Oral Hygiene Measures Research Articles

Description of the Implementation of Oral Hygiene Measures for Stroke Patients at Bhayangkara Hospital Makassar

This research generally aims to determine the description of the implementation of oral hygiene in stroke patients at Bhayangkara Hospital Makassar. This research uses descriptive research with observational methods. The number of samples in this study was 30 respondents. Sample selection was carried out using Accidental Sampling. Data was collected using a check list observation questionnaire, analyzed using the SPSS 16 program. The results of the analysis showed that most of the nurses' actions in providing oral hygiene had been carried out correctly, supported by data of 60.0%, and the majority of patients had teeth and mouths that were correct. net, this statement is supported by data of 60.0%. It can be concluded that the nurses' actions in providing oral hygiene have been carried out appropriately and the majority of patients have clean teeth and mouths. For further research, more respondents and better measuring tools are needed to increase the accuracy of the research results.

876 VENTRICULAR SEPTAL DEFECT AND RIGHT-SIDED INFECTIVE ENDOCARDITIS

Abstract Introduction Right-sided infective endocarditis (IE) accounts for 5-10% of IE cases; it is most frequently associated with intravenous drug abuse but can also be observed in patients with cardiac implantable electronic devices, central venous catheters or congenital heart diseases. Case report A 34-year-old female, with unrepaired perimembranous ventricular septal defect (VSD) and right ventricle and tricuspid valve (TV) IE with lung septic embolism treated conservatively with antibiotic therapy 16 years ago, was admitted to our hospital for persistent fever and cough unsuccessfully treated with empiric antibiotic therapy. She denied intravenous drug abuse and recent surgical or dental procedures. Blood cultures resulted positive for multi sensitive Staphylococcus lugdunensis, so antibiotic therapy with Oxacillin and Gentamicin was started. Suspecting IE, transesophageal echo (TEE) was performed and showed, inside VSD, a small fluctuating vegetation and, along the right side of the interventricular septum, next to the VSD, a voluminous hypomobile vegetation; septal and anterolateral TV leaflets appeared thickened and infiltrated by vegetations floating into the right atrium; at color-Doppler moderate TV regurgitation. A whole-body computed tomography showed right lung abscess and right kidney septic infarct. Endocarditis Team, considering hemodynamic stability and inflammatory biomarkers and surveillance blood cultures negativization, decided for medical therapy with echocardiographic follow-up. TEE performed at the end of antibiotic therapy demonstrated complete disappearance of the above described vegetations and surgical VSD closure was scheduled. Discussion Patients with unoperated small VSDs and without volume overload signs usually remain asymptomatic and do not require surgery; nevertheless, a small percentage of them develops problems later in life and IE represents one of the main concerns. Even if unrepaired VSD is associated with increased risk of IE compared with the general population, antibiotic prophylaxis is still recommended only for high-risk patients undergoing at-risk dental procedures, while non-specific oral and cutaneous hygiene measures should always be applied. Latest ESC Guidelines for the management of adult congenital heart disease state that in patients with no significant left to right shunt, but a history of repeated episodes of IE, VSD closure should be considered (IIa, C); it's still matter of debate whether closure should be performed after the first episode of IE. Conclusion IE should always be suspected in patients with VSD and persistent fever. Optimal oral and skin hygiene are effective prevention measures, while prophylactic antibiotic therapy is indicated only in selected cases. Surgery should be considered after repeated episodes of IE.

Brushing Characteristics and Dietary Patterns of Orthodontic Patients with Fixed Appliances

