Oral Health Examination Research Articles

Investigating the impact of oral health on pregnancy and offspring outcomes: protocol for the Lifetime Impact of ORal heAlth (LIORA) cohort study

IntroductionOral health is a fundamental component of well-being, and is closely associated with overall health and quality of life. Oral health may also affect the next generation. The children of...

The effect of antiretroviral therapy initiation on vitamin D levels and four oral diseases among Kenyan children and adolescents living with HIV.

ObjectivesThe impact of antiretroviral treatment (ART) on the occurrence of oral diseases among children and adolescents living with HIV (CALHIV) is poorly understood. The aim of this study was to determine the effect of ART timing on vitamin D levels and the prevalence of four oral diseases (dry mouth, dental caries, enamel hypoplasia, and non-herpes oral ulcer) among Kenyan CALHIV from two pediatric HIV cohorts.MethodsThis nested cross-sectional study was conducted at the Kenyatta National Hospital, Nairobi, Kenya. CALHIV, 51 with early-ART initiated at <12 months of age and 27 with late-ART initiated between 18 months-12 years of age, were included. Demographics, HIV diagnosis, baseline CD4 and HIV RNA viral load data were extracted from the primary study databases. Community Oral Health Officers performed oral health examinations following standardized training.ResultsAmong 78 CALHIV in the study, median age at the time of the oral examination was 11.4 years old and median ART duration at the time of oral examination was 11 years (IQR: 10.1, 13.4). Mean serum vitamin D level was significantly higher among the early-ART group than the late-ART group (29.5 versus 22.4 ng/mL, p = 0.0002). Children who received early-ART had a 70% reduction in risk of inadequate vitamin D level (<20 ng/mL), compared to those who received late-ART (p = 0.02). Although both groups had similar prevalence of oral diseases overall (early-ART 82.4%; late-ART 85.2%; p = 0.2), there was a trend for higher prevalence of dry mouth (p = 0.1) and dental caries (p = 0.1) in the early versus late ART groups. The prevalence of the four oral diseases was not associated with vitamin D levels (p = 0.583).ConclusionsAfter >10 years of ART, CALHIV with early-ART initiation had higher serum vitamin D levels compared to the late-ART group. The four oral diseases were not significantly associated with timing of ART initiation or serum vitamin D concentrations in this cohort. There was a trend for higher prevalence of dry mouth and dental caries in the early-ART group, probably as side-effects of ART.

Health status of children's first permanent molars in Henan province from 2015 to 2020.

To investigate the eruption, caries, and pit and fissure sealing of the first permanent molars in children aged 6-9 years in Henan province. The data of oral health examination in Henan province from 2015 to 2020 were analyzed in the information management system of China Children Oral Disease Comprehensive Intervention Project. Among 486 865 children in Henan province, the total eruption rate of the four first permanent molars was 73.44%, The prevalence rate of dental caries was 30.35%, DMFT was 0.67±1.18, the ratio of caries fil-ling was 4.45%, and the rate of pit and fissure sealing was 2.36%. From 2015 to 2020, the total eruption rates of the four first permanent molars in children aged 6, 7, and 8 showed a decreasing trend (χ2trend was 385.793, 964.142, and 71.964, respectively, all P<0.05). The prevalence rates of dental caries, DMFT caries filling ratio, and pit and fissure sealing rate in children aged 6-9 increased (χ2trend/Ftrend was 1 115.87, 1 270.53, 1 215.02, 763.48, respectively, all P<0.05). The total eruption rates of the four first permanent molars in suburban counties (75.41%) were higher than those in urban areas (71.90%) (χ2=756.44, P<0.05). The prevalence rates of dental caries, DMFT, filling ratio, and pit and fissure sealing rate in urban areas (34.23%, 0.76±1.24, 4.99%, and 3.75%, respectively) were higher than those in suburban areas (25.39%, 0.55±1.09, 3.50%, and 0.58%, respectively) (χ2 was 4 435.30, 3 922.56, 390.89, and 5 262.76, respectively, P<0.05). The first permanent molar eruption completely rate maxillary (84.96%) was higher than mandible (82.88%) (χ2=1 565.70, P<0.05), and the dental caries risk of the mandible (26.07%) was higher than that of the upper (13.88%) (χ2=38 112.53, P<0.05). The health status of the first permanent molars of children aged 6-9 years in Henan province is not optimistic. The eruption rate decreased, the incidence of caries increased, and the rates of caries filling and pit and fissure sealing were low. We should pay attention to children's eating habits and oral health, strengthen oral health education, and improve oral health awareness.

