Práticas integrativas e complementares de saúde em Sergipe / Integrative and complementary health practices in Sergipe

A atenção primária em saúde (APS) é o primeiro nível de atenção em saúde, sendo um elo entre a população e o setor de saúde. Tem-se buscado a humanização dos atendimentos, e essa mudança, refletida pelas mudanças da sociedade, trouxe a implementação da Política Nacional de Práticas Integrativas e Complementares (PNPIC) no SUS. O objetivo deste trabalho foi realizar uma análise da tendência da quantidade das práticas integrativas e complementares realizadas nas regionais de saúde de Sergipe de 2017 a 2023, associando com a cobertura da atenção primária. Foi realizada análise de dados secundários através do Departamento de Informática do Sistema Único de Saúde (DATASUS), como forma de organização no período de junho/2015 a junho/2023 por regional de saúde de Sergipe. As análises dos dados foram descritivas e de correlação e por meio de análise de série temporal. A regional de saúde de Lagarto foi a que mais executou as práticas integrativas e complementares no período analisado e algumas regionais não tiveram continuidade na realização destas práticas. A regional de saúde com maior cobertura de APS foi Itabaiana. Não foi possível observar associação entre o número de práticas e a cobertura de atenção primária. Com o intuito de que o atendimento aos indivíduos seja cada vez mais humanizado, e em virtude da realização das práticas integrativas ter baixo índice ou descontinuidade em algumas regiões de Saúde de Sergipe, é relevante que os profissionais de saúde busquem conhecimentos sobre essas práticas, como também, os gestores em saúde incentivem esta ação.

Primary health care (PHC) is the first level of health care, being a link between the population and the health sector. The aim has been to humanize care, and this change, reflected by changes in society, has led to the implementation of the National Policy on Integrative and Complementary Practices (PNPIC) in the SUS. The objective of this work was to carry out an analysis of the trend in the number of integrative and complementary practices carried out in the health regions of Sergipe from 2017 to 2023, associating it with primary care coverage. Secondary data analysis was carried out through the Department of Informatics of the Unified Health System (DATASUS), as a form of organization from June/2015 to June/2023 by health region in Sergipe. Data analyzes were descriptive and correlational and through time series analysis. The Lagarto health region was the one that carried out the most integrative and complementary practices in the period analyzed and some regions did not continue to carry out these practices. The health region with the highest PHC coverage was Itabaiana. Observing an association between the number of practices and primary care coverage was impossible. With the aim that care for individuals is increasingly humanized, and because the implementation of integrative practices has a low rate or discontinuity in some Health regions of Sergipe, health professionals must seek knowledge about these practices as well as health managers encourage this action.

Effectiveness of Psychological Intervention in Improving Adolescents' Oral Health: A Systematic Review and Meta-analysis.

OBJECTIVES: This systematic review aimed to evaluate the effectiveness of psychological interventions in improving oral health behaviors and status among adolescents. SOURCES: A comprehensive search was conducted in the following six electronic databases, PubMed, Ovid Medline, Ovid Embase, Cochrane Library, APA PsycINFO (ProQuest) and Web of Science. STUDY SELECTION: The PICO format was used to select eligible studies. Population was adolescents aged 12 to 18 years old. Intervention was psychological interventions based on psychological theories or models. Comparison was conventional oral health education or negative control. Outcomes were oral health-related behaviors, oral health status, oral health-related quality of life (OHRQoL), self-efficacy and psychological cognitive factors. The risk of bias tool used was RoB 2. DATA: Sixteen papers on 14 studies met the inclusion criteria. The studies were conducted in school or clinic settings. Regarding risk of bias, most studies had some concerns and the others had a high risk. The psychological interventions improved adolescent's oral hygiene and periodontal status in the short-term (up to 6 months), with the overall SMD=-0.97 (-1.45, -0.49) in plaque level and SMD=-1.18 (-2.32, -0.04) in periodontal status. No significant difference in plaque level was found in the long-term (12 to 24 months), with the overall SMD=-0.31 (-0.64, 0.02). There was improvement in OHRQoL in the short-term, with the overall SMD=1.04 (0.34, 1.73). Additionally, significant differences were found regarding self-efficacy, oral health-related behaviors (tooth brushing and dental flossing) and psychological cognitive factors between the intervention group and control group (all p<0.05) in the short-term. Due to the heterogeneity of the studies, meta-analysis could not be conducted in the above three outcome measurements. CONCLUSIONS: Low certainty of evidence shows that psychological intervention is effective in improving adolescents' oral hygiene in short-term. In addition, very low certainty of evidence was found in improving periodontal status, self-efficacy, oral health-related behaviors, psychological cognitive factors, and OHRQoL in short-term. CLINICAL SIGNIFICANCE: By targeting the psychological process and cognitive factors of oral health-related behaviors among adolescents, psychological interventions have the potential to improve oral health behaviours and promote oral health among adolescents. Implementing evidence-based psychological interventions in dental practice can lead to more comprehensive and effective dental care for adolescents.

