Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren's syndromes patients - a cross-sectional study.

BACKGROUND: Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. METHODS: Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. RESULTS: The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8). CONCLUSIONS: Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

Co-occurrence of dental caries and periodontitis: multilevel modelling approach.

BACKGROUND: Previous studies reported varyingly positive, negative, or no relationships between caries and periodontitis. Therefore, the aim was to assess the potential co-occurrence of caries experience and periodontal inflammation on the same teeth. METHODS: This cross-sectional study used data from the Lithuanian National Oral Health Survey. The study included a stratified random sample of 1405 individuals aged 34-78, recruited from 5 Lithuanian cities and 10 peri-urban/rural areas (response rate 52%). Information about sociodemographic (age, sex, education, residence), behavioral (sugar-containing diet, tooth brushing frequency, use of interdental care products, last dental visit, smoking) and biological (systemic disease, use of medication and xerostomia) determinants was collected using the World Health Organization (WHO) Oral Health Questionnaire for Adults supplemented with additional questions. Clinical data were recorded using the WHO criteria and collected by one trained and calibrated examiner. Dental caries status was recorded as sound, decayed, missing, filled surfaces. Subsequently for the analyses, status was recorded at a tooth-level as decayed- and filled-teeth (DT and FT) including proximal, buccal, and oral surfaces. Two measures were used for periodontal status. The probing pocket depth (PPD) was measured at six sites and recorded at a tooth level into the absence of PPD or presence of PPD ≥ 4 mm. Bleeding on probing (BOP) was measured at the same six sites and was recorded as either present or absent at a tooth-level. Univariable and multivariable 2-level random intercept binary logistic regression analyses were utilized. RESULTS: Positive associations were found between DT and BOP (OR 1.42, 95% CI 1.20-1.67), FT and BOP (OR 2.07, 95% CI 1.82-2.23), DT and PPD (OR 1.38, 95% CI 1.15-1.67) and FT and PPD (OR 2.01, 95% CI 1.83-2.20). CONCLUSIONS: Our findings add evidence for the co-occurrence of periodontal inflammation and caries on the same teeth. This suggests the need for increased emphasis on a transdisciplinary approach in designing oral health interventions that target dental caries and periodontal disease simultaneously. In addition, longitudinal studies exploring the co-occurrence of caries and periodontal disease at the same sites, taking into consideration the levels of both conditions and genetic variation, are warranted.

Gingival Tissue MiRNA Expression Profiling and an Analysis of Periodontitis-Specific Circulating MiRNAs.

This study aimed to identify the microRNAs (miRNAs) associated with periodontitis (PD) in gingival tissues, and to evaluate the levels of these selected miRNAs in the saliva and blood plasma among participants with and without rheumatoid arthritis (RA). A genome-wide miRNA expression analysis in 16 gingival tissue samples revealed 177 deregulated miRNAs. The validation of the miRNA profiling results in 80 gingival tissue samples revealed that the PD-affected tissues had a higher expression of miR-140-3p and -145-5p, while the levels of miR-125a-3p were significantly lower in inflamed tissues. After a thorough validation, four miRNAs, namely miR-140-3p, -145-5p, -146a-5p, and -195-5p, were selected for further analysis in a larger sample of salivary (N = 173) and blood plasma (N = 221) specimens. Increased salivary levels of miR-145-5p were associated with higher mean values of pocket probing depth and bleeding on probing index. The plasma-derived levels of miR-140-3p were higher among the participants with PD. In conclusion, the gingival levels of miR-140-3p, -145-5p, and -125a-3p were independently associated with PD presence and severity. The salivary and blood plasma levels of the target miRNAs were diversely related to PD. Similar miRNA associations with PD were observed among the participants with and without RA.

SARS-CoV-2 RT-qPCR Ct values in saliva and nasopharyngeal swab samples for disease severity prediction.

