People living with mental illness experience significantly poorer oral health compared with the general population, yet oral hygiene behaviours are often overlooked in mental health care. This mixed-methods study explored behavioural drivers of daily toothbrushing among mental health consumers and their care coordinators, using the Capability, Opportunity, Motivation - Behaviour framework. Participants from two community mental health centres engaged in an oral health program that included education, oral health assessments, plaque disclosure and brushing diaries to support routine-building. Follow ups at 4 and 8weeks reinforced habit formation. Semi-structured interviews were conducted with consumers and care coordinators. Quantitative data, including the Treatment Self-Regulation Questionnaire, Perceived Competence Scale, plaque score and oral health knowledge, were drawn from a preceding feasibility study to support triangulation of findings. Data were analysed using a hybrid inductive-deductive approach guided by the Capability, Opportunity, Motivation - Behaviour framework. Consumers described psychological barriers, such as forgetfulness, low mood and cognitive overload, that disrupted oral hygiene routines. Visual and hands-on tools, such as animated videos and plaque disclosure, enhanced motivation. Linking toothbrushing with existing routines, such as taking medication, emerged as a practical enabler through habit stacking. Care coordinators highlighted the importance of social support, structured prompts and environmental cues. Quantitative findings aligned with qualitative insights, underscoring the importance of autonomous motivation and perceived competence in supporting behavioural change. Integrating oral health promotion into routine mental health care through person-centred, behavioural strategies appears to support oral health practices and may reduce health disparities in this vulnerable population.

People in custodial settings are disproportionately affected by, often preventable, oral diseases. Addressing oral health inequities is vital to achieving the United Nations Sustainable Development Goals and Universal Health Coverage by 2030. Obstacles to achieving Universal Health Coverage for oral health in the custodial context include the deficit of oral health professionals in such settings. Innovative workforce models of non-dental professionals are recommended to integrate oral health into routine custodial care. Despite this, no comprehensive review has been undertaken to synthesise the evidence relating to the role of non-dental professionals working in custodial settings in providing oral health promotion. A scoping review, focusing on non-dental professionals working in custodial settings, was conducted from the data of database inception until 3 April 2024 examining oral health knowledge, attitudes and practices; availability of guidelines/recommendations; and oral health-related interventions. We conducted a comprehensive search for indexed and grey literature and initiated a global call for data. Twenty-three sources of evidence from high-income countries (Australia, United Kingdom [UK], United States [USA]) met our inclusion criteria. Guidelines/recommendations defining the role of non-dental professionals in oral health promotion were located (n=15), yet translation into clinical practice may be variable given the few practices located (n=8). Nurses, physicians, and correctional officers were primarily involved in some aspect of oral health education, screening, treatment, and referral, highlighting the importance of interprofessional collaboration. Oral health-related knowledge was limited among nurses (n=1) yet nurses may be receptive to potential training (n=1). Nine interventions focussed on oral health-related prevention and management, including in-service training, resources, officer escort program, motivational interviewing and whole of prison education program, yet only three were evaluated. Correctional professionals reported oral health-related education and training as feasible, acceptable, and improved their knowledge, attitudes, and behaviours. Integrating essential oral health care into routine care among people in custodial settings needs to be prioritised. Championing the workforce reform agenda by strengthening and diversifying the oral health workforce in custodial settings can achieve this. Further research is required to explore innovative models of care involving non-dental professionals working in custodial settings. The protocol was registered with the Open Science Framework (OSF) (DOI 10.17605/OSF.IO/GPY76) before the review was conducted.

Oral health is fundamental to overall well-being, as it influences physical health, social confidence, mental stability, and daily functioning. Public Health Dentistry (PHD) addresses oral health at the population level by developing strategies to improve access and outcomes. This narrative review examines the current state, challenges, and opportunities in PHD in India. It incorporates peerreviewed literature as well as policy documents and strategic reports from relevant government health agencies and professional dental organisations to ensure contextual relevance and completeness. The review highlights key areas, including workforce distribution, oral health awareness, mobile dental services, and community outreach. However, persistent challenges such as insufficient manpower, limited funding and a lack of integrated policies continue to pose significant obstacles. Disparities in access to dental care between urban and rural areas underscore the need for targeted interventions to address these inequities. The review emphasises the importance of a robust national oral health policy, integrating oral health care into general health services, and fostering interdisciplinary collaboration. Newer techniques, such as teledentistry and mobile health applications, have the potential to address service deficiencies, particularly in remote or isolated areas. Enhancing community-based oral health education and targeted prevention can lead to lasting improvements in population oral health. Coordinated action among government agencies, academic institutions, and local health systems is crucial to maintain service delivery that is reliable, accessible, and sustainable. A community-centered and equitable approach is essential for reducing the prevalence of oral illnesses in India. Overall, aligning public health priorities with oral health needs can contribute to meaningful and long-term improvements in national health outcomes.

