Domains, competences and learning outcomes for undergraduate education in periodontology.

AIM: This review is intended to adapt the current conceptual framework in dental education based on four domains to propose a set of competences, learning outcomes and methods of teaching, learning and assessment for undergraduate education in periodontology. REVIEW: Based on the current framework of competences and learning outcomes recommended by the Association for Dental Education in Europe (ADEE), undergraduate education in periodontology has been updated using the classification and clinical practice guidelines for the diagnosis and treatment of periodontal and peri-implant diseases. CONCLUSIONS: Specific learning outcomes have been proposed within each competence area, that is in Domain I (n = 10), Domain II (n = 13), Domain III (n = 33) and Domain IV (n = 12). Teaching methods and learning activities based on the different dimensions of the cognitive process have been proposed. Additionally, 10 key learning outcomes have been proposed as exit outcomes, which implies their accomplishment within the final assessment of any graduating student.

Caries prevalence and water fluoridation in Israel: a cross-sectional study.

OBJECTIVES: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5,000 individuals was fluoridated. In 2014, CWF in Israel stopped. METHOD AND MATERIALS: Data on 12-year-old children from all areas in Israel from the national cross-sectional epidemiological survey conducted in 2011 to 2012 were stratified by city water fluoridation and by city and school socioeconomic status. Two dependent variables were defined: (1) DMFT index of caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov classification of fluorosis. RESULTS: Data from 2,181 12-year-olds were analyzed. The average DMFT was 1.17 ± 1.72, and 49% were caries-free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs 0.98 in fluoridated cities) and there were more caries-free children in fluoridated cities (56.4% vs 40.6% in nonfluoridated). DMFT was higher in cities with lower socioeconomic status than high socioeconomic status (1.29 vs 1.05, respectively, P < .001) and there were fewer caries-free children in low socioeconomic status cities (44.5% vs 53.0% in high socioeconomic status cities, P < .0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in the Thylstrup-Fejerskov index), had questionable to mild fluorosis (9.3%). CONCLUSIONS: CWF is a cheap, simple method of dental health protection that reaches all socioeconomic levels, and cessation of water fluoridation reduced the health of Israel's children. CLINICAL SIGNIFICANCE: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

Caries prevalence and water fluoridation in Israel: a cross-sectionalstudy.

OBJECTIVES: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5000 individuals was fluoridated. In 2014 CWF in Israel stopped. METHODS: Data on 12-year-old children from all areas in Israel from the national crosssectional epidemiological survey conducted in 2011-2012 were stratified by city water fluoridation and by city and school socio-economic status (SES). Two dependent variables were defined: (1) DMFT index -caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov (TF) classification of fluorosis. RESULTS: Data from 2181, 12-year-olds was analyzed. the average DMFT was 1.17+1.72 and 49% were caries free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs. 0.98 in fluoridated cities) and there were more caries free children 56.4% in fluoridated cities vs. 40.6% in non-fluoridated. DMFT was higher in cities with lower SES than high SES (1.29 vs. 1.05 respectively, p<0.001) and there were less caries free children in low SES (44.5% vs. 53% in high SES cities, p<0.0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in TF index), had questionable to mild fluorosis (9.3%). CONCLUSIONS: CWF is a cheap, simple method of dental health protection that reaches all socio-economic levels and cessation of water fluoridation reduced the health of Israel's children. CLINICAL SIGNIFICANCE: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

Exploring the Effect of Ethnicity on Chronic Orofacial Pain: A Comparative Study of Jewish and Arab Israeli Patients.

