Oral Conditions Of Patients Research Articles

Application of improved Beck oral score in oral care of burn patients with mechanical ventilation

Objective: To explore the application effect of improved Beck oral score in oral care of burn patients with mechanical ventilation, to provide practical basis for oral care of such patients.Methods: A total of 42 patients with tracheotomy and mechanical ventilation in the Department of Burn Surgery of Baogang Hospital in Inner Mongolia from January 2021 to December 2022 were selected as the study objects, and the patients were randomly divided into observation group and control group, with 21 cases in each group. The control group was given routine oral care, and the observation group was given oral care according to improved Beck oral score. The following were compared between the two groups: Age, total burn area, third-degree burn area, acute physiological and chronic health assessment scores, as well as improved Beck oral scores; the incidence of oral odor, plaque index, mouth ulcer and ventilator-associated pneumonia (VAP) after 7 days; the detection of microorganism in oral secretions.Results: After 7 days, the oral condition of patients in observation group was effectively improved, and the oral comfort level was significantly improved. The incidence of oral odor (2.57±1.59), dental plaque index (2.62±1.47), oral ulcer evaluation (2.24±1.09), VAP incidence (9.52%) and improved Beck oral score (8.09±1.92) in observation group were all lower than those in control group, which was (3.95±1.82), (3.57±1.21), (3.14±1.24), (38.09%), and (9.90±2.21) respectively. The difference was statistically significant (p < .05). The oral normal flora in observation group (71.43%) was higher than that in control group (28.57%), and the difference was statistically significant (p < .05). The oral gram-positive bacteria (19.05%) and Gram-negative bacteria (23.81%) in observation group were lower than those in control group, which was 52.38% and 57.14% respectively, and the difference was statistically significant (p < .05).Conclusions: The application of the improved Beck oral assessment method in dynamic oral care can effectively reduce the content of oral pathogens, lower the incidence of pulmonary infection, and improve the quality of life of patients.

Oral Health-Related Quality of Life in Adult Patients with Depression or Attention Deficit Hyperactivity Disorder (ADHD).

The aim of this cross-sectional study was the evaluation of the oral health-related quality of life (OHRQoL) in patients with depression or attention-deficit/hyperactivity disorder (ADHD) in comparison with a group of mentally healthy individuals. Patients from the Department of Psychiatry and Psychotherapy, University of Leipzig, Germany, were recruited. A healthy comparison group (HC) was recruited from the Department of Cariology, Endodontology and Periodontology. The OHRQoL was assessed using the Oral Health Impact Profile G14 (OHIP G14). Furthermore, a questionnaire regarding oral hygiene behaviour was applied. A total of 141 patients with depression or ADHD (depression n = 94, ADHD n = 47) and 145 HC individuals with a balanced age and gender distribution were surveyed. OHIP G14 median scores were significantly higher in the overall psychiatric patient group compared to HC (5.00 vs. 0.00, p < 0.001). This was also found for the four dimensions of OHIP G14 (p < 0.001). The OHIP G14 sum score of patients with depression and ADHD was comparable (5.00 vs. 6.50, p = 0.302). A significant association among psychiatric patients between smoking, gum bleeding, professional tooth cleaning, oral health education, interdental cleaning, and elevated OHIP scores was found (p < 0.001). In conclusion, patients with depression and adults with ADHD show a reduced OHRQoL. A contradictory association between oral hygiene/oral health behaviour and OHRQoL supports the hypothesis of a changed perception of oral conditions in patients with mental diseases. Interdisciplinary collaboration between psychiatric specialists and dentists should be fostered.

