Oral health inequalities in immigrant populations worldwide: a scoping review of dental caries and periodontal disease prevalence.

BACKGROUND: Inequalities in immigrants' oral health are often masked in population-level data. Therefore, this paper was planned to assess the prevalence data on oral health diseases, namely dental caries, and periodontitis, among immigrants worldwide. METHODS: Following a systematic search in Scopus, Embase, and PubMed for studies published between 2011 and 2023, 1342 records were identified. Following title and abstract screening, 76 studies remained for full-text eligibility-screening based on predefined inclusion criteria. Thirty-two studies were included in the review. RESULTS: Dental caries figures were higher in immigrant populations compared to the local population, regardless of host countries, age, gender, or nationality. In children, the overall mean and standard deviation (SD) for decayed, missing, and filled teeth in the primary dentition (d3mft) was 3.63(2.47), and for D3MFT (permanent dentition), it was 1.7(1.2). Upon comparing overall mean caries counts in children and adults with their control groups in the included studies, untreated dental caries (D3T and d3t) constituted the dominant share of caries experience (D3MFT and d3mft) in immigrant children. For the local population, the highest proportion of caries experience was attributed to filled teeth (FT and ft). Dentin caries prevalence among immigrants ranged from 22% to 88.7% in the primary dentition and 5.6% to 90.9% in the permanent dentition. Gingivitis ranged from 5.1% to 100%. Oral health varied greatly between studies. Regarding oral health accessibility, 52% to 88% of immigrant children had never been to a dentist, suggesting a very limited level of accessibility to dental health services. CONCLUSION: It is imperative to develop interventions and policies that have been customized to address the oral health disparities experienced by immigrant populations. Additionally, host countries should actively implement measures aimed at enhancing the accessibility of oral health care services for these individuals. The utilization of available data is crucial in establishing a hierarchy of objectives aimed at enhancing the oral health of immigrant populations. TRIAL REGISTRATION: The Scoping review protocol was registered at OSF Registries with registration number ( https://doi.org/10.17605/OSF.IO/MYXS4 ).

Evaluating the Effectiveness of the Nudge Theory in Improving the Oral Self-Care of Schoolchildren with Refugee and Immigrant Backgrounds in Mashhad, Iran.

Nudge theory proposes using subtle interventions to encourage individuals to make better decisions. The aim of this study was to evaluate the effectiveness of the Nudge theory in plaque control and assess caries experience among third-grade primary schoolchildren with refugee and immigrant backgrounds in Mashhad, Iran. Moreover, Afghan and Iranian schoolchildren were compared to assess differences in oral health outcomes. A quasi-experimental field trial was conducted in three public primary schools, comprising 309 participants approximately 9 years old. Interventions were randomly assigned to three schools: School I Messages based on Social Norms (MSN), School II Messages based on Fear of Negative Outcome (MFNO), and School III control group (C). MSN and MFNO received customized motivational video clips at baseline, while C only received Oral hygiene instruction (OHI). All participants received OHI, a brush, and toothpaste. Baseline plaque index (PI) and caries experience in primary and permanent dentition (dmft/DMFT) were recorded. PI was reassessed at two weeks, two months, and six months post-intervention. All data were subjected to statistical analysis. The mean PI decreased significantly in all three groups at the two-week follow-up (p < 0.01). The PI improvements declined over a six-month follow-up period in all groups, and the mean PI difference after six months compared to the pre-intervention was significant only in MSN and MFNO (p < 0.01), while C reverted almost to the pre-study level. Schoolchildren with at least one filled tooth or Iranian nationality showed a greater PI reduction (p < 0.01, p = 0.05). The overall mean ± SD dmft and DMFT were 4.24 ± 2.11 and 1.70 ± 1.24, respectively. Among all the examined participants, 32 (10.40%) individuals were caries-free. The mean dmft was statistically significantly higher in Afghan children than in Iranians (p = 0.01). MSN was more effective on PI reduction in the short term, while MFNO was more long-lasting. Using the Nudge theory via visual aids was more effective in motivating children to perform better oral self-care than solely traditional OHI.

Sex Determination Using Human Sphenoid Sinus in a Northeast Iranian Population: A Discriminant Function Analysis.

Statement of the Problem: Sex determination, using skeletal remains, is of paramount importance in forensic studies. The skull accounts for the most sexual dimorphism after the pelvis. Recent studies have shown that paranasal sinuses are valuable in sex determination and considering the location of the sphenoid sinus, the risk of traumatic injuries to this structure is low. Purpose: The present study aimed to evaluate the morphology of the sphenoid sinus and determine the validity of sphenoid sinus volume (SSV) in sex determination using cone beam computed tomography (CBCT) images. Materials and Method: In this cross-sectional retrospective study, CBCT images of 469 Iranian patients (186 male and 283 female), aged 24-45 years, were selected. The morphology of the sphenoid sinus was recorded. 3D Slicer software (4.10.0) was used to assess SSVs in coronal and axial planes. For data analysis, t-test, chi-square test, and discriminant function analysis (DFA) were performed using predictive analytics software (ver. 18.0). Results: The most common morphology of the sphenoid sinus in both genders was the sellar type (50.5%). SSV was significantly larger in males than in females (p< 0.001). DFA showed that the capability of SSV in sex identification was 86.0% and 92.9% in males and females, respectively. Conclusion: The findings of this study suggest that SSV is a reliable variable in gender discrimination in a northeast Iranian population. However, since the morphology of the sphenoid sinus and sex were independent of each other, the morphology of the sphenoid sinus is not a suitable indicator for sex determination.