Background: Proper brushing practices are required to maintain good oral hygiene. This is of utmost importance in patients with fixed orthodontic appliances as these appliances can facilitate plaque accumulation and make cleaning process difficult. Hence if good oral hygiene is not maintained with these appliances then deterioration of gingival and periodontal health will result. Frequent intake of acidic drinks and sweet food can further harm the teeth. Aim: To determine tooth brushing characteristics of orthodontic patients with fixed appliances. Determine dietary patterns of such patients. Determine other oral hygiene measures used by them. Study Design: Cross sectional study Duration of the study: 6 months Methodology: Questionnaires were conveniently distributed among 104 orthodontic patients who met the inclusion criteria and provided consent to provide the information. Data collected was analyzed using SPSS 2020. Results: Most (70%) of the responding patients brush two times daily. Correct brush type (soft) is in use by 77% of the individuals. Approximately 64-66% of individuals combine vertical and horizontal technique of tooth brushing, use interdental toothbrush and report that they hardly intake fizzy drinks. However, only 55% patients have reported brushing for total duration of 2 minutes. Around 30% of the respondents have frequent intake of junk food and sugary food. Practical Implication: According to our knowledge, this study is the first study to date to evaluate the brushing habits and dietary patterns in Pakistani orthodontic patients with fixed appliances. Conclusions: The present study shows that majority of the patients show good brushing practices but need to improve their total duration of brushing. Frequent intake of junk food, sweets and fizzy drinks are also avoided by most patients. Use of fluoride mouthwashes and floss was seen in lesser proportion of surveyed patients. Keywords: Brushing characteristics, oral hygiene measures, dietary patterns, orthodontic patients with fixed appliances.

PERBANDINGAN TINGKAT NYERI PADA PASIEN TERPASANG VENTILASI MEKANIK SELAMA ISTIRAHAT DAN TINDAKAN KEPERAWATAN RUTIN DI RUANG INTENSIVE CARE UNIT RUMAH SAKIT PUSAT PERTAMINA

Pain is the most common stressor experienced by patients in the ICU. Nearly 5 million patients are treated in the Intensive Care Unit (ICU), and 71% experience pain during treatment. Most of the pain felt by patients in the ICU is when the patient is mechanically ventilated. Pain can occur during routine nursing actions such as positioning, suction, and oral hygiene. This study aims to compare the level of pain in patients on mechanical ventilation during rest and routine nursing actions in the Intensive Care Unit of Pertamina Central Hospital. This research is an analytical observational research design with a cross-sectional approach, a sample of 31 patients with mechanical ventilation installed and the sampling technique used is non-probability sampling with accidental sampling. Data were taken using the Critical Pain Observation Tool (CPOT) questionnaire to measure pain levels. The results showed that there was a comparison of pain levels during rest and positioning with a comparison value of 15.00 (p<0.05); There is a comparison of pain levels during rest and suction action with a comparison value of 15.00 (p<0.05); There is a comparison of pain levels during rest and oral hygiene measures with a comparison value of 7.00 (p <0.05).

Dental Neglect Score amongst Orthodontic Braces patients in Punjab Dental Hospital

Background: Dental Neglect refers to ones attitudes and behavior that cause harmful consequences in oral health. Subjects with greater dental negligence are linked with more caries, lesser remaining teeth, irregular visits to the dentist and are more likely to have prolonged time duration between their dental appointments.. The Dental Neglect Scale (DNS) is valued as a reliable measure of dental negligence in various samples of children, adolescents and adults. Maintenance of conscientious practice related to oral health is key to success in orthodontic patients. This is because orthodontic appliances facilitate the accumulation of plaque by making cleaning difficult over the teeth. Failure to keep up the proper oral hygiene measures can lead to accumulation of plaque. This causes gingival inflammation and damages periodontal health. Aim: To determine dental negligence score among orthodontic patients with braces and assess their associated oral hygiene practices. Study Design: Cross sectional study Place and duration of the study: This study took 6 months to complete and was conducted in Punjab Dental Hospital, Lahore, Pakistan. Methodology :104 orthodontic patients willing to participate and who had given informed consent were chosen for the study. Questionnaires were distributed and data was analyzed using SPSS 2020. Results: Before starting orthodontic treatment only 14% of respondents went regularly to the dentist and majority 64% had never been to a dentist before. However, after starting the orthodontic treatment 88% of the respondents became regular in their visits. This shows their dental negligence before and after starting the orthodontic treatment. Percentage of respondents brushing twice daily are around 70 %, using soft tooth brush are 77%, combining horizontal and vertical technique of brushing are 64%. Interdental brush is used by 66% of the respondents. However, other oral hygiene and dental care measures are inadequately maintained by orthodontic patients at home. This is especially true with regards to use of floss which is done by only 4% of the respondents. Conclusions: Dental neglect results in numerous harmful effects to the oral health. This study has shown variation in oral hygiene practices among responding patients. Orthodontist should encourage different practices that enhance oral hygiene in patients. Patients should also understand the increased need to maintain oral hygiene with use of braces and hence apply all the preached dental care and oral hygiene measures. Keywords: Dental negligence scale, orthodontic patients with fixed appliances, braces, oral hygiene

