Frontiers in oral health最新文献

Introduction: Cerebrovascular stroke, a leading cause of global morbidity and mortality, is influenced by several modifiable risk factors such as hypertension, diabetes, and smoking. Emerging evidence highlights the significant role of inflammation in stroke pathogenesis, with conditions like periodontitis potentially exacerbating this risk. The aim of this systematic review was to identify and quantify the real impact of periodontal disease in individuals with cerebral stroke through the analysis of inflammatory periodontal indices.

Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of case-control studies assessing periodontal indices in stroke patients. Data sources included PubMed, Scopus, and Cochrane Library, with searches extended to grey literature. The review protocol was registered on PROSPERO (CRD42024529767). Studies were evaluated using the Newcastle-Ottawa Scale to assess risk of bias, and meta-analyses were conducted using Review Manager 5.4 and TSA software.

Results: The review included seven case-control studies, comprising 723 stroke patients and 787 controls. Meta-analyses revealed significant differences between stroke and control groups in clinical attachment loss [MD 1.04 mm, 95% CI (0.54, 1.54)], probing pocket depth [MD 0.68 mm, 95% CI (0.31, 10.6)], and radiological bone loss (MD 2.15 mm, 95% CI [-1.58, 5.89]. These findings indicate that stroke patients exhibit worse periodontal health compared to controls, supporting a potential link between periodontal inflammation and stroke.

Conclusion: This study confirms the significant impact of periodontal disease on stroke patients and highlights the importance of oral health in preventing adverse cerebrovascular events.

Systematic review registration: PROSPERO, identifier (CRD42024529767).

Introduction: Household food insecurity, defined as inconsistent access to sufficient food in a household, affects 1 in 15 individuals over the age of 60 years in the US. In these individuals it is associated with numerous chronic conditions, medication underuse leading to poorly controlled conditions such as diabetes and hypertension, and poor oral health. However, the relationship between food insecurity and oral health is understudied. We therefore evaluated the associations between food insecurity and aspects of oral health in older US adults.

Methods: We prospectively evaluated a subset of participants of the Health and Retirement Study (HRS) who responded to questions evaluating food insecurity in 2013 and a supplemental questionnaire regarding dental health and dental health services in 2018 (N = 472).

Results: Approximately 1 in 5 people in our study reported being food insecure in the last year. Food insecurity was correlated with poor oral health-related quality of life scores and more tooth loss. Individuals who were food insecure reported worse self-rated oral health (OR = 2.67), greater odds of losing 8 or more teeth (OR = 2.35), and lower odds of receiving oral care (OR = 0.60) compared to their food secure peers.

Conclusions: Though individuals experiencing food insecurity were likely to have more unmet oral health needs than their peers, they were less likely to seek dental care. To improve the oral health status of this group, in addition to making oral health care more accessible, it may also be necessary to address the social and environmental factors preventing these people from seeking oral health care.

Introduction: Unfavorable beliefs about oral health and dental treatment during pregnancy can lead to the avoidance of dental care and the underutilization of dental services, adversely affecting adherence to good oral hygiene practices and, consequently, the health of the fetus. This study investigated the commonly held oral health beliefs among pregnant women in Southwestern Ontario, Canada.

Methods: Participants were recruited from the Family Medicine Obstetrics Clinic in London, Ontario, Canada. Eligible participants were pregnant women aged 18 or older, excluding those unwilling to participate. Participants completed a 33-item self-administered questionnaire, including three open-ended questions about oral health beliefs and their impacts on pregnancy, which were analyzed for this study. Thematic analysis in NVivo identified key patterns, while analysis determined the most common beliefs and the degree of diversity in responses. Responses were categorized into sub-themes, and the frequency and percentage of each category were calculated.

Results: A total of 130 participants met the inclusion criteria. Among them, 40.7% (n = 46) believed that oral health impacts their child's health, 48.2% (n = 53) believed that dental treatment affects fetal health, and 64.4% (n = 76) believed that pregnancy influences their oral health. Many beliefs regarding oral health during pregnancy regarded infection risks. Participants held negative beliefs about the effects of antibiotics, analgesics, and dental x-rays during pregnancy. Common beliefs about the impacts of pregnancy on oral health included developing conditions, such as tooth sensitivity, caries, and gingivitis, as well as a loss of minerals to the fetus.

Conclusion: This study revealed important misconceptions and concerns about oral health and dental treatment among pregnant women in Southwestern Ontario. The findings highlighted the need for enhanced oral health education for pregnant women to address these misconceptions and promote proper care during pregnancy. Healthcare providers are encouraged to focus on dispelling myths, emphasizing the safety of necessary dental treatments, and reinforcing the significance of maintaining good oral health for maternal and fetal well-being.

