Knowledge, attitude, and practice of patients with oral diseases toward oral examinations: a cross-sectional survey study.

Background: Properly adhering to oral hygiene and medical care is an important public health issue. Several studies examined the knowledge, attitudes, and practices (KAP) toward oral care in various populations and generally reported relatively sufficient knowledge but unfavorable attitudes and poor practice. However, no previous studies have examined the KAP toward oral examinations among Chinese patients with oral diseases. This study aimed to examine the KAP toward oral examinations among patients with oral diseases in China. Methods: This cross-sectional study was conducted in patients with oral diseases who visited The Affiliated Stomatological Hospital of Tongji University between December 2023 and February 2024. Data collection and KAP scores assessment were performed using a self-designed questionnaire. Results: A total of 519 valid questionnaires were included, with 292 females. The mean knowledge, attitude, and practice scores were 6.42 ± 2.47 (possible range: 0-9 points), 35.04 ± 5.68 (possible range: 10-50 points), and 16.22 ± 2.05 (possible range: 4-20 points), respectively, indicating sufficient knowledge, positive attitudes, and proactive practice. Pearson's correlation analysis showed that knowledge was positively correlated to attitude (r = 0.468, p < 0.001) and practice (OR = 0.416, p < 0.001). Attitude was positively correlated to the practice (r = 0.503, p < 0.001). Moreover, the structural equation model showed that knowledge influenced attitude (estimate = 1.010, p < 0.001) and practice (estimate = 0.169, p < 0.001). Attitude influenced practice (estimate = 0.122, p < 0.001). The frequency of oral examination per year influenced knowledge (estimate = -0.761, p < 0.001) and practice (estimate = -0.515, p < 0.001). Expenses for oral disease per year influenced attitude (estimate = 0.537, p < 0.001). Conclusion: Patients with oral disease might have sufficient knowledge, positive attitude, and proactive practice toward oral examinations. Specific knowledge items were identified to require improvements.

Are parental sociodemographic factors, oral health knowledge and practices linked to the oral health habits of their children with cleft lip and palate?

OBJECTIVE: Children with cleft lip and palate (CLP) have a greater risk of dental caries. The parents' knowledge and attitudes may have an impact on their children's oral health and dietary habits. Therefore, the aim of this study was to assess the socio-demographic characteristics, oral health knowledge, oral health behaviours, and habits of the parents in addition to the relationship with the oral health and dietary practices of their children with CLP. MATERIAL AND METHODS: The parents of 343 patients with CLP participated in the study. An online questionnaire with 52 questions regarding sociodemographic characteristics, oral health and oral hygiene practices was presented to them. RESULTS: Parents with higher level of education had better oral health knowledge (p < 0.05). Logistic regression analysis showed that the factors affecting the child's tooth brushing habits were the mother's age (odds ratio [OR] = 1.071, 95% confidence interval [CI]: 1.062-1.153), the father's employment status (OR = 2.089, 95%CI: 1.065-4.097), and the mother's last dental visit (OR = 1.995, 95%CI: 1.119-3.557). The factors affecting the child's toothpaste usage were the mother's age (OR = 1.106, 95%CI: 1.030-1.114), the father's employment status (OR = 2.124, 95%CI: 1.036-4.354), and the mother's last dental visit (OR = 2.076, 95%CI: 1.137-3.79). CONCLUSIONS: Parental factors have a significant influence on the oral health-related behaviours of children with CLP.

Dental treatment of children under general anesthesia during the period of matrial law.

OBJECTIVE: Aim: To summarize the experience of providing dental medical care under general anesthesia to children from different regions of Ukraine during the martial law, taking into account the factors affecting the choice of optimal conditions for dental treatment. PATIENTS AND METHODS: Materials and Methods: Dental treatment under general anesthesia of 1,258 children from different regions of Ukraine has been performed since March 2022. The condition of the teeth (df, df+DMF, DMF) and hygienic state of the oral cavity (OHI-S) were determined. The level of awareness of parents regarding the preservation of children's dental health was studied through a questionnaire. RESULTS: Results: An unsatisfactory oral hygiene, a high level of caries were found in the vast majority of children. The highest df was observed in the group of children aged 3 to 6 years (7.14±0.33), which is significantly higher than in the group of children under 3 years of age (4.32±1.04, p≤0.05). The worst oral hygiene was observed in children aged 6-12 years (OHI-S 2.62±0.32). An insufficient level of awareness of parents and children regarding dental health was revealed. A total of 1,712 operations under general anesthesia were performed. The majority of patients could not regularly appear for follow-up examinations due to the forced departure from the country. CONCLUSION: Conclusions: The organization of dental treatment under general anesthesia allows solving a number of problems of dental care for children during the war.

