Oral Hygiene Research Articles

Chlorhexidine is not effective at any concentration in preventing ventilator-associated pneumonia: a systematic review and network meta-analysis

IntroductionOral chlorhexidine has been widely used for ventilator-associated pneumonia prevention in the critical care setting; however, previous studies and evidence synthesis have generated inconsistent findings. Our study aims to investigate if different concentrations of oral chlorhexidine may be effective in preventing such complication in intensive care unit patients.MethodsAfter pre-registration (Open Science Framework: 8CUKF), we conducted a network meta-analysis with the following PICOS: adult patients (age > 18 years old) undergoing invasive mechanical ventilation admitted in ICU (P); any concentration of chlorhexidine used for oral hygiene (I); placebo, sham intervention, usual care, or no intervention (C); rate of VAP (primary outcome), mechanical ventilation length, ICU length of stay (LOS), hospital LOS, mortality (secondary outcomes) (O); randomized controlled trials (S). We used the following database: PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and EMBASE without any limitation in publication date or language.ResultsChlorhexidine did not demonstrate any significant advantage over the control group in preventing ventilator-associated pneumonia or reducing mortality, duration of mechanical ventilation, length of stay in the intensive care unit, or overall mortality.ConclusionsChlorhexidine oral decontamination does not reduce the rate of ventilator-associated pneumonia in critically ill adult patients and its routine use could not be recommended.Trial registrationRegistration number: Open Science Framework: 8CUKF.

ВЛИЯНИЕ ИРРИГАТОРА НА ВЫРАЖЕННОСТЬ ВОСПАЛИТЕЛЬНЫХ ПРОЦЕССОВ В ТКАНЯХ ПАРОДОНТА У ПАЦИЕНТОВ НА АНТИКОАГУЛЯНТНОЙ ТЕРАПИИ

Introduction. Anticoagulant therapy is prescribed for surgical interventions in the heart and blood vessels, atrial fibrillation, thromboembolism and thrombophlebitis of various etiologies, myocardial infarction, new coronavirus infection. This group of patients is characterized by a decrease in physical and social activity, and motivation to care about their own health. As a result, poor oral hygiene can cause gum bleeding, which is often mistaken for a side effect of the anticoagulant being taken. Without proper attention, the process risks moving into severe stages of the development of periodontitis, which has a direct impact on the course of cardiovascular diseases. Maintaining a level of personal oral hygiene is especially important. An additional tool, in addition to a toothbrush and toothpaste, is an irrigator - a device that creates a pulsating stream of water, which under pressure washes and removes food debris and soft plaque. Aim. To evaluate the effect of the irrigator on the severity of inflammatory processes in periodontal tissues in patients on anticoagulant therapy. Methodology. 30 patients were examined (15 using warfarin, 15 using new oral anticoagulants) according to the following criteria: complaints of bleeding gums, degree of gum bleeding according to Mullemann, hygiene index, objective periodontal index (OPI – patent No. 265521 of 2018). Signs were assessed by statistical methods before professional oral hygiene and after 1.5 months of using irrigators OMIO-350, OMIO-450, OMIO-560 to maintain personal hygiene and prevention. Results and its discussion. After using the irrigator, complaints of bleeding gums remained in 4 patients out of 16 examined. The average hygiene index decreased by 48.7%, the objective periodontal index decreased by 42.9%. In most patients, bleeding disappeared or decreased in intensity. Conclusions. The positive effect of irrigators, as an additional means of personal hygiene, on periodontal tissue and improvement of oral health in patients has been proven.

Dental hygiene students' and recent graduates' intentions, attitudes, and perceptions of academic careers.

The purpose of this study was to explore dental hygiene students' and recent graduates' awareness, attitudes, perceived barriers, motivators, and intentions to pursue a career in academia as a dental hygiene educator. Cross-sectional survey research was conducted with a non-probability sample of dental hygiene students and recent graduates (n=451). The survey included sections for familiarity regarding academic careers for dental hygienists, attitudes toward academic careers, barriers and motivating factors for this career path, and future academic career intentions. Analysis included descriptive, correlations, and regression. Of 451 surveys started, 296 were at least 80% complete for a completion rate of 66%. The most reported barrier to a career in academia was the cost to obtain the required degree to become an educator (67.6%, n=200), and for motivating factors was a sense of accomplishment (62.8%, n=186). Regression analysis of likelihood to pursue a higher education degree showed two main predictors; belief that higher education would advance the dental hygiene profession (β=0.35, p<0.001) and willingness to take a pay cut to become an educator (β=0.24, p<0.001). Overall dental hygiene students and recent graduates were familiar with and had a positive view of careers in academia. However, barriers included cost and time for obtaining a higher degree, as well as the pay differential between academia and private practice. The educator shortage in dental hygiene may be alleviated by providing educators with loan forgiveness and offering salaries comparable to clinical practice.

