Oral Impact Research Articles

Oral health-related quality of life, impaired physical health and orofacial pain in children and adolescents with juvenile idiopathic arthritis – a prospective multicenter cohort study

BackgroundKnowledge on oral health-related quality of life (OHRQoL) in children and adolescents with juvenile idiopathic arthritis (JIA) is limited, and longitudinal studies are lacking. We aimed to describe OHRQoL in children and adolescents with JIA compared to controls, and to explore the validity and internal consistency of the Early Childhood Oral Health Impact Scale (ECOHIS) and the Child Oral Impact on Daily Performance (Child-OIDP). Furthermore, we wanted to investigate associations between OHRQoL and orofacial pain, physical health, disease activity, and temporomandibular joint (TMJ) involvement in JIA.MethodsThe Norwegian prospective, multicenter cohort study recruited participants with JIA between 4 and 16 years of age and corresponding controls from three pediatric university hospital departments and public dental health services. In the present study, we analyzed OHRQoL in all children < 12 years with the ECOHIS and adolescents ≥ 12 years with the Child-OIDP at the first visit and the two-year follow-up. Associations between OHRQoL and JIA characteristics, collected in clinical exam and questionnaires, were analyzed in logistic regressions.ResultsThe same OHRQoL questionnaire was completed both at first visit and two-year follow-up in 101 children < 12 years (47 JIA, 54 controls) and 213 adolescents ≥ 12 years (111 JIA, 102 controls). The frequency of OHRQoL impacts in children was similar at the first visit and the two-year follow-up (ECOHIS > 0: JIA group 81% and 85%, p = 0.791; control group 65% and 69%, p = 0.815), while adolescents with JIA reported fewer impacts at the two-year follow-up (Child OIDP > 0: JIA group 27% and 15%, p = 0.004; control group 21% and 14%, p = 0.230). The internal consistency of the OHRQoL instruments was overall acceptable and the criterion validity indicated that the instruments were valid at both visits. Orofacial pain was more frequent in children and adolescents with JIA than in controls. We found associations between OHRQoL impacts and orofacial pain, impaired physical health, disease activity, and TMJ involvement.ConclusionsChildren and adolescents with orofacial pain or impaired physical health were more likely to report impacts on daily life activities than those without. Pediatric rheumatologists and dentists should be aware of impaired OHRQoL in individuals with JIA with active disease or temporomandibular joint involvement.Trial registrationRegistered on clinicaltrials.gov (NCT03904459, 05/04/2019).

Oral Health Status, Behaviours and Oral Healthcare Utilization among Indian Migrants Compared to the Host Population in the Netherlands: A Descriptive Cross-sectional Study

The aim of this study was to assess the oral health status, oral health behaviours and oral healthcare utilization among Indian migrants living in the Netherlands and how they compare with the host population. Based on a random sample from Dutch municipalities, cross-sectional data were obtained for the Indian migrants living in the Netherlands (n = 148) and the host population (n = 244). A questionnaire was used to collect information on socio-demographic, self-reported oral health status, oral health behaviours and oral healthcare utilization. The distribution of self-reported oral health variables for both groups were tabulated and compared using logistic, ordinal and multinomial regression analysis. When adjusted for covariates such as age, gender, marital status, education, income, occupation and dental insurance, regression analysis for oral health status showed that the odds of reporting oral impact on daily performances (OIDP) was 5.87 times higher for Indians compared to the host population (95%CI:3.45;9.65). In contrast, the odds of Indians reporting bleeding gums [OR = 0.44 (95%CI:0.27;0.73)] and diagnosed with gum diseases [OR = 0.23(95%CI:0.13;0.39)] were lower than the host population. Also, the odds of consuming alcohol and cakes or chocolates was significantly lower among Indian migrants compared to the host population [(OR = 0.15(95%CI:0.09;0.25)] and [OR = 0.33(95%CI:0.21;0.52)], respectively. But the odds of consuming sugar in hot beverages were significantly higher among Indians [OR = 10.44(95%CI:5.99;18.19)]. The odds of Indians visiting a dental professional were 9.22 times (95%CI:4.62;18.40) lower compared to the host population. We found that oral health status and behaviours among Indian migrants were different in certain aspects compared to the host population. However, their oral healthcare utilization remained overall lower. The underlying determinants for such observations merit further research. Migrant friendly approach from both the dental professionals and policy makers can encourage dental visits and improve the utilization patterns among Indians migrants in the future.

