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Innovative Clinical Approaches in Oral Health Prevention and Management

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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 (20 January 2026) | Viewed by 14326

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Dr. Giulia Orilisi

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Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
Interests: dental materials; pediatric dentistry; restorative dentistry; vibrational spectroscopy; biomaterials; high-resolution analytical techniques; remineralizing agents
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Dr. Rossana Izzetti

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Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
Interests: oral medicine; oral surgery; clinical dentistry; intraoral ultrasonography; diagnostic imaging
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Dr. Flavia Vitiello

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Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
Interests: cariology; minimally invasive dentistry; oral microbiome in children; clinical prevention and early interventions
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Special Issue Information

Dear Colleagues,

I invite you to submit a contribution for a Special Issue on “Innovative Clinical Approaches in Oral Health Prevention and Management” in the Journal of Clinical Medicine.

Oral health plays a crucial role in sustaining overall health, well-being, and quality of life. Despite significant advances in dental care, oral diseases remain among the most prevalent health conditions globally, affecting individuals across all age groups and socioeconomic backgrounds.

The focus of this Special Issue involves oral health, preventive strategies, innovative approaches, and their implications for current clinical practices, as well as the state of oral health literacy and policy. It aims to encourage contributions from researchers, clinicians, and policymakers to expand knowledge, improving both preventive and therapeutic approaches in oral health.

In this Special Issue, we welcome authors to submit papers on oral health prevention and management, clinical application of innovative biomaterials and clinical procedures used in preventive dentistry, and multidisciplinary and translational collaboration in oral healthcare. Original articles and reviews are all welcome for submission.

Dr. Giulia Orilisi
Dr. Rossana Izzetti
Dr. Flavia Vitiello
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

oral health
oral prevention
teeth remineralization
oral pathology
oral health management
preventive dentistry
translational dentistry

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Published Papers (9 papers)

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19 pages, 1825 KB

Open AccessArticle

Oral Health Assessment in Adolescents with End-Stage Chronic Kidney Disease

by Natalia Sergeevna Morozova, Ekaterina Andreevna Maslikova, Alina Alekseevna Elovskaya, Olga Vladimirovna Nesterova, Arif Fuad Allahverdiyev, Natalya Zhorzhevna Dikopova, Alexander Grigorievich Volkov, Oleg Vitalievich Sergeyev, Ellina Valerievna Velichko, Larisa Dmitrievna Maltseva and Olga Leonidovna Morozova

J. Clin. Med. 2026, 15(1), 165; https://doi.org/10.3390/jcm15010165 - 25 Dec 2025

Viewed by 813

Abstract

Background/Objectives: End-stage chronic kidney disease (ESKD) represents a complex condition that also impacts oral health. This pilot study evaluates and compares some approaches to oral health assessment and aims to define the specific oral features common in adolescents with ESKD. Methods: A total of 50 children aged 12 to 17 years were examined, including 30 adolescents with ESKD (Group 1) and 20 adolescents without urinary pathology (Group 2). The decayed, missing, filled teeth (DMFT) index, oral hygiene index-simplified, papillary marginal attached index, and periodontal index were used for dental and periodontal assessment. The Milwaukee PH56 device was used to determine salivary pH. Oral microbiota was analyzed by chromatography–mass spectrometry and polymerase chain reaction detection of periodontopathogenic bacteria. Salivary and gingival crevicular fluid (GCF) biomarkers (IL-1β, TNF-α, IL-8, VEGF, sIgA) and total antioxidant capacity (TAC) were determined using an enzyme-linked immunosorbent assay. Results: DMFT did not differ between the groups. Periodontal indices in Group 1 were increased compared to Group 2 (p < 0.0001). Salivary pH in Group 1 was slightly alkaline; in Group 2, it was slightly acidic (p < 0.0001). Oral dysbiosis and periodontopathogenic bacteria were found in ESKD adolescents. Salivary IL-1β, TNF-α, VEGF, and IL-1β in GCF were elevated in Group 1 compared to Group 2 (p < 0.05). TNF-α, IL-8, and VEGF in GCF and TAC in both fluids were lower in Group 1 compared to Group 2 (p < 0.0001). Salivary IL-8 and sIgA in both saliva and GCF did not differ between the groups. Conclusions: ESKD adolescents had poor oral hygiene and significant oral dysbiosis including periodontopathogenic bacteria. Evaluation of biomarkers in saliva and GCF allowed us to vindicate inflammation, dysbiosis severity, and periodontal diseases. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

