Tobacco smoking and its impact on pain intensity of temporomandibular disorders: A systematic review and metanalysis.

BACKGROUND: Temporomandibular disorders (TMDs) encompass a spectrum of orofacial conditions characterised by pain and dysfunction in the temporomandibular joint and surrounding structures. Tobacco smoking has been posited as a potential factor influencing the prevalence and intensity of TMD. However, the nature and extent of this relationship remain unclear due to variations in study outcomes. This systematic review aimed to consolidate existing research findings to elucidate the association between tobacco smoking and TMD pain intensity. METHODS: A comprehensive search of electronic databases was conducted to identify relevant studies published up to June 2023. Studies investigating the relationship between tobacco smoking and TMD pain were included. Data extraction was conducted by two reviewers. Quality assessment was performed using the New Castle-Ottawa scale. Review Manager 5.4 was used to quantitatively analyse the results. RESULTS: The review included four studies employing similar TMD assessment techniques. All studies reported elevated TMD pain intensity among tobacco users, with non-smokers exhibiting lower pain intensity. The quality of the included studies was good. Meta-analytic results showed that TMD pain intensity was higher in the smokers group compared to the non-smokers group, with a weighted mean difference (WMD) of 0.65 (BPM) (95% CI: [0.10, 1.19], p = .02). CONCLUSION: This systematic review provides a comprehensive synthesis of the existing literature on tobacco smoking and TMD symptoms. The findings underscore the multifaceted nature of the relationship between smoking and TMD pain, highlighting its clinical relevance and the need for tailored interventions. Further research is warranted to elucidate underlying mechanisms and potential moderating factors, contributing to a more nuanced understanding of this complex association.

Impact of clear aligner therapy on masticatory musculature and stomatognathic system: a systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions.

BACKGROUND: Clear aligner therapy has gained popularity as a minimally invasive orthodontic treatment option. However, its impact on the masticatory musculature and the stomatognathic system is an area of growing interest, as it involves the adjustment of occlusion and tooth movement. This systematic review aims to comprehensively assess and synthesise existing evidence regarding the influence of clear aligner therapy on the masticatory musculature and the stomatognathic system. METHODS: An exhaustive search was performed on electronic databases that adhered to PRISMA guidelines. Clinical studies that evaluated the impact of patients receiving aligner orthodontic treatment on the muscles of the mastication and stomatognathic systems were included. A standardised data extraction form was devised for relevant variables. Two reviewers extracted the data variables. ROB-2 was used for bias evaluation in the selected studies. RESULTS: A total of six studies met the inclusion criteria. The wearing of clear aligners significantly impacted the muscles of mastication. Muscle activity and discomfort showed a significant alteration in the initial days of appliance placement. but this observation was temporary, with no significant changes thereafter in subsequent follow-up. Bite force reduction was also noted. All the studies evaluated showed good methodological quality. CONCLUSION: The review found that aligned orthodontic treatment may have a variable impact on muscles of mastication, with a potential for initial exacerbation of symptoms followed by possible improvement. However, due to the limited number of studies and their heterogeneous nature, further robust research is recommended to fully understand the relationship between aligned orthodontic treatment and masticatory muscles.

Effectiveness of Motivational Interviewing and cross platform messaging application in improving oral health knowledge, attitude and behaviours among pregnant women- A Randomized Controlled Trial.

Background: Body goes through significant hormonal and physiological changes during pregnancy, which could be linked to changes in oral health. Many women are unaware of the negative consequences of poor dental health during and after pregnancy, both for themselves and their children. Therefore, this study aimed to assess the effectiveness of Motivational Interviewing (MI) and cross platform messaging application (WhatsApp messenger) for oral health education on the oral health knowledge, attitude and behaviours among pregnant women attending ante natal care. Methods: A randomized controlled trial was conducted among 84 pregnant women. Simple random sampling was employed to select participants after oral examination. Participants were randomly allocated to two groups (Group 1: Cross-platform messaging application [WhatsApp]; Group 2: MI) using a lottery method. Pregnant women aged 18 years and older, gestational age between 8 and 30 weeks were included. A face-to-face interview and oral examination were conducted to assess baseline knowledge and oral hygiene status. A follow-up examination was conducted after one month of intervention. Inferential statistics, including the chi-square test and independent t-test, were used to compare variables between the two groups. Results: The mean knowledge score at baseline was comparable between Group 1 (WhatsApp) and Group 2 (MI). However, post-intervention, Group 2 showed a significantly higher mean knowledge score compared to Group 1. Post-intervention, Group 2 exhibited a significantly better oral hygiene status compared to Group 1. Significant improvements in oral health behaviours were observed in Group 2 compared to Group 1 (p < 0.001). Conclusions: The findings suggested that while both interventions were effective, MI showed superior results in improving knowledge, oral hygiene status, and oral health behaviours. The personalized and client-centred approach of MI enables participants to explore and resolve ambivalence, promoting a deeper understanding of the importance of oral health during pregnancy. Registration: CTRI ( CTRI/2021/09/036407, 10/09/2021).