АНАЛИЗ ФАКТОРОВ РИСКА КСЕРОСТОМИИ И ЗДОРОВОГО ОБРАЗА ЖИЗНИ СТУДЕНТОВ СТОМАТОЛОГИЧЕСКОГО ФАКУЛЬТЕТА УРАЛЬСКОГО ГОСУДАРСТВЕННОГО МЕДИЦИНСКОГО УНИВЕРСИТЕТА

Subject. Xerostomia. Objectives. To analyze risk factors, to identify the incidence of xerostomia and a healthy lifestyle of students of the Faculty of Dentistry of the Ural State Medical University (USMU). Methodology. The work was carried out at the Department of Therapeutic Dentistry and Propaedeutics of Dental Diseases, at the Department of General Chemistry of USMU, at the Department of Controlled Systems Modeling of UrFU. The objects of the study were: a questionnaire consisting of two parts and volunteers – students of the Faculty of Dentistry of USMU. The first part of the questionnaire is based on the questionnaire "List of cases of xerostomia" modified by the authors of this study to 12 questions. The second part of the questionnaire (author's) consists of 29 questions on a healthy lifestyle (HLS), which also affect the development of xerostomia. Thus, the total number of questions in the questionnaire was 41. Statistical processing of the results was carried out on a personal computer using the Microsoft Excel 2007 application software package; the reliability of the differences was assessed by the Student's t-distribution using the Statistica 6.0 software package; the confidence interval for mathematical expectation M ± m was determined, where M is the sample average. The differences are considered. Conclusions. Students of the Faculty of Dentistry of USMU adhere to the rules aimed at maintaining the health of the oral cavity: they change their toothbrush (from 3 to 5 times a year – 85%), brush their teeth for at least three minutes (more than 48%) twice a day (77.7%) and use additional means of interdental hygiene (76.7%). 38% indicate dry lips. Dryness in the nose is emphasized by 14.1% of students. "Dry mouth is associated with elevated blood sugar", 2% of the study participants noted. It is advisable to investigate the problem of prevention of dental diseases, individual and professional oral hygiene programs, as well as regular general hygiene measures and the elimination of bad habits among students.

Application of Modern Technology in Minimal Invasive Dentistry - A Narrative Review

Preserving human anatomy and physiology is the ultimate goal of all health-related endeavours.The conservation of healthy tooth structure is the goal of minimal-intervention dentistry. The concept of "minimum/minimal intervention dental care" first appeared in the early 1980s. From its origins in general medicine, the minimum intervention philosophy in dentistry was created, focusing patient-oriented oral and dental care to prevent and treat oral disorders and maintaining over all oral health. A more conservative approach to tooth preparation and restoration in operative dentistry is called minimally invasive restorative dentistry. This terminology is relatively new. It comprises prompt identification prior to the onset of cavitation, sealing fissures and pits in uninfected areas, fluoride administration, minimum surgical repair of carious lesions, caries risk evaluation, and patient education regarding self-care. A wide range of methods are used, from initial identification of any demineralized tooth structure to evaluation and therapy, including air abrasion, laser cavity preparation, chemo-mechanical caries removal, and hand instrumentation. Adopting the current advanced method requires sufficient knowledge. The trio that comprises tissue histology, dental biomaterials science and professional patient care and management of materials are considered by the "golden triangle" of minimally invasive treatment options for dental caries in order to enable the successful application of minimally invasive dentistry in all patients. The term "minimal intervention dentistry" (MID) was first used in the early 2000s in a policy statement. Maintaining the greatest amount of healthy tooth structure and keeping teeth functional for life are the goals of MID. This approach is endorsed by the World Dental Federation (FDI) as the modern approach to dental caries management

