Periodontal pathogens of the interdental microbiota in a 3 months pregnant population with an intact periodontium.

Steroid hormones and the oral microbiota of pregnant women both appear as cumulative risk factors for gingivitis. This cross-sectional study, using real-time PCR, investigated the composition and diversity of the microbiota in interdental spaces of 3 months pregnant women with intact periodontium according the 2018 EFP/AAP classification. Bacteria identified were belonged to the red (Porphyromonas gingivalis Treponema denticola, and Tanerella forsythia), orange (Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Parvimonas micra), and green (Eikenella corrodens and A. actinomycetencomitans) Socransky complexes. Approximatively 109.11 bacteria were counted per interdental space in pregnant women. Bacteria from the red complex represented 33.80% versus 62.81% for the orange group versus 3.39% for the green group of the total number spread over the 3 groups. Dietary habits and physical activity did not have a significant impact on interdental microbiota, although a decrease in the median amount of 9 periodontopathogens was observed when fruit and vegetable consumption increased. Pregnant women who brushed their teeth at least twice a day had lower counts of total bacteria and 9 periodontal pathogens than those who brushed less. In 3 months pregnant women at high risk of periodontal disease (>30% bleeding sites), the dendogram revealed 2 clusters of the 9 periodontopathogens. This provides further support for the "key pathogen" hypothesis, among which Porphyromonas gingivalis plays a key role, indicating that specific bacteria in limited quantities can influence the host immune system and convert the microbiota from symbiotic to dysbiotic to induce inflammatory disorder. As a result, this study reported that 3 months pregnant women with healthy periodontium had high levels of interdental bleeding and a dysbiotic microbiota with periodontal pathogens of the Socransky orange and red complexes. These subjects were therefore potentially at increased risk of developing periodontal disease and, consequently, an adverse pregnancy outcome. So, preventive oral prophylaxis measures, in particular individual interdental prophylaxis, should be implemented as soon as pregnancy is established.

Prevalence, Severity of Extension, and Risk Factors of Gingivitis in a 3-Month Pregnant Population: A Multicenter Cross-Sectional Study.

The scope of this study was to assess the prevalence, severity of extension, and risk factors of gingivitis among pregnant women. In this cross-sectional study, 220 nulliparous women at 3 months of pregnancy were recruited in 2022 at the first obstetrical visit in Dakar, Senegal. Demographic characteristics, lifestyle habits, prenatal clinical status, and oral clinical parameters were recorded. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. Eighty-eight percent of women had gingivitis, 15% were classified as moderate and 73% as severe. A total of 66.7% (95% CI [28.8-92.1]) of the sites had bleeding on interdental brushing. The odds for gingivitis decreased significantly for women consuming more than five portions of fruits and vegetables per day (OR = 0.15; 95% CI [0.03-0.66]) and increased in women who had a professional activity (OR = 6.75; 95% CI [1.27-35.87]) and high education. Concomitantly, the percentage of dental plaque (OR = 131.6; 95% CI [10.80-1619.71] and the severity of clinical attachment loss (OR = 7.70; 95% CI [3.16-18.92]) were important risk factors. Inverse associations were observed with increasing body mass index (OR = 0.76; 95% CI [0.63-0.93]). Our results underline that gingivitis cases and bleeding were particularly high among 3-month pregnant women. Literacy and adequate oral hygiene actions to modify behaviors and to achieve meticulous biofilm disorganization could make a favorable change in the gingival health outcome. Additionally, further research is necessary to precisely determine the role of biofilm-induced gingivitis and systemic-induced gingivitis in improving gingival conditions.

Determinants of maternal and household social inequalities of dental caries among Senegalese children in the Department of Pikine.

