Oral Hygiene Research Articles

Impact of the COVID-19 lockdown on the oral health behaviour of young children.

Children up to the age of 10 are dependant primarily on their caregivers for oral care; COVID-19 lockdowns may have disrupted this care. We therefore assessed whether the COVID-19 lockdown affected routine parental oral care for their children. A short online survey regarding oral health behaviour and changes in the home setting during the COVID-19 lockdown was emailed to parents (n = 782, response 15%) participating in an existing study 'Healthy Teeth All Aboard (HTAA)'. During the lockdown, 29% of parents reported that they skipped their children's toothbrushing more often than before the lockdown, and 49% of the children were allowed to consume sugary snacks or drinks more often. These behaviours were not significantly associated with socio-economic status, country of birth of the mother, work situation of the parents, school attendance patterns or HTAA participation status. The COVID-19 lockdown affected the daily oral hygiene routines of children, potentially increasing caries risk. Dental professionals should be aware of the potential impacts on oral health in children in the circumstance of a new lockdown. Parents should be made aware of the oral health consequences of a lockdown.

Advances in the Study of the Relationship Between Orthodontics and Periodontitis

This comprehensive study employed a multifaceted research methodology encompassing a systematic review of existing literature, clinical case analyses, and a series of controlled clinical trials to explore the complex relationship between orthodontic treatments and periodontal health. The study focused on evaluating the biomechanical impacts of orthodontic procedures on the periodontium, including risks such as gum recession and bone loss, particularly in patients with varying periodontal biotypes and pre-existing periodontal conditions. The research methodology involved detailed assessments of periodontal health pre- and post-orthodontic intervention, monitoring changes in gingival and bone structures using advanced imaging techniques, and recording patient-reported outcomes regarding oral health quality. The findings of this study revealed a significant correlation between orthodontic force application and changes in periodontal tissue health, highlighting the necessity of personalized treatment planning that incorporates the patient's periodontal status. Preventive measures, including the use of controlled orthodontic forces, meticulous monitoring of tooth movement, and enhanced oral hygiene practices, were shown to be effective in minimizing periodontal complications. This study contributes significantly to the dental field by providing a deeper understanding of the orthodontic-periodontal relationship and offers practical guidelines for dental professionals in managing orthodontic treatments for patients with periodontal considerations. The study's findings underscore the importance of an interdisciplinary approach in dental care, advocating for closer collaboration between orthodontists and periodontists to optimize treatment outcomes and ensure comprehensive oral health care.

Evaluation of E-max Porcelain Veneer Failures: A Retrospective Study.

Aim This retrospective study aimed to evaluate if E-max veneers over five years caused changes in gingival, periodontal health, and veneer failures. Background As aesthetic dentistry progresses, dental veneers are becoming increasingly popular in both general and specialized dental practices. Due to technological advancements in dental ceramics and adhesive systems, porcelain veneers have become a highly sought-after solution for improving aesthetics in dental patients. The success of porcelain laminate veneers, a commonly used method for aesthetic restoration, relies on various factors. E-max veneers are frequently utilized, with their long-term durability contingent upon factors such as color stability, resistance to abrasion, as well as good compressive, tensile, and shear strength, along with maintaining marginal integrity. Methodology In this study, data was collected through a checklist form used to record clinical parameters. The clinical parameters evaluated were inflammation and bleeding on probing (BOP). The gingival health was evaluated by gingival index, gingival color, texture, and bleeding on probing, and periodontal health was evaluated by the pocket depth and radiographic evaluations. Finally, the veneer was visually inspected for chipping, staining, and debonding history. The score for most of the cases ranged between 0-1, with only 10 cases displaying moderate gingival inflammation and BOP (Gingival Index 2). Siemens Orthopantomogram (OPG) systems were used for radiological evaluation and documentation of cases. E-max porcelain veneers were only included in the research. Results Out of 28 patients, each with 6-to-10-unit veneer cases was examined, 18 patients (64.3%) displayed healthy gingival status with no bleeding area recorded in none of the veneers amongst the 6 to 10 units. In 10 patients (35.7%) most of the veneers had inflamed gingival tissue that was bleeding on probing. The majority revealed the presence of stippling (92.9%), absence of recession (96.4%), and pocket depth (67.9%). Half of our participants had their veneer for more than five years (50%) and the majority presented with no significant changes in veneer recorded like marginal staining, debonding, or chipping (89.3%). Conclusion Multiple factors such as patient selection, proper treatment planning, and design, including material selection, play a significant role in the long-lasting success of ceramic veneers. The retrospective study indicated that proper oral hygiene measures are vital for the long-term sustainability of E max veneers.