Impact of Pregestational Obesity on the Oral Health-Related Quality of Life in Brazilian Pregnant Women: A Cohort Study.

The oral health-related quality of life of pregnant women and its effects on health conditions are important topics to be investigated in scientific research. The objective of this study was to evaluate the impact of pre-pregnancy obesity on oral health-related quality of life (OHRQoL) in pregnant women. A prospective cohort study was carried out with 93 pregnant women who were evaluated in the 2nd trimester of pregnancy (T1) and after delivery (T2). The following were analyzed: dental caries (DMFT), OHRQoL (OHIP-14), anthropometric data (BMI), socioeconomic, demographic, oral hygiene behavioral habits and the use of dental services. Unadjusted and adjusted Poisson regression analyses were performed to determine the impact of predictors on OHRQoL. The results of the adjusted analysis showed lower education relative risk (RR) (1.37; 95%CI 1.02-1.83; <0.00), low income (RR 2.19; 95%CI 1.63-2.93; <0.00) and higher BMI pre-pregnancy (RR 1.03; 95% CI 1.01-1.04; <0.00) were associated with worse OHRQoL in postpartum pregnant women. Flossing was a predictor of better OHRQoL at T2 (RR 0.73; 95%CI 0.57-0.93; <0.01). Higher BMI, low education, low income and inadequate oral hygiene habits were predictors of worse OHRQOL of pregnant women after the birth of the baby.

Oral Health Knowledge and Oral Hygiene Habits in a Sample of 12-Year-Old Hispanics: A Cross-sectional Study.

OBJECTIVE: To explore the association between hygiene knowledge and habits and gingivitis in Puerto Rican school children. METHODS: Questionnaires on oral health knowledge and hygiene habits were provided to almost half of the 12-year-olds who participated in an island-wide cross-sectional oral health study. The evaluations included gingival examinations in 2 quadrants. Odds ratios (ORs) (with 95% CIs) were computed using logistic regression models and oral health-related knowledge and hygiene habits to gingivitis. RESULTS: Of the 823 participants who completed the questionnaire 53.43% were female, and 81% had gingivitis. Most reported having received instructions on brushing (98%), flossing (89.5%), and using mouthwash (90%). The majority (75%) rated their gums as healthy, and 44.68% agreed that oral health affects general health. Nearly half (44%) reported brushing their teeth at least 2 times a day, and 80.25%, flossing daily. In multivariate analysis, not having been instructed on how to brush was related to greater odds of having gingivitis (OR: 7.32; 95% CI: 1.5-35.67). Flossing more than once a day was associated with half the odds of gingivitis (OR: 0.50; 95% CI: 0.29-0.88). CONCLUSION: The children had knowledge of oral hygiene methods but were mostly unaware that gingival health could affect systemic health. Fewer than half reported brushing 2 or more times a day. Not having been instructed on how to brush was associated with higher odds of gingivitis.

Minimal changes in daily flossing behavior among US adults from 2009 through 2020.

BACKGROUND: Flossing is considered to be an integral component of oral hygiene. The authors evaluated trends in daily flossing and their associations with sociodemographic variables. METHODS: The authors used data from the 2009-2020 National Health and Nutrition Examination Surveys, accounting for survey weights in all analyses. Descriptive statistics were computed for all study variables. Pooled univariable and multivariable logistic regression were performed to evaluate which sociodemographic factors were associated with daily flossing and to assess potential interactions with survey periods. Multivariable logistic regression was performed and stratified according to survey period. RESULTS: This study included 26,624 adults. Although the prevalence of daily flossing increased from 29.4% in 2009 through 2010 to 34.8% in 2017 through 2020, this increase was not significant after multivariable adjustment. Results of the pooled survey logistic regression also showed that participants who were older, female, Hispanic, and had a higher income to poverty ratio had higher odds of daily flossing. The interaction between education and survey period was significantly associated with daily flossing (P = .012). Logistic regression for each survey period corroborated the pooled model results. CONCLUSIONS: Approximately 1 in 3 adults in the United States reported flossing daily (32.7%). Although the prevalence of daily flossing increased from 2009 through 2020, this change was not significant after controlling for sociodemographic variables. PRACTICAL IMPLICATIONS: The nonsignificant changes in flossing behavior from 2009 through 2020 suggest that messaging to encourage adults to floss daily has had little effect. Although the authors did not elucidate the benefits of flossing, dental providers should continue to consider encouraging patients to floss until new evidence suggests otherwise.

Unique dietary and oral hygiene behaviors in a cohort with clinically severe obesity: A cross sectional study.

