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Dental Care: Oral and Systemic Disease Prevention

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 25166

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Dr. Kacper Nijakowski

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Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
Interests: dentistry; oral health; biostatistics; salivary diagnostics; medical education
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Anna Surdacka

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Guest Editor

Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
Interests: oral health; changes in the oral cavity environment in systemic diseases; saliva research; prevention of dental caries
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Dear Colleagues,

Oral health is closely linked to general health status in a bidirectional relationship. Poor oral health, caused by inadequate dental hygiene and care, can aggravate the course of systemic diseases. Similarly, systemic diseases or accompanying therapies may be reflected in the form of oral manifestations. It is essential to emphasize the importance of dental prevention and care for all age groups, from children to the elderly.

Occasionally, it is the dentist who first notices the symptoms of a systematic disease. Patients may be taking a variety of medicines that may experience xerostomia, which is a common side effect on the oral condition. Therefore, regular dental examinations with oral hygiene instructions are indispensable today as a preventive measure. In addition, the outbreak of the COVID-19 pandemic had a significant impact on dental treatment when the first wave required radical surgical interventions in patients suffering from toothache. This event reminded us that preventing diseases, including those affecting the oral cavity, should always be a priority.

I cordially invite you to submit your contributions to this Special Issue. High-quality papers (original articles, systematic reviews, narrative reviews, case reports) focusing on an interdisciplinary approach to oral health and disease prevention are welcome.

You may choose our Joint Special Issue in IJERPH.

Dr. Kacper Nijakowski
Prof. Dr. Anna Surdacka
Guest Editors

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Keywords

oral health
oral diseases
oral manifestations
systemic diseases
oral care
prevention
dental caries
periodontal disease
oral medicine
dentistry

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Published Papers (11 papers)

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11 pages, 1130 KiB

Open AccessArticle

Associations Between Glycemic Control, Self-Reported Gingival Bleeding and Lifestyle Factors in Hospitalized Diabetic Patients

by Aida Meto, Adora Shpati, Adela Alushi, Tommaso Filippini, Alba Kamberi, Agron Meto and Adem Alushi

J. Clin. Med. 2025, 14(12), 4201; https://doi.org/10.3390/jcm14124201 - 13 Jun 2025

Abstract

Background/Objectives: Diabetes mellitus is associated with significant health complications, including challenges in periodontal health. Gingival inflammation is especially common among diabetic patients and can significantly impact overall diabetes management. This study aims to investigate the correlation between glycosylated hemoglobin (HbA1c) levels, an established marker of glycemic control, and gingival inflammation using the Quantitative Gingival Bleeding Index (QGBI) among hospitalized diabetic patients, thereby placing the question within a broader clinical context. Methods: The study enrolled 671 hospitalized patients with diabetes complications at “Mother Theresa University Hospital” in Tirana, AL, USA. Glycemic control was assessed through glycosylated hemoglobin (HbA1c) levels, and gingival health was evaluated using the Quantitative Gingival Bleeding Index (QGBI). Behavioral variables were also documented, including smoking habits and routine oral care practices. Spearman’s correlation coefficient (r_s) was applied to determine the relationship between HbA1c levels and QGBI scores. Results: Our findings revealed a strong positive correlation between glycemic control (HbA1c) and gingival inflammation (QGBI) among the participants (Spearman’s coefficient r_s = 0.868, p < 0.001). Additionally, significant positive associations were observed between behavioral factors, such as smoking habits and regular oral care practices, further underscoring their role in periodontal health in diabetic patients. Conclusions: The study highlights a significant positive relationship between poor glycemic control and increased gingival inflammation, emphasizing the importance of periodontal health in the comprehensive management of diabetes mellitus. Our results support integrating periodontal evaluation and management into standard diabetes care, which could improve patient outcomes and overall well-being. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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19 pages, 1026 KiB

Open AccessArticle

Factors Influencing the Choice of Conservative and Surgical Procedures in Dental Patients from Poland: A Single-Center Retrospective Analysis

by Kacper Łaganowski, Martyna Ortarzewska, Kornela Cieślik, Jakub Jankowski and Kacper Nijakowski

