Linking Migraine to Gut Dysbiosis and Chronic Non-Communicable Diseases.

In the world, migraine is one of the most common causes of disability in adults. To date, there is no a single cause for this disorder, but rather a set of physio-pathogenic triggers in combination with a genetic predisposition. Among the factors related to migraine onset, a crucial role seems to be played by gut dysbiosis. In fact, it has been demonstrated how the intestine is able to modulate the central nervous system activities, through the gut-brain axis, and how gut dysbiosis can influence neurological pathologies, including migraine attacks. In this context, in addition to conventional pharmacological treatments for migraine, attention has been paid to an adjuvant therapeutic strategy based on different nutritional approaches and lifestyle changes able to positively modulate the gut microbiota composition. In fact, the restoration of the balance between the different gut bacterial species, the reconstruction of the gut barrier integrity, and the control of the release of gut-derived inflammatory neuropeptides, obtained through specific nutritional patterns and lifestyle changes, represent a possible beneficial additive therapy for many migraine subtypes. Herein, this review explores the bi-directional correlation between migraine and the main chronic non-communicable diseases, such as diabetes mellitus, arterial hypertension, obesity, cancer, and chronic kidney diseases, whose link is represented by gut dysbiosis.

The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases.

Several studies have demonstrated a strong relation between periodontal diseases and chronic kidney disease (CKD). The main mechanisms at the base of this link are malnutrition, vitamin dysregulation, especially of B-group vitamins and of C and D vitamins, oxidative stress, metabolic acidosis and low-grade inflammation. In particular, in hemodialysis (HD) adult patients, an impairment of nutritional status has been observed, induced not only by the HD procedures themselves, but also due to numerous CKD-related comorbidities. The alteration of nutritional assessment induces systemic manifestations that have repercussions on oral health, like oral microbiota dysbiosis, slow healing of wounds related to hypovitaminosis C, and an alteration of the supporting bone structures of the oral cavity related to metabolic acidosis and vitamin D deficiency. Low-grade inflammation has been observed to characterize periodontal diseases locally and, in a systemic manner, CKD contributes to the amplification of the pathological process, bidirectionally. Therefore, CKD and oral disease patients should be managed by a multidisciplinary professional team that can evaluate the possible co-presence of these two pathological conditions, that negatively influence each other, and set up therapeutic strategies to treat them. Once these patients have been identified, they should be included in a follow-up program, characterized by periodic checks in order to manage these pathological conditions.

Diet Implications and Oral Health Status of Women in Central Italy.

OBJECTIVE: The relationships between oral health habits, dietary practices, and oral health status, as well as general health status, in the population of Italian women, are complex, with many mutual and interrelating factors. The purpose of this study is to investigate oral habits, oral status, and dietary habits of a sample of women in Italy, highlighting the links between nutrition and oral health and discussing how oral health care professionals can integrate nutrition counseling that aimed at improving the oral health of their patients into their practices. MATERIALS AND METHODS: In the period between February 2020 and July 2020, an anonymous questionnaire made up of 20 questions was administered to a randomized sample of 120 Italian women. RESULTS: Most of women declare good manual skills in oral hygiene (50%) but just less than half of them brushes their teeth more than three times a day. Statistically significant correlations were found between frequency of dental checkups and dental mobility (p = 0.036), and halitosis (p = 0.006), as well as between frequency of flossing and gum bleeding. Correlation between the type of diet and oral health status showed more halitosis (∼21%), sensitivity (∼26%), and xerostomia (∼53.3%) for vegetarian and vegan women. CONCLUSION: More awareness need to be raised concerning oral hygiene habits, and regarding the importance of regular dental checkups. Brushing at least twice or three times a day needs to be encouraged and the valid support of dental aids has to be in the everyday domestic oral hygiene protocol, as scientific evidence demonstrates. Future clinical studies need to be performed on a more consistent number of vegetarian and vegan patients, to obtain more statistically significant results and support future research that will compare omnivorous, vegetarian, and vegan diets and their influence on oral health status.

Schizophrenia and Dental Health: A Systematic Review.

ABSTRACT: Schizophrenia is characterized not only by psychopathological symptoms but also by medical comorbidities. Among the latter, there are limited data on dental health. We conducted a systematic review with the primary aim of clarifying the extent of the relationship between dental diseases and schizophrenia. The second aim was to delineate an intervention program based on illness-related factors that influence dental health. The preferred reporting items for systematic reviews and meta-analyses statement for reporting systematic reviews was used. Only articles published in English language peer-reviewed journals were considered; we excluded case reports, meta-analyses, and systematic reviews, as well as studies that did not clearly report statistical analysis, diagnostic criteria, or the number of patients included. Twenty-one studies comprising 13,110 patients with schizophrenia and 9025 healthy controls were included. Negative symptomatology, long duration of illness, smoking habit, drug-induced xerostomia, and neuroinflammation are the most critical areas. We suggest an intervention program for prevention and treatment of dental diseases in schizophrenia.

Cariogenic Risk and COVID-19 Lockdown in a Paediatric Population.

