Association between COVID-19 stress, coping mechanisms and stress-related oral conditions among Egyptian adults: a cross-sectional study.

The present study investigated the association between COVID-19 stresses and oral conditions including gingivitis, oral hygiene, oral ulcers, and dry mouth. This was a cross-sectional study that collected data from adults in community settings in Alexandria, Egypt, between October 2021, and February 2022. Gingival condition and oral hygiene were assessed using the gingival and plaque indices. Participants were asked if they experienced oral ulcers during the past week and dry mouth during the past year. COVID-19 fears and coping were assessed using the COVID Stress Scale (CSS), and the Brief Resilience Coping Scale (BRCS), respectively. Oral health behaviors were assessed using the World Health Organization questionnaire. Regression analyses were used to assess the association between the dependent variables (clinically assessed gingival and plaque indices, reported presence of oral ulcers, and dry mouth) and explanatory variables (CSS and BRCS) after adjusting for confounders (COVID-19 status, oral health behaviors, smoking, age in years, sex, and highest educational level). The response rate was 88.8% (373/420). The mean (SD) age = 39.26 (11.45) with 74.3% females and 49.3% reporting completing high school or higher education. The mean (SD) plaque and gingival indices were 1.59 (0.66) and 1.39 (0.59), respectively. Only 20.1% reported the presence of oral ulcers and 41.6% reported xerostomia. Lower plaque score was associated with higher COVID-19 contamination fears (B = - 0.03, 95% CI - 0.05, - 0.02) and higher compulsive checking and reassurance-seeking (B = - 0.02, 95% CI - 0.03, - 0.009). Lower gingival score was associated with higher COVID-19 contamination fears (B = - 0.02, 95% CI - 0.03, - 0.002). Higher odds of reporting dry mouth were associated with greater fear of COVID-19 socioeconomic consequences (AOR = 1.05, 95% CI 1.001, 1.09), and lower coping scores (AOR = 0.93, 95% CI 0.88, 0.99). The findings suggest an association between COVID-19 specific stresses and stress-related oral conditions and shed light on the possible link between mental and oral health, emphasizing the importance of integrated planning of care services.

Comparison of two minimally invasive restorative techniques in improving the oral health-related quality of life of pregnant women: a six months randomized controlled trial.

BACKGROUND: Women tend to delay dental treatment due to misconceptions regarding the safety of dental procedures during pregnancy which may negatively affect their quality of life. Minimally invasive restorative techniques offer alternatives for caries treatment and can improve their oral health-related quality of life (OHRQoL) during this stage. METHODS: A randomized controlled clinical trial was conducted in 2019 and included 162 pregnant women visiting public family health centers in Alexandria, Egypt, with mild to moderate dental pain due to caries. Participants were randomly assigned into Papacarie-Duo group (n = 82) and ART group (n = 80). The outcome variable was percent change in OHRQoL (oral health impact profile, OHIP-14) after 6 months. T test/Mann Whitney U test were used to compare groups and a multivariable linear regression analysis was conducted to evaluate the factors affecting the outcome variable. RESULTS: A significant reduction (P < 0.002) was noted in OHIP-14 between baseline and 6 months indicating improvement in OHRQoL in the Papacarie-Duo and ART groups (16.26% and 18.91%, P = 0.120 in bivariate analysis). Multiple linear regression revealed significantly greater reduction in OHIP-14 scores in the Papacarie-Duo than the ART group (regression coefficient = 4.03, 95% confidence interval: 0.652, 7.409, P = 0.020). CONCLUSION: Minimally invasive restorative techniques, such as ART and chemo-mechanical caries removal using Papacarie- Duo can improve the OHRQoL of pregnant women suffering from mild to moderate pain due to dental caries. Significantly more improvement was noted in the Papacarie-Duo group after adjusting all other variables. Trial registration ID NCT04619264 ( https://clinicaltrials.gov/ ); November 6 2020, retrospective registration. ( https://clinicaltrials.gov/ct2/show/NCT04619264?term=NCT04619264&draw=2&rank=1 ).

