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OBJECTIVE: To evaluate the exposure frequency effect of 0.454% stannous fluoride (SnF2) toothpaste in controlling gingivitis. METHODS: Two randomized controlled trials enrolled generally healthy adults with gingivitis. The study duration was 1 mo (study 1) and 3 mo (study 2). Gingivitis was assessed using the Löe-Silness Gingival Index (LSGI) at baseline, 1 mo (both studies), and 3 mo (study 2); bleeding scores were derived from the LSGI. Study groups consisted of positive control (twice-daily use of 0.454% SnF2 toothpaste), experimental group (brushing in the morning with SnF2 toothpaste and in the evening with 0.76% sodium monofluorophosphate [SMFP] toothpaste), and negative control (twice-daily use of SMFP toothpaste). The primary endpoint was number of bleeding sites. RESULTS: Study 1 and study 2 each enrolled and randomized 90 participants; 86 and 89 participants, respectively, completed the trials. At baseline, the mean (SD) number of bleeding sites was 47.6 (18.54) in study 1 and 41.5 (17.84) in study 2. At 3 mo (study 2), the positive control produced 51.3% fewer bleeding sites, and the experimental group produced 32.5% fewer bleeding sites versus the negative control (P < 0.001 for both). At 1 mo, the positive control produced 45.1% (study 1) and 45.8% (study 2) fewer bleeding sites versus the negative control (P < 0.001 for both), and the experimental group produced 33.0% (study 1) and 24.8% (study 2) fewer bleeding sites, respectively, versus the negative control (P ≤ 0.002 for both). The benefit was observed as early as 1 mo and was consistent with 3-mo results. CONCLUSION: This research is to our knowledge the first to demonstrate a gingivitis-reduction response effect for the frequency of bioavailable SnF2 toothpaste use, with maximum benefit from twice-daily use, followed by a single-daily exposure versus the negative control. Clinical trial registration numbers: NCT05916508 and NCT05916521. KNOWLEDGE TRANSFER STATEMENT: The results of this study can be used by dental professionals to guide their recommendations for therapeutic toothpaste for gingival health. Emphasis on the importance of twice-daily brushing with bioavailable stannous fluoride dentifrice will help patients optimize gingival health benefits achieved via self-care.
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BACKGROUND: Toothbrushing twice daily is essential for maintaining oral hygiene, which is a cornerstone of overall health. This is particularly important during childhood and adolescence, when lifelong habits are established. Nevertheless, many children and adolescents worldwide face challenges in maintaining good oral health due to limited access to resources and education. OBJECTIVES: This study used nationally representative samples from the Global School-based Student Health Survey (GSHS) (2010-2019) to determine the frequency of toothbrushing among school-going students (N = 266,113) in 72 countries. MATERIAL AND METHODS: The country-specific sample size ranged from 130 in Tokelau to 25,408 in Malaysia. The outcome variable was the frequency of brushing or cleaning teeth once daily within the past 30 days prior to the survey. Bivariate analysis was conducted following a descriptive study to determine the frequency of toothbrushing or cleaning across different age groups (≤12, 13, 14, 15, ≥16 years), sexes, World Health Organization (WHO) regions, and gross domestic product (GDP) per capita quintiles. RESULTS: The overall proportion of males to females in the sample was 50.9:49.1. In 45 countries or territories (62.5%), the proportion of participants who reported brushing their teeth at least once a day was above 90%. Participants from 10 countries or territories (13.9%) reported never or rarely brushing their teeth. In 69 countries or territories (95.8%), male students were more likely than female students to never or rarely brush their teeth. The highest rate of individuals who never or rarely brush their teeth (32.1%) was reported in the Eastern Mediterranean Region. In comparison, the Region of the Americas had the highest frequency of brushing twice or more daily (82.9%). CONCLUSIONS: Educational interventions focused on dental health implemented in schools and aimed at early adolescents have the potential to promote the formation of healthy habits, which may lead to improved well-being over both short and long terms.