Background: Comparison of clinical value of RT-qPCR-based SARS-CoV-2 tests performed on saliva samples (SSs) and nasopharyngeal swab samples (NPSs) for prediction of the COVID-19 disease severity. Methods: Three paired SSs and NPSs collected every 3 days from 100 hospitalised COVID-19 patients during 2020 Jul-2021 Jan were tested by RT-qPCR for the original SARS-CoV-2 virus and compared to 150 healthy controls. Cases were divided into mild+moderate (Cohort I, N = 47) and severe disease (Cohort II, N = 53) cohorts and compared. Results: SARS-CoV-2 was detected in 65% (91/140) vs. 53% (82/156) of NPSs and 49% (68/139) vs. 48% (75/157) of SSs collected from Cohort I and II, respectively, resulting in the total respective detection rates of 58% (173/296) vs. 48% (143/296) (P = 0.017). Ct values of SSs were lower than those of NPSs (mean Ct = 28.01 vs. 30.07, P = 0.002). Although Ct values of the first SSs were significantly lower in Cohort I than in Cohort II (P = 0.04), it became negative earlier (mean 11.7 vs. 14.8 days, P = 0.005). Multivariate Cox proportional hazards regression analysis showed that Ct value ≤30 from SSs was the independent predictor for severe COVID-19 (HR = 10.06, 95% CI: 1.84-55.14, P = 0.008). Conclusion: Salivary RT-qPCR testing is suitable for SARS-CoV-2 infection control, while simple measurement of Ct values can assist in prediction of COVID-19 severity.

Association between Carbonic Anhydrase VI Gene Copy Number Variations and Dental Caries Experience.

The current study examined the association between the carbonic anhydrase VI (CA VI) copy number variations (CNVs) and dental caries experience in adults. In total, 202 of 35-72 years old subjects participating in the Lithuanian National Oral Health Survey (LNOHS) agreed to provide saliva samples; thus, their data were included in the current study. Information about sociodemographic, environmental, and behavioural determinants was acquired via the self-administered World Health Organization (WHO) questionnaire. Fluoride levels in the drinking water were recorded based on information provided by water suppliers. Dental caries experience was recorded by one calibrated examiner using the WHO criteria for recording caries on smooth (including proximal, buccal, and oral) or occlusal surfaces. Caries experience was measured as the total number of decayed (D3), missing (M), filled (F) surfaces. DNA was extracted from saliva samples to examine CA VI CNVs using the QX200 Droplet Digital PCR system. Negative binomial regression and Poisson regression analyses were employed for data analyses. Based on multivariable regression analyses, higher copy number of CA VI were associated with higher caries experience on smooth surfaces (IRR 1.04, 95% CI: 1.005-1.08) and occlusal surfaces (IRR 1.02, 95% CI: 1.003-1.04). Positive associations between higher copy number of CA VI and higher caries experience on smooth and occlusal surfaces were found, suggesting that the CA VI coding gene may be associated with caries development. Future studies are needed to validate our results and to examine the underlying mechanisms of such associations.

Web-Based Interventions Reduced Dental Anxiety among Adults in Lithuania and Norway: A Pilot Study.

Dental anxiety (DA) is a prevalent public health issue. However, there is a lack of self-administered DA interventions. The aim of this study was to evaluate the short-term effects of web-based interventions aiming to reduce DA in adults in two European countries. A pretest posttest design was used. Tailor-made websites were developed in Lithuania and Norway. Volunteers who self-reported DA were invited to participate. DA levels measured by the Modified Dental Anxiety Scale (MDAS) were assessed at baseline and after two weeks via online questionnaires. The interventions were completed by 34 participants in Lithuania and 35 participants in Norway. In Lithuania, the median posttest MDAS score (9.5, IQR 5.25) decreased compared to the median pretest MDAS score (14.5, IQR 8; Z value = -4.246, p < 0.001). The same was found in Norway-the median posttest MDAS score (12, IQR 9) was lower compared to the median pretest MDAS score (15, IQR 7; Z value = -3.818, p < 0.001). The present study demonstrated that two tailor-made web-based interventions had the potential to reduce dental anxiety levels when assessed in the short term in Lithuania and Norway. Studies with more controlled designs assessing long-term outcomes are needed to validate the results of this pilot study also in other cultures.

