Oral Systemic Health Research Articles

Oral Infections and Systemic Health - More than Just Links to Cardiovascular Diseases.

During the past 20 years, a plethora of research reports has been published showing a statistical association between poor oral health and cardiovascular diseases. The aim of this narrative review was to focus on associations between oral infections and non-atherosclerosis-related systemic diseases. An open literature search and evaluation of articles were conducted on Medline and Cochrane databases with the key words 'oral infection', 'periodontitis', 'pneumonia', 'osteoarthritis', 'rheumatic diseases', 'inflammatory bowel disease', 'kidney disease', 'liver diseases', 'metabolic syndrome', 'diabetes', 'cancer', 'Alzheimer's disease'. Cardiovascular diseases were excluded from the analysis. The scarcity of controlled studies did not allow conducting a systematic review with meta-analysis on the topics, but dental infections have been shown be associated with several general diseases also beyond the atherosclerosis paradigm. However, there is no causal evidence of the role of dental infections in this regard. Poor oral health has nevertheless often been observed to be associated with worsening of the diseases and may also affect treatments. Maintaining good oral health is imperative regarding many diseases, and its importance in the daily life of any patient group cannot be over emphasised.

Alzheimer's Disease and Oral-Systemic Health: Bidirectional Care Integration Improving Outcomes.

Dentistry is an effective healthcare field that can impact Alzheimer's disease through prevention and education. Every day dental providers use an arsenal of assessment protocols directly coinciding with modifiable Alzheimer's risk factors. An innovative way to help in the prevention of Alzheimer's disease is to utilize oral health professionals who reach the public in ways other health care providers may not. Bidirectional care integration is needed to stifle many systemic diseases and Alzheimer's disease is no different. Ultimately with collaborative care the patient reaps the benefits. Alzheimer's is associated with many etiologies and pathophysiological processes. These include cardiovascular health, smoking, sleep, inflammatory pathogens, and diabetes. In the United States, dental providers assess each of these factors daily and can be instrumental in educating patients on the influence of these factors for dementia prevention. Globally, by 2025, the number of people with Alzheimer's disease is expected to rise by at least 14%. Such increases will strain local and national health care systems, but for the US if Medicare were expanded to include dental services, many older adults could be spared needless suffering. The goal of this perspective article is to highlight existing practices being used in the field of dentistry that can easily be adapted to educate patients in preventive care and treat risk factors. It is the duty of healthcare professionals to explore all opportunities to stem the advance of this disease and by integrating oral and systemic health into transdisciplinary science, health care and policy may do just that.

Nonventilator hospital-acquired pneumonia: A call to action.

In 2020 a group of U.S. healthcare leaders formed the National Organization to Prevent Hospital-Acquired Pneumonia (NOHAP) to issue a call to action to address non-ventilator-associated hospital-acquired pneumonia (NVHAP). NVHAP is one of the most common and morbid healthcare-associated infections, but it is not tracked, reported, or actively prevented by most hospitals. This national call to action includes (1) launching a national healthcare conversation about NVHAP prevention; (2) adding NVHAP prevention measures to education for patients, healthcare professionals, and students; (3) challenging healthcare systems and insurers to implement and support NVHAP prevention; and (4) encouraging researchers to develop new strategies for NVHAP surveillance and prevention. The purpose of this document is to outline research needs to support the NVHAP call to action. Primary needs include the development of better models to estimate the economic cost of NVHAP, to elucidate the pathophysiology of NVHAP and identify the most promising pathways for prevention, to develop objective and efficient surveillance methods to track NVHAP, to rigorously test the impact of prevention strategies proposed to prevent NVHAP, and to identify the policy levers that will best engage hospitals in NVHAP surveillance and prevention. A joint task force developed this document including stakeholders from the Veterans' Health Administration (VHA), the U.S. Centers for Disease Control and Prevention (CDC), The Joint Commission, the American Dental Association, the Patient Safety Movement Foundation, Oral Health Nursing Education and Practice (OHNEP), Teaching Oral-Systemic Health (TOSH), industry partners and academia.

