Genesis of a novel pediatric oncodental team in a Tertiary Care Hospital

Pediatric oncology and bone marrow transplant patients are at high risk of infection, and limitations to dental expertise among medical providers render patients vulnerable to central line-associated bloodstream infections from oral pathogens. Traditionally, oral health maintenance relied on patients and bedside nurses; however, routine methods are often suboptimal to prevent central line-associated bloodstream infection in high-risk patients. Limited overlap of medical and dental expertise, and limited dental resources in typical oncology units, prevent optimal oral care for children with cancer, requiring novel solutions to better integrate specialties. Here, we outline the creation of a novel Pediatric oncodental team to address oral-systemic infection prevention strategies for high-risk patients. Our oncology and dental teams created a systematic approach for increasing oral surveillance and treatment in select high-risk patients. Supervised pediatric dental residents participated in scheduled oncology rounds, and a permanent oral health educator with a background in dental hygiene was also hired as a dedicated dental professional within our oncology department. Our pediatric oncodental team aims to sustain optimal oral complication prevention strategies to reduce the risk of infection, provide education on the significance of the oral-systemic link in cancer care, and improve access and continuity of care.

To assess the effectiveness of an intervention on caregivers' assisted toothbrushing techniques and oral health maintenance for preschool-aged children, and to determine whether these effects differ by age. A single group pre/post intervention study was conducted among children aged 3-5 years and their caregivers in Callao, Peru. Eligible caregivers were trained on assisted toothbrushing using large and real-scale typodonts, along with practical demonstrations by a dentist. Additionally, they were instructed on healthy practices and oral health in children. Children's oral hygiene status (OHS) was assessed using the Simplified Oral Hygiene Index (OHI-S) at baseline and three months postintervention. To assess the effectiveness and quantify the magnitude of the difference between the OHI-S before and after the intervention, we used Wilcoxon signed-rank test and the Cliff's Delta test, respectively. Results were stratified by age group to examine potential differences. The sample (n = 210) predominantly comprised 3-year-old Peruvian females, primarily cared for by their mothers, who identified as single mothers who had not previously received instruction in oral hygiene practices. We found improvement in children's OHI-S in most age groups. Specifically, among 3-year-olds, the OHI-S score improved significantly from 'fair' (m = 2.6, ± 0.2, range 2.4-2.8) to 'good' (m = 1.1, ± 0.2, range 0.9-1.3). The intervention showed a moderate effect size (δ = -0.15, 95% CI -0.18, -0.10) in the 3-year-olds and a moderate effect size (δ = -0.05, 95% CI -0.08, -0.01) in the 4-year-olds. No significant improvements were observed in the 5-year-old group. A caregiver-focused intervention significantly improved OHS among preschool-aged children, particularly in younger age groups. Substantial improvements in OHI-S scores were noted for 3- and 4-year-olds, while age-specific factors may have limited efficacy in the 5-year-old group. These findings highlight the importance of early, targeted oral health education for caregivers.

The aim of this study was to investigate the association between serum biomarkers and oral health parameters in children with chronic kidney disease (CKD). Serum hemoglobin, blood urea nitrogen, serum creatinine, calcium, parathormone, magnesium, and phosphorus levels were measured in 62 children with CKD aged between 4 and 17years. Intraoral examinations of the patients were performed by two different pediatric dentists. Dental caries was assessed using the decayed-missing-filled-teeth (DMFT/dmft) indexes, and oral hygiene was assessed using the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indexes. Spearman's rho coefficient and generalized linear modeling were used to examine the association between serum biomarkers and oral health parameters. The results of the study showed that there were negative and statistically significant correlations between serum hemoglobin and creatinine levels and dmft scores in pediatric patients with CKD (p = 0.021 and p = 0.019, respectively). Furthermore, blood urea nitrogen levels and DI and OHI-S scores (p = 0.047 and p = 0.050, respectively); serum creatinine levels and DI, CI, and OHI-S scores (p = 0.005, p = 0.047, p = 0.043, respectively); and parathormone levels and CI and OHI-S scores (p = 0.001 and p = 0.017, respectively) were found to be positively and statistically significantly related. There are associations between various serum biomarker levels and dental caries and oral hygiene parameters in pediatric patients with CKD. The impact of changes in serum biomarkers on oral and dental health is important for dentists' and medical professionals' approaches to patients' oral and systemic health.