The oral microbiome is a complex community of microorganisms residing in the oral cavity interacting with each other and with the host in a state of equilibrium. Disruptions in this balance can result in both oral and systemic conditions. Historically, studying the oral microbiome faced limitations due to culture-dependent techniques that could not capture the complexity and diversity of the microbial community. The emergence of advanced genomic technologies and the ease of sample collection from the oral cavity has revolutionized the understanding of the oral microbiome, providing valuable insights into the bacterial community in both health and disease. This review explores the oral microbiome in children, discussing its formation and dynamics in both states of health and disease, its role in various conditions such as dental caries, periodontal disease, oral cancer, cleft lip and palate, and explores its connection to several systemic consequences.

Introduction: In 2022, the Government of Canada introduced the Interim Canada Dental Benefit (CDB) to support Canadian families with children <12 years of age. This program operated from October 1, 2022, to June 30, 2024, with two application periods. The purpose of this study was to analyze data on applications accepted by the Canada Revenue Agency (CRA) during the first 18 months of the program.

Methods: This study used available data sourced from the CRA for applicants as of March 29, 2024, and assessed as of April 5, 2024. Data covered the entirety of the first period (October 1, 2022-June 30, 2023) of the Interim CDB and the first nine months of the second period (July 1, 2023-March 29, 2024). The rate of child participation was calculated using population data from Statistics Canada (2021).

Results: Over the first 18 months of the Interim CDB, a total of 410,920 applications were submitted and $403M distributed; $197M for 204,270 applications in period 1 and $175M for 173,160 applications in the first nine months of period 2. Overall, 321,000 children received the Interim CDB in period 1 and 282,130 children received the Interim CDB in the first nine months of period 2. A total of 91.8% of applicants had a net family income <$70,000, receiving the maximum benefit amount. The provinces with the highest rate of child participation were Manitoba (77.1/1,000 period 1; 74.9/1,000 period 2), Ontario (82.5/1,000 period 1; 72.2/1,000 period 2), Nova Scotia (73.4/1,000 period 1; 71.1/1,000 period 2), and Saskatchewan (72.3/1,000 period 1; 68.2/1,000 period 2). Overall, projections suggest that there will be an increase in the number of applications approved in period 2 compared to period 1.

Conclusions: Uptake in the first three quarters of period 2 remained consistent and in many instances, revealed higher rates of applications by parents for the Interim CDB. However, it is uncertain how much of the funds were directly used for dental care. Analyzing this data will aid in policy recommendation for enhancement of the Canadian Dental Care Program.

Introduction: During development of dental caries, oral biofilms undergo changes in microbial composition and phenotypical traits. The aim of this study was to compare the acid tolerance (AT) of plaque from two groups of children: one with severe caries (CA) and one with no caries experience (CF) and to correlate this to the microbial composition and metabolic profile of the biofilms.

Methods: Dental plaque samples from 20 children (2-5 years) in each group were studied. The AT was analyzed by viability assessment after exposure to an acid challenge (pH 3.5), using LIVE/DEAD® BacLight™ stain and confocal microscopy. Levels of acid tolerance (AT) were evaluated using a scoring system ranging from 1 (no/low AT), to 5 (high/all AT). Metabolic profiles were investigated following a 20 mM glucose pulse for one hour through Nuclear Magnetic Resonance (NMR). Microbial composition was characterized by 16S rRNA Illumina sequencing.

Results: The mean AT score of the CA group (4.1) was significantly higher than that of the CF group (2.6, p < 0.05). When comparing the end-products of glucose metabolism detected after a glucose-pulse, the CA samples showed a significantly higher lactate to acetate, lactate to formate, lactate to succinate and lactate to ethanol ratio than the CF samples (p < 0.05). The bacterial characterization of the samples revealed 25 species significantly more abundant in the CA samples, including species of Streptococcus, Prevotella, Leptotrichia and Veillonella (p < 0.05).

Discussion: Our results show that AT in pooled plaque from the oral cavity of children with severe caries is increased compared to that in healthy subjects and that this can be related to differences in the metabolic activity and microbial composition of the biofilms. Thus, the overall phenotype of dental plaque appears to be a promising indicator of the caries status of individuals. However, longitudinal studies investigating how the AT changes over time in relation to caries development are needed before plaque AT could be considered as a prediction method for the development of dental caries.

Introduction: In the last decades, dermal fillers have gained widespread acceptance for cosmetic purposes since their approval for different health conditions, including lip augmentation and aesthetic intervention of the face. Unfortunately, while filler lip procedures are performed using biomaterials with improved physical characteristics, they are not devoid of adverse drug reactions (ADRs), including those with late-onset.

