Dental Screening Research Articles

Impact of mandatory preoperative dental screening on infective endocarditis in patients undergoing surgical valve replacement

Abstract Background Guidelines recommend preoperative dental screening (PDS) prior to surgical valve replacement (SVR) to reduce risk of prosthetic valve infective endocarditis (IE). However, limited data support these recommendations. Purpose Investigate the effect of mandatory PDS on risk of IE in patients undergoing SVR. Methods A total of 1,207 patients undergoing SVR in Western-Denmark from 2020 to 2022 were included in this observational study. Patients were considered based on two applied PDS practices: mandatory PDS (MPDS), and no routine referral PDS (NPDS). Outcome data were retrieved from Danish registries and adjudicated using medical records. The primary endpoint was incidence of IE. Secondary endpoints were all-cause mortality, and the composite endpoint of IE and all-cause mortality. Key endpoints were also analyzed in a propensity score-matched (PSM) population. Results Of 805 patients in the MPDS, 93% (n=751) underwent subsequent PDS, compared to 5% (n=21) among 402 patients in the NPDS. Patients in the MPDS were older with higher rates of coexisting co-morbidities. During a median follow-up of 2.6 years (interquartile range 1.9-3.2 years), 3.3% (n=40) developed IE. The yearly incidence IE rate was higher in MPDS compared with NPDS (1.5% vs. 0.7%; p=0.08). All-cause mortality rate was higher in the MPDS (2-year mortality of 6.2% vs 2.3%, p=0.02) as well as the composite endpoint (p<0.01). Differences in IE rates, all-cause mortality, but not composite endpoint were abolished in 370 propensity score-matched patients. Conclusion Risk of IE was low regardless of PDS practice. MPDS prior to surgery did not alter the risk of IE or all-cause mortality in patients undergoing left-sided SVR in Denmark.Kaplan-Meier plot

Early dental visit affects dental treatment in Korean preschool children born preterm: a nationwide population-based study

This study investigated the effect of early dental visit on subsequent dental treatments in preterm infants and whether there was a significant difference in dental treatment between children born preterm and full-term (FT). National data from the Health Insurance Review and Assessment Service in Korea were analyzed. Prescription codes related to dental treatments were collected. This study included 3,354,662 patients under age 6 years, who were categorized by gestational age: extremely preterm (EPT), very preterm (VPT), and late preterm (LPT). In the preterm group, the percentage of children with no dental visits was 63.87% although the preterm group visited the dentist earlier than the FT group (EPT = 2.84, VPT = 2.78, LPT = 2.52, FT = 3.9 years old). Glass ionomer and 1-visit pulpectomy were significantly higher in the preterm group than in the FT group (p < 0.001). Preschool children who had their first dental visit after age 2 years received any dental treatment earlier than those who visited the dentist before age 1 year (p < 0.001). Early dental visits in infants may delay the timing of dental treatments and reduce their severity, suggesting the importance of early dental screenings for efficient dental management in preterm infants.

Guidelines Within And For Public Health Services: Results Of An Online Survey On Current Practical Needs

Evidence-based guidelines are recognized and well-established in everyday medical practice. However, in the Public Health Service (PHS), evidence-based guidelines are not yet widely available. To promote the development of guidelines within and for the ÖGD, the Federal Joint Committee (GBA) issued a funding directive in June 2024. This study presents the results of an online survey on the prioritization of guideline topics in the ÖGD, conducted by the German Society for Public Health Services (DGÖG). The survey focused on 17 guideline topics proposed by the GBA, which were divided into six task areas. Out of over 900 participants, comprehensive responses from nearly 500 respondents were analyzed, 85% of whom work in local health departments. The results showed that all 17 guideline topics were assigned high or very high priority. Particularly frequently prioritized were the areas of infection hygiene monitoring, medical expert assessment, and psychosocial emergency care. Additionally, experts highlighted dental screening, health literacy on oral health, and monitoring of drinking and bathing water. The qualitative analysis further identified additional relevant topics, including health reporting and planning, health promotion and prevention, child welfare, as well as crisis management and communication. The survey provides insights into the priority topics for guidelines as perceived by practitioners and ÖGD researchers. The results underscore the significant need for evidence-based guidelines in and for the ÖGD and provide valuable insights for further development and prioritization.

