Association of low occlusal force as an oral hypofunction with the prevalence of irritable bowel syndrome in Japanese adults.

BACKGROUND AND AIM: We investigated whether oral-dental conditions may be associated with the prevalence of irritable bowel syndrome (IBS) in a cross-sectional study in Japan. METHODS: Information on lifestyle and abdominal symptoms was collected, and oral-dental examinations were performed from 2013 to 2017. To investigate the association between oral-dental conditions and IBS, this study used logistic regression analyses adjusted for relevant confounding factors, such as age, sex, BMI, stress, and eating between meals. RESULTS: The prevalence of IBS was 484 (13.4%) among 3626 participants. The mean maximum occlusal force in the IBS group was significantly lower than that in the non-IBS group (0.306 ± 0.192 kN vs. 0.329 ± 0.205 kN, P = 0.014). The maximum occlusal force of the constipation-type IBS was significantly lower than that of other types of IBS without constipation type (0.269 ± 0.164 kN vs. 0.317 ± 0.198 kN, P = 0.010). Compared with those who had high values of maximum occlusal force (≧0.265 kN), those with a low value of maximum occlusal force (<0.265 kN) had a significantly greater risk for IBS (OR, 1.426; 95% CI, 1.135-1.792; P = 0.002), by multivariate analyses, across different categories of oral-dental condition in women, not in men. Women who had lowest third occlusal force (<0.206 kN) had approximately 35% significantly greater odds of having IBS compared with those who had highest third occlusal force (≧0.386 kN). CONCLUSIONS: Results suggest that a reduction in the maximum occlusal force increases the risk of IBS in Japanese women.

Variations in temporal trends in non-traumatic dental condition related emergencies.

OBJECTIVE: The objective of the study was to investigate temporal trends in non-traumatic dental condition (NTDC) related emergency visits at Emergency Department (ED), urgent care (UC), and at a Federally Qualified Health Center (FQHC) that providing dental services to a mid-sized rural community. METHODS: Temporal trends over a 9-year period (2008-2016) in NTDC rates at ED, UC, FQHC and in a region around the FQHC were determined. Statistically significant changes (α = 0.05) in the proportion of NTDC visits between FQHC and UC across each of the time points were investigated. RESULTS: Proportion of NTDC ED visits was relatively stable over the study period; whereas those at FQHC exceeded those at UC site beginning 2012 and were significantly (α = 0.05) higher than that of UC subsequently (2015-2016). CONCLUSIONS: NTDCs are preventable dental conditions and the care provided in treating NTDCs in emergency settings is palliative and does not address the underlying conditions resulting in poor outcomes. The results presented elucidate the critical role of FQHCs in significantly reducing NTDC visits. These might be precursors to a potential shift in NTDC care seeking behavior and expected to favorably impact oral health outcomes.

Determining the relationship between food texture and dental condition: First bite and chewing aspects.

Among the sensory properties of foods, texture perception is a complex modality due to catastrophic changes during eating. Relating dental conditions and capacity of texture sensation are still paucities in the literature. Different dental areas emphasize the difference in texture sensation. Anterior teeth are responsible for biting, ripping or tearing; while posterior teeth are chewing and grinding. Hence, the absence of any is expected to cause disruptions in mastication functions. The hypothesis of the present study was dental loss or missing is a burden for hardness perception for first-bite and twice chewed for anterior and posterior teeth, respectively. Patient groups were divided according to anterior-posterior tooth deficiencies and hardness sensation was assessed at first bite and twice chewed modal food (white cheese) with various hardness levels obtained with different fat content. The modal food was tested for its physicochemical, textural and sensory properties with dental assessment. Findings suggest that first-bite hardness judgements were not affected by the loss of the anterior. Oppositely, twice chewed hardness has a significant effect on the loss of a posterior tooth. These findings can indicate to future researchers to be tested according to their dental status especially if chewing is necessary for their sensory tests.

Hospital-based Emergency Department Visits with Periapical Abscess: Updated Estimates from 7 Years.

