Investigating the relationship between dental cavities and protective factors among children aged 0-5 years.

The purpose of this study was to determine the protective factors that contribute to the prevention of children aged 0-5 years from developing dental cavities. The oral hygiene practices of 266 children aged 0-5 years were assessed through surveys administered from 2019 to 2022 to identify clinical, dietary, social and parental factors. The Partial Least Squares (PLS) Regression and Artificial Neuron Networks (ANN) Models were used to determine protective factors associated with the prevention of dental cavities in children. The race distribution of the children as identified by caregivers is as follows: (1) Black or African-American (53.4%); (2) Asian (25.9%); (3) White (18.4%); and (4) Native American (2.3%). We found behavioral protective factors to significantly affect the oral health outcome (cavities) among children aged 0-5 years (p < 0.05). We also found that children whose parents/caregivers flossed their teeth were less likely to develop cavities. In addition, children were least likely to have cavities if their parents/caregivers used toothpaste and mouthwash, avoided sharing chewed food, and refrained from drinking 100% juice. In contrast, children were more likely to obtain cavities if their parents/caregivers had a lower education level, rarely cleaned their teeth, and often consumed marijuana, cow or goat milk, juice drinks and sugary beverages. The education level of parents, and on the contrary, oral hygiene practices of the family, play a significant role in influencing the prevalence of cavities in children aged 0-5 years.

Sugar-Sweetened Beverage Consumption and Caries Prevalence in Underserved Black Adolescents.

Purpose: The purpose of this study was to examine the association between sugar-sweetened beverage (SSB) consumption and dental caries prevalence among underserved Black adolescents. Methods: This was a cross-sectional study of 545 Black adolescents, ages 12 to 17 years, who participated in the Howard Meharry Adolescent Caries Study (HMACS). The outcome was dental caries prevalence, measured using the decayed, missing, and filled permanent tooth surfaces (DMFS) index. Participants were recruited from middle and high schools in Washington, D.C., USA, and Nashville, Tenn., USA. Questionnaires were used to assess beverage intake, demographic, and health-related behavioral characteristics. The multivariable analysis used marginalized zero-inflated Poisson regression (MZIP) stratified by toothbrushing frequency to estimate adjusted mean caries ratios (MRs), adjusted odds ratios (ORs), and 95 percent confidence intervals (95 percent CIs). Results: The mean age of the participants was 14.1 years. Participants in the highest quartile for SSB consumption had a higher caries ratio than those in the lowest quartile [MR equals (=) 1.59, 95 percent CI equals 1.15 to 2.20] and a lower odds of not being at risk for caries (OR = 0.24, 95 percent CI = 0.09 to 0.61). These findings were only observed among those brushing once a day or less (n =202). Conclusions: Among Black adolescents in this study who brushed once a day or less, high levels of sugar-sweetened beverage consumption were associated with greater caries prevalence and a reduced likelihood of remaining caries-free than those with lower levels of SSB consumption. Future studies will focus on interventions to reduce SSB consumption.

Food Insecurity, Meal Behaviors, Beverage Intake, and Body Mass Index in Underserved Adolescents.

OBJECTIVE: Associations between food insecurity, meal patterns, beverage intake, and body mass index (BMI) were investigated using data from the Howard Meharry Adolescent Caries Study. METHODS: Secondary analyses of food security status used the Wilcoxon rank sum, chi-square, and Fisher's exact tests. RESULTS: The group of adolescents (n=627) was 42.1% male, 14.2±1.9 years, 86.9% African American, and 19.9% food-insecure. Meal frequency, meal structure, most beverage intake, and BMI did not differ by food-security status. Adolescents from Washington, DC were more likely to be food insecure than adolescents from Nashville, TN (P=0.003). Most had unstructured meal patterns and irregular breakfast intake. Median milk intake was below and sugar-sweetened beverage intake above dietary recommendations. CONCLUSIONS: This study extends our knowledge concerning food insecurity in urban African American adolescents and suggests public health initiatives designed to encourage meal structure, increase milk intake, and reduce sugar-sweetened beverage intake can improve diet quality of underserved youth.

