The effect of oral massage intervention on oral hygiene at home care.

INTRODUCTION: Oral hygiene for individuals with disabilities living at home heavily relies on caregiver assistance. This study investigates differences in mouth opening, dental plaque index and halitosis grade among home-dwelling individuals with and without oral massage intervention. It is important to consider that extended bedridden periods, the presence of nasogastric tubes and difficulties in mouth opening can affect caregivers' oral cleaning effectiveness. METHOD: This single-blind controlled experiment spanned 12 weeks. Primary caregivers underwent a 15- to 20-min demonstration. The experimental group received guidance on the Bass brushing method, instructions for using oral cleaning tools and training in oral massage. The control group received guidance on the Bass brushing method and instructions for oral cleaning tools. Measurement tools included basic participant information, oral examination records, mouth opening assessments, dental plaque index evaluations and halitosis ratings. RESULTS: The study included 38 subjects, all over 80 years old with disabilities. Dental plaque index significantly improved after massage (p = 0.001). Compared to their pre-massage conditions, the experimental group showed significant improvements in maximum mouth opening (11.65-20.71 mm, p = 0.001), dental plaque index (98.04%-59.74%, p < 0.0001) and halitosis rating (4.12-3.76, p = 0.034). CONCLUSIONS: Oral massage effectively improved mouth opening, reduced the dental plaque index and lowered halitosis ratings in the experimental group, underscoring its positive impact on oral hygiene. The study's insights can significantly benefit oral care for individuals with disabilities living at home.

Flipped classroom teaching model with video instruction improves skills in local anesthesia training.

Background/purpose: Local anesthesia (LA) training is an essential clinical skill in dental education. However, the traditional teaching method of student-to-student injection has ethical concerns. This study investigated whether a flipped classroom (FC) teaching model with instructional videos improves students' skills in administering LA. Materials and methods: Fourth-year dental students in 2017 (traditional teaching, n = 70) and 2018 (FC model, n = 79) were assessed for their ability to perform an inferior alveolar nerve block and lingual nerve block. The FC group watched pre-recorded videos prior to a hands-on training session. Skills were evaluated using a 24-item checklist converted to letter grades. Perceptions of the FC approach were also surveyed. Results: The FC group showed statistically significantly higher final grades than the traditional teaching group (P < 0.05). Most FC students agreed that the videos improved clarity and learning objectives. Conclusion: The FC teaching model with procedural video instruction improved skills and confidence in administering LA over traditional teaching methods. Videos can be a beneficial supplement in pre-clinical dental training.

A survey study for the dental students' satisfaction with the "needling therapies for temporomandibular disorders" lectures.

Background/purpose: Dry needling therapy and acupuncture can effectively relieve myofascial pain in temporomandibular disorders (TMDs). This study evaluated dental students' satisfaction with the "needling therapies for TMDs" lectures given in 2022 and 2023. Materials and methods: The "needling therapies for TMDs" lectures included mainly a dry needling therapy lecture and an acupuncture lecture which were given to the fifth-year dental students in both 2022 and 2023. An additional needling therapy demonstration lecture was given in 2023 only. Immediately after the lectures, the students were asked to complete an online-based questionnaire with four survey questions regarding their satisfaction with (1) the dry needling therapy, (2) the acupuncture, (3) the overall, and (4) the needling therapy demonstration lectures using 5-point Likert scale ratings. Results: Fifty-three (80 %) of 66 and 60 (81 %) of 74 students answered the questions in 2022 and 2023, respectively. The satisfaction rates improved from 70 % in 2022 to 83 % in 2023 for the dry needling therapy lecture, from 64 % in 2022 to 85 % in 2023 for the acupuncture lecture, and from 70 % in 2022 to 88 % in 2023 for the overall lecture. The satisfaction rate was 88 % in 2023 for the needling therapy demonstration lecture. Conclusion: The results of this study suggest that inclusion of the needling therapy demonstration lecture in 2023 can results in a marked increase in the satisfaction rates for the lectures. The relatively-lower satisfaction rate for the acupuncture lecture in 2022 may be due to the difficulty in understanding the mechanisms underlying the acupuncture therapy.

Analysis of approved dental teaching projects in the teaching practice research program in 8 dental schools of Taiwan from 2018 to 2023.

Background/purpose: The teaching practice research program was initiated by Taiwan's Ministry of Education in 2018 to improve medical teaching quality. This study analyzed dental teaching projects conducted under this program from 2018 to 2023. Materials and methods: Data of submitted and approved medical (including dental) teaching projects from 2018 to 2023 were obtained from the annual reports released by the program committee. The annual passing rates were calculated by dividing the number of approved dental teaching projects by the total number of approved medical teaching projects in the category of medical and healthcare sciences in a particular year. The 24 approved dental teaching projects were reviewed, classified into different topics in the dental field, and then reported. Results: There were 24 approved dental teaching projects out of a total of 822 approved medical teaching projects from 2018 to 2023. The annual passing rates increased gradually from 2018 (1.4 %) to 2022 (3.9 %) and 2023 (3.8 %) with an overall mean passing rate of 2.9 % over a period of 6 years. Of the 24 approved dental teaching projects, digital dentistry was the most common teaching research topic (9 projects), followed by new teaching models (7 projects), 3D technology (3 projects), endodontics (3 projects), dental histology (one project), and evidence-based method (one project). Conclusion: Digital dentistry and new teaching models were the two predominant dental teaching research topics, suggesting that both are the modern trends in the dental education. However, the dental teaching research projects are still very limited in 8 Taiwanese dental schools.