Dental education in nursing schools: A pan-Canadian study

ObjectivesThe aim of this study was to gather data on Canadian nursing programs regarding oral health curriculum and attitudes towards oral health curriculum to evaluate the level of oral health education in nursing programs and provide a reference for understanding dental and oral health in the nursing field. MethodsData to inform models for oral health curriculum in nursing were collected through an online survey using a secured google form. The web-based questionnaire examined main aspects of dental and oral health in nursing educational institutions. Eligibility criteria for this study included faculty members of an accredited nursing program in Canada. ResultsOf the 76 institutions approached, a total of 47 nursing faculty members from 35 nursing programs responded to the online survey. The vast majority (85.1 %) of the participants stated they believe oral health should be taught within nursing programs. Relating to the current curriculum, 70.2 % of the respondents stated their institution currently teaches anatomy relating to the oral cavity, but only 38.3 % reported their institution implemented oral diseases and pathology into the curriculum. Moreover, 48.9 % of the participants noted that dental screening was not covered in the nursing curriculum; 27.7 % of the respondents stated that their institution implemented education regarding gum disease, 25.5 % noted implementing education regarding oral cancer and oral lesions screening. Overall, 80.9 % of the participants noted that future nurses should be educated about oral cancer and disease prevention. However, in order to implement dental and oral health curriculums, participants noted certain needs such as time to implement curriculum (87.2 %) and more knowledge about the topic (83 %). ConclusionsThere is a current lack of content regarding dental and oral health in the curriculum of nursing programs throughout Canada. Due to this deficiency, many nursing graduates lack general knowledge about various aspects of dental and oral health.

Assessment of the Potential Role of Preoperative Dental Clearance in Total Joint Arthroplasty Optimization: A Pilot Study.

Periprosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA) and is associated with significant morbidity, mortality, and cost. This pilot study primarily aimed to investigate if preoperative dental screenings would impact the rate of PJI following TJA when compared to historical controls. Secondarily, this study aimed to evaluate the prevalence of dental pathology in patients undergoing TJA. Charts from 103 consecutive patients undergoing primary or revision total hip arthroplasty (THA, rTHA) or total knee arthroplasty (TKA, rTKA) by a single surgeon at a single academic institution over a two-year period were reviewed and selected for inclusion. All patients were referred to a dentist for preoperative clearance using a standardized form. The rate of dental pathology before surgery, details of the dental intervention required, and any dental work performed within six months postoperatively were evaluated. The demographic and comorbidity composition of our patient population was also collected. Finally, rates of PJI following each type of TJA were obtained for demographic- and comorbidity-matched historical controls from similar study designs to examine the potential impact of preoperative dental intervention. Of the 103 patients, 31 (30.1%) were found to have preoperative dental pathology. Twenty-eight of these 31 patients (90.3%) required dental intervention prior to surgery. Based on demographic- and comorbidity-matched historical data, we expected two (95% CI (0, 6)) PJI cases for the THA group, 0 (95% CI (0, 2)) PJI cases for the TKA group, two (95% CI (0, 5)) PJI cases for the rTHA group, and two (95% CI (0, 5)) PJI cases for the rTKA group. However, in our study, there were no PJIs after any TJA up to the latest follow-up, which was unlikely for THA, rTHA, and rTKA groups given the calculated Poisson probabilities (9.39%, 15.11%, and 11.26%, respectively). Finding 0 cases was likely for the TKA group given the calculated Poisson probability of 72.61%. This pilot study demonstrated that preoperative dental screening, which aims to decrease the chance of PJI due to bacteremia, may have an impact on the rate of PJI following THA, rTKA, and rTHA but not TKA based on Poisson probabilities calculated from demographic- and comorbidity-matched historical controls that lacked preoperative dental screening. For THA, rTKA, and rTHA, the Poisson probabilities of observing 0 cases of PJI postoperatively, as was the case in our study, were unlikely, suggesting that some variable in our cohort was decreasing the PJI rate for these groups. However, in the case of TKA, the Poisson probability of observing 0 cases was likely and matched the results of our study, suggesting that no variable in our cohort was affecting the PJI rate for this group. We cannot draw direct conclusions from this retrospective observational study, but the preliminary findings prompt further investigation through an appropriately controlled, blinded, multi-centered, and powered prospective randomized controlled trial.

