Prenatal tobacco and postbirth second-hand smoke exposure and dental caries in children.

OBJECTIVES: Second-hand smoke (SHS) exposure has been identified as a risk factor for several childhood health problems including dental caries. The purpose of this study was to examine the association of postbirth SHS exposure and dental caries and to determine whether the association is independent of prenatal tobacco exposure, sugar consumption and dental utilization. METHODS: NHANES 2013-2014 and 2015-2016 were used to examine the research question in 1733 children, 4-11 years old with full primary or mixed dentition and serum cotinine levels below 10 ng/mL. Weighted multivariable logistic regression models were developed to examine the independent association between SHS exposure and the prevalence of (i) any dental caries experience and (ii) any decayed teeth. RESULTS: Children exposed to postbirth SHS differed from children not exposed regarding decayed teeth prevalence in the total sample (OR = 1.80, 95% CI: 1.20, 2.71) and mixed dentition (OR = 1.86, 95% CI: 1.20, 2.90) after confounder adjustment. However, no association was found in the primary dentition or between SHS exposure and total caries experience. CONCLUSIONS: The findings partially show that postbirth SHS is associated with dental caries in children. However, the inconsistencies in findings across the three samples and between the two outcome measures, dental caries experience and decayed teeth prevalence raise questions regarding the validity of the hypothesis. Further, the findings suggest that postbirth SHS is likely a marker for true causes of dental caries and the association is likely confounded with other factors associated with dental caries.

Patterns of Current Cigarette Smoking, Quit Attempts and Cessation Counseling among Survivors of Smoking-Related and Nonsmoking-Related Urological Malignancies: A Nationally Representative Cross-Sectional Analysis.

PURPOSE: Cigarette smoking is the leading modifiable risk factor for several genitourinary malignancies. Although smoking cessation after genitourinary cancer diagnosis is a critical component of survivorship, factors related to continued smoking are under studied. MATERIALS AND METHODS: A cross-sectional analysis was conducted using data from the National Health Interview Survey (2014-2018). Our primary study outcome was the prevalence and correlates of cigarette smoking among adults with a history of smoking-related (kidney or bladder) urological cancer compared to a nonsmoking-related control (prostate cancer). We used regression analyses to assess the association of having a smoking-related genitourinary cancer history with continued cigarette smoking after diagnosis. Secondary outcomes were yearly smoking trends, quit attempts and reported receipt of smoking cessation counseling. RESULTS: A total of 2,664 respondents reported a history of genitourinary cancer, representing weighted estimates of 990,820 (smoking-related genitourinary cancer) and 2,616,596 (prostate cancer) adults. Survivors of smoking-related genitourinary cancers had a significantly higher overall prevalence of current cigarette use (14.8% vs 8.6%, p <0.001) and also reported more frequent receipt of counseling (79.8% vs 66.2%, p=0.02) but did not attempt to quit any more often than those with prostate cancer (52.4% vs 47.2%, p=0.44). Time trends demonstrated stable and persistent cigarette use among survivors of all genitourinary cancers. After adjustment for sociodemographic confounders, cancer type was not associated with current cigarette smoking (OR 1.23, 95% CI 0.86-1.77). However, older age and more advanced educational attainment were associated with lower odds of current cigarette smoking, while single marital status was associated with higher odds. CONCLUSIONS: In this population-based cross-sectional study of survivors of genitourinary cancers, those with a reported smoking-related genitourinary cancer had a higher prevalence of current cigarette smoking compared to those with prostate cancer, our nonsmoking-related control. Those with smoking-related genitourinary cancers reported more frequent receipt of smoking cessation counseling.

Carcinogen Biomarkers in the Urine of Electronic Cigarette Users and Implications for the Development of Bladder Cancer: A Systematic Review.

CONTEXT: Use of electronic cigarettes (e-cigarettes) has rapidly increased despite unclear longitudinal health effects. Once thought to be a safer alternative to tobacco smoke, it is possible that e-cigarettes expose the user to similar carcinogenic byproducts during the vaping process. These toxicants are metabolized and excreted in the urine, and may have oncogenic implications for bladder urothelium. OBJECTIVE: To characterize and summarize known urinary carcinogenic biomarkers in e-cigarette users as they relate to the risk of developing bladder cancer. EVIDENCE ACQUISITION: A systematic literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles published in peer-reviewed journals, through January 2019, that reported on urinary biomarkers in e-cigarettes users were included. Parent compounds and urinary biomarkers were classified according to the International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans and cross referenced using the Collaborative on Health and the Environment, Toxicant and Disease Database to determine a link to bladder cancer, grouped by strength of evidence. EVIDENCE SYNTHESIS: Our initial search identified 1385 articles, 22 of which met final inclusion criteria and were included for analysis. In summation, these studies described 40 different parent compounds and four metals found in the urine of e-cigarette users. Since each parent compound can be metabolized several different ways, 63 unique toxicant or carcinogenic metabolite biomarkers were identified. Compared with nonuser controls, e-cigarette users had higher concentrations of urinary biomarkers of several carcinogenic compounds linked to bladder cancer. The majority of studies were limited by heterogeneous reporting and a dearth of control individuals who had never smoked. CONCLUSIONS: Biomarkers of carcinogens, several with a strong link to bladder cancer, are present in the urine of e-cigarette users. Long-term implications of urothelial exposure to these toxicants are unknown but concerning, given the similarities to tobacco smoke and its established relationship with bladder cancer. Further study on the urological safety of e-cigarettes is necessary. PATIENT SUMMARY: Our review shows that several carcinogens that have a known link to bladder cancer are present in the urine of electronic cigarette (e-cigarette) users. Further study on the urological safety of e-cigarettes is necessary.

