Unique dietary and oral hygiene behaviors in a cohort with clinically severe obesity: A cross sectional study.

BACKGROUND: An association between increased risk of dental caries with increased levels of clinically severe obesity has been reported. Data linking body mass index (BMI) and dietary behaviors, including at-risk dietary factors and oral hygiene habits, are lacking in a cohort with clinically severe obesity. This study aimed to explore the dietary and oral hygiene behaviors in individuals with clinically severe obesity attending a hospital-based obesity service. METHODS: Adult patients attending a hospital-based obesity service in Greater Western Sydney with clinically severe obesity were invited to participate in a self-administered survey, which collected data on their nutritional and oral hygiene behaviors. Demographic data (age, gender) and BMI were extracted from the participants' medical records. The primary outcome was the relationship between BMI and frequency of toothbrushing. RESULTS: Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire. The median BMI of the cohort was 49.1 kg/m2 (interquartile range [IQR]: 43.2-57.3 kg/m2) and median age 51 (IQR: 39-63) years. BMI was not significantly correlated with individual oral health behaviors (p > .05). Many participants reported dietary risk behaviors, which have the potential to influence their oral health. CONCLUSIONS: While oral health behaviors were not associated with increasing BMI, patients with clinically severe obesity in this study reported unique dietary behaviors and mixed oral hygiene habits that may complicate nutritional and dental management. Awareness of these behaviors among clinicians including dental professionals is required in this cohort.

The Effect of Marijuana-Smoking on Dental Caries Experience.

OBJECTIVE: This cross-sectional study aims to examine the effect of marijuana-smoking on dental caries experience and to explore the potential combined effects of tobacco and marijuana cigarette-smoking. METHODS: We used data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). We examined demographics, tobacco- and marijuana-smoking, dental examination, and dietary intake. Caries was measured as decayed, missing, filled teeth (DMFT). Data analysis included univariate, bivariate analyses, and linear regression model (LRM) to examine the association between marijuana-smoking and DMFT. RESULTS: Mean DMFT score was lowest for nonsmokers (8.72) and highest for current marijuana smokers (9.87) (P < .0001); however, LRM results revealed that marijuana-smoking was not associated with caries. Adjusted DMFT was the highest for current tobacco and former marijuana smokers (ß estimate = 1.18; 95% CI, -0.27 to 2.62), but the relationship was not statistically significant. CONCLUSIONS: After controlling for potential confounders, there was no significant association between marijuana-smoking and dental caries experience. However, when marijuana and tobacco were smoked concurrently, there was a notable increase in DMFT, although the difference was not statistically significant. Future research should be directed towards exploring the effects of different forms of marijuana consumption, such as edibles and drinkables, on caries development. Health promotion programmes should be aimed at educating the public regarding the combined health impacts of smoking both marijuana and tobacco, considering the potential heightened caries risk.

Quantitative analysis on dental utilisation in culturally and linguistically diverse mothers.

BACKGROUND: Culturally and linguistically diverse (CALD) mothers are influential in children's behaviours, yet little is known about this population. Furthermore, insufficient quantitative and context-based studies are available with CALD mothers and their access to oral health care. To address this gap, the study investigates oral health behaviours, psychological factors and remoteness area with dental utilisation in CALD mothers, within the NSW context. METHODS: Informed by middle-range theory and a CALD-specific rainbow model, the 2013 and 2015 NSW Adult Population Health Survey was analysed. Variables for CALD mothers included household structure, age and language spoken. Multivariable analysis was conducted with oral health behaviours, psychological and remoteness variables, with dental utilisation as the outcome. RESULTS: The sample was weighted (n =190,283). In total, 39.8% did not have a dental visit, and older mothers (aged 36-55 years) sought more dental services than younger mothers (aged 18-35 years). Higher odds for treatment dental care (aOR 2.21, 95% CI 1.12-4.37) than prevention-oriented care were found. Mothers experiencing moderate levels of psychological distress (aOR 0.49, 95% CI 0.31-0.77), or residing in outer regional and remote regions (aOR 0.19, 95% CI 0.04-0.85) were less likely to utilise dental care. CONCLUSION: Findings underline geographical issues in dental care utilisationand the need for integrated care for CALD mothers experiencing psychological distress, and to encourage uptake of preventive oral health care. Addressing cost barriers necessitates for universal health coverage. Multidisciplinary integration of healthcare services with improved primary sector collaboration between governments and healthcare providers, and the expansion to regional services are required for equity in CALD communities.

