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.

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.

The educational gradient in dental caries experience in Northern- Norway: a cross-sectional study from the seventh survey of the Tromsø study.

BACKGROUND: Although, studies from Norway indicate a reduction in dental caries experience, in Northern-Norway this non-communicable oral condition is still prevalent. There is conflicting evidence of presence of social inequalities in dental caries in an adult population. Therefore, the aim of this study was to assess an association between educational level and dental caries experience in adults in urban Tromsø municipality, Northern-Norway, using The World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) framework of health determinants. METHODS: Data from 3752 participants having recorded dental caries status and educational level in the seventh survey of the Tromsø Study: Tromsø7 were included. Dental status was examined clinically as decayed-, missing-, filled-teeth (DMFT score). For statistical analyses DMFT score was grouped into lower (DMFT < 19) and higher (DMFT ≥ 20). Educational level was obtained from a questionnaire and categorized as primary/partly secondary education, upper secondary education, tertiary education, short and tertiary education, long. Data on social and intermediary determinants was also self-reported. Univariable and multivariable binary logistic regression analyses were applied. RESULT: This study included 1939 (52%) women and the mean age of the participants was 57.11. The mean DMFT score was 18.03. The odds of having higher DMFT score followed a gradient based on educational level. Participants who reported lower than secondary education had 2.06 -fold increased odds of having higher DMFT score than those with tertiary education, long (OR: 2.06, 95% CI: 1.50-2.83). Those with upper secondary education had 60% higher odds of having higher DMFT score (OR: 1.60, 95% CI: 1.21-2.11), and those with tertiary education, short had 66% higher odds of having higher DMFT score (OR: 1.66, 95% CI: 1.24-2.22). CONCLUSION: The current cross-sectional study suggested an educational gradient in dental caries experience in an adult population of Northern- Norway. Further studies validating our results and investigating mechanisms of educational inequalities in oral health are warranted.

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.

Web-Based Interventions Reduced Dental Anxiety among Adults in Lithuania and Norway: A Pilot Study.

Dental anxiety (DA) is a prevalent public health issue. However, there is a lack of self-administered DA interventions. The aim of this study was to evaluate the short-term effects of web-based interventions aiming to reduce DA in adults in two European countries. A pretest posttest design was used. Tailor-made websites were developed in Lithuania and Norway. Volunteers who self-reported DA were invited to participate. DA levels measured by the Modified Dental Anxiety Scale (MDAS) were assessed at baseline and after two weeks via online questionnaires. The interventions were completed by 34 participants in Lithuania and 35 participants in Norway. In Lithuania, the median posttest MDAS score (9.5, IQR 5.25) decreased compared to the median pretest MDAS score (14.5, IQR 8; Z value = -4.246, p < 0.001). The same was found in Norway-the median posttest MDAS score (12, IQR 9) was lower compared to the median pretest MDAS score (15, IQR 7; Z value = -3.818, p < 0.001). The present study demonstrated that two tailor-made web-based interventions had the potential to reduce dental anxiety levels when assessed in the short term in Lithuania and Norway. Studies with more controlled designs assessing long-term outcomes are needed to validate the results of this pilot study also in other cultures.

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.

Using storytelling in undergraduate dental education: Students' experiences of emotional competence training.

AIM: The aim of the study was to explore the use of storytelling as a teaching method for emotional competence interventions within undergraduate dental curriculum (dental and dental hygiene students). MATERIALS AND METHODS: Students participated in five sessions related to emotional competence: one theoretical and four practical. During the latter, divided in small groups, students told individually two stories: a story about a clinical situation in which they had an emotional experience and a story concerning a patient's experience of the same emotion. Each session focused on a single emotion: happiness, fear, anger and shame. A questionnaire was used to collect perceptions about enjoyment, how stories were chosen, what was learned and if the sessions were stimulating in any way. A focus group was organised to collect reflections about the learning environment, process of learning and specific skill set developed during these sessions. RESULTS: The majority of the students enjoyed listening, telling and preparing the stories. They reported to experience social support and feeling a sense of community during the sessions. The students believed that stories helped them to reflect on their clinical work and to regulate their emotional experiences more efficiently in clinical situations. Regarding the learning environment, the dental students pointed out the distinctiveness and dissimilarities between the dental and dental hygiene students, but also expressed that they had a desire to learn more about the other student group. CONCLUSION: Storytelling used as part of an emotional competence course appears to have benefits for students' reflection about their role as dental health professionals. This teaching method was well-perceived by the students included in this study.

How does indirect air-cooling influence pulp chamber temperature in different volume teeth and absence/presence of resin-based composite during light curing?