The Severe Acute Respiratory Syndrome Coronavirus 2 disease COVID-19 pandemic caused several lifestyle changes, especially among younger people. The study aimed to describe the impact of eating habits, lifestyle, and home oral hygiene during the COVID-19 pandemic, on the cariogenic risk in the Italian paediatric population, by using an online survey. The survey was conducted through a virtual questionnaire divided into four parts: child personal and anthropometric data; oral health; child dietary habits (KIDMED test); and child lifestyle, before and during COVID-19 lockdown. During the lockdown, only 18.6% of the participants had high adherence to a Mediterranean diet, recording an increase in sweets consumption and the number of meals (p < 0.001). In terms of lifestyle, the percentage of moderately and vigorously active children decreased (41.4% and 5.0%, respectively) (p = 0.014). The percentage of children sleeping more than 9 h increased (p < 0.001). They watched more television programs (p < 0.001). Regarding oral hygiene, children did not change their brushing habits (p = 0.225). The percentage of children using non-fluoridated toothpaste was higher (6.4%), and no changes were observed (p > 0.05). In some cases, dental pain and abscesses were declared (10% and 2.7%, respectively). This study confirms the need for campaigns to promote hygiene and dental care in combination with food education for a correct habit and promotion of a healthy and sustainable dietary style.

Oral health in children with cerebral palsy: A systematic review and meta-analysis.

AIMS: Aim of the present systematic review and meta-analysis is to investigate the oral health status of children with cerebral palsy and to compare it to that of healthy children. METHODS AND RESULTS: An electronic search extended to October 2019 was conducted on PubMed, Scopus, Web of Science and Cochrane Library. Two independent reviewers selected publications using a two-stage process; data were extracted according to PRISMA statement. The Newcastle Ottawa Scale was used to evaluate the risk of bias in individual studies. After screening of the 5460 studies selected 20 publications were included in the systematic review, 15 underwent quantitative analysis. In the palsy population statistical analysis showed an OR = 1.45 (95% CI: 1.05-2.00) for dental caries in the primary dentition and OR = 1.87 (95% CI: 1.07-3.24) for the simplified oral hygiene index. The OR of Angle's Class II and anterior open bite were 3.27 (95% CI: 1.22-8.81) and 14.06 (95% CI: 6.26-31.62), respectively. CONCLUSION: Children with cerebral palsy seem to present an increased risk of dental caries in the primary dentition, of Angle's Class II malocclusion, anterior open bite and a lower gingival status.

Relationship between preterm birth and developmental defects of enamel: A systematic review and meta-analysis.

BACKGROUND: A putative relationship between preterm birth and developmental defects of enamel (DDE) has been described in the literature. Although systematic reviews have found preterm birth may lead to DDE, the effect size has not been quantified. AIM: The aim of this systematic review and meta-analysis was to determine the association between preterm birth and DDE. DESIGN: An electronic search was performed in PubMed, Cochrane Library, Scopus, and Web of Science to identify relevant studies. Two independent reviewers selected the studies in a two-stage process in accordance with the PRISMA statement. The risk of bias was also analysed using the Newcastle-Ottawa Scale criteria. RESULTS: A total of 1041 publications were considered after an electronic search, 20 of which were included in the systematic review. Of these 20 publications, 18 articles were included in a meta-analysis. The meta-analysis detected an increased risk of developing DDE in preterm children [OR: 3.27 (95% CI 2.02, 5.30; P < .001)], with a greater risk in the primary dentition. In addition to this, a subgroup analysis showed a greater risk in the development of hypoplasia in preterm children. CONCLUSIONS: The results of this meta-analysis showed a three times increased risk of developing DDE in preterm children.

Can psychobiotics intake modulate psychological profile and body composition of women affected by normal weight obese syndrome and obesity? A double blind randomized clinical trial.

BACKGROUND: Evidence of probiotics effects on gut function, brain activity and emotional behaviour were provided. Probiotics can have dramatic effects on behaviour through the microbiome-gut-brain axis, through vagus nerve. We investigated whether chronic probiotic intake could modulate psychological state, eating behaviour and body composition of normal weight obese (NWO) and preobese-obese (PreOB/OB) compared to normal weight lean women (NWL). METHODS: 60 women were enrolled. At baseline and after a 3-week probiotic oral suspension (POS) intake, all subjects underwent evaluation of body composition by anthropometry and dual X-ray absorptiometry, and psychological profile assessment by self-report questionnaires (i.e. EDI-2, SCL90R and BUT). Statistical analysis was carried out using paired t test or a non-parametric Wilcoxon test to evaluate differences between baseline and after POS intake, one-way ANOVA to compare all three groups and, where applicable, Chi square or t test were used to assess symptoms. RESULTS: Of the 48 women that concluded the study, 24% were NWO, 26% were NWL and 50% were PreOB/OB. Significant differences in body composition were highlighted among groups both at baseline and after a POS (p < 0.05). After POS intake, a significant reduction of BMI, resistance, FM (kg and %) (p < 0.05), and a significant increase of FFM (kg and  %) (p < 0.05) were observed in all subjects in NOW and PreOB/OB. After POS intake, reduction of bacterial overgrowth syndrome (p < 0.05) and lower psychopathological scores (p < 0.05) were observed in NWO and PreOB/OB women. At baseline and after POS intake, all subjects tested were negative to SCL90R_GSI scale, but after treatment subjects positive to BUT_GSI scale were significantly reduced (8.33%) (p < 0.05) compared to the baseline (33.30%). In NWO and PreOB/OB groups significant differences (p < 0.05) in response to the subscales of the EDI-2 were observed. Significant improvement of the orocecal transit time was observed (p < 0.05) after POS intake. Furthermore, significant differences were observed for meteorism (p < 0.05) and defecation frequency (p < 0.05). CONCLUSIONS: A 3-week intake of selected psychobiotics modulated body composition, bacterial contamination, psychopathological scores of NWO and PreOB/OB women. Further research is needed on a larger population and for a longer period of treatment before definitive conclusions can be made. Trial registration ClinicalTrials.gov Id: NCT01890070.