Arthroplasty and oral health-an overview

Despite limited evidence for a preoperative dental screening examination and needs-based focal rehabilitation, as well as the need for antibiotic prophylaxis prior to invasive dental procedures, oral health is and remains a relevant topic in arthroplasty. The aspect of oral health should not be neglected in the future in connection with periprosthetic infections and should continue to be the subject of intensive research. The frequency of conspicuous dental findings in middle and old age underlines the importance of this problem. A dental examination prior to arthroplasty implantation can generally contribute to minimizing the risk of arthroplasty infection. It would be desirable for further studies to provide evidence on this topic in order to make recommendations for action. Independently of this, the development of an interdisciplinary guideline (arthroplasty and dentistry) on this topic should be encouraged.This could help to ensure that standardized treatment procedures are integrated into everyday clinical practice across the board.

INDEKS KESEHATAN GIGI SISWA TAMAN KANAK-KANAK DI KELURAHAN MERGOSONO, MALANG

Dental and oral health, especially for children, is often considered a trivial matter. In fact, a healthy oral cavity condition at an early age will support the health of the oral cavity as an adult. The high rate of tooth decay in children should be a concern for parents, teachers and medical personnel. When complex dental and oral abnormalities occur in children, medical treatment causes trauma to their psychological condition, so it is much easier to prevent tooth decay through efforts to improve dental and oral health from an early age. Based on the results of dental and oral screening conducted on kindergarten children in Mergosono, Malang, it was found that the def-t score in children aged 4 years old is in the criteria of high (4,5), 5 years old is very high (7,7) and 6 years old is very high (6,8). The cause of the high incidence of dental caries in kindergarten children is the lack of knowledge about oral health, which can be concluded from the wrong behavior or way of brushing their teeth and the right knowledge about when to brush their teeth. Efforts that can be made to improve this behavior are education which is included in promotive and preventive efforts.

Incidence of Carotid Atheroma in Patients Received Radiotherapy in Neck Field-A Case Series Study

Introduction: Atheroma is a condition that affects various blood vessels, primarily forming at junctions of moderate to large vessels, such as the carotid artery, where it is known as carotid atheroma (CA). Atheroma can lead to myocardial infarction or stroke. Previous studies have shown that head and neck radiotherapy can induce CA, even in young patients. Early diagnosis of atheroma in panoramic views can help prevent ischemic attacks in the brain and potentially save lives. Case Presentation: Thirty-six patients were referred to Semnan Dental School for dental screening by a hematologist-oncologist. An oral medicine specialist ordered panoramic radiographs for each patient, and radiopaque lesions were detected in the para-spinal region in four patients. These lesions were diagnosed as Carotid Atheroma by an Oral and Maxillofacial Radiologist, and this case series was reported. Conclusions: Radiotherapy is a component of treatment for head and neck malignancies and can cause atherosclerosis in carotid junctions. Dentists should monitor panoramic views of patients receiving radiotherapy for any signs of suspicious lesions. If carotid atheroma is detected, the patient should be referred to a cardiovascular specialist for further evaluation and treatment.

Snus Use in Adolescents: A Threat to Oral Health.

