Bleeding Gums Research Articles

Self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh

BackgroundBad breath (halitosis) is a common problem affecting psycho-social wellbeing of young people. We aimed to explore the extent of self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh.MethodsA cross-sectional study was conducted among university students from November 2021 to April 2022. Six private and two public universities were approached. A total of 318 participants were conveniently selected for the study. A self-administered questionnaire was used for data collection. Students unwilling to participate were excluded. Multivariable logistic regression analysis was used to examine factors associated with halitosis. Statistical analysis was conducted using Stata Version 17.ResultsA total of 55.97% of students had self-perceived halitosis, with females (74.53%) having a significantly higher proportion than males (36.94%) (p < 0.001). A significantly higher proportion of halitosis was found among participants who were overweight ( 61%), had obesity (60.77%), smoked cigarette (46.79%), consumed alcohol (71.43%), lacked exercise (66.29%), were on unhealthy diet (57.35%), consumed coffee/tea (61.35%), breathed through mouth (64.60%), brushed tooth infrequently (85.71%), changed toothbrush after 6 months (77.42%), did not use toothpaste (94.74%), did not use/ sometimes used fluoride toothpaste (75.76%), lacked dental floss use (60.85%), did not use toothpick (62.87%), did chew or sometimes chewed sugar-free chewing gum (75.82%), did not clear / cleaned tongue sometimes (76.14%), did use mouth freshener regularly or occasionally (64.97%), did not use or used mouthwash sometimes (58.87%) were also associated with higher self-perceived halitosis (p < 0.05 for all). Students with gum bleeding, swollen gums, dry mouth, dental caries, food accumulation, and tooth sensitivity had a significantly (p < 0.05 for all) higher proportion of self-perceived halitosis (76.85%, 81.82%, 72.50%, 67.78%, 64.13% and 67.40%, respectively) compared to those without this problem. Being female (OR = 5.04; 95% CI: 2.01–12.62; p < 0.001), alcohol consumers (OR 7.35; 95% CI: 1.77–30.50; p = 0.006); not using sugar free chewing gum (OR = 0.25; 95% CI: 0.10–0.58; p = 0.001), lack of tongue cleaning (OR 4.62; 95% CI: 2.16–9.84; p < 0.001), and gum bleeding (OR = 7.43; 95% CI: 3.00-18.35; p < 0.001) were independently associated with halitosis on multivariable regression.ConclusionThis study reveals a high proportion of self-perceived halitosis and relevant factors. There should be more public education on the causes of halitosis and potential management approaches.

Fibromyalgia and Orofacial Health: Administration of a Dental Disease Assessment Questionnaire

Aim: This study examines the prevalence and severity of orofacial disorders in patients with fibromyalgia syndrome (FMS). The research assesses the correlation with the Fibromyalgia Assessment Status (FAS) index. The goal is to improve the clinical approaches to these patients. Methods: A cross-sectional study was conducted using a structured questionnaire focused on the correlation between FMS and orofacial problems. The research involved 107 rheumatology patients diagnosed with FMS. Statistical analyses, including Spearman’s correlation, were utilized to investigate the relationships between the FAS index scores and various orofacial symptoms. Results: Of the participants, 11.2% responded that they were aware of the correlation between fibromyalgia and oral health. The statistical analysis showed statistically significant correlations between the FAS index and symptoms such as gum bleeding, teeth grinding during the day, and neck pain (p &lt; 0.05). The correlation between the FAS index and joint noise upon opening the mouth, as well as dissatisfaction with one’s smile, also proved to be highly significant (p &lt; 0.001). Conclusion: The outcomes demonstrate that, as the FAS index increases, the likelihood of developing orofacial disorders also increases among FMS patients. This highlights the importance of a multidisciplinary treatment approach.

Clinical Features, Etiopathogenesis, and Therapeutic Approaches of Acute Gingival Lesions: A Narrative Review.

