Importância da assistência odontológica dentro do ambiente hospitalar / Importance of dental care within the hospital enviroment

A assistência odontológica é imprescindível para a prevenção de doenças infecciosas e para a manutenção da integridade da cavidade oral de pacientes internatos em unidades de terapia intensiva. O objetivo deste estudo foi avaliar o conhecimento e as práticas de higiene oral dos acadêmicos do curso de Enfermagem de uma instituição de ensino superior, que realizam estágio em hospital, no controle de higiene bucal de pacientes internados em ambiente hospitalar. Participaram do estudo 40 alunos, que responderam 14 perguntas com o intuito de avaliar o conhecimento e as práticas no controle de higiene bucal, realizadas por eles, em pacientes internados em ambiente hospitalar. Os resultados demonstraram que os acadêmicos entrevistados tinham idade média de 25,8 anos, sendo 95% do sexo feminino e apenas 5% do sexo masculino. Destes, 42,5% afirmaram não haver presença de um Cirurgião-Dentista em ambiente hospitalar e 82,5% responderam que o responsável pela saúde bucal dos pacientes é do técnico de enfermagem. Quanto aos cuidados em pacientes internados em UTI, 52,5% dos entrevistados relataram que estes pacientes recebem higienização bucal, porém 30% alegaram que esta pratica não era realizada e 17,5% não sabiam responder. Além disso, 47,5% dos entrevistados afirmam ter insegurança ao realizar os procedimentos de higiene bucal dos pacientes. Pode-se concluir que os acadêmicos entrevistados possuem bom conhecimento acerca da importância dos cuidados com a saúde bucal dos pacientes internados em ambiente hospitalar. No entanto, ainda existem muitas dúvidas relacionadas ao manejo clínico de procedimentos de promoção de saúde bucal, que poderiam ser solucionados com a presença de um profissional de Odontologia inserido em uma equipe multidisciplinar(AU)

Oral care is essential for the prevention of infectious diseases and for maintaining the integrity of the oral cavity of patients hospitalized in intensive care units. The objective of this study is to evaluate the knowledge and oral hygiene practices of Nursing students at a higher education institution, who carry out internships in a hospital, in controlling the oral hygiene of patients admitted to a hospital environment. 40 students participated in the study, who answered 14 questions with the aim of evaluating the knowledge and practices in controlling oral hygiene, carried out by them, on patients hospitalized in a hospital environment. The results demonstrated that the academics interviewed had an average age of 25.8 years, with 95% being female and only 5% being male. Of these, 42.5% stated that there was no presence of a Dental Surgeon in a hospital environment and 82.5% responded that the nursing technician is responsible for the patients' oral health. Regarding care for patients admitted to the ICU, 52.5% of those interviewed reported that these patients receive oral hygiene, however 30% claimed that this practice was not performed and 17.5% did not know how to answer. Furthermore, 47.5% of those interviewed say they are insecure when carrying out oral hygiene procedures for patients. It can be concluded that the academics interviewed have good knowledge about the importance of oral health care for patients hospitalized in a hospital environment. However, there are still many doubts related to the clinical management of oral health promotion procedures, which could be resolved with the presence of a dentistry professional within a multidisciplinary team(AU)

An Evaluation of Occupational Stress and Periodontal Status Among Indian Army Male Personnel: A Cross-Sectional Study.

BACKGROUND: Oral illnesses are multifactorial and also behavior-related. Stress and habits influence periodontal disease. Based on this premise, assessing the influence of stress on military personnel and understanding its influence on oral and periodontal health becomes imperative. AIM: The aim of this study was to evaluate the occupational stress and periodontal status among Indian army personnel. METHODS: A cross-sectional study was carried out among 1000 army personnel divided into four groups of 250 each. Group A had recruits, Group B had trainee officers, Group C personnel were serving in the army below the officer's rank and Group D had officers who were currently serving in the army. Oral Hygiene Index - Simplified (OHI-S), Gingival Bleeding Index (GBI), pocket depth, and clinical loss of attachment (CLOA) were assessed for periodontal status. Stress levels were evaluated using the Modified Occupational Stress Index Questionnaire. Analysis of variance (ANOVA) test was applied to compare OHI-S, GBI, presence of pocket depth, and occupational stress scores, while the Kruskal-Wallis test was used to compare the occupational stress index and CLOA among the study groups. RESULTS: Significant differences were observed among the four groups in terms of OHI-S (p = 0.001), GBI (p = 0.001), CLOA (p = 0.001), occupational stress scores (p = 0.001), and occupational stress index (p = 0.001). Differences observed among the four groups regarding periodontal disease based on the presence of pockets were weakly significant (p = 0.05). On intergroup comparison, a significant association could not be established between the groups as the p-value was ≥ 0.05. However, a weak association could be established between Groups A and C with a p-value of 0.031. Participants with moderate to high occupational stress showed more risk of developing pockets and CLOAs as compared to those having low stress. CONCLUSION: The study revealed that the majority of army personnel were suffering from gingival bleeding and periodontal diseases; however, the association between stress level and periodontal diseases in Indian army personnel was less and not significant.

