Diet, Oral Hygiene Habits, and Approach to Dental Visits of Early School-Aged Children during the COVID-19 Pandemic and Possible Long-Term Health Consequences.

INTRODUCTION: Early school-aged children are in a transitional phase from primary to permanent dentition. Established dietary and oral hygiene habits will influence the condition of the oral cavity in the future. AIM: This study aimed to evaluate alterations in early school children's dietary and oral hygiene practices during the COVID-19 pandemic and to anticipate potential long-term health implications. MATERIAL AND METHODS: This cross-sectional online study involved guardians of Polish children aged 6-10 years, living in Western Poland, who were socially isolated at home during the COVID-19 pandemic. A total of 180 guardians were invited to participate in this study. The questionnaire included 17 questions divided into four different sections-the child's anthropometric data, dietary habits, oral health, and attitude to dental visits. RESULTS: The survey was completed by 106 guardians. The mean (standard deviation) age of the children was 8.12 (0.93) years (range 6-10 years). Overall, 24.5% of the surveyed individuals reported buying healthy products (fresh vegetables, fruit) more frequently during the pandemic. Furthermore, 35.8% admitted to snacking between meals more frequently and 16.0% less frequently. Almost one-quarter of the parents acknowledged that their children were less motivated to maintain oral hygiene during the pandemic and 28.3% declared a lower frequency of visits to the dentist from the outbreak of the pandemic for two main reasons: a fear of coronavirus transmission and economic reasons. CONCLUSIONS: In the group studied, the results of the assessment indicate that the COVID-19 pandemic had some effects on oral health that may lead to an increased risk of oral disease development, such as tooth decay in children. None of the respondents noticed an increase in their child's motivation about good oral hygiene despite spending more time at home. The irregularity of follow-up visits for one-third of the respondents hindered preventive measures and the continuation of dental treatment.

Evaluation of Undergraduate Learning Experiences in Pediatric Dentistry during the COVID-19 Pandemic.

The aim of the study was to analyze students' opinions on the learning outcomes they achieved during clinical classes in pediatric dentistry. The classes were run in various periods: before the SARS-CoV-2 coronavirus pandemic (onsite classes), in the first months of the pandemic (online classes), and in the following months of the pandemic (onsite classes with additional infection control and administrative changes in patients' admission procedures). MATERIAL AND METHODS: The research was conducted among fifth-year dentistry students at Poznan University of Medical Sciences. Students who completed the entire course and passed the diploma exam in pediatric dentistry were asked to complete the anonymous questionnaire providing their opinion. RESULTS: The research results showed that, in the students' opinion, clinical classes-regardless of their form-allowed them to achieve the knowledge necessary to perform pediatric dental procedures. However, the students appreciated onsite classes significantly more compared to information and communication technologies (ICT) classes in gaining practical skills and social competence. CONCLUSIONS: (1) The significant limitations introduced because of the SARS-CoV-2 pandemic impacted the development and implementation of modern online teaching techniques, which may very well be applied to convey theoretical knowledge after the pandemic has ended. (2) Skills and social competence, indispensable in the future dental practice of dental students, can only be obtained during onsite classes. (3) Medical universities should design standards of teaching to enable them to address a possible epidemiological threat in the future, which will enable rapid response and safe continuation of practical dental education during a pandemic.

Fluoride Intake and Salivary Fluoride Retention after Using High-Fluoride Toothpaste Followed by Post-Brushing Water Rinsing and Conventional (1400-1450 ppm) Fluoride Toothpastes Used without Rinsing.

This study aimed to compare the fluoride intake and salivary fluoride levels after brushing with conventional (1400-1450 ppm) fluoride toothpaste containing different fluoride agents: amine fluoride (AmF), sodium fluoride (NaF), sodium monofluorophosphate (SMFP), potassium fluoride (KF), and a high-fluoride (5000 ppm) toothpaste containing NaF. Fourteen volunteers took part in the study. They were instructed to brush and spit without rinsing after using conventional toothpaste or brush and rinse with water after using a high-fluoride toothpaste. Fluoride concentrations were determined using ion-selective fluoride (09-37 type) in the saliva samples before and after procedures. Fluoride intake was estimated based on fluoride recovered after brushing. Additionally, the amount of fluoride present in the oral fluids and lost during the rapid clearance phase after toothbrushing was calculated based on salivary fluoride levels and saliva flow immediately after brushing. Salivary fluoride after using high-fluoride toothpaste was significantly higher than those observed after conventional products. Two hours after brushing, salivary fluoride concentrations did not differ significantly from baseline values (p > 0.05) unless a high-fluoride product was used. Results indicate that by refraining from rinsing after brushing with conventional toothpaste, we cannot obtain fluoride retention in saliva as with high-fluoride toothpaste. Fluoride ingestion was higher after using a high-fluoride product.