INTRODUCTION: The impact of the Affordable Care Act (ACA) on the utilization of the emergency department (ED) for periapical abscess (PA) is unknown. The objectives of this study were to provide nationwide estimates of hospital-based ED visits with PA and to examine the effect of the ACA on the use of EDs for PAs. METHODS: We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS) for 2008 to 2014. All ED visits with a diagnosis of PA were selected. The International Classification of Diseases, Ninth Revision-Clinical Modification code was used to identify PA. Patient- and hospital-level characteristics were examined. Descriptive statistics were used to summarize the data. RESULTS: From 2008 to 2014, a total of 3,505,633 ED visits for PA occurred. The proportion of ED visits with PA significantly increased over the study period (from 460,260 in 2008 to 545,693 in 2014). Medicaid was the primary payer (30.3%) and more than 40% were uninsured. Mean charge per PA-related ED visit was $1080.50 and total PA-related ED charge across the United States was $3.4 billion. Among those hospitalized following PA-related ED visits, mean hospitalization charges were $34,245 and total hospitalization charges were $5.7 billion. CONCLUSION: Oral health continues to be overlooked in health care. A large proportion of ED visits with PA were made by those covered by Medicaid and uninsured. The passing of the ACA has not reduced the number of ED visits with PA.

Dental condition and salivary characteristics in Vietnamese patients with chronic kidney disease.

OBJECTIVES: To determine the dental status and salivary characteristics and to analyse the correlation between creatinine clearance with DMFT index and salivary flow rate in Vietnamese patients with chronic kidney disease (CKD). METHODS: This study was conducted on 111 CKD and 109 non-CKD patients. The socio-demographic characteristics associated with dental habits and xerostomia status were recorded from a self-administered questionnaire. Dental status (DT, MT, FT) and salivary characteristics (flow rate; pH; buffering capacity; urea and creatinine concentrations) were examined. The multivariate regression models were used to assess the correlation of creatinine clearance with DMFT index and salivary flow rate with adjustment for confounders. RESULTS: Patients with CKD made MT and DMFT indices significantly higher than non-CKD subjects. Chronic kidney disease patients had reduced salivary flow rate; but higher xerostomia level, salivary pH and buffering capacity than those in non-CKD subjects. Results of multivariate regression models showed that with lower creatinine clearance 1 mL/min, DMF index was higher 0.02 teeth, and salivary flow rate lower 0.003 mL/min. CONCLUSIONS: There were no differences in dental status between patients with CKD and those without CKD, except that poor renal function is directly related with a higher DMFT index and lower salivary flow rate. Dental professionals should pay greater attention to oral problems during the progression of CKD to prevent deterioration of oral health.

Oral Health and Brain Injury: Causal or Casual Relation?

BACKGROUND: To systematically review the current literature investigating the association between oral health and acquired brain injury. METHODS: A structured search strategy was applied to PubMed, Embase, Web of Science, and CENTRAL electronic databases until March 2017 by 2 independent reviewers. The preferred reporting items for systematic review and meta-analysis guidelines were used for systematic review. RESULTS: Even though the objective was to assess the association between oral health and acquired brain injury, eligible studies focused solely on different forms of stroke and stroke subtypes. Stroke prediction was associated with various factors such as number of teeth, periodontal conditions (even after controlling for confounding factors), clinical attachment loss, antibody levels to Aggregatibacter actinomycetemcomitans and Prevotella intermedia. The literature showed no consensus on the possible association between gingivitis and stroke. Patients with stroke generally had poorer oral hygiene practices and oral health. Dental prophylaxis and professional intervention reduced the incidence of stroke. CONCLUSIONS: Overall, oral health and stroke were related. Periodontitis and tooth loss were independently associated with stroke. However, prevention and timely intervention may reduce the risk of stroke. Stroke was the main cerebral lesion studied in the literature, with almost no publications on other brain lesions.

Work-related traumatic dental injuries: Prevalence, characteristics and risk factors.

