Improvement In Oral Health Status Research Articles

Probiotics for oral health: a critical evaluation of bacterial strains.

Oral health is critical for total body health and well-being; however, little improvement in oral health status has occurred in the U.S. over the past 20 years. Tooth decay and gum disease remain highly prevalent, with more than 90% and 50% of adults suffering from these conditions, respectively. To combat this lack of improvement, alternative approaches to dental care are now being suggested. One such alternative therapy is probiotics for oral care. In the oral cavity, probiotic strains have been shown to reduce levels of oral pathogens, inhibit the formation of dental caries, and reduce the levels of bacteria that cause halitosis. However, as the oral care probiotic market expands, many products contain bacterial species and strains with no documented health benefits leading to confusion and mistrust among consumers and clinicians. This confusion is enhanced by the regulatory status of probiotic products which puts the onus of safety and efficacy on the manufacturer rather than a central regulatory body. The overarching goal of this review is to provide consumers and clinicians with documented evidence supporting (or refuting) the health benefits of oral care probiotics marketed for sale in the United States. This includes defining what constitutes an oral care probiotic product and a strain level analysis of candidate probiotics from the genera Streptococcus, Lactobacillus, Bifidobacterium, and Bacillus. Additionally, prebiotics and postbiotics will be discussed. Finally, a set of considerations for consumers and clinicians is provided to empower probiotic product decision making. Together, this review will improve understanding of oral care probiotics marketed in the US for dental professionals and consumers.

The pathological oral cavity as a preventable source of postoperative pneumonia in thoracic surgery: a prospective observational study.

BackgroundPneumonia after thoracic surgery considerably contributes to perioperative morbidity and mortality. So far, the forced expiratory volume in one second and diffusing capacity of the lungs for carbon dioxide are the most common validated prognosticators to estimate individual risk. Beyond functional parameters, modifiable risk factors for respiratory complications like pneumonia are poorly investigated in a prospective way. Thus, we aimed to assess the impact of oral health status in patients undergoing thoracic surgery and its correlation to perioperative outcomes.MethodsA prospective observational study included adult patients undergoing elective thoracic surgery from October 2, 2018 to April 29, 2020. The day before surgery, patients were examined by a dentist. Oral health status (caries, periodontal disease, tooth loss, and regular dental visits) was correlated with perioperative outcomes.ResultsDuring the study period, 230 consecutive patients were included. Oral health status was poor in the study population. Postoperative complications were associated with active caries [odds ratio (OR) 2.5, P<0.03]. Patients with frequent dental visits and treated teeth had a lower risk for postoperative complications compared with patients without regular visits (OR 0.3, P<0.02). Patients with a high burden of caries had a significantly increased risk for pneumonia (OR 7.9, P<0.002). The forced expiratory volume in one second was a significant prognosticator for postoperative complications; however, no association between the forced expiratory volume in one second and oral health parameters was observed.ConclusionsA pathological oral health status is a modifiable factor predicting postoperative complications and pneumonia. A prospective randomized interventional study is warranted to clarify whether an improvement in oral health status can lead to a reduction of perioperative risk.

Effect of Dental Anxiety on Oral Health among the First-Time Dental Visitors: A Hospital-based Study.

