Syphilis: Understanding the disease and the role of dental professionals.

Background: Eating disorders (EDs) are serious mental health conditions characterized by disordered eating behaviors and excessive concern about body weight, shape, or food intake, affecting an individual's psychological, physical, and oral health. Oral health professionals are often the first to recognize these signs and symptoms, thus playing a crucial role in early detection and timely intervention. Aim: To assess the knowledge of dental students and professionals regarding the psychological, physical, and oral health implications of EDs. Material and Methods: A cross-sectional study was conducted using a structured and validated questionnaire among 193 clinical-year dental students (DS) and 40 practicing dental professionals (DP) in Malaysia, selected through a convenience sampling method. The questionnaire consisted of three sections: demographic data, and assessments of knowledge and awareness regarding the psychological, physical, and oral health manifestations of EDs. Differences in participants' knowledge was assessed using Fisher’s exact test and the Chi-square test. A p-value of <0.05 was considered statistically significant. Results: Participants showed poor knowledge of certain EDs symptoms, including gender predilection (DS: 34.7%, DP: 35.0%), low body weight (DS: 41.5%, DP: 52.5%), parotid gland enlargement (DS: 28.5%, DP: 25.0%), and poor oral hygiene (DS: 36.3%, DP: 47.5%). Good level of knowledge was noted for associations with stress and anxiety (DS: 89.6%, DP: 90.0%), and mirror checking (DS: 78.2%, DP: 65.0%). Moderate knowledge was observed for social withdrawal (DS: 51.3%, DP: 50.0%), knuckle bruises, (DS: 51.3%, DP: 57.5%), low self-esteem (DS: 69.4%, DP: 72.5%), nail erosion, dental caries, hypersensitivity, angular cheilitis, and oral pain/burning(DS: 59.6%, DP: 55.0%). Significant differences between DS and DP were found for mirror checking (p<0.05), oral candidiasis (p<0.05), and symptoms such as burning sensation, taste changes, and unexplained oral pain (p<0.05). Conclusions: DS and DP demonstrated varying levels of knowledge about EDs, with poor levels of knowledge on certain key physical and oral manifestations. Therefore, integrating education on EDs into dental training is essential to support early diagnosis and timely referral.

Based on national surveillance data, we describe an unprecedented increase in syphilis case reports in Japan, with a surge in 2021-2022 reaching 10141 cases in Week 42, 2022, a 1.7-fold increase over the same period in 2021. This already represented the highest annual case count in nearly half a century; by Week 52, 2022, the number reached 12 966, far surpassing the 7978 cases in 2021. Predominantly affecting heterosexual men and young women, the proportionate increase in primary and secondary syphilis cases suggests a true increase in incidence. The syphilis surge during the pandemic poses a serious public health concern and underscores the importance of adequate testing and preventive measures.

BackgroundThere is evidence from qualitative and quantitative studies of the presence of weight stigma in the dental setting from the patient perspective. However, the perspectives of various members of the dental team and their observations and experiences of weight stigma are unknown. Given dental specialists in Special Needs Dentistry (SND) are often referred patients living with severe obesity for dental management, their perspectives are of specific importance, particularly with respect to currently employed and recommended weight stigma reduction strategies.AimsOur qualitative study aimed to identify and explore among dental professionals and support staff in Australia, their perspectives and experiences of weight stigma. We aimed to identify any currently employed, and recommendations for, stigma reduction from SND specialists.MethodsFocus groups and semi-structured interviews (n = 34 participants) were conducted with two groups; dental professionals and support staff from regional New South Wales; and SND specialists in Australia. Recordings were transcribed verbatim and analysed using thematic (inductive) analysis.ResultsKey themes emerged related to observed experiences with weight stigma, with differing perspectives based on professional roles. The impact of weight stigma on dental management was highlighted. Stigma reduction strategies with an educational focus were also identified from SND specialist participants.ConclusionThe current study explored observations of weight stigma in various dental settings and perspectives which differed based on participant awareness and professional role. The negative impact of weight stigma on preventive dental discussions was identified. Stigma reduction strategies need to target the identified barriers and address the complex drivers of weight stigma before implementation. The findings of the current study emphasise the role for team-based education, led and guided by SND specialists through their professional advocacy roles and encourages the development of a dental team action plan to respond to observed experiences of weight stigma in the workplace.