ИЗУЧЕНИЕ СТРУКТУРЫ ПОВЕРХНОСТИ ЭМАЛИ ЗУБОВ ПОСЛЕ ОБРАБОТКИ ВОЗДУШНО-ПОРОШКОВЫМИ СИСТЕМАМИ РАЗЛИЧНЫХ ПОКОЛЕНИЙ

Subject. Today, there are many different air-powder systems (APS) for professional oral hygiene (PAH). The problem of selecting a powder for performing PPGP is still relevant. Objectives. The aim of the study was to evaluate the effect of different air-powder systems on the structure of tooth enamel. Matodology. The study consisted of 2 parts: experimental and clinical-laboratory. The experimental part of the study consisted in the allocation of experimental groups, their subsequent processing depending on the active component of the UPP (sodium bicarbonate, calcium carbonate, their mixture, glycine, trehalose) and study by scanning electron microscopy. Clinical and laboratory research is aimed at studying the time spent on the removal of soft pigmented plaque; the degree of cleaning of the tooth surface; the amount of powder required to perform PGPR; as well as the atomization of powder during the procedure; the traumatic effect of these systems on the structure of tooth enamel by interpreting the index of tooth sensitivity of L.Yu. Orekhova – S.B. Ulitovsky (TS-O-U index, %); and studying the average linear (Vas) velocity of blood flow in periodontal tissues using the method of Doppler ultrasound. Results. Powders with a mixture of sodium bicarbonate and calcium carbonate have the greatest damaging effect on tooth enamel structure, and powders with trehalose and glycine have the least damaging effect. On the basis of clinical study it was revealed that powders based on trehalose and glycine have less damaging effect both on tooth enamel and periodontal tissues, which is confirmed by the index of tooth sensitivity of L.Yu. Orekhova – S.B. Ulitovsky and the results of ultrasound Dopplerography. Conclusions. The conducted research allows recommending therapeutic dentists, periodontists, as well as dental hygienists to use glycine- and trehalose-based UPDs in their clinical practice due to their effective, safe and ergonomic use.

The oral health status and treatment needs of adults with intellectual disabilities in Auckland.

Adults with intellectual disabilities (ID) are known to have poor oral health and complex dental needs requiring treatment under general anesthesia (GA). This retrospective chart review aimed to provide information on the oral health status and treatment needs of adults with ID in Auckland. Data on 1075 adult patients with ID seen through the Auckland public dental service during the period June 2016 to April 2020 were drawn from electronic notes. Analyses focused on age group differences and the characteristics associated with the use of GA for dental treatment. More cumulative caries experience, poorer oral hygiene, and more missing teeth were observed among those who were older. About half (50.8%) of the patients used GA for dental treatment. This proportion was higher among those who were younger, less independent, non-verbal, with poorer oral hygiene, or who had active decay. Adults with ID are a heterogeneous population with unmet dental treatment needs. Different age groups require consideration of distinct characteristics for dental care provision. It is important to be for public sector service provision to be developed to consider predictors for GA service use in patients who are younger, less independent, non-verbal, or have active decay.

Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review

BackgroundThe goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC.MethodsThe two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework.ResultsIn total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4–12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services.ConclusionThe study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.

Salivary microbiome and MRP-8/14 levels in children with gingivitis, healthy children, and their mothers.

Gingivitis is the most common form of periodontal disease among children and adolescents and is associated with disrupted host-microbiome homeostasis. Family is an important factor influencing the prevalence of gingivitis. In the present study, we investigated the salivary microbiome, oral hygiene habits, and the salivary level of myeloid-related protein (MRP)-8/14 in children aged 7-12 years with gingivitis, periodontally healthy children, and their mothers. This study included 24 children with gingivitis (including four sibling pairs) and 22 periodontally healthy children (including two sibling pairs) and their mothers. The whole saliva was collected, DNA was extracted, the variable V3-V4 region of the eubacterial 16S ribosomal RNA gene was amplified, and sample library preparation was performed according to the Illumina protocol. The salivary levels of MRP-8/14 were analyzed by ELISA. Alpha diversity of the salivary microbiome was considerably higher in gingivitis children and mothers of gingivitis children compared to healthy children and their mothers, respectively. Significant differences in beta diversity between healthy and gingivitis children, healthy children and their mothers, and gingivitis children and their mothers were detected. Overall, the number of common core amplicon sequence variants between children and their own mothers was significantly higher than between children and other mothers. The salivary MRP-8/14 levels in children with gingivitis were significantly higher compared to healthy children; a similar tendency was also mentioned for mothers. Our study underlines the importance of family as an essential factor influencing oral health.