Oral Hygiene With Neutral Electrolyzed Water and Systemic Therapy Increases Gastric Helicobacter pylori Eradication and Reduces Recurrence.

OBJECTIVES: Helicobacter pylori gastric infection strongly correlates with gastric diseases such as chronic gastritis, functional dyspepsia, and complications such as peptic ulcers and gastric cancer. In developing countries, systemic therapies are not usually successful due to elevated antibiotic resistance. Additionally, oral H. pylori infection and periodontal disease correlate with gastric treatment failures. This study aimed to explore the effect of an integral therapy, comprising oral hygiene and concomitant systemic treatment, to increase the eradication of gastric infection and recurrences. MATERIALS AND METHODS: A prospective, randomized, four-arm, parallel-group, open-label clinical trial was conducted to investigate the efficacy of integral therapy to eradicate gastric H. pylori infection and avoid recurrences in double-positive (real-time PCR oral and gastric infection) patients. Oral hygiene involved mouthwash with neutral electrolyzed water (NEW), with or without periodontal treatment. One hundred patients were equally distributed into four groups: NS, NS-PT, NEW, and NEW-PT. All patients had concomitant systemic therapy and additionally, the following oral treatments: mouthwash with normal saline (NS), periodontal treatment and mouthwash with normal saline (NS-PT), mouthwash with NEW (NEW), and periodontal treatment and mouthwash with NEW (NEW-PT). Gastric and oral infection and symptoms were evaluated one and four months after treatments. RESULTS: Integral therapy with NEW-PT increased gastric eradication rates compared with NS or NS-PT (84%-96% vs. 20%-56%; p < 0.001). Even more, a protective effect of 81.2% (RR = 0.1877; 95% CI: 0.0658-0.5355; p = 0.0018) against recurrences and 76.6% (RR = 0.2439; 95% CI: 0.1380-0.4310; p < 0.001) against treatment failure (eradication of infection and associated symptoms) was observed in patients from the NEW and NEW-PT groups. CONCLUSIONS: Implementation of oral hygiene and systemic treatment can increase the eradication of gastric infection, associated symptoms, and recurrences. NEW is recommended as an antiseptic mouthwash due to its efficacy and short- and long-term safety.

Effectiveness of oral health education on oral hygiene status among adult male inmates in central jail, Kolkata - an interventional study.

PURPOSE: Oral health is an integral part of general health. Different population groups have been assessed for oral health status in India, but still, many have been neglected; one such group is the prisoners. The prison population is a unique and challenging one with many health problems, including poor oral health, which may be due to lack of knowledge about good oral health practices. This study aims to assess effectiveness of oral health education on oral health knowledge, attitude and practices and oral hygiene status among the male prison inmates of central jail in Kolkata, India. DESIGN/METHODOLOGY/APPROACH: An interventional study was done among 240 male convicts. The data was elicited using a structured proforma; oral health status was assessed by recording OHI-S index, and the severity of gingivitis was assessed by recording the gingival index. Oral health education was delivered by using audio-visual aid. Oral health knowledge, attitude, practices and oral hygiene and gingival status were reassessed among the inmates before and after dental education at the end of three and six months. FINDINGS: A significant change in oral health knowledge, attitude and practices was seen, which in turn resulted in an appreciable decrease in the mean gingival index score (1.73 ± 0.382 to 1.20 ± 0.321) and OHI-S (3.31 ± 0.815 to 2.57 ± 0.551) in all the inmates after oral health education program over the period of time. ORIGINALITY/VALUE: The oral health education with reinforcement proved to be an effective tool to instil good oral hygiene practices in the inmates.