A bacterial infection is typically the source of gingivitis, a non-destructive condition that produces gum inflammation. Unlike chronic lesions, which have well-defined features and a gradual onset, acute lesions are unpleasant. Usually, the first symptoms are bleeding, swollen, and red gums. If gingivitis is not treated, it can lead to periodontitis, a more serious condition where the gums separate from the teeth. It seems that gingival disease-induced inflammation is a necessary condition for the breakdown of connective tissue attachment apical to the cementoenamel junction (CEJ). This may result in damage to the bone and soft tissue that support the teeth, leading to loosening and unstable teeth, andif the infection worsens, eventual tooth loss may occur. While one of the most prevalent inflammatory diseases in humans is plaque-induced gingivitis, there are several less common but frequently very significant non-plaque-induced gingival illnesses. Maintaining regular dental hygiene can help prevent gingivitis and make it reversible. Non-plaque-induced gingival lesions might be pathologic alterations restricted to gingival tissues, but they are also frequent signs of systemic disorders. Diagnosing patients with these lesions and creating treatment regimens for them must be the aim of the therapy.

Associations of activity, sedentary and sleep behaviors with oral health indictors in children and adolescents: a cross-sectional analysis

BackgroundThe purpose of this study was to examine the associations of physical activity (PA), recreational screen time, and sleep with indicators of poor oral health in youth.MethodsParticipants were children and adolescents whose parents completed the 2022 National Survey of Children’s Health (N = 34,342; 49% female; Mean age = 11.9 +/- 3.5 years). The dependent variables were three binary response items that indicated the presence of toothaches, bleeding gums, and cavities within the previous 12 months. Independent variables were three items indicating the weekly frequency of 60 min of PA, hours of recreational screen time, and hours of weeknight sleep. Relationships between variables were examined using double-selection logistic regression with demographic, dietary, oral hygiene, and dental service covariates selected using the plug-in method of the least absolute shrinkage and selection operator.ResultsCompared to zero days of PA, 4–6 days of PA per week was associated with 30% lower odds of bleeding gums (p = 0.021). Compared to less than 1 h of recreational screen time, 2 h or more hours of recreational screen time were associated with a 1.26 to 1.62 times higher odds of cavities (p < 0.01). Compared to 5 h or less of sleep, 7 to 10 h of sleep was associated with 47–61% lower odds of bleeding gums and 31–47% lower odds of cavities (p < 0.01). Secondary analyses indicated that at least 2 of the movement behavior recommendations had to have been adhered to for positive associations with indicators of oral health to be observed. For toothaches, bleeding gums, and cavities, meeting 2 or 3 recommendations was associated with lower odds of poor oral health; whereas adhering to only one recommendation was not.ConclusionChildren with higher PA and sleep durations had improved oral health indicators and children with longer periods of screen time exposure had poorer oral health indicators. Our findings recommend adhering to multiple movement behavior recommendations to achieve improvements in oral health indicators.

Aesthetic surgical crown lengthening on teeth 11 and 21

Background: In dental treatment planning, aesthetic considerations are crucial due to the relationship between a smile and facial beauty. Crown lengthening is a procedure used to achieve aesthetic smiles, particularly in cases of subgingival caries, fractures, and short clinical crowns. Purpose: The purpose of this case report is to achieve aesthetic improvement of the central incisors through crown lengthening procedures. Case: A 31-year-old female patient presented with a complaint of a broken upper left front tooth and easily bleeding gums. Clinical examination revealed Ellis class 1 fracture at the incisal-distal of tooth 21. The patient exhibited poor oral hygiene with visible calculus on upper and lower jaw teeth. There was gingival hyperplasia, redness, bleeding tendency, and the gingival margin height of teeth 11 and 21 appeared lower than teeth 12 and 22. Radiographically, the alveolar crest was distant from the CEJ. Case Management: Treatment plan included crown lengthening on teeth 11 and 21 with composite restoration on tooth 21. Crown lengthening, a surgical procedure designed to increase the extent of supragingival tooth structure for restorative or aesthetic purposes by repositioning the gingival margin apically was performed. This procedure is indicated for teeth with subgingival caries, extensive caries shortening the tooth, fractures, and short clinical crowns. Conclusion: Crown lengthening should consider the biological width to prevent bone resorption, gingival recession, inflammation, or hypertrophy. When performed under ideal clinical conditions, crown lengthening provides satisfactory outcomes both functionally and aesthetically.

