Dental Care Research Articles

Oral Health Complications of SCUBA Diving

OBJECTIVE This review aims to assess the specific oral health complications associated with SCUBA diving, including barodontalgia, barosinusitis, and temporomandibular joint (TMJ) disorders, and to examine the dental implications of hyperbaric oxygen therapy (HBOT) used in decompression sickness treatment. Additionally, this review identifies gaps in the literature and suggests areas for further research to improve dental care guidelines for divers. MATERIALS AND METHODS A systematic literature search was conducted using PubMed and Scopus databases from 2004 to 2024, focusing on terms such as "barodontalgia," "dental barotrauma," and "diving dentistry." From 77 initial articles, 25 studies were selected based on relevance to pressure-induced oral complications, diving-related barotrauma, and dental management for SCUBA divers. RESULTS The review identifies barodontalgia as a prevalent issue, commonly triggered by untreated caries or defective restorations, with symptoms intensified by pressure changes. TMJ disorders, linked to prolonged clenching on diving mouthpieces, and sinus-related barotrauma also emerged as significant concerns. Preventive measures, including regular dental checkups, use of resin-based cements, and customized mouthpieces, are recommended to reduce risks. Furthermore, the review highlights a need for larger, controlled studies across diverse diver populations to validate current recommendations and develop accessible guidelines, especially for recreational divers who may lack access to specialized dental care.

The Relationship Between Smile Type, Dental Composition, and Personality Traits in Young Adults

Introduction. This study investigates the complex interplay between dental compositions, smile styles, and personality traits in young adults seeking oral and dental care, guided by the Visagism paradigm. Methods. A total of 150 young adult volunteers aged 18-35 years participated in the study. The participants completed a questionnaire designed to assess personality traits. A survey containing various personality characteristics was administered to determine the participants’ fundamental personality traits, with respondents encouraged to indicate the traits they most closely identified with honestly. Based on the survey responses, individuals were categorized into one of four main personality groups: melancholic/sensitive, sanguine/dynamic, choleric/strong, and phlegmatic/peaceful. Subsequently, a careful clinical examination was conducted to assess each patient’s tooth form, smile style, and the visibility of teeth and gums at different smile stages (stages III and IV). Statistical analysis was then conducted. Results. Oval tooth forms (36%) and the commissure (Mona Lisa) smile style (72.5%) were most frequently observed, aligning with previous research. Notably, women exhibited a higher prevalence of a melancholic temperament. However, the study found no significant relationship between self-reported personality traits and dental compositions or smile styles. Conclusions. The study did not confirm a significant association between personality traits and smile styles or dental forms. While the findings align with existing research, they highlight the complexity of the Visagism paradigm, emphasizing the need for further investigations into the relationship between temperament and dental aesthetics.

The Strategies to Improve Primary Health Care Services: A Scoping Review

Context: Evaluation of health policies and identification of their challenges are vital for improving and implementing reforms in the healthcare system. The present study was conducted to identify interventions aimed at improving primary healthcare (PHC) services in Iran. Evidence Acquisition: This research utilizes a scoping review to examine reform interventions in PHC services across 10 selected countries: Qatar, Oman, Turkey, Georgia, Armenia, United Arab Emirates, Saudi Arabia, Bahrain, Kazakhstan, and Kuwait. The study covers areas such as the PHC delivery system, human resource management, financial mechanisms, and the framework of community participation and intersectoral collaboration from 2010 to 2022. Results: The main reform strategies for PHC systems in the reviewed countries included the establishment of family medical centers with nurse support as a comprehensive strategy for service provision in public health centers; providing comprehensive and quality healthcare service packages including maternal and child health, infectious disease immunization, chronic disease monitoring, and dental care services; health education; access to essential medications; improvement of electronic health services; implementation of health promotion and continuous prevention programs; capacity enhancement; and a greater focus on health screening programs and grading of healthcare centers. Conclusions: The major findings from the reviewed countries indicate that healthcare policymakers focus on providing preventive care services, reducing maternal and child mortality, and increasing life expectancy. Programs such as referral systems, service grading, and the adoption of electronic health services are part of their reform agenda.

