Oral Status Research Articles

Oral health knowledge, attitudes, and practices and oral health-related quality of life among stroke inpatients: a cross-sectional study

BackgroundStroke patients have poor oral hygiene, experience oral dysfunction due to disease factors, and have impaired oral health-related quality of life (OHRQoL). This study aimed to determine the oral health knowledge, attitudes, and practices of stroke inpatients, assess the OHRQoL of these patients, and identify their correlates.MethodsIn this cross-sectional study, 281 stroke inpatients aged between 22 and 88 years (57.94 ± 10.94) were conveniently selected from three hospitals in Guangzhou, China. OHRQoL was measured among these stroke patients using a Chinese version of the Oral Health Impact Profile-14 (OHIP-14). SPSS 26.0 was used for statistical analysis. Mean scores, standard deviations, and frequency distributions were obtained. The Mann–Whitney U test, Kruskal‒Wallis H test, Spearman's correlation, and multiple linear regression were used in the analysis.ResultsThe mean score of the patients' OHRQoL was 8.37 ± 6.67, with the highest score in the pain or discomfort of the mouth dimension (3.11 ± 2.13) and pain being the most common negative effect (13.5%). In multiple linear regression analysis, significant differences were found between patients only in age (P = 0.008), toothache (P < 0.001), self-rated oral health (P < 0.001), time since last dentist visit (P = 0.037) and reason for not having visited a dentist in the past year (P < 0.001).ConclusionThe OHRQoL of patients hospitalised with stroke was moderate, and oral conditions still need to be improved. Increasing age, toothache, a longer time since the last dental visit and the reason for not visiting a dentist in the past year had a negative effect on OHRQoL, and better self-rated oral health had a positive effect. Therefore, in clinical work, greater attention should be given to elderly stroke patients, patients with poor oral status and poor oral health behaviours, timely assessment of patients’ swallowing function, nutritional function, and self-care ability, and early and targeted oral health interventions and guidance.

Assessment of glucose levels in pregnant women with history of COVID-19 in a case-control study.

Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection may negatively affect glucose metabolism. This study aims to assess glucose levels, prevalence of gestational diabetes mellitus (GDM) and perinatal outcome in women with history of COVID-19. To this purpose, a group of 65 patients with history of COVID-19 and 94 control patients were retrospectively recruited among pregnant women who attended the pregnancy outpatient department between 01/2020 and 02/2022. Glucose data from an oral glucose tolerance test (OGTT), GDM status and obstetric complications were assessed. We observed no differences in average (p = 0.37), fasting (p = 0.62) or post-load glucose concentrations (60 min: p = 0.19; 120 min: p = 0.95) during OGTT. A total of 15 (23.1%) women in the COVID-19 group and 18 (19.1%) women in the control group developed GDM (p = 0.55). Moreover, caesarean section rate, weight percentiles and pregnancy outcomes were comparable between the groups (p = 0.49). In conclusion, in this study we did not identify a possible impact of COVID-19 on glucose metabolism in pregnancy, especially with regard to glucose concentrations during the OGTT and prevalence of GDM.

Effect of the oral health care program (FUNDEE) on the oral health care behavior status of elderly ethnic groups living in rural areas: a quasi-experimental study

The oral health of elderly people plays a major role in their overall health and quality of life and is an integral part of personal care. The aim of this study was to evaluate the effect of implementing the oral health care program on the oral health status of elderly people living in rural areas. This quasi-experimental study was carried out using a pretest-posttest design on 60 elderly people (30 in the intervention group and 30 in the control group) residing in two randomly selected rural areas of lower-northern Thailand. In the intervention group, the “FUNDEE” model was applied to Hmong elderly people for 12 weeks. The control group received routine care. Using the oral health care behavior assessment tool, the oral health behavior status of elderly people was assessed in both groups on two occasions: a pretest at the onset of the study, and the 12th week after the start of the study. The oral health behavior status of the elderly people in both groups was not statistically significantly different at the baseline, but it changed significantly at the 12th week (p&lt;0.01). The implementation of the “FUNDEE” model for elderly people residing in rural areas may improve their oral health status after 12 weeks. It is recommended that the “FUNDEE” model be included in the care plans of all rural areas to improve the elderly people’s oral health behavior status.