Association of occlusal support with type 2 diabetes: A community-based study.

Occlusal support was proved to be associated with type 2 diabetes. Our aim was to investigate the association between the Eichner index and the prevalence of type 2 diabetes. We included 715 participants with oral health examinations in the Shanghai Aging Study. The occlusal support status was determined by the number of functional occlusal support areas and Eichner index classifications. Those with fasting plasma glucose ≥126 mg/dL and/or hemoglobin A1c ≥6.5% and/or current medications for type 2 diabetes with relevant medical history were diagnosed with type 2 diabetes. Multiple logistic regression models were used to analyze the relationship between occlusal support status and type 2 diabetes. The average age of 715 participants was 73.74 ± 6.49 years old. There were 84 diabetics with 1.71 occlusal supporting areas on average. Seven hundred and fifteen participants were divided into 3 groups according to Eichner classifications: Eichner group A with 4 occlusal functional areas, Eichner group B with 1-3 occlusal functional areas or 0 area with anterior occlusal contact, and Eichner group C with no functional occlusal contact. Blood glucose level was significantly lower in participants of Eichner group A compared to those in group B or C. The ordinal logistic regression showed more occlusal supporting areas were significantly associated with less type 2 diabetes cases with an Odds Ratio(OR) of 0.253(95%CI 0.108-0.594) after adjusting covariates. Participants in Eichner group A had a significantly much lower OR of 0.078 for type 2 diabetes (95%CI 0.009-0.694) compared to those in Eichner group C after adjustment. The number of functional occlusal support areas might be inversely related to the blood glucose level and the prevalence of type 2 diabetes.

Habituation of Clean and Healthy Life Behavior in Islamic ECE Unit

Every human being has basic needs such as eating, drinking, breathing, shelter, and nutrition. To meet the nutritional needs, it is necessary to have the habit of Clean and Healthy Life Behavior (PHBS) in children so that the provisions can be applied by children when they grow up. This qualitative descriptive study, which was conducted in 2021 at ABA Pabelan Kindergarten, used interviews, observations, and documentation as data collection techniques. The data sources include the head of ABA Kindergarten, teachers, and children. The collected data were analyzed through data reduction, data display, and inference. The results showed that the habituation of PHBS in ABA Pabelan Kindergarten was carried out through the following activities: 1) measuring weight, height and head circumference; 2) Familiarity with washing hands; 3) Inspection of nails once a week; 4) Dispose of garbage in its place; 5 Provision of clean bathrooms; 6) Examination of oral health, teeth and ears by health personnel; 7) Familiarize children to eat and drink healthy and nutritious; 8) Regular exercise.

Health behaviors and tooth retention among older adults in China: findings from the 4th Chinese national oral health survey

BackgroundThis study aimed to examine the association between oral health behaviors and tooth retention among Chinese older adults.MethodsData were used from the 4th Chinese National Oral Health Survey, a nationally representative sample. The sample included 9054 older adults aged 55 to 74. Control variables and oral health behaviors were measured through a questionnaire interview, and the number of remaining teeth and periodontal health were obtained from an oral health examination. A chi-square test was used for univariate analysis. Multivariate Logistic regression was used to explore the association between health behaviors and the number of remaining teeth.ResultsThe average number of remaining teeth in the sample was 24.4 ± 7.7. There was a higher proportion of older adults living in urban areas with 20 or more teeth than those living in rural areas (83.2% vs. 79.4%, P < 0.001); and a higher proportion of individuals with high education levels with 20 or more teeth compared to those with low education levels (P < 0.001). Logistic regression models showed that older adults who used toothpicks `(OR = 3.37, 95% CI 2.94–3.85), dental floss (OR = 1.93, 95% CI 1.05–3.53), toothpaste (OR = 3.89, 95% CI 3.14–4.83); and never smoked (OR = 1.43 95% CI 1.20–1.70) were more likely to retain 20 or more natural teeth; whereas older adults who had a dental visit were less likely to retain 20 or more natural teeth (OR = 0.45, 95% CI 0.39–052).ConclusionGood oral hygiene practices, never smoking, and regular dental visits focusing on prevention are significantly associated with teeth retention. It is critical to promote a healthy lifestyle and improve prevention-oriented oral health care systems.