Oral health in older adults with cancer

Cancer is a disease of older adults, with 60% of cancer diagnoses and 70% of cancer deaths occurring in individuals ≥ 65 years. Normal oral aging may transition to disease in the presence of one or more potential modifiers, such as a new oncological diagnosis or a new treatment. Oral conditions in patients with cancer cause significant morbidity. Previous work suggests that oral conditions are neither elicited/assessed/reassessed nor well-managed or investigated in older patients. However, frequently reported oral conditions in patients undergoing cancer therapy include xerostomia, dysgeusia, candidiasis, mucositis, and dental caries. Some oncological treatments such as hematopoietic stem cell transplant or chemotherapy/radiotherapy for head and neck cancers entail higher risks of oral complications. No specific recommendations in the case of older adults with cancer-associated oral conditions are available. Treatment recommendations are based on low levels of evidence and/or evidence extrapolated from younger patients with câncer.

Evaluation of dental demands and needs of people experiencing homelessness in the city of Rome, Italy.

Poor oral health and oral diseases are common among people experiencing homelessness. The aim of this study was to evaluate the dental demands and needs of a population of homeless persons in the city of Rome, Italy. The clinical records of 165 homeless patients admitted between October 2020 and October 2021 to the dental service of the Primary Care Services of the Eleemosynaria Apostolica, Vatican City, were retrospectively reviewed. The service employed dentists to evaluate dental needs and oral conditions in patients experiencing homelessness. The main dental and oral pathological conditions were noted. One hundred and sixty-five records of homeless patients were included in the study. The sample consisted in 138 males (76.97%) and 27 females (23.03%) with a mean age of 46.9 years (range 7-85 years). Acute tooth pain was reported by 132 (80%) patients, 42 (25.45%) had edentulism or missing teeth and 18 (10.91%) patients had oral lesions. Both dental and oral pathologies were intercepted and managed in secondary healthcare facilities. Given the specific peculiarities of this vulnerable population, it is important to implement strategies that facilitate the access of persons experiencing homelessness to dental evaluation with a preventive and curative perspective.

Time to integrate oral health screening into medicine? A survey of primary care providers of older adults and an evidence-based rationale for integration.

Primary care providers were assessed regarding their training and interest to screen oral conditions in patients ≥55years old. Oral health (OH) is an essential component of overall health and can affect systemic health. Medical/dental integration in older adults is underdeveloped. A brief survey assessed primary care providers' self-reported skills, practices and barriers towards integrating OH screening into adult primary care. Data were collected using Survey Monkey® . Respondents were physicians and advanced practice providers (APPs) working at a large mid-western safety-net hospital. Descriptive statistics, T-tests and Chi-squared tests were reported. Eighty-two of 202 participants (41%) completed the survey. Most respondents were female (75%). A majority were physicians (68%); the remainder APPs. All providers (100%) reported OH was important or extremely important to overall health. More physicians (93%) reported not being well-trained to address adult OH issues and perceived less medical-oral health integration in their practice (16%) compared to APPs (P<.05). Time was more of a barrier with APPs (74%), compared to physicians (51%), to integrate OH screening activities (P<.05). Most providers reported other barriers such as inadequate OH training and insurance coverage. Providers endorsed that OH should be assessed frequently (56%) including providing referrals to dentists (77%) and educating patients on oral-systemic issues (63%). More female than male providers endorsed dental referrals and educating patients (P<.05). Primary care providers embraced greater medical/dental integration for older adults. Instituting OH activities appears to be supported. Future interventions that are feasible in primary care settings are examined.

Dental disorders and self-perception of oral health in patients with paracoccidioidomycosis