Introduction: the problematic of social Inequalities in oral health remains a global concern; it constitutes evidence of social injustice. The present work aims to study the determinants of maternal and household social inequalities of children´s dental caries in Pikine. Methods: cross-sectional epidemiological survey has been conducted in the department of Pikine, Senegal on 315 children aged 3 to 9 and their mothers. The clinical data on children´s caries have been obtained by clinical examination and the socio-economic data by a questionnaire submitted to mothers. Pearson chi-square and trend tests as well as a logistic model were used in the data analysis. Results: the prevalence of dental caries in children was 64.8% and the mixed decayed, filled, missing (DFM) index was 2.5 (±2.7). The trend test showed significant inequalities in the prevalence of dental caries according to level of studies (p<0.001), profession (p<0.010) and contacts frequency (p<0.001) of mothers; the level of wealth (p<0.001) and structure (p<0.005) of households. According to the logistic regression model, the level of secondary or university education [OR (IC 95%) = 0.59 (0.33'>OR (IC 95%) = 0.59 (0.33-0.93)] or social network dynamism [OR (IC 95%) = 0.32(0.15'>OR (IC 95%) = 0.32(0.15-0.67)] of mothers; as well as wealthy families [OR (IC 95%) = 0.23(0.08'>OR (IC 95%) = 0.23(0.08-0.64) were associated to fewer risks of dental caries among children. Conclusion: some socio-economic characteristics of the mother and the household social conditions are identified as determinants of dental caries social inequalities in Children. Proportionate universalism may be a good approach to reduce this problematic in Pikine.

Provenance des prescriptions de médicaments reçues dans les officines de pharmacie du Département de Dakar / Origin of drug prescriptions received in pharmacies in the Department of Dakar

Introduction. L'accessibilité à des médicaments de qualité constitue un véritable problème de santé publique en Afrique. Cela est dû à des besoins énormes en soins de santé associés à des ressources limitées. La prescription de médicaments qui est un acte médical pour traiter les malades après avoir posé le diagnostic, est réservée aux professionnels de santé. L'objectif de ce travail est d'étudier la provenance des prescriptions de médicaments reçues dans les officines de Dakar. Matériels et méthodes. Il s'agit d'une étude descriptive et transversale. Elle porte sur l'exploitation de prescriptions médicales reçues dans des officines du département de Dakar. Résultats. Les résultats révèlent que plus de la moitié des prescriptions soit 61%, provient du secteur privé et 30.52% sont faites par des médecins généralistes. De plus, la classe de la parasitologie et infectiologie est la plus prescrite (18.26%). Conclusion. L'analyse de ces paramètres nous aide à mieux évaluer la situation sanitaire pour estimer les besoins en médicaments et ainsi faire des recommandations pour une meilleure accessibilité.

Introduction. Accessibility to quality drugs is a real public health problem in Africa. This is due to huge health care needs associated with limited resources. The prescription of drugs, which is a medical procedure for treating patients after having made the diagnosis is reserved for health professionals. The objective of this work is to study the origin of prescription of drugs received in the pharmacies of Dakar. Materials and methods. This is a descriptive and cross-sectional study. It is based on the use of medical prescriptions received in pharmacies in the department of Dakar. Results. The result reveal that more than half of the prescriptions are 61%, come from the private sector and 30,52% are made by general practitioners. In addition, the class of parasitology and infectiology is the most prescribed (18,26%). Conclusion. The analysis of these parameters helps us to better assess the health situation in order to estimate the drug needs and thus make recommendations for a better accessibility.

Chemical vs. natural toothpaste: which formulas for which properties? A scoping review.

Introduction: The proliferation of the oral care industry has made it more challenging for shoppers to zero in on the best possible toothpaste for their preventative requirements. It also makes the toothpaste's various components safer. Objective: The researchers set out to evaluate the state of information about the biological properties and cytotoxicity of adult toothpaste so that they might make some informed recommendations. Methods: A scoping review of research published between 2015 and 2020 according to PRISMA guidelines was performed. Results: In vitro clinical trials account for 44% of the papers, in vivo clinical trials for 25%, systematic reviews for 19%, and metaanalyses for 12%. They have active chemical components that have been shown to be antimicrobial, anti-inflammatory, or desensitizing. Herbal toothpaste has these characteristics and is very secure to use. Toothpaste with sodium lauryl sulfate has been found to be harmful. Conclusions: Scientists have investigated the biological effects of a wide range of chemically active compounds and plant extracts. Herbal toothpaste, it has been discovered, is both efficient and secure. Companies making toothpaste should be required to clearly label the product's qualities, active ingredients, and potentially harmful ingredients on the packaging.