Dental Pain Medication Prescriptions in Minas Gerais, Brazil (2011-2021): A Time-Series Analysis.

To describe trends of dentist-prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, from January 2011 to December 2021, as well as to examine the relationship between these trends and characteristics of public oral health services in Minas Gerais, Brazil. In this time-series analysis, all drugs were classified according to the Anatomical Therapeutic Chemical classification system. Drugs categorized as NSAIDs (M01A), and other analgesics and antipyretics (N02B) were included for analysis. The outcome was the number of Defined Daily Doses (DDDs)/1000 inhabitants/year for NSAIDs and analgesics in each town. Covariates referred to characteristics of public oral health services, such as coverage, estimates of dental procedures, and frequency of toothache. Linear time-series regression models were used to determine the influence of covariates on the outcome. Overall, there were 58,482 prescriptions of NSAIDs recorded in thirty-eight towns, while 47,499 prescriptions of analgesics in forty-three towns. For each year, there was a 0.38 (p < 0.001), and 0.28 (p < 0.001) increase in the average log of DDD/1000 inhabitants/year for NSAIDs and analgesics, respectively. A positive association was detected between toothache (p < 0.001) and the prescription of NSAIDs. Over the eleven years, there was a general rising trend in the prescriptions. Toothache was the only characteristic of public oral health services associated with the prescription rates of NSAIDs, implying that as the frequency of toothaches increase, so do the prescriptions of NSAIDs in the studied towns.

Poor dental service utilization in those with clinically severe obesity: A neglected issue with solutions needed.

Data linking body mass index (BMI) and dental service utilization with oral and general health, quality of life, wellbeing, and mental health are lacking. Adult patients with clinically severe obesity attending a hospital-based obesity service in Greater Western Sydney were invited to participate in a cross-sectional survey that collected data on dental utilization and visiting patterns, dental anxiety, and oral health-related quality of life (OHRQoL). General health data were obtained from participants' medical records. Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire, and 74 (91.3%) answered additional screening questions related to their general wellbeing and mental health. Of the participants, 50 (61.7%) reported that their last dental visit was more than 1 year ago, 43 (53.1%) visited only as needed and 22 (27.2%) participants reported favourable dental visiting patterns. Twenty-four (29.6%) participants reported high levels of dental anxiety, and low levels of OHRQoL compared with national data. Screening questions suggested low general wellbeing and poor mental health in this patient cohort. Within this group, BMI was not significantly correlated with any of the variables of dental service utilization, dental anxiety, OHRQoL, wellbeing, or mental health (p > .05). There was a negative correlation between dental anxiety and dental utilization (p < .05). Patients with clinically severe obesity reported poor dental utilization, low OHRQoL, and high levels of dental anxiety. This study highlighted the frequency of medical complications, lack of wellbeing, and poor mental health, which were evident in this cohort and may complicate dental management.

Systematic review and meta-analysis on the effect of self-assembling peptide P11-4 on arrest, cavitation, and progression of initial caries lesions.

