Fear control and danger control amid COVID-19 dental crisis: Application of the Extended Parallel Process Model.

OBJECTIVES: There is high risk of contamination with COVID-19 virus during routine dental procedures and infection control is crucial. The aim of this study was to determine the factors associated with Covid-19 preventive behaviors among oral health care providers using an extended parallel process model (EPPM). METHODS: In a cross-sectional study, short text message invite surveys were sent to 870 oral health care providers in west part of Iran. Data were collected through validated self-report EPPM questionnaires. Descriptive statistics, Chi-square and Fishers exact tests were used for data analysis. RESULTS: In total, 300 completed questionnaires were received and the mean age of respondents was 29.89 ± 11.17 years (range: 20-75 years). Among the study population, 284 (94.67%) perceived the threat of infection highly. Washing hands frequently with water and soap and use of hand sanitizer was reported by 93.33%, of participants. Age (P = 0.010), sex (P = 0.002) and occupation field (P = 0.010) were significantly associated with danger control responses. Data identified that those oral health care providers that were on the danger control response adopted preventive behaviors more strictly than those on fear control response. CONCLUSION: The results of this study showed how degrees of perceived threat and perceived efficacy influenced oral health providers' willingness to perform recommended health behaviors. These findings can assist public health agencies in developing educational programs specifically designed for promoting preventive behaviors among oral health providers in pandemic situations.

The Effect of Smoking on Mast Cells Density and Angiogenesis in Chronic Periodontitis.

BACKGROUND AND OBJECTIVE: Gingival bleeding reduction in smokers has been associated with decreased blood vessel density. The mechanism of suppressive effect of cigarette smoking on blood vessel density is not precisely defined. The aim of this study was to evaluate the impact of smoking on angiogenesis by assessing mast cells density and VEGF expression in chronic periodontitis. MATERIALS& METHODS: 52 paraffin embedded block of gingiva tissues with periodontitis obtained from 30 nonsmokers and 22 smokers undergoing flap surgery were examined immunohistochemically for VEGF expression. Mast cell counts was completed on toluidine blue stained slides. Exposure to cigarette smoking was calculated by the number of packs × year. Patients were classified into 4 groups based on the number of smoked cigarettes. The correlation between VEGF expression and mast cell counts was evaluated and compared in nonsmokers and smokers. RESULTS: The mean number of mast cells (p=0.004) and average value of VEGF expression (p = 0.000) in nonsmokers was significantly higher than smokers. No correlation was noted between VEGF expression / mast cell counts and number of smoked cigarettes in four groups of smokers (p=0.29,0.12 , 0.20 and 0.11, respectively). CONCLUSION: Mast cells and VEGF expression may account for suppressive effect of cigarette smoking on blood vessels in periodontitis.

Relationship between tonsil odor and oral malodor: a clinical study on 48 Iranian patients.

The objective of this study is to evaluate tonsil odor as a contributor to halitosis and to study the reduction of oral malodor by mouth rinsing, without tonsil treatment. In 48 halitosis patients, tonsil odor and oral malodor were assessed through the 0-5 scale. In tonsil odor assessment, a dental burnisher was inserted into the tonsilar crypts and was sniffed by an odor judge. Oral malodor was analyzed through a plastic straw using the same scale by the same judge. The concentrations of H(2)S, CH(3)SH and (CH(3))(2)S were measured by a portable gas chromatograph (GC) (OralChroma) in ppb. After the baseline evaluations the subjects were instructed to scrape the surface of the tongue daily and rinse with a zinc-containing mouthwash twice daily for 1 month. After this period the same evaluations were repeated. Data were analyzed by SPSS software, paired t-test and Pearson correlation. Before mouthwash test: mean values of oral malodor scores and tonsil odor scores were 4.2 and 3.7, respectively. Pearson correlation analysis showed that oral malodor scores and tonsil odor scores had a significant correlation (p = 0.025). Oral malodor scores were correlated with the concentrations of H(2)S (p = 0.0001), CH(3)SH (p = 0.041) but not with (CH(3))(2)S concentration. After mouthwash test: mean values of oral malodor scores and tonsil odor scores were 2.2 and 3.0, respectively. Tonsil odor scores and oral malodor scores were not correlated. Also the paired t-test results showed that the effect of the mouthwash on the reduction of oral malodor and tonsil odor was not the same. Since oral malodor was successfully reduced while tonsil odor remained with a little reduction, it is concluded that tonsilar treatment such as tonsillectomy and laser cryptolysis might be considered only after the failure of mechanochemical therapy.

Clinical evaluation of 222 Iranian patients with halitosis.

The primary objectives of the study were to investigate the levels of volatile sulfur compounds (VSCs) in Iranian patients and to find the most prevalent class of halitosis among them. The secondary objective was to study the measures employed by the patients to reduce halitosis. 46.4% of the 222 patients were female (average 32.1 years) and 53.6% were male (average 32.1 years). Contrary to other reports, males were dominant in this study. All the subjects were evaluated through oral examination, gas chromatographic analysis, organoleptic assessment and mouth cleaning and rinsing test (MCART). Finally, each patient was classified according to current classification. The patients were also asked about the measures employed by them to reduce halitosis. The data were statistically analysed using SPSS software. Gas chromatographic analysis revealed that the median values for H(2)S, CH(3)SH and (CH(3))(2)S levels were 214 ppb, 64 ppb and 2 ppb, respectively. Average values of H(2)S, CH(3)SH and (CH(3))(2)S were 358.7 ppb, 143.0 ppb and 19.5 ppb, respectively. A correlation was demonstrated between organoleptic scores and the concentration of only H(2)S, CH(3)SH and the total of three gases. In 62.2% of the subjects, no oral pathologic condition was found, but tongue coating was observed. The patients were in only class I (genuine halitosis) and class II (pseudo-halitosis) halitosis. None of them was diagnosed as halitophobia. The percentages of classes I and II were 98.6% and 1.4%, respectively. The percentages of sub-classes of class I halitosis in total subjects were as follows: 60.8% physiologic halitosis, 37.8% oral pathologic halitosis and 0% extraoral pathologic halitosis. The mean value of organoleptic score for physiologic halitosis was 4.0 and those for oral pathologic halitosis and pseudo-halitosis were 4.3 and 1.6, respectively. MCART was a useful tool to distinguish oral halitosis from extraoral halitosis. Levels of VSCs were not as high as those measured in other countries. Although in most cases VSCs were a contributing factor to halitosis, VSCs levels were not useful diagnostic criteria for the minority of the patients. The most prevalent class and sub-class of halitosis in the patients were genuine halitosis and physiologic halitosis. Measures employed by the patients to reduce halitosis were mostly related to the oral cavity.