Paracoccidioidomycosis, a systemic fungal disease, can lead to dental disorders. As studies on dental problems in patients with paracoccidioidomycosis are few, we evaluated dental disorders and self-perceived oral health in this population. The objective is to evaluate the oral condition of patients with paracoccidioidomycosis as well as their perception of the problem through a cross-sectional study of 52 adult patients with current or previous paracoccidioidomycosis in a reference hospital in Mato Grosso do Sul between December 2017 and July 2018. Demographic data, dental history, and self-perception of oral health were obtained from the National Oral Health Survey—SB Brazil 2010. The number of permanent decayed, missing, or filled teeth; presence and intensity of gingival bleeding; dental calculus; periodontal pockets; and periodontal attachment loss were recorded. Most patients had chronic paracoccidioidomycosis (n = 50; 96.2%), with involvement of the mouth in the active phase of the disease (n = 38; 73.1%). Participants had a high number of decayed, missing, or filled teeth (median: 30 teeth). The most compromised component was “missing” teeth (median of 21 teeth), and total edentulism was observed in 17 patients (32.7%). Periodontal disease was seen in 15 of 35 patients (43.3%) who had at least one tooth. Regarding satisfaction with their oral health, 27 patients (51.9%) reported being satisfied or very satisfied. There was no association between the degree of satisfaction with the other data. Tooth loss is the major dental problem in patients with paracoccidioidomycosis, and in patients with teeth, periodontal disease was highly prevalent. A general positive self-perception of oral health observed in these patients may reduce their willingness to seek dental treatment.

CONSIDERAÇÕES CLÍNICAS E MANEJO ODONTOLÓGICO DE PACIENTES COM DOENÇA RENAL CRÔNICA

Chronic Kidney Disease (CKD) is characterized by the slow and irreversible destruction of the nephrons, compromising glomerular filtration and promoting the accumulation of toxic substances in the blood. Initially, the diagnosis is made only by hematological tests, but as the condition advances, the signs and symptoms become more evident and the replacement renal therapy becomes necessary. Approximately 90% of patients have some oral symptom resulting from the disease, the effects of treatment, or negligence of oral hygiene measures. This study aims to review the literature about CKD, discuss its implications on the oral condition of patients and present a protocol that allows safe and effective dental care. The review was done using the databases Medline, SciELO and LILACS limiting the search to the period 2010 to 2020, using the descriptors: “Chronic Kidney Failure”, “Dental Care” and “Oral Alterations”. It is important that the dentist knows the systemic condition of CKD and how it reflects on the oral health, thus, he will be able to choose the ideal conduct for dental care, which must happen from prevention to clinical therapy in order to promote a better quality of life for these patients.

Impact of radiotherapy to the head and neck region on the oral condition

Investigations of the oral function of patients undergoing radiotherapy (RT) to the head and neck region are relevant for the overall quality of life. Considering the possible impact of the side-effects on nutrition, the recovery of these patients might be impaired. This study aimed at investigating the oral condition of patients submitted to RT to the head and neck region. A single-center, cross-sectional mixed analysis assessing the oral conditions of patients before RT (group 1) and after 12-months of RT (group 2) was performed. Following inclusion and exclusion criteria consideration, fifty (n=25) patients were included in this study. A calibrated examiner conducted the oral examination, the following variables were assessed: a) DMF index: decayed, missing and filled teeth; b) xerostomia and dysgeusia, subjective assessment of salivary function and taste; c) simplified oral hygiene index – OHI-S, with plaque disclosing solution; d) unstimulated sialometry, assessment of salivary function. Statistical analysis compared the groups considering a significance level of 5%. The group evaluated after 12 months of RT showed high rate of dry mouth (92%) and dysgeusia complaint (72%) while no patient reported in group 1. Statistically significant difference was observed in the comparison of group 1 and 2 regarding DMF index (&gt; 64%), OHI-S index (&gt;38%), and unstimulated sialometry (&lt;70%). Patients submitted to RT to the head and neck region for the treatment of cancer experience oral complications even at 12 months after the last session of RT.

