Introduction: chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, and owing to its increasing global prevalence, poses a serious public health challenge. Patients with CKD frequently experience protein-energy wasting, frailty, sarcopenia, and cachexia, necessitating complex dietary restrictions, including protein, salt, and potassium limitation. Although a nutrition support team (NST) can improve nutritional status in hospitalised patients, additional interventions such as swallowing evaluation, oral care, and medication adjustments are crucial for effective outcomes. CKD is also strongly correlated with periodontal disease and diabetes: tooth loss and oral frailty exacerbate low nutritional intake, especially in older individuals. Objectives: to examine whether NST intervention combined with dental care would enhance nutritional and oral parameters in hospitalised patients referred for dental treatment. Methods: twenty-seven patients were assigned to either an NST-intervention (n = 10) or non-NST (n = 17) groups. We assessed serum albumin, C-reactive protein (CRP), body mass index (BMI), Subjective Global Assessment scores, remaining teeth, periodontal pocket depth, and bleeding on probing. Results: over a 1-month period, both groups showed significant decline in body weight and BMI, whereas albumin, CRP, and periodontal indices did not substantially change. The NST group demonstrated a higher proportion (50 %) of improved carbohydrate intake than the non-NST group (11 %), but this difference was not statistically significant. Reduced appetite was correlated with meal reduction, decreased body weight and meal reduction, and swallowing difficulties. Conclusions: short-term periodontal or NST interventions are insufficient for achieving significant improvements in CKD-associated malnutrition or periodontal status; therefore, more specialised interventions are needed.

Tobacco use and eligibility for lung cancer screening among dental patients at an academic institution in Houston, Texas.

The role of chlorhexidine in oral care for mechanically ventilated elderly patients remains debated, particularly regarding its impact on oral microbiota and clinical outcomes. To compare oral microbiota composition and prognosis among elderly mechanically ventilated patients receiving oral care with either chlorhexidine solution or normal saline. Sixty intubated patients (≥ 65 years) were randomized to receive oral care with 0.12% chlorhexidine (intervention group) or 0.9% saline (control group) three times daily during mechanical ventilation. All patients underwent standardized oral hygiene during mechanical ventilation. Oral samples were analyzed by 16S rRNA sequencing, with outcomes compared to oral health and clinical data. Secondary outcomes included dental plaque index, ventilator-associated pneumonia (VAP), 28-day mortality, patient outcomes, and oral complications. One week after intervention, the chlorhexidine group exhibited a significant decrease in oral bacterial diversity (Simpson index, P = 0.037). Despite this, no significant differences were observed in clinical infection symptoms-defined as fever, purulent airway secretions, elevated white blood cell count, or increased C-reactive protein levels requiring evaluation by the attending physician. All participants received standard ICU antimicrobial prophylaxis or therapy according to institutional protocols; no additional systemic antibiotics were initiated solely for oral or respiratory infections. There were no significant differences between groups in ventilator-associated pneumonia (VAP) incidence (P = 1.000), duration of mechanical ventilation (P = 0.063), ICU stay (P = 0.191), 28-day mortality (P = 0.82), or rates of complications and plaque formation. The chlorhexidine group also showed a decrease in dominant microbial taxa and an increase in specific anaerobic bacteria. Chlorhexidine temporarily altered oral microbiota composition without improving short-term clinical outcomes. Although no infections increased, its potential impact on microbial balance warrants caution, and larger studies are needed to validate these findings. ClinicalTrials.gov ID NCT06691841. Registeration Date 23 September 2022, https://clinicaltrials.gov/study/NCT06691841.