Assessment of Third Molar-related Symptoms Affecting Quality of Life using Nepali Version of Oral Health Impact Profile-14: A Descriptive Cross-sectional Study.

INTRODUCTION: Impacted third molars often cause pain, infections, swelling, and functional limitations. This study is an attempt to assess impacted third molars-related symptoms affecting quality of life using standardised Nepali version of oral health impact profile-14 (OHIP-14) questionnaire. METHODS: This descriptive cross-sectional study was conducted at Kathmandu Medical College Teaching Hospital from October 2021 to February 2022 after institutional ethical approval. Patients with impacted third molars were included by convenience sampling technique. Patients with psychiatric illness, taking psychotropic drugs, pregnant, and lactating females were excluded. third molars-related symptoms were recorded in OHIP-14 questionnaire. Data entered in Microsoft Excel sheet were analysed. The findings have been presented as frequency, percent, mean, and standard deviation. The point estimate was calculated at a 95% Confidence Interval. RESULTS: Mean OHIP-14 score of participants was 21.77±11.59. Due to TM, "pain in the mouth" had score of (2.33±1.24) and followed by "uncomfortable experience on eating food" (2.12±2.15). Among seven OHIP-14 dimensions, "physical pain" with two items OHIP3 and OHIP4 had score of 4.53±2.19 implying most participants had "quite a lot" of physical pain due to TM: OHIP3 = 194 (50.2%) and OHIP4 = 183 (47.3%). CONCLUSIONS: Impacted third molars-related symptoms were affecting quality of life of participants.

Is there an association between salivary immune and microbial profile with dental health in systematically healthy children?

OBJECTIVE: This study aimed to characterize the inflammatory profile of systemically healthy children's saliva and its association with clinical diagnoses of caries and gingival inflammation. MATERIALS AND METHODS: Unstimulated saliva was collected from 100 children before clinical dental examinations. The saliva samples were analyzed for total protein and specific inflammatory cytokines (IL-10, IL-8, IL-6, and TNFα) with Bradford and ELISA assays, respectively. Salivary bacteria were quantified using a quantitative real-time polymerase chain assay. The salivary values were then correlated with age, DMFT index, plaque index (PI), and gingival index (GI). RESULTS: The mean age of the cohort was 8.08 ± 0.23 years with 49% females, the mean DMF of the cohort was 2.64 ± 0.31, the mean GI was 0.51 ± 0.06, and the mean PI was 1.33 ± 0.07. Significant correlations were found between PI with DMFT and GI. Children with DMFT > 2 had significantly higher levels of IL-8 compared with children with DMFT ≤ 2. IL-6 and TNFα were significantly higher among children with PI > 1 than among children with PI ≤ 1. CONCLUSIONS: Salivary cytokine were found to be associate with clinical parameters as DMFT and PI, thus may be a potential tool that reflects dental health status. CLINICAL RELEVANCE: The presence of salivary cytokines in children may reflect evaluation of dental caries and oral inflammation.

Age, Purpose, and Perception With Regard to the First Dental Visit of Children of Goa State in India.

BACKGROUND AND AIM: Early first dental visits (FDVs) are crucial for educating and informing parents about their children's oral health. The age for the FDV is dependent on several factors and data regarding the same is unavailable in Goa state. The aim of the study was to determine the age, purpose, and parental perception with regard to the FDV of children in Goa State. METHODS: A cross-sectional study was conducted in the Department of Pedodontics and Preventive Dentistry for children reporting for their FDV. Data for the study was recorded from validated and pilot-tested questionnaires. Statistical analysis was performed using the STATA (version 17; StataCorp LLC, College Station, TX) software. Categorical variables were summarized using frequencies and percentages. Continuous variables were summarized using means and standard deviations. RESULTS: A total of 544 children were included in the study. The mean age of the FDV was 7.15 ± 2.98 years. Out of the total, 257 (47.24%) children reported with pain. The absence of dental problems was the reason why 485 (89.01%) children and their parents had not visited earlier. Most parents perceived the FDV to be important but were unaware of the ideal age for the same. CONCLUSIONS: Children in Goa state have delayed FDVs. Although parents recognized the importance of early dental visits and oral health, their knowledge regarding the recommended age was found to be deficient.