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Toothbrushing , Humans , Toothbrushing/statistics & numerical data , Adolescent , Male , Female , Child , Global Health/statistics & numerical data , Students/statistics & numerical data , Health Surveys , Oral Health/statistics & numerical data , Oral Hygiene/statistics & numerical data , Schools/statistics & numerical dataABSTRACT
AIM: This study aimed to compare the effectiveness of two visual pedagogy methods, video modeling and educational posters, on improving tooth-brushing autonomy in 10-12-year-old children with mild autism. METHODS: Sixty-four autistic children were randomly assigned to either the video or poster groups using the Rand function in Excel. Toothbrushing skills were divided into five stages: preparation, buccal, occlusal, lingual surfaces, and the end. These five stages comprised a total of 20 steps, with each step scored from 1 (not done at all) to 5 (done independently). The final score was calculated by averaging the scores of the five stages. The FONES method of toothbrushing was used for training. Follow-up assessments were conducted after 1 and 3 months. The data were analyzed using SPSS V26, including t-tests, Mann-Whitney U tests, and repeated-measures ANOVA. RESULTS: After 3 months, there were significant improvements in autonomy scores for both groups, with the video group showing greater benefits (4.37 ± 0.43) compared to the poster group (4.11 ± 0.49) (p = .03), with an effect size of η2 = .07. CONCLUSION: Both video and poster methods were effective in improving tooth-brushing skills, but video modeling was associated with a higher total autonomy score.
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Objectives: Oral health literacy (OHL) is suggested as an important denominator of oral health. This study aimed to identify ways to improve oral health by exploring the association between oral health literacy and oral health-related behaviours among female adolescents in the Eastern Province of the Kingdom of Saudi Arabia (KSA). Methods: This cross-sectional study assessed OHL among 1,889 10th grade female students in the Eastern Province of the KSA. OHL was assessed using an Arabic version of the short version of the Health Literacy in Dentistry scale (A-HeLD-14). Self-reported socio-demographic information and oral health-related behaviours (toothbrushing, dental attendance, and sugary diet consumption) were also collected. The relationship between OHL and oral health-related behaviours was investigated using binary logistic regression, adjusted for socio-demographic information. Results: The binary logistic regression analyses showed that poor OHL was significantly associated with infrequent toothbrushing (p < 0.001) and irregular dental attendance (p = 0.005) but not with consumption of sugary diets. All A-HeLD-14 domains were significantly associated with infrequent toothbrushing, and the domains concerning access, receptivity, and financial barriers were significantly associated with irregular dental attendance. The highest odds ratios (ORs) for infrequent toothbrushing were found in the domains of receptivity (OR = 4.19) and understanding (OR = 3.85) and for irregular dental attendance in the financial barriers (OR = 1.61) and access (OR = 1.49) domains, followed by the receptivity domain (OR = 1.35). Conclusion: Poor OHL was significantly associated with infrequent toothbrushing and irregular dental attendance. Interventions focusing on OHL are warranted to improve oral health-related behaviours and thereby oral health in the population. The aspects that seem most vital to target are improved access to dental care, including the reduction of economic barriers, as well as increased awareness of oral health in the population.
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OBJECTIVES: Understanding the pathways linking caregiver- and family-level psychosocial factors and child oral health behaviors is critical for addressing oral health disparities. The current study examined the associations between caregiver psychosocial functioning and family chaos and child toothbrushing behaviors in children at high risk for poor oral health outcomes. METHODS: Data were drawn from the baseline wave of the CO-OP Chicago Cohort Study (U01DE030067), a longitudinal study on child/caregiver dyads exploring oral health behaviors and caries development in young children (N = 296 dyads; child mean age = 5.36, SD = 1.03; caregiver mean age = 33.8 years, SD = 6.70; caregiver race = 43% Black; caregiver ethnicity = 55% Latinx). The oral health behavioral outcomes included child toothbrushing frequency, child plaque levels, and caregiver assistance with child toothbrushing. The data included demographics; caregiver depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, social functioning, social support, and resilience; and family-level household chaos. RESULTS: Multiple regression models indicated that greater household chaos was significantly related to lower caregiver assistance with child toothbrushing (p = 0.0075). Additionally, caregiver anxiety and PTSD symptoms as well as number of children in the home significantly predicted higher levels of household chaos (p < 0.01). Notably, 18% of caregivers reported clinically significant PTSD. The relationships between caregiver-level psychosocial factors and child oral health behaviors were not significant. CONCLUSIONS: The results suggest household chaos may play an important role in child oral health behaviors and highlight the importance of investigating family-level factors for understanding and addressing child oral health risk.
