Effects of tongue lesions and palatal coverage on oral sensory functions.

STATEMENT OF PROBLEM: Oral stereognosis (OS) plays a significant role in the oral rehabilitation of patients with edentulism, as it influences their adaptation to new prostheses. Because of the essentially tactile characteristic of oral sensory perception, the tongue and palate appear to have a crucial function in OS. However, little is known about the influence of tongue lesions on OS and sensorial function. In addition, controversies remain regarding the role of the palate. PURPOSE: The purpose of this clinical study was to evaluate whether tongue lesions and palatal coverage are disruptive to OS and gustatory function. MATERIAL AND METHODS: Seventy participants (mean age=30.7 ±6.7 years) were divided into a tongue lesion group (experimental; n=35) and a control group (n=35). The tongue lesion group included participants with geographic, fissured, or hairy tongue. OS was evaluated with the oral stereognosis ability (OSA) test. Gustatory function was assessed with exposure to flavored solutions. After completing the above tests, the participants received a palate covering device, and then OS and gustatory function were immediately reevaluated. Data were analyzed with the Mann-Whitney and Wilcoxon tests (α=.05). RESULTS: OSA and gustatory function scores did not differ among the tongue lesion and control groups with and without palatal coverage (all P>.05). After palatal coverage, the tongue lesion group took more time to perform the OSA test than the control group (P<.05). CONCLUSIONS: Neither the presence of tongue lesions nor palatal coverage influenced OS or gustatory function. The OSA test response times were longer for the tongue lesion group after they had received palatal coverage.

Health-related quality of life of institutionalized older adults: Influence of physical, nutritional and self-perceived health status.

INTRODUCTION: Institutionalized older adults have higher risks of diseases and worse health-related quality of life (HRQoL) than noninstitutionalized. OBJECTIVE: To evaluate the influence of physical state, nutritional status and self-perceived general health and oral health on the quality of life of institutionalized older adults in two Brazilian cities. METHODS: A multicenter cross-sectional study was conducted in 17 homes for the aged of two Brazilian cities. Six trained researchers interviewed 344 older adults. The performance of activities of daily living (Katz scale) and frailty status (Fried scale) were applied to evaluate the physical state. The Mini Nutritional Assessment Short-Form (MNA-SF®) and the body composition were used to screening the nutritional status. A hand dynamometer was used to measure the dominant hand grip strength. The 12-Item Short Form Survey for self-perceived health (SF-12) was used to determine the HRQoL. A Likert scale was used to assess the general and oral health self-perception. Multiple Poisson regression model was applied to analyze the data (α = 0.05). RESULTS: The mean (SD) score of the SF-12 was 60.89 (14.50) points. The factors associated with the highest SF-12 score were being able to walk, being nonfrail, being normal nourished, taking fewer medications, having greater dominant hand grip strength and higher self- perceived general health (p < 0.05). CONCLUSION: Better HRQoL in institutionalized older adults was associated with better physical state, nutritional status and self-perceived general health.

Red propolis hydroalcoholic extract inhibits the formation of Candida albicans biofilms on denture surface.

BACKGROUND: To evaluate the antifungal activity of the red propolis hydroalcoholic extract (RPHE) against Candida albicans biofilms. MATERIAL AND METHODS: The minimum inhibitory and fungicidal concentrations (MIC and MFC) of the RPHE were determined by the microdilution technique. C. albicans biofilms were formed on the surface of resin specimens preconditioned with artificial saliva (1h). The specimens (N=48) were equally divided according to the four solutions used for anti-biofilm evaluation (n=12 per group). After overnight incubation, biofilms were daily exposed (2x/day for 15 min) along 3 days with 3% RPHE, 0.12% chlorhexidine (CHX), 50,000 IU/mL nystatin (NYS) or saline (0.9% NaCl). Biofilms were analyzed regarding the number of viable microorganisms (CFU/mL), the metabolic activity (MTT assay) and the proportion of hyphae (optical microscopy). RESULTS: The MIC and MFC of RPHE were respectively 0.29 mg/mL (0.03%) and 1.17 mg/mL (0.12%). There was no difference in the microorganisms' viability (CFU/mL) among groups treated with RPHE (4.92×103), CHX (3.33×102) or NYS (6.8×104), being all of them different from NaCl (3.93×107) (p<0.05). The CHX (0.133) had the lowest metabolic activity (p<0.05), followed by RPHE (0.292) and NYS (0.302) (p>0.05). All experimental groups had a mean proportion of hyphae <10%, lower than NaCl (70%). CONCLUSIONS: RPHE has antifungal activity against C. albicans biofilms, suggesting its use for the biofilm control on denture surfaces. Key words:Propolis, Candida albicans, biofilm, dentures, antifungal agents.

Masticatory function in nursing home residents: Correlation with the nutritional status and oral health-related quality of life.