Evaluation of Oral Hygiene-Related Mobile Apps for Children in Sub-Saharan Africa.

In sub-Saharan Africa, oral health is a real epidemiological challenge. Mobile applications represent a hope for the learning of oral hygiene in children and the fight against oral diseases. This study overviews and assesses the quality of mobile applications linked to oral hygiene for children currently featured on the iOS and Android stores in sub-Saharan Africa. Ten oral health professionals (OHP) used the French Mobile App Rating Scale (MARS-F) to rate 15 selected applications. The highest MARS-F scores for overall quality were reported for Bonne nuit Caillou (3.89 ± 0.74), Mon Raccoon (3.63 ± 0.95), and Chomper Chums (3.54 ± 0.54) while the lowest MARS-F scores for overall quality were achieved by Brushing time (2.31 ± 0.61), De belles dents (2.55 ± 0.55) and Brushing Hero (2.77 ± 0.53). The subjective quality scores ranged from 1.50 ± 0.68 for Brushing time to 3.25 ± 0.97 for Bonne nuit Caillou. Specificity scores ranged from 1.95 ± 0.88 (Brushing time) to 3.75 ± 0.84 (Bonne nuit Caillou). Thus, OHP rated positively the quality of the majority of mobile applications linked to oral hygiene for children, their effect on users' knowledge, attitudes, and intentions to change, and the probability of effective oral hygiene behavior modification. They stated that they would recommend their use to their patients who need them. However, studies analyzing the change in oral hygiene behavior of children using these apps need to be conducted.

Characteristics of oral health literacy in Senegal: A cross-sectional study among women in the Department of Pikine.

Senegal having a significant prevalence of socially differentiated oral diseases, oral health literacy (OHL), an individual and social resource, should be considered alongside a remedial response. This work aimed to analyze women's OHL characteristics. A cross-sectional study on 315 women in Pikine County was carried out, using the Oral Health Literacy-Adult Questionnaire (OHL-AQ) for the OHL data collection and a questionnaire for the women's socioeconomic characteristics data. These women had an OHL average score of 6.5±3.1 and a median of 6. Among them, 56.5% had a seemingly low OHL level, a little over 68.9% had a score above the median as regards the "listening, communication and understanding" aspect, 58.4% to "decision making", 55.2% to "understanding numbers" and 33% to "reading and understanding". According to a multivariate analysis, secondary and higher educated women (p<0.001) with an active social network (p<0.023), in a wealthy household (p<0.0001) and of nuclear household type (p<0.036) had a higher OHL level. Women in Pikine have low OHL and are from working- class households. Therefore, oral health policies must take into account the women's social network contribution to the OHL improvement.

Characteristics of oral health literacy in Senegal: A cross-sectional study among women in the Department of Pikine

Senegal having a significant prevalence of socially differentiated oral diseases, oral health literacy (OHL), an individual and social resource, should be considered alongside a remedial response. This work aimed to analyze women's OHL characteristics. A cross-sectional study on 315 women in Pikine County was carried out, using the Oral Health Literacy-Adult Questionnaire (OHL-AQ) for the OHL data collection and a questionnaire for the women's socioeconomic characteristics data. These women had an OHL average score of 6.5±3.1 and a median of 6. Among them, 56.5% had a seemingly low OHL level, a little over 68.9% had a score above the median as regards the "listening, communication and understanding" aspect, 58.4% to "decision making", 55.2% to "understanding numbers" and 33% to "reading and understanding". According to a multivariate analysis, secondary and higher educated women (p<0.001) with an active social network (p<0.023), in a wealthy household (p<0.0001) and of nuclear household type (p<0.036) had a higher OHL level. Women in Pikine have low OHL and are from working- class households. Therefore, oral health policies must take into account the women's social network contribution to the OHL improvement.

