Periodontitis is associated with impaired olfactory function: A clinical study.

AIM: To explore the association between periodontitis and olfactory disorders. METHODS: Clinical data were collected from 198 individuals between the ages of 18 and 60 years living in Denmark. The exposure was periodontitis, and the outcome was olfactory function (Threshold, Discrimination, Identification - TDI score), both measured clinically. Covariates included sex, age, education level, income, usage of nasal spray, tongue coating, halitosis, xerostomia, smoking, and history of COVID-19. Structural equation modeling was used to estimate the association between periodontitis and olfactory function. Periodontitis was defined using the AAP/EFP classification and dichotomized into "no" (healthy subjects) and "yes" (Stages I, II, and III). Olfactory function was treated as a one-factor latent variable, including the different olfactory scores. In addition, extra models were performed considering each olfactory component as a separate outcome and the TDI Global Score. RESULTS: The results showed that periodontitis was associated with a lower olfactory function [standardized coefficient (SC) -0.264, 95% CI -0.401, -0.118]. Additionally, periodontitis was also associated with a lower olfactory Threshold (odorant concentration required for detection) (SC -0.207, 95% CI -0.325, -0.089), Discrimination (ability to discriminate between odorants) (SC -0.149, 95% CI -0.270, -0.027), Identification (ability to identify odorants) scores (SC -0.161, 95% CI -0.277, -0.045), and TDI Global Score (SC -0.234, 95% CI -0.370, -0.099). CONCLUSIONS: This study suggests that periodontitis is associated with olfactory impairment.

Oral conditions are associated with salt taste disability among American adults.

AIM: To explore the association between oral conditions and their interaction with salt taste disability among American adults. METHODS: Data from the 2013-2014 NHANES cycle were used (n = 2373). The exposures were periodontitis, defined by the 2017 EFP-AAP classification, dental caries, missing teeth, and edentulism, as per the DMF-T index, and xerostomia. The outcome was salt taste disability, objectively assessed. Covariates included sex, age, educational level, poverty index, obesity, diabetes, smoking, alcohol consumption, and medications related to mouth dryness. Weighted multivariable logistic regression modeling was used to evaluate the relationship between oral conditions and their interaction and salt taste disability. RESULTS: Participants who reported xerostomia were more likely to have salt taste disability (OR 2.42; 95%CI 1.44-4.07), especially those older than 60 years (OR 3.63; 95%CI 1.72-7.63). Among participants aged 40-59, xerostomia increased the chance of salt taste disability; however, the confidence interval included the null value. The interactions between xerostomia and edentulism increased the chance of salt taste disability. CONCLUSION: Oral conditions seem to influence the ability to taste salt. Dental professionals may help identify individuals with taste alterations and raise their awareness of the risk of systemic diseases that require the reduction of salt intake.

Self-reported periodontitis association with impaired smell and taste: A multicenter survey.

OBJECTIVES: To investigate the association between self-reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities. MATERIALS AND METHODS: Data were collected through a digital survey. A total of 1239 individuals from Aarhus University - Denmark, the University of Iowa, and the University of Florida - USA were included. Self-reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self-perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID-19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach. RESULTS: The total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self-reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]). CONCLUSION: Our findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.

The association between halitosis and oral-health-related quality of life: A systematic review and meta-analysis.

AIM: To investigate whether halitosis is associated with impaired oral-health-related quality of life (OHRQoL). MATERIALS AND METHODS: This is a systematic review of the literature. Electronic searches were performed in PubMed via Medline, Web of Science, Scopus, and EMBASE up to and including June 2021. Observational studies that assessed halitosis in association with OHRQoL were included. The pooled standardized mean difference (SMD) was estimated by meta-analysis. RESULTS: Thirteen studies were included in the review; however, the meta-analysis included only 10 studies, all cross-sectional, comprising 2692 individuals. The overall meta-analysis showed an association between halitosis and impaired OHRQoL (SMD 0.51; 95% confidence interval 0.27-0.75). Subgroup analyses, however, indicated that this association remained only among adults. Neither the OHRQoL instrument nor the halitosis assessment method, or the cultural background, influenced the pooled estimates. Meta-regression analyses revealed that the OHRQoL instrument, the halitosis assessment method, and the sample composition did not explain the between-study heterogeneity. Methodological quality appeared to explain 20% of the overall heterogeneity, as studies with high risk of bias overestimated the magnitude of the association. CONCLUSION: Our findings suggest that halitosis is associated with impaired OHRQoL.

