Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren's syndromes patients - a cross-sectional study.

BACKGROUND: Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. METHODS: Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. RESULTS: The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8). CONCLUSIONS: Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

Barriers to pursuing further education among Canadian dental hygienists: a qualitative exploration.

Purpose: In recent years, C,anada has seen the development of new educational pathways to baccalaureate education for dental hygienists. Research has demonstrated that degree education strengthens dental hygienists' cognitive and practice abilities and increases career opportunities. However, the 2021 Canadian Dental Hygienists Association (CDHA) Job Market and Employment Survey reported that only 27% of respondents held a baccalaureate degree. The current study was the first to explore levels of interest in and barriers to pursuing degree education among Canadian diploma-holding dental hygienists. Methods: This qualitative explorative study utilized purposeful maximum variation sampling to select Canadian dental hygienists across 10 provinces and 1 territory for 3 e-focus groups. Selected participants (N = 17) were CDHA members who held a dental hygiene diploma as their highest educational credential. E-focus groups were thematically analysed for barriers using Saldaña's descriptive and in vivo coding. Results: All participants expressed an interest in pursuing further education at some point during their career. Reported barriers to doing so were family commitments, financial restrictions, accessibility, limited employer support, unfamiliarity with eligibility criteria, unfamiliarity with existing programs, stress/anxiety over returning to school, and unfamiliarity with the benefits of earning a degree. Conclusions: The qualitative research findings supplemented answer options for a subsequent national online research survey distributed to all CDHA members; results of that survey are not included in this article. National and provincial dental hygiene associations and educational institutions can use the study findings to develop strategies to reduce barriers and raise awareness of degree education among Canadian dental hygienists.

But: Le Canada constate un mouvement grandissant vers l'élaboration de nouvelles voies d'accès à l'obtention d'un baccalauréat pour les hygiénistes dentaires. La recherche a démontré que les études universitaires renforcent les capacités cognitives et de pratique des hygiénistes dentaires et augmente leurs possibilités de carrière. Toutefois, le Sondage sur le marché du travail et de l'emploi mené en 2021 par l'Association canadienne des hygiénistes dentaires (ACHD) a révélé que seulement 27 % des répondants détenaient un baccalauréat. La présente étude a été la première à examiner les niveaux d'intérêt et les obstacles liés la poursuite d'études universitaires chez les hygiénistes dentaires du Canada titulaires d'un diplôme. Méthodes: Cette étude qualitative exploratoire a utilisé une sélection maximale d'échantillons variés pour sélectionner par choix raisonné des hygiénistes dentaires dans 10 provinces et un territoire du Canada pour 3 groupes de discussion en ligne. Les participants sélectionnés (N = 17) étaient des membres de l'ACHD qui détenaient un diplôme en hygiène dentaire comme diplôme d'études le plus élevé. Les groupes de discussion en ligne ont été analysés par thème pour déterminer les obstacles à l'aide du codage descriptif et in vivo de Saldaña. Résultats: Tous les participants ont exprimé leur intérêt à poursuivre leurs études à un moment ou à un autre de leur carrière. Les obstacles signalés étaient les engagements familiaux, les restrictions financières, l'accessibilité, le soutien limité de l'employeur, la méconnaissance de l'admissibilité, la méconnaissance des programmes existants, le stress et l'anxiété liés au retour aux études et la méconnaissance des avantages de l'obtention d'un diplôme. Conclusion: Les résultats de la recherche qualitative ont enrichi les options de réponse pour un sondage national de recherche en ligne subséquent qui serait distribué à tous les membres de l'ACHD; les résultats de ce sondage ne sont pas inclus dans le présent article. Les associations nationales et provinciales d'hygiène dentaire et les établissements d'enseignement peuvent utiliser les résultats de cette étude pour élaborer des stratégies visant à réduire les obstacles et à sensibiliser les hygiénistes dentaires canadiens aux études universitaires.

Co-occurrence of dental caries and periodontitis: multilevel modelling approach.