The contrasting short-term effects of COVID-19 on dental care practices in the United States.

OBJECTIVES: The study utilized a cross-sectional survey to determine the short-term effects of the COVID-19 pandemic on dental care practices. The authors hypothesized that the effects of the pandemic would indicate differences based on the ethnicity of the participating dentist. MATERIALS AND METHODS: The survey was available online between June 1, 2020 and July 10, 2020, a period when many dental offices remained closed, and for the most part, unable to provide non-emergency dental care. The link to the survey was made available to dentists through outreach to several national dental organizations. Descriptive statistics summarized the characteristics of the entire sample and Fisher's exact test was used to examine respondents' answers stratified by ethnicity using frequencies and percentages. RESULTS: All ethnic groups reported decreased revenue and African American dentists were the least likely to report a decrease in revenue compared to White and Other ethnic groups (84.2%, 87.2% and 92.9%). African American dentists were the most likely to report willingness to contribute to a task force to address the new challenges resulting from COVID-19 when compared to White and Other ethnic groups (46.4%, 18.8%, and 29.6%, respectively). African American dentists were more likely to indicate a need for a stronger connection to academic programs as compared to White or Other dentists in order to address current and future challenges (12.3%, 0.0%, and 9.1%). CONCLUSION: The COVID-19 pandemic has affected dental practices differently, highlighting racial disparities, and strategies that factor in the race or ethnicity of the dentist and the communities in which they practice need to be considered to ensure that underserved communities receive needed resources.

SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges.

The novel corona virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and the disease it causes, COVID-19 (Coronavirus Disease-2019) have had multi-faceted effects on a number of lives on a global scale both directly and indirectly. A growing body of evidence suggest that COVID-19 patients experience several oral health problems such as dry mouth, mucosal blistering, mouth rash, lip necrosis, and loss of taste and smell. Periodontal disease (PD), a severe inflammatory gum disease, may worsen the symptoms associated with COVID-19. Routine dental and periodontal treatment may help decrease the symptoms of COVID-19. PD is more prevalent among patients experiencing metabolic diseases such as obesity, diabetes mellitus and cardiovascular risk. Studies have shown that these patients are highly susceptible for SARS-CoV-2 infection. Pro-inflammatory cytokines and oxidative stress known to contribute to the development of PD and other metabolic diseases are highly elevated among COVID-19 patients. Periodontal health may help to determine the severity of COVID-19 infection. Accumulating evidence shows that African-Americans (AAs) and vulnerable populations are disproportionately susceptible to PD, metabolic diseases and COVID-19 compared to other ethnicities in the United States. Dentistry and dental healthcare professionals are particularly susceptible to this virus due to the transferability via the oral cavity and the use of aerosol creating instruments that are ubiquitous in this field. In this review, we attempt to provide a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the various effects it has had on the dental profession and patients visits to dental clinics. Finally, this review is a valuable resource for the management of oral hygiene and reduction of the severity of infection.

Porphyromonas gingivalis infection alters Nrf2-phase II enzymes and nitric oxide in primary human aortic endothelial cells.

