Oral health education strategies for patients living with cardiovascular disease within hospital settings: a scoping review.

Objective: To identify and describe the impact of current oral health education programmes provided to patients in cardiology hospital wards and outpatient clinics. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews statement. Searches were conducted using electronic databases: Cochrane, Medline, and Scopus, as well as grey literature searching. Results: Three eligible studies were identified. All included studies reported generalised poor oral health in their participants at baseline, with significant improvement at follow-up. They all reported significant reductions in plaque deposits and gingival bleeding. One study reported significantly less bacteria on participant tongues, as well as fewer days with post-operative atrial fibrillation in the intervention group. Furthermore, in this study, one patient in the intervention group developed pneumonia, whilst four patients in the control group did. Conclusion: Oral health education for patients with cardiovascular disease is limited and many have poor oral health. Educational programmes to improve oral health behaviours in patients with cardiovascular disease can improve both oral and general health outcomes. Implications for public health: Oral disease is a modifiable risk factor for cardiovascular disease. Integrating oral health education into cardiology hospital settings is a simple strategy to improve access to oral health information and improve both oral and cardiovascular outcomes.

Obesity/overweight and dental caries experience in children and adolescents: an umbrella review.

PURPOSE: The present umbrella review aimed to synthesize and critically assess the methodological and reporting quality of previous systematic reviews about the potential relationship between obesity or overweight and caries dental experience in pediatric patients. METHOD: Electronic database and manual searches were conducted in PubMed, Embase, and Cochrane Library up to July 2023. The risk of bias assessment of eligible systematic reviews was performed using the Risk Of Bias In Systematic reviews (ROBIS) tool. A systematization of the results was carried out in order to understand the possible relationship between the two conditions. RESULTS: Electronic and manual searches identified 136 titles and abstracts. After the removal of duplicates, 15 full-text articles were assessed for eligibility. Six studies were excluded, resulting in 8 systematic reviews and 1 scoping review that met the inclusion criteria. Five were systematic reviews without meta-analysis and the rest were conducted with quantitative analysis. CONCLUSION: Conflicting findings to date from this umbrella review suggest that the relationship between obesity and dental caries in children is still inconclusive and likely to be complex.

UCP2 polymorphisms, daily step count, and number of teeth associated with all-cause mortality risk in Sado City: A hospital-based cohort study.

Objective: Uncoupling protein 2 (UCP2) is an ion/anion transporter in the mitochondrial inner membrane that plays a crucial role in immune response, regulation of oxidative stress, and cellular metabolism. UCP2 polymorphisms are linked to chronic inflammation, obesity, diabetes, heart disease, exercise efficiency, and longevity. Daily step count and number of teeth are modifiable factors that reduce mortality risk, although the role of UCP2 in this mechanism is unknown. This study aimed to assess the possible effects of UCP2 polymorphisms on the association between daily step count and number of teeth with all-cause mortality. Methods: This study was conducted as a cohort project involving adult Japanese outpatients at Sado General Hospital (PROST). The final number of participants was 875 (mean age: 69 y). All-cause mortality during thirteen years (from June 2008 to August 2021) was recorded. The functional UCP2 genotypes rs659366 and rs660339 were identified using the Japonica Array®. Survival analyses were performed using multivariate Cox proportional hazard models. Results: There were 161 deaths (mean observation period: 113 months). Age, sex, daily step count, and the number of teeth were significantly associated with mortality. In females, UCP2 polymorphisms were associated with mortality independent of other factors (rs659366 GA compared to GG + AA; HR = 2.033, p = 0.019, rs660339 C T compared to CC + TT; HR = 1.911, p = 0.029). Multivariate models, with and without UCP2 genotypes, yielded similar results. The interaction terms between UCP2 genotype and daily step count or number of teeth were not significantly associated with mortality. Conclusion: The effects of UCP2 polymorphisms on the association between daily step count or the number of teeth and all-cause mortality were not statistically significant. In females, UCP2 polymorphisms were significantly associated with all-cause mortality. Our findings confirmed the importance of physical activity and oral health and suggested a role of UCP2 in mortality risk independently with those factors.

Care-resistant Behavior Trajectories during Mouth Care among Nursing Home Residents with Dementia.

