Oral Health Examination Research Articles

Investigation and analysis of oral health status of the elderly in nursing homes in Taiyuan

This study aims to investigate awareness of oral health care and health status among elderly people in nursing homes in Taiyuan. Strategies for preventing and treating oral diseases and improving the quality of life of the elderly in nursing homes were formulated on the basis of analyzed data. A total of 359 participants from 48 nursing homes in six districts were selected randomly. Awareness, attitude, and behavior with regard to oral health care among the elderly were investigated through a survey using questionnaires and oral health examinations. Data were statistically analyzed with SPSS 20.0. Among the elderly in the nursing homes in Taiyuan, awareness and behavior with regard to oral health care were deficient and inappropriate, and thus professional guidance was needed. In addition to method and time of brushing teeth and bad oral habits, the oral health status of the elderly was statistically affected by age and education. Compared with the data of the Fourth National Oral Epidemiological Investigation, the number of elderly people aged 55-64 or 65-74 years who brush their teeth every day and accept oral diagnosis and treatment was lower. However, the ratios of edentulous and missing teeth without treatment were higher than the national average level for the same age groups. The awareness and attitude of the elderly in nursing homes with regard to oral health care are unsatisfactory, and their oral health status is poor. Education on oral health care, development of good oral care habits, and regular oral health examination are essential to the maintenance of oral health in elderly people.

#66: An Educational Needs Assessment of Oral Health Knowledge, Attitude and Practices Among Graduates of St. Jude Global Infectious Diseases Training Programs

Abstract Background Chemotherapy and radiotherapy for oncologic diseases can cause oral complications during therapy or thereafter. These oral complications and their consequences may interfere with cancer treatment, prolong hospital stay, and increase overall treatment costs. Therefore, oral examination of children with cancer by healthcare providers must be part of routine clinical examination. According to published literature, oral examination and recommendations of best oral care in children with cancer might not be routinely practiced and varies among providers. We suspect that personal knowledge, attitude and practice may play an important role in the routine practice of healthcare professionals and that the introduction of an oral health curriculum may complement existing practice. To tailor oral health training, we must know the healthcare professional’s educational needs and their attitude toward oral health. Methods Steps followed to build the needs assessment of our targeted learners included: (1) literature review of published surveys; (2) reviews of oral healthcare policies; (3) key-informant interviews with practicing healthcare providers regarding oral health training; (4) selection of essential survey items; (5) face validity; and (6) pilot testing. We used the ©2019Qualtrics® software to build this survey. Face validity was evaluated and approved by five subject matter and survey experts. Graduates of the St. Jude Global Infectious Disease training served as pilot testing subjects. Results Interviews indicated that information about oral health examination is often contained in institutional policies; training in oral health is cursory. Surveys published in the literature have assessed knowledge related to oral complications such as oral mucositis and dental caries. We have added gingival conditions to our survey, which is also one of the most prevalent oral manifestation in pediatric cancer patients. Our 31-item survey is comprised of multiple choice and Likert scale questions distributed in seven sections, namely: (1) demographics; (2) clinical settings; (3) participant’s view of own oral healthcare; (4) knowledge and practice on oral infections; (5) knowledge, attitude and practice of oral examination; (6)attitude and practice of oral healthcare preventive measures, and; (7) continuing education. Validity testing indicated two questions that required modifications—the definition of plaque, its causes, and oral infections and manifestations. The final survey tool will take participants approximately 15 minutes to complete. Conclusion We developed a 31-item survey tool that will be used for assessing the needs of global healthcare providers, from which we can develop targeted and appropriate educational programs.

What variables are associated with use of and need for dental prosthesis? A cross-sectional study.