BACKGROUND: Previous studies reported varyingly positive, negative, or no relationships between caries and periodontitis. Therefore, the aim was to assess the potential co-occurrence of caries experience and periodontal inflammation on the same teeth. METHODS: This cross-sectional study used data from the Lithuanian National Oral Health Survey. The study included a stratified random sample of 1405 individuals aged 34-78, recruited from 5 Lithuanian cities and 10 peri-urban/rural areas (response rate 52%). Information about sociodemographic (age, sex, education, residence), behavioral (sugar-containing diet, tooth brushing frequency, use of interdental care products, last dental visit, smoking) and biological (systemic disease, use of medication and xerostomia) determinants was collected using the World Health Organization (WHO) Oral Health Questionnaire for Adults supplemented with additional questions. Clinical data were recorded using the WHO criteria and collected by one trained and calibrated examiner. Dental caries status was recorded as sound, decayed, missing, filled surfaces. Subsequently for the analyses, status was recorded at a tooth-level as decayed- and filled-teeth (DT and FT) including proximal, buccal, and oral surfaces. Two measures were used for periodontal status. The probing pocket depth (PPD) was measured at six sites and recorded at a tooth level into the absence of PPD or presence of PPD ≥ 4 mm. Bleeding on probing (BOP) was measured at the same six sites and was recorded as either present or absent at a tooth-level. Univariable and multivariable 2-level random intercept binary logistic regression analyses were utilized. RESULTS: Positive associations were found between DT and BOP (OR 1.42, 95% CI 1.20-1.67), FT and BOP (OR 2.07, 95% CI 1.82-2.23), DT and PPD (OR 1.38, 95% CI 1.15-1.67) and FT and PPD (OR 2.01, 95% CI 1.83-2.20). CONCLUSIONS: Our findings add evidence for the co-occurrence of periodontal inflammation and caries on the same teeth. This suggests the need for increased emphasis on a transdisciplinary approach in designing oral health interventions that target dental caries and periodontal disease simultaneously. In addition, longitudinal studies exploring the co-occurrence of caries and periodontal disease at the same sites, taking into consideration the levels of both conditions and genetic variation, are warranted.

Measuring the outcomes of lateral ridge augmentation using cone-beam computed tomography.

OBJECTIVES: Lateral ridge augmentation (LRA) is a surgical technique to gain bone prior to implant placement. Performing cone-beam computed tomography (CBCT) pre- and post-surgery allows for quantitative comparison of the buccal-lingual width and the vertical height of the edentulous ridges. This study used CBCT images to evaluate the bone regeneration following surgery. METHODS: A total of 30 cases from adult patients who underwent LRA and had high-quality CBCT images taken pre- and post-surgery from the same CBCT scanner were available for the retrospective study. Study data included linear measurements of the bone ridge width and height obtained from the middle of the edentulous ridge and a volumetric measurement of bone growth at the edentulous site observed on the CBCT scan. RESULTS: The reliability of the measurements was excellent as indicated by Intra-Class Coefficient values of 0.974 or higher. There was a significant mean bone increase from pre-surgery compared to post-surgery for both the linear and volumetric measurements. The linear bone gain ranged from 1.5 to 2.5 mm and volumetric gain from 250 to 750 mm3 . However, two patients did not gain any bone. Multivariate regression showed the strongest predictors of bone gain post-surgery were the pre-surgery bone volume and a surgical site being in the mandible. For maxillary surgical sites, particularly anterior areas, the LRA surgeries were the least successful. CONCLUSIONS: LRA before implant placement helped to increase bone for the majority of patients, particularly for surgical sites in the mandible. The quantitative analyses in the CBCT images showed excellent intra-examiner agreement.

Non-odontogenic maxillofacial infections - a 17-years retrospective cohort study.

PURPOSE: A retrospective 17-year review of the epidemiology, microbiological aspects, and treatment of patients hospitalized for non-odontogenic maxillofacial infections. METHODS: A retrospective study reviewed 4040 medical records of patients hospitalized at Vilnius University Hospital Zalgiris Clinic during the period of 2003 to 2019. The following data were collected: patient sociodemographic characteristics, length of hospitalization, sources of infection, affected anatomical regions, treatment modalities, microbiological findings, and sensitivity to antibiotics. RESULTS: The mean (sd) annual incidence of non-odontogenic maxillofacial infections over the past 17 years was 237 (49) cases, and the mean (sd) hospital stay was 7.3 (4.5) days. The male-to-female ratio was 1.9:1, while the mean (sd) patient age was 42.1 (19.0) years. The need for an additional incision and the involvement of multiple anatomical regions were the strongest predictors of longer hospitalization. A total of 139 microorganism species were identified, with Bacteroides, Prevotella, and Staphylococcus showing the highest resistance to penicillin. CONCLUSIONS: Longer hospital stays were associated with older age (≥ 65 years), smoking, systemic diseases, type of treatment, involvement of multiple anatomical regions, and the need for additional surgery. Most of the cultured microorganisms were Staphylococcus species.

Cone-beam computed tomographic reconstructions in the evaluation of maxillary impacted canines.