The relationship between ethnicity and chronic pain has been studied worldwide. The population of Israel includes two main ethnic groups, 75% Jews and 21% Arabs. The purpose of this study was to compare orofacial chronic pain characteristics and treatment outcomes between Jewish and Arab Israeli citizens. Two hundred patients admitted to the Orofacial Pain Clinic at Hebrew University-Hadassah School of Dental Medicine between 2017 and 2022 were selected randomly for this historical cohort study. Our cohort included 159 (79.5%) Jews and 41 (20.5%) Arabs. Twenty-six pain-related variables were compared of which only two differed significantly between the two groups, awakening due to pain and mean muscle sensitivity; both indicators were higher in the Arab group (p < 0.05). No differences were found in any of the other variables such as diagnosis, pain severity, onset, and treatment outcome. This minimal difference may be explained by the equal accessibility to medical services for all citizens, and the diversity of our staff that includes Jew as well as Arab service providers. These factors minimize or even eliminate racial bias, language, and cultural barriers, and is reflected in the minor differences in orofacial pain characteristics found between the two main ethnic groups in Israel.

Brazilian version of Positive Oral Health and Well-Being: cross-cultural adaptation and psychometric analysis.

Specific measures to evaluate positive oral health have been in a nascent stage in Dentistry, especially in developing countries. The present study aimed to translate, cross-culturally adapt and evaluate the psychometric properties of the Brazilian version of Positive Oral Health and Well-Being (B-POHW). After forward-backwards translation to Brazilian Portuguese language, the cross-cultural adaptation of B-POHW was pretested, followed by the main study to perform psychometric analysis. We tested the model fit by Confirmatory Factor Analysis with categorical factor indicators in bifactor and simple structure models on a sample of 209 participants (mean age: 39.36 ± 12.26. Questionnaires about sociodemographic status, self-reported oral health-related outcomes, and general well-being were administered and used as external validation measures. Moreover, dental caries experience was clinically diagnosed. For test-retest reliability, 53 participants completed the B-POHW a fortnight later. The following results were found: a) the bifactor model presented the best model fit; b) the B-POHW demonstrated satisfactory internal consistency (Cronbach's α and McDonald's ω > 0.8); c) the intraclass correlation coefficient suggested good reliability for the Global Factor of B-POHW in the test-retest (ICC = 0.84); d) evidence based on other variables and construct representation was in line with the positive oral health framework. The B-POHW is psychometrically sound to be used in a Brazilian context, and evidence of its internal structure confirmed its theoretical framework for measuring positive oral health. These findings advance in holistic approaches, enabling to assess positive oral health in Dental practice in Brazil.

Establishment of "Smiles": an innovative inclusive program for the promotion of oral health among preschool children.

OBJECTIVES: To describe the planning stage and the first year of "Smiles," an innovative, inclusive oral health promotion program among preschool children, ages 3 to 5, encompassing the enhancement of daily toothbrushing skills, engagement of teaching staff and parents, and integration of a supportive environment of supervised toothbrushing in kindergartens. METHOD AND MATERIALS: The major components of the first year of the program included workshops with the teaching staff, working sessions with the preschool children, and workshops with the parents. Program participation, program cooperation, program satisfaction, and kindergarten teachers, kindergarten parents, and dental hygienists' attitudes towards this component of the program were recorded and evaluated. Minor components of the first year of the program included assimilation and integration of daily supervised toothbrushing in some of the kindergartens. Program participation, kindergarten teachers, kindergarten teachers' assistants, and kindergarten parents' attitudes towards this component of the program were recorded and evaluated. RESULTS: In total, 180 kindergartens, in nine locations across Israel, including 5,311 preschool children, their parents, and teaching staff, took part in the first year of the program. High levels of participation (80% and above), cooperation (9.55 to 9.78) and satisfaction (9.62 to 9.81) were recorded in the first year of the program. Kindergarten teachers, parents, and dental hygienists expressed high levels of support for continuing the program beyond its first year (9.86 to 10.00). Regarding the daily supervised toothbrushing model in the kindergartens, high levels of satisfaction (9.50 to 9.75) and willingness to continue the program (9.50-10.00) were recorded among kindergarten teachers, assistants, and parents. CONCLUSION: The "Smiles" program serves as an example of successful collaboration between many partners and stakeholders from different organizations, sectors, and government ministries, local authorities, kindergarten management and staff, parents, and the most important partners, the preschool children. Its adherence to the basic principles of health promotion, and its professional adjustment to early childhood with positive atmosphere of happiness, joy, and shared warmth, contributed to the success of the program.