Impact of oral diseases on 12- and 15-year-old children’s quality of life: condition-specific oral health related quality of life analysis

BackgroundOral diseases can affect children’s quality of life. The aim of the present study was to assess the Condition-Specific (CS) impacts from oral diseases in 12- and 15-year-old Thai population using data from the two consecutive national oral health-related quality of life surveys.MethodsThe oral health–related quality of life surveys were conducted for this study as a part of 6th and 7th national oral health survey. The study sample of 1,066 12- and 815 15-year-olds from 6th national oral health survey; and 556 12- and 351 15-year-olds from 7th national oral health survey were from Bangkok and four regions of Thailand. Oral impacts were assessed by the Child-Oral Impacts on Daily Performances index for 12- and Oral Impacts on Daily Performances index for 15-year-olds. The overall impacts and CS impacts attributed to oral diseases were calculated. The detailed characteristics of the CS impacts were analyzed. Cochran’s Q test and McNemar’s test were used to determine the difference between the proportions of CS impacts of caries, gingival diseases, oral lesions, and malocclusion.ResultsCS impacts-caries were prevalent for both age, followed by gingival disease and oral lesions. CS impacts-caries were the highest in the intensity and extent for both age groups. CS impacts-caries were significantly higher than those of gingival diseases for eating, speaking, relaxing, emotional state, and studying. CS impacts-gingival disease was significantly higher than caries for cleaning in one survey.ConclusionsCS impacts-caries were the most prevalent and severe among adolescent. Gingival disease was infrequently related to severe impacts on daily performances.

Assessment of Oral Health-Related Quality of Life Using the Oral Impact on Daily Performance (OIDP) Instrument Among Secondary School Teachers of Modinagar, Uttar Pradesh: A Cross-Sectional Study.

Introduction Oral health has an impact on a person's general health, well-being, and quality of life. Due to their expertise and interactions with people, school staff members can actively contribute to the promotion of children's health if provided with the proper training. Methodology A cross-sectional survey was conducted to assess the "oral health-related quality of life" using the Oral Impact on Daily Performance (OIDP) instrument among the secondary school teachers of Modinagar, Uttar Pradesh. The study included a sample of 400 government secondary school teachers and 400 private secondary school teachers.The independent sample t-test was performed to assess the relationship between the mean of OIDP dimensions and the prevalence of dental caries. Any p-value less than 0.05 was considered significant. The data was analyzed using the SPSS version 20.0 software package (IBM Corp., Armonk, NY). Results In the present study, most of the participants (174 (43.5%) government teachers and 197 (49.2%) private teachers) were in the age group of 41-50 years. According to the Decayed, Missing, and Filled Teeth (DMFT) index, the mean decayed teeth present for government and private school teachers were 0.45 ± 0.503 and 0.41 ± 0.493, respectively, and the mean DMF scores for government and private teachers were 1.27 ± 0.736 and 1.03 ± 0.757, respectively.There was a positive correlation between the DMFT scores and the mean scores for the dimensions of the OIDP among both government and private secondary school teachers. Conclusion The poor dental health status of teachers' has a bad impact on everyday performance and academic work. The findings of the study highlight the need for oral health education and good oral health maintenance among school teachers since they are the ones who can easily influence the behavior of the children.

A randomized clinical trial investigating the effect of three vital tooth bleaching protocols on oral health-related quality of life