Purpose: Prior to cone-beam computed tomography (CBCT), orthodontic competence included radiological interpretation. Nevertheless, maxillary impacted canines (MICs), because of their position and adjacent complex anatomy, have been challenging to interpret, particularly with regard to root resorption. Although CBCT cross-sectional reconstructions of MICs yielded clearer insights into its diagnosis and treatment planning, the value of simultaneously using 2 different cross-sectional or multiplanar reconstructions of the CBCT datasets - orthogonal and curved/panoramic multiplanar reconstructions - has hitherto not been considered. Materials and Methods: Both orthogonal and curved/panoramic multiplanar reconstruction series of 5 screenshots were each reconstructed from the 5 cm × 5 cm CBCT datasets of 15 separate MICs. Fifteen credentialled and experienced orthodontist volunteers reviewed 2 separate PowerPoints of 15 randomized series each, 1 week apart. Their review considered 6 factors that could affect treatment: the position and level of the MIC, the presence or absence of root resorption, ankylosis, cysts, and dilaceration. Results: All 15 orthodontists were statistically similar regarding overall years of experience and of CBCT use. Although either reconstruction alone allowed the orthodontists to determine whether ankylosis and, to a lesser extent, most of the other features were present or absent in the MIC, reviewing both reconstructions together was necessary to determine whether root resorption was present or absent in the adjacent tooth. Conclusion: Reviewing both orthogonal and curved/panoramic multiplanar reconstructions was necessary to evaluate the presence or absence of root resorption in the teeth adjacent to MICs and that of many other features.

Association between Carbonic Anhydrase VI Gene Copy Number Variations and Dental Caries Experience.

The current study examined the association between the carbonic anhydrase VI (CA VI) copy number variations (CNVs) and dental caries experience in adults. In total, 202 of 35-72 years old subjects participating in the Lithuanian National Oral Health Survey (LNOHS) agreed to provide saliva samples; thus, their data were included in the current study. Information about sociodemographic, environmental, and behavioural determinants was acquired via the self-administered World Health Organization (WHO) questionnaire. Fluoride levels in the drinking water were recorded based on information provided by water suppliers. Dental caries experience was recorded by one calibrated examiner using the WHO criteria for recording caries on smooth (including proximal, buccal, and oral) or occlusal surfaces. Caries experience was measured as the total number of decayed (D3), missing (M), filled (F) surfaces. DNA was extracted from saliva samples to examine CA VI CNVs using the QX200 Droplet Digital PCR system. Negative binomial regression and Poisson regression analyses were employed for data analyses. Based on multivariable regression analyses, higher copy number of CA VI were associated with higher caries experience on smooth surfaces (IRR 1.04, 95% CI: 1.005-1.08) and occlusal surfaces (IRR 1.02, 95% CI: 1.003-1.04). Positive associations between higher copy number of CA VI and higher caries experience on smooth and occlusal surfaces were found, suggesting that the CA VI coding gene may be associated with caries development. Future studies are needed to validate our results and to examine the underlying mechanisms of such associations.

Effect of Temporary Cement, Surface Pretreatment and Tooth Area on the Bond Strength of Adhesively Cemented Ceramic Overlays-An In Vitro Study.

Several viewpoints have been reported regarding the effect of temporary cements, different surface pretreatment protocols before adhesive cementation, and predictive factors. This in vitro study tested if temporary cement, pretreatment of the tooth surface, the size of enamel or dentine influence adhesive cementation to zirconia ceramics. Twenty premolars were prepared for determination of enamel and dentin area, bond strength test and failure analysis. The samples were divided into two groups: untreated prior adhesive cementation (n = 10) and with temporary cementation done, pretreated prior adhesive cementation (n = 10). Zirconia overlays (Katana Zirconia STML) were cemented on the grounded flat teeth surfaces using Panavia V5. An additional six premolars underwent dentine tubule analysis with SEM to detect temporary cement residues after temporary cementation on an untreated tooth surface (n = 3) and on a pretreated surface (n = 3). The independent sample t-test was used to compare the two groups and the means of the total tooth, dentin or enamel areas did not differ significantly between the untreated and pretreated specimens. The mean tensile bond strength was significantly (p = 0.005) higher in the pretreated specimens (337N) than in the untreated ones (204N). The overall multivariable linear regression model with three predictors (surface pre-treatment, enamel area and dentine area) was significant (p = 0.003), among which the size of enamel was the strongest predictor (ß = 0.506; p = 0.049), followed by the pretreatment effect (ß = 0.478; p = 0.001) and the size of dentin area (ß = -0.105; p = 0.022).