Aeronautics in dentistry: Navigating oral health challenges in zero gravity

Space, an expansive environment beyond Earth’s atmosphere, poses challenges for astronauts and spacecraft due to microgravity and radiation. These conditions disrupt saliva production, alter oral microbial composition, and challenge hygiene practices, leading to oral health concerns such as dental caries, periodontal diseases, and discomfort. Astronauts also face risks such as masticatory muscle atrophy and oral cancer during extended space missions. Thus, comprehensive dental care in space is crucial for astronaut well-being and overall health as humanity explores farther into space. This review delves into these challenges, exploring strategies to maintain optimal oral health during space travel and advancements in dental practices for astronauts on prolonged missions.

Equimolar oxygen-nitrous oxide (EMONO) in dental pediatric care: which patients achieve therapeutic effects? A French national exploratory prospective observational multicenter study.

Equimolar oxygen-nitrous oxide mixture (EMONO) is considered as a reference for dental care in children. Completion of dental treatment has usually been used as a criterion to assess EMONO treatment. However, other patient-reported outcomes are needed. We sought to assess the prevalence of complete therapeutic effects (analgesia and anxiolysis) experienced by children during dental care under EMONO and identifying associated factors. A national prospective observational multicentric study was conducted between September 2018 and June 2020 in 13 French university hospitals. Participants were children between 3 and 15years of age requiring dental care under EMONO. 677 children were analyzed. Anxiolysis and analgesia were experienced by a large majority of patients (86.5% and 79.0%, respectively, and 73% experienced both effects). Several factors were associated with both analgesia and anxiolysis effects: the presence of expected effects (no loss of judgment and slight decrease in level of consciousness), the absence of agitation and distress, a positive perception of EMONO and ethnicity. Most patients benefit from the therapeutic effects (anxiolysis and analgesia) expected by EMONO during dental treatment. It is reassuring to observe that most sociodemographic characteristics and medical history do not seem to influence the effectiveness of care. The study was registered at www. gov under the reference number NCT03453411.

Unmet Needs for Dental Care Before and During the COVID-19 Pandemic in Greece: A Cross-Sectional Study

Background/Objectives: Unmet dental needs involve cases wherein someone needed dental care and did not receive it. Published data on unmet dental needs are limited. This cross-sectional study investigates unmet dental needs in Greece before and during the COVID-19 pandemic. Methods: For this study, a questionnaire was created and distributed to a non-random sample. It was completed by 277 individuals. The questionnaire was based on the European Union Statistics on Income and Living Conditions (EU-SILC) tool, which is used to investigate unmet health needs. It was enriched with questions about unmet dental needs before and during the COVID-19 pandemic. Results: Of the 277 participants, 23.1% reported unmet dental needs before the onset of the COVID-19 pandemic, which decreased to 13.4% after the onset of the pandemic. However, a significant proportion of the sample (48.3%) reported no need for dental care after the onset of the COVID-19 pandemic. It is also worth noting that there were instances of dental visit avoidance, both when symptoms were present and for standard check-up/follow-up purposes, at rates of 17% and 27.8%, respectively. Conclusions: Unmet dental needs occurred at lower rates after the onset of the COVID-19 pandemic than those recorded before the pandemic. The main reasons for unmet needs before the pandemic were the cost of dental services and fear of treatment procedures or the visit to the dentist, while after the onset of the COVID-19 pandemic, lack of time and fear of coronavirus transmission were added.

GDC publishes dental care professionals' working patterns data

GDC publishes dental care professionals' working patterns data

Assessment of oral disease burden among head and neck cancer patients in the Merseyside region.