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OBJECTIVE: To assess the effect of the toothbrush handle on video-observed toothbrushing behaviour and toothbrushing effectiveness. METHODS: This is a randomized counterbalanced cross-over study. N = 50 university students and employees brushed their teeth at two occasions, one week apart, using either a commercial ergonomically designed manual toothbrush (MT) or Brushalyze V1 (BV1), a manual toothbrush with a thick cylindrical handle without any specific ergonomic features. Brushing behaviour was video-analysed. Plaque was assessed at the second occasion immediately after brushing. Participants also rated their self-perceived oral cleanliness and directly compared the two brushes regarding their handling and compared them to the brushed they used at home. RESULTS: The study participants found the BV1 significantly more cumbersome than the M1 or their brush at home. (p < 0.05). However, correlation analyses revealed a strong consistency of brushing behavior with the two brushes (0.71 < r < 0.91). Means differed only slightly (all d < 0.36). These differences became statistically significant only for the brushing time at inner surfaces (d = 0.31 p = 0.03) and horizontal movements at inner surfaces (d = 0.35, p = 0.02). Plaque levels at the gingival margins did not differ while slightly more plaque persisted at the more coronal aspects of the crown after brushing with BV1 (d = 0.592; p 0.042). DISCUSSION: The results of the study indicate that the brushing handle does not play a major role in brushing behavior or brushing effectiveness.
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Cross-Over Studies , Toothbrushing , Humans , Toothbrushing/instrumentation , Male , Female , Adult , Young Adult , Equipment Design , Dental Plaque , Video Recording , Habits , Dental Plaque Index , Ergonomics , Middle Aged , Dental Devices, Home Care , Oral Hygiene , Time FactorsABSTRACT
OBJECTIVE: The objective of this long-term clinical study was to evaluate the influence of a newly developed powered toothbrush (PT) on the size and number of pre-existing gingival recessions (GR) in comparison to a manual toothbrush (MT). METHODS: This was a prospective, single-blind, parallel-group, randomized controlled clinical study. Participants without periodontitis, but with at least two teeth (index teeth) showing GR ≥2 mm were randomized to brush either twice daily with a MT or with a PT with a linear magnetic drive causing the round brush head to produce gentle micro vibrations along with oscillating-rotating movements. Primary outcome parameter was the mean change of GR at the index teeth over 36 months. RESULTS: Totally 87 out of 92 participants completed the study (MT/PT: n = 42/n = 45). At the 36-month evaluation the mean (standard deviation) change of GR at index teeth differed significantly between MT 0.17 (0.77) and PT -0.10 (0.63) (p = 0.013). Furthermore, the amount of GR sites which improved ≥1 mm or remained stable during the study period did not differ between MT and PT, but the number of sites worsened ≥1 mm was significantly in favour for PT (MT 23 (25.5%) versus PT 10 (10.6%); p = 0.009). A binary logistic regression identified tooth type (OR = 2.991 for pre-/molar (1.096 [95% CI 1.002-8.933]; p = 0.050)) and manual brushing (OR = 3.341 (1.206 [95% CI 1291-8648]; p = 0.013)) as risk factors for recession impairment at the index teeth. There were no differences between groups for adverse events. CONCLUSION: In a population with pre-existing gingival recessions and consequently a high risk of developing further recession the PT seems to be favourable with regard to further development of GR.