The return of the old masquerader—scurvy: a case report of pediatric limping and bone pain

BackgroundScurvy has been a rare condition in the developed world due to the increasing availability of adequate nutrition and easy access to fruits and vegetables. Scurvy is caused by severe vitamin C deficiency and has been historically associated with malnutrition in high-risk populations such as sailors. As it is an uncommon nutritional deficiency, scurvy is seldom suspected and usually under-diagnosed especially in the pediatric population.Case presentationWe report a case of a pediatric patient with a history of autism spectrum disorder presenting with atypical symptoms of scurvy with gait abnormalities, diffuse rash, musculoskeletal deconditioning, and bleeding manifestations. After multiple extensive investigations and a prolonged hospitalization, a detailed dietary analysis revealed a severely restricted diet devoid of fruits and vegetables. Physical examination revealed specific signs of corkscrew hair with peri-follicular hemorrhages, hypertrophic, and bleeding gums with a concurrent low vitamin C level. Treatment with vitamin C supplementation was initiated and he was ambulant within 1 month of discharge.ConclusionThis case highlights the importance of nutrition history for determining micronutrient deficiency in children with special needs. Enhanced physician education and higher index of suspicion regarding nutritional deficiencies will avoid over-investigations and delays for the institution of specific 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.

TREATMENT OF CHRONIC PERIODONTITIS WITH THE USE OF PHYTOEXTRACT

Background. Periodontal diseases are one of the most common and complex pathologies of the dental system. Chronic inflammatory diseases of periodontal tissues are second only to caries in terms of prevalence. The aim of the study is to conduct a comprehensive treatment of patients using a phytoextract based on a clinical analysis of the incidence of mild and moderate chronic generalized periodontitis (CGPP). Material and methods. A comprehensive dental examination and treatment was performed on 120 patients diagnosed with mild chronic generalized periodontitis (MGPP LS) and moderate chronic generalized periodontitis (MGPP SS). Results. The results showed that the use of the phytoextract in patients with CGP LS severity contributed to the improvement of the dental status parameters of patients in this group. The course of complex treatment with the additional inclusion of the phytoextract in the OG led to a decrease in GI by 54.13% (p 0.05), with a decrease in the parameter in patients using Metrogyl Denta (GS) - by 26.3% (p 0.05) compared to the initial values. In this case, there is a significant decrease in CI in the MG by 69.2% (p 0.05), with a similar shift in CG patients - by 32.13% (p 0.05), a decrease in PI in the MG - by 52.9% (p 0.05), in CG patients - by 38.9% (p 0.05) compared to the initial values. Discussion. The use of the phytoextract in MG patients contributed to the improvement of the dental status, with a reliable decrease in hygienic indices and contributed to a prolonged effect in the late period, which allowed us to conclude that it has a good anti-inflammatory effect. Conclusion. As a result of the course of treatment and observation in patients with MG with CGP LS and CGP SS: clinical signs of inflammation in the periodontal tissues were relieved, which was accompanied by an improvement in the condition of the oral cavity of patients, the absence of complaints associated with the severity of inflammation (bleeding gums, swelling, pain, exudate release from periodontal pockets and tooth mobility) and is confirmed by the values of periodontal indices.

Formulation of mouth rinse from natural plant\'s leaf extract and evaluation of antibacterial activity

Herbal liquid formulations are the preparation for oral health related issues like toothache, swelling, redness, bacterial or fungal infection in mouth, tooth decay, bleeding gums, weakened gums, etc. Such preparation also improves gums strength, removing bad breath and give fresh feel during good start of the day. Dentists generally use such preparations as antimicrobials before or after oral surgery to sanitize the surface of affected gums and teeth to avoid further contamination. Herbs like Tulsi, Clove, Mint, Ginger etc., are generally used either alone or in combination in herbal mouth-wash preparations which also render antibacterial activities. The other herbs like Eucalyptus and Liquorices have been reported to possess antibacterial, anti-oxidant, aromatic, anti- inflammatory and sweetening properties. In the present work, the research continues with formulation and evaluation of a herbal mouth rinse by using a combination of selected herbal extracts of Tulsi, Bael, Eucalyptus leaves and Liquorices rhizome for their antimicrobial activity against S. aureus using agar well diffusion plate technique. It was found that the formulated herbal mouth rinse or preparations gave satisfactory results in controlling the microorganism. Different physicochemical tests of prepared preparations were performed to figure out their pH, phase separation, homogeneity and scent.,