Streptococcus mutans carriage in the saliva of mothers and its association with dental caries and Streptococcus mutans carriage in the saliva of children between 6 and 30 months old in a low-income setting in Karachi, Pakistan.

Early childhood caries poses a significant health issue in children under 6 years old. It is determined that Streptococcus mutans is a primary etiological agent, likely to be transferred through maternal contact. To determine the association of maternal S. mutans counts with S. mutans counts in their children between 6 and 30 months of age, and to determine the maternal and child DMFT (decayed, missing, and filled teeth) indices. A community-based cross-sectional study was conducted in Karachi, Pakistan. A sample of 193 dyads of mother-children (6-30 months of age) was selected via purposive sampling. Saliva samples of the dyads were collected to assess S. mutans count. Caries assessment was performed for both using the DMFT index. A pretested questionnaire was used. The association of bottle-feeding, oral hygiene measures, and other factors with S. mutans counts in children were also explored. Zero-inflated negative binomial regression model at a 5% level of significance was applied using STATA version 12.0. Out of 193 children, 109 (56.47%) were males and 84 (43.52%) were females. The mean age of mothers and children was 29.4 ± 6.2 years and 19.54 ± 6.8 months, respectively. Maternal S. mutans counts were not statistically associated with child's S. mutans counts (Mean child's S. mutans count ratio: 1; 95% confidence interval [CI]: 1, 1.01; p = .882). Compared with children who were breastfed, S. mutans counts were higher in children who were bottle-fed (mean S. mutans count ratio= 4.85 [95% CI: 1.53, 15.41], p = .007). Age of mother and present caries status of mothers was significantly associated with the child's S. mutans count. No association between maternal S. mutans and child S. mutans was observed. However, maternal age, children who were breastfed, children who did not use pacifiers,and children with mothers who did not have caries, exhibited low S. mutans counts in their saliva.

Assessment of attitudes and practices regarding oral healthcare during the COVID-19 pandemic among the parents of children aged 4-7 years.

The coronavirus disease 2019 (COVID-19) pandemic has brought about radical changes in our habits and lifestyles. The suspension of schools has led children to spend long hours at home, with reduced socialization, and changes in dietary patterns, oral hygiene practices and sleep routines. During a pandemic, appropriate oral health management and disease prevention are very important for the child's oral and general health. The aim of this study was to assess the attitudes and practices of parents with regard to their children's oral healthcare, dietary habits and dental care during the COVID-19 pandemic. This cross-sectional study included 381 Indian parents of children aged 4-7 years. A self-instructed questionnaire was designed in English using the Google Forms platform. The questionnaire consisted of 4 parts: sociodemographic data; dietary habits of the child; oral hygiene measures; and dental information. The collected data was analyzed using descriptive and analytical statistics (the χ2 test). Among the children included in the study, 48% of those who experienced dental problems during the pandemic consumed more snacks and packaged foods between meals. Among the parents, 80% reported that their children used electronic devices at mealtimes, and 60% reported the food pouching habit in their children. A total of 71% of parents assisted their child at tooth brushing, while only 28% of the parents would take their child to the dental clinic for treatment. This study highlights the shortfalls in attitudes and practices among parents in relation to dietary habits, oral hygiene measures and the use of dental services during the COVID-19 pandemic regarding their children. This could be attributed to a lack of awareness, the fear of exposure and the inconveniences faced by parents.

Polyetheretherketone computer-aided design and computer-aided manufacturing framework for All-on-Four mandibular full-arch prosthesis: 3 Years' retrospective study of peri-implant soft tissue changes and ridge base relationship.

