Correlation between Periodontal Diseases and COVID-19: Systematic Review and Meta-Analysis

Objective: To finding the correlation of COVID-19 with periodontal status. Methods: This systematic review and meta-analysis were aimed to overview studies of the relationship between periodontal disease and the severity of COVID-19 (hospitalization). There were nine studies, analyzed in this systematic review (nine reviews and three meta-analyses). The quality assessment of studies was using Newcastle-Ottawa Scale (NOS) and the pooling effect of meta-analysis were using random-effects model. Results: The NOS scores were Satisfied (5-6 stars) for seven studies, meanwhile good (7 stars) for two studies. The estimated OR was 2.68 (P= 0.006). The heterogeneity (I2 ) was 61%, showed moderate (P=0.006). The heterogeneity (I2 ) was 61%, showed moderate het-erogeneity. COVID-19 and severity depended on the host and viral factors that influence the immune response. The surge of cytokines (especially IL-6) was found as an imperative role in the COVID-19 and periodontal diseases. Finally, periodontal diseases were found positively contributed to the severity of COVID-19. Conclusion: Periodontal diseases were found associated with the severity and mortality of COVID-19. However, further studies are a necessity to generalize in other populations of COVID-19 patients. © 2022 JDMFS.

Effect of stress on periodontium and oral health in COVID-19 positive patients: an online questionnaire-based survey

Background: Emergence of Covid-19 pandemic resulted in stressful living conditions throughout the world leading to an alteration of habits and detrimental effects on overall health particularly oral health and hygiene of people throughout the world. The aim was to access perceived stress and its impact on periodontium and oral health in Covid-19 positive patients. Material & Methods: An online health questionnaire was submitted by Covid-19 positive patients over a period of six months with answers regarding their systemic health, perceived stress, existing habits and their alteration, oral hygiene maintenance and symptoms of oral and periodontal diseases during covid positivity. Results: Results showed that there was increase in stress levels of Covid-19 positive patients with alteration of habits and increased incidence of negative effects on oral and periodontal health. Conclusions: Although Covid-19 positive patients experienced more stress and higher incidence of oral and periodontal diseases but no direct relation could be established.

Self-reported periodontitis association with impaired smell and taste: A multicenter survey.

OBJECTIVES: To investigate the association between self-reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities. MATERIALS AND METHODS: Data were collected through a digital survey. A total of 1239 individuals from Aarhus University - Denmark, the University of Iowa, and the University of Florida - USA were included. Self-reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self-perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID-19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach. RESULTS: The total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self-reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]). CONCLUSION: Our findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.

Post-COVID mucormycosis in presentation of periodontal abscess.

COVID-19 pandemic has traumatized deep inside in minds and lives of human beings. Those who have survived are at risk of many post-COVID complications; mucormycosis being one of the most common as well as morbid infections. Mucormycosis is also known as black fungus, it is a life-threatening opportunistic fungal infection. Inoculation occurs by inhalation of spores in nose, paranasal air sinuses and in lungs. Mucormycosis is often associated in patients with compromised immunity and it presents with characteristic black necrotic eschar and necrosis. Disease affecting the facial region possess a challenge because it often disseminates with sino-orbital and cranial involvement at the time of diagnosis. Dental practice occasionally encounters unusual and subtle symptoms with non-pathognomonic clinical signs of several fatal diseases which may pretend like a common oral disease. Hence, the key knowledge to oral and primary care physicians and its precise application is necessary for the early diagnosis of such fatal infections to prevent untoward consequences in this COVID era. This article presents a case of mucormycosis with chief complaint of pain and swelling in right front tooth region, which mimicked as periodontal abscess in a patient, leading to delay in the diagnosis possess greater challenges during the treatment.

Clinical, immunological, and microbiological analysis of the association between periodontitis and COVID-19: a case-control study.