BackgroundEdentulism is a major global burden that contributes to disability and impairment. Globally, edentulous patients frequently receive removable complete dentures because they are still a preferred treatment modality. However, effective adaptation to removable complete dentures remains challenging. This study explored the post-insertion challenges patients present to dental practitioners after receiving and wearing removable complete dentures.MethodsThis was a qualitative exploratory study conducted at Makerere University Dental Hospital in Kampala, Uganda. Twenty-five key informant interviews were conducted with dental surgeons and dental technologists, who were purposively selected based on their training, years of practice and roles in removable complete denture fabrication and fitting. Audio recordings were transcribed verbatim. Data were analyzed using inductive thematic analysis. The analysis was managed using NVivo software.ResultsDental technologists and dental surgeons revealed that patients commonly reported substantial post-insertion challenges like pain and discomfort, drooling, difficulty speaking, eating, oral hygiene and salivating. They also noted that patients’ confidence and self-esteem were severely influenced by their displeasure with the way their dentures looked. Furthermore, they stated that patients frequently experienced denture instability. Dental technologists and dental surgeons reported providing post-insertion advice on hygiene, oral care adaptation. They encouraged patients to keep wearing their dentures despite all inconveniences and assured them that they would eventually get used and become comfortable with wearing the dentures.ConclusionPatients presented several post insertion challenges relating to pain, discomfort, speech, drooling, salivating and hygiene which consequently affected their self-esteem. Post insertion advice and assurance was key in restoring confidence to patients to adapt to the removable complete dentures.

Impact of Oral Habits on Malocclusion in Pediatric Dental Patients: A Dental Educational Institute-based Cross-sectional Observational Study

Background: The oral stereognostic ability (OSA) examines an individual's oral functioning and determines how patients respond to various dental therapy. Natural tooth loss may result in a reduction in oral perception. Reduced oral perception has been linked to cognitive deterioration in the elderly. The aim of this study was to assess the oral stereognostic ability among dental implant patients in relation to cognition status and compare them with partially edentulous and fully dentate patients. Material and method: The study group included 90 dental implant patients aged 50-60 years old compared with partially edentulous and fully dentate patients. Five different test samples were used to assess the oral stereognostic ability including (cubic, circle, pyramid, star and cross). The criteria for the assessment of oral stereognostic ability were the time required for the patient to recognize the shape of the samples. The cognition status was assessed using the Self-Administered Gero-cognitive Examination (SAGE) test according to which the participants were divided into two groups poor and good. Data were statistically analyzed using SPSS 22, Chicago, Illinois, USA. Results: The mean time is taken to recognize the shape of all samples was less in the fully dentate group followed by the implant group and then the partially edentulous group with a statistically significant difference. Concerning the cognition status, the mean time taken to distinguish the shape of all sample were significantly higher among person with poor than good cognitive status for implant, partially edentulous and fully dentate groups. Conclusion: The results of the current research revealed that loss of natural teeth decreases both cognitive status and oral perception represented by oral stereognosis ability as the oral stereognosis of partially edentulous subjects was significantly poorer than that of fully dentate subjects.

Background: There is a limited amount of published research on the dimensionality and reliability of the Epworth Sleepiness Scale (ESS) questionnaire for adult patients referred for oral appliance therapy. This information is crucial for dentists, who often lack objective measures of sleep-disordered breathing (SDB) during titration process of an oral appliance. This study investigated the dimensionality and reliability of ESS scores in adult dental patients with SDB undergoing oral appliance treatment. Methods: In 103 dental patients with SDB referred by a physician (mean age: 52.3 ± 13.0 years; 35% female), the dimensionality of the ESS was investigated using exploratory (EFA) and confirmatory factor analyses (CFA) to determine how many scores are needed to characterize the construct. ESS questionnaires were administered twice before treatment. Internal consistency and test-retest reliability were assessed. Results: Horn’s parallel analysis suggested a one-factor model. Extracting one factor and standardizing loadings led to strong loadings for all items, ranging from 0.53 to 0.82. The fit indices indicated a good model fit (Comparative Fit Index = 0.999, Root Mean Square Error of Approximation = 0.020, and Standardized Root Mean Square Residual = 0.064). Cronbach’s alpha with 95% confidence interval (CI) was 0.85 (0.82–0.88), indicating strong internal consistency. The intraclass correlation coefficient type 2,1 (95% CI) was 0.86 (0.79–0.90), and the weighted kappa ranged from 0.50 to 0.81. Conclusions: In this patient population, the ESS reliably characterizes excessive daytime sleepiness with a single score and appears suitable for individual assessment in dental patients undergoing oral appliance treatment for SDB.