This study was conducted to evaluate the clinical peri-implant soft tissue changes during the first year after occlusal loading and the ridge base relation after 3 years for mandibular computer-aided design and computer-aided manufacturing (CAD-CAM) screw-retained implant-supported hybrid prosthesis of polyetheretherketone (PEEK) framework utilized with All-on-Four treatment concept. Sixteen completely edentulous patients were rehabilitated by four implants following the All-on-Four protocol. After 3 months, the definitive prosthesis was constructed to be a screw-retained CAD-CAM milled framework from the modified PEEK (BioHPP), bonded to polymethylmethacrylate teeth and a pink shaded indirect light-polymerized nanofilled composite resin imitating the soft tissues. Peri-implant soft tissue changes regarding plaque, bleeding, gingival scores, and probing depth were evaluated at prosthesis insertion (T0), 6 months (T1), and 12 months (T2) after insertion. Also, monitoring of the ridge base relation was performed using cone beam computed tomography at time of insertion (T0), and 1 year (T1), 2 years (T2), and 3 years (T3) after mandibular fixed detachable All-on-Four framework insertion. Using Shapiro-Wilk tests using SPSS® software version 22 (SPSS Inc., Chicago, IL), all clinical data were nonparametric, while the ridge base relation data were parametric. There were statistically significant differences regarding a plaque, gingival, and bleeding scores for all implants with the advancement of time. However, there was a statistically insignificant difference regarding probing depth in the posterior implants (p = 0.581). Regarding ridge base relation, there was a significant difference between observation times only in the anterior ridge area in between the two anterior implants (p = 0.011). Within the limitations of the study, the full-arch PEEK framework of fixed-detachable, hybrid prosthesis used with the All-on-Four concept for rehabilitation of mandibular edentulous arches is an acceptable treatment approach. Based on the stable ridge base relation posteriorly found in this study, less stress is distributed to the underlining bone due to the shock-absorbing ability of PEEK. Special considerations for frequent soft tissue follow-up and regular maintenance of oral hygiene measures are recommended.

Assessment of Knowledge, Attitude, and Practices of Adjunctive Oral Hygiene Aids Brushing Among Medical and Dental Students in UCMS, Nepal

INTRODUCTIONPeriodontal disease is a bacterial infection that affects tissues that support the teeth and bacterialplaque is the primary cause of this disease. In the interdental spaces, periodontal disorders are more common as a result, removing plaque from these regions is critical. This can be managed by using various interdental cleaning aids such as dental floss, interdental brushes, and chemical agents such as mouth washes. Thus, the aim of our study is to assess the knowledge of other oral hygiene aids except brushing among medical and dental students in a Teaching hospital. This is a knowledge, attitude, and practices model of analyzing the knowledge of adjunctive oral hygiene aids performance and measures other than tooth brushing among medical and dental students. MATERIAL AND METHODSA Knowledge, Attitude and Practices (KAP) survey was designed for the present cross-sectional study which was conducted for a period of three months from July 2021 to September 2021 among a sample of 275 medical and dental undergraduates in a Teaching hospital. Pre-tested structured 22-item closed-ended questionnaire was given to each on survey tool and the link was passed to the participants. Statistical analysis was done using SPSS (version 21.0) software. RESULTSThe response rate for the present survey was 98.9% (272 participants). It was seen that, 29.78% participants reported that poor oral hygiene is the main cause of bleeding and 59.19 % believed that poor oral hygiene is responsible for bad breath. A total of 65.81% reported that most widely recommended interdental aid to be used is dental floss. On gender wise comparison, significant positive response (p< 0.05) was seen among females for items (2,6,11) as compared to males. On stream wise comparison, significant positive response (p< 0.05) was seen among dentists for items (16,17,20) as compared to medical students. CONCLUSIONThe study concluded that dental and medical students must be encouraged to be good role models in practicing as well as promoting oral health for their patients, families, friends and ultimately the society.

