Oral health-related quality of life among women early postpartum: A cross-sectional study.

BACKGROUND: Periodontal diseases can negatively impact the oral health-related quality of life (OHRQoL) of pregnant women. This study investigates the association between maternal oral inflammatory load (OIL), sociodemographic characteristics, and the OHRQoL in postpartum women. METHODS: In this cross-sectional study, breastfeeding mothers were recruited from St. Michael's Hospital, Toronto within 2-4 weeks postpartum. Mothers were categorized into "Normal/low" and "High" OIL groups based on the absolute counts of oral polymorphonuclear neutrophils (oPMNs). The Oral Health Impact Profile-14 questionnaire was used to assess the impact of the maternal OIL on the OHRQoL. Multiple linear regression analyses were performed to examine the association between maternal sociodemographic factors including age, marital status, education level, employment status, parity, and their OHRQoL. RESULTS: Forty-seven mothers were included in this study. Mothers with high OIL reported higher impact on their OHRQoL (30%) than mothers with normal/low OIL (21%), but these differences were not statistically different. There was a negative relationship between the mother's education level and the extent of impact of OHRQoL on the "physical pain" dimension (p < 0.05), and between the mothers' age and employment status and the "physical disability" dimension (p < 0.05). A positive correlation was noted between multi-parity and the extent of impact of OHRQoL on the "physical disability" dimension (p = 0.009), and between the marital status and the "psychological disability" dimension (p < 0.05). CONCLUSION: This study highlighted the significant impact of sociodemographic characteristics on the OHRQoL of mothers, showcasing the importance of considering these factors when implementing targeted preventive dental care programs for mothers.

The Association between Maternal Oral Inflammation and Neutrophil Phenotypes and Poly-Unsaturated Fatty Acids Composition in Human Milk: A Prospective Cohort Study.

This prospective cohort study aimed to investigate the impact of maternal oral inflammation on human milk composition including neutrophil counts, activation state (based on cluster of differentiation (CD) markers expression), and fatty acid levels. Fifty mothers were recruited from St. Michael's hospital, Toronto, and followed up from 2-4 weeks until 4 months postpartum. Oral rinse and human milk samples were collected at both timepoints. Oral polymorphonuclear neutrophils (oPMNs) within the rinses were quantified using flow cytometry and the participants' oral health state was categorized into three groups (i.e., healthy, moderate, and severe) based on the oPMNs counts. Fatty acids were identified and quantified using a gas chromatography-flame ionization detector (GC-FID). Compared to mothers with a healthy oral health state, mothers with moderate to severe oral inflammation had a statistically significant decrease in the expression of CD64 biomarker, an increase in the expression of CD14 biomarker on human milk neutrophils and a decrease in the levels of eicosapentaenoic acid (C20:5n-3) in their human milk at follow-up compared to baseline. This study demonstrates for the first time that maternal oral inflammation can affect human milk composition. The mechanism by which these alterations can affect infant health outcomes in the long term critically needs to be considered.

A Scoping Review of 4 Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies-Part 2: Outcome Measures.

INTRODUCTION: Inconsistencies in the definitions of endodontic outcome terminology jeopardize evaluations of proposed interventions and patient care quality. This scoping review aimed to provide groundwork to develop a set of basic outcomes in endodontics. METHODS: We performed a comprehensive literature search for randomized controlled trials, cohort studies, case-control studies, and case series (≥10 patients) published after 1980 with patients ≥10 years of age with any preoperative pulpal and periapical diagnosis in permanent teeth requiring nonsurgical root canal treatment, retreatment, or apexification. Abstracted data on outcome assessment methods, assessors, and domains were reported after univariate and bivariate analyses. RESULTS: Treatment outcomes were evaluated radiographically (88%) or clinically (73%). Although 2-dimensional radiography exceeded 3-dimensional radiography, the use of the latter has increased since 2010, mostly for nonsurgical retreatments. Of 19 identified outcomes, 5 were most frequent: success (168 studies, 40%), radiographic healing (128 studies, 30%), survival (of an asymptomatic tooth [48 studies, 12%] or of a procedure code in administrative databases [31 studies, 7%]), pain assessment (14 studies, 3%), and quality of life (11 studies, 3%). Clinician-centered outcomes have been most frequently studied since the 1980s (71%), in academic settings (76%), and using a prospective design (45%). Patient-centered outcomes were reported in 19% of studies before 2010 and 30% since 2010. They were more common among retrospective studies (49%). CONCLUSIONS: Patient-centered outcome measures are lacking in endodontic studies. The state of available research can provide a baseline for the development of a core outcome set in endodontics, which should represent the important patient-centered outcomes in conjunction with well-validated clinician-centered outcomes.

A Scoping Review of 4 Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies-Part 1: Process and General Results.

INTRODUCTION: Despite initiatives to standardize reports, variances in study design, outcomes assessed, and tools used are persistent in the literature. This review scoped the existing literature on endodontic outcome studies for future development of core outcome sets. METHODS: A comprehensive literature search of randomized controlled trials, cohort studies, case-control studies, and case series (≥10 patients) published after 1980 including patients ≥10 years of age with any preoperative pulpal and periapical diagnosis in permanent teeth requiring nonsurgical root canal treatment (NS-RCT), retreatment (NS-ReTx), or apexification was performed. Abstracted data were reported through descriptive statistics. RESULTS: Of the 9957 studies screened, 354 were included. An increase in the quantity of endodontic outcome publications and levels of evidence in their study design was noted over the past 4 decades. Although 41% of the studies included participants 26-50 years of age, literature including participants >50 years old has increased since 2000. Apexification and NS-ReTx were mostly provided by specialists and postgraduate students. The most common follow-up period was 2-5 years (35%), and most randomized controlled trials (58%) reported follow-up times <1 year. Multiple-visit treatment was most common in apexification studies (85%). Deficiency, inconsistency, and ambiguity were observed across many reports. CONCLUSIONS: NS-ReTx and NS-RCT/NS-ReTx studies have increased over the past 2 decades, particularly those focusing on molars and patients >50 years old. Despite the progress in endodontic research, heterogeneity in reporting styles yields considerable limitations, particularly data standardization challenges and inconsistencies in methods and results reporting. This scoping review highlighted the state of available research and supported the development of standardized guidelines for future investigations.

Impact of Poor Oral Health on Community-Dwelling Seniors: A Scoping Review.

The aim of this scoping review was to determine health-related impacts of poor oral health among community-dwelling seniors. Using MeSH terms and keywords such as elderly, general health, geriatrics, 3 electronic databases-Medline, CINAHL, and Age Line were searched. Title and abstracts were independently screened by 3 reviewers, followed by full-texts review. A total of 131 articles met our inclusion criteria, the majority of these studies were prospective cohort (77%, n = 103), and conducted in Japan (42 %, n = 55). These studies were categorized into 16 general health outcomes, with mortality (24%, n = 34), and mental health disorders (21%, n = 30) being the most common outcomes linked with poor oral health. 90% (n = 120) of the included studies reported that poor oral health in seniors can subsequently lead to a higher risk of poor general health outcomes among this population. Improving access to oral healthcare services for elderly can help not only reduce the burden of oral diseases in this population group but also address the morbidity and mortality associated with other general health diseases and conditions caused due to poor oral health. Findings from this study can help identify shortcomings in existing oral healthcare programs for elderly and develop future programs and services to improve access and utilization of oral care services by elderly.