Gingivitis Research Articles

The role of oral and prenatal healthcare providers in the promotion of oral health for pregnant women

BackgroundHormonal alterations and lowered immunity during pregnancy aggravated by poor oral hygiene increase the risk of pregnant women of developing oral diseases. We conducted this cross-sectional study to examine the role of oral and prenatal health providers in promoting dental care for pregnant women attending primary healthcare centers (PHCs) in Saudi Arabia.MethodsAn online questionnaire was sent to a random sample of women who attended PHCs in Jeddah, during 2018–2019. From a total of 1350 women who responded to our questionnaire, 515 women reported having a dental visit before pregnancy. These women comprised our study sample. Bivariate analyses and multiple logistic regression models were conducted to examine associations between oral practices of dental and prenatal health providers (exposures) and women’s utilization of dental care during pregnancy (outcome). Covariates included age, education (< 12 years of education, 12 years of education, and > 12 years of education), family income (≤ 5,000, 5,001–7,000, 7,001–10,000, and > 10,000 Saudi Riyals), health insurance (yes/no), nationality (Saudi Arabian/non-Saudi Arabian), and presence of dental problems, such as toothache, dental caries, gingival inflammation, and the need for dental extractions.ResultsOnly 30.0% of women were informed by a dentist during their dental visit before pregnancy about the importance of visiting a dentist during pregnancy. About 37.0% of women were asked about oral health, 34.4% were informed about the importance of dental care during pregnancy, and 33.2% had their mouths inspected by prenatal health providers. Women informed by dentists about the importance of dental visits during pregnancy were twice as likely (Odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.63–3.60) to visit a dentist during pregnancy. Women who were referred to dentists, had their mouth inspected, or were advised to visit a dentist during pregnancy by prenatal providers were 4.29 (95% CI: 2.67–6.88), 3.79 (95% CI: 2.47–5.82), and 3.37 (95% CI: 2.16–5.27) times as likely to visit a dentist during pregnancy.ConclusionThe partaking of oral and prenatal healthcare providers in evidence-based oral health promotion practices, antenatal-dental collaboration, and closing the referral loop increase pregnant women’s access to and utilization of preventive and treatment dental services.

Comparative Evaluation of Novel Herbal Mouthwash with 12.5% Xylitol Mouthwash and 0.7 M Saline Mouthwash on Plaque Control: An Interventional Study

Background and Aim: Among the wide array of herbal plants possessing medicinal values, Andrographis paniculata (Nilavembu) stands out as a time-tested premiere medicinal herb. A. paniculata (Nilavembu) extracts exhibited varying degrees of inhibitory activity against the growth of all the microorganisms. Hence, this research was made to assess and compare the effect of Nilavembu extract (A. paniculata) with 12.5% xylitol mouthwash and control group (0.7 M saline mouthwash) on dental plaque and gingival inflammation. Materials and Methods: A double-blinded parallel-arm randomized clinical trial was done among 40 participants aged 20–30 years. Participants were randomly allotted into four groups: Group 1 - Nilavembu extract with 0.7 M saline wash; Group 2 - Nilavembu extract with 12.5% xylitol mouthwash; Group 3-0.7 M saline mouthwash; and Group 4-12.5% xylitol mouthwash. The plaque and gingival status were assessed using oral hygiene simplified index and Loe and Silness index at baseline and end of the study (7th day). Statistical analysis was carried out to compare the effect of all four treatments groups using the Kruskal–Wallis test, Wilcoxon sign rank test, and post hoc test; P ≤ 0.05 was considered statistically significant. Results: Among four groups, Group 2 showed a greater mean reduction followed by Group 1 in oral hygiene index score and gingival score. There was a statistically significant difference between the scores of the four groups. Conclusion: It can be concluded that A. paniculata (Nilavembu extract) could serve as a potential herbal alternative in the therapeutic management of dental plaque and gingivitis.