The Effect of Zingiber, Alpinia Officinarum with Periodontal Therapy on Clinical Outcome and Oxidative Stress

Many popular mouthwashes containing herbal products have helped to control dental plaque and gingivitis; however, they are used for a short time and only as an adjunct to other oral hygiene measures such as brushing and flossing. Recently, herbs such as Zingiber ginger and Alpinia officinarum, with antioxidant, antifungal, anti-inflammatory, and antibacterial properties apart from being cheap and safe, have been used as plant extracts in mouthwashes. The aim of this study was to assess the effect of both herbal mouthwashes and periodontal therapy on oxidative stress, total antioxidant capacity, and antioxidant enzyme activities in the saliva of patients with periodontitis as well as to investigate the association between oxidative stress, antioxidant enzymes, total antioxidant capacity, and periodontal parameters. 72 patients were selected using random sampling and divided into three categories. Each category consisted of 24 patients: the first group received non-surgical periodontal treatment and Zingiber ginger mouthwash, the second group received Alpine officinarum and non-surgical periodontal therapy, while the third control group received non-surgical periodontal therapy only. Periodontal parameters (Clinical Attachment Loss and Plaque Index) were recorded by a calibrated periodontal probe (William probe). Salivary oxidative stress (eight hydroxy deoxyguanosine) was measured by ELISA, and catalase and total antioxidant capacity were measured using a spectrophotometer. The concentration of salivary antioxidants significantly increased, and the periodontal parameter and eight hydroxy deoxyguanosine significantly decreased after two weeks. The p-value in the ginger group was (P < 0.0001). For the alpine officinarum group, the clinical parameters showed a significant decrease, and the p-value was (P < 0.0001). While catalase displayed a significant increase (P < 0.0001), the eight hydroxy deoxyguanosine markers showed a significant decrease (P < 0.02). Zingiber ginger and Alpine officinarum mouthwashes, in addition to periodontal therapy, can be effective in controlling inflammation, reducing oxidative stress, and improving dental health in patients with chronic periodontitis. Mostly positive associations were detected among clinical and biochemical parameters.

Oral-Periodontal Health and Cytokine Storm: Correlation and Preventive Measures

Coronavirus disease 19 (COVID-19) has taken the world by storm, affecting all age groups alike and presenting a plethora of signs and symptoms. Showcasing a high mortality rate, cytokine storm is identified as one of the most common culprits for death in affected individuals. In patients undergoing severe complications in the form of intubations and intensive care unit (ICU) admissions, increased cytokine levels have again been identified as a significant factor, indicating their substantial role in disease outcomes. Periodontitis, which is identified as a silent pandemic, is the most common oral disease that is found in individuals. The increased accumulations of plaques and calculus are the main causative agents, stimulating inflammatory cells in the periodontal tissue, leading to cytokine release. Individuals with the removable or fixed dental prosthesis are at increased risk of contracting fungal infections, which are also identified as increasing the cytokine levels and worsening an individual’s condition contracted with COVID-19. This review focuses on oral hygiene measures and scientifically proven aids that can be used by patients at home for reducing oral cytokine levels and the risk of COVID-19 related complications, thereby sensitizing them at a time when elective dental procedures are discouraged and patients are devoid of professional dental intervention. Mechanical removal of plaques and calculus cannot be substituted with auxiliary aids, but it is important that adjunct practices be adopted for efficient hygiene. Toothbrush hygiene should also be practiced to prevent disease progression and transmission. Adherence to these recommendations is not only required for healthy or infected individuals but also for viral infection recovered patients to avoid the possible risk of developing the black fungus infection.

Knowledge Awareness and Perception towards Prosthodontics Treatment and Services among Medical Students in Jeddah City, Saudi Arabia- A Cross Sectional Pilot Study