BACKGROUND: An association between increased risk of dental caries with increased levels of clinically severe obesity has been reported. Data linking body mass index (BMI) and dietary behaviors, including at-risk dietary factors and oral hygiene habits, are lacking in a cohort with clinically severe obesity. This study aimed to explore the dietary and oral hygiene behaviors in individuals with clinically severe obesity attending a hospital-based obesity service. METHODS: Adult patients attending a hospital-based obesity service in Greater Western Sydney with clinically severe obesity were invited to participate in a self-administered survey, which collected data on their nutritional and oral hygiene behaviors. Demographic data (age, gender) and BMI were extracted from the participants' medical records. The primary outcome was the relationship between BMI and frequency of toothbrushing. RESULTS: Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire. The median BMI of the cohort was 49.1 kg/m2 (interquartile range [IQR]: 43.2-57.3 kg/m2) and median age 51 (IQR: 39-63) years. BMI was not significantly correlated with individual oral health behaviors (p > .05). Many participants reported dietary risk behaviors, which have the potential to influence their oral health. CONCLUSIONS: While oral health behaviors were not associated with increasing BMI, patients with clinically severe obesity in this study reported unique dietary behaviors and mixed oral hygiene habits that may complicate nutritional and dental management. Awareness of these behaviors among clinicians including dental professionals is required in this cohort.

Dental caries prevalence in relation to the cardiovascular diseases: cross-sectional findings from the Iranian kurdish population.

OBJECTIVE: Oral and dental health (ODH) is a significant public health concern globally, affecting billions of people. This cross-sectional study aimed to examine the prevalence of dental caries using the DMFT index and investigate its relationship with cardiovascular diseases in the Iranian Kurdish population. METHODS: A total of 3,996 individuals aged 35-70 years were included from the Dehgolan prospective cohort study (DehPCS). Clinical examinations were performed to assess decayed (DT), missing (MT) and filled (FT) teeth (DMFT index). Data on demographics, socioeconomic status, medical history, oral hygiene practices were also collected. Cardiovascular disease (CVD) history was self-reported via questionnaires assessing heart disease, heart attack and stroke. Logistic regression was used to assess associations between oral health indicators and self-reported CVD, adjusting for potential confounders. RESULTS: The mean DMFT score was 18.18 ± 19, indicating a high oral disease burden. Specifically, 60.04% had DT, 37.82% had more than 16 MT, and 38.83% had FT. Only 13.21% reported flossing regularly and 43.17% brushed less than daily, showing suboptimal oral hygiene. The overall CVD prevalence was 9.21%. Individuals with high DMFT (≥ 14) scores had approximately two times higher CVD prevalence than those with low DMFT. DMFT decreased by 10.23% with increase in education level, and by 5.87% as economic status increased In adjusted analyses, high DMFT scores (OR = 1.5, 95%CI: 1.2-1.9) and MT (OR = 1.5, 95%CI: 1.1-2.1) were associated with 50-150% increased odds of CVD, though associations weakened after adjusting for age. Among men, DMFT remained a significant predictor for CVD after age adjustment, with an odds ratio of 2.37 (95% CI: 1.22-4.60). CONCLUSION: This population had substantial oral disease and poor oral hygiene. Higher DMFT scores and MT positively correlated with increased CVD prevalence. Promoting preventive oral care and health education could help reduce dental issues and potentially lower CVD risk. Further research is needed to clarify biological mechanisms linking oral and systemic health.

Oral self-care among dependent older New Zealanders.

OBJECTIVES: The objective of the study was to describe the occurrence and associations of oral self-care by dependent older New Zealanders. BACKGROUND: Dependent older adults who require some level of assisted daily care have been shown to have poorer oral health than their independent counterparts, yet national estimates are lacking. MATERIALS AND METHODS: A secondary analysis was conducted of data from New Zealand's 2012 Older People's Oral Health Survey, a national survey that interviewed and examined a representative sample of 2,218 dependent older adults living in aged residential care or receiving home-based care. Survey data were weighted for statistical analyses, and modelling was carried out using a modified Poisson approach. RESULTS: Overall, 59.5% (95% CI: 55.1, 63.7) of participants brushed their teeth twice a day, with this rate higher among women, Asians and those without cognitive or physical impairment. Cleaning interdentally at least once a week was less common than brushing, at 25.9% (95% CI: 21.5, 30.9), and that proportion was significantly lower among those with higher dependency or who were cognitively or physically impaired. Almost 9 in 10 (87.8%; 95% CI 83.1, 91.4) used fluoride toothpaste, and adults of high socio-economic status had lower rates of fluoride toothpaste use. Only 15.0% (95% CI 12.4, 18.0) used mouthwash, with this being most prevalent in Pasifika. More than half of those who wore dentures also wore them at night. CONCLUSION: Oral self-care was sub-optimal among dependent older New Zealanders. Improving the situation should be a high priority.

Oral care measures for preventing nursing home-acquired pneumonia.