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12 pages, 837 KB

Open AccessArticle

Prediction of Periodontal Disease Progression During Supportive Periodontal Therapy Using an Oral Fluid Lactate Dehydrogenase Activity-Based Test Strip

by Tatsuo Yamamoto, Satsuki Sato, Yohei Kamata, Takahisa Hirata, Keiichiro Nanashima, Koichiro Irie and Motohiro Komaki

J. Clin. Med. 2025, 14(24), 8810; https://doi.org/10.3390/jcm14248810 - 12 Dec 2025

Viewed by 835

Abstract

Background/Objectives: Periodontal disease may progress despite supportive periodontal therapy (SPT), and conventional clinical parameters exhibit limited predictive value. This study evaluated the prognostic utility of measuring the oral fluid lactate dehydrogenase (LD) activity using a chairside test strip to predict disease progression during SPT. Methods: A cohort of 92 patients (33 males and 59 females; median age, 68 years) undergoing SPT at a university clinic in 2023 were followed up for approximately one year. Oral fluid LD activity was measured using a test strip, and clinical periodontal parameters were assessed at baseline and follow-up. Periodontitis progression was defined as ≥4 sites showing a 2 mm increase in the probing pocket depth, which reached ≥4 mm. Receiver operating characteristic analyses and stepwise logistic regression were used to evaluate the predictive performance of oral fluid LD activity and develop a multivariate model. Results: Seventeen patients (18.5%) developed progressive periodontitis. Progressive cases demonstrated significantly higher baseline LD activity and periodontal parameters. The optimal cutoff value for LD activity was 3.5, yielding a sensitivity, specificity, and negative predictive value of 1.00, 0.53, and 1.00, respectively. Logistic regression identified oral fluid LD and medications as independent predictors, with the multivariate model achieving an area under the curve of 0.785. Conclusions: Oral fluid LD activity measured using the test strip provided prognostic information for periodontitis progression during SPT. Incorporating LD with information obtained from medical interviews did not markedly enhance the predictive accuracy. This rapid and noninvasive method may facilitate risk-based patient management and personalized supportive care. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

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10 pages, 1075 KB

Open AccessArticle

Medication-Induced Xerostomia: Cross-Sectional Analysis of Salivary Flow, Intraoral Aching, and Anxiety

by Olga A. Korczeniewska, Eli Eliav and Szilvia Arany

J. Clin. Med. 2025, 14(18), 6624; https://doi.org/10.3390/jcm14186624 - 19 Sep 2025

Cited by 1 | Viewed by 2122

Abstract

Background: This cross-sectional study investigated the associations between medication-induced xerostomia (perceived oral dryness) and intraoral painful aching in 141 middle-aged adults (45–64 years) with self-reported xerostomia resulting from anticholinergic medications. Methods: Xerostomia severity, anxiety, and intraoral painful aching were evaluated using questionnaires, including the semiquantitative Xerostomia Inventory survey. Reduction in saliva secretion (hyposalivation) was objectively assessed by the measurement of unstimulated whole saliva (UWS) flow. Results: Multivariate stepwise linear regression was used to identify factors associated with XI scores, adjusting for potential confounders including age, sex, diabetes, smoking status, and race. The final model identified UWS flow (p = 0.0023), intraoral painful aching (p = 0.0030), and diabetes (p = 0.0097) as significant predictors of xerostomia severity. Anxiety demonstrated a marginal association (p = 0.0643) and accounted for a smaller proportion of model variance. Relative importance analysis revealed that UWS flow contributed 33.16% to the overall model fit, followed by intraoral pain (31.30%), diabetes (23.60%), and anxiety (11.93%). Conclusions: The findings indicate that reduced salivary flow, intraoral discomfort, and the presence of diabetes are significant contributors to xerostomia severity in individuals taking anticholinergic medications. These results highlight the importance of individualized evaluation in xerostomia care and inform targeted clinical strategies for managing xerostomia symptoms in patients with intraoral painful aching, anxiety, or comorbid diabetes. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