Advances in dental technology have improved treatment quality but increased costs. In Poland, where the scope of services reimbursed by the National Health Fund (NFZ) is limited, the cost of dental treatment can be a financial barrier - especially for lower-income patients, particularly for older adults. The aim of this study was to analyze how income levels affect patients' awareness of dental treatment costs and their decisions regarding available treatment options. A cross-sectional survey of 282 participants (dental patients, medical students, healthcare and education professionals, and their families) was conducted from late 2023 to early 2024. Data from a self administered questionnaire were analyzed in Python using chi-square tests, Cramér's V, and phi coefficients (p < 0.05). Income was dichotomized (<PLN 3,500 vs. >PLN 3,500) when necessary. Lower-income patients (<PLN 3,500) were more likely to postpone check-ups due to cost (24.8% vs. 13.1%, p = 0.03) and preferred NHF-covered treatments, whereas higher-income individuals opted for private care. No significant associations were found regarding awareness of NHF benefits, installment usage, or treatment withdrawal rates. Income significantly affects dental care utilization, influencing check-up postponement and treatment choices. However, weak correlations suggest other factors - such as health awareness, service quality and appointment availability - also play key roles.

While full-coverage crowns are the conventional solution for restoring severely compromised vertical distance of occlusion restoration, this approach is inherently invasive. This report details a conservative alternative using veneers in a dental fluorosis patient - a clinical scenario seldom documented in developed regions. A 57-year-old patient from a high-fluoride area presented with impaired masticatory function and severe occlusal wear. Severe attrition of the upper and lower dentition. Severe dental fluorosis. A minimally invasive protocol was selected, involving the restoration of the vertical dimension and occlusal function with veneers. This case demonstrates that minimally invasive veneer rehabilitation can successfully manage severe occlusal wear in dental fluorosis, reestablishing functional occlusion and aesthetics while preserving vital tooth structure. It represents a viable, tooth-preserving alternative to conventional full-coverage crowns. Compared to traditional full-coverage crowns, the presented minimally invasive approach offers the distinct advantage of preserving sound tooth structure, which is a cornerstone of contemporary adhesive dentistry. This is particularly pertinent for fluorotic teeth, where maximizing the retention of healthy enamel is desirable.

A bstract Objective: This study compared conventional rubber dam (CRD) and OptiDam isolation systems during routine dental procedures, exploring both operator and patient perspectives. Materials and Methods: A total of 114 patients were randomly allocated to either CRD ( n = 57) or OptiDam ( n = 57) groups. After watching a standardized instructional video, procedures were performed by dental students at Umm Al-Qura University. Placement time was recorded, and patient comfort was reported by both the operator and patient using the visual analog scale. Structured questionnaires recorded demographics, operator preference, and patient satisfaction after treatment. Statistical analysis was performed at α &lt; 0.05. Results: Both systems were applied within comparable time frames. However, 65 of 114 operators (57%) preferred the OptiDam over CRD ( P &lt; 0.05). The ease of use was the main reason for preferring OptiDam (31%), while availability was the main reason for selecting CRD (23%). Patients reported significantly greater comfort with OptiDam (1.40 ± 1.69) compared to (3.08 ± 2.39) CRD ( P &lt; 0.001). Operator-assessed comfort ratings were consistent with these findings: OptiDam: 1.40 ± 1.69 versus CRD: 2.96 ± 2.30 ( P &lt; 0.001). No statistical differences were observed between groups in relation to the operator, patient, and treatment variables. Conclusion: OptiDam offers clear advantages in ease of use, operator preference, and patient comfort, supporting its value in clinical settings. However, competence in CRD application remains critical as it continues to serve as the standard method for dental isolation.

Leveraging large language models for patient instructions in dentistry-A systematic review and meta-analysis.