Determination of gingival temperatures of dogs with healthy gums by means of a thermal camera

In this study, the gingival inflammation degree of dogs was determined according to the Gingival Index (GI). According to this index, it was aimed to determine the free gingiva (FG), attached gingiva (AG) and alveolar mucosa (AM) temperatures of the gingiva of dogs with healthy gums by means of a thermal camera. The material of the study consisted of the gingiva of 140 dogs aged 2 years and older, who were brought to Burdur Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Animal Hospital, Surgery Clinic, non-brachiocephalic and without periodontal destruction in their gingiva. Healthy maxillary (n= 427) and mandibular (n= 671) gums in addition maxillary (n=432) and mandibular (n= 463) gums with gingivitis were included in the study. The FG temperature of the buccal surface of the healthy maxillary gingiva was 36.25±1.43°C, the AG temperature was 36.81±1.37°C, and the AM temperature was 37.53±1.30°C. The FG temperature of the buccal surface of the healthy mandibular gingiva was 35.46±1.42°C. In addition the AG temperature was 36.26±1.35°C, and the AM temperature was 37.01±1.22°C. The FG temperature of the maxillary gums with gingivitis was 36,40±1,32°C, the AG temperature was 36,95±1,21°C, and the AM temperature was 37,57±1,21°C. The FG temperature of the mandibular gums with gingivitis was 35,82±1,26°C, the AG temperature was 36,57±1,16°C, and the AM temperature was 37,27±1,10°C. Temperature difference (r) between in maxillary and mandibular FG (r= 0.78°C and p= .000), AG (r= 0.52°C and p= .000) and AM (r= 0.51°C and p= .000) of dogs with healthy gums temperatures were found to be significant. Temperature difference between maxillary and mandibular FG with gingivitis (r= 0.58°C and p= .000), AG (r= 0.38°C and p= .000) and AM (r= 0.29°C and p= .000) were found to be statistically significant. It was concluded that the thermal camera can be an effective diagnostic tool in detecting inflammatory changes in the gingiva.

Anti-inflammatory and antioxidant property of a novel floral mouthwash.

It is of interest to prepare and evaluate the antioxidant and anti-inflammatory activity of a novel Clitoria ternatea and Matricaria chamomilla infused mouthwash. The floral extract using the two flowers in dried form was prepared in concentrations of 10µL, 20µL, 30µL, 40µL and 50µL. To assess the antioxidant activity, DPPH assay was done with L-ascorbic acid as the control agent. The anti-inflammatory activity of the floral extract was assessed by the Albumin Denaturation Assay for which diclofenac sodium was used. The absorbance value of the floral extract was determined for each of the concentrations for the antioxidant and anti-inflammatory properties. After 50 µL the prepared extract began to show close absorbance values compared to the standard solutions; at this concentration, the mouthwash was prepared. The preparation and evaluation of the floral extract of Clitoria ternatea and Matricaria chamomilla infused mouthwash shows promising anti-inflammatory and antioxidant properties and can be used as an adjunct in oral hygiene practices to reduce gingival inflammation. Further clinical studies using the prepared mouthwash are needed to test its efficacy.

Clustering of children’s oral diseases in families and villages in a rural setting in Egypt

BackgroundThis study assessed the clustering of children’ caries experience, plaque accumulation and gingival inflammation in families and villages in Northwestern Egypt and the factors related to the severity of these conditions.MethodsThis was a secondary analysis of a 2019 household survey of children in villages around Alexandria, Egypt. Clinical examination assessed primary and permanent teeth caries experience (dmft/ DMFT using the World Health Organization criteria), plaque accumulation (Plaque Index (PlI)) and gingival inflammation (Gingival Index (GI)). A child questionnaire assessed child’s age, sex, the frequency of toothbrushing (at least twice daily versus less) and frequency of consuming eight types of sugary products (daily sugar consumption score, sum of sugary products consumed daily). Mothers’ questionnaire assessed the number of children in the family, mother’s education (at least high school versus less), at least twice daily toothbrushing and daily sugar consumption similar to the child. Multilevel regression analyses assessed clustering, calculated by the intraclass correlation coefficient (ICC) of the three conditions in families and villages. Regression estimates (B) and 95% confidence intervals (CIs) of individual and family factors were calculated.ResultsComplete data were available for 450 children (246 families, seven villages], mean = 9.9 years-old and 56% females. The mean caries experience score = 3.6, mean plaque index = 1.5 and mean gingival index = 1.2. Caries experience, plaque accumulation and gingival inflammation were not clustered in villages (ICC < 0.01) but clustered in families (ICC = 0.10, 0.44 and 0.29). Child factors significantly improved model fit for caries experience and gingivitis (p < 0.001) but not plaque accumulation (p = 0.90). Family factors did not improve any model fit (p > 0.05). Child’s age was significantly associated with caries experience (B= -0.48, p < 0.001) and gingival inflammation (B = 0.032, p < 0.001). Children who brushed their teeth twice daily had significantly more caries experience (B = 1.04, p = 0.01).ConclusionThe three oral conditions were not clustered in villages but clustered in families. Plaque accumulation showed the greatest within-family clustering. Family factors were not associated with the three conditions and individual factors indicated the need for interventions to promote preventive behaviors and identify families at risk of oral conditions.