BACKGROUND: Light-curing of materials during restorative dental procedures poses a risk for pulp tissue overheating. Therefore, the aim of this study was to investigate the effect of indirect air-cooling on pulp chamber temperatures during light-curing of varying volume teeth and absence/presence of resin-based composite (RBC) at different exposure time. METHODS: The volume of 11 human teeth was measured by micro computed tomograph. An experimental rig controlled the thermal environment of the teeth and a thermocouple inserted retrograde into the root canal measured temperature changes. Pulp chamber temperature was measured with and without air-cooling on teeth without and with RBC at 15 s, 30 s and 60 s intervals. Generalized estimating equations were used for statistical analysis. RESULTS: The temperature increase with air-cooling (versus no air-cooling) was lower in teeth despite absence/presence of RBC (ß = - 4.26, 95%CI - 5.33 and ß = - 4.47, 95%CI - 5.60, respectively). With air-cooling, the temperature increase in teeth with RBC was lower compared to teeth without RBC (ß = - 0.42, 95%CI -0.79; - 0.05). Higher teeth volume resulted in lower temperature increase with air-cooling than without air-cooling (ß = - 0.04, 95%CI -0.07; - 0.01 and ß = - 0.17, 95%CI -0.30; - 0.05, respectively). CONCLUSIONS: Air-cooling resulted in lower pulp chamber temperature increase. Using air-cooling, the temperature increase was lower in teeth with RBC compared to teeth without RBC. Lower volume teeth resulted in higher temperature increase, thus they seemed to benefit more from air-cooling compared to higher volume teeth. Air-cooling could be an effective tool in controlling pulp temperature increase during light-curing, especially when the tooth volume is small.

Changes in Management Preference of Deep Carious Lesions and Exposed Pulps: Questionnaire Studies with a 10-Year Interval among Dentists in Lithuania.

We aimed to investigate changes in management preferences for deep carious lesions and pulps exposed during carious tissue removal that occurred during the last 10 years and identify associated dentists' background factors. The data were collected among dentists registered with the Lithuanian Dental Chamber at two time points using a similar questionnaire. In 2011, 400 randomly selected dentists received a questionnaire by mail, and 153 (38.3%) responded. In 2021, an electronic invitation to an online questionnaire was sent to all members of the Lithuanian Dental Chamber, and 213 (8.9%) dentists responded. The questionnaire included the definitions of management options, a radiograph, and a clinical picture of a deep carious lesion reaching to the inner fourth of dentine in a mature permanent tooth, asked management preferences in four different scenarios, as well as participants' background characteristics, reasons for management, and procedural preferences. Data were analyzed using bivariate and multivariable analyses. Compared to 2011, participants in 2021 had 60% lower odds of preferring nonselective versus selective caries removal (OR 0.4, 95% CI 0.2-0.7) and endodontic treatment versus nonselective and selective caries removal (OR 0.4, 95% CI 0.2-0.6) in the scenario of asymptomatic and symptomatic (indicating reversible pulpitis at most) deep lesions, respectively. For exposed pulp, participants in 2021 had lower odds than in 2011 of preferring endodontic treatment versus vital pulp therapy (direct pulp capping and pulpotomies) for both scenarios without symptoms (OR 0.4, 95% CI 0.2-0.7) and with symptoms (OR 0.2, 95% CI 0.1-0.4). A higher proportion of respondents in 2021 reported using rubber dam (44% vs. 17% in 2011, p < 0.001) and hydraulic calcium silicate cements as a capping material (68% vs. 40% in 2011, p < 0.001). The management preferences were associated with the university of graduation and the number of years in dental practice, indicating "recommended in textbooks" and "recommended in scientific publications" as reasons for management preferences. To conclude, a change toward less invasive management options was observed. To a certain extent, dentists have implemented evidence-based recommendations in dental practice. To ensure further adoption of scientific evidence, dentists should be encouraged to update themselves on the newest evidence-based practices.

Periapical status transitions in teeth with posts versus without posts: a retrospective longitudinal radiographic study.