Oral health problems in nursing homes, revision of oral health care delivery is needed

Prevalence of oral health problems among nursing home residents is common, they suffer from oral diseases and need dental service. The aim of this study was to examine clinical oral health of Icelandic nursing home residents and their oral health quality of life. Total (N=82) residents in two nursing homes in Reykjavik gave their consent to be involved in this descriptive cross-sectional study. Residents participated in a clinical oral health examination at site and answered oral health quality of life questionnaire. Total 89% (N=73) residents completed the study, mean age 86.8 years (SD=5.7, range 73-100 years), of whom third had their own teeth and like had teeth, and partial dentures, while 41.1% were completely edentulous. The clinical oral health examination showed high prevalence of untreated oral health problems (67%). Residents with the worst oral health scored significantly higher than those who were better dentate, affecting their oral health quality of life (p=0.014), functional limitation (p=0.002) and physical disability (p=0.000). Most oral health problems interrelated to chewing, eating and limited ability to eat certain foods affecting their capability of food intake. Current administration of oral health care in nursing home needs alteration and the qualification in geriatric oral health and oral health care must be guaranteed among nursing staff in these settings. The public and health professions should work together in oral care matters in nursing homes to maintain oral health and lifelong oral health quality of life among residents.

Relationship between Bone Mineral Density and Dental Caries in Koreans by Sex and Menopausal State.

We aimed to investigate the relationship between bone mineral density and dental caries in adults of over 19 years of age who were categorized according to their sex and menopausal status. The Korea National Health and Nutrition Examination Survey (KNHANES) dataset was used for the study. Bone mineral density (BMD) and oral health examination data were collected between 2008 and 2011. A total of 17,141 adults of ≥19 years old were eligible for inclusion in the present study. Multiple regression analysis was performed after adjustment for age, household income, educational level, smoking status, and alcohol drinking status for men, and pre- and post-menopausal women. In men, the β-value for the mean decayed, missing, and filled teeth (DMFT) index was 0.98 (95% confidence interval (CI) = 0.71–1.25), and was significantly higher in osteoporotic participants than in participants with normal BMD (p < 0.05). In post-menopausal women, the β-value for the mean DMFT index was 0.86, and was higher in the osteoporotic participants than in the participants with normal BMD (p < 0.05). Men and post-menopausal women with osteoporosis had higher DMFT indexes than those with normal BMD. In addition, there was a correlation between DMFT index and BMD in men and post-menopausal women. Therefore, the prevention of osteoporosis should be implemented alongside proper oral care.

Effects of two-year oral health information provision on changes in gingival crevicular fluid in male day–night shift workers

Background/purposeAlthough dental diseases are related to systemic diseases and daily habits and are known to affect the quality of life, little attention has been paid to the importance of oral hygiene in Japanese working-age adults. We, thus, aimed to assess changes in the periodontal condition of working-age adults after providing regular oral health information at their workplace for two years. Materials and methodsTwo years of oral health information were provided to workers at four printing companies. The effectiveness thereof was assessed using gingival crevicular fluid (GCF) test results—lactoferrin (Lf), alpha-1-antitrypsin (AT), and aspartate aminotransferase (AST). Questionnaires on health literacy (HL) and dental terminology were also administered to the workers during annual check-ups. ResultsThe baseline survey participants included were 234 male workers, of which 104 workers followed the same work schedule/day–night shifts and completed the two-year follow-up survey were examined. Providing continuous oral health information with regular updates did not improve participants’ self-administered GCF tests (Lf: P = 0.272, AT: P = 0.723, and AST: P = 0.067), and there were no significant changes in HL, perceived symptoms, and use of interdental cleaning tools. ConclusionDirect oral health education or examination might be necessary for working-age adults to achieve optimum oral conditions, and one-on-one health information provision might not improve their oral condition. A combination of methods to provide oral health promotion must be considered.