Accuracy of Artificial Intelligence-Based Photographic Detection of Gingivitis

ObjectivesGingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous professional advice. Artificial intelligence may be used to provide automated visual plaque control advice based on intraoral photographs. MethodsFrontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement. ResultsA total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50. ConclusionsArtificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients’ plaque control.

Potency of Turmeric Extract Solution (Curcuma Longa) as on Alternative Herbal Mouthwash in Gingivitis Marginalis

Marginal gingivitis is an inflammation of the gingiva at the margin and is the earliest stage characterized by a reddish inflammation that is not persistent but prominent in areas where bacterial plaque is concentrated. Preventive efforts to rinse mouthwash contain antibacterial, long-term use has side effects, so we need herbal ingredients that have antibacterial properties, one of which is turmeric. This researcher aims to prove the potential of turmeric extract solution (Curcuma longa) as an alternative herbal mouthwash against gingivitis marginalis. This type of research uses a Quasy experiment with a pre and post test design with a control group design. Consisting of the intervention group using turmeric extract mouthwash with a concentration of 2.5%, 5% and the control group without active ingredients, the sample consisted of 27 people gargling for 1 minute for 5 consecutive days. Index gingival examination before and after rinsing. The results of the independent t-test for reducing marginal gingivitis at concentrations of 2.5% and 5% on days 1 and 2 showed a sig value of 0.002, on day 3 the sig value was 0.004, on days 4 and 5 the sig value was 0.000 meaning that there was a significant difference in reduction of marginal gingivitis. The conclusion of this study is that herbal mouthwash is effective as an alternative to herbal mouthwash in reducing marginal gingivitis compared to formulas without active ingredients.

Information Technology-Based Educational Video Model For Changes In Gingival Health Status In Adolescents

The health problem that is often experienced by adolescents is dental and oral hygiene, RISKESDAS data for 2018, 57.6% of Indonesian people have dental and oral health problems. Gingival problems are common in adolescents. Lack of dental and oral hygiene causes gingival inflammation. Plaque, bacteria, and calculus that accumulate on the tooth surface are the main causes of periodontal disease. Early detection that is carried out independently as well as providing solutions for prevention and treatment to patients is very necessary. Media that is currently developing among adolescents is technology-based media which is increasingly creative and can be a solution for preventing dental disease. Proving appropriate information technology-based educational videos and their effective application to changes in gingival health status in adolescents. The research method used is Research and Development (RnD) with Quasy Experiment pre-test post-test control group design. Educational video based on information technology is appropriate for changes in gingival health status with the results of expert validation of 83% and p-value 0.044 and its application is effective in increasing knowledge (p=0.000), attitude (p=0.002), skills (p=0.000), GI (p = 0.001). As well as indicated by the delta value of knowledge (2.14), attitude (1.29), skills (2.14), decreased GI score (0.44) compared to the control group. Educational videos have proven to be appropriate and effective in their application to changes in gingival health status in adolescents marked by a decrease in the gingival index score.

Improving oral health of adolescent girls in Kenya through education - An observational study.

