Oral Health Management for Children, Adolescents, and Adults

Poor oral hygiene and excessive consumption of soda are among the main drivers of systemic health issues in adolescents in the United States. This non-randomized pilot clinical trial focused on the effects of a health text message system and smartphone-based intervention on adolescent tooth-brushing behavior and dietary choices, with a convenience sample of 94 participants aged 12 to 14 years old. A group of 75 participants agreed to use a tooth-brushing app and received a health text message; the other group of 15 agreed to use the tooth-brushing app, but did not receive a health text message. Saliva specimens were collected directly before and at the end of each experiment; changes in the salivary presence of cariogenic bacteria over the duration of the study were evaluated and compared with the demographics and behavioral variables. Within the text message group, 5% of participants increased the frequency of daily tooth brushing. Within the non-intervention group, 29% of participants increased the frequency of their daily tooth brushing. There were reductions in the total salivary bacteria and total streptococci in both groups (p < 0.001), but no change in the presence of cariogenic Mutans streptococci. Raising adolescents’ consciousness of oral health behavior resulted in marginal to moderate improvements to oral hygiene and dietary choices, as well as reductions in total salivary bacteria. Full article

Treatment of unilateral or bilateral maxillary lateral incisor agenesis is challenging, time-consuming, expensive, and requires careful treatment planning, predictability, and esthetics. This review aimed to identify differences in esthetic perception among orthodontists, general dentists, differentiated dentists, and laypersons, which may interfere with treatment options. EBSCO, PubMed, ScienceDirect, Cochrane Library databases, and Google Scholar were searched using keyword pairing and a Boolean expression, “(congenitally missing OR agenesis OR hypodontia) AND (maxillary lateral incisors) AND (esthetic perception OR smile) AND (laypersons OR dental professional OR general dentist OR orthodontists).” Reviews and case studies were excluded. A total of 13 studies were selected for qualitative analysis (adapted ROBINS-I) and 11 were selected for meta-analysis (p < 0.05) after being sub-grouped into “Opening vs. Closure” and “No remodeling vs. Dental remodeling vs. Dental and gingival remodeling” groups. A meta-analysis evaluated the magnitude of the difference between groups based on differences in means and effect sizes (α = 0.05; 95% CI; Z-value 1.96), revealing that the esthetic perception of maxillary lateral incisor agenesis treatment remains controversial even among professionals. Gingival remodeling was not valued compared to isolated dental remodeling. Studies lack rigorously comparable methodologies. Discussion with the patient is pertinent in doubtful situations, as the best treatment option remains unclear, and overtreatment should be avoided. Full article

Background: The aim of this systematic review was to analyse the published literature on dental infections leading to hospitalisations in Australia. It was hoped that understanding the patterns and trends would form a basis for improved preventive and management policies. Methods: An electronic search was performed using Web of Science, Medline via Ovid and Google Scholar. Inclusion and exclusion criteria were applied. The included studies were analysed for demographics, aetiology, management, length of hospital stay and outcome of dental infections requiring hospitalisation. Results: Nine retrospective studies were eligible for inclusion. A total of 2196 cases of dental infections leading to hospitalisations were reported, with a male predominance (55–67%). Mental health issues, illicit substance abuse and immunosuppression were the main associated comorbidities (up to 58%). Dental caries (59–90%) and pericoronitis (10–19%) were the leading causes of dental infections. Empirical antibiotics were utilised in up to 75% of cases prior to hospital presentation. Six mortalities were reported. Conclusions: The available published data show that dental infection is a significant public health problem. However, only general conclusions were possible due to the variably small sample size and data collection that was inconsistent and incomplete across studies. Improved data collection is required to develop policies for prevention and management. Full article

Background: Health coaching-based interventions can support behaviour change to improve oral health. This scoping review aims to identify key characteristics of health coaching-based interventions for oral health promotion. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute manual for evidence synthesis were used in this review. A search strategy using medical subject heading terms and keywords was developed and applied to search the following databases: CINAHL, Ovid, PubMed, Cochrane Library and Scopus. Thematic analysis was used to synthesise the data. Results: Twenty-three studies met the inclusion criteria and were included in this review. These studies were predominantly based on health coaching and motivational interviewing interventions applied to oral health promotion. The following are the characteristics of health coaching-based interventions extracted from themes of the included studies: (a) Health professionals should be trained on the usage of motivational interviewing/health coaching interventions; (b) oral health professionals should acquire motivational techniques in their practice to engage patients and avoid criticisms during the behaviour change process; (c) routine brief motivational interviewing/health coaching intervention sessions should be introduced in dental clinics; (d) traditional oral health education methods should be supplemented with individually tailored communication; and (e) for cost-effectiveness purposes, motivational interviewing/health coaching strategies should be considered. Conclusions: This scoping review reveals that health coaching-based techniques of health coaching and motivational interviewing can significantly impact oral health outcomes and behaviour change and can improve oral health professional–patient communication. This calls for the use of health coaching-based techniques by dental teams in community and clinical settings. This review highlights gaps in the literature, suggesting the need for more research on health coaching-based intervention strategies for oral health promotion. Full article