Prosthodontics is concerned with the design, manufacture and fitting of artificial replacements for teeth and other parts of the mouth. Prosthodontic treatment involves the replacement of missing teeth by means of removable or fixed partial denture, implants, complete dentures, or over dentures. The aim of this study was to evaluate the level of knowledge, perception, awareness and attitude of the medical students towards Prosthodontic treatment. A cross-sectional, Questionnaire based study was conducted among Medical students, covering various Medical colleges in Jeddah city. The study population was selected using cluster random sampling. Altogether 151 undergraduate medical students throughout Jeddah city participated in this study. The data was collected, compiled, and statistically analyzed using SPSS software version 21 and
 Chi-square test, t-test, and ANOVA. was performed A total of 151 participants, out of which there were 88 female participants (58.3%) and 63
 male participants (41.7%), completed and returned the questionnaire. 134 participants (88.7%) were aware that missing teeth could be replaced
 and 17 participants (11.3%) were unaware. 93 participants (61.6%) felt implant Supported Prosthesis is a better Option for replacement of missing teeth and 58 participants (38.4%) did not feel so. 75 participants (49.7%) chose fixed partial denture as an option for replacement of missing teeth whereas 76 participants (50.3%) opted for removable partial denture. 64 participants (42.4%) had fear of prosthodontic replacement and 87 participants (57.6%) had no fear. Within the limitations of this study, following conclusions were drawn: Majority of the medical students was aware that missing teeth could be replaced. Most of them thought Implant supported prosthesis would be a better option for replacing missing teeth. Equal number of participants opted for fixed prosthesis. The most important finding of this study was that majority of the participants showed a lack of knowledge regarding oral hygiene measures with dental prosthesis.

Prevalence of oral manifestations in patients with lupus erythematosus in a sample of the Egyptian population: a hospital based cross-sectional study.

Background: Several systemic diseases manifest themselves in the oral cavity. Dentists who are unaware of these lesions will possibly miss them. This cross-sectional study aimed to assess the prevalence of oral manifestations in patients with LE in a sample of the Egyptian population. Methods: The present cross-sectional study was performed on 189 patients attending the Internal Medicine Department, Rheumatology Clinic in EL Qasr El Ainy Hospital, Cairo University. Every patient was examined clinically after completing a questionnaire. Patients' medical records were evaluated. The oral manifestations were assessed according to the WHO guide to physical examination of the oral cavity and classified according to their morphologic aspects and localization. Results: Out of 189 patients, there were 182 females (96.3%) and seven males (3.7%). The prevalence of oral lesions in SLE patients was 55.6%. The most affected site was the tongue 25.7%. The most common clinical aspect was patches, 53%. About 77.1% of the lesions were asymptomatic. Conclusions: The present study emphasizes the importance of early diagnosis of oral lesions to recognize patients with SLE as the WHO considers oral manifestations of SLE a widespread state. Also, the implementation of oral hygiene measures to improve patients' nutritional state and health-related quality of life is recommended.

RADIOGRAPHIC EVALUATION OF CRESTAL BONE LOSS FOR BAR RETAINEDIMPLANT OVERDENTURE SUPPORTED BY FOUR IMPLANTS VERSUS ALL ON 4 SCREW RETAINED PROSTHESIS

To compare in-vivo conventional 4 parallelimplant placement and bar attachment with cantilever supporting complete overdenture with All-on four configuration supporting fixed screw-retained denture in the term of crestal bone loss around implants Materials and methods:Twelve male patients with good health and firm mucosa were selected to participate in this study. Each patient received four implants in the canine and second premolar areas of the mandible. The patients were randomly classified according to posterior implants angulation into two equal groups,Group(A) received four parallel implants in the canine and second premolar areas, bar-clip attachment with cantilever retaining complete overdenture while Group(B) recievedTwo anterior parallel implants in the canine region and two posteriorly 30° tilted implants in the second premolar area supporting fixed screw retained prosthesis. Crestal bone loss around implants was measured for each patient by using cone beam computed tomography (CBCT) and evaluation made at T6 and T12 Results:Therewassignificantdifference during comparing Marginal bone loss at 6 months with that of 12 months at mesial, distal, buccal and palatal bone for Group (A)(P=0.01, 0.025, 0.0001 and 0.007 respectively) and Group (B) (P=0.03, 0.028, 0.007 and 0.001 respectively). Comparing the two groups, there was no statistical difference at 6 months or 12 months. Conclusion: Despite the limitations in this study, it can be denoted than both treatment options provide the same values of marginal bone loss Only the patient desire is still the contributing factor for choosing the type of restoration, if the patient desire fixed prosthesis with reduced extensions then treatment option used for group(B) (fixed detachable prosthesis screwed to four implants with the posterior implants tilted 30° posteriorly) however when access for oral hygiene measures is more important with patients that cant maintain hygiene with fixed prosthesis, then the selection of group (A) will be more appropriate.