Prevalence and Pattern of Oral and Maxillofacial Pathology in Al-Qassim Region, Saudi Arabia.

Objective: The purpose of this study is to determine the prevalence and features of oral and maxillofacial lesions found in the residents of Al-Qassim region, Saudi Arabia. Methods: A retrospective study was conducted at King Fahad Specialist Hospital, Buraidah, Qassim, KSA. The data for all biopsied oral and maxillofacial lesions were retrieved from January 2014 until August 2022. All patients' data including age, gender, location of the lesion, and histopathologic diagnosis were reviewed and analyzed using IBM SPSS version 23 and Microsoft Excel. Results: A total of 381 oral pathology biopsies for individuals aged 18 and above were included in a descriptive analysis. One hundred ninety five (51.18%) of patients were male, and 186 (48.82%) were female. The site most commonly biopsied was the oral mucosa (26%). The diagnosis was categorized according to the histopathological diagnosis into 13 categories including all pathological lesions in the oral and maxillofacial area. The frequently biopsied category was soft tissue pathological lesion category (26%), second to that is the odontogenic cyst category (22%), and third is the immunological-mediated lesion category (13%). The sub-diagnosis that was mostly observed was radicular cyst, lichen planus, and focal fibrous hyperplasia with the percentages of 13.6%, 10.8%, and 9.4%, respectively. Conclusion: The findings provide important information about the oral and maxillofacial pathology in Al-Qassim region, Saudi Arabia. This study found that biopsied oral lesions were more prevalent in males and in patients in the fourth decade of life. The oral mucosa was the most biopsied site, and the majority of the biopsies were soft tissue pathological lesions and radicular cyst was the most frequent diagnosis. Knowledge of such demographic and clinical features of oral and maxillofacial pathology cases helps in prediction of disease incidence and subsequent proper patient care in the region.

Prior incarceration length and edentulism among formerly incarcerated older adults in the United States.

BACKGROUND: This study investigated the association between prior incarceration length and edentulism among US adults 55 years and older. Analyses explored indirect factors such as wealth, smoking status, mental health, and chronic health conditions that may explain this relationship. In addition, the study analyzed how associations between incarceration and edentulism vary by race and ethnicity. METHODS: The authors used data from the 2012-2014 Health and Retirement Study (unweighted N = 11,630; weighted N = 72,872,877) to assess the relationship between incarceration duration and edentulism through multivariable logistic regression. The Karlson-Holm-Breen method evaluated indirect effects, and multiplicative interaction terms examined variations by race and ethnicity. RESULTS: Net of control variables analyses showed a positive association between having been incarcerated for more than 1 month and higher odds of edentulism. However, this association was rendered statistically nonsignificant after accounting for wealth, current smoking status, mental health, and chronic disease. Collectively, wealth and smoking explained approximately 60% of the association between prior incarceration length and edentulism. Racial moderation models indicated that longer incarceration times increased edentulism likelihood in non-Hispanic Whites specifically. CONCLUSIONS: To the authors' knowledge, this is the first study on the association between prior incarceration length and edentulism among older adults. Study findings indicated the relationship between incarceration and edentulism was explained by higher wealth and current smoking status. PRACTICAL IMPLICATIONS: These findings highlight the need for adequate access to oral health care services for formerly incarcerated older adults to improve oral health and enhance their overall health and quality of life.

Reliability and validity of a Hindi version of the Oral Health Impact Profile (OHIP-EDENT-H) for edentulous subjects: A Cross-Sectional study.