Oral hygiene management issues vary across types and clinical stages of dementia. We aimed to clarify the issues related to oral hygiene management in older adults with Alzheimer’s disease (AD) according to stages defined by the Functional Assessment Staging of Alzheimer’s Disease (FAST). In all, 397 records (45 men and 352 women; average age, 86.8 years; age range, 65–106) from older adults with AD were used for the cross-sectional study. We used data from a cohort of older adults (≥65 years old) who required long-term care and lived in the Omorimachi area of Yokote City, Akita Prefecture, Japan. Multilevel logistic regression analysis was conducted to examine the associations of the FAST stage, set as the exposure variable, with oral hygiene management parameters set as outcome variables. Compared to the reference category (combined FAST stage 1–3), FAST stages 6 and 7 had significantly higher odds ratios for refusal of oral health care, dependence in performing oral health care, and rinsing and gargling disability. FAST stages 4 and 7 were associated with dental plaque accumulation. Oral health care for older adults with AD should be planned appropriately according to dementia severity. Full article

The presence of a supernumerary tooth is one of the most common dental anomalies, and surgical treatment is often required to address this anomaly. Moreover, it may lead to malocclusion, and long-term follow-up is important to monitor its status. A 4-year-and-11-month-old boy was referred to our hospital for dental caries treatment. At 5 years and 5 months of age, a radiographic examination showed a supernumerary tooth (first supernumerary tooth) near the permanent maxillary left central incisor, and it was extracted 6 months later. Eighteen months after the extraction of the first supernumerary tooth, a new supernumerary tooth (second supernumerary tooth) was detected in the same region, which was extracted when the patient was aged seven years and seven months. Seven months later, another supernumerary tooth (third supernumerary tooth) was detected and extracted immediately. However, the permanent maxillary left central incisor did not erupt spontaneously even after 6 months. Therefore, surgical exposure was performed, and the central incisor erupted into the oral cavity. This report describes our experience with this patient with three metachronous supernumerary teeth and their management until the eruption of the permanent tooth. This report highlights the importance of long-term follow-up after supernumerary tooth extraction until the permanent teeth in that region have erupted completely. Full article

This cross-sectional study was to evaluate the association between the oral health-related quality of life (OHRQoL) of older Thai people with obesity and oral health indicators. General and oral conditions were assessed. Oral dryness was determined using the Xerostomia Inventory-11 (XI-11) and clinical oral dryness score (CODS). OHRQoL was evaluated by the oral health impact profile (OHIP-14). Participants were aged 60–86 years; 73 (59.3%) were overweight or obese, and 50 (40.7%) were normal weight. Older patients with obesity had almost four times the rate of hypertension (OR = 3.59; 95%CI:1.34–9.60; p = 0.002), more missing teeth (p = 0.025), and higher CODS (p = 0.014) than those without obesity. The total XI-11 scores were positively associated with the total CODS, after adjusting for BMI (r = 0.267, p = 0.003). Those with obesity had almost three times the tendency for a negative OHRQoL compared with the non-obese (OR = 2.73; 95%CI:1.12–6.71; p = 0.04). After adjusting for all related factors, the chances of predicting an OHIP-14 score of four based on obesity and total XI-11 score were 4.42 (95%CI:1.57–12.47; p = 0.005) and 1.11 (95%CI:1.02–1.20; p = 0.013), respectively. Obesity had an increasingly undesirable negative impact on the OHRQoL of older Thai people and was influenced by BMI and oral dryness. Full article

Oral health behaviors, risk aversion, and the health belief model are associated with health behaviors. However, there have been few studies that investigated the association between these factors and the willingness to undergo regular dental check-ups. The purpose of this cross-sectional study was to investigate the associations between the willingness of Japanese university students to undergo regular dental check-ups and oral health behaviors, the health belief model, and absolute risk aversion. An analysis was conducted with the cooperation of questionnaire respondents (n = 748) who underwent dental check-ups at Okayama University. The students answered questionnaires on oral health behaviors, the health belief model, absolute risk aversion, and willingness to undergo regular dental check-ups. The logistic regression analysis showed significant positive associations (p < 0.05) between oral health behaviors (use of the inter-dental brush and the dental floss) and the health belief model with the willingness to undergo regular dental check-ups. However, there was no significant association with absolute risk aversion (p > 0.05). These results suggest that willingness to undergo regular dental check-ups was associated with oral health behaviors and the health belief model, but not with absolute risk aversion. Full article

Background: This controlled clinical trial evaluated the impact of a specific collagen peptide food supplement on parameters of periodontal inflammation in aftercare patients. Methods: A total of 39 study patients were enrolled. At baseline, bleeding on probing (BoP; primary outcome), gingival index (GI), plaque control record (PCR), recession (REC) and probing pocket depth (PPD) for the calculation of the periodontal inflamed surface area (PISA) were documented. After subsequent professional mechanical plaque removal (PMPR), participants were randomly provided with a supply of sachets containing either a specific collagen peptide preparation (test group; n = 20) or a placebo (placebo group; n = 19) to be consumed dissolved in liquid once daily until reevaluation at day 90. Results: PMPR supplemented with the consumption of the specific collagen peptides resulted in a significantly lower mean percentage of persisting BoP-positive sites than PMPR plus placebo (test: 10.4% baseline vs. 3.0% reevaluation; placebo: 14.2% baseline vs. 9.4% reevaluation; effect size: 0.86). Mean PISA and GI values were also reduced compared to baseline, with a significant difference in favor of the test group (PISA test: 170.6 mm² baseline vs. 53.7 mm² reevaluation; PISA placebo: 229.4 mm² baseline vs. 184.3 mm² reevaluation; GI test: 0.5 baseline vs. 0.1 reevaluation; GI placebo: 0.4 baseline vs. 0.3 reevaluation). PCR was also significantly decreased in both experimental groups at revaluation, but the difference between the groups did not reach the level of significance. Conclusions: The supplementary intake of specific collagen peptides may further enhance the anti-inflammatory effect of PMPR in periodontal recall patients. Full article

Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status. Full article

This study investigates the effects of professional ethics on the job satisfaction of dental technicians and dental hygienists among health and medical personnel. From 1 July to 30 September 2021, a survey was conducted with 178 dental technicians and dental hygienists. Frequency analysis, correlation analysis, and multiple regression analysis were performed. The collected data were processed using SPSS version 22.0 statistical program (IBM, Armonk, NY, USA). The significance level was set to 0.05. As factors influencing the professional ethics of dental technicians and dental hygienists, diligence, reduced leisure, work orientation, and time saving were found to affect job satisfaction. In addition to morality, various elements of professional ethics and their causal relationships with job satisfaction were investigated. In the future, in preparation for the increasing ethical problems in the medical environment, education on professional ethics should be standardized and conducted more systematically. Full article

Despite the fact that healthy, sugar-reduced nutrition has been propagated by the media and in schools for years, dental caries in children remains a major health problem worldwide, caused primarily by an unhealthy diet. The objective of this study is to compare statements on nutrition and hygienic knowledge with those on children’s actual dietary and hygienic behavior. A random sample of 554 children and adolescents aged 3–19 years was enrolled. Designed as a cross-sectional interview-based community survey, this study was conducted consecutively during three one-day public science-promoting events at the Saarland University’s Medical Faculty. Participants’ oral hygiene and nutritional knowledge was profound; however, the reported translation into practice showed deficiencies. Boys and younger children (3–10 years) often showed better oral hygiene knowledge than girls and older children (over 11 years) but had problems implementing it into their daily life practice. In contrast, girls and older children often showed less oral hygiene knowledge but reported more favorable behavior. Finally, children up to the mixed dentition phase preferred drinking sweets more often than older children, posing a risk to the developing permanent dentition. Intensifying well-known controlled motivation training approaches to encourage children and adolescents is recommended to put their knowledge into practice. Full article

The periodontal inflamed surface area (PISA) is a useful indicator of periodontal status. However, its formula was based on a meta-analysis involving five countries, and racial differences in tooth root morphology could have affected the calculations. This study aimed to develop a Japanese version of the PISA and compare it with the original version. The formulas reported by a previous Japanese study calculating the amount of remaining periodontal ligament from clinical attachment measurements were used to calculate the PISA. A simulation was performed to compare the Japanese version with the original version by inputting probing pocket depth (PPD) from 1 to10 mm and by using clinical data. The PISA values in the Japanese version were larger and smaller than those in the original version for PPDs of 1–5 mm and 6–10 mm, respectively. The PISA values for the clinical data from the Japanese version were significantly higher than those from the original version. Both versions of the PISA values correlated equally well with body mass index. The Japanese version of the PISA can be used to assess the amount of inflamed periodontal tissue resulting from periodontitis in Japanese populations, taking into account racial heterogeneity in root morphologies. Full article

In modern society, evaluation and management of psychological stress may be important for the prevention of periodontal disease. The purpose of this study was to examine the relationship between psychological stress (vitality and mental activity) evaluated by Mind Monitoring System (MIMOSYS) and periodontal status. Forty students of Okayama University underwent the oral examination and self-reported questionnaire on the first day (baseline) and the 14th day (follow-up). Voice recording was performed every day with the MIMOSYS app during the whole study period. The participants completed the Patient Health Questionnaire (PHQ)-9 and Beck Depression Inventory (BDI) at baseline and at follow-up. Spearman’s rank correlation coefficient was used to determine the significance of correlations among variables. The PHQ-9 and BDI scores were negatively correlated with vitality in the morning. Change in vitality in the morning was significantly correlated with changes in periodontal inflammation. Mental activity was significantly correlated with change in mean probing pocket depth. This result shows that measurement of psychological stress using a voice-based tool to assess mental health may contribute to the early detection of periodontal disease. Full article

Background: Children suffer from various oral and periodontal diseases. Dental caries is one of the most prevalent oral diseases among children in the world. This study was conducted to identify the prevalence and risk factors of dental caries in children in Mymensingh, Bangladesh. Methods: A cross-sectional study was conducted on 362 pediatric patients who attended the Dental Unit of Mymensingh Medical College from March to September 2019. The sample size was calculated using a statistical formula and the children were selected using a systematic random sampling technique. Children and their guardians were interviewed and data were recorded using a structured questionnaire. Risk factors were analyzed using multivariate logistic regression. Results: The overall prevalence of dental caries was 82.7%. The prevalence of caries was significantly higher in aged children (8–10 years) and also in rural, low-income, and illiterate families. Seven significant risk factors were identified that included residence in the rural area (OR: 7.31 [1.73–30.83]), a parental income of BDT ≤ 20,000 per month (OR: 4.75 [1.49–15.05]), reduced duration (≤1 min) of teeth cleaning (OR: 18.54 [2.05–168.17]), teeth cleaning before breakfast (OR: 93.30 [10.95–795.32]), the spoon-feeding method (OR: 12.57 [2.09–75.61]), long-term (37–48 months) breastfeeding (OR: 212.53 [8.69–5195.25]), and family oral problem (OR: 8.20 [2.57–26.16]). Conclusions: The prevalence of dental caries among the children in Mymensingh is very high and was associated with residence in rural areas, parental income, reduced duration of teeth cleaning, teeth cleaning before breakfast, the spoon-feeding method, long-term breastfeeding, and family oral problems. Full article