Effect of Oral Prophylactic Measures on the Occurrence of Pre-Eclampsia (OP-PE) in High-Risk Pregnant Women: A Cluster Randomized Controlled Trial.

Pre-eclampsia (PE), a pregnancy-specific hypertensive disorder, characterized by the development of placental endothelial dysfunction, remains a major source of maternal and perinatal morbidity and mortality, especially in low- and middle-income settings. Periodontal disorders during pregnancy, and particularly periodontal pathogens, may be related to the risk of PE. Standard oral hygiene methods, based mainly on the joint use of toothbrushes and interdental brushes, reduce periodontal inflammatory risk and modulate the dysbiosis of the oral microbiome. The aim of this trial is to compare the PE outcomes in high-risk pregnant women receiving oral prophylactic measures to a control group. This trial is designed as a two-arm, parallel, cluster randomized controlled trial with the antenatal obstetric clinic as the unit of randomization and an allocation ratio of 1:1. The pregnant women will be included at 3 months of pregnancy and will be followed throughout the pregnancy. The primary outcome measure will be the incidence of PE from a baseline during the pregnancy. Secondary outcomes measures will include changes from the baseline in quantification of the pathogenic bacterial load of the interdental microbiota, the severity scores of periodontal indicators, and the incidence of adverse perinatal outcomes. This trial should demonstrate that the implementation of daily oral hygiene reduces oral dysbiosis, the incidence of periodontal disease, and the risk of PE.

Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review.

BACKGROUND: Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. OBJECTIVES: This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. METHODS: The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. RESULTS: Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. CONCLUSION: A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists.

The role of health insurance in the coverage of oral health care in Senegal.

Oral diseases costs are among the most expensive health care benefits. In Senegal, households contribute up to 37.6% of the national health spending through direct payments. The aim of this work was to study the role of health insurance in the coverage of oral health care in Senegal. The study was based on health insurance agents and policyholders. The study reveals that oral health care coverage through health insurance still does not meet requirements for treatment of oral infections. In financial terms, oral health care costs health insurance too much. As a result, carriers cover them partially. On top of that, the majority of the population's lack of knowledge about mutual, because they have a little background on oral health care, the latter weighs heavily on health insurance leading to the use of self-medication, traditional medicine and handicraft prosthetists. The analysis reveals an unequal access to oral health care through the health insurance system. To bring under control the expenditure for oral health care, carriers and dental surgeons must work together to raise the populations' awareness on community solidarity.

Relation entre santé parodontale chez la femme enceinte et faible poids du nouveau-né à la naissance à Dakar/Sénégal: étude cas-témoin

INTRODUCTION: Plusieurs facteurs de risques ont été incriminés dans la survenue du faible poids. Cependant Barnett et al trouvent que 25% des naissances de faible poids ou prématurés se produisent sans facteurs de risque connus. La relation entre la maladie parodontale et la grossesse et particulièrement le faible poids à la naissance a été évoquée par Offenbacher en 1996. L'objectif de ce travail est d'étudier la relation état parodontal chez la femme enceinte et la survenue du faible poids à la naissance du nouveau-né. MÉTHODE: L'étude était de type cas-témoin portant sur 397 patients dont 129 femmes enceintes donnant un bébé de faible poids (cas) versus 258 femmes enceintes donnant un bébé de poids normal (témoins). Les données collectées concernaient les caractéristiques sociodémographiques, les habitudes de vie, les données concernant le faible poids et celles parodontales : indice de plaque, indice de saignement papillaire perte d'attache clinique, profondeur de poche et le CPITN. Les données en analyse univariée étaient exprimées en proportions et moyennes puis des rapports de cotes avec leurs intervalles de confiance en analyse multivariée. RÉSULTATS: Les caractéristiques parodontales sont plus élevées chez les cas que chez les témoins. Il apparait que la parodontite était significativement associée au faible poids (P= 0,00013) ajustée sur l'âge de la mère, l'IMC et les autres paramètres parodontaux. L'âge de la mère et l'indice de plaque étaient marginalement associés au faible poids (P= 0,05 et 0,053) tandis que l'IMC, l'indice gingival et de saignement papillaire étaient aussi associés à la survenue du faible poids

