Search Results (187)

Obstructive sleep apnea is a highly prevalent respiratory disease linked to increased morbidity and mortality, a reduced quality of life, and increased economic costs if not treated. Oral appliances are an emerging treatment option for obstructive sleep apnea. This review concluded that many oral appliances marketed as “custom” include modifications and prefabricated items, and therefore do not meet the definition of “custom” oral appliances. This misclassification could hinder the accurate characterization, evaluation, and appropriate prescription of oral appliances. To better inform the clinical utilization of custom oral appliances and to more closely align sleep medicine with the benefits of personalized medicine, we propose that the custom oral appliance classification be further refined into semi-custom and precision-custom categories. Full article

Background/Objectives: Tongue thrust (TT) occurs when abnormal tongue movements cause anterior tongue placement with pressure and contact against or between the teeth, potentially affecting the oral phase of swallowing, impacting eating, breathing and speaking. There is limited literature on the diagnostic and treatment approaches for TT, as well as involvement of health practitioners in its management. This study aims to examine the current knowledge and practices related to TT diagnosis and treatment among health professionals in Australia. Methods: A two-phase explanatory sequential mixed methods approach was adopted, comprising an online survey that collected participants’ demographic information and details on assessment, diagnosis, management, referral practices, and relevant experience and training. Phase one involved 47 health professionals from various disciplines in Australia who completed an online survey in its entirety. Phase two included in-depth interviews with seven speech-language pathologists (SLPs) to gain further insights into their experiences in managing TT. Survey data were analysed descriptively, and interview data was analysed thematically. Results: Most participants diagnosed TT using clinical assessments, such as general observation and oral motor examinations. Treatment approaches commonly included orofacial myofunctional therapy and the use of myofunctional devices. Interviews with SLPs identified four key themes: tongue thrust as a symptom rather than a diagnosis, facilitators to effective treatment, multidisciplinary approaches to management, and training and education gaps in clinical practice. Conclusions: This study provides valuable insights into how TT is identified, assessed, diagnosed, and managed by health professionals in Australia. It highlights the perspectives of SLPs on treatment approaches, as well as their views on the availability and adequacy of training and education in this field. The findings suggest the need for a broader understanding of TT management, emphasising the importance of multidisciplinary collaboration and professional development. These insights are globally relevant, as they stress the shared challenges and the value of international collaboration in improving TT diagnosis and treatment practices. Full article

Background and Objectives: The common complaints of head and neck cancer patients receiving concurrent chemo-radiotherapy (CCRT) are dry mouth, dysphagia, trismus, hoarseness, sore throat, and oral mucosal damage, which result in retained secretions and difficult expectoration. We aimed to investigate the effect of adjuvant respiratory therapy on secretion expectoration and treatment completion in patients with head and neck cancer receiving CCRT. Materials and Methods: From November 2016 to May 2018, 56 head and neck cancer patients were recruited retrospectively, and according to their respiratory therapy in the medical record, were divided into the control group (CG, n = 27) or the research group (RG, n = 29). In the CG, the patients were treated via the teaching of routine breathing exercises and expel techniques, while patients in the RG were treated with the inhalation of a ß-agonist bronchodilator agent five times each week, in addition to the standard treatment administered in the CG. Results: The total completion rate of treatment was significantly higher in the RG (21 patients) compared with the CG (12 patients) (72.4% vs. 44.4%, p < 0.05). After therapy, the rates of clinical symptoms were significantly increased in the RG compared with the CG, including smooth expectoration (76.2% vs. 75.0%), decreased secretions (61.9% vs. 58.3%), reduced viscosity of secretions (66.7% vs. 58.3%), lower cough frequency (71.4% vs. 50.0%), improved sore throat (52.4% vs. 41.7%), and swallowing function (52.4% vs. 50.0%). The continuation of chemo-radiotherapy without disruption was higher in the RG than it was in the CG (66.7% vs. 50.0%). There was no significant difference in adverse effects between the two groups. Conclusions: Adjuvant respiratory therapy not only improves secretion expectoration, but also reduces side effects, thus promoting the completion of the CCRT schedule in patients with head and neck cancer. Full article