Investigation of Genetic Markers for Predicting Oral Cancer Progression and Patient Outcomes.

Background: Genomic methylation being used as a sensitive indicator for identifying oral potentially malignant disorders (OPMDS) and oral cancer could be a viable option. DNA methylation is a potential approach for "cancer therapeutics" and can help researchers truly understand the genomic mechanism that leads to cancer. Aim: Investigation of genetic markers for predicting oral cancer progression and patient outcomes. Methods and Materials: One hundred and twelve patients having oral premalignant lesions and malignant lesions were included in this study. Saliva samples were obtained for analysis of the expression of genetic markers, such as p16, DAP-K, and MGMT. The Illumina Infinium HumanMethylation450 BeadChip (Illumina Inc., USA) would be used to assess genome-wide DNA methylation according to the manufacturer's instructions. Results: Methylation of all the genes, that is, p16, DAP-K, and MGMT, was observed in 12.7% of oral cancer lesions. 41.94% of oral cancer lesions were found to have methylation of two genes. 13.23% cases were found to be associated with methylation of p16 and DAP-K, 12.12% cases were found to have methylation in the p16 and MGMT, and 15.27% cases of oral cancer lesions showed methylation of DAP-K and MGMT. Conclusion: Genetic markers, such as p53, DAP-K, and MGMT, can be used for predicting oral cancer progression and patient outcomes.

Association Between ABO Blood Group, Dental Caries, Gingivitis, Impacted Teeth and Malocclusion Among Saudi Adults: A Cross-Sectional Study.

Background: Whether there is a relationship between blood group and the likelihood of acquiring oral diseases. Therefore, the present study investigated the potential association between ABO blood groups and various dental conditions, including dental caries, gingivitis, malocclusion, and impacted teeth, in Saudi adults aged 18 years and older. Methods: A cross-sectional study was conducted on 300 participants who met the inclusion criteria. Data collection included assessment of dental caries status using the decayed missing filled teeth (DMFT) and decayed missing filled surfaces (DMFS) indices, evaluation of gingivitis using the Gingival Index, classification of malocclusion according to Angle's classification system, and recording the presence or absence of impacted teeth. Results: The AB blood group had the significantly highest mean DMFS score (8.58±6.63), while the O blood group had the lowest mean DMFS score (6.37±4.43). Additionally, blood group O showed a slightly higher prevalence of gingivitis (51.92%) than the other blood groups. Blood group A demonstrated a higher prevalence of both Class II (34.2%) and Class III (19%) malocclusions, with statistically significant differences. Regarding impacted teeth, blood group AB (48.8%) had the highest occurrence. Conclusion: There exists an association between oral disease and ABO blood group in Saudi adults. The results of this study indicate that individuals with specific blood types may be more prone to oral diseases, which can aid in the early diagnosis and prevention of these conditions.

Exploring the use of Virtual Surgical Planning (VSP) in Maxillofacial Reconstructions.

Background: Virtual surgical planning (VSG), also known as computer-assisted reconstruction, has started to become the norm for more complex patients in many centers in recent times. Aim: This study was conducted to evaluate the VSG in maxillofacial reconstruction surgery. Methods and Materials: This study included 20 patients who underwent surgery for maxillofacial reconstruction. The study participants were divided into two main categories: Category 1: Conventional surgical planning (CSG). Category 2: VSG. The surgical planning in both categories, including the evaluation of volume of defect, length, width, and height of graft, to be placed. Results: The gap between defect to be reconstructed and graft placed was greater in CSG as compared to VSG. The distance of graft from actual location was lesser in VSG as compared to CSG. The findings were significant statistically. Frequency of success was 93.21% and 97.47%, respectively. The frequency of success was greater in VSG as compared to CSG. Conclusion: Virtual surgical planning is more effective in maxillofacial reconstruction surgery.

Artificial Intelligence and its Awareness and Utilization among Dental Students and Private Dental Practitioners at Alkharj, Saudi Arabia.