The aim of the current study is to observe how different pediatric drugs and tooth brushing affect the color stability of different esthetic restorative materials. Three restorative materials (composite, compomer, and glass ionomer cement (GIC)) were each used to produce 72 specimens (10 mm × 2 mm). The specimens were divided into six groups and immersed in distilled water and five different pediatric drugs (amoxicillin, ibuprofen, ventolin, paracetamol, and multivitamins). Each group was divided into two subgroups (brushed and non-brushed). Over the course of two weeks, the specimens were agitated for one minute every eight hours. Color changes in all the specimens were evaluated using a spectrophotometer at 1 and 2 weeks. GIC showed a change in color that was significantly greater than that in all the other materials in each solution, except for those in amoxicillin. After a period of 1 to 2 weeks, the most noticeable change in color was detected in the amoxicillin composite and amoxicillin GIC unbrushed groups, and after 2 weeks, a significant difference was found in the ventolin GIC unbrushed group. The color stability of the restorative materials used in pediatric dentistry can be influenced by using popular liquid pediatric medications. GIC was the least color-stable material when subjected to liquid medications. Full article

This study accesses the impact of lady health worker (LHWs) visits in the community and distance to a healthcare facility on the nutritional status of under-five children. Additionally, it explores the perceptions and attitudes of the community about the performance of LHWs. A self-administered instrument was applied to gather data on different parameters, such as children’s height, age, weight, and socioeconomic status from 384 rural households in a marginalized district of Punjab province with the help of a purposive random sampling technique. The binary logistic regression model was employed for the computation of the probability of malnutrition. The prevalences of stunting, underweight children, and wasting in the district were 34.8%, 46.1%, and 15.5%, respectively. The logistic results illustrate that those households in which LHW visits occur regularly within 15 days (OR = 0.28 with 95% CI: 0.09–0.82) have a lower probability of malnutrition prevalence among their children. The distance to the health facility shows that the odds of malnutrition were higher from 3–4 Kilometers (Km) (OR = 2.61, 95% CI: 0.85–8.14), and odds were also higher for the ≥5 km category (OR = 2.88, 95% CI: 0.94–8.82). Children from richer families had lower chances of being malnourished (OR = 0.28, 95% CI: 0.07–1.14). Furthermore, the respondents show a positive attitude towards LHWs. They have given the first rank to their performance being beneficial to mothers and childcare, especially on checkups and safe deliveries, while they have shown negative responses and given lower ranks to their performance due to irregular visits (6th rank) and poor community awareness (7th rank). We conclude that LHWs’ regular visits to targeted households and less distance to healthcare facilities reduce the malnutrition risk in under-five children. Full article

The occupational environment is an important factor for oral health because people spend a long time in the workplace throughout their lives and are affected by work-related stress and occupational health policies. This study aimed to review evidence for the association between occupation and oral health status and behaviors. A literature search of PubMed was conducted from February to May 2022, as well as a manual search analyzing the article origins. Articles were screened and considered eligible if they met the following criteria: (1) published in English; (2) epidemiological studies on humans; and (3) examined the association between occupation and oral health status and behaviors. All 23 articles identified met the eligibility criteria. After full-text assessments, ten articles from Japan were included in this review: four on the association between occupation and dental caries, three on occupation and periodontal disease, two on occupation and tooth loss, and one on occupation and oral health behaviors. An association was apparent between occupation, oral health status and behaviors among Japanese workers. In particular, skilled workers, salespersons, and drivers who work longer hours and often on nightshifts, tended to have poor oral health. Full article

In Ecuador, national data on dental caries are scarce and the detection of incipient enamel lesions has been omitted. The objective of this study was to determine the prevalence of caries in school children aged 6 and 12 years of both sexes, belonging to urban and rural areas of three provinces of the country, using the International Caries Detection and Assessment System (ICDAS II). The sample consisted of 665 children from public schools, examined according to ICDASII. Caries prevalence and caries index were established using ICDAS II 2-6/C-G and ICDAS II 4-6/E-G criteria for comparison with WHO indicators. The Mann–Whitney U statistical test was used for comparison of two groups, the effect size was measured with the correlation coefficient. and the Kruskal–Wallis H test (p < 0.05) for multiple comparisons. Caries prevalence exceeded 87% for primary and permanent dentition. There were no significant differences according to province (p ≤ 0.05). The caries index at 6 years was 6.57 and at 12 years 9.21. The SIC was high at 12 years in rural areas. The prevalence of caries in the population studied was high despite the preventive measures established by health agencies. Full article