Oral health and the presence of infectious microorganisms in hospitalized patients: a preliminary observational study

Objective Characterise oral health, and the presence in the oral cavity of pathogenic non-oral microorganisms potentially associated with nosocomial infections and antimicrobial resistance in non-intubated patients admitted to a Brazilian university hospital. Materials and methods An intraoral examination and oral swab were performed on hospitalized individuals at three different times, T1 (within 48 h of hospitalization), T2 (48 h after T1) and T3 (7 days after hospitalization). The oral health status was defined by the Oral Health Assessment Tool (OHAT) and Tongue Coating Status (TCS). The swabs were processed and microorganisms potentially related to nosocomial infections were phenotypically identified through colony morphology, staining and microscopy. Results The most prevalent microorganisms were Escherichia coli, Enterococcus spp., Enterobacter spp., Pseudomonas spp., Candida albicans and Staphylococcus aureus. The oral health status was considered median, and the tongue coating index was considered high throughout the study period. The prevalence of potentially pathogenic non-oral microorganisms was high and constant from the first 48 h to the seventh day of hospitalization. Conclusions The results point out that the mouth can act as a reservoir of epidemiologically important pathogens within hospital settings, even in patients without mechanical ventilation, thus increasing the risk of nosocomial infections in susceptible individuals. KEY MESSAGES The present study investigated the oral health status and the presence of pathogenic non-oral microorganisms in the oral cavity of patients hospitalized in the ward, non-intubated and mostly independent of self-care. The presence in the mouth of microorganisms related to the epidemiology of nosocomial infections and resistance to antimicrobials was high and constant from the first 48 h to the 7th day of hospitalization. The results of this study point out that the mouth can act as a reservoir of epidemiologically important pathogens within hospital settings even in patients without mechanical ventilation, increasing the risk of nosocomial infections in susceptible individuals.

The Effect of Non-surgical Periodontal Treatment on the Quality of Life of Patients With Moderate to Severe Periodontitis

Background: Compared to other oral conditions, the effect of periodontal diseases on the quality of life (QoL) has received less attention. Hence, the present study aimed at determining changes in QoL related to oral health in patients with periodontal diseases after non-surgical periodontal therapy. Methods: This clinical trial study was conducted on 60 patients with periodontal diseases (moderate to severe periodontitis) referring to the periodontics department. The Oral Health Impact Profile (OHIP) index questionnaire and OHIP-14 were completed for all patients in order to assess the effects of oral status on daily activities before and one month after scaling and root planning. Its association with the age and gender of patients was examined as well. Statistical data were analyzed using the t test, paired t test, and one-way ANOVA. Results: The results revealed that the QoL of patients with periodontal diseases improved after scaling and root planning (P=0.001). Based on the findings, changes in QoL were not associated with the patients’ gender (P=0.001 and P=0.001 for males and females, respectively) or age (P=0.001 and P=0.001 for less than or equal to 30 years and more than 30 years, respectively). Conclusions: This study suggested a positive association between non-surgical treatment (NST) of periodontal disease and oral-health-related QoL.

Risk factors for breast cancer in women: an update review.

Breast Cancer remains, according to the World Health Organization, the most complex disease cancer in 2021 in the world and the most common cause of death among women. Based on unequivocal scientific data, the establishment of an operative program for prevention could save lives of millions women suffering from breast cancer. In this update review, we highlight the major risk factors related to breast cancer investigated in women over the last 5years. Thus, we clarify the involvement of these risk factors in the occurrence and growth of breast cancer. Investigations of 15 studies (n = 1,254,418; six case-control studies, five cohort studies, three prospective studies, and one meta-analysis) revealed that age, family history, obesity, use of oral contraceptives, status menopausal, smoking, alcohol consumption, lifestyle, and genetics factors are significantly linked to breast cancer. Additional studies are needed to corroborate these outcomes and initiate new practices aimed at preventing breast cancer.