A retrospective study on the oral health of patients in the intesive care unit

&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt;: the oral condition of patients in the Intensive Care Unit (ICU) is extremely important for clinical status monitoring,&lt;br /&gt;as lesions in the oral mucosa may imply complications and worsening of the health status of these patients. A higher probability&lt;br /&gt;of adherence, colonization, and bacterial infection in the oral cavity of patients in the ICU has also been reported. The poor oral&lt;br /&gt;hygiene conditions of these patients may be related to the reduction of salivary flow and difficulties in maintaining oral hygiene in a&lt;br /&gt;hospital environment, which rarely employs dentists on staff. &lt;strong&gt;Objective&lt;/strong&gt;: to analyze the dental condition of patients admitted to the&lt;br /&gt;ICU of Roberto Santos General Hospital, Salvador, Bahia, Brazil. &lt;strong&gt;Methodology&lt;/strong&gt;: a total of 73 patients were evaluated through an oral&lt;br /&gt;examination performed with a wooden spatula and sterile gauze under natural light, and data were collected and analyzed. &lt;strong&gt;Results&lt;/strong&gt;:&lt;br /&gt;The most commom oral lesions were tongue-coating (41%) and ulcerations in the oral mucosa caused by trauma or dehydration&lt;br /&gt;(19.1%). The occurrence of pseudomembranous candidiasis (8.2%), dehydration of the lips and mucosa (26%), and angular cheilitis&lt;br /&gt;(9.5%) was additionally recorded. It was observed that 31.5% patients had more than 10 days of hospitalization and of these, 26%&lt;br /&gt;presented pseudomembranous candidiasis. This clinical condition was not seen in patients with a shorter hospital stay. &lt;strong&gt;Conclusions&lt;/strong&gt;:&lt;br /&gt;this study suggest a possible association between the length of stay of these patients and the clinical conditions presented. Thus, the&lt;br /&gt;results of this study may guide preventive and curative measures implemented by dental surgeons who may, in the future, be part&lt;br /&gt;of the multidisciplinary team of professionals working in the hospital environment, especially in ICUs.&lt;/p&gt;

Effects of the fixed orthodontic therapy on biochemical and microbiological parameters of saliva

Introduction/Objective. Malocclusions are one of the most frequent disorders in dentistry, and pose a risk for the onset of caries and periodontal diseases. Fixed orthodontic treatment solves the problem of malocclusions; however, it requires simultaneous cooperation of the patients, parents, and dentists involved. The objective of this study is to examine the effects of fixed orthodontic therapy on the Streptococcus mutans and Lactobacillus spp. bacteria in saliva, the pH value, and buffering capacity of saliva. Methods. The research was carried out at the Faculty of Medicine in Foca, Department of Dentistry. The study included 100 respondents, aged 13 to 17 years. The respondents were divided into two groups: the study group (respondents wearing fixed braces) and the control group (respondents not subjected to fixed braces therapy). Saliva samples were taken from the respondents four, 12, and 18 weeks after the start of the orthodontic therapy. The study used the bacteria caries risk test (CRT) and CRT buffer (Ivoclar Vivadent). Results. The study showed an increased number of bacteria in saliva of the respondents during all three follow-up periods (?2 test, p = 0.001). The largest numbers of the Streptococcus mutans and Lactobacillus spp. bacteria were found in week 12 of the therapy. Saliva pH value and buffering capacity of saliva increased statistically significantly in week 12 of the therapy (?2 test, p = 0.001). Conclusion. Oral conditions in patients changed during the fixed orthodontic therapy: the number of bacteria increased, the pH value and buffering capacity of saliva changed. It was necessary to use preventive measures in order to avoid complications during the fixed orthodontic appliances therapy.

Assessment of Frequency of Oral Conditions in Patients with Hematological Malignancies: A Hospital-Based Study

Assessment of Frequency of Oral Conditions in Patients with Hematological Malignancies: A Hospital-Based Study

Periodontitis deteriorates peripheral arterial disease in Japanese population via enhanced systemic inflammation.

Peripheral arterial disease (PAD) is a common manifestation of arterial stenosis of the extremity that reduces arterial flow. While patients with periodontitis are at a high risk of PAD, little causal information has been provided to date. To clarify the relationship, we conducted this cross-sectional study. The oral condition of patients with or without PAD, who attended Tokyo Medical and Dental University Hospital, was evaluated. Blood examinations and dental clinical measurements, including number of teeth, probing pocket depth (PPD), bleeding on probing (BOP) and clinical attachment level (CAL) were performed. Chi-square test was performed to compare gender, smoker rate, prevalence of DM, hypertension and dyslipidemia and edentulous rate. Wilcoxon test was used to compare bacterial counts and anti-bacterial antibodies and Student's t test was used to compare the other numerical values. The subjects were patients with (n=34) or without (n=956) PAD. We revealed that the PAD patients had more missing teeth (17.5±11.0), a higher rate of edentulism (18%), and higher serum inflammatory factor levels than non-PAD patients (10.9±8.7, 5%, respectively). On the other hand, there was no significant difference between hypertension, dyslipidemia, smoking status, HbA1c, bacterial antibody titers, and bacterial counts between the groups. In conclusion, we clarified that PAD patients had decreased tooth number and worsened oral and periodontal condition with enhanced systemic inflammation.

