Oral health status among recreational cannabis (marijuana and hashish) users in the USA: A NHANES-based cross-sectional study.

Background: As of November 2023, twenty-four states, two territories, and DC have legalized marijuana for non-medical use, leading to concerns about its potential oral health effects. This study investigated the association between marijuana use and clinical dental outcomes among adults in the US. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 using a cross-sectional survey of non-institutionalized US civilians. Marijuana use was assessed among 18-59-year-old adults and categorized as never, former, or current frequent use. The dental outcomes included the prevalence of untreated coronal caries, root caries, and missing teeth. We employed logistic and negative binomial regressions to assess the crude and adjusted associations between marijuana use, dental caries, and tooth loss. Results: Of the 6,424 participants, 13.85% of US adults aged 18-59 years were current frequent marijuana users (21.67 million), with the highest prevalence among 18-29-year-olds (21.31%), males (17.54%), and non-Hispanic Black individuals (21.31%). Frequent marijuana users showed the highest prevalence of untreated coronal caries (33.4%). Before adjusting for socioeconomic confounders, current frequent marijuana users had 1.76 times higher odds of having teeth with coronal caries, whereas former frequent users had 1.47 times higher odds. However, the associations between marijuana use and all dental outcomes were attenuated after adjusting for socioeconomic confounders, tobacco use, and access to dental care. Conclusion: Although marijuana use was associated with worse dental health, socioeconomic factors, tobacco use, and access to dental care were more significant contributors to the prevalence of untreated dental caries and missing teeth than marijuana use alone.

Crystal methamphetamine and its effects on mental and oral health: A narrative review.

The purpose of this comprehensive literature review is to present the available evidence on the effects of methamphetamine on mental and oral health, as well as provide an overview of the most widely used medical and dental care strategies in the management of meth mouth. For this purpose, PubMed and Google Scholar electronic databases were searched for relevant articles, yielding 115 search results, which were further scrutinized for their relevance, leaving 55 for a detailed review. The analysis of the gathered data indicates that a comprehensive patient-centered approach that takes into consideration the physical, mental, and social aspects is crucial for mitigating the detrimental effects of increasing methamphetamine use.

Knowledge and application of antimicrobial photodynamic therapy among restorative dentist in Saudi Arabia.

BACKGROUND: The aim was to identify the restorative dentist, knowledge and application of Antimicrobial photodynamic therapy (aPDT) in dental practice; and to provide an overview of the potential challenges faced by restorative dentists (RD) in Saudi Arabia. METHODS: A 15-item cross sectional study questionnaire was distributed through online portal to assess the knowledge, and practice of RD towards aPDT and its practice. The questionnaire consisted of 3 sections, exploring the demographics of participants, knowledge, application and perception of aPDT using yes/no response and Likert scale. Response means, frequencies, and chi-square tests to compare subgroups based on gender, education level, and practice experience. RESULTS: Out of 500 participants, 375 completed the survey forms (75% response rate). The majority was male (68%) with a mean age of 46 years. Respondents demonstrated a moderate level of knowledge (60.5%). Only 33% expressed confidence in aPDT as a standalone treatment, while 67% showed limited referrals to specialists. However, 88.5% expressed interest in receiving training and attending workshops for aPDT therapy. Education and experience significantly influenced overall knowledge question responses (p = 0.031). CONCLUSION: Majority of restorative dentists demonstrated a moderate understanding of the role of aPDT in dentistry. More than two thirds of respondents (77%) believed that aPDT is an effective adjuvant therapy. Increased experience (> 10 years) and education (Post-graduates) showed higher application of aPDT. The study reveals the potential for incorporating aPDT knowledge into restorative dental practices, particularly among general dentists.

Relationship between Hormonal Changes and Self-Perceived Halitosis in Females: A Cross-Sectional Study.

Halitosis is a growing concern for patients seeking dental treatment. Women experience hormonal changes throughout different phases of their life. These changes may affect volatile organic compound (VOC) production and can be linked to halitosis. The aim of this study was to evaluate the effect of hormonal changes on self-perceived halitosis in a sample of females using a self-administered questionnaire. This study used a cross-sectional observational design. The questionnaire was distributed electronically through Google forms. A total of 1089 participants completed the questionnaire. Almost 50% of participants were below the age of 25; and 12% were of menopausal age (defined as 45 years and older). Most participants reported having regular menstrual cycles (63.5%) while only 20% reported having hormonal disturbances. Almost 62% of the sample reported that they notice halitosis on themselves with 27.6% indicating their perception of halitosis occurred at different times of the month. Around 12% of the sample thought that a relationship between halitosis and their menstrual cycle existed with 4.6% reporting halitosis during menstruation. The present study found that regularity of menstrual cycle and hormonal disturbances can affect females' self-perceived halitosis and the prevalence of oral health symptoms.