Comparison of the effects of two oral cares on thirst and oral status following nasal surgery: Oral swab versus non-swab using cold water gauze

Purpose: This study aimed to compare the effects of oral swab and non-swab using cold water gauze on patients’ thirst and oral status following nasal surgery under general anesthesia.Methods: A non-equivalent control group was applied. Participants were divided into a control group (n=30) that was treated by cared for with cold water gauze application without oral swab and an experimental group (n=29) that was treated cared for with oral swab using cold water gauze after nasal surgery at the G University Hospital in Korea. Data were collected from May 14, 2020, to April 30, 2021, and analyzed using descriptive statistics, a chi-squared test, independent t-test, Wilcoxon signed-ranks test, and Mann-Whitney test.Results: The results showed no significant differences between the two groups in thirst (U=-0.04, &lt;i&gt;p&lt;/i&gt;=.693) and overall oral condition (U=-0.34, &lt;i&gt;p&lt;/i&gt;=.813) after the intervention. However, participants’ thirst and oral condition were significantly improved in each group after intervention.Conclusions: It was confirmed that both oral care methods reduced thirst and improved oral condition after nasal surgery. These findings indicate the need for intervention for patients’ thirst and oral condition after nasal surgery. Furthermore, they show that these oral care protocols can be used as a safe and effective nursing intervention for patients who undergo nasal surgery under general anesthesia.

Oral Health Self-Management Ability and Its Influencing Factors among Adolescents with Fixed Orthodontics in China: A Mixed Methods Study.

Objective To understand the oral health self-management ability status and influencing factors among adolescent patients with fixed orthodontics in Nanjing and to provide a reference for formulating targeted intervention measures. Methods A mixed research method was used. First, the convenience sampling method was used to select adolescent patients with fixed orthodontics admitted to the orthodontic department of a dental hospital in Nanjing from November 2021 to March 2022. The oral health self-management ability questionnaire was used for the investigation; then, 15 children with poor oral health management ability were selected for in-depth interviews. Results The total score of oral health self-management ability of 290 adolescent children with fixed orthodontics was 45.6-90.8 points, with an average score of 69.63 ± 7.40 of which knowledge, belief, and behavior dimension scores were 72.09 ± 10.47, 68.50 ± 10.13, and 67.63 ± 8.67, respectively, and the environmental score was 69.91 ± 12.50. Multiple regression analysis showed that sex, age, bracket wearing time, grade, and place of residence were related to the scores of each dimension of self-management. Qualitative research shows that the main reasons for the poor oral health self-management ability of adolescents with fixed orthodontics are the lack of awareness during fixed orthodontics, lack of knowledge channels, low compliance, inability to solve oral problems during treatment, difficulty in adhering to oral care behaviors, and lack of motivation to treat. Conclusion The oral health self-management ability of adolescent children with fixed orthodontics needs improvement, and a precise health intervention plan should be formulated.

The effect of care receivers' dysphagia severity on caregiver burden among family caregivers.

Dysphagia has received much attention as a factor that affects caregiver burden. However, few studies have examined how its severity can affect caregiver burden. This study aimed to examine the effect of dysphagia severity on caregiver burden. A cross-sectional online survey was carried out among family caregivers. We assessed caregiver burden using the Zarit Burden Interview. The dysphagia severity was assessed using the Functional Oral Intake Scale, and the caregivers were divided into three groups based on care receivers' oral intake status (levels 1-3: tube-feeding group; levels 4-6: texture-modified food group; level 7: normal group). To investigate the relationship between caregiver burden and dysphagia severity, univariable and multivariable logistic regression analyses were applied to caregiver burden. The Zarit Burden Interview was significantly higher in the texture-modified food group, and the proportions of high caregiver burden reached 25.2%, 39.5% and 23.4% in the normal group, texture-modified food group and tube-feeding group, respectively. The multivariable analyses applied to caregiver burden (reference, normal group) showed that the texture-modified food group was significantly associated with caregiver burden (OR 1.55, 95% CI 1.04-2.32), whereas the tube-feeding group had no relationship with caregiver burden (OR 0.68, 95% CI 0.31-1.49). Our study showed that the intake of texture-modified food significantly affected caregiver burden even after adjusting for confounding factors, whereas the use of tube feeding did not increase caregiver burden. These results suggest that it is necessary to consider dysphagia severity to reduce dysphagia-related caregiver burden. Geriatr Gerontol Int 2022; 22: 870-875.