Population-based studies assessing the factors associated with use of and need for dental prosthesis among older adults are scarce. To evaluate the use of and need for dental prosthesis and associated factors in the older adult population of a southern city of Brazil. A cross-sectional study, involving community-dwelling older adults (≥60years), was performed. A probabilistic per cluster sampling was used, and 282 participants from Veranópolis, Brazil, were included. A clinical oral health examination was performed, and a structured questionnaire was applied. Bivariate and multivariate analyses were performed to verify associations using Poisson regression with robust variance. The prevalence of use of dental prosthesis was 87.2% (n=246), while the prevalence of need for dental prosthesis was 27% (n=76). Older adults with medium/high levels of education had 17.8% (P=.019) lower prevalence ratio (PR) for use of dental prosthesis. Unmarried and retired older adults had, respectively, 11.1% (PR:1.111; 95%CI:1.022-1.207) and 19.5% (PR:1.195; 95%CI:1.009-1.415) higher PR for use of prosthesis. Those without access to dental care had 11.8% (P=.012) higher PR for use of dental prosthesis. Older adults living in rural areas had 64.7% (PR:1.647; 95%CI:1.079-2.514) higher PR of need for dental prosthesis. High and low prevalence of use of and need for dental prosthesis, respectively, were detected in this sample. Level of education, marital status, retirement status and access to dental care were associated with the use of dental prostheses. However, only residence area was associated with the need for oral rehabilitation.

Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database.

Background: Dental health is an important factor in daily life routines and is closely associated with maintaining a health-related quality of life. This study examined denture procedure changes after implementation of the National Health Insurance (NHI) Coverage of Dentures for the elderly. Methods: We used the “Korean Community Health Survey (KCHS)” developed by the Korea Centers for Diseases Control and Prevention. We analyzed the association between policy implementation and dental health-related outcomes using difference-in-differences (DID) analysis to compare patients aged ≥75 with those 65–74 years before and after coverage. Results: A comparison of age groups and coverage periods showed that patients aged ≥75 years had higher (OR: 1.038, 95% CI: 1.021–1.055) procedure rates after coverage. In particular, elderly patients on medical aid had significantly higher denture procedure rates, while those without oral health screening were more likely to have denture procedures. Conclusions: This study determined the impact of the NHI Coverage of Denture procedure policy for the elderly and found increased denture treatments in the elderly. This policy appeared to positively affect older patients by increasing denture procedures for low-income and medical aid beneficiaries. Hence, the government needs to increase oral health examination and dental health policies for the elderly.

Oral health care in urban general practice: what are the support and training needs?

Patients with oral health problems often attend GPs instead of dentists, particularly in rural areas. There has been little research exploring challenges in providing oral health care in urban general practice. A cross-sectional survey of GPs in Greater Western Sydney explored their experiences, knowledge, confidence, and their oral health educational needs. Descriptive statistics and content analysis was undertaken. Forty-nine GPs reported experience of a wide range of oral health presentations. Approximately 60% were confident to undertake oral health examinations and determine the cause of acute toothache. Although 87% were confident providing preventative oral health advice, most did not include this in routine health assessments. Only 41% were confident explaining eligibility for public dental services. Barriers to providing oral health care were time constraints, lack of equipment and limited oral health training. Our research highlights oral health support and training needs in urban Australian general practice, as well as the need for systems-wide change to oral health training in outer urban settings to tackle health inequity, similar to those advocated in rural Australia.

Oral health status of diabetic patients visiting a private dental hospital, Chennai

Diabetes mellitus is the second most common non-communicable disease in India. There are various diseases of the oral cavity resulting as a complication of diabetes. This underlying systemic disease could affect the prognosis of any dental treatment. The aim of the study is to evaluate the prevalence of various types of oral lesions associated with diabetes. A total of 343 diabetic patients visiting the dental hospital in Chennai over a period of one year (1 June 2019 to 1 June 2020) were selected for the study. Detailed case history and clinical examination were carried out under visible light. The study population was age 30 years and above. Data collected were analysed using SPSS software and the results were recorded. The majority of the diabetic patients were males, aged 61-75 years. Dental caries was the most common oral disease, followed by pulpitis and periodontitis. The premalignant lesions like Oral Sub Mucous Fibrosis, Lichen Planus and Leukoplakia were also found. It was found that male diabetic patients are more prone to oral diseases compared to females. Hence, it is recommended that awareness on oral hygiene and periodic oral health examination will improve the oral health status of diabetic patients.