ObjectivesThis study aimed to compare changes in oral health-related quality of life (OHRQoL) resulting from three vital tooth bleaching protocols. MethodsThe participants (n = 105) were randomly assigned to one of three vital bleaching treatment groups: home bleaching (HB), in-office bleaching (IOB), or combined bleaching (CB). HB involved the use of custom-made trays and 10% carbamide peroxide for a 14-day treatment period. IOB utilized 37.5% hydrogen peroxide applied in three cycles. CB treatment involved the use of IOB followed by HB. Tooth colour change was evaluated using a shade guide (ΔVS) and a digital spectrophotometry device (ΔES). The Oral Health Impact Profile-14 (OHIP-14) and Oral Impact on Daily Performance-22 (OIDP-22) instruments were used to assess changes in OHRQoL at baseline, 15-days and 6-month recalls. Linear mixed models were used to estimate between- and within-group differences. ResultsAll bleaching protocols led to significant improvements in overall OHIP-14 scores at the 6-month recall (p ≤ 0.037). CB and IOB treatments were associated with more substantial positive impacts on overall scores, psychological discomfort, physical disability (CB only), and psychological disability (CB only) compared to HB (p ≤ 0.011). Significant enhancements in OIDP-22 scores were observed in the CB and HB groups at the 6-month recall compared to baseline (p ≤ 0.006), with evidence indicating that these improvements were greater in the CB group compared to the IOB group (p = 0.007). ConclusionAll bleaching treatments demonstrated a positive impact on OHRQoL. However, the positive impact was most consistent across domains and age groups in the CB group. The positive impact was less pronounced in older age groups.

Health-related quality of life aspects of the 'Periodontitis prevalence in ulcerative colitis and Crohn's disease' (PPCC) cohort.

To assess whether oral health problems affect disease-specific quality of life (QoL) of inflammatory bowel disease (IBD) patients, and vice versa, whether IBD affects oral-health-related QoL. Individuals reporting IBD and matched controls were surveyed on general anamnestic information, oral-health-related questions and the Oral Health Impact Profile (OHIP)-5. IBD patients were additionally surveyed on years since diagnosis, disease activity and severity as well as health-related QoL (Short Inflammatory Bowel Disease Questionnaire, sIBDQ). OHIP-5 and sIBDQ were defined as primary outcome parameters, and several predictors and confounders were used in adjusted univariable and multivariable regression analyses. Answers from 1108 IBD patients and 3429 controls were analysed. Compared with controls, IBD patients reported significantly more frequently an oral impact on daily life and worse oral-health-related QoL, with Crohn's disease (CD) patients being more severely affected than ulcerative colitis (UC) patients. The diagnosis of UC and CD, having <20 teeth, severe periodontitis and stressful daily-life experience were associated with a higher prevalence of poor oral-health-related QoL. Among IBD patients, an impaired IBD-specific, health-related QoL was significantly associated with the diagnosis of CD and depression, IBD activity and severity, having <20 teeth, presence of oral lesions and stressful daily-life experience, while a longer time since diagnosis was significantly associated with an improved IBD-specific, health-related QoL. The results of the present study indicate, for the first time, that oral health problems are associated with an impairment of IBD-specific health-related QoL, and vice versa, IBD is associated with an impaired oral health-related QoL. This emphasizes the potential advantages of including dental professionals in the multi-disciplinary treatment teams of IBD patients.

An online survey of oral health behaviours and impact on young children and families in Wales.

Introduction Studies outside Wales have consistently reported reduced quality of life as measured by the Early Childhood Oral Health Impact Scale. With relatively high levels of tooth decay in Wales as found through the regular dental surveys, it is important to understand different oral health-related behaviours and impact so that findings can inform oral health promotion in Wales.Methods An oral health questionnaire was made available to volunteers registered with Health Wise Wales. Parents of children (2-6 years old) participated in the study. Frequency analyses were carried out to understand the oral health-related behaviours and regression analysis was carried out to understand the predictors of reported oral health impacts.Results Overall reported oral health impact was low in this study. In total, 20% of parents reported that their child brushed their teeth less than twice a day and 23% reported toothbrushing without adult supervision. Drinking plain water twice a day or more was associated with good oral health in children.Conclusion Overall, reported oral health impact was low, which is likely to be due to under-representation of study participants from the deprived areas in Wales. There is plenty of room for improvement in oral health-related behaviours.

Impact of molar incisor hypomineralization on oral health-related quality of life in 8-10 years old children: A systematic review and meta-analysis.