Introduction: Tongue strength reserve is the difference between the maximum isometric pressure (MIP) and swallowing pressure of the tongue. People with decreased tongue strength reserve may have a higher risk of presbyphagia or dysphagia. Thus, this study explored the effects of tongue strengthening exercise (TSE) on tongue strength reserve and detraining effects in healthy adults. Materials and Methods: In total, 102 healthy volunteers without any reported history of speech or swallowing deficits were recruited and assigned to experimental (n = 50) and control groups (n = 52). Exercises in the experimental group consisted of compressing an air-filled bulb between the tongue and hard palate for 30 min a day, 5 days a week, for 8 weeks. Thereafter, the experimental group underwent a 4-week detraining period. Results: Following the TSE training, posterior tongue strength reserve (F = 4.92, p = 0.029) of the experimental group was significantly higher than that of the control group. No significant detraining effects were observed on the MIP and swallowing pressure from 4 weeks after the completion of TSE training. Conclusions: According to the study results, TSE may be an effective approach for improving swallowing function. Full article

Dental care for hospitalized patients can improve nutritional status and feeding function while reducing complications. However, such care in Japan is not uniformly provided. This investigation examined the presence and characteristics of hospitals where dentists work and the collaboration between medical and dental teams. This cross-sectional study involves 7205 hospitals using the administrative reports on the Hospital Bed Function of 2018. Indicators described were the proportion of hospitals employing dentists, those providing perioperative oral care, and those with a nutrition support team (NST) that included dentists. A two-level logistic regression model was performed using hospital-based and secondary medical area-based factors to identify factors associated with hospitals employing dentists and dental care services. Some hospitals had poor medical and dental collaboration, even those with dentists, and no-dentist hospitals had rare medical and dental collaboration. Factors positively associated with hospitals that employed dentists were diagnosis-procedure-combination-hospital types, the Japanese government-established hospitals compared with hospitals established by public organizations, among others. In conclusion, the present study found poor medical and dental collaboration was observed in some hospitals and that hospital type, region, and hospital founders were associated with the performance of collaborative medical and dental care. Full article

This retrospective case-control study is the first to examine the spatial conformity between pacifiers and palates in 39 preterm infants (12 females, 27 males) and 34 term infants (19 females, 15 males), taking into account the facial-soft-tissue profile and thickness. The shape of 74 available pacifiers was spatially matched to the palate, and conformity was examined using width, height, and length measurements. In summary, the size concept of pacifiers is highly variable and does not follow a growth pattern, like infant palates do. Pacifiers are too undersized in width, length, and height to physiologically fit the palate structures from 0 to 14 months of age. There are two exceptions, but only for premature palates: the palatal depth index at 9–11 months of age, which has no clinical meaning, and the nipple length at <37 weeks of age, which bears a resemblance to the maternal nipple during non-nutritive sucking. It can be concluded that the age-size concept of the studied pacifiers does not correspond to any natural growth pattern. Physiologically aligned, pacifiers do not achieve the age-specific dimensions of the palate. The effects attributed to the products on oral health in term infants cannot be supposed. Full article

Dental eruption refers to the vertical displacement of a tooth from its initial non-functional towards its functional position. Tooth eruption disorders may be expressed in various clinical conditions, which may be grouped as “primary retention” and “secondary retention”. The purpose of this article is to review the literature and the clinical parameters of the various conditions related to tooth eruption disorders. Materials and Methods: The search strategy of this critical review included keywords in combination with MeSH terms in Medline, Scopus, and Cochrane Library until February 2022 and only in English. Results: “Primary Failure of Eruption” (PFE) occurs during the eruption process and includes clinical characteristics of both primary and secondary retention, which make diagnosis difficult. PFE is distinguished by Types I and II. In Type I, the defect in the eruption process occurs in all the relative teeth at the same time, whilst in Type II, the clinical expressions vary in multiple quadrants of the mouth, and the second molars erupt more. The variability of the PFE’s clinical spectrum seems to be connected to a genetic origin. The differential diagnosis among single ankylosis, secondary retention, and PFE is based on the occlusal relationship between the upper and the lower teeth distally, most commonly the first molar, which has not yet fully erupted. The treatment approach depends on many factors and combines surgical and orthodontic techniques. Full article

This systematic review evaluates published evidence on oral hygiene interventions conducted in Alzheimer’s disease (AD) patients. PubMed, Embase, Cochrane Library, CINAHL, Dentistry & Oral Sciences Source, and Web of Science were searched for articles published up to 19 April 2021. The main outcomes of interest were the Plaque index score (PI), oral health knowledge of participants or their caregivers, and behaviors and attitudes towards oral hygiene. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Institutes of Health. The study was conducted under PROSPERO registration code CRD42021247733. Two studies met the inclusion criteria. One was a pre-post study conducted in Brazil, and the other was a prospective cohort study carried out in China. The sample sizes of these studies were 29 and 168, respectively. Both studies were carried out in institutionalized patients and presented a significant loss to follow-up. The PI and gingival index scores both improved after the application of the respective interventions, yet the differing methodologies used precluded further comparisons. The studies were deemed to be of good and regular quality, respectively. Despite the need for more comprehensive interventions to ensure a better oral health status and a higher quality of life for AD patients, an alarming lack of studies have been conducted in this population. Full article