The 20-Year Trends in Caries and Associated Determinants among Adults in Post-Soviet Lithuania: Repeated Cross-Sectional Studies.

AIM: The aim of the study was to examine the 20-year trend in dental caries and associated determinants among adults in Lithuania after the country restored its independence. MATERIAL AND METHODS: Data from two cross-sectional national surveys included samples of 35-44-year-olds (adults) and 65-74-year-olds (early elderly). The 1997/1998 survey (first survey) recruited a stratified random sample of 569 individuals from 10 selected areas in Lithuania (response rate 52%), and the 2017/2019 survey (second survey) recruited a stratified random sample of 723 individuals from 5 biggest Lithuanian cities and one randomly selected peri-urban/rural area from each of 10 Lithuanian counties (response rate 53%). The information about the social (sex, residence, education) and behavioral (toothbrushing frequency, use of fluoridated toothpaste, and last dental visit) determinants was collected via self-reports using the World Health Organization (WHO) Oral Health Questionnaire for Adults questions. Information about the fluoride level in the drinking water was retrieved from the water suppliers. Dental caries was recorded at the surface level following the WHO criteria by two calibrated examiners, one at each of the national surveys. Bivariate and multivariate analyses were used. RESULTS: According to multivariable negative binomial regression analysis, in adults, 67% lower DS scores (IRR 0.33, 95% CI 0.26-0.42) and in early elderly 47% lower DS scores (IRR 0.53, 95% CI 0.38-0.74) were observed in the second survey. Adults in the second survey (vs. first survey) had 62% lower MT scores (IRR 0.38, 95% CI 0.32-0.46), and the early elderly had 19% lower MT scores (IRR 0.81, 95% CI 0.72-0.92). Adults in the second survey had 21% lower DMFT scores (IRR 0.79, 95% CI 0.73-0.85). The changes in behavioral determinants were observed over the 20-year period. CONCLUSION: An improvement in dental health during the 20-year period, mainly related to reduction in untreated caries and missing teeth, was observed in adults and early elderly. However, early elderly still had high numbers of missing teeth. The decrease in total caries experience during the 20 years was significant only in adults. Our findings support an urgent need to design and implement national oral health promotion and prevention programs with increased focus on oral self-care and fluoridated toothpaste use.

Lip morphometry and morphologic pattern variation by ethnicity.

The aim of this research is to document and classify common lip print patterns and lip measurements, to evaluate their variations in Polish, Russian, Lithuanian women populations. 371 women (151 Lithuanians, 145 Poles, 75 Russians) from Vilnius University participated in this research. A questionnaire and lip print collection were administered. Each lip print was divided into six sextants, examined and classified. 120 women were photographed by Vectra M3 3D (Canfield Imaging Systems, USA) camera, lip morphometry was analyzed. In all lip print sextants, Type I was the most common among Lithuanians, Type III - among Polish and Type V - among Russian women. A statistically significant difference was found between Type I lip print pattern and Lithuanian ethnicity (p = 0.001) and Type III and Polish ethnicity (p = 0.015). The values of medial vertical height of cutaneous upper lip (p = 0.045), height of upper lip (p = 0.034), philtrum width (p = 0.020), height of lower vermilion (p = 0.015), upper lip vermilion area (p = 0.022), upper lip volume (p = 0.034) and total lip volume (p = 0.05) statistically significantly varied between the ethnicities. Morphometric findings were similar to other morphometric research on Caucasians.

Changes in Management Preference of Deep Carious Lesions and Exposed Pulps: Questionnaire Studies with a 10-Year Interval among Dentists in Lithuania.