Dental caries and periodontal diseases are significant health concerns in developing nations. This study assessed the impact of a comprehensive oral health education program on adolescent girls in rural Kenya. Eighty-seven girls aged 13-18 years attending school in rural Nanyuki, Kenya, were enrolled in the study. The comprehensive program included personalized oral hygiene training, education and health advocacy coaching. Dental caries, gingival inflammation and dental plaque biofilm were assessed at baseline, 1- and 2.5-year post-implementation. The intervention was highly effective in arresting pre-existing carious lesions and preventing the formation of new ones in this population. The data revealed that there was a significant remineralization of incipient caries lesion, as shown by decreases in modified ICCMS™ scores from baseline to 1-year post-implementation. From baseline to the 2.5-year post-implementation assessment, only six new carious lesions developed. Dental plaque biofilm was reduced by 83.6%, and gingival inflammation was reduced by 81.6%. A comprehensive oral health program, which included behavioural awareness and educational approaches, resulted in significant positive oral health outcomes in caries, dental plaque biofilm and gingival inflammation.

Comparison of the efficacy of active oxygen - containing mouthwash (BlueM) with chlorhexidine mouthwash (Hexidine) and its effect on plaque, calculus, and gingival inflammation

: To compare the efficacy of active oxygen - containing mouthwash (BlueM) with chlorhexidine mouthwash (Hexidine) and its effect on plaque, calculus, and gingival inflammation.A Double blind parallel study was done on 20 systemically healthy patients with the presence of generalized chronic gingivitis in the age group of 20-45 years. Each subject will rinse their mouth with the mouthrinse assigned to them, or twice daily for one minute in the morning and before going to bed. They will be instructed to swish it properly around the mouth and avoid its ingestion. Descriptive statistics was performed by calculating mean and standard deviation for the continuous variables. Intergroup and intragroup comparisonbetween chlorhexidine and Blue M at baseline (To) and at the end of 3 weeks (T1) showing no statistical differences between the two groups.Blue M can be used as a safe alternative to chlorhexidine in reducing the microbial load. But when compared to each other there wasn't a significant change between them. Chlorhexidine has the edge in being very cheaper compared to Blue M. Further studies are required with conclusive evidence to be able to determine whether oxygen enriched mouthwashes can replace chlorhexidine in the future.

Evaluation of anti-inflammatory effect of vitamin c using mesotherapy approach in the treatment of persistent gingivitis

Vitamin C, being a strong reducing agent, can regulate the resolution of the inflammatory process and stimulate the tissue repair. It enhances the synthesis of collagen type I, reduced by inflammatory process, keeps the balance between collagen I and collagen III, and modifies the rate of fibroblast proliferation. Mesotherapy is a minimally invasive procedure which involves local intradermal therapy with biologically active substances given in minor quantities to the area of pathology. However, the studies on local injection of Vitamin C showed inconclusive results. The aim of the present study is to evaluate the efficiency of the locally injected vitamin C in the treatment of persistent gingival inflammation. After one week of SRP, ten patients with persistent gingival inflammation were included in the study. In the test group, five patients were treated with single application of locally delivered vitamin C into the gingival tissues and the other five patients in the control group were given saline as the placebo. Plaque index and sulcus bleeding index were evaluated at baseline and at 1 week post-operatively. Group A (Test group) showed a mean difference of 1.75 (pre and post op) in plaque scores which are statistically significant compared to that of group B (control group) that showed a mean difference of 0.15 in plaque scores which is not statistically significant. Sulcus bleeding index scores where statistically significantly (pre and post op) only in test group. There is no difference in plaque index and sulcus bleeding index between the test and control group at baseline, but a significant difference was observed between the two groups at 1 week follow up in plaque and sulcus bleeding index, favouring the test group. Vitamin C that is injected using mesotherapy approach has a synergistic interaction with SRP for treating persisting inflammation of the gingiva than compared to that of placebo at 1 week follow up period.

Assessment of Periodontal Health Among Removable and Fixed Partial Denture Wearers in Aseer Region of Saudi Arabia.