The 20-Year Trends in Caries and Associated Determinants among Adults in Post-Soviet Lithuania: Repeated Cross-Sectional Studies.

AIM: The aim of the study was to examine the 20-year trend in dental caries and associated determinants among adults in Lithuania after the country restored its independence. MATERIAL AND METHODS: Data from two cross-sectional national surveys included samples of 35-44-year-olds (adults) and 65-74-year-olds (early elderly). The 1997/1998 survey (first survey) recruited a stratified random sample of 569 individuals from 10 selected areas in Lithuania (response rate 52%), and the 2017/2019 survey (second survey) recruited a stratified random sample of 723 individuals from 5 biggest Lithuanian cities and one randomly selected peri-urban/rural area from each of 10 Lithuanian counties (response rate 53%). The information about the social (sex, residence, education) and behavioral (toothbrushing frequency, use of fluoridated toothpaste, and last dental visit) determinants was collected via self-reports using the World Health Organization (WHO) Oral Health Questionnaire for Adults questions. Information about the fluoride level in the drinking water was retrieved from the water suppliers. Dental caries was recorded at the surface level following the WHO criteria by two calibrated examiners, one at each of the national surveys. Bivariate and multivariate analyses were used. RESULTS: According to multivariable negative binomial regression analysis, in adults, 67% lower DS scores (IRR 0.33, 95% CI 0.26-0.42) and in early elderly 47% lower DS scores (IRR 0.53, 95% CI 0.38-0.74) were observed in the second survey. Adults in the second survey (vs. first survey) had 62% lower MT scores (IRR 0.38, 95% CI 0.32-0.46), and the early elderly had 19% lower MT scores (IRR 0.81, 95% CI 0.72-0.92). Adults in the second survey had 21% lower DMFT scores (IRR 0.79, 95% CI 0.73-0.85). The changes in behavioral determinants were observed over the 20-year period. CONCLUSION: An improvement in dental health during the 20-year period, mainly related to reduction in untreated caries and missing teeth, was observed in adults and early elderly. However, early elderly still had high numbers of missing teeth. The decrease in total caries experience during the 20 years was significant only in adults. Our findings support an urgent need to design and implement national oral health promotion and prevention programs with increased focus on oral self-care and fluoridated toothpaste use.

Theory-Guided Remote Cooperative Learning-Based Preventive Dental Education as Part of the School Curriculum.

BACKGROUND: Oral health is fundamental to overall well-being. As teens are at high risk for tooth decay, we require a unique approach to motivate them to maintain oral health. METHODS: Sixty-four adolescents (10-13 years) were recruited from 2 schools. Oral health education was based on cooperative learning guided by the social determination theory (SDT) principles. Students' oral health knowledge and oral self-care skills were assessed at baseline (before education), 3 weeks, and 6 months after the education. RESULTS: Complete data were available for 51 students (follow-up rate 79.7%). There were significant (p < 0.001) changes in the mean (SD) toothbrushing score from 10.1 (±6.3) (baseline) to 26.5 (±6.0) (follow-up 1) and to 28.1 (±5.3) (follow-up 2). The mean (SD) tooth brushing time significantly (p < 0.001) increased from the baseline of 84.0 (±43.5) to the first follow-up to 107.0 (±39.8) and to 102.3 (±33.1) at the second follow-up. The mean (SD) diet knowledge scores significantly (p < 0.001) increased from 8.2 (±2.1) at the baseline to 10.2 (±2.7) at the first follow-up and remained the same at the second follow-up. CONCLUSION: Social determination theory-guided cooperative learning was efficient in improving student oral health-related knowledge and oral self-care skills, and this improvement was maintained for 6 months after the discontinued education.

Community service-based preventive dental education for elementary school-aged children.

