Nederlands tijdschrift voor tandheelkunde最新文献

Tinnitus can be influenced by somatosensory input from the temporomandibular area and is then called somatic tinnitus. However, not much research has been conducted on whether orofacial treatment can decrease tinnitus severity in patients with somatic tinnitus. Therefore, the purpose of this thesis was 1) to evaluate the effect of orofacial treatment on tinnitus complaints, 2) to investigate potential prognostic indicators for a positive treatment outcome after orofacial therapy, and 3) to explore to what extent a decrease in temporomandibular disorder contributes to a reduction in tinnitus severity. In this thesis, it was found that orofacial therapy can reduce tinnitus severity in 61% of the patients with temporomandibular-related somatic tinnitus. Specifically, young female patients with a shorter duration of their tinnitus have the best prognosis. The analysis showed that 35% of the decrease of the tinnitus severity can be explained by the reduction in temporomandibular disorder.

Circa 35% of English-language professional dental care associations' websites provide advice and/or information on toothbrushing. Although the advice and information given varies considerably, there is consensus on the importance of brushing twice daily with a manual toothbrush and fluoride toothpaste. Alignment of national and international information on preventive oral care provided on websites, e.g. from the World Dental Federation and the International Federation of Dental Hygienists, seems necessary. It was also found that the oral hygiene behaviour of patients with periodontitis changed after initial treatment: they brushed longer daily and used an electric toothbrush, wooden toothpicks, and interdental brushes more often. Based on research with single-brushing exercises the electric toothbrush was found to be more effective than the manual toothbrush with respect to plaque reduction. If a chlorhexidine mouthwash is recommended, it can be used without creating problems before or after toothbrushing with a sodium lauryl sulphate dentifrice. Chlorhexidine and sodium fluoride may be simultaneously present in the same mouthwash without reducing chlorhexidine efficacy.

Dry mouth has a complex aetiology which makes proper diagnosis complicated. Until now, dry mouth diagnosis has mainly focused on the overall oral dryness, without taking into account regional differences within the mouth. This research showed, among other things, that there are unique patterns of oral dryness, each with its own cause. For example, patients suffering from Sjogren's syndrome mainly experienced dryness of the posterior of the palate. Patients with dry mouth due to the side effects of medication, in contrast, experienced the front part of the tongue as the driest. These findings suggest that mapping of intraoral dryness may be a useful diagnostic tool to differentiate between possible causes of dry mouth.

Parkinson's disease is a neurodegenerative disease, characterized by motor and non-motor symptoms. Because of the higher prevalence of Parkinson's disease in older adults, the hypothesis was that Parkinson's disease patients would have worse oral health. Since the quality of life deteriorates with Parkinson's disease, it is important to study what the influence of the mouth is in this. The aim of this thesis was to further our knowledge of Parkinson's disease and oral health (oral health and its diseases, and orofacial pain and dysfunction). The overall conclusion was that oral health is worse in patients with Parkinson's disease than in healthy patients, with consequences for Oral Health-Related Quality of Life. Furthermore, it is argued that to overcome disease-related problems, interdisciplinary collaboration is needed. However, because this also brings several difficulties with it, the discussion was initiated that if dental and medical students are more often taught together, a natural collaboration would occur.

Fibrodysplasia ossificans progressiva is a rare hereditary bone disease characterized by so-called heterotopic bone formation: the formation of new bone in areas of the body where bone normally never develops. Due to the formation of this heterotopic bone, approximately 70% of patients eventually also experience limitations in the mobility of the jaw, which in many cases results in a significantly reduced maximum mouth opening. Because of these jaw-related problems, teeth are sometimes extracted in these patients. Periodontal ligament fibroblasts can be isolated from these teeth, cells that play a role in both bone formation and bone breakdown. The location in the jaw area where heterotopic bone formation takes place determines the effect on maximal mouth opening. In addition, periodontal ligament fibroblasts are shown to be very useful for (fundamental) research into exceptional bone diseases such as fibrodysplasia ossificans progressiva.

Only too often, it is automatically assumed that dental checkups or treatments are avoided by a subset of the patient population out of fear. To put it more correctly: to avoid the anxiety associated with dental appointments - anxiety believed to be based on fear of pain and pain increase. Following this assumption, three other subtypes of avoidant patients are being overlooked. These are care-avoiders with fear caused by trauma, self-effacing behavior or depression. Well-informed questions can initiate an understanding conversation which can break and stop this care-avoiding behavior. Patients can be referred to the general practitioner (formental health care), or to special dentistry, in more complex cases.

A 12-year-old boy was referred with a painless swelling of the labial gingiva. The swelling was caused by the antihypertensive amlodipine, which he used because of arterial hypertension due to a chronic kidney disease. The treatment consisted of discontinuation of the causative drug after which the swelling of the gingiva slowly subsided.

Dental care professionals regularly see patients with hypodontia. Hypodontia can be acquired, for example through chemotherapy or radiation at a young age, but is hereditary in most patients. Due to an error (pathogenic variant) in one of the many genes that control odontogenesis, the formation of the tooth germ is disrupted at an early stage. The genes involved are not only crucial for tooth development, but they also play an important role in other physical processes. This article provides background information on hypodontia. Based on an inventory of gastrointestinal complaints in patients with hypodontia and a case description of the simultaneous occurrence of a coagulation disorder and hypodontia, the importance of a broad view of this patient group is illustrated. It is concluded that, in addition to a dental assessment, examination of these patients should include a limited physical examination and the medical history of the patient and his close relatives.

For this exploratory study, ALS patients and their partners/caregivers were interviewed to find out what problems they encounter when performing oral care. In addition, the tooth brushing procedure was recorded on video. Most mentioned by the six patients was that the performance of oral care is hampered by the loss of motor skills and by the gag reflex. They also mentioned various adjustments that would ease dental visits. Three of the four partners indicated that an instructional video would have additional value, and two partners said they sometimes felt insecure whether they were performing oral care properly. The five videos showed that there are major differences regarding tooth brushing duration, which surfaces are being brushed, and the brushing technique. This study shows that there are several ways in which oral care is performed in ALS patients. Furthermore, not all caregivers are aware of how oral care should be performed.