BACKGROUND AND OBJECTIVES: This study examined day-to-day variation in care-resistant behaviors (CRBs) exhibited by persons living with dementia during mouth health care and the potential influence of time-of-day on CRB trajectories. RESEARCH DESIGN AND METHODS: A secondary analysis was conducted on a sample of 75 nursing home-dwelling persons living with dementia who exhibited CRBs during mouth care activities. Over 21 days, CRBs were measured using the revised Resistiveness to Care Scale (RTC-r) during morning and afternoon mouth care sessions. Group-based Trajectory Modeling was used to identify trajectory patterns and assess differences between morning and afternoon CRB patterns. RESULTS: Three trajectory patterns were identified: morning CRB trajectory patterns showed 50.6% of persons living with dementia had consistently low RTC-r scores, 37.5% of persons living with dementia exhibited fluctuating, moderate RTC-r scores, and 11.9% exhibited RTC-r scores that started high and then decreased over time. Similarly, CRB trajectory patterns during afternoon mouth care showed a consistently low RTC-r score for 54.5% and a fluctuating moderate RTC-r score for 38.6% of persons living with dementia. However, the third CRB trajectory group followed a high-increasing trajectory, with RTC-r scores starting high and continuing to increase for 6.9% of persons living with dementia. DISCUSSION AND IMPLICATIONS: CRBs are dynamic and vary within days and over time; however, the time of the day is often not considered in interventions to manage CRBs. Thus, it is important to consider the timing of providing mouth care for persons living with dementia. Based on the characteristics of the trajectories, we suggest that morning mouth activities may be more efficient.

Evaluating the harmonization potential of oral health-related questionnaires in national longitudinal birth and child cohort surveys.

BACKGROUND/OBJECTIVES: Effective use of longitudinal study data is challenging because of divergences in the construct definitions and measurement approaches over time, between studies and across disciplines. One approach to overcome these challenges is data harmonization. Data harmonization is a practice used to improve variable comparability and reduce heterogeneity across studies. This study describes the process used to evaluate the harmonization potential of oral health-related variables across each survey wave. METHODS: National child cohort surveys with similar themes/objectives conducted in the last two decades were selected. The Maelstrom Research Guidelines were followed for harmonization potential evaluation. RESULTS: Seven nationally representative child cohort surveys were included and questionnaires examined from 50 survey waves. Questionnaires were classified into three domains and fifteen constructs and summarized by age groups. A DataSchema (a list of core variables representing the suitable version of the oral health outcomes and risk factors) was compiled comprising 42 variables. For each study wave, the potential (or not) to generate each DataSchema variable was evaluated. Of the 2100 harmonization status assessments, 543 (26%) were complete. Approximately 50% of the DataSchema variables can be generated across at least four cohort surveys while only 10% (n = 4) variables can be generated across all surveys. For each survey, the DataSchema variables that can be generated ranged between 26% and 76%. CONCLUSION: Data harmonization can improve the comparability of variables both within and across surveys. For future cohort surveys, the authors advocate more consistency and standardization in survey questionnaires within and between surveys.

Evaluation of Parents' Perceptions of the Dental and Oral Health in Children with Disability in the Bandung City.

Background: Children with disability have a risk of poor dental health because of their mental and physical limitations. They depend on caregivers in their daily life Parents have an important role in maintaining children's dental health. Parents attitudes can be influenced by parents' perceptions of children's dental health. This study explored parental perceptions regarding the dental and oral health of children with special needs in Bandung City. Methods: This study utilized a descriptive observational research using a cross-sectional survey. The subjects in this study were 239 parents who had children aged 0-18 years who were taken from 9 special schools. The variables of this study were parents' perceptions and the dental and oral health status of children with disability. Primary data were obtained through a validated questionnaire. Results: Parents' perceptions of the dental and oral health of children with disability consists of 84.94% good enough perceptions, 12.13% good perceptions, and 2.93% bad perceptions. Conclusion: Most parents have a fairly good perception of the dental and oral health of children with special needs.

Capturing the smile: Exploring embodied and social acts of smiling.