Using patients' oral photographs for oral hygiene motivation promotes periodontal health: a prospective randomized controlled trial.

OBJECTIVES: The aim of this prospective, randomized, controlled, single-centered, examiner-blinded clinical trial was to evaluate the effectiveness of a personalized and visual oral health education program in addition to conventional oral hygiene education. MATERIALS AND METHODS: Fifty-six non-smoker, right-handed participants (aged 30.34 ± 11.46 years) without clinical signs of periodontitis were randomly grouped: the intervention group (n = 28) received a personalized visualized oral health education combined with conventional oral hygiene education, and the control group (n = 28) received conventional oral hygiene education only. All participants were assessed for improved periodontal parameters (PI, GI, BOP, and PPD) at baseline, first month, and third month. RESULTS: A significant reduction (p < 0.001) was observed in PI, GI, and BOP during two follow-up sessions compared to the baseline for the two groups. No differences were found for inter-group (p > 0.05) or intra-group (p = 1) comparison of PPD. PI (p = 0.012), GI (p = 0.032), and BOP (p = 0.024) scores were significantly reduced at the third-month follow-up assessment in the intervention group compared to the control group. CONCLUSIONS: Clinical outcomes of periodontal health were significantly enhanced by the personalized and visual oral health education program applied in this study compared to the conventional oral hygiene education program. CLINICAL RELEVANCE: Numerous studies reported additional interventions to the oral hygiene education program. However, we did not find any published studies investigating the role of patients' intra-oral photographs in oral care. This study's results demonstrated that a visually aided education program for oral hygiene motivation may help improve oral health. CLINICAL TRIAL REGISTRATION: Registration number is "NCT06316505" and date of registration is 18/03/2024.

Radiologic Evaluation of Oral Health Status in Patients Admitted to the Intensive Care Unit: A Multi-Institutional Retrospective Study.

Introduction: Surveys distributed among intensive care unit (ICU) nurses reveal a significant need for dental care, with many acknowledging poor oral hygiene management. Poor oral health in ICU patients is linked to systemic problems, including aspiration pneumonia, necessitating pre-intervention assessments for bacterial diseases and dental risks. This study aims to evaluate the oral health status of ICU patients across three institutions through retrospective analysis. Methods: This retrospective study assessed the oral health status of ICU patients, using computed tomography (CT) images from three institutions over ten years. Through CT images, the oral status was evaluated in terms of total and lost tooth count and the presence of oral lesions (periapical lesions, cysts and tumors, caries, tartar, moderate to severe periodontal bone loss, tooth fractures). Variables included gender, age, the duration of ICU stay, and types of ICU. Statistical analysis was performed using chi-square tests, independent-sample t-tests, and logistic regression analysis. Results: Of the 450 participants, 430 were analyzed, revealing a prevalence of oral lesions in 67.0% of subjects. The prevalence of oral lesions was higher in males (71.5%) than females (57.7%, p = 0.006), and higher in those aged 40 and above (72.1%) compared to those under the age of 40 (47.8%, p < 0.001). This study found significant differences in oral health status based on gender, age, and ICU type, with surgical ICU patients generally having better oral health. Risk factors for oral lesions included gender, age, and duration of ICU stay. Conclusions: Most ICU patients have at least one oral lesion, regardless of the reason for their ICU admission. In particular, male ICU patients aged 40 and above have a higher prevalence of oral lesions, necessitating careful oral health assessment and treatment.

Effect of mobile app-based oral hygiene instructions on clinical parameters, oral bacterial diversity, and composition of subgingival microbiota in periodontitis patients.

Introduction: Oral hygiene instruction (OHI) is essential during periodontitis treatment. Various OHI approaches have been explored, including mobile apps. Objective: To evaluate the mobile app-based OHI's effect on periodontitis management by analyzing clinical parameters and subgingival microbiota. Methods: Forty-four periodontitis patients were randomly assigned into two groups. The test group (n = 22) received scaling and root planing (SRP), OHI, and mobile app-based OHI, whereas the control group (n = 22) received SRP and OHI. Full mouth plaque score (FMPS), bleeding on probing (BOP) and probing pocket depth at the sampling sites (site-PPD) were assessed at baseline, one- and three-month visits. The 16S rRNA next-generation sequencing (NGS) was used to analyze subgingival plaque samples. Results: Significant reduction in FMPS, BOP, and site-PPD at one- and three-month visits compared to baseline (p < 0.001) with no significant differences across groups (p > 0.05). In test groups, intra-group analysis showed better improvement in BOP and site-PPD (p < 0.05) than control. The diversity and composition of subgingival microbiota did not differ between groups or timepoints (p > 0.05). Conclusions: Mobile app-based OHI showed no superior effects on improving clinical parameters and subgingival microbiota compared to conventional OHI. Further investigation into its long-term impact on periodontitis treatment is needed.

