Search Results (63)

Background & Objectives: Periodontal disease (PD) is a common oral disease that affects the supporting structures of the teeth and is a leading cause of tooth loss worldwide. This study aimed to estimate the prevalence of PD among 9th-grade teachers in the northern West Bank and examine its association with key behavioral and socioeconomic factors. Methods: A cross-sectional study was conducted among 920 teachers selected through proportional stratified random sampling from governmental and private schools. Periodontal health was assessed using the WHO Community Periodontal Index for Treatment Needs (CPITN), and oral hygiene status was measured with the Simplified Oral Hygiene Index (S-OHI). A structured questionnaire was administered to collect data on socioeconomic status, oral hygiene practices, dietary habits, and smoking behaviours. Data was analysed using descriptive statistics, bivariate and multivariate logistic regression. Results: Only 11.8% of participants exhibited completely healthy gingiva, with the mean condition ranging between calculus and shallow pockets. Oral hygiene practices were the strongest predictors of periodontal outcomes: frequent tooth brushing (Adjusted Odds Ratio: AOR = 0.015), morning brushing (AOR = 0.015), and regular toothbrush replacement (AOR = 2.514) were protective. Higher red meat intake was negatively associated with periodontal health (AOR = 0.032), while frequent nut consumption was protective (AOR = 0.227). The number of cigarettes smoked per week was positively associated with PD (AOR = 1.085). Conclusions: PD is highly prevalent among Palestinian adults, with significant behavioural and lifestyle-related determinants. Targeted oral health interventions are urgently needed to improve adults’ oral health. Full article

Background/Objectives: This study examined the association between energy drink consumption and self-reported bruxism behaviors and temporomandibular joint (TMJ) pain among young adults in Jordan. Methods: A cross-sectional, self-administered survey was distributed to young adults aged 18–30. After applying predefined exclusion criteria, the analytic sample for the TMD-related analyses comprised n = 1373 participants. The questionnaire captured demographics, frequency and duration of energy drink consumption, self-reported bruxism behaviours (clenching, grinding, bracing, thrusting), TMJ pain symptoms adapted from DC/TMD screening items, and psychological stress measured by the validated Perceived Stress Scale (PSS-10). Questionnaire reliability was assessed in a pilot (n = 20) using Cohen’s Kappa. Descriptive statistics, chi-square tests and multivariable logistic regression (adjusting for age, sex, smoking and stress) were used to evaluate associations. Results: Among participants, 309 (22.5%) reported daily energy drink use. Self-reported bruxism behaviors were present in 19.4% (n = 60) of consumers, with an additional 26.9% suspecting these behaviors. TMJ pain on awakening was reported by 41.1% (n = 127) of consumers. Energy drink consumption was significantly associated with higher odds of self-reported bruxism behaviors (χ² = 115.6, p < 0.001). In multivariable analyses, daily consumption remained independently associated with bruxism (adjusted OR 1.9; 95% CI 1.3–2.7; p = 0.001). Higher consumption frequency was also linked to an increased number of oral health symptoms. Conclusions: after adjusting for key confounders, energy drink consumption was associated with greater prevalence of self-reported bruxism behaviors and TMJ pain among young Jordanian adults. These findings emphasize the potential oral health risks of habitual energy drink use and underscore the need for targeted education and preventive strategies in this population. Full article

Background: Malnutrition is common among older adults with cognitive impairment and contributes to frailty and poorer health outcomes. Many individuals with dementia require mealtime assistance, yet differences in caregiving practices across hospital and nursing home settings remain underexplored. Aim: The aim of this study was to compare eating encouragement practices, feeding skills, feeding difficulties, and nutritional status between family caregivers in hospitals and professional caregivers in nursing homes. Methods: A cross-sectional observational study was conducted between June 2020 and December 2023 in New South Wales, Australia. The study included 82 older adults (≥65 years) with cognitive impairment: 31 hospital patients supported by family caregivers and 51 nursing home residents supported by assistant nurses. Eating encouragement, feeding skills, and feeding difficulties were assessed using structured observation tools, and nutritional status was evaluated using the Mini Nutritional Assessment–Short Form (MNA-SF). Group differences were analysed using chi-square tests and independent t-tests (p < 0.05). Results: Family caregivers in hospitals demonstrated stronger relational and engagement-based practices, including consistent handwashing (χ² = 31.945, p < 0.001), encouraging self-feeding (χ² = 21.678, p < 0.001), verbal cueing (χ² = 12.083, p = 0.002), touch prompting (χ² = 51.817, p < 0.001), and sitting face to face (χ² = 38.697, p < 0.001). Nursing home caregivers showed more advanced technical skills, such as task simplification (χ² = 54.135, p < 0.001), mirroring (χ² = 78.456, p < 0.001), hand-over-hand guidance (χ² = 73.076, p < 0.001), mouth- and lip-opening techniques (both χ² = 81.000, p < 0.001), and stronger choking management (p < 0.001). Feeding difficulties also differed: refusal behaviours were more common in nursing homes, while distraction and oral–motor issues were more frequent in hospitals. Overall, nursing home residents had significantly poorer nutritional status (t = −12.592, p < 0.001). Conclusions: Family caregivers provide stronger relational support, whereas professional caregivers demonstrate superior technical competence. Integrating these complementary strengths may enhance mealtime care and reduce malnutrition among cognitively impaired older adults. Full article