We aimed to investigate changes in management preferences for deep carious lesions and pulps exposed during carious tissue removal that occurred during the last 10 years and identify associated dentists' background factors. The data were collected among dentists registered with the Lithuanian Dental Chamber at two time points using a similar questionnaire. In 2011, 400 randomly selected dentists received a questionnaire by mail, and 153 (38.3%) responded. In 2021, an electronic invitation to an online questionnaire was sent to all members of the Lithuanian Dental Chamber, and 213 (8.9%) dentists responded. The questionnaire included the definitions of management options, a radiograph, and a clinical picture of a deep carious lesion reaching to the inner fourth of dentine in a mature permanent tooth, asked management preferences in four different scenarios, as well as participants' background characteristics, reasons for management, and procedural preferences. Data were analyzed using bivariate and multivariable analyses. Compared to 2011, participants in 2021 had 60% lower odds of preferring nonselective versus selective caries removal (OR 0.4, 95% CI 0.2-0.7) and endodontic treatment versus nonselective and selective caries removal (OR 0.4, 95% CI 0.2-0.6) in the scenario of asymptomatic and symptomatic (indicating reversible pulpitis at most) deep lesions, respectively. For exposed pulp, participants in 2021 had lower odds than in 2011 of preferring endodontic treatment versus vital pulp therapy (direct pulp capping and pulpotomies) for both scenarios without symptoms (OR 0.4, 95% CI 0.2-0.7) and with symptoms (OR 0.2, 95% CI 0.1-0.4). A higher proportion of respondents in 2021 reported using rubber dam (44% vs. 17% in 2011, p < 0.001) and hydraulic calcium silicate cements as a capping material (68% vs. 40% in 2011, p < 0.001). The management preferences were associated with the university of graduation and the number of years in dental practice, indicating "recommended in textbooks" and "recommended in scientific publications" as reasons for management preferences. To conclude, a change toward less invasive management options was observed. To a certain extent, dentists have implemented evidence-based recommendations in dental practice. To ensure further adoption of scientific evidence, dentists should be encouraged to update themselves on the newest evidence-based practices.

Importance of education on infection control and on the hand skin health of dental personnel.

BACKGROUND: Hand hygiene plays a significant role in infection control, yet it is performed correctly only 40% of the time. The daily use of soap, disinfectants and gloves can also affect hand skin health. Periodical educational interventions regarding hand hygiene can improve infection control. OBJECTIVES: The current study aimed to identify the existing hand hygiene practices applied by dental personnel, to evaluate knowledge about infection control, to determine the adverse effects of hand hygiene on the skin, and to assess the effectiveness of the educational interventions concerning these topics. MATERIAL AND METHODS: This study was carried out at the Vilnius University Hospital Zalgiris Clinic, Lithuania. At the 1st stage, data was collected by using a self-administered questionnaire. At the 2nd stage, dental personnel underwent an educational intervention and the surveys were redistributed to determine any changes in the level of knowledge. RESULTS: In most cases, dental workers performed hand hygiene when it was needed. The proper method was selected by 53.4% on average. The main mistakes were the excessive use of soap and only occasional use of a disinfectant. The reported hand skin side effects included dryness (68.8%) and fissures (37.5%). Only half (50.5%) of the staff regularly used emollients. After the educational intervention, there was a 24.9% improvement in hand hygiene compliance. CONCLUSIONS: The correct procedure for hand hygiene was reported by half of the participants. Washing hands with soap was the preferable choice, while alcohol-based hand rub (ABHR) was avoided. Skin problems were reported by more than 70% of the respondents. Training had a positive impact on the hand hygiene knowledge of the dental personnel.

Oral Health among Adult Residents in Vilnius, Lithuania.

According to the World Health Organization (WHO) oral conditions may be determined by social, biological, behavioral, and psychosocial factors. The study assessed oral health status and its determinants associated with oral health conditions among adult residents in Vilnius, Lithuania. A total of 453 of 35-74-year-olds participated (response rate 63%). A self-reported questionnaire was administered. Dental caries experience (D3MFS score), periodontal probing depth (PPD), andnumber of missing teeth were assessed clinically. Data were analyzed using χ2 test, independent samples t-test, and multivariable linear regression. The mean (sd) of D3MFS scores was 67.3 (33.5), the mean (sd) number of teeth with PPD 4+ mm was 5.9 (5.3), prevalence of periodontitis was 33%, the mean (sd) number of missing teeth was 6.9 (6.8), and prevalence of total edentulism was 3.8%. Medication use was associated with all oral health conditions, while age was associated with caries experience, and missing teeth. Sugar-containing diet was associated with caries experience, and missing teeth, and smoking with caries experience and periodontal status. Systemic diseases were associated with periodontal status, while behavioral determinants, last dental visit, and use of fluoridated toothpaste were associated with missing teeth. Oral health status among adult Vilnius residents was poor. Oral conditions were associated with both biological and behavioral determinants. Oral health promotion should focus on modifying behavioral determinants.