Background Weight stigma refers to discriminatory acts and ideologies targeted towards individuals because of their body weight and/or size. Weight stigma in healthcare settings generates major health disparities. To date, there have been no previous reviews exploring the issue of weight stigma among dental professionals (DPs) and in the dental setting.Aims To synthesise current evidence on weight stigma among DPs and in dental care settings via a scoping review.Methods A comprehensive search was carried out across four relevant electronic databases (Medline, Scopus, Psychinfo and Cinahl). A total of 25 full-text papers were included in the scoping review.Results Most papers addressed the subject of weight stigma as a secondary finding (20 papers). Both quantitative and qualitative study methods were used to explore weight stigma across the broad categories of attitudes and beliefs about obesity, weight-based discussions, obesity education and training and service implications of obesity. Recommendations regarding weight stigma among DPs and in the dental setting were proposed but have not been formally assessed.Conclusion Further studies addressing weight stigma in dental settings, including causes and consequences among DPs, are required to better inform and address this issue.

BackgroundDengue virus (DENV) infection, a mosquito-borne disease, presents a significant public health challenge globally, with diverse clinical manifestations. Although oral dengue manifestations are uncommon, they can serve as crucial diagnostic indicators and impact patient management in dental practice. This scoping review aims to map the evidence on the oral manifestations associated with DENV infection and their clinical implications for dental practice.MethodsThis review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was registered on PROSPERO (CRD42022337572). A comprehensive search was conducted across six electronic databases (MEDLINE, Web of Science, Scopus, Embase, Cochrane Library, and LILACS/BBO) up to June 2024. Eligible studies included case reports, case-control, cohort, and cross-sectional studies reporting oral manifestations in patients with DENV infection.ResultsA total of 41 studies were included, comprising 17 case reports, 15 retrospective cohort studies, 4 prospective cohort studies, and 5 cross-sectional studies. Gingival bleeding, oral ulceration, bilateral inflammatory increase in the parotid glands, and lingual hematoma were the most frequently reported oral manifestations. Less common manifestations included Ludwig’s angina, osteonecrosis of the jaw, and angular cheilitis. These findings suggest a broad spectrum of oral symptoms that could aid in the early identification and management of dengue patients.ConclusionsThis review highlights the importance of recognizing oral manifestations in dengue patients, which can facilitate early diagnosis and intervention, particularly in dengue-endemic regions. Dental professionals play a crucial role in identifying these symptoms and improving patient outcomes. Further research is needed to explore the pathophysiological mechanisms underlying these manifestations and to develop standardized protocols for clinical assessment and management.Clinical relevanceThis paper highlights the role of dental professionals in early dengue diagnosis, emphasizing oral manifestations like gingival bleeding. It promotes interdisciplinary care, improving patient outcomes and management in dengue-endemic regions.

HIV point of care testing (POCT) is a common approach to expanding testing into non-specialised settings. Dental services have untapped potential to screen for health conditions including HIV. However, the perspectives of UK dental patients, dental professionals, and people with HIV are unknown. Ten focus groups were undertaken with dental patients, professionals, and people with HIV. The Framework method was used to analyse the qualitative data. Six themes were generated from the focus group data. The themes explored perceptions of HIV, the purpose, appropriateness, and acceptability of HIV testing in dental settings, and new processes that would need to be established in order to successfully implement point of care HIV testing in UK dental settings. Training needs were identified including communication skills and updates to current knowledge about HIV. HIV testing in dental settings is generally acceptable to dental patients, dental professionals, and PWH. However, of concern were logistical challenges and the risk of patients surprised at being offered an HIV test during a visit to the dentist. Nonetheless, the public health benefits of the intervention were well understood, i.e., early detection of HIV and initiation of treatment to improve health outcomes. Dental teams were able to generate novel solutions that could help to overcome contextual and logistical challenges to implementing HIV testing in dental settings.