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Introduction Airline pilots are susceptible to mental health issues, with depression prevalence ranging from 1.9% to 12.6%. Recent research in the general population indicates a potential link between depression and oral health. In this cross-sectional study, we sought to investigate the association between self-reported oral hygiene practices and depressive symptoms among airline pilots. Methods One hundred actively working male airline pilots of Caucasian descent voluntarily enrolled in the study during routine occupational health visits. Depressive symptoms were assessed using the Beck Depression Inventory II (BDI-II). Self-reported oral hygiene practices, including toothbrushing frequency and mouthwash usage, were examined. Univariable and multivariable logistic regression analyses were performed to investigate associations between depressive symptoms and oral hygiene practices. Results Twelve pilots (12%) demonstrated mild depressive symptomatology (BDI-II scores 14-19). Pilots with mild depression reported significantly lower rates of brushing teeth twice or more per day (33.3% vs. 80.7%) and higher rates of rarely brushing (16.7% vs. 1.1%) compared to those with minimal depressive symptoms (p < 0.001). Nonuse of mouthwash was more prevalent among pilots with mild depression (66.6% vs. 23.9%, p = 0.008). Multivariable logistic regression analysis revealed that pilots who rarely brushed their teeth (adjusted odds ratio (OR) = 14.6; 95% confidence interval (CI) = 1.3-197.9; p < 0.05) or did not use mouthwash (adjusted OR = 5.7; 95% CI = 1.4-25.2; p < 0.05) had significantly higher odds of mild depressive symptoms. Conclusions Self-reported oral hygiene habits may serve as a proxy indicator for mild depressive symptoms among airline pilots. Incorporating oral health assessments into routine aeromedical examinations could provide a practical method of identifying pilots at risk for depression, supporting timely interventions and enhancing flight safety.
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The COVID-19 pandemic has had an unprecedented impact on population health and hospital operations. Over 7 million patients have been hospitalized for COVID-19 thus far in the United States alone. Mortality rates for hospitalized patients during the first wave of the pandemic were > 30%, but as we enter the fifth year of the pandemic hospitalizations have fallen and mortality rates for hospitalized patients with COVID-19 have plummeted to 5% or less. These gains reflect lessons learned about how to optimize respiratory support for different kinds of patients, targeted use of therapeutics for patients with different manifestations of COVID-19 including immunosuppressants and antivirals as appropriate, and high levels of population immunity acquired through vaccines and natural infections. At the same time, the pandemic has helped highlight some longstanding sources of harm for hospitalized patients including hospital-acquired pneumonia, ventilator-associated events (VAEs), and hospital-acquired respiratory viral infections. We are, thankfully, on the leeside of the pandemic at present; but the large increases in ventilator-associated pneumonia (VAP), VAEs, bacterial superinfections, and nosocomial respiratory viral infections associated with the pandemic beg the question of how best to prevent these complications moving forward. This paper reviews the burden of hospitalization for COVID-19, the intersection between COVID-19 and both VAP and VAEs, the frequency and impact of hospital-acquired respiratory viral infections, new recommendations on how best to prevent VAP and VAEs, and current insights into effective strategies to prevent nosocomial spread of respiratory viruses.
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COVID-19 , Cross Infection , Pneumonia, Ventilator-Associated , Humans , Pneumonia, Ventilator-Associated/epidemiology , Pneumonia, Ventilator-Associated/prevention & control , COVID-19/complications , COVID-19/epidemiology , Cross Infection/epidemiology , Cross Infection/prevention & control , SARS-CoV-2 , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pneumonia, Viral/complications , Healthcare-Associated Pneumonia/epidemiologyABSTRACT
This research aims to evaluate the efficiency of cavitary varnishes containing experimental bioglasses in the occlusion of dentinal tubules. One hundred and sixty-eight cervical buccal dentin samples were obtained from bovine teeth. Samples were randomized into the following groups: I. Distilled Water (DW); II. Cavity Varnish (CV); III. Colgate® Sensitive Pro-Relief™ (CS); IV. 45S5 Bioglass (45S5); V. KSr Bioglass strontium potassium (KSr); VI. P Bioglass phosphorus (P); and VII. PSi Bioglass phosphorus silica (PSi). The treatments were applied to the surfaces of the samples, which were then subjected to simulated brushing. The samples were analyzed for a) characterization of bioactive glasses; b) surface roughness; c) descriptive analysis of the dentin surface; d) total versus occluded number of dentinal tubules; e) diameter of the dentinal tubules; f) chemical composition of the dentin surfaces, and g) dentin permeability. All groups treated with biomaterials without the brushing challenge showed an increase in roughness and (total or partial) occlusion of the dentinal tubules. The PSi group had the best values for occlusion, while the KSr group had the highest calcium and phosphorus concentrations. After the brushing challenge the roughness was controlled by the presence of biomaterials; 45S5, KSr, and PSi showed occlusion of the dentin tubules. All bioactive glasses showed reduced tooth permeability compared to distilled water. The PSi group had the smallest tubule diameter and highest phosphorus concentration. KSr and PSi bioglasses are promising materials for dentin occlusion and remineralization and are promising new biomaterials for the treatment of dentin hypersensitivity.