Refining the Mechanism of Drug-Influenced Gingival Enlargement and Its Management.

Drug-influenced gingival enlargement (DIGE) or overgrowth manifests as abnormal enlargement of the gingiva due to an adverse effect of certain drug reactions in patients treated with anticonvulsants, immunosuppressants, or calcium channel blockers (CCBs). As the gingival enlargement became significant, it may interfere with the normal oral hygiene measures, aesthetics, as well as masticatory functions of the patients. The exact mechanism of how this undesirable condition develops is yet unknown, and complicated, with non-inflammatory and inflammatory pathways involved. This review illuminates these putative pathways of DIGE and highlights various treatment approaches based on existing research and current observations.

Assessment of effect of probiotics to nonsurgical treatment of chronic periodontitis

Background: Periodontal disease represents an inflammation of both soft and hard tooth-supporting tissues which is regarded as one of the major causes of tooth loss worldwide. The present study was conducted to assess effect of probiotics to nonsurgical treatment of chronic periodontitis. Materials & Methods: 48 patients of chronic periodontitis of both genders was included. In all patients, bacterial cultures and clinical evaluation were recorded in 70 sites in patients. After scaling and root planning (SRP), oral hygiene measures were reassured, and sites were divided into 2 groups 35 sites each. Group I received SRP only and group II received SRP and subgingival delivery of 1 ml of probiotic L. Results: Out of 48 patients, males were 23 and females were 25. The mean plaque index showed score 3 at baseline was seen in 35 in group I and 35 in group II. At 3 months score 1 was seen in 17 in group I and 35 in group II, score 2 in 18 in group I. At 6 months, score 2 was seen in 17 in group I and 25 in group II and score 3 in 18 in group I. and 10 in group II.

Removable partial dentures in Libya: patient expectations, satisfaction and maintenance

Background: Patient satisfaction is considered the definitive aim of any oral restoration procedure. This study aimed to assess the level of Libyan patient expectation of and satisfaction with a Removable Partial Denture (RPD). Furthermore, to explore the level of patient awareness and application of oral hygiene care pertaining to RPD. Materials and Methods: A cross-sectional retrospective survey was undertaken by administering self-reported questionnaires to 160 patients wearing RPD and living in Benghazi, Libya. The included questions explored expectation of a RPD as well as subjective satisfaction with the treatment outcome. Moreover, the questionnaire included a section to evaluate the attitude of patients’ towards their use of oral hygiene measures. Descriptive statistics and Spearman’s correlation coefficient were undertaken to calculate the correlation between the various examined parameters. Results: revealed that the RPD met the expectations of 63.1% and met the partial expectations of 16.9% of the participants. Overall satisfaction was experienced by 68.1% of the sample, while 31.9% had one concern or more. The majority of patients (91.3%) cared about and paid attention to their oral hygiene. Spearman’s correlation coefficient showed a weak but significant correlation between the level of patient expectation and patient satisfaction (r=0.369, P<0001) and between the type of denture base and the level of satisfaction (r=0.211, P=0.007). There was a weak but significant correlation between oral health care and sex (r=0.178, P=0.024) where females surpassed males in their oral hygiene care. Conclusions: A high percentage of patients were satisfied with their RPDs and most took good care of their oral hygiene after using RPD.

Phenytoin Induced Gingival Enlargement and Its Management- A Case Report

Background: Gingival enlargement is associated with multiple factors including congenitaldiseases, hormonal disturbances, poor oral hygiene condition, inflammation, neoplasticconditions, and adverse drug reactions including anticonvulsants, calcium channel blockers,and immunosuppressants. This can have a deleterious effect on the quality of life and also onhigh oral bacterial load caused by plaque-retentive areas. Method: Various treatment modalitiesinclude both surgical (gingivectomy, periodontal flap, electrosurgery, and laser excision) andnonsurgical approaches (oral hygiene measures, oral prophylaxis, discontinuation of the drug, orthe replacement of the drug with other alternative). Conclusion: Surgical intervention is requiredwhen non-surgical treatment fails to resolve the problem. Proper maintenance phase should befollowed for better esthetic outcome along with drug replacement.