Background/Objectives: Infants admitted to neonatal intensive care units (NICUs) face challenges in achieving successful oral feedings. During oral feedings, these infants commonly present with suck–swallow–breathe incoordination, with approximately 30% developing dysphagia, leading to feeding aversion, prolonged hospitalization, and increased parental stress. Cold liquid feeding has demonstrated benefits in improving feeding safety in adults with dysphagia; however, its application in neonates is relatively limited. This study aimed to examine global neonatal feeding practices, with a specific emphasis on cold milk feeding as an intervention for dysphagia. Methods: A cross-sectional global electronic survey was distributed via professional society listservs and closed online professional group forums targeting neonatal providers and feeding therapists from June 2023 to June 2024. The survey assessed institutional feeding protocols, oral feeding practices, and the use of cold milk for infants with dysphagia. Responses were analyzed descriptively. Results: A total of 210 complete responses were received from level IV (51%), level III (42%), and level II (5%) NICUs. While 30% of the respondents were aware of cold milk feeding as a dysphagia intervention, only 15% of the total respondents reported using it in practice. Among the 32 institutions implementing cold milk practices, only one had an established protocol. Additionally, 72% reported having a feeding protocol in place, often incorporating cue-based tools. Most respondents (87.5%) did not allow oral feeding during nasal continuous positive airway pressure (nCPAP), whereas 78% permitted it during high-flow nasal cannula (HFNC) support. Conclusions: Although the awareness of cold milk feeding in neonates is increasing, its implementation remains limited and lacks standardization. Significant variability exists in oral feeding practices, particularly regarding feeding during respiratory support. This underscores the need for further research and evidence-based guidelines to ensure safe and consistent care for preterm infants. Full article

Background: Periodontitis is linked to sleep-disordered breathing (SDB), including snoring, with 50–75% of cases involving mouth breathing (MB). Standard treatment includes scaling and root planing (SRP). Oral appliance therapy (OAT) is used to treat snoring and SDB. OAT plus a mouth shield (OAT+) worn during sleep may reduce MB to enhance periodontal health. This study evaluated whether OAT+, as an adjunct to SRP, improves periodontal health by reducing periodontal pathogens and facilitating upper airway patency. Methods: Fourteen participants with mild–moderate periodontitis were randomized to receive SRP on one side of the mouth at baseline (T0). Pocket depth (PD), bleeding on probing (BOP), and plaque index (PI) were recorded, and bacterial DNA from periodontal pockets were analyzed via PCR at baseline (T0) and 12 weeks (T3). At 4 weeks (T1), all participants received a self-titrated myTAP^® OA, followed by a mouth shield at 8 weeks (T2). Sleep metrics, including respiratory disturbance index (RDI), were recorded using the NOX T3 at T0–T3. Results: BOP and deep PD levels exhibited slight improvements from the baseline for both SRP and non-SRP (OAT+ only) treated sites but did not achieve significance. BOP decreased significantly more from the baseline in the SRP than in the non-SRP group at T3 (p = 0.028); P. gingivalis’ presence declined on both sides (p = 0.0135). Other periodontal and bacterial parameters showed no significant differences between or within groups. Snoring (p = 0.011), MB (p = 0.025), and RDI (p = 0.019) significantly decreased with OAT+ at T3. Conclusions: In mild–moderate periodontitis patients who snore, OAT+ reduces snoring, MB, and obstructive events, serving as an adjunct to SRP with no negative clinical effects over the short term. The combined therapy yielded similar results to OAT+ alone, likely due to minimization of MB. Its capacity to improve the oral environment is worthy of further investigation. Full article