Background/Objectives: Dental anxiety has been demonstrated to exert a significant influence on the frequency of treatment, the degree of patient compliance, and the long-term implications for oral health. The objective of this study was to evaluate the extent of dental anxiety experienced by patients attending an oral surgery practice in Germany. In addition, the study sought to assess their preventive dental behaviour and to explore any potential associations between anxiety levels and the utilisation of preventive care services. Methods: The present study comprised 102 consecutive adult outpatients from a private oral surgery practice. The assessment of dental anxiety was conducted using the Corah’s Dental Anxiety Scale (DAS). The behaviour of the subjects in relation to preventative dental care was measured using a series of six standardised items, including the frequency of tooth brushing, tartar removal, and professional tooth cleaning. The data analysis comprised descriptive statistics, chi-square (χ²) tests, multiple linear regression, and one-way analysis of variance (ANOVA). Results: The mean DAS score was 12.69 (SD = 3.36). According to the DAS classification system, 28.4% of patients reported low anxiety, 50.0% moderate anxiety, and 21.6% high dental anxiety. Regression analysis explained 10% of the variance in DAS scores (R² = 0.128, adj. R² = 0.100). The analysis revealed that age (β = −0.218, p = 0.035) and lower educational level (β = −0.357, p < 0.001) were associated with higher anxiety scores, whereas sex was not a significant predictor. Preventive dental behaviour, encompassing practices such as tooth brushing, professional tooth cleaning, and tartar removal, did not exhibit significant disparities across anxiety groups (all p > 0.05). Conclusions: While dental anxiety was prevalent among the patient sample, it did not exert a significant influence on preventive dental behaviours. However, patients with lower levels of education and younger age exhibited higher dental anxiety scores. These findings underscore the necessity for targeted educational and preventive strategies in patients with elevated dental anxiety. Full article

Background/Objectives: Early detection of undiagnosed prediabetes (PD) and type 2 diabetes (T2D) could prevent or delay the onset of diabetes and its complications. The dental setting has been suggested as a location for expanding diabetes screening in primary care. This study aimed to investigate behavioural factors that influence an oral healthcare professional’s (OHP) participation in diabetes screening and their decision to refer individuals at a high risk of diabetes for medical follow-up and confirmatory diagnosis. These factors provide targets for future interventions to encourage screening implementation and increase referral guideline compliance. Methods: This qualitative study utilised OHPs who had participated in a diabetes screening trial in Victoria, Australia. Qualitative, semi-structured interviews were conducted by telephone or videoconferencing and transcribed and analysed thematically. The themes identified were deductively mapped onto the Capability, Opportunity, Motivation, and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Results: In total, eight interviews were conducted (seven dentists and one oral health therapist). Five COM-B domains were identified: reflective motivation, automatic motivation, social opportunity, physical opportunity, and psychological capability. Nine TDF domains were associated with issues related to knowledge, the environmental context and resources, memory, attention and decision processes, skills, social influences, beliefs about consequences, emotion, beliefs about capability, and social influence. Conclusions: This is the first study to investigate the factors influencing an OHP’s participation and decision making in diabetes screening and referral processes in the dental setting. The results demonstrate that OHPs need more education and training to screen for diabetes in dental clinics. This study represents the first step in developing interventions to target these factors and improve the effectiveness of diabetes screening in the dental setting. Full article