OBJECTIVES: The aim of this study was to compare periapical status transitions in teeth after post placement compared with other post-endodontic treatments in root-filled teeth. MATERIAL AND METHODS: This retrospective longitudinal radiographic study included radiographs of 284 patients with root filled and restored teeth with composite fillings (Endo-fill group, n = 100), crown or fixed prosthesis (Endo-crown group, n = 82) or post and core restorations (Endo-post group, n = 102). All post and core restorations were made of gold alloy. The radiographs taken at the end of endodontic treatment, at the end of post-endodontic treatment and at least 8 months after post-endodontic treatment were evaluated. Post-operative periapical status was assessed according to the periapical index (PAI) and all teeth included in the study had no apical periodontitis preoperatively. Multi-state Markov analysis was used to assess periapical status transitions among the treatment groups. RESULTS: Of 284 root-filled teeth without apical periodontitis at baseline, 7.7% developed clear apical pathology within a minimum of 8 months observational period. In the Endo-post group 11 (10.78%) teeth transited from Healthy (PAI 1) to Disease (PAI 2-4) state compared with eight (9.75%) in the Endo-crown group and four (4%) in the Endo-fill group. The transition probabilities from Healthy (PAI 1) to Mild diseased (PAI 2) were 17.5% in the Endo-post group, 13.1% in the Endo-crown group and 5.3% in the Endo-fill group. Multivariate analysis showed that teeth in the Endo-fill group had 60% lower hazard to transit from Healthy (PAI 1) to Mild diseased (PAI 2) state [HR 0.40; 95% CI 0.12, 0.94]. A period exceeding 8 months between the end of the endodontic treatment and prosthetic treatment significantly increased the hazard of disease progression by three times compared with a period of ≤8 months [HR 3.16; 95% CI 1.06, 9.42]. CONCLUSIONS: Teeth without radiographic lesions at baseline and restored with posts had higher hazard to transit from healthy to diseased periapical status compared with teeth restored with composite restorations. Controlled clinical trials with longer follow-up periods are needed to validate these findings.

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.

Oral Health among Adult Residents in Vilnius, Lithuania.

According to the World Health Organization (WHO) oral conditions may be determined by social, biological, behavioral, and psychosocial factors. The study assessed oral health status and its determinants associated with oral health conditions among adult residents in Vilnius, Lithuania. A total of 453 of 35-74-year-olds participated (response rate 63%). A self-reported questionnaire was administered. Dental caries experience (D3MFS score), periodontal probing depth (PPD), andnumber of missing teeth were assessed clinically. Data were analyzed using χ2 test, independent samples t-test, and multivariable linear regression. The mean (sd) of D3MFS scores was 67.3 (33.5), the mean (sd) number of teeth with PPD 4+ mm was 5.9 (5.3), prevalence of periodontitis was 33%, the mean (sd) number of missing teeth was 6.9 (6.8), and prevalence of total edentulism was 3.8%. Medication use was associated with all oral health conditions, while age was associated with caries experience, and missing teeth. Sugar-containing diet was associated with caries experience, and missing teeth, and smoking with caries experience and periodontal status. Systemic diseases were associated with periodontal status, while behavioral determinants, last dental visit, and use of fluoridated toothpaste were associated with missing teeth. Oral health status among adult Vilnius residents was poor. Oral conditions were associated with both biological and behavioral determinants. Oral health promotion should focus on modifying behavioral determinants.

Restorative treatment decisions for carious lesions: Do Russian dentists and dental students apply minimal intervention dentistry?

BACKGROUND: The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions. METHODS: We included 171 general dental practitioners and dental therapists (collectively referred to here as "dentists") from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis. RESULTS: For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13-15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33-6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite. CONCLUSIONS: The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results.

Association between Diet and Xerostomia: Is Xerostomia a Barrier to a Healthy Eating Pattern?

OBJECTIVE: Xerostomia is a subjective feeling of dry mouth and is commonly observed in patients with autoimmune diseases. Our study examines the association between xerostomia and diet. MATERIALS AND METHODS: The cross-sectional study includes 1405 adults from 15 Lithuanian geographical areas (52% response rate). A self-reported questionnaire inquired about xerostomia, sex, age, education, residence, and consumption of selected 23 diet items. For the multivariable analysis, 23 diet items were categorized into eight major diet groups. The data were analyzed by bivariate and multivariable analyses. RESULTS: When comparing participants with and without xerostomia, there were significant differences in consumption frequencies concerning cold-pressed oil (p = 0.013), bread (p = 0.029), processed meat products (p = 0.016), fat and lean fish (p = 0.009), and probiotic supplements (p = 0.002). In the multivariable binary logistic regression model, when controlled for other determinants, the higher consumption of carbohydrates (OR 0.39, 95% CI 0.23-0.65), proteins (OR 0.56, 95% CI 0.32-0.99), and oils (OR 0.58, 95% CI 0.34-1.00) was associated with a lower likelihood of xerostomia. CONCLUSIONS: The association between xerostomia and the consumption of the six diet items-cold-pressed oils, lean and fat fish, bread, processed meat, and probiotic supplements- and the three major diet groups-carbohydrates, proteins, and oils-was observed. Longitudinal studies are needed to validate the observed associations.