Caries Experience among Tribal Gypsies in Thoothukudi District - A Cross-Sectional Study

Dental caries, or tooth decay, is an infectious process involving breakdown of the tooth enamel. Caries form through a complex interaction between cariogenic acid-producing bacteria in combination with fermentable carbohydrates and other dietary, genetic, behavioural, social, and cultural factors. Poor oral hygiene and low dental service levels were found in marginalised areas. The study aimed to assess the caries experience of Narikuravars in Thoothukudi district. A cross-sectional study was done among gipsies in Thoothukudi district. Oral health examination was done the gipsies in the above three taluks in which they were present. All the study participants were examined under adequate illumination, and clinical data were collected on dental caries as described by the World Health Organization (WHO). DMFT (Decayed, Missing and Filled teeth) was used to assess the caries experience. For statistical analysis, t-test and ANOVA was used. The total size of the screened population was 164. There were 128 adults and 36 children who are below 18 years of age. Mean Decayed teeth, mean Missed teeth and mean Filled teeth was found to be 3.38±1.730, 1.01± 2.109, 0.01± 0.088 respectively. Decayed teeth were most common in the study population. Mean DMFT score among the adult study population was found to be 4.40 ± 2.603. The difference between the different age groups to Mean DMFT and was found to be statistically significant (F value- 22.679; p < 0.05). The present study concluded that the experience of dental caries was low in the study population. It was more prevalent in males as compared to the female population.

Oral health status among low-income people admitted to Osaka Socio-Medical Center in Japan

To examine the dental condition, perceived oral symptoms, and frequency of dental visits among low-income people admitted to Osaka Socio-Medical Center (OMSC) and to compare with Japanese national survey respondents. Oral health examinations for inpatients admitted to OMSC were performed from August to November 2004. In total, 113 inpatients who were in the recovery period without acute symptoms, were selected. 109 inpatients received dental examination. All participants were male. About half of the subjects (49%) did not have any medical insurance, and the percentage of subjects who had 20 or more teeth was smaller than in a national survey in all age groups. The subjects had a higher reported frequency of oral symptoms compared with respondents to the national survey. Accessibility to dental clinics among subjects was notably low. Dental condition and perceived oral symptoms among the subjects were poor compared to national survey respondents. Dental care to improve the oral health condition of this segment of the population is needed.

Does oral health-related quality of life of patients after solid organ transplantation indicate a response shift? Results of a systematic review

BackgroundThe physical oral health and dental behaviour of patients after solid organ transplantation (SOT) has repeatedly been reported as insufficient. The objective of this systematic review was to detect whether the oral health-related quality of life (OHRQoL) of patients after SOT is reduced compared to that of healthy individuals.MethodsA systematic literature search was performed by two independent individuals based on the PubMed, Web of Science and Scopus databases by using the following search terms: “transplantation” AND “oral health-related quality of life”. The findings were checked to determine eligibility, whereby publication prior to 31 October 2020, examination of adult patients (age at least 18 years) with SOT, reporting of an OHRQoL outcome and full text in English language were the prerequisites for inclusion in the qualitative analysis. Quality appraisal of the included studies was performed using the Agency for Healthcare Research and Quality methodology checklist.ResultsSeven of 25 studies that examined patients after kidney (3), heart (2), liver (1) and lung transplantation (1) were included. Four studies included healthy controls, and five studies included a cohort of patients before transplantation for comparison. Clinical oral health examinations were heterogeneous between groups. The majority of studies (5/7) applied the short form of the “Oral Health Impact Profile” (OHIP 14) to assess OHRQoL. The OHIP 14 values ranged between 1.7 and 8.9 across studies, indicating an unaffected or just slightly reduced OHRQoL. Only one study found better OHRQoL in patients after SOT compared to a group before SOT, and one study confirmed worse OHRQoL of SOT recipients compared to a healthy control. Only two studies revealed an association between OHRQoL and oral health parameters. Furthermore, two studies each found a relationship between OHRQoL and general health-related quality of life or disease-related parameters.ConclusionsPatients after SOT show an unaffected or only slightly reduced OHRQoL, which was mainly independent of the insufficient oral status. This might indicate a shift in the perception threshold for oral diseases and conditions caused by the general health burden related to the SOT.