Objective:The objective was to assess dental anxiety and to find its association with oral health status and oral health-related quality of life (OHRQoL) among 20–40-year-old patients visiting Vokkaligara Sangha Dental College and Hospital.Materials and Methods:A single-center, hospital-based cross-sectional study was done among first-time dental visitors in the Department of Oral Medicine and Radiology, Vokkaligara Sangha Dental College and Hospital over a period of 8 months (July 14–February 18). The sample size was determined to be 700. Participants in the age group of 20–40 years were selected based on inclusion and exclusion criteria. Data were collected using Corah's Modified Dental Anxiety Scale, Oral Health Impact Profile-14 (OHIP-14), and clinical examination was done using the WHO oral health assessment form and OHI-S. Data were analyzed using Chi-square test and t-test. The associations found through bivariate analysis were entered as predictor variables into linear and binomial logistic regression models with high dental anxiety as the outcome variable.Results:The results of the study suggested that 56% of the study participants were having dental anxiety. Local anesthetic injection (80%) and fear of tooth drilling (60%) were the most anxiety-provoking stimulus. Analysis of OHIP-14 suggested that respondents perceiving oral health as affecting their life quality (very often/fairly often) in the past year were observed for items such as tension, difficulty to relax, irritability, difficulty in doing usual jobs, and totally unable to function because of oral problems. Dental anxiety was significantly associated with gender (odds ratio [OR] = 1.32), education (OR = 1.43), occupation (OR = 2.07), poor oral hygiene status (OR = 3.15), presence of dental caries (OR = 2.67), bleeding on probing (OR = 1.57), presence of periodontal pockets (OR = 2.64), clinical attachment loss (OR = 1.63), and OHRQoL (OR = 1.76). Stepwise linear regression model of independent variables (<0.05 variables included) explained dental caries as highest predictor (39%), followed by debris (22%), calculus (38%), mean OHIS (27%), mean OHIP-14 (29%), deep pocket (14%), and the least predictor was shallow pocket (9%).Conclusion:Dental anxiety was associated with poor oral health status seeking further attention to modify patients' behavior regarding improvement in oral health status.

Training dental hygienists to place interim therapeutic restorations in a school‐based teledentistry program: Oregon's virtual dental home

The objectives of this study on Oregon's virtual dental home were to: 1) demonstrate the feasibility of pilot project training of existing Expanded Practice Dental Hygienists (EPDHs) to perform interim therapeutic restorations (ITRs) in the community settings after diagnosis by the supervising dentist via teledentistry and 2) evaluate satisfaction of parents/guardians of children participating in a pilot program that provides school-based/on-site preventive dental care services utilizing expanded scope EPDHs to conduct dental screenings and place ITRs. This demonstration project was a 4-years longitudinal cohort study (2016-2019) in the school/community-based settings focusing on children in kindergarten to 3rd grade. EPDHs and dentists from a Dental Care Organization were trained to utilize teledentistry and EPDHs were trained to place ITRs, the latter provided onsite dental care. Data was collected regarding child's demographics and oral health status; and parents reported level of satisfaction from services received by their children. Data analysis included descriptive statistics and logistic regression analysis to assess the relative importance of demographic and clinical factors on caries status. Onsite dental care was provided to 759 children. Of repeat patients (n = 377), 201 (53.3%) children had untreated decay at their first visit. Of these, 13% saw improvements in oral health status at their most recent visit (MRV). There were 162 ITRs planned out of which 50 patients received 99 ITRs. No adverse events were experienced. Of the repeat children receiving ITRs (n = 43), 28% saw improvement in their caries status at their MRV. Parents reported very high levels of satisfaction with the dental care program. Oregon's virtual dental home project was successful in training EPDHs to perform ITRs safely in school settings after caries diagnosis by the supervising dentist via teledentistry and in integrating this component into a regular school-based preventive dental program.

Oral Mouth Rinses against Supragingival Biofilm and Gingival Inflammation.

Caries and inflammatory periodontal diseases have a high prevalence worldwide. Although improvements in oral health status in our patients have been shown, there is still an increased demand for preventive measurements - especially in view of the systemic influence of the chronic disease periodontitis. The main focus of such measurements lies on an optimal biofilm management which can be divided into professional biofilm management and home care measurements. Since home care mechanical measurements such as toothbrushing and interdental cleaning are often insufficient or not on a regular basis, they can be supported by antibacterial agents which are able to inhibit or kill any oral microorganisms that remain. Besides a proven effect on plaque bacteria and gingival inflammation, agents should have a high substantivity in the oral cavity that outlast the short rinsing period. This chapter aims to present the background and rationale of using antibacterial mouth rinses, their common agents, to show sensible indications, and to evaluate the scientific evidence of their additional effect over toothbrushing alone.

Children's Oral Health: Progress, Policy Development, And Priorities For Continued Improvement.