Integration of arts into dental education: Beauty in the histological photomicrographs.

Background/purpose: Integration of arts and humanities into dental education is important for developing holistically oriented dental professionals. This study aimed to survey dental students' perception of integrating arts and sciences into dental education with an innovative pedagogical approach through a photomicrograph competition. Materials and methods: Students used digital imaging tools and creative approaches to capture photomicrographs that revealed hidden beauty in oral tissue sections. The photomicrograph works were posted online for scoring. The scoring activity, questionnaire survey, and complimentary comments of the participants were conducted online using a Google form. Results: The photomicrograph competition garnered a 24% participation rate from the 490 undergraduate dental students. Of the 116 participants, 65% agreed that the photomicrograph competition increased their interest in learning microscopic lessons, 87% very strongly or strongly supported to hold the photomicrograph competition every year, and 72% believed that the photomicrograph competition could be adopted to the dental students in all dental schools in Taiwan. The overall satisfaction rate of the photomicrograph competition was 91%. The free comments from all participants were generally positive towards this photomicrograph competition. Conclusion: The photomicrograph competition shows the transformative potential of integrating arts and humanities into dental education. Through the lens of photomicrography, the hidden wonders in oral tissue sections have been unveiled. This photomicrograph competition, a pioneering endeavor with no precedent in English literature, has proven to be a resounding success that unites the realms of scientific inquiry and artistic expression, and may be a transformative agent in nurturing holistic dental professionals.

Domiciliary Dental Care for Medically Compromised Patients in Aging and Super-aged Societies: Policy and Education.

Domiciliary dental care (DDC) is a specialized dental service provided at patients' residences, especially for medically compromised patients. The importance of DDC has been highlighted in aging and super-aged societies. Confronted with burdens of a super-aged society, governmental efforts have promoted DDC in Taiwan. To provoke awareness of DDC in healthcare professionals, a series of continuing medical education (CME) lessons on DDC for dentists and nurse practitioners were organized between 2020 and 2021 at a tertiary medical center and demonstrating center of DDC in Taiwan, during which 66.7% of participants were very satisfied. Through political and educational efforts of the government and medical centers, an increasing number of healthcare professionals participating in DDC was observed, including both those in hospitals and those who were primary care practitioners. CME modules may promote DDC and improve the accessibility to dental care for medically compromised patients.

miR-146a participates in the regulation of cancer stemness of oral carcinoma cells.

Background/purpose: Increasing evidence regarded the existence of cancer stem cells (CSCs) as a leading cause of therapy failure and tumor relapse due to their self-renewal and differentiation abilities. Although ectopic overexpression of micro-RNAs (miRNAs) can modulate the cancer stemness and tumor development in oral cancer, their molecular mechanism is still unclear. Therefore, in the present study, we attempt to uncover the role of miR-146a in the maintenance of oral CSCs. Materials and methods: The expression of miR-146a was determined using qRT-PCR analysis. Aldehyde dehydrogenase (ALDH) enzymic activity and sphere formation assays were used to evaluate the cancer stemness and self-renewal, respectively. Functional assays, including migration/invasion Transwell and colony formation assay, were used to evaluate the aggressive abilities. Luciferase reporter assay was performed to validate the relationship between miR-146a and Numb. Results: In the present study, we reported an increased expression of miR-146a in the oral squamous cell carcinoma (OSCC) specimen, primary OSCC cells sphere, and high ALDH1 activity population within OSCC cells. Inhibition of miR-146a significantly suppressed the ALDH1 activity, self-renewal capacity, and aggressive abilities, including migration, invasion, and colony formation. Moreover, we demonstrated that Numb is a functional target of miR-146a in OSCC-CSCs. Notably, silencing of Numb could retrieve the self-renewal and migration impaired by knockdown of miR-146a. Conclusion: Our results indicate that miR-146a can regulate the cancer stemness in OSCC by modulating Numb, and hence miR-146a/Numb axis can serve as a potential target for oral cancer therapy.

Bibliometric analysis of top-cited articles in Journal of Dental Sciences.