The impact of oral health on prognosis of older multimorbid inpatients: the 6-month follow up MPI oral health study (MPIOH).

There is clear evidence for an association between oral health and systemic illnesses, geriatric syndromes, and mortality. Frail and multimorbid older people often suffer from insufficient oral health care, but standardized dental examinations are not routinely performed in clinical settings. The aim of this study was to verify the practicability of in-hospital oral health examinations and to identify their association with patients' prognosis as assessed by means of the Comprehensive Geriatric Assessment (CGA)-based Multidimensional Prognostic Index (MPI). One hundred hospitalized patients aged 65years and older (mean age 76.9years (SD 6.4); 58.2% male, 41.8% female) underwent a CGA-based MPI calculation at discharge with subdivision into three mortality risk groups (MPI-1, low risk, score 0-0.33; MPI-2, moderate risk, score 0.34-0.66; MPI-3, high risk, score 0.67-1). To identify the current oral health status and the Oral Health-related Quality of Life (OHRQoL), three oral health examinations were performed. Information on survival, the incidence of oral diseases, dental appointments, and treatments up to 6months after discharge were collected. All oral health examinations were feasible during hospitalization and were associated with MPI prognosis, even though they were not associated with 6-month mortality. The MPI could not predict the use of dental health care or treatment, as, irrespective of MPI and oral health examinations, dental services were underutilized during follow up. Besides MPI evaluation, oral health examinations should be implemented into an inhospital course to improve clinical decision-making as well as secondary and tertiary prevention of oral health- and related systemic diseases. German Clinical Trials Register: DRKS00013607 (07.02.2019, retrospectively registered).

Implementation fidelity of school oral health programs at a District in South Africa.

It is important that components contributing to success of a program are well understood to ensure better outcomes and strengthen interventions. Hence the purpose of the study was to assess the level of fidelity achieved by school oral health programs in our study district and to determine elements of fidelity that predict the risk of dental decay. A cross-sectional study design was utilised. A multistage sampling technique was employed to randomly select 10 schools, two grades in each school were selected and all pupils in the selected grades were included in an oral health examination. Ten oral hygienists were observed and interviewed as they carried out the activities of the program and records were reviewed. Data collection tools included an oral health examination form, and an implementation fidelity checklist. The average level of fidelity obtained was 40% and it was shown to be inversely correlated with levels of decay, as decay was predicted to decrease with increasing levels of fidelity. The fidelity elements that were found to directly predict the outcome of decay included duration (IRR, 0.49; p = 0.02) coverage (IRR, 0.54; p = 008), content (IRR, 1.36; p = 0.03) and age (IRR, 2.14; p = 0.00). Moderating factors of fidelity which indirectly influenced the outcome of decay included facilitation strategy, duration and age. These were predicted to reduce the risk of decay by 92%, 83% and 48% respectively. The school oral health programs exhibited high levels of pupil coverage, however, the content of the programs offered was low (28%). Coverage was high in the context of lack of dental assistance and time. Multi-sectoral participation is therefore necessary to re-organise the program for improving implementation fidelity and bringing about quality implementation.

Oral health and changes in lipid profile: A nationwide cohort study.

