Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis.

BACKGROUND: Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants. METHODS: The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature. RESULTS: The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth. CONCLUSION: Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched. TRIAL REGISTRATION: Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.

The oral microbiome of treated and untreated chronic HCV infection: A preliminary study.

OBJECTIVES: Chronic hepatitis C virus (HCV) infection is a debilitating disease that is lately treated using direct-acting antivirals (DAAs). Changes in the oral microbiome were detected in other liver diseases; however, oral microbiome was never investigated in patients having chronic HCV infection, whether pre- or post-treatment. MATERIALS AND METHODS: This case-control preliminary study enrolled three equal groups: Group (I): untreated HCV patients; group (II): HCV patients who achieved viral clearance after DAA administration; and group (III): healthy controls. For each participant, a buccal swab was harvested and its 16S rRNA was sequenced. RESULTS: The oral microbiome of chronic HCV patients had a significantly distinct bacterial community compared to healthy controls, characterized by high diversity and abundance of certain pathogenic species. These changes resemble that of oral lichen planus patients. After treatment by DAAs, the oral microbiome shifted to a community with partial similarity to both the diseased and the healthy ones. CONCLUSIONS: Chronic HCV is associated with dysbiotic oral microbiome having abundant pathogenic bacteria. With HCV clearance by DAAs, the oral microbiome shifts to approach the healthy composition.

How Difficult is it for Patients Having Oral Ulcers to Get Diagnosed?

ABSTRACT: Oral ulcers cause high levels of impairment of the patients' quality of life. Therefore, patients having oral ulcers visit clinicians while seeking treatment. This study aims to investigate the extent of patients' suffering till reaching the correct clinician specialty, and therefore, proper diagnosis and treatment. The study included 62 diagnosed oral ulcer patients. They filled a questionnaire about previously visited clinicians and their specialties, causes of their referral and Oral Health Impact Profile-14 indicating their quality of life. The study revealed that participants visit a mean number of 2.93 clinicians before reaching a specialist. Furthermore, the number of the visited clinicians was positively correlated to the impact of the oral ulcer on quality of life. The study reflects the degree of unnecessary suffering of patients having oral ulcers due to unnecessary delay of diagnosis. It, thereby, highlights the necessity for higher awareness about Oral Medicine specialty among medical practitioners and among general population as well.

RESUMEN: Las úlceras orales y su diagnóstico tardío causan un nivel de deterioro significativo en la calidad de vida de los pacientes. Este estudio tuvo como objetivo investigar el nivel de sufrimiento de los pacientes hasta llegar a la especialidad clínica y lograr un diagnóstico y tratamiento adecuado. El estudio incluyó a 62 pacientes diagnosticados con úlcera oral. Los pacientes completaron un cuestionario sobre los médicos consultados previamente, las especialidades, las causas de su derivación y el Perfil de Impacto en la Salud Oral-14, que refleja su calidad de vida. El estudio reveló que los participantes visitaron una media de 2,93 médicos antes de consultar con un especialista. Además, el número de médicos visitados se correlacionó positivamente con el impacto que tiene la úlcera oral en la calidad de vida. El estudio refleja el grado de sufrimiento innecesario de los pacientes que presentan úlceras orales debido a un diagnóstico tardío. Por lo tanto, se destaca la necesidad de una mayor conciencia sobre la especialidad de medicina oral entre los médicos y también de la población en general.