Background & Objectives: Periodontal disease is a common but preventable condition characterised by chronic inflammation of the periodontium caused by microbial infection. School-based oral health education can promote healthy behaviours and enhance periodontal health. This study was to assess the effects of an interactive oral educational program on periodontal status, oral hygiene, and related behaviours among 9th-grade students in Nablus City. Method: A pre-test/post-test experimental design was conducted from 2023 to 2024 in governmental and private schools. A stratified random sampling procedure selected 536 students for the intervention group and 410 for the control group. Baseline and two-month follow-up data were collected via a self-administered questionnaire and clinical examinations using the Community Periodontal Index for Treatment Needs (CPITN) and the Simplified Oral Hygiene Index (S-OHI). Statistical analysis (chi-square test; paired and independent t-tests) was performed with significance set at p < 0.05. Results: At follow-up, the intervention group showed significant reductions in CPITN (from 10.99 ± 2.77 to 10.00 ± 2.64; p < 0.001) and S-OHI (from 12.90 ± 3.10 to 10.89 ± 2.78; p < 0.001). Significant improvements were also observed in oral hygiene practices, dietary habits, and smoking behaviour scores (all p < 0.001). No significant changes occurred in the control group. Conclusions: The interactive, school-based oral health education program effectively improved periodontal health, oral hygiene status, and related behaviours among adolescents. Full article

Introduction: Type 1 diabetes mellitus (DM1) can influence oral health, increasing susceptibility to various oral manifestations. Objectives: This study aimed to characterise oral health-related quality of life (OHRQoL), reported oral symptoms, and oral health behaviours in paediatric individuals with DM1, and compare them with those without DM1; as well as to identify factors associated with OHRQoL in both groups. Methods: A cross-sectional study was conducted using an online questionnaire completed by caregivers of Portuguese children with or without DM1. The questionnaire collected information on sociodemographic, oral health behaviours, perceived oral health, reported oral manifestations, and OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS). Descriptive statistics were calculated, along with chi-square tests and negative binomial regression analyses (α = 0.05). Results: The sample included 235 individuals (115 with DM1 and 120 without). No significant differences were observed in overall OHRQoL between the groups, although children with DM1 had slightly higher ECOHIS total scores (4.38 vs. 4.02). Oral health behaviours were comparable in both groups. Children with DM1 reported significantly more xerostomia (p < 0.001). Within the DM1 group, better OHRQoL was significantly related to the following variables: female sex, absence of caries, absence of gingivitis, and no taste changes. In contrast, in the non-DM1 group, OHRQoL was associated with different conditions: the caregiver perception, frequent sugar intake, recurrent aphthous stomatitis, burning mouth sensations, and age. Conclusion: Although OHRQoL levels and oral health behaviours were similar between children with and without DM1, the factors influencing these outcomes varied considerably, emphasising the need for targeted oral health strategies tailored to the specific context of this chronic condition. Full article

Background: The objective of this investigation was to assess the oral health (OH) of Bosnia and Herzegovinian adolescents in relation to differences and socioeconomic status (SES). Methods: This cross-sectional study included 306 school children from high schools located in the Tuzla Canton (Bosnia and Herzegovina). The sample consisted of 183 females and 123 males between 15 and 18 years old (mean of 16.82 years old). The study was conducted between December 2019 and March 2020, via an Annex 8 questionnaire from the World Health Organization (WHO), which collected information on OH behaviours, self-perceptions of oral health and dietary factors responsible for the OH of each subject. SES was categorized using five variables (occupation, education, income, place of residence and number of family members). Cross-tabulations were evaluated according to sex and socioeconomic status (SES) via the chi-square test. Results: Over 40% of the participants consumed sweets, cakes and biscuits on daily basis, whereas 41.5% of the participants visited a dentist only in the case of pain. The consumption of sweets (p = 0.024) and cakes and biscuits (p = 0.011) on a daily basis was significantly greater in female adolescents than in male adolescents. Compared with male adolescents, female adolescents reported occasional toothaches more frequently (p = 0.001) and were more dissatisfied with their dental appearance (p = 0.008) but presented a greater frequency of flossing (p = 0.001) and toothbrushing (3–5 times a day) (p = 0.0001). There was no association between the different levels (below average, average, above average) of SES and factors affecting OH status of adolescents. Conclusions: The study revealed significant sex differences in several factors affecting OH status and revealed no relationship between SES and OH behaviours or between perceptions and risk factors affecting OH in 15–18-year-old adolescents. Data obtained from this study might help in the creation of new OH prevention programs aimed at improving the OH status of adolescents in Bosnia and Herzegovina. Full article