Understanding the impact of the COVID-19 pandemic on dental emergencies. A systematic review of the literature (PubMed/Scopus) searching for articles on COVID-19 and dental abscess and a retrospective cohort study with quantitative/qualitative data analysis of our hospital E.R. patients admitted for cervico-facial abscess of dental origin were performed. Thirteen studies could be included in the review, concerning characteristics/management of patients with dental emergencies in hospitals/private practices, generally with poor evidence. For the retrospective analysis, 232 consecutive patients were included (100 study vs. 132 control). The prevalence of dental emergencies (abscess) and relative complications (mediastinitis, exitus) increased. Dental care availability was limited, with strong heterogeneity amongst regions/nations. At-risk (aerosol-generating) procedures were generally avoided, and hospitalization length reduced. Comorbidity patients and males seem less likely to restore regular dentist attendance during the post-lockdown pandemic. Despite the poor scientific evidence, COVID-19 seems to have impacted dental emergencies through limited routine dental care availability and influence on physicians’ and patients’ behaviour. Full article

Background: Poor oral health practices and high levels of dental caries have been reported among children in the developing world. Video games have been successful in promoting oral health in children. The aim of this study was to assess the impact of an oral-health-education video game on children’s dietary knowledge and dietary and toothbrushing practices; Methods: Two Schools in Amman, Jordan were randomly selected and assigned to either intervention or control. Six- to eight-year old children took part. The intervention group played the oral-health-education video game; the control group received no intervention. The groups were compared in terms of changes in: child dietary knowledge, dietary and toothbrushing practices, plaque scores, and parental familiarity with preventive treatments. Data were submitted to statistical analysis with the significance level set at p ≤ 0.05. Results: Two hundred and seventy-eight children took part. Most (92%) had carious teeth. At baseline, children reported having more than one sugary snack a day and only 33% were brushing twice a day. Most parents were unaware of fluoride varnish (66%) or fissure sealants (81%). At follow-up, children in the intervention group had significantly better dietary knowledge, and parents in both groups became more familiar with fluoride varnish. There were no significant changes in children’s plaque scores, toothbrushing and dietary practices, or parental familiarity with fissure sealants in either group. Conclusions: Using an oral-health-education video game improved children’s dietary knowledge. However, future efforts should target children together with parents, and need to be supplemented by wider oral-health-promotion. Full article

Background: Oral care reduces the incidence of ventilator-associated pneumonia. In addition, it is important that critically ill patients to maintain their oral health in order to restore their quality of life and to receive adequate nutrition after recovery. Objective: The purpose of this study was to evaluate the effect of professional oral hygiene care (POHC) on the oral health status of patients using a ventilator. Methods: Fifty-seven ventilated trauma patients were admitted to a tertiary medical institution. For 5 days, the dental hygienist performed POHC every 24 h along with routine oral hygiene care (ROHC) every 8 h for the experimental group (Exp.) (n = 29), whereas only ROHC was provided the control group (Cont.) (n = 28). Oral health status was evaluated using a modified bedside oral exam (MBOE). Results: There was no significant difference between the two groups in the total MBOE score up to 48 h after admission. However, the difference between the two groups was significant for MBOE (F = 16.10, p = 0.000), gingiva (F = 6.02, p = 0.018), buccal mucosa (F = 4.21, p = 0.046), and dental plaque score after 72 h (F = 13.15, p = 0.000). Conclusion: This study confirms the importance of POHC in improving the oral health. Full article

Probiotics have aroused increasing concern as an intervention strategy for periodontitis (PD), but their underlying mechanism of action remains poorly characterized. Regarding the significance of oral microbiota dysbiosis related to PD, we predicted that the preventive activity of probiotics may be influenced by suppressing the bacterial pathogenicity. Herein, we investigated the effects of Lactobacillus paracasei L9 (L9) and Bifidobacterium animalis A6 (A6) on PD using a rat model, and demonstrated a regulatory effect of probiotics on oral flora from a metagenomics perspective. Oral administration of A6 or L9 effectively relieved gingival bleeding, periodontal inflammatory infiltration, and alveolar bone resorption. In addition, A6 or L9 treatment reduced the inflammatory response and increased the expression of anti-inflammatory cytokines, which we expected to ameliorate alveolar bone resorption as mediated by the receptor activator of the nuclear factor-κB ligand/OPG signaling pathway. More importantly, using metagenomic sequencing, we showed that probiotics significantly altered the taxonomic composition of the subgingival microbiome, and reduced the relative proportions of pathogenic bacterial genera such as Streptococcus, Fusobacterium, Veillonella, and Escherichia. Both probiotics significantly inhibited levels of bacterial virulence factors related to adherence, invasion, exoenzyme, and complement protease functions that are strongly correlated with the pathogenesis of PD. Our overall results suggest that A6 and L9 may constitute promising prophylactic agents for PD, and should thus be further explored in the future. Full article

