Special Care in Dentistry最新文献

Objectives: This study aimed to conduct a preliminary validation of the Chilean version of the Ageism Scale for Dental Students (ASDS-CL).

Methods: A cross-sectional study was carried out among 303 dental students from six Chilean universities. The original ASDS was translated and culturally adapted. The internal structure was assessed using principal component analysis (PCA) and confirmatory factor analysis (CFA). Internal consistency was measured with Cronbach's alpha. Discriminant validity was evaluated by comparing scores across sociodemographic variables.

Results: PCA identified a four-factor solution comprising 18 items: (1) Preconceived notions about older adults' oral health, (2) Negative views and professional decisions, (3) Students' competence and confidence, and (4) Social perception and access barriers. These factors explained 50% of the total variance (KMO = 0.76; Bartlett's test p < 0.001). Internal consistency was acceptable (α = 0.72). CFA confirmed the four-factor structure (RMSEA = 0.071; CFI = 0.82; TLI = 0.80). Discriminant validity analyses revealed significant differences by gender, academic year, and prior experience with older adults.

Conclusions: The ASDS-CL showed satisfactory psychometric properties and cultural adequacy in Chilean dental students. Future research should assess longitudinal changes and aim to establish an internationally relevant core of ageism assessment in dental education.

Objective: To assess the frequency of annual preventive dental visits among older adults with self-reported mental health conditions receiving care at a dental school and to identify the variables associated with visit prevalence.

Methods: Data were extracted from electronic health records for all individuals aged 65 years or older who self-reported a mental health condition between 2008 and 2024. Demographic and clinical characteristics of the participants were summarized using descriptive statistics, and significant predictors of annual preventive dental visits were identified through a multivariable logistic regression analysis.

Results: A total of 3846 subjects met the inclusion criteria. From this total, 1,853 (48.2%) received preventive dental services and 1,294 (33.6%) had at least one annual preventive dental visit. Within this group, 64.2% were female, the average age was 76.0 ± 9.1 years, 54% were self-paying, 62% resided within 30 miles of the clinic, and 70.9% were treated by pre-doctoral students. Nearly 43% were obese, and they reported taking an average of 7.8 ± 7.2 daily medications. The average number of teeth was 25.0 ± 7.3. Additionally, 83.7% had heart disease, 54.9% experienced xerostomia, and 5.3% reported a history of illicit drug addiction. Approximately 40% used tobacco, 45.7% had diabetes, and 30.7% struggled with alcohol addiction. Each additional year of age was associated with a 4% increase in the odds of attending two or more annual preventive dental visits (OR = 1.04, 95% CI: 1.01-1.08; p = 0.004). Additionally, patients treated by faculty members had significantly higher odds of attending two or more annual preventive dental visits compared to those treated by predoctoral students (OR = 3.77, 95% CI: 2.24-6.36; p < 0.001).

Conclusion: In this sample of older adults with self-reported mental health condition, about one-third had at least one annual preventive dental visit during the observation period. Receiving care from faculty members was significantly associated with increased odds of attending annual preventive dental visits.

Introduction: There is a notable lack of scientific data on the prevalence and risk factors of halitosis among monastic populations. This study aimed to determine the prevalence of halitosis and its associated risk factors among monastic residents in Vietnam.

Methods: A cross-sectional study was conducted in four monasteries, enrolling 47 monks and 71 nuns. Data on demographics, oral hygiene behaviors, and clinical oral health status were collected through questionnaires and dental examinations. Halitosis was assessed using both organoleptic evaluation and self-reported measures. Logistic regression was used to identify predictors of halitosis.

Results: The prevalence of halitosis was 50.8% by organoleptic test and self-report. Higher debris index, calculus index, and tongue coating were the strongest predictors of halitosis, while periodontal parameters showed weaker associations. Poor oral hygiene practices, including infrequent brushing and neglecting tongue cleaning, were also associated with increased halitosis.