Considerable progress has occurred in the US over the past quarter-century in terms of improving children's oral health. Federal and state policies, programs, and partnerships have contributed to improvements in oral health status. Medicaid and Children's Health Insurance Program coverage expansions helped increase the use of dental services, and investments in safety-net facilities and training programs helped expand service delivery and the oral health workforce. Nevertheless, dental caries remains the most common chronic disease of childhood, notable oral health disparities persist, and the adoption of evidence-based innovations remains slow and uneven. This article highlights improvements during the past twenty-five years in US children's oral health and oral health care that stem from major federal and state initiatives, as well as persistent disparities. We offer promising strategies for reducing gaps and suggestions for overcoming challenges to future progress, including renewed emphasis on oral health during early childhood; greater integration in education and clinical service delivery programs; development of standardized quality measures; and data collection systems that support more robust surveillance, program monitoring, and system improvements.

Effect of routine dental attendance on child oral health‐related quality of life: A cohort study

There is an improvement in oral health status among people who receive preventive dental care during their lifetime, highlighting the possible effect in resolving oral health problems and consequently oral health-related quality of life (OHRQoL). Assessed the effect of routine dental attendance on child OHRQoL. This cohort study used baseline data from 639 preschoolers from 2010. After 7 years, 449 children were re-examined (70.3%). Mothers of the children completed a questionnaire collecting data on the pattern of use of dental services. Children were classified as adhering to long-term routine dental attendance according to their pattern of use (routine versus curative) in the baseline and in follow-up. The child OHRQoL was assessed through the Child Perception Questionnaire (CPQ8-10). The association between routine dental attendance and child OHRQoL was assessed using multilevel Poisson regression models. The proportion of participants who reported the worst CPQ8-10 scores were higher among those who, at some point in their life, experienced a curative dental attendance. Also, the mean CPQ8-10 was two times higher for non-routine dental attendance. The findings showed that there is an impact of long-term routine attendance on child OHRQoL. This is important for tackling oral health iniquities.

Effect of a collaborative transdisciplinary team approach on oral health status in acute stroke patients.

Oral function deteriorates easily during the acute phase of cerebral stroke. Therefore, oral health care involving a transdisciplinary approach consisting of dental and medical professionals might be important, but has not been studied in detail. This study assessed the oral health status of patients with cerebral stroke in the acute phase, with the aim of elucidating the efficacy of collaborative, transdisciplinary oral health care involving dentists, dental hygienists, nurses and speech therapists. The participants were 115 consecutive acute cerebral stroke patients, who received oral health care while hospitalised at the university hospital. Their oral health status was assessed using the oral health assessment tool (OHAT) on admission and discharge. Patients with acute cerebral stroke had high OHAT scores on admission, meaning poor oral health status. The collaborative oral health care resulted in significant decrease of OHAT scores at discharge, indicative of the improvement of oral health status. Multivariate analysis identified OHAT score for tongue, dentures and oral cleanliness on admission as the significant variables associated with poor oral health status at discharge. Thus, the oral health of cerebral stroke patients in the acute phase can be improved by implementing transdisciplinary collaboration of medical and dental professionals. Particularly, patients with problems pertaining to the tongue, dentures and oral cleanliness as revealed through OHAT on admission may require more intensive intervention.

Improvement of Oral Health Status in a Group of Students with Visual Impairment in Istanbul

Objectives: The purpose of this study was to determine the oral health status of a group of students with vision impairment and to compare the changes of oral hygiene after oral health education.Materials and Methods: Dental examination of 6-19-year-old of 136 students with vision impairment in a Primary School for Individuals with Vision Impairment in Istanbul was performed. The students were divided into 6-9-year-age group (Group I) and 10-19-year-age group (Group II) and in the first visit, they were examined and their findings were recorded according to DMFT (Decayed, Missing, and Filled Teeth), DMFS (Decayed, Missing, and Filled Surfaces) indices of permanent teeth, dft and dfs indices of primary teeth and in the first visit and 3rd follow up period, their Dental Plaque (PI), Calculus (CI) and Oral Hygiene (OHI) Indexes were recorded. They received one-to-one oral health education (OHE). Statistical evaluation was carried out with Wilcoxon and Mann-Whitney U tests and p&amp;lt;0.05 was found as statistically significant.Results: Regarding the pre and post OHE results of periodontal indexes, PI and OHI scores statistically significantly increased after OHE in Group I (p&amp;lt;0.05). On the other hand, CI results significantly decreased after OHE in Group II (p=0.042). Comparing post OHE results of PI and OHI, Group I showed statistically significantly higher scores than Group II (p&amp;lt;0.05). Comparing the difference values of PI and OHI between pre and post OHE, Group I showed statistically significantly lower scores than Group II (p&amp;lt;0.05).Conclusions: Students with vision impairment have a high prevalence of dental caries and poor oral hygiene. We emphasise the importance of providing proper dental education and regular dental visits to them.