Comparison of oral health status, oral hygiene management behaviours and satisfaction of patients with fixed orthodontic appliance and clear aligner: A quasi-experimental design.

This study aimed to determine the overall oral health statuses of patients with fixed orthodontic appliance and clear aligner, as well as their oral hygiene management behaviours and satisfaction. We selected 40 participants (20 each with fixed orthodontic devices and clear aligners) who visited a dental clinic. We conducted a survey to determine the oral hygiene management behaviours of the subjects and their satisfaction with their orthodontic treatment. Three measurements were also conducted at 4-week intervals to determine the oral health statuses of the subjects. The Löe and Silness gingival index of patients with fixed orthodontic appliances indicated moderate gingivitis (1.1 ± 0.3), and those with clear aligners had mild gingivitis (0.6 ± 0.4) (p < 0.001). The modified O'Leary index also indicated that the degree of dental plaque deposition in the oral cavity was lower in patients treated with a clear aligner (43.0 ± 18.2 points) than in those treated with a fixed orthodontic (28.1 ± 10.9 points) (p = 0.004). Regarding oral hygiene management, the fixed orthodontic group received scaling more frequently (p = 0.006), received more oral health education (p < 0.001) and had a longer brushing time (p = 0.008) than the clear aligner group. No significant difference was observed in satisfaction between the fixed orthodontic appliance and the clear aligner. Regarding the oral health status by orthodontic appliance type, the clear aligner group had the advantages of reduction in dental plaque attachment and gingival health. The fixed orthodontic group exhibited better oral hygiene management behaviours. Satisfaction with orthodontic treatment was found to be similar for the two device types.

Oral Health and the Association with Blood Parameters in Neurogeriatric Inpatients without Relevant Systemic Inflammation: An Observational Study.

As little evidence is available, we report the oral health of neurogeriatric inpatients and the association with hematological parameters representing systemic health. We performed a cross-sectional investigation of 30 patients undergoing neurogeriatric early rehabilitation and excluded systemic inflammation as a trigger for oral infection (C-reactive protein >5 mg/dL). Outcomes included oral health and hygiene status and routine laboratory parameters. Patients (mean age 79 ± 6 years, mean comorbidities 7 ± 3, and mean Barthel Index at hospital admission 31 ± 18) had impaired oral health (mean 18 ± 7 of their own teeth, elevated plaque indices (2.5 ± 0.4), and bleeding on probing (26 ± 17)), representing short- and long-term reduced oral hygiene. Twenty-four (80%) patients had periodontitis. Laboratory parameters for inflammation, nutrition, and anemia did not correlate with oral health parameters (p > 0.05). The number of teeth correlated moderately with total protein (Spearman's rank correlation coefficient (rs) = 0.524; p = 0.003). Plaque indices correlated weakly with number of teeth (rs = -0.460; p = 0.010) and periodontitis diagnosis (rs = 0.488; p = 0.006). Thus, highly vulnerable neurogeriatric inpatients had reduced oral health and hygiene independent of laboratory parameters, representing a high-risk population for oral health problems even without clinically proven systemic infection. This should be considered in future interprofessional therapy planning.

Case-finding for HPV vaccination eligibility within a dental office with concurrent development of a dialogue tool