Clinical and self-reported oral conditions and quality of life in the 1982 Pelotas birth cohort.

AIM: To investigate and compare the effects of clinical and self-perceived oral conditions on oral health-related quality of life (OHRQoL) among young adults. MATERIALS AND METHODS: Adults enrolled in the 1982 Pelotas birth cohort were included in this study. OHRQoL was assessed by the Oral Health Impact Profile-14 (OHIP-14) instrument. Clinical parameters such as dental caries, periodontitis, aesthetics, and occlusal characteristics, and tongue coating were collected through clinical evaluation, while dental anxiety and halitosis were self-reported. Direct and indirect effects of clinical and self-perceived oral conditions on OHRQoL were assessed using structural equation modelling. RESULTS: Five-hundred and thirty-nine individuals participated in this study. Dental caries (ß = 0.12) and periodontitis (ß = 0.11) were directly and indirectly (via halitosis, ß = 0.05 for periodontitis only) associated with greater OHIP-14 scores, while the other clinical conditions did not influence the OHIP-14 scores. Dental anxiety and halitosis were also associated with higher OHIP-14 scores (ß = 0.31 and ß = 0.27, respectively). CONCLUSIONS: This study found a positive association between clinically diagnosed and self-reported oral conditions and OHRQoL; however, the self-reported conditions had a higher impact on OHRQoL.

Soft tissue cone beam computed tomography (ST-CBCT) for the planning of esthetic crown lengthening procedures.

OBJECTIVE: The aim of this study was to measure the clinical crown, anatomical crown, and amount of gingiva covering the enamel of anterior maxillary teeth with soft tissue cone beam computed tomography (ST-CBCT) and thus propose a protocol for the application of this noninvasive method for the planning of esthetic crown lengthening procedures to prevent undesired root exposure. MATERIALS AND METHODS: Ten young patients (mean age 22.8 years) requiring esthetic crown lengthening surgeries but not restorative procedures were included in this study. The ST-CBCT images were analyzed with an image editor and analysis software (Pixelmator 3.2), and the clinical crown, anatomical crown, and amount of gingiva covering the enamel were measured. RESULTS: The mean value of the length of the anatomical crowns of the central incisors, lateral incisors, and canines were 11.06 mm, 9.55 mm, and 9.77 mm, respectively. Thus, the canines were approximately 1.3 mm shorter than the central incisors. CONCLUSION: It was shown that ST-CBCT is a useful tool to assess the actual length of the anatomical crown and the amount of gingival tissue that needs to be surgically removed in an esthetic crown lengthening procedure to prevent undesired root exposure. Thus, ST-CBCT is a helpful noninvasive procedure for the planning of esthetic crown lengthening surgeries, making it possible to better predict their final outcome.

Reproducing Optical Properties of Anterior Teeth after Ultra-Conservative Preparation.

OBJECTIVE: Selecting the appropriate material is essential when restoring color and appearance of esthetically compromised anterior teeth. CLINICAL CONSIDERATIONS: Most of the conventional restorative techniques require tooth reduction in order to mimic optical properties of a natural tooth. Fortunately, bonding techniques associated with improvements on dental ceramics esthetics allow for highly conservative treatment options in which maximum preservation of dental tissues can be attained. An analysis of different ceramic materials available and different types of tooth preparation is presented in a format of a decision tree for treatment planning. CONCLUSIONS: The suggested decision-making aims to facilitate clinicians' selection of the most appropriate restorative technique for reproducing color and appearance of anterior teeth after ultra-conservative preparation and according to different clinical scenarios CLINICAL SIGNIFICANCE: The selection of the appropriate ceramic material for each case is of major importance, since the entire treatment plan will be determined based on the type of ceramic material that will be used for the final restoration. Each restorative material has a specific tooth preparation requirement, indications, and limitations that shall be respected for maximum esthetical outcomes. (J Esthet Restor Dent 28:267-276, 2016).