BACKGROUND Prosthetic rehabilitation will have harmful effects on periodontal structure if the patient fails to maintain an oral hygiene protocol. This study aimed to evaluate oral hygiene in fixed and removable partial denture wearers in the Aseer Province of Saudi Arabia. MATERIAL AND METHODS This was a cross-sectional study done on 286 prosthesis wearers aged between 25 and 55 years; 142 were men and 144 women. Clinical examination was done using 3 periodontal parameters: plaque index, gingival index, and calculus surface index. RESULTS It was found that 72% and 25% of patients used fixed and removable partial prostheses, respectively. Most patients were in the 45-55 year age group (38.1%), were medically fit (78%), and used toothbrush and paste (70.6%). Most patients were instructed regarding the use of oral hygiene measures for their prostheses (71.3%). However, around half of the study group (52.8%) had odor from their prostheses. Most fixed prostheses were in the posterior teeth (73.2%) and had 3 units or more (58.7%). Removable partial dentures were mostly tooth-tissue supported (74%). A statistically significant difference was found for plaque index and gingival index between natural teeth and abutments in terms of various prosthetic parameters (P£0.001). The higher prevalence of gingival inflammation, plaque, and calculus accumulation in this study may be correlated to improper oral hygiene methods used by patients. CONCLUSIONS It can be concluded that there is a need to reinforce meticulous oral hygiene practices among patients using prosthodontic appliances.

Quality by design driven development and evaluation of thermosensitive hydrogel loaded with IgY and LL37-SLNs to combat experimental periodontitis

Egg yolk immunoglobulin (IgY) and LL37, potent antibacterial substances, can fight against periodontitis. This work aimed to develop a locally injectable hydrogel for potential co-delivery of special IgY and LL37-loaded solid lipid nanoparticles (LL37-SLNs) to synergistically inhibit the proliferation of oral pathogens, thus relieving periodontal inflammation and redness. The formulation of thermosensitive hydrogel loaded with IgY and LL37-SLNs was developed by adopting the Quality by Design approach. Then the formulations were optimized by two-factor three-level full factorial design by Design-Expert software. Finally, the optimized formulation was characterized and estimated in vitro and in vivo. In vitro release and antibacterial activity studies have revealed that the optimized formulation was homogeneous and can be released slowly, with sustainably antibacterial power. And the physical and chemical composition analysis and morphological observations further confirmed the sustained-release capability. On the other hand, in vivo studies proved that the optimized formulation significantly decreased gingival redness, bleeding, and plaque formation, avoided excessive resorption of alveolar bone, and reduced the levels of inflammatory factor in periodontitis rats. In conclusion, the optimized thermosensitive hydrogel loaded with IgY and LL37-SLNs may be a promising local sustained-release preparation for the effective treatment of periodontal diseases.

Antigingivitis, Desensitizing, and Antiplaque Effects of Alkaline Toothpastes: A Randomized Clinical Trial.

Gingivitis is a widespread disease commonly associated with dentin hypersensitivity, that, in turn, may complicate routine dental care, leading to plaque accumulation. We aimed to assess the antigingivitis, desensitizing, and antiplaque effects of a fluoride-containing (TWF) alkaline toothpaste and a fluoride-free (TW) alkaline toothpaste. Eighty-four consenting patients aged 20-25 years with diagnosed gingivitis and dentin hypersensitivity (DH) were recruited in this double-blind, parallel-group study and randomly divided into two groups (each n = 42). Eighty-two patients completed the entire study protocol. The outcomes were assessed after 4 weeks of intervention. A significant improvement in gingival condition was found according to the modified gingival index, with effect sizes of 0.99 [CI95%: 0.52-1.46] and 1.71 [CI95%: 1.18-2.24], and the gingival bleeding index, with effect sizes of 3.17 [CI95%: 2.39-3.94] and 2.64 [CI95%: 1.96-3.32] in the TW and TWF groups, respectively. DH also decreased in both groups, with a significantly greater reduction in the TWF group (effect sizes of 3.28 [CI95%: 2.51-4.04] and 3.10 [CI95%: 2.40-3.80] according to the visual analog scale and Schiff scale, respectively). No side effects were registered. In conclusion, the use of alkaline toothpaste provided a significant reduction in gingival inflammation and bleeding, DH, and oral hygiene after 4 weeks of daily use in young adults. Trial Registration: NCT0562376. Funding: none.