European student wellness, stress, coping, support and perceptions about remote dental training during COVID-19.

OBJECTIVES: The aim of this study was to compare wellness, stress, ability to cope, social support and perceptions about remote training amongst European dental students during COVID-19. METHODS: 1795 undergraduate dental students from six countries and eight dental schools participated. The anonymous survey collected data about different aspects in each of the following domains: wellness, stress, ability to cope, social support and perceptions about remote training. Complex multi-item scales were used for all domains. RESULTS: There were differences amongst countries in all the domains. Overall, student stress scores were lower than either their coping or support scores. The highest wellness score (mean ±sd) was observed in Romania: 62.5% ± 11.2% whilst the highest mean stress scores were observed in Albania: 46.3% ± 11.7% and Lithuania: 42.2% ± 13.8%. Overall, student stress and coping ability scores were lower and their support scores higher. About 10% of students did not have any support. In the linear multivariable regression analysis, significant predictors of wellness were being female (ß = 0.073), not being in a graduating year (ß = 0.059), having less stress (ß = 0.222), ability to cope (ß = 0.223) and having support (ß = 0.179). The student positive perceptions about remote training were predicted by less stress (ß = 0.080), coping (ß = 0.182) and support (ß = 0.057). CONCLUSIONS: Students varied in wellness, stress, coping, social support and perceptions of remote training. Also, there were significant differences amongst students from different countries. Coping was the best predictor of both student wellness and their positive perceptions about remote training.

Prevalence of and factors associated with dental service utilization among early elderly in Lithuania.

BACKGROUND: There is no recent information about dental service utilization (DSU) among elderly in Lithuania. We examined DSU and its associated factors in Lithuanian early elderly based on the Andersen's behavioural model. METHODS: The cross-sectional study conducted in 2017-2019 included a nationally representative stratified sample of 370 Lithuanian early elderly aged 65-74 years (response rate of 54.5%). Information on predisposing factors (age, sex, nationality and education), enabling factor (residence), need-based factors (status of teeth, oral pain or discomfort, and dry mouth), general health, personal health practices and perceived stress was obtained from a structured, self-administered questionnaire. Clinically-assessed need-based factors included number of missing teeth and dental treatment need. Multivariable Poisson regression with robust variance estimates was used. RESULTS: A total of 239 study participants (64.6%) reported a dental visit during the last year and 338 (91.4%) needed dental treatments. A higher level of education (adjusted prevalence ratio [aPR] = 1.21, 95% confidence interval [CI]:1.04-1.40), pain or discomfort in teeth/mouth (aPR = 1.35, 95%CI: 1.13-1.62) and lower number of missing teeth (aPR = 0.99, 95%CI: 0.98-1.00) were associated with DSU. CONCLUSIONS: Even though majority of early elderly needed dental treatments, only two-thirds visited a dentist during the last year. Predisposing and need-based factors were significant predictors of having a dental visit in the last year. A national oral health program for Lithuanian elderly with the focus on regular preventive dental check-ups is needed. More studies, both quantitative and qualitative, are warranted to investigate in depth the barriers for DSU among elderly in Lithuania.

Relationship Between Job Satisfaction and Health of Hygienists in Lithuania.