Decoding children dental health risks: a machine learning approach to identifying key influencing factors.

Introduction and objectives: This study investigates key factors influencing dental caries risk in children aged 7 and under using machine learning techniques. By addressing dental caries' prevalence, it aims to enhance early identification and preventative strategies for high-risk individuals. Methods: Data from clinical examinations of 356 children were analyzed using Logistic Regression, Decision Trees, and Random Forests models. These models assessed the influence of dietary habits, fluoride exposure, and socio-economic status on caries risk, emphasizing accuracy, precision, recall, F1 score, and AUC metrics. Results: Poor oral hygiene, high sugary diet, and low fluoride exposure were identified as significant caries risk factors. The Random Forest model demonstrated superior performance, illustrating the potential of machine learning in complex health data analysis. Our SHAP analysis identified poor oral hygiene, high sugary diet, and low fluoride exposure as significant caries risk factors. Conclusion: Machine learning effectively identifies and quantifies dental caries risk factors in children. This approach supports targeted interventions and preventive measures, improving pediatric dental health outcomes. Clinical significance: By leveraging machine learning to pinpoint crucial caries risk factors, this research lays the groundwork for data-driven preventive strategies, potentially reducing caries prevalence and promoting better dental health in children.

Evaluation of plaque removal by a single-headed versus a triple-headed manual toothbrush using different plaque assessment tools.

Background: Dental plaque is a common issue that can be effectively managed with proper oral hygiene practices and regular oral health care. The aim of this crossover study was to assess dental plaque using different methods (digital and clinical plaque scores) and evaluate the effectiveness of toothbrushing with a triple-headed manual toothbrush compared to a single-headed manual toothbrush in removing dental plaque. Methods: Plaque staining was performed to assess dental plaque amounts before and after brushing with the triple-headed (test) and single-headed (control) manual toothbrush in 21 study participants after plaque was allowed to accumulate for 48 hours. Dental plaque was scored both clinically as well as digitally. Results: Toothbrushing with a manual single-headed toothbrush and a triple-headed toothbrush was found to be equally effective when comparing plaque removal ability. Brushing time was shorter when using a triple-headed toothbrush, compared to a single-headed toothbrush. Conclusion: The triple-headed manual toothbrush may be a good alternative to the single-headed manual toothbrush for certain patient groups.

Contexte: La plaque dentaire est un problème courant qui peut être géré efficacement en adoptant de bonnes pratiques d'hygiène buccale et en obtenant régulièrement des soins buccodentaires. L'objectif de cette étude croisée était d'évaluer l'état de la plaque dentaire à l'aide de différentes méthodes (cotes de plaque numériques et cliniques) et d'évaluer l'efficacité du brossage à l'aide d'une brosse à dents manuelle à 3 côtés comparativement au brossage avec une brosse à dents manuelle à 1 côté pour éliminer la plaque dentaire. Méthodes: On a coloré la plaque dentaire pour en évaluer la quantité avant et après le brossage avec une brosse à dents manuelle à 3 côtés (essai) et à 1 côté (contrôle) parmi les 21 participants à l'étude après avoir laissé la plaque s'accumuler pendant 48 heures. On a attribué une cote clinique et numérique à la plaque dentaire. Résultats: Le brossage avec une brosse à dents manuelle à 3 côtés s'est révélé tout aussi efficace que le brossage avec une brosse manuelle à 1 côté sur le plan de l'élimination de la plaque. Le temps de brossage était plus court avec une brosse à dents à 3 côtés qu'avec une brosse à dents à 1 côté. Conclusion: Pour certains groupes de patients, la brosse à dents à 3 côtés peut être une bonne alternative à la brosse à dents ordinaire.