Localization and expression profiles of gingival monocyte chemoattractant protein-1-induced protein-1 (MCPIP-1) and mucosa-associated lymphoid tissue lymphoma translocation protein 1 (MALT-1)

ObjectivesThe purposes of this study were to localize monocyte chemoattractant protein-1-induced protein-1 (MCPIP-1) and its suppressor mucosa-associated lymphoid tissue lymphoma translocation protein 1 (MALT-1) in gingival tissues and to profile their protein expression levels in relation to the clinical inflammation, Porphyromonas gingivalis colonization, and interleukin (IL)-8 levels.Materials and methodsStudy samples were collected from two independent study populations: (1) Gingival tissues were collected from eight periodontally healthy individuals and eight periodontitis patients to localize MCPIP-1 and MALT-1 immunohistochemically, and (2) forty-one gingival tissue samples with marginal, mild, or moderate to severe inflammation were collected from 20 periodontitis patients to determine MCPIP-1 and MALT-1 levels using immunoblots, P. gingivalis levels with qPCR, P. gingivalis gingipain activities with fluorogenic substrates, and IL-8 levels with multiplex technique.ResultsMCPIP-1 was detectable in the epithelium and in connective tissue, being especially prominent around the blood vessel walls in healthy periodontal tissues. MALT-1 was observed at all layers of gingival epithelium and especially around the accumulated inflammatory cells in connective tissue. No difference in gingival tissue MCPIP-1 and MALT-1 levels was observed in relation to the severity of gingival inflammation. MALT-1 levels were elevated (p = 0.023) with the increase in tissue P. gingivalis levels, and there was an association between MALT-1 and IL-8 levels (β = 0.054, p = 0.001).ConclusionsInteractions of MALT-1 levels with gingival tissue P. gingivalis counts and IL-8 levels suggest that activation of MALT-1 can take part in P. gingivalis-regulated host immune responses.Clinical relevancePharmacological targeting the crosstalk between immune response and MCPIP-1/MALT-1 may have benefits in periodontal treatment.

The relationship of gingival inflammation and salivary pH to hormonal variation during menstruation.

The normal female life cycle is associated with a number of hormonal milestones: menarche, pregnancy, contraceptive use, menopause, and the use of replacement sex hormones. The menstrual cycle is the result of a carefully orchestrated sequence of interactions among the hypothalamus, pituitary, ovary glands, and endometrium, with the sex hormones acting as modulators and effectors at each level. Gingivitis is Inflammation of the gingiva as a response to bacterial plaque on adjacent teeth; characterized by erythema, edema, and fibrous enlargement of the gingiva without resorption of the underlying alveolar bone. The gingiva is a target tissue for the actions of steroid hormones, clinical changes in the tissues of the periodontium have been identified during periods of hormonal fluctuation’ Women have lower flow rates and seem to have more variation in salivary pH than men. Hormonal fluctuations during events like puberty, menstruation, pregnancy and menopause could explain those differences.&#x0D; the aim of this study is to find the relationship between plaque accumulation, gingival inflammation, and salivary pH with the female hormone level during menstruation. The study includes 25 volunteer young female with regular menstrual cycle, all the volunteers underwent periodontal examination by record plaque index (PLI) and gingival index (Gl) and measurement of salivary pH in the 2nd day of menstrual cycle (first reading) and in the 201' day of menstruation (second reading) then we analyze the differences among the two readings.&#x0D; Results of this study revealed that the plaque accumulation and gingival inflammation increase significantly with increasing level of female hormones and decrease when these hormones decline. As well as the salivary pH decrease slightly during increase level of female hormones and the saliva become more alkaline when the level of hormones decreased.

Systemic Profile and Periodontal Condition of Hospitalized Women with High-Risk Pregnancy: A Cross-Sectional Study.