Introduction Head and neck cancer (HANC) significantly impacts the oral cavity and dental health issues may complicate cancer treatment and post-treatment quality of life. Pre-treatment dental evaluation is critical for identifying and managing existing oral health problems. However, limited literature exists on the dental health status of patients at the time of HANC diagnosis. This study aims to address this gap and emphasise the importance of dental care in the management of HANC.Methods A retrospective analysis of medical records was conducted on patients scheduled for radiotherapy for HANC. Data on demographic characteristics, tumour characteristics and dental exam findings were extracted from the patient record.Results Of the 191 included patients, the average age was 62.9 years (SD: 10.09), with 80% being men. The prevalence of dental disease revealed 59% of cases presenting with unstable periodontal disease and an average decayed, missing, and filled teeth score of 19.9. Two-thirds of patients exhibited one or more carious lesions.Conclusion This retrospective study sheds light on the dental health status of patients with HANC at their pre-treatment evaluation. The high prevalence rates of dental caries and unstable periodontal disease highlight the importance of dental evaluation and intervention as part of the overall management of HANC patients.

Gender differences in periodontal pocket microflora in patients with chronic generalized periodontitis

Background: Periodontal disease, the primary cause of tooth loss, is a critical public health concern with a considerable impact on quality of life. It is of interest to explore gender differences in the course of inflammatory periodontal diseases, as well as the prospects of their personalized treatment and prevention in males and females. Aim: To assess the dental health and quantitative composition of periodontal pocket microflora in periodontitis patients, taking into account gender differences. Materials and Methods: The study included 39 patients with moderate chronic generalized periodontitis aged 40–60 years. The diagnosis was made using both primary and secondary dental diagnostic tools. The study had two groups: males (41%, n=16) and females (59%, n=23). The following parameters were assessed: oral hygiene index (OHI-S), severity of gingival inflammation (PMA), and quantitative composition of periodontal pocket microflora (DENTOSCREEN, “Lytech” Co. Ltd., Russia), taking into account gender differences. The study findings were statistically processed using Microsoft Office Excel 2016 with Data Analysis and AtteStat 12.0.5 add-ins. The Shapiro–Wilk test was used. The data are presented as median and interquartile range: Me [Q1; Q3]. The frequency of microorganisms is presented as percentage of the mean and standard error of the mean. The confidence interval was calculated using the Wald method, according to the formula for proportions and frequencies. For small values, the Wald method with Agresti–Coull correction was used. Samples were compared using the following tests: the Mann–Whitney U test was used for quantitative data and Fisher’s angular transformation (φ*emp) for frequency (nominal) attributes. Significant differences were defined as a probability 95% (p 0.05). Results: The quantitative composition of periodontal pocket microflora in patients with moderate periodontitis revealed significant gender differences, as demonstrated by an increase in the count of Fusobacterium nucleatum and Prevotella intermedia, as well as the frequency of Porphyromonas gingivalis, in males compared to females (φ*emp=1.736; p 0.05). Dental health indices confirmed the hypothesis of significant differences between males and females in terms of plaque index (OHI-S) and РМА. In males, poor oral hygiene was reported in 93.7% cases, which was significantly higher (φ*emp=2.04; p 0.05) than in females (69.6%). Moderate gingival inflammation was more prevalent in males, while mild gingival inflammation was more prevalent in females (p 0.05). Conclusion: The study findings emphasize the importance of oral hygiene in the prevention of chronic periodontitis and can be used to improve complex treatment algorithms for patients with periodontal diseases. This includes more frequent dental check-ups and professional oral care sessions, as well as oral hygiene training and monitoring, in males compared to females. Diagnosis by polymerase chain reaction allows for the identification and quantitative determination of DNA from periodontopathogenic bacteria at low concentrations, as well as the justification of treatment algorithms and prediction of treatment outcomes.