BackgroundHuman papillomavirus (HPV) immunization can prevent cancers, but uptake has been incomplete (and worse with the COVID-19 pandemic). Dental clinicians already screen for oral cancers, many of which are caused by HPV, and could identify vaccination candidates, but this requires a case-finding strategy. ObjectiveThe purpose of this study was (1) to develop and test a case-finding approach to identify patients who were candidates for HPV vaccinations, (2) to test an HPV vaccination intervention by dental professionals on vaccination uptake. MethodsDesign: Prospective, non-randomized feasibility case finding study with a 4-week enrollment period and a 6 week follow up period in general dental offices.Setting: Two general and non-commercial dentistry offices in Edmonton, Alberta Canada.Subjects: Consecutive scheduled (non-emergent) patients who met the Health Canada criteria for HPV vaccination: immunocompetent males and females aged 9–45 years and those who are immunocompromised. Consent for the discussion was obtained from each subject or parent.Intervention: Scheduled dental patients meeting the inclusion criteria were flagged by a research assistant who reviewed the appointment schedule each week for 4 weeks. For these subjects, dental clinicians (dentists and dental hygienists) used our Dental Dialogue Tool to discuss HPV vaccination and answer questions. Participating patients who consented to receive the HPV vaccine were given a prescription by the attending dentist and were directed to follow-up with a local pharmacy to have the vaccine administered. Each participant that was provided with an HPV prescription was contacted after 6 weeks to identify if they received the first dose of vaccine.Outcomes: Yield of our case-finding strategy and receipt of a patient’s first HPV vaccine dose during 6 weeks post vaccine prescription. ResultsOur case-finding strategy assessed 656 scheduled patients over 4 weeks. From this screening,179 (a case-finding yield of 20.4 %), were candidates for HPV vaccine discussion. Forty-three of these 179 patients (24 %) were already vaccinated.. Two patients (1.1 %) did not consent to be spoken with and 134 (74.8 %) consented to the HPV vaccine discussion.. Forty-eight of 134 patients (35.8 %) of patients accepted a prescription from the dentist after speaking with the dental clinician. Ultimately, 8/48 (16 %) (patients received their first dose of the HPV vaccine by the 6 week of follow-up call. However, this is only 4.5 % (8/177) of those patients who did consent for the discussion of HPV cancers and vaccination from their dentist. ConclusionWe demonstrated that case-finding for HPV vaccine candidates in general dental offices was feasible, with a reasonable yield. While the dental dialogue tool was described as a great resource to explain the facts and answer questions, very few patients were vaccinated after 6 weeks of follow-up. Further work is necessary to sharpen the intervention, perhaps including follow-up discussions with the dental clinicians.

ANALYSIS OF THE PREVALENCE AND STRUCTURE OF DENTAL MORTALITY AMONG APPLICANTS TO THE MILITARY MEDICAL ACADEMY OF S.M. KIROVA

ANALYSIS OF THE PREVALENCE AND STRUCTURE OF DENTAL MORTALITY AMONG APPLICANTS TO THE MILITARY MEDICAL ACADEMY OF S.M. KIROVA

Perceived strengths, weaknesses, opportunities and threats related to the utilization of oral health services among pre-conceptive married women before their first pregnancy in Kalutara District

Introduction: Utilization of oral health services during pre-conce ptive period is important for a woman to accomplish a healthy oral environment prior to her pregnancy. Objectives: To describe the perceived strengths, weaknesses, oppor tunities and threats (SWOT) related to the utilization of oral health services among pre-conceptive married women before the ir first pregnancy in Kalutara District Methods: In-depth interviews among pre-conceptive married wome n before their first pregnancy in Kalutara District were conducted using semi-structured interview guide. Purposive sampli ng method was used to select 18 study participants. Data were analysed manually using the thematic analysis method. The i nductive method was used to identify and generate codes and themes from the data itself. The theoretical perspective of qua litative data analysis carried out in this study was the ‘grounded theory approach’. Results: Identified strength was knowledge on benefits of oral health for the pregnancy and quality of life of women. Identified weaknesses were lack of motivation regarding oral health care seeki ng, lack of awareness that the pre-conception period is a crucial period for the oral health promotion among married women, f ear for dental treatment, myths related to the oral health and barriers related to attending dental clinics due to personal-level factors. Identified opportunities were availability of oral health component in the Healthcare for Newly Wedded Programme (HNWP), provision of the oral health education by the medical officer of health (MOH) office staff at the HNWP session s, help and guidance from the MOH office staff at the HNWP sessions to clarify oral health related issues, satisfactory pro vision of the government dental services, dental clinics in the MOH office premises and favourable working hours of the priva te dental clinics. Identified threats were barriers related to attending dental clinics due to service-related factors and lack of information regarding the oral health component of the HNWP from peer groups. Conclusions &amp; Recommendations: Perceived SWOT related to t he oral health services among pre-conceptive married women were identified. These findings will be important to the poli cy makers and service providers to plan an effective oral health service for married women before their first pregnancy.

Assessment of periodontal health status in patients with Parkinson's disease-A systematic review and meta-analysis of cross-sectional studies.