OBJECTIVES: This study aimed to determine the perceived musculoskeletal and psychological symptoms and job satisfaction of Lithuanian dental hygienists. Second, the study aimed to examine the relationships between job satisfaction and musculoskeletal and psychological symptoms amongst dental hygienists in Lithuania. METHODS: A 41-item survey was sent by email to all members of the Lithuanian Dental Hygienists Association (N = 328) up to 3 times. The questionnaire comprised 5-point Likert scale structured questions, which were developed according to 3 existing questionnaires. RESULTS: The final response rate was 52.4% (N = 172). The level of overall work-related physical health was 3.76 ± 0.65, and the most common physical health symptom was upper back pain; the level of overall work-related psychological health was 3.84 ± 0.64, and the most common symptom was stress. The level of overall job satisfaction was 3.87 ± 0.62, and the most satisfying areas were their relationships with colleagues, relationships with dentists, and working conditions (equipment, work environment); the least satisfying practice areas were income, work-related physical and psychological health, and social security. CONCLUSIONS: According to the results of this study, Lithuanian dental hygienists were quite satisfied with their job but sometimes experienced work-related musculoskeletal and psychological disorders. Their physical health score and the total psychological health score were significantly correlated with all job satisfaction criteria. The better the self-evaluation of physical and psychological health, the higher the job satisfaction reported.

Gingival crevicular fluid microRNA associations with periodontitis.

PURPOSE: The present study was performed to assess the associations of gingival crevicular fluid (GCF) microRNAs miR-140-3p, miR-145-5p, miR-146a-5p, and miR-195-5p with periodontitis (PD) and to evaluate the possible influence of rheumatoid arthritis (RA) in this context. METHOD: GCF samples were collected from 134 individuals with PD and 76 periodontally healthy individuals, with or without RA. After miRNA extraction from GCF, the levels of miR-140-3p, miR-145-5p, miR-146a-5p, and miR-195-5p were assessed using RT-qPCR. RESULTS: MiR-146a-5p levels were significantly lower among the patients with PD than among the healthy individuals (P < 0.001) and negatively correlated with PD severity based on PD stage and periodontal outcome parameters (P < 0.05). Patients with severe PD had higher GCF levels of miR-140-3p and miR-145-5p than did periodontally healthy individuals (P < 0.05). Significant AUC values for diagnosis of severe PD were revealed for miR-140-3p (AUC = 0.614, P = 0.022), miR-145-5p (AUC = 0.621, P = 0.016) and miR-146a-5p (AUC = 0.702, P < 0.001). Combination of the aforementioned miRNAs increased the diagnostic performance (AUC = 0.709, P < 0.001). CONCLUSION: It was demonstrated that miR-140-3p, miR-145-5p and miR-146a-5p were associated with PD and would be potentially effective for GCF-based non-invasive periodontitis diagnostics in patients with and without RA.

Association between Diet and Xerostomia: Is Xerostomia a Barrier to a Healthy Eating Pattern?

OBJECTIVE: Xerostomia is a subjective feeling of dry mouth and is commonly observed in patients with autoimmune diseases. Our study examines the association between xerostomia and diet. MATERIALS AND METHODS: The cross-sectional study includes 1405 adults from 15 Lithuanian geographical areas (52% response rate). A self-reported questionnaire inquired about xerostomia, sex, age, education, residence, and consumption of selected 23 diet items. For the multivariable analysis, 23 diet items were categorized into eight major diet groups. The data were analyzed by bivariate and multivariable analyses. RESULTS: When comparing participants with and without xerostomia, there were significant differences in consumption frequencies concerning cold-pressed oil (p = 0.013), bread (p = 0.029), processed meat products (p = 0.016), fat and lean fish (p = 0.009), and probiotic supplements (p = 0.002). In the multivariable binary logistic regression model, when controlled for other determinants, the higher consumption of carbohydrates (OR 0.39, 95% CI 0.23-0.65), proteins (OR 0.56, 95% CI 0.32-0.99), and oils (OR 0.58, 95% CI 0.34-1.00) was associated with a lower likelihood of xerostomia. CONCLUSIONS: The association between xerostomia and the consumption of the six diet items-cold-pressed oils, lean and fat fish, bread, processed meat, and probiotic supplements- and the three major diet groups-carbohydrates, proteins, and oils-was observed. Longitudinal studies are needed to validate the observed associations.