Associations between oral health and general health: a surveywide association study of the NHANES.

This proof of concept study uses data from the National Health and Nutrition Examination Survey (NHANES) to explore potential associations between oral and systemic health in a survey-wide association study (SWAS). Data from n=9,971 records in the 2015-2016 NHANES survey were used to evaluate associations between self-rated oral health and the various systemic health conditions that are included in the survey. Associations were estimated using survey-weighted linear regression models adjusted for age, sex, race, and smoking status. Substantial associations with self-rated oral health were evident after correction for multiple comparisons. The study revealed associations in categories of mental health, cardiovascular disease, and diabetes adding to the body of evidence. The study also suggested associations with physical functioning, vision, hearing, genitourinary symptoms, and the prevalence of hepatitis. The SWAS method demonstrated the ability to identify associations between oral health and systemic health. Suggested associations should be investigated further investigated with emphasis on both biologic and societal mechanisms. The noteworthy associations with mental health, physical activity, and cardiovascular disease in this study inform clinicians from each of these disciplines that they may benefit from collaborations with oral health care providers to promote whole-person health.

Knowledge and Practices of Oral Hygiene among Undergraduate Students of Dayalbagh Educational Institute, Agra

Background: Healthy and well-functioning teeth in all phases of life is a necessity. Teeth help in proper mastication of food as well as in word pronunciation. It gives fullness to the face, thereby helping in the social appearance of a person. Oral health and systemic health are interconnected. Past studies indicate that oral diseases cause or increase the severity of noncommunicable diseases. The general public is unaware of this connection. Thus, the present research work was planned to assess the oral hygiene practices of students and their awareness for maintenance of oral health. Research Methodology: The present survey was conducted among 510 students (135 boys and 335 girls) in the age group of 17–30 years studying in Dayalbagh Educational Institute. Data were collected through a questionnaire adapted from the standard tool of oral health questionnaire by the WHO. Results and Discussion: The result of the present study showed that 93% of the students were using toothpaste and toothbrush for cleaning teeth, but only 31% and 2% of the students were using other measures such as mouthwash and floss. Data also showed that only 44% of the students brush twice a day and only 27% visit dentist for routine checkup. Conclusion: Majority of the students were aware of the linkage between oral health and systemic health. Thus, it is essential to organize oral health education program at mass level to create awareness in public so that not only their oral health but also their general health can be improved.

Oral Health in People Who Use Methamphetamine

Oral health directly affects systemic health, yet a large proportion of the population has insufficient access to oral health care. People who use methamphetamine are at particularly high risk of having poor oral health due to a combination of pathophysiologic and socioeconomic factors. Nurse practitioners are well positioned to improve access to oral health care for this population through early screening, prompt referral, and targeted harm reduction strategies. The purpose of this article is to enhance nurse practitioner competency in providing oral-systemic health care to vulnerable populations. This article summarizes current knowledge regarding methamphetamine-associated dental decay and explores opportunities for health promotion and harm reduction in this vulnerable population.

10080 Quantifying type of dental treatment rendered for patients with special needs

ABSTRACT IMPACT: Quantifying the types of dental procedures patients with healthcare needs receive can help understand and improve modalities of dental care to improve healthcare outcomes. OBJECTIVES/GOALS: 1. Quantify how medical complexity based on special needs diagnosis impacts dental treatment rendered2. Comprehend how medical diagnosis of a special need can affect rate of treatment and type of treatment METHODS/STUDY POPULATION: This study consists of a chart review of all active patients in a dental school setting who have one of the following diagnoses of a special need: autism, developmental disorder, epilepsy, cerebral palsy, neuromuscular disorder, and hydrocephaly. Medical diagnoses were used to extract records and quantify the types of dental treatment rendered for these patients (preventative, restorative, and surgical), as well as the rates of appointments for this patient population. RESULTS/ANTICIPATED RESULTS: The medical complexity of patients of this population, as defined by the number medical diagnoses, impacts the type of treatment rendered as well as how frequently these patients are seen for dental care (rate of appointments). DISCUSSION/SIGNIFICANCE OF FINDINGS: Over- or under-utilization of dental treatment modalities can impact the oral health status and outcomes for patients with special needs. The differences in types and frequency/ rate of dental treatment rendered for patients of different medical complexity can further impede their oral health and systemic health status and health outcomes.