OBJECTIVES: The effectiveness of one-to-one preventive dental education provided by dental undergraduate students for improving elementary school-aged children's oral self-care skills, diet-related knowledge, and diet behavior was tested. METHODS: The sample consisted of 106 children between the ages of 5 and 12 years who attended the same school. Oral self-care skills were assessed by undergraduate dental students using a tooth-brushing assessment form, and diet knowledge and behaviors by means of a questionnaire. The effectiveness of education (two one-to-one sessions) was evaluated by measuring the post-educational changes in the children's oral self-care skills, diet knowledge, and behavior. RESULTS: There were significant improvements in the means (sd) of tooth-brushing skill scores (range: 0-18) from 6.2 (4.0) at the baseline to 8.4 (4.1) at the first and to 10.3 (3.0) at the second follow-up. Total tooth-brushing time (in seconds) significantly increased from 76.0 (59.1) at the baseline to 110.7 (74.3) at the first follow-up then decreased to 102.6 (73.1) at the second follow-up. The means (sd) of diet knowledge scores (range: 0-30) improved significantly from 18.5 (5.6) at the baseline to 23.0 (7.3) at the first and to 24.5 (4.0) at the second follow-ups. The means (sd) of weekly sugar intake scores (range: 0-18) significantly decreased from 4.9 (2.1) at the baseline to 3.1 (2.0) at the first follow-up and remained unchanged until the second follow-up. CONCLUSIONS: One-to-one dental education improved children's oral self-care skills, diet-related knowledge, and diet behavior. The post-educational improvements were maintained for 6 months in older children but not in the younger children.

Self-determination theory guided oral self-care training for adolescents-A cluster randomised controlled trial.

Quality oral self-care is a key element in maintaining oral health, which is important for students' general health, their overall well-being and learning. The cluster randomised controlled trial tested the following hypotheses: (1) self-determination theory (SDT)-guided dental education is superior to conventional dental instruction in modifying oral self-care in adolescents; (2) after the discontinued dental education, improved oral self-care is only maintained for short rather than long term and (3) multiple predictors explain variations in adolescents' oral self-care at different observation periods. The intervention group (N = 97) received three face-to-face educational sessions to facilitate adolescents' intrinsic motivation, while the control group (N = 99) had one conventional dental instruction session. Dental plaque scores (% of tooth area covered by dental plaque) indicated a lack of oral self-care. Linear multivariable models tested the following predictors of oral self-care at different observation periods: socio-demographics (sex, socio-economic status, school) and self-determination attributes (autonomy, relatedness, competence). Results indicated that from baseline to the 6-month follow-up, dental plaque scores decreased (oral self-care improved) in the intervention group but not in the control group. At the 12-month follow-up point, there were no significant differences in mean plaque scores between the study groups. Baseline plaque levels (ß = 0.807), the type of dental instruction (theory guided vs. conventional) (ß = 0.208), relatedness (ß = 0.106) and competence (ß = 0.102) were significant predictors that explained 67.6% of the variance in dental plaque scores at the 12-month follow-up point. The theory-guided education was superior to conventional verbal instruction in improving adolescent oral self-care; however, this improvement was only maintained short term. Variations in adolescent oral self-care at short- and long-term observation points were explained by baseline oral self-care levels and two SDT components: relatedness and competence.

Parental psychosocial factors, unmet dental needs and preventive dental care in children and adolescents with special health care needs: A stress process model.

BACKGROUND: Children and adolescents with special health care needs (SHCN) have higher unmet dental needs, but the potential mechanisms by which parental factors can influence dental care use have not been determined. Parenting a child with SHCN can present special demands that affect parents' well-being and, in turn, their caregiving. Hence, the study's overall aim was to apply the stress process model to examine the role of parental psychosocial factors in the association between child SHCN and dental care. Specifically, the study tested hypotheses regarding how (a) children's SHCN status is associated with child dental care (unmet dental needs and lack of preventive dental visits), both directly and indirectly via parental psychosocial factors (parenting stress, instrumental, and emotional social support) and (b) parental social support buffers the association between parenting stress and child dental care. METHODS: A secondary data analysis of the 2011-2012 US National Survey of Children's Health was performed for 6- to 11-year-old children (n = 27,874) and 12- to 17-year-old adolescents (n = 31,328). Our age-stratified models estimated associations between child SHCN status and parental psychosocial factors with two child dental care outcomes: parent-reported unmet child dental needs and lack of preventive dental care. RESULTS: Parents of children with (vs without) SHCN reported higher unmet child dental needs, higher parenting stress, and lower social support (instrumental and emotional). Instrumental, but not emotional, parental support was associated with lower odds of their child unmet dental needs in both age groups. The association between parenting stress and child dental care outcomes was modified by parental social support. CONCLUSION: Differences existed in child unmet dental needs based on SHCN status, even after adjusting for parental psychosocial factors. SHCN status was indirectly associated with unmet dental needs via parental instrumental support among adolescents, and parental instrumental support buffered the negative association between parenting stress and both child dental care outcomes. Hence, parental social support was an important determinant of child dental care and partially explained the dental care disparities in adolescents with SHCN.

Peer-led oral health education model for elementary school-aged children in British Columbia, Canada.