Primary school teachers’ contributions to oral health promotion in urban and rural areas of the Gulu District, Northern Uganda: a qualitative study

BackgroundDental caries remains the most prevalent non-communicable disease globally affecting 60–90% of children. The World Health Organisation’s (WHO) health-promoting school program offers a framework for dental intervention in low- and middle-income countries (LMICs). This study explored teacher contributions to children’s oral health in relation to the WHO health-promoting school framework in rural Uganda.MethodsSemi structured interviews were conducted with a purposive sample of 18 teachers. All interviews were transcribed verbatim and analysed thematically.ResultsMany teachers reported preparing children to practise proper oral hygiene care through skills training and demonstrations around proper teeth brushing. Teachers’ roles included raising health awareness by providing information on oral health topics using different educational methods. Many teachers mentioned performing oral health examinations on children at the school, first aid, referral for dental treatments and engaging parents, students and health workers in oral health promotion.ConclusionsTeachers play an essential role in oral health promotion in countries like Uganda. Teachers are implementing key principles of the WHO’s health-promoting school framework on the ground and need to be considered as a key public health resource. If improvements in oral health are to be attained in Sub-Saharan Africa and other LMICs, government interventions need to harness teachers’ contributions in delivering oral health promotion.

The seventh survey of the Tromsø Study (Tromsø7) 2015-2016: study design, data collection, attendance, and prevalence of risk factors and disease in a multipurpose population-based health survey.

Aims:The Tromsø Study is an ongoing population-based health study in Tromsø, Norway, initiated in 1974. The purpose of the seventh survey (Tromsø7) 2015–2016 was to advance the population risk factor surveillance and to collect new types of data. We present the study design, data collection, attendance, and prevalence of risk factors and disease.Methods:All inhabitants in Tromsø municipality, Norway, aged 40 years and older (N=32,591) were invited to a health screening including extensive questionnaires, face-to-face interviews, biological sampling (blood, urine, saliva, nasal/throat swabs, faeces), measurements (anthropometry, blood pressure, pulse, pulse oximetry) and clinical examinations (pain sensitivity, echocardiography, cognitive, physical, and lung function, accelerometer measurements, eye examinations, carotid ultrasound, electrocardiography, dual-energy X-ray absorptiometry, and heart, lung and carotid auscultation). New research areas in this round were dental and oral health examinations, collection of faecal samples for studies of normal bacterial flora and antibiotic resistance, and 24-hour urine samples for examination of sodium and iodine intakes.Results:Attendance was 65% (N=21,083), and was higher in women, age group 50–79 years, previous attenders, and Norwegian-born individuals. Cardiovascular risk factor levels and prevalence of chronic obstructive lung disease decreased since the last survey, while the prevalence of obesity and diabetes increased.Conclusions:Attendance was stable from the sixth survey. Interaction with participants might be key to maintain participation. Favourable trends in risk factors continue, except for a continued increase in obesity. Both new data collection technology and traditional physical examinations will be crucial for the impact of future population studies.

Relationship between 6-n-propylthiouracil (PROP) taster status, dietary intake and dental caries among young adult subjects

Introduction: Previous studies have established an association between 6-n-propylthiouracil (PROP) taster and dietary intake. However, those studies mostly emphasised on macronutrients. The present study examined the dietary intake, including macro- and micronutrients, and caries experience among university students according to their PROP taster status. Methods: A total of 158 university students participated in this study. PROP taster status was determined using filter paper method. Dietary intake was collected using 24-hour diet recall method. Oral health examination was conducted to determine dental caries experience. Results: The results showed that majority of subjects were supertasters. No significant differences (p&gt;0.05) were found in the macronutrient intakes among supertasters, medium tasters, and non-tasters. Significant differences (p&lt;0.05) were found in the intakes of micronutrients, namely pantothenic acid, vitamin D, magnesium, manganese, and fluoride. There were no significant differences among group tasters in the dental caries experience scores of decayed (D), missing (M), and filled (F) teeth. Conclusion: In general, this study indicated that all group tasters had no difference in macronutrients intake and caries experience, but supertasters had significantly lower intakes of some micronutrients as compared to non-tasters and medium tasters. This suggested that PROP taster status could have some influence on micronutrient intakes.

The Influence of Periodontal Disease on Oral Health Quality of Life in Patients with Cardiovascular Disease: A Cross-Sectional Observational Single-Center Study.

