Oral - Health, Diseases, Therapies, and Technologies

Background: Infective endocarditis (IE) is a severe and multifactorial condition historically linked to dental procedures. Current evidence shows that most cases arise from complex host–microbe interactions and biofilm colonization on damaged endothelium or intracardiac/prosthetic material, while the inappropriate use of antibiotics in dentistry promotes antimicrobial resistance. Objectives: To provide a narrative synthesis of contemporary evidence on (i) the relative contribution of dental procedures versus daily oral inflammatory burden to bacteremia and IE risk, (ii) the role of periodontal disease and the oral resistome in AMR, and (iii) the clinical and medico-legal implications of antibiotic prescribing and guideline adherence in dental practice. Materials and Methods: A narrative review was conducted using PubMed, Scopus, ResearchGate, and Google Scholar, complemented by manual screening of reference lists and relevant guideline documents. The search covered approximately the last decade (2015–2025) and included ESC 2023 and AHA 2021 guidance on IE prevention. Search terms combined concepts related to “infective endocarditis”, “antibiotic prophylaxis”, “dentistry/dental procedures”, “periodontitis/periodontal disease”, “bacteremia”, “biofilm”, “oral microbiome/oral resistome”, and “antimicrobial stewardship/antibiotic resistance”, using Boolean operators. Eligible sources included clinical studies, systematic reviews/meta-analyses, consensus statements and guidelines, and selected medico-legal literature relevant to dental decision-making and documentation. Editorials and non-peer-reviewed items without retrievable full text were not considered for evidence synthesis. Results: The reviewed evidence supports that spontaneous bacteremia associated with active periodontitis and daily oral activities may be more frequent than procedure-related bacteremia, suggesting that inflammation control and biofilm management represent a major preventive lever. Antibiotic prophylaxis should be reserved for a limited subset of high-risk cardiac patients as per contemporary ESC/AHA recommendations, whereas routine “defensive” prescribing in low-risk contexts provides minimal expected benefit and carries individual and societal harms (adverse events, microbiome disruption, AMR selection). Integrating periodontal care pathways with risk stratification and targeted antibiotic stewardship can improve patient safety and support public health. Conclusions: Dentistry plays a strategic preventive role in IE and AMR primarily through periodontal inflammation control, asepsis, and prudent antibiotic use. From a medico-legal standpoint, professional liability should be assessed on a process-based standard (risk assessment, adherence to updated guidelines, causal local treatment, informed consent, and traceable follow-up) rather than on outcome-driven hindsight.

Studies on links between Oral Health-Related Quality of Life (OHRQoL) and use of dental services among UK children are lacking. This study aimed to assess the relationship between OHRQoL and dental attendance in 12- and 15-year-old children in the UK using secondary data from the UK Child Dental Health Survey (CDHS, 2013). Methods: OHRQoL was measured as the exposure using the Child-OIDP (Oral Impacts on Daily Performances), and dental attendance was the outcome in this analysis. Dental attendance was measured by asking children whether they visited the dentist regularly, only when in trouble, or never. Logistic regression models analysed the relationship between OHRQoL and dental attendance accounting for potential confounding factors such as socio-demographic characteristics, health behaviours, and anxiety. Results: Data from 4136 children aged 12 and 15 years found that the prevalence of dental attendance ‘only when in trouble or never’ was 20.5% among children who reported at least one impact, compared to 13.6% among children reporting no impacts. A social gradient was apparent, as 28% of children living in deprived areas exhibited problem-oriented dental attendance compared with 8.6% in affluent areas. Logistic regression unadjusted estimates of children who reported at least one impact on QoL had 1.64 times greater likelihood of visiting the dentist ‘only when in trouble or never’ compared to children reporting no impacts (OR: 1.64, 95%CI: 1.24, 2.17). Adjusting for confounders reduced this to OR 1.39 (95% CI: 1.10, 1.77). Furthermore, the greater the number of negative impacts that were reported, the higher the odds of visiting a ‘dentist only when in trouble or never’. In the fully adjusted model, children who reported either two or more impacts had higher odds of visiting the dentist ‘only when in trouble’. Children who reported only one impact were as likely to seek dental treatment ‘only when in trouble’ as children reporting no impacts. Conclusions: Both poorer OHRQoL and problem-oriented attendance were more evident in children from lower-socio-economic backgrounds. Barriers to regular dental attendance affecting children from disadvantaged backgrounds should be addressed and dental care prioritised.

Objectives: To compare artificial intelligence (AI) crown design with expert or non-AI computer-aided (CAD) design for single-unit tooth and implant-supported crowns across efficiency, marginal and internal fit, morphology and occlusion, and mechanical performance. Materials and Methods: This systematic review was conducted and reported in accordance with PRISMA 2020. PubMed MEDLINE, Scopus, Web of Science, IEEE Xplore, and Dentistry and Oral Sciences Source were searched from 2016 to 2025 with citation chasing. Eligible studies directly contrasted artificial intelligence-generated or artificial intelligence-assisted crown designs with human design in clinical, ex vivo, or in silico settings. Primary outcomes were design time, marginal and internal fit, morphology and occlusion, and mechanical performance. Risk of bias was assessed with ROBINS-I for non-randomized clinical studies, QUIN for bench studies, and PROBAST + AI for computational investigations, with TRIPOD + AI items mapped descriptively. Given heterogeneity in settings and endpoints, a narrative synthesis was used. Results: A total of 14 studies met inclusion criteria, including a clinical patient study, multiple ex vivo experiments, and in silico evaluations. Artificial intelligence design reduced design time by between 40% and 90% relative to expert computer-aided design or manual workflows. Marginal and internal fit for artificial intelligence and human designs were statistically equivalent in multiple comparisons. Mechanical performance matched technician designs in load-to-fracture testing, and modeling indicated stress distributions similar to natural teeth. Overall risk of bias was judged as some concerns across tiers. Conclusions: Artificial intelligence crown design delivers efficiency gains while showing short-term technical comparability across fit, morphology, occlusion, and strength for single-unit crowns in predominantly bench and in silico evidence, with limited patient-level feasibility data. Prospective clinical trials with standardized, preregistered endpoints are needed to confirm durability, generalizability, and patient-relevant outcomes, and to establish whether short-term technical advantages translate into clinical benefit.