Oral pathologies in anticancer therapy: a literature review

Anticancer therapy is associated with a wide range of systemic symptoms, including oral pathologies, such as dry mouth, mucositis, masticatory spasm, osteoradionecrosis, dental caries, opportunistic infections, dysphagia, hypogeusia, dysgeusia, and hyposalivation. Dental professionals are the most qualified experts in the diagnosis and treatment of oral pathologies, as well as their prevention and control in cancer patients receiving radiation therapy or chemotherapy. The aim of the review was to assess domestic and international literature on primary oral complications associated with anticancer therapy. The review also aimed to highlight the importance of dental care in improving the quality of life of these patients, as well as to provide practical guidelines for managing these complications. The search was performed using electronic databases PubMed, eLIBRARY.RU, and Google Scholar. The search yielded 55 literature sources, which were included in the review. Anticancer therapy may result in significant oral pathologies, including mucositis, infections, hyposalivation, changes in taste, and pain. These symptoms can affect various functions of the oral cavity and oropharynx, causing dry mouth and difficulties chewing and swallowing, which impairs nutrition. Moreover, they can affect speech, oral hygiene, denture treatment, and appearance, all of which can be detrimental to oral health, as well as social and emotional wellbeing. These side effects may also reduce compliance with anticancer therapy, affecting treatment outcomes, overall health, and therapy costs. When examining cancer patients, a dental professional must consider the prescribed therapy, as well as potential long-term complications similar to those in patients receiving bisphosphonates. As a result, a cancer patient will continue to receive the necessary treatment, and any new problems will be identified early.

Letter to the Editor: Exploring the integration of dentistry within a multidisciplinary palliative care team: does bedside dental care improve quality of life and symptom burden in inpatient palliative care patients?

Letter to the Editor: Exploring the integration of dentistry within a multidisciplinary palliative care team: does bedside dental care improve quality of life and symptom burden in inpatient palliative care patients?

Twelve-Year Changes in Pre-Schoolers’ Oral Health and Parental Involvement in Children’s Dental Care: Results from Two Repeated Cross-Sectional Surveys in Lithuania

Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from two repeated cross-sectional surveys. The objectives were (1) to assess the temporal changes in children’s dental health status and oral health-related behaviours, (2) to examine temporal changes in parental attitudes toward their children’s oral health care, and (3) to analyze the associations between observed changes. Materials and methods: Two identical cross-sectional surveys were conducted in 2010/2011 (n = 294) and 2023 (n = 304). In both surveys, parents answered questions regarding their children’s oral health care and completed the 38-item ‘Parental Attitudes toward Children’s Oral Health’ (PACOH) scale, while the dental health of their 3–7-year-old children was clinically assessed. Changes in the examined characteristics were analyzed using general linear models. Results: Significant positive changes (p < 0.001) were observed when comparing the surveys: the dmf-t (decayed, missing, filled teeth) score for deciduous teeth decreased from 5.56 to 3.31; the Silness–Löe Plaque Index decreased from 1.45 to 1.15; the percentage of children brushing their teeth regularly increased from 33.0% to 55.3%; the percentage of parents assisting their child with tooth brushing increased from 19.2% to 85.1%; and regular visits to a children’s dentist increased from 36.4% to 85.1%. Moreover, the study revealed better parental attitudes toward their children’s oral health care, as reflected by a change in the total score of the PACOH scale from 112 to 122. Conclusions: It was concluded that changes in parental attitudes played a crucial role in driving positive trends in oral health-related behaviours, which likely contributed to the improvement of dental health in children. Therefore, understanding and influencing parental attitudes can be essential for promoting good oral health skills and good oral health in young children.

Global, Regional, and Country-Level Economic Impacts of Oral Conditions in 2019.

The recent World Health Organization (WHO) Oral Health Resolution and the subsequent WHO Global Oral Health Action Plan highlight the key relevance of providing information on the economic impacts of oral conditions. The purpose of this study was to provide updated estimates for the global, regional, and country-level economic impacts of oral conditions in 2019. Extending previously established methods, dental expenditures (costs for treatments) and productivity losses for 5 oral conditions (caries in deciduous and permanent teeth, periodontitis, edentulism, other oral diseases) were estimated for the year 2019. The estimated total worldwide economic impacts of oral conditions in 2019 were US $710B, of which US $387B (US $327B to US $404B) was due to direct costs and US $323B (US $186 to US $460) was due to productivity losses for the 5 main oral conditions. Low-income countries spent an average of US $0.52 (US $0.22 to US $0.96) per capita on dental care, while high-income countries spent an average of US $260 (US $257 to US $268) per capita-a 500-fold difference. These findings suggest that oral conditions continue to substantiate an enormous economic burden to individuals and society. The comprehensiveness of estimates supersedes that of previous work as the primary information on direct costs was identified for a larger number of countries. The need for more and better routine reporting and monitoring of the economic impact of oral conditions is emphasized. The relevance of such information is also highlighted by its inclusion in the first-ever WHO Global Oral Health Status Report and Global Strategy on Oral health 2023 to 2030. Given the persistently high economic burden of oral conditions, there is a key role for better prioritization of cost-efficient oral health programs as well as needs-responsive capacity planning.

