Oral and Systemic Health Implications of Electronic Cigarette Usage as Compared to Conventional Tobacco Cigarettes: A review of the literature.

Purpose The health implications related to electronic cigarettes are not fully understood and has created a public health concern. The purpose of this narrative review was to highlight the oral and systemic health concerns associated with electronic cigarettes and compare these concerns to those associated with conventional tobacco cigarettes.Methods The literature was obtained from PubMed, Ovid Medline, CINAHL, and Scopus databases in June 2021 and updated in February 2023. Sources were chosen based on the following inclusion criteria: date of publication between 2011 and 2023 and written in English. Articles were excluded based on irrelevance to the topic, weak study designs, lack of outcome data, low quality randomized control trials, unavailability of the full text article, and non-empirical research designs. The Cochrane tool, ROBINS-I, was used to assess the risk of bias.Results A total of 78 studies were included in the review. E-cigarette use was associated with significant adverse effects for cardiovascular, respiratory, immunological, and periodontal health as compared to nonusers; however, impacts were worse with conventional smoked cigarettes. Long term health effects remain unknown with e-cigarettes, but associations have been identified with periodontal and peri-implant disease, oral cancer, and mental health disorders. The heterogeneity of e-cigarette use related to vaping behavior, devices, and liquids limits the ability to generalize results. There is a need for the development of a research standard for exposure methods to establish a consensus with e-cigarette use and support the validity of results among researchers.Conclusion According to current research, e-cigarettes may induce less harm than traditional tobacco products, but e-cigarettes do not remove the carcinogenic and toxic risk that has been associated with conventional cigarettes. Further research is needed to make broad conclusions on the safety of e-cigarettes compared to conventional cigarettes and to nonusers.

Efficacy of a Revised Prototype Solution to Facilitate the Removal of Dental Calculus: A follow-up proof-of-concept study.

Purpose The purpose of this follow-up proof-of-concept study was to determine the efficacy of a revised calculus disruption solution in facilitating the removal of both supragingival and subgingival calculus in-vivo, as measured by time, difficulty, and pressure required to remove supragingival and subgingival calculus.Methods Patients from a dental school in Minnesota were recruited to participate in a randomized, split-mouth, cross sectional proof-of-concept study comparing time, difficulty and pressure used with hand instrumentation alone compared to the use of a calculus disruption solution and hand instrumentation. Quadrants were randomized to either treatment or control group. Descriptive and inferential statistics were used to analyze the amount of time used. A paired Student's t-test was used to analyze the primary outcome (α = 0.05). Post-treatment questionnaires were completed by the investigator and participants to score the perceived difficulty and pressure required to remove calculus.Results Thirty participants completed the study. An average of 3.1 minutes less time was needed to remove supra and subgingival calculus in the treatment quadrants although this was not statistically significant (p=0.5757). The secondary outcomes, the investigator and participants' perceived difficulty and pressure used for calculus removal showed either no difference, or slight improvements in the treatment quadrants. Overall, the product was well tolerated by participants.Conclusion Quadrants treated with a calculus disruption solution, required slightly less time than control quadrants for calculus removal with hand instruments although the difference was not statistically significant. Reformulation to increase the viscosity of the solution may improve efficacy. Future studies should include a larger sample size, using multiple operators, and a double-blind study design.

Knowledge, Attitudes and Perceptions of Dental Hygiene and Dental Therapy Students towards End-stage Renal Disease: A pilot study.

Purpose Chronic kidney disease is highly prevalent in the general population and can progress to end-stage renal disease (ESRD). The purpose of this pilot study was to assess dental hygiene and dental therapy students' knowledge, attitudes, and perceptions towards ESRD and evaluate the feasibility of a larger scale study.Methods A convenience sample (n=59) of dental hygiene (DH) and dual degree DH/dental therapy students were invited to participate in an electronic survey for the pilot study. The investigator designed survey consisted of a total of 37 items: demographics (4), perceived knowledge, confidence, importance and attitudes (14), knowledge of chronic kidney disease (18). The knowledge questions were adapted from the Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT) with permission. Descriptive statistics and the non-parametric two-sample Wilcoxon rank sum test were used to analyze the data.Results Twenty-five participants completed the survey for a 42% response rate. Fewer than half (36%) perceived having some knowledge regarding ESRD, its oral manifestations (28%) and mental health implications (12%). The importance of managing oral health for ESRD was rated by most respondents as "very important" or "extremely important" (76%). Respondent attitudes indicated high interest (68%) regarding employment in hospital settings to care for individuals with ESRD.Knowledge scores from the CKD-SMKT were low in the categories of general knowledge of ESRD and dental hygiene care modifications for individuals with ESRD.Conclusion Results of this pilot study indicate that using a validated instrument on a national sample is feasible to determine the knowledge, attitudes and perceptions of dental hygiene students regarding ESRD. Future research should include knowledge and awareness of hypertension, diabetes, and the role that management of chronic kidney disease plays in the prevention of ESRD.

Efficacy of a Prototype Solution to Facilitate the Removal of Supragingival Dental Calculus: A proof of concept study.

Purpose: The purpose of this study was to determine whether the adjunctive use of an experimental calculus disruption solution (EXP-955), combined with the exclusive use of hand instruments, decreases the amount of time required to remove supragingival dental calculus deposits.Methods: A single-site, randomized, split-mouth clinical trial was conducted to compare the time needed to remove supragingival dental calculus on deposits pretreated with an experimental calculus disruption solution vs. calculus deposits that were not pretreated. Quadrants were randomized to either the treatment or control group and the principal investigator (PI) was timed while using hand instruments to remove the calculus. At the end of each session, both the subjects and the PI completed a questionnaire assessing their perceptions regarding the various aspects of the appointment and the solution. Descriptive statistics were used to analyze the data. Recurring themes from the questionnaire were examined.Results: Twenty-five healthy subjects, each having two quadrants matched for number of teeth and level of calculus deposits, completed the study (n=25). A statistically significant difference was found in in the supragingival calculus removal times between the control, (M=12.5 minutes; SD=6.0), and the treatment, (M=9.7; SD=4.6), quadrants; Mean difference (95% CI) = 2.8 (1.8-3.7), p<0.0001. Thematic analysis of the questionnaire responses showed that the perceptions of the principal investigator and subjects were positive towards the use of the solution with less pain being a common participant comment. The experimental calculus disruption solution was well tolerated by all subjects.Conclusions: Results from this proof of concept study provide preliminary evidence that use of an experimental calculus disruption solution (EXP-955) reduced the time needed to remove supragingival calculus while using hand instrumentation.