Smiling is an embodied and complex social act. Smiling is presented as facilitating individual health and wellbeing, but the value placed on smiling raises questions about structural conditions acting on the body. While smiling has been considered sociologically, psychologically and historically, we argue that further exploration of the embodied smile offers fruitful avenues for future research. This article attempts to advance understanding of the smile and its importance by: (I) Bringing together literature on smiling as a social act and smiling as embodied. (II) Systematically identifying key themes, which recognise sociological insights and the relevance of oral health. (III) Pointing to useful directions for future sociological research into smiling. In this article, we review literature on body techniques; impression management and social interaction; gender, race and smiling; and emotional, aesthetic and affective labour. We move on to embodiment, considering the mouth as a body project and in relation to the ageing body, before reflecting on the significance of oral health and dentistry. We highlight future directions for sociological research on smiling, building on eight interrelated and cross-cutting themes: norms and expectations, aesthetic ideals, self and identity, health and wellbeing, body work, commodification and labour, inclusion and exclusion and resistance.

Perception of Care Givers about Oral Health Services for Institutionalized Elderly - A Mixed Method Study.

Background: In India, the absence of formal training in geriatric dentistry and the lack of recognition of it as a speciality contributes to the deterioration of oral health in the older adults. India lacks specific oral healthcare policies for older adults. Additionally, caregivers' perspective in Indian old age homes regarding oral health care services remains underexplored, necessitating further studies in this context. Methods: A mixed method study was conducted, and the quantitative component focused on assessing the oral health status of institutionalized older adults and caregivers' perceptions using a questionnaire. The qualitative part evaluates caregivers' perceptions of providing oral health care services for institutionalized older adults by conducting in-depth interviews. Results: More than 50% of caregivers perceived that the oral health status of institutionalized older adults was fair even though institutionalized older adults has poor oral health status. Barriers include autonomy, difficulty in traveling, lack of financial support, lack of knowledge and time. Approaches for enhancing oral health services for institutionalized older adults include oral health education for older adults and caregivers, monthly dentist visits to the institution, utilization of portable dental chair services, collaboration with dental colleges/dental clinics, distribution of oral health education materials, and provision of oral hygiene aids. Conclusion: Caregivers face barriers in providing oral health care services to institutionalized older adults, especially those who are functionally reliant and cognitively impaired. Findings from our study show that there is a need to collaborate with the dental colleges to provide oral health services in old age homes.

This year sees an opportunity for long-needed oral health reforms. Cancer patients, in particular, stand to benefit.

The long-standing divide in Australia between medicine and dentistry has left many with inequitable access to dental care. People with oral cancer, in particular, may have few options for dental rehabilitation after cancer treatment, even with private health insurance. However, 2024 could finally see health care reforms that address these inequities, with significant momentum building in Australia. In this Perspective, we argue for a national approach to reforms that incorporate aspects of preventive health, primary health care, Medicare Benefits Schedule item review, and the value of Private Health Insurance rebates for dental care.

Knowledge, attitude and practices towards oral health among secondary school students in Huye district, Rwanda.

Background: Good oral health knowledge is considered to be crucial for health-related practices and better oral hygiene. Objective: This study was aimed to assess knowledge, attitudes and practices towards oral health among secondary student in Huye district. Methods: A cross-sectional survey was conducted with 386 students from public secondary schools with advanced level. Boarding secondary schools were excluded. Stratified Clustering sampling technique was used for selecting study participants. A closed ended questionnaire was used for collecting data. Results were found on the basis of percentage and frequency using SPSS 21.0 version. Results: The majority of participants, 222 (57.5%) were female and 164 (42.5%) were male. The majority of the participants, 168 (43.5%) were between 15-17 years old. Out of the total population of students 1.8% had good knowledge, 56.2% had average knowledge and 42% had poor knowledge about oral health. Moreover, 56.2% had negative and 43.8% had positive oral health attitudes and overall practice towards oral hygiene of students showed that 74.6 % had poor practice and 24.4% had good practices. Conclusion: Oral hygiene has to be long life practice and oral health education have to be included as part of the school environment.

Patient-centric periodontal research: A pioneering application of patient-reported outcome measures.

Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes. Clinical research is driven by the statistical significance of outcome parameters rather than the satisfaction level of the patient. In this context, patient-centric periodontal research (PCPR) is an approach that considers the patient´s feedback concerning their functional status, experience, clinical outcomes, and accessibility to their treatments. It is argued that data self-reported by the patient might have low reliability owing to the confounding effect of their personal belief, cultural background, and social and economic factors. However, literature has shown that the incorporation of "patient-centric outcome" components considerably enhances the validity and applicability of research findings. Variations in the results of different studies might be due to the use of different and non-standardized assessment tools. To overcome this problem, this editorial enlists various reliable tools available in the literature. In conclusion, we advocate that the focus of researchers should shift from mere periodontal research to PCPR so that the results can be effectively applied in clinical settings and the therapeutic strategy can also change from mere periodontal therapy to patient-centric periodontal therapy.

Making the case for a new typology of dental care systems.

BACKGROUND AND RATIONALE: Dental care systems have the potential to influence population oral health and patterns of socioeconomic inequalities. Therefore, understanding the impact of the ways in which countries fund, provide, and organize their dental care services is key in the analysis of determinants of oral health. In this commentary we offer a synopsis of recent typologies of healthcare systems, based on a rapid review, and highlight that none of them fit dental care services given the separation of dental care from general healthcare provision in many countries. The paper also summarizes evidence on dental care systems as determinants of population oral health and argues why a new typology of dental care systems is needed. CHALLENGES AND WAYS FORWARD: We argue that a typology must consider institutional arrangements, structures, and processes behind the provision of dental care, and that specific dimensions/variables that inform the typology should result from a process of discussion and consensus. Some methodological considerations for developing typologies are also discussed, including the challenges in the collection and analysis of data followed by an advanced cluster analysis. Despite their limitations, typologies have evolved into an essential tool for comparing the similarities and differences of healthcare systems across countries. Therefore, a dental specific typology for health systems will be useful for researchers, policymakers, and dental professionals to characterize the provision of dentalcare services in different countries. This will also enable examining their potential role as determinants of population oral health and inequalities.

The impact of parental dental anxiety and oral health literacy on child oral health and dental-visit patterns: a cross-sectional study.

BACKGROUND: Identifying the risk indicators of parental dental anxiety (PDA) and oral health literacy (OHL) can help oral healthcare professionals recognise challenges in this field. Armed with the appropriate information, they can effectively engage with parents to build trust and promote early and regular child dental visits. OBJECTIVES: This study aimed to investigate the association between PDA and OHL with the sociobehavioural characteristics of families, self-reported child oral health (presence of ≥ 1 untreated decayed teeth) and the dental visit patterns amongst children living in Al Jouf Province, Kingdom of Saudi Arabia. SUBJECTS AND METHODS: A total of 430 parents with children aged ≥ 14 years were invited using a systematic random sampling method. PDA was assessed using the Dental Anxiety Scale-Revised (DAS-R) scale, and parents' OHL was measured using the Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30). The relationships amongst participant characteristics, PDA and OHL were evaluated through the Chi-square and ANOVA. Additionally, binary regression analysis was conducted to identify predictor variables associated with PDA and OHL. A P value of < 0.05 was considered statistically significant. RESULTS: Children with ≥ 1 untreated decayed tooth were 2.5 times more likely to have PDA (95% confidence interval [CI] = 1.37, 4.37). Children who visited the dentist in < 6 months had 93% lower likelihood to have PDA (adjusted odds ratio (AOR) = 0.07; 95% CI = 0.03, 0.18). Parents aged 20-25 years were 81% less likely to have OHL than those above 30 years (AOR = 0.19; P = 0.038). Similarly, parents with medium family income were 52% less likely to have OHL than the high-income group (AOR = 0.48; P = 0.013). Finally, parents of children who visited the dentist within < 6 months were 34 times more likely to have OHL than those whose children visited the dentist > 12 months ago (AOR = 34.94; P < 0.001). CONCLUSION: PDA and OHL were significantly affected by parental age, family income, the presence of ≥ 1 untreated decaying tooth and the child dental visit patterns. During a child's first dental visit, paediatric dentists should always assess the PDA, OHL and sociobehavioural characteristics of a family by using appropriate scales and semistructured interviews.

