The Influence of Circadian Rhythm on the Antioxidant Capacity of Saliva in Periodontal Diseases.

Background Saliva has a powerful antioxidant activity proposing that it might have a protective role in the oral cavity. It is yet unclear, how circadian rhythm might affect this activity. Objective The main goal of this study was to compare the antioxidant status of saliva in patients with periodontal diseases (PD) to that of healthy people on a diurnal basis. Material and methods A total of 18 periodontal healthy individuals and 18 patients with chronic periodontitis were chosen. Samples of saliva were collected in the morning between 6:00 and 8:00 and in the evening between 6:00 and 8:00 (both stimulated and non-stimulated). The amount of glutathione (GSH), malondialdehyde (MDA), and total antioxidant status (TAS) in the salivary samples were analyzed, and its flow was also assessed. In addition, the scavenging capacity of saliva was tested in three systems generating oxygen free radicals. Results Results showed that GSH and TAS concentrations in the evening saliva of healthy subjects were significantly higher than those in the morning saliva, while MDA levels decreased (p<0.05). Conversely, there was no significant increase in GSH and TAS levels in the evening saliva of subjects with PD, and lipid peroxidation remained constant. On the other hand, the evening saliva of healthy subjects but not of subjects with PD was significantly more potent in scavenging free radicals in vitro than the morning saliva, especially for the superoxide (O2.-) radical (p<0.05). Moreover, scavenging activity was higher in stimulated than non-stimulated saliva. This activity was higher in evening saliva compared to the morning one and greater in healthy subjects compared to patients with PD (p<0.05). Conclusion A balance exists between oxidative stress and antioxidant mechanisms to maintain homeostasis in the oral cavity. This balance is deregulated in patients with PD as their saliva is unable to properly scavenge free radicals that might potentially increase over the day. Antioxidant supplements may be used in accordance with the circadian rhythm to minimize oxidative damage.

Lebanese Dentists' Preparedness to Deal With Medical Emergencies in Their Clinics: A National Survey.

INTRODUCTION AND AIMS: Health-related emergencies, from minor incidents to life-threatening situations, can occur unexpectedly in dental clinics. Ensuring that dentists and their teams are well-prepared with adequate training and essential equipment is crucial. Proper preparedness can lead to effective management of emergencies and reduce potential complications. This cross-sectional national study aimed at assessing the preparedness of Lebanese dentists in managing medical emergencies. METHODS: Data was collected between August and October 2024 using an online questionnaire which was distributed to all registered Lebanese dentists through the Lebanese Dental Associations located in Beirut and Tripoli. RESULTS: The study found that 38.2% of dentists had an emergency kit in their clinics, and 88.0% had some emergency equipment; yet only 5.9% had a defibrillator. While 71.3% had emergency training in university, 28.5% never received it. Only 18.8% reported staff training in medical emergencies. Most dentists (74.2%) encountered minor medical issues, and 22.4% faced major emergencies, with only 1.8% reporting cardiac arrest cases. Vasovagal reactions, hypoglycemia, and orthostatic hypotension were common emergencies. While 69.0% felt capable of managing minor issues, confidence dropped for major emergencies and specific procedures. An overwhelming 87.8% expressed a need for more emergency training. Post-graduation training, prior defibrillator use, and having an emergency kit were linked to better emergency management capabilities in the logistic regressions. CONCLUSION: The findings of this study indicate significant gaps in emergency preparedness among Lebanese dentists. Many lack adequate training and resources, highlighting the urgent need for further training and better-equipped clinics. Strengthening policy frameworks and resource allocation is crucial. CLINICAL RELEVANCE: Stakeholders should prioritize implementing mandatory training programs and developing clear guidelines to ensure that dental clinics in Lebanon are adequately prepared to manage health-related emergencies effectively.

The Knowledge, Attitude, and Practice of Lebanese Mothers Toward Their Children's Oral Health: A Cross-Sectional Survey.