Development of a tongue-tie case definition in newborns using a Delphi survey: The NYU-Tongue-Tie Case Definition.

OBJECTIVE: The primary purpose of this study was to develop an operational definition of the oral condition of ankyloglossia (also called tongue-tie) that occurs in newborns (i.e., age birth-6 months) and that could consistently be used in research studies. STUDY DESIGN: This 4-round Delphi survey developed the consensus New York University-Tongue-Tie Case Definition (NYU-TTCD) by using a panel of ankyloglossia treatment experts. RESULTS: This tongue-tie case definition (TTCD) was carefully created in a step-wise manner from the bottom up by expert panelists over 4 rounds of inquiry. As a functioning case definition, it offers the diagnostician 2 separate pathways to identifying a newborn as being tongue tied. One pathway requires but a single pathognomonic anatomic feature, and the other pathway requires a single functional deficit accompanied by at least 2 of 12 other diagnostic items (functional, anatomic, or behavioral). CONCLUSIONS: This Delphi survey, as administered to a panel of ankyloglossia treatment experts, produced the first consensus case definition of tongue-tie for newborns (i.e., age birth-6 months) for use in epidemiologic research studies ranging from descriptive prevalence studies to clinical trials. Next-step studies should establish the validity, reliability, and utility of this novel NYU-TTCD case definition for epidemiologic and clinical purposes.

Delayed tooth emergence in children infected with human immunodeficiency virus.

OBJECTIVE: There is limited evidence that early deficits in growth might be reflected in tooth emergence in children infected with human immunodeficiency virus (HIV). The purpose of this study was to prospectively evaluate tooth emergence timing between children positive and negative for HIV in the exposed and unexposed groups, respectively. STUDY DESIGN: A longitudinal study of children positive for HIV and HIV-negative household peers, aged 2 to 15 years was conducted between 1993 and 1996. Emergence status was determined for the maxillary and the mandibular permanent first molars and the central and lateral incisors. A multivariable, discrete time, proportional hazards model was fitted to the data. Median age of emergence for each of the six pairs of teeth was calculated using the parameter estimates from the regression model. RESULTS: A total of 116 participants (62 HIV positive, 54 HIV negative) completed six examinations over the 36-month study period. Statistical differences in tooth emergence timing were observed for five of the six tooth pairs, with children positive for HIV being less likely to have emergence of the corresponding tooth compared with the children negative for HIV. Age differences for each tooth pair ranged from 0.7 to 1.5 years, with a median emergence age difference of 1.03 years. CONCLUSIONS: Delayed tooth emergence of the permanent dentition was observed in children with HIV.

Skills in assessing the professional literature (SAPL): a 7-year analysis of student EBD performance.

PURPOSE: The primary goal of this project was to describe the level of knowledge acquisition using detailed test performance outcomes of the EBD SAPL curriculum over its first 7-years of implementation at the NYU College of Dentistry. A secondary goal was to compare performance outcomes impact of the full 60 h base SAPL curriculum as taught to 4-year DDS students vs an abbreviated 30 h base SAPL curriculum as taught to 3-year Advanced Placement DDS students. METHODS: The findings for the period 2004-2010 are reported for 1647 dental students (63.6% 4-year DDS students, 36.3% 3-year Advanced Placement DDS students). The database consisted of the score earned by each student on each individual question of the SAPL course's 4 h final examination in which each student read an original research article and answered all questions on the Literature Analysis Form. RESULTS: The major findings were overall high performance by both groups of students (SAPL exam scores of 85.8 vs 83.7, respectively) as well as very similar outcomes between these two student groups on: 1) recognizing research design elements and on interpreting those design elements for clinical application, 2) detailed performance of knowledge within the specific five traditional sections of research articles, and 3) detailed performance across 18 identified research design topics. CONCLUSION: In conclusion, both course formats appear to be highly effective for their respective student groups, but should not be interpreted as evidence favoring the shorter format given the different characteristics of the two student groups.

Use of Ayurvedic diagnostic criteria in Ayurvedic clinical trials: a literature review focused on research methods.

OBJECTIVES: The objective of this literature review is to evaluate whether Ayurvedic diagnostic criteria or Western medicine diagnostic criteria have been used in published clinical trials testing an Ayurvedic intervention/treatment. DESIGN: The PubMed, Embase, and Allied and Complementary Medicine databases were searched to identify Ayurvedic clinical trials published from 1980 to 2009. A total of 45 Ayurvedic clinical trials were identified and grouped into two time periods: pre- and post-2000 periods. Each article was independently reviewed by two calibrated reviewers. RESULTS: Analysis revealed that not 1 of these 45 studies, in either time period, reported "only-and-full" use of the 23 available Ayurvedic diagnostic criteria. In fact, 24.4% of these 45 articles never specified any diagnostic criteria at all. While the percentage of articles using Ayurvedic diagnostic criteria (either as "only use" or "combined use with Western Medicine diagnostic criteria") doubled over the two time periods (27.7% to 59%), rarely were more than 2 of the 23 Ayurvedic diagnostic criteria ever used. CONCLUSIONS: To improve confidence in their findings, future studies should strive to correct this observed inappropriate and gross underuse of Ayurvedic diagnostic criteria in the designing of clinical studies that aim to rigorously test the effectiveness of Ayurvedic treatments.