Oral health is an important aspect of overall well-being, especially for frail older people, who are increasingly ageing in place. As this population with associated complex health care needs grows, integrated and collaborative oral health care becomes more urgent. Despite its importance, oral health is often overlooked in both practice and policy. This study aims to identify barriers and facilitators at the micro, meso, and macro levels to improve interprofessional collaboration for oral health care of frail, community-dwelling older people. This qualitative study was conducted in the Netherlands and comprised two data collection methods: six semistructured interviews and five discipline-specific focus group discussions, involving a total of 38 health care professionals. Each focus group consisted of professionals from a single discipline, including oral health care professionals, general practitioners, home care professionals, pharmacists, and public health professionals. Participants represented health care professionals both within nationally recognized integrated geriatric care networks and those not yet participating in such networks. Data were analysed inductively using thematic analysis in Atlas.ti. At the micro level, barriers included limited awareness, knowledge, and prioritization of oral health, unclear responsibilities, time constraints, and inconsistent referral pathways. At the meso level, participants reported insufficient standardized protocols, lack of interprofessional education, and poor digital integration of medical record systems. At the macro level, key issues were inadequate funding and reimbursement, fragmented policies, and limited support for home-based oral care. Facilitators at the micro and meso level included raising awareness and interprofessional education, practical tools and clear referral pathways, improved ICT systems, and appointing regional coordinators to strengthen multidisciplinary collaboration. At the macro level, national guidance and structural financial incentives were viewed as crucial for sustainable integration. In conclusion, this study, identified critical barriers and facilitators for effective interprofessional collaboration and better oral health care for community-dwelling frail older people at the micro, meso, and macro levels. Improvement requires increasing awareness and education among professionals, better integration of oral health care in multidisciplinary care networks, shared electronic medical record systems, and adequate reimbursement. These findings should inform guidelines and be validated through implementation studies.

Design and evaluation of an oral health booklet during pregnancy

While adult oral health has been consistently linked to cardiovascular disease, the long-term impact of childhood oral health remains underexplored. Thus, we investigated the association between dental caries and gingivitis in childhood and the incidence of atherosclerotic cardiovascular disease (ASCVD) in adulthood. This nationwide Danish cohort study included 568,778 individuals born between 1963 and 1972, with oral health data from the National Child Odontology Registry (1972-1987) and ASCVD outcomes from the National Patient Register (1995-2018). Dental caries and gingivitis were categorized by severity and trajectory across childhood. Cox regression models stratified by sex, education level, and type 2 diabetes status were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for incident ischemic heart disease, myocardial infarction, and ischemic stroke. Severe childhood dental caries was associated with increased ASCVD incidence in both males (HR 1.32; 95% CI: 1.18-1.50) and females (HR 1.45; 95% CI: 1.25-1.68). High gingivitis scores also predicted elevated ASCVD risk (males: HR 1.21; 95% CI: 1.10-1.32; females: HR 1.31; 95% CI: 1.14-1.50). Disease trajectories with moderate to severe level oral disease and oral health deterioration were significantly associated with higher ASCVD incidence. Within the limitations of this study, poor childhood oral health, particularly persistent or worsening dental caries and gingivitis, is associated with an increased risk of ASCVD in adulthood. These findings highlight the potential of early oral health interventions in reducing long-term cardiovascular risk.

A Meta-analysis of Oral Health Interventions in Children: Impacts on Knowledge, Behaviour, and Clinical Outcomes.