BACKGROUND/AIMS: The prevalence of work-related oral trauma is underestimated because minor dental injuries are often not reported in patients with several injuries in different parts of the body. In addition, little data are available regarding their characteristics. The aim of this epidemiological study was to determine the prevalence, types, and characteristics of occupational traumatic dental injuries (TDIs) in a large working community. MATERIALS AND METHODS: Work-related TDIs that occurred during the period between 2011 and 2013 in the District of Genoa (Northwest of Italy, 0.86 million inhabitants) were analyzed. Patients' data were obtained from the National Institute for Insurance against Accidents at Work database. RESULTS: During the 2 year period, 112 TDIs (345 traumatized teeth) were recorded. The prevalence was 5.6‰ of the total amount of occupational trauma. The highest prevalence was found in the fourth and fifth decades of life (OR=3.6, P < .001), and males were injured more often than females (70.5% vs 29.5%, OR=2.8, P < .001). Service and office workers represented 52% of the sample, and construction/farm/factory workers and craftsmen were 48%. TDIs involved only teeth and surrounding tissue in 66% of cases, or in combination with another maxillofacial injury in 34%. They were statistically associated with construction/farm/factory workers group (Chi squared P < .01). Crown fracture was recorded in 34.5% of cases, subluxation/luxation in 10.7%, avulsion in 9%, root fracture in 3.8%, and concussion in 3.5%. Thirty-two subjects (28.6%, 133 teeth, OR=4.3, P < .001) presented at least 1 traumatized tooth with previous dental treatment. Among 212 (61.4%) traumatized teeth, 67.5% were upper incisors, 17.5% were lower incisors, 3.3% were upper canines, 1.9% were lower canines, and 9.9% were bicuspids and molars. CONCLUSIONS: Work-related TDIs had a low overall prevalence, and fractures were the most frequent dental injury. Age, gender, and preexisting dental treatments represented risk factors for work-related TDIs.

Obesity and its association with comorbidities and hospital charges among patients hospitalized for dental conditions.

AIM: The aim of the present study was to examine the impact of obesity on hospitalization charges and comorbid burden following hospitalization due to dental conditions. METHODS: The Nationwide Inpatient Sample for 2004-2010 was used. All hospitalizations due to dental conditions were selected. The prevalence of obesity was estimated among these hospitalizations. Multivariable linear regression models were used to examine the impact of obesity on outcomes. RESULTS: A total of 11 965 hospitalizations were attributed to dental conditions; 5.6% were related to obesity. The proportion of those who were obese increased over the study period (ranging from 3.7% in 2004 to 7.3% in 2010). The mean age of those who were obese was 45 years (compared to 38.7 years for those who were not obese). Close to 41% of those who were obese were males (compared to 51% who were not obese). Whites comprised 62.4% of those who were obese (compared to 59.2% of those who were not obese). Those who were obese had a higher comorbid burden compared to those who were not obese (83.5% of those who were obese had at least one comorbid condition, whereas 56.4% of those who were not obese had at least one comorbid condition). Those who were obese had higher hospitalization charges ($US2225 more, P = 0.0001). CONCLUSIONS: Obesity is associated with high comorbid burden and hospital charges among patients hospitalized due to dental conditions.

Mandibular fossa depth variations: relation to age and dental state / Variaciones en la profundidad de la fosa mandibular: relaciones con edad y estado dental

A mandibular fossa depth correlation with dental condition and age in humans. 120 fresh male mandibular fossas were measured from the deepest area of the fossa to a horizontal reference line. The samples were classified according to age and dental state (dentate, partially dentate and totally edentulous) and a multivariate analysis was employed. Subjects average age was 41.1 (20-85). There were more partially dentate individuals (59.16 percent) than dentate (30 percent) or edentulous ones (10.83 percent). Average fossa depth was 6.9 mm (6.6-7.1 mm 95 percent CI) which significantly decreased with increased age and dental health deterioration (p<0.01). A period of five years edentulism increased the likelihood of mandibular fossa flattening (<6.9 mm) by 20.6 percent and 7.2 percent in dentate ones. Our findings found an association between dental state and age as determinant factors in reducing mandibular fossa depth.

Se observó la correlación entre la profundidad de la fosa mandibular con la condición dental y la edad en los humanos. 120 fosas mandibulares frescas de hombres fueron medidas desde la zona más profunda de la fosa a una línea horizontal de referencia. Las muestras fueron clasificadas de acuerdo a la edad y el estado dental (dentados, parcialmente dentados y desdentados en total) empleando un análisis multivariado. La edad media de los sujetos fue de 41,1 (20-85). Hubieron más personas parcialmente dentadas (59,16 por ciento) que los dentadas (30 por ciento) o desdentadas (10,83 por ciento). La profundidad media de la fosa media fue de 6,9mm (6.6 a 7.1 mm, IC 95 por ciento) la cual disminuyó significativamente con el aumento de edad y el deterioro de la salud dental (p <0,01). Un periodo de cinco años de edentulismo aumentó de la probabilidad de aplanamiento de la fosa mandibular (<6,9 mm) en un 20,6 por ciento y 7,2 por ciento en los dentados. Nuestros hallazgos encontraron una asociación entre el estado dental y la edad como factores determinantes en la reducción de profundidad en la fosa mandibular.