Conclusion: Oral hygiene factors, particularly plaque, calculus, and tongue coating, are the strongest predictors of halitosis among Vietnamese monastic residents. Improved oral hygiene education and regular professional care are essential to reduce halitosis in this population.

Aims: The aim of this study is to characterize the clinical and microscopic features of recurrent oral/labial HSV-1 infection with unusual clinical presentations.

Methods: A literature review and retrospective case series of patients with recurrent oral/labial HSV-1 with unusual presentations were conducted. Data were collected from medical records, and all cases were confirmed by histopathology and immunohistochemistry.

Results: Eight patients (five males, 62.5%; three females, 37.5%) with a mean age of 61.8 years presented with unusual HSV-1 manifestations, including solitary lesions, white plaque-like appearance, non-keratinized site involvement, or prolonged duration. Lesions involved the tongue border (n = 4, 50%), anterior ventral tongue, hard palate, posterior ridge crest, and lower lip (n = 1, 12.5% each). Presented as well-demarcated solitary ulcers (n = 6, 75%), solitary papule (n = 1, 12.5%), and whitish plaque-like lesions (n = 1, 12.5%). Only two patients were immunosuppressed. All cases responded successfully to management, including pharmacotherapy, surgical excision, or photobiomodulation. Unusual clinical presentations of oral/labial HSV-1 infection are scarcely reported in the literature.

Conclusion: Unusual HSV-1 manifestations can occur in immunocompetent individuals; however, exclusion of undiagnosed immunosuppression remains necessary. A definitive diagnosis relies on careful histopathological evaluation of ulcer edges, which is crucial for guiding appropriate treatment. Further documentation of similar cases is essential to reinforce that these unusual presentations can indeed affect immunocompetent patients.

Background: Children with visual impairment face oral hygiene challenges, relying on tactile cues rather than visual feedback. Conventional toothbrushes create barriers to adequate plaque control, while triple-headed toothbrushes offer simultaneous multi-surface cleaning through tactile positioning. This study aimed to compare the effectiveness of triple-headed toothbrushes versus conventional toothbrushes in reducing plaque and gingival scores among children and adolescents with visual impairment.

Methods: This single-centre, single-blind, randomized controlled trial enrolled 108 children and adolescents (mean age 12.17 ± 3.48 years) with visual impairment in Belagavi, Karnataka, India. Participants were randomly allocated to triple-headed toothbrush or conventional single-headed toothbrush groups (54 each). All received structured oral health education and brushed twice daily under caregiver supervision for 3 months. Gingival score and plaque score were assessed using the Loe and Silness Gingival Index and the Silness and Loe Plaque Index at baseline and post-intervention. The triple-headed toothbrush acceptability was evaluated through structured questionnaires at the first week and 3 months.

Results: Both groups demonstrated statistically significant reductions in gingival and plaque scores compared to baseline (p < 0.05). The triple-headed toothbrush group demonstrated a greater improvement in gingival health compared to the conventional toothbrush group. Post-intervention gingival scores were significantly lower in the triple-headed toothbrush group than in the conventional toothbrush group (p = 0.009). Plaque reduction was also greater in the test group (p < 0.001). Acceptability of the triple-headed toothbrush increased significantly over 3 months (p < 0.001). No adverse events were recorded.

Conclusion: The triple-headed toothbrush demonstrated superior effectiveness in both plaque reduction and gingival health improvement compared to the conventional toothbrush in children and adolescents with visual impairment. The intervention showed high user acceptability and safety, offering a promising oral hygiene solution for this vulnerable population.

Trial registration: CTRI/2025/03/082795 (registered 19/03/2025).

Objectives: To assess parents' perceived oral health status, oral hygiene behaviors, and dental care for their children with visual impairments (VI).

Methods: A descriptive cross-sectional study was conducted among parents of students with VI attending special schools in Al-Ahsa, Saudi Arabia. Convenience sampling was used to recruit the participants. Data were collected using a structured questionnaire. Descriptive and analytical statistics were used for data analysis.