Detection of xerostomia, Sicca, and Sjogren's syndromes in a national sample of adults.

OBJECTIVES: To assess the prevalence and determinants of xerostomia among adults and identify how many of the ones experiencing xerostomia have Sicca and Sjogren's syndromes. MATERIALS AND METHODS: This cross-sectional study included 1405 35-74-year-old Lithuanians (51.7% response rate) from the five largest Lithuanian cities and 10 peri-urban and rural areas that were randomly selected from each of the 10 Lithuanian counties. Xerostomia was determined by the self-reported experience of dry mouth as "often" or "always". A dentist diagnosed Sicca syndrome by unstimulated whole sialometry and the Schirmer's test, and all cases were referred to a rheumatologist to confirm Sjogren's syndrome. Self-reported questionnaires collected data about the determinants. RESULTS: The prevalence of xerostomia was 8.0% (n = 112), Sicca syndrome was diagnosed for 8 participants (0.60%), and Sjogren's syndrome for 2 participants (0.14%), with this being the first time it was diagnosed. Experiencing xerostomia was associated with older age (OR 1.7, 95% CI 1.1-2.6), urban residence (OR 3.3, 95% CI 1.6-5.0), presence of systemic diseases (OR 2.5, 95% CI 1.4-3.3), and the use of alcohol (OR 0.6, 95% CI 0.4-0.9). The higher proportion of participants with Sicca syndrome involved females, of older age, having systemic diseases, and using medications. CONCLUSIONS: The prevalence of xerostomia was 8.0% and the determinants of xerostomia were older age, urban residence, systemic diseases, and absence of using alcohol. In total, 0.6% of participants had Sicca syndrome, which was more prevalent among females, older subjects, those with systematic diseases, and those using medications. Sjogren's syndrome was diagnosed in 0.14% of participants. Clinical relevance Dental clinicians need to be trained to identify potential Sjogren's syndrome cases.

Light-curing units used in dentistry: Effect of their characteristics on temperature development in teeth.

This study aimed to investigate pulp chamber and surface temperature development using different LED light curing units (LCUs). Eight brands of LED-LCUs were tested in a laboratory bench model. The pulp chamber and surface temperature were recorded with a type T thermocouple and infrared cameras, respectively. The highest pulp chamber and surface temperature increase was 6.1±0.3°C and 20.1±1.7°C, respectively. Wide-spectrum LED-LCUs produced higher pulp chamber temperature increase at 0 mm and 2 mm but lower at 4 mm. Narrow-spectrum LED-LCUs produced higher surface temperature increase. LED-LCU featuring modulated output mode resulted in lower increase in pulp chamber temperature but higher on surface temperature. LED-LCU with light guide tip delivering an inhomogeneous beam caused higher increase in temperature on the surface and in the pulp chamber. LED-LCUs with different spectral emission, output mode and light guide tip design contributed to different temperature development in the pulp chamber and at the surface of teeth.

Fluoride in the drinking water and dental caries experience by tooth surface susceptibility among adults.

BACKGROUND: Dental caries is the most prevalent non-communicable health condition globally. The surface-based susceptibility hierarchy indicates that surfaces in the same group have similar susceptibility to caries, where the most susceptible group consists of occlusal surfaces of first molars and buccal surfaces of lower first molars, and the least susceptible surfaces are smooth and proximal surfaces of first premolars, canines and incisors. Therefore, fluoride in the drinking water could impact one group more than the other group. The present study examined the association between fluoride levels in the drinking water and dental caries experience in adults in the context of varying tooth surface susceptibility. METHODS: Data from the cross-sectional National Lithuanian Oral Health Survey conducted in 2017-2019 included a stratified random sample of 1398 35-74-year-olds (52% response rate). Dental caries experience in dentine was measured at a surface level. The surfaces were grouped according to their caries susceptibility (group 1 being the most and group 4 the least susceptible), and dental caries experience was calculated separately for each susceptibility group, creating four outcomes. Information about explanatory variable, fluoride levels in the drinking water, was provided by the water suppliers. The questionnaire inquired about potential determinants: sociodemographic characteristics and oral health-related behaviors. Chi-square, Mann-Whitney U and Kruskal Wallis tests were used for descriptive statistics, and linear regression analyses to examine the association between fluoride levels and four outcomes. RESULTS: The proportions of median decayed, missing, filled surfaces decreased following the surface-based susceptibility hierarchy (group 1-33%, group 2-28%, group 3-24%, group 4-15%). When adjusted for potential determinants, higher-level fluoride (≥ 0.7 ppm vs < 0.7 ppm) in the drinking water associated with lower dental caries experience in all surface-based susceptibility hierarchy groups; Group 1: ß = - 0.23 (95 %CI - 0.44; - 0.001), Group 2: ß = - 0.44 (95 %CI - 0.82; - 0.07), Group 3: ß = - 1.14 (95 %CI - 1.88; - 0.41) and Group 4: ß = - 6.28 (95 %CI - 9.29; - 3.30). CONCLUSIONS: The higher-level fluoride in the drinking water associated with lower dental caries experience in adults and this was observed in all surface-based susceptibility groups. However, there is a need to validate the surface-based susceptibility hierarchy in longitudinal adult studies.