Shear bond strength of resin modified glass ionomer cement following photodynamic therapy, Er,Cr:YSGG and chlorhexidine in hypoplastic primary teeth.

PURPOSE: This study investigates the micro shear bond strength of resin-modified glass ionomer cement (RMGIC) bonded to hypoplastic teeth after the application of chlorhexidine (CHX), sodium hypochlorite (NaOCl), Er;Cr:YSGG and methylene blue mediated antimicrobial photodynamic therapy (APDT). METHODS: A total sample of 60 erupted and extracted hypoplastic teeth collected from < 16 years children were subjected to different conditioning protocols including control group that involved bonding of hypoplastic teeth with RMGIC; CHX and NaOCl groups that included hypoplastic enamel being treated with 0.2% CHX and 2% NaOCl solution for 30 s followed by rinsing and drying for 5 s, MB-PDT group involved methylene blue photosensitizer and Er,Cr:YSGG group. All specimens were processed for microshear bond strength in a universal tester. The fractured surface was examined using a stereomicroscope at 40 × magnification and categorized under adhesive, cohesive and mixed. RESULTS: The highest microshear bond strength was noted for the control group (∼29 MPa). Whereas the specimens conditioned by NaOCl showed the lowest microshear bond strength (∼17 MPa). Among the treatment groups, APDT showed the highest bond strength values (∼22 MPa) as compared to chemical disinfection protocols. However, Er, Cr:YSGG showed slightly lower microshear bond strength as compared to APDT. No significant difference was noted between CHX and NaOCl groups (p > 0.05). There was a statistically significant difference when all the groups were compared together (p < 0.05). Microscopic analysis revealed that specimens bonded after APDT showed the highest adhesive failures (70%). The highest cohesive failures were seen in NaOCl group (40%). The mixed type of failures was seen in the control groups with none appearing for chemical disinfection protocols. CONCLUSIONS: This study concludes that APDT could be a potential therapeutic strategy for increasing the microshear bond strength of RMGIC to hypoplastic enamel.

Influence of Reinforcing Agents on the Mechanical Properties of Denture Base Resin: A Systematic Review.

Knowledge about the influence of fillers in denture base resin is vague. This systematic review aimed to report the reinforcing effect of fillers on the mechanical properties of denture base resin by following PRISMA guidelines. Two electronic databases (Pubmed/Medline & Web of Science) were searched for articles using the keywords: fibers in denture base, fillers in denture base, and reinforcement of denture base. Laboratory studies complying with the inclusion criteria were reviewed according to the set protocol. The established focus question was: "Do reinforcing fillers positively influence the mechanical properties of polymethyl methacrylate (PMMA) heat polymerized denture base material?" A total of twenty-nine relevant papers qualified for final inclusion. Of these, 24 were determined to have a moderate risk of bias. Micron or nano-sized metal/metal oxides particles and glass fibers were the frequently used reinforcing agents. The trend of evaluating fractural strength (FS) was common. Most of the studies limited the use of reinforcing agents up to 5 wt.%. FS, fracture toughness (FT), and impact strength (IS) tend to increase if the fillers are chemically bonded and well-dispersed in denture base resin. Though fillers with a higher elastic modulus increase the hardness of the reinforced denture base resin, they compromise other mechanical properties. Well-dispersed lower filler loading PMMA denture base resin can enhance the FS, FT, and other related mechanical properties.

Depression, periodontitis, caries and missing teeth in the USA, NHANES 2009-2014.

PURPOSE: This study aimed to investigate the association between self-reported depressive symptoms and oral diseases in US adults, including periodontitis, caries, missing teeth and untreated dental caries. DESIGN: This study was designed as a secondary data analysis of a cross-sectional survey. We conducted descriptive, multivariable logistic and Poisson regression analyses on weighted data. SETTING: US National Health and Nutrition Examination Survey 2009-2014 data. PARTICIPANTS: Individuals aged ≥30 years who completed a periodontal examination and depression screening (n=9799). RESULTS: 21.6% (28.9 million) of adults aged ≥30 years reported depressive symptoms, with a higher prevalence among females, current smokers and participants with lower income and education status. More than half of the adults with moderate depressive symptoms had periodontal diseases, and more than one-third had teeth with untreated dental caries. After adjusting for sociodemographics, behavioural factors, having diabetes and psychotherapeutic medication use, depressive symptoms were associated with poorer oral health. Severe depressive symptoms were associated with higher odds of mild periodontitis (2.20; 99% CI 1.03 to 4.66). For those with mild depressive symptoms, the mean number of missing teeth was 1.20 (99% CI 1.06 to 1.37) times the average of non-symptomatic individuals; and 1.38 times (99% CI 1.15 to 1.66) among individuals with moderate depressive symptoms. CONCLUSIONS: Depressive symptoms were associated with mild periodontitis and a greater number of missing teeth, while having teeth with untreated dental caries was attributed to sociodemographic factors. Awareness of oral health status among patients with depressive symptoms can inform both dental and mental health providers to develop tailored treatment and help patients achieve overall wellness.