Background: Snus consumption is increasingly popular, mainly among the youth, due to the promotion of the tobacco industry and the lack of knowledge regarding its adverse effects. Even though some of its systemic complications are common knowledge, the oral consequences are rarely known. Aim: Therefore, the objective of this study is to evaluate the oral health effects of snus consumption among a highly exposed group of adolescent athletes. Design: Participants received an interactive presentation, followed by interviews and dental screenings by young doctors to establish trust. They were categorized into groups based on the frequency of snus usage. The oral hygiene habits and status, snus consumption habits, and awareness about its adverse effects were evaluated. Results: Statistically significantly (p < 0.05), more regular snus users experience gum bleeding while tooth brushing than nonusers (60% and 37%, p = 0.004). Snus consumption and poor oral hygiene have a cumulative effect on oral health. Some young athletes experience ulcerous oral mucosal lesions coinciding with snus placement. Nonusers exhibit greater awareness of the adverse effects of snus than regular users (27% and 49%). Conclusions: Regular snus use negatively affects oral health, especially the gums. Early education is of the utmost importance in preventing snus usage by raising awareness.

Evaluating Oral Hygiene and Caries Prevalence among Deaf and Hard of Hearing Orphans at Karya Murni Orphanage in Medan

Access to equal oral health attention is the right of all human beings, including orphan children with hearing loss or deaf and hard of hearing (DHH) conditions. Therefore, this study aimed to determine the correlation between the level of oral hygiene and caries indexing among the sub-population of DHH orphans receiving special care at Karya Murni orphanage in Medan City. A cross-sectional design was used with non-probability sampling to select 58 orphans willing to engage in the Oral Hygiene Index-Simplified (OHI-S) and mean of Decayed, Missing, and Filled Permanent Teeth (DMFT) assessment during dental and oral cavity screening after participating in counseling activities. Furthermore, the results showed a positive correlation (p=0.007) between oral hygiene and caries, suggesting that OHI-S impacted DMFT by approximately 34.9%, with both index scores presenting proportional equivalence. There is a need to conduct regular dental health monitoring along with education on visual methods and sign language among DHH orphans. Additionally, DHH orphan caregivers should actively engage in enhancing personal health behaviors, particularly to maintain oral and dental health.

Investigation of Oral Health in Children from Urban Slums of Nairobi, Kenya.

For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral health status of children living in Nairobi slums. A cross-sectional study on school-aged subjects was conducted in June 2022 in three urban slum areas of Nairobi through a pediatric dental screening. The PI (Plaque Index), CPITN (Community Periodontal Index of Treatment Needs), and dmft (decayed, missing, and filled teeth index-deciduous) were considered as primary outcomes of dental health. Multivariate statistical analysis, based on ordinal and zero-inflated negative binomial regression models, was conducted to identify determinants of the oral outcomes in a wide set of potential predictors. A sample of 359 children aged 2-17 was examined. The PI was significantly associated with age, the type of bite, and the use of a toothbrush. The CPITN is influenced by different types of malocclusions, abnormal frenulum, dental trauma, and fluorosis. Dietary habits were found to significantly impact the susceptibility to dental caries. Fluorosis and a dental visit in the last year were highlighted as risk and protective factors, respectively, against higher rates of caries. The oral health features of children living in Nairobi slums are differently affected by socio-demographic conditions, dietary habits, dental characteristics, and oral care practices.

Association of oral frailty with medical expenditure in older Japanese adults: The study of late-stage older adults in Tottori (START Tottori).

This study aimed to determine the association between annual medical expenses and oral frailty in later-stage older adults (aged ≥ 75 years). No studies have investigated the association between medical costs and oral frailty, which would elucidate the association between oral frailty and the deterioration of mental and overall physical function. In this cross-sectional study, 2190 adults (860 men and 1330 women aged 75-94 years) covered by the Medical System for the Elderly and residing in Tottori Prefecture, Japan, between April 2016 and March 2019, were included. Participants were classified into three groups: healthy, pre-orally frail or orally frail, based on dental health screening findings. The medical and dental expenses over the years, number of days of consultations and comorbidities were obtained from the Japanese Health Insurance Claims Database. The number of days of medical and dental consultations and annual medical expenses for outpatient care differed among the three study groups. A significant association was observed between oral frailty and high annual expenses for outpatient medical and dental care. Oral frailty was associated with higher medical expenses in participants with poor masticatory function. Higher and lower dental expenses were associated with subjective poor masticatory function and subjective impairment of swallowing function respectively. Medical and dental expenses for orally frail older adults are high, indicating that oral frailty may be related to the occurrence and severity of diseases other than oral health issues. Future studies should examine the mechanism by which oral weakness affects physical and mental functions.