Background/Objectives: Research on oral dysfunctions as contributing factors to obstructive sleep apnea (OSA) is needed to prevent and treat OSA. This study aimed to explore the association of OSA with oral dysfunction and examine its impact on nutrient intake, physical activity, and handgrip strength. Methods: This cross-sectional study analyzed data from the Eighth cycle Korea National Health and Nutrition Examination Survey (KNHANES, 2019–2021). The OSA group included diagnosed individuals and those over 40 years with symptoms such as snoring, fatigue, or witnessed breathing pauses during sleep. The non-OSA group included individuals not meeting these criteria. Using 1:1 propensity score matching to control for confounders (sex, age, lifestyle factors), 7636 participants were included. Oral dysfunction was assessed based on chewing problems, complaints of chewing discomfort, and speech difficulties. Nutrient intake, physical activity, and handgrip strength were analyzed using the Rao–Scott χ² test, complex sample t-test, and complex sample logistic regression. Results: The OSA group demonstrated significantly more oral dysfunction elements than the non-OSA group (p < 0.001). Higher energy intake was observed in the OSA group, with no significant differences in macronutrient intake. Physical activity levels were similar between groups; however, OSA participants without oral problems had higher handgrip strength (p < 0.05). Regression analysis showed increased OSA risk correlated with greater oral dysfunction and lower protein intake. Conclusions: This study revealed a strong association between oral dysfunction and OSA risk. Focusing on the assessment and early intervention of oral dysfunctions that influence OSA risk factors may aid in the early detection and prevention of OSA. Full article

The clinical efficacy of inhalation therapy in chronic respiratory diseases is fundamentally constrained by particle deposition patterns. This study employs computational fluid dynamics (CFD) and response surface methodology (RSM) to elucidate the mechanistic interplay of deposition determinants through multifactorial sensitivity mapping. The study comprises two key components: (i) the development of an accurate three-dimensional respiratory airway model spanning from the oral cavity to the fifth-generation bronchi and (ii) the integration of a Box–Behnken Design (BBD) experimental framework with computational fluid dynamics simulations. Furthermore, we developed a multifactorial regression model to analyze the synergistic interactions among deposition determinants. The study demonstrated a positive correlation between breath-holding time and drug deposition efficiency, revealing a hierarchical order of critical parameters: peak flow rate > breath-holding time > particle diameter. These findings have important implications for optimizing respiratory drug delivery strategies in clinical settings. Full article

A majority of dogs suffer from some form of periodontal disease. This frequently manifests as halitosis or oral malodor, caused by microbes underlying poor oral health. Pathogenic oral microbes process dietary or host proteins into volatile sulfur compounds (VSCs), which are perceived as malodorous and can further contribute to inflammation and periodontal disease progression. This double-blind, placebo-controlled, randomized clinical trial evaluated the ability of Superculture^® Pet Oral, a novel canine oral health postbiotic (COHP), to reduce canine oral malodor. In total, 24 dogs were stratified into two groups based on starting VSC levels. The groups received either COHP or a placebo as a powder topper for 14 days. VSC levels were measured via a Halimeter on Days 0, 7, and 14. Perceived malodor was also scored on the same days. COHP significantly decreased VSCs from baseline by Day 7 by 22% (p = 0.002). In the placebo group, VSCs increased over the course of the study. Throughout the study, COHP lowered VSC levels by 27% compared to the placebo (p = 0.004), and fully prevented an increase in VSCs compared to the baseline. Additionally, VSCs were correlated with the human perception of malodor, and twice as many dogs in the COHP group had perceptibly improved breath on Day 7 compared to the placebo, measured through a 10-point scaled survey. These findings validate the ability of this novel postbiotic to effectively reduce canine oral malodor and provide preliminary evidence that it may more broadly help to maintain canine oral health. Full article

Objectives: This narrative review aims to redefine Open Mouth Posture Syndrome (OMPS) as a multifactorial condition with overlapping symptoms and a cyclical pathophysiology. A novel classification system for OMPS subtypes is proposed to standardize research approaches and enhance clinical understanding. Methods: An interdisciplinary literature review was conducted, focusing on structural, functional, and adaptive mechanisms underlying OMPS. Subtype definitions were refined based on recent findings. Results: OMPS is categorized into five subtypes: Obstructive, Habitual, Anatomical, Sleep-Disordered Breathing, and Tongue-Related Pathologies. These subtypes share interconnected etiologies and manifestations, contributing to a feedback loop that complicates diagnosis and management. Conclusions: This classification system lays the foundation for future research and clinical protocols, emphasizing the need for a systematic approach to understanding OMPS. Full article