RISK FACTORS FOR JAW OSTEORADIONECROSIS: A CASE CONTROL STUDY

Objectives To identify factors that predispose to development of osteoradionecrosis (ORN) of the jaw. Study Design A retrospective hospital-based case-control study was conducted with patients with head and neck cancer submitted to ≥60 Gy external radiotherapy with incidence over the jaws. A total of 19 cases of ORN and 43 controls were included. Patients’ demographic data, tumor type, staging, treatment and outcome information, and pretreatment oral status were collected. Results Univariate analysis showed that oral cavity/oropharynx was associated with a 9.77-fold increased risk of ORN development compared to other sites (P = .005). Being an active smoker was associated with a 3.95-fold increased risk of ORN development (P = .01). A tendency toward an increased risk for ORN was observed particularly when the extraction occurred after radiotherapy (odds ratio [OR] = 3.04; P = .08). On multivariate analysis, tumor site was the only significant risk factor in this analysis, with an OR of 21.03 (P = .01). Conclusions Oral and oropharyngeal primary site should be considered as an important risk factor for ORN. However, being an active smoker and being submitted to dental extraction after radiotherapy should be taken in account during the management of these patients. To identify factors that predispose to development of osteoradionecrosis (ORN) of the jaw. A retrospective hospital-based case-control study was conducted with patients with head and neck cancer submitted to ≥60 Gy external radiotherapy with incidence over the jaws. A total of 19 cases of ORN and 43 controls were included. Patients’ demographic data, tumor type, staging, treatment and outcome information, and pretreatment oral status were collected. Univariate analysis showed that oral cavity/oropharynx was associated with a 9.77-fold increased risk of ORN development compared to other sites (P = .005). Being an active smoker was associated with a 3.95-fold increased risk of ORN development (P = .01). A tendency toward an increased risk for ORN was observed particularly when the extraction occurred after radiotherapy (odds ratio [OR] = 3.04; P = .08). On multivariate analysis, tumor site was the only significant risk factor in this analysis, with an OR of 21.03 (P = .01). Oral and oropharyngeal primary site should be considered as an important risk factor for ORN. However, being an active smoker and being submitted to dental extraction after radiotherapy should be taken in account during the management of these patients.

Effect of oral health intervention program on the self oral care of children attending childcare facilities: a quasi-experimental study

This study aimed to conduct a quasi-experimental study for assessing the effects of an oral health intervention program (OHIP), on the self-management of oral health in children attending childcare centers. The participants recruited were 83 children from two childcare centers, who were allocated to the intervention and control groups. The intervention group received the OHIP. At baseline, a self-reported survey of parents was conducted. In addition, the oral status of the children at baseline and at 5 weeks was evaluated. Their brushing behavior was assessed once a week and every day during the OHIP intervention period and at home, respectively. After the follow-up at 12 weeks, dental plaque index (PI) was measured and two-way repeated measures analysis of variance was performed. The PI of the intervention group significantly decreased at week 5, compared to the baseline (1.90 ± 0.53, p &lt; 0.001). Despite a substantial increase in week 12 (2.67 ± 0.08, p &lt; 0.001), the PI was significantly lower than that of the control group (3.37 ± 0.60). The OHIP was effective in reducing the PI and modifying the brushing behavior among children. It is necessary to develop and expand a systematic oral health education program to promote self-management of oral health in children.

Hemodynamic signal changes and swallowing improvement of repetitive transcranial magnetic stimulation on stroke patients with dysphagia: A randomized controlled study.