Brazilian version of Positive Oral Health and Well-Being: cross-cultural adaptation and psychometric analysis

Abstract: Specific measures to evaluate positive oral health have been in a nascent stage in Dentistry, especially in developing countries. The present study aimed to translate, cross-culturally adapt and evaluate the psychometric properties of the Brazilian version of Positive Oral Health and Well-Being (B-POHW). After forward-backwards translation to Brazilian Portuguese language, the cross-cultural adaptation of B-POHW was pretested, followed by the main study to perform psychometric analysis. We tested the model fit by Confirmatory Factor Analysis with categorical factor indicators in bifactor and simple structure models on a sample of 209 participants (mean age: 39.36 ± 12.26. Questionnaires about sociodemographic status, self-reported oral health-related outcomes, and general well-being were administered and used as external validation measures. Moreover, dental caries experience was clinically diagnosed. For test-retest reliability, 53 participants completed the B-POHW a fortnight later. The following results were found: a) the bifactor model presented the best model fit; b) the B-POHW demonstrated satisfactory internal consistency (Cronbach's α and McDonald's ω > 0.8); c) the intraclass correlation coefficient suggested good reliability for the Global Factor of B-POHW in the test-retest (ICC = 0.84); d) evidence based on other variables and construct representation was in line with the positive oral health framework. The B-POHW is psychometrically sound to be used in a Brazilian context, and evidence of its internal structure confirmed its theoretical framework for measuring positive oral health. These findings advance in holistic approaches, enabling to assess positive oral health in Dental practice in Brazil.

Beneficial effect of aged garlic extract on periodontitis: a randomized controlled double-blind clinical study.

The purpose of this study is to assess the long-term efficacy of aged garlic extract to improve periodontitis. Two hundred and one participants were randomly stratified and assigned equally to the regimen group or the control group. At the start, 12 month, and 18 month subjects received dental examination and periodontal evaluation. Probing Pocket Depth and Gingival Recession were examined. For each efficacy parameter, the mean value of examination was calculated and assessed using paired-difference t tests. Statistical tests were two-sided using a 5% significance level. The mean value of pocket depth for the aged garlic extract group at 18 month was 1.06 ± 0.49 as compared to the baseline value of 1.89 ± 0.74 (p<0.001) and the corresponding value of 1.50 ± 0.46 for the placebo group (p<0.001), indicating the beneficial effect of aged garlic extract on periodontitis. According to a Multiple linear regression analysis the only three variables which reached statistical significance as predictors of PPD level were the baseline PPD scores (p<0.001), smoking (p = 0.020), and consumption of daily dose of aged garlic extract (p<0.001). These results demonstrated that aged garlic extract is an effective supplement for preventing or improving periodontal disease. The well demonstrated benefits of aged garlic extract for the oral disease may also be used as a means to improve general health because of the close relationship between periodontitis and some systemic diseases such as diabetes, hypertension, atherosclerosis, and others.

Caries prevalence among 18 years old, an epidemiological survey in Israel.

BACKGROUND: There is a lack of evidence on caries prevalence among 18 years old Israeli young adults with only a scarce evidence regarding this index age group. In the last few years dental care policy in Israel underwent substantial changes and a major reform in dental services was led by the Israeli Ministry of Health, including coverage of dental care for children by the state. In addition, a cessation of community water fluoridation was in a debate. The objective of the current study was to describe prevalence of caries among 18 years old Israeli young adults and to evaluate possible associations with personal and demographic variables. METHODS: The study was a cross sectional clustered survey. Participants were recruited to the study at their first day of military service. Participants completed a questionnaire for personal and demographic data, including: age, country of birth, education, and current smoking status. Then participants underwent clinical evaluation included DMFT and caries free rates. No radiographic evaluation was included in the current study. Univariate and multivariate statistical analysis were performed. RESULTS: A total of 702 participants were included in the study, 58.4% were males. Their mean age was 19.03 ± 0.65 years, 91.3% of the participants were born in Israel. Mean DMFT was 1.95 ± 2.67, and 46.7% (n = 328) were caries free. Higher DMFT score was significantly associated with participant's parents' education, country of birth, and smoking status. Lower caries free rates were significantly associated with participant's parents' education, and smoking status. After linear regression for total DMFT, all variables were significant predictors to higher DMFT, except father's education, while logistic regression for caries free, only mother's education was found to be a significant predictor. CONCLUSIONS: The current study presents encouraging low DMFT levels. Participants in this study were not included in the dental care services reform, and did enjoy the benefits of water fluoridation, enabling the results to play an important baseline data for future reference. Additionally, results should be considered when planning intervention programs for at risk groups. TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov (Identifier No. NCT02958891 , November 8th, 2016) and was approved by the IDF Institutional Review Board (#1524-2015).