Ayurvedic Management Of Sheetada With Special Reference To Gingivitis

Sheetada is one of the common problems of Dantamoola which is portrayed by the Raktasrava (Bleeding gum), Durghandha (halitosis), Krushnta (Discolouration of gums), Kledata (Excessive dischargre) Mruduta (Softnes of gums), Sheernata (gum downturn). It very well may be associated by Gingivitis. Gingivitis is caused mainly by the accumulation of debris, plaque, and calculus at the tooth margin, due to neglect of oral care . Among all periodontal disease Sheetada is an early stage of periodontal disease. It is caused by vitiated Kapha and Rakta which produces spontaneous bleeding from dark, slimy and soft gums with offensive odour and gum recession. In present study we have discussed a case of 52 year old female patient came to our OPD with chief complaints of foul smell from mouth,bleeding from gums on brushing,pain and swollen gums from last 6 months. This case was intervened with Dantamoola shodhana(dental scaling) followed by Pratisarana with Kushtadi Churna and Gandoosha with Lakshadi Taila.These intervention showed a potential improvement in the management of Sheetada.

Glanzmann Thrombasthenia – A Rare Case Report

Glanzmann thrombasthenia is a rare inherited bleeding disorder resulting from mutation in platelet membrane glycoprotein (GP) IIb or IIIa leading to impaired platelet function which is characterized by defective platelet aggregation and diminished clot retraction. Glanzmann thrombasthenia patients commonly visit to physician with features of bleeding. Here we discuss about the case of a 32-years-old young female presented with menorrhagia, ecchymosis and occasional gum bleeding. Her coagulation profile was in favor of Glanzmann thrombasthenia. This rare disease has a good outcome if early diagnosis and proper management can be ensured. Delta Med Col J. Jan 2021;9(2): 101-103

Causal effects of denture wearing on epigenetic age acceleration and the mediating pathways: a mendelian randomization study

BackgroundThe epigenetic-age acceleration (EAA) represents the difference between chronological age and epigenetic age, reflecting accelerated biological aging. Observational studies suggested that oral disorders may impact DNA methylation patterns and aging, but their causal relationship remains largely unexplored. This study aimed to investigate potential causal associations between dental traits and EAA, as well as to identify possible mediators.MethodsUsing summary statistics of genome-wide association studies of predominantly European ancestry, we conducted univariable and multivariable Mendelian randomization (MR) to estimate the overall and independent effects of ten dental traits (dentures, bleeding gums, painful gums, loose teeth, toothache, ulcers, periodontitis, number of teeth, and two measures of caries) on four EAA subtypes (GrimAge acceleration [GrimAA], PhenoAge acceleration [PhenoAA], HannumAge acceleration [HannumAA] and intrinsic EAA [IEAA]), and used two-step Mendelian randomization to evaluate twelve potential mediators of the associations. Comprehensive sensitivity analyses were used to verity the robustness, heterogeneity, and pleiotropy.ResultsUnivariable inverse variance weighted MR analyses revealed a causal effect of dentures on greater GrimAA (β: 2.47, 95% CI: 0.93–4.01, p = 0.002), PhenoAA (β: 3.00, 95% CI: 1.15–4.85, p = 0.001), and HannumAA (β: 1.96, 95% CI: 0.58–3.33, p = 0.005). In multivariable MR, the associations remained significant after adjusting for periodontitis, caries, number of teeth and bleeding gums. Three out of 12 aging risk factors were identified as mediators of the association between dentures and EAA, including body mass index, body fat percentage, and waist circumference. No evidence for reverse causality and pleiotropy were detected (p > 0.05).ConclusionsOur findings supported the causal effects of genetic liability for denture wearing on epigenetic aging, with partial mediation by obesity. More attention should be paid to the obesity-monitoring and management for slowing EAA among denture wearers.

Healthy lifestyles and better periodontal health: Results from two large population-based surveys.