Annual alveolar bone loss in subjects with cardiovascular disease adjusting for associated systemic diseases and risk factors: a retrospective study.

BACKGROUND: To detect annual alveolar bone loss in subjects with cardiovascular disease (CVD) adjusting for associated systemic diseases and risk factors. METHODS: A total number of 132 subjects that reported having CVD from 2008 to 2015 (N = 132). For longitudinal data analysis, 58 subjects eligible for inclusion with at least two exposures of complete mouth set or repeated BW radiographs with at least one-year interval compared with a control group. Alveolar bone level on mesial and distal sites of posterior teeth was measured on bitewing (BW) radiographs available in the electronic health records of each subject. RESULTS: Subjects who reported having cardiovascular diseases experienced higher annual mean alveolar bone loss (0.062 mm per year) compared to Subjects with no cardiovascular diseases (0.022 mm per year). CONCLUSION: Subjects who have reported CVD had higher rate of annual bone loss compared to subjects who did not have any CVD. This observation indicates that targeting high-risk individuals for risk assessment is fundamental to provide the best healthcare possible to those who are the most in need. Periodic examination and assessment of periodontal health is an essential key factor for better oral health, however, it has to be more emphasized and prioritized for individuals that are more prone to the disease.

Prevalence of periodontitis and alveolar bone loss in a patient population at Harvard School of Dental Medicine.

BACKGROUND: Although several studies assessed the prevalence of alveolar bone loss, the association with several risk factors has not been fully investigated. The aim of this article is to measure the prevalence of periodontitis by calculating the mean alveolar bone loss/level of posterior teeth using bitewing radiographs among the patients enrolled in the clinics at Harvard School of Dental Medicine and address risk factors associated with the disease. METHODS: One thousand one hundred thirty-one patients were selected for radiographic analysis to calculate the mean alveolar bone loss/level by measuring the distance between the cementoenamel junction and the alveolar bone crest on the mesial and distal surfaces of posterior teeth. Linear regression with Multi-level mixed-effect model was used for statistical analysis adjusting for age, sex, race, median household income, and other variables. RESULTS: Mean alveolar bone level of the whole sample was 1.30 mm (±0.006). Overall periodontitis prevalence for the sample was 55.5% (±1.4%). Moderate periodontitis prevalence was 20.7% (±1.2%), while 2.8% (±0.5%) of the whole sample had severe periodontitis. Adjusted mean alveolar bone loss was higher in older age groups, males, Asian race group, ever smokers, and patients with low median household income. CONCLUSION: The effect of high household income on the amount of bone loss can be powerful to the degree that high household income can influence outcomes even for individuals who had higher risks of developing the disease. Public health professionals and clinicians need to collaborate with policy makers to achieve and sustain high quality of healthcare for everyone.

Annual alveolar bone loss in older adults taking oral bisphosphonate: a retrospective cohort study.

BACKGROUND: Although several studies assessed the effect of bisphosphonate (BIS) administration on alveolar bone loss, this relationship has not been fully investigated using longitudinal analysis. The aim of the this article is to predict annual alveolar bone loss in a subpopulation of older adults patients who were taking oral bisphosphonate (BIS), adjusting for systemic diseases and associated risk factors. METHODS: This is a retrospective cohort study. We identified all subjects who reported receiving oral bisphosphonate from 2008 to 2015 (N = 30) using the electronic health records of each patient to identify suitable radiographs for analysis. For the longitudinal data analysis, 26 subjects were eligible for inclusion, having at least two exposures of the complete mouth set or repeated bitewing radiographs at least a one-year interval; they were then matched on age and sex to another 26 patients who did not report receiving bisphosphonate at any point of their life. RESULTS: Mild periodontitis was higher in the BIS group compared to the no BIS group; however, moderate periodontitis was higher in the no BIS group. For those who did not take oral BIS, change over time was not significant after the two-year period. However, the BIS group had experienced 0.088 mm more bone loss compared to the no BIS group (95% CI: 0.001, 0.176. P-value = 0.048), adjusting for all other variables included in the model. CONCLUSION: The group that reported receiving oral bisphosphonates showed no improvement in maintaining alveolar bone level, and the use of oral BIS may not be effective in reducing annual alveolar bone loss; however, emerging evidence is promising for the use of bisphosphonate as an adjunctive local delivery medication for the management of periodontal diseases.