The physiological changes in mother-infant pairs during pregnancy increase the susceptibility to a series of infections, including those of the oral cavity. Therefore, the oral and systemic health of pregnant women is related to adverse pregnancy outcomes. This cross-sectional study aimed to evaluate the systemic profile and periodontal status of women with a high-risk pregnancy. Eighty-nine pregnant women at risk of preterm labor admitted to a hospital in southern Brazil were interviewed and received a periodontal examination. Data related to obstetric complications during pregnancy (pre-eclampsia, infections, medication use, and gestational diabetes) and systemic diseases were collected from medical records. The periodontal parameters of probing pocket depth, bleeding on probing, and clinical attachment level were evaluated. The data were tabulated, and statistical analysis was performed (p < 0.05). The mean age of participants was 24 years (SD = 5.62). Gingival bleeding was recorded in 91% of the participants. The prevalence of gingivitis was 31.46%, and periodontitis was 29.21%. No association between systemic conditions and periodontal disease was observed. Periodontal inflammation was not associated with the systemic profile during pregnancy. However, women with high-risk pregnancies showed higher levels of gingival inflammation, emphasizing the importance of dental care during pregnancy.

Self-reported Knowledge and Practice of Saudi Dental Hygiene Students Towards the use of Chlorhexidine Mouthwash

Aim: To assess the knowledge and practice of Saudi dental hygiene students regarding the use of mouthwashes in clinical practice. Background: Mouthwashes are chemical plaque control agents which are widely used for the prevention of tooth decay, gaining fresh breath, reducing plaque and calculus formation, and reducing gingival inflammation. Chlorhexidine is considered a gold standard mouthwash because of its substantivity action. Thus, it is very important for dental practitioners to understand the knowledge and practices regarding the use of Chlorhexidine mouthwash Objective: The primary objective of this study was to find dental hygiene students’ knowledge about chlorhexidine mouthwash and its side effects and also identify their practice toward the use of mouthwashes as plaque inhibiting agents. Methods: An online version of a pre-tested and validated questionnaire was used to test the knowledge and practices towards the use of Chlorhexidine mouthwash. Thus, A Cross-sectional questionnaire survey was carried out in Saudi Arabia on dental hygiene students. Results: A total of 144 filled questionnaires were obtained out of which 88% were male and 12% were female. After converting the scores into percentages, any score &lt;60% was categorized as a poor score, 60-80% as an average score, and &gt;80% as a good score. Dental hygiene students showed an average knowledge about Chlorhexidine mouthwash with a score of 62.27% and also poor practice with a score of 57.98%. Conclusion: The findings of this cross-sectional study demonstrate that most of the Dental hygiene students in Saudi Arabia have got average knowledge and poor practice about the usage of Chlorhexidine mouthwash. Clinical Significance: Being the oral health care providers, it is mandatory for dental hygiene students to have adequate knowledge regarding the usage of mouthwashes. With optimum knowledge, they will be able to deliver the right information to the patients thereby ensuring the proper practice of the same.

The Effect of Anterior Crowding Toward Oral Hygiene Index-Simplified and Gingival Index Score

Dental crowding is one form of malocclusion characterized by disparities between the size of the tooth and the arc dimension. It is commonly found in the anterior region. Keeping the crowded and misaligned tooth is hard, leading to more plaque accumulation and increasing the risk of gingival inflammation. This research aims to find the effects of anterior dental crowding on the Oral Hygiene Index-Simplified (OHI-S) and Gingival Index scores of Poltekkes Kemenkes Kupang students. This is a cross-sectional study performed by observational analytical study design. The population was the student of Poltekkes Kemenkes Kupang with anterior crowding. Using 70 samples were chosen using purposive sampling technique. The result showed that most of the students had moderate anterior crowding (45.7%), followed by mild crowding (30%) and severe crowding (20%). The chi-square test showed a significant effect of anterior crowding toward OHI-S (p=0.03) and GI scores (p=0.04). While Socio-economical aspect also showed a significant effect (p=0.00) on OHI-S scores. A significant effect of socioeconomic status was also recorded on GI score (p=0.00). An observation of the students' oral hygiene intention showed that they mostly had a moderate intention (72.9%) to keep their mouth clean, and the rest, 27.1% had high oral hygiene intention. This aspect also significantly affects their scores of OHI-S (p=0.00) and GI (p=0.01). This study concluded that anterior crowding, socioeconomic status, and oral hygiene intention can affect OHI-S and GI scores of the students of Poltekkes Kemenkes Kupang

Basic periodontitis manual: what it is, symptoms and treatments.