The role of health insurance in the coverage of oral health care in Senegal

Oral diseases costs are among the most expensive health care benefits. In Senegal, households contribute up to 37.6% of the national health spending through direct payments. The aim of this work was to study the role of health insurance in the coverage of oral health care in Senegal. The study was based on health insurance agents and policyholders. The study reveals that oral health care coverage through health insurance still does not meet requirements for treatment of oral infections. In financial terms, oral health care costs health insurance too much. As a result, carriers cover them partially. On top of that, the majority of the population's lack of knowledge about mutual, because they have a little background on oral health care, the latter weighs heavily on health insurance leading to the use of self-medication, traditional medicine and handicraft prosthetists. The analysis reveals an unequal access to oral health care through the health insurance system. To bring under control the expenditure for oral health care, carriers and dental surgeons must work together to raise the populations' awareness on community solidarity

Dental Care Risk Management Provided by Social Protection Institutions of Senegal.

Nowadays in Senegal, located in West Africa, social protection institutions are confronted with a substantially increased healthcare expenditure in general, and oral care in particular. The ability of the leadership to use techniques to contain the impact of risks they are facing determine their viability. The aim of our study was to analyze the risk management of dental care coverage by those institutions. The study was descriptive, extensive and focused on all active social protection Institutions in Senegal since 2005, at least. Our results showed that, in spite of the implementation of risk management mechanisms such as patient co-payment (97% of institutions), coverage ceiling (26%) and dentist council (15%), healthcare expenditure still growing. For the containment of oral care expenditure increase, it is important to raise awareness among social protection institutions for a greater use of existing risk management mechanisms.

Strategies to promote better research on oral health in Africa: A Delphi consensus study.

BACKGROUND: Research on oral health contributes to improved health outcomes; it is an indispensable tool in health policy. But how to fill the gaps in research oral health and to strengthen its capacity is the question. The main objective of the present study is to identify the current status of oral health research and potential strategies, thereby strengthening the research infrastructure and capacity. Delphi consultation, in the perspective of assisting decision-makers to identify strategies to promote better research on oral health in Africa, was initiated. DESIGN AND METHODS: The panels of 30 experts were asked to complete the questionnaire with 42 items into four groups by web survey. Each indicator statement was considered to be in consensus if the expert's opinion rating was of "A or B" for more than 75% in a scale of seven categories. Quantitative analysis was made from the answers of Delphi round. RESULTS: There was a strong consensus about three items concerning the role of oral health research, the development of research policy for oral health going through an effective governance of research institutes, migration of researchers and fund raising. CONCLUSION: This study shows strong many dispersal opinions by experts, but highlights the need for to improve the effectiveness of oral health research capacity strengthening activities. Africa's researchers, policy makers and partners will have to give special attention to ensuring that knowledge generated from oral health research is acted on to improve health for all.

Current status of oral health research in Africa: an overview.

BACKGROUND: Research in oral health contributes effectively to decisions and strategies aimed at improving the oral health of populations. Further contributions to enhance current knowledge of oral health in Africa are required. OBJECTIVES: The principal objective of this study was to produce an analysis of oral health research published from different subregions of Africa and to estimate bilateral and multilateral international cooperation in oral health research during the period 2005-2010. METHODS: The PubMed database was searched for published articles on topics related to oral health in Africa. A total of 935 oral health-related articles were retrieved during April and May 2011. RESULTS: Publications emanating from Nigeria and South Africa accounted for a striking 68% of all oral health-related material published from Africa during the study period. Researchers from 30 different countries had participated in collaboration on at least one published article. A total of 262 journals had published at least one item examining oral health in Africa, but only 29 journals had published more than seven articles. These 29 journals accounted for 66% of all published material and induced non-African reviews (26%) and African reviews (40%). CONCLUSIONS: This study shows strong variation among countries in the production of articles on oral health whereby rich countries produce greater quantities of published research and poorer nations more frequently develop research partnerships with other countries.