Association between oral health and gastric precancerous lesions.

Although recent studies have suggested that tooth loss is positively related to the risk of gastric non-cardia cancer, the underlying oral health conditions potentially responsible for the association remain unknown. We investigated whether clinical and behavioral measures of oral health are associated with the risk of gastric precancerous lesions. We conducted a cross-sectional study of 131 patients undergoing upper gastrointestinal endoscopy. Cases were defined as those with gastric precancerous lesions including intestinal metaplasia or chronic atrophic gastritis on the basis of standard biopsy review. A validated structured questionnaire was administered to obtain information on oral health behaviors. A comprehensive clinical oral health examination was performed on a subset of 91 patients to evaluate for periodontal disease and dental caries experience. A total of 41 (31%) cases of gastric precancerous lesions were identified. Compared with non-cases, cases were significantly more likely to not floss their teeth [odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.09-7.64], adjusting for age, sex, race, body mass index, smoking status, educational attainment and Helicobacter pylori status in serum. Among participants who completed the oral examination, cases (n = 28) were more likely to have a higher percentage of sites with gingival bleeding than non-cases [OR = 2.63, 95% CI: 1.37-5.05 for a standard deviation increase in bleeding sites (equivalent to 19.7%)], independent of potential confounders. Our findings demonstrate that specific oral health conditions and behaviors such as gingival bleeding and tooth flossing are associated with gastric precancerous lesions.

The Baccalaureate as the Minimum Entry-Level Degree in Dental Hygiene.

A growing body of evidence indicates the baccalaureate degree is needed for dental hygiene (DH) graduates to address the changes in oral health delivery and health systems, develop the societal expectations of a professional, and practice to the full extent of their education. Transitioning from the associate to the baccalaureate as the minimum entry-level degree in DH will better prepare graduates to address the increasingly complex oral health care needs of the public. The higher degree prepares the dental hygienist to serve in roles that will improve access to high-quality care and allow for interprofessional collaboration as a part of a health care team. A higher entry-level degree is also needed to advance the public perception of DH and its recognition as a unique health care profession. However, reported student barriers to the entry-level baccalaureate degree include time and funding constraints, and the belief that the associate degree education is sufficient for clinical practice coupled with a lack of perceived value/benefit of the higher-level degree. This narrative literature review examines relevant policies, standards, and survey data to assess the support for the baccalaureate degree as minimum entry-level education in DH. As the roles for dental hygienists expand to meet the needs of the changing population demographics, the health care market demands for a baccalaureate degree educated dental hygienist will follow. More research is needed to document the value of the baccalaureate-prepared dental hygienist.

Chronic Periodontal Disease, Periodontal Pathogen Colonization, and Increased Risk of Precancerous Gastric Lesions.

BACKGROUND: This study assesses the association between periodontal pathogen colonization and the potential risk of developing precancerous lesions of gastric cancer (PLGC) in a clinical setting. METHODS: Included were 35 newly diagnosed patients with PLGC and 70 age-matched individuals without PLGC. A full-mouth intraoral examination was performed to assess periodontal conditions. Stimulated whole saliva and pooled plaque samples were collected to evaluate colonization by Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans and to characterize oral microbial diversity in saliva and dental plaque. RESULTS: Compared with the control group, patients with PLGC experienced higher prevalence of bleeding on probing (31.5% versus 22.4%; P <0.05), higher levels of T. denticola (P <0.01) and A. actinomycetemcomitans (P <0.01), and less bacterial diversity in their saliva (P <0.01). The final multivariate logistic regression model consisting of all key sociodemographic characteristics, oral health behavioral factors, and periodontal assessments revealed that elevated colonization with periodontal pathogens, specifically T. forsythia, T. denticola, and A. actinomycetemcomitans, decreased bacterial diversity in dental plaque, and not flossing teeth regularly was a significant predictor of increased risk of PLGC (P = 0.022). CONCLUSION: Findings of the present study provide new evidence suggesting that periodontal pathogen burdens and bacterial diversity in the oral cavity are important factors contributing to a potentially increased risk of developing precancerous gastric lesions.