Aim: The study aimed to translate the OHIP-EDENT into Hindi and assess its validity and reliability. Methods: The study included 150 participants whose demographic information was collected using the Modified Kuppuswamy Socio-economic Scale. The Oral Health Impact Profile in Edentulous (OHIP-EDENT) was translated into Hindi using the standard forward-backward method. Test-retest reliability was assessed using the Intra-class Correlation Coefficient (ICC) and internal consistency using Cronbach's alpha. The Kaiser-Meyer-Olkin (KMO) test and Bartlett's test of sphericity coefficient were used to conduct Exploratory Factor Analysis (EFA) and confirm the Construct validity. To establish Convergent validity, the relationship between the global question and the OHIP-EDENT-H subscale scores was observed. Results: The data was analyzed with a confidence level of 95 %, and statistical significance was interpreted as a p-value of less than 0.05. The Cronbach's alpha score for OHIP-EDENT-H was 1.00, indicating high internal consistency. The corrected item-total correlations ranged from 0.665 to 0.923, and the total ICC score was 0.763, demonstrating good reliability. The subscales' intra-class correlation coefficient values ranged from 0.968 to 0.997, indicating high reliability. However, items 4, 6, 13, 17, 18, and 19 had factor loadings below the acceptable threshold of 0.40 in the factor analysis. Additionally, the total and subscale scores of the OHIP-EDENT-H showed significant correlations with global question, with correlation coefficients ranging from 0.665 to 0.923. Conclusion: The Hindi version of OHIP-EDENT is a reliable and valid tool for evaluating the OHRQoL of Hindi-speaking edentulous individuals.

Oral health-related quality of life among women with temporomandibular disorders and hypermobile Ehlers-Danlos syndrome or hypermobility spectrum disorder.

BACKGROUND: People with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSDs) are at greater risk of developing temporomandibular disorders (TMDs), perhaps due to the general joint hypermobility. There is, however, no information on how oral health-related quality of life (OHRQoL) is affected in people with hEDS or HSD with TMD. The authors' aim was to assess OHRQoL via the 14-item, short version Oral Health Impact Profile (OHIP-14), as well as associated risk factors in women with TMD symptoms and confirmed hEDS or HSD. METHODS: A digital questionnaire was sent to members of The Swedish National EDS Association who reported having a confirmed or suspected EDS or HSD diagnosis in the health care system from January through March 2022. Then, a sample of 133 women with confirmed hEDS or HSD and TMD symptoms was constructed, and information on the following variables was collected: TMD symptoms, age, general health, oral health-related factors, comorbid symptoms, and psychological factors. Linear regression analysis was conducted to investigate the association between these variables and the OHIP-14 summary score as the outcome. RESULTS: Most participants reported TMD pain symptoms (93.9%), temporomandibular joint clicking (89.5%), and crepitation (55.6%). The mean (SD) total OHIP-14 summary score was 21.0 (13.2). Oral function had the lowest impact (2.0 [2.4]) and orofacial pain had the highest impact on OHRQoL (3.9 [2.5]). Self-reported bruxism, poor general health, and comorbid symptoms were significantly associated with impaired OHRQoL. CONCLUSIONS: Women with confirmed hEDS or HSD and TMD symptoms have a considerably impaired OHRQoL. PRACTICAL IMPLICATIONS: The multidimensional phenomenon of OHRQoL in this group needs to be considered in management strategies.

Exploring Dental Fusion in Primary Dentition: A Pediatric Dental Perspective.

Developmental anomalies of dentition includes abnormalities in teeth size, shape, structure, and number. Dental fusion is one such condition and is one of the most important and frequent developmental dental anomalies that can affect children's oral health. This condition can present various clinical challenges, including aesthetic concerns, occlusal disturbances, and potential impacts on the development and eruption of permanent teeth. The etiology of dental fusion is multifactorial, involving genetic, environmental, and possibly mechanical factors during tooth development. Diagnosis is done based on clinical examination and radiographic imaging to differentiate fusion from other similar anomalies such as gemination and concrescence. The present case report describes dental fusion in primary teeth seen in two young pediatric patients. These case reports aim to provide an overview of the prevalence, diagnosis, and management strategies for fusion in primary teeth, emphasizing the importance of a Pediatric Dentist in optimizing outcomes for affected children.