Context: Diabetes rates are high in Black and some other ethnic communities, often leading to more severe complications. We conducted a study to identify the prevalence and risk of diabetes among African Caribbean Black (ACB) individuals aged 18–39 and to assess the sensitivity of glycated hemoglobin (HbA1c) compared to an oral glucose tolerance test (OGTT) to diagnose diabetes. Methods: In this mixed-methods study, maximum variation sampling was used to recruit 272 ACB participants from fourteen African and five Caribbean countries from Toronto. Participants’ height, weight, waist circumference, HbA1c, OGTT, demographic, and behavioural data were collected. SPSS was used to analyze the quantitative data. This study used descriptive statistics for frequency distribution and cross-tabulation while inferential statistics (regression, ANOVA, factor analysis, etc.) were used for relational analysis. Because of the small sample size, qualitative data were analyzed manually using the charting technique. Results: This study found that 1.5% of participants had diabetes, 9.2% had prediabetes, and 44.9% were at risk of developing diabetes. The mean value of HbA1c, FBS, and 2hPG was 5.5%, 4.8 mmol/L, and 5.7 mmol/L, respectively. The mean BMI was 28.2 kg/m², and the waist circumference was 85.8 cm. This study found a correlation between glucose intolerance and increasing body mass index (BMI) and waist circumference (WC). Dietary habits, physical inactivity, and mental health challenges were risk factors among the participants. HbA1c was found to be a more sensitive and culturally acceptable screening measure than OGTT in diagnosing diabetes. Conclusions: ACB individuals are at high risk of having diabetes, requiring culturally tailored peer-based health promotion strategies to reduce diabetes prevalence and risk. HbA1c is a culturally acceptable and statistically more capable measure than OGTT in identifying individuals with prediabetes. Further longitudinal research is needed. Full article

Background: The World Health Organisation (WHO) included silver diamine fluoride (SDF) in the WHO Model List of Essential Medicines for the management of early childhood caries. SDF is typically available as a 38% aqueous solution, which is watery to apply. A 38% SDF gel has recently been developed, but its caries-arrest effectiveness remains unsubstantiated. The objective of this study is to determine whether the efficacy of a 38% SDF gel is non-inferior to a 38% SDF solution in arresting early childhood caries. Methods: This is a 30-month, randomised, active-controlled, parallel-group non-inferiority pragmatic clinical trial with two arms. The hypothesis is that the 38% SDF gel is not worse than the 38% SDF solution by a non-inferiority margin of 10% caries-arrest rate when applied semi-annually to preschool children. This trial will recruit 630 3-year-old kindergarten children through block randomisation to receive either an application of SDF gel or SDF solution on cavitated carious lesions in their primary teeth every 6 months. The primary outcome is the proportion of soft (active) carious tooth surfaces that turn hard (arrested) at the 30-month follow-up. The same calibrated dentist will conduct 6-monthly dental examinations in the kindergartens to assess the status of carious lesions over 30 months. The examiner, the children, and parents will be blinded to treatments. The parents will be surveyed on their child’s oral health-related behaviours and socioeconomic background to allow adjustment for effect modification. Results: If the anticipated results are obtained, clinicians can use the 38% SDF gel as an alternative of the 38% SDF solution in arresting early childhood caries. Conclusions: As SDF gel is cost-effective, non-invasive, and non-aerosol-generating, it can be widely recommended for caries control. Trial registration: ClinicalTrials.gov NCT06241261. Registered on 7 February 2024. Full article

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

Background/Objectives: The use of oral anticancer agents (OAA) dates to the late 20th century in cancer treatment. It is crucial that patients implement self-care behaviours to keep their disease stable and manage their OAA treatment. The three dimensions of self-care according to Riegel et al., self-care maintenance, self-care monitoring, and self-care management, may be implemented to avoid negative outcomes. This paper seeks to identify outcomes associated with self-care in breast cancer patients during treatment with OAA and to compare which of these outcomes fall into the core outcome categorizations in oncology (minimal set of outcomes that research on a given health issue should measure). Methods: A systematic review with narrative synthesis was conducted. This study included patients with breast cancer taking any kind of OAA and described outcomes of self-care. The search was performed on MEDLINE, Web of Science and CINAHL/PsycINFO; Results: Of 4173 records, eight studies were selected and reviewed. The core outcomes mainly considered were mortality, survival, disease recurrence and quality of life. All studies focused only on pharmacological adherence outcome; none of them focused on other dimensions of self-care. Conclusions: This systematic review highlighted that there is a great lack of research on outcomes related to self-care in patients with breast cancer taking OOA. Even though pharmacological adherence to OAA is important, other behaviours are also important to improve patients’ outcomes, but they have not been studied. Further research is needed to study how self-care behaviours can impact patients’ outcomes. Full article

Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from two repeated cross-sectional surveys. The objectives were (1) to assess the temporal changes in children’s dental health status and oral health-related behaviours, (2) to examine temporal changes in parental attitudes toward their children’s oral health care, and (3) to analyze the associations between observed changes. Materials and methods: Two identical cross-sectional surveys were conducted in 2010/2011 (n = 294) and 2023 (n = 304). In both surveys, parents answered questions regarding their children’s oral health care and completed the 38-item ‘Parental Attitudes toward Children’s Oral Health’ (PACOH) scale, while the dental health of their 3–7-year-old children was clinically assessed. Changes in the examined characteristics were analyzed using general linear models. Results: Significant positive changes (p < 0.001) were observed when comparing the surveys: the dmf-t (decayed, missing, filled teeth) score for deciduous teeth decreased from 5.56 to 3.31; the Silness–Löe Plaque Index decreased from 1.45 to 1.15; the percentage of children brushing their teeth regularly increased from 33.0% to 55.3%; the percentage of parents assisting their child with tooth brushing increased from 19.2% to 85.1%; and regular visits to a children’s dentist increased from 36.4% to 85.1%. Moreover, the study revealed better parental attitudes toward their children’s oral health care, as reflected by a change in the total score of the PACOH scale from 112 to 122. Conclusions: It was concluded that changes in parental attitudes played a crucial role in driving positive trends in oral health-related behaviours, which likely contributed to the improvement of dental health in children. Therefore, understanding and influencing parental attitudes can be essential for promoting good oral health skills and good oral health in young children. Full article

Background: Obesity is one of the most neglected public health problems affecting both developed and developing countries. The most clinically severe obesity (Class 3 obesity) has both clinical and service delivery implications on dental services. However, associations between Class 3 obesity and oral health are minimally explored in the literature and thus poorly understood. Aims: This scoping review aimed to explore the existing evidence on Class 3 obesity and oral health. Methods: A literature search was performed via Medline, Scopus, Google scholar and Embase research databases. Results: A total of 375 papers were sourced from the database search. Twenty seven full-text papers were included in the final literature review. Results revealed findings from both quantitative and qualitative studies. Papers included results pertaining to associations with dental disease, oral health and associated behaviours, oral health-related quality of life and the barriers experienced by adults with Class 3 obesity in accessing dental services. Conclusions: While mixed findings were identified, this scoping review reports associations between Class 3 obesity and poor oral health across various domains including clinical parameters and oral health related quality of life. The literature has also highlighted important barriers to dental care in those with the most severe Class 3 obesity. Based upon our findings, we have summarised current oral health management implications and directions for future research. Full article

Background: The objectives of this pilot study are to compare the oral health status of institutionalised and non-institutionalised elderly people in Xiamen, China, and investigate oral health-related factors among this population. Methods: One elderly residential centre and one community centre in the same district were invited to join this study. Elderly people who were aged 65 years or older and able to participate in the oral health examination and questionnaire survey were recruited. Their demographic information, oral health-related behaviours, and oral health-related quality of life were collected through a questionnaire survey. The Decayed, Missing, and Filled Teeth (DMFT) index and the Community Periodontal Index were adopted to assess caries experience and periodontal status, respectively. A chi-square test, a t-test, and a correlation analysis were conducted for data processing. Results: Forty-nine elderly people participated in this study. There is no significant difference in the demographic background between non-institutionalised and institutionalised people. The mean DMFT index in the institutionalised group is significantly higher than that in the non-institutionalised group (p = 0.004). In contrast, the non-institutionalised group showed a significantly higher prevalence of gingival bleeding (p = 0.013) and a higher prevalence of periodontal pockets (p = 0.006) than the institutionalised group. Monthly income is also associated with the caries experience in this population. Conclusions: Institutionalised elderly people showed a higher severity of dental caries but a lower prevalence of periodontal symptoms than the non-institutionalised group. It is noteworthy that the generalisation of this pilot study is limited. Future research should be conducted to comprehensively investigate the oral health status of this population. Full article