Prevalence and Comparison of Dental Caries of 6 to 12 Years Age in Government and Private School Children of Peshawar City, Pakistan

Background: Dental caries remains a significant public health issue globally, affecting both developed and developing nations. Studies have shown varying prevalence rates based on geographic, socioeconomic, and cultural factors, particularly among school-aged children. The city of Peshawar, with its diverse population, provides a unique setting to study these variables in relation to oral health outcomes among children. Objective: This study aimed to determine the prevalence of dental caries among school children aged 6 to 12 years in Peshawar, Pakistan, and to compare the rates between students from government and private schools. Additionally, the study sought to explore the association of dental caries with dietary habits, particularly the consumption of sweets, chocolates, and candies. Methods: A cross-sectional study was conducted involving 376 school children from both government and private schools in Peshawar. Participants underwent detailed oral examinations to assess for dental caries, and data on their dietary habits were collected through questionnaires. Informed consent was obtained from parents or guardians according to the Declaration of Helsinki. The Statistical Package for the Social Sciences (SPSS) Version 22 was used for data analysis, employing descriptive statistics to calculate frequencies, percentages, and mean values. Results: The overall prevalence of dental caries among the participants was 55.05%. Boys exhibited a slightly higher prevalence (53.2% in males compared to 62.7% in females). The consumption of sugary snacks was significantly associated with the presence of caries; 95.6% of carious children regularly consumed sweets, chocolates, or candies. There was no significant difference in caries prevalence between children from government (53.2%) and private schools (57.5%). Conclusion: The study highlights a high prevalence of dental caries among school-aged children in Peshawar, which correlates strongly with sugar consumption but not with the type of school attended. These findings underscore the need for targeted public health interventions to reduce sugar intake and improve oral hygiene among children.

Multi-nutrients and periodontal disease - a new adjunct to improving treatment outcomes? A randomised placebo-control clinical trial.

This study by Laky et al. is a single-centre, double-blinded randomised placebo-controlled clinical trial, examining the effects of micronutrient supplementation in combination with non-surgical hygiene phase therapy (nsHPT)for Stage III and IV periodontal disease. The study was carried out at the Medical University of Vienna (Austria), School of Dentistry. The patients enrolled in the study were randomised to receive a commercially available multi-nutrient supplement (containing: vitamin C, vitamin E, zinc, selenium, alpha-lipoic-acid, cranberry extract, grapeseed extract, and coenzyme Q10) or a cellulose placebo to take for 2 months, alongside a course of non-surgical hygiene phase therapy. At baseline, the patients had a periodontal index screening (PSI) performed. Patients scoring >3 and meeting the inclusion criteria were enrolled in the trial. Oral hygiene instruction and patient education was performed, followed by 1 or more sessions of nsHPT depending on the clinical assessment of each patient, and a full periodontal probing depth (PPD) chart was recorded. The patients were then randomised to receive either the multi-nutrient supplement or the placebo to take twice daily for 8 weeks. Following this 8-week period the PPD as well as bleeding on probing (BOP), gingival recession (GR) and clinical attachment loss (CAL) were measured. The randomisation was carried out by a study-independent member of staff at the centre using a computer programme. A total of 149 patients were assessed for eligibility for this trial. Out of these patients, 83 were deemed to be unsuitable for the trial as they failed to meet the inclusion criteria, and 24 declined to participate. A total of 42 patients were then randomised to each arm of the study. The inclusion criteria included patients with Stage III and IV periodontal disease. Patients were deemed eligible if they met the following criteria: presence of 18 or more scorable teeth (excluding 3rd molars); >4 teeth with PPD of >6 mm; CAL > 5 mm, and no previous periodontal treatment in the past. Percentage bone loss at the most severe site, smoking status, and presence of diabetes and diabetic control were all taken into consideration. Patients were deemed ineligible for the trial if they were pregnant or under 18 years old. Exclusion criteria also included: recent periodontal abscess; a past or current co-morbidity which may confound the results of the study or endanger patients partaking in the study (i.e. malignancy, rheumatoid arthritis, and other severe systemic conditions); and obesity. PPD was used as the primary variable in this study. Other measured outcomes such as GR, CAL, BOP and other measurements taken, such as papillary bleeding index (PBI) and papillary inflamed surface area (PISA), were considered as secondary outcome variables. A variety of tests were used in order to assess the collected data. The Kolmogorov‒Smirnov test and Levene test were used for the equality of variances, and ICC and 95% CI were used when comparing periodontal chartings for PPD (in mm). Chi-square or Fisher tests were used for categorical data between intervention and placebo. The baseline and reevaluation data was compared using the McNemar test. All data was analysed using statistical software. Significant data is indicated by a p value < 0.05. The number of patients included for analysis was reduced to n = 20 for the intervention group and n = 19 for the placebo group. Patients were lost due to a variety of reasons including need for antibiotics and lost to follow-up. The authors concluded that in each arm of the trial, periodontal and hygiene parameters improved overall. The results show that the intervention group had a significantly higher reduction in PPD; however, following data analysis, these findings were found to be statistically insignificant. The authors conclude that the addition of a multi-nutrient supplement, alongside nsHPT for patients undergoing treatment for Stage III and IV periodontal disease, showed a reduction in PPD and BOP when compared with a placebo and nsHPT.