Aim: This study aimed to determine the oral health profile of children with autism spectrum disorder and to analyze the impact of their oral health status on their personal quality of life and the quality of life of their families. Materials and Methods: A cross-sectional online study was conducted on 121 parents. A self-structured questionnaire was used to collect data on sociodemographic characteristics, parents’ perceptions of their child’s oral health, oral hygiene practices, and access to dental care. Additionally, the Parental–Caregiver Perceptions Questionnaire (P-CPQ-16, 16 items) and the Family Impact Scale (FIS-8, 8 items) were employed. The data were analyzed descriptively and using the Mann–Whitney U test and the Kruskal–Wallis H test. Results: No significant differences were found in FIS-8 and P-CPQ-16 scores between parents and children based on their sociodemographic characteristics. However, a significant association was observed between P-CPQ-16 and FIS-8 total scores and the type of used dental care (general dental practice vs. adapted practice and general anesthesia, p ≤ 0.001), dental visit frequency (regular vs. occasional, p < 0.05), child cooperation level during dental visits (cooperative vs. uncooperative, p ≤ 0.001), and dental care access challenges (p < 0.05). Parents reported a high prevalence of poor oral health in their children: the experience of tooth decay (48.1%), malocclusion (47.1%), bruxism (38.8%), bad breath (34.7%), and toothache (28.8%) in the previous 12 months. Most children brushed their teeth daily (89.3%), often with the help of their parents (44.6%). The most frequently reported difficulty in maintaining oral hygiene was the children’s unwillingness to cooperate (62.8%). Conclusions: Poor perceived oral health in children with autism spectrum disorder is significantly linked to a lower quality of life for both them and their families, especially when access to dental care is difficult and there is a lack of cooperation. Addressing these barriers and the high prevalence of oral health problems through tailored strategies is critical to improving children’s well-being. Full article

Background and Objectives: Oral appliances (OAs) are commonly used to manage sleep-disordered breathing conditions, including primary snoring, and offer an alternative treatment for individuals with obstructive sleep apnea (OSA) who cannot tolerate continuous positive airway pressure (CPAP) therapy. Our study analyzed the possible factors associated with higher snoring rates compared with those associated with lower snoring rates. Materials and Methods: A customized dental brace with a tongue compressor was the essential part of the Lin OA (LOA). The compressor is available in various lengths, ranging from 0.5 to 3.0 cm across different versions. The participants wore the LOA throughout the night while sleeping. Their snoring rates were recorded using the SnoreClock app on their cell phones. Results: The analysis included 36 participants, comprising 30 males and 6 females. The participants had a mean age of 44.91 ± 9.96 years, a mean BMI of 26.18 ± 3.50 kg/m², and an average recording duration of 398.27 ± 77.56 min per session. In total, 4052 sleep recordings were analyzed. The number of files for females was less than that for males (563 vs. 3489). In this study, individuals belonging to the highest one-third based on the baseline snoring rate (H group) experienced a significant reduction in snoring, approximately 84.8%, when using the LOA-3 cm device equipped with a 3 cm tongue compressor. The individuals who belonged to the lower two-thirds based on the baseline snoring rate were classified as the L group. Among male participants, snoring decreased by approximately 66.4%. Similarly, among female participants in the L group, snoring decreased by approximately 69.3% when using the LOA-3 cm. Conclusions: In this study, we observed a significant reduction in snoring for the two groups of participants wearing the LOA-3 cm, with the rate decrements ranging from 66.4% to 84.8%. This reduction was more pronounced in the H group than in the male participants in the L group. Further studies are needed to explore the reasons for these findings. Full article

Continuous monitoring of pulmonary function is crucial for effective respiratory disease management. The COVID-19 pandemic has also underscored the need for accessible and convenient diagnostic tools for respiratory health assessment. While traditional lung sound auscultation has been the primary method for evaluating pulmonary function, emerging research highlights the diagnostic potential of nasal and oral breathing sounds. These sounds, shaped by the upper airway, serve as valuable non-invasive biomarkers for pulmonary health and disease detection. Recent advancements in artificial intelligence (AI) have significantly enhanced respiratory sound analysis by enabling automated feature extraction and pattern recognition from spectral and temporal characteristics or even raw acoustic signals. AI-driven models have demonstrated promising accuracy in detecting respiratory conditions, paving the way for real-time, smartphone-based respiratory monitoring. This review examines the potential of AI-enhanced respiratory sound analysis, discussing methodologies, available datasets, and future directions toward scalable and accessible diagnostic solutions. Full article