BACKGROUND: Simple noninvasive evidence-based interventions for caries are needed to overcome limitations in the restorative paradigm. The self-assembling peptide P11-4 is a noninvasive intervention that regenerates enamel in initial caries lesions. STUDIES REVIEWED: The authors conducted a systematic review and meta-analysis on the effectiveness of the P11-4 products Curodont Repair (Credentis; now manufactured by vVARDIS) (CR) and Curodont Repair Fluoride Plus (Credentis; now manufactured by vVARDIS) on initial caries lesions. Primary outcomes were lesion progression after 24 months, caries arrest, and cavitation. Secondary outcomes were changes in merged International Caries Detection and Assessment System score categories, quantitative light-induced fluorescence (QLF; Inspektor Research System), esthetic appearance, and lesion size. RESULTS: Six clinical trials met the inclusion criteria. Results of this review represent 2 primary and 2 secondary outcomes. When compared with parallel groups, use of CR likely results in a large increase in caries arrest (relative risk [RR], 1.82 [95% CI, 1.32 to 2.50]; 45% attributable risk [95% CI, 24% to 60%]; number needed to treat [NNT], 2.8) and likely decreases lesion size by a mean (SD) of 32% (28%). The evidence also suggests that use of CR results in a large reduction in cavitation (RR, 0.32 [95% CI, 0.10 to 1.06]; NNT, 6.9) and is uncertain about lowering merged International Caries Detection and Assessment System score (RR, 3.68 [95% CI, 0.42 to 32.3]; NNT, 19). No studies used Curodont Repair Fluoride Plus. No studies reported adverse esthetic changes. PRACTICAL IMPLICATIONS: CR likely has clinically important effects on caries arrest and decreased lesion size. Two trials had nonmasked assessors, and all trials had elevated risks of bias. The authors recommend conducting longer trials. CR is a promising treatment for initial caries lesions. The protocol for this systematic review was registered a priori with PROSPERO (304794).

High prevalence of potential psychotropic drugs interactions among Brazilian dental patients.

OBJECTIVE: To determine the prevalence of potential drug-drug interactions involving psychotropics prescribed by dentists, and dispensed by the public healthcare system, as well as to describe the severity and level of evidence of those interactions in the state of Minas Gerais, Brazil. MATERIALS AND METHODS: We conducted data analysis from pharmaceutical claims in which dental patients received systemic psychotropics in 2017. Data from the Pharmaceutical Management System provided the drug dispensing history of the patients, allowing the identification of those on concomitant medication use. The outcome was the occurrence of potential drug-drug interactions, which were detected according to IBM Micromedex®. Independent variables were the patient's sex, age, and the number of drugs used. Descriptive statistics was performed using SPSS v. 26. RESULTS: Overall, 1480 individuals were prescribed psychotropic drugs. The prevalence of potential drug-drug interactions was 24.8% (n = 366). The total of 648 interactions was observed and, most of which were of major severity (n = 438, 67.6%). Most interactions occurred in female individuals (n = 235; 64.2%), with 46.0 (±17.3) years-old, concurrently taking 3.7 (±1.9) drugs. CONCLUSION: A substantial proportion of dental patients presented potential drug-drug interactions, mostly of major severity, which might be life-threatening.

Barriers and facilitators to dental care among culturally and linguistically diverse carers: A mixed-methods systematic review.

OBJECTIVES: Culturally and linguistically diverse (CALD) communities experience widespread inequalities in dental care utilization. While, several studies have reported factors contributing to such inequalities, a synthesis of evidence is lacking for CALD carers. This review examined the barriers and facilitators to dental care utilization among CALD carers. METHODS: Medline, CINAHL, ProQuest, Scopus and Web of Science were searched for dental utilization and related factors, without geographic limitations. An integrated mixed-method design was adopted, where both qualitative and quantitative findings were combined into a single synthesis. Critical appraisal was conducted using JBI tools, and a Universal Health Coverage (UHC) framework guided the synthesis approach. Reliability and researcher triangulation occurred throughout the conduct of this review. RESULTS: A total of 20 papers were included: qualitative (n = 8), quantitative (n = 8) and mixed method (n = 4). Studies were from Australia, Canada, South Korea, Trinidad and Tobago, United Kingdom and the United States. Three studies insufficiently reported confounding variables and nine qualitative papers lacked philosophical perspectives. Affordability was the foremost barrier at the system level, followed by psychosocial negative provider experiences and language/communication issues at the provider level. Cultural, knowledge, attitudes and beliefs were individual-family level factors. Utilizing a UHC framework, the barriers and facilitators were aggregated at three levels; financial-system, provider and individual-family levels and illustrated in the rainbow model of CALD oral health. CONCLUSION: The review strengthens evidence for multilayered, system-related policies and culturally sensitive provision of services for reducing oral healthcare inequalities in CALD carers.