Introduction: Artificial intelligence (AI) is commonly used in the modern day medical system for medical and dental imaging diagnostics, decision support, precision, hospital monitoring, robotic assistants, and so on. All branches of dentistry have a role of AI, like endodontics, cancer diagnosis, and cephalometric analysis. With the advancing technology, dental professionals need to upgrade themselves. Aim of the Study: To assess awareness and attitude of dental students and dental practitioners in Alkharj toward AI. Methodology: A total of 100 dental students from a teaching institute and 100 private dental practitioners participated in the study. A closed-ended questionnaire was used containing 14 questions related to awareness and attitude toward AI. Participation was voluntary. Results: 33% of study participants were aware of the working principle of AI; 68% of study subjects are aware of uses of AI in the dental field. 87% thinks AI helps in radiological diagnosis; 56.5% thinks AI helps in cancer detection. Conclusion: Awareness about AI among study participants was less than 50%. The overall attitude of dental professionals was positive.

Effect of non-surgical periodontal therapy with adjunct photodynamic therapy on periodontal and glycemic statuses in prediabetic patients with periodontal disease.

OBJECTIVE: Studies have shown that non-surgical periodontal therapy (NSPT) helps reduce periodontal inflammation and glycemic levels in patients with type-2 diabetes mellitus; however, the role of NSPT with adjunct photodynamic therapy on glycemic status and periodontal parameters in prediabetic patients remains unclear. The aim of the present study was to assess the effect of NSPT with and without adjunct PDT on periodontal and glycemic statuses in prediabetic patients with periodontal disease. METHODS: Prediabetic (Group-1) and non-diabetic (Group-2) patients diagnosed with periodontal inflammation were included. In both groups, patients were randomly assigned to test and control-groups. In the test- and control groups, patients underwent NSPT with and without adjunct PDT, respectively. The following parameters were assessed at baseline and at four weeks' follow-up: plaque index (PI); gingival index (GI), probing depth (PD), clinical attachment loss (CAL) and hemoglobin A1c (HbA1c). Collection of demographic data and assessment of full mouth marginal bone loss was performed at baseline. Level of significance was set at P < 0.05. RESULTS: At baseline, there was no difference in PI, GI and PD among patients with and without prediabetes. At 3-weeks' follow up there was no difference in PI, GI and PD among patients without prediabetes. PI (P < 0.01), GI (P < 0.01) and PD (P < 0.01) were significantly higher in the control-group compared with the test-group at 3-weeks' follow-up in patients without prediabetes. The HbA1c levels were significantly higher in patients with prediabetes throughout the study duration compared with individuals without prediabetes. CONCLUSION: One session of NSPT with or without PDT reduce periodontal inflammation but do not influence glycemic levels in prediabetic patients.

Assessment of Knowledge and Practice of Ergonomics among Dental Practitioners in Riyadh City in Saudi Arabia.

Aim: The present study was undertaken to assess the knowledge and practice of ergonomics among dental practitioners in Riyadh, Saudi Arabia. Methodology: A self-administered questionnaire was distributed among dental practitioners through Google Forms. Link of the questionnaire was sent through social media and e-mail. The questionnaire was focused on the awareness of ergonomics and practice of ergonomics during dental practice. Results: About 97.9% of participants are aware of different operating positions. About 71.7% of participants rate their operating procedure chair positions as good. 52.5% admit they feel numb fingers while working. Many questions were statistically significant according to educational qualification and type of practice (P < 0.050. Conclusion: Majority of the study population were aware of proper chair positions, correct operating procedures and were practicing four-handed dentistry, maintained proper back support while working, and even performed stretching exercises during clinical working hours.

Knowledge and Anxiety for Dental Treatments Due to COVID-19 among General Public.

Introduction: The fears, anxiety, and worries created among general population by COVID-19 are severe. The procedures which generate aerosols transmit most of COVID-19 transmission and we know one such procedure is dental treatment. After the COVID-19 pandemic, there is a change in health-care services; hence, this droplet transmission in dentistry became an issue which needs to be addressed. Methodology: A descriptive, online questionnaire survey was conducted among adults above 20 years. The questionnaire consisted of demographic details and questions related to anxiety and fear of considering dental treatment during this pandemic situation. Results: 680 people responded for the study, among which 32% had COVID symptoms. 27% of them said that they are afraid of dental treatment during the pandemic whereas 47% said that they will accept if there is an emergency. The main reason for this fear was droplet infection in dental clinics. Conclusion: The fear of dental treatment during pandemic is moderate. This may be due to the self-care, positive behavior toward oral care by the people, and fear of cross-contamination due to airborne infections though the personal protective measures were followed.

Knowledge of Caries Risk Assessment Among Dental Students in Riyadh Region Saudi Arabia.