Results: Seventy-seven parents completed the survey (response rate: 63.6%). Most children were aged 6-11 years (38.9%). Tooth brushing varied: 16.9% brushed at least twice a day; 40.2% brushed irregularly; 7.8% flossed regularly; and 49.3% consumed sweets once or twice a day. Parents' perceptions of their children's oral health were as follows: positive, 61.0%; fair or poor, 39.0%. A significant association was found between sweets intake frequency and perceived oral health status (p = 0.035). Many of the children had not visited a dentist for over a year (29.9%) or had never visited one (25.9%).

Conclusion: There is a need to enhance oral health promotion and dental care access for students with VI. A collaborative approach involving teachers, parents, and dental professionals is recommended to support their oral health needs.

Introduction: Dental management in patients with congenital bleeding disorder (CBD) can be complex, as even minor oral surgery may precipitate prolonged bleeding. Effective treatment requires a thorough medical and dental history evaluation, including pre-, intra-, and post-operative planning. This systematic review (SR) aims to analyze data on CBD patients, including age, treatment techniques, outcomes, and recommendations for minimizing bleeding risks.

Materials and methods: A comprehensive electronic search was conducted across five databases-PubMed via MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science-using expert-validated keywords. Manual searches complemented the selection process, covering studies from first January 2009, to December 31, 2024. The SR followed PRISMA guidelines, with PICOS parameters defining study inclusion criteria.

Results: A total of 1221 records were identified, with three additional articles from manual and grey literature searches, resulting in 12 publications for data extraction and thematic analysis. Findings showed that patients with various CBD from seven countries underwent different dental procedures with structured pre-, intra-, and post-operative management, leading to positive outcomes.

Conclusions: This SR highlights the importance of standardized care protocols and multidisciplinary collaboration in ensuring safe dental treatment for CBD patients. Advanced hemostatic methods and tailored interventions significantly minimized intra- and post-operative complications.

Aims: The aim of this systematic review was to analyze the efficacy, advantages and adverse effects of midazolam in outpatient pediatric dentistry.

Methods: This review was carried out in accordance with the PRISMA criteria. A systematic electronic search was conducted through MEDLINE/PubMed, Scopus, and the Cochrane Library databases up to September 2024. An advanced and reproducible search strategy was used to identify relevant studies. Articles were excluded if they focused solely on midazolam as a premedication for general anesthesia or elective surgery, involving patients with special diseases. Inclusion criteria required participants aged 0-16 years, patients with behavioral and/or cooperation disorders and undergoing simple dental restorative procedures under local anesthesia, such as fillings, pulp therapies, stainless steel crowns, or basic extractions. Patients with specific medical conditions, as well as those who were not monitored for vital signs during sedation, were excluded from the study. The risk of bias assessment was analyzed using the criteria set out in the Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0.

Results: A total of 28 studies were included in the analysis, which were conducted across 11 countries and involved a total of 4374 children aged between 2 and 14 years. Most studies demonstrated a low risk of bias. Many of the participants were ASA I or II status and were assessed using behavioral scales, primarily the Frankl scale. Twelve adjunct drugs were combined with midazolam, and various administration routes were explored, including oral, intranasal, and buccal. Dosing protocols varied, as did fasting guidelines prior to sedation. Outcome measures included vital sign monitoring and behavioral assessments, most commonly via the Houpt and MOAA/S scales. Midazolam generally proved effective in reducing anxiety and improving cooperation, with reported benefits extending to future dental visits. Adverse effects were infrequently noted and typically mild, including nausea, vomiting, and paradoxical reactions.

Conclusions: Midazolam has been shown to be an effective and safe agent for moderate sedation in pediatric dental procedures when administered orally at a dose range of 0.3-0.5 mg/kg. The evidence suggests that it reliably reduces anxiety and improves cooperation. Supervision, preferably by an anesthesiologist, is recommended when combined with other drugs to ensure patient safety.