Sickle cell disease (SCD) is a chronic genetic disorder causing severe pain, anemia, and systemic complications that negatively affect patients' physical and mental well-being. The aim of this global cross-sectional study was to evaluate the relationship between oral pain medication (OPM) use frequency and health outcomes, emotional well-being, social participation, and satisfaction with care among people with SCD. Data were collected via an online survey across five continents from February to September 2024. A total of 123 participants were divided into two groups based on OPM use frequency: weekly or more (n=62) and once or twice a month (n=61). Participants in OPM weekly group reported poorer self-rated health, shortness of breath, more frequent hospitalizations, and missed school days due to SCD crises compared to the monthly group (p<0.05). However, use of treatments such as hydroxyurea and preventive screenings like transcranial Doppler was similar across groups. Emotional well-being also significantly differed in the weekly group, with lower happiness levels, difficulty in emotional regulation, and reduced social participation (p<0.01). Satisfaction with medical care was significantly lower among weekly OPM users (p<0.001). These findings suggest that higher OPM use is associated with poorer physical, emotional, and social outcomes. The results highlight the importance of comprehensive and multidisciplinary care approaches that may support the overall well-being of individuals with SCD and utilize OPM as a relevant clinical metric to assess disease burden in SCD. The authors have confirmed clinical trial registration is not needed for this submission.

Is Online Oriented-Centred Information About Dry Mouth Trustworthy? An Infodemiologic Study.

Introduction: The oral cavity is the second largest microbial niche in the human body, following the gut. The colonisation of microorganisms on the teeth and gums harbours harmful bacteria, which can trigger inflammation, potentially leading to periodontal breakdown and tooth loss. To eliminate bacterial biofilms, several methods are employed. Among these, the most effective are chemical methods, which include antiseptic and antimicrobial agents. Although these agents can have potential benefits, they also come with side-effects. To minimise the sideeffects of chemical-based plaque control, there is a paradigm shift towards herbal alternatives. One such plant known for its medicinal properties is Commiphora myrrha, which possesses antimicrobial properties that improve plaque control. Aim: To assess the efficacy of Commiphora myrrha in the management of gingivitis. Materials and Methods: A comprehensive search was conducted using Medline via PubMed, Cochrane, ProQuest and Google Scholar. The combination of keywords used was: Myrrh OR Commiphora myrrha OR Herbal extract AND Gingivitis AND Plaque AND Inflammation, Myrrh AND Commiphora myrrha AND Gingivitis. Articles published from January 1, 2014, to December 31, 2024, were included to identify the efficacy of Commiphora myrrha in the management of gingivitis. After a thorough search, a total of five articles were included in the review. The inclusion criteria were: patients aged between 18-35 years, signs of chronic gingivitis in at least six sites, Bleeding on Probing (BOP) and periodontal pockets with a depth of no more than 3 mm. Exclusion criteria included patients with periodontal pockets greater than 3 mm, those with severe malocclusion, use of antibiotic or anti-inflammatory medication, pregnant or breastfeeding women, oral prophylaxis in the past six months, a history of allergy to chemical or herbal products and patients using smoking or smokeless tobacco. The reporting of this systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment of the studies was performed using the Cochrane risk of bias assessment tool for Randomised Controlled Trials (RCT), the Risk of Bias in Non randomised Studies (ROBINS) tool for non randomised trials and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results: A total of five studies were included (four randomised and one non randomised controlled trial), comprising 166 patients who met the inclusion criteria. One of these studies was conducted in India, three in the Kingdom of Saudi Arabia and one in Egypt. Diagnoses in all five studies were based on clinical and histological examination. The p-values of the included studies were as follows: p&lt;0.006, p&lt;0.05, p=0.08, p&lt;0.001 and Zahid p&gt;0.05. All five studies found Commiphora myrrha to be effective in reducing gingival inflammation, with results comparable to chemical plaque control and minimal side-effects. Therefore, Commiphora myrrha shows promise as an effective adjunct therapy for managing gingivitis. Conclusion: The present systematic review demonstrates that Commiphora myrrha exhibits significant anti-inflammatory properties. When used in combination with other oral healthcare regimens, Commiphora myrrha could offer beneficial effects in improving overall oral health and managing gingivitis.