Response to commentary: See Original Article here.

This letter is a response to commentary by Dr. Smith on 'Examining the association between cancer history in early life and dental care utilization'. We provided additional information and clarification regarding our analysis and results in response to Dr. Smith's questions and comments. Despite the limitations and weaknesses of our study, we still believe that it provides important information and further research questions.

Factors Affecting Masticatory Performance of Older Adults Are Sex-Dependent: A Cross-Sectional Study.

This cross-sectional study assessed the oral and physical factors contributing to improvement of the masticatory performance of community-dwelling older adults in South Korea. We enrolled 84 healthy older adults (38 men, 46 women; age, 71.40 ± 5.15 years) and assessed their skeletal muscle mass index (SMI), functional tooth units (FTUs), and mixing ability index (MAI). Associations between variables were analyzed using Spearman's correlation coefficient, and the effects of SMI and FTUs on the MAI were evaluated through linear multiple regression. FTUs were positively associated with the MAI in men and women (r = 0.339, p = 0.038 and r = 0.461, p = 0.001, respectively). SMI and FTUs were moderately associated in men (r = 0.459, p = 0.004). MAI showed an approximately 4.4 times increase for each FTU in men (B = 4.442, p = 0.037); however, after the SMI was added, this effect was no longer significant. In women, the MAI increased by about 6.7 times with each FTU (B = 6.685, p = 0.004). FTUs had a significant effect on the MAI only in women with low muscle mass. While there was no significant effect of the SMI on the MAI, its influence should not be overlooked.

Dental hesitancy: a qualitative study of culturally and linguistically diverse mothers.

BACKGROUND: Oral healthcare is paramount and inextricably linked to well-being. Yet, the evidence indicates that culturally and linguistically diverse (CALD) migrant communities have unequal access to mainstream dental services due to several barriers. The purpose of this study was to investigate the oral healthcare experiences, attitudes and barriers to oral healthcare utilisation in CALD mothers. METHODS: A qualitative study with semi-structured interviews was conducted within a social constructivism epistemology. CALD mothers who identified as non-English speaking, foreign country born, with a child under 12, were recruited though purposive snowball sampling. Questions probed oral healthcare experiences, barriers, enablers, and attitudes. Verbatim typed transcripts were thematically analysed using grounded methodology. RESULTS: Thirty-three CALD mothers participated; twenty from India, five from Fiji, four from China, two from Nepal and one each from Israel and Macedonia. Languages included Cantonese, Fiji-Hindi, Gujrati, Hebrew, Hindi, Kannada, Mandarin, Maharashtrian, Macedonian, Nepalese, Punjabi, Sanskrit, Telegu and Urdu. Cost was the foremost barrier to oral healthcare services, followed by Confidence in quality care for the provision of services and treatment. Confusion in navigating a public and private healthcare system was highlighted and Competing priorities took precedence. Complacency referred to 'no need' or lack of urgency in dental care. Subsequently, dental hesitancy (superordinate theme) described the patterning of data as comprising the five 'C' factors and was theorised as the dental hesitancy phenomenon to explain the occurrence of delay or avoidance in utilising dental care. CONCLUSION: Findings highlight the utility of the dental hesitancy phenomenon unearthed within this study. CALD mothers explained five 'C' dimensions: cost, confidence, confusion, competing priorities and complacency as barriers to accessing timely dental care. Multisectoral collaboration between healthcare systems, universal health coverage and primary sector support is required to address dental hesitancy in CALD mothers. Further, this study contributes to the field of behavioural and social sciences in oral health and augments the literature on dental avoidance.

Dental diaspora: oral health care attitudes and experiences in culturally and linguistically diverse mothers in Australia.