Background: Sleep apnea is a breathing affliction that affects sleep quality, with significant implications for overall physical and oral health, as well as mental health. Aim: The aim of this study was to evaluate the validity of the STOP-Bang and Epworth questionnaires as preoperative screening tools for obstructive sleep apnea (OSA) in the adult population from the NE region of Romania. Materials and Methods: A total of 222 participants were selected. The questionnaire method was used, with the subjects completing the STOP-Bang and Epworth questionnaires. A chi-squared test, an ANOVA, and Student’s t-tests were used for the statistical analysis. Results: the STOP-Bang questionnaire revealed an increased risk of OSA among those with a high BMI, an age over 50 years, or a large neck circumference. Regarding the Epworth questionnaire, daytime sleepiness was more frequent among obese individuals and those with associated pathologies. Significant correlations were found between OSA and obesity, age, and associated pathologies, with limited observations on the influence of gender on the risk of OSA. Conclusions: The studied questionnaires are effective and easy-to-use tools for the preoperative screening of OSA, demonstrating a significant correlation between the identified risk factors and the disease severity. Full article

Background and Objectives: Dental anxiety is a common barrier to pediatric oral care. Non-pharmacological relaxation techniques like Jacobson’s Progressive Muscle Relaxation (JPMR) and Breathing Control (BC) may help reduce psychological and physiological stress. This study assessed the utility of JPMR and BC in reducing dental anxiety and physiological arousal in children and adolescents. Materials and Methods: In this observational study, 189 participants aged 8–17 undergoing non-invasive dental procedures were assigned to JPMR (n = 63), BC (n = 63), or control (n = 63) groups. Dental anxiety was measured with the Romanian-validated IDAF-4C⁺, and physiological stress was measured via blood pressure and heart rate. Pre and post-intervention data were analyzed using paired t-tests, ANOVA, and cluster analysis. Results: JPMR led to the highest reductions in IDAF-4C⁺ scores (Δ = −1.23, p < 0.001, d = 1.12) and systolic blood pressure (Δ = −9.4 mmHg, p < 0.01). BC showed moderate anxiety reduction (Δ = −0.64, p < 0.05, d = 0.61) with minor physiological changes. The control group showed no significant change. Cluster analysis revealed three response patterns: (1) high anxiety–strong responders (n = 58), mainly benefiting from JPMR; (2) moderate anxiety–partial responders (n = 74); and (3) low anxiety–non-responders (n = 57). Younger age and female gender were linked to better JPMR response. Conclusions: JPMR is an effective and practical method for reducing dental anxiety and physiological stress in pediatric dental care. Full article

Background: Breathing conditions influence ventilatory efficiency and exercise performance, but little research has examined how different breathing conditions affect cardiorespiratory responses in women. Despite the growing popularity of nasal-only breathing in fitness culture, its physiological benefits remain unclear. The purpose of the current study is to examine the ventilatory responses to nasal, oral, and oronasal breathing during treadmill exercise at speeds of 5 to 11 km/h in 10 healthy females. Methods: Participants completed sessions under each breathing condition while heart rate (HR), oxygen uptake (VO₂), ventilatory equivalent for CO₂ (VE/VCO₂), respiratory frequency (Rf), tidal volume (VT), minute ventilation (VE), and respiratory timing variables were measured. Results: Breathing condition had minimal impact at lower speeds (5–7 km/h). However, at higher intensities (10–11 km/h), nasal breathing resulted in lower Rf and VE but elevated VE/VCO₂, indicating reduced ventilatory efficiency. In contrast, oral and oronasal breathing facilitated greater VE and shorter inspiratory and expiratory times, supporting ventilation under vigorous exercise. Conclusions: While nasal breathing may suffice at low intensities, it is inadequate at higher intensities, potentially leading to carbon dioxide accumulation and early fatigue. These findings support the use of oral or oronasal breathing during higher-intensity activity and highlight the need for individualized breathing strategies. Full article