Effect of Treating Periodontal Disease in Pregnant Women to Reduce the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review.

Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR-2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.

hTERT Peptide Fragment GV1001 Prevents the Development of Porphyromonas gingivalis-Induced Periodontal Disease and Systemic Disorders in ApoE-Deficient Mice.

GV1001, an anticancer vaccine, exhibits other biological functions, including anti-inflammatory and antioxidant activity. It also suppresses the development of ligature-induced periodontitis in mice. Porphyromonas gingivalis (Pg), a major human oral bacterium implicated in the development of periodontitis, is associated with various systemic disorders, such as atherosclerosis and Alzheimer's disease (AD). This study aimed to explore the protective effects of GV1001 against Pg-induced periodontal disease, atherosclerosis, and AD-like conditions in Apolipoprotein (ApoE)-deficient mice. GV1001 effectively mitigated the development of Pg-induced periodontal disease, atherosclerosis, and AD-like conditions by counteracting Pg-induced local and systemic inflammation, partly by inhibiting the accumulation of Pg DNA aggregates, Pg lipopolysaccharides (LPS), and gingipains in the gingival tissue, arterial wall, and brain. GV1001 attenuated the development of atherosclerosis by inhibiting vascular inflammation, lipid deposition in the arterial wall, endothelial to mesenchymal cell transition (EndMT), the expression of Cluster of Differentiation 47 (CD47) from arterial smooth muscle cells, and the formation of foam cells in mice with Pg-induced periodontal disease. GV1001 also suppressed the accumulation of AD biomarkers in the brains of mice with periodontal disease. Overall, these findings suggest that GV1001 holds promise as a preventive agent in the development of atherosclerosis and AD-like conditions associated with periodontal disease.

A review of oral health promotion programmes in Eastern Mediterranean Region.

Background: Oral health conditions, such as dental caries, periodontal disease, tooth loss, dental fluorosis, dental trauma, and oral cancer, are prevalent in the WHO Eastern Mediterranean Region. However, there has been no systematic review of oral health promotion interventions in the region. Aims: To review existing literature on oral health promotion programmes in the Eastern Mediterranean Region and recommend improvements for the future. Method: We reviewed on PubMed and Google Scholar 61 articles published in the Eastern Mediterranean Region between 2010 and 2023. Quality assessment of included studies was performed using established criteria. We used the content analysis approach to create appropriate themes from the studies and to document meaningful conclusions about oral health promotion. Results: Majority of the studies were cross-sectional, a few were randomized controlled, quasi-experimental, longitudinal studies, or reviews. Oral health problems identified included poor oral health knowledge, dental caries, periodontal disease, tooth loss, dental fluorosis, and oral cancer. Although oral disorders were common in most of the countries, very few have implemented oral health promotion programmes. Conclusion: We recommend prioritization of oral health promotion programmes in the Eastern Mediterranean Region to tackle the diverse oral health challenges. To be effective, such programmes should be region- and context-specific. More studies on oral health promotion are needed in the region.

Oral Irrigation Devices: A Scoping Review.

OBJECTIVES: Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that may benefit oral health. However, the effects of oral irrigation on oral health, its role in oral home care, and its mechanism of action are not fully understood. A comprehensive search of the literature revealed no existing broad scoping reviews on oral irrigators. Therefore, this study aimed to provide a comprehensive systematic review of the literature on oral irrigation devices and identify evidence gaps. METHODS: The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were utilized to prepare the review. Four databases and eight gray literature sources were searched for English publications across any geographical location or setting. RESULTS: Two hundred and seventy-five sources were included, predominantly from scientific journals and academic settings. Most studies originated from North America. Research primarily involved adults, with limited studies in children and adolescents. Oral irrigation was safe and well-accepted when used appropriately. It reduced periodontal inflammation, potentially by modulating the oral microbiota, but further research needs to clarify its mechanism of action. Promising results were reported in populations with dental implants and special needs. Patient acceptance appeared high, but standardized patient-reported outcome measures were rarely used. Anti-inflammatory benefits occurred consistently across populations and irrigant solutions. Plaque reduction findings were mixed, potentially reflecting differences in study designs and devices. CONCLUSIONS: Oral irrigators reduce periodontal inflammation, but their impact on plaque removal remains unclear. Well-designed, sufficiently powered trials of appropriate duration need to assess the clinical, microbiological, and inflammatory responses of the periodontium to oral irrigation, particularly those with periodontitis, dental implants, and special needs. Patient-reported outcome measures, costs, caries prevention, and environmental impact of oral irrigation need to be compared to other oral hygiene aids.

Antibacterial activities of phytochemicals against Porphyromonas gingivalis with and without experimental fluoride varnish for periodontal disease prevention.

We aimed to evaluate the antibacterial activity of phytochemicals with or without an experimental fluoride varnish against Porphyromonas gingivalis. Five phytochemicals, chrysophanol (CHR), emodin (EMO), anthrarufin (ANT), bavachalcone (BCC), and isobavachromene (IBC), were tested using agar diffusion, minimal inhibition concentration (MIC), and minimum bacterial concentration (MBC) assays. We also assessed the cell viability and cytotoxicity of phytochemicals. All phytochemicals showed clear inhibition zones in the agar diffusion test. The inhibition zones of all phytochemical-containing fluoride varnishes were similar to or larger than that of the positive control, excluding that of 1 mM EMO. With or without the fluoride varnish, BCC exhibited the lowest MIC and MBC levels. Cell viability was high in the presence of all phytochemicals except 200 µM EMO. In conclusion, BCC was most effective as a phytochemical alone, while all phytochemical-containing fluoride varnishes inhibited P. gingivalis growth without cytotoxicity.

The role of probiotics for preventing dysbiosis in periodontal disease: a randomized controlled trial.

Background/aim: Scaling and root planing remain inadequate in periodontitis treatment caused by dysbiotic microbial dental plaque. The aim of this clinical trial is to evaluate the effects of probiotics and kefir consumption in initial periodontal therapy (IPT) on oral microbiota composition and treatment outcomes in patients with periodontitis. Materials and methods: The study was carried out in the Gazi University Department of Periodontology, including a sample size of 36 individuals and utilizing a randomized controlled design. Thirty-six patients with periodontitis were randomly allocated to three groups: one receiving probiotic treatment, another receiving kefir, and a third serving as the control group. Obtaining subgingival microbial samples, we recorded plaque, gingival index, bleeding on probing, periodontal pocket depth, and clinical attachment level (periodontal clinical indices) and then performed IPT. For 14 days, patients took either probiotics, kefir, or no supplements. Data for the first and third months were collected using periodontal clinical indices. DNA sequencing was performed to detect Tannerella forsythia, Porphyromonas gingivalis, and Treponema denticola in subgingival plaque samples collected at baseline and three months. Results: Significant differences were observed regarding periodontal clinical indices among groups in the intragroup comparisons. Moreover, levels of Tannerella forsythia were significantly decreased in all groups. Conclusion: Kefir can be administered in addition to IPT, providing results similar to those observed with probiotics.

The orthodontic treatment and the periodontal status of patients.

OBJECTIVE: Aim: To review and analyze modern professional literature on the impact of orthodontic treatment of maxillofacial anomalies on the periodontal status of patients, in particular, the subsiqent pathogenetic mechanisms of the development of periodontal diseases in this category of patients. PATIENTS AND METHODS: Materials and Methods: Bibliometric and analytical methods were used data from international scientific sources in the field of studying the impact of orthodontic treatment on the state of periodontal tissues were used. Conclusions: Patients undergoing orthodontic treatment need the increased attention to the state of periodontal tissues and regular high-quality both professional and individual oral hygiene. A comprehensive approach to treatment and preventive measures for periodontal diseases, taking into account all pathogenetic links of their development in this category of patients, aims not only to keep the periodontium healthy, but also to ensure successful completion of orthodontic treatment. Taking into account consideration the periodontal status of patients allows individual correction of the treatment plan to increase its clinical effectiveness both in the early and in the long term.

Supportive periodontal care in dental practice: Part 1 - the importance and implications for general dental practitioners.

Supportive periodontal care is an essential component of maintaining the outcome of periodontal treatment. It is essential to ensure cost benefit to both patients and the health services where millions are spent on treating patients with periodontal disease. The dentist must be able to recognise the crucial and important role they play in providing supportive care and therapy to periodontally compromised patients, either independently or as part of a wider dental team, over and above the various challenges they may experience in the provision of such care in general dental practice. The timely intervention with treatment or referral during this phase will help reduce the risk of tooth loss and adverse consequences to the dentist and their team by way of litigation. The aim of this paper is to provide an update on the delivery of supportive periodontal care in general dental practice with a particular reference to the role of the dentist.

Oral health knowledge, attitudes and behaviours of adults: Findings from a National Oral Health Survey in Singapore.

OBJECTIVES: Prevention complements the curative management of oral diseases. Effective preventive interventions involve the adoption of oral health promoting behaviours. Little is known about the awareness of oral disease and its prevention among Singaporean adults as well as their prevailing oral health attitudes and behaviours. The aim of the study was to describe the oral health knowledge, attitudes and behaviours of adults in Singapore. METHODS: A random sample of adults (≥21 years old) in Singapore was selected to complete an interviewer-administered questionnaire. The questionnaire gathered information about their knowledge of the aetiology, signs and symptoms as well as prevention of dental caries and periodontal disease; attitudes about the value of teeth, locus of control in maintaining oral health and oral health behaviours including toothbrushing, flossing and dental attendance. RESULTS: A total of 1196 adults of weighted mean age 48 years old with almost equal proportions of males and females responded to the questionnaire. Participants were more unaware about the causes of periodontal disease (25.7%) than dental caries (4%). While more than 90% of participants felt that healthy teeth were important and could affect their overall health, many (67.0%) felt it was natural to lose their teeth with old age. Among the participants, 83.5% brushed their teeth twice a day; 41.9% flossed their teeth and 53.9% visited the dentist at least once a year. CONCLUSIONS: The study findings showed good knowledge around dental caries but some gaps around periodontal disease. It also found that participants perceived having limited control over preventing tooth loss. Irregular dental attendance and poor denture wearing habits were also noted. The findings shed light on key areas to focus on through oral health promotion to improve overall oral health.

Sports Diet and Oral Health in Athletes: A Comprehensive Review.

Food and fluid supply is fundamental for optimal athletic performance but can also be a risk factor for caries, dental erosion, and periodontal diseases, which in turn can impair athletic performance. Many studies have reported a high prevalence of oral diseases in elite athletes, notably dental caries 20-84%, dental erosion 42-59%, gingivitis 58-77%, and periodontal disease 15-41%, caused by frequent consumption of sugars/carbohydrates, polyunsaturated fats, or deficient protein intake. There are three possible major reasons for poor oral health in athletes which are addressed in this review: oxidative stress, sports diet, and oral hygiene. This update particularly summarizes potential sports nutritional effects on athletes' dental health. Overall, sports diet appropriately applied to deliver benefits for performance associated with oral hygiene requirements is necessary to ensure athletes' health. The overall aim is to help athletes, dentists, and nutritionists understand the tangled connections between sports diet, oral health, and oral healthcare to develop mitigation strategies to reduce the risk of dental diseases due to nutrition.

Medicinal herbs, especially Hibiscus sabdariffa, inhibit oral pathogenic bacteria.

OBJECTIVES: Medicinal herbs are plants with potential medicinal and health benefits. In recent years, they are being increasingly used as a treatment alternative owing to their effectiveness against various diseases. In this study, we investigated the inhibitory effects of 15 medicinal herbs on causative bacteria for dental caries and periodontal disease. METHODS: This study evaluated the effects of the extracts of 15 medicinal herbs on growth and biofilm formation in five oral pathogenic bacterial strains. The herbs were processed into extracts, and bacterial strains were cultured. Then, bacterial growth and biofilm formation were assessed using various methods. Finally, the extract of the herb Hibiscus sabdariffa (hibiscus) was analyzed using high-performance liquid chromatography. RESULTS: Incubation of bacteria with the herbal extracts showed that hibiscus exerted a significant inhibitory effect on all the oral pathogenic bacterial strains evaluated in this study. In addition, the pigment delphinidin-3-sambubioside, which is found in hibiscus extract, was identified as a particularly important inhibitory component. CONCLUSIONS: These results lay the ground work for the potential development of novel therapeutic or preventive agents against dental caries and periodontal disease, two major oral diseases.

Effects of interdental aids on clinical periodontal indices.

BACKGROUND: Removal of plaque and food particle between teeth represent interdental cleaning. Every patient's self-care program includes plaque removal efficiently and systematically. Periodontal disease, tooth decay and tooth loss may result from the absence of interdental cleaning or even an irregular and unsuccessful interdental cleaning. AIM: The aim of the current study was to assess the effect of inter-dental aids, including dental floss and toothpicks, on gingival and plaque indices. METHODS: A questionnaire including age, gender, education level and other information was obtained from 150 male subjects who were systemically and periodontally healthy. Clinical periodontal parameters (including plaque index and gingival index) were taken from each subject. The participants were categorized into different groups according to the use of inter-dental aids (dental floss, dental picks and without any interdental aids). The participants were divided into the toothbrush-alone group, including participants who did not use either dental floss or toothpicks; the dental floss group, including participants who used dental floss; and the toothpick group including participants who used toothpicks. Plaque and gingival indices compared among groups. RESULTS: Statistical analysis showed that the maximum mean of Plaque index was found in the toothbrush-alone group (1.09 ± 0.43), while the lowest mean of Plaque index was found in the dental floss group (0.87 ± 0.39). Plaque index of the toothpick group was (0.99 ± 0.41) with statistically significant difference among groups (p-value = 0.04*). CONCLUSION: In conclusion, dental floss is the most effective mean of removing interdental plaque.

Factors associated with periodontal diseases in pregnancy: Findings of the 2015 Pelotas Birth Cohort Study.

Although periodontal disease is common during pregnancy, little is known about socioeconomic, behavioral, or biological determinants related to clinically assessed periodontal condition during this period. We assessed the prevalence of periodontal disease and associated factors in pregnant women. This population-based survey used data used from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth between December 2014 and May 2016 were interviewed and clinically examined by trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Outcomes were periodontitis (using the 2012 Centers for Disease Control and Prevention and the American Academy of Periodontology criteria) and gingivitis (by the 2018 European Federation of Periodontology/ American Academy of Periodontology classification). Multivariate hierarchical Poisson regression was used to assess the associations between socioeconomic, systemic, and clinical oral factors and periodontal disease. A total of 2,474 pregnant women participated in the study. Prevalence of periodontitis and gingivitis was 14.63% and 21.67%, respectively. Lower educational level and calculus were associated with higher prevalence periodontitis and gingivitis (P<0.05). Smoking was also associated with periodontitis (P=0.05), and lower frequency of toothbrushing (P=0.005) with gingivitis. Periodontal disease, especially gingivitis, was prevalent in pregnant women and their determinants were socioeconomic, environmental, and clinical oral health factors.

Sex as a Biological Variable in Oral Diseases: Evidence and Future Prospects.

The interest of the scientific community on sex and gender differences in health and disease has increased substantially over the past 25 to 30 y as a result of a long process of events and policies in the biomedical field. This is crucial as compelling evidence from human and animal model studies has demonstrated that sex and gender influence health, molecular and cellular processes, and response and predisposition to disease. The present scoping review aims to provide a synthesis of sex differences in oral diseases, ranging from periodontal disease to orofacial pain conditions, from risk of caries development to apical periodontitis. Overall, findings from this review further support a role for sexual dimorphism influencing disease predisposition and/or progression in oral diseases. Of note, this review also highlights the lack of consideration of additional factors such as gender and other psychosocial and external factors potentially influencing oral health and disease. New conceptual frameworks capable of capturing multiple fundamental domains and measurements should be developed in clinical and preclinical studies to inform sex-based individualized preventive and treatment strategies.

Screening and Preventive Interventions for Oral Health in Adults: US Preventive Services Task Force Recommendation Statement.

Importance: Oral health is fundamental to health and well-being across the life span. Dental caries (cavities) and periodontal disease (gum disease) are common and often untreated oral health conditions that affect eating, speaking, learning, smiling, and employment potential. Untreated oral health conditions can lead to tooth loss, irreversible tooth damage, and other serious adverse health outcomes. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate screening and preventive interventions for oral health conditions in adults. Population: Asymptomatic adults 18 years or older. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults. Recommendations: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement).

Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Adults: A Systematic Review for the US Preventive Services Task Force.

Importance: Dental caries and periodontal disease are common adult oral health conditions and potentially amenable to primary care screening and prevention. Objective: To systematically review the evidence on primary care screening and prevention of dental caries and periodontal disease in adults to inform the US Preventive Services Task Force. Data Sources: MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (to October 3, 2022); surveillance through July 21, 2023. Study Selection: Diagnostic accuracy studies of primary care screening instruments and oral examination; randomized and nonrandomized trials of screening and preventive interventions; cohort studies on primary care oral health screening and preventive intervention harms. Data Extraction and Synthesis: One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. Diagnostic accuracy data were pooled using a bivariate mixed-effects binary regression model. Main Outcomes and Measures: Dental caries, periodontal disease, morbidity, quality of life, harms; and diagnostic test accuracy. Results: Five randomized clinical trials, 5 nonrandomized trials, and 6 observational studies (total 3300 participants) were included. One poor-quality trial (n = 477) found no difference between oral health screening during pregnancy vs no screening in caries, periodontal disease, or birth outcomes. One study (n = 86) found oral health examination by 2 primary care clinicians associated with low sensitivity (0.42 and 0.56) and high specificity (0.84 and 0.87) for periodontal disease and with variable sensitivity (0.33 and 0.83) and high specificity (0.80 and 0.93) for dental caries. Four studies (n = 965) found screening questionnaires associated with a pooled sensitivity of 0.72 (95% CI, 0.57-0.83) and specificity of 0.74 (95% CI, 0.66-0.82) for periodontal disease. For preventive interventions no study evaluated primary care counseling or dental referral, and evidence from 2 poor-quality trials (n = 178) of sealants, and 1 fair-quality and 4 poor-quality trials (n = 971) of topical fluorides, was insufficient. Three fair-quality trials (n = 590) of persons with mean age 72 to 80 years found silver diamine fluoride solution associated with fewer new root caries lesions or fillings vs placebo (mean reduction, -0.33 to -1.3) and decreased likelihood of new root caries lesion (2 trials; adjusted odds ratio, 0.4 [95% CI, 0.3-0.7]). No trial evaluated primary care-administered preventive interventions. Conclusions and Relevance: Screening questionnaires were associated with moderate diagnostic accuracy for periodontal disease. Research is needed to determine benefits and harms of oral health primary care screening and preventive interventions.

Periodontal examination and screening.

Periodontal screening is an important tool in dental practice, and the BPE system is recommended. Clinically, visual examination should identify inflammatory change, recession and enlargement. However, detailed periodontal charting is required in all patients with significant levels of disease. In addition, radiographic examination is important to verify loss of bone and to show root anatomy.

Dental Care Of The Pregnant Patient: An Update Of Guidelines And Recommendations.

Pregnancy is a dynamic state marked by several physiological changes. Oral healthcare in pregnancy is often avoided and misunderstood, with healthcare professionals struggling to interpret the safety and appropriateness of dental treatment during this period. Despite international guidelines and consensus reports indicating that preventive and restorative dental treatment are safe and essential, there is still a widespread belief among healthcare professionals and general population in Pakistan that dental treatment during pregnancy may pose damage to the foetus. Over the past three decades, as human knowledge of the biology behind periodontal diseases broadened, its systemic impact upon various physiological states is better understood and management protocols are accordingly formulated. Lack of knowledge among dentists regarding the timing of routine dental treatment, avoidance of certain medications and poor understanding of the clinical changes in the periodontium of the pregnant patient needs to be addressed so that timely treatment is provided. The current narrative review was planned to highlight the physiological and pathological changes that may occur in the oral cavity of a pregnant patient.

Association between Dental Diseases and Oral Hygiene Care and the Risk of Dementia: A Retrospective Cohort Study.

OBJECTIVES: To investigate the associations of dental diseases and oral hygiene care with the risk of dementia. DESIGN: Retrospective longitudinal cohort study. SETTING AND PARTICIPANTS: We conducted a population-based study of individuals in the Korean National Health Insurance System. A total of 2,555,618 participants who underwent cardiovascular and dental screenings in 2008 were included. METHODS: Dental diseases including periodontal diseases, dental caries, and tooth loss were assessed by dentists. Information on oral hygiene care, including professional dental cleaning and the frequency of tooth brushing, was collected using a self-administered questionnaire. Study outcomes were all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). RESULTS: Periodontal diseases [adjusted hazard ratio (aHR) 1.07, 95% CI 1.04-1.09], dental caries (aHR 1.03, 95% CI 1.00-1.05), and 8-14 missing teeth (aHR 1.07, 95% CI 1.02-1.12) were associated with an increased risk of all-cause dementia. In contrast, either professional dental cleaning or frequent tooth brushing were associated with decreased risks of all-cause dementia (aHR 0.91, 95% CI 0.89-0.93 each; aHR 0.83, 95% CI 0.80-0.86 for both). The increased risks by dental diseases were reduced by oral hygiene care: periodontal diseases with professional dental cleaning (aHR 0.94, 95% CI 0.91-0.98) or tooth brushing ≥2 times/day (aHR 0.97, 95% CI 0.94-1.00) and 1 to 7 missing teeth with professional dental cleaning (aHR 0.94, 95% CI 0.89-0.98) or tooth brushing ≥2 times/day (aHR 0.92, 95% CI 0.89-0.95). Consistent results were noted for AD and VaD and in various subgroup analyses. CONCLUSION AND IMPLICATIONS: Periodontal disease, dental caries, and a high number of missing teeth were independently associated with a higher risk of dementia. Conversely, improved oral hygiene care, such as professional dental cleaning and frequent tooth brushing, may modify the risk of dementia associated with dental diseases.