Oral health status and its associated factors among post-stroke inpatients: a cross-sectional study in Hungary.

BACKGROUND: Post-stroke inpatients are at risk of poor oral health for a number of reasons. The aim of this study was to assess the oral health status of post-stroke patients and also to explore the factors that may influence it. METHODS: This cross-sectional study was organised at National Institute for Medical Rehabilitation in Hungary. Altogether 410 post-stroke patients were enrolled in the survey. Personal medical history and functional assessment was obtained from the final medical reports of the patients. The clinical examination and data collection were conducted according to the World Health Organization (2013) criteria. Socio-demographic background and behaviours related to oral health were assessed using a questionnaire. The dental status was explained by the number of Decayed, Missing and Filled Teeth (DMFT). The association of socio-demographic factors, stroke and functional assessment with oral health status and behaviour was evaluated. Chi-square test, Fisher's exact test, Welch test, Mann-Whitney U test, Kruskal-Wallis test, ANOVA model and correlation analysis were used to analyse our data. The level of significance was set at p < 0.05. RESULTS: Mean age of stroke patients was 59.21(Standard Deviation [SD] 14.74) years. Mean DMFT score was 20.13 (8.08), including 3.28 (4.24) decayed teeth, 15.02 (10.29) missing teeth and 1.83 (2.94) filled teeth score. Factors that influenced the oral health status were gender, age, occupational status, level of education, type and risk factors for stroke. Significant correlation was found between the Functional Independence Measure and oral health-related behaviours with patients brushing their teeth once a month showing the lowest value. CONCLUSION: According to the results, low socio-demographic and economic status, low level of education and the Functional Independence Measure score, unemployment, the combination of risk factors for stroke and residual dysfunctions are associated with poor oral health status. The data indicate that a series of changes are needed, for special attention and care in oral health for patients who have had a stroke. Based on the findings of this research, a new model of prevention and care can be developed, with an interdisciplinary collaboration, to promote the quality of life of these individuals.

[Oral health related quality of life of patients undergoing physical medicine and rehabilitation]. / Orvosi rehabilitációs kezelésben részesülo betegek orális egészségügyi állapotának vizsgálata.

INTRODUCTION: More than 1 billion people in the world live with some form of disability. According to the 2011 census in Hungary, their number can be around 500 000. These people are considered as a vulnerable group even from a dental point of view, since the loss of function makes regular oral hygienic routine and dentistry control more difficult. In 2015, The Department of Community Dentistry and The National Institute of Medical Rehabilitation started to operate together a dental office to examine the dental and oral hygiene condition of the inpatients and to make their oral rehabilitation. AIM: aAim: A total of 608 patients have gone through a full dental examination including a stomato-oncological screening. From this we gathered comprehensive information on the oral health of patients currently undergoing rehabilitation and living with disabilities. METHOD: This study was approved by the Medical Research Council. Clinical examinations were done on the basis of the recommendation by WHO. We analysed the DMF-T values, restorative index, periodontal status and lesions of the oral mucosa. From a survey of 20 questions we asked about oral hygiene practices, toothbrushing frequency, last visit to a dentist, eating habits, addictions and social background. RESULTS: The patients had poor oral hygiene. The number of lost teeth is high, but the prosthetic care is not satisfying. The DMF-T value was 20.5, from this D-T = 2.6, M-T = 11.2, F-T = 6.7. The patients' complaints about dental and oral mucosal lesions are minimal compared to their general dental condition. A majority of them did not experienced toothaches in the last 12 months. The last dental checkup in the case of most patients exceeds 12 months. CONCLUSIONS: The oral hygiene of patients living with some form of disability is poor since their daily oral hygiene routine and care in practice are not solved. Orv Hetil. 2018; 159(52): 2202-2206.

The Effectiveness of Individualized Oral Hygiene Education in Preventing Dental Diseases: A Clinical Study.

Background: Without mechanical cleaning, gingivitis can develop within three weeks. The first clinical sign is bleeding on positive probing. The accumulation of dental biofilm triggers an inflammatory gingival response. In the past decade, attention has focused mainly on interproximal areas and the use of customized interproximal toothbrushes. The aim of this study was to evaluate the effectiveness of individualized oral hygiene education and its role in dental disease prevention among patients with dental problems. Methods: Altogether, 102 patients, 38 males and 64 females, were included in the study. All patients were aged over 18 years. Before treatment, patients were clinically and radiologically examined, their full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and bleeding on brushing (BOB) were recorded, and matrix-metalloproteinase-8 (MMP-8) was measured by using a chair-side MMP-8 measuring system. Patients in group A had gingivitis but no periodontal damage, and group B had periodontal damage. Patients in both groups were divided into four subgroups based on their toothbrushing habits and the oral health education they received. Three months after the initial examination, each patient was examined three more times (2, 4, and 12 weeks later). Results: It was concluded that subjects in groups A1 and B1 showed a significant reduction in BOB, MMP-8, FMBS, and FMPS levels after two weeks. Solo Prophylaxis (A1 and B1) remained a well-constructed protocol and caused the complete resolution of interdental inflammation after two weeks. Other subgroups achieved significant reductions only after 12 weeks. Conclusions: BOB and MMP-8 tests are valuable complements in preventive dentistry, and are able to detect potential pathological processes. The clinical relevance of BOB testing, in addition to FMBS, FMPS and gingival inflammation testing, can be demonstrated to patients, which may increase compliance.

An Experience of Public Dental Care during the COVID-19 Pandemic: Reflection and Analysis.

Since its emergence in China, the COVID-19 pandemic has become the number 1 health challenge in the world with all affected countries trying to learn from each other's experiences. When it comes to health services, dental care does not seem to be a priority area, despite the fact that it is among the highest risk medical specialisations in terms of spreading the infection. Using the Department of Community Dentistry of Semmelweis University as a case study, the objective of this paper is to introduce and analyze the system and organizational level measures, which have been implemented in dental care in Hungary during the first months of the COVID-19 outbreak. The system level measures to promote social distancing, to reduce the use of health services and to protect high risk health professionals, together with the deployment of protective equipment and the reorganization of patient pathways at the organizational level proved to be effective in keeping the outbreak in control. There are two, less frequently mentioned ingredients of successful coping with the COVID-19 challenge. First, mental health support is at least as important as physical protection. Second, most of the interventions do not require big financial investments, but behavioural change, which in turn requires leadership and change management skills.

Oral Health Status of Physically Disabled Inpatients - Results from a Hungarian Single-Centre Cross-Sectional Study.

PURPOSE: The aim of this study was to assess the aetiological factors having an impact on the prevalence of dental caries, missing or filled teeth in a subsample of a single-centre cross-sectional study conducted among the inpatients of the National Institute of Medical Rehabilitation in Hungary. MATERIALS AND METHODS: Data collection was carried out through the full mouth screening for dental caries according to World Health Organization (WHO) criteria and a questionnaire covering social background, oral hygiene routine, eating habits for all inpatients who underwent rehabilitation between May 2019 and March 2020. RESULTS: The mean + standard deviation (SD) DMF-T score in the study sample of 110 physically disabled patients was 18.90 + 7.85. Factors which influenced DMF-T were age, frequency of dental visits and frequency of toothbrushing. The caries prevalence was higher than in the general Hungarian non-disabled population. CONCLUSION: In the current study it was apparent that patients with physical disability had less favourable oral health with frequent occurrence of dental caries and missing teeth. Based on the results of the current study, new, targeted prevention and intervention can be developed.