Articulation plays a crucial role in dental function, yet existing classification systems lack comprehensiveness, limiting their clinical and research applications. The aim of this study was to propose a new articulation classification to improve clinical practice and research, enhancing the diagnosis and treatment of occlusal problems, ultimately leading to better dental care and patient outcomes. Occlusal contacts were recorded using 8-micron shim stock during static and dynamic jaw movements. All positive occlusal contacts in the lower arch were recorded, then categorized according to articulation classification principles based on tooth contact counts and patterns of occlusal stability. The classification encompasses intercuspal position, centric relation, right/left excursions, and protrusion, introducing articulation ratios as quantitative tools. The proposed classification included four main classes and two divisions: Class I, Class II Division 1, Class II Division 2, Class III Division 1, Class III Division 2, and Class IV. Additionally, articulation ratios were introduced as quantitative tools for further analysis of occlusal issues in relation to other factors. This classification enhances the identification and analysis of occlusal conditions, offering a standardized approach for both clinical and research applications. It facilitates a more precise understanding of occlusal problems.

Amelogenesis imperfecta (AI) is a hereditary disorder that compromises the formation of dental enamel, affecting function, esthetics, and patients’ quality of life. This narrative review aimed to synthesize the main restorative and functional strategies described in the literature for managing AI. The literature search was conducted in the PubMed database, prioritizing publications from the past five years. The analyzed studies show that, in primary and mixed dentition, provisional treatment with stainless-steel crowns and direct restorations is essential to protect dental structure and preserve the vertical dimension of occlusion. In adolescents and young adults, direct and indirect restorative options, such as prefabricated veneers and ceramic crowns, provide good esthetic and functional outcomes. In more complex cases, full-mouth rehabilitation with an increased vertical dimension—especially using lithium disilicate crowns—demonstrates high predictability and durability. The literature also highlights the importance of a multidisciplinary approach and longitudinal planning. It is concluded that AI treatment must be individualized, considering age, phenotype severity, and functional demands, prioritizing structural preservation, esthetics, and full restoration of oral function.

Background and Objectives: This study was conducted in order to develop and validate the Latvian version of the Orofacial Aesthetic Scale (OES-LV) and to assess its psychometric properties in patients with aesthetic, functional or no treatment needs. Materials and Methods: The English version of the OES was translated into Latvian following international guidelines for establishing cultural equivalency of instruments. The test group consisted of 101 subjects comprised of those without treatment requirement, with functional impairment (tooth loss) and with aesthetic treatment needs. Internal consistency, test–retest reliability and convergent validity were investigated. Responsiveness was not tested in the current study. Results: The test–retest assessment of this study was performed on 31 subjects and showed intra-class correlation coefficients ranging from 0.80 to 0.81, which was considered to be good. Cronbach’s α was 0.91, demonstrating the strong internal consistency of the scale. Spearman’s rank correlation coefficients between the OHIP and OES scores varied across subgroups, ranging from −0.35 to −0.57 and showed a negative correlation between OES-LV and selected OHIP items. Conclusions: The Latvian OES demonstrated strong psychometric properties, supporting its use in assessing self-perceived orofacial aesthetics, clinical research, prosthodontic evaluation and dental education. Further studies on responsiveness are recommended.

This study aims to evaluate the effectiveness and applicability of the IOSN (Indicator of Sedation Need, IOSN) tool in assessing dental anxiety and sedation needs among Chinese patients undergoing common dental treatments. This cross-sectional study enrolled 153 adult patients from the Painless Dental Center at Peking Union Medical College Hospital after ethical approval. Participants completed a structured Chinese questionnaire including personal/clinical data, the translated IOSN scale, and evaluation of received anesthesia. Descriptive statistics, two-way ANOVA, and Kappa analysis were used to assess differences and agreement. The mean age was 39.5 ± 13.8 years; 75.2% were female. Significant differences in IOSN scores were observed across anesthesia types (P < 0.001), gender (P = 0.048), and treatment type (P = 0.016). The majority (94.8%) rated their anesthesia as appropriate. The Kappa statistic showed moderate agreement (κ = 0.4615) between IOSN-based sedation recommendations and the adjusted ideal anesthesia plan, indicating that the tool effectively identifies patients who may benefit from sedation. The IOSN tool shows preliminary potential in assessing sedation needs among Chinese dental patients, though further validation is required. The study was registered in the Chinese Clinical Trial Registry (no. ChiCTR2300074190). Registered on 1/8/2023.