Aplicação clínica da laserterapia de baixa potência na atenção primária à saúde / Clinical praxis of low-level laser therapy in primary health care

LASER é um acrônimo que sumariza a amplificação da luz por emissão estimulada de radiação (eletromagnética). O Programa Saúde em Ação equipou diversas Unidades Básicas de Saúde com aparelhos de laser diodo. Cirurgiões Dentistas têm aplicado a laserterapia de baixa potência para acelerar a remissão de várias condições clínicas, sem necessidade de encaminhamento imediato para Atenção Secundária. O objetivo deste artigo é apresentar protocolos de laserterapia de baixa potência empregados por Cirurgiões Dentistas da Atenção Primária à Saúde de Campinas-SP, por meio da ilustração com casos clínicos atendidos em consultas de urgência. Aplicações para ulceração traumática e desordem temporomandibular foram realizadas em uma senhora de 60 anos de idade, que aguardava a substituição das próteses totais. Irradiou-se por laser vermelho (660nm) com energia de 1J as margens da ulceração. Após palpação da articulação e dos músculos mastigatórios para mapeamento, os pontos álgicos foram irradiados por laser infravermelho (808nm) com energia de 4J. Um homem de 50 anos de idade queixava-se de paralisia hemifacial havia 10 dias. A tentativa de recuperação do nervo facial ocorreu com irradiação por laser infravermelho com energia de 8J por ponto, em 22 pontos dos ramos do nervo facial. Em ambos os casos, a regressão do quadro clínico desconfortável foi observada. Os Profissionais do Sistema Único de Saúde (SUS) que são aptos ao uso dos equipamentos para laserterapia de baixa potência podem utilizar este recurso de modo seguro e bem sucedido, observando comprimento de onda do laser e doses protocolares para cada alteração a ser tratada.

LASER is an acronym which means light amplification by stimulated emission of radiation (electromagnetic). Many Primary Health Care Units received diode laser devices from the Brazilian Health in Action Program. Dental practitioners have applied low-level laser therapy for accelerating the resolution of several clinical problems, without the need to prompt referral for Secondary Attention. This manuscript aimed at presenting low-level laser therapy protocols, used by Dentists in Primary Health Care Units from Campinas-SP, illustrated with case reports of urgency consultations. Applications for traumatic ulcers and temporomandibular disorder were performed in a 60-year-old woman who was waiting for dental prosthesis replacement. Red laser irradiation (660nm) with 1J energy was delivered at the margins of the ulcer. Upon articular and masticatory muscles palpation for mapping, trigger points were irradiated with infrared laser (808nm), 4J energy. A 50-year-old man complained of hemifacial paresis for 10 days. The recovery attempt of the facial nerve was carried out by infrared laser irradiation with 8J energy per point in 22 points of the facial nerve branches. In both case reports, regression of the uncomfortable clinical problem was noted. Professionals from the Unified Health System (SUS) who are able to use a low-level laser device may safe and successfully operate this equipment, selecting the appropriate laser wavelength and protocol doses for managing each clinical problem.

Oral health status and dental treatment needs in children with autism spectrum disorder.

Objective: To evaluate oral health care practices, health status, and dental treatment needs in children with Autism Spectrum Disorder (ASD). Methods: This cross-sectional study included 96 children diagnosed with ASD per the DSM-V criteria and 96 typically developing healthy children. The WHO form assessed oral health status and dental treatment needs. Results: Over 50 % of ASD children had mild/moderate autism, 35.4 % had severe autism, and 13.5 % had autistic traits. ASD children experienced more toothbrushing difficulties compared to non-ASD children. Based on Nyvad's criteria and decayed/filled teeth (dft) index, non-ASD children had higher caries prevalence than ASD children, indicating less need for restorative treatments in the ASD group. However, ASD children had poorer plaque scores than non-ASD children. A significantly higher percentage of ASD children exhibited harmful oral behaviors, including mouth breathing, lip biting, bruxism, nail biting, object biting, and self-injury (p < 0.001). ASD children also showed increased traumatic dental injuries compared to non-ASD children. Conclusion: Compared to non-ASD peers, children with ASD have lower dental caries prevalence and less need for restorations, yet poorer plaque control. They also demonstrate more frequent oral self-injuries. ASD status appears related to toothbrushing difficulties. These findings highlight the need for tailored oral health interventions for children with ASD.

Effectiveness of Different Oral Health Interventions on Plaque and Gingivitis Incidence in Children Under Seven Years of Age: A Systematic Review and Meta-Analysis.