BACKGROUND: Globally oral health care is unequally accessible or utilised within culturally and linguistically diverse (CALD) migrant communities. Yet much remains unknown about CALD mothers and their oral healthcare experiences in Australia. Hence, this paper explores the oral health care attitudes and experiences of CALD mothers within the Australian context with the broader objective to reduce oral health inequalities. METHODS: Qualitative semi-structured interviews were conducted from a social constructivism paradigm. Participants were foreign country born, spoke language/s other than English and have a child. Purposive snowball sampling and recruitment was conducted through CALD organisations and social media. Participants were interviewed for their attitudes and experiences to dental care and frequency of utilisation in Australia and the home country. Interviews were transcribed verbatim and grounded analysis (Strauss and Corbin) performed. Researcher bias was reduced through reflexivity and triangulation. RESULTS: The participants (n = 33) included 20 CALD mothers born in India and 13 from either China, Fiji, Nepal, Macedonia and Israel. The theme, experiences with health workforce personnel revealed positive attitudes toward CALD providers from similar cultural and/or linguistic backgrounds. We coin these CALD providers as the 'dental diaspora'. The dental diaspora facilitated CALD mothers through culture and/or language factors, alleviating cost barriers and flexibility in appointments. Dental travel to the home country was affirmed, however family visitation was the foremost reason for travel. CONCLUSION: The findings suggest that the dental diaspora plays a significant role in promoting oral health care utilisation for first generation CALD mothers in Australia. This paper brings to light the phenomenon of the 'dental diaspora' as an essential health workforce that contributes to addressing inequities in oral healthcare utilisation within CALD migrant communities. Universal health coverage in oral health is further affirmed, as aligned to the WHO policy context.

Encounters and management of oral conditions at general medical practices in Australia.

BACKGROUND: Poor oral health has been widely recognised as an ongoing public health issue. Patients with oral conditions may visit either a general practitioner (GP) or a dental practitioner for management. The aims of this study are to report (i) the GP management rate of oral health conditions by patient and GP demographics, (ii) what specific oral conditions were managed, and (iii) how GPs managed oral conditions. METHODS: Data from the Bettering the Evaluation and Care of Health study (2006 to 2016 inclusive) were analysed. Descriptive statistics with 95% confidence intervals around point estimates were used to summarise data. Multivariate logistic regression was performed to determine the independent effect of patient and GP characteristics. RESULTS: A total of 972,100 GP encounters were included in the dataset, with oral condition-related encounters managed at a rate of 1.19 oral conditions per 100 GP encounters. Patients who were aged 54 years or younger, resided in a socioeconomically disadvantaged area, came from a non-English speaking background or Indigenous background were more likely to have oral conditions managed by GPs. The most commonly reported oral conditions were dental and oral mucosa-related. Over 60% of oral conditions were managed by GPs through prescribed medications. CONCLUSIONS: This study provided an overview of management of oral conditions by GPs in Australia. Patients from certain vulnerable demographic groups were more likely to attend a GP for management of oral conditions. Common oral conditions and management approaches were identified. The findings of this study contribute to public health and health policy discussions around optimising primary care provision in oral health.

Oral health impact of sugar-sweetened beverage consumption among Korean adolescents.

OBJECTIVES: This study aimed to investigate the association between the frequency of SSB consumption and the prevalence of oral symptoms in adolescents. METHODS: We analysed the data collected from the 2017 (13th) Korea Youth Risk Behaviour Web-based Survey (KYRBWS). KYRBS collected beverage consumption data from 64,991 Korean adolescents. Self-reported oral symptoms including sensitivity to food, sharp aches and pains in the teeth, and painful or bleeding gums were also collected. Multivariable logistic regression modelling was used to test the association between the frequency of SSB consumption and oral symptoms groups. RESULTS: It was found that Korean adolescents who consumed SSB at least once a week (94.4%) experienced more subjective oral symptoms (46.5%) even after controlling for confounding variables. In addition, as the frequency of SSB intake in adolescents increased, the subjective oral symptoms increased. CONCLUSIONS: The results of this study clearly revealed that the SSB consumption impacted adolescents' subjective oral symptoms. Compared with those who did not consume SSBs, those who consumed SSBs showed increased for developing subjective oral symptoms.