Oral Care Recommendation for Cystic Fibrosis Patients-Recommendation for Dentists.

Cystic fibrosis (CF) is a genetic disease that is caused by a defect in the gene coding for the transmembrane cystic fibrosis transmembrane conductance regulator (CFTR). Research papers published so far point out that despite the numerous dental treatment needs of CF patients, there are no oral care guidelines for this group of patients. The aim of the article is to propose standards of dental prophylactic and therapeutic procedures for CF patients in different age groups. Regardless of the CF patient's age, dental check-ups should be scheduled at least every 6 months. However, taking into account the actual condition of the individual CF patients, therapeutic visits may be scheduled for earlier dates, to provide well-fitting treatment, considering the level of risk of oral diseases. The described management standards may be helpful and may improve the quality of dental care provided to CF patients.

Diagnosis of Papillon-Lefèvre syndrome: review of the literature and a case report.

Papillon-Lefëvre syndrome (PLS), classified as ectodermal dysplasia, is an autosomal recessive condition related to the cathepsin C (CTSC) gene mutation. The first clinical symptoms, occurring most commonly between the ages of 1 and 4, are palmoplantar hyperkeratosis and also periodontitis resulting in the loss of most or all teeth in the same sequence in which they erupted. Most often the redness of palms and soles precede the occurrence of keratoderma. Moreover, excessive sweating, moderate mental retardation, the tendency to purulent skin and internal organs infection may occur. Lack of cathepsin seems to have a crucial role in the intensity of symptoms. In most of the patients, there can be observed impairment of phagocytosis and chemotaxis of neutrophils, granulocytes, leukocytes and cytotoxic lesion of fibroblasts and macrophages. Also, functional impairment of lymphocytes, neutrophils, and monocytes is observed. The study, using flow cytometry, showed a decreased percentage of T cells CD8+ and increased CD4:CD8 ratio.

Limited Mandibular Movements as a Consequence of Unilateral or Asymmetrical Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis Patients.

This study aimed to assess the asymmetry of the lower face and motor dysfunction of the masticatory system resulting from unilateral or asymmetrical bilateral temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) patients. The study consisted of clinical examination and cone beam computed tomography (CBCT) of TMJs. Statistical analysis showed correlations between several factors: facial asymmetry and mandibular lateral deviation; the direction of mandibular deviation and the degree of radiological deformities in TMJs; the child's age at the time of the onset and the range of lateral movement towards the healthy or less destructed joint. In addition, there was a significant difference in ranges of lateral movements; a significantly smaller range was observed for the joint with fewer condylar abnormalities compared to the range in the opposite direction. In JIA children, among the clinical markers of unilateral or asymmetrical TMJ involvement, the asymmetry of the lower face, deviation of the mandible on opening, and an uneven range of mandibular lateral movements deserve attention. The obtained results do not show a relationship between the degree of condylar changes and the asymmetry of the lower face and the presence and degree of mandibular motor dysfunction.

Adolescent idiopathic scoliosis and malocclusion - a cross sectional study of female patients without previous orthodontic treatment.

The purpose of the present study was to assess the prevalence of various types of malocclusions in a group of female patients with adolescent idiopathic scoliosis (AIS), as well as the association between occlusal anomalies and the side, location, and severity of the spine deformity. The study group was comprised of 60 females aged 12-16 years with AIS and 54 healthy controls. Apart from clinical examination, alginate impressions and wax bites were taken. Occlusal traits were assessed on the casts in maximum intercuspation. Data were statistically analyzed with a significance taken as p < 0.05. All patients with AIS showed at least one abnormal orthodontic trait, while 9 (16.7%) patients from the control group had dentition free from any orthodontic anomaly. The difference was statistically significant (p = 0.0032). In the sagittal dimension, patients with AIS had a higher frequency of bilateral distocclusion and unilateral mesiocclusion as compared to the control group (p = 0.0004 and p = 0.0034, respectively). They also showed crowding, increased overjet and overbite more often than healthy age- mates (p = 0.0417, p = 0.0121, and p = 0.0166, respectively). Regarding the association between site, side, or severity of scoliosis and the occurrence of the malocclusion, asymmetric molar occlusion was more frequently observed in patients with right convex (p = 0.0149), while unilateral mesiocclusion, appeared more often in patients with the thoracic apex of the curve (p = 0.0349). The results emphasize a need for collaboration between orthopedists and orthodontists in the complex medical care for scoliotic individuals. Orthodontic treatment can alleviate negative impact that a malocclusion has on the oral health, aesthetics, and psychological well-being of this vulnerable group of patients.