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BACKGROUND: Parent-led toothbrushing with fluoride toothpaste is part of an evidence-based strategy to prevent caries in children. There is a gap in the literature regarding perceptions of how and when to assist a child with toothbrushing from the maternal perspective. METHODS: A qualitative cross-sectional study was conducted with participants in North and North Central Appalachia to examine maternal perceptions of when and how to assist with toothbrushing. From 2018 through 2022, 301 mothers of children aged 3 through 5 years volunteered to participate in semistructured interviews from a more extensive parent study (Center for Oral Health Research in Appalachia cohort). The qualitative data were transcribed, coded, and analyzed using Nvivo software, Version 12 (QSR International). The data were analyzed using grounded theory, constant comparative method, and template analysis. RESULTS: A total of 301 mothers were interviewed for this study; 156 (52%) lived in West Virginia and 145 (48%) lived in Pittsburgh, Pennsylvania. Four main themes emerged: (1) assisting with child toothbrushing, (2) ceasing to provide assistance with child toothbrushing, (3) lacking recommendations from dental care professionals on child toothbrushing, and (4) adhering to recommendations from dental care professionals on child toothbrushing assistance. CONCLUSIONS: Understanding the factors that influence how parents brush their children's teeth and the information they receive to guide daily dental hygiene behavior for children is essential in developing effective interventions for preventing caries in children. PRACTICAL IMPLICATIONS: These insights can improve child toothbrushing quality through improved oral hygiene education, recommendations, terminology, and policies from the dental community.
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Mothers , Toothbrushing , Humans , Child, Preschool , Toothbrushing/psychology , Mothers/psychology , Female , Cross-Sectional Studies , Adult , Qualitative Research , Dental Caries/prevention & control , Male , PennsylvaniaABSTRACT
OBJECTIVES: To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. METHODS: A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. RESULTS: Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. CONCLUSIONS: This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.
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BACKGROUND/AIM(S): Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore. METHODS: Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD. RESULTS: Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies. CONCLUSION: Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.
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Income , Patient Acceptance of Health Care , Humans , Female , Male , Cross-Sectional Studies , Adult , Singapore/epidemiology , Income/statistics & numerical data , Child , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Young Adult , Child, Preschool , Middle Aged , Dental Care for Disabled/economics , Dental Care for Disabled/statistics & numerical data , Disabled Persons/statistics & numerical dataABSTRACT
In Australia, dental caries are observed in almost half of children starting school. Oral health promotion programs are being implemented in early childhood education and care (ECEC) settings to promote oral health. This study examined children's perceptions of one such program, the Bright Smiles Bright Futures (BSBF) program in ECEC settings in New South Wales, Australia. Data were collected using focus group discussions from 15 children aged 3-5 years, transcribed verbatim, and analysed through inductive thematic analysis. Three themes were identified as follows: (i) oral health knowledge of children, (ii) oral hygiene practices routine and skills development, and (iii) evaluation of the oral health promotion kit and opportunities for improvement. Children's perspectives highlight the BSBF program's success in communicating key messages to promote oral health. The integration of family-centric approaches, acknowledgement of children's preferences, and the use of interactive tools collectively enhance the overall effectiveness of the oral health promotion program.
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BACKGROUND: Research on caregivers for children with intellectual disabilities, particularly those with autism spectrum disorder (ASD), has highlighted several obstacles to achieving better oral health. These include challenges with tolerating oral care, sensory processing differences, uncooperative behaviors, and communication impairments. There is limited understanding of what caregivers would consider "successful assistance" in improving oral health for these children. OBJECTIVES: This pilot study aimed to examine caregivers' and user's experiences with a Kids Smart Electric Toothbrush used by children with ASD. METHODS: It involved open-ended interviews and questionnaires with caregivers prior to utilization of the toothbrush and after 4 weeks of product use by the child. RESULTS: Seventeen children with ASD, aged 5-12, participated. A total of 58.8% of caregivers said their child brushed more often, and all reported brushing at least twice a day by week 4. Caregivers reported that children became more independent while brushing their teeth and achieved better quality brushing. Caregivers' frustration with the brushing process, satisfaction with the device, and need to assist the child with brushing were improved. Caregivers did encounter some technical difficulties with the app. CONCLUSION: This study will assist in exploring "smart" toothbrush technologies for oral hygiene in children with ASD.