Parents' Knowledge and Awareness About the Importance of Primary Teeth and Space Maintainers in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Primary teeth are important for eating, speaking, and esthetics, as well as for guiding the eruption and maintaining the space for the permanent teeth. The best space maintainers (SM) for permanent dentition are the natural primary teeth. The aim of this study was to assess parents' knowledge and awareness of the importance of primary teeth and SM in Saudi Arabia. METHOD: This cross-sectional study invited parents who were living in Saudi Arabia via different social media platforms to complete a validated questionnaire. The data collected included demographic characteristics, questions about parents' knowledge of their children's oral hygiene, and the importance of primary teeth, as well as questions about knowledge of SM. RESULTS: A total of 392 participants completed the questionnaire. Dental problems and pain were the most common reasons for visiting the pediatric dentist (n=260; 66.3%). With respect to the age at which the first primary tooth erupted, more than half of the parents (n=270; 68.9%) knew the correct age. Only 43.3% (n=168) of the parents had received any information about SM and only 39.5% (n=155) of them knew their purpose. CONCLUSION: Most parents agree that treating primary teeth is important for their children's oral health and development. However, most are unaware of an SM's purpose. We recommend that dentists discuss SM's importance with parents actively after extracting their child's teeth. This will help increase parents' awareness and understanding of SM and encourage them to be more informed about this dental treatment option.

It is the habit not the handle that affects tooth brushing - a randomised counterbalanced cross over study with young and healthy adults.

OBJECTIVE: To assess the effect of the toothbrush handle on video-observed toothbrushing behaviour and toothbrushing effectiveness. METHODS: This is a randomized counterbalanced cross-over study. N = 50 university students and employees brushed their teeth at two occasions, one week apart, using either a commercial ergonomically designed manual toothbrush (MT) or Brushalyze V1 (BV1), a manual toothbrush with a thick cylindrical handle without any specific ergonomic features. Brushing behaviour was video-analysed. Plaque was assessed at the second occasion immediately after brushing. Participants also rated their self-perceived oral cleanliness and directly compared the two brushes regarding their handling and compared them to the brushed they used at home. RESULTS: The study participants found the BV1 significantly more cumbersome than the M1 or their brush at home. (p < 0.05). However, correlation analyses revealed a strong consistency of brushing behavior with the two brushes (0.71 < r < 0.91). Means differed only slightly (all d < 0.36). These differences became statistically significant only for the brushing time at inner surfaces (d = 0.31 p = 0.03) and horizontal movements at inner surfaces (d = 0.35, p = 0.02). Plaque levels at the gingival margins did not differ while slightly more plaque persisted at the more coronal aspects of the crown after brushing with BV1 (d = 0.592; p 0.042). DISCUSSION: The results of the study indicate that the brushing handle does not play a major role in brushing behavior or brushing effectiveness.

Craniosynostosis: orofacial and oral health perspectives with masticatory insights.

BACKGROUND: Craniosynostosis (CS), premature fusion of one or more cranial sutures, leads to abnormal skull development, impacting both facial esthetics and oral function. This study aimed to evaluate the specific orofacial and oral health characteristics, including masticatory performance, in Thai patients with CS. METHODS: A comparative study was conducted with Thai CS patients aged 6-17 years and a control group of healthy individuals with similar age distribution. Assessments included craniofacial morphology, oral health status, and masticatory performance. Intergroup comparisons utilized appropriate statistical tests. RESULTS: The study included 24 CS patients with a mean age of 10.11 ± 2.98 years and 30 controls. CS patients exhibited a significantly higher prevalence of various oral conditions compared to controls: cleft palate (20.8%), anterior open bite (41.7%), anterior crossbite (54.2%), posterior crossbite (50%), combined anterior-posterior crossbite (45.8%), dental crowding in both maxilla and mandible (50% and 45.8% respectively), congenitally missing teeth (50%), supernumerary teeth (12.5%), and eruption failure (54.2%). Furthermore, CS patients exhibited significantly higher caries prevalence and susceptibility, alongside poorer oral hygiene, compared to controls. Regarding jaw relationships, CS patients exhibited a significantly higher proportion of Angle's Class III malocclusion (50%) compared to the control group, where Class I malocclusion was predominant (50%). Masticatory performance, assessed using the two-color gum mixing ability test, showed significantly higher hue variance in CS patients (0.12 ± 0.07) compared to the control group, indicating reduced chewing performance. CONCLUSION: This study underscores the significant orofacial and oral health challenges faced by children with CS, including a high prevalence of malocclusions, dental anomalies, elevated caries experience, and compromised masticatory function. These findings emphasize the importance of tailored interventions and comprehensive oral healthcare strategies to address the unique needs of this population and improve their overall quality of life.