Background: Caries is a preventable dental disease; further, it is associated with many risk factors. If risk factors are identified and evaluated in time, prevention can be achieved. Aim: Present study attempts to assess the knowledge of caries risk evaluation among dental students in Riyadh using a cross-sectional observational study design. Materials and Methods: The study comprised 390 dental students, interns, from the Riyadh region, Saudi Arabia. Questionnaire was developed to assess knowledge about Caries Risk Assessment (CRA). Questionnaire included ten straight statements with options for acceptance or refusal by marking true or false. Results: About 10.3% of the participants accepted dental caries as transmissible disease. About 69.5% of the participants think White spot lesions as carious lesions. 66.9% predict radiographic approximal lesions are disease indicators. Conclusion: Majority of the participants possessed knowledge about caries risk assessment, although prevention-oriented knowledge needs to be improved because knowledge of caries inducing aspects and risk of occurrence among clinicians help to deliver tailored preventive measures and appropriate execution of treatment.

Use of Internet as a Source of Oral Health Information in Riyadh Region, Saudi Arabia.

Aim: This study aimed to assess the use of Internet as a source of oral health among adult population in Riyadh region, Saudi Arabia. Methodology: A self-administered questionnaire was distributed among adults aged above 18 years through Google Forms. Questionnaire consisting of demographic characteristics and questions related to use of Internet, reason for use of Internet, whether they use Internet for searching information related to oral health, which is the media they use more preferably to search oral health information, and does they found the information beneficial or not was asked. Results: Almost 98.2% of the participants uses Internet for one or the other reasons. About 71.3% of the participants use the Internet for searching oral health information. Google is the most common platform for searching oral health information on the Internet. Age and education wise, there was a statistically significant difference in many responses (P < 0.050). Conclusion: Majority of the study population have access to Internet, also search oral health information on the Internet. There is a need for regulations and guidelines so that oral health information available from the Internet can be used as a media to promote oral health.

Knowledge and Practice about Self-Medication for Oral Health Problems among Population in Riyadh Region, Saudi Arabia.

AIM: The aim of this study was to know self-medication practices among the population of Riyadh region for oral health issues. METHODOLOGY: A questionnaire consisting of demographic self-practice of medication for oral health problems and knowledge about self-medication practices was sent through Google forms and it was in Arabic and English languages. The link of the questionnaire was sent through social and requested to send the link to their friends and relatives. RESULTS: About 50.4% of study participants were having self-practice of medication for oral health problems. Self-practice of medication for oral health issues was statistically significant according to age gender and education (P < 0.05). Toothache (62.4%) is the main problem triggering self-medication and lack of time (44.6%) is the main reason for self-medication. Pain killer (68.8%) was the main medication and antibiotics were used by 2.2% of subjects. CONCLUSION: Self-medication practice is prevalent in the world and hence, education regarding its consequences and adverse effects for the general public is mandatory.

Oral Health Myths among General Population at Riyadh Region, Saudi Arabia.

BACKGROUND: Taboos or myths have got a connection from the history where there was no scientific understanding about the concepts of health they are part of culture and information shared or communicated by a number of people. Understanding myths and misbelieves are important to provide good oral care with health education to the people. AIM: The aim of this study is to assess the prevalence of oral health myths and to find its association between the demographic factors of general public in the Riyadh region of Saudi Arabia. METHODOLOGY: Questionnaire consisting of demographic details and myths about oral health problems was sent through Google forms. The link of questionnaire was sent through social media and requested to send the link to their friends and relatives. RESULTS: About 50.71% of the study participants were against to myths and 23.48% of study participants were toward myths. The response in terms of agreement, disagreement or do not know was statistically not significant according to age, gender, or education. CONCLUSION: The prevalence of myths about dental treatment is almost 50%. This population needs to be educated to know the fact and to take action to rectify them about dental treatments.

Awareness and Knowledge about Sugar Substitutes among Population in Riyadh Region.