This study aimed to evaluate the impact of molar incisor hypomineralization (MIH) and its different severities on various aspects of oral health-related quality of life (OHRQoL) in children between 8 and 10 years of age. The search terms were chosen according to the Medical Subject Headings (MeSH) and non-MeSH. Potentially eligible studies involved the OHRQoL evaluation in 8-10 years old children with MIH. An electronic search of published studies was carried out in August 2022 on Scopus, Web of Science, and PubMed databases. Of 130 papers retrieved initially, 21 were eligible to be included in the systematic review, of which 8 were excluded. The OHRQoL questionnaires used in the studies included Caregivers Perceptions Questionnaire (CPQ) 8-10, Child Oral Health Impact Profile questionnaire, and Child Oral Impacts on Daily Performances questionnaire. Nine studies using CPQ8-10 contributed to the meta-analysis. According to meta-analysis, the results revealed that in MIH children a significant increase was observed in the total score of CPQ 810 with the pooled mean of 15.89 (95% confidence interval [CI]:8.95-22.84; P-value = .001) and in oral symptoms, functional limitation and emotional well-being domains with the pooled means of 6.25 (95% CI:4.01-8.50; P-value = .001), 3.88 (95% CI:1.93-5.83; P-value = 0.001), and 3.24 (95% CI:0.96-5.52; P-value = .01), respectively. While the increase in social well-being with the pooled mean of 1.65 (95% CI: -0.47 to 3.76; P-value = .13) was not significant. Subgroup analysis based on MIH severity showed no significant difference in OHRQoL means for all variables. Suffering from MIH, negatively affected the total score and all domains of the CPQ 8-10 questionnaire, except for social well-being. Furthermore, different severities of MIH had no significant impact on OHRQoL in children.

Binge drinking and oral health-related quality of life in older adults: Socioeconomic position matters.

The objective of the study was to investigate whether the association between binge drinking and oral health-related quality of life (OHRQoL) differs by socioeconomic position (SEP) in Brazilian older adults. The adverse health effects of alcohol consumption disproportionately affect socioeconomically disadvantaged and older individuals. Moreover, measures of binge drinking may capture different domains of the association between alcohol misuse and health that might be independent of the traditional markers of volume or frequency of consumption. Evidence of the association between alcohol use and oral health outcomes has failed to consider binge drinking and possible effect modification by SEP. We conducted a secondary cross-sectional analysis using the baseline data from The Brazilian Longitudinal Study of Ageing (2015-2016). Effect Measure Modification analyses using multivariable Poisson regression models tested whether the association between past-month binge drinking and higher scores of the Oral Impacts on Daily Performance (OIDP) questionnaire differed in magnitude by level of household wealth and educational attainment, assessed using Relative Excess Risk due to Interaction (RERI) and simple slope test. The analytical sample comprised 8857 individuals. Participants who were from low-wealth households or with lower education and reported past-month binge drinking had 27% (95% CI: 1.16 to 1.39) and 28% (95% CI: 1.18 to 1.40) higher OIDP scores, respectively, than those not binge drinkers from higher SEP, and super-additive associations were detected (RERI for household wealth: 0.12; RERI for educational attainment: 0.14). Binge drinkers from low SEP have poorer OHRQoL. Public oral health initiatives aiming to combat binge drinking are likely to disproportionately benefit vulnerable groups.

Comparison of masticatory myofunctional rehabilitation combined with conventional functional appliances for the treatment of class Ⅱ, division 1 malocclusion. A retrospective cohort study

ObjectiveTo estimate the clinical efficacy of early masticatory myofunction rehabilitation combined with conventional functional appliances for the treatment of class Ⅱ, division 1 malocclusion in orthodontic children during the growing phase. Materials and methodA comparative retrospective cohort study, enrolled patients diagnosed with class Ⅱ/1 in the stage of late mixed or early permanent dentition. Patients were divided into a TBA group (Cohort 1): receiving Twin-block appliance treatment; and a MMR group (Cohort 2): receiving either early masticatory myofunction rehabilitation as adjunctive therapy combined with the same conventional functional appliances. The study variables were active (Phase 1) treatment duration, oral esthetic subjective impact score (OASIS), several cephalometric indices calculated from X-ray photographs, the maximum voltage (mV) and asymmetry index (AsI) of anterior temporalis (TA) and masseter muscles (MM) before and after treatment. Complications were also recorded. ResultsA total of 424 cases were enrolled. The mean treatment duration in the MMR group was 168.33 days (SD: 25.43) and 215.00 days (SD: 28.81) in the TBA group; mean difference: -46.67 days (95% CI: [-81.62, -11.71]), P<0.001. For the OASIS outcome measure, there was no statistically significant difference between the mean total scores for the MMR group (18.83±7.73) or TBA group (17.67±6.47) groups adjusted to include pre-treatment OASIS scores (P = 0.783). After treatment, sella-nasion-B point (SNB), mandibular incisor angle, maxillary base and mandibular base in both two groups were significantly increased, while AB plane angle (ANB), maxillary incisor angle, overjet and overbite were significantly decreased. The mV and AsI of TA and MM were also improved following treatment. However, no significant differences were observed between two groups. ConclusionOur results confirmed that early masticatory myofunction rehabilitation in combination with conventional TBA for patients in the growing phase was significantly effective in the management of class Ⅱ/1 in orthodontic treatment, which could significantly shorten the treatment duration and had the similar improvement in the cephalometry data, OASIS scores and masticatory muscles function when comparing to conventional TBA alone.