Background: There may be an impairment of oral self-care post-stroke which may compromise oral hygiene and health. However, there is paucity of information on oral hygiene and oral health status of stroke patients in Nigeria. Objective: To assess the oral hygiene and health status of stroke outpatients. Method: A cross-sectional study of stroke patients attending the neurology outpatient clinic of a tertiary hospital in North Central Nigeria was conducted. Data on sociodemographic variables and oral health behaviour was obtained. Each patient was examined to determine the oral hygiene status using the Simplified Oral Hygiene index, DMFT index for the status of caries, Modified gingival index for the presence or absence of gingival disease and Modified Rankin score for functional impairment Results: There were 120 participants with a mean age of 60.30±13.21 years. Poor oral hygiene status was found in 29.7% while 28.8% had good oral hygiene status. The mean DMFT was 1.37±2.672. Dental caries was seen in 48/120 (40%) while 28 (23.3%) had gingival diseases. A modified Rankin score of 3-5 was independently associated with poor oral hygiene status (OR 1.367; 95% CI 1.020-1.832; p=0.036). Conclusion: Poor oral hygiene status is common in patients with stroke and the risk of this is higher in those with poor functional status. Oral health status should be considered in the holistic rehabilitation of stroke patients.

The authors describe the impact of the Title VII, Section 747 Training in Primary Care Medicine and Dentistry (Title VII) grant program on the development, growth, and expansion of general and pediatric dentistry residency programs in the United States. They first briefly review the legislative history of the Title VII program as it pertains to dental education, followed by a historical overview of dental education in the United States, including a description of the differences between dental and medical education and the routes to professional practice. The authors then present an extensive assessment of the role of the Title VII grant program in building general and pediatric dental training capacity, diversifying the dental workforce, providing outreach and service to underserved and vulnerable populations, stimulating innovations in dental education, and engaging collaborative and interdisciplinary training with medicine. Finally, the authors call for broadening the scope of the Title VII program to allow for predoctoral training (dental student education) and faculty development in general and pediatric dentistry. In doing so, the Title VII program can more effectively address current and future challenges in dental education, dentist workforce, and disparities in oral health and access to care.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

The background of this research is that oral hygiene is an important aspect of healthcare, especially for diabetes mellitus patients who are prone to oral complications. Diabetes mellitus, characterized by high blood sugar levels, can trigger bacterial growth and worsen oral hygiene. The problem is that the behavior of diabetes mellitus patients greatly affects their oral hygiene status, yet many diabetes mellitus patients exhibit inadequate oral care behaviors. This study aims to determine the relationship between the behavior of diabetes mellitus patients and their oral hygiene status at Puskesmas Mutiara Barat, Pidie District. The research methodology employs a cross-sectional design with a sample of 40 diabetes mellitus patients visiting the Mutiara Barat Health Center in Pidie District. Data collection was conducted through interviews using a questionnaire and assessment of oral and dental hygiene status using the OHIS index. The research took place from March 8 to May 2 2024. The results showed that of the 40 respondents, 62.5% had poor behavior and 62.5% had poor oral and dental hygiene status. Bivariate analysis using the Chi-Square test indicated a significant relationship between the behavior of diabetes mellitus patients and their oral and dental hygiene status (p = 0.000). Poor behavior, such as not regularly maintaining oral hygiene, contributes to poor oral conditions in diabetes mellitus patients. The study concludes that there is a significant relationship between the behavior of diabetes mellitus patients and their oral and dental hygiene status. It is recommended that diabetes mellitus patients improve their oral hygiene habits, control blood sugar levels well, and regularly check their teeth. Health workers are expected to provide comprehensive and ongoing education on the importance of maintaining oral and dental hygiene for diabetes mellitus patients.

Introduction: Every human being, including prisoners, has the right to general health and dental health. Prisoners have the right to receive treatment, both spiritual and physical, namely health services. Dental and oral health status is a health problem in Indonesia that has received little attention. In West Sulawesi Province, 68.4% had dental problems, 78.3% received treatment, and 93.0% never sought treatment. Based on research results, dental and oral health care facilities in prisons are still very limited, making it difficult for prisoners to get treatment. Therefore, researchers want to know the behavior and dental health status of prisoners at the research location. Materials and Methods: This study used an analytical observational design with a cross-sectional research design. Sampling was carried out by purposive sampling, where the samples that met the inclusion criteria were 109. Results and Discussion: Oral health maintenance behavior in the sufficient category is 47 prisoners (37.06%), dental caries status in the Decay Missing Filled-Teeth (DMF-T) score category is very high, namely 41 prisoners (37.06%), oral hygiene status and Oral Hygiene Index Simplified (OHI-S) category is moderate, 79 prisoners (72.48%). The results of the correlation or relationship test using Spearman, p-value <0.001, which means that there is a relationship between oral health behavior with DMF-T and OHI-S scores. Conclusion: From the results of the study, it can be concluded that there is a relationship between oral health maintenance behavior and DMFT and OHI-S caries scores in prisoners at Class IIB Polewali Mandar Prison, West Sulawesi.

