Oral Health Needs and Barriers to Care in Children with Learning Difficulties

@#Introduction: Children with learning difficulties (LD) have poorer oral health compared to those without LD due to barriers in maintaining oral care. However, the scarcity of data for this population in Malaysia has left a huge gap in understanding their problems and how to overcome those barriers. Therefore, this study was conducted to evaluate the unmet dental needs and barriers to care perceived by the guardians of children with learning difficulties (CWLD) attending the Special Education Integrated Programmes of a mainstream primary school, in comparison to children without learning difficulties. Methods: This cross-sectional study surveyed the guardians of CWLD (case) and those without LD (control), aged 6-12 years old. A total of 225 questionnaires were distributed to the guardians with a response rate of 40.4% (N=91). Unmet dental needs and barriers in both groups were analysed using the chi-square test. Barriers with significant Chi-square results were further tested with logistic regression to investigate possible confounders. Results: Unmet dental needs of 23.1% of CWLD were found. Most of the guardians agreed that regular dental check-ups were the most needed dental treatment (27.1%) compared to other treatments. The child’s behaviour and the unwillingness of the dentists to treat were among the significant barriers to dental care within the CWLD group. Conclusion: Despite regular dental visits, guardians of CWLD perceived that their children had the most unmet dental needs compared to other children without LD, with significant barriers in terms of accessing professional dental services.

A novel CARD containing splice-isoform of CIITA regulates nitric oxide synthesis in dendritic cells

MHC class II expression is controlled mainly at transcriptional level by class II transactivator (CIITA), which is a non-DNA binding coactivator and serves as a master control factor for MHC class II genes expression. Here, we describe the function of a novel splice-isoform of CIITA, DC-expressed caspase inhibitory isoform of CIITA (or DC-CASPIC), and we show that the expression of DCCASPIC in DC is upregulated upon lipopolysaccharides (LPS) induction. DC-CASPIC localizes to mitochondria, and protein-protein interaction study demonstrates that DC-CASPIC interacts with caspases and inhibits its activity in DC. Consistently, DC-CASPIC suppresses caspases-induced degradation of nitric oxide synthase-2 (NOS2) and subsequently promotes the synthesis of nitric oxide (NO). NO is an essential regulatory molecule that modulates the capability of DC in stimulating T cell proliferation/activation in vitro; hence, overexpression of DC-CASPIC in DC enhances this stimulation. Collectively, our findings reveal that DC-CASPIC is a key molecule that regulates caspases activity and NO synthesis in DC.