Periodontal condition and periodontal risk assessment in adult patients with cystic fibrosis.

INTRODUCTION: The presence of chronic inflammation in the mouth, such as infectious disease of the periodontal tissues, may be the reservoir of microorganisms that are not usually present, including Pseudomonas aeruginosa. OBJECTIVE: The purpose of the study was to create a profile of periodontal conditions and periodontal risk assessment in adult patients with cystic fibrosis. MATERIAL AND METHODS: The study involved 22 patients with cystic fibrosis (CF) aged 29.43 years. The following parameters were included in the clinical study: number and cause of permanent teeth loss (excluding third molars), the presence of plaque (PCR), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL). On the basis of obtained clinical data, the periodontal status and the periodontal risk were determined. RESULTS: The study showed healthy periodontal tissues in 9 people (41%), gingivitis in 5 (23%), and mild periodontitis in 8 (36.36%). The periodontal risk in the vast majority of patients (90.91%) was at a low level - only 2 people, on average. CONCLUSIONS: The poor oral hygiene in CF patients indicates the need to develop standards of dental care for this group aimed at education and elimination of risk factors for oral diseases. The obtained results of clinical trials do not rule out the likelihood of auto-infections of the respiratory system originating from periodontal tissues, which, in CF patients, may adversely affect the general state of health and conducted therapy.

Dental Anomalies in Rare, Genetic Ciliopathic Disorder-A Case Report and Review of Literature.

BACKGROUND: Primary ciliary dyskinesia (PCD) is a rare, ciliopathic disorder. In many ciliopathies, dental anomalies are observed alongside other symptoms of the disease. To date, there are no published reports concerning the dental developmental problems that are associated with ciliary defects in PCD patients. METHODS: Patients suffering from PCD underwent dental clinical examination, which included the assessment of developmental disorders regarding the number and morphological structure of the teeth (size and shape) as well as developmental disorders of mineralised dental tissues. Then, three-dimensional radiographic examination was performed utilising Cone Beam Computed Tomography (CBCT). RESULTS: Four PCD patients, aged 31-54, agreed to enter the study. Dental examinations showed the presence of dental developmental disorders in three of them. Additionally, CBCT showed abnormalities in those patients. CONCLUSIONS: 1. The dental phenotype in PCD patients seems to be heterogeneous. Tooth developmental disorders resulting from abnormal odontogenesis may be a symptom of PCD that is concomitant with other developmental abnormalities resulting from malfunctioning primary cilia. 2. Patients with ciliopathies are likely to develop dental developmental defects. Therefore, beginning in early childhood, they should be included in a targeted specialised dental programme to enable early diagnosis and to ensure dedicated preventive and therapeutic measures.

Salivary Biomarkers and Oral Microbial Load in Relation to the Dental Status of Adults with Cystic Fibrosis.

The mutation of cystic fibrosis transmembrane conductance regulator (CFTR) can modify the physical and chemical properties of saliva, which in turn can affect the oral microflora and oral health in patients with cystic fibrosis (CF). The aim of the study was to examine oral health status, salivary properties, and total oral bacteria count in CF adults. Dental status was assessed using the decayed missing filled surfaces (DMF-S) index, and oral clearness using the approximal plaque index (API). The Saliva-Check BUFFER test was used to assess saliva, and real-time polymerase chain reaction (PCR) test to determine the total oral bacteria count. CF patients in comparison to healthy controls showed a higher level of examined clinical indices, higher total oral bacteria count, lower salivary flow rate, lower salivary pH, and increased viscosity. Conclusions: In CF patients, saliva properties, accompanied by insufficient dental care, might be an essential dental caries risk factor. In CF patients, among the etiological factors for dental caries, the bacterial agent seems to be less significant. The frequent and long-term infectious pharmacotherapy can probably explain that. A great deal of the information collected on the oral environment in CF patients, which has helped us understand the etiological conditions for inflammation and infection in this area of the body, indicates that proper dental care can mostly counteract these pathologies.

Periodontal Status and Subgingival Biofilms in Cystic Fibrosis Adults.