Association between Oro-Facial Defects and Systemic Alterations in Children Affected by Marfan Syndrome.

BACKGROUND: It is important to establish an early diagnosis of the Marfan Syndrome (MFS) for providing an adequate pharmacological or surgical therapy. Nevertheless, this diagnosis may be complex, given the multi-organic involvement of this disease. AIMS: In this work, we evaluated the oral phenotype in a group of paediatric patients with a clinical diagnosis of MFS, to quantify the association of the oro-facial defects with other systemic alterations. SETTINGS AND DESIGN: Paediatric subjects who were aged, with a clinical diagnosis of MFS, were selected from our regional Marfan monitoring unit. METHODS AND MATERIAL: All the patients were subjected to Paediatric Dentistry examinations and a radiological screening with Panoramic and Cephalometric X-Rays. The aortic dilation (Aortic Z-score value), the hyperlaxity of the ligaments and scoliosis were evaluated by cardio-surgical and orthopaedics specialists. STATISTICAL ANALYSIS: The correlations between the oral and systemic alterations were analyzed by using the chi square test for the nominal variables. RESULTS AND CONCLUSIONS: We found a significant correlation of the Aortic Z - score with multiple oral defects which included retrognathia, malar hypoplasia, cross bite, oral respiration and an ogival palate. An association of the oral defects with hyperlaxity of the ligaments and scoliosis was also found. Thus, the data suggested that dentists should be more involved in a multidisciplinary approach, to provide an early MFS diagnosis in paediatric patients.

Comparing the efficacy in reducing dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a commercial sensitive toothpaste containing 2% potassium ion: an eight-week clinical study in Rome, Italy.

OBJECTIVE: This paper presents the results of one of two eight-week dentin hypersensitivity clinical studies in which the efficacy of a novel toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate (MFP) was compared to that of a benchmark commercial toothpaste containing 2% potassium ion, dosed as 3.75% potassium chloride, and 1450 ppm fluoride as sodium fluoride (NaF). METHODS: An eight-week clinical study, with eighty patients, was conducted in Rome, Italy using a double-blind, stratified, two-treatment design. Tactile sensitivity assessments, as well as air blast sensitivity assessments, were used to compare the efficacy of the two products. RESULTS: This clinical study showed that the new toothpaste containing 8.0% arginine and 1450 ppm fluoride as MFP in a calcium carbonate base provided a significant reduction in dentin hypersensitivity when used over a period of eight weeks. The study also showed that this new arginine toothpaste provided significantly greater reductions (p < 0.05) in dentin hypersensitivity in response to tactile (37.0%, 30.0%, and 12.2%) and air blast (23.9%, 32.0%, and 29.3%) stimuli than the commercial sensitive toothpaste containing 2% potassium ion and 1450 ppm fluoride as NaF in a silica base, after two weeks, four weeks, and eight weeks of product use, respectively. CONCLUSION: A new toothpaste containing 8.0% arginine calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate (MFP) provides significantly increased dentin hypersensitivity relief (p < 0.05) compared to a commercial sensitive toothpaste containing 2% potassium ion after two weeks, four weeks, and eight weeks of product use.

Desensitizing efficacy of a new toothpaste containing 5.5% potassium citrate: a 4-week clinical study.

PURPOSE: To evaluate the desensitizing capabilities of a new toothpaste containing 5.5% potassium citrate (Colgate Sensitive Multi Protection Toothpaste) to another toothpaste containing 3.75% potassium chloride (Sensodyne Total Care F Toothpaste). METHODS: A 4-week clinical study was conducted in 75 subjects at the University of Rome, at Tor Vergata, in Rome, Italy, using a double blind, stratified, two treatment design. Tactile sensitivity as well as air blast sensitivity assessment was used to compare the efficacy of the two products. RESULTS: There was no statistically significant difference in tactile sensitivity scores and air blast sensitivity scores between the tested toothpastes at baseline, 2 weeks and 4 weeks. Both toothpastes provided statistically significant improvement in tactile sensitivity scores and air blast sensitivity scores after 2 weeks of use and 4 weeks of use as compared to baseline scores.