Background/purpose: Bibliometric analysis is a method for quantifying the article distribution, impact, and performance. The purpose of this study was to identify the most top-cited articles published in Journal of Dental Sciences (JDS) and further analyze their main characteristics. Materials and methods: Web of Science, Journal Citation Reports database was searched to retrieve the most-cited articles in JDS published from 2007 to July 31, 2022. Among the included top-cited articles, the following parameters were recorded and analyzed: article title, article type, year, country, number of citations, and average citations pre year. Microsoft Excel was applied for the descriptive bibliometric analysis. Results: 41 top-cited articles were filtered from total 1165 JDS articles in Web of Science database. The results showed that 41 top-cited articles were cited between 20 and 186 times from Journal Citation Reports. Most of the article types are original article (28/41, 68.29%) following by review article (7/41, 17.07%). The majority of articles were originated from Taiwan (23/41, 56.10%). The top 4 most cited articles were relative to the research topic on COVID-19, lateral canal, guided-tissue regeneration barriers, and platelet-rich fibrin, respectively. However, articles analyzed by the average citations per year since publication were focused on COVID-19 followed by artificial intelligence. Conclusion: This bibliometric analysis illustrates the progress and trend of researches in JDS. The results may also offer a reference for recognizing the hot issues with the most citations in JDS.

XIST/let-7i/HMGA1 axis maintains myofibroblasts activities in oral submucous fibrosis.

Long non-coding RNA XIST promotes the development of various types of head and neck cancers, but its role in the progression of precancerous oral submucous fibrosis (OSF) has not been determined yet. As such, we aimed to examine whether XIST implicates in the regulation of myofibroblast activation. Our results showed that the expression of XIST was upregulated in OSF tissues and fibrotic buccal mucosal fibroblasts (fBMFs), and the silencing of XIST downregulated several myofibroblasts features. We demonstrated that elevation of let-7i after inhibition of XIST may lead to reduced myofibroblast activation. On the contrary, overexpression of high mobility group AT-Hook 1 (HMGA1) following the suppression of let-7i may result in enhanced myofibroblast activities. Moreover, we showed that the suppressive effect of silencing of XIST on myofibroblasts hallmarks was reversed by let-7i inhibition or HMGA1 overexpression, suggesting the pro-fibrotic property of XIST was mediated by downregulation of let-7i and upregulation of HMGA1. These findings revealed that myofibroblast activation of fBMFs may attribute to the alteration of the XIST/let-7i/HMGA1 axis. Therapeutic approaches to target this axis may serve as a promising direction to ameliorate the malignant progression of OSF.

Is OLP potentially malignant? A clue from ZNF582 methylation.

OBJECTIVE: Whether oral lichen planus (OLP) was potentially malignant remains controversial. Here, we examined associations of ZNF582 methylation (ZNF582m ) with OLP lesions, dysplastic features and squamous cell carcinoma (OSCC). MATERIALS AND METHODS: This is a case-control study. ZNF582m was evaluated in both lesion and adjacent normal sites of 42 dysplasia, 90 OSCC and 43 OLP patients, whereas ZNF582m was evaluated only in one mucosal site of 45 normal controls. High-risk habits affecting ZNF582m such as betel nut chewing and cigarette smoking were also compared in those groups. RESULTS: OLP lesions showed significantly lower ZNF582m than those of dysplasia and OSCC. At adjacent normal mucosa, ZNF582m increased from patients of OLP, dysplasia, to OSCC. In addition, ZNF582m at adjacent normal sites in OLP patients was comparable to normal mucosa in control group. Dysplasia/OSCC patients with high-risk habits exhibited significantly higher ZNF582m than those without high-risk habits. However, ZNF582m in OLP patients was not affected by those high-risk habits. CONCLUSIONS: OLP is unlikely to be potentially malignant based on ZNF582m levels. ZNF582m may also be a potential biomarker for distinguishing OLP from true dysplastic features and OSCC, and for monitoring the malignant transformation of OLP, potentially malignant disorders with dysplastic features and OSCC.

Improving the Diagnostic Performance by Adding Methylation Marker to Conventional Visual Examination in Identifying Oral Cancer.

BACKGROUND: Visual oral examination (VOE) is a conventional oral cancer screening method. This study aimed to evaluate the value of methylation marker to assist VOE in identifying oral epithelial dysplasia and oral squamous cell carcinoma (OED/OSCC) from non-cancerous lesions in a real-world situation. METHODS: 201 patients with high-risk personal habits who self-perceived oral anomaly were VOE examined, ZNF582 methylation (ZNF582m) tested, and histologically diagnosed. RESULTS: Among them, 132 patients (65.7%) were histologically diagnosed OED/OSCC. Using VOE, 56.1% OED/OSCC patients had possible oral cancer, whereas 37.7% non-OED/OSCC patients had leukoplakia. ZNF582m-positive was detected in 90.2% OED/OSCC patients and 44.9% non-OED/OSCC patients. Various logistic regression models were postulated to evaluate the diagnostic performance of conventional VOE and new strategies using ZNF582m. ROC analysis and its corresponding C-index demonstrated that either triage or co-testing models of VOE and ZNF582m could improve diagnostic performance and discriminative abilities compared with the VOE only approach. CONCLUSIONS: In conclusion, methylation marker test shows equivalent performance to an experienced judgment by oral maxillofacial surgeons and plays a significantly supplementary role in increasing the efficacy in identifying oral malignant lesions. ZNF582m may be an especially important tool for family physicians or general dentists to properly diagnose suspicious oral lesions.