PURPOSE: Periodontitis and coronavirus disease (COVID-19) share risk factors and activate similar immunopathological pathways, intensifying systemic inflammation. This study investigated the clinical, immunological and microbiological parameters in individuals with COVID-19 and controls, exploring whether periodontitis-driven inflammation contributes to worsening COVID-19 endpoints. METHODS: Case (positive RT-PCR for SARS-CoV-2) and control (negative RT-PCR) individuals underwent clinical and periodontal assessments. Salivary levels of TNF-α, IL-6, IL-1ß, IL-10, OPG, RANKL, neutrophil extracellular traps, and subgingival biofilm were analyzed at two timepoints. Data on COVID-19-related outcomes and comorbidity information were evaluated from medical records. RESULTS: Ninety-nine cases of COVID-19 and 182 controls were included for analysis. Periodontitis was associated with more hospitalization (p = 0.009), more days in the intensive care unit (ICU) (p = 0.042), admission to the semi-ICU (p = 0.047), and greater need for oxygen therapy (p = 0.042). After adjustment for confounders, periodontitis resulted in a 1.13-fold increase in the chance of hospitalization. Salivary IL-6 levels (p = 0.010) were increased in individuals with COVID-19 and periodontitis. Periodontitis was associated with increased RANKL and IL-1ß after COVID-19. No significant changes were observed in the bacterial loads of the periodontopathogens Porphyromona gingivalis, Aggregatibacter actinomycetemcomitans, Tanerella forsythia, and Treponema denticola. CONCLUSIONS: Periodontitis was associated with worse COVID-19 outcomes, suggesting the relevance of periodontal care to reduce the burden of overall inflammation. Understanding the crosstalk between SARS-CoV-2 infection and chronic conditions such as periodontitis that can influence disease outcome is important to potentially prevent complications of COVID-19.

Dental calculus - An emerging bio resource for past SARS CoV2 detection, studying its evolution and relationship with oral microflora.

The most grievous threat to human health has been witnessed worldwide with the recent outbreak of Corona virus disease 2019 (COVID-19). There is mounting evidence available regarding theconnect of COVID -19 and oral cavity, particularly periodontal disease. The current review provides an update on the diagnostic potential of dental calculus and how this bio resource may help in providing us huge amount of diagnostic regarding the causative virus. Contemporary standard method of diagnosis via nasopharyngeal swabs (NPS) is tedious, may enhance the risk of aerosol contamination by inducing sneezing and detects the presence of active infection only.However,dental calculus being a mineralized deposit serves as a reservoir for biomoleculesand provides detection of past SARS CoV2 infection. Further, the abundance of information that can be obtained from this remarkable mineralized deposit on teeth regarding the viral genome, its evolution and interactions with the oral microflora shall enhance the understanding of the viral disease process and its connection with the periodontal disease. Additional diagnostic information, which may be obtained from this simple bio reservoir can complement the contemporary diagnostic strategies adopted in the management of COVID-19pandemic and enhance our existing knowledge for developing improvised novel approaches to mitigate the effects of mutated variants of the infectious agent.

Oral Health Implications of SARS-CoV-2/COVID-19: A Systematic Review.

PURPOSES: The aim of this sytematic review was to evaluate the potential association of COVID-19 infection with oral health. MATERIALS AND METHODS: Screening in different databases (PubMed/MEDLINE, Google Scholar, and Embase databases) was performed to identify relevant articles, focusing on the oral health of patients with COVID-19, and published up to November 2021. 5194 articles were identified, and 29 fulfilled the inclusion criteria. RESULTS: Patients presenting more severe periodontal or dental diseases were at an increased risk of developing COVID-19 complications and being admitted to intensive care units. According to the included articles, U-shaped lingual papillitis and aphthous-like ulcers on the tongue are the most frequent lesions assessed in the oral cavity of COVID-19 patients, while xerostomia seems to be an early COVID-19 diagnostic symptom. Apart from the presence of the virus, the global lockdown had a detrimental impact on oral health. The occurrence of dental emergencies was augmented during this time due to the postponement of numerous non-emergency dental procedures. CONCLUSIONS: The presence of SARS-CoV-2 in periodontal tissues and salivary fractions may explain the presence of oral lesions during the infection. However, the virus's direct or indirect effect on oral mucosa is unclear. It is important to consider that these manifestations might be attributed to underlying comorbidities, or co-existing or subsequent lesions produced by local irritants.

Periodontal disease and COVID-19: Prognosis and potential pathways of association in their pathogenesis.