BACKGROUND: Periodontal disease (PD) is known to be associated with endothelial dysfunction in patients with coronary artery and/or cardiovascular disease. In our study, we sought to explore the virulence of P. gingivalis (Pg) affecting glycogen synthase kinase 3 beta (GSK-3ß)/nuclear factor (erythroid-derived 2)-like 2 (Nrf2)/tetrahydrobiopterin (BH4 )/ nitric oxide synthase (NOS) expression in primary human aortic endothelial cells (pHAECs). METHODS: pHAECs were infected for 48 hours with Pg in vitro using the Human oxygen-Bacteria anaerobic coculture technique. Cell viability was determined, and target gene expression changes were evaluated by quantitative real-time polymerase chain reaction at the end of each incubation period. RESULTS: Pg impaired pHAEC viability 24 hours post-infection. Pg infection reduced mRNA expression levels of endothelial NOS (eNOS), Nrf2, and Phase II enzymes (heme oxygenase-1, catalase, superoxide dismutase-1) in a time-dependent manner. Significant (P <0.05) increase in the inflammatory markers (interleukin [IL]-1ß, IL-6, and tumor necrosis factor-α) were observed in the medium as well as in the infected cells. Interestingly, inducible NOS mRNA levels showed a significant (P <0.05) increase at 12 hours and 24 hours and were reduced at later time points. BH4 (cofactor of eNOS) biosynthesis enzyme dihydrofolate reductase (DHFR, salvage pathway) mRNA levels showed a significant (P <0.05) decrease, while mRNA levels of GSK-3ß were elevated. CONCLUSIONS: These results suggest that periodontal bacterial infection may cause significant changes in the endothelial GSK-3ß/BH4 /eNOS/Nrf2 pathways, which may lead to impaired vascular relaxation. Greater understanding of the factors that adversely affect endothelial cell function could contribute to the development of new therapeutic compounds to treat PD-induced vascular diseases.

An Approach to Engaging Schools In Oral Health Initiatives: The Howard Meharry Adolescent Caries Study (HMACS).

Use of community-based participatory research (CBPR) principles can help identify strategies for development and implementation of studies that can address oral health disparities disfavoring African American youth. This paper summarizes approaches of the Howard Meharry Adolescent Caries Study (HMACS) to provide sustained oral health services beyond the life of a research study.

Identification of Specific Oral and Gut Pathogens in Full Thickness Colon of Colitis Patients: Implications for Colon Motility.

Impaired colon motility is one of the leading problems associated with inflammatory bowel disease (IBD). An expanding body of evidence supports the role of microbiome in normal gut function and in progression of IBD. The objective of this work is to determine whether diseased full thickness colon specimens, including the neuromuscular region (critical for colon motility function), contain specific oral and gut pathogens. In addition, we compared the differences in colon microbiome between Caucasians (CA) and African Americans (AA). Thirty-nine human full thickness colon (diseased colon and adjacent healthy colon) specimens were collected from Crohn's Colitis (CC) or Ulcerative Colitis (UC) patients while they underwent elective colon surgeries. We isolated and analyzed bacterial ribosomal RNA (rRNA) from colon specimens by amplicon sequencing of the 16S rRNA gene region. The microbiome proportions were quantified into Operational Taxonomic Units (OTUs) by analysis with Quantitative Insights Into Microbial ecology (QIIME) platform. Two hundred twenty-eight different bacterial species were identified by QIIME analysis. However, we could only decipher the species name of fifty-three bacteria. Our results show that proportion of non-detrimental bacteria in CC or UC colon samples were altered compared to adjacent healthy colon specimens. We further show, for the first time in full thickness colon specimens, that microbiome of CC and UC diseased specimens is dominated by putative oral pathogens belonging to the Phyla Firmicutes (Streptococcus, Staphylococcus, Peptostreptococcus), and Fusobacteria (Fusobacterium). In addition, we have identified patterns of differences in microbiome levels between CA and AA specimens with potential implications for health disparities research. Overall, our results suggest a significant association between oral and gut microbes in the modulation of colon motility in colitis patients.

Role of oral and gut microbiome in nitric oxide-mediated colon motility.

Periodontal disease (PD), a severe form of gum disease, is among the most prevalent chronic infection in humans and is associated with complex microbial synergistic dysbiosis in the subgingival cavity. The immune system of the body interacts with the microbes as the plaque extends and propagates below the gingival sulcus. Once bacteria reach the gingival sulcus, it can enter the blood stream and affect various areas of the human body. The polymicrobial nature of periodontal disease, if left untreated, promotes chronic inflammation, not only within the oral cavity, but also throughout the human body. Alterations seen in the concentrations of healthy gut microbiota may lead to systemic alterations, such as gut motility disorders, high blood pressure, and atherosclerosis. Although gut microbiome has been shown to play a vital role in intestinal motility functions, the role of oral bacteria in this setting remains to be investigated. It is unclear whether oral microbial DNA is present in the large intestine and, if so, whether it alters the gut microbiome. In addition, polybacterial infection induced PD reduced nitric oxide (NO) synthesis and antioxidant enzymes in rodent colon. In this review, we will discuss the interactions between oral and gut microbiome, specifics of how the oral microbiome may modulate the activities of the gut microbiome, and possible ramifications of these alterations.