The Indigenous Adolescent Oral Health Partnership Study: A Co-Design Study Protocol.

BACKGROUND: in this protocol we outline a method of working alongside Aboriginal communities to learn about and facilitate improvement in the oral health habits in Aboriginal adolescents. By facilitating positive oral health in Aboriginal adolescents, we hope to achieve lifelong improvement in oral health and general wellbeing. METHODS: this paper outlines a co-design methodology through which researchers and Aboriginal communities will work together to create a custom oral healthcare program aimed at Aboriginal adolescents. Researchers, a youth advisory group, Aboriginal community-controlled health services and three regional NSW communities will together devise an oral health strategy focused on five components: application of topical fluoride, increasing water consumption, improving nutrition, daily toothbrushing, and enhancing social and emotional wellbeing. Capacity building is a key outcome of this program. DISCUSSION: as the gap in health status between Aboriginal and non-Aboriginal people remains wide, it is clear that new approaches and attitudes are needed in Aboriginal public health research. This protocol is representative of this shifting approach; giving power to Aboriginal communities who seek to have sovereignty and self-determination over their healthcare. TRIAL REGISTRATION: TRN: ISRCTN15496753 Date of registration: 20 October 2021.

Refugee and Asylum Seeker Trauma Informed Care Training for Oral Healthcare Professionals in NSW, Australia.

People from refugee and asylum seeker (RAS) backgrounds who have re-settled in Australia experience inequitable health outcomes. As a result, people from RAS backgrounds need access to culturally safe and responsive care. To provide this care, oral health professionals must understand how experiences of trauma influence a patient's oral health. The aim of this study was to highlight the lessons learnt from providing trauma informed care (TIC) to oral health professionals in New South Wales (NSW). TIC is a model that emphasises trust, patient safety, choice and empowerment to foster healthcare equity. This study was designed and piloted by the Centre for Oral Health Strategy (COHS), NSW Ministry of Health in partnership with NSW Refugee Health Service, local Multicultural Health Services, and four Local Health Districts (LHDs): Hunter New England, Mid-North Coast, Murrumbidgee and Illawarra Shoalhaven. Pre and post TIC training surveys were distributed to oral health professionals. This captured baseline versus intervention data to understand their knowledge of TIC. Seven training sessions were provided by NSW Refugee Health Service in four LHDs. A total of 152 participants attended a TIC training session, 106 participants completed the pre-survey, and 67 participants completed the post-survey. At baseline, only 50% of staff reported confidence in delivering TIC care to RAS populations. After the intervention, 97% of staff reported feeling extremely, very, or somewhat confident in understanding and delivering TIC. Findings demonstrate that TIC training can support oral health professionals to provide culturally safe and responsive care to people from RAS backgrounds.

Barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools: a systematic review.

BACKGROUND: Untreated dental caries negatively impacts a child's quality of life including overall health and wellbeing, growth and development, social interaction ability, and school attendance. School-based toothbrushing programs have been recognised as an effective intervention to reduce the burden of dental caries. However, limited information is available to understand the real-world enablers and challenges in the implementation and sustainability of toothbrushing programs. This review aims to understand the barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools. METHODS: Five electronic databases [i.e., CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), Web of Science, and PsycINFO] and backward citation chasing were performed. The last updated databases searches were conducted in May 2022. Studies reporting on barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings or primary schools were included in the review. The methodological quality of included studies was assessed by using Joanna Briggs Institute [JBI] and mixed methods appraisal tool [MMAT] critical appraisal tools and results were reported in accordance with PRISMA guidelines. RESULTS: A total of six studies met the eligibility criteria and were included in the review. Toothbrushing programs in early childhood settings and primary schools were mostly implemented under the supervision of staff and teachers. A positive attitude of the staff, the flexibility of toothbrushing sessions, involvement of community volunteers and parents were a few of the identified enablers. However, the timing of the communication of the program, inadequate transfer of information among staff, frequent staffing turnover, lack of parental support, and staff feeling overburdened while acting as pseudo parents were frequently reported as barriers. CONCLUSION: The results of this systematic review identify key enablers and barriers for toothbrushing programs in early childhood settings and primary schools which need to be considered for developing oral health promotion initiatives.

