The antecedents of oral care in nursing facilities - a qualitative interview study among supervisor nurses.

OBJECTIVES: This qualitative study describes the views of supervisor nurses related to antecedents of oral care in Finnish nursing facilities. METHODS: In the six largest cities in Finland, 19 supervisor nurses were interviewed and asked five semi-structured questions related to the antecedents of oral care in the units. The interviews were analyzed using inductive content analysis. RESULTS: Qualitative content analysis revealed five main categories: awareness of nurses (3 categories, 9 subcategories), attitude and motivation (3 categories, 10 subcategories), supporting quality of life and health (4 categories, 11 subcategories), the meaning of oral health in the unit (3 categories, 10 subcategories), and the role of the supervisor nurse in oral health care (4 categories, 14 subcategories). The awareness of nurses regarding oral health was in most cases good. Nurses' attitudes towards oral health and their motivation to oral care vary but were mostly good. Nurses were aware that oral care enhances the quality of life. The role of the supervisor nurse in organizing oral care was crucial. CONCLUSIONS: The performed analysis identified five main categories to describe antecedents for oral care in Finnish nursing facilities. The categories that needed to be improved were knowledge and attitude, and motivation related to oral care.

Implementation of oral hygiene practices in nursing homes - a qualitative approach among supervisor nurses.

OBJECTIVES: This study describes daily oral health care in private enhanced service housing units and nursing homes in Finland using a qualitative method. METHODS: Nineteen supervisor nurses were interviewed in the six largest cities in Finland. The interviews consisted of semi-structured questions. The interviews were then transcribed and analyzed using inductive content analysis. RESULTS: The qualitative content analysis revealed five main categories: diet, education in the oral health of older people, oral care equipment and taking care of them, caring for the mouths of residents, and professional oral health care. The results revealed that sugary snacks were given daily in the units and there was a need for oral health care education. The dental equipment of residents was taken care of well and the oral health of the residents was taken care of moderately well. Furthermore, there was a need for co-operation between dental professionals and only half of the residents had an individual oral care plan. CONCLUSIONS: It can be concluded that based on this qualitative study, the implementation of daily oral health care in most nursing homes and enhanced housing units seems to be at a sufficient level and more oral health-related practical and theoretical education is needed.

The Use of Patient-Oriented Mobile Phone Apps in Oral Health: Scoping Review.

BACKGROUND: Oral health is a significant part of general health. Poor oral health can influence an individual's appearance, self-esteem, eating, and speaking. The use of mobile phone apps has been growing in the field of medicine, including dentistry. However, to date, there is no evidence related to the availability of mobile apps focusing on various branches of dentistry. OBJECTIVE: The aim of this study was to review the scientific literature on the use of patient-oriented mobile phone apps in oral health and summarize the key findings. METHODS: A scoping review of published scientific literature on the use of patient-oriented mobile phone apps in oral health was conducted in accordance with the Joanna Briggs Institute. A search was performed in PubMed and Scopus for studies published between January 2000 and June 2021 that were written in English. All study types except for those reporting developmental protocols were included in this review. In total, 2 reviewers independently screened the studies using the eligibility criteria. The study protocol was registered in the Open Science Framework registries in June 2021. RESULTS: The initial search yielded a total of 977 studies, 45 (4.6%) of which met the inclusion criteria. All the studies (45/45, 100%) were published after 2009. Most studies (31/45, 69%) concerned oral health promotion using mobile phone apps, followed by behavior management (5/45, 11%). More than half (23/45, 51%) of the included studies were conducted in Asian countries. Overall, 31% (14/45) of the studies focused on adolescents. A total of 51% (23/45) of the studies were randomized controlled trials (RCTs). Approximately 39% (9/23) of the included RCT studies reported a substantial reduction in dental plaque, and 26% (6/23) of the studies reported significant improvement in gingival health. Regarding dental anxiety management, 13% (3/23) of the RCT studies reported a significant decrease in mean heart rate and lower Facial Image Scale scores. CONCLUSIONS: According to the literature, the use of mobile apps in oral health is increasing among patients, mainly children and adolescents. Many studies that have used mobile apps have focused on promoting oral health. However, other areas such as diagnostic and remote consultations (teledentistry) have until recently been neglected despite their great potential.