Effects of personalized oral hygiene management on oral health status of pregnant women.

BACKGROUND: The Cariostat caries activity test (CAT) was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral health status of pregnant women. AIM: To investigate whether personalized oral hygiene management enhances the oral health status of pregnant women. METHODS: A total of 114 pregnant women who were examined at Dalian Women's and Children's Medical Center were divided into four groups: High-risk experimental group (n = 29; CAT score ≥ 2; received personalized oral hygiene management training), low-risk experimental group (n = 29; CAT score ≤ 1; received oral health education), high-risk control group (n = 28; CAT score ≥ 2), and low-risk control group (n = 28; CAT score ≤ 1). No hygiene intervention was provided to control groups. CAT scores at different times were compared using independent samples t-test and least significant difference t-test. RESULTS: No significant difference in baseline CAT scores was observed between the experimental and control groups, either in the high-risk or low-risk groups. CAT scores were reduced significantly after 3 (1.74 ± 0.47 vs 2.50 ± 0.38, P < 0.0001) and 6 months (0.53 ± 0.50 vs 2.45 ± 0.42, P < 0.0001) of personalized oral hygiene management intervention but not after oral health education alone (0.43 ± 0.39 vs 0.46 ± 0.33, P > 0.05 and 0.45 ± 0.36 vs 0.57 ± 0.32, P > 0.05, respectively). Within groups, the decrease in CAT scores was significant (2.43 ± 0.44 vs 1.74 ± 0.47 vs 0.53 ± 0.50, P < 0.0001) for only the high-risk experimental group. CONCLUSION: Personalized oral hygiene management is effective in improving the oral health of pregnant women and can improve pregnancy outcomes and the oral health of the general population.

Oral health practices related risk factors and prevalence of dental caries in Armed Forces: A multicentric study.

Background: Dental caries is a multifactorial disease known to be associated with the individual's lifestyle and attitude to health. Prevalence of dental caries in military personnel is higher due to their rugged profession, where soldiers endure the toughest of hostilities. The aim of this study was to assess the prevalence of dental caries in Indian Armed Forces and its association with oral health related behaviours, i.e., tooth brushing, flossing, smoking, use of fluoride toothpaste, and pattern of dental attendance. Methods: Total of 22690 individuals with a mean age of of 35 ± 8 were examined. A cross-sectional questionnaire survey was conducted to collect data on oral hygiene habits, following which oral inspection of the individuals was done. Once the data was compiled, the Decayed, Missing and Filled Teeth (DMFT) index was used to determine caries experience and to compare with oral health behaviours. Results: Armed Forces of India has a pan India presence, and as a result, study pertaining to soldiers becomes cumbersome. The study was conducted to assess the changing patterns of oral diseases, create oral awareness, and to initiate oral health bank data of soldiers. The prevalence of dental caries 58.4% and DMFT rate 4.67+/-1.94 of Indian soldiers remains lower than those of the rest of the Armed Forces of the world. Conclusion: Prevalence of caries in Indian soldiers is lower than that of the rest of the Armies. The study depicts caries experience was lesser in soldiers practising positive oral health behaviours and a strong association between the rate of caries experience and oral health-related behaviours.

Linking the impact of aspiration to host variables using the BOLUS framework: support from a rapid review.

Purpose: The purpose of this rapid review was to identify the level of evidence for a previously proposed theoretical framework to assess risks associated with prandial aspiration using the host as a central theme. Methods: Covidence software was used to search two databases (PubMed and Web of Science). PEDro scale was utilized to determine the quality of individual studies. Data points were evaluated for level of support and determined to be either conclusive, suggestive, unclear, or not supportive. Within each component of the framework, data points were clustered to determine the level of evidence as strong, moderate, insufficient, or negative. Results: The rapid review process resulted in a limited number of publications investigating host variables impact on outcomes for patients with swallowing disorders. Overall, it yielded 937 articles, of which, upon review, 16 articles were selected for data extraction. There was a strong level of evidence to support that (a) as viscosity and density of aspirate increased, so did the likelihood of general medical complications, (b) poor oral care and oral health increase the risk of a pulmonary or general medical complication, and (c) the presence of oropharyngeal or laryngeal tubes increases the risk of a pulmonary consequence. There was moderate evidence to support the impact of amount and frequency of aspiration on outcomes. There was insufficient evidence to determine relationships for all other aspects of the BOLUS framework. Conclusion: Additional evidence to support the BOLUS framework was obtained; however, the number of studies was limited. A more thorough review such as a systematic review should be employed.