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10 pages, 742 KB

Open AccessArticle

Virtual Reality-Based Versus Traditional Teaching Approaches in the Oral Hygiene Education of Children with Autism Spectrum Disorder

by Antonio Fallea, Carola Costanza, Simona L’Episcopo, Massimiliano Bartolone, Francesco Rundo, Daniela Smirni, Michele Roccella, Maurizio Elia, Raffaele Ferri and Luigi Vetri

J. Clin. Med. 2025, 14(16), 5795; https://doi.org/10.3390/jcm14165795 - 15 Aug 2025

Cited by 5 | Viewed by 1527

Abstract

Background/Objectives: Maintaining proper oral hygiene is particularly challenging for individuals with autism spectrum disorder (ASD) due to sensory sensitivities, communication difficulties, and anxiety. Traditional oral hygiene education methods may be ineffective for this population, thereby necessitating innovative solutions. This study evaluates the effectiveness of a virtual reality (VR)-based educational program in improving home oral hygiene practices among children and adolescents with ASD. Methods: Sixty-four children with ASD (Level 1) were recruited and divided into two groups. Group 1 received traditional oral hygiene education, while Group 2 used a VR-based intervention featuring a virtual domestic bathroom with an avatar demonstrating proper brushing and flossing techniques. The intervention lasted eight weeks, with two one-hour sessions per week. The oral health assessment tool (OHAT) was used to evaluate oral hygiene status before and after the intervention. An unpaired t-test compared outcomes between groups. Results: Both groups showed improvements in oral hygiene, but the VR intervention group exhibited a significantly greater reduction in OHAT scores compared to the traditional education group (p < 0.001) due to a greater improvement in oral health. The VR-based approach enhanced engagement and adherence to oral hygiene routines, particularly benefiting children with ASD who struggle with conventional methods. Conclusions: VR-based education appears to be a promising tool for improving oral hygiene habits in children with ASD by providing an interactive and immersive learning experience. Future research should explore long-term adherence and the broader application of VR in healthcare education. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

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12 pages, 264 KB

Open AccessArticle

The Oral Health Status of Spanish Naval Military Personnel: A Retrospective Study

by Bárbara Manso de Gustín, Alfonso Alvarado-Lorenzo, Juan Manuel Aragoneses and Manuel Fernández-Domínguez

J. Clin. Med. 2025, 14(15), 5236; https://doi.org/10.3390/jcm14155236 - 24 Jul 2025

Viewed by 1079

Abstract

Background/Objectives: Oral health has specific importance and consequences from a military and Navy standpoint. The aim of this study was to determine and compare caries prevalence and dental care in Spanish Navy personnel. Methods: A retrospective observational study was carried out with a sample size of 1318 individuals (34.65 ± 8.82 years old) stationed at the Rota naval base in Spain, whose dental charts were examined. Caries prevalence was assessed using the Decayed, Missing, Filled Teeth (DMFT) index; dental care was evaluated using the care index (CI); and demographic and occupational factors were recorded. Results: The population of this study had a mean DMFT index of 5.99 ± 4.71 and a CI of 79%. Through the results of the DMFT index and CI, the statistical significance of the age and rank variables (p < 0.01) was confirmed, with personnel >45 years old and non-commissioned officers (NCOs) having the highest mean DMFT values and the youngest and officer groups having the greatest CI variable. Comparing the DMFT index across genders and ages and between age and rank also revealed significant differences. Conclusions: This study’s findings show a low prevalence of cavitated caries (14.5%), with intermediate DMFT values and higher CIs compared to those in previous published data. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