The impact of orthodontic treatment on a young person’s quality of life, esthetics, and self-esteem in hypodontia: A longitudinal study

This research aimed to evaluate the impact of orthodontic treatment on a young person's oral health-related quality of life, self-esteem, and esthetics concerning hypodontia. A prospective longitudinal hospital-based study recruited 97 participants with hypodontia, aged 11-18 years. Forty-one participants (42%) originally planned to have space closure and the remainder space opening, with subsequent prosthetic replacement. The following questionnaires were completed before and after orthodontic treatment: the child perception questionnaire, Bristol condition-specific questionnaire for hypodontia (BCSQ), the child health questionnaire, and the Oral Aesthetic Subjective Impact Scale (OASIS). The Wilcoxon and matched pairs t tests approach was applied to compare before and after orthodontic treatment for significant testing (P<0.05). Fifteen participants were lost to follow-up, resulting in 82 participants completing orthodontic treatment, with an average age of 13.8 ± 1.71 years. A total of 282 teeth were missing in the sample. Treatment resulted in significantly lower indexes (P<0.001) to overall BCSQ, OASIS, appearance, and how others would treat them. In comparing the 2 subgroups, those treated with space closure had significantly reduced functional limitations (child perception questionnaire), appearance concerns, self-esteem (child health questionnaire), OASIS, and overall BCSQ scores. Orthodontic treatment in participants with hypodontia appears to significantly impact a range of psychological and esthetic scales. In particular, space closure appears to significantly improve the quality of life of participants compared with those undergoing space opening.

Patient-reported outcomes for bone regenerative procedures.

Evidence-based dentistry used for decision-making and assessment of treatment includes three components: evidence from the literature, clinical expertise, and patient expectations. Patient satisfaction embraces affability, availability, and ability and can be examined using questionnaires or structured questions to the patient to evaluate patient perception of the treatment. The questions can be quantified using dichotomous, point, or visual analog scales. This would be a straightforward patient-reported outcome measure (PROM). Validated and specific oral health-related quality of life (OHRQoL) questionnaires such as the oral health impact profile (OHIP), oral impact on daily performance (OIDP), or the dental impact on daily living (DIDL) can be used as PROMs, and these measures are appropriate for population studies, where you can measure changes over time and differences between treatment groups. PROMs have shown to enhance patient engagement when integrated into clinical care. PROMs for bone regenerative procedures are mainly used as secondary outcome and are concentrating on the prosthetic outcome more than the pain, discomfort, anxiety, and cost of the surgical procedures. Surprisingly, most patients are satisfied and willing to have the procedures performed again. Whether this is recall bias or not and how the information's from the dentist and the team influence the patients answers to PROMs questionnaires are discussed. The importance of patient perspectives in bone regeneration procedures is obvious and combined with clinical outcome measures, it increases our ability to provide better care. Studies using PROMs as a primary outcome variable are required.

The Impact of Oral Argument Attendance

Abstract How does oral argument attendance impact public perceptions of the judiciary? Judicial independence is partly contingent on public support, but the conditions that generate institutional good will are not well understood. We examine how judicial outreach and court exposure inform public attitudes. Leveraging a field-experiment randomizing in-person attendance at oral arguments conducted by a federal circuit court of appeals on a university campus, we find that exposure increases perceptions of institutional legitimacy and the extent to which judicial decisions are motivated by law versus politics. The results have important implications for judicial politics and policy debates concerning reform initiatives involving circuit riding, courtroom cameras, and public outreach.

Does the timing of treatment affect the clinical and psychological outcomes of Twin-block therapy?

