Oral health-related quality of life among women early postpartum: A cross-sectional study.

BACKGROUND: Periodontal diseases can negatively impact the oral health-related quality of life (OHRQoL) of pregnant women. This study investigates the association between maternal oral inflammatory load (OIL), sociodemographic characteristics, and the OHRQoL in postpartum women. METHODS: In this cross-sectional study, breastfeeding mothers were recruited from St. Michael's Hospital, Toronto within 2-4 weeks postpartum. Mothers were categorized into "Normal/low" and "High" OIL groups based on the absolute counts of oral polymorphonuclear neutrophils (oPMNs). The Oral Health Impact Profile-14 questionnaire was used to assess the impact of the maternal OIL on the OHRQoL. Multiple linear regression analyses were performed to examine the association between maternal sociodemographic factors including age, marital status, education level, employment status, parity, and their OHRQoL. RESULTS: Forty-seven mothers were included in this study. Mothers with high OIL reported higher impact on their OHRQoL (30%) than mothers with normal/low OIL (21%), but these differences were not statistically different. There was a negative relationship between the mother's education level and the extent of impact of OHRQoL on the "physical pain" dimension (p < 0.05), and between the mothers' age and employment status and the "physical disability" dimension (p < 0.05). A positive correlation was noted between multi-parity and the extent of impact of OHRQoL on the "physical disability" dimension (p = 0.009), and between the marital status and the "psychological disability" dimension (p < 0.05). CONCLUSION: This study highlighted the significant impact of sociodemographic characteristics on the OHRQoL of mothers, showcasing the importance of considering these factors when implementing targeted preventive dental care programs for mothers.

The Association between Maternal Oral Inflammation and Neutrophil Phenotypes and Poly-Unsaturated Fatty Acids Composition in Human Milk: A Prospective Cohort Study.

This prospective cohort study aimed to investigate the impact of maternal oral inflammation on human milk composition including neutrophil counts, activation state (based on cluster of differentiation (CD) markers expression), and fatty acid levels. Fifty mothers were recruited from St. Michael's hospital, Toronto, and followed up from 2-4 weeks until 4 months postpartum. Oral rinse and human milk samples were collected at both timepoints. Oral polymorphonuclear neutrophils (oPMNs) within the rinses were quantified using flow cytometry and the participants' oral health state was categorized into three groups (i.e., healthy, moderate, and severe) based on the oPMNs counts. Fatty acids were identified and quantified using a gas chromatography-flame ionization detector (GC-FID). Compared to mothers with a healthy oral health state, mothers with moderate to severe oral inflammation had a statistically significant decrease in the expression of CD64 biomarker, an increase in the expression of CD14 biomarker on human milk neutrophils and a decrease in the levels of eicosapentaenoic acid (C20:5n-3) in their human milk at follow-up compared to baseline. This study demonstrates for the first time that maternal oral inflammation can affect human milk composition. The mechanism by which these alterations can affect infant health outcomes in the long term critically needs to be considered.

Should dental schools adopt teledentistry in their curricula? Two viewpoints.

INTRODUCTION: Teledentistry is a cutting edge technology that could be used to improve access to care to underserved populations and those in remote areas. OBJECTIVES: To discuss the advantages and disadvantages of adopting teledentistry into the predoctoral dental curriculum. METHODS: Two teams of dentists reviewed the pros and cons of introducing teledentistry into the predoctoral dental curriculum. RESULTS: Viewpoint 1 produced evidence that teledentistry is a cutting-edge technology that can improve access to care for underserved populations in a practical, cost-effective manner. Viewpoint 2 showed evidence that teledentistry is too new to have an evidence base to support its widespread use, legal and regulatory requirements have not been established and there is no precedent for third party payers to reimburse for this service. CONCLUSION: The authors feel that a national teledentistry policy should be developed starting at the state level with stakeholders from the dental profession, dental education, government, patient advocates, and third party payers working together to determine the best way forward.

The impact of oral health education taken by personal support workers caring for a geriatric population in a long-term care facility: A mixed-methods study.