Can systematic dental examinations or treatments in addition to routine multidisciplinary treatment in a palliative care unit (PCU) improve the quality of life (QoL) and symptom burden (SB) of patients (Pt) receiving palliative care (PC)?

e23163 Background: Pt with advanced cancer who require PC often experience not only common symptoms such as pain, shortness of breath, or nausea, but also oral health and dental problems. In many PC teams, and even in dedicated PCUs, the inclusion of dentists in the Pt care team is rare, resulting in a lack of routine dental screening or treatment. Objectives:To investigate the extent to which Pt admitted to a PCU suffer from oral health or dental problems and to explore the impact of incorporating dentists into inpatient PC, with a focus on improving QoL and reducing SB. Methods: In this monocentric study, data were collected in one PCU over a period of eight months. At admission, T0, Pt underwent both a dental examination and interviews using established questionnaires, the EORTC QLQ-C30 (core, general) and OH 15 (oral health). One week later, at T1, Pt underwent a follow-up examination and interview. The QLQ-C30 is a widely accepted instrument developed to assess health-related QoL in cancer Pt. Results: A total of n = 103 Pt (48.5% women) were enrolled. The median time since the last dental visit was 1 year. The dental status at T0 was worse (Table 1). At T1, statistically and clinically significant changes in oral QoL and SB were observed. Notable changes were observed in OH-QoL score (mean 60.60 vs. 88.40, p &lt; 0.001), sticky saliva (mean 38.10 vs. 11.28, p &lt; 0.001), sensitivity to food and drink (mean 35.25 vs. 8.16, p &lt; 0.001), sore mouth (mean 23.87 vs. 4.98, p &gt; 0.001), and poorly fitting dentures (mean 38.63 vs. 8.07, p &lt; 0.001). Improvements in xerostomia, candidiasis and mucositis were also observed. A confidential survey was administered to both Pt and palliative care staff to assess their satisfaction with the addition of systematic dental care to routine multidisciplinary PC. 97% of respondents indicated a high level of satisfaction with this treatment program. Conclusions: The study underscores the powerful contribution of integrating a dentist into the PC, e.g. in a PCU, resulting in a notable reduction in oral symptom burden. This contributes to improved care status, alleviation of distressing symptoms and ultimately an improvement in QoL. The results strongly support the consideration of dental support (e.g. routine dental screening) as an integral part of PC. [Table: see text]

Retrospective study of a pilot program focused on educating dental patients on human papillomavirus and vaccination in a hospital setting.

Human papillomavirus (HPV) is an epidemic currently affecting 80 million people in the United States. The HPV virus can be passed from one person to another via sexual intercourse, oral sex, open mouth kissing and skin-to-skin contact. In some cases, the infection is not eliminated by the immune system and can cause cancer of the head and neck, cervix, anus, and genitals. There has been a rise in oropharyngeal cancer (OPC) associated with HPV, which can be missed on conventional dental screening examinations. Dentists should engage in promoting HPV vaccination as a primary measure for OPC prevention. The goal of this HPV pilot program was to educate and offer same day HPV vaccination to dental patients by using a multidisciplinary approach in a hospital setting. Patients 18 through 26 years of age who presented to the Erie County Medical Center's dental clinic were approached and educated on HPV. Eligible patients received a direct recommendation for the HPV vaccine. Those interested in same day vaccination were referred to the division of infectious diseases' YOU Center for Wellness. A retrospective chart review was completed for patients who were HPV educated from March 5, 2020, through December 15, 2021. Charts were evaluated for age, sex, race, ethnicity, reason for visit, HPV vaccine referral, and HPV vaccine administration. 326 patients were included in the chart review. The prominent sex, race, and ethnicity were male, Black or African American, and non-Hispanic origin. The median age was 23. Most patients presented to the dental clinic for an emergency visit and were not previously vaccinated against HPV. 110 patients were unvaccinated, and 44 patients were referred to the division of infectious disease for same day vaccination. Of these 44, 24 patients initiated the vaccination process. Five patients received all three doses, three patients received two doses, and 16 patients received one dose. This pilot program successfully vaccinated 24 patients with at least a single dose of the HPV vaccine. This multidisciplinary model can be implemented in other health care settings.