To evaluate the effectiveness of cartoon animated video, caregiver-supervised training, and pamphlet-based oral health education on plaque control, oral hygiene status, and oral health knowledge, attitude, and practice (KAP) among orphaned adolescents with plaque-induced gingivitis. A total of ninety adolescents were randomly selected and allocated into three different groups. Group A received the pamphlet (n=30), Group B received the cartoon animated video (n=30), and Group C received the caregiver-supervised training (n=30). A two-stage random sampling methodology was employed to select orphanages and the study population in Puducherry, India. Clinical examinations were conducted using the plaque index and simplified Oral Hygiene Index (OHI-S), and a pre-validated questionnaire was administered to assess oral hygiene KAP, which were recorded at baseline, 3-month, and 6-month intervals. All three groups experienced statistically significant reductions in plaque scores (from 3.7±0.8 to 0.9±0.2 in the pamphlet group, 3.9±0.8 to 0.4±0.2 in the animated video group, and 3.6±0.8 to 0.7±0.1 in the caregiver group) and OHI-S scores (from 3.9±0.6 to 1.3±0.3, 3.7±0.5 to 1.0±0.2, and 3.9±0.7 to 0.5±0.1, respectively). Notably, the caregiver-based training and animated video methods demonstrated superior outcomes in reducing dental plaque and improving oral hygiene, while also an increase in the KAP scores compared to the pamphlet method. Both caregiver-supervised training and cartoon animated video methods proved to be more effective than the pamphlet method on plaque control and improvement of oral hygiene status, oral health knowledge, attitude, and its application in oral hygiene maintenance.

REVIEW QUESTION/OBJECTIVE The objective of this review is to critically appraise and synthesize evidence on the effectiveness of professional oral health care intervention on the oral health of aged care residents with dementia. More specifically the objectives are to identify the efficacy of professional oral health care interventions on general oral health, the presence of plaque and the number of decayed or missing teeth. INCLUSION CRITERIA Types of participants This review will consider studies that include residents with a formal diagnosis of dementia currently residing in permanent care in Residential Aged Care Facilities. This review will exclude participants that have not received a formal diagnosis of dementia as well as those who are not living as a permanent admission in Residential Aged Care Facilities. Studies conducted on community dwelling individuals with a formal diagnosis of dementia will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate the efficacy of professional oral health care performed by a dental hygienist. These studies involve professional oral health care performed by a dental hygienist using a toothbrush, interdental brushes, floss and hand scalers if necessary to remove plaque and food debris and in some instances hardened calculus or tartar. If there are studies involving the professional oral health care being performed by dentists or a combination of dentists and dental hygienists they will be included in the analysis. This review will exclude interventions involving staff training interventions and interventions performed by nurses/assistant nurses. TRUNCATED AT 250 WORDS

Introduction: Oral health is an essential component of overall health. Oral health maintenance is more complex for the physically challenged children; the essential problem is lack of cooperation and coordination because of their physical or mental inability. Thus, physically challenged children are considered as a high-risk group for having dental problems. Aim: The aim of this study is to assess dental caries experience, oral hygiene status, periodontal status, and prevalence of malocclusion among differently abled children attending special schools in Delhi. Materials and Methods: A total of 1060 (610 males and 450 females), differently abled children were included in the study. The children were grouped into visually impaired, hearing and speech impaired, and orthopedic physically challenged only. Clinical examination was recorded using Dentition Status and Treatment Need Index and periodontal status recommended by the World Health Organization (WHO), 2013 and examination for malocclusion was made according to the Dental Aesthetic Index as described by the WHO Oral Health Survey 1997. The Simplified Oral Hygiene Index introduced by John C Greene and Jack R Vermillion in 1964 was used to assess the oral hygiene status. Results: Out of 1060 physically challenged children, 56.4% (598) had dental caries with the mean index or decayed, missing, and filled teeth (DMFT) being 1.10 (standard deviation ±1.26). It was observed that prevalence of dental caries was high in visually impaired group (63.2%) and least in hearing and speech impaired group (51.7%). The overall oral hygiene status recorded was good in 58.5%, fair in 40.8%, and poor in 0.7% of the study population. Conclusion: The cumulative neglect of oral health was seen among the physically challenged children. Children with visual impairment had much more poorer oral health when compared to the hearing and speech impairment and orthopedically physically challenged group. An improved accessibility to dental services as well as dental health education is necessary to ensure that optimum dental care should reach this special group.