J. Clin. Med. 2025, 14(5), 1508; https://doi.org/10.3390/jcm14051508 - 24 Feb 2025

Viewed by 539

Abstract

Background/Objectives: Oral health behaviors can be shaped by various factors, both global (such as the COVID-19 pandemic) and individual (e.g., gender, age). This retrospective study aims to assess the factors influencing the choice between conservative and surgical dental procedures among patients based on the example of the university specialized center in Poznan. Methods: We explored the patient dataset from the University Center of Dentistry and Specialized Medicine (Poznan, Poland), covering the period from 1 January 2017 to 31 December 2023. A total of 182,654 medical records were analyzed, focusing on procedures such as restorations, endodontic interventions, and extractions. Multivariate logistic regression and multidimensional correspondence analyses were employed to assess the impact of demographic factors (age and gender) and tooth-specific characteristics on clinical decisions. Results: Females, particularly younger, were more likely to choose restorative procedures, while males, especially those over 50, predominantly underwent surgical procedures. Endodontic treatments were most common in males aged 18–30, primarily for maxillary anterior teeth and premolars. Molar extractions, especially in the mandible, were the most frequent surgical procedure. Maxillary teeth, particularly canines and premolars, were more likely to be treated conservatively. Conclusions: Economic factors, limited treatment access, and variations in patient preference influenced the observed patterns. Despite a national trend toward increased conservative treatments, disparities persisted based on age, gender, and tooth type. These findings emphasize the need for targeted prevention strategies and equitable access to advanced dental care. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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18 pages, 1909 KiB

Open AccessArticle

Associations Between Lifestyle Factors, Oral Health Behaviors, and Glycemic Control in Type 2 Diabetic Patients

by Vanessa Bolchis, Iulia Alexa, Nicoleta A. Toderas, Ramona Dumitrescu, Ruxandra Sava-Rosianu, Octavia Balean, Vlad Tiberiu Alexa, Simona Popescu, Daniela Jumanca, Atena Galuscan, Iosif Ilia and Doina Chioran

J. Clin. Med. 2025, 14(2), 450; https://doi.org/10.3390/jcm14020450 - 12 Jan 2025

Cited by 2 | Viewed by 1273

Abstract

Introduction: T2DM mellitus (T2DM) is a major global health issue associated with significant morbidity, mortality, and economic burden. While the role of lifestyle factors in glycemic control is well-established, the influence of oral health behaviors remains underexplored. Objective: This study aimed to investigate the interplay between lifestyle habits, oral health behaviors, and glycemic control in patients with T2DM. Methodology: A cross-sectional study was conducted on 132 patients (66 men and 66 women) with T2DM at the Pius Brînzeu Emergency Hospital in Timișoara, Romania. Data on smoking, physical activity, alcohol consumption, tooth brushing frequency, and dental visits were collected using structured questionnaires, and glycemic control was assessed through HbA1c measurements. Statistical analyses, including Pearson correlations and linear regression, were performed. Results: Among men, HbA1c levels were negatively associated with exercise frequency (ß = −0.26, p < 0.05) and education level (correlation coefficient −0.27, p < 0.05), and positively associated with dental visits and tooth brushing frequency (correlation coefficient 0.26, p < 0.05). In the combined analysis, education level positively correlated with both dental visits (correlation coefficient 0.24, p < 0.01) and alcohol consumption (correlation coefficient 0.22, p < 0.05). Conclusions: These findings underscore the importance of integrating oral health and lifestyle interventions into diabetes management to optimize patient outcomes. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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12 pages, 985 KiB

Open AccessArticle

Comparison of the Effects of Oral Hygiene Instruction Methods on Oral Hygiene and Self-Perception in Older Adults: A Randomized Controlled Trial

by Inês Caetano Santos, Catarina Colaço, Giancarlo De la Torre Canales, Luís Proença, Mário Polido, José João Mendes, Helena Canhão and Ana Cristina Manso

J. Clin. Med. 2024, 13(24), 7642; https://doi.org/10.3390/jcm13247642 - 15 Dec 2024

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Abstract

Background: Age-related conditions, such as being misinformed, having limited oral health literacy, and the loss of manual dexterity, autonomy, or visual acuity, may act as barriers to oral health. The aim of this study was to evaluate the effectiveness of two different oral hygiene instruction methods on oral hygiene and the self-perception of oral health in older adults. Methods: This randomized controlled trial included participants aged 65 and older who completed a questionnaire on socio-economic factors, self-perceived oral health, and oral hygiene behaviours. Oral hygiene status was assessed using the Oral Hygiene Index—Simplified (OHI-S). Participants were randomly allocated into two different groups, according to the method of oral hygiene instruction: a “General Approach” (GA) (n = 28) and a “Personalized Technique” (PT) (n = 26). After two months, a follow-up session was conducted. Data were analysed using descriptive and inferential methodologies. Results: The GA and PT methods were effective in promoting oral hygiene behaviours, with a significant increase in the use of interdental devices, but no significant differences were found between the two methods. Self-perceived oral health did not change significantly, neither after the instruction nor between methods. Significant improvements were achieved with both methods for the OHI-S, with significant differences between the two methods for the Calculus Index, where the PT achieved better results. Conclusions: Oral hygiene education leads to improvements in the adoption of oral hygiene behaviours and clinical indicators. Furthermore, a personalized approach promoted better results in clinical indicators. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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13 pages, 586 KiB