BACKGROUND: The food we consume will have sugar in one or the other form, which is not ideal for our teeth. This can be replaced by the use of sugar substitutes available in the market. Sugar substitutes have beneficial and adverse effects on health. In spite of their beneficial effects, long-term use of sugar substitutes is not recommended because of their health-related complications. Therefore, before consuming any sugar substitutes, everyone needs to know about both health benefits and their health hazards; hence, the present study was designed to assess the awareness, knowledge, and utilization of sugar substitutes among the general population in Riyadh Region, Kingdom of Saudi Arabia. OBJECTIVES: The aim is to assess the awareness and knowledge about sugar substitutes. METHODOLOGY: Questionnaire consisting of demographic details, awareness, and knowledge about sugar substitutes were sent through social media and it was in the Arabic and English Language. After completing the questionnaire, participants are requested to send the link to their friends and relatives. RESULTS: About 60.20% of participants were aware of sugar substitutes. Statistically significant difference was observed for gender and awareness of sugar substitutes (P < 0.05). About 31.5% of the participants are of the view that sugar substitutes have got side effects. About 61.9% of participants are of the view that Sugar substitute reduces the chance of occurrence of dental caries. CONCLUSIONS: Overall, 60.2% of study participants were aware of sugar substitutes, but the controversy on most of the artificial sweeteners cannot be ignored. Hence, the safety of these sweeteners is of prime importance for scientists. Any usage of sugar substitutes should be weighed against the adverse effects.

Knowledge and attitude of male schoolteachers towards primary dental care.

INTRODUCTION: Children are the most important natural resources. School is a location which helps to promote the health of staff, families, and community members along with the students. Teachers are the most resourceful manpower available to deliver any healthcare at school setup. AIMS AND OBJECTIVES: To assess the knowledge and attitude towards primary dental care among male schoolteachers at Al-Kharj Saudi Arabia. METHODOLOGY: A descriptive cross-sectional questionnaire survey was carried out involving male teachers working in primary schools at Al-Kharj KSA. A total of 350 teachers were included in this study. The data were collected using a self-administered questionnaire survey consisting of 17 questions related to knowledge and attitude towards dental care and oral hygiene practices. RESULTS: The overall knowledge was fair among the schoolteachers (65.4%). Al-Kharj male schoolteachers were having a positive attitude. Teaching experience and knowledge showed a statistically significant relation (P < 0.05. CONCLUSION: Although primary schoolteachers had a fair knowledge and good attitudes towards dental care, there is a need to conduct training programs about oral health education in schools and check how teachers educate their children to maintain dental care.

Antimicrobial Activity of Curcuma longa L. Extract on Periodontal Pathogens.

AIM: The aim of this study was to evaluate the antimicrobial activity of Curcuma longa L. extract (CLE) on periodontal pathogens. MATERIALS AND METHODS: Sixty patients were divided into three groups: Group I (n = 20) patients treated with scaling and root planning (SRP) only, Group II (n = 20) patients treated with SRP followed by subgingival irrigation with 1% CLE solution, and Group III (n = 20) patients treated with SRP followed by subgingival irrigation with 0.2% chlorhexidine (CHX) solution. The clinical parameters (plaque index [PI], gingival index [GI] scores, probing pocket depths) were recorded at baseline, 4 weeks, and 8 weeks. The antimicrobial efficacy of 1% CLE and 0.2% CHX solutions against Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans were evaluated by disk diffusion method. RESULTS: There was no significant difference in the mean values of zone of inhibition exhibited by both CLE and CHX solutions. All the groups showed significant improvement in the clinical parameters when compared to baseline values. The improvement in the PI and GI scores in the CLE group was lesser than that in CHX group by the end of the study period. CONCLUSION: CLE possess antimicrobial efficacy against the common periodontopathic bacteria. However, further large-scale studies evaluating the substantivity of C. longa are required to support its beneficial use in the treatment of periodontal diseases.

Diabetes and Oral Health – A Review.

Oral health is an integral component of the general health. There is increasing evidence to suggest that oral health and systemic health are interrelated to each other. Evidence indicates that diabetes mellitus has a major role in altering the oral environment. The oral manifestation is generally seen in uncontrolled or poorly controlled diabetic patients due to reduction in defense mechanism and the increased susceptibility to infections. Both advanced periodontal disease and dental caries may lead to the loss of teeth. Xerostomia is also a common symptom in diabetics. Hypo salivation and changes in salivary composition may contribute to the increased susceptibility to oral infections, impaired wound healing and increased rate of dental caries in diabetics. Fungal infections are more common in type 1 and type 2 diabetics than in non-diabetics and the oral infections appear to be more severe in diabetics than in non-diabetics. Periodontal disease is considered as a sixth complication of diabetes mellitus. The other frequently encountered clinical signs are, gingival polyps, periodontitis, periodontal abscess, loosened teeth due to bone loss, delayed post surgical healing and striking enlargement and erythema of the attached gingiva. It is worth to review the available literature so that one can have a comprehensive knowledge and understanding of the oral manifestation related to diabetes mellitus which in turn will help dentists in taking necessary precautions, while delivering oral health care services for patients with diabetes mellitus.