Background: Oral health is an integral component of general health. School age, especially younger ages, is a period of overall development. Although enjoying good oral health includes more than just having healthy teeth, many children have inadequate oral and general health because of improper oral hygiene, bad eating habits etc. Oral health affects the general health, well-being, education and development of children and diminishes their quality of life. Objectives were to assess the oral health status and oral hygiene of rural school children and to determine the factors associated with it.Methods: A Community based cross-sectional study was conducted in the rural field practice area of Rajahmahendravaram for a period of 3 months. All the children between 1st to 5th classes were screened to evaluate the oral health and hygiene status. Findings were documented in a pre-validated proforma and subsequently analyzed.Results: Total 620 students were screened in 4 rural schools. About 165 (26.6%) students were 10 years age and 54.3% were boys. Decayed tooth were present in 294 (47.4%). About 17% had only 1 decayed tooth, six teeth were seen decayed among 4 (0.6%) students. Dental morbidities are seen in 509 (82.1%). Pulp involvement was seen in 11 (1.8%) students, tooth fracture in 4 (0.8%), gingival involvement in 13 (2.1%), calculus in 52 (8.4%) and scaling in 80 (12.9%). Good oral hygiene was seen in 156 (25.2%).Conclusions: Oral health status and oral hygiene among rural school children is not satisfactory and needs attention.

In order to determine the association between oral health and oral hygiene conditions and nutritional status in children using a health facility in the Huánuco region, a cross-sectional descriptive study was conducted in 118 children who attended the Growth and Development Control (CRED) of the health clinic "La Esperanza." Oral health and hygiene conditions were evaluated by visible bacterial plaque, simplified oral hygiene, simplified bleeding, and gingival inflammation indices. Nutritional status was obtained from the last CRED control recorded in the clinical history. Acute malnutrition (AM) was the most common nutritional status. Among children with AM, the proportion of severe gingival inflammation was 60.3%; gum bleeding, 61.5%; dentobacterial plaque presence, 59.3%; and poor oral hygiene, 60.3%. There is evidence of a greater impact of oral health and oral hygiene on children with malnutrition, mainly acute.

Aim. To assess the prevalence of dental caries, oral hygiene knowledge, status, and practices among visually impaired individuals in Chennai, Tamil Nadu. Materials and Methods. A cross-sectional study was conducted among 404 visually impaired individuals in Chennai city, Tamil Nadu. Four schools were randomly selected for conducting the study. The oral hygiene status, prevalence of caries, and knowledge and attitude towards oral care among visually impaired individuals were collected and analysed. Results. In the present study, whilst 42% of individuals had fair oral hygiene status, 33% had good hygiene followed by 25% having poor oral hygiene. The overall mean number of DMFT was estimated to be 4.5 ± 2.7. The mean number of decayed teeth was 3.1 ± 2.2, mean number of missing teeth was 0.8 ± 1.4, and mean number of filled teeth was 0.5 ± 1.3. Conclusion. Whilst oral hygiene status was found to be relatively fair, there was a high rate of dental caries among the sample population. This shows that there is lack of knowledge regarding oral health maintenance. Therefore, early identification of caries coupled with effective oral health promotion programs providing practical knowledge to visually impaired students would prove beneficial.

Oral health of people with dementia

Background: Good oral hygiene is necessary for optimal oral health and sound systemic health. Oral hygiene practices of undergraduates in various disciplines are well documented, but little is known about their oral hygiene status in relation to the oral hygiene practices. Objective: The objective of the present study was to determine the oral hygiene status and practices of undergraduate students at the Obafemi Awolowo Obafemi University, Ile-Ife, Nigeria. Methods: Demographic details and oral health practice information were obtained from consenting participants using structured, examiner-administered questionnaires. The participants were randomly selected from all the university undergraduate students and examined. Oral hygiene status was determined using simplified Green and Vermilion Oral Hygiene Index (OHI). Data were analysed using STATA 11 statistical software. Results: A total of 150 participants, comprising 78 (52.0%) females and 72 (48.0%) males, participated in the study. The mean (standard deviation) age of the participants was 22.8 (2.7) years with a median age of 23 years. Seventy-three (48.7%) of the 150 participants had good oral hygiene with mean OHI of 0.86 (0.9). Majority (148, 98.7%) of the participants cleaned their teeth with toothpaste and toothbrush. Seventy (46.6%) attended dental care only on account of pain. Faculty of Dentistry had the highest proportion of students with good oral hygiene. Conclusions: Less than 50% of the participants had a good oral hygiene. This was rather not encouraging for undergraduate students. The fact that Faculty of Dentistry had the highest proportion of students with good oral hygiene suggests that long-term exposure to oral health education and knowledge of good oral health practices are important for oral health hygiene. This was supported by the fact that those with longer stay in university had higher proportion of students with oral hygiene.