Search Results (460)

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article

Background and Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder that primarily affects young adults and is frequently accompanied by psychiatric comorbidities such as depression and anxiety, both of which significantly diminish patients’ quality of life (QoL). This study investigated the effect of two oral disease-modifying therapies (DMTs), fingolimod and cladribine, on mental health and QoL in patients with relapsing-remitting MS (RRMS). The aim of the study was to compare levels of depression, anxiety, and health-related quality of life (HRQoL) in RRMS patients treated with fingolimod or cladribine, and to evaluate their associations with clinical and radiological parameters. Materials and Methods: Eighty RRMS patients aged 18 to 50 years with Expanded Disability Status Scale (EDSS) scores of 3.0 or less, no recent disease relapse, and no history of antidepressant use were enrolled. Forty patients were treated with fingolimod and forty with cladribine. Depression and anxiety were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). QoL was evaluated using the Multiple Sclerosis QoL-54 (MSQOL-54) instrument. Additional clinical data, including MRI-based lesion burden, EDSS scores, age, disease duration, and occupational status, were collected. Results: No statistically significant differences were observed between the two groups regarding HDRS and HARS scores (p > 0.05). However, patients treated with fingolimod had significantly higher scores in the Energy/Fatigue subdomain (7.55 ± 2.02 vs. 6.56 ± 2.57, p = 0.046) and Composite Mental Health (CMH) score (64.73 ± 15.01 vs. 56.00 ± 18.93, p = 0.029) compared to those treated with cladribine. No significant differences were found in the independent items of the MSQOL-54. A negative correlation was identified between total lesion load and QoL scores. Conclusions: Although fingolimod and cladribine exert comparable effects on depression and anxiety levels, fingolimod may be associated with better mental health outcomes and reduced fatigue in RRMS patients. Furthermore, lesion burden and clinical parameters such as age and EDSS score may independently influence QoL, regardless of the DMT used. Full article

Students, particularly those in the medical field, are exposed to various stressors that can affect their health-related behaviors, including smoking habits, with implications for oral health and quality of life. Background and Objectives: to analyze the relationship between smoking, oral health, perceived stress level, and self-assessed quality of life in a sample of dental students. Materials and Methods: The cross-sectional study included 338 students, who completed validated questionnaires and were clinically examined. Lifestyle was assessed using a smoking behavior questionnaire, stress levels were measured with the Student Stress Inventory (SSI), and quality of life was evaluated using the EQ-5D-5L instrument. The DMFT index was calculated to determine oral health status. Results: Among the 338 participating students, 53.8% were smokers. The lifestyle analysis revealed slightly higher average scores among non-smokers across all domains—social (3.26 vs. 3.09), attitudinal (2.75 vs. 2.97), and behavioral (3.82 vs. 3.49), but without statistically significant differences (p > 0.25). The mean DMFT score was 12.48, with no significant differences between smokers and non-smokers (p = 0.554). The SSI total score averaged 83.15, indicating a moderate level of perceived stress, again with no statistically significant differences between the groups (p > 0.05). However, slightly higher average stress scores among smokers may suggest the use of smoking as a coping mechanism. In contrast, quality of life as measured by EQ-5D-5L showed significantly worse outcomes for smokers across all five dimensions, including mobility (78.6% vs. 95.5%, p = 0.000) and self-care (93.4% vs. 100%, p = 0.001). Multivariable logistic regression identified smoking (OR = 1.935; p = 0.047) and moderate stress levels (OR = 0.258; p < 0.001) as independent predictors of oral health status. Conclusions: The results obtained suggest that smoking may function as a stress management strategy among students, supporting the relevance of integrating specific psychobehavioral interventions that address stress reduction and oral health promotion among student populations. Full article