We aimed to investigate the association of periodontitis and oral hygiene indicators with changes in blood lipid parameters in a nationwide, population-based cohort in a longitudinal setting. We included nationwide health screening program participants who underwent oral health examination in 2009-2010 and follow-up examinations for lipid profile without exposure to lipid-lowering agents. During the 5.19-year median follow-up, 65,078 individuals (mean age at baseline examination: 55.41±7.30years) underwent 286,218 health examinations. The prevalence of periodontitis was 39%. In the multivariate mixed model analysis, periodontitis and tooth loss were associated with decreased high-density lipoprotein cholesterol levels (β=-0.0066mmol/L, standard error=0.0026, p=.013) and increased triglyceride levels (β=0.0307, mmol/L, standard error=0.0049, p<.001), respectively. Compared with tooth brushing ≤1 time/day, tooth brushing ≥3 times/day was associated with increased high-density lipoprotein cholesterol levels (β=0.0176mmol/L, standard error=0.0052, p=.006) and decreased triglyceride levels (β=-0.0285mmol/L, standard error=0.0090, p=.001). Periodontitis and tooth loss may be attenuating factors for blood high-density lipoprotein cholesterol and triglyceride levels, respectively. Frequent tooth brushing may improve dyslipidaemia, particularly blood high-density lipoprotein cholesterol and triglyceride levels. Oral hygiene improvement may reduce the risk of dyslipidaemia.

Non-Invasive Diagnostic System Based on Light for Detecting Early-Stage Oral Cancer and High-Risk Precancerous Lesions-Potential for Dentistry.

Simple SummaryThe early detection of oral cancer and oral potentially malignant disorders can facilitate minimum intervention and subsequent improvements in prognosis and quality of life after treatment. Recently, several non-invasive adjunctive fluorescence-based detection systems have improved the accuracy of detection and diagnosis of oral cancer and oral potentially malignant disorders. This article summarizes current knowledge about fluorescence-based diagnostic methods and discusses their benefits and drawbacks from a clinical viewpoint.Oral health promotion and examinations have contributed to the early detection of oral cancer and oral potentially malignant disorders, leading to the adaptation of minimally invasive therapies and subsequent improvements in the prognosis/maintenance of the quality of life after treatments. However, the accurate detection of early-stage oral cancer and oral epithelial dysplasia is particularly difficult for conventional oral examinations because these lesions sometimes resemble benign lesions or healthy oral mucosa tissues. Although oral biopsy has been considered the gold standard for accurate diagnosis, it is deemed invasive for patients. For this reason, most clinicians are looking forward to the development of non-invasive diagnostic technologies to detect and distinguish between cancerous and benign lesions. To date, several non-invasive adjunctive fluorescence-based detection systems have improved the accuracy of the detection and diagnosis of oral mucosal lesions. Autofluorescence-based systems can detect lesions as a loss of autofluorescence through irradiation with blue-violet lights. Photodynamic diagnosis using 5-aminolevulinic acid (ALA-PDD) shows the presence of very early oral cancers and oral epithelial dysplasia as a red fluorescent area. In this article, currently used fluorescence-based diagnostic methods are introduced and discussed from a clinical point of view.

Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis \u2013 a Norwegian cross- sectional multicentre study

BackgroundChildren and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD.MethodsThis comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the TMJaw Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs.ResultsIn our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthy controls presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p < 0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p < 0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation.ConclusionSymptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

Road-to-Health Booklet assessment and completion challenges by nurses in rural primary healthcare facilities in South Africa

Background. Appropriate completion of the Road-to-Health Booklet (RTHB) remains crucial as it facilitates the provision of essential packaged health services for the growth and well-being of children under 5 years old. Objective. To assess the new RTHB completion and its utilisation challenges by nurses in rural primary healthcare (PHC) in the West Rand District, Gauteng Province, South Africa. Methods. A concurrent mixed-method design was used to conduct a retrospective record review of the 75 RTHBs completed by the nurses in the two PHC facilities. Nine in-depth interviews were also conducted with purposefully selected nurses to explore their RTHB utilisation challenges. Categorical data were analysed descriptively, comparing ‘fully completed’, ‘partially completed’ and ‘not completed’ sections of the RTHB. In-depth interviews were analysed using a thematic analysis approach which involved conducting inductive coding, grouping codes according to their similarity and identifying emerging themes. Results. The highest completed sections of the RTHB were the weight-for-age growth chart (81%) and mother PMTCT/HIV (78%). The lowest completed section was the oral health examination, with only one booklet completed (7%). Length/height × age (37%) and weight × length/height (33%) charts were partially completed. RTHB utilisation challenges included healthcare provider dilemmas (lack of time, burnout, habitual practices); patient-related dilemmas (language barriers, tampering with RTHB pages, lack of resources); and health system dilemmas (equipment shortages and lack of training for health personnel). Conclusion. Although the quality of the RTHB is improving, there are still considerable challenges concerning its completion. It is therefore necessary to implement ways to improve its utilisation in this rural district, for effective under-5 child health management. Without substantial improvement, opportunities for enhancing under-5 child health will be missed.