The impact of minimally invasive restorative techniques on perception of dental pain among pregnant women: a randomized controlled clinical trial.

BACKGROUND: The public dental care sector is striving to fulfill the preventive and restorative needs of Egyptians, including pregnant women, who may not receive timely care due to misconceptions about dental treatment during pregnancy. Because of this, they are likely to suffer dental pain, with higher risk of infection affecting their offsprings. AIM OF THE STUDY: To compare the effectiveness of chemo-mechanical caries removal using Papacarie-Duo and Atraumatic Restorative Treatment (ART) in reducing dental pain among pregnant women. MATERIALS AND METHODS: A randomized controlled clinical trial was conducted, in 2019, and included 162 pregnant women visiting family health centers in Alexandria, Egypt, with dental pain due to dental caries not extending to pulp. Patients were randomly assigned to Papacarie-Duo group (n = 82) and ART group (n = 80) after stratification by number of treated surfaces. The outcome variables were reduction in pain assessed using Visual Analogue Scale (VAS), satisfaction with treatment, and time taken for dental caries removal. T test/ Mann Whitney U test were used to compare groups and Freidman test was used to compare change across time. RESULTS: Pain reduction was significantly greater in the Papacarie-Duo than the ART group (81.55% and 69.43%, P = 0.001). Patients in the Papacarie-Duo group were significantly more satisfied with treatment than those in the ART, immediately after treatment (mean = 9.60 and 8.00, P = < 0.01) and after 6 months (mean = 9.63 and 8.16, P = < 0.01). Significantly less excavation time was recorded in the Papacarie-Duo group than in the ART group (mean = 10.38 and 11.56 min, P = < 0.01). CONCLUSION: Chemo-mechanical caries removal using Papacarie-Duo is more effective in reducing dental pain, in pregnant women, and is associated with more satisfaction and less excavation time than ART. TRIAL REGISTRATION: ID NCT04573608 ( https://clinicaltrials.gov/ ); 5/10/2020, retrospective registration.

Parenting practices and oral health status in rural areas in Egypt: a household survey.

BACKGROUND: Parenting practices influence children's health and development. The present study assessed the association between parenting practices and oral health status of children living in rural areas in Egypt. METHODS: A cross-sectional household survey including 190 households and 392 children was conducted from May 2019 to January 2020 in four villages in Egypt. Data were collected through clinical examination and interview-based questionnaires of children. Clinical examination assessed caries (DMFT and dft), oral hygiene and gingival condition. Parenting practices were assessed using the short version of the Alabama Parenting Questionnaire (APQ) and oral health practices were assessed using the WHO questionnaire-child form. Four linear regression models were used to assess the relationship between four outcome variables (oral health indicators: (DMF, df, plaque and gingival indices) and parenting practices and oral health behaviors (exposure) after adjusting for potential confounders. Regression coefficients (B), 95% confidence intervals (CI) and model adjusted R2 were calculated. RESULTS: Complete questionnaires and clinical data were available for 392 children (response rate = 86.34%). The mean (SD) age = 9.93 (3.05) with 54.60% females. Most children (67.60%) had caries in their primary teeth, mean ± SD of df = 2.94 ± 3.10, while only 27.30% had caries in their permanent teeth, mean DMF ± SD = 0.57 ± 1.13. There was a statistically significant difference between parenting practices of both fathers and mothers (p < 0.001, < 0.001, < 0.001, 0.008 and < 0.001 for the five parenting constructs). The adjusted R2 of the models that included parenting practices (for DMF = 0.168, for df = 0.400, for plaque index = 0.061 and for gingival index = 0.090) were similar to the models that included oral health behaviors (for DMF = 0.197, for df = 0.421, for plaque index = 0.059 and for gingival index = 0.084). CONCLUSION: The association between oral health status and parenting practices which- although not statistically significant- was similar in impact to that between oral health behaviors and oral health status, highlighting the importance of parenting practices to oral health.