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Diet is a modifiable factor in healthy population aging. Additionally, oral health and diet are important factors affecting depressive symptoms. To assess the mediating role of dietary diversity (DD) in oral health and depressive symptoms in older adults, we selected 8442 participants aged ≥ 65 years from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS) for a cross-sectional study. Depressive symptoms were determined based on scores on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Dietary diversity scores (DDS) were established based on the frequency of intake of food groups. Oral health was measured by denture use and toothbrushing frequency. Stepwise multiple linear regression and PROCESS macros were used for mediated effects analysis and testing. The sample had a positive detection rate of 44.1% for depressive symptoms, 40.8% for denture use, and 41.9% for once-a-day toothbrushing. Denture use (ρ = -0.077, p < 0.01) and toothbrushing frequency (ρ = -0.115, p < 0.01) were negative predictors of depressive symptoms in older adults. DD significantly mediated the association between denture use (indirect effect -0.047; 95%CI: -0.068-0.028; p < 0.001), toothbrushing frequency (indirect effect -0.041; 95%CI: -0.054-0.030; p < 0.001), and depressive symptoms. Denture use and toothbrushing frequency not only directly reduce the risk of depressive symptoms in older adults, but also indirectly affect depressive symptoms through DD.
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Depression , Diet , Oral Health , Toothbrushing , Humans , Aged , Depression/epidemiology , Oral Health/statistics & numerical data , Male , Female , Cross-Sectional Studies , China/epidemiology , Diet/statistics & numerical data , Toothbrushing/statistics & numerical data , Aged, 80 and over , Dentures/statistics & numerical data , Longitudinal Studies , Asian People/psychology , East Asian PeopleABSTRACT
Background: Most cancers are lifestyle-related and are thus preventable. Lifestyle habits can be improved by individual efforts; for example, because oral health is suggested to play a preventive role in cancer risk, toothbrushing is considered a critical and fundamental measure for controlling oral health. This study aimed to investigate the association between toothbrushing and cancer risk. Methods: Cross-sectional data from the Japan COVID-19 and Society Internet Survey, a large-scale (n = 32,000) online survey conducted in 2022, were used. From September 12 to October 19, 2022, questionnaires were distributed to candidates selected by simple random sampling from a Japanese Internet research company's panelists to represent the Japanese population. The association between toothbrushing and cancer risk according to cancer prevalence was then analyzed. Results: Among all 32,000 participants, 2,495 (7.8%) who had any cancer previously were analyzed. Multivariable logistic regression analysis revealed a significant association between toothbrushing habit and cancer risk. Conclusion: The findings of this study suggest that daily toothbrushing is essential for maintaining oral health and preventing cancer.
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AIM: To identify toothbrushing patterns among schoolchildren with no prior dental hygiene training and associate them with effectiveness for eliminating dental biofilm. MATERIALS AND METHODS: Eight calibrated dentists assessed dental biofilm, toothbrushing procedure and dental status and registered: grip, bristle angle with respect to tooth, type of movement, surfaces brushed, simultaneous brushing of both jaws, including all six sextants and duration of brushing dental biofilm before and after brushing was determined in 944 children. Frequency distribution was calculated for nominal variables and central tendency and dispersion for quantitative variables of the toothbrushing procedure. Effectiveness was evaluated in 236 children by calculating differences between biofilm levels before and after brushing using Student's test. A cutoff value was established for the difference in reductions in biofilm levels by means of an ROC curve. RESULTS: The variables including all 6 sextants and bristle angle showed positive association with biofilm reduction. The cutoff point for biofilm reduction for including all 6 sextants was 66.85% (OR 6.4 [3.6-11.38]). The cutoff value for biofilm reduction for bristle angle was 68.35% (OR 3.2 [1.83-5.8]). CONCLUSION: The variables associated with biofilm reduction can be used to optimize the modality of future educational interventions in schoolchildren.