Вступ. Актуальність дослідження зумовлена зростанням рівня тривожності у населення, зокрема серед стоматологічних пацієнтів, що часто залишається поза увагою медичного персоналу. Вивчення психологічних чинників, які впливають на рівень тривожності у стоматологічних пацієнтів, є важливою умовою для розвитку психологічно чутливого підходу до надання медичної допомоги. Мета: виявлення впливу інтерособистісних чинників – попереднього досвіду стоматологічного лікування та сімейних установок – на рівень і види тривожності у стоматологічних пацієнтів. Методи: «Модифікована шкала Нормана Кора» (MDAS), авторська анкета та шкала реактивної й особистісної тривожності Ч.Д. Спілбергера для оцінки психоемоційного стану респондентів. Для статистичної обробки результатів застосовано критерій Краскела-Уолліса та тест DSCF для парних порівнянь. Результати. Виявлено, що ключовим чинником розвитку страху перед стоматологічними втручаннями є негативний попередній досвід пацієнтів –особливо, якщо він був повторюваним або наявним у дитинстві. Також було встановлено, що конфлікт із лікарем-стоматологом значно впливає на ситуативну тривожність. Водночас неспецифічний негативний медичний досвід, не пов’язаний безпосередньо зі стоматологією, не виявив статистично значущого впливу. Доведено, що серед сімейних чинників найбільш впливовим виявився досвід батьків щодо лікування зубів: якщо цей досвід був негативним, то діти демонстрували підвищений рівень страху. Висновки. Отримані результати мають практичну значущість для розробки психопрофілактичних програм у стоматологічній практиці, а також вказують на потребу залучення психолога до міждисциплінарної команди медичних фахівців. Перспективами подальших досліджень є розробка інтервенцій, спрямованих на подолання страху стоматологічного лікування через зміну когнітивних схем, впровадження психоедукації для батьків та пацієнтів, а також дослідження ролі соціального навчання в передачі страхів.

The COVID-19 pandemic had a profound impact on dental practices worldwide, and the University Clinical Dentistry Center of Kosovo was no exception. This study aimed to investigate the effect of the pandemic on dental practice, patient management, and antibiotic use in the absence of routine dental care. In March 2020, Kosovo's Ministry of Health mandated the suspension of non-emergency dental services to mitigate the spread of the virus, which led to an increased reliance on antibiotics to manage dental infections remotely. This qualitative study used semi-structured interviews with 16 dentists working at UCDCK, all with more than 10 years of experience, to explore the effects of the pandemic on dental practice, patient management, and antibiotic prescribing. Interview data were thematically analyzed, and findings were supplemented with antibiotic prescription trends from 2019 to 2022. During the suspension of services mandated in March 2020, the study found that 75% of dentists admitted to prescribing antibiotics as a preventive measure during the service suspension, driven by concerns about the potential for escalating infections without in-person care. Patients also exerted pressure on dentists to prescribe antibiotics during this period. The reliance on antibiotics raised concerns about antimicrobial resistance, which was exacerbated by the lack of clear prescribing guidelines. The data showed an increase in antibiotic prescriptions during the peak of the pandemic, particularly Penicillin, with a slight decline once routine dental services resumed. The COVID-19 pandemic disrupted dental services at UCDCK, resulting in worsened patient oral health, ethical challenges for practitioners, and increased reliance on antibiotics. These findings underscore the urgent need for clear antibiotic stewardship protocols, robust infection control measures, and the integration of tele-dentistry to improve resilience in future crises.