Amylase Alpha 1 Gene (AMY1) Copy Number Variation and Dental Caries Experience: A Pilot Study among Adults in Lithuania.

INTRODUCTION: Genetic biomarkers have the potential to be used in personalised dentistry for improved prevention and decision-making in caries management. The amylase alpha 1 gene (AMY1) encodes salivary α-amylase and may be one such biomarker. We examined the association between AMY1 copy number variation (CNV) and dental caries experience in adults. MATERIALS AND METHODS: A stratified random sample of 193 participants from the Lithuanian National Oral Health Survey (LNOHS) agreed to provide saliva samples and were included in this analysis (age 35-44 years; participation rate 43%). Information on socio-demographic and behavioural characteristics was taken from the LNHOS, which used the self-administered World Health Organisation (WHO) questionnaire. Data on fluoride levels in drinking water at the recruitment areas was recorded based on information provided by water suppliers. Dental caries experience was recorded at a surface level (smooth-surface and occlusal-surface decayed, missing, filled surfaces [D3MFS] score) by one trained and calibrated examiner using WHO criteria, and subsequently dichotomised for the statistical analyses. DNA extracted from saliva samples was used to investigate AMY1 CNV using the QX200 droplet digital PCR system. Bivariate and multivariable statistical analyses were employed. RESULTS: When compared to participants with an AMY1 copy number (CN) of 2-3, higher odds of smooth-surface D3MFS >14 was observed for participants with a CN of 4-5 (OR 13.3, 95% CI 2.1-86.3), 6-9 (OR 7.0, 95% CI 1.4-34.1), and 10-16 (OR 5.8, 95% CI 1.2-32.2). Female sex was independently associated with a smooth-surface D3MFS >14 (OR 5.7, 95% CI 1.9-17.2). CONCLUSIONS: Our study demonstrated an association between AMY1 CNV and high smooth-surface caries experience. Studies with larger sample sizes are needed to validate this association.

Common social determinants for overweight and obesity, and dental caries among adolescents in Northern Norway: a cross-sectional study from the Tromsø Study Fit Futures cohort.

BACKGROUND: Non-communicable general and oral health conditions share common risk factors. Studies investigating common social determinants as risk factors for overweight/obesity and dental caries among the same adolescents are scarce and inconclusive. METHODS: This cross-sectional study included data from 464 girls and 494 boys from the population-based Tromsø study Fit Futures, which included first-year students attending upper secondary school in 2010-2011 from two municipalities in Northern Norway (1038 participants in total, 93% participation rate). Multivariable binary logistic regression analyses stratified by sex were used to investigate the association between socioeconomic position indicators (adolescent's own study program, parents' education and employment status) and overweight/obesity indicated by body weight and waist circumference, untreated dental caries in dentine, and when these conditions were considered simultaneously. RESULTS: Boys enrolled in the general studies and sports programs (versus vocational) had lower odds of being overweight/obese (POR 0.42, 95% CI 0.20-0.86 and POR 0.24, 95% CI 0.08-0.73, respectively), of having high waist circumference (POR 0.39, 95% CI 0.21-0.75 and POR 0.25, 95% CI 0.10-0.64, respectively), dental caries (POR 0.57, 95% CI 0.32-0.99 and POR 0.47, 95% CI 0.22-0.98, respectively), and being simultaneously overweight/obese, having high waist circumference and dental caries (POR 0.24, 95% CI 0.07-0.81 and POR 0.11, 95% CI 0.01-0.98, respectively). Girls enrolled in the general studies program (versus vocational) had lower odds of having dental caries (POR 0.50, 95% CI 0.30-0.84). CONCLUSIONS: Adolescent's own study program was identified to be a common social determinant for overweight/obesity and dental caries among boys. These results support the broader concept of social determinants as common risk factors for general and oral health conditions, and call for common health promotion strategies addressing these common social determinants among adolescents. However, there is a need for more studies to investigate and better understand the influence of social determinants on health conditions among adolescents.