Oral health is crucial for young children, yet plaque and gingivitis pose significant challenges. This review evaluates oral health interventions for children under seven years to identify effective strategies. A systematic review was conducted across multiple databases using predefined criteria. Thirteen thousand five hundred records were identified, with 13 studies meeting the inclusion criteria. Various interventions were assessed, including tactile models, digital tools, fluoride varnish, and education programs. The meta-analysis showed heterogeneity in outcomes, with some interventions significantly reducing plaque and gingivitis. Tactile models and digital tools demonstrated effectiveness, particularly among children who were visually impaired and had congenital heart defects. However, fluoride varnish showed mixed results. School-based interventions and advanced toothbrushing technologies effectively reduce early childhood caries and plaque. Despite publication bias, a low risk of bias was observed across studies. The findings underscore the importance of tailored interventions and collaboration among stakeholders. Comprehensive oral health education, innovative digital tools, and multifaceted approaches are recommended to promote lifelong oral health habits. Further research is needed to standardize protocols and assess long-term effectiveness. Evidence-based interventions can significantly improve oral health outcomes for children under seven, laying the foundation for lifelong oral health.

Assessment of the Effectiveness of Probiotics-assisted Physical Interventions in the Management of Chronic Periodontitis: A Randomized Controlled Clinical Trial.

Live micro-ecological agents, such as probiotics, have demonstrated a significant role in the preservation of human health, encompassing oral health maintenance and regulation of oral microbiota. Here, a total of 20 patients diagnosed with chronic periodontitis were recruited and randomly assigned into two cohorts based on completion of physiotherapy: a placebo group (n = 10) and a probiotic group (n = 10). The actual efficacy was assessed by administering chewable tablets (5 × 109 CFU/tablet) containing the probiotics Lactobacillus salivarius LS97, Lactobacillus paracasei LC86, and Lactobacillus acidophilus LA85 to patients with chronic periodontitis. For the placebo group, chewable tablets without probiotics were administered, while maintaining consistency with the rest of the ingredients used in the probiotic group. Saliva and plaque samples were collected at different time points (0, 1, and 3 months) and subjected to 16S amplicon sequencing for microbial structure analysis. Salivary IgA content was determined using enzyme immunoassay, whereas clinical chronic periodontal pocket depth (PD) and bleeding on probe index (BOP +) were employed to evaluate the actual efficacy of probiotic-assisted physiological intervention in chronic periodontitis treatment. Compared to the placebo group, the probiotic intervention resulted in a significant increase in salivary IgA levels among patients, accompanied by a notable decrease in PD and BOP + levels. Furthermore, the probiotic intervention led to a substantial reduction in Fusobacterium and Porphyromonas counts, while significantly increasing Lactobacillus abundance within the dental plaque microbiota of patients. Importantly, no significant alterations were observed in the overall structure of both salivary and dental plaque microbiota following the probiotic intervention. The administration of this live probiotic agent consistently and significantly enhances the oral immune response in patients with chronic periodontitis, thereby augmenting the effectiveness of physical interventions for this condition. Moreover, it effectively reduces the abundance of pathogenic microbes associated with chronic periodontitis without causing substantial alterations to the salivary and dental plaque microbiota composition. Trial registration: Chinese Clinical Trial Registry (ChiCTR) ( https://www.chictr.org.cn ) under the registration number ChiCTR2300074108.

Relationships Between Test Results for Oral Hypofunction, Subjective Frailty Symptoms and Oral Health-Related Quality of Life of Japanese Dental Outpatients: A Multicentre, Cross-Sectional Study.

BACKGROUND: Oral hypofunction is the stage before oral dysfunction. The subjective symptoms of poor oral function and the decline in oral health-related quality of life (OHRQoL) that occur in the oral hypofunction stage can be missed. OBJECTIVE: This multicentre cross-sectional study was performed to examine the relationships between the test results for oral hypofunction, subjective frailty symptoms and OHRQoL of outpatients in dental clinics. METHODS: The basic characteristics and oral function test results of 637 dental clinic outpatients were evaluated. The subjective symptoms of physical and oral frailty were investigated using a questionnaire. OHRQoL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16) and OHRQoL dimension score. RESULTS: The overall prevalence of oral hypofunction was 37.8%, with no significant difference between men and women. No significant differences in the presence or absence of subjective symptoms of frailty and a high OHIP score were observed based on sex. However, the prevalence of oral hypofunction was significantly different among the age groups and increased with age. The subjective symptoms of frailty score, OHIP score and OHRQoL dimension score were significantly higher in patients with versus without oral hypofunction. Age, number of underlying diseases, total score for subjective symptoms of frailty, total score for OHIP and OHRQoL dimension score were significantly associated with oral hypofunction. CONCLUSION: Oral hypofunction may affect the subjective symptoms of frailty and OHRQoL in older adults.

Linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China: a cross-sectional study.