To ascertain whether healthy lifestyles are associated with periodontal diseases in two large-scale surveys in the US (National Health and Nutrition Examination Survey - NHANES) and the UK Biobank. 9854 US adults and 111 679 UK adults were included in the analyses. A healthy lifestyle score (HLS), ranging between 0 and 5, was calculated based on the reported number of healthy behaviours, including never smoking, no heavy alcohol consumption, top third of leisure-time physical activity, higher dietary quality, and ideal sleep duration. The prevalence of periodontal diseases was the primary outcome in both surveys. In the NHANES, periodontal status was assessed through a full-mouth periodontal examination, while in the UKB, only self-reported periodontal status was available. Multiple regression analyses confirmed that the presence of at least 2-3 healthy behaviours (vs. 0-1) was associated with lower odds of overall and severe periodontitis (ORs 0.5, 0.4-0.6; p < .001 and 0.5, 0.3-0.8; p = .003, respectively) in the NHANES, and of bleeding gums (OR = 0.9, 0.8-1.0; p = .092) and loose teeth (OR = 0.6, 0.5-0.7; p < .001) in UKB. This association increased when considering prevalence of 4-5 healthy behaviours (vs. 0-1) in both the NHANES (periodontitis: OR = 0.3, 0.2-0.4; p < .001; severe periodontitis: OR = 0.1, 0.01-0.2; p < .001) and the UKB (bleeding gums: OR = 0.8, 0.7-0.9; p < .001; loose teeth: OR = 0.5, 0.4-0.6; p < .001). Mediation analyses revealed how these protective associations could be partially mediated (1-14%) by differences in biomarkers of systemic inflammation (white blood cells and neutrophils count as well as C-reactive protein). Adoption of healthy lifestyle behaviours is associated with a lower prevalence of periodontal diseases within two large population-based samples. This relationship exhibits a dose-response pattern, implying that greater adherence to healthy habits leads to a more significant protective effect against the odds of periodontal diseases. Additionally, our findings suggest that this protective effect is, in part, mediated by reductions in systemic inflammation.

Natural history study of Pseudoachondroplasia: A focus on oral health.

Pseudoachondroplasia (PSACH) is a rare dwarfing condition characterized by short limbs and fingers, and multiple skeletal abnormalities/complications. There are few natural history studies delineating the medical problems in PSACH leaving a gap in many areas, especially oral health. Our study aimed to obtain information pertaining to oral health and other health-related problems (pregnancy and childbirth, skeletal health, joint pain) in patients with PSACH. To ascertain this information, an online Qualtrics survey was distributed to members of Little People of America, a support group, and through a PSACH online chatroom. Ninety-nine of 115 surveys were completed and included in the descriptive and multivariable analyses. PSACH individuals regularly sought dental care, but flossing was challenging because of short fingers. Untreated carries (5%), bleeding gums (16%) malocclusion (37%), obstructive sleep apnea (9%), and TMJ disorder (3%) occurred less frequently compared to the general population. Delivery was by Caesarean section in 100% of female respondents who delivered a baby. Bowlegs (74%), scoliosis (43%) and osteoarthritis (36%) were the most common skeletal complications. Joint pain was reported by 85% of respondents. This study provides novel insights into oral health, pregnancy and childbirth while confirming previously identified skeletal complications in PSACH. Our findings suggest that oral healthcare in PSACH presents unique challenges.

Evaluation of oral complications in children undergoing chemotherapy: An observational study.

Chemotherapy, a cornerstone treatment for childhood cancers, can negatively impact oral health. This study aimed to evaluate the prevalence and evolution of oral complications in these patients. A prospective observational study enrolled 44 children diagnosed with malignancy undergoing chemotherapy at a tertiary care institute in central India. Oral examinations were performed at baseline, with follow-ups at 3-6 and 9-12 months. Data collected included demographics, medical history, oral hygiene practices, and oral lesions. Blood counts and World Health Organization grading for mucositis were used. Descriptive statistics and appropriate statistical tests analyzed the data (P ≤ 0.05). Acute lymphoblastic leukemia (ALL) was the most prevalent malignancy. Children reported various oral complaints such as ulcers, bleeding gums, and difficulty eating. Mucositis prevalence significantly decreased over follow-up visits (baseline: 56.8% and second follow-up: 13.3%). Gingival inflammation was present, though mean scores decreased over time. Oral hygiene scores varied without significant changes. Caries experience scores increased from baseline to follow-up. This study identified a high prevalence of ALL and diverse oral complications in children undergoing chemotherapy. While mucositis severity lessened over time, other issues such as caries persisted. These findings highlight the critical need for preventive oral care strategies to safeguard this vulnerable population's oral health.