Parkinson's disease (PKD) is neurodegenerative disorder marked by tremors, bradykinesia, muscle rigidity and reduction in precise hand movements which could lead to improper oral hygiene and Periodontal disease. Current systematic review aims to review existing literature and provide assessment of periodontal health in PKD patients through a meta-analysis METHODS: Review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in PROSPERO-CRD42023451700. Databases were searched for studies having sufficient data on periodontal health in patients with PKD compared to healthy controls and reporting outcomes in terms of various periodontal parameters of probing depth (PD), plaque index (PI), clinical attachment level (CAL), presence of bleeding on probing and gingivitis. Quality assessment of included was evaluated using Newcastle Ottawa Scale (NOS). Eleven studies fulfilled the eligibility criteria, of which ten studies were suitable for meta-analysis. Pooled estimate through the SMD showed that all periodontal parameters were altered and significantly deteriorated in PKD compared to controls but this group differences were statistically insignificant (p>0.05). Publication bias through the funnel plot showed symmetric distribution with absence of systematic heterogeneity. Parkinson's disease could be a possible factor in deterioration of periodontal health.

Current Status and Family Factors Influencing Caries in the Deciduous Teeth of Children 3-6 Years of Age in Families Residing in Rural Heishanzui Township.

To determine the caries status in children's deciduous teeth and examine the influence of family oral health behaviours on the caries status. This cross-sectional study included 329 children aged 3-6 years in rural Heishanzui Township, Hebei Province, China, and used a completely random sampling method. These children underwent physical and oral health examinations. The questionnaires were given to the parents and caregivers of the examined children. The prevalence of caries in the deciduous dentition among children aged 3-6 years was 80.55%, with a dmft index of 4.93. Children in the caries group ate sweets, chocolates, and carbonated drinks more frequently than did children in the caries-free group (p < 0.05). Children in the caries-free group brushed their teeth more frequently, with parents helping their children brush, more often than did those in the caries-affected group (p < 0.05). The level of parental education and annual household income also had statistically significant effects on the prevalence of caries in the two groups (p < 0.05). Logistic regression analysis revealed that the frequency of eating sweets was a risk factor for caries in deciduous teeth (odds ratio = 2.20; p < 0.05). The prevalence of caries in deciduous teeth among children aged 3-6 years in rural Heishanzui Township was high. Compared to children in the caries-affected group, the families and children in the caries-free group had better oral hygiene behaviours. Moreover, the frequency of eating sweets was shown to be a risk factor for caries in deciduous teeth in children aged 3-6 years.

Ethnographic perspectives of mothers and professionals on including children with disabilities in oral health in the Kingdom of Saudi Arabia.

Children with disabilities generally face poorer oral health outcomes compared with their non-disabled peers due to a range of factors including inadequate oral hygiene, infrequent dental visits and systemic barriers in accessing care. This ethnographic study explored the perspectives of caregivers and professionals to identify the ways that children with disabilities are included in oral health. A purposive sample of 10 caregivers, all mothers with disabled children aged 9-15 years, five healthcare providers and five educators in Saudi Arabia, participated. Data collection used participant observation and semi-structured in-depth interviews. Data were analysed using reflexive thematic analysis. The findings suggest that mothers lacked a supportive environment to develop their skills and knowledge about oral health care, preventing them from including their children in oral health. Inaccessible services added to the exclusion of both mothers and children. Some dental professionals exhibited poor communication skills and discriminatory attitudes towards the children and problematising mothers. Educators tended to discuss disabled children in terms of inability, displaying a deficit approach to impairment. The evidence suggests the exclusion of mothers from oral health. This has an impact on how they enable their children. Recommendations include adopting a social model of disability in dental education and policies in Saudi Arabia to address inequalities. Provision of support, education and focusing on societal barriers moves towards inclusion rather than conceptualising disability as an individual problem.

Understanding oral cancer disparities in India: Exploring socioeconomic and demographic factors impacting access to care and outcomes

The high prevalence rates, inequalities in treatment outcomes and access to care and other factors make oral cancer a major public health concern in India. The diverse aspects of oral cancer disparities in India are examined in this article, with a particular emphasis on the socioeconomic and demographic variables that affect outcomes and access to care. Disparities still exist even with improvements in treatment modalities. These are caused by low socioeconomic position, low health literacy, cultural customs, and gender variations in risk behaviors. A comprehensive strategy that includes investments in healthcare infrastructure, health education programs, and tobacco control measures is needed to reduce the disparities in oral cancer. India may strive toward providing equal access to oral cancer care for all its population by eliminating systemic injustices and encouraging preventative measures.

Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore.

Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore. Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD. Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies. Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.