Objective: The objective of this narrative review is to determine if periodontal disease is a factor in the development of a poor prognosis for COVID-19. Method: A bibliographic search was conducted in PubMed, Virtual Health Library, Google Scholar, and in the databases of Science Direct, Scopus, Lilacs, Bireme, Scielo, and Web of Science, using the following keywords: "COVID-19," "SARS-CoV-2," and "periodontal diseases." Results: Fifty-six records were retrieved from the database searches. After screening, 39 articles were selected for study: 13 reviews, 2 case-control studies, 1 systematic review, 8 letters to the editor, 2 cohort studies, 1 thesis, 7 hypotheses, 1 short communication, 3 commentaries, and 1 scoping review. Discussion: Both periodontal disease and COVID-19 produce an inflammatory response. This immune response generates an over-production of inflammatory cytokines that can harm overall health. Conclusion: The mouth serves as the entryway for many microorganisms that can harm health in general, among them SARS-CoV-2. It is important to maintain good oral health to lower the inflammatory load present in periodontal disease, lessening the possibility of complications from COVID-19.

Objectif: L'objectif de cette revue narrative est de déterminer si la maladie parodontale est un facteur dans le développement d'un mauvais pronostic de la COVID-19. Méthodologie: Une recherche bibliographique a été effectuée dans PubMed, la bibliothèque virtuelle de la santé, Google Scholar, et dans les bases de données de Science Direct, Scopus, Lilacs, Bireme, Scielo, et Web of Science, en utilisant les mots-clés suivants : « COVID-19 ¼, « SRAS-CoV-2 ¼ et « maladie parodontale ¼ (en anglais). Résultats : Cinquante-six dossiers ont été extraits à partir des recherches dans les bases de données. Après la sélection, 39 articles ont été choisis pour l'étude : 13 revues, 2 études cas-témoins, 1 revue systématique, 8 lettres à l'éditeur, 2 études de cohorte, 1 thèse, 7 hypothèses, 1 courte communication, 3 commentaires et 1 examen de la portée. Discussion: La maladie parodontale et la COVID-19 produisent toutes deux une réponse inflammatoire. Cette réponse immunitaire produit une surproduction de cytokines inflammatoires qui peuvent nuire à la santé globale. Conclusion: La bouche sert de voie d'entrée à de nombreux micro-organismes qui peuvent nuire à la santé en général, parmi lesquels le SRAS-CoV-2. Il est important de préserver une bonne santé buccodentaire pour diminuer la charge inflammatoire présente dans la maladie parodontale, réduisant ainsi la possibilité de complications de la COVID-19.

Associations between Periodontitis, COVID-19, and Cardiometabolic Complications: Molecular Mechanisms and Clinical Evidence.

Periodontitis is a microbially driven, host-mediated disease that leads to loss of periodontal attachment and resorption of bone. It is associated with the elevation of systemic inflammatory markers and with the presence of systemic comorbidities. Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the majority of patients have mild symptoms, others experience important complications that can lead to death. After the spread of the COVID-19 pandemic, several investigations demonstrating the possible relationship between periodontitis and COVID-19 have been reported. In addition, both periodontal disease and COVID-19 seem to provoke and/or impair several cardiometabolic complications such as cardiovascular disease, type 2 diabetes, metabolic syndrome, dyslipidemia, insulin resistance, obesity, non-alcoholic fatty liver disease, and neurological and neuropsychiatric complications. Therefore, due to the increasing number of investigations focusing on the periodontitis-COVID-19 relationship and considering the severe complications that such an association might cause, this review aims to summarize all existing emerging evidence regarding the link between the periodontitis-COVID-19 axis and consequent cardiometabolic impairments.

Updates and Original Case Studies Focused on the NMR-Linked Metabolomics Analysis of Human Oral Fluids Part III: Implementations for the Diagnosis of Non-Cancerous Disorders, Both Oral and Systemic.