BACKGROUND: Pneumonia in residents of nursing homes can be termed nursing home-acquired pneumonia (NHAP). NHAP is one of the most common infections identified in nursing home residents and has the highest mortality of any infection in this population. NHAP is associated with poor oral hygiene and may be caused by aspiration of oropharyngeal flora into the lung. Oral care measures to remove or disrupt oral plaque might reduce the risk of NHAP. This is the first update of a review published in 2018. OBJECTIVES: To assess effects of oral care measures for preventing nursing home-acquired pneumonia in residents of nursing homes and other long-term care facilities. SEARCH METHODS: An information specialist searched CENTRAL, MEDLINE, Embase, one other database and three trials registers up to 12 May 2022. We also used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that evaluated the effects of oral care measures (brushing, swabbing, denture cleaning mouthrinse, or combination) in residents of any age in nursing homes and other long-term care facilities. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed search results, extracted data, and assessed risk of bias in the included studies. We contacted study authors for additional information. We pooled data from studies with similar interventions and outcomes. We reported risk ratios (RRs) for dichotomous outcomes, mean differences (MDs) for continuous outcomes, and hazard ratios (HRs) or incidence rate ratio (IRR) for time-to-event outcomes, using random-effects models. MAIN RESULTS: We included six RCTs (6244 participants), all of which were at high risk of bias. Three studies were carried out in Japan, two in the USA, and one in France. The studies evaluated one comparison: professional oral care versus usual oral care. We did not include the results from one study (834 participants) because it had been stopped at interim analysis.  Consistent results from five studies, with 5018 participants, provided insufficient evidence of a difference between professional oral care and usual (simple, self-administered) oral care in the incidence of pneumonia. Three studies reported HRs, one reported IRRs, and one reported RRs. Due to the variation in study design and follow-up duration, we decided not to pool the data. We downgraded the certainty of the evidence for this outcome by two levels to low: one level for study limitations (high risk of performance bias), and one level for imprecision. There was low-certainty evidence from meta-analysis of two individually randomised studies that professional oral care may reduce the risk of pneumonia-associated mortality compared with usual oral care at 24 months' follow-up (RR 0.43, 95% CI 0.25 to 0.76, 454 participants). Another study (2513 participants) reported insufficient evidence of a difference for this outcome at 18 months' follow-up. Three studies measured all-cause mortality and identified insufficient evidence of a difference between professional and usual oral care at 12 to 30 months' follow-up. Only one study (834 participants) measured the adverse effects of the interventions. The study identified no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining. No studies evaluated oral care versus no oral care. AUTHORS' CONCLUSIONS: Although low-certainty evidence suggests that professional oral care may reduce mortality compared to usual care when measured at 24 months, the effect of professional oral care on preventing NHAP remains largely unclear. Low-certainty evidence was inconclusive about the effects of this intervention on incidence and number of first episodes of NHAP. Due to differences in study design, effect measures, follow-up duration, and composition of the interventions, we cannot determine the optimal oral care protocol from current evidence.  Future trials will require larger samples, robust methods that ensure low risk of bias, and more practicable interventions for nursing home residents.

Oral health status and practices of 6- to 7-year-old children in Amman, Jordan: a cross-sectional study.

BACKGROUND: Dental caries affects the majority of children in Jordan, with some evidence of its prevalence steadily increasing. Previous studies have shown that families struggle to establish good oral health practices. The aim of this study was to evaluate the current oral health status and practices of 6- to7-year-old children in Amman, Jordan.r METHODS: A cross-sectional cohort study. The sample consisted of 6- to 7-year-old children attending six randomly selected schools in Amman, Jordan. Measures collected were: I) Caries experience (d3mft/D3MFT), II) Oral hygiene, measured using the Simplified Oral Hygiene Index, III) Dietary, toothbrushing, and dental attendance practices, measured using diaries and parental questionnaires, IV) Participants' basic characteristics: age, education and employment. Data were analysed using SPSS20. RESULTS: In total, 942 children were recruited. Four hundred and fifty-seven were boys, 485 were girls. Their average age was 6.5 years. Eighty-nine percent had decay in their primary teeth. Mean d3mft was 5.1(1 (range = 0-12, SD = 2.9). Only 8% of carious teeth were restored. Mean DMFT score was 0.3 (range = 0-4, SD = 0.8). Mean debris score was 1.07 (range = 0-3, SD = 0.37). Children indicated that they brush their teeth 1.6 times a day (range = 0-3, SD = 0.6). The majority (81%) were unsupervised. Sixty-seven percent of parents did not know the appropriate fluoride toothpaste concentration. Children were having 1.5 sugary snacks in-between their meals (Range = 1-6, SD = 1.1). They scored a mean of 2.5 (Range = 0-5.87, SD = 1.7) in sweetened drinks intake (recommended ≤ 1) and 2.8 (Range = 0-18.57, SD = 1.5) in non-core food intake (recommended ≤ 2) on a dietary questionnaire. Most parents (84%) indicated that their child attends the dentist only when in pain, and 18% indicated that their child is extremely afraid of dentists. Only 32% and 18% were familiar with fluoride varnish and fissure sealants, respectively. Regression analysis revealed that debris score and dental attendance were reliable predictors of caries experience. CONCLUSIONS: Six- to seven-year-old children in Amman, Jordan have a high caries experience. Most show signs of poor oral hygiene, excessive intake of cariogenic foods, and symptomatic dental attendance. Their parents lack knowledge on fluoride varnish and fissure sealants. There is a need for oral health promotion tailored to this cohort's need.