An Attempt to Use Virtual Reality as a Tool to Reduce Patient Anxiety During Dental Treatment

Background/Objectives: Dental fear and anxiety are prevalent issues in both children and adult patients, often leading to avoidance of dental care and deterioration in overall health. While virtual reality (VR) has been increasingly studied as a distraction tool in pediatric dentistry, its effectiveness among adults remains under-researched. This study aims to evaluate the impact of VR distraction on reducing anxiety and physiological stress indicators in adult dental patients. Methods: The study was conducted in a private dental office in Dobrodzień, Poland, involving 90 adult dental patients divided into three groups: two experimental (VR1 and VR2) and one control (C), with 30 patients each. Patients in the VR1 group experienced VR distraction during the first visit, and the second visit was conventional; the VR2 group experienced this in reverse; and the control group underwent traditional treatment in both visits. Physiological parameters (heart rate, saturation, and stress) and psychological anxiety levels (MDAS and STAI-X1) were measured at three time points during each visit. Results: Significant reductions in heart rate and stress levels were observed after VR exposure compared to the control group. VR also demonstrated a significant effect in decreasing anxiety levels (based on STAI-X1) during the visit with VR distraction. No significant changes were found in the saturation levels across the groups. Conclusions: The use of VR as a distraction tool during dental procedures effectively reduces physiological stress and anxiety in adult patients, suggesting its potential as a valuable tool in managing dental anxiety. Further research is recommended to explore the long-term benefits and patient satisfaction with VR-based interventions in dental care.

Stem Cells: Innovations, Applications, and Future Directions

ABSTRACT Stem cells offer great promise in dentistry by regenerating critical oral tissues. Derived from sources such as dental pulp, periodontal ligament, and dental follicle, these cells can be pluripotent or multipotent and are capable of differentiating into various cell types, including odontoblasts and osteoblasts. This regenerative potential could transform treatments for dental conditions like periodontal disease and pulpitis. Advancing this field requires understanding stem cell differentiation and exploring tissue engineering and biomaterial scaffolds. Despite the potential, evolving legal and ethical issues shape the integration of these innovations. Research in dental stem cells represents a significant advance in regenerative medicine, promising to enhance dental treatments and patient care.

A case-control study on oral health knowledge and dental behavior among individuals with developmental delays in Jordan: caregiver perspective

Aimthe aim of this study is to assess oral health knowledge and dental behavior among individuals with developmental delays intellectual and developmental disabilities (IDD) in comparison with individuals without (IDD) in Jordan.MethodsA case–control study was conducted among 317 caregivers of individuals with IDD (n = 168) and control (n = 149) groups, which involved the completion of the questionnaire. A closed-ended, validated self-designed questionnaire was distributed. The questionnaire included questions addressing participants’ oral health knowledge and behavior. Convenience sampling was used to select the caregivers from centers associated with IDD by collecting data from nearby locations. Using SPSS® software Version 22 with a 0.05 level of significance data were analyzed. A Chi-square test and contingency-table analysis were performed on the data.ResultsCaregivers for individuals with IDD in Jordan were less knowledgeable about different oral health aspects than control group (P value < 0.05). Fewer individuals in the IDD caregiver group brushed their teeth once or twice daily (83.2%), compared to the control group (93.3%). Only 22.6% of the IDD participants could brush their teeth without assistance. On the other hand, the IDD group consumed significantly less sugary foods and soda than the control group (P value < 0.05).ConclusionThe lack of knowledge among IDD caregivers in Jordan is critical which can result in poor oral health outcomes for this vulnerable population. Increasing the knowledge level for the IDD caregivers on the specific needs for IDD individuals is highly important to enhance their understanding of oral health and improve their quality of life. Caregivers with IDD should receive training programs given by oral health professionals about the need for regular dental check-up and effective oral hygiene care reduce the risk of having dental problems and oral disease.