Convergence of inflammatory response: Salivary cytokine dynamics in coronavirus disease 2019 and periodontal disease.

Background: Periodontal disease is associated with immune dysregulation, and cytokines released can add on to the coronavirus disease 2019 (COVID-19)-associated cytokine storm, further worsening the related adverse outcomes. Specific studies investigating cytokine levels in COVID-19 patients with periodontal disease are lacking. Examining the correlation between these conditions could aid in categorizing risk categories, determining referrals, and strengthening oral hygiene protocols. The current study sought to evaluate cytokine levels in the saliva of COVID-19-positive patients with and without periodontal disease. Materials and Methods: Twenty-six COVID-19-positive patients were subjected to periodontal examination, saliva collection, and assessment of cytokine levels through cytokine bead-based multiplex assay, using fluorescence-encoded beads with flow cytometry (BD FACS LSRFortessa). Eleven cytokines were assessed (interleukin [IL] 2, 4, 6, 10, 17A, and interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-α), chemokine ligand 2 (CCL2/monocyte chemoattractant protein-1), C-X-C motif chemokine ligand (CXCL) 8/IL 8, CXCL 9/monokine-induced gamma interferon [MIG]), and CXCL 10 (chemokine IFN-gamma inducible protein 10 kDa). The cytokine levels of the recruited subjects were also compared graphically with the salivary cytokine levels reported in the literature for health, COVID-19, and periodontal disease alone. Results: Out of 26 COVID-19-positive patients, 17 had periodontal disease. Levels of all cytokines were raised in patients with both diseases when compared to values reported in literature for health, periodontal disease alone, or COVID-19 alone. However, there was no statistical difference among the recruited subjects for IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-gamma, TNF-α, CCL2, CXCL 8, and CXCL 10. MIG levels were found to be higher in periodontally healthy, COVID-19-positive subjects (P = 0.01). Conclusions: Periodontal disease might contribute to the COVID-19-induced cytokine storm, potentially amplifying its impact.

Oral Hygiene Profile of Schoolchildren from Bucharest, Romania-How It Can Be Used and Improved for Better Prevention of Oral Diseases.

BACKGROUND: Oral hygiene is essential for low caries or gingivitis prevalence in children. This study aimed to determine the oral hygiene profile of children from secondary schools (10-17 years) in Bucharest, Romania, and to explore options for preventing their future oral diseases. METHODS: The study was cross-sectional, with a sample of n = 1595 pupils. The sample was stratified by clusters in city areas, grades, and the criterion of the presence/absence of in-school dental service. Dental check-ups were performed by using a commune dental examination kit. The oral hygiene simplified index (OHI; Silness and Löe) was used to assess the children's oral hygiene status. Five questions were used to determine oral hygiene habits. RESULTS: The mean value of the OHI was 1.04. Some differences in oral hygiene scores were found for different socioeconomic variables, such as parents' education (p < 0.05): parents with vs. without a university degree-0.95/0.94 (male/female) vs. 1.06. Most of the children used manual toothbrushes (88%). CONCLUSIONS: The analysis of objective data (OHI) revealed a good level of oral hygiene, with many socioeconomic disparities.

Time spent away from bed is associated with oral hygiene and oral function: A cross-sectional and multi-institutional study.

BACKGROUND: Spending time away from bed is important in older adults. Not doing so can lead to functional decline rapidly. OBJECTIVE: To investigate the association between oral function and time spent away from bed in older adults living in nursing homes. METHODS: We enrolled 748 adults aged ≥65 years across eight nursing homes between April 2022 and March 2023. 'Problems with oral hygiene' and 'problems with oral function' were the dependent variables in the multiple regression analyses to determine their association with time spent away from bed. RESULTS: We selected 304 participants (76 men; mean age, 86.3 ± 7.5 years) and divided them into three groups: group S (< 4 h), group M (4 to < 6 h) and group L (≥ 6 h), with 28, 23 and 253 participants, respectively. Comparison of the characteristics between the groups demonstrated significant differences in the Barthel index (p < .001), time spent away from bed (p < .001), history of aspiration pneumonia (p < .001), confirmation of meals and food forms (p = .010), problems with oral hygiene (p = .014), and problems with oral function (p = .002). Based on multiple regression analyses, 'problems with oral hygiene' (p < .001) and 'problems with oral function' (p < .001) were significantly associated with time spent away from bed. CONCLUSIONS: The time spent away from bed was significantly associated with both oral hygiene and function in older adults, suggesting the importance of extending the time that older adults spend away from bed.