Association between the level of indifference to dental treatment and habits of oral hygiene in adults / Asociación entre el nivel de indiferencia al tratamiento dental y los hábitos de higiene bucal

Introduction: Inadequate oral hygiene habits such as lack of tooth brushing, use of irrigators, fluoridated toothpastes, and dental floss, as well as the importance of worrying about going to the dentist in the event of any problem in the oral cavity and the continuity of treatment are factors that could increase the risk in patients. Objetive: To determine the association between the level of indifference to dental treatment and the oral hygiene habits of those surveyed adults. Material and Methods: An observational, analytical and cross-sectional study. The level of indifference to dental treatment was evaluated using a translated virtual questionnaire and subsequently internally validated (Cronbach's alpha: 0.91). There were a total of 249 participants, 150 males and 99 females, with a mean age of 30.69 years. For the association of the qualitative variables and the report of the crude and adjusted odds' ratio (OR), a logistic regression was used. We worked with a level of statistical significance of p<0.05 and a confidence interval of 95%. Results: A high level of indifference to dental treatment was obtained in 57.83% of the respondents. Likewise, a statistically significant association was found between indifference to dental treatment and education (p = 0.012). Regarding oral hygiene habits, a statistically significant association was found with flossing (OR = 2.22; 95% CI: 1.10-4.46) (p = 0.025) and brushing before sleeping (OR = 5.26; 95%: 2.26-12-22) (p<0.001). Conclusion: There is a statistically significant association between the level of indifference to dental treatment with oral hygiene habits, flossing and brushing before sleeping. It is advisable to carry out activities in the communities to promote oral health care to reduce levels of indifference to dental treatment.

Introducción: Los inadecuados hábitos de higiene bucal como la falta de cepillado dental, uso de irrigadores, pastas dentales fluoradas e hilo dental, así como la importancia de preocuparse por acudir al odontólogo ante cualquier problema en la cavidad oral y la continuidad del tratamiento son factores que podrían agravar el riesgo en los pacientes. Objetivo: Determinar la asociación entre el nivel de indiferencia al tratamiento dental y los hábitos de higiene bucal de los encuestados en adultos en edades comprendidas entre los 18 a 45 años de la urbanización Buenos Aires de Villa en Chorrillos, Perú. Material y Métodos: Se realizó un estudio observacional, analítico y transversal. El nivel de indiferencia al tratamiento dental fue evaluado mediante un cuestionario virtual traducido y posteriormente validado internamente (alpha de Cronbach: 0.91). Se tuvo un total de 249 participantes, entre ellos 150 hombres y 99 mujeres con una media edad de 30,69 años. Para la asociación de las variables cualitativas y el reporte de las Odds Ratio (OR) crudas y ajustadas, se empleó una regresión logística. Se trabajó con un nivel de significancia estadística de p<0.05 y un intervalo de confianza del 95%. Resultados: Se obtuvo un alto nivel de indiferencia al tratamiento dental en el 57.83% de los encuestados. Asimismo, se encontró una asociación estadísticamente significativa de la indiferencia al tratamiento dental con la educación (p= 0.012). Respecto a los hábitos de higiene bucal, se encontró asociación estadísticamente significativa con uso de hilo dental (OR=2.22; IC del 95%: 1.10-4.46) (p=0.025) y el cepillado antes de dormir (OR=5.26; IC del 95%: 2.26-12-22) (p<0.001). Conclusión: Se concluyó que existe una asociación estadísticamente significativa entre el nivel de indiferencia al tratamiento dental con los hábitos de higiene bucal uso de hilo dental y cepillado antes de dormir. Se aconseja realizar actividades en las comunidades para promover el cuidado de la salud bucal con la finalidad de reducir los niveles de indiferencia al tratamiento dental.

Medical Conditions, Oral Health Practices, and Barriers to Treatment among Patients Visiting a Teaching Dental Hospital in Eastern Saudi Arabia.