Aging is a multifactorial process that affects various physiological functions, including masticatory performance, which is crucial for oral health and nutritional well-being. Impaired masticatory function, often due to factors such as tooth loss, reduced salivation, or muscle atrophy, can lead to significant nutritional challenges and compromise the overall health of elderly individuals. Recent research has illuminated the interconnectedness of masticatory function, oral microbiota, and gut health, suggesting that altered chewing ability may disrupt oral microbial communities, which in turn affect gastrointestinal health and systemic inflammation. This commentary review provides a comprehensive analysis of the role of masticatory function in aging, exploring its impact on the oral microbiota, gut health, and broader nutritional status. We discuss the potential consequences of impaired mastication, including malnutrition, dysbiosis, and gastrointestinal disorders, and explore possible strategies for improving masticatory function and maintaining a healthy gut microbiome through interventions like dietary modifications, oral care, and rehabilitation. We aim to underscore the importance of integrating masticatory function management into the broader context of aging-related healthcare, promoting holistic, multidisciplinary approaches to support nutritional needs and quality of life in older adults. Full article

Iron deficiency (ID) is the most prevalent micronutrient deficiency globally, affecting approximately one in four individuals, with a particularly high burden among children, women of reproductive age, and populations in low- and middle-income countries. It contributes significantly to the global burden of disease, with consequences ranging from impaired cognitive and motor development in children to increased risks during pregnancy, including low birth weight, preterm delivery, and maternal mortality, as well as reduced physical performance and quality of life in adults. ID often precedes iron deficiency anemia (IDA), though clinical and functional impairments—such as cognitive deficits, immune dysfunction, and fatigue—can occur even in the absence of anemia. Despite its widespread nature, challenges remain in precisely defining, diagnosing, and treating ID effectively. Advances in diagnostic tools allow for earlier detection, while novel therapeutic strategies, including updated oral dosing regimens and modern intravenous iron formulations, offer improved efficacy and tolerability. These approaches are particularly valuable in minimizing gastrointestinal side effects and enhancing patient adherence. This review is based on a comprehensive literature search conducted primarily through PubMed and Scopus, emphasizing studies published within the past 10–15 years. It is thematically structured to explore the epidemiology, health consequences, diagnostic complexities, and therapeutic developments related to ID. It highlights the multifactorial nature of ID and underscores the urgent need for early identification, targeted interventions, and updated clinical guidelines to reduce the long-term health and societal impacts of this preventable and treatable condition. Full article

Objectives: Burning mouth syndrome (BMS) is a chronic, painful, idiopathic condition of the oral cavity, characterized by the absence of visible pathological changes on the oral mucosa and normal laboratory findings. Recent evidence from the literature supports the classification of BMS as a neuropathic condition. It has been proposed that oxidative stress may contribute to neuropathic pain. N-acetylcysteine (NAC) is an antioxidant that exhibits neuroprotective properties. The aim of the study was to evaluate the efficacy of N-acetyl cysteine in the treatment of burning mouth syndrome (BMS). Methods: Eighty female patients with previously diagnosed BMS were randomly assigned to one out of two groups. One group received N-acetyl cysteine (600 mg/twice a day) and the other received placebo, for an eight-week period. The outcome was measured by the Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire and Numeric Pain Rating Scale, for burning and discomfort, both before and after completing the therapy. Results: Both groups experienced a significant reduction in burning and discomfort sensations, along with a significant improvement in oral health-related quality of life. However, the difference between the treatment and control group was not statistically significant. Conclusions: NAC does not significantly improve the oral health-related quality of life, burning sensations, and discomfort in BMS subjects compared to placebo. Full article