Food insecurity and its relationship to mental health and oral health in older adults.

Poor oral health disproportionately affects low-income older adults, for whom food insecurity and poor mental health may affect dental health. We explored the associations between food insecurity, mental health, and dental health. Furthermore, we examined whether mental health impacted the associations between food insecurity and dental health. We conducted a cross-sectional study with a convenience sample of 226 older adults (aged 50+), employing survey and dental screening data. Participants were recruited from seven community-based organisations in Washington State, USA. We calculated descriptive statistics and conducted Chi-square tests, t tests, and logistic regression analyses to assess the associations between aspects of dental health (untreated decay, gum disease, and unmet dental needs), mental health (depression and cognitive function), and food insecurity. In our sample, food insecurity was observed in 28.4%, 40.6% had untreated decay, 31.6% gum disease, and 42.5% unmet dental needs. Food insecurity was associated with a higher occurrence of untreated decay and unmet dental needs. Participants experiencing food insecurity had higher odds of gum disease (aOR = 2.3; 95% CI: 1.1, 5.2) and unmet dental needs (aOR = 3.2; 95% CI:1.4, 7.6). Greater gum disease due to food insecurity was observed among individuals with lower levels of cognitive impairment. Food insecurity is associated with poorer oral health among older adults and cognitive function may modify this relationship. These findings underscore the importance of addressing both food insecurity and cognitive impairment as integral components of efforts to improve the oral health of older adults.

Modeling perceiving of recommendations provided by clinical decision support system based on predictive modeling within dental preventive screening

Modeling perceiving of recommendations provided by clinical decision support system based on predictive modeling within dental preventive screening

Optimizing dental screening protocols for children with special healthcare needs: Enhancing access and prevention

Children with special healthcare needs face significant barriers to accessing dental care, resulting in higher rates of untreated dental disease and poorer oral health outcomes compared to their peers. Optimizing dental screening protocols tailored to the unique needs of this population is crucial to enhancing access to care and preventing dental disease. This paper explores the challenges in accessing dental care for children with special healthcare needs, reviews current screening protocols, and proposes strategies for optimization. The literature review highlights the multifactorial nature of barriers to care, including socioeconomic factors, physical and cognitive limitations, and cultural considerations. Despite existing challenges, success stories and emerging technologies offer promising avenues for improvement. Multidisciplinary collaboration, tailored screening protocols, technology integration, community outreach, and policy advocacy are identified as key strategies for optimization. The proposed strategies are underpinned by the principles of equity, inclusivity, and person-centered care. Implementation plans include pilot programs, professional training, and integration with existing healthcare systems. Evaluation metrics will assess the effectiveness and sustainability of optimized screening protocols. Expected outcomes include increased access to dental care, reduced prevalence and severity of dental disease, improved oral health-related quality of life, and cost-effectiveness. The conclusion emphasizes the importance of ongoing evaluation and adaptation to meet the evolving needs of children with special healthcare needs. This paper calls for concerted efforts from stakeholders across healthcare, education, policy, and advocacy sectors to implement and support the proposed strategies. By optimizing dental screening protocols, we can make significant strides towards enhancing access to care and improving oral health outcomes for children with special healthcare needs.

Systematic Dental Screening Before Transcatheter Aortic Valve Replacement: A Call to Action!