(1) Background: Nano-hydroxyapatite (nHAp) has been reported to have a remineralizing effect on early carious lesions. The objective of this scoping review was to analyze the remineralization potential of nano-hydroxyapatite (nHAp)-containing dentifrices, by mapping the existing literature. (2) Methods: This review was performed using the PRISMA-ScR Checklist, which is an extension of the PRISMA Checklist for Systematic Reviews and Meta-Analyses. In this study, the population, concept, and context (PCC) framework was used to find relevant papers published between 2010 and 2021. Nano-hydroxyapatite (nHAp) and dentifrices containing nHAp as one of the ingredients were the two main concepts of the research question. MeSH phrases, keywords, and other free terms relevant to nano-hydroxyapatite and dentifrices were used to search the literature databases. (3) Results: Preliminary searches yielded 59 studies; the title and abstract screening results excluded 11 studies. The remaining studies were thoroughly reviewed by two reviewers on the basis of the inclusion and exclusion criteria. Finally, 28 studies were included, and 20 studies were excluded. Most of the studies that were included reported that when nHAp was used alone, it had many different effects, such as remineralization, caries prevention, less demineralization, brighter teeth, less pain, and remineralization of enamel after orthodontic debonding. (4) Conclusions: Dentifrices that contain nHAp offer a variety of therapeutic and preventative effects. Currently, there is insufficient evidence to support the efficacy of nHAp dentifrices in primary teeth. Additional long-term investigations using standardized protocols are required to reach decisive conclusions about the effects of nHAp dentifrices on primary and permanent dentitions. Full article

Previous studies on individual-level variables have improved our knowledge base of oral health service use. However, environmental or contextual variables are also important in understanding oral health disparities in racial and ethnic neighborhoods. Based on Bronfenbrenner’s ecological framework, this study examines the geographic availability of oral health providers in Washing-ton DC, U.S.A. Census tract-level data were drawn from the American Community Survey, joined with tract-level shapefiles, and overlaid with the geographic location of dental services throughout the city. Visual maps, descriptive statistics, and spatial lag regression models showed that census tracts with higher concentrations of African Americans were significantly farther from their nearest oral health providers (r = 0.19, p < 0.001), after controlling for neighborhood poverty rate, median age, and gender. Such findings confirm that in urban areas with highly di-verse populations such as Washington DC, racial disparities in oral health care access are signifi-cant. The study highlights that identifying neighborhoods with limited oral health care providers should be a priority in diminishing racial disparities in oral health service access. Improving access to racial/ethnic minority communities, especially African American neighborhoods, will require changes in health policies and programs, workforce development, resource allocation, community outreach, and educational programs. Full article

(1) Background: Antibiotics are used in every medical field including dentistry, where they are used for the prevention of postoperative complications in routine clinical practice during the third molar extraction. (2) Methods: This study is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The present systematic review aimed to evaluate and systematize the use of antibacterial drugs in order to prevent postoperative complications in outpatient oral surgery for wisdom teeth extraction. We conducted a systematic review using electronic databases such as Medline PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. Considering inclusion and exclusion criteria, we included randomized clinical trials published up to 2021 investigating the antibiotic prescription for third molar extraction. (3) Results: We selected 10 studies after the application of inclusion and exclusion criteria. The results showed that the most widely used antibiotic was amoxicillin both with and without clavulanic acid, in different dosages and duration. There were no statistically significant differences between treatment groups for development of postoperative complications. (4) Conclusions: Based on the analysis of the included studies, penicillin is currently the most widely prescribed group of antibiotics. The widespread use of this antibiotic group can lead to antimicrobial resistance (AMR). Due to increasing prevalence of bacteria resistance to penicillins, clinicians should carefully prescribe these antibiotics and be aware that the widespread use of amoxicillin may do more harm than good for the population. Full article

Cancers have a highly negative impact on the quality of life of paediatric patients and require an individualised oral treatment program for the phases of the disease. The aim of this study was to update existing research on oral care in children diagnosed with cancer. We carried out a literature search (in English, Spanish and Portuguese) in the Pubmed, Cochrane Library, EBSCO, WOS, SciELO, Lilacs, ProQuest, and SCOPUS databases and the websites of hospitals that treat childhood cancers. We found 114 articles and two hospital protocols. After review, we describe the interventions necessary to maintain oral health in children with cancer, divided into: phase I, before initiation of cancer treatment (review of medical record and oral history, planning of preventive strategies and dental treatments); phase II, from initiation of chemo-radiotherapy to 30–45 days post-therapy (maintenance of oral hygiene, reinforcement of parent/patient education in oral care, prevention and treatment of complications derived from cancer treatment); phase III, from 1 year to lifetime (periodic check-ups, maintenance, and reinforcement of oral hygiene, dental treatments, symptomatic care of the effects of long-term cancer treatment). The use of standardised protocols can avoid or minimise oral cancer complications and the side effects of cancer therapies. Full article

Background: This cross-sectional study evaluated patient-reported outcome measures (PROMs) on (1) oral hygiene, (2) periodontal health, (3) retainer failure, (4) orthodontic treatment satisfaction, and (5) outcome satisfaction in orthodontic retention patients. The purpose of the study was to evaluate whether orthodontic retention treatment is associated with patient-reported outcome measures on oral hygiene, periodontal health, and treatment satisfaction. Methods: A ten-item questionnaire on the five PROMs was conducted among 211 consecutive retention patients up to ten years following orthodontic treatment. Linear regression models were computed to detect possible associations between the PROMs and retention treatment or patient characteristics. Results: The presence of a fixed lingual retainer was not associated with the reduced ability to perform oral hygiene, self-perceived periodontal health, or orthodontic outcome satisfaction. Older patients were more content with the orthodontic treatment result (p < 0.05). Patients with fixed lingual retainers in the mandible were less satisfied with the course of orthodontic treatment (p < 0.05). Smokers more often reported gingival bleeding (p < 0.05). Females reported increased gingival recessions (p < 0.05) and perceived their teeth as longer than before treatment (p < 0.05). Longer orthodontic treatment duration corresponded to retainer failure (p < 0.05). Conclusions: In general, long-term orthodontic retention patients were satisfied with orthodontic treatment. These patients reported the satisfactory ability to perform adequate oral hygiene and periodontal health, and they communicated a high degree of treatment and outcome contentment. However, patients with a retainer in the mandible were less satisfied with orthodontic treatment. Full article