This communication represents Part III of our series of reports based on the applications of human saliva as a useful and conveniently collectable medium for the discovery, identification and monitoring of biomarkers, which are of some merit for the diagnosis of human diseases. Such biomarkers, or others reflecting the dysfunction of specific disease-associated metabolic pathways, may also be employed for the prognostic pathological tracking of these diseases. Part I of this series set the experimental and logistical groundwork for this report, and the preceding paper, Part II, featured the applications of newly developed metabolomics technologies to the diagnosis and severity grading of human cancer conditions, both oral and systemic. Clearly, there are many benefits, both scientific and economic, associated with the donation of human saliva samples (usually as whole mouth saliva) from humans consenting to and participating in investigations focused on the discovery of biomolecular markers of diseases. These include usually non-invasive collection protocols, relatively low cost when compared against blood sample collection, and no requirement for clinical supervision during collection episodes. This paper is centred on the employment and value of 'state-of-the-art' metabolomics technologies to the diagnosis and prognosis of a wide range of non-cancerous human diseases. Firstly, these include common oral diseases such as periodontal diseases (from type 1 (gingivitis) to type 4 (advanced periodontitis)), and dental caries. Secondly, a wide range of extra-oral (systemic) conditions are covered, most notably diabetes types 1 and 2, cardiovascular and neurological diseases, and Sjögren's syndrome, along with a series of viral infections, e.g., pharyngitis, influenza, HIV and COVID-19. Since the authors' major research interests lie in the area of the principles and applications of NMR-linked metabolomics techniques, many, but not all, of the studies reviewed were conducted using these technologies, with special attention being given to recommended protocols for their operation and management, for example, satisfactory experimental model designs; sample collection and laboratory processing techniques; the selection of sample-specific NMR pulse sequences for saliva analysis; and strategies available for the confirmation of resonance assignments for both endogenous and exogenous molecules in this biofluid. This article also features an original case study, which is focussed on the use of NMR-based salivary metabolomics techniques to provide some key biomarkers for the diagnosis of pharyngitis, and an example of how to 'police' such studies and to recognise participants who perceive that they actually have this disorder but do not from their metabolic profiles and multivariate analysis pattern-based clusterings. The biochemical and clinical significance of these multidimensional metabolomics investigations are discussed in detail.

Can dentists prevent black fungus in post-COVID-19 patients?

In the southeast India, post-COVID-19 black fungus is increasingly being reported in medically compromised individuals. Diabetes and systemic steroids in COVID-19 patients constitute the double-edged sword that results in post-COVID-19 fungal infections. Black fungus is a part of normal flora that thrives in an immunocompromised state, resulting in rhino-orbital-cerebral mucormycosis. Majority of patients, suffering from black fungus, have uncontrolled diabetes and have undergone steroid therapy. Intra-oral signs are the earliest warning signs in black fungus and dentists should be on the lookout for these, so as to prevent the development of deadly infection. Comprehensive intra-oral signs are enlisted in this review for dentists that include tooth mobility and periodontal clinical attachment loss amongst others. Evidence-based preventive approaches are highlighted in this review to reduce morbidity and mortality, associated with black fungus. Regular dental check-ups are vital to prevent and diagnose early the secondary fungal infections in post-COVID-19 patients, reducing morbidity significantly.

Chronic Obstructive Pulmonary Disease and Apical Periodontitis and Other Oral Health Variables: A Case-Control Study

Background: The relationship between chronic inflammatory diseases and their comorbidities and correlation with periodontal diseases has become an increasing focus of research. Objectives: The aim of this case-control study was to conclude if patients suffering from COPD (Chronic Obstructive Pulmonary Disease) tend to have more AP (Apical Periodontitis) than non-COPD patients. Materials and Methods: The study was conducted on 30 patients assigned as cases, associated with 30 control patients linked by age (+/−5 years) and sex. Results: A total of 60 patients were recorded, and a total of 12 radiographic variables were analyzed. A total of 43 (71.7%) patients were registered with PAI (Periapical Index) ≥ 3, and there was a slightly tendency in the patients from the control group 22 (73.3%) compared to those from the cases 21 (70%), respectively (p > 0.05). Conclusions: It was concluded that there was not a significant association between the levels of PAI (Periapical Index) ≥ 3 per patient in those suffering from COPD. In fact, it could be concluded that patients diagnosed with COPD tend to have more teeth with PAI ≥ 3, more endodontic treatments and their periodontitis tended to accumulate more caries. Clinical Significance: This study establishes, in a case-control study, some specific aspects of oral health in patients with COPD, as well as analyzing the importance of oral health in this disease.

Evaluation of oral hygiene habits and periodontal disease according to the COVID-19 history by teledentistry: a cross-sectional study

Objective: To evaluate oral hygiene habits and periodontal disease status with teledentistry and to compare oral hygiene and periodontal disease status according to the COVID-19 history. Materials and Methods: Patients who had applied to our faculty before the pandemic and were reached via teledentistry were included. A questionnaire consisting of 4 sections and 25 questions was administered through telephone conversation. Demographic information, medical history, smoking habits, and COVID-19 history (with [COVID(+)] or without COVID-19 [COVID(-)]) were questioned in the first section, while dental hygiene (DH), environmental dental hygiene (EH), history of periodontal disease (PH) were evaluated in the next three sections. The answers were scored in a way that increased values symbolize negative attitude. Taking into account the minimum and maximum values that can be obtained from the sum of the scores;DH, EH and PH scales with low, medium and high value ranges were created. The groups were compared in terms of the mean value from the scales and the distribution in the scale ranges.