Open AccessArticle

by David Ribas-Perez, Carlos Muñoz-Viveros, Angel Luis Formoso-Veloso, Francisco Jesus Carrillo-Sanchez, Luis El Khoury-Moreno, Julio Torrejon-Martinez and Antonio Castaño-Seiquer

J. Clin. Med. 2024, 13(9), 2449; https://doi.org/10.3390/jcm13092449 - 23 Apr 2024

Viewed by 1611

Abstract

Introduction: During the summer of 2019 and within the framework of a social dentistry program carried out in the low-income town of San Francisco de Macorís (Dominican Republic), a descriptive study was carried out on oral health-related quality of life (OHRQoL), aiming to find out the oral health status of a population of children in the aforementioned Dominican city. Objective: The aim of this study was to describe the oral health status of a child population and its relationship with the quality of life perceived by these children in the aforementioned population of San Francisco de Macorís in order to develop an specific oral health program taking into account not only the existing oral health status but also the perceptions and feelings of the child population in this regard. Method: A descriptive cross-sectional study was carried out on a representative sample of children who were examined on their oral health status, following WHO guidelines, by professionals from the University of Seville (Spain) together with professionals from private practice (USA) and students from the Universidad Católica Nordestana (UCNE, Dominican Republic). Likewise, the children’s parents voluntarily completed the Oral Quality of Life questionnaire COHIP-19 in its culturally adapted Spanish version. Results: For this purpose, 94 children with a mean age of 10.34 (SD 3.38) were observed in our study following WHO recommendations for oral health studies and evaluating OHQoL using the specific questionnaire validated in Spanish COHIP-19 in its short format (SF). The results show a state of oral health with a significant prevalence of caries (80.9%) and a DMFT of 1.70 (SD 1.90). The OHQoL perceived by these children shows that pain, bad breath or feeling sad because of the condition of their teeth were the factors with the worst evaluation score. Conclusions: The conclusion that mainly emerges from this study is that caries continues to be the main problem to be solved (more than other variables studied, such as malocclusion or fluorosis), and this ailment also causes pain, dysfunction, and bad breath and is therefore perceived as a problem to be solved in the children of this Dominican city. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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Review

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24 pages, 622 KiB

Open AccessReview

Minimally Invasive Surgical Techniques for Periodontal Regeneration: Preserving the Entire Papilla Without Dissection—A Narrative Review

by Sylwia Jakubowska and Bartłomiej Górski

J. Clin. Med. 2025, 14(12), 4117; https://doi.org/10.3390/jcm14124117 - 10 Jun 2025

Viewed by 107

Abstract

Background: The aim of the present narrative review is to synthesize the available scientific evidence on the minimally invasive surgical techniques for periodontal regeneration preserving the entire papilla without dissection. Surgical treatment of intrabony defects may result in compromising the integrity of the interdental tissues and subsequent papilla loss. Therefore, it is indicated to investigate the approaches avoiding papillary incision over the osseous defect, thus optimizing wound healing conditions. Methods: Authors performed a search of literature via electronic databases such as PubMed, Web of Science, Cochrane, and Scopus, and extended by manual searching with a stop date of February 2025. Based on inclusion criteria only randomized clinical trials (RCT), cohort studies, case–control studies, and case series were included, and 106 records were initially identified. Various aspects of described novel approaches preserving the entire papilla were finally discussed. Results: A total of 12 studies were evaluated. There is a significant lack of randomized controlled clinical trials on minimally invasive techniques without incision in the papilla. However, numerous modifications of existing techniques have emerged, mainly in the form of case series and case reports with short-term data. Among them, some authors stated that the entire papilla preservation approaches may facilitate early soft tissue healing, reduce papilla trauma and the risk of gingival recession, minimize procedure time, improve flap stability, and alleviate discomfort and side effects, while others reported similar outcomes to conventional approaches and emphasize the need for further comparative clinical trials. Conclusions: Preserving papilla integrity and the soft tissue profile is essential for minimizing complications, especially in the esthetic zone. Within the limitations of this narrative review, presented findings emphasize the effectiveness of entire papilla preservation techniques in preventing post-surgery tissue loss compared to conventional incisions and flaps. Randomized controlled trials with longer follow-up periods and larger sample sizes are necessary to validate the efficacy of these approaches in comparison to established papilla preservation techniques. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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19 pages, 867 KiB