Transcatheter aortic valve implantation (TAVR) offers an alternative to surgical aortic valve replacement for high-risk patients. Despite its benefits, concerns arise from its association with prosthetic valve endocarditis (PVE), a severe complication. Recent studies indicate a potential higher incidence of PVE in TAVR recipients, especially within the first year postimplantation. A significant proportion of these cases trace back to oral-pharyngeal bacteria. However, no consensus exists on dental screening for TAVR, unlike the standard procedure for surgical aortic valve replacement. Dental screenings could reduce PVE risks and aid in patient recovery. This article underscores the importance of dental screenings, calling for more research to establish its efficacy and systematic application for TAVRI candidates. Collaborative efforts between oral and maxillofacial surgeons and cardiologists are crucial for optimal patient outcomes.

Personalizing dental screening and prevention protocols in dentulous patients with oropharyngeal cancer undergoing radiotherapy: A retrospective cohort study

ObjectivesPatients with head and neck cancer are routinely screened for dental foci prior to radiotherapy (RT) to prevent post- RT tooth extractions associated with an increased risk of osteoradionecrosis. We evaluated the risk factors for post-RT tooth extraction to personalise dental screening and prevention protocols prior to RT. Materials and methodsThis retrospective cohort study included dentulous patients diagnosed with oropharyngeal cancer who had undergone radiation therapy at doses 60–70 Gy and achieved a disease-free survival of ≥ 1 year (N = 174). Risk factors were assessed using Cox regression models. ResultsThe cumulative incidence of post-RT tooth extraction was 30.7 % at 5 years. Main indications for extraction (n = 62) were radiation caries (n = 20) and periodontal disease (n = 27). Risk factors associated (p < 0.05) with radiation caries-related extractions included active smoking, alcohol abuse, poor oral hygiene, parotid gland irradiation, and mandibular irradiation. A high-dose volume in the mandible was associated with periodontal disease events. ConclusionPost-RT extractions due to radiation caries were influenced by lifestyle factors and RT dose in the mandible and parotid glands. Periodontal disease-related extractions were primarily associated with the mandibular dose. During dental screening these post-RT risk factors should be taken into account to prevent osteoradionecrosis.

Barriers and facilitators for oral health screening among tobacco users: a mixed-methods study

ObjectivesTobacco consumption adversely affects general and oral health and is considered one of the significant public health burdens globally. The present study aims to assess the barriers and facilitators for attending oral and dental health screening among tobacco users who seek cessation advice.MethodologyThe present mixed-methods study used group concept mapping (GCM) to identify the facilitators/barriers to attending oral health screening among young adults attending face-to-face and virtual Tobacco Cessation Clinic at King Saud University (Riyadh, Saudi Arabia) between September 2022 and April 2023. Study investigators included healthcare social workers, dental interns, and oral and maxillofacial medicinists. Information about demographics, general health, oral/dental health and tobacco use were collected using self-completed questionnaires. The barriers and facilitators were assessed following GCM by brainstorming, sorting, rating, and interpretation activities. Descriptive, multidimensional scaling and hierarchical cluster analysis were used to describe the study participants and produce concept maps of the generated statements.ResultsThe study included 148 participants who generated 67 statements summarised into 28 statements as facilitators or barriers. Based on a 5-point importance scale, the participants indicated the importance of facilitators under health-related cluster [e.g. when I feel pain] as the highest, followed by personal [e.g. to maintain my mouth hygiene], social [e.g. the quality of treatment] and financial clusters [e.g. the reasonable cost]. Concerning barriers, financial factors [e.g. high cost] acted as the highest-rated barrier, followed by personal [e.g. lack of dental appointments] and health-related [e.g. worry that dental problems will worsen]. The social factors were the least considerable barrier [e.g. lack of time]. Clustering these facilitators/barriers on the concept map indicated their conceptual similarity by an average stress value of 0.23.ConclusionPain was the most important facilitator to attending oral health screening by young adults seeking tobacco cessation advice. Notable barriers included the high cost of dental treatment and the lack of scheduled appointments. Thus, oral health care providers need to consider scheduling periodic and timely dental check-ups to prevent and reduce the burden of tobacco-associated and pain-causing oral diseases.