Introduction: The prevalence of Periodontal diseases is a global epidemic, and several preventive and therapeutic procedures are carried out to curb it. Manual and ultrasonic scaling of teeth to remove supragingival deposits is one of the most executed procedures worldwide, but this is not without some unpleasant experience for the patients. Objective: This study is to investigate patients' experience during the dental scaling procedure and to determine their perception of effectiveness between manual and ultrasonic scaling methods. Methodology: The study involved 124 patients who presented at the Periodontology Department of the Dental Centre at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos. Data was collected with a self-administered questionnaire to obtain the sociodemographic parameters. The patients' experience, with both manual and ultrasonic scaling, was assessed, and their preference and recommendation for either was recorded with the questionnaire. Data analysis was carried out using SPSS version 24. For descriptive variables that are continuous, the mean and measures of variability were determined. Simple frequency and percentages were determined for categorical variables. Bivariate analysis was done using a Pearson's chi-square or Fisher's exact as appropriate for the independent variables and the variables which assess the patients' perception of effectiveness for manual or ultrasonic scaling. Statistical significance was determined at p≤ 0.05. Results The mean age of the subjects is 40.1 ± 16.5 years, with an age range of 14 to 78 years. The mean oral hygiene score was 1.96±0.82. The majority of the subjects were in the 20-29 years age group. The professionals were the most, 48(38.7%), followed by the skilled workers, 36(29%). Ten (8.1%) reported that manual is more effective compared to 114(91.9%) who reported that ultrasonic scaling is more effective. The preference for ultrasonic scaling was consistent and profound in all the determinant parameters assessed, although only the occupation of the subjects was significant (p = 0.02). Conclusion: It is evident from this study that most of the patients prefer ultrasonic scaling to manual. This emphasises pre-scaling counselling and motivation of the patients while also spelling out the possible unpleasant experience that may accompany the procedure. The provision of ultrasonic scalers by the health authorities will also benefit most dental patients who prefer their use.

Massouda J, Ghaltakhchyan N, Judd J, Bocklage C, Selden R, TumSuden O, Nanney E, Lee J, Ginnis J, Strauman T, Sawicki C, Hodges EA, Graves C, Divaris K, Jacox L. Evaluating effects of animal-assisted therapy on paediatric dental care patients: A pilot clinical trial. J Am Dent Assoc. 2025;156:447-457. https://doi.org/10.1016/j.adaj.2025.03.006 DATA SOURCES: This commentary is based on the published pilot clinical trial by Massouda et al. (2025) evaluating animal-assisted therapy (AAT) in paediatric dental care. The study included children aged 7-14 undergoing invasive dental procedures, allocated to either an AAT or control group. Outcome measures included validated self-reported anxiety and pain scales, physiological stress markers, and behavioural observations. Data was synthesised narratively given pilot design and small sample size. A prospective, non-randomised pilot trial carried out in a university paediatric dental setting assessed the practicality and initial effects of integrating animal-assisted therapy (AAT) into dental treatment. Thirty-nine children aged 7-14 years scheduled for invasive dental procedures were enroled. Participants were allocated to an AAT group (n = 18) or a control group (n = 21). Inclusion criteria included the ability to assent and a willingness to interact with a certified therapy animal. Exclusion criteria included previous traumatic experiences with AAT, or significant developmental or behavioural disorders affecting cooperation. Physiological and psychological measures were recorded at baseline, during treatment, and post-operatively. Primary outcomes included self-reported pain and anxiety scores using validated scales. Secondary outcomes included heart rate monitoring, salivary cortisol, α-amylase, and video-coded behavioural relaxation. Given the small sample size, statistical analyses employed nonparametric 35 tests with significance set at P < 0.05. Children exposed to the therapy dog reported significantly lower postoperative pain scores (P = 0.001) and demonstrated smaller heart rate fluctuations during stressful procedural moments, suggesting lower physiological stress responses. Behavioural observations indicated longer periods of relaxed posture in the AAT group, though this did not reach statistical significance (P = 0.204). No significant differences were detected in salivary cortisol or α-amylase. AAT was reported as safe, well-tolerated, and feasible to implement. AAT shows potential for reducing distress in paediatric dental settings, but larger, randomised studies are required. Within the limits of a pilot design, animal-assisted therapy may reduce pain and physiological stress in paediatric dental patients. While encouraging, larger randomised trials are needed to confirm these effects, explore mechanisms, and assess practicality and cost in routine dental practice.

Validity and reliability of digital occlusal analyzing methods in Dentistry. A systematic review.