Prior oral conditions in patients undergoing heart valve surgery.

BackgroundPatients scheduled for heart valve surgery should be free of any oral infectious disorders that might pose a risk in the postoperative period. Few studies have been made on the dental conditions of such patients prior to surgery. The present study describes the most frequent prior oral diseases in this population group.Material and MethodsA prospective, observational case-control study was designed involving 60 patients (30 with heart valve disease and 30 controls, with a mean age of 71 years in both groups). A dental exploration was carried out, with calculation of the DMFT (decayed, missing and filled teeth) index and recording of the periodontal parameters (plaque index, gingival bleeding index, periodontal pocket depth, and attachment loss). The oral mucosa was also examined, and panoramic X-rays were used to identify possible intrabony lesions.ResultsSignificant differences in bacterial plaque index were observed between the two groups (p<0.05), with higher scores in the patients with valve disease. Probing depth and the presence of moderate pockets were also greater in the patients with valve disease than among the controls (p<0.01). Sixty percent of the patients with valve disease presented periodontitis.ConclusionsPatients scheduled for heart valve surgery should be examined for possible active periodontitis before the operation. Those individuals found to have periodontal disease should receive adequate periodontal treatment before heart surgery. Key words:Valve disease, aortic, mitral, heart surgery, periodontitis.

Evaluation of oral conditions in patients with neurodegenerative diseases treated in geriatric centers

ABSTRACT Objective: To compare the general clinical conditions and oral alterations, and also evaluate the prosthesis, in subjects diagnosed with Alzheimer's disease (AD) or Parkinson's disease (PD), attended at two geriatric centers in the city of Fortaleza - Ceará. Methods: 70 patients were analyzed (between 57 to 91 years) with AD and PD, through evaluation of neurological medical records and oral clinical examination. Variables as sex, age, race, comorbidities, oral manifestations and prosthetic conditions were observed. A total of 20 elderly patients without neurological disease consisted the control group (CG). Fisher's exact test and Kruskal-Wallis were used as statistical analysis. Results: In both groups, blood hypertension was the most frequent comorbidity. As for the oral examination in the group with AD, it was observed that 54.2% had periodontal disease, 34.2% caries. Similar results were found in PD patients (31.4%; 22.8% - respectively). However, no difference was observed between the groups, as the systemic and oral manifestations in both geriatric centers (p&gt; 0.05). Was identified more than half of the subjects (57.7%) using dentures, and 86.5% of these had become maladaptive, with some kind of defect. There was statistical difference in the presence of associated oral pathology, denture stomatitis, between dementia and control group (p = 0.0213). Conclusion: Elderly patients with AD and PD have poor oral health, as well as those without neurodegenerative diseases. However, have more defects and disorders associated with the use of removable dentures.