A randomised controlled trial to evaluate the effectiveness of personalised oral hygiene advice delivered via video technology.

OBJECTIVES: To determine whether video-technology oral hygiene advice (OHA) improved clinical plaque and bleeding on probing (BOP) scores in individuals diagnosed with gingivitis, compared to conventional OHA after 3-months. METHODS: This parallel, randomised 2-arm treatment, single-centre study, assessed Turesky Plaque Index (TPI) and BOP at baseline and 3-months in adult participants with mild-moderate gingivitis. Eligible participants with smartphones were randomised at baseline to intervention (tailored video OHA), or control (conventional OHA). Oral hygiene (OH) habits/attitudes were recorded with a questionnaire. All participants used a manual toothbrush with anti-gingivitis toothpaste twice daily. RESULTS: 57 participants completed the study. Both groups had improved gingival health (BOP) after 3-months, change from baseline being significantly greater in the intervention group (12.21% vs 6.80%, p<0.05). TPI scores decreased more in the intervention than control group, but the difference did not reach significance (1.15 vs 0.92, p=0.079). OH habits and attitudes were similar at baseline and few differences between the groups were observed after 3-months, however frequency of interdental brush use was significantly increased, while self-rated oral health was significantly decreased in the intervention as compared to control group at this timepoint (p<0.05). CONCLUSIONS: The combination of an individually tailored instructional video with appropriate toothbrushing using anti-gingivitis toothpaste and interdental brush, significantly improved participants' gingival health over 3-months compared to brushing with an anti-gingivitis toothpaste with conventional OHA as delivered in the general dental services. This study demonstrates the benefit of changing OH behaviour and delivering OHA using an individually tailored approach with contemporary methodology. CLINICAL SIGNIFICANCE: OHA is usually verbally delivered over short time periods. This study demonstrates video technology with individualised OHA improves OH adherence and empowers individuals, the recipient receiving personal visual cues with ability to replay advice and technique reiteration. This real-world technology could be better utilised in general dental practice.

Dental health status of children with diabetes in Riyadh, Saudi Arabia.

Objective: The impact of diabetes on oral diseases remains debatable. We aimed to determine the prevalence of dental caries, gingival health status and knowledge, and oral hygiene level and practice in children with type 1 diabetes mellitus in Riyadh, Saudi Arabia. Methods: The teeth of Sixty children with diabetes (33 males and 27 females; age 11.3 ± 2.2 [7-14] years) were examined for dental caries following the modified World Health Organization criteria. Data on age, sex, medical history, gingival health status and knowledge, and oral hygiene level and practice were collected from parents. Results: In this study, 53 % of the children had dental caries with decayed, missing, and filled primary and permanent teeth scores of 5.6 ± 3.8 and 3.6 ± 3.2, respectively, with similar scores for male and female children. Children with and without caries had similar oral hygiene practices and oral health knowledge but differed in the rates of good or fair oral hygiene status (89.2 vs. 56.6 %; P = 0.024) and normal gingival health status or mild gingivitis (96.5 vs. 81.3 %; P = 0.010). Conclusions: We found that the oral hygiene status and rate of gingivitis differed in children with type 1 diabetes mellitus with or without dental caries.

Can oral health care be a gateway to improve cardiovascular disease? A scoping review.