Background and Objectives: Cardiovascular disease is a leading cause of global death with a rising prevalence and a heavy economic burden. Periodontal disease has been associated with cardiovascular diseases—including incident coronary heart disease, peripheral artery disease and ischemic stroke. The study evaluates the quality of life of patients with cardiovascular and periodontal disease from the point of view of oral health by using the short version of the Oral Health Impact Profile (OHIP-14) questionnaire. Materials and Methods: This study included a total of 221 patients (61.86 ± 15.03 years old) selected from the Emergency Hospital of Sibiu, Romania. The participants self-completed the OHIP-14 questionnaire and they benefited from an oral health examination conducted to assess the presence and the severity of periodontal disease. Results: Out of the 147 patients with cardiovascular disease, 77.5% had periodontal disease (32.6% stage I, 29.2% stage II, and 15.6% stage III and IV). The presence of periodontal disease was associated with a lower oral-health-related quality of life (p < 0.001, ANOVA) and with a higher OHIP-14 score in patients with cardiovascular disease (18.67 ± 8.17, p < 0.001 ANOVA). No significant difference was observed concerning patient sex and background; however, age, body mass index and the lack of an appropriate oral hygiene routine had a strong association with the individual quality of life. The general OHIP-14 score was higher in patients with periodontal disease and associated cardiovascular disease, the presence of both cardiovascular and periodontal disease being associated with a lower quality of life. Conclusions: By increasing the patients’ awareness to oral healthcare measures, better outcomes and improved oral-health-related quality of life could be observed.

MULTIDISCIPLINARY MANAGEMENT OF DIFFUSE LARGE B-CELL LYMPHOMA OF THE MANDIBLE

We present a case of a 25-year-old Hispanic female with a diffuse large B-cell lymphoma of the mandible. The case documents the patient's complete cancer treatment and the role of the dental team as part of a larger oncology team to help prevent and manage oral complications. The dental team collaborated with the medical and radiation oncology teams to screen, diagnose, stage, treat, and manage the patient. Prior to cancer treatment, the dental team completed an oral health examination and established a schedule of dental treatment. Treatment consisted of patient education, oral hygiene instruction, dental prophylaxis, elimination of acute oral infections, fabrication of custom gel-applicator trays, fluoride gel prescription, and fabrication of a customized tongue-displacing (CTD) stent with a novel design. We believe it is the first reported use of a CTD for a gnathic non-Hodgkin lymphoma. During and after cancer treatment, the dental team managed complications of chemotherapy and radiation therapy including dysgeusia, xerostomia, oral mucositis, and trismus. No recurrence has been recorded after eighteen months. Dentists play an important role in managing and preventing oral complications of cancer treatment.

The validity of self-reported number of teeth and edentulousness among Norwegian older adults, the HUNT Study

BackgroundNumber of teeth is an established indicator of oral health and is commonly self-reported in epidemiological studies due to the costly and labor-intensive nature of clinical examinations. Although previous studies have found self-reported number of teeth to be a reasonably accurate measure, its accuracy among older adults ≥ 70 years is less explored. The aim of this study was to assess the validity of self-reported number of teeth and edentulousness in older adults and to investigate factors that may affect the accuracy of self-reports.MethodsThis study included two different samples of older adults ≥ 70 years drawn from the fourth wave of the Trøndelag Health Study (the HUNT Study), Norway. Sample 1 (n = 586) was used to evaluate the validity of self-reported number of teeth and sample 2 (n = 518) was used to evaluate self-reported edentulousness. Information on number of teeth and background variables (education, smoking, cognitive function, and self-perceived general and oral health) were self-reported in questionnaires, while clinical oral health examinations assessed number of teeth, number of teeth restored or replaced by fixed prosthodontics and edentulousness. Spearman and Pearson correlation coefficients, Bland–Altman plot, chi-square test and kappa statistics were used to assess the agreement between self-reported and clinically recorded number of teeth.ResultsThe mean difference between self-reported and clinically recorded number of teeth was low (− 0.22 teeth), and more than 70% of the participants reported their number of teeth within an error of two teeth. Correlations between self-reports and clinical examinations were high for the total sample (0.86 (Spearman) and 0.91 (Pearson)). However, a lower correlation was found among participants with dementia (0.74 (Spearman) and 0.85 (Pearson)), participants having ≥ 20 teeth (0.76 (Spearman) and 0.67 (Pearson)), and participants with ≥ 5 teeth restored or replaced by fixed prosthodontics (0.75 (Spearman) and 0.77 (Pearson)). Self-reports of having teeth or being edentulous were correct in 96.3% of the cases (kappa value 0.93, p value < 0.001).ConclusionsAmong older Norwegian adults, self-reported number of teeth agreed closely with clinical tooth counts and nearly all the edentulous participants correctly reported having no teeth.

Age of First Oral Health Examination and Dental Treatment Needs of Medicaid-Enrolled Children.