Oral health status of community dwelling adults aged 50 years and over in Ireland. A cross-sectional analysis of the Wave 3 TILDA cohort.

Background: Little is known about the current oral health status of adults in Ireland. The aim of this study was to measure the oral health status of community dwelling adults aged 50 years and over in Ireland, and to compare the current status to previous surveys of oral health in adults. Methods: The Irish Longitudinal Study on Ageing (TILDA) Wave 3 provided an opportunity to assess the oral health of a subset of TILDA participants. Respondents attending for health assessments at the TILDA centre were offered an oral health examination. The World Health Organization examination criteria were used. Results: Out of the 3111 people who were offered the oral health assessment (OHA), 2525 were examined. Adults below 50 years of age (n=17) and 4 respondents whose oral health data were unavailable at time of analysis were omitted, giving a final sample of 2504 respondents. Among the OHA sample, 9.9% (249) were edentate; 11.5% (159) of females and 8% (90) of males. Of those aged 65 years and older, 15.6% were edentate compared with 40.9% in 2000-02. The mean number of teeth present in those aged 65 years or older was 14.9 for males and 14.2 for females compared with 9.9 and 7.4, respectively, in 2000-02. 56.8% of the dentate sample had 10 or more tooth contacts. The mean DMFT of those aged 50 years or more was 18.5 and the Root Caries Index (RCI) was 6.3. For adults aged 65 years and over, the mean DMFT decreased from 25.9 to 20.1 and the Root Caries Index decreased from 11.6 to 9.1, between 2000-02 and 2014-15. Conclusion: The results suggest an improvement in oral health status of community dwelling adults aged 50 years and over in Ireland as compared to the previous Irish survey of 2000-02.

Does Instruction of Oral Health Behavior for Workers Improve Work Performance?—Quasi-Randomized Trial

Oral disease can cause economic loss due to impaired work performance. Therefore, improvement of oral health status and prevention of oral disease is essential among workers. The purpose of this study was to investigate whether oral health-related behavioral modification intervention influences work performance or improves oral health behavior and oral health status among Japanese workers. We quasi-randomly separated participants into the intervention group or the control group at baseline. The intervention group received intensive oral health instruction at baseline and a self-assessment every three months. Both groups received oral examinations and answered the self-questionnaire at baseline and at one-year follow-up. At follow-up, the prevalence of subjects who use fluoride toothpastes and interdental brushes/dental floss were significantly higher in the intervention group than in the control group. Three variables (tooth brushing in workplace, using fluoride toothpaste, and experience of receiving tooth brushing instruction in a dental clinic) showed significant improvement only in the intervention group. On the other hand, work performance and oral status did not significantly change in either group. Our intensive oral health-related behavioral modification intervention improved oral health behavior, but neither work performance nor oral status, among Japanese workers.

Prevalence of the Signs and Symptoms of Temporomandibular Disorders Among Spanish Adults and Seniors According to Five National Surveys Performed Between 1993 and 2015.