Oral health-related quality of life and loneliness: results based on a cross-sectional survey.

BACKGROUND: The aim of this study was to clarify the link between oral health-related quality of life (independent variable) and loneliness (outcome) among the general adult population (also stratified by sex). METHODS: Data were taken from a quota-based survey of the German general adult population (representative in terms of state, sex and age group), with n = 5,000 individuals (mean age was 46.9 years, SD: 15.3 years, ranging from 18 to 74 years). Oral health-related quality of life was quantified using the OHIP-G5. Loneliness was quantified using the De Jong Gierveld tool. Multiple linear regressions were conducted. RESULTS: After adjusting for several covariates, multiple linear regressions revealed that poor oral health-related quality of life is associated with higher loneliness levels in the total sample (ß = 0.12, p < 0.001). Such associations were also found in both sexes (men: ß = 0.12, p < 0.001, women: ß = 0.12, p < 0.001). CONCLUSION: Study findings showed an association between oral health-related quality of life and loneliness. Such knowledge is important for addressing individuals at risk for higher loneliness levels. Future research is required to clarify the underlying mechanisms.

Oral health care for individuals with intellectual and developmental disabilities: A statewide model.

BACKGROUND AND AIM: Effective strategies and practices can assist in forming future initiatives and policies to improve oral health for individuals with intellectual and developmental disabilities (IDD). This manuscript aims to describe the Tufts Dental Facilities (TDF), a university-state collaboration providing sustained statewide access to comprehensive oral health care for individuals with IDD. PROGRAM DESCRIPTION: The TDF program was established in 1976 as the result of a class action lawsuit to improve medical and dental care for individuals with IDD residing at state institutions in Massachusetts. TDF, A partnership, between Tufts University School of Dental Medicine (TUSDM) and the Commonwealth of Massachusetts, is a network of seven dental clinics strategically positioned across the state. These clinics are specifically designed to meet the oral health needs of individuals with IDD. TUSDM's oral health providers with expertise in special care dentistry deliver comprehensive oral health care for over 6500 individuals with IDD, incorporating supportive care services and access to general anesthesia. Additionally, the program provides training in special care dentistry for dental residents and pre-doctoral dental students. CONCLUSIONS: Leveraging state and university resources, TDF provides a model of a sustainable, long-term system for statewide access to oral health care for individuals with IDD.

Professional dental care and survival rates in long-term care recipients: A cohort study of 1 459 163 individuals in South Korea.

OBJECTIVES: To determine the dental care pattern and survival rates of participants who received long-term care (LTC) and a matched control cohort in South Korea. BACKGROUND: Global ageing trends and the development of superaged societies pose healthcare challenges. South Korea's LTC system aids those with chronic illnesses and disabilities. Despite the link between oral health and systemic diseases, providing dental care in LTC facilities often reflects social neglect. METHODS: We identified 1 459 163 individuals eligible for LTC insurance in the Korean National Health Insurance Service database from July 2008 to 2015 (LTC cohort) and 1 459 544 individuals matched through propensity-score matching (matched cohort). The LTC recipients were further categorised into subgroups based on their care type (institutional, home or mixed care). Population of utilising dental services and the average number of dental visits were counted in each cohort, and the survival rate of the LTC cohort was determined according to dental utilisation. RESULTS: Population of utilising dental services increased steadily in all cohorts except for institutional care, with the highest utilisation (around 30%) observed in the matched cohort. Lower independence in LTC cohorts was associated with lower dental utilisation: 18-27% for home care, 12-18% for mixed care, and 10% for institutional care. The survival rates in the LTC cohort were significantly lower than in the matched cohort (P < .0001), with 28.1% survival in LTC vs 59.3% in the matched cohort. CONCLUSION: Long-term care recipients experience social neglect for oral care, while higher survival rates were observed in those utilised dental services.