Porphyromonas gingivalis Infection is Associated with Increased Vascular Inflammation in Patients with and Without Coronary Artery Disease

Vascular inflammation is a critical measure of risk for major adverse cardiac events in patients with and without known coronary artery disease. It is recognized that patients with poor oral hygiene tend to have an increased prevalence of coronary artery disease and myocardial infarction. Porphyromonas gingivalis (PG) is the keystone pathogen leading to periodontal disease. Despite evidence suggesting a link between active PG infection and coronary artery disease, there is limited data investigating whether PG can contribute to increased markers of vascular inflammation in patients with coronary artery disease. In this study, we studied 112 consecutive patients who presented at a community preventive cardiology clinic who consented to be assessed for the presence of PG. Subjects were enrolled in a mouth along assessment with measures of vascular inflammation, which was part of their routine clinical care. The average age of patients was 70.4 ± 8.5 years with 48.6% of the patients positive for PG and 20.5% with a history of coronary artery disease (CAD). The distribution of PG positivity was 48.3% and 34.8% in patients without and with a history of CAD, respectively. Patients with CAD have significantly greater levels of high sensitivity C-reactive protein (hsCRP_ (1.3 ± 0.3 vs. 3.2 ± 1.1 mg/dL, p = 0.04) and MPO (245.1 ± 19.4 vs. 371.4 ± 39.1 pmol/L, p = 0.003). Patients without a history of CAD, only Myeloperoxidase (MPO) was significantly increased. Statin use was significantly greater in those patients with a history of CAD. Interestingly, statin use tended to be greater in PG+ patients (71% vs. 62%) regardless of CAD status. The data from this early study demonstrate a link between active PG infection and increase in markers of vascular inflammation, especially in patients with established CAD. The findings suggest PG as a marker of cardiovascular risk, especially in patients with residual inflammatory risk.

Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden: a multicentre repeated cross-sectional study

ObjectiveThe aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.DesignThe...

New powers for dental hygienists and therapists announced by government

New powers for dental hygienists and therapists announced by government

Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors.

This study was undertaken with an aim to explore the influence of factors associated with anxiety and fear of dentistry on oral health behavior. A total of 84 patients aged 20-40 years visiting the dental institute for the management of gum diseases (gingivitis and periodontitis) and tooth decay (dental caries) were enrolled. Fear of dentistry and oral health behaviors were recorded employing a dental fear survey (DFS) and oral health behaviors checklist. Each of the 20-item scale of DFS was rated on a 5-point Likert scale. The oral health behavior checklist was based on oral hygiene habits, patterns of utilization of dental services, food habits, and use of tobacco products. Each of the 13-item checklist comprised a closed-ended statement with a high score corresponding to more positive oral health behavior. Domains of dental fear (avoidance of dentistry, physiological arousal, and fear of specific stimuli) and total dental fear did not predict oral hygiene habits and nutritional preferences (p > 0.05). Physiological arousal was a positive predictor of utilization of dental services (p = 0.009) and oral health behavior (p = 0.042). Oral health behaviors were found to be positively correlated with three factors of DFS. Anxiety and fear of dentistry are not found to influence personal preventive oral care with reference to oral hygiene habits. Avoidance of dentistry factor of DFS is positively correlated with oral health behavior. Dental fear and anxiety do not impact oral health behaviors adversely. In this era of youth and beauty, the utilization of professional dental care services is not affected by fear of invasive nature of dental procedures. Establishing the groundwork for knowledge regarding the scope of fear appeals in anxiety for dentistry may help to augment positive oral health behaviors for effective primary prevention of oral diseases. Interactions among personality characteristics, attitudes, emotions, and health behavior need further exploration. How to cite this article: Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024;25(3):280-288.