Case Report on Caries Assessment Using Intraoral Scanner Compared with Bitewing Radiographs.

Dental caries remains one of the main reasons patients seeing their dentist. They either show up for preventive measures, diagnostics, or treatment of present caries lesions. To date, diagnostics are performed visually, supported by using bitewing radiographs. While radiographic diagnostics should only be performed on a biannual basis, and some caries process will not be seen with visual diagnostics, there remains a lack in regular checkups. Therefore, different technical applications can be used for regular diagnostics. One of those is the near-infrared imaging (NIRI) technology. In this case report, a patient presented with incipient caries lesions. These lesions were diagnosed visually, radiographically, and using NIRI. After diagnosis of incipient caries lesions, the patient was advised to use a hydroxyapatite toothpaste and a hydroxyapatite gel for the remineralization of the lesions and prevention of caries progression. The patient was followed up for 6 months with regular checkups in between. Visual diagnostics and NIRI were used to detecting the caries progress. After 6 months, bitewing radiographs were used in addition. In this clinical investigation we were able to show for the first time that NIRI and bitewing radiographs are able to detect and follow incipient caries lesions. Additionally, this study highlights that hydroxyapatite-containing oral care products are able to arrest and remineralize the caries process.

Effects of cold spray on thirst, frequency of oral care, and pain of general surgery intensive care unit patients

This study aims to investigate the effects of intraoral cold water spray on thirst, frequency of oral care and postoperative period pain at surgical incision site in patients having abdominal surgery. The study was carried out as a randomized controlled trial, registered under Clinical Trial Number: NCT05940818. The study involved 110 participants, divided equally into two groups (n = 55): the experimental group and the control group. Data were collected using patient information form, NRS, Intensive Care Oral Care Frequency Assessment Scale (ICOCFAS) and Visual Analog Scale (VAS). The severity of thirst at 1st, 8th, 16th h of post-operative period (p < 0.01) and the frequency of oral care application at 16th h were statistically significantly decreased in the experimental group when compared to the control group (p < 0.01).There wasn’t statistically significant difference between the patients in the experimental and control groups in terms of pain at surgical incision site (p > 0.05). The patient’s thirst and need for frequent oral care in the postoperative period were reduced by the application of a cold water spray. In patients undergoing abdominal surgery, the use of cold water spray application may be recommended to reduce thirst and the need for frequency of oral care application.

Labial ankyloglossia - a case report on fusion of frenums

Labial ankyloglossia is a rare condition where the lingual frenum is found to be continuous with the labial frenum. It is a rare condition that can have a significant impact on a patient’s quality of life. Early recognition and appropriate intervention can lead to substantial improvements in speech, oral hygiene, and overall well-being. This case report underscores the importance of considering labial ankyloglossia as a differential diagnosis in patients with lip-related issues and highlights the potential benefits of surgical correction in improving lip function and aesthetics.

Exploring the Benefits of Antioxidants in Dentistry: New Frontiers in Oral Care

ABSTRACT In recent years, antioxidants have gained significant attention in the field of dentistry due to their potential therapeutic benefits in various dental conditions. This comprehensive review aims to provide a detailed analysis of the role of antioxidants in dentistry, focusing on their mechanisms of action, clinical applications, and future prospects. The review highlights the potential of antioxidants in preventing and managing oral diseases, promoting oral health, and enhancing the outcomes of dental treatments.