General Health and Pharmacological Benefits of Curcumin – A Natural Healing Agent

The use of therapeutic agents in medicine has lead to the development of resistant strains of many pathogens. As an alternative medicine, many herbal formulations were introduced. From ancient times, various medicinal plants have been used as a treatment agent for various diseases due to their alarming herbal properties. Turmeric, a rhizome of curcumin long a is one among them which has anti-infective and anti-inflammatory properties. Due to its novel properties, it is used in various treatments options for oral health and systemic health. Curcumin, due to its complex interaction between inflammation, immunity and oxidative stress, it was used in various oral and neck pathologies also apart from general health benefits. Curcumin suppresses pro-inflammatory cytokines in head and neck pathologies showing various changes in salivary Ph and salivary stress biomarkers. In dentistry, curcumin has been proved to have antiplaque efficiency in various studies, but long term study is required to substantiate its properties. Recently nanostructured lipid carrier containing curcumin was used in dentistry to bring about bone regeneration. This article depicts various properties, applications of curcumin in healthcare and its pharmacological action for systemic and oral health.

Attaining interprofessional competencies by connecting oral health to overall health

The purpose of this study was to evaluate the effectiveness of an annual oral-systemic health interprofessional education (IPE) clinical simulation and case study experience with nurse practitioner/midwifery (NP/MW), dental (DDS), medical (MD), and pharmacy (PharmD) students. The Interprofessional Collaborative Competency Attainment Scale (ICCAS) was used to measure students' self-reported attainment of interprofessional competencies before and after the IPE experience. Pre- and post-test surveys were completed by NP/MW, DDS, MD, and PharmD student cohorts from 2017 to 2019. Students also had the opportunity to provide qualitative feedback about their experience at post-test. Data were collected from IPE faculty facilitators to assess their perception of the value of the Teaching Oral-Systemic Health (TOSH) program. Student ICCAS results demonstrated statistically significant improvement in self-reported interprofessional competencies among all types of students across all 3 years (P<0.001); qualitative student comments reflected positive experiences with the TOSH program. Survey data from IPE faculty facilitators supported the value of the IPE experience for all students. The findings demonstrate the effectiveness of the TOSH program in using oral-systemic health as a clinical exemplar to develop interprofessional competencies. The 2017-2019 data reinforce the credibility of scaling the TOSH model for developing interprofessional competencies with students from different health professions.

Factors associated with the counts of selected oral microorganisms in nursing home residents.

To analyze potential factors associated with levels of selected oral pathogens, as well as total aerobic bacterial species, among nursing home residents. Nursing home residents were divided into three groups (G1 included people with teeth but no dentures, G2 included people with teeth and dentures, and G3 included people with no teeth and with dentures). All participants had microbiological samples collected from their oral cavity and dentures. Counts of total aerobic bacterial species, Porphyromonas gingivalis, Fusobacterium nucleatum, Actinomyces viscosus, Aggregatibacter actinomycetemcomitans, and Candida albicans were compared among groups using the Wilcoxon rank sum test. A multivariate analysis was also performed to control other available covariates. Bivariate analysis revealed significant differences among the groups, and multivariate analysis showed that sex, the presence of natural teeth, denture wearing, oral hygiene indices, and systemic health conditions were associated with bacterial and Candida albicans log counts. Presence of natural teeth and denture wearing, as well as oral hygiene, sex and systemic health conditions were associated with bacterial and Candida albicans log counts among nursing home residents.

Exploring the Role of Fusobacterium nucleatum in Preterm Birth: A Narrative Review

In recent years, substantive attention has been drawn to the relationship between oral microbiome homeostatic equilibrium disruption and systemic health, demonstrating the negative impacts of this reciprocal biological interplay. Increasingly, there is a concern over the potential noxious effect of oral microbiome dysbiosis on obstetric poor outcomes, focusing on preterm birth. This epidemiological observation remains unexplained, although biologically plausible mechanism has been proposed. Intrauterine infection has long been associated with adverse pregnancy, when the elicitation of an immune response is determinant. There is evidence that Fusobacterium nucleatum (FN), a Gram-negative anaerobe ubiquitous in the oral cavity, infects the mouse placenta originating in the decidua basalis. Based on the current data in literature, we performed a review to provide resources for the explanation of the potential impact of microbiome dysbiosis on poor obstetric outcomes, focusing on the role of FN.

Perception Pertaining to Oral and Systemic Health: A Mixed Method Model

Background: Oral health is an indispensible part of general health is an often ignored by masses including health care personnel. There have been health policies launched by the government recently including oral care but to what extent the people are aware of these policies are yet to be assessed. Aim: To assess the oral health status and perception pertaining to link between oral and systemic health, Ayushman Bharath Yojana and the concept of Universal Health Coverage (UHC) amongst the people visiting the exhibition on 64th Institute Day, AIIMS, New Delhi, India. Materials and Methods: People who came to the dental booth at the exhibition over a period of 3 days from 25th September 2019 to 27th September 2019, fulfilling the inclusion criteria were included in the study. Data collection was performed through clinical examination and open ended questionnaire for the assessment of perception regarding association between oral health and systemic health, concept of Universal Health Coverage and Ayushman Bharath Yojana. Result: Mean DMFT score was found to be 2.6 ± 3.4, 41.3% had bleeding on probing, 2.8% showed dental trauma and 2% had dental fluorosis. Nearly 73.6% felt that oral health does affect general health. Majority of the study population was not aware of the concept of UHC. Around 60% participants were aware of the Ayushman Bharath Yojana. Conclusion: The study findings conclude the need to spread awareness amongst masses about government health policies and effects of oral health on general health.

COVID-19 and Periodontitis: A Reality to Live with

Coronavirus disease-19 (COVID-19) is a r ecent pandemic that is advancing at a r apid r ate. The future course of the disease includes severe r espiratory infection and also leads to death if unattended. Meticulous measures are necessary before attending any patient. The dental operatories and the clinic surroundings must be well sanitized so as to prevent the spread of pandemic. This r eview discusses in brief about the pathophysiology and course of COVID-19. Further, we discussed in detail the management aspects of patients in periodontal perspective and the sanitization procedures required for the dental clinic. The SARS coronavirus enters the human circulation via the angiotensin-converting enzyme (ACE) receptors which are also found on the oral mucosal surfaces. Furin and Cathepsin L are the pro-inflammatory molecules released during pathogenesis of periodontitis and mediate the molecular pathways that help the virus invade into the host. The clinic set-up should be modified to best suit the pandemic conditions. This includes the three phases, i.e., phase I: preparatory phase; phase II: implementation phase; and phase III: follow-up. The patient management is explained based on the emergency needs of the patient based on the recent AAP classification of periodontal diseases and conditions 2017 as emergency, urgent, and elective treatment needs which have been explained in detail. It can be strongly concluded that there is direct relationship between oral health and systemic health. The treatment procedures and sanitization protocols must be definitely modified. Further consensus and systematic reviews help us arriving at a more standardized protocol. This review would help clinicians modify the way they treat patients in the clinic and provide better services depending upon the emergency needs of the patient.

Nonsurgical Treatment for Oral Submucous Fibrosis: A Comprehensive Review

Oral submucous fibrosis (OSMF), and recently termed areca nut-induced oral fibrosis, is a debilitating disorder that hampers oral health and systemic health of patients. The management for this disorder involves a wide variety of modalities, including palliative, medicinal, and surgical. Regardless of tremendous research published in the literature, the management of OSMF has remained controversial due to the complexity of the disorder. Accordingly, this article aims to enlighten the clinicians with a comprehensive review of the current situation of the disorder and discuss the available medicinal treatment modalities for OSMF.

Moderating Effects of Oral Health and Control effect of Self-efficacy on the Relationship between Dental Care Disorders and Systemic Health

Objectives: This study analyzes the effect of dental disease recognized by individuals on systemic health by mediating oral health. The control effect of self-efficacy, which is a psychological factor of individuals, is likewise examined. On the basis of this study, we will prepare basic data on the various interventions that should be provided for individuals to improve overall health. Methods: In this study, persons who understood the research purpose and agreed to participate were selected as the study target for adults in Busan, Gyeongnam, and Ulsan, and 240 people were used in the analysis. Data collection was conducted from May 22, 2019 to June 10, 2019. Results: The average dental disability, oral health, self-efficacy, systemic health, and dental health disorders of the study subjects scored 3.08, 3.79, 3.73, 3.09, and 3.09 points, respectively (r=&#8722;.41, p<.00). Systemic health (r=&#8722;27, p<.00) was found to have a correlation between oral health and systemic health (r=.44, p<.001). In the relationship between dental and systemic health, the role of oral health was found to be complete intermediation. In both the high and low oral health-related self-efficacy tests, systemic health was low when dental health was high. In the case of low dental disorders, self-efficacy groups were found to be higher than those with low self-efficacy. Conclusions: It is believed that by developing oral health education and mediation programs, it is necessary to reduce dental health disorder by enhancing oral health related self-efficacy, and to form living habits and behaviors of health promotion activities to promote systemic health as well as oral health.

BIOCHEMICAL AND CLINICAL EVALUATION OF CORRELATION OF PERIODONTITIS AND EARLY CAROTID ATHEROSCLEROSIS

Periodontal disease is a disease characterized by inflammation of the periodontal tissues caused by microorganisms in the oral cavity and affects approximately 90% of the world population. Losses in the alveolar bone and connective tissue are observed due to periodontal diseases, which may lead to tooth loss. In addition, periodontal disease has been associated with many systemic diseases such as coronary artery diseases, stroke, head and neck cancer, pregnancy complications and diabetes. Periodontal disease is affected by risk factors such as smoking and diabetes, similar to vascular diseases. Hence based on above findings the present study was planned for Biochemical and Clinical Evaluation of Correlation of Periodontitis and Early Carotid Atherosclerosis.&#x0D; The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. In the present study 20 cases of the Generalized chronic Periodontitis were enrolled in the Group A as study group patients. And 20 cases of Periodontally healthy individuals were enrolled in Group B as control group patients for comparative evaluation. Under aseptic measures, venous blood samples were drawn by venipuncture in antecubital fossa using 5ml syringe and collected in a plain vacuum tubes and transported to clinical laboratory for lipid profile analysis. Both the groups were subjected for ultrasonography for the assessment of Carotid Intima-Media Thickness (IMT) and Lipid Profile.&#x0D; The data generated from the present study concluded that periodontal disease has association with early carotid atherosclerosis which is a risk factor for cardiovascular diseases .Thus oral health and systemic health are closely related and overall systemic health of an individual can be improved by maintaining a proper oral health regimen. It is important in terms of health policies that there is no need for an additional cost for this early diagnosis.&#x0D; Keywords: Periodontitis, Early Carotid Atherosclerosis, Heart disease, etc.

BARRIERS TO ORAL HEALTH IN THE OLDER POPULATION

A strong challenge is posed for patients and their caretakers by the growing need for promoting oral healthcare for this population, as research substantiates the connection between oral health and systemic health. This study identified the major barriers to providing optimal oral care to the older population. Fifty patients aged 60 and over visiting the Columbia University College of Dental Medicine Clinic were administered a questionnaire which reflected possible barriers to oral health care. Statistical analysis of data revealed that the top three barriers in order of relevance were the (1) cost of treatment, (2) anxiety, and (3) transportation. The youngest old (60-69) indicated that the lack of time and conflict with work schedules were additional barriers, while the older sample (70+) experienced obstacles due to disability and illness. When gender differences were analyzed, transportation was the most significant as a barrier among males, and fear/anxiety was most significant for females. Ethnically, non-Hispanics indicated that (1) shortage of time, (2) anxiety, and (3) lack of social/physical support were significant barriers. Findings indicated that even those with Medicaid insurance coverage believed that the cost of dental treatment and caregiving responsibilitieswere major barriers to seeking care. Conversely, even those without dental insurance indicated that disability and illness were barriers to seeking care. This pilot study highlighted various barriers to oral health care and highlighted the need for intervention to address barriers, such as social services, expanded Medicaid coverage, and transportation assistance, to ultimately improve access to optimal oral health care.

The Msp Protein of Treponema denticola Interrupts Activity of Phosphoinositide Processing in Neutrophils.

Periodontal disease is a significant health burden, causing tooth loss and poor oral and overall systemic health. Dysbiosis of the oral biofilm and a dysfunctional immune response drive chronic inflammation, causing destruction of soft tissue and alveolar bone supporting the teeth. Treponema denticola, a spirochete abundant in the plaque biofilm of patients with severe periodontal disease, perturbs neutrophil function by modulating appropriate phosphoinositide (PIP) signaling. Through a series of immunoblotting and quantitative PCR (qPCR) experiments, we show that Msp does not alter the gene transcription or protein content of key enzymes responsible for PIP3 signaling: 3' phosphatase and tensin homolog (PTEN), phosphatidylinositol 3-kinase (PI3K), or 5' Src homology 2 domain-containing inositol phosphatase 1 (SHIP1). Instead, using immunoblotting and enzyme-linked immunosorbent assays (ELISAs), we found that Msp activates PTEN through dephosphorylation specifically at the S380 site. Msp in intact organisms or outer membrane vesicles also restricts PIP signaling. SHIP1 phosphatase release was assessed using chemical inhibition and immunoprecipitation to show that Msp moderately decreases SHIP1 activity. Msp also prevents secondary activation of the PTEN/PI3K response. We speculate that this result is due to the redirection of the PIP3 substrate away from SHIP1 to PTEN. Immunofluorescence microscopy revealed a redistribution of PTEN from the cytoplasm to the plasma membrane following exposure to Msp, which may contribute to PTEN activation. Mechanisms of how T. denticola modulates and evades the host immune response are still poorly described, and here we provide further mechanistic evidence of how spirochetes modify PIP signaling to dampen neutrophil function. Understanding how oral bacteria evade the immune response to perpetuate the cycle of inflammation and infection is critical for combating periodontal disease to improve overall health outcomes.

Responsibilities borne by a dental health professional towards public dental health education and awareness

Dental public health is a unique and a challenging specialty, because the patient per se is just not a single entity but the whole community or a population, like a school, neighborhood, city, state, or the entire nation. At the community level the concept of dental health education has its importance as the oral health is essential for the overall health and wellbeing. With the ever increasing links between oral health and systemic health, it is a social and professional responsibility of a dental health professional to educate the community about oral health issues. Poor oral health affects the quality of day to day life both at psychological and social aspect. This paper aims to present a few efforts that can be put forward, as a dental health professional, for bringing awareness, improving oral health literacy, empowering individual's ability to maintain their oral health and seek dental treatment in time and also to accept oral health importance as a priority. Keywords: Public dental health, Oral health programme, National oral health survey, Lack of awareness, Dental education camps.

Pediatric Oral Systemic Health: From Fetus to Adolescence

Every species depends on adaptation to survive. Humans have managed to survive and flourish while directly influencing the environment of the entire planet, encompassing all other forms of life. While there may be philosophical disagreements