Dental Caries Postradiotherapy in Head and Neck Cancer.

Treatment for head and neck cancer (HNC) such as radiotherapy (RT) can lead to numerous acute and chronic head and neck sequelae, including dental caries. The goal of the present study was to measure 2-y changes in dental caries after radiotherapy in patients with HNC and test risk factors for caries increment. Cancer and dental disease characteristics, demographics, and oral health practices were documented before and 6, 12, 18, and 24 mo after the start of RT for 572 adult patients with HNC. Patients were eligible if they were age 18 y or older, diagnosed with HNC, and planned to receive RT for treatment of HNC. Caries prevalence was measured as decayed, missing, and filled surfaces (DMFS). The association between change in DMFS and risk factors was evaluated using linear mixed models. On average, DMFS increased from baseline to each follow-up visit: 6 mo, +1.11; 12 mo, +2.47; 18 mo, +3.43; and 24 mo, +4.29 (P < 0.0001). The increase in DMFS during follow-up was significantly smaller for the following patient characteristics: compliant with daily fluoride use (P = 0.0004) and daily oral hygiene (brushing twice daily and flossing daily; P = 0.015), dental insurance (P = 0.004), and greater than high school education (P = 0.001). DMFS change was not significantly associated with average or maximum RT dose to the parotids (P > 0.6) or salivary flow (P > 0.1). In the subset of patients who had salivary hypofunction at baseline (n = 164), lower salivary flow at follow-up visits was associated with increased DMFS. Increased caries is a complication soon after RT in HNC. Fluoride, oral hygiene, dental insurance, and education level had the strongest association with caries increment after radiotherapy to the head and neck region. Thus, intensive oral hygiene measures, including fluoride and greater accessibility of dental care, may contribute to reducing the caries burden after RT in HNC. The results of this study can be used by clinicians when deciding how to minimize oral complications related to cancer therapy for patients with head and neck cancer. Identification of modifiable factors (e.g., oral hygiene and prescription fluoride compliance) associated with increased caries risk can minimize radiation caries burden.

Oral-care adherence. Service design for nursing homes - initial caregiver reactions and socio-economic analysis.

Background: Lack of proper oral care among elderly people in nursing homes is associated with increased morbidity and hospitalisation. The ability of the individual to maintain sufficient oral self-care is difficult for caregivers to assess, and thus, caregivers often risk providing suboptimal oral care. Sensor-based tools exist that can support the caregiving staff in achieving a better understanding of who among the elderly are able to perform proper self-care, and who cannot and thus need additional assistance from caregivers. How such systems should be designed and deployed in nursing homes, and how they will be perceived by caregivers has not been investigated sufficiently yet.Objectives: The aim of this study was to gain a better understanding of how caregiving staff perceives the introduction of sensor-based systems that allow the caregivers to automatically discover who among the elderly residents are able to adhere to the given recommendation on daily oral self-care, and who among them are in need of further assistance, as well as whether there is potential for saving costs.Methods: In a mixed methods qualitative study, we visited three nursing homes where we had recently deployed, or were about to deploy, electrical toothbrushes and a basic oral-care adherence aid system. Nursing home staff was interviewed during the field studies about their initial reactions to introducing such a system as part of their daily workflow. The field study was supported by a literature review.Results: Caregiving staff welcomed the introduction of a sensor-based oral-care adherence aid system, which would identify any elderly who could no longer achieve a sufficient level of oral self-care. Improving oral care for the elderly may not only prevent serious consequential diseases, but also generate considerable savings with a return on investment of at least 1:2.5.Conclusion: Sensor-based oral-care adherence aid systems that monitor oral-care adherence, meaning the ability of the individual elderly to properly perform teeth and/or denture brushing as part of normal self-care efforts, appear useful and relevant to introduce. More work is needed to provide a better understanding of the long-term user experience of both caregiving staff and elderly. There is also a need for more high-quality long-term clinical studies of further preventive effects of oral hygiene measures and their economic benefit.