Objective: To examine the effectiveness of peer-led preventive oral health education for elementary school-aged children. Methods: A controlled, non-randomized interventional study included children in grades 4 to 6 (N = 372) from 6 schools in British Columbia, Canada. The control group (3 schools) received a class-based lecture on oral health. In the intervention group (3 schools), each sixth grader mentored a small group of fourth and fifth graders. The study outcomes were 1) need for oral care referrals (visual screening); 2) oral health knowledge (self-reports); 3) oral self-care practice (OSC-P); and 4) oral self-care skills (OSC-S). Assessments of OSC-P and OSC-S were based on disclosed dental biofilm levels. Study group comparisons were done at baseline and 8 to 12 months. Results: A high need for oral care referrals was found, with a substantial reduction achieved during the study period. Dietary knowledge improved minimally in the intervention group. In both study groups and within age groups, there was a wide variation in OSC-P and OSC-S. Overall, children's OSC-P scores were substantially higher than their OSC-S scores. Oral self-care outcomes improved over time in both groups (except for fourth graders in the control group), with a more substantial improvement in the intervention group. From baseline to study end, the mean OSC-P improved by 11.9% (intervention group) and 5.9% (control group). Improvement values for OSC-S were 12.8% and 5.2%. Conclusions: The need for oral care referrals was reduced, but improvement in oral health knowledge was minimal. Oral self-care outcomes improved more in the intervention than in the control group.

Objectif: Examiner l'efficacité de l'éducation préventive sur la santé buccodentaire menée par les pairs pour les enfants en âge de fréquenter l'école primaire. Méthodologie: Un groupe d'intervention, contrôlé et non randomisé comprenait des enfants de la 4e à la 6e année (N = 372) de 6 écoles en Colombie-Britannique, au Canada. Le groupe témoin (3 écoles) a reçu une leçon en classe sur la santé buccodentaire. Dans le groupe d'intervention (3 écoles), chaque élève de la sixième année a encadré un petit groupe d'élèves de la quatrième et de la cinquième année. L'étude a produit les résultats suivants : 1) besoin d'aiguillage vers des soins buccodentaires (dépistage visuel); 2) connaissances en matière de santé buccodentaire (auto-évaluations); 3) pratique en matière de soins buccodentaires personnels (P-SBP); et 4) compétences en matière de soins buccodentaires personnels (C-SBP). Les évaluations de la P-SBP et des C-SBP étaient fondées sur la divulgation des niveaux de biofilms dentaires. Les comparaisons des groupes d'études étaient effectuées au début de l'étude et après 8 à 12 mois. Résultats: Un besoin important d'aiguillages vers des soins buccodentaires a été constaté, accompagné d'une réduction substantielle réalisée au cours de la période d'étude. Les connaissances nutritionnelles se sont peu améliorées dans le groupe d'intervention. Il y avait une importante disparité entre la P-SBP et les C-SBP dans les 2 groupes d'étude et au sein des groupes d'âge. Dans l'ensemble, les cotes de la P-SBP des enfants étaient nettement plus élevées que leurs cotes de C-SBP. Les résultats en matière de soins buccodentaires personnels se sont améliorés au fil du temps dans les 2 groupes (à l'exception des élèves de quatrième année du groupe témoin). L'amélioration était la plus importante dans le groupe d'intervention. Entre le début et la fin de l'étude, l'amélioration moyenne de la P-SBP était de 11,9 % (groupe d'intervention) et de 5,9 % (groupe témoin). Les valeurs d'amélioration des C-SBP étaient de 12,8 % et de 5,2 %. Conclusions: Les aiguillages vers des soins buccodentaires étaient moins nécessaires, alors que l'amélioration des connaissances en matière de santé buccodentaire était minime. L'amélioration des résultats des soins buccodentaires était plus importante dans le groupe d'intervention que dans le groupe témoin.

Accuracy of Estimating Periodontitis and Its Risk Association Using Partial-Mouth Recordings for Surveillance Studies: A Systematic Review and Meta-Analysis.