Large adenomatoid odontogenic tumor: Case report

The adenomatoid odontogenic tumor (AOT) is an uncommon, benign neoplasm of odontogenic epithelial origin, believed to have originated from two remnants of the dental lamina or enamel organ, representing 2-7% of all odontogenic tumors. Clinically, they are slow growing, asymptomatic and rarely exceed 3.0 cm in diameter. TOA presented three different clinicopathological variants without relevant clinical and radiographic differences: intraosseous follicular (associated with dental impaction, generally comprising 70% of the two cases); extra-follicular intraosseous (present between erupted teeth, representing 25% of the two cases); and peripheral (extra-osseous, 5% two cases). The aim of this paper is to report a case of a large and aggressive adenomatoid odontogenic tumor. Patient, male, 13 years old, undergoing direct increase in maxillary volume with evolution of 01 month. Upon physical examination, an increase in volume in the middle third of the face was observed, directly causing facial asymmetry. normal appearance, absence of unit, tooth 13, stable dental occlusion, poor mouth opening, poor oral hygiene. On imaging (face tomography) there was a hypodense image in the maxillary region directly, osteolytic, well circumscribed, with a radiopaque halo, causing expansion of the cortical bones without breaking them, associated with the impacted and included dental unit 13. Enucleation and complete healing of the lesion and associated extraction of unit 13 were performed, with a lesion presenting a fibrous capsule in the non-transoperative period. The patient is being followed up by a team, weeks of recurrence at the moment. In this way, a rapid and aggressive evolution appears, being clinically perceptible and confused with the behavior of an amelolastoma, however, the histopathological diagnosis of TOA was confirmed, although the lesion responded to a conservative surgical technique through enucleation and dressing, presenting a excellent result.

IMPACT OF AGING AND STRESS ON THE PERIODONTAL HEALTH OF THE GERIATRIC POPULATION BEFORE AND AFTER PERIODONTAL TREATMENT IN OLD HOMES OF KARACHI, PAKISTAN

Age and stress-related periodontal diseases are prevalent in the geriatric population and continue to provide a significant epidemiological concern. Objective: To assess the impact of ageing and stress on the periodontal health of the senior population before and after periodontal treatment Method: A cross-sectional study was conducted between February and October 2023. Twenty-two senior patients aged 55 to 77 were selected through purposeful random sampling, excluding those unwilling or unable to participate. A semi-structured questionnaire, translated into the native language, assessed periodontal health using the Basic Periodontal Examination (BPE). Informed consent was obtained from participants, who were assured confidentiality and the right to withdraw. Data analysis was performed using SPSS version 23, employing mean and standard deviation for continuous data and frequency tables for categorized data. Cross-tabulation and significance testing were utilized to demonstrate associations. Results: The results of the prevailing cross-sectional study reveal that there exists an association between moderate to elevated levels of perceived stress and the manifestation of severe instances of periodontal disease. As per the study findings, periodontitis tends to afflict individuals across older adult age demographics. Conclusion: The study emphasised that stress and ageing are key risk factors for periodontal diseases, underlining the importance of addressing them during therapy. Consistent oral hygiene can prevent periodontitis in older adults.

Enhanced control of periodontitis by an artificial intelligence-enabled multimodal-sensing toothbrush and targeted mHealth micromessages: A randomized trial.

Treatment of periodontitis, a chronic inflammatory disease driven by biofilm dysbiosis, remains challenging due to patients' poor performance and adherence to the necessary oral hygiene procedures. Novel, artificial intelligence-enabled multimodal-sensing toothbrushes (AI-MST) can guide patients' oral hygiene practices in real-time and transmit valuable data to clinicians, thus enabling effective remote monitoring and guidance. The aim of this trial was to assess the effect of such a system as an adjunct to clinical practice guideline-conform treatment. This was a single-centre, double-blind, standard-of-care controlled, randomized, parallel-group, superiority trial. Male and female adults with generalized Stage II/III periodontitis were recruited at the Shanghai Ninth People's Hospital, China. Subjects received a standard-of-care oral hygiene regimen or a technology-enabled, theory-based digital intervention consisting of an AI-MST and targeted doctor's guidance by remote micromessaging. Additionally, both groups received guideline-conform periodontal treatment. The primary outcome was the resolution of inflamed periodontal pockets (≥4 mm with bleeding on probing) at 6 months. The intention-to-treat (ITT) analysis included all subjects who received the allocated treatment and at least one follow-up. One hundred patients were randomized and treated (50 tests/controls) between 1 February and 30 November 2022. Forty-eight tests (19 females) and 47 controls (16 females) were analysed in the ITT population. At 6 months, the proportion of inflamed periodontal pockets decreased from 80.7% (95% confidence interval [CI] 76.5-84.8) to 52.3% (47.7-57.0) in the control group, and from 81.4% (77.1-85.6) to 44.4% (39.9-48.9) in the test group. The inter-group difference was 7.9% (1.6-14.6, p < .05). Test subjects achieved better levels of oral hygiene (p < .001). No significant adverse events were observed. The tested digital health intervention significantly improved the outcome of periodontal therapy by enhancing the adherence and performance of self-performed oral hygiene. The model breaks the traditional model of oral health care and has the potential to improve efficiency and reduce costs (NCT05137392).