Dental abnormalities and oral health in patients with Hypophosphatemic rickets

INTRODUCTION:Hypophosphatemic rickets represents a group of heritable renal disorders of phosphate characterized by hypophosphatemia, normal or low serum 1,25 (OH)2 vitamin D and calcium levels. Hypophosphatemia is associated to interglobular dentine and an enlarged pulp chambers.AIM:Our goal was to verify the dental abnormalities and the oral health condition in these patients.MATERIAL AND METHODS:Prospective study of oral conditions in patients with Hypophosphatemic rickets. This report employed a simple method to be easily reproducible: oral clinical exam and radiographic evaluation.RESULTS:Fourteen patients were studied, 5 males, median age of 11years (4 to 26). Occlusion defects (85,7%) and enamel hypoplasia (57,1%) were significant more frequently than dental abscesses (one patient). We observed enlarged pulp chambers in 43% of the patients and hypoplasia and dentin abnormalities in 14,3%. We could not detect a significant correlation between dental abnormalities and delayed treatment (p>0,05). DMFT index for 6 to 12 years patients (n = 12) showed that the oral health is unsatisfactory (mean DMFT = 5).CONCLUSIONS:Patients with Hypophosphatemic Rickets frequently present dental alterations and these are not completely recovered with the treatment, unless dental abscess and they need a periodical oral examination.

Cephalometric findings in patients with Papillon-Lefèvre syndrome

Literature regarding oral conditions in patients with Papillon-Lefèvre syndrome (PLS) often covers the periodontal aspects, but no literature was found describing specific craniofacial findings in this group. The aim of this retrospective study was to investigate the cephalometric findings of patients with PLS. Lateral cephalograms of 8 patients with PLS were traced, and hard- and soft-tissue variables were analyzed. Class III skeletal relationship was evident (ANB angle, 2 degrees +/- 3.1 degrees ; Wits appraisal, -9.1 mm +/- 3.7 mm). Other findings include maxillary retrognathia, decreased lower facial height, retroclined mandibular incisors, and upper lip retrusion. Patients affected with PLS have a Class III skeletal pattern. These findings can be of clinical value not only for diagnosis, but also for proper treatment planning.

Oral condition of patients with leukemia and lymphoma.

Different oral manifestations, the most prominent characteristics of the different oral symptoms, and oral colonization by Candida albicans were studied in 97 patients with leukemia and lymphoma. Oral manifestations usually occurred in both leukemias and lymphomas. The most common manifestation in both diseases was mucosal pallor. Oral colonization by Candida albicans in all patients was determined by the use of Sebouraud's agar plates and quantitative estimation of the colonization was made on a scale of +1 to +4 according to its presence in the four quadrants of the agar plates. Oral colonization by Candida albicans was between +1 and +4 in the patients with leukemia and was between +1 and +3 in the patients with lymphoma. Professional dental follow-up should be integrated into the medical follow-up. This is important not only for diagnosis of the disease, but also for prevention and treatment of complications during subsequent treatment.

Oral condition of patients with leukemia and severe aplastic anemia: Follow-up 1 year after bone marrow transplantation

Twenty patients with leukemia and seven patients with severe aplastic anemia who had been treated with bone marrow transplantation were investigated 1 year after transplantation to assess their oral condition. Ten patients had mild clinical chronic graft-versus-host disease (GVHD), and three patients had moderate or severe GVHD. Histopathologic changes in the oral mucosa or the minor salivary glands were observed in nineteen patients. Clinical changes in the oral mucosa were observed in sixteen of those patients. Colonization with Candida albicans was more frequent in patients with advanced histopathologic changes in oral mucosa. The numbers of Streptococcus mutans and lactobacilli and the whole salivary flow rate were not correlated to high or low caries incidence. Whole salivary flow rate were not correlated to GVHD but rather, to conditioning with total body irradiation (p <0.05).

Epidermolysis Bullosa Dystrophica: Report of Two Cases

Oral conditions of patients with an advanced form of epidermolysis bullosa dystrophica, a rare disease of unknown cause, include poorly calcified teeth and hypoplastic enamel. Generally, the patients cannot use good oral hygiene techniques because of trauma to the gingival tissues. The dental treatment of a young boy with the disease involved restoration of all carious deciduous teeth. A fourteen-year-old patient is undergoing extraction of all his teeth. Although he had complained of toothaches and abscess formations, he never had had dental treatment.

Influences of Milk of Magnesia and Chewing Gum on Oral Conditions of Patients

Influences of Milk of Magnesia and Chewing Gum on Oral Conditions of Patients