Objectives: Our aim is to conduct an up-to-date systematic review and meta-analysis pertaining to the accuracy of using the partial-mouth recording protocol (PRP) in surveillance studies to estimate the periodontitis prevalence, extent, severity, and its risk associations. Methods: Medline and Embase databases were searched for studies which assessed the periodontitis prevalence, severity, extent, or its risk associations using PRPs versus full-mouth recording protocols (FRPs); searches were conducted up until May 26, 2021. The risk of bias and the applicability of the studies were assessed using the QUADAS-2 tool. Both qualitative data synthesis and quantitative data synthesis were performed, and comparisons were done for the accuracy and precision of PRPs for different periodontitis outcomes. The study's protocol was registered through the International Platform of Registered Systematic Review and Meta-analysis Protocols (registration number: INPLASY202160032). Results: A total of 14 studies were included. The studies had a considerable degree of heterogeneity, along with a moderate risk of bias and applicability concerns. Several factors influenced the accuracy or precision of using PRPs, including the age, distribution of periodontitis in the studied population, PRP selection, total PRP sites, the threshold for minimum sites with CAL, and the severity of periodontitis case definitions. Overall, the PRP with the highest accuracy and precision mainly included (1) a full-mouth protocol at the following partial sites: mesiobuccal-midbuccal-distolingual (MB-B-DL), mesiobuccal-distolingual (MB-DL), mesiobuccal-midbuccal-distobuccal (MB-B-DB), mesiobuccal-distobuccal (MB-DB), and 84 sites using the random site selection method (RSSM) and (2) random-half-mouth (RHM) protocols. Conclusions: The PRPs with the highest overall accuracy and precision in estimating the periodontitis prevalence, extent, severity, and risk associations included the full-mouth assessment at the following partial sites: MB-B-DL, MB-DL, MB-B-DB, MB-DB, and 84 sites using RSSM and RHM protocols.

External cervical resorption - Treatment outcomes and determinants: A retrospective cohort study with up to 10 years of follow-up.

AIM: To assess long-term external cervical resorption (ECR) treatment outcomes in relation to both local and treatment-related determinants. METHODOLOGY: Information was available for 76 patients (98 teeth) who were diagnosed with ECR during the period from 2008 to 2018 at the University of British Columbia graduate endodontics clinic. The ECR patients were followed up, and a clinical and radiographic examination was conducted. Chi-square test compared failure rates amongst different subgroups. The survival analysis was used to evaluate the overall ECR survival/failure rates in relation to several local and treatment-related determinants. RESULTS: Overall, 67 patients (89 teeth) were followed up. The mean follow-up time was 3.9 years, and the minimum was 1 year. Twenty-four teeth failed (19 extracted, 5 not functional), and the overall probability of failure was 50.0% 8 years after the diagnosis. Significant (p < .05) local ECR determinants were tooth location and the Heithersay classification, and treatment-related determinants were root canal treatment (RCT) and the ECR repair combined with RCT. Treatment outcomes for Heithersay class 1 and 2 cases were better than for class 3 and 4 cases. CONCLUSIONS: Higher failure rates were associated with posterior tooth location and higher Heithersay class, whilst RCT and ECR repair combined with RCT were associated with lower failure rates.

Accuracy and precision of using partial-mouth recordings to study the prevalence, extent and risk associations of untreated periodontitis.

To study the accuracy and precision of estimating the prevalence, extent and associated risks of untreated periodontitis using partial-mouth recording protocols (PRPs) Methods: A purposive sample of 431 individuals who had never been treated for periodontal disease was recruited from screening clinics at the King Saud bin Abdul-Aziz University for Health Sciences. Data were collected using questionnaires and clinical examinations. The prevalence, extent and risk associations of periodontitis were evaluated. Three PRPs were compared to full-mouth recordings (FRPs) in terms of the sensitivity, specificity, predictive values, and absolute bias. Results: The prevalence of periodontitis was estimated with the highest accuracy and precision by examinations of the full mouth at the mesiobuccal and distolingual sites (FM)MB-DL, followed by random half-mouth (RHM) recordings. The extent of periodontitis was estimated with high precision using all the PRPs, and the absolute bias ranged from -0.6 to -2.3. The absolute bias indicated by OR for risk associations was small for the three PRPs and ranged from -0.8 to 0.8. Conclusion: (FM)MB-DL and RHM were the PRPs with moderate to high levels of accuracy and precision for estimating the prevalence and risk associations of periodontitis. The extent of periodontitis was estimated with high precision using all three PRPs. The results of this study showed that the magnitude and direction of bias were associated with the severity of periodontitis, the selected PRPs and the magnitude of the risk associations.

Comparison of digital and conventional methods of fit evaluation of partial removable dental prosthesis frameworks fabricated by selective laser melting.

STATEMENT OF PROBLEM: Three-dimensional (3D) printing technology may improve the fit of partial removable dental prosthesis frameworks made by selective laser melting. Conventionally, the gaps between definitive casts and prostheses are evaluated by using clinical replicas, but digital evaluations may provide a better alternative. PURPOSE: The purpose of this in vitro study was to compare digital and conventional methods for evaluating the fit of partial removable dental prosthesis frameworks made by selective laser melting. MATERIAL AND METHODS: A printed resin definitive cast representing a Kennedy class II modification 2 design with 5 reference markers was made from a dentiform cast. Twelve cobalt-chromium partial removable dental prosthesis frameworks were fabricated by selective laser melting on this definitive cast with a digital design software program. The gaps between the frameworks and the cast were assessed by using the clinical replica method with a silicone impression material and measuring the thickness at each marker with calipers. Digital casts of each framework and the definitive cast were scanned and then registered with the CloudCompare software program to measure 3D gaps at the 5 reference markers and 3 occlusal rests. The results were analyzed individually for each technique by 1-way analysis of variance (ANOVA) with post hoc Bonferroni tests (α=.05). RESULTS: For clinical registration, the mean gap between the frameworks and definitive cast was 13.9 ±7.6 µm. For digital registration, the root mean square gap was 70.7 ±24.2 µm. Statistically significant differences among the gaps for different markers were found for both approaches (P<.05). There were no significant differences among the gaps between the different frameworks. In both situations, the gap measurements were below the 300-µm clinically acceptable standard. CONCLUSIONS: Both registration methods determined whether the fit of a framework fabricated by selective laser melting was within a clinically acceptable standard. The differences in the values produced most likely arose from the different registration methods.

European student wellness, stress, coping, support and perceptions about remote dental training during COVID-19.

OBJECTIVES: The aim of this study was to compare wellness, stress, ability to cope, social support and perceptions about remote training amongst European dental students during COVID-19. METHODS: 1795 undergraduate dental students from six countries and eight dental schools participated. The anonymous survey collected data about different aspects in each of the following domains: wellness, stress, ability to cope, social support and perceptions about remote training. Complex multi-item scales were used for all domains. RESULTS: There were differences amongst countries in all the domains. Overall, student stress scores were lower than either their coping or support scores. The highest wellness score (mean ±sd) was observed in Romania: 62.5% ± 11.2% whilst the highest mean stress scores were observed in Albania: 46.3% ± 11.7% and Lithuania: 42.2% ± 13.8%. Overall, student stress and coping ability scores were lower and their support scores higher. About 10% of students did not have any support. In the linear multivariable regression analysis, significant predictors of wellness were being female (ß = 0.073), not being in a graduating year (ß = 0.059), having less stress (ß = 0.222), ability to cope (ß = 0.223) and having support (ß = 0.179). The student positive perceptions about remote training were predicted by less stress (ß = 0.080), coping (ß = 0.182) and support (ß = 0.057). CONCLUSIONS: Students varied in wellness, stress, coping, social support and perceptions of remote training. Also, there were significant differences amongst students from different countries. Coping was the best predictor of both student wellness and their positive perceptions about remote training.

Prevalence of and factors associated with dental service utilization among early elderly in Lithuania.

BACKGROUND: There is no recent information about dental service utilization (DSU) among elderly in Lithuania. We examined DSU and its associated factors in Lithuanian early elderly based on the Andersen's behavioural model. METHODS: The cross-sectional study conducted in 2017-2019 included a nationally representative stratified sample of 370 Lithuanian early elderly aged 65-74 years (response rate of 54.5%). Information on predisposing factors (age, sex, nationality and education), enabling factor (residence), need-based factors (status of teeth, oral pain or discomfort, and dry mouth), general health, personal health practices and perceived stress was obtained from a structured, self-administered questionnaire. Clinically-assessed need-based factors included number of missing teeth and dental treatment need. Multivariable Poisson regression with robust variance estimates was used. RESULTS: A total of 239 study participants (64.6%) reported a dental visit during the last year and 338 (91.4%) needed dental treatments. A higher level of education (adjusted prevalence ratio [aPR] = 1.21, 95% confidence interval [CI]:1.04-1.40), pain or discomfort in teeth/mouth (aPR = 1.35, 95%CI: 1.13-1.62) and lower number of missing teeth (aPR = 0.99, 95%CI: 0.98-1.00) were associated with DSU. CONCLUSIONS: Even though majority of early elderly needed dental treatments, only two-thirds visited a dentist during the last year. Predisposing and need-based factors were significant predictors of having a dental visit in the last year. A national oral health program for Lithuanian elderly with the focus on regular preventive dental check-ups is needed. More studies, both quantitative and qualitative, are warranted to investigate in depth the barriers for DSU among elderly in Lithuania.