Background: Cardiovascular diseases (CVDs) are a significant cause of morbidity and mortality worldwide, resulting in a high socioeconomic burden. Growing evidence has shown a link between oral diseases and several chronic conditions including CVDs. The focus of this review is to investigate and summaries the evidence surrounding oral health interventions and their potential impact on reducing both the risk and/or severity of CVDs. Methods: A scoping review was conducted to examine oral health interventions for managing CVD outcomes and risks. The review adhered to the Joanna Briggs Institute (JBI) framework for evidence synthesis and followed the reporting standards outlined by the Preferred Reporting Items for Systematic Reviews and Meta-analysis- extension to Scoping Review (PRISMA-ScR). A systematic search across EBSCOhost, PubMed, and Scopus databases from 2012 to 2024 was utilized to identify relevant studies. Inclusion criteria focused on English language articles with a sample size of at least 50, evaluating the impact of oral health interventions on CVD outcomes. Results: Out of the initial 2,154 studies identified in the search, 12 studies met the inclusion and exclusion criteria and were included in the final analysis. Overall, the studies revealed that along with surgical and non-surgical periodontal therapy, regular oral hygiene care practices, including toothbrushing, tongue brushing, and flossing, significantly reduced the risk of cardiovascular events and mortality. These interventions in patients with or without CVD baseline have shown a decrease in CVD risk markers as well as a reduction in bacterial colonization. Similarly, consistent oral hygiene routines, combined with regular dental visits, were associated with a lower risk of heart failure and CVD risk mortality. Conclusion: The evidence extracted from this review suggests that periodontal therapy, regular dental cleaning, and re-enforcing of oral health regimes can stabilize oral health conditions and subsequently improve CVD progression/risks. However, limited to no evidence exists regarding the therapeutic effects of oral health promotion in managing CVD markers and its direct impact on disease outcomes, warranting further investigation.

Clinical and Demographic Profiling of Periodontal Diseases: A Retrospective Analysis Using the 2018 Periodontal Classification Algorithm.

The research presented in this retrospective study aimed to investigate the prevalence of periodontal diseases within a population and explore potential demographic and clinical variations among patients diagnosed with periodontitis. The study involved the analysis of 104 patient records from the Periodontology Clinic at the University of Medicine and Pharmacy in Craiova, collected between 2018 and 2019. Utilizing the 2018 classification algorithm for periodontal diseases, patients were categorized into three groups: a control group without periodontal issues (Group H), a gingivitis group (Group G), and a periodontitis group (Group P). The collected data encompassed demographic information, oral hygiene indicators, and clinical parameters. Statistical analysis and graphical representation revealed notable trends, such as the higher prevalence of periodontitis (51%) compared to gingivitis (14%), with 35% of participants showing no signs of periodontal involvement. Detailed group analyses highlighted specific patterns, including a substantial male predominance among patients without periodontal issues and varying distributions of periodontal stages based on gender. Additionally, the study explored age-related variations, revealing an increasing average age from the control group (33.04 years) to the gingivitis group (34.86 years) and a significant rise in the periodontitis group (45.49 years). The findings underscore the importance of early detection and intervention in periodontal diseases and provide valuable insights for clinicians in tailoring individualized diagnostic and treatment approaches.

The efficacy and safety of an enzyme-containing lozenge for dental biofilm control-a randomized controlled pilot trial.

OBJECTIVES: To evaluate the effect of daily use of a multiple-enzyme lozenge on de novo plaque formation, on gingivitis development, and on the oral microbiome composition. METHODS: This trial with two parallel arms included 24 healthy adults allocated to the Active (n = 12) or Placebo (n = 12) group. Subjects consumed one lozenge three times daily for seven days, and no oral hygiene procedures were allowed. Differences in de novo plaque accumulation between a baseline period, and one and seven days of intervention were assessed by the Turesky-modification of the Quigley-and-Hein-Plaque-Index (TM-QHPI). The development of gingivitis after seven days of intervention was assessed by the Gingival Index (GI). Plaque and saliva samples were collected at baseline and after seven days of intervention, and evaluated by 16S rRNA gene sequencing. RESULTS: All subjects completed the study, and no adverse events were reported. After one day, the average TM-QHPI was significantly lower in the Active than in the Placebo group, as compared to baseline (p = 0.012). After 7 days, average TM-QHPI values did not differ significantly between groups (p = 0.37). GI values did not increase during the intervention period, with no difference between groups (p = 0.62). Bacterial richness increased in both plaque and saliva samples over a seven-day oral hygiene-free period, with a statistically significant difference for the saliva samples (p = 0.0495) between groups. CONCLUSIONS: A multiple-enzymes lozenge decreased the build-up of de novo plaque after one day and slowed down the process of species increment in saliva. The lozenge may be an adjunct to regular mechanical plaque removal. CLINICAL SIGNIFICANCE: Dental plaque is the main cause of caries, gingivitis, and periodontitis. The search for therapeutic adjuncts to mechanical plaque removal that have no harmful effects on the oral microbiome is important. Treatment with multiple plaque-matrix degrading enzymes is a promising non-biocidal approach to plaque control.