ObjectiveOur study aims to measure the cortical correlates of swallowing execution in patients with dysphagia after repetitive transcranial magnetic stimulation (rTMS) therapy using functional near-infrared spectroscopy (fNIRS), and observe the change of pattern of brain activation in stroke patients with dysphagia after rTMS intervention. In addition, we tried to analyze the effect of rTMS on brain activation in dysphagia patients with different lesion sides. This study also concentrated on the effect of stimulating the affected mylohyoid cortical region by 5 Hz rTMS, providing clinical evidence for rTMS therapy of dysphagia in stroke patients.MethodsThis study was a sham-controlled, single-blind, randomized controlled study with a blinded observer. A total of 49 patients completed the study, which was randomized to the rTMS group (n = 23) and sham rTMS group (n = 26) by the random number table method. The rTMS group received 5 Hz rTMS stimulation to the affected mylohyoid cortical region of the brain and the sham rTMS group underwent rTMS using the same parameters as the rTMS group, except for the position of the coil. Each patient received 2 weeks of stimulation followed by conventional swallowing therapy. Standardized Swallowing Assessment (SSA), Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration-Aspiration Scale (PAS), and functional oral intake status were assessed at two times: baseline (before treatment) and 2 weeks (after intervention). Meanwhile, we use the fNIRS system to measure the cerebral hemodynamic changes during the experimental procedure.ResultsThe rTMS group exhibited significant improvement in the SSA scale, FEDSS scale, and PAS scale after rTMS therapy (all P < 0.001). The sham rTMS group had the same analysis on the same scales (all P < 0.001). There was no significant difference observed in clinical assessments at 2 weeks after baseline between the rTMS group and sham rTMS group (all P > 0.05). However, there were statistically significant differences between the two groups in the rate of change in the FEDSS score (P = 0.018) and PAS score (P = 0.004), except for the SSA score (P = 0.067). As for the removal rate of the feeding tube, there was no significant difference between the rTMS group and sham rTMS group (P = 0.355), but there was a significant difference compared with the baseline characteristics in both groups (PrTMS < 0.001, PshamrTMS = 0.002). In fNIRS analysis, the block average result showed differences in brain areas RPFC (right prefrontal cortex) and RMC (right motor cortex) significantly between the rTMS group and sham rTMS group after intervention (Pchannel30 = 0.046, Pchannel16 = 0.006). In the subgroup analysis, rTMS group was divided into left-rTMS group and right-rTMS group and sham rTMS group was divided into sham left-rTMS group and sham right-rTMS group. The fNIRS results showed no significance in block average and block differential after intervention between the left-rTMS group and sham left-rTMS group, but differences were statistically significant between the right-rTMS group and sham right-rTMS group in block average: channel 30 (T = −2.34, P = 0.028) in LPFC (left prefrontal cortex) and 16 (T = 2.54, P = 0.018) in RMC. After intervention, there was no significance in left-rTMS group compared with baseline, but in right-rTMS group, channel 27 (T = 2.18, P = 0.039) in LPFC and 47 (T = 2.17, P = 0.039) in RPFC had significance in block differential. In the sham rTMS group, neither sham left-rTMS group and sham right-rTMS group had significant differences in block average and block differential in each brain area after intervention (P > 0.05).ConclusionsThe present study confirmed that a 5-Hz rTMS is feasible at the affected mylohyoid cortical region in post-stroke patients with dysphagia and rTMS therapy can alter cortical excitability. Based on previous studies, there is a dominant hemisphere in swallowing and the results of our fNIRS analysis seemed to show a better increase in cortical activation on the right side than on the left after rTMS of the affected mylohyoid cortical region. However, there was no difference between the left and right hemispheres in the subgroup analysis. Nevertheless, the present study provides a novel and feasible method of applying fNIRS to assessment in stroke patients with dysphagia.

Use of smartphone photos to document the oral care status of nursing home residents.