OBJECTIVE: To assess the prevalence of medical conditions, oral hygiene practices, and dental visits among patients who attended a teaching dental hospital in Dammam, Saudi Arabia. Materials & Methods. This retrospective cross-sectional study used patient records from 2009 to 2015 from the dental hospital of the College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam. Patients' demographics, medical history, oral hygiene practices, reasons for attending the facility, attendance patterns, and smoking habits were studied. RESULTS: The study included 1502 records of patients with 65.1% of males and 34.9% of females. The prevalence of medical conditions was 25.7% in the study. The most common medical conditions included diabetes mellitus (7.2%), hypertension (6.5%), and anemia (4.7%). Only 21.8% reported visiting the dental hospital in the past one year. The prevalence of smoking was 16.7%, and this did not differ significantly between healthy and medically compromised patients (P=0.165). Fillings were the most common (21.6%) reason for visiting a dental hospital, followed by treatment for periodontal problems (12.9%) and oral lesions (12.6%), whereas treatment for braces (orthodontics) was the least common (5%) reason for visiting the hospital. The reasons for visiting the hospital did not differ significantly between healthy and medically compromised patients (P > 0.05). The three most common barriers to dental visits included long waiting time (18.1%), fear of dental treatment (14.4%), and difficulty in getting an appointment (11.3%). CONCLUSION: The study showed that dental patients had a high prevalence of medical conditions. Diabetes mellitus was the most prevalent problem. Most patients visited the dental hospital to receive restorative treatment, and a long waiting time was the most common barrier to dental visits. Public health measures should be taken to improve the general health and oral care of patients.

Improved oral hygiene care and chronic kidney disease occurrence: A nationwide population-based retrospective cohort study.

ABSTRACT: Oral diseases or poor oral hygiene have close connections with systemic inflammatory reaction, which is one of major mechanism in the development of chronic kidney disease (CKD). We conducted a research assuming that better oral hygiene care would be negatively related with the risk of developing new-onset CKD.From 2003 to 2004, a total of 158,495 participants from the Korean national health insurance data sharing service which provides health screening data including variables as age, sex, vascular risk factors, medication information, indicators regarding oral hygiene, and laboratory results. The diagnosis of CKD and vascular risk factors were defined according to the International Statistical Classification of Diseases and Related Health Problems codes-10th revision. The follow-up period for the study subject was until the occurrence of CKD, until death, or Dec 31, 2015.Approximately 13.3% of the participants suffered from periodontal disease, and 40.7% brushed their teeth at least three times a day. With a median of 11.6 (interquartile range 11.3-12.2) years' follow-up, the cohort included 3223 cases of incident CKD. The 10-year incidence rate for CKD was 1.80%. In multivariable analysis with adjustment for age, sex, demographics, vascular risk factors, blood pressure, and blood laboratory results, frequent tooth brushing (≥3 times a day) was negatively related to occurrence of CKD (hazard ratio: 0.90, 95% confidence interval [0.83-0.99], P  =  .043, P value for trend  =  .043).Participants with improved oral hygiene (≥3 times a day) have showed less risk of CKD. Additional interventional studies are in need to establish causative relationship between oral hygiene and risk of CKD.

The prevalence and socio-behavioural and clinical covariates of oral health related quality of life in Ugandan mothers with and without HIV-1.

BACKGROUND: There is limited evidence regarding oral health related quality of life of HIV positive populations in sub-Saharan Africa. Focusing HIV positive- and HIV negative Ugandan mothers, this study assessed the influence of HIV status on oral health related quality of life in terms of oral impacts on daily performances, whilst adjusting for clinical- and socio-behavioural factors. We also examined whether any association of clinical and socio-behavioural factors with oral impacts on daily performances vary according to mothers' HIV status. METHODS: This cross-sectional study used data from a trial (n = 164) and a comparison group (n = 181). The trial comprised of mothers with HIV-1 participating in the ANRS 121741-PROMISE-PEP-trial (NCT00640263) conducted between 2009 and 2013 and from the ANRS 12341-PROMISE-PEP-M&S follow-up study conducted in 2017. The comparison group comprised of HIV negative mothers recruited in 2017. Interviews and clinical oral examinations were performed. The oral health related quality of life was assessed using the oral impacts on daily performances frequency scale. Caries experience and gingival bleeding were assessed using the World Health Organization's Decayed, Missed and Filled teeth indices and community periodontal index. Logistic and negative binomial regression analyses were performed. RESULTS: 29% of HIV-1 positive and 32% among the comparison reported any oral impact on daily performance. In adjusted logistic regression analysis, HIV status was not significantly associated with oral impacts on daily performances. Mother's self-reported oral health, caries experience, gingival bleeding and oral health related quality of life of their children were independently associated with oral impacts on daily performances. Corresponding prevalence ratios and 95% confidence intervals were: 0.3 (0.2-0.6), 1.8 (1.0-3.2), 1.1 (1.0-1.1), and 2.1 (1.1-4.3). No significant interaction between HIV status and covariates were observed. CONCLUSIONS: Oral health related quality of life was substantially impaired in Ugandan mothers but did not discriminate between HIV positive and negative participants. Mothers with impaired oral health related quality of life were more likely to have dental caries and children with impaired oral health related quality of life. HIV positive and negative mothers in Uganda deserve special attention regarding their oral disease and quality of life status.