Open AccessReview

Periodontitis and Depressive Disorders: The Effects of Antidepressant Drugs on the Periodontium in Clinical and Preclinical Models: A Narrative Review

by Damiano Taccardi, Alessandro Chiesa, Carolina Maiorani, Alessia Pardo, Giorgio Lombardo, Andrea Scribante, Silvia Sabatini and Andrea Butera

J. Clin. Med. 2024, 13(15), 4524; https://doi.org/10.3390/jcm13154524 - 2 Aug 2024

Cited by 1 | Viewed by 2578

Abstract

Background/Objectives: Several psychological conditions, including stress and depression, can adversely affect oral health; in fact, antidepressants, commonly used to treat depressive disorders, may have conflicting effects on the periodontal status of individuals. The aim of this review was to determine the effects of antidepressants on the periodontium. Methods: A literature search was conducted using electronic databases, Pubmed/MEDLINE, Cochrane Library, focusing on the use of antidepressants and their effects on periodontal health in animals or humans. Results: Seventeen articles have been included with the use of amitriptyline (two studies), desipramine (one study), imipramine (two studies), desvenlafaxine (one study), fluoxetine (six studies), venlafaxine (three studies) and tianeptine (two studies). One study evaluated several categories of antidepressants, such as selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), tricyclic, atypical and monoamine oxidase inhibitors (MAO). Most trials showed improvements in periodontal health, especially with fluoxetine, but also with imipramine, desipramine, desvenlafaxine and tianeptine; on the contrary, worsening of clinical periodontal indices and increased loss of alveolar bone were reported with venlafaxine. Conclusions: This review suggests that in the presence of comorbidity between periodontitis and depression, pharmacological treatment with SNRIs, SSRIs and mixed antidepressants is associated with improvement in periodontal parameters, except for venlafaxine. Healthcare professionals (especially oral and mental health professionals) should investigate proper adherence to medication therapy in patients with a history of periodontitis and depression. Further clinical trials are needed to confirm these results. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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13 pages, 5550 KiB

Open AccessCase Report

Entire Papilla Preservation Technique with Enamel Matrix Proteins and Allogenic Bone Substitutes for the Treatment of Isolated Intrabony Defects: A 3-Year Follow-Up of a Prospective Case Series

by Bartłomiej Górski, Sylwia Jakubowska and Beata Wyrębek

J. Clin. Med. 2025, 14(7), 2374; https://doi.org/10.3390/jcm14072374 - 30 Mar 2025

Cited by 1 | Viewed by 1034

Abstract

Background: This study aimed to assess the effectiveness of a modified entire papilla preservation technique (MEPPT) for treating isolated intrabony defects in patients with stage III periodontitis. Material and Methods: Fifteen patients with 15 interdental intrabony defects were treated with a MEPPT using enamel matrix derivative and allogenic bone. Their probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), keratinized tissue width (KTW), defect depth (DD), full-mouth plaque score (FMPS), full mouth bleeding score (FMBS), radiographic images (radiographic angles, BF and LDF) and intrasurgical parameters were assessed at baseline and 3 years postsurgery. Standardized measurements were taken to evaluate the defect characteristics and treatment outcomes. Results: At 3 years, significant improvements from baseline were maintained. Probing pocket depth (PPD) decreased from 7.03 ± 1.61 mm to 3.33 ± 0.89 mm (p < 0.0001), clinical attachment level (CAL) improved to 3.08 ± 1.16 mm (p < 0.001) and defect depth (DD) decreased from 4.59 ± 1.24 mm to 0.38 ± 0.31 mm (p < 0.001). The changes in gingival recession and keratinized tissue were not statistically significant. The results demonstrate sustained clinical stability over a 3-year period. Conclusions: Within the limitations of this study, the findings suggest that the modified entire papilla preservation technique (MEPPT) in conjunction with enamel matrix proteins and allogenic bone grafting is an effective approach for the treatment of intrabony defects, leading to statistically significant and sustained clinical improvements over a 3-year period. The study protocol was registered in ClinicalTrials.gov ID NCT05029089. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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16 pages, 586 KiB

Open AccessSystematic Review

Oral Manifestations of Crohn’s Disease: A Systematic Review

by María Pilar Pecci-Lloret, Emma Ramirez-Santisteban, Adraz Hergueta-Castillo, Julia Guerrero-Gironés and Ricardo Elías Oñate-Sánchez