This study is a multicenter, two-arm parallel randomized control trial carried out across 3 hospital orthodontic units. A total of 75 patients participated in the study, with 41 randomly allocated in an Immediate Treatment Group (ITG) and 34 randomly allocated into an 18-month delayed Later Treatment Group (LTG). The patients were aware as to which group they were being allocated, as were the clinicians. Both patient groups received the same twin block appliance for use during the study. The appliance was to be worn full time, including eating, but to be removed while participating in contact sports or swimming. Achieving an overjet reduction between 2-4 mm was defined as being the clinical endpoint. After this, the appliance was only worn at night up until the next data collection point, allowing an 18-month window to finish treatment. Blinded clinicians measured skeletal changes using lateral cephalograms and overjet change via study models. Psychological impact was measured using two questionnaires: Oral Aesthetic Subjective Impact Scale (OASIS) and the Oral Health Quality of Life (OHQL). Data was collected from when the patient first registered in the study (DC1), 18 months after registration (DC2) and 3 years after registration (DC3). In total, 41 boys and 34 girls were included in the study. Ages for the boys ranged from within 1 month of their 12th birthday to 13.5 years old. For the girls, the range was from within 1 month of their 11th birthday to 12.5 years old. Further inclusion criteria included a class II skeletal pattern and having an overjet of 7 mm+. Exclusion criteria included patients of non-white Caucasian origin, girls aged 12.5 years+ and boys aged 13.5 years+. Furthermore, patients with a history of cleft lip or palate, mandibular asymmetry, muscular dystrophy, general health precluding compliance with treatment, a medically diagnosed growth excess or deficiency, not dentally fit or having previously received orthodontic treatment were not included in the study. SPSS Version 25 software was used to undertake the data analysis. No formal statistical testing was undertaken. To analyze and compare the scores between the two groups, independent t-tests were used. All analysis was carried out at 0.05 level of significance. The reliability of the examining clinicians was assessed using Bland-Altman limits of agreement. As only the ITG were in treatment over the periods of DC1-DC2 a comparison of the clinical outcomes cannot be made. With regards to the psychological outcome, no statically significant impact was noted for the ITG when compared with the LTG, who had not started treatment (OASIS P = 0.53, OHQL P = 0.92). When comparing the treatment effects of twin block therapy for the ITG (DC1-DC2) and the LTG (DC2-DC3), study model overjet and cephalometric changes were not statistically significant with the exception of % lower facial height (which was deemed not to be clinically significant) and mandibular unit length. There was no statistical significance with regards to the psychological outcomes post treatment when comparing the groups (OASIS P = 0.30, OHQL P = 0.85) CONCLUSIONS: The findings of this study suggest that adolescents (with a mean age of 12 years 8 months for boys and 11 years 8 months for girls) will not be disadvantaged, either clinically or psychologically, by waiting 18 months for twin block therapy.

Oral findings in children with congenital cholestatic disease: A systematic review of case reports and case series

Multiple causes of congenital neonatal cholestasis have been identified, and are classified as extrahepatic or intrahepatic. Biliary atresia (BA), Alagille syndrome (AGS), and progressive familial intrahepatic cholestasis (PFIC) are the most common of these. Many factors associated with cholestatic diseases are known to degrade the oral health of these children. What are the oral manifestations associated with these diseases in the pediatric population? The aim of this article was to evaluate the impact of congenital cholestasis on oral health in pediatric patients.A systematic review of case reports and case series was carried out in PubMed, the Cochrane Library, and the Web of Science to identify relevant articles in French and English published up to April 2022.The review included 19 studies, 16 case reports, and three case series. Only studies dealing with BA and AGS were found. These studies showed an impact on jaw morphology, dental structure, and periodontal health. The facial dysmorphism observed in AGS was specific. Exposure to high levels of bilirubin during the period of dental calcification led to particular coloration. Regarding periodontal status, gingival inflammation was common in these patients, probably resulting from the use of certain treatment-associated drugs and poor oral hygiene. Cohort studies are needed to confirm the classification of these children as being at high individual risk of caries.Many major oral manifestations are found in children with AGS and BA, confirming the need to include a dentist in the care team of patients with congenital cholestatic disease as early as possible. It appears necessary to carry out individual prospective studies of each phenotype in order to confirm and better describe the oral impact of these cholestatic diseases and provide adequate medical care.