Periodontitis is an inflammation and chronic infection in the gum, caused by the accumulation of plaque or tartar between the teeth and the gum, and excessive proliferation of bacteria, which over time, results in the destruction of the tissue that supports the tooth, which may affect a or more teeth.&#x0D; Periodontitis can be noticed by swelling in the gum, which can also be red and bleed during brushing and eating. Also, when you observe that your teeth are becoming crooked or gradually separated, it may be a sign that the supporting tissues of your teeth are weakened.&#x0D; It is important to consult the dentist whenever symptoms of periodontitis appear so that the diagnosis is made and the most appropriate treatment is indicated, which can be done with removal of bacterial plaque and tartar, use of antibiotics or surgery.&#x0D; &#x0D; Image 1: Teeth with generalized periodontitis.&#x0D; &#x0D; Symptoms of periodontitis&#x0D; The main symptoms of periodontitis are:&#x0D; &#x0D; - Bad breath;&#x0D; - Very red gums;&#x0D; - Swollen gums;&#x0D; - Gum bleeding after brushing your teeth or eating;&#x0D; - Red and swollen gums;&#x0D; - Crooked teeth;&#x0D; - Teeth softening;&#x0D; - Increased tooth sensitivity;&#x0D; - Loss of teeth;&#x0D; - Increased space between teeth;&#x0D; - Waking up with blood on the pillow.&#x0D; &#x0D; Periodontitis can be localized, affecting only one or the other tooth, or generalized, when it affects all teeth at the same time. The change in the appearance of the teeth is what most attracts the attention of the person, or people close to them.&#x0D; &#x0D; Most people suffer from an episode of gum inflammation at least once in their lives, being particularly common in women during pregnancy, due to hormonal changes, but not everyone will have periodontitis, which despite having gingivitis as a symptom, is a more serious condition, which may even require deep scaling of the gums and dental surgery.&#x0D; &#x0D; How to confirm the diagnosis&#x0D; The diagnosis of periodontitis can be made by the dentist by observing the person's teeth and gums, and assessing the health history, to identify lifestyle habits or use of medicines that may be leading to the emergence of symptoms.&#x0D; In addition, to confirm periodontitis, the dentist should request an image exam, such as a panoramic X-ray, in order to assess the bone loss in the affected region. Learn how the panoramic X-ray is done.&#x0D; &#x0D; Possible causes&#x0D; The main cause of periodontitis is the formation of bacterial plaque and tartar on the teeth and between the teeth and the gums, causing chronic inflammation in the gums, and the development of pockets containing bacteria, plaques and tartar, between the gums and the teeth, which can lead to deep infections and loss of bone tissue.&#x0D; &#x0D; Some factors can increase the risk of developing periodontitis, such as:&#x0D; &#x0D; - Poor oral hygiene;&#x0D; - Habit of smoking or chewing tobacco;&#x0D; - Hormonal changes in pregnancy or menopause;&#x0D; - Electronic cigarette or VAPE use;&#x0D; - Vitamin C deficiency;&#x0D; - Type 2 diabetes;&#x0D; - Obesity;&#x0D; - Rheumatoid arthritis;&#x0D; - Crohn's disease;&#x0D; - Use of oral contraceptives;&#x0D; - Use of drugs that reduce saliva production, such as antihistamines, antidepressants or antihypertensives.&#x0D; &#x0D; In addition, genetic factors or diseases that affect the immune system, such as HIV infection or leukemia, can also increase the risk of developing periodontitis.&#x0D; &#x0D; Treatment of periodontitis&#x0D; Treatment to end periodontitis involves scraping the root of the tooth, in the office and under anesthesia, to remove tartar plaque and bacteria that are destroying the bone structure that supports the tooth. The use of antibiotics may be part of the treatment in some cases.&#x0D; Maintenance at the dentist periodically decreases the evolution of this inflammation and helps to control the disease, reducing bone loss and preventing tooth loss. In addition, not smoking, brushing your teeth daily and flossing are ways to control and cure periodontitis.