Association of Healthy Eating, Juice Consumption, and Bacterial Counts with Early Childhood Caries.

PURPOSE: To investigate the association of healthy diet, snacking, and bacterial count with early childhood caries in a group of preschool children in Alexandria, Egypt. METHODS: Sixty preschoolers were divided into three groups: (1) caries-free children; (2) children with early childhood caries (ECC); and (3) children with severe early childhood caries (S-ECC). Saliva was cultured to determine bacterial counts. A questionnaire collected information about background, oral health practices, and snacking habits. A 24-hour food recall form assessed dietary intake and was analyzed using the Health Eating Index 2005. RESULTS: Compared to caries-free children, children with ECC and S-ECC had significantly lower odds of drinking juices (odds ratio equals 0.10 and 0.02). Caries-free children had significantly higher Healthy Eating Index values than children with ECC and S-ECC (P=0.003 and P<0.0001). Total streptococci and Streptococcus mutans counts were significantly higher in children with ECC and S-ECC (P<0.0001 for all), whereas Streptococcus sanguis counts were lower (P=0.04 and P=0.01). CONCLUSIONS: Drinking juices was associated with less early childhood caries and severe early childhood caries among preschoolers. Snacking on sweets was associated with more S-ECC. Healthy eating, brushing, and bacterial counts were not significantly associated with ECC or S-ECC in multivariate regression.

Assessment of the Accuracy of Two Dental Screening Methods Used in a School Setting.

PURPOSE: To assess the accuracy of two screening methods used by dentists in the Health Insurance Organisation in Alexandria, Egypt aiming at identifying children who need referral for treatment. MATERIALS AND METHODS: The study included 45 dentists who examined 30 children using exclusively visual screening (VS) and visual screening with tongue blade (VSTB). A benchmark dentist examined the same group of children using mirror and probe (MP). VS and VSTB were compared to MP. Sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV and NPV, respectively) were calculated. The effect of dentist's gender, year of graduation and having postgraduate studies on the accuracy of the two methods was assessed. RESULTS: VS had greater accuracy than VSTB. Both methods had a Sn and Sp>82%. The PPV of both methods was >97%, whereas that of NPV was ≤44%. Males and recent graduates performed better than females and senior dentists when using VS and VSTB methods. CONCLUSIONS: It is questionable whether screening using VS or VSTB can ensure effective referral of children for treatment. Further studies are needed to assess other aspects of screening, including whether referred children actually seek care and whether screening improves children's oral health.

Assessment of the Healthy Eating Index-2005 as a predictor of early childhood caries.

BACKGROUND: Early childhood caries (ECC) is a multifactorial disease resulting mainly from a time-specific interaction of micro-organisms with sugars on a tooth surface. AIM: The purpose of this study was to assess the relationship of dietary intake, as measured by the Healthy Eating Index-2005 (HEI-2005) to ECC. DESIGN: Cross-sectional analytical study. METHODS: Sixty preschool children were equally divided into three groups according to their caries experience [Group 1: caries-free children, group 2: children with ECC, group 3: children with severe early childhood caries (S-ECC)]. The decayed (non-cavitated or cavitated), missing (due to caries) and filled tooth surfaces (dmfs) score was determined through visual dental examination for each child. Questionnaires were collected recording the demographic characteristics of the families as well as 24-h food recall forms capturing the dietary intake of the children during the previous day. Accordingly, the HEI-2005 score was calculated for each child. RESULTS: The caries experience of the children in this study was significantly associated with their age. Caries-free children showed significantly higher 'Whole fruit', 'Milk', 'Sodium' and total HEI-2005 scores. CONCLUSIONS: The study findings illustrate the prominent protective role played by healthful dietary practices against dental caries in preschool children.