ESPEN Guideline on Nutrition and Hydration in Dementia – Update 2024

Background & aimsDementia is accompanied by a variety of changes that result in an increased risk of malnutrition and low-intake dehydration. This guideline update aims to give evidence-based recommendations for nutritional care of persons with dementia in order to prevent and treat these syndromes. MethodsThe previous guideline version was reviewed and expanded in accordance with the standard operating procedure for ESPEN guidelines. Based on a systematic search in three databases, strength of evidence of appropriate literature was graded by use of the SIGN system. The original recommendations were reviewed and reformulated, and new recommendations were added, which all then underwent a consensus process. Results40 recommendations for nutritional care of older persons with dementia were developed and agreed, seven at institutional level and 33 at individual level. As a prerequisite for good nutritional care, organizations caring for persons with dementia are recommended to employ sufficient qualified staff and offer attractive food and drinks with choice in a functional and appealing environment. Nutritional care should be based on a written care concept with standardized operating procedures. At the individual level, routine screening for malnutrition and dehydration, nutritional assessment and close monitoring are unquestionable. Oral nutrition may be supported by eliminating potential causes of malnutrition and dehydration, and adequate social and nursing support (including assistance, utensils, training and oral care). Oral nutritional supplements are recommended to improve nutritional status but not to correct cognitive impairment or prevent cognitive decline. Routine use of dementia-specific ONS, ketogenic diet, omega-3 fatty acid supplementation and appetite stimulating agents is not recommended. Enteral and parenteral nutrition and hydration are temporary options in patients with mild or moderate dementia, but not in severe dementia or in the terminal phase of life. In all stages of the disease, supporting food and drink intake and maintaining or improving nutrition and hydration status requires an individualized, comprehensive approach. Due to a lack of appropriate studies, most recommendations are good practice points. ConclusionNutritional care should be an integral part of dementia management. Numerous interventions are available that should be implemented in daily practice. Future high-quality studies are needed to clarify the evidence.

Coordination of oral anticoagulant care at hospital discharge (COACHeD): pilot randomised controlled trial

ObjectivesTo evaluate whether a focused, expert medication management intervention is feasible and potentially effective in preventing anticoagulation-related adverse events for patients transitioning from hospital to home.DesignRandomised, parallel design.SettingMedical wards at...

White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives

White spot lesions (WSLs) refer to localized areas of hypo-mineralization limited to the enamel of the teeth surface, which is noticeable clinically to the naked eye on drying of the teeth. During fixed orthodontic treatment, it is very hard for the patient to maintain excellent oral hygiene as the brackets, bands, wires, elastics, and other appliances and attachments worn intra-orally provide a platform for food retention, plaque formation, and then colonization by acidogenic bacteria like Streptococcus mutans and Lactobacillus. This review aims to elaborate and focus on etiology, pathophysiology, diagnosis, treatment aspect, and future scope for research about the WSLs occurring due to fixed orthodontic treatment.

Herbal Dentistry: Nurturing Oral Health with Natural Remedies

ABSTRACT Herbal dentistry, also known as natural or holistic dentistry, is a field of dental care that utilizes natural remedies and herbal medicine to prevent and treat oral health issues. This approach focuses on the use of herbs, plant extracts, and other natural substances to promote oral hygiene and address dental problems. In recent years, there has been a growing interest in herbal dentistry as an alternative to conventional dental treatments. This comprehensive review aims to explore the use of herbal remedies in dentistry, their potential benefits, and their limitations.

The Efficacy of Three Different Oral Hygiene Regimens in Preventing Chemotherapy-Induced Oral Mucositis in Pediatric Patients Receiving Hematopoietic Stem Cell Transplantation.

Oral mucositis is one of the side effects developed post-hematopoietic stem cell transplant. This retrospective study aimed to assess the efficacy of a mouthwash mixture (lidocaine, sodium alginate, sucralfate, pheniramine) versus hyaluronic acid and a solution of sodium bicarbonate in terms of healing time and weight gain in the treatment of oral mucositis in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation with hemato-oncological malignancies. A total of 171 patients that received chemotherapy for the hematopoietic stem cell transplant were divided into three groups; group 1, treated with a mixed mouthwash of lidocaine, sodium alginate, sucralfate, and pheniramine; group 2, treated with hyaluronic acid; and group 3, treated with an aqueous solution of 5% sodium bicarbonate. Weight and mucositis scale scores derived from medical records of patients. There was a statistically significant difference in the mucositis scale scores between the groups on the transplant day and days 5, 10, 15 and 20 after the transplantation. At these measurement points, Group 2 (receiving hyaluronic acid) had a lower score, and Group 3 (who received sodium bicarbonate) had a higher score, especially on days 5 and 10 after the transplantation. The results suggest that hyaluronic acid is a more effective treatment option than the other oral care solutions that are frequently used for prophylaxis and treatment of oral mucositis.