J. Clin. Med. 2023, 12(20), 6450; https://doi.org/10.3390/jcm12206450 - 10 Oct 2023

Cited by 10 | Viewed by 7834

Abstract

Crohn’s disease (CD) is a chronic inflammatory intestinal condition that can affect the entire gastrointestinal tract. It is characterized by its clinical heterogeneity and irregularities in its course. The etiology and pathogenesis are not well established, so it is difficult to establish an early diagnosis and an effective treatment plan. The objective of this systematic review was to present a qualitative synthesis of the studies referring to the oral manifestations of CD. This systematic review was carried out following the PRISMA guide. Research was conducted in the Pubmed, Web of Science, Scopus, Scielo, and Cocrahne Library databases on 23 February 2023, and updated on 1 September 2023. Articles published between 2012 and 2023 were selected. Articles that analyzed the oral manifestation of CD patients and met the established search terms. In addition, the quality of all the selected studies was analyzed following the CARE guidelines for case reports and the STROBE scale for observational studies. A total of 19 articles were included in this review that met the inclusion criteria. Regarding the oral manifestation of CD, oral ulcers, angular cheilitis, and gingivitis stand out. Periodontitis and vegetative pyostomatitis were the least representative manifestations. The most prevalent locations were lips, mucosa, and gingivae. Ulcers, gingivitis, and angular cheilitis are the most frequent oral manifestations in patients with CD. Their early identification and possible relationship with the disease are important for an early diagnosis and an adequate treatment plan. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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17 pages, 6276 KiB

Open AccessSystematic Review

Eating Disorders and Dental Erosion: A Systematic Review

by Kacper Nijakowski, Jakub Jankowski, Dawid Gruszczyński and Anna Surdacka

J. Clin. Med. 2023, 12(19), 6161; https://doi.org/10.3390/jcm12196161 - 24 Sep 2023

Cited by 7 | Viewed by 5690

Abstract

Both eating disorders and dental erosion are increasingly affecting adolescents and young adults. Thus, our systematic review was designed to answer the question: “Is there a relationship between dental erosion and eating disorders?” Following the inclusion and exclusion criteria, 31 studies were included in this systematic review (according to the PRISMA statement guidelines). Based on the meta-analysis, 54.4% of patients with bulimia nervosa and 26.7% with anorexia nervosa experienced tooth erosion. For the whole group of 1699 patients with eating disorders, erosive lesions were observed in 42.1% of patients. Bulimics were more than 10 times more likely to experience dental erosion compared to healthy individuals (OR = 10.383 [95%CI: 4.882–22.086]). Similarly, more than 16 times increased odds of tooth erosion were found in patients with self-induced vomiting (OR = 16.176 [95%CI: 1.438–181.918]). In conclusion, eating disorders are associated with an increased risk of developing erosive lesions, especially in patients with bulimia nervosa. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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11 pages, 1893 KiB

Open AccessSystematic Review

Relationship between Prostate Inflammation and Periodontal Disease—A Systematic Review and Meta-Analysis

by Pablo Ortíz de Urbina Comerón, Álvaro Zubizarreta-Macho, Ana Belén Lobo Galindo, José María Montiel-Company, María-Fernanda Lorenzo-Gómez and Javier Flores Fraile

J. Clin. Med. 2023, 12(18), 6070; https://doi.org/10.3390/jcm12186070 - 20 Sep 2023

Cited by 6 | Viewed by 1653

Abstract

The aim of this systematic review and meta-analysis was to analyze the association between periodontal disease and prostate inflammation with a null hypothesis stating that periodontal disease does not increase the incidence of prostate inflammation. Materials and methods: A systematic literature review and meta-analysis of longitudinal observational cohort and case-control studies that evaluated the odds ratio or hazard ratio and confidence interval was undertaken based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations (2020). A total of four databases were consulted in the literature search: PubMed-Medline, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and quantitative analyses. Results: Four observational cohort studies and three observational cohort case-control studies were included in the meta-analysis. The four observational cohort studies were combined using the random effects model to estimate a hazard ratio of 1.32 with a confidence interval of 95% between 0.87 and 1.77. The meta-analysis presented high heterogeneity (Q test = 56.1; p value < 0.001; I² = 94.9%). Moreover, the three observational case-control studies were combined using the random effects model to estimate an odds ratio of 1.62 with a confidence interval of 95% between 1.41 and 1.84. The meta-analysis presented high heterogeneity (Q test = 1.07; p value = 0.782; I² = 0%). Conclusions: The incidence of periodontal disease does not increase the risk of the incidence of prostate inflammation. Full article

(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)

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