OBJECTIVE: To evaluate the impact of an online oral health education module on personal support workers' (PSW) knowledge and beliefs in their care for long-term care (LTC) residents in one Canadian LTC residence. BACKGROUND: LTC residents are dependent on PSWs for their oral health needs. However, PSWs receive minimal to no oral health education placing residents at risk for poor oral health. METHODS: A mixed-methods convergent design comprising a before-and-after questionnaire (N = 88), focus groups (N = 23) and interviews (N = 4) exploring module learning. Analysis of each data set was followed by their amalgamation and comparison. RESULTS: The online module had limited impact on the PSWs' knowledge and beliefs regarding resident oral health care. The quantitative results demonstrated knowledge improvements in two domains and changes in two belief domains. However, the qualitative results demonstrated new knowledge was not developed or sustained in practice. Themes that emerged include the following: lack of module recall, unmet learning needs and methods for oral care delivery, and timing of oral care in a busy clinical environment. CONCLUSION: Online oral health education alone has limited impact on PSWs' knowledge and beliefs. Research evaluating multifaceted education interventions including hands-on training with a dental expert is warranted.

The Effect of Contamination of Implant Screws on Reverse Torque.

PURPOSE: To determine if contamination of abutment screws with titanium nanoparticles affects the preload by measuring the reverse torque after multiple cycles of screw closing-opening. MATERIALS AND METHODS: The study included 30 internal hex implants, titanium abutments, and titanium abutment screws. Fifteen abutment screws were contaminated with 60- to 80-nm titanium nanoparticles (contamination group), and the remaining 15 screws did not receive titanium nanoparticle contamination (noncontamination group). Each abutment screw was initially tightened to 25 Ncm with a digital torque gauge to stabilize the abutment to the implant. The second torque, 25 Ncm, was applied 10 minutes after the initial torque. After an additional 5 minutes, the screw was loosened to measure the reverse torque. Ten cycles of screw insertion and removal were conducted, and reverse torque values were measured in each cycle. Repeated measures analysis of variance and the Student t test were used for statistical analysis. The level of significance was set at α = .05. After 10 cycles of closure-opening, abutment screw threads were observed under ×40 magnification. RESULTS: Abutment screws at every cycle generally showed preload values less than the initial applied torque. The mean reverse torque values in both groups had a tendency to decline as the test cycle progressed, except at the 6th, 9th, and 10th cycle in the contamination group. The noncontamination group always had higher mean reverse torques than the contamination group at the same test cycle with significant differences at the 1st, 2nd, 4th, 5th, 7th, and 8th cycles. The preload loss in percentages were 7.83% and 12.57% after the 1st cycle, 14.48% and 19.77% after 5 cycles, and 18.83% and 19.83% after 10 cycles in the noncontamination and contamination group, respectively. Abutment screws in both groups showed various degrees of wear and metal debris on screw surfaces. CONCLUSION: Contamination of abutment screws with titanium nanoparticles decreased screw reverse torque values because of a settling effect, though this effect seemed minimal after five cycles. A future clinical study is indicated to validate if cleaning of contaminated screws before the delivery of the prosthesis will increase preloads.

Performance of conical abutment (Morse Taper) connection implants: a systematic review.

In this systematic review, we aimed to compare conical versus nonconical implant-abutment connection systems in terms of their in vitro and in vivo performances. An electronic search was performed using PubMed, Embase, and Medline databases with the logical operators: "dental implant" AND "dental abutment" AND ("conical" OR "taper" OR "cone"). Names of the most common conical implant-abutment connection systems were used as additional key words to detect further data. The search was limited to articles published up to November 2012. Recent publications were also searched manually in order to find any relevant studies that might have been missed using the search criteria noted above. Fifty-two studies met the inclusion criteria and were included in this systematic review. As the data and methods, as well as types of implants used was so heterogeneous, this mitigated against the performance of meta-analysis. In vitro studies indicated that conical and nonconical abutments showed sufficient resistance to maximal bending forces and fatigue loading. However, conical abutments showed superiority in terms of seal performance, microgap formation, torque maintenance, and abutment stability. In vivo studies (human and animal) indicated that conical and nonconical systems are comparable in terms of implant success and survival rates with less marginal bone loss around conical connection implants in most cases. This review indicates that implant systems using a conical implant-abutment connection, provides better results in terms of abutment fit, stability, and seal performance. These design features could lead to improvements over time versus nonconical connection systems.