(1) This study aimed to do a longitudinal validation of the psychosocial impact of dental aesthetics questionnaire (PIDAQ) and determine its minimal important difference (MID) following orthodontic treatment; (2) 42 adolescents (11 to 18 years old) were recruited for treatment with fixed appliances and the participants answered the Malaysian PIDAQ prior to treatment (T0), mid-treatment (T1), and post-treatment (T2), plus a global health transition scale at T1 and T2. Data analyses included repeated measures ANOVA and paired sample t-tests. Test–retest was administered 2 to 6 weeks from T0; (3) The final sample comprised 37 subjects (response rate = 88.1%). The 95% limits of agreement were −10.3 to 8.5 points. In the anchor-based approach, those who experienced the smallest changes by reporting their dental aesthetics as “a little improved” had an insignificant PIDAQ score change of −5.3 at T1. At T2, the PIDAQ scores of those in this category were reduced significantly (mean change = −26.2; effect size (ES) = 1.0; p = 0.34). In the distribution-based approach, standardized PIDAQ scores were significantly reduced, with medium (0.7) to large (1.5) ES at T1 and T2, respectively; (4) The PIDAQ can detect orthodontic-related changes in patients’ psychosocial well-being. The post-treatment MID is 26 scale points with large ES. Full article

(1) The aim of the study was to investigate the association between age, gender, and the component of psychosocial impact of dental aesthetics (PIDAQ) in Malaysian young people. (2) Cross-sectional data on the PIDAQ (comprised of dental self-confidence, social impact, psychological impact, and aesthetic concern variables) of Malaysian youth (n = 1425) recruited through multi-stage sampling were analyzed for mediation and moderated mediation analyses using the PROCESS macro on SPSS software. (3) Participants (mean age 16.0 ± 2.8) represented 54.8% of girls and 45.2% of boys. In the mediation model, psychological impact and aesthetic concern completely mediated the effects of social impact on dental self-confidence. In the moderated mediation model, social impact directly influenced dental self-confidence amongst participants at one standard deviation below the sample mean age and among boys. However, psychological impact completely mediated the influence of social impact on dental self-confidence amongst participants at the sample mean age and at one standard deviation above the sample mean ages, and among girls. Neither age nor gender moderated the effect of aesthetic concern on dental self-confidence. (4) Age and gender moderated the influence of social impact and psychological impact on dental self-confidence. Full article

Guidelines for using toothpaste during tooth-brushing in public places during the coronavirus epidemic are lacking. In addition, the advantages and disadvantages of using toothpaste in terms of droplet generation during brushing, the number of droplets generated, and their scatter range are unknown; therefore, we investigated the relationships between diluted toothpaste viscosity, the number of droplets generated, and the droplets’ flight distance. We developed a system to quantitate droplet generation during tooth-brushing. Brushing with water generated 5965 ± 266 droplets; 10.0× diluted toothpaste generated 538 ± 56, 4.00× diluted toothpaste generated 349 ± 15, and 2.00× diluted toothpaste generated 69 ± 27 droplets. Undiluted toothpaste generated no droplets. Droplet number tended to increase with increased toothpaste dilution ratio and decreased viscosity (r = −0.993). The maximum flight distances were 429 ± 11, 445 ± 65, 316 ± 38, and 231 ± 21 mm for water, 10.0×, 4.00×, and 2.00× diluted toothpaste, respectively. The maximum flight distance and toothpaste viscosity correlated negatively (r = −0.999). Thus, the less diluted the toothpaste, the fewer the droplets generated during brushing, and the shorter their flight distance. The use of an appropriate amount of toothpaste is recommended to prevent droplet infection during tooth-brushing. Full article

(1) Background: the variety of autism spectrum disorder makes the definition of guidelines for dental care a challenging task. The aim of this review was to evaluate the literature concerning the use of conscious sedation for dental treatments in pediatric autistic patients. (2) Methods: we searched MEDLINE/PubMed, EMBASE, Cochrane databases in order to identify pertinent studies. The search strategy was based on these areas of interest: autistic spectrum disorder, pediatric patients, dentistry, tranquilizing agents, and conscious sedation. (3) Results: the search yielded 177 non-duplicated articles, of which 24 articles were retrieved for full text review, and 2 were found to address our review aim. The first paper was a retrospective study that included 83 autistic patients sedated either with an oral premedication combined with nitrous oxide/oxygen inhalation or with nitrous oxide/oxygen inhalation alone; the second article was a prospective trial on the effectiveness of 0.3 mg/kg of oral diazepam with 0.5 mg/kg of oral midazolam in 13 sedated uncooperative autistic patients. (4) Conclusions: this review highlights the insufficiency of studies that can provide concrete indications for the dental treatment in conscious sedation of pediatric patients with autism. New studies are needed to better define the appropriate drugs, dosages, sedation level and evaluate patient cooperation. Full article