Detection of xerostomia, Sicca, and Sjogren's syndromes in a national sample of adults.

OBJECTIVES: To assess the prevalence and determinants of xerostomia among adults and identify how many of the ones experiencing xerostomia have Sicca and Sjogren's syndromes. MATERIALS AND METHODS: This cross-sectional study included 1405 35-74-year-old Lithuanians (51.7% response rate) from the five largest Lithuanian cities and 10 peri-urban and rural areas that were randomly selected from each of the 10 Lithuanian counties. Xerostomia was determined by the self-reported experience of dry mouth as "often" or "always". A dentist diagnosed Sicca syndrome by unstimulated whole sialometry and the Schirmer's test, and all cases were referred to a rheumatologist to confirm Sjogren's syndrome. Self-reported questionnaires collected data about the determinants. RESULTS: The prevalence of xerostomia was 8.0% (n = 112), Sicca syndrome was diagnosed for 8 participants (0.60%), and Sjogren's syndrome for 2 participants (0.14%), with this being the first time it was diagnosed. Experiencing xerostomia was associated with older age (OR 1.7, 95% CI 1.1-2.6), urban residence (OR 3.3, 95% CI 1.6-5.0), presence of systemic diseases (OR 2.5, 95% CI 1.4-3.3), and the use of alcohol (OR 0.6, 95% CI 0.4-0.9). The higher proportion of participants with Sicca syndrome involved females, of older age, having systemic diseases, and using medications. CONCLUSIONS: The prevalence of xerostomia was 8.0% and the determinants of xerostomia were older age, urban residence, systemic diseases, and absence of using alcohol. In total, 0.6% of participants had Sicca syndrome, which was more prevalent among females, older subjects, those with systematic diseases, and those using medications. Sjogren's syndrome was diagnosed in 0.14% of participants. Clinical relevance Dental clinicians need to be trained to identify potential Sjogren's syndrome cases.

Fluoride in the drinking water and dental caries experience by tooth surface susceptibility among adults.

BACKGROUND: Dental caries is the most prevalent non-communicable health condition globally. The surface-based susceptibility hierarchy indicates that surfaces in the same group have similar susceptibility to caries, where the most susceptible group consists of occlusal surfaces of first molars and buccal surfaces of lower first molars, and the least susceptible surfaces are smooth and proximal surfaces of first premolars, canines and incisors. Therefore, fluoride in the drinking water could impact one group more than the other group. The present study examined the association between fluoride levels in the drinking water and dental caries experience in adults in the context of varying tooth surface susceptibility. METHODS: Data from the cross-sectional National Lithuanian Oral Health Survey conducted in 2017-2019 included a stratified random sample of 1398 35-74-year-olds (52% response rate). Dental caries experience in dentine was measured at a surface level. The surfaces were grouped according to their caries susceptibility (group 1 being the most and group 4 the least susceptible), and dental caries experience was calculated separately for each susceptibility group, creating four outcomes. Information about explanatory variable, fluoride levels in the drinking water, was provided by the water suppliers. The questionnaire inquired about potential determinants: sociodemographic characteristics and oral health-related behaviors. Chi-square, Mann-Whitney U and Kruskal Wallis tests were used for descriptive statistics, and linear regression analyses to examine the association between fluoride levels and four outcomes. RESULTS: The proportions of median decayed, missing, filled surfaces decreased following the surface-based susceptibility hierarchy (group 1-33%, group 2-28%, group 3-24%, group 4-15%). When adjusted for potential determinants, higher-level fluoride (≥ 0.7 ppm vs < 0.7 ppm) in the drinking water associated with lower dental caries experience in all surface-based susceptibility hierarchy groups; Group 1: ß = - 0.23 (95 %CI - 0.44; - 0.001), Group 2: ß = - 0.44 (95 %CI - 0.82; - 0.07), Group 3: ß = - 1.14 (95 %CI - 1.88; - 0.41) and Group 4: ß = - 6.28 (95 %CI - 9.29; - 3.30). CONCLUSIONS: The higher-level fluoride in the drinking water associated with lower dental caries experience in adults and this was observed in all surface-based susceptibility groups. However, there is a need to validate the surface-based susceptibility hierarchy in longitudinal adult studies.