Saliva pH and Flow Rate in Patients with Periodontal Disease and Associated Cardiovascular Disease.

BACKGROUND Periodontal disease, a frequent oral health problem, is connected with cardiovascular morbidity and mortality. This study aimed to assess the unstimulated saliva flow rate and saliva pH as markers of the severity of periodontal disease in patients with cardiovascular disease. MATERIAL AND METHODS A cohort of 155 patients (78 men and 77 women, aged 30-92 years) was included, and a structured questionnaire obtained information about their health status, oral healthcare behaviors, and eating habits. An oral examination was performed to assess periodontal status and presence of dental calculus. The unstimulated whole salivary flow rate and salivary pH were measured. An oral hygienization was performed, and 3 months later, salivary flow rate and pH were reevaluated. RESULTS A severe form of periodontal disease was found in 22.4% of patients. Disease severity was strongly correlated with low pH values (6.25 in stage IV periodontal disease), lower salivary flow rate (0.28 mL/min), smoking, poor oral hygiene habits and obesity, with no significant differences by sex. We observed a significant increase of pH (up to 6.30±0.17) in patients with severe periodontal disease (P=0.001) and salivary flow rate values (0.29±0.07 mL/min; P=0.014) 3 months after oral hygienization. There was a strong association between the severity of periodontal disease and presence of cardiovascular disease (P=0.001). CONCLUSIONS Our study suggests that the decrease of salivary flow rate and pH level might be associated with the severity of periodontal disease.

Disparities in Preventive Oral Health Care and Periodontal Health Among Adults With Diabetes.

INTRODUCTION: People with diabetes are more vulnerable to periodontal disease than those without; thus, practicing preventive oral health care is an important part of diabetes self-care. Our objective was to examine disparities in preventive oral health care among US adults with diabetes. METHODS: We performed a secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Periodontal examinations were conducted in adults aged 30 and older. We compared the weighted prevalence of periodontal disease and the practice of preventive oral health care, including practicing dental interproximal cleaning (flossing or using other interproximal cleaning devices) and use of preventive dental services, among people with and without diabetes. Multivariable logistic regressions were performed to examine the relationship between the presence of diabetes, periodontal disease, and preventive oral health care practices. RESULTS: Weighted prevalence of periodontal disease in the US population was higher among adults with diabetes than those without (58.0% vs 37.6%). This difference persisted after controlling for sociodemographic characteristics and smoking status. People with diabetes were more likely to have periodontal disease (adjusted odds ratio [aOR] 1.39; 95% CI, 1.17-1.65), less likely to practice daily interproximal cleaning (aOR 0.85; 95% CI, 0.75-0.95), and less likely to visit a dentist for preventive care in the past year (aOR 0.86; 95% CI, 0.76-0.96) than people without diabetes. CONCLUSION: Adults with diabetes reported suboptimal preventive oral health care behaviors in use of preventive dental services and interproximal dental cleaning than people without diabetes, despite their health disparity related to periodontal disease. Educating people to improve their preventive oral health care is essential for good oral health and diabetes self-management.

Knowledge, awareness, attitude and practice of dental practitioners regarding Covid-19 pandemic and infection control: a cross sectional study in Kolkata metropolitan region.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic with more than 53,973 people affected in West Bengal state of India. OBJECTIVES: The aim of present study was to assess the Knowledge, Attitudes and Practices (KAP) of dental practitioners in Kolkata city, West Bengal, India regarding COVID-2019 pandemic. MATERIALS AND METHOD: Online questionnaire was distributed among dentists across West Bengal city, using a combination of convenience and snowball sampling. The questionnaire had 17 questions: (1) Section A was 'General section' which comprised of socio-demographic and professional details of the subjects; and (2) Section B comprised of 14 questions depicting knowledge, awareness attitude and practice regarding COVID-19. The data collected was subjected to statistical analysis with level of significance at p=0.05. The descriptive statistical analysis was done to compute frequency and percentages. Intergroup comparison was determined by Chi-square statistical analysis to determine the level of significance for responses of each question. RESULTS: Around 70.4% undergraduates participated in the study. Only 4.3% showed accurate knowledge with respect to the incubation period of coronavirus. Coughing and sneezing was considered to be the most common mode of transmission. 98.9% of dentists considered fever to be the characteristic symptom of the disease. Hand washing and alcohol rubs was advocated by 99.5% of the dentist. Emergency procedures were considered necessary by 90.8% dentists. 75.1% of dentists agree that their practice has been affected by the pandemic. CONCLUSION: A constant update regarding COVID-19 should be made available to dental health care professionals through webinars, seminars, discussions and articles. Dentists should keep themselves updated and help to fight against this pandemic.