Oral Health Status and Risk Factors for Caries in Permanent Teeth among 12-year-old Students in Guangdong, Southern China: A Population-based Epidemiological Survey.

To assess the current prevalence of caries, gingival bleeding, calculus, and fluorosis and to determine the risk factors for caries in permanent teeth of 12-year-old students in Guangdong Province, China. A cross-sectional survey was carried out among 1920 12-year-old students in Guangdong Province. All participants were required to undergo an oral health examination. Information concerning the subjects' family background, dietary habits, and relevant oral health behaviour were collected in a structured questionnaire. Chi-squared tests, Wilcoxon rank-sum tests, and the logistic regression model were used in the statistical analysis. The prevalence rates of caries in permanent teeth, gingival bleeding, calculus, and fluorosis were 43.07%, 40.57%, 43.75%, and 5.05%, respectively; the average decayed, missing, and filled teeth (DMFT) index was 1.06±1.721. Residence (odds ratios [OR] rural=1.798, 95% CI: 1.485-2.177), sex (OR female=1.352, 95% CI: 1.121-1.631), paternal education level (OR >9 years=0.755, 95% CI: 0.608-0.936), presence of calculus (OR yes=1.279, 95% CI: 1.057-1.548), and frequency of consumption of sugary snacks (OR frequently=1.418, 95% CI: 1.064-1.890) were statistically significantly associated with the risk of permanent teeth caries. Oral health in 12-year-olds in Guangdong Province remains to be improved. Rural residence, female sex, the presence of calculus, and frequent consumption of sugary snacks could increase the risk of caries. The paternal educational level was negatively associated with the risk of caries, whereas we found no association between the maternal educational level and the risk of caries in this population.

Concern with dental appearance and associated factors among the elderly of two southern Brazilian cities

Aim: This study aimed to evaluate the prevalence of concern with dental appearance (DA) and associated factors among the elderly of two southern Brazilian cities. Methods: A cross-sectional study was conducted in the cities of Cruz Alta and Veranópolis, Brazil. Oral health examination and a structured questionnaire were applied. Questions from the PCATool-SB Brasil tool and the Questionnaire about Teeth Appearance, both validated to Brazilian samples, were used. The collected independent variables were: sex, age, ethnicity, education level, marital status, retirement, health problem, use of medication, smoking exposure, alcohol exposure, access to the dentist, toothbrushing frequency, use of dental floss, edentulism, use of and need for dental prosthesis. Concern with DA was dichotomized into yes/no. Associations between dependent and independent variables were assessed by Chi-square or Mann-Whitney tests. Moreover, uni- and multivariate analyses were conducted by Poisson regression with robust variance. Level of significance was established as p&lt;0.05. Results: The prevalence of concern with DA was 18.8% (n=107). The prevalence ratio (PR) of concern with DA decreased 5.8% for each year increase (PR:0.942; 95% confidence interval [95%CI]:0.911–0.973). Elderly without access to the dentist in the last 12 months presented 62.5% (p=0.006) higher PR of concern with DA when compared to those with access to dental care. Dentate elderly showed 219% higher PR for concern with DA (PR:2.197; 95%CI:1.364–3.539) in comparison to edentulous individuals. Conclusion: Prevalence of concern with DA was low and associated with demographics, access to dental care and edentulism.

Oral health indices predict individualised recall interval.

