Special Care in Dentistry最新文献

Objective: This systematic review aimed to assess the available literature on the subgingival bacterial microbiota profiles of PLHIV undergoing HAART.

Materials and methods: This research was conducted in accordance with the PRISMA guidelines. Electronic searches were performed in the Cochrane Library, LILACS, PubMed, and Science Direct databases to identify primary studies evaluating the subgingival bacterial microbiota of individuals living with HIV-1 undergoing HAART. The search was performed by two independent researchers and covered the period from January 2001 to July 2022. Studies published in English, Portuguese, and Spanish were included.

Results: A total of 457 articles were initially retrieved. Of these, 9 met the eligibility criteria. The included studies revealed a high frequency of periodontal pathogens among individuals living with HIV-1 on HAART, including Treponema denticola (44%, n = 4 studies) and Porphyromonas gingivalis (33%, n = 3 studies), as well as species not commonly found in patients with periodontal disease, such as Enterococcus faecalis (33%, n = 2 studies).

Conclusions: According to the present findings, the most frequently identified subgingival bacterial species in patients living with HIV-1 and receiving antiretroviral therapy were T. denticola and P. gingivalis, without establishing a consistent or unique microbiological profile.

Introduction: Sexual and gender minorities are victims of discrimination in health services, which might be associated with disparities in subjective oral health measures.

Aims: This cross-sectional study aimed to identify the association between different forms of discrimination experienced by Brazilian LGBTQIA+ people, and other independent variables, with subjective oral health outcomes.

Methods and results: Seven hundred sixty-two individuals responded to an online questionnaire about their sociodemographic characteristics, discriminatory experiences on a daily basis and in dental services, access to these services, and oral health. Binary and multinomial logistic regression analyses estimated the association between independent variables and outcomes. The results were presented in odds ratios (OR) and respective 95% confidence intervals (95% C.I.). The emotional state was the category with the highest prevalence of impact (39.8%). Discrimination in dental services and self-perceived need for treatment were associated with both self-perceived oral health and its impacts on daily activities. Gender identity was associated with self-perceived oral health, and sexual orientation was associated with oral impacts on daily performance.

Conclusion: The study indicated oral health disparities in this population, associated with discrimination, gender identity, and sexual orientation, and the need for more welcoming dental services.

Aim: The aim of this qualitative descriptive study was to identify the perceived barriers of Swiss dental hygienists (DHs) in providing domiciliary dental care (DDC) to care-dependent institutionalized (LTCF) older adults.

Methods and results: This study used a qualitative thematic analysis approach that elicited rich and in-depth information from participants. Twenty-two DHs (mean age: 46.5 ± 11.5) working in Switzerland were interviewed following a topic guide. The interviews were recorded, transcribed, and analyzed. Six overarching major themes emerged: patient-related barriers, infrastructure-related barriers, difficult working conditions, LTCF-related barriers, financial factors, and factors related to training and education. Findings revealed that DDC provision required strong self-motivation and a service-oriented mindset, with care providers demonstrating empathy, dedication, and a genuine desire to help rather than solely for financial gain. The DHs who provided DDC were passionate about geriatric dentistry and/or strived to excel in this field.

Conclusion: This qualitative study concludes that improving domiciliary dental care by dental hygienists in Switzerland requires targeted strategies to enhance training, ensure adequate infrastructure, reduce workload, address financial and systemic barriers, and strengthen collaboration with long-term care facilities.

Aims: Developmental defects of enamel (DDEs) can negatively affect both the esthetics and function of teeth, especially in children with neurological impairments. The impact of dental treatments on caregivers' emotional well-being is an important but often overlooked aspect. Herein, we describe the esthetic and functional management of DDEs in a child with hydrocephalus and cerebral palsy (CP), using a minimally invasive resin infiltration technique, and the impact of the treatment on the maternal caregiver.

Methods: A 10-year-old male patient presented to the dental clinic accompanied by his mother, who reported concern regarding the presence of whitish stains on the anterior teeth. Clinical examination identified DDEs consistent with molar-incisor hypomineralization (MIH) and fluorosis. Lesion characteristics were assessed by transillumination. A minimally invasive resin infiltration protocol (Icon) was performed, resulting in immediate esthetic improvement and effective masking of enamel opacities. Caregiver-reported outcomes, assessed through a qualitative interview, revealed a significant emotional impact, including enhanced satisfaction and improved quality of life.

Conclusion: This case highlights the potential of resin infiltration as a minimally invasive treatment for enamel defects in patients with disabilities, improving esthetics, psychosocial well-being, and reinforcing the importance of a family-centered approach in dental care.

Aim: There is a well-documented link between oral health and cognitive ability; however, evidence on oral health factors linked with cognitive and physical function decline remains limited. The aim is to determine the oral health factors linked to cognitive ability and physical function.

Methods: This cross-sectional study involved people 60 years old and above with a Charlson Comorbidity Index score of ≤ 1.2. A multistage sampling technique and a WHO-structured questionnaire were administered. Oral examination, short physical performance battery (SPPB), and mini-mental state examination (MMSE) were done. sociodemographics, oral hygiene habits, perception of oral health, decayed, missing, and filling teeth (DMFT), and use of professional dental care data were analyzed using SPSS version 26 (t-test, ANOVA, Pearson correlation) with statistical significance set at p < 0.05.

Results: An assessment of 426 participants was done, with an average age of 69.29 ± 7.73 years (minimum age is 60 years and maximum age is 95 years), and 68.5% were females. A significant association was found between higher socioeconomic status (p = 0.0001) and cognitive function. Younger age (p = 0.03) and toothbrush use (p = 0.04) were significantly associated with better physical function.

Conclusions: Toothbrush use appears to be associated with physical function. Sociodemographic factors such as age and socioeconomic status may be linked to physical and cognitive function.

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.