How North Carolina’s New Center on the Workforce for Health Can Contribute to Oral Health Improvements

The recently created North Carolina Center on the Workforce for Health can help to ensure an adequate oral health workforce to appropriately meet the dental care needs of all our state’s residents.

A comprehensive exposition of the synergistic collaboration between the public and private spheres in healthcare

Public–private partnerships (PPPs) are a type of partnerships between the government and the private sector. PPPs promote innovation in healthcare by combining the resources of the public and private sectors. They provide advantages such as improved service, enhanced accessibility, and cost savings. However, they also have drawbacks such as divergent goals, hesitancy, influence imbalances, and limited data. This review focuses to examine types of PPP in healthcare such as service contracts, operations, maintenance contracts, and capital projects, with a focus on their diverse applications and impacts, its benefits, efficiency, cost-effectiveness, challenges, divergence goals, issues about prices, disputes, and the influence of private sector on healthcare quality, access, and costs in Indian scenario. The review also provides a comprehensive and globally relevant exploration of PPP in healthcare, with a special focus on dental care, non-clinical services, and pragmatic insights into its challenges and solutions, offering a valuable resource for stakeholders in the field.

Oral Health and Systemic Disease: A Systematic Review of the Impact of Dental Care on Overall Health

Oral health is increasingly recognized as a critical component of overall health, with research highlighting its potential impact on various systemic diseases. This systematic review examines the current evidence on the association between oral health, particularly dental care, and systemic conditions such as cardiovascular disease, diabetes, respiratory illnesses, and adverse pregnancy outcomes. A comprehensive literature search was conducted across multiple databases, focusing on studies published from 2016 onward. Studies indicate that periodontal disease and other oral health issues may contribute to systemic inflammation, a common factor in many chronic conditions. Specifically, findings suggest that managing oral health can have beneficial effects on cardiovascular health, glycemic control in diabetic patients, and respiratory function, as well as reduce risks for adverse pregnancy outcomes. However, while associations are evident, causality remains difficult to establish, and further longitudinal research is needed to clarify these relationships. This review underscores the importance of incorporating dental care into holistic health approaches, advocating for greater collaboration between dental and medical professionals. Public health initiatives promoting regular dental check-ups and preventive care may play a crucial role in improving overall health outcomes.

Developing and implementing a teledentistry educational model in a predoctoral dental program.

Teledentistry (TD) education has become essential to ensure that future dentists acquire the requisite competencies to navigate the evolving landscape of dental care. However, there is a dearth of comprehensive prior research that outlines a specific pedagogy for integrating TD education and training into the predoctoral dental curriculum. This article describes the development and implementation of an innovative TD educational model for predoctoral dental students. The dental public health course for fourth and fifth-year students was redesigned to include a TD educational model, comprising four components: foundational knowledge and case discussions, critical thinking activities, designing TD programs, and hands-on and field training. Student feedback was gathered through a questionnaire. Out of 47 students enrolled in the course, 39 responded to the questionnaire. The feedback was predominantly positive, with most students expressing satisfaction with the instructor's performance, particularly in providing adequate help and feedback. Students felt the TD sessions gave them a solid foundational understanding of TD and helped them grasp its various modalities. However, some students desired more hands-on clinical training and faced time constraints that affected their ability to fully understand the material and complete assignments. Integrating the TD educational model into the predoctoral dental curriculum has significantly improved the learning experience. This model has equipped students with essential practical and hands-on TD experience, preparing them for the dynamic field of dental practice and enabling them to meet the diverse needs of patients in various settings.