Investigate whether clinically assessed oral care status by an external dentist can be replicated using smartphone photographs. Many people with care needs have poor oral hygiene. To help maintain oral health, caregivers require a simple way of communicating oral care status to the dental team. Cross-sectional study in which smartphone photographs of the oral and prosthetic care situation of N=50 nursing-home patients (mean age 85.6 [SD 6] years, 74% women) were assessed by two blinded, external examiners (D1/D2) and compared with clinical assessments made by the onsite dentist who also took the photographs (D0). Intraoral care status was clinically evaluated using the modified Plaque Index for Long-Term Care (PI-LTC) and Denture Hygiene Index (DHI). The intraclass correlation coefficient (ICC) determined correlations between clinical and photographic findings. The ICC was assessed for the PI-LTC (upper jaw, n=41; lower jaw, n=49) and DHI (upper jaw, n=25; lower jaw, n=18). The DHI showed excellent reliability between clinical assessment and smartphone evaluation for the determination of positive surfaces (ICC: upper 0.91 [95% confidence interval (CI) 0.83-0.96], P < 0.001; lower 0.95 [95% CI 0.89-0.98], P < 0.001). The PI-LTC showed good reliability between clinical assessment (D0) and D1/D2 for determination of vestibular plaque (ICC: upper 0.84 [95% CI 0.74-0.91], P < 0.001; lower 0.87 [95% CI 0.79-0.92], P < 0.001). Although limited, this pilot study demonstrated that standardised smartphone photographs can simply communicate the intraoral care status of patients who have difficulties accessing their dentist. This should be considered when planning improved communication between dentists, care recipients, and their support network.

A Systematic Review: Study on Challenges Faced by Dental Interns in the Workforce: Suggestions for Pacific Nations

Aim To identify challenges faced by dental interns in the workforce and to suggest Pacific Island Countries (PIC) on further research in this area. Materials and Methods A comprehensive search of Medline, Embase, Scopus and ProQuest databases was conducted using relevant keywords. All studies, published from 1st January 2000 to 31st January 2021, were taken into consideration. Removal of duplicates and screening the full-text articles using eligibility criteria were used to finalise the number of articles. The significant findings and conclusions were extracted and grouped under themes. Results A total of 16 studies met the inclusion criteria, involving dental interns, medical interns, postgraduate and undergraduate. Five themes were identified as the main challenges faced by dental interns in the workplace including workplace bullying, handling medical emergencies, community placement, lack of interdisciplinary approach and poor record keeping. Conclusion There is a need for PIC to conduct research and surveys, to identify the challenges its dental interns may be facing. This will create an ideal foundation from which strategies and initiatives can be implemented and enforced in the dental internship programme. Ensuring that oral health services are delivered efficiently and oral status of the Pacific is not compromised.

August 2022 Stroke Highlights

August 2022 Stroke Highlights

Association between oral function and nutrition in gastric cancer patients undergoing chemotherapy.

This study aimed to clarify the relationship between the oral assessment guide (OAG), a simple method for assessing oral function and poor nutrition in gastric cancer patients and investigate the reduction of oral mucositis through appropriate oral function management. Gastric cancer patients who underwent chemotherapy at the Nagoya Ekisaikai Hospital between January 2015 and December 2020 were evaluated. The prognostic nutritional index (PNI), as the objective variable, was used to assess nutritional status. The explanatory variables were sex, age, smoking status, body mass index (BMI), number of remaining teeth, cancer stage, albumin level, C-reactive protein level, white blood cell count and the OAG score. PNI was significantly associated with age, number of remaining teeth, cancer stage and the OAG score (p < 0.05) among the 217 patients. There were significant differences in age, BMI, cancer stage and the OAG score among the patients. An abnormal BMI and an advanced cancer stage were more common in older patients, and abnormal OAG scores were associated with a lower PNI. For gastric cancer patients undergoing postoperative chemotherapy, worse oral functional status is associated with worse PNI and nutritional status.