Implementation of oral hygiene practices in nursing homes - the view of supervisor nurses.

OBJECTIVES: The aim of our study was to analyse the implementation of oral health-related practices in private enhanced service housing units and nursing homes in Finland reported by supervisor nurses. METHODS: We sent an anonymous, voluntary Webropol-questionnaire to the supervisor nurses of private enhanced service housing units and nursing homes (N = 245). The questionnaire included items about the implementation of oral healthcare-related practices in the care units and items based on the Nursing Dental Coping Beliefs index (DCBS index). Five dimensions of the implementation of oral healthcare-related practices, Oral hygiene practices and Favourable diet for oral health, Oral hygiene equipment, Professional dental services, and Knowledge and opinions were used as outcomes. The factors in the nursing DCBS index and background variables were used as explanatory variables. RESULTS: Our main results showed that in care units, Oral hygiene practices, Favourable diet for oral health, Oral hygiene equipment, and Professional dental services were partly implemented. Furthermore, according to Knowledge and opinions supervisor nurses had challenges in oral health-related knowledge and difficulties in managing oral care. In the DCBS index, better self-efficacy in "Managing bleeding gums" was associated with better implementation of oral health practices. Furthermore, supervisor nurses' better own oral health habits were associated with better implementation of oral health-related practices. CONCLUSIONS: It can be concluded that based on the responses of the supervisor nurses, oral health-related practices were partly implemented in private enhanced service housing units and nursing homes in Finland.

Effects of ionizing radiation and HPSE1 inhibition on the invasion of oral tongue carcinoma cells on human extracellular matrices in vitro.

Chemoradiation is an established approach in the treatment of advanced oral tongue squamous cell carcinoma (OTSCC), but therapy may cause severe side-effects due to signal interchanges between carcinoma and the tumour microenvironment (TME). In this study, we examined the potential use of our human 3D myoma disc and Myogel models in in vitro chemoradiation studies by analysing the effects of ionizing radiation (IR) and the combined effect of heparanase I (HPSE1) inhibitors and IR on OTSCC cell proliferation, invasion and MMP-2 and - 9 production. Finally, we analysed the long-term effects of IR by studying clones of previously irradiated and invaded HSC-3 cells. We found that in both human uterine leiomyoma-based extracellular matrix models IR inhibited the invasion of HSC-3 cells, but blocking HPSE1 activity combined with IR induced their invasion. Low doses of IR increased MMP expression and initiated epithelial-mesenchymal transition in cells cultured on myoma discs. We conclude that myoma models offer consistent methods for testing human carcinoma cell invasion and phenotypic changes during chemoradiation treatment. In addition, we showed that IR had long-term effects on MMP-2 and - 9, which might elicit different HSC-3 invasion responses when cells were under the challenge of HPSE1 inhibitors and IR.

Anti-heparanase aptamers as potential diagnostic and therapeutic agents for oral cancer.

Heparanase is an endoglycosidase enzyme present in activated leucocytes, mast cells, placental tissue, neutrophils and macrophages, and is involved in tumour metastasis and tissue invasion. It presents a potential target for cancer therapies and various molecules have been developed in an attempt to inhibit the enzymatic action of heparanase. In an attempt to develop a novel therapeutic with an associated diagnostic assay, we have previously described high affinity aptamers selected against heparanase. In this work, we demonstrated that these anti-heparanase aptamers are capable of inhibiting tissue invasion of tumour cells associated with oral cancer and verified that such inhibition is due to inhibition of the enzyme and not due to other potentially cytotoxic effects of the aptamers. Furthermore, we have identified a short 30 bases aptamer as a potential candidate for further studies, as this showed a higher ability to inhibit tissue invasion than its longer counterpart, as well as a reduced potential for complex formation with other non-specific serum proteins. Finally, the aptamer was found to be stable and therefore suitable for use in human models, as it showed no degradation in the presence of human serum, making it a potential candidate for both diagnostic and therapeutic use.