OBJECTIVES: This study aims to assess the knowledge, attitude, and practice of Lebanese mothers toward their children's oral health, examine the association between the three variables, and identify their predictors. METHODS: A cross-sectional online survey was administered to Lebanese mothers residing in Lebanon with children aged six months to 12 years between April and May 2022. The survey was administered to mothers from various geographical areas who presented to academic medical centers, private clinics, and dispensaries. The survey gathered sociodemographic data as well as assessed the knowledge, attitude, and practice of the participating mothers toward their children's oral health. RESULTS: A total of 357 responses were included in the final analysis. The mean age of mothers was 32.67 years +/- 6.35. The majority of mothers had one or two children (35.8% and 37.5%, respectively). More than two-thirds of the mothers were unemployed. Only 13% of the mothers followed best practices for their children's dental health, while 48.6.2% possessed above-average knowledge and 88.9% had great attitudes. Mothers with a university education had higher knowledge, better attitudes, and practice scores than those with school-level education (elementary, high school). Employed mothers had a significantly better knowledge score (p=0.036) and practice score (p=0.043) than unemployed mothers. The decrease in the number of children was associated with an increase in the maternal knowledge score. An increase in the mother's age was associated with a higher knowledge score. CONCLUSION: The findings of this study suggest the need for targeted oral health education programs for Lebanese mothers to enhance their attitudes and practices toward their children's oral health. It highlights the importance of early oral health interventions and emphasizes the significant role of mothers in promoting good oral health practices for their children. Further research is needed on a larger scale to comprehensively understand these variables and inform the development of appropriate national oral health programs for children in Lebanon.

Prevalence of Oral Mucosal Lesions Among the Institutionalized Elderly Population in Lebanon.

This study aimed to determine the prevalence of oral mucosal lesions and risk factors among the institutionalized elderly Lebanese population. A representative sample of 526 individuals (49% males and 61% females) aged 65 years and above was examined. A questionnaire and clinical examination were administered. Bivariate and multivariate regressions were carried out. The frequency of oral mucosal lesions was 22.8% and it was associated to the use, integrity (p < .002), and hygiene level (p < .047) of removable mandibular and maxillary prosthesis. Multiple regression analysis also predicted the relationship between the mandibular prosthesis hygiene level and the occurrence of mucosal lesions. The factors controlling the occurrence of oral mucosal lesion were mainly related to the level of oral care given to the individuals. Therefore, a proper oral health care system should be implemented in the Lebanese residential homes to ensure the well-being of the residing population.

Oral health status and care of institutionalized elderly individuals in Lebanon.

BACKGROUND: Oral health of the elderly is a major public health challenge. Data on oral health and dental care of the institutionalized elderly is lacking in Lebanon. AIMS: (1) Assess the oral health of Lebanese people aged 65 years and over living in residential facilities; and (2) identify factors associated with poor oral status. MATERIALS AND METHODS: A.sample of 526 nursing home residents aged 65 years and older was randomly selected from 46 residential facilities. Information collected were sociodemographic characteristics, degree of autonomy regarding toilet use and nutrition, presence of chronic diseases and medications, dry mouth sensation, dental brushing, access to oral health and reasons of dental visits. A structured oral examination was conducted to gather data on DMFT index, oral hygiene indices modified gingival index, and the unmet need for prosthesis. Statistical methods included bivariate and multivariate analyses. RESULTS: 55.9% of the participants were edentates, 41.4% used partial and/or complete dentures, and the minority used dentures with good hygiene. 15% of the dentate sample reported regular tooth brushing, 7% reported to have visited the dental office in the past 12 months, and 57% presented an unmet need for prosthesis. Oral health status was significantly related to age, smoking, daily tooth brushing, and autonomy (P < 0.05). Subjects with chronic diseases and consuming medications were more likely to have xerostomia. CONCLUSION: Oral health status is poor in the elderly institutionalized Lebanese population, which should promote a multidisciplinary team sharing responsibility for daily oral hygiene and access to dental treatment.