Phentolamine Mesylate May be a Safe and Effective Option to Reduce Discomfort and Time to Recovery After Dental Care With Local Anesthesia.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effectiveness and safety of phentolamine mesylate in routine dental care. Daubländer M, Liebaug F, Niedeggen G, Theobald K, Kürzinger M-L. J Am Dent Assoc 2017; 148(3):149-56. SOURCE OF FUNDING: The study was funded by Sanofi-Aventis Deutschland, Berlin, Germany TYPE OF STUDY/DESIGN: Two study designs were used: a prospective noninterventional, postauthorization efficacy (controlled observational) study, and a prospective noninterventional uncontrolled observational study.

Community water fluoridation online: an analysis of the digital media ecosystem.

OBJECTIVES: Research demonstrates the safety and efficacy of community water fluoridation (CWF). Yet, the digitization of communication has triggered the spread of inaccurate information online. The purpose of this study was to analyze patterns of CWF information dissemination by a network of sources on the web. METHODS: We used Media Cloud, a searchable big data platform of over 550 million stories from 50 thousand sources, along with tools to analyze that archive. We generated a network of fluoridation publishers using Media Cloud's keyword identification from August 1, 2015 to July 31, 2016. We defined the media type and sentiment toward CWF for each source and generated a network map of the most influential sources during our study period based on hyperlinking activity. RESULTS: Media Cloud detected a total of 980 stories from 325 different sources related to water fluoridation. We identified nine different media types participating in the dissemination of information: academic, government, scientific group, natural medicine, blogs, mainstream media, advocacy groups, user-generated (e.g., YouTube), and "other." We detected five sub-networks within the overall fluoridation network map, each with its own characteristics. Twenty-one percent of sources were pro-fluoridation, receiving 57 percent of all inlinks, 22 percent of sources were anti-fluoridation, and the rest were neutral (54 percent). CONCLUSIONS: The dominant neutral sentiment of the network may signify that anti- and pro-sides of the debate are viewed as balanced, not just in number but also in quality of information. Despite high inlinks to pro-sources, anti-fluoridation sentiment maintains influence online.

Vaccine Hesitancy and Online Information: The Influence of Digital Networks.

AIMS: This article analyzes the digital childhood vaccination information network for vaccine-hesitant parents. The goal of this study was to explore the structure and influence of vaccine-hesitant content online by generating a database and network analysis of vaccine-relevant content. METHOD: We used Media Cloud, a searchable big-data platform of over 550 million stories from 50,000 media sources, for quantitative and qualitative study of an online media sample based on keyword selection. We generated a hyperlink network map and measured indegree centrality of the sources and vaccine sentiment for a random sample of 450 stories. RESULTS: 28,122 publications from 4,817 sources met inclusion criteria. Clustered communities formed based on shared hyperlinks; communities tended to link within, not among, each other. The plurality of information was provaccine (46.44%, 95% confidence interval [39.86%, 53.20%]). The most influential sources were in the health community (National Institutes of Health, Centers for Disease Control and Prevention) or mainstream media ( New York Times); some user-generated sources also had strong influence and were provaccine (Wikipedia). The vaccine-hesitant community rarely interacted with provaccine content and simultaneously used primary provaccine content within vaccine-hesitant narratives. CONCLUSION: The sentiment of the overall conversation was consistent with scientific evidence. These findings demonstrate an online environment where scientific evidence online drives vaccine information outside of the vaccine-hesitant community but is also prominently used and misused within the robust vaccine-hesitant community. Future communication efforts should take current context into account; more information may not prevent vaccine hesitancy.

The sensitivity, specificity and predictive values of post mortem computed tomography in detecting liver and splenic injury due to road traffic accident

Objective: The purpose of the study was to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of post mortem computed tomography (PMCT) in detecting liver and splenic injuries due to road traffic accidents. Material & Method: 61 road traffic accidental death cases underwent both PMCT and conventional autopsy. The imaging findings were compared to the conventional autopsy findings. Result: The sensitivity, specificity, PPV and NPV for liver injuries in PMCT was 71%, 82%, 68% and 85% while that of splenic injuries was 73%, 80%, 55% and 90% respectively. The accuracy of PMCT scan was 79% for both liver and splenic injuries. There is strong association between lower left ribs fracture and splenic injury (p=0.005) and significant association between positive liver and splenic PMCT finding and intraabdominal fatal injury (p=0.037). Conclusion: In conclusion PMCT has high specificity and NPV for liver and splenic injuries; however the sensitivity and PPV are low. The overall accuracy is not high enough to enable PMCT to be used as a replacement for conventional autopsy; however it is a useful complementary examination and has potential to be used as decision making tool for selective internal autopsy.