Periodontitis and COVID-19: Biological Mechanisms and Meta-analyses of Epidemiological Evidence.

Since the beginning of 2020, the entire global health care system has been severely challenged by the outbreak of coronavirus 2019 disease (COVID-19). Robust evidence has demonstrated a more severe course of COVID-19 in the presence of several comorbidities, such as cardiovascular diseases, diabetes mellitus, and obesity. Here, we critically appraise the recent research discoveries linking periodontitis to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to severe COVID-19, with a special focus on the associated biological mechanisms and the available epidemiological evidence. SARS-CoV-2 main receptors and coreceptors (ACE2, TMPRSS2, furin, CD147) are overexpressed in periodontal tissues of periodontitis patients, with inflammation, periodontal pathogens, and damage-induced pyroptosis triggering a positive feedback loop. However, meta-analyses of epidemiological studies only indicated a nonstatistically significant tendency for an increased risk of SARS-CoV-2 infection in subjects with periodontitis (odds ratio [OR] = 1.69; 95% CI, 0.91-3.13, P = 0.09). Furthermore, periodontitis may worsen clinical COVID-19 courses through multiple direct and indirect pathways, including damage to lower airways due to aspiration of periodontal pathogens, exacerbation of the cytokine storm via the low-grade chronic systemic inflammation, and SARS-CoV-2 dissemination through the ulcerated gingival epithelium with consequent induced pulmonary vessels vasculopathy. Indeed, meta-analyses of epidemiological studies indicated that periodontitis subjects are more likely to experience a more severe course of COVID-19. Specifically, periodontitis was associated with a 4-fold increased odds of hospitalization (OR = 4.72; 95% CI, 1.11-20.03, P = 0.04), 6-fold of requiring assisted ventilation (OR = 6.24; 95% CI, 2.78-14.02, P = 0.00), and more than 7-fold of death due to COVID-19 complications (OR = 7.51; 95% CI, 2.16-26.10, P = 0.00). The breakthrough analyzed here emphasizes the relevance of the mouth-systemic connection as a target to mitigate the current COVID-19 emergency and the future predicted coronavirus pandemics.

Apitherapy and Periodontal Disease: Insights into In Vitro, In Vivo, and Clinical Studies

Periodontal diseases are caused mainly by inflammation of the gums and bones surrounding the teeth or by dysbiosis of the oral microbiome, and the Global Burden of Disease study (2019) reported that periodontal disease affects 20–50% of the global population. In recent years, more preference has been given to natural therapies compared to synthetic drugs in the treatment of periodontal disease, and several oral care products, such as toothpaste, mouthwash, and dentifrices, have been developed comprising honeybee products, such as propolis, honey, royal jelly, and purified bee venom. In this study, we systematically reviewed the literature on the treatment of periodontitis using honeybee products. A literature search was performed using various databases, including PubMed, Web of Science, ScienceDirect, Scopus, clinicaltrials.gov, and Google Scholar. A total of 31 studies were reviewed using eligibility criteria published between January 2016 and December 2021. In vitro, in vivo, and clinical studies (randomized clinical trials) were included. Based on the results of these studies, honeybee products, such as propolis and purified bee venom, were concluded to be effective and safe for use in the treatment of periodontitis mainly due to their antimicrobial and anti-inflammatory activities. However, to obtain reliable results from randomized clinical trials assessing the effectiveness of honeybee products in periodontal treatment with long-term follow-up, a broader sample size and assessment of various clinical parameters are needed.

The biological role of vitamin D

Resume. The article discusses diseases that depend on the level of vitamin D in the body, possible methods of correcting its level and their consequences. The dependence of the body on the level of this vitamin in the blood is considered. At the moment, there is a global vitamin D deficiency worldwide, which was revealed during the global COVID-19 pandemic. The positive effect of vitamin D on the immune system has been proven, and therefore its deficiency can worsen the course of various diseases. Vitamin D also acts as a hormone, the lack of which leads to pathologies of the cardiovascular system, rickets, osteoporosis, diabetes, obesity, and other serious diseases. The influence of its level on postoperative recovery is also considered. In addition, the article provides methods of correction by means of UV treatment in winter, which, as the data has shown, is dangerous. The article describes neurodegenerative disorders, which are greatly influenced by the level of this vitamin and its prevention. The influence of its level on the health of postmenopausal patients, leading to undesirable consequences, including osteoporosis, is analyzed. Examples of the effect on the protective properties of the oral cavity in periodontal disease and caries are given. The article describes the effect on the course of acute respiratory diseases in children, as well as the effect on the course of the disease in diabetes mellitus.