Interprofessional Collaborative Practice: An Oral Health Paradigm for Women.

Interprofessional collaborative practice (IPC) is paramount to the future of oral health education. As such, it is critical that today's health care education continues to expand its curriculum to promote oral health as an essential component in the IPC approach to women's health. This article explores models that can be implemented using an IPC framework to foster better approaches in the delivery of care to female patients.

Assessing dental caries prevalence in African-American youth and adults.

It has been well documented that dental caries affect millions of children in the USA with the majority experiencing decay by the late teens. This is especially true for low-income minorities. The objective of this descriptive study was to determine dental caries prevalence in a sample of low-income African-American youth and adults. A total of 1034 individuals were examined. They were divided into two age groups: youth, 9-19 years and adults, 20-39 years. Females comprised approximately 65 percent (64.5) of the study group. The DMFT Index was used to determine caries prevalence in this study population. The DMFT findings showed that approximately 73 percent (72.9 percent) of the youth had either decayed, missing or filled teeth. Male youth had slightly higher DMFT mean scores than female youth: male mean = 7.93, standard error = 0.77, female mean = 7.52, standard error = 0.36; however, as females reached adulthood their DMFT scores increased substantially, mean = 15.18, standard error = 0.36. Caries prevalence was much lower in male adults, DMFT, mean = 7.22, standard error of 0.33. The decayed component for female adults mean score was 6.81, a slight increase over adult males, mean = 6.58. Although there were few filled teeth in both age groups, female adults had slightly more filled teeth than male adults, females mean = 2.91 vs. males; however, adult males experienced slightly more missing teeth, mean = 5.62 as compared to adult females, mean = 5.46. n = 2.20. Both female and male adults had an increase in missing teeth. As age increased there was a significant correlation among decayed, missing and filled teeth as tested by Analysis of Variance (ANOVA), p < 0.01. A significant correlation was found between filled teeth by sex, p < .005. We conclude that caries prevalence was higher in female and male youth, but dental caries increased more rapidly in females as they reached adulthood.

Streptococcus mutans levels and caries prevalence in low-income schoolchildren.

Previous studies have shown that persons having high Streptococcus mutans levels in the saliva are "at risk" for dental caries. Most investigators agree, that if high levels of S. mutans were identified early in the life of at-risk children, dental decay could be reduced or eliminated through intervention. The purpose of this study is to show an association between S. mutans levels and caries prevalence in a sample of elementary school children. The study group consisted of 242 school children, ages 5-13 years. The subjects were divided into two age groups, 5-8 years and 9-13 years. Approximately 59 percent were African Americans. The sample of 242 children were equally females and males, 50 percent in each group. The Dentocult SM Test was used to make S. mutans determinations. The df-t index was used to determine the number of decayed and filled teeth of children ages 5-8 years; the DMF-T Index estimated the number of decayed, missing or filled teeth of children ages 9-13 years. Dental caries were found in 58 percent of the children (mean = 2.67, and range of 1-11). Approximately 47 percent of the children with caries had high S. mutans levels (100K-1M). Females had higher S. mutans levels than males in the 9-13 age group, p < .05. Analysis of Variance Test indicated that S. mutans levels for older females (ages 9-13) were significantly higher than those observed in males the same age (p < .01). This trend was not observed in younger children, ages 5-8 years. In addition, no significant difference or interaction was noted by sex for S. mutans levels and decayed or filled teeth (df-t) for younger children. We conclude that high levels of Streptococcus mutans are related to increased number of decayed teeth and conversely, low Streptococcus mutans levels are related to fewer dental caries. This study was supported in part by Colgate-Palmolive Company and the National Dental Association Foundation, Inc.