Evaluation of metronidazole oral monotherapy in anaerobic oral infections.

OBJECTIVES: To evaluate the indications and dosing regimens for oral metronidazole monotherapy (OMM) for the management of oral anaerobic infections (OAIs) other than periodontitis. MATERIALS AND METHODS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in literature of PubMed/Medline, Scopus, and Cochrane databases. Data were retrieved from reports published in English in the period January 1, 1980 - August 30, 2023. Joanna Briggs Institute Critical Appraisal Tools were used to assess study risk of bias. RESULTS: A total of 228 articles were retrieved from the databases of which 16 met the inclusion criteria necessary for achieving the aims of the study. OAIs in which OMM was used or recommended included pericoronitis; necrotizing ulcerative gingivitis/periodontitis/stomatitis, osteomyelitis, acute periapical infection, and cellulitis. OMM was prescribed in dosages ranging from 200 to 500 mg t.i.d. for periods ranging from 2 to 7 days. Osteomyelitis of the jaw was the only infection for which the dosage regimen of metronidazole was not clearly described. CONCLUSION: Evidence from the databases searched support the view that OMM has clinical efficacy in the treatment of specific OAIs namely pericoronitis and necrotizing oral infections in immune-competent and immune-compromised patients. The evidence does not support the use of OMM in "deep tissue" infections such as osteomyelitis, and odontogenic infections such as acute apical infection and cellulitis. Clinical trials are warranted to determine the efficacy of OMM in comparison with other antibiotic regimens.

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.

A Video-Game-Based Oral Health Intervention in Primary Schools-A Randomised Controlled Trial.

BACKGROUND: Poor oral health practices and high levels of dental caries have been reported among children in the developing world. Video games have been successful in promoting oral health in children. The aim of this study was to assess the impact of an oral-health-education video game on children's dietary knowledge and dietary and toothbrushing practices; Methods: Two Schools in Amman, Jordan were randomly selected and assigned to either intervention or control. Six- to eight-year old children took part. The intervention group played the oral-health-education video game; the control group received no intervention. The groups were compared in terms of changes in: child dietary knowledge, dietary and toothbrushing practices, plaque scores, and parental familiarity with preventive treatments. Data were submitted to statistical analysis with the significance level set at p ≤ 0.05. RESULTS: Two hundred and seventy-eight children took part. Most (92%) had carious teeth. At baseline, children reported having more than one sugary snack a day and only 33% were brushing twice a day. Most parents were unaware of fluoride varnish (66%) or fissure sealants (81%). At follow-up, children in the intervention group had significantly better dietary knowledge, and parents in both groups became more familiar with fluoride varnish. There were no significant changes in children's plaque scores, toothbrushing and dietary practices, or parental familiarity with fissure sealants in either group. CONCLUSIONS: Using an oral-health-education video game improved children's dietary knowledge. However, future efforts should target children together with parents, and need to be supplemented by wider oral-health-promotion.

Failure on all fronts: Qualitative analysis of the oral health care experience in individuals with intellectual disability.

AIM: To explore the oral health care experience of individuals with intellectual disability and their families. METHODS: A qualitative approach utilising face-to-face semi-structured interviews with parents of individuals with intellectual disability. All interviews were audio recorded and transcribed verbatim, and Qualitative Framework Analysis was used to present the results. RESULTS: Twenty-six parents of 26 individuals with intellectual disability were interviewed. The interviewees were 10 males and 16 females, and their average age was 46.4 ± 11.2 years (range 28-66). The average age of individuals with intellectual disability was 17.9 ± 9.2 years (range 6-48), and there were 11 (42.3%) males and 15 (57.7%) females. The interviewees reported that challenges to oral health care do occur on multiple levels: (a) home environment; (b) primary dental care; (c) secondary dental care facilities; (d) health and education policies and systems; and (e) societal views on individuals with intellectual disability. CONCLUSION: Individuals with intellectual disability and their families are being failed at multiple levels of oral health care, leaving parents feeling frustrated, isolated, and sometimes helpless. Collaborative efforts are needed to train families to prevent oral health disease at home, establish better primary and secondary oral health care systems, and overcome wider cultural, social, and economic barriers.