To determine the prevalence of the signs and symptoms of temporomandibular disorders (TMD) and associated variables over the past two decades in samples of Spanish adults and seniors. Data from Spanish national oral health surveys from the last two decades (1993, 2000, 2005, 2010, and 2015) were analyzed from a total of 2,602 adults (35-44 years of age) and 2,529 seniors (65-74 years of age). All surveys were carried out using similar methods (according to World Health Organization standards) for determining prosthetic, dental, and periodontal statuses. For TMD (assessed only among the adults and seniors), inspection/palpation of the temporomandibular joint and masticatory muscles was used to evaluate three different domains: joint sounds; pain-related conditions (joints/muscles); and range of jaw motion. Risk factors were identified using bivariate analysis and were confirmed after a multivariate logistic regression analysis for predicting the presence of TMD pain/dysfunction. Despite the clear improvement in oral health status observed over the entire study period (1993-2015), the prevalence of temporomandibular pain and dysfunction increased over time in both adults and seniors (the odds ratio [OR] 95% confidence interval [CI] for the entire study period increased, to 2.39 to 4.29). The odds of women and those living in rural areas developing TMD were higher than for men (OR = 1.85; 95% CI 1.52 to 2.25; P < .001) and for those living in urban areas (OR = 1.55; 95% CI 1.24 to 1.94; P < .001), respectively; however, the prevalence of joint sounds (with no pain or functional restrictions) appeared to be stable throughout the study period at around 14%. The prevalence of painful or dysfunctional TMD has significantly increased in the last 22 years in Spain. Besides the time factor, other major predictors of TMD were gender and place of residence.

Oral Health Status and Oral Health-Related Quality of Life in Italian Deinstitutionalized Psychiatric Patients.

The aim of this study is to investigate the oral health status and Oral Health-Related Quality of Life (OHRQoL, measured with OHIP- 14) in psychiatric patients assisted by the unique Italian mental health care system, in accordance to regulatory Law 180/78. Demographic and medical variables were retrieved from institutional medical records. General health and oral health variables, oral health-related behavior and last dental contact were recorded. Clinical evaluation was performed on each patient. For oral health data collection, a standardized medical form was used. The study involved an overall number of 67 patients. Primary diagnosis of mental illness was at mean age of 29 years. The average number of teeth per patient was 25.45 ±6,55. The overall mean value of caries experience was 9.1 decayed, missing and/or filled teeth (DMFT Index). Among affected patients (60%, n=33) the mean value of DMFT for all age groups was 11.3 (range 2-27). The present study highlighted a direct linear relationship between caries experience and OHRQoL. As the caries level increased, pain, functional and psychological discomfort scores increased. The overall caries experience value of 9.1 DMFT was lower than that reported in existing literature, which is usually related to traditionally institutionalized psychiatric patients, and most important of all, data on access to dental care is fairly good. These results, although derived from a pilot study on a limited sample, suggest that, where a psychosocial rehabilitative program is set out for psychiatric patients, as in the case of the Italian experience, the program can also determine an improvement in oral health status. It is important that programs for oral health promotion are developed in collaboration with mental health services and social measures are patient-centered as an integral part of the individual's rehabilitation program.

Assessing the Oral Health Needs of African American Men in Low-Income, Urban Communities.

Despite improvements in oral health status in the United States, pronounced racial/ethnic disparities exist. Black men are less likely to visit the dentist, are twice as likely to experience tooth decay, and have a significantly lower 5-year oral cancer survival rate when compared to White men. The Minority Men's Oral Health Dental Access Program employed a community-based participatory research approach to examine the oral health barriers and opportunities for intervention among Black men in a low-income, urban neighborhood. A cross-sectional study design was implemented through a self-administered survey completed among 154 Black males. The majority reported not having dental insurance (68.8%). Most frequently cited oral health care barriers were lack of dental insurance and not being able to afford dental care. Attitudes related to the significance of dental care centered on cancer prevention and feeling comfortable with one's smile. The impact of oral health on daily life centered on social interaction, with men citing insecurities associated with eating, talking, and smiling due to embarrassment with how their teeth/mouth looked to others. Multivariate logistic regression revealed that those who had difficulty finding dental care were 4.81 times (odds ratio = 4.65, 95% confidence interval [1.80, 12.85]) more likely to report no dental insurance, and 2.73 times (odds ratio = 3.72; 95% confidence interval [1.12, 6.70]) more likely to report poor oral health. Community-based participatory approaches include assessment of neighborhood residents affected by the health issue to frame interventions that resonate and are more effective. Social, physical, and infrastructural factors may emerge, requiring a multilevel approach.

A comparative evaluation of oral hygiene using Braille and audio instructions among institutionalized visually impaired children aged between 6 years and 20 years: A 3-monthfollow-up study.

Aim:The aim of this study is to compare the oral hygiene status among institutionalized visually impaired children of age between 6 and 20 years given with Braille and audio instructions in Raichur city of Karnataka.Materials and Methods:A total of 50 children aged between 6 to 20 years were included in this study from a residential school for visually impaired children. These children were randomly divided into two equal groups. One group was given oral hygiene instructions by audio recordings and another written in Braille and were instructed to practice the same. After three months time the oral hygiene status and dental caries experience was recorded and compared using patient performance index. Statistical analysis was done by student paired t test and multiple comparison by Tukey's HSD (honest significant difference) test.Results:The mean PHP (Patient Hygiene Performance) score of group A at baseline was 3.88 compared to 3.90 of group B. At 7 days PHP score of group A and group B was 3.42 and 3.45 respectively. At 3 month PHP score of group A and group B was 2.47 and 2.86 respectively. Even though over a period of time the mean score of PHP index reduced the score comparison between the 2 groups were statistically non significant. In group A the mean difference of PHP score between baseline and 7 days was 0.46, between baseline and 3 months it was 1.40. The PHP score between 7 days and 3 months was 0.94. All the above values were statistically significant.Conclusion:Effective dental health education method has to be instituted for visually impaired children. The present study shows improvement of oral health status in both the study population by decrease in the mean plaque score. Hence continuous motivation and reinforcement in the form of Braille and audio instruction is beneficial to achieve good oral hygiene levels in visually impaired children.

Adult Oral Health Programs in Japanese Municipalities: Factors Associated with Self-Rated Effectiveness.

Health Japan 21 plan establishes specific targets for aspects of health including oral health for 2010, in an effort to increase health expectancy. Despite this, there has been insufficient improvement in oral health status in adults. The objective of this cross-sectional study was to determine the factors associated with effective oral health programs for adults in Japanese municipalities. Questionnaires were mailed to all 1,472 municipalities in Japan and responses were obtained from 862 municipalities (response rate: 58.6%). After excluding 71 municipalities with "unknown" answer, no answer, or lack of relevant information, we analyzed the data from the remaining 791 municipalities with or without oral health programs for adults self-reported as effective within three years. Multilevel Poisson regression models were used to examine the associations of effective programs with oral health personnel, contact with related agencies, the establishment of Health Japan 21 goals, financial status, the density of dentists and population density at the municipality level, and having oral health personnel at the prefecture level. Three hundred and fifty-four municipalities reported having effective programs. In the fully adjusted model, having dental hygienists in the municipal office (P < 0.05) and a high number of contacts with related agencies (P < 0.05) were significantly associated with having effective programs. These results suggest that having dental hygienists and contact with related agencies such as residents, local dental associations, companies, community general support centers, or medical, nursing or welfare facilities are promoting factors for effective adult oral health programs in Japanese municipalities.

Relationship of self-liking, self-competence with self-reported oral health status among 15-year-old children of Davangere city: A cross-sectional survey

Introduction: Psychological constructs have been found to have potential effects in the improvement of health. Self-esteem (expressed in the form of sub-constructs: Self-liking and self-competence) is a construct, which makes one realize the self. This in turn will result in positive oral-health-seeking behavior and improvement in oral health status. Aim: To assess the relationship of self-liking, self-competence with self-reported oral health status in children aged 15 years, in Davangere city. Materials and Methods: A descriptive, cross-sectional survey was conducted on 220 15-year-old subjects in Davangere City. Specially designed pro forma containing Romanian self-administered questionnaire to record the self-reported oral health status and Tafarodi's SLC scale to measure self-liking/self-competence was used. Chi-square test was used for statistical analysis. Results: A majority of the participants were found to have moderate self-competence and self-liking and their self-reported oral health status was expressed as excellent. They reported very less or no untreated decayed teeth and no extracted teeth or gingival bleeding. Conclusion: The participants with better self-competence and self-liking perceived their oral health status as good. They reported lesser incidence of oral diseases and discomfort. Self-esteem and oral health were found to be positively related.

Associations between school deprivation indices and oral health status

Despite an overall improvement in oral health status in several countries over the past decades, chronic oral diseases (COD) remain a public health problem, occurring mostly among children in the lower social strata. The use of publicly available indicators at the school level may be an optimal strategy to identify children at high risk of COD in order to organize oral health promotion and intervention in schools. To investigate whether school deprivation indices were associated with schoolchildren oral health status. This ecological study used a sample of 316 elementary public schools in the province of Quebec, Canada. Data from two sources were linked using school identifiers: (i) Two school deprivation indices (in deciles) from the Ministry of Education, a poverty index based on the low income cut-offs established by Statistics Canada and a socioeconomic environment index defined by the proportions of maternal under-schooling and of unemployed parents and (ii) Oral health outcomes from the Quebec Schoolchildren Oral Health Survey 1998-99 aggregated at the school level. These included proportions of children with dental caries and reporting oral pain. The relation between school deprivation indices and oral health outcomes was assessed with linear regression for dental caries experience and logistic regression for oral pain. The mean DMF-S (mean number of decayed, missing and filled permanent teeth surfaces) by school was 0.7 (SD = 0.5); the average proportions of children with dental caries and reporting oral pain were 25.0% and 3.0%, respectively. The poverty index was not associated with oral health outcomes. For the socioeconomic environment index, dental caries experience was 6.9% higher when comparing schools in unfavourable socioeconomic environments to the most favourable ones [95% confidence interval (CI): 2.1, 11.7%]. Furthermore, the most deprived schools, as compared to least deprived ones, were almost three times as likely to have children reporting oral pain in the previous week. The school socioeconomic environment index was associated with oral health outcomes, and should be studied for its potential usefulness in planning school-based oral health promotion and screening strategies.

Effects of Oral Care with Essential Oil on Improvement in Oral Health Status of Hospice Patients

This study was done to examine the effects of oral care with essential oil in improving the oral health status of hospice patients with terminal cancer. The participants were 43 patients with terminal cancer admitted to K hospital in G city, Korea. Twenty-two patients were assigned to the experimental group and 21 to the control group. Participants in the experimental group received special mouth care with essential oil (application of essential oil mixture consisting of geranium, lavender, tea tree, and peppermint). The control group received special mouth care with 0.9% saline. The special mouth care was performed twice daily for one week in both groups. The scores for subjective oral comfortness, objective oral state, and numbers of colonizing Candida albicans were measured before and after the treatment. The score for subjective oral comfortness and objective oral state were significantly higher in the experimental group compared to the control group. The numbers of colonizing Candida albicans significantly decreased in the experimental group compared to the control group. Oral care with essential oil could be an effective oral health nursing intervention for hospice patients with terminal cancer.

Lennox gastaut syndrome, review of the literature and a case report

BackgroundLennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy that is defined by generalized multiple type seizures, slowness of intellectual growth, and a specific EEG disturbance. Children affected might previously have infantile spasms or underlying brain disorder but etiology can be idiopathic. In South Africa, the incidence of secondary epilepsy is higher than what is found in developed countries resulting in higher incidence of the disease. LGS seizures are often treatment resistant and the long term prognosis is poor.ReportA twenty six year old female, presented with anterior open bite, macroglossia, supragingival as well as subgingival calculus. The gingiva was red, swollen and friable and there was generalized bleeding and localized suppuration. The patient had gingival recession. After periodontal therapy a remarkable improvement in oral health status was noted.ConclusionThe clinical findings in LGS included facial deformities, periodontitis and gingival swellings. Interdisciplinary treatment of these patients is fundamental and oral attention is of outstanding importance. Non-surgical periodontal therapy was effective in controlling periodontal disease in the reported case, but prevention of periodontal and dental diseases is preferable for this high-risk group of patients.