The aim of this study was to assess the periodontal status of cystic fibrosis (CF) adult patients and to evaluate whether there is a correlation between the bacterial population of the subgingival biofilm and the health status of the periodontal tissues in this group of adults. The study involved 22 cystic fibrosis adult patients. The periodontal condition was assessed using Plaque Index (PLI), Gingival Index (GI), and Probing Pocket Depth (PPD). The gingival sulcus samples were analyzed by the Real-Time PCR assay (RT-PCR). Majority of patients showed moderate or severe bacterial dental plaque accumulation, but none of them had clinical symptoms of periodontal diseases. RT-PCR showed the presence of periopathogens in 50% of patients. Red complex microorganisms were detected in 9.09%, orange complex in 27.27%, and green complex in 31.82% of the samples analyzed. In cystic fibrosis patients colonized by periopathogens, the periodontal markers were significantly higher in comparison to not colonized by periopathogens patients. Despite the widespread presence of bacterial dental deposits in the cystic fibrosis adult patients examined, none of them has clinical symptoms of periodontal disease; however, the presence of periodontal pathogens in subgingival biofilm may represent a possible risk factor of this disease in the future. An unsatisfactory level of oral hygiene in any patient with cystic fibrosis indicates a need to focus on standards of dental care for such patients.The aim of this study was to assess the periodontal status of cystic fibrosis (CF) adult patients and to evaluate whether there is a correlation between the bacterial population of the subgingival biofilm and the health status of the periodontal tissues in this group of adults. The study involved 22 cystic fibrosis adult patients. The periodontal condition was assessed using Plaque Index (PLI), Gingival Index (GI), and Probing Pocket Depth (PPD). The gingival sulcus samples were analyzed by the Real-Time PCR assay (RT-PCR). Majority of patients showed moderate or severe bacterial dental plaque accumulation, but none of them had clinical symptoms of periodontal diseases. RT-PCR showed the presence of periopathogens in 50% of patients. Red complex microorganisms were detected in 9.09%, orange complex in 27.27%, and green complex in 31.82% of the samples analyzed. In cystic fibrosis patients colonized by periopathogens, the periodontal markers were significantly higher in comparison to not colonized by periopathogens patients. Despite the widespread presence of bacterial dental deposits in the cystic fibrosis adult patients examined, none of them has clinical symptoms of periodontal disease; however, the presence of periodontal pathogens in subgingival biofilm may represent a possible risk factor of this disease in the future. An unsatisfactory level of oral hygiene in any patient with cystic fibrosis indicates a need to focus on standards of dental care for such patients.

Dental and periodontal manifestations in patients with cystic fibrosis - A systematic review.

BACKGROUND: The oral cavity is an important reservoir of microorganisms and can be a potential source of infection of the respiratory tract in CF patients. The literature on the oral health does not explicitly determine dental problems in these patients. The aim of the study was to systematically review the studies relating to oral status in CF patients. METHODS: A systematic review of papers published from 1997 to 2018 regarding oral status in CF children and adults, carried out in accordance with the Cochrane Collaboration guidelines. RESULTS: The search resulted in 143 studies. Thirteen publications were included in the systematic review.

Enamel defects and dental caries among children attending primary schools in Poznan, Poland.

BACKGROUND: Both positive and negative associations between developmental enamel defects (DED) and dental caries have been reported in the literature. OBJECTIVES: The aim of this study was to assess the prevalence of DED of permanent dentition and its association with dental caries in schoolchildren living in Poznan (Wielkopolskie Voivodeship, Poland). MATERIAL AND METHODS: A total of 2,522 6th grade children and 3,112 1st grade children were examined. Developmental enamel defects were described using the modified Developmental Defects of Enamel Index. Dental caries experience was assessed in accordance with the number of decayed, missing and filled teeth (DMFT). RESULTS: The study revealed 475 children (9.6%) to have at least 1 enamel defect of permanent dentition. In 6th-graders, statistical analysis confirmed significant differences between DMFT, DT (decayed teeth) and FT (filled teeth) numbers of various DED groups with subjects affected by diffuse opacities having generally the lowest caries indices and subjects with enamel hypoplasia and/or demarcated opacities having the highest caries indices. In both age groups, dental caries prevalence was statistically significantly higher in subjects with hypoplasia and/or demarcated opacities as compared to subjects without DED or with diffuse opacities (p < 0.05). CONCLUSIONS: The prevalence of DED in the examined population was low and comparable to those reported in regions without fluoridated water. The study confirmed that children affected by diffuse enamel opacities were less susceptible to dental caries, while demarcated opacities and hypoplasia should be considered important dental caries risk factors.