BACKGROUND: Depression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China. METHODS: From November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately. RESULTS: Based on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (ß) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (ß = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (ß = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (ß = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (ß = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes. CONCLUSION: Both the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life.

The Feasibility and Acceptability of a Mobile Application for Oral Health Education Among Adults in Rwanda.

Background: Mobile technology health application (mobile Apps) can assist people manage their health and wellness, encourage healthy lifestyles, and provide valuable information whenever necessary. Objective: This study aimed to evaluate the feasibility and acceptability of a mobile App for oral health education among adults in Rwanda. Methods: This was a descriptive cross-sectional study. A total of 111 adult participants evaluated the acceptability and feasibility of the BrushDJ mobile App after using it for three months. At the end of this period, an online survey was conducted using a structured questionnaire consisting of questions on demographics, habitual oral health, assessing acceptability, and assessing the feasibility of the mobile App. Descriptive statistics were performed to analyse demographic characteristics, the feasibility and acceptability of the mobile App. Bivariate analysis using the Chi-square test was performed to detect significant associations amongst the variables. Results: The response rate was 81% (n=90) of 111 participants who took part in the study, with the majority of participants 44.44% (n=40) aged between 18 and 27 years old. Just over half of the participants were male 51.11% (n=46). The mobile App was found to be highly acceptable (87.78%; n=79) and considered highly feasible (84.44%; n=76) by most of the participants. The differences in acceptability and feasibility across education levels were statistically significant (p=0.000 for acceptability and p=0.038 for feasibility). Conclusion: The study revealed that the mobile App for oral health education (BrushDJ) was highly acceptable and feasible among the participants. The mobile App had a user-friendly interface and comprehensive guidance on oral hygiene procedures facilitated by its diverse and well-integrated functions.

Dental Erosion in Competitive Swimmers and Preventive Treatments: An In Vitro Study.

The aim of this in vitro study was to evaluate the effectiveness of highly concentrated fluoride products and remineralizing products (F-APC) in preventing erosive dental lesions in competitive swimming patients. A total of 48 teeth were extracted, preserved in saline solution and divided into three groups. In G1 (control group), each tooth was half-immersed in chlorinated pool water; in G2 (fluoride-treated group), after being totally immersed in chlorinated water, each tooth had half of its surface treated with a highly concentrated fluoride product once a week; in G3 (remineralization product-treated group), each tooth was totally immersed in chlorinated water and half of its surface was treated with a remineralizing product after each immersion. The study was conducted over a 4-week period, immersing the teeth for 4 h per day. In G1, statistically significant differences were observed in submerged versus non-submerged tooth surfaces at week 3 (T3) (p = 0.019) and week 4 (T4) (p = 0.0007), with four and eight surfaces showing erosive tooth wear (ETW), respectively. In G2, a difference was observed between fluoride-treated and non-fluoride-treated surfaces at T4 (p = 0.039), with three surfaces with ETW among the non-treated ones. In G3, the difference was observed between portions treated with F-APC and those not treated at T4 (p = 0.019), with four surfaces with ETW among the untreated ones. Chlorinated pool water is a potential erosive agent for teeth if water pH values reach a critical value. Treating the teeth surface with highly concentrated fluoride products, once a week for 5 min, and F-APC are effective in protecting teeth against tooth erosion.

Dental Coverage for Medicare Beneficiaries.

Poor oral health has been associated with various systemic diseases (e.g., endocarditis, pneumonia, cardiovascular disease, and diabetes) and decreased quality of life. When enacted in 1965, Medicare excluded coverage for comprehensive dental services. As of 2023, Medicare has allowed coverage of limited dental services inextricably linked to specific medical conditions. Many Medicare Advantage plans (Medicare Part C) offer dental coverage. Yet in 2019, approximately 24 million Medicare beneficiaries (47% of all Medicare enrollees), lacked dental coverage. Seventy-one percent of traditional Medicare enrollees (those not enrolled in a Medicare Advantage Plan) reported that high cost was the primary reason that they did not obtain dental care. The importance of oral health for the older adults has been the main reason that a national interprofessional consortium, which includes several national nursing organizations, has been advocating for legislation to expand Medicare to include dental coverage. The consortium's efforts have been thwarted by fierce opposition from the American Dental Association and many Republican legislators. Given the vital role that nurses and advanced practice nurses play in caring for the nation's older adults and disabled, nursing's voice needs to be strengthened as leaders in advocating for inclusion of dental benefits in traditional Medicare.