12 pages, 442 KB

Open AccessArticle

Clinical and Microbiological Study on Local Application of an Ozonated Olive Oil Gel in the Periodontal Pockets: A Randomized Double-Blind Trial

by Roberta Grassi, Fabio Ciccone, Domenico De Falco, Matteo Castaldi, Maria Teresa Agneta, Gianna Maria Nardi and Massimo Petruzzi

J. Clin. Med. 2025, 14(15), 5182; https://doi.org/10.3390/jcm14155182 - 22 Jul 2025

Cited by 4 | Viewed by 2450

Abstract

Objectives: This study aims to evaluate the clinical and microbiological efficacy of a novel Activated Ozonated Extra-Virgin Olive Oil (AOEOO) gel as a topical adjunct in the treatment of periodontal pockets. Methods: In this double-blind, randomized clinical trial, patients diagnosed with stage II–IV periodontitis received either scaling and root planing (SRP) and placebo gel or SRP combined with subgingival AOEOO gel application (test group). Periodontal indices—probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP)—were measured at baseline, 3, and 6 months. Microbiological analysis using real-time PCR quantified six key periodontal pathogens at baseline and after 6 months. Results: AOEOO-treated patients showed significantly greater improvements in PPD, CAL, PI, and BOP at both 3 and 6 months compared to the placebo group (p < 0.05). Also, microbiologically, the AOEOO group exhibited a significant reduction in total bacterial load and in all target pathogens, with reductions ranging from 63.8% to 98.7% (p < 0.05). No adverse effects were reported. Conclusions: The adjunctive use of AOEOO gel significantly improved periodontal outcomes and reduced pathogenic bacterial load, supporting its potential role as a safe and effective supportive treatment in periodontitis management. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

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11 pages, 222 KB

Open AccessArticle

Clinical Features and Patient-Reported Outcomes in a Cohort of Patients with Sjögren’s Disease

by Rossana Izzetti, Chiara Cinquini, Giovanni Fulvio, Marco Nisi, Chiara Baldini and Antonio Barone

J. Clin. Med. 2025, 14(6), 2027; https://doi.org/10.3390/jcm14062027 - 17 Mar 2025

Cited by 2 | Viewed by 1694

Abstract

Background: Sjögren’s disease (SD) is an autoimmune condition causing progressive salivary and lacrimal glands dysfunction following lymphocytic infiltration in the glandular tissue. SD patients are more prone to oral health impairment due to a reduction in salivary flow. This study evaluated the relationship between oral health, functional tests, and patient reported outcomes in a cohort of SD patients. Methods: Patients diagnosed with SD underwent complete dental examination, with the recording of the decayed–missing–filled teeth index (DMFT), probing pocket depth (PPD), full mouth bleeding score (FMBS), and full mouth plaque score (FMPS). Hyposalivation was assessed using the unstimulated whole saliva flow rate (UWS). Patients were administered the European League Against Rheumatism (EULAR) Sjögren’s Syndrome Patient Reported Index, EULAR Sjögren’s syndrome disease activity index, Oral Health Impact Profile-14 (OHIP-14), Patient Acceptable Symptom State questionnaires, and a visual analog scale for xerostomia (VASx). Results: Fifty patients in total were enrolled. Reduced UWS was associated with higher DMFT, FMBS, and FMPS. Significant correlation was observed for UWS with VASx and OHIP-14 (p < 0.05). Conclusions: Quality of life and oral health appear mildly impaired in SD patients as an effect of reduced salivary flow, with higher DMFT and tendency towards gingival inflammation and plaque accumulation. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

13 pages, 1237 KB

Open AccessArticle

Leveraging Dental Visits for Systemic Health: Diabetes Screening and Referral Compliance in Periodontitis Patients in Malaysia

by Nur Adila Mohd Norwir, Shahida Mohd-Said, Aznida Firzah Abdul Aziz and Tuti Ningseh Mohd-Dom