This in vitro pilot study evaluated the effects of two professional cleansing protocols on surface roughness and color stability of various resins for complete dentures. 50 resin specimens were prepared and divided into five groups (n = 10): Probase Hot (PH, Ivoclar AG), IvoBase CAD (IBC, Ivoclar AG), Ivotion Dent (ID, Ivoclar AG), Dima Print Denture Base (DPDB, Kulzer), and Dima Print Denture Teeth (DPDT, Kulzer). After a 7-day immersion in coffee solution, two cleansing protocols were applied: a chemical one using an alkaline solution, and a combined mechanical+chemical one involving an acid-based cleaning agent with a rotating needle device followed by the same chemical protocol. Surface roughness was measured before and after cleaning using a structured light profilometer (Confovis) connected to a microscope (Eclipse LV150N, Nikon). Color stability was assessed with a colorimeter (Easy_Color, SmartVision). One specimen per group underwent SEM analysis at baseline and after both protocols. The data analysis was performed by using Kruskal-Wallis test and post-hoc Dunn test for comparison. Surface roughness was not significantly affected by either protocol (p>0.05). All ΔE values were below the perceptibility threshold (ΔE<1.2), except for ID after both the chemical (ΔE = 2.28) and the mechanical+chemical protocol (ΔE = 2.39) and DPDB after both the chemical (ΔE = 2.06) and the mechanical+chemical protocol (ΔE = 2.33). Surface roughness and color stability of PMMA resins were not affected by the tested cleansing protocols, so they could be used by clinician during the periodically control visit. The proposed cleansing protocols help preserve the long-term aesthetic and functional integrity of dentures, enhancing patient satisfaction and oral health.

In Vitro Antimicrobial Effect of Tetrahydrocannabinol on Streptococcus mutans and Its Anticariogenic Potential.

Anticariogenic potential, phytochemical and molecular docking analysis of Momordica charantia: An in vitro study.

Introduction: Odontogenic Infections (ODIs) are common, originating from dental or supporting structures, often presenting as periapical abscesses, pericoronitis, or periodontal abscesses, and are polymicrobial in nature and often require antibiotic treatment. If left untreated, they can lead to severe complications. Most ODIs can be managed with local treatments, and antibiotics are only recommended when systemic symptoms are present, to prevent Antimicrobial Resistance (AMR). Despite clear guidelines, inappropriate antibiotic prescribing remains widespread in dental practice, contributing significantly to the growing burden of AMR, especially in countries like India. Aim: To understand the Knowledge, Attitudes, and Practices (KAP) of Indian dentists in treating ODIs. Materials and Methods: The present descriptive crosssectional survey was conducted across 12 Indian cities from August to September 2024 with 250 dentists. A questionnaire comprising seven main questions and 47 Likert-style statements was utilised. Using Computer-Assisted Personal Interviewing (CAPI), KAP on antibiotic use was assessed. Data were analysed descriptively using R software (v4.3.1). Results: Of the 250 dentists enrolled in the study, 110 were from metro cities, 80 were from tier 1, and 60 belonged to tier 2 cities. Most dentists, 225/250 (90%), scored 50-79% on knowledge questions. Most dentists (n=232/250; 92.8%) emphasised updating antibiotic knowledge for ODIs. Notably, 68.4% agreed (171/250) that adding metronidazole to amoxicillin-clavulanic acid improves outcomes. Of the participants, 36% (n=90/250) of dentists believed antibiotic resistance is rarely encountered in practice, while 38% (n=95/250) had no opinion. Only 46% (n=115/250) felt that clinical experience alone should guide antibiotic selection for ODIs, with 30.4% (n=76/250) believed it as sometimes. A majority (78%; 194/250) believed local measures should be prioritised before prescribing antibiotics. Additionally, 58.8% (n=147/250) agreed that culture and sensitivity testing is essential for selecting oral antibiotics. Most dentists follow thorough clinical protocols- 96.4% (n=241/250) assess patient history and symptoms, and 90.8% (n=227/250) use X-rays. While 49.2% (n=123/250) prescribe empiric broadspectrum antibiotics, 85.6% (n=214/250) switch if there's no improvement. Conclusion: The present study identified current practices and possible gaps in appropriate antibiotic prescribing for ODIs. Targeted education programs for dentists, leveraging appropriate methods, are desirable to mitigate antibiotic misuse.

Clinical Implications of Sterilization Methods Applied to 3D-Printed Implant Surgical Guides: An In Vitro Study.