Relationship between diabetes self-care practices and control of periodontal disease among type2 diabetes patients in Bangladesh.

INTRODUCTION: The prevalence of periodontal disease is high in diabetes patients worldwide, including Bangladesh. Although associations of periodontal disease outcomes and clinical determinants of diabetes have been investigated, few studies have reported on the relationship between periodontal diseases outcomes with modifiable factors, such as self-care and oral hygiene practices, in patients with diabetes. Moreover, in order to develop targeted strategies, it is also important to estimate their aggregated contribution separately from that of the established sociodemographic and diabetics related clinical determinates. Therefore, this study was performed to elucidate 1) the relationship of diabetes patients' self-care and oral hygiene practices to periodontal disease and 2) the relative contributions of selected factors to periodontal disease outcome in type 2 diabetes patients. METHODS: The data were obtained from the baseline survey of a multicentre, prospective cohort study. A total of 379 adult patients with type 2 diabetes from three diabetic centres in Dhaka, Rajshahi and Barishal, received periodontal examinations using the community periodontal index (CPI) probe, glycated haemoglobin examination, other clinical examinations, and structured questionnaires. Multiple logistics regression analyses were performed to assess the associations between selected factors and prevalence of any periodontal disease and its severity. RESULTS: More than half of the participants were female (53.8%) and 66.8% of the total participants was 21-50 years old. The prevalence of any (CPI code 2+3+4; 75.7%) and severe form (CPI code 4; 35.1%) of periodontal disease were high in type 2 diabetes patients. In multivariate analysis, the odds of periodontal disease increased with unfavourable glycaemic control indicated by HbA1c ≥ 7%, and decreased by 64%, 85% and 92% with adherence to recommended diet, physical activity, and oral hygiene practices, respectively. Diabetes self-care practice explained the highest proportion of the variance (13.9%) followed by oral hygiene practices (10.9%) by modelling any periodontal disease versus no disease. Variables of diabetes conditions and oral hygiene practices explained 10.9% and 7.3% of the variance by modelling severe (CPI code 4) or moderate (CPI code 3) forms of periodontal disease versus mild form of periodontal disease. Findings also conferred that while poor diabetes control had an individually adverse association with any form of periodontal diseases and its severity, the risk of diseases was moderated by oral hygiene practices. CONCLUSIONS: This study suggested that, in addition to diabetes-related clinical determinants, self-care practices, and oral hygiene practices must be taken into consideration for prevention and control of periodontal disease in patients with diabetes.

Oral Health and Risk of Upper Gastrointestinal Cancers in a Large Prospective Study from a High-risk Region: Golestan Cohort Study.

Tooth loss and periodontal disease have been associated with several cancers, and poor oral health may be an important risk factor for upper gastrointestinal (UGI, i.e., esophageal and gastric) cancers. We assessed the relationship between oral health and UGI cancers using a large prospective study of over 50,000 adults living in Golestan Province, Iran, a high-incidence area for these cancers. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated for the association between three different measures of oral health [frequency of tooth brushing; number of missing teeth; and the sum of decayed, missing, and filled teeth (DMFT)] and UGI cancers. During a median follow-up duration of 13 years, there were 794 incident UGI cancers (396 esophageal and 398 gastric cancers). Daily tooth brushing was associated with a decreased risk of developing both esophageal (HR = 0.670; 95% CI: 0.486-0.924) and gastric (HR = 0.741; 95% CI: 0.544-1.01) cancers (combined UGI cancer HR = 0.697; 95% CI: 0.558-0.871) compared with never brushing. Tooth loss in excess of the loess smoothed, age- and sex-specific median number of teeth lost was significantly associated with esophageal (HR = 1.64; 95% CI: 1.08-2.47) and gastric cancers (HR = 1.58; 95% CI: 1.05-2.38). There were some adverse associations between DMFT and UGI cancers but most were not statistically significant. These results suggest increased risk of developing UGI cancers among individuals with poor oral health, and those who do not perform regular oral hygiene. PREVENTION RELEVANCE: Poor oral health is associated with the risk of upper gastrointestinal cancers, and oral hygiene practices may help prevent these cancers.