J. Clin. Med. 2025, 14(3), 739; https://doi.org/10.3390/jcm14030739 - 23 Jan 2025

Cited by 3 | Viewed by 2317

Abstract

Background/Objectives: Opportunistic diabetes screening in dental clinics is an innovative strategy with significant public health implications. Methods: This prospective observational study assessed diabetes risk and referral compliance among periodontitis patients using the Finnish Diabetes Risk Score (FINDRISC) and capillary fasting blood glucose (cFBG). Patients with FINDRISC ≥ 11 and/or cFBG ≥ 5.6 mmol/L were classified as high-risk and referred for further medical evaluation, with compliance tracked through medical practitioner feedback. Results: A total of 142 participants were recruited by 20 general dental practitioners (GDPs). Of these, 36.4% (n = 47) had a FINDRISC ≥ 11, with a mean score of 7.7 ± 4.5, and 26.3% (n = 34/129) had cFBG levels ≥ 5.6 mmol/L. There was no significant difference between periodontal status and FINDRISC (p = 0.291) or between periodontal status and cFBG (p = 0.129). Overall, 54 patients (41.8%) were referred for follow-up, with 33 (61.1%) completing the process. Among those who completed referrals, 10 (30.3%) were diagnosed with prediabetes and seven (21.2%) with diabetes. Non-compliance was more common among patients from lower socioeconomic backgrounds. Conclusions: This study shows the feasibility of integrating diabetes risk screening into private dental practice and its potential to identify high-risk individuals. Shared care models and policy adaptations are essential to improve interdisciplinary collaboration and overcome referral compliance barriers. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

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17 pages, 1107 KB

Open AccessSystematic Review

Intraligamentary Anesthesia in Pediatric Patients: Is It an Effective Technique? A Systematic Review and Meta-Analysis

by Claudia Salerno, Silvia Cirio, Aesha Allam, Marta Mazur and Maria Grazia Cagetti

J. Clin. Med. 2026, 15(5), 1828; https://doi.org/10.3390/jcm15051828 - 27 Feb 2026

Viewed by 470

Abstract

Background: Effective pain control is fundamental in pediatric dentistry. Supraperiosteal infiltration (SPA) and inferior alveolar nerve block (IANB) are the most used local anesthesia (LA) techniques. This review evaluated the available evidence on intraligamentary anesthesia (ILA) to assess its efficacy, safety, and viability as an alternative to conventional techniques. Methods: The review protocol was registered in PROSPERO (CRD420261284494) and conducted in accordance with PRISMA guidelines. Three databases were searched for RCTs published in English after 2000 involving children. Studies that compared ILA, delivered via either traditional or computer-controlled systems (CC-ILA), with other LA techniques were included. Risk of bias was assessed using the Cochrane’s RoB 2.0 tool. Meta-analysis was performed using a random-effects model with Stata/SE 18.0. Results: The database search yielded 347 records; after duplicate removal, 153 articles were screened. Thirty-four papers were assessed, of which thirteen studies were included, and three were retained for the meta-analysis. Significantly lower pain perception and improved physiological parameters were reported with ILA compared with IANB. CC-ILA demonstrated greater efficacy and reduced procedural discomfort than conventional ILA. Patients favored CC-ILA over IANB (68.0% vs. 32.0%). Postoperative lip biting occurred more frequently following IANB and CC-SPA than after ILA. Overall risk of bias was low. Meta-analysis revealed no significant difference in pain perception between ILA and IANB (z = −0.26; p = 0.79). Conclusions: ILA, particularly CC-ILA, appears to be an effective, safe, and well-tolerated technique and may be considered a valid anesthetic option in pediatric dentistry. The review did not receive any funding. Full article

(This article belongs to the Special Issue Innovative Clinical Approaches in Oral Health Prevention and Management)

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