Nudging oral habits; application of behavioral economics in oral health promotion: a critical review.

Background: Oral health disorders significantly contribute to the global incidence of chronic diseases. Nudge interventions have demonstrated effectiveness in enhancing people's decision-making and self-management capacities in a cost-efficient manner. As a result, these interventions could be valuable tools for fostering improved oral care habits. This critical review explores potential behavioral nudges applicable to promoting oral health. Methods: A thorough electronic literature search was conducted on Scopus, Embase, and PubMed databases for papers published post-2008. The search focused on empirical evidence concerning the direct and indirect application of Nudge theory in oral health enhancement. In addition, the investigation included the nudge intervention's role in managing common non-communicable disease risk factors (tobacco, alcohol, and sugar) and their use in other health sectors. Results and conclusion: There is a dearth of studies on behavioral economics, particularly those involving reward and reminder techniques. However, various successful nudge interventions have been identified in other sectors that aim to improve health decisions. These include strategies encouraging healthier nutritional choices, tobacco and alcohol cessation, medication compliance, routine physical activity, and regular health check-ups. Such interventions can also have direct or indirect positive impacts on oral health. Implementing these interventions within an oral care framework could promote oral health due to similar underlying cognitive mechanisms. However, different types of nudge interventions have varying degrees of effectiveness. Furthermore, factors such as the method of delivery and the characteristics of the targeted population significantly influence the outcome of the intervention. Hence, it is imperative to conduct extensive studies in diverse socioeconomic settings to fully understand the potentials, limitations, and impacts of nudge interventions in promoting oral health.

Higher prevalence of dental caries and periodontal problems among refugees: A scoping review.

Background: We assessed the prevalence data on oral health diseases, namely dental caries and periodontitis, among refugees and asylum seekers worldwide. Methods: A systematic search of Scopus, Embase, and PubMed retrieved 1225 records; following title and abstract screening, 58 studies remained for full-text eligibility screening based on pre-defined inclusion criteria. Twenty-six studies were included in the review. Results: Dental caries and tooth loss due to caries were high in refugee populations, regardless of their age, gender, or nationality. The adult population had a mean decayed, missing, and filled teeth (DMFT) index score of 9.2 (standard deviation (SD) = 2.3); children had a score of 3.1 (SD = 1.1) for deciduous teeth and 2.5 (SD = 1.1) for permanents. Caries prevalence among refugees ranged from 4.6% to 98.7%, and gingivitis from 5.7% to 100%, indicating a high heterogeneity in their oral health. Regarding oral health accessibility, 17% to 72% of refugees had never been to a dentist, showing a very low level of accessibility to dental health services. Conclusions: Interventions and policies need to be designed to reduce oral health inequalities among refugee populations and asylum seekers, and host countries must implement strategies to increase their access to oral health care. Existing data should be used to set priorities for improving the oral health of refugees. Registration: Open Science Framework: https://doi.org/10.17605/OSF.IO/SU59K.

How the COVID-19 Pandemic Affects Risk Awareness in Dentists: A Scoping Review.

Dentists are on the frontline of infection, especially when it comes to respiratory viruses like the new coronavirus. The purpose of this paper is to conduct a scoping review to better understand dentists' risk awareness, awareness of COVID-19 symptoms, preventive measures, and effective methods of COVID-19 infection prevention and management. This paper systematically assesses the published literature on dentistry and COVID-19. Various electronic databases including Ovid MEDLINE, Scopus, Embase, and MEDLINE via PubMed were searched up to 9 September 2021. Overall, 39 papers were included. Almost the entirety of dentists (94.5%) reported awareness of the three most common COVID-19 symptoms, and a risk awareness score of about 90% was shown, while 88.2% of dentists reported adopting preventive measures. More than 50% did not want to treat infected people. While 70.3% of dentists recommended usage of N95 masks, the rate of dentists using them was below 40%. Sufficient awareness of risks during the pandemic was found in dentists. Although they were using preventive measures, there remains upside potential for adopting all recommended measures. Further, the usage of N95 masks is improvable, even though the benefit of wearing them could not be confirmed.

Comparison of interdental papillae around single implants in the tissue-level (TL) and bone-level (BL) implants: A clinical trial.

Background: This study aimed to evaluate the effect of bone-level implants in comparison with tissue-level implants on dental papilla dimensions in single-tooth implants. Methods: In the present clinical trial, 50 patients, 24 females (48%) and 26 males (52%), were selected among patients requesting single implants in the posterior area of the jaws. The subjects were divided into two groups (n=25). The subjects in the first group were treated with a bone-level implant (Implantium, Dentium, Korea), and the subjects in the second group were treated with a tissue level implant (Implantium, Dentium, Korea). None of the implants were loaded during this period, and only the healing effect was measured. All the implants underwent one-stage surgery (none-submerged), and healing abutments were placed after implantation. The papilla heights in both the mesial and distal aspects of the adjacent teeth were measured. A periodontal probe was used to measure from the top of the papilla to the CEJ of the adjacent teeth in two time intervals. Descriptive statistics were performed using tables and Shapiro-Wilk, chi-squared, Mann-Whitney, and independent t-tests. Results: The findings showed that the interdental papilla in TL single implants performed better than that in BL implants at the three-month interval. This difference was statistically significant on the mesial aspect but not on the distal aspect. However, the difference was not clinically significant. Conclusion: A comparison of papilla dimensions in two implant types showed that papilla formation in TL implants was better than that in BL implants at the three-month postoperative interval.