Early childhood caries (ECC), despite being preventable, remains the most prevalent disease of childhood, particularly in children between the ages of 2 and 5 y. The association between the type of health care provider completing initial oral health examinations and subsequent dental caries in children under 6 y of age is unclear. The objective of the current study is to longitudinally assess the association between age at first oral health examination and provider type at first oral health examination on dental treatment for children under 6 y of age. Deidentified administrative claims data were used from the IBM Marketscan Multi-State Medicaid Database (n = 2.41 million Medicaid-enrolled children younger than 6 y in 13 states from 2012 to 2017). A Kaplan-Meier survival analysis was used to examine the association between age at first oral health examination and provider type with first treatment of dental caries at follow-up. The adjusted hazard ratio (HR) of dental caries for children whose first oral health examination at 4 y of age is 5.425 times higher than for children whose first oral health examination was before 1 y of age (95% confidence interval [CI], 5.371-5.479). The adjusted HR of dental caries for children seen by pediatric dentists (HR = 1.215; 95% CI, 1.207-1.223) and physicians (HR = 2.618; 95% CI, 2.601-2.635) was higher than those seen by a general dentist. Findings from this study highlight the importance of children having their first oral health examination no later than 12 mo of age in accordance with existing guidelines and referrals from physicians to prevent the need for invasive treatment. Results of this study emphasize the need for a child's first oral health examination to be completed no later than 12 mo of age to prevent dental caries. Reinforcement and referrals by physicians based on this recommendation facilitate early establishment of a dental home in young children.

Assessment of Oral Health Care Needs among Fishermen Living in North Chennai, India – A Cross Sectional Study

Introduction: Studies conducted among fishermen shows that there was a high prevalence rate in Oral mucosal lesions. However, data on oral health care needs among fisherman is scarce. Hence this was undertaken to obtain a data that can be used to plan programmes for the prevention and treatment of such oral mucosal lesions in the fishermen.&#x0D; Materials and Methods: A study was carried out among 71 fishermen after obtaining clearance from the institutional ethical committee and concerned authorities. A self administered questionnaire is distributed among the study group comprising questions relating to personal history and deleterious habits. Clinical examination was carried out using mouth mirror, explorer and under proper illumination. Oral health examination was done using WHO Basic Oral health Assessment proforma, 2013. Data collected and analysed statistically using SPSS software.&#x0D; Results: Among the 71 fishermen, 56(78.9%) were males and 15 (21.1 %) were females. In the study population, 44(62%) were tobacco chewers, 39(54.9%) were snuff users, 24(33.8%) were alcohol consumers and 19(26.8%) were smokers. Smokeless tobacco (41.5%) was the most common deleterious habit after which by alcohol consumption (33.8%) and smoking (26.8%).The prevalence of oral mucosal lesions was 20.8%.It was found that statistically significant association existed between the deleterious habits and leukoplakia.&#x0D; Conclusion: According to the our study, the prevalence of oral mucosal lesions was 20.8% among the fishermen who had a clear association with deleterious habits such as tobacco chewing, smoking, alcohol consumption and snuff.

Oral health status and associated factors among Sudanese older adults: A cross-sectional study.

The aim was to assess the oral health status, prosthetic needs and the associated factors among older adults living in Khartoum State, Sudan. Understanding the extent of the oral health problems and the associated factors in the older population is important for the determination of treatment needs and future planning of dental services. A cross-sectional study among individuals ≥60years attending Health Care Centers. Two calibrated examiners examined participants according to the WHO oral health examination form for adults. DMFT, periodontal conditions, oral mucosal lesions, tooth wear, prosthetic status and prosthetic needs were reported. Risk indicators investigated include age, gender, socioeconomic status, general health, oral hygiene practices, tobacco use and utilisation for dental services. Two hundred forty-nine older adults participated in the study, and 64.3% were males. The mean age was 68.4 years (SD ±6.7). The mean DMFT was 15.9 (SD ±9.1), with 85.3%, 94.8% and 19.3% of the participants having decayed, missing or filled teeth respectively. Periodontal pockets were present in 41.9%, mucosal lesions in 14.9% and tooth wear in 46.2% of the participants. Although only 5.2% were completely edentulous, 93.2% need prosthetic replacement. Risk indicators for poor oral health were being female, oral hygiene practices, frequency and reason of dental visits. Old adults showed a high experience of missing and decayed teeth, periodontal inflammation and prosthetic treatment needs. Future oral health policies need to consider the different needs between men and women, exposure to risk factors and barriers to access dental care.