BACKGROUND: Masticatory function of institutionalised elders and its relationship with nutrition and oral health-related quality of life (OHRQoL) are unknown. OBJECTIVES: This multicentre cross-sectional study evaluated the influence of the presence of teeth and dentures on masticatory function (masticatory performance and swallowing threshold) in institutionalised elders. Correlation of masticatory function with nutrition and OHRQoL was also verified. METHODS: Older adults (n = 344; mean age (SD) = 77.70 (9.10)), selected from nursing homes in two Brazilian cities, were classified as edentulous with or without complete dentures (CDs), and partially dentate with or without prosthesis. Masticatory performance was assessed using a two-colour chewing gum. Swallowing threshold was set by the number of chewing cycles performed until swallowing 3.7 g of peanuts. Nutrition was screened by Mini-Nutritional Assessment-Short Form and body composition. OHRQoL was evaluated through Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-14). The Kruskal-Wallis test and Spearman's correlation were used (α = 0.05). RESULTS: Edentulous elders without CDs had lower masticatory performance than those with CDs and partially dentate with or without prosthesis (P < .05). Swallowing threshold of edentulous elders with CDs and partially dentate with prosthesis was greater than edentulous elders without CDs and partially dentate without prosthesis (P < .05). Masticatory function was not correlated with nutrition. Masticatory performance was correlated (P < .05) with GOHAI (r2  = -.154) and swallowing threshold with GOHAI (r2  = .162) and OHIP-14 (r2  = -.146). CONCLUSION: The absence of teeth and dentures negatively affected the masticatory function. Although the masticatory function was not correlated with institutionalised elders' nutrition, their OHRQoL was negatively impacted.

Does the institutionalization influence elderly's quality of life? A systematic review and meta-analysis.

BACKGROUND: Institutionalization is a global phenomenon and its impact on elderly's quality of life (QoL) is under discussion. This systematic review and meta-analysis evaluated the influence of the institutionalization on elderly's QoL. METHODS: Searches were performed in Medline, Scopus, Web of Science, Lilacs, Cochrane Library and SIGLE by two independent reviewers up to May 2019. The eligibility criteria were based on PECO strategy, considering observational studies in elderly (P), which were (E) or not (C) institutionalized to identify differences in their QoL (O). For qualitative synthesis, data were extracted and risk of bias was evaluated through a validated guideline. Meta-analysis was based on Mean Difference (MD) and Standard Mean Difference (SMD) calculation (p ≤ 0.05). The evidence was quality-tested using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: The initial search identified 3841 articles. Duplicates were removed, titles and abstracts were read and eligibility criteria were applied, remaining 16 sixteen cross-sectional studies that were included for data extraction and qualitative synthesis. Out of 16 articles, 14 evaluated the Health-Related Quality of Life, using Leipad (n = 2), WHOQOL-BREF and/or OLD (n = 8), SF-36 or RAND-36 (n = 4) questionnaires, and two assessed the Oral Health-Related Quality of Life, through GOHAI questionnaire. One eligible article was considered as low risk of bias. In the meta-analysis, 12 studies were included. Leipad questionnaire did not show differences on elderly's QoL (MD 0.11 [- 0.10, 0.32] I2 = 76%). Differences on elderly's QoL were detected through WHOQOL-BREF (SMD -0.70 [CI95%: - 0.94, - 0.47] I2 = 93%), WHOQOL-OLD (SMD -1.13 [- 1.47, - 0.80] I2 = 91%) and SF-36/RAND-36 (MD -5.97 [CI95%: - 11.29, - 0.64] I2 = 90%). All studies had very low or low certainty of evidence, since the study design influenced evidence classification, and show high heterogeneity. CONCLUSION: Although the institutionalization influences negatively the elderly's QoL, further well-designed studies are needed to confirm this evidence.

Factors associated with health and oral health-related quality of life of children and adolescents with cerebral palsy.

AIMS: To verify factors associated with impact on Health-Related Quality of Life (HRQoL) and Oral Health-Related Quality of Life (OHRQoL) of children and adolescents with cerebral palsy (CP). METHODS AND RESULTS: Sample of 149 individuals with CP aged 2 to 18 years and their caregivers, who provided information regarding HRQoL (PedsQL 4.0), OHRQoL (PedsQL 3.0 Oral Health, and socioeconomic factors. A calibrated investigator performed dental examinations, with dental caries, traumatic dental injury, periodontal, and occlusal evaluation. HRQoL and OHRQoL scores were transformed into a 0 to 100 scale, dichotomized in absence or presence of impact (score < 50) and analyzed by Mann-Whitney test and Poisson regression (α = .05). The mean HRQoL score was 50.3 ± 10.2. Impact on HRQoL was observed in 51.7% and associated with gender, general health perception, and communication skills. The mean OHRQoL score was 78.0 ± 24.6. The presence of impact on OHRQoL (12.1%) was associated with age, presence of gastroesophageal reflux, dental caries, and periodontal diseases. CONCLUSION: Individuals with CP had low HRQoL and OHRQoL scores. The impact on HRQoL was shown to be associated with gender, health perception. and communication skills. Regarding OHRQoL, the presence of impact was associated with age, gastroesophageal reflux, dental caries. and periodontal diseases.