ABSTRACTThe dental setting is a largely untapped venue to identify patients with undiagnosed HIV infection. Yet, uptake of rapid HIV testing within the dental community remains low. This study sought to better understand the experiences of dental professionals who have administered the test and how these experiences might inform efforts to promote greater uptake of rapid HIV testing in dental settings. Qualitative interviews were conducted with United States dentists (N = 37) and hygienists (N = 5) who offered rapid HIV testing in their practices. The data revealed both the impeding and facilitating factors they experienced in implementing testing in their setting, as well as the reactions of their staff, colleagues, and patients. Overall, participants viewed rapid HIV testing favorably, regarding it as a valuable public health service that is simple to administer, generally well accepted by patients and staff, and easily integrated into clinical practice. Many had experience with a reactive test result. Participants described facilitating factors, such as supportive follow-up resources. However, they also cited persistent barriers that limit acceptance by their dental colleagues, including insufficient reimbursement and perceived incompatibility with scope of practice. The widespread adoption of routine HIV testing amongst dental professionals will likely require an expanded notion of the proper scope of their professional role in overall patient health, along with greater support from national dental organizations, dental education, and dental insurance companies, especially in the form of sufficient reimbursement.

Background: In recent years, a notable increase in syphilis cases has been observed in Japan, aligning with global trends. We aimed to elucidate the trends in sexually transmitted infections (STIs) incidence (specifically syphilis) in Japan and examine its relationship with the number of sex industry-related businesses in prefectures.Methods: Data on STIs and the number of sex industry-related businesses from 2000 to 2022 were obtained from the National Institute of Infectious Diseases (NIID) and the official website of the Japan National Crime Prevention Association, respectively. Joinpoint analysis and regression analysis were used to identify inflection points in the trend of syphilis and describe the association between STI incidence and the overall number (and the number of different categories) of sex industry-related businesses (i.e., store-based soaplands, store-based fashion health, nude studio, love hotels, adult shops, and meeting cafes, and non-store-based including dispatch-type fashion health and adult video mail orders). The population data was obtained from the 2022 population estimates provided by the Statistics Bureau of the Ministry of Internal Affairs and Communications.Results: In this study, a significant increase in the number of syphilis cases has been observed in Japan in recent years, with joinpoint analysis identifying a significant inflection point in 2020 (annual percent change: 43.8). Multiple regression analysis adjusted for the prefectural population revealed a strong association between the incidence of STIs and number of sex industry-related businesses. Specifically, a strong association was observed between the number of Category I non-store-based sex-related business syphilis cases among men (standardized β=0.908, p<0.001, R2=0.938) and women (standardized β=1.017, p<0.001, R2=0.921), as well as AIDS cases for men (standardized β=0.991, p<0.001, R2=0.910).Conclusions: The significant increase in syphilis cases in Japan among men and women may be related to an increase in non-store-based, dispatch-type fashion health sex-related businesses. These findings indicate that public health policies should consider these specific social and behavioral factors in future interventions.

ObjectivesThis study aimed to determine whether the current syphilis resurgence in Japan is attributable to incident syphilis in people living with HIV (PLWH). MethodsThis observational, retrospective, population-based study used data from the Japanese National Database. Data were extracted for PLWH who received antiretroviral treatment between January 2009 and December 2018. Using these data, along with the annual number of PLWH and syphilis diagnoses in the total population of Japan acquired from the National Institute of Infectious Diseases, the fraction of PLWH with syphilis compared to the total number of syphilis patients reported each year was calculated. ResultsThere was a dramatic increase in syphilis cases during the study period. However, the incidence of syphilis in PLWH was stable during 2010–2018; the fraction of PLWH with newly diagnosed syphilis remaining at approximately 2% of the total PLWH cases in Japan each year. The proportion of newly diagnosed syphilis cases in PLWH decreased during the study period and accounted for <10% of the total syphilis cases in Japan since 2016 (14.9% in 2015 to 9.5% in 2016 and 5.9% in 2018). An increasing trend in the number of newly diagnosed syphilis cases in PLWH aged >50 years was observed (7.4% in 2010 to 10.4% in 2014 and 14.9% in 2018). ConclusionsThe recent dramatic increase in syphilis cases in Japan was not seen in PLWH. Thus, the resurgence of syphilis in Japan cannot be attributed to its transmission in the PLWH population.