The Efficacy of Aged Garlic Extract on Gingivitis - A Randomized Clinical Trial.

OBJECTIVES: To assess gingivitis and gingival bleeding following the consumption of Aged Garlic Extract versus placebo for a period of four months. METHODS: A randomized, controlled, examiner-blind, two-treatment parallel group study was conducted. Participants were stratified and randomly assigned equally to a regimen group using Aged Garlic Extract (AGE) or a control group, based on gender, age, baseline number of bleeding sites, and gingival health status. Assessment was performed at baseline and at one, two, three, and four months. Clinical assessment was conducted by three experienced calibrated examiners. RESULTS: One hundred and fifty-one participants followed the inclusion criteria; 50.3% males, with an average age of 32.7 ± 8.2 years. Only 134 subjects completed the four-month study (11.3% attrition rate). A statistically significant decrease of the Modified Gingival Index and Gingival Bleeding Index scores was shown for the AGE compared to the placebo group, both between and within groups (p < 0.001). CONCLUSIONS: This research demonstrated that daily consumption of AGE benefits oral health by reducing gingival inflammation and gingival bleeding, as compared to a placebo control.

Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood - The Tinea Capitis Cohort.

While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low-moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (p = 0.002). Controlling for gender, age, education, income, smoking, dental visit in the last year, and brushing teeth behavior, irradiation was associated with a 72% increased risk for higher DMFT level (95% CI: 1.19-2.50). A quantification of the risk by dose absorbed in the salivary gland and in the thyroid gland showed adjusted ORs of 2.21 per 1 Gy (95% CI: 1.40-3.50) and 1.05 per 1 cGy (95% CI: 1.01-1.09), respectively. Childhood exposure to ionizing radiation (0.2-0.4 Gy) might be associated with late outcomes of dental health. In line with the guidelines of the American Dental Association, these results call for caution when using dental radiographs.

Professional occupation and the number of teeth retained among older adults aged 50 and above.

OBJECTIVE: To examine the association between occupational characteristics and number of natural teeth retained among older adults aged 50 and above. BACKGROUND: Despite the integral part of the professional occupation of a person's time, few studies have examined the effect of the occupational environment on one's oral health. MATERIAL AND METHODS: Self-administered questionnaires were randomly distributed among 280 participants, who had at least one professional occupation over a period of 10 years or more. Data from the questionnaire were collected concerning variables related to professional occupation and the self-reported number of natural teeth retained. The data were analysed using a logistic regression analysis with stepwise-backward selection. RESULTS: Significant risk factors for the number of natural teeth being ≤25 were age (p < 0.001), years of education (p = 0.019) and a hospital/commercial environment of work (p = 0.021). The odds ratio for the number of natural teeth ≤25 increased with each year by 1.109, decreased with each additional year of education by 0.881, and was 2.693 folds higher for individuals working in a hospital/commercial environment compared to those in an office environment. CONCLUSIONS: These findings suggest the importance of operating community-based oral health programmes for these occupational risk groups. The results from this study also implicate the need for further studies of this subject to find the underlying reasons for these occupational environmental risks.

Validation of an innovative instrument of Positive Oral Health and Well-Being (POHW).

INTRODUCTION: Most existing measures of oral health focus solely on negative oral health, illness, and deficiencies and ignore positive oral health. In an attempt to commence exploration of this challenging field, an innovative instrument was developed, the "Positive Oral Health and Well-Being" (POHW) index. This study aimed to validate this instrument and to explore an initial model of the pathway between oral health attributes and positive oral health. METHODS: A cross-sectional, multicenter study (Israel, USA, and Germany), was conducted. Our conceptual model suggests that positive oral health attributes, which integrate with positive unawareness or positive awareness on the one hand and with positive perception on the other hand, may result via appropriate oral health behavior on positive oral health. The 17-item self-administered index was built on a theoretical concept by four experts from Israel and Germany. Reliability, factor, and correlation analyses were performed. For external correlations and to measure construct validity of the instrument, we utilized the oral health impact profile-14, self-perceived oral impairment, life satisfaction, self-perceived well-being, sociodemographic and behavioral data, and oral health status indices. RESULTS: Four hundred and seventy participants took part in our three-center study. The combined data set reliability analyses detected two items which were not contributing to the index reliability. Thus, we tested a 15-item construct, and a Cronbach's α value of 0.933 was revealed. Primary factor analysis of the whole sample indicated three subconstructs which could explain 60 % of variance. Correlation analyses demonstrated that the POHW and OHIP-14 were strongly and negatively associated. The POHW correlated strongly and positively with general well-being, moderately with life satisfaction, and weakly with the perceived importance of regular dental checkups. It correlated moderately and negatively with perceived oral impairment, and marginally and negatively with dental caries experience (DMFT) and periodontal health status (CPI) scores. When DMFT and CPI clinical measurements were categorized, a higher score of POHW was revealed for better oral health. DISCUSSION: Our study introduced a new instrument with good reliability and sound correlations with external measures. This instrument is the first to allow measurability of positive instead of impaired oral health. We utilized subjective-psychological and functional-social measures. The current results indicate that by further exploring our conceptual model, POHW may be of importance for identifying patients with good and poor oral health, and building an effective and inexpensive strategy for prevention, by being able to evaluate the effect of interventions in a standardized way.

Long-Term Effects of Exposure to Ionizing Irradiation on Periodontal Health Status - The Tinea capitis Cohort Study.

Studies among long-term survivors of childhood cancer who had received high-dose irradiation therapy of 4-60 Gy, demonstrated acute and chronic dental effects, including periodontal diseases. However, the possible effects of low to moderate doses of radiation on dental health are sparse. The aim of this study is to investigate the association between childhood exposure to low-moderate doses of ionizing radiation and periodontal health following 50 years since exposure. The study population included 253 irradiated subjects (treated for Tinea capitis in the 1950s) and, 162 non-irradiated subjects. The estimated dose to the teeth was 0.2-0.4 Gy. Dental examination was performed according to the community periodontal index (CPI). Socioeconomic and health behavior variables were obtained through a personal questionnaire. Periodontal disease was operationally defined as "deep periodontal pockets." A multivariate logistic regression model was used for the association of irradiation status and other independent variables with periodontal status. The results showed that among the irradiated subjects, 23%, (95% CI 18-28%) demonstrated complete edentulousness or insufficient teeth for CPI scoring as compared to 13% (95% CI 8-19%) among the non-irradiated subjects (p = 0.01). Periodontal disease was detected among 54% of the irradiated subjects as compared to 40% of the non-irradiated (p = 0.008). Controlling for education and smoking, the ORs for the association between radiation and periodontal disease were 1.61 (95% CI 1.01-2.57) and 1.95 (95% CI 1.1-3.5) for ever never and per 1 Gy absorbed in the salivary gland, respectively. In line with other studies, a protective effect for periodontal diseases among those with high education and an increased risk for ever smokers were observed. In conclusion, childhood exposure to low-moderate doses of ionizing radiation might be associated with later outcomes of dental health. The results add valuable data on the long-term health effects of exposure to ionizing radiation and support the implementation of the ALARA principle in childhood exposure to diagnostic procedure involving radiation.

Professional burnout: Its relevance and implications for the general dental community.

As very few studies regarding dentists' professional burnout have been published, we provide an updated review and recommendations with regards to the published dental literature of this phenomenon, which is relevant to the general dental community around the world. Professional burnout has been found to be prevalent among dentists and dental students. The challenge lies in early recognition and developing intervention programs specifically for the dental profession. Attention to realistic career expectation and the type of dentist one prefers to be, attention to practice management skills and the stressfulness of work, as well as longitudinal monitoring of newly qualified dentists on burnout development are recommended. Learning about professional burnout and its potentially serious consequences, as well as increasing knowledge about how to prevent and treat it are crucial. It is not only a caregiver problem, but also a public health problem.

Dental erosive wear assessment among adolescents and adults utilizing the basic erosive wear examination (BEWE) scoring system.

OBJECTIVES: To investigate erosive tooth wear and related variables among adolescents and adults in Israel, utilizing the new basic erosive wear examination (BEWE) scoring system, in an attempt to contribute to the ongoing review, evaluation, and further development of an international standardized index. MATERIAL AND METHODS: A cross-sectional, descriptive, and analytic survey was conducted among 500 subjects of five age groups. Dental erosion was measured according to the new BEWE scoring system. Independent variables included gender, age, origin, education, employment status, and diet. A backward stepwise linear regression model was applied to identify significantly associated variables. RESULTS: Fifty percent of the survey subjects demonstrated erosive tooth wear; among them, 10 % had distinct erosion of over 50 % of the dental surface. Total BEWE score differences by age groups were statistically significant; as the age increased, the mean total BEWE scores increased (p < 0.001). The association between acidic foods and erosion was evident among the younger population (p = 0.038). In a multiple regression model, age (p < 0.001) and diet (p = 0.044) achieved statistical significance as variables associated with dental erosive wear. CONCLUSIONS: Our study is one of the first to use the BEWE scoring system in an epidemiological survey among adolescents and adults. It was found that the BEWE index is straightforward, easy to conduct, and comfortably accepted by the examinees. CLINICAL RELEVANCE: The present findings, together with further international research, should contribute toward continued evaluation of the BEWE system as an international standard and thereby, toward more optimal understanding, evidence-based treatment, and prevention of dental erosive wear.

Media exposure and oral health outcomes among adults.

OBJECTIVE: To assess the impact of media exposure on oral health outcomes among Jewish adults in Jerusalem, Israel, by means of a conceptual hierarchical model. METHOD AND MATERIALS: A cross-sectional study was conducted using a stratified sample of 254 adults 35 to 44 years (mean age, 38.63 years) in Jerusalem, Israel. Media exposure was operationally categorized by type and frequency. Behavioral data included toothbrushing, dental attendance, oral hygiene aids use, plaque level, sugar consumption, and smoking. Clinical outcomes were assessed according to the decayed/missing/filled teeth (DMFT) index and the community periodontal index (CPI). Results were analyzed by chi-square test, independent test, one-way ANOVA, and linear and multiple logistic regression models. RESULTS: A total of 254 examinees consisted of 127 men and 127 mean (married couples). High type and high frequency of media exposure, as compared with other modes, revealed statistically significant higher caries experience (DMFT, 13.10), higher level of untreated decay (D, 1.67), and lower periodontal health (CPI [0], 0.39). A conceptual hierarchical regression model identified that the relationship described was mediated by sociodemographic determinants (education) and behavioral determinants (dental attendance and plaque level). CONCLUSION: Media exposure should be observed by community health program planners and general practitioners to examine the type and frequency of the messages. They also need to react on time to balanced bad advertising and add a good message at the community. This pragmatic approach could lead to better use of the media and improve oral health behavior and outcomes.

Oral and pharyngeal cancer among the Arab population in Israel from 1970 to 2006.

BACKGROUND: Israeli Arabs are considered as a developing society characterized by poverty and high levels of smoking among men. The purpose of this study was to describe their incidence, mortality and survival rates for oral and pharyngeal cancer between the years 1970-2006. Studies such as this in the Arab world, where the population is almost the same as the Arab population in Israel, are rare. METHODS: The incidence and survival data were derived from all relevant registered data at the National Cancer Registry. The group of lesions included cancer of the lips, tongue, buccal mucosa, floor of the mouth, salivary glands, gums, palate and pharynx. Morphological description was according to WHO classification. RESULTS: Most diagnosed patients were male. The mean age was 54.4 years, and mean years of survival were 3.83. The oropharynx was the most common site (28.3%) while the palate was the least frequent (3.12%). Squamous cell carcinoma (SCC) was the most common histological feature (66.3%), while basal cell carcinoma (BCC) was the least (3.9%). The overall 5 years survival rate was 59.4%, this being highest for BCC (82.1%), while SCC was significantly lower (56.2%) (p<0.001). Lip cancers survived better than other sites. CONCLUSIONS: Data from this society are similar to other developing societies in the majority of the results. The incidence of oral and pharyngeal cancer is lower among the Arab population, in comparison to the Jewish population in Israel.

The association between demographic and oral health-related quality of life factors and dental care attendance among underprivileged older people.

AIM: In order to identify whether demographic and oral health-related quality of life factors are associated with dental care attendance among an underprivileged older population, a comparison was performed between people who have and have not attended dental care. METHODS: A cross-sectional purposive sample of 344 older underprivileged people comprised the study population. The dependent variable was dental care attendance. The 14-item version of the Oral Health Impact Profile index (OHIP-14) was used as the independent variable, together with other social and general variables, using a structured interview. RESULTS: The variables that were significantly associated with dental care attendance were family status (not married, the highest attendance), dwelling location (living at home, the highest attendance), caregiver (family member, the highest attendance), place of birth (Western countries, the highest attendance) and income (pension, the highest attendance). Sex, welfare support, functional ability, education, age and OHIP-14 were not associated with dental care attendance. CONCLUSIONS: Attending dental care was not associated with oral health-related quality of life measured by OHIP-14. Several socioeconomic variables were strongly associated.

Teeth and implant surroundings: clinical health indices and microbiologic parameters.

OBJECTIVE: Dental implants and peri-implant tissue are susceptible to disease conditions that may lead to implant loss. The objective of the present study was to describe teeth and implant surroundings as well as clinical health indices and oral microbiologic parameters. METHOD AND MATERIALS: A group of 83 adults (42 men and 41 women) were enrolled in the study. Clinical assessments of dental implants and contralateral natural teeth included dental plaque, gingival inflammation, and bleeding on probing. Microbiologic assessments included bacterial culture, light and phase contrast microscopy, and DNA probe hybridization for a panel of 14 target microorganisms. Clinical and microbiologic data were compared by paired t test and ANOVA. P < .05 was considered statistically significant. RESULTS: The Plaque Index for the implants was 1.85 ± 0.47, whereas the score for natural teeth was significantly higher, 2.15 ± 0.52. Compared to the samples obtained from the dental implants, the samples from natural teeth demonstrated significantly higher total bacterial cell numbers (P < .05). Consistent with the clinical measures of dental plaque, significantly higher numbers of oral bacteria, including aerobic and anaerobic bacteria, were found in dental plaque samples from teeth (aerobic 5.648 ± 0.512, anaerobic 6.243 ± 0.535, P < .0001) compared to implants (aerobic 5.430 ± 0.541, anaerobic 5.917 ± 0.523, P < .0001). In addition, there were significantly higher numbers of anaerobic (6.243 ± 0.535 and 5.917 ± 0.523, P < .0001) than aerobic (5.648 ± 0.512 and 5.430 ± 0.541, P < .008) bacteria for samples from teeth and implants, respectively. CONCLUSION: Clinical and microbiologic analyses provide consistent findings that suggest differences in quantity of plaque and bacterial species between teeth and dental implants. For long-term treatment success, the importance of plaque control and oral hygiene of both periodontal and dental implant therapy is emphasized.