Methods: This systematic aims to investigate the ADRs associated with lip augmentation procedures using dermal fillers. A systematic review search was conducted in Medline/PubMed, Scopus, Web of Science to answer the PEO question: What are the ADRs in patients undergoing lip augmentation procedures with dermal fillers, and how frequent are they?

Results: The risk of bias was assessed, and a systematic review was conducted. Nineteen studies were included. In total, 30 patients affected by filler lip ADRs were analyzed, of which 29 were females and only 1 was male with a mean age of 50.9 ± 12.8 years. Hyaluronic acid was the most commonly dermal filler used and granulomatous foreign body reaction was the most common filler lip reaction reported. The mean time between filler lip injection and granulomatous foreign body reaction onset was 57.9 ± 54 months (median 24 months).

Discussion: No study reported ADRs to regulatory authorities. Our results indicate that adverse reactions can occur even long-term after the aesthetic procedure. Therefore, ongoing short-term and long-term follow-up visits are essential, as biocompatible materials are not free from ADRs. Additionally, a lack of reporting ADRs to regulatory authorities has emerged, which is crucial for patient safety.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=534656, identifier: CRD42024534656.

Background: Abnormal positioning and dislocation of the central incisor can disturb tooth eruption. Generally, inversely impacted maxillary central incisors do not erupt naturally. Performing traction and applied extrusion of an inversely impacted maxillary central incisor with a high inclination angle of the crown is challenging. This study aimed to examine the possibility of orthodontic treatment for severely inversely impacted maxillary central incisors in a series of case studies.

Methods: The inclination angle of the tooth crown, curvature of the tooth root, and length of the formed tooth root were measured using radiography. The teeth were then fenestrated and traction was applied using a lingual arch appliance with elastics.

Results: The average crown axis inclination was 113°, the degree of root curvature was 97.3°, and the root formation was 36.1%. Although the crown axis inclination and root curvature were severe, all the incisors were aligned in the correct position as vital teeth through surgical and orthodontic treatments.

Conclusions: Traction should be performed in the early period of incisor development when root formation is not progressing, regardless of the tooth angle.

Introduction: This cross-sectional study aimed to investigate dental practitioners' knowledge and practices regarding Caries risk assessment (CRA) in routine clinical practice in Guangzhou, China.

Methods: An online questionnaire was disseminated to dental practitioners to gather socio-demographic information, factors associated with CRA, the implementation of preventive treatment, and the level of awareness regarding personalized preventive treatment in relation to CRA. Statistical analyses included descriptive statistics, Chi-square tests, ANOVA, MANCOVA, linear regression, and scatter plots.

Results and discussion: Out of the 695 dental practitioners who were contacted, 206 dentists participated in the online survey. However, out of the total number of dentists, 198 were successfully recruited, while the remaining 8 dentists had incomplete data in their questionnaires. 92.4% of dentists provided in-office fluoride treatments, and 73.2% held a strong belief in the correlation between current oral hygiene and tooth cavities. 23.7% of dentists evaluated caries risk on an individual basis, and a significant 41.9% never utilized a particular type of CRA. 53.5% of dentists recommended non-prescription fluoride rinses, whereas 51% advocated prescription fluoride treatments. Significant statistical relationships were found between the use of in-office fluoride and the effectiveness of restorative treatment (P < 0.05). Additionally, a significant association was discovered between the use of a specific form for CRA and the kind of dental school (P < 0.05). The study suggests that a significant number of dental practitioners in Guangzhou, China, do not utilize dedicated assessment forms for CRA in their routine professional activities. These findings highlight the im-portance of encouraging dentists to utilize CRA systems to effectively identify patients who are at risk of acquiring dental caries.

Periodontal diseases are chronic inflammatory conditions influenced by bacterial biofilm formation and host immune responses, affecting millions worldwide. Traditional treatments like mechanical debridement and systemic antibiotics often face limitations, including biofilm resilience and antibiotic resistance. Gum Arabic (GA), a natural exudate from Acacia trees, presents a promising alternative with its anti-biofilm and anti-inflammatory properties. This review highlights the role of GA in periodontal therapy, particularly its ability to interfere with quorum sensing (QS) pathways, specifically the AI-2 signaling system used by key periodontal pathogens such as Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum. By disrupting QS, GA inhibits biofilm formation, reduces bacterial virulence, and promotes a balanced oral microbiome. GA's prebiotic properties also encourage the growth of beneficial bacteria, enhancing the host's immune response while preserving the systemic microbiome. Clinical studies demonstrate GA's effectiveness as an adjunct in periodontal therapy, with significant reductions in plaque accumulation, gingival inflammation, and bleeding. This highlights GA's potential as a natural therapeutic agent, offering an effective, antibiotic-sparing option in managing periodontal disease. However, further research is warranted to fully establish GA's role in comprehensive periodontal care and its long-term benefits.