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Background Attachments play a vital role in aligner-led orthodontic therapy, first passively through retention of the appliance and secondly, through bringing about tooth movement, by virtue of its active surfaces, to achieve treatment goals. Additionally, irregularities on the surface of attachments attract plaque adhesion. Thus the effect of brushing with different toothbrushes on the surface of attachments is an important factor to study. This would allow clinicians to better advise patients who are undergoing aligner therapy. Four types of brushes are available commercially, namely hard, medium, soft, and ultra-soft. This study analyses the interaction between the kind of toothbrush used and the wear of the surface of the aligner attachment, to understand the impact of a toothbrush on the attachment. Aim To observe the surface wear and change in the shape of the aligner attachment on brushing with four varying hardness of toothbrush bristle (ultra-soft, soft, medium, and hard) over six months to three years. Material and methods One attachment was bonded to the buccal surface of extracted premolars. One tooth with attachment was subjected to SEM analysis and the rest were divided into four groups of five teeth each, based on the type of toothbrush to be used. Brushing with hard, medium, soft, and ultra-soft toothbrushes was carried out in a brushing simulator in two cycles simulating six months, one year, 18 months, and three years of brushing. A contact profilometer was used to evaluate surface roughness before and after brushing and pre- and post-surface roughness values were compared to quantitate changes after which SEM analysis was carried out for qualitative assessment of the surface of the samples. The Shapiro-Wilks test was applied to evaluate the normality of the data, followed by the one-way ANOVA, and statistical significance was applied at p<0.05. Results At six months, the samples brushed with the medium toothbrush showed the least surface roughness (0.2±0.192) and those brushed with the ultra-soft toothbrushes showed the highest surface roughness (1.9±0.159). At one year, the samples brushed with the soft toothbrush showed the least surface roughness (0.46 ±0.31) and those brushed with the ultra-soft toothbrushes showed the highest surface roughness (2.12 ±0.12). At the 1.5-year point, the surface roughness of the samples was lowest in the ultra-soft toothbrush group (0.43±0.39) and the highest in the soft toothbrush group (1.6± 0.41). At the three-year point, the surface roughness of the samples was lowest in the ultra-soft toothbrush group (0.28 ± 0.17) and the highest in the medium toothbrush group (1.6 ± 0.31). Conclusion Ultra-soft toothbrushes have a high abrasive potential, as seen by higher surface roughness values over six months and one year. Morphometric changes were the most noticeable for attachments brushed by hard-bristled toothbrushes and medium-bristled brushes.
ABSTRACT
This study aims to investigate the impact of a tooth-brushing guidance system on the enchancement of the dental plaque removal in preschool children. In this study, we selected a group of 124 healthy children in which their aged were between 3 and 5 years old following by treatment at the Pediatric Dentistry Center at Jinzhou Stomatological Hospital (JinZhou, Liaoning Province, China). We then followed up to check and identify the Turesky modification of the Quigley-Hein plaque index (TMQHPI). Study group was randomly assigned to an experimental group in which they received constantly guidance on intelligent tooth-brushing and a control group which was used by manual brushing techniques. The total numbers in each group were 62 participants that were gone under the clinical investigation for seven days. The plaque index of both groups were assessed by using a plaque display instrument and a periodontal probe for up day 28. It was shown that the experimental group had a lower average TMQHPI value (0.98 ± 0.15) in comparison with control group (1.41 ± 0.17), and this difference was statistically significant (p < 0.05). The experimental group had a significantly lower TMQHPI value (0.89 ± 0.13) on the tongue/palatal side of the anterior teeth area in comparison with control group (1.41 ± 0.17) (p < 0.05). We observed that experimental group showed significantly lower TMQHPI value (1.16 ± 0.12) on the tongue/palatal side of the posterior dental region in comparison with control group (1.70 ± 0.13) (p < 0.05). It was confirmed a significant difference in the average plaque clearance rate between the experimental and control groups (p < 0.05). Our study clearly indicates that a developed method of toothbrush guide effectively improved the removal rate of plaque compared with manual tooth-brush, specifically in hard-to-reach areas like the tongue and palate.