0.001). Multiple linear regression models also showed that the addicted patients had significantly more scores in DMFT index, PI, and CPI (all p < 0.001). Conclusions Overall, oral health status of the HIV-infected patients was unsatisfactory. Therefore, effective interventional programs are needed for prevention and early treatment of dental problems among this population, especially for more vulnerable groups such as older men with low socioeconomic status, and those with high-risk behaviors.

Relationship between DMFT index and number of pregnancies: a cross-sectional study on enrollment phase of the Tabari Cohort Study

Background People of all age and gender groups are at risk of dental diseases; however, some groups, such as pregnant women, are more vulnerable than others due to their specific physiological situations. The protection of maternal and fetal is critical. Therefore, the present study intended to investigate the relationship between the Decayed, Missing, and Filled Teeth (DMFT) index and the number of pregnancies. Methods The present cross-sectional study was performed using the Tabari Cohort Study (T.C.S.) data. Data of 5,496 women enrolled in the T.C.S. were included in the study. After obtaining the approval of the Ethics Committee, the related data on the variables of age, age at the first pregnancy, number of pregnancies, total number of teeth at the time of examination, number of DMFT, employment status, socioeconomic status, educational level, residence location, body mass index, and the status of diabetes mellitus, hypertension, and cardiovascular diseases were extracted. Finally, data analysis was performed in the STATA software (version 14). Results The mean DMFT index in women with 1, 2, 3, 4, 5, 6, and more than six pregnancies were obtained at 12.74 ± 7.11, 13.09 ± 7.06, 14.80 ± 7.81, 17.07 ± 8.11, 19.82 ± 9.02, 22.89 ± 8.98, and 26.17 ± 8.01, respectively (P < 0.001). Using the multivariate linear regression and adjusting the effect of potential confounding variables, it was found that the DMFT index increased by 34% for each unit increase in the number of pregnancies (β = 0.34, P < 0.001). Conclusions According to our results, there was a significant relationship between the DMFT index and the number of pregnancies. The DMFT index was increased with an increased number of pregnancies. Therefore, oral healthcare promotion should receive special attention in healthcare planning and related policies by raising awareness and providing easy access to dental services for women of childbearing age, especially pregnant women.

Periodontitis, dental plaque, and atrial fibrillation in the Hamburg City Health Study

Background/Aim Atrial fibrillation (AF) is a major health problem and causes heart failure and stroke. Pathophysiological mechanisms indicate a link with oral health including periodontitis (PD), but supporting data are scarce. The aim was to investigate the link between features of oral health and the prevalence of AF. Methods This cross-sectional analysis of the Hamburg City Health Study included 5,634 participants with complete data on their PD and AF status. AF was assessed via self-reported questionnaire or medically diagnosed by standard 12-lead resting ECG. The oral health examination included full-mouth measurements of the dental plaque index (PI), the clinical attachment loss (CAL) at 6 sites per tooth, the bleeding on probing (BOP) and the decayed, missing and filled teeth (DMFT) index. Descriptive analyses for all variables stratified by the status of PD were performed. To test for an association between prevalent PD and prevalent AF, multivariable logistic regression models were used. Mediation analysis was used to test if interleukin-6 (IL-6) and/or C-reactive protein (CRP) mediated the association between PD and AF. Results Atrial fibrillation (prevalence: 5.6%) and the severity of PD (prevalence: moderate: 57.7%, severe: 18.9%) increased with age in men and women. Prevalent severe PD, CAL ≥3 mm, PI, and BOP were all associated with prevalent AF in unadjusted regression analysis. However, no association except for PI (odds ratio (OR): 1.22, 95% confidence interval (CI): 1.1–1.35, p<0.001) could be observed after adjusting for age, sex, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), body mass index, diabetes, smoking, and educational level. Participants brushing their teeth at least twice daily had a lower AF prevalence compared with those brushing only once daily. Hs-CRP, IL-6, and the odds of AF increased as a function of PD severity grades in unadjusted analysis. However, neither the DMFT index nor IL-6 or CRP was associated with AF after adjusting for age and sex. Mediation analyses could not provide support for the hypothesis that IL-6 or CRP acted as mediator of the association between prevalent PD and prevalent AF. Conclusion The study shows an association between prevalent AF and increased dental plaque levels indicated by a higher PI. In contrast, an association of prevalent PD with prevalent AF after adjustments for several confounders could not be demonstrated. Further studies are necessary to investigate the mechanisms underlying poor oral hygiene and AF as well as the influence of improved oral hygiene on AF onset.