Dental caries remains a major challenge in clinical dentistry, with successful resin restoration relying on the formation of a durable dentin-resin interface. In minimally invasive dentistry (MID), caries-affected dentin (CAD) is routinely preserved and often becomes the primary bonding substrate. However, bonding to CAD is suboptimal, and current strategies to improve this interface are limited. Here, we present a novel bonding strategy based on a dual-reactive functional monomer, ITCM, in combination with pretreatment application techniques. A simple 5-s ITCM pretreatment significantly enhanced both immediate and aged bond strength to CAD. Acting as a "molecular bridge", ITCM bridges hydrophilic CAD layer with hydrophobic adhesive layer, facilitating the formation of a chemical interlocking structure, increasing CAD surface energy, and promoting deep adhesive infiltration. In addition, ITCM improves collagen enzymatic resistance and functions as a non-zinc-binding inhibitor of MMPs. Biocompatibility assessments demonstrated acceptable in vitro and in vivo safety, supporting its clinical potential. This study addresses a critical challenge in dentistry by introducing a chemical bonding strategy tailored to CAD. The ITCM pretreatment strategy provides a foundation for next-generation adhesives aimed at reinforcing the CAD-resin interface, extending restoration longevity, and preventing secondary caries.

1,10-Phenanthroline enhances dentin bond durability via dual-site binding to collagen and matrix Metalloproteinase-8.

Antimicrobial resistance and biofilm-associated infections present major challenges in oral healthcare, necessitating sustainable nanomaterials with multifunctional efficacy. This study reports the green synthesis of zinc oxide nanoparticles (ZnO NPs) from Pergularia daemia (P. daemia) fibre (PDF) extracts and evaluates their structural, thermal, and biological properties for dental and biomedical applications. ZnO NPs were synthesised using aqueous PDF extracts as natural reducing and stabilising agents. Structural crystallinity was examined by X-ray diffraction (XRD), functional groups by Fourier-transform infrared spectroscopy (FTIR), morphology by scanning electron microscopy (SEM), and thermal stability by thermogravimetric analysis (TGA). Antibacterial performance against Klebsiella pneumoniae and Streptococcus mutans was assessed via agar well diffusion, while antibiofilm efficacy was evaluated using confocal laser scanning microscopy (CLSM). XRD confirmed a semi-crystalline ZnO phase with a crystallite size of 28.6 nm and a crystallinity index of 21%. FTIR revealed hydroxyl, carbonyl, and carboxylate groups contributing to nanoparticle stabilisation. SEM micrographs showed irregular, porous, and agglomerated morphologies spanning nanometre to submicron scales. TGA indicated multi-step degradation with a stable residual fraction of ∼14% at 670 °C. Antibacterial assays demonstrated strong inhibition zones (27 mm, 32 mm at 75 µg; 31 mm, 41 mm at 100 µg), comparable to streptomycin (34 mm and 43 mm). CLSM confirmed significant antibiofilm activity through membrane disruption and reduced bacterial viability. The enhanced antibacterial and antibiofilm performance of PDF-derived ZnO NPs arises from synergistic effects of nanoparticle cores, reactive oxygen species generation, and phytochemical surface functionalization. Their stability and bioactivity underscore their promise as sustainable nanomaterials. PDF-mediated ZnO NPs show potential for dental applications, including caries prevention, root canal disinfection, and biofilm-resistant coatings for restorative and implant materials. Their multifunctional profile further supports broader biomedical use in antimicrobial therapy, drug delivery, and composite engineering.

In 2020, a children's hospital-sponsored pediatric dentistry program affiliated with the school-based dental clinic (SBDC) was established to improve equity in dental access and provide a community-based dental training environment. The creation of this comprehensive SBDC provides valuable lessons for sponsor and partner institutions on legal, compliance, epidemiology, information technology, and safety considerations. This program met the goals of providing treatment for a diverse and underserved patient population while providing unique experiences for trainees. The mobile equipment model is feasible for school and community settings. Careful planning is needed when designing staffing models, selecting equipment, and selecting appropriate partners. Comprehensive SBDC programs require considerable investment but provide critical dental access to vulnerable populations and can benefit sponsor and partner institutions.

Bridging the gap in implant dentistry education: Perspectives from Malaysia's graduating dental cohort.