Analysis of the Role of Vitamin C Hypovitaminosis in Scurvy on Bone Health: A Single Center Observational Study at Dr. Moewardi General Hospital, Surakarta, Indonesia

Background: Scurvy, vitamin C deficiency, is a rare condition but remains relevant in Indonesia. This study aims to analyze the role of vitamin C hypovitaminosis in the development of scurvy and its impact on bone health through an observational study at Dr. Moewardi General Hospital. Surakarta. Methods: A cross-sectional observational study was conducted on 30 patients diagnosed with scurvy at Dr. Moewardi General Hospital Surakarta during the 2020-2023 period. Demographic data, medical history, nutritional status, and severity of scurvy were collected. A radiological examination of the bone is performed to assess scurvy-related changes. Descriptive, comparative, and Spearman correlation statistical analyzes were used. Results: The majority of patients were men (66.7%) with a mean age of 45 years. A history of an unbalanced diet with low fruit and vegetable intake was found in the majority of patients (86.7%). Common symptoms include fatigue (86.7%), joint pain (73.3%), bleeding gums (60%), and skin bleeding (53.3%). The severity of scurvy varied, with 10 patients (33.3%) experiencing severe scurvy. Radiological examination shows significant changes in long bones, especially osteoporosis and thinning of the cortex, which is more obvious in patients with severe scurvy. Spearman correlation analysis showed a positive correlation between the severity of scurvy and the incidence of osteoporosis (rho = 0.495, p = 0.005) and cortical thinning (rho = 0.394, p = 0.031). Conclusion: Vitamin C hypovitaminosis plays a significant role in the development of scurvy and has a negative impact on bone health. Early screening and diagnosis of scurvy are important to prevent musculoskeletal complications. Nutritional education and dietary interventions to increase vitamin C intake need to be intensified, especially in high-risk groups.

Gingival health, plaque accumulation, and restoration outcomes in deciduous anterior teeth: evaluating zirconia crowns versus composite resin strip crowns.

Zirconia crowns, resembling crystals and with enamel-like aesthetics, are recent entrants in pediatric restorative dentistry. Despite growing use, their empirical efficacy remains under-explored. The aim of this study is to compare resin composite strip crowns and premanufactured zirconia crowns on primary maxillary incisors. In the Pediatric Dental Clinics, 240 primary maxillary incisors (69 patients) were treated with either zirconia (120 teeth) or composite strip crowns (120 teeth). Evaluations of gingival health, plaque, secondary caries, restoration failure, and opposing teeth wear occurred at 3, 6, and 12-month intervals. At 3 months, zirconia crowns showed less gum bleeding (P=0.006) and plaque. Through 6 and 12 months, zirconia crowns exhibited fewer failures but higher opposing teeth wear. Strip crowns indicated greater tooth material loss. Zirconia crowns demonstrated superior gingival health and durability over composite resin strip crowns but caused increased wear on opposing teeth.

CLINICAL AND MORPHOLOGICAL ASSESSMENT OF THE EFFECTIVENESS OF THE APPLICATION INNOVATIVE THERAPEUTIC AND PROPHYLACTIC TOOTHPASTE IN THE COMPLEX TREATMENT OF PATIENTS WITH MAJOR DENTAL DISEASES

The social and economic development of a society is largely determined by the level of health of its young population. The objective of this study was to increase the effectiveness of preventive and comprehensive treatment of young patients with major dental diseases using an innovative therapeutic and preventive toothpaste based on organic gel. A group of 32 volunteers participated in the study. All patients underwent a complex dental examination that included basic and additional methods (determination of indices of caries intensity, indicators of oral hygiene (simple hygiene index OHI-S, Silnes-Low index), evaluation of periodontal tissue status (papillary-limbal alveolar abscess index PMA, gingival bleeding in inflammatory periodontal disease index BI Müllmann), evaluation of pain (hypersensitivity) to stimuli using a visual analog scale (VAS), measurement of the electrical conductivity of tooth enamel using the Dentest electrodiagnostic device (ZAO Geosoftident), clinical evaluation of enamel remineralization rate, spectrophotometer "VITA (Easy Shade) (VITA) to evaluate tooth discoloration, oral fluid immunoassay, and cytomorphometric studies of the buccal epithelium. The results of the clinical trials showed that the therapeutic and prophylactic toothpaste has excellent consumer characteristics, has no allergic or local irritant effects on the oral mucosa, improves the natural protection of the oral cavity, effectively cleans up to 100% of the oral cavity, provides anti-inflammatory effects, eliminates gum swelling and bleeding from the first use, reduces tooth sensitivity, reduces tooth enamel structure, and was shown to have no toxic effect on the cells of the buccal epithelium. The results of the clinical trial suggest that the innovative therapeutic and prophylactic dentifrice can be recommended for daily use in a wide range of individuals, as well as in patients with low tooth enamel resistance, various periodontal diseases, and oral mucosa.