Countermeasures against COVID-19 from the viewpoints of dental diseases: strengthening innate immunity with the toothpick method of brushing. (Special Issue: COVID-19 and historical pandemics part 2.)

Coronavirus disease (COVID-19) patients with periodontal disease have an 8.8-fold higher mortality rate than those in the patients without periodontal diseases. This was higher than the odds ratio for patients with diabetes. Periodontal disease is associated with ulcers in the periodontal pocket, and gram-negative bacteria called periodontal pathogens invade the tissue through ulcers. Bacteria in the ulcer site are phagocytosed and sterilized by leukocytes. Following the autolysis of leukocytes, lipopolysaccharides (LPS) on the bacterial cell wall spread throughout the body, which is a major cause of multiple organ failure. Thus, periodontal disease is considered to contribute to the mortality rate of COVID-19. Ulcers in the periodontal pocket can be repaired using by a new developed brushing method called the toothpick method. The toothpick method can significantly improve gingival bleeding in one week, which is quicker than conventional periodontal treatment methods. Mechanical stimulation by the toothbrush causes gingival basal cells, fibroblasts, vascular endothelial cells and osteoblasts to proliferate and repair the tissue. However, these cell proliferations cease to occur 0.5 mm away from where the toothbrush bristles make contact with the gingiva. The toothpick method of brushing is characterized by its ability to stimulate the interdental gingiva, which is the initial site of periodontitis. As the toothpick method can repair periodontal ulcers, it will strengthen biological defense mechanisms against chronic degenerative and infectious diseases.

Novel coronavirus infection and periodontal clinic: are we prepared?

Novel coronavirus infection or COVID-19 has become a major challenge and a matter of concern not only for India but for the whole world. This viral infection has been recognized in almost whole world and clinically represented with dry cough, fatigue, coughing sputum, shortness of breath. This article is an attempt to throw light on coronavirus infection and enumerates certain preventive measures to be taken in a periodontal set up for prevention of the same.

Special Issue: Predictive, preventive and personalised (3P) medical approach in population health: life-style and sleep quality, periodontal health, microbiome, anti-cancer and anti-COVID-19 protection. (Special Issue: Predictive, preventive and personalised (3P) medical approach in population health: life-style and sleep quality, periodontal health, microbiome, anti-cancer and anti-COVID-19 protection.)

This special issue contains 8 articles that discuss topics such as: blood transcriptome profiling as potential biomarkers of suboptimal health status;periodontal health related-inflammatory and metabolic profiles of patients with end-stage renal disease;population health in focus of predictive, preventive and personalised (3P) medical approach;metabolomics platform for lifestyle monitoring supporting the development of novel strategies in predictive, preventive and personalised medicine;flavonoids as an effective sensitizer for anti-cancer therapy;positive influence of gut microbiota on the effects of Korean red ginseng in metabolic syndrome;the interplay between the vaginal microbiome and innate immunity in the focus of predictive, preventive, and personalized medical approach to combat HPV-induced cervical cancer;and sleep quality and COVID-19 outcomes.

NEWS BRIEFS

In making the nomination, Cathy Roberts, commended his service as the Federal District Trustee to the ADAA Board, noting that "he is always a great addition to the meeting!" Pacific Dental Services and American Diabetes Association Partner To Increase Awareness of the Link Between Oral Health and Diabetes The American Diabetes Association® (ADA) has announced a new partnership with Pacific Dental Services® (PDS) to increase awareness of the link between periodontal disease and diabetes, and how oral health providers can assist patients in preventing and managing this chronic health condition. According to the American Academy of Periodontology, people with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. [...]periodontal disease is often considered a complication of diabetes. HIPAA does not prohibit providers from requesting COVID-19 vaccination status The Health Insurance Portability and Accountability Act does not prohibit any businesses and individuals, including HIPAA-covered entities such as certain health care providers, from asking if someone is vaccinated against COVID-19, according to the U.S. Department of Health and Human Services' Office for Civil Rights.