The oral cavity cannot be forgotten in the COVID-19 era: Is there a connection between dermatologic and oral manifestations?

To report a multifocal case of paracoccidioidomycosis (PCM) with oral, pulmonary, and adrenal involvement, highlighting diagnostic challenges and the role of dental professionals in early detection. A 50-year-old Brazilian man, smoker, and alcohol user presented with oral ulcers, weight loss, and respiratory symptoms. Clinical, histopathological, and imaging analyses confirmed PCM by Paracoccidioides brasiliensis with pulmonary and adrenal dissemination. Treatment included liposomal amphotericin B, hydrocortisone replacement, and photodynamic therapy (PDT) for oral lesions, followed by sulfamethoxazole-trimethoprim maintenance. Combined therapy led to resolution of oral and cutaneous lesions, respiratory improvement, and adrenal stabilization. After 10 months, the patient showed weight gain and no recurrence. Despite Brazil’s high PCM prevalence, delayed diagnosis remains common due to non-mandatory reporting and limited professional awareness. Oral manifestations preceded systemic symptoms, emphasizing the dentist’s role in early diagnosis. PCM is an underdiagnosed systemic mycosis with potentially severe outcomes. Recognition of oral lesions as early indicators enables timely intervention and prevents systemic complications. Strengthening awareness among dental and medical professionals, along with improved epidemiological surveillance, is essential to enhance prognosis and reduce morbidity.

There is increasing evidence for oral lesions and manifestations of COVID-19. The aim of this meta-analysis was to investigate the types of oral manifestations of COVID-19 and their prevalence. PubMed/Medline, Scopus, Web of Science, and Google Scholar databases were used to search for publications on oral manifestations in patients with PCR-confirmed COVID-19. A total of 310 records were selected, and 74 were included. Oral lesions in COVID-19 were classified according to their etiologies, including iatrogenic lesions caused by intubation and opportunistic infections. Of the included studies, 35 reported oral lesions probably caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection. Meta-analysis of prevalence data on oral manifestations and aphthous lesions indicated high heterogeneity, while meta-analysis of xerostomia prevalence data revealed a pooled prevalence, with considerable heterogeneity. In conclusion, the meta-analysis yielded high heterogeneity between studies: oral lesions yielded a prevalence of 0.33 (95% CI 0.11–0.60), xerostomia lesions a prevalence of 0.44 (95% CI 0.36–0.52) and aphthous lesions 0.10 (95% CI 0.01–0.24). In addition, a gap in the evidence regarding the prevalence of oral lesions in COVID-19 was identified and the need for further observational studies focusing on this issue and on the causal relationships between oral lesions and COVID-19 was highlighted.

Integration of smoking cessation program into routine oral health care has been advocated by World Health Organization since it brings extensive benefits to oral health. By tobacco cessation, patients are less prone to progression of periodontal disease, have less future tooth loss, have reduced risks of oral mucosal lesions and head and neck cancers. Evidence indicates that dentists are in a favorable position to deliver effective smoking cessation advice to improve patients’ oral health. This article aims to present the current situation of smoking cessation in dental setting, including dental management of smoking patients, perceptions of dentists and dental students towards smoking cessation, challenges dental professionals face when carrying out cessation interventions. Patients’ perspectives are also evaluated to provide a clearer picture of smoking cessation practice in the dental field. Review of past surveys show most patients welcome smoking cessation advice from dental practitioners. Meanwhile dentists may have wrong assumption that patients would disapprove them if they advise patient to quit smoking. On top of that, main obstacles identified are lack of training, inadequate treatment time and insufficient knowledge towards smoking cessation guidelines and referral routes. With regard to the potential barriers, evidence demonstrates that more trainings on smoking cessation strategies are needed. Future research in this aspect is also indicated to further foster the practice of smoking cessation counselling in dental setting.

Patient perceptions of healthy weight promotion in dental settings

BackgroundEstablishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients.MethodsAs part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level.ResultsA total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists.ConclusionsA high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry.