Risk For Poor Oral Health Research Articles

Body mass index change and risk of poor oral health in Norwegian adults: the HUNT longitudinal study

Abstract Background Oral diseases and obesity share common risk factors and are highly prevalent. However, the relationships between body mass index (BMI), BMI change and oral health conditions in adults are less studied. In this study, we investigate the associations of long-term obesity and BMI change with risk of poor self-rated oral health among adults. Methods This study include individuals aged 29-90 years (57.8 % women, mean age at baseline, HUNT3, was 54.9 years) who participated in the first (HUNT1, 1984-86), second (HUNT2, 1995-97), third (HUNT3, 2006-08) and fourth (HUNT4, 2017-19) survey of the Trondelag Health Study (HUNT). Weight and height were measured at each survey. We estimated average BMI values and BMI change over a 10-year (HUNT2- HUNT3, N = 19,729) and 20-year (HUNT1- HUNT3, N = 14,276) period and linked to their information on oral health status at HUNT4. We employed logistic regression models with adjustment for confounders and computed odds ratio (OR) with 95 % Confidence Interval (CI). Results At HUNT4, 1812 (9.2 %) participants rated their oral health as poor or very poor. The multivariable-adjusted ORs for average BMI over 30 kg/m2 were 1.3 (95 % CI: 1.1-1.5) and 1.2 (95 % CI: 1.0-1.5) over a 10-year and 20-year period, respectively, when compared to normal weight. After adjustment for most recent BMI (HUNT4), the associations of long-term obesity with poor self-rated oral health weakened. Compared with stable BMI, both loss and gain in BMI over a 10-year period were associated with increased risk of poor oral health. In the adjusted analysis, we found that a BMI loss of more than 2.5 kg/m2 and a BMI gain of more than 5 kg/m2 was associated with 1.5 times (OR = 1.5, 95 % CI: 1.1-1.9) and 1.3 times (OR = 1.3, 95 % CI: 1.1-1.6) greater risk of poor oral health. Conclusions Our findings suggest that individuals with long-term obesity and BMI change have a markedly higher risk of poor self-rated oral health. Key messages • Long-term obesity was associated with increased risk of poor self-rated oral health. • Compared with stable body mass index (BMI), loss- and gain in BMI were associated with increased risk of poor self-rated oral health.

Identification and Management of Dental Anxiety by New Zealand Dentists.

More than 1 in 8 New Zealand (NZ) adults are dentally anxious, which can lead to avoiding dental care and a higher risk of poor oral health. However, little is known about how dentally anxious patients are identified and managed by NZ general dentists. This survey aimed to investigate how NZ dentists identify and manage dentally anxious patients. We conducted an email survey of NZ dentists in 2022, obtaining 212 responses. Along with demographic information, respondents were queried about whether they ask patients about past/current dental fears and their likely origin, how they assessed those fears, their usual management of dentally anxious patients, and how the management of dentally anxious patients could be improved. Almost three-quarters reported personally asking patients about past and/or current dental fears, and half enquired about bad life experiences that had led to those fears. Only 6 respondents (2.8%) reported using a formal dental anxiety/phobia assessment tool prior to treatment. For managing severely anxious adult dental patients, all dentists used at least 1 pharmacologic or psychological technique or referral to a colleague. The study identified several weaknesses among NZ dentists in identifying and managing dental anxiety patients. The use of formal dental anxiety/phobia assessment tools prior to treatment needs improvement. Addressing dental anxiety is a complex issue that requires a multipronged approach involving improved education, the development and implementation of better assessment tools, and a greater understanding of how dentists' current assessment and management of dental anxiety can be improved.

Investigating the Relationship between Oral Health and Severe Mental Illness: Analysis of NHANES 1999-2016.

To explore whether: (i) people with severe mental illness (SMI) experience worse oral health than the general population, and (ii) the risk factors for poor oral health in people with SMI. Cross-sectional data were extracted from the National Health and Nutrition Examination Survey (1999-2016), including on self-rated oral health, oral pain, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. Ordinal logistic regression and zero-inflated negative binomial models were used to explore predictors of oral health outcomes. There were 53,348 cases included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.60, 95% CI: 1.34-1.92). In people with SMI, risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes. People with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Performing regular physical exercise and flossing may lower the risk of poor oral health, while smoking and diabetes may increase the risk. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes in people with SMI.

Healthcare professionals’ perspectives on oral health care in acute stroke patients: a qualitative study

BackgroundStroke is a major public health problem, with the disabilities of the patients increasing their risk of poor oral health. Currently, in Ghana and Nigeria, no guideline exists for oral health care in stroke patients, while most of our acute stroke care settings have no documented protocol.AimThis study sought to understand the perspectives of healthcare professionals in Ghana and Nigeria about oral healthcare in acute stroke patients.MethodsA qualitative inductive approach was employed to explore healthcare professionals’ perspectives. After obtaining informed consent, in-depth interviews were conducted among doctors, nurses, and physiotherapists using semi-structured question guides. Participants’ responses were audiotaped for transcription and analysis. Interviews were conducted until data saturation was reached. Data were analyzed thematically to generate themes and sub-themes using an inductive approach.The resultsTwenty-five (25) health care professionals (HCP) aged 25–60 years with a mean age of 36.2 ± 4.2 years were interviewed. There were 15 (60.0%) males and 10 (40.0%) females. HCP included nurse practitioners 14 (56.0%), medical doctors 7 (28.0%), and physiotherapists 4 (16.0%). The HCP demonstrated adequate knowledge of stroke and considered oral health important for esthetic and clinical reasons. They, however, reported being unable to give it the required attention due to inadequate collaboration between the various professional cadres, insufficient equipment, and a skewed focus on other clinical needs of the acute stroke patients.ConclusionsThe findings indicate that HCPs perceived oral health care as very important among patients with acute stroke. However, they reported a lack of collaboration and integration of oral health care in routine stroke care as a major impediment.

Perceptions of patients towards oral health care in a spinal cord injury rehabilitation unit: A qualitative study.

Individuals with spinal cord injuries (SCIs) are at an increased risk of poor oral health compared to the general population. However, little is known about the related barriers and facilitators experienced by these individuals within the hospital setting. Understand the oral health knowledge, attitudes and practices of people with SCIs, barriers and facilitators to managing their oral health, and recommendations to improve oral care at acute/rehabilitation hospital settings. Semi-structured interviews were conducted with 11 participants, from a major metropolitan hospital in Sydney, Australia. The interviews were thematically analysed. Three themes were constructed. Participants believed that the onus was on them to manage their oral health. Individuals also had limited knowledge of its importance to general health, and placed a lower priority on oral health compared to other aspects of health. All participants identified a combination of factors, such as cost, time, resources and prior negative experiences, that contributed to the neglect of their oral care. Participants also discussed the need of support from the multidisciplinary team and family/carers to facilitate oral care and identified various appropriate oral health education formats. This study highlighted some areas where oral health knowledge among people with SCIs could be improved. It also identified the need for oral health training for the multidisciplinary team, as well as carers, to better integrate oral care during rehabilitation in the hospital. The development of oral health interventions would need to utilise a co-design approach to best support clients and their carers to facilitate oral care self-management.

Frequency of Going Outdoors and Risk of Poor Oral Health Among Older Japanese Adults: A Longitudinal Cohort From the Japan Gerontological Evaluation Study.

The association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive. We conducted a 3-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2-3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RRs) and 95% confidence intervals (CIs) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects. During the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight. Compared to going outdoors ≥4 times/week, the multivariable RRs of composite poor oral health conditions were 1.12 (95% CI, 1.05-1.20) for 2-3 times/week and 1.22 (95% CI, 1.07-1.39) for ≤1 time/week (P-trend < 0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs were 1.07 (95% CI, 0.97-1.19) and 1.36 (95% CI, 1.13-1.64) (P-trend = 0.002), 1.18 (95% CI, 1.06-1.32) and 1.30 (95% CI, 1.05-1.60) (P-trend < 0.001), and 1.15 (95% CI, 1.01-1.31) and 1.38 (95% CI, 1.08-1.77) (P-trend = 0.002), respectively. The frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.

Abstract TMP77: Oral Health as a Risk Factor for Spontaneous Intracerebral Hemorrhage: A Mendelian Randomization Analysis

Background: Poor oral health is a highly prevalent and modifiable risk factor that is associated with higher risk of cardiovascular disease, including ischemic stroke. However, the relationship between oral health and spontaneous intracerebral hemorrhage (ICH) has not been studied. We tested the hypothesis that genetically-determined poor oral health increases the risk of ICH. Methods: We conducted a two-sample Mendelian Randomization (MR) study using summary statistics from the largest genome-wide associations studies of oral health and ICH conducted to date. As genetic instruments (e.g., genetic risk variants for oral health), we identified 105 independent single nucleotide polymorphisms known to be associated with higher risk of caries, dentures and missing teeth at genome wide levels (p&lt;5x10 -8 ). The primary analysis employed summary statistics-based MR to assess the relationship between poor oral health and risk of ICH in any brain location. Secondary analyses evaluated deep and lobar ICH separately. Results: The primary analysis using the inverse variance-weighted MR method showed that genetically-increased risk of poor oral health was associated with a higher risk of ICH (OR 2.34, [1.08-5.06], p=0.029). Secondary analyses indicated a more potent association with deep ICH (OR 3.20 [1.34-7.6], p=0.008), whereas the link with lobar ICH was not statistically significant (OR 1.32 [0.53-3.27], p=0.543). Sensitivity analyses detected no horizontal pleiotropy in our findings (MR-PRESSO global test p-values &gt;0.05). Conclusion: Genetically-determined poor oral health is associated with an increased risk of ICH, particularly in the case of deep ICH. Because gene-disease associations are less prone to confounding, our results suggest that this association is causal. However, further analyses are needed to validate these results and identify the mediating mechanisms. Because oral health is an easily modifiable process, it may be a promising target for very early interventions focused on mitigating the risk of hemorrhagic stroke.

Prevention of oral diseases for the older person (Part 2).

Older adults often experience poorer levels of oral health than younger adults, especially if they have become dependent on a third party to support their daily oral care routine. However, the deterioration of oral health does not need to be a part of the ageing process. Most oral diseases are largely preventable with the daily removal of dental plaque that forms on teeth and dentures, using a fluoride toothpaste, eating a healthy diet and reducing any tobacco consumption. The dental team have a duty of care to ensure that older people receive evidence-based oral health preventative advice tailored to the individual, taking into account individual risk factors that can increase with age. This can include the clinical application of topical fluoride and minimally invasive dentistry. Older people at an increased risk of poor oral health include those with cognitive conditions, physical impairments and certain medical conditions. Care home residents face particular barriers to attaining a satisfactory standard of oral care which are discussed herein. Good oral health preventative routines must be established early after the diagnosis of progressive chronic conditions and will help to prevent the need for dental intervention later in life when treatment can be more difficult to tolerate. Inclusion of oral health prevention within health policy and legislation is necessary to improve the oral health for older people living in all health and care settings.

Prevention of oral diseases for the older person (Part 1).

Older adults often experience poorer levels of oral health than younger adults, especially if they have become dependent on a third party to support their daily oral care routine. However, the deterioration of oral health does not need to be a part of the ageing process. Most oral diseases are largely preventable with the daily removal of dental plaque that forms on teeth and dentures, using a fluoride toothpaste, eating a healthy diet and reducing any tobacco consumption. The dental team have a duty of care to ensure that older people receive evidence-based oral health preventative advice tailored to the individual, taking into account individual risk factors that can increase with age. This can include the clinical application of topical fluoride and minimally invasive dentistry. Older people at an increased risk of poor oral health include those with cognitive conditions, physical impairments and certain medical conditions. Care home residents face particular barriers to attaining a satisfactory standard of oral care which are discussed herein. Good oral health preventative routines must be established early after the diagnosis of progressive chronic conditions and will help to prevent the need for dental intervention later in life when treatment can be more difficult to tolerate. Inclusion of oral health prevention within health policy and legislation is necessary to improve the oral health for older people living in all health and care settings.

ORAL HEALTH INTERVENTIONS AND TREATMENTS FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT AND DIABETES

Abstract Older adults with cognitive impairment or diabetes have a higher risk of poor oral health. It is therefore critically important to develop effective intervention strategies to improve oral health for these vulnerable populations. In this session, we have included three studies that aim to achieve this goal using different strategies. The first study used stakeholder engaged processes to develop an app that provides information and guidance to caregivers (i.e., paid and family caregivers) to support their oral care provision for older adults with dementia. Findings from this study show that the app was well-accepted and provided an easily accessible tool for caregivers during care provision. The second study aimed to improve oral hygiene outcomes (plaque index and gingival index) for individuals with mild cognitive impairment (MCI) or mild dementia (MD). In this study, the authors identified and compared active behavior change techniques (BCT) used in a care partner-assisted oral health intervention for individuals with MCI and MD using a qualitative, secondary analysis of coaching sessions with care partners. Findings from this study provide insight into the mechanisms of change in individuals’ behaviors using these interventions. The third study was a systematic review aiming to explore the age differences in the effect of multi-component periodontal treatments on oral and metabolic indicators among individuals with periodontitis and diabetes. This study identified 115 eligible trials. This study found that the effect of multi-component periodontal treatments on periodontal outcomes and HbA1c may be more effective among younger populations. This is an Oral Health Interest Group Sponsored Symposium.

Assessing the impact of sociodemographic and lifestyle factors on oral health: a cross-sectional study in the Hungarian population.

Oral health, a critical aspect of overall well-being, is influenced by various sociodemographic and lifestyle factors, with poor oral health associated with systemic diseases and diminished quality of life. This cross-sectional study leverages data from the Hungarian European Health Interview Survey (EHIS) representative of the Hungarian population, to conduct a comprehensive examination of the intersection between these factors and oral health, aiming to identify potential risk factors and contribute to the development of targeted interventions. The research examined associations between sociodemographic/lifestyle factors and oral health. Statistical techniques included Pearson's Chi-square test, multivariate and ordinal logistic regression analyses. Weighting was applied to assure the representativeness of the population and enhance the validity of the survey results. The study identifies gender, age, education, financial status, smoking, and self-perceived oral health as key factors influencing oral health outcomes. Notably, regular dental visits significantly reduced the risk of poor oral health and caries. Females, non-smokers, university graduates, high-income individuals, and those with good self-perceived health had fewer missing teeth and better self-perceived oral health. Teeth extractions due to decay, especially when not replaced, significantly increased the perception of poor oral health, while regular dental visits improved it. The study highlights the need for personalized oral health interventions considering the different sociodemographic and lifestyle factors, along with promotion of healthy lifestyle, more frequent dental office visits and equitable dental care access. The findings offer the potential to inform regional oral health policies and prevention strategies, improving oral health and overall wellbeing.

Oral health and type 2 diabetes in a socioeconomic perspective

AimsThis study aimed to examine the association between type 2 diabetes and poor self-rated oral health, and to investigate whether such association is modified by socioeconomic position. MethodsWe conducted a cross-sectional study, including a population aged 18–75 years with self-reported type 2 diabetes (N = 41,884) and a sex-, age- and municipality-matched reference population from the Health in Central Denmark survey (2020). Multivariable logistic regression was used, and effect modification of indicators of socioeconomic position was examined. ResultsOral health was rated as poor in 37.0% of the population with type 2 diabetes and in 23.8% of the reference population without diabetes. Individuals with diabetes had higher risk of poor oral health (adjusted odds ratio (OR) 1.46 (95% CI: 1.39; 1.53)) than references. Interaction was seen between type 2 diabetes and highest attained education (p < 0.001). Stratified analyses showed higher risk of poor oral health in people with type 2 diabetes across all educational levels. ConclusionsPeople with type 2 diabetes were more likely to rate their oral health as poor than the reference population. Low education strengthened the association between diabetes and poor oral health.

Genetic Analyses of Oral Health and Neuroimaging Markers of Brain Health in Persons without Stroke (S49.001)

<h3>Objective:</h3> We hypothesize that genetically-determined poor oral health leads to worse neuroimaging brain health profiles in persons without stroke. <h3>Background:</h3> Oral health is a modifiable risk factor for stroke. However, the role of oral health on brain health among clinically asymptomatic persons remains understudied. <h3>Design/Methods:</h3> We conducted a two-sample Mendelian Randomization (MR) study. As instruments, we used 105 genetic variants known to be associated (p&lt;5×10⁻⁸) with a composite of caries, dentures and missing teeth in the Gene-Lifestyle Interactions in Dental Endpoints (GLIDE) Consortium. In stroke-free participants enrolled in the UK Biobank, we tested for associations between these genetic variants and white matter hyperintensity volume (natural log-transformed), fractional anisotropy and mean diffusivity. For the last two neuroimaging traits, we evaluated composite scores defined by the first principal component of measurements obtained across 48 brain regions. <h3>Results:</h3> Our primary analysis using the inverse variance-weighted MR method indicated that genetically-increased risk of poor oral health was associated with: (1) higher burden of silent cerebrovascular disease, as represented by a 30 % increase in white matter hyperintensities volumes (beta=0.30, SE=0.06 p-value=3×10⁻⁶), and (2) increased microstructural damage, as represented by a 43% change in composite FA scores (beta=0.43, SE=0.06; p=6×10⁻¹¹) and a 10% change in composite MD scores (beta=0.10, SE=0.03; p=0.005). Sensitivity analyses identified horizontal pleiotropy in our primary results, but an outlier-corrected analysis confirmed each of our findings (all p-values &lt;0.001). <h3>Conclusions:</h3> Among persons without stroke, genetically-determined poor oral health is associated with worse neuroimaging brain health profiles. Because gene-disease associations are immune to confounding, our results suggest that this association is causal. Early treatment of poor oral health may lead to significant brain health benefits, even in persons without stroke. <b>Disclosure:</b> Dr. Rivier has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pyxis Partners. Dr. Renedo has nothing to disclose. Dr. De Havenon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Integra. Dr. De Havenon has stock in Certus. The institution of Dr. De Havenon has received research support from NIH/NINDS. The institution of Dr. De Havenon has received research support from Regeneron Pharmaceuticals. The institution of Dr. De Havenon has received research support from AMAG Pharmaceuticals. The institution of Dr. De Havenon has received research support from AMGEN. Dr. De Havenon has received publishing royalties from a publication relating to health care. Sam Payabvash has nothing to disclose. Mr. Torres-Lopez has nothing to disclose. Thomas Gill has nothing to disclose. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.

Do transgender patients experience more barriers in accessing oral healthcare and suffer an increased risk of poor oral health: can this lead to a lower oral health-related quality of life?

Do transgender patients experience more barriers in accessing oral healthcare and suffer an increased risk of poor oral health: can this lead to a lower oral health-related quality of life?

Dental health of patients with X-linked hypophosphatemia: A controlled study.

The present study compared the dental health of patients with X-linked hypophosphatemia (XLH) with healthy age- and gender-matched controls to increase our knowledge of the impact of XLH on oral health. Twenty-two adult patients with XLH in the Stockholm region of Sweden were referred to the Department of Orofacial Medicine at Karolinska Institutet for an extended clinical and radiological examination. Pre-existing radiologic examinations of 44 healthy age- and gender-matched controls were retrieved from the Department of Oral Radiology, at Karolinska Institutet. The 22 patients with XLH (15 females, median age 38 years, range 20-71; 7 males, median age 49 years, range 24-67) had a significantly higher number of root-filled teeth compared to healthy controls (p = .001). In the XLH group, females had significantly better oral health than males, especially concerning endodontic and cariological status (p's = .01 and .02, respectively). Periodontal status differed non-significantly between the XLH and control groups. Patients with XLH had a significantly lower oral health status compared to a healthy population especially concerning endodontic conditions. Male patients with XLH had a higher risk of poor oral health compared to female patients with XLH.

Association between Asthma and Oral Health Symptoms in Adolescents.

Oral health is an indicator of patients' overall quality of life. Poor oral health among adolescents with asthma can affect their health in adulthood. This study researched the association between asthma and oral health symptoms in South Korean adolescents. Data from the 2020 Korea Youth Risk Behavior Web-based Survey were used. A total of 44,940 students participated in this study. The dependent variables were self-reported oral health symptoms. Asthma was the primary independent variable based on diagnosis in the past 12 months. The chi-squared test and multivariable logistic regression analysis were used. Students with asthma were associated with oral health symptoms, compared with those without asthma (boys, odds ratio (OR): 1.29, 95% confidence interval (CI) = 1.01-1.66; girls, OR: 1.94, 95% CI = 1.40-2.69). Poor health habits, such as low physical activity, higher sweetened beverage consumption, and fewer sleeping hours, were associated with oral health symptoms. Students who did not receive asthma treatment also had higher oral health symptoms (boys, OR: 1.29, 95% CI = 1.13-1.48, girls, OR: 1.34, 95% CI = 1.15-1.57). Students with absence due to asthma had a higher risk of oral health than those without asthma (boys, OR: 1.31, 95% CI = 1.17-1.46, girls OR: 1.28, 95% CI = 1.12-1.46). Students with asthma had a high risk of poor oral health among South Korean adolescents, suggesting more attention be given to regular dental check-ups and maintaining oral hygiene.

Abstract 126: Genetic Analyses Of Oral Health And Neuroimaging Markers Of Brain Health In Persons Without Stroke

Background: Oral health is a modifiable risk factor for stroke. However, the role of oral health in the brain health of clinically asymptomatic persons remains understudied. We hypothesize that genetically-determined poor oral health leads to worse neuroimaging brain health profiles in persons without stroke. Methods: We conducted a two-sample Mendelian Randomization (MR) study. As instruments, we used 105 genetic variants known to be associated (p&lt;5x10 -8 ) with a composite of caries, dentures and missing teeth in the GLIDE Consortium. In stroke-free participants enrolled in the UK Biobank, we tested for association between these genetic variants and white matter hyperintensity volume (natural log-transformed), fraction anisotropy and mean diffusivity. For the last two neuroimaging traits, we evaluated the first principal component of measurements obtained across 48 brain regions. Results: Our primary analysis using the inverse variance-weighted MR method indicated that genetically-increased risk of poor oral health was associated with: (1) higher burden of silent cerebrovascular disease, as represented by higher volumes of white matter hyperintensities (beta=0.24, SE=0.07 p-value=0.001), and (2) increased microstructural damage, as represented by lower fractional anisotropy (beta=-2.53, SE=0.38; p=1x10 -9 ) and higher mean diffusivity (beta=3.42, SE=0.41; p=2x10 -11 ). Sensitivity analyses identified horizontal pleiotropy in our primary results, but an outlier-corrected analysis confirmed all three initial results (all p-values &lt;0.001, Table 1). Conclusion: Among persons without stroke, genetically-determined poor oral health is associated with worse neuroimaging brain health profiles. Because gene-disease associations are immune to confounding, our results indicate that this association is causal. Early treatment of poor oral health may lead to significant brain health benefits, even in persons without stroke.

ASSESSING INTERPROFESSIONAL ORAL HEALTH EDUCATION AND PRACTICE FACILITATION OUTCOMES WITHIN LONG-TERM CARE

Abstract Older adults residing in long-term care (LTC) settings are at an increased risk of poor oral health due to comorbidities and limited ability to provide self-care. Routine oral care is essential for maintaining overall health. Coupled with resident vulnerability is a traditional lack of training and focus on oral health care in LTC. MOTIVATE (Maine’s Oral Team-Based Initiative: Vital Access to Education) is a pilot (N = 8 sites) interprofessional education program focused on daily oral health care within LTC, providing education and technical assistance to advance staff knowledge, skills, and attitudes about oral health. An evaluation was carried out using a pre/post survey design with instruments administered immediately before and after learning module completion along with a survey administered one month after implementation. Knowledge, attitudes, and oral health practices were assessed. A statistical comparison between baseline (N = 491) and post-launch (N = 215) scores revealed a statistically significant improvement (p &amp;lt; 0.001) across all knowledge and attitudes measures including the perceived importance of oral health, understanding of interprofessional roles among the care team, the role of oral health in supporting resident dignity and quality of life, and confidence in providing oral health care. Factors facilitating the transfer of knowledge to practice (N = 478) included personal interest in the topic (46.4%), knowing where to obtain information when needed (47.6%), and knowing how to apply learning to LTC daily care responsibilities (62.4%). Findings underscore the importance of oral health training and implications for practice transformation in an interprofessional context.

Associations Between Mental Health and Oral Health in Saudi Arabia: An Online Survey-Based Cross-Sectional Study.

Background Mental disorders cause psychological stress and lead to poor lifestyle behaviors and an increased risk of poor oral health. This study aims to explore the potential association between mental illnesses with oral health and personal oral care in the Saudi population. Methodology Saudi Arabians aged ≥18 years were eligible to participate in this cross-sectional study. The study questionnaire had the following five sections: demographics, a brief depression severity measure (Patient Health Questionnaire-9), a brief generalized anxiety disorder measurement tool (Generalized Anxiety Disorder-7), an oral health measurement tool, and personal oral health care. The data were analyzed using SPSS software version 26 (IBM Corp., Armonk, NY, USA). The results were presented as numbers and (percentages) or mean and standard deviations (SD). Results This study included a total of 522 participants. The mean scorefor dental health and care was 4 (SD = 1.9) and 13.6 (SD = 1.9), respectively, reflecting a moderate level of dental health and positive dental care. Males had better oral health, whereas females had better dental care. A college degree or higher was linked to better dental care, and chronic diseases were linked to lower dental health scores. Minimal depression had a significantly higher dental care score than mild-to-severe depression. Depression and anxiety did not affect dental health. Conclusions This study showed that minimal depression was associated with a higher dental care score than mild-to-severe depression. However, the degree of depression was not associated with dental health. Furthermore, anxiety had no association with dental health or care.

Interventions supporting community nurses in the provision of Oral healthcare to people living at home: a scoping review

BackgroundOral health is a critical issue for public health and poor oral health is associated with significant chronic health conditions and lower quality of life. There has been little focus on providing oral health care to people who receive care in their own homes, despite the high risk of poor oral health in older people. Nurses practicing in the community are well placed to deliver this care, but little is known about how to build this capability through education or training interventions.MethodsA scoping review methodology was employed to find and review studies of oral health interventions involving populations of people receiving care in their own home or those nurses who deliver this care. The research question asked what previous research tells us about oral health interventions delivered by nurses in the community. Data was extracted for four areas: setting and type of intervention, patient outcomes, changes to nursing practice and implementation and process evaluations of interventions.ResultsTwo thousand eighty papers were found from the searches, and only nine were ultimately deemed eligible for inclusion in the review. Included studies spanned community nursing for older people (n = 3) and health visiting or community nursing for children and infants (n = 6). Patient outcomes were generally positive, but this is based on a low level of evidence. Changes to practice including increased oral health care administered by nurses were found, but this required professional support to be sustainable.ConclusionsThis review has found that there is a clear gap in the research around interventions designed to be used by community nurses to improve oral health care for people receiving care in their own homes. The results also suggest that any future intervention must make use of a participatory, co-design approach and consider the complex setting of nursing practice in the community and the barriers to delivering this care, such as time pressure and lack of prior experience.