Psychometric properties of the Child Oral Impacts on Daily Performances (C-OIDP) index: a cross-sectional and an intervention study of adolescents in Bosnia and Herzegovina

BackgroundThe clinical measures are not sufficient to assess oral health because they don’t tell us anything about functional and psychosocial aspects of oral health and do not reflect person’s concerns and subjectively perceived symptoms. This study aimed to investigate the validity, reliability and responsiveness of the child Oral Impacts on Daily Performances (C-OIDP) index among Bosnian 12-14 years old schoolchildren.MethodsThe study population comprised 203 primary schoolchildren aged 12-14 years attending three schools in the eastern part of Bosnia and Herzegovina. Data were collected through: a clinical oral examination, oral health questionnaire and C-OIDP questionnaire. The validity and reliability of the C-OIDP were tested on a sample of 203 school-going children while responsiveness of the C-OIDP was assessed on 42 randomly chosen participants requiring a dental treatment.ResultsIn terms of reliability, Cronbach’s alpha coefficient and the intraclass correlation coefficient were 0.86 and 0.85, respectively. Regarding the testing of construct validity, the C-OIDP score was increased as children’s self-reported oral health changed from excellent to very bad and from very satisfied to dissatisfied. There was a significant improvement in C-OIDP post-treatment score compared with C-OIDP pre-treatment score. Overall, 63.4% of participants reported at least one oral impact in the last 3 months. The most affected performances were “eating” (38.4%) and “speaking” (25.1%).ConclusionThe Bosnian version of the C-OIDP showed satisfactory validity, reliability and responsiveness and can be used as an appropriate OHRQoL measure for further epidemiological researches.

Drug Formulation of Securigera securidaca Seed Extracts

S. securidaca seeds are reported to treat a variety of diseases; they contain multiple antidiabetic constituents and are widely used as anti-hyperglycemic, antibacterial, as well as anti-hyperlipidemic agents. The present work aimed to propose tablet formulations containing extracts of S. securidaca seeds in an attempt to obtain antibacterial and anti-hyperglycemic formulations with a more efficient oral hypoglycemic impact, limited side effects, and higher patient compliance for the first time, resulting in multiple benefits. Tablet formulations were created by encapsulating granules from S. securidaca seed extracts with varying concentrations of sodium starch glycolate as a super-disintegrant (0–3%). The final formulations were examined for weight variation, solubility, hardness, water content, disintegration time, friability, drug content (trigonelline and diosgenin), and in vitro drug release. The S. securidaca tablet formulations completed the weight test because the percentage deviation in the personal tablet weight and mechanical resistance from the mean were identified to be within the average range. In accordance with the results, formulations containing diosgenin as well as trigonelline as a super-disintegrant were identified as the ideal formulations. The amount of the active substance released from the tablet (S. securidaca seed extract formulation) was consistent throughout the results with the standard methods recommended by the FDA (94.05%) for diosgenin and 87.25% for trigonelline after 45 min. The acceptable limit, according to the FDA, is not more than (N.L.T.) 80% after 45 min for phase #1. The present study aimed to obtain an optimized formula for S. securidaca extract tablets that met the requirements of a good pharmaceutical preparation according to the United States Pharmacopeia (USP) and National Formulary (NF). This has important implications for the development of novel, effective treatments and significantly advances the development of natural medicine. Our findings are expected to be of interest to researchers, clinicians, and other experts in this field of study. Based on these findings, it can be inferred that the formulation of S. securidaca seed extracts with appropriate and compatible herbal dosage forms has fewer side effects and is more effective than traditional treatments.

#3716 EFFECT OF IMMUNO-NUTRITION ON SYSTEMIC INFLAMMATION AND MUSCLE MASS IN A HAEMODIALYSIS POPULATION: A FEASIBILITY STUDY