The relationship between oral hygiene level and gingivitis in children.

BACKGROUND: The condition of the teeth, periodontium and oral mucosa determines directly and indirectly the general health of the organism and, therefore, requires to be monitored. Childhood, especially the first years of life, is the time when proper health-promoting behaviors are formed, allowing the future prevention of such diseases as dental decay and gingivitis. Studies concerning the gingival status and bleeding in children are scarce, although such knowledge can be useful in planning preventive programs. OBJECTIVES: The aim of the study was to determine the relationship between oral hygiene level and the likelihood of gingival bleeding. MATERIAL AND METHODS: The examined group comprised 2,856 children aged 7 years, living in an urban area in western Poland. The hygiene status was evaluated according to the simplified Debris Index (DI-S) criteria and the periodontal status was evaluated according to the Community Periodontal Index (CPI) criteria. Logistic regression analysis was used to determine the predictors of gingival bleeding. RESULTS: The average value of DI-S was 0.91; it was not significantly different between girls and boys. In more than a half of the studied subjects (59.10%), oral hygiene was fair, in 12.46% - poor. Clinically healthy periodontium was observed in 91.32% of cases, bleeding on probing was present in 7.46% of cases. Calculus was detected in 1.22% of the children. Logistic regression analysis of the predictors of gingival bleeding showed that children with fair and poor oral hygiene were respectively 6 and 25 times more likely to show bleeding on probing compared to the children with very good oral hygiene. CONCLUSIONS: In the studied group, it was noted that there is a need to promote oral hygiene, as it contributes to the fall in gingivitis prevalence among school children.

[Special dental management in patients with Williams syndrome].

Introduction: The Williams syndrome (WS) is a rare genetic disease. The disorder is characterized by symptoms, such as facial dysmorphism, defects within the masticatory organ and cardiovascular system as well as intellectual and physical disability. Moreover, the disorder may also affect vision or hearing, gastrointestinal and urogenital system and skin. Limited cooperation with children suffering from WS is related not only from their young age and fear of dental treatment but also with hypersensitivity to sounds, which is one of the symptoms of this disease. Therefore, there is a need to carry out special dental treatment of such patients. Aim: The aim of the paper is to describe the case of a patient with Williams syndrome. Case report: The girl showed characteristic findings of the disease such as heart defect and typical facial features (known as " elfin face" with full lips, wide mouth, long and smooth philtrum, prominent forehead and malocclusion). A radiological examination revealed lack of few permanent premolars and incisor. In addition, the patient had many teeth with active caries process and its complications. Therefore, comprehensive dental therapeutic procedures were carried out. At the beginning of the treatment the sensitivity to high-pitched sounds as well as the significant anxiety of the child before dental intervention were the problem. Conclusions: In individuals with congenital syndromes it is necessary to prepare the patient for dental prophylaxis and therapeutic approach with regard to a variety of physical and intellectual limitations. In addition, there is a need for systematic dental care from their infancy.

[Focal infection in children - an underestimated problem].

The authors discuss the problem of joint inflammation based on the case of a 3 years old girl in whom the changes occurred in the lower limbs. The detailed diagnostic investigations confirmed the existence of the active focus in the oral cavity. The paper presents the case of a 3-year old girl with lower limbs joints inflamation. After their extraction a complete remission of inflammatory markers was achieved, which confirmed the correctness existence of an active focus. Furthermore, the presented case report demonstrates that oral health is a very important factor, which should be considered in the diagnosis and treatment of systemic diseases, including rheumathoid arthritis. It proves also that prevention of dental caries and oral hygiene should be implemented from early childhood.

[Epidemiological evaluation of soft drinks consumption--students surveys]. / Epidemiologiczna ocena spozywania napojów erozjogennych--badania ankietowe studentów.

Non carious lesions, including erosion changes, are becoming increasingly apparent. There are multiple factors involved in the etiology of dental erosion i.a. acids in commercially available drinks. The aim of this study was to determine the frequency of soft drink consumption that promote dental erosion among young adults. The 266 subjects were asked to fill in a questionnaire. The questionnaire inquired questions about consumption of drinks favouring tooth erosion. The students declared frequent drinking of isotonic drinks, energetic drinks, fizzy drinks and coca-cola type drinks. On the basis of a survey of Poznan University of Medical Sciences students it can be determined, that they have relatively high risk of dental erosion. To minimize the risk of dental erosion occurrence in young population there is a need to disseminate knowledge about the etiology.