ABO Blood Group as a Potential Risk Factor for Dental Caries: A Cross-Sectional Study

Introduction: Dental caries is a multifactorial disease that affects people of all ages due to a complex interplay between genetic and environmental variables. The significance of genetics in an individual's vulnerability to caries has recently been explored in scientific literature. One such inherited genetic characteristic is blood group. The relationship between blood type, lifestyle, and dental caries may shed light on the above idea. Aim: To explore into blood type as a possible risk factor for the development of dental caries. Material And Methods: Blood samples from 39 people of the index ages (5, 12, 15, 35-44, and 60-74 years) were taken, and blood grouping was done before oral screening to determine the DMFT index. A self-administered questionnaire was used to conduct a complete diet analysis. SPSS software was used to do statistical analysis on the data. Results: In different age groups, there was a strong link between different blood types, DMFT index, and diet. Conclusion: The current study's results demonstrate that genetic and epigenetic variables play a significant influence in the development of dental caries. As a result, blood groups can be utilised to detect if a certain diet is associated with the development of dental caries. Keywords: Dental caries, ABO antigens, Blood group, DMFT index, risk predictors

Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics

Background The treatment of acute pain is part of everyday dental practice. Often, these symptoms result from years of patients' inadequate or missing dental routines and lead to a reduction in the quality of life or health of the patients and to high costs for the health care system. Despite the enormous advantages of modern dentistry, many patients avoid going to the dentist. Therefore, the study aimed to determine the reasons and behaviours that cause patients to avoid visits to the dentist. Methods We conducted semi-structured interviews with patients who had an above-average DMFT index and had been going to the dentist only irregularly for years. The sample participants were recruited from the northern German region of Mecklenburg-Western Pomerania. 20 individual interviews were recorded, transcribed verbatim and coded. We used a qualitative framework approach to code the transcripts in order to establish a consensus among the researchers. Ultimately, through discussions and reviews of the attributes and meaning of the topics, a typology could be established. Results A typology of patients who avoid the dentist was developed. Four independent characteristic patterns of dentist avoidance could be developed: avoiding the dentist due to "distance" (type A; includes subtype A1 "avoiding the dentist due to negligence" and subtype A2 "dental avoidance due to neutralization"), "disappointment" (type B), "shame" (type C), and "fear" (type D). Using the typology as a generalised tool to determine the minimum and maximum contrasts, it was possible to capture the diversity and multidimensionality of the reasons and behaviours for avoidance. All patients had negative dental experiences, which had led to different avoidance patterns and strategies. Conclusions The identified avoidance characteristics represent a spectrum of patients from Northern Germany who avoid going to the dentist. This is the first comprehensive study in Germany representing avoidance behaviour of dentist patients in the form of a typology. The results suggest that dentistry also needs qualitative research to better understand patient characteristics and provide direct access to patients who avoid regular dental visits. Thus, the results make a potentially fundamental contribution to the improvement of dental care and enrich its understanding.

Evaluation of Oral and Dental Health Status in Pregnant Women Referring to Fatemieh Hospital in Hamadan City during 2018

Introduction: Physiological changes during pregnancy affect the teeth and tissues of the mouth and gums, which increases the severity of problems such as caries, inflammation, bleeding and swelling of the gum. Therefore, pregnant people need regular check-ups and provide adequate education. The aim of this study was evaluation of oral and dental health status in pregnant women referring to Fatemieh Hospital in Hamadan City during 2018. Methods: This study was performed on 96 pregnant women. The adjusted questionnaire was completed for each individual by interview method in order to complete the section on personal and pregnancy data and examination in order to complete the section on oral and dental health status. Statistical analysis was performed using SPSS version 16 software. Results: The mean age of the participants was 29.64. The Decay Missing Filling Teeth (DMFT) index in pregnant women was 10.48 ± 3.81. 75.74% of the participants were positive in terms of BOP. 12.50% had dry mouth. Using gingival index, 68.75% of the subjects had gingivitis and the mean gingival index was 0.98 ± 0.79%. In terms of oral hygiene, using the index plaque assessment, the majority of the participants was moderate (45.83%) and the mean plaque index was 1.27 ± 0.62%. Conclusion: Pregnant mothers have a moderate oral health. For this reason, it is necessary to inform physicians in order to refer them to dentists and educate pregnant women to observe oral hygiene and prevent the occurrence of oral diseases and gingivitis in pregnancy.