Yogurt product intake and reduction of tooth loss risk in a Japanese community.

AIM: To evaluate the longitudinal association between yogurt product intake and oral health in a population-based study. MATERIALS AND METHODS: This study included 1967 Japanese residents aged 40-79 years who underwent dental examinations in 2012. Among them, 1469 participants were followed up in 2017 for the incidence of tooth loss, which was defined as two or more teeth lost over 5 years. The intake of yogurt products, defined as yogurt and lactic acid beverages, was estimated using a semi-quantitative food frequency questionnaire. The composition of the salivary microbiota was evaluated. RESULTS: The Poisson regression model showed that a higher intake of yogurt products was negatively associated with the incidence of tooth loss (p for trend = .020), adjusted for potential confounding factors. Mediation analysis confirmed that periodontal condition partly mediated the effect of yogurt product intake on tooth loss, while dental caries experience did not. Additionally, we confirmed the association of a high intake of yogurt products with a low percentage of the salivary microbiota pattern, which was associated with poor oral health. CONCLUSION: These findings suggest that the intake of yogurt products is associated with a lower risk of tooth loss resulting from periodontal disease, probably via modulation of the oral microbiome composition.

Dental Practice Patterns for Oral Care in Medical Oncology Patients-a Survey-Based Assessment of Massachusetts Dentists.

Oral complications associated with cancer therapy lead to a significant deterioration of oral health and overall quality of life. The primary aim of this study was to assess dental practice patterns followed by dentists for oral care of medical oncology patients and to identify potential barriers to recommended care. A questionnaire-based survey was developed using the Qualtrics online platform. It was electronically distributed to all dentists within the Massachusetts Dental Society (MDS). Descriptive statistics were automatically computed by Qualtrics. A total of 363 responses (10.7%) were received. Dentists reported minimal correspondence from the oncology team during referrals. Most dentists communicate treatment recommendations to the oncology team with regard to extractions (74.6%), restorations (66.7%), periodontal health (68.8%), and other urgent needs (73.5%). Potential obstacles to providing care included insufficient time for dental care before start of therapy (61%), lack of patient education on oral complications associated with therapy (56%), and lack of dental insurance (31%). Only 50% of the dentists felt adequately trained to treat oncology patients, and 46% of dentists infrequently followed the recommendations set by the National Institute of Dental and Craniofacial research (NIDCR). The findings of this study indicate significant variability in the referral patterns and practice protocols for medically necessary oral care in oncology patients. The major barriers to following established guidelines for care may be attributed to the lack of correspondence between provider teams, inadequate training of professionals, and financial or insurance factors associated with increased cost of supportive care.

Examining the association between cancer history in early life and dental care utilization.

OBJECTIVES: This study aims to examine associations between cancer history in early life (diagnosed at 20 years of age or younger) and utilization of dental care. METHODS: We analysed data of 10,185 participants, aged ≥20 years, from the National Health and Nutrition Examination Survey cycles 2015-2018. The main predictor was self-reported past history of any type of cancer diagnosed at 20 years of age or younger (yes/no). The outcome variables were having a dental visit within the past year, treatment or preventative visit, urgent need for care, and unmet dental need. Covariates included gender, age, race, marital status, education, and income. Bivariate and multiple logistic regression were conducted, accounting for the complex sampling design. RESULTS: There was no difference between early life cancer survivors in regards to dental visit within the past year (OR: 0.7; 95% CI: 0.3-1.6), visit for dental treatment (OR: 0.6; 95% CI: 0.3-1.6), urgent need for care (OR: 0.8; 95% CI: 0.3-2.0), or unmet dental need (OR: 0.6; 95% CI: 0.2-1.6) compared to cancer-free participants. CONCLUSIONS: Cancer history in early life doesn't impact dental care visits, type of last dental visit, dental care recommendation, or unmet dental need. Future cohort studies are needed to confirm this association.