Composition of gastrointestinal microbiota in association with treatment response in individuals with metastatic castrate resistant prostate cancer progressing on enzalutamide and initiating treatment with anti-PD-1 (pembrolizumab)

Recent studies in cancer patients and animal models demonstrate that intestinal microbiota influence the therapeutic efficacy of cancer treatments, including immune checkpoint inhibition. However, no studies to-date have investigated relationships between gastrointestinal microbiota composition and response to checkpoint inhibition in advanced metastatic castrate resistant prostate cancer (mCRPC). We performed 16S rRNA gene sequencing of fecal DNA from 23 individuals with mCRPC progressing on enzalutamide and just prior to treatment with anti-PD-1 (pembrolizumab) to determine whether certain features of the microbiome are associated with treatment response (defined as serum PSA decrease >50% at any time on treatment or radiographic response per RECIST V.1.1). Global bacterial composition was similar between responders and non-responders, as assessed by multiple alpha and beta diversity metrics. However, certain bacterial taxa identified by sequencing across multiple 16S rRNA hypervariable regions were consistently associated with response, including the archetypal oral bacterium Streptococcus salivarius. Quantitative PCR (qPCR) of DNA extracts from fecal samples confirmed increased Streptococcus salivarius fecal levels in responders, whereas qPCR of oral swish DNA extracts showed no relationship between oral Streptococcus salivarius levels and response status. Contrary to previous reports in other cancer types, Akkermansia muciniphila levels were reduced in responder samples as assessed by both 16S rRNA sequencing and qPCR. We further analyzed our data in the context of a previously published “integrated index” describing bacteria associated with response and non-response to checkpoint inhibition. We found that the index was not reflective of response status in our cohort. Lastly, we demonstrate little change in the microbiome over time, and with pembrolizumab treatment. Our results suggest that the association between fecal microbiota and treatment response to immunotherapy may be unique to cancer type and/or previous treatment history.

The Assessment of Early Server Childhood Caries Status in Abandoned Institutionalized Children.

Oral health is a critical indicator of children’s quality of life, which at this early age, depends exclusively on the attention, involvement, and guidance of parents or caregivers. Assessing carious damage and measuring the prevalence of early severe tooth decay in temporary teeth in children is obtained by calculating the dmft index, giving the sum of an individual’s decayed, missing, and filled teeth. The aim of our study was to conduct a clinical examination of the oral status of institutionalized children from Romania. We selected and included in the study 144 children, both boys and girls in equal number, with ages of five or six years old, from which 110 were eligible for the study and met the inclusion criteria. Of all children, 20.90% were five years old girls, 27.27% five years old boys, 26.36% six years old girls, and 25.46% six years old boys. Of all, 10,45% had more than three incisors presenting decays, equally affected by gender. Of the boys’ group, 20% of age six had more de two canines affected, and 26.7% of five years old girls had more than three affected canines. Of the five years boys’ group, 24.3% had more than three affected temporary molars, 44.9% of six years boys had more than five. Of the five years old girls, 33.3% had more than four temporary molars affected and, 56.6% of the six years old girls’ group had more than five molars presenting carious lesions. The dental status and dmft values were similar for five years old and six years old children and similar boys and girls. Due to the vulnerability of young children that consists not only in their inability to identify, express, and address their own needs but also the lack of parental support, lack of an optimal diet for age, and proper hygiene, they reach adolescence with an impaired dental status, inappropriate for their age.

A matter of taste: alteration in patients with cancer.

Taste alteration (dysgeusia) is a common nutritional impact symptom in people affected by cancer, as a result of either the cancer itself or its treatments. It can have a significant impact on oral intake and nutritional status. Taste alteration can also have a negative impact on food behaviours and quality of life. There is a paucity of evidence both on how the problem is assessed in patients and on strategies and guidelines to manage it. This article gives an overview of taste alterations in cancer, highlights recent reviews and summarises some key practical management themes.

Corynebacterium matruchotii: A Confirmed Calcifying Bacterium With a Potentially Important Role in the Supragingival Plaque.

Corynebacterium matruchotii is a reported calcifying bacterium that can usually be isolated from dental calculus and induce mineralization in vitro. In recent years, based on in situ hybridization probe and sequencing technology, researchers have discovered the central “pillar” role of C. matruchotii in supragingival plaque, and many studies focused on bacterial interactions in the biofilm structure dominated by C. matruchotii have been conducted. Besides, C. matruchotii seems to be an indicator of “caries-free” oral status according to imaging and sequencing studies. Therefore, in this review, we summarize C. matruchotii ‘s role in supragingival plaque based on the structure, interactions, and potential connections with oral diseases.