ObjectivesThe individualised recall interval (IRI) is part of the oral health examination. This observational, register‐based study aimed to explore how oral health indices DMFT (decayed, missing, filled teeth), DT (decayed teeth), CPI (Community Periodontal Index, maximum value of individual was used) and number of teeth are associated with IRI for adults.MethodsOral health examination includes an assessment of all oral tissues, diagnosis, a treatment plan and assessment and a determination of the interval before the next assessment. It is called the IRI. This cross‐sectional study population included 42,533 adults (age range 18–89 years), who had visited for an oral health examination during 2009, provided by the Helsinki City Social Services and Health Care. The recall interval was categorised into an ordinal scale (0–12, 13–24, 25–36 and 37–60 months) and was modelled using a proportional odds model. ORs less than one indicated a shorter recall interval.ResultsRecall interval categories in the study population were 0–12 months (n = 4,569; 11%), 13–24 months (n = 23,732; 56%), 25–36 months (n = 12,049; 28%), and 37–60 months (n = 2,183; 5%). The results of statistical models clearly showed an association between the length of recall intervals and oral health indices. In all models, higher values of DMFT, DT and CPI indicated a shorter recall interval. The number of teeth were not so relevant. The association was not influenced when different combinations of other predictors (age, gender, socioeconomic status, chronic diseases) were included in the model. The severity of periodontitis predicted a short recall interval, for example, in the Model 1, CPI maximum value 4 was OR = 0.35 (95% confidence interval 0.31–0.40).ConclusionsThe oral health indices showed a clear association with the length of the IRI. Poor oral health reduced IRI. The indices provide information about the amount of oral health prevention required and are useful to health organisations.

Lack of associations between lactoferrin (LTF) and mannose-binding lectin 2 (MBL2) gene polymorphism and dental caries susceptibility.

ObjectiveWith the development of human genomics, the genetic factors associated with dental caries have receiving increasing attention. This study was performed to evaluate the relationship between lactoferrin (LTF) and mannose-binding lectin 2 (MBL2) gene single nucleotide polymorphisms (SNPs) and dental caries susceptibility in Chinese children.MethodsThis prospective case–control study included 360 unrelated children (aged 12–15 years) who received oral health examinations and questionnaire surveys. The children were divided into two groups by counting the numbers of decayed, missing, and filled teeth (DMFT/dmft): case group (n = 162, DMFT/dmft ≥ 1) and control group (n = 198, DMFT/dmft = 0); non-invasive saliva samples were collected to extract genomic DNA. Six SNPs (rs2073495C/G, rs1042073C/T, rs10865941C/T, and rs1126477A/G in LTF; rs7096206C/G and rs7095891G/A in MBL2) were tested by mass spectrometry.ResultsThe study included 360 individuals with (85 boys and 77 girls) and without a history of caries (96 boys and 102 girls). There were no statistically significant differences in alleles and genotypes among the six SNPs between the two groups.ConclusionThere is no evidence that polymorphisms of LTF and MBL2 genes are associated with dental caries susceptibility in populations from northwest China; further confirmation is needed with larger sample sizes.

Changes in Oral Mucosa during Pregnancy

The main aim of this review is to understand the changes in oral mucosa during pregnancy. This review&#x0D; highlights the major oral complication during pregnancy. Changes in the gingiva and physiological&#x0D; structure of the tooth take place in addition to hormonal, immunologic, dietary and behavioural changes.&#x0D; Characteristics of pregnancy gingivitis are that it gets swollen, smooth and tends to bleed easily. Enlargement&#x0D; of gingiva may occur but it tends to resolves within few months after delivery. Due to the increase in salivary&#x0D; microorganisms, there may be a decrease in salivary pH and impairment of buffer effect. This may also lead&#x0D; to dental caries or erosion during lactation period.&#x0D; The dental management of pregnant patients requires special attention. Dentists, for example, may delay&#x0D; certain elective procedures so that they coincide with the periods of pregnancy which are devoted to&#x0D; maturation versus organogenesis. At other times, the dental care professionals need to alter their normal&#x0D; pharmacological armamentarium to address the patients’ needs versus the foetal demands. Applying the&#x0D; basics of preventive dentistry at the primary level will broaden the scope of the prenatal care. Dentists&#x0D; should encourage all the patients of the childbearing ages to seek oral health counselling and examinations&#x0D; as soon as they learn that they are pregnant