Prevalence of Pregnancy Tumor in Tripoli, Libya: A Multicenter Cross-Sectional Study

Background and objectives. Pyogenic granuloma (pregnancy tumor) is one of the gingival inflammatory changes with an increased incidence during pregnancy. The present study aimed to determine the prevalence and characteristics of pregnancy tumors in pregnant Libyan women in Tripoli, Libya. Methods. In this descriptive cross-sectional study, pregnant Libyan women were assessed at the National Heart Center-Tajoura, Jalaa Maternity Hospital, and Tripoli University Hospital during the period from August to November 2023. Data were collected through interviewing and clinical examination of the participants and filling out a data form. Results. During four months period, of 402 pregnant Libyan women, 4 (1.0%) were clinically diagnosed with pregnancy tumors. The four cases were in their third trimester of pregnancy. Half (50%) of pregnancy tumor cases were more than 30 years old, and the other half (50%) were early 20 years old. The gingiva was the only site of the lesions, and were observed equally in the maxilla and the mandible. All pregnancy tumor cases have calculus on their teeth, bleeding gums, and poor oral hygiene status. All lesions were sessile had lobulated surfaces, and showed spontaneous and provoked bleeding. Conclusions. Although the results of this study indicate that the prevalence of pregnancy tumors in pregnant Libyan women is considered low (1.0%), oral health education programs are very important during pregnancy, and if pregnant women notice any abnormal growth during pregnancy in their mouth, they should consult a dentist.

Association of Oral Health and Periodontal Disease with Hypertension: A Cross-Sectional Study

Objectives: The association of orodental and cardiovascular health has been an area of extensive research for many years. As per American Heart Association hypertension 2017 guidelines, good periodontal health is associated with better systolic blood pressure control. However, there have been conflicting results for hypertension and dental correlation in a few other studies. Moreover, there are no recognized oral manifestations, seen in patients with hypertension. Indian data on this subject are scarce. Therefore, the present study was contemplated to determine the frequency and nature of oral manifestations in hypertensive patients as compared to normotensive patients. Materials and Methods: In this observational cross-sectional study, participants were divided into two groups. Group A included 40 hypertensive subjects and group B included 40 healthy normotensive volunteers. Oral symptoms such as dry mouth, altered taste sensation, mouth odor, and bleeding from gums were noted. An oral examination was performed to check periodontal pockets, lichenoid reactions, and gingival hyperplasia. Russell’s Periodontal Index was used to estimate gingival and periodontal health. Results: The mean age of patients in the hypertensive group was higher than normotensive groups (53.8 ± 11 vs. 42.45 ± 12, P = 0.001). Oral symptoms in the form of dry mouth, halitosis, and altered taste were reported in 60%, 52.5%, and 42.5% of hypertensive patients which were significantly higher as compared to the control group. Bleeding gums, lichenoid reactions, and gingival enlargement were also significantly higher in hypertensive than normotensive groups. The mean value of Russell’s index was 1.09 ± 0.41 in group A which was significantly different from group B (0.05 ± 0.10). Gingival hyperplasia and gum bleeding were predominantly found in patients on calcium channel blockers, whereas lichenoid reactions were significantly present in patients on angiotensin receptor blockers. Hyposalivation was reported with all four classes of antihypertensive drugs, predominantly diuretics. Conclusion: The orodental involvement in hypertensive subjects has a wide spectrum from mildly symptomatic halitosis and dryness of mouth to severe bleeding gums, lichenoid lesions, irreversible bone loss, and periodontitis that may require dental visits and interventions. The documented mucosal changes can also be attributed to antihypertensive drugs. Regular dental examinations should be made part of routine screening programs of hypertensive patients to protect them from various oral complications and subsequent inflammation-mediated changes in vasculature endothelium.