Abstract Background and Aims Decreased skeletal muscle mass (SMM) and systemic inflammation are frequent complications associated with poor outcomes in people receiving haemodialysis. Although these problems are widely acknowledged, it has become clear that simply providing conventional oral nutritional supplements (ONS) is often not effective in increasing SMM. This is partly because systemic inflammation causes “anabolic resistance”, a condition that inhibits optimal rates of muscle protein synthesis being achieved despite adequate protein intake/availability. Immuno-nutrition supplements are high in energy and protein (similar to conventional ONS), but also contain a unique combination of nutrients that have shown to reduce inflammation in people with cancer. Therefore, the purpose of this feasibility study is to explore the potential effect of immuno-nutrition on systemic inflammation and SMM in a haemodialysis population. Method This was a single-centre, non-randomised, interventional feasibility study where 14 haemodialysis patients received 1 sachet per day (74 g dissolved in 125 ml of water) of a commercially available immuno-nutrition supplement (Oral Impact®, Nestlé) for 6 weeks. C reactive protein (CRP), skin autofluorescence (SAF, a marker of systemic inflammation), body composition assessment using bioelectrical impedance analysis (InBody 770), weight, body mass index (BMI), handgrip strength (HGS), routine biochemical variables (pre-dialysis), and energy, protein and fat intake were measured at baseline and after the 6-week intervention. Results Mean participant age was 69 ± 13 years and median dialysis vintage was 26 (interquartile range 9 to 94) months. Twelve participants (86%) were male and of white ethnicity. Diabetes and heart disease were present in 9 (64%) and 7 (50%) participants, respectively. Adherence to the intervention was high (98%). Participants reported that the taste of the supplement was nice and acceptable. No safety issues were observed in terms of development of hyperkalaemia or fluid overload. We observed a significant increase in HGS and urea. Fat-free body mass and SMM remained stable, while body weight, BMI and body fat mass tended to increase, though changes did not reach statistical significance. Markers of systemic inflammation and dietary intake did not show any significant change (Table 1). Conclusion In this interventional feasibility study, we observed that provision of an immuno-nutrition supplement was associated with an improvement in muscle strength, as well as maintenance of SMM. This suggests that immuno-nutrition may be effective in preventing SMM loss over time in people on haemodialysis. The findings of this feasibility study will help design a randomised controlled clinical trial investigating whether immuno-nutrition supplementation can improve SMM and other nutritional markers, and to evaluate the impact on long-term outcomes, including quality of life.

Thai version of shortened Oral Impact on Daily Performances index for evaluating oral lichen planus patients

BackgroundPatients’ perceptions and Oral Health-related Quality of life (OHRQoL) are important parts of dental treatment in all fields, including oral lichen planus (OLP) patients. A shortened version of the Oral Impact on Daily Performances (OIDP) might be more practical and feasible in clinical setting due to the busy nature of oral medicine clinics and staff availability to conduct the interview for data collection. The aim of the study was to develop a Thai version of shortened OIDP for assessing the OHRQoL in OLP patients.MethodsTwo types of shortened OIDP versions were tested in 69 OLP patients, one comprising the most commonly interfered with daily performances (OIDP-3 and OIDP-2) and another comprising either the highest frequency (OIDP frequency) or severity score (OIDP severity). The Numeric Rating Scale (NRS) and Thongprasom sign score were used to assess oral pain and clinical severity. Spearman rank-order correlation coefficients (rs) were used to demonstrate the associations between the shortened and original OIDP, pain, and clinical severity.ResultsOIDP-3 (Eating, Cleaning, and Emotional stability) and OIDP-2 (Eating and Emotional stability) were developed. The associations of the original OIDP with OIDP-3 and OIDP-2 (rs = 0.965 and 0.911) were significantly higher than those of the original OIDP with OIDP frequency and OIDP severity (rs = 0.768 and 0.880). The original OIDP, OIDP-3, and OIDP-2 were more significantly associated with pain compared with OIDP frequency and OIDP severity. The association between the clinical severity and oral impacts assessed by the original OIDP, OIDP-3, and OIDP-2 were similar and had higher correlation coefficients compared with those of OIDP frequency and OIDP severity.ConclusionOIDP-3 and OIDP-2 performed more similarly to the original OIDP than OIDP frequency and OIDP severity in assessing the OHRQoL of OLP patients.Trial registrationThe trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR 20190828002).

RWD84 A Comparison of Oral Aripiprazole with an Ingestible Sensor with Oral Atypical Antipsychotic Treatment and Impact on Psychiatric Hospitalizations in Adults with Schizophrenia in a Real-World Care Setting

To compare the risk of psychiatric hospitalization among adults with schizophrenia using aripiprazole with an ingestible sensor (AS), to those on oral atypical antipsychotic (OAA) treatment in the real world.