Analysis of periodontitis-associated miRNAs in gingival tissue, gingival crevicular fluid, saliva and blood plasma.

OBJECTIVE: Periodontitis (PD) is a chronic inflammatory disease which is associated with multiple systemic comorbidities, including rheumatoid arthritis (RA), meanwhile the etiopathology of PD may be modulated by various factors including microRNA (miRNA). The present study aimed to reveal miRNAs associated with PD in gingival tissue, gingival crevicular fluid (GCF), saliva, plasma and to assess the possible influence of RA. DESIGN: The cross-sectional study included 30 patients with PD and 31 periodontally healthy participants. A total of 25 participants were additionally diagnosed with RA. Microarray analysis of eight gingival tissue samples was performed and four PD-associated miRNAs were selected: miR-199a-5p, miR-483-5p, miR-3198 and miR-4299. Target miRNAs were further assessed by means of RT-qPCR in 61 gingival tissue samples and corresponding bodily fluids - GCF, saliva and plasma. RESULTS: The upregulation of miR-199a-5p and downregulation of miR-4299 in gingival tissue was associated with the presence of PD and RA (P < 0.05). GCF level of miR-3198 was higher amongst participants with PD (P = 0.019) and showed a good diagnostic ability (AUC = 0.72, P = 0.008). Increased miR-199a-5p salivary level and decreased miR-199a-5p plasma level were observed amongst patients with worse clinical status of PD (P < 0.05). MiR-3198 and miR-4299 combination in GCF demonstrated AUC value of 0.86 and reached sensitivity of 68 % and specificity of 96 %. CONCLUSIONS: Aberrant expression of miR-199a-5p, miR-483-5p, miR-3198, miR-4299 in gingival tissues is associated with the presence and/or severity of PD. MiR-3198, miR-4299 level in GCF and miR-199a-5p level in plasma strongly correlated with PD, demonstrating significant diagnostic performance.

Vitamin D and VDR Gene Polymorphisms' Association with Rheumatoid Arthritis in Lithuanian Population.

Background and Objectives: Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune, multi-factorial disease, in which environmental and genetic factors play a major role. RA is possibly linked to vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms, and research demonstrates that FokI variant susceptibility is associated with increased disease risk among Caucasians. The aim of this study was to evaluate vitamin D deficiency prevalence and its correlation to RA clinical parameters, and to determine the possible association of VDR gene polymorphisms and RA susceptibility in the Lithuanian population. Materials and Methods: Overall, 206 RA patients and 180 age- and sex-matched healthy controls were enrolled at Vilnius University Hospital Santaros Klinikos after informed consent was obtained. The disease activity score 28 C-reactive protein (DAS28 CRP), rheumatoid arthritis impact of disease (RAID) score, and health assessment questionnaire (HAQ) were recorded in RA patients, and 25(OH)D serum levels were evaluated by chemiluminescent microparticle immunoassay for all subjects. Four VDR gene polymorphisms, BsmI, FokI, ApaI, and TaqI, were assessed using real-time PCR instruments and genotyping assays in both groups. Results: The study registered a high prevalence of 25(OH)D deficiency (<50 nmol/L) in RA patients (61.55% (n = 127)). The mean serum concentration in RA patients (44.96 ± 21.92 (nmol/L)) was significantly lower than in the healthy controls (54.90 ± 22.82 (nmol/L)), p < 0.0001. A significant inverse correlation between vitamin D level, DAS28 CRP, and HAQ scores was confirmed in RA patients, with p < 0.05. Still, there was no significant association between the overall risk of RA disease for any allele or genotype of the four VDR loci tested. Conclusions: The study confirmed that vitamin D deficiency is prevalent among RA patients and the 25(OH)D level is significantly lower compared with healthy controls. Lower vitamin D concentration was related with increased disease activity and disability scores. However, genetic analysis of four VDR polymorphisms did not confer the susceptibility to RA in Lithuanian population.