Dental fluorosis among people and livestock living on Gihaya Island in Lake Kivu, Rwanda

BackgroundDental fluorosis is caused by prolonged exposure to excessive fluoride during the period of permanent tooth formation and is characterized by tooth discoloration, pitting, and loss of shape. Communities living near Lake Kivu in Western Rwanda exhibit a high prevalence of dental fluorosis; however, data on prevalence and risk factors are scarce.MethodsThis cross sectional, quantitative study used a One Health approach to investigate dental fluorosis prevalence among people and livestock and to measure fluoride content in the environment. In 2018, oral health examinations were conducted to assess the prevalence of fluorosis in children (aged 9 to 15 years), cattle and goats residing on Gihaya Island (Rwanda, East Africa). All children and cattle/goats meeting basic eligibility criteria (e.g., island residence) were invited to participate. Presence and severity of dental fluorosis was categorized according to the Dean’s Fluorosis Index. Samples of local foods, water, soil and grass were collected from communal sources and individual households and analyzed for fluoride content using standard laboratory techniques. Descriptive and binomial analyses (Fisher Exact Test) were used to assess this dataset.ResultsOverall, 186 children and 85 livestock owners (providing data of 125 livestock -23 cattle and 102 goats) participated. Dental fluorosis was recorded in 90.7% of children and 76% of livestock. Moderate to severe fluorosis was observed in 77% children while goats and cattle most often exhibited mild or absent/questionable severity, respectively. Water from Lake Kivu (used primarily for human cooking water and livestock drinking water) contained fluoride levels that were consistently higher than the maximum threshold (1.5 mg/L) recommended by the World Health Organization. Other sources (borehole and rainwater) were within safe limits. All food, soil and grass samples contained fluoride. The highest levels were observed in porridge (0.5 mg/g) and small fishes (1.05 mg/g).ConclusionsAltogether, dental fluorosis was highly prevalent among children and goats on Gihaya Island with various food and water sources contributing a cumulative exposure to fluoride. An immediate and coordinated response across human, animal and water professionals is needed to reduce fluoride exposure within safe limits for island residents.

Periodontitis, dental plaque, and atrial fibrillation in the Hamburg City Health Study.

Atrial fibrillation (AF) is a major health problem and causes heart failure and stroke. Pathophysiological mechanisms indicate a link with oral health including periodontitis (PD), but supporting data are scarce. The aim was to investigate the link between features of oral health and the prevalence of AF. This cross-sectional analysis of the Hamburg City Health Study included 5,634 participants with complete data on their PD and AF status. AF was assessed via self-reported questionnaire or medically diagnosed by standard 12-lead resting ECG. The oral health examination included full-mouth measurements of the dental plaque index (PI), the clinical attachment loss (CAL) at 6 sites per tooth, the bleeding on probing (BOP) and the decayed, missing and filled teeth (DMFT) index. Descriptive analyses for all variables stratified by the status of PD were performed. To test for an association between prevalent PD and prevalent AF, multivariable logistic regression models were used. Mediation analysis was used to test if interleukin-6 (IL-6) and/or C-reactive protein (CRP) mediated the association between PD and AF. Atrial fibrillation (prevalence: 5.6%) and the severity of PD (prevalence: moderate: 57.7%, severe: 18.9%) increased with age in men and women. Prevalent severe PD, CAL ≥3 mm, PI, and BOP were all associated with prevalent AF in unadjusted regression analysis. However, no association except for PI (odds ratio (OR): 1.22, 95% confidence interval (CI): 1.1-1.35, p<0.001) could be observed after adjusting for age, sex, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), body mass index, diabetes, smoking, and educational level. Participants brushing their teeth at least twice daily had a lower AF prevalence compared with those brushing only once daily. Hs-CRP, IL-6, and the odds of AF increased as a function of PD severity grades in unadjusted analysis. However, neither the DMFT index nor IL-6 or CRP was associated with AF after adjusting for age and sex. Mediation analyses could not provide support for the hypothesis that IL-6 or CRP acted as mediator of the association between prevalent PD and prevalent AF. The study shows an association between prevalent AF and increased dental plaque levels indicated by a higher PI. In contrast, an association of prevalent PD with prevalent AF after adjustments for several confounders could not be demonstrated. Further studies are necessary to investigate the mechanisms underlying poor oral hygiene and AF as well as the influence of improved oral hygiene on AF onset.