Polycystic ovary syndrome (PCOS) is an endocrine disorder prevalent in women of reproductive age, often requiring complex pharmacological management. The heterogeneity of the syndrome and the use of on- and off-label therapeutic agents—ranging from insulin sensitizers and ovulation inducers to oral contraceptives and herbal supplements—pose significant challenges, including adverse effects, drug interactions, and poor adherence. This narrative review explores the role of pharmacists in identifying and mitigating drug-related problems (DRPs) associated with PCOS therapy. Through thematic synthesis of the current literature, the study highlights common DRPs such as suboptimal drug selection, inappropriate dosing, prolonged therapy duration, and treatment-related safety concerns. It underscores the value of pharmacists’ interventions in enhancing medication adherence, optimizing therapeutic regimens, providing patient education, and monitoring adverse events. A structured, patient-level pharmaceutical care model is proposed, emphasizing personalized assessment, interdisciplinary collaboration, and continuous follow-up. The integration of clinical pharmacists into PCOS care teams has the potential to improve treatment effectiveness, patient satisfaction, and long-term health outcomes. Pharmacists’ contributions are especially critical given the widespread use of off-label therapies and supplements with variable evidence of benefit. Tailored pharmaceutical care can thus bridge the existing gaps in PCOS management and enhance the quality of life for the affected individuals. Full article

Background: Cachexia worsens prognosis, quality of life and chemotherapy treatment compliance of patients with lung cancer. Chemotherapy-induced cachexia has also been implicated in lowered mortality. This study aimed to evaluate the frequency of cachexia-related measures and symptoms as outcomes in lung cancer chemotherapy trial protocols and to examine how key trial characteristics influence them. Method: We conducted a cross-sectional data analysis of randomised controlled chemotherapy trials of lung cancer registered in four public trial registries between 2012 and 2023. Trial outcome measures included overall survival, treatment toxicity/side effects and cachexia-related indicators such as physical activity, weight/body mass index (BMI), dietary limitations, caloric intake and lean muscle mass. Symptom-related outcomes, including appetite loss, diarrhoea, pain, fatigue/insomnia, constipation, nausea, vomiting, dysphagia, dyspnoea and oral mucositis, were also extracted. Additionally, the number and type of performance status and assessment tool were recorded. Data were summarised descriptively. Chi-square tests were used to examine associations between trial outcomes and characteristics including cancer type, trial location, lead investigator/funding source, assessment tools and trial commencement year. A p < 0.05 was considered statistically significance. Results: Of the 335 trial protocols (non-small cell (87.2%) and small cell (12.8%)), most were from Europe (50.4%). The trial lead investigator was from industry (56.7%) followed by academia (25.1%). Allied health professional involvement was minimal (0.6%). Trial protocols mostly recorded overall survival (96.4%) and toxicity (83.9%). However, physical activity, weight/BMI, dysphagia, dyspnoea and oral mucositis were recorded in <30%, with dietary limitations, caloric intake and lean muscle mass recorded in <3% of the trials. Measures and symptoms were not associated with cancer type. Trial location was associated with the measures toxicity, physical activity and caloric intake and all symptoms. Lead investigator was associated with the measures toxicity and weight/BMI and all symptoms except for dyspnoea. Performance status and assessment tools were mentioned in 93.4% and 41.8% of the trials, respectively, with significant associations between assessment tools and outcomes, except for weight/BMI, dietary limitations, lean muscle mass, dysphagia and oral mucositis. There was a significant trend with trial commencement year for the measures physical activity (p = 0.002) and weight/BMI (p = 0.000) and all symptoms, except for appetite loss (p = 0.115) and pain (p = 0.433). Conclusions: While the reporting of measures and outcomes was generally higher compared to gastrointestinal chemotherapy cancer trials, it still faced significant under-reporting. Assessment tools should include cachexia-specific symptoms to accurately assess the quality of life in patients with lung cancer undergoing chemotherapy clinical trials. Full article

Tooth wear is a growing oral health concern with implications for function, esthetics, and psychological well-being, ultimately affecting oral health-related quality of life (OHRQoL). While clinical indices assess tooth wear severity, they fail to capture patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs). This narrative review aims to identify and synthesize the use of PROs and PROMs used in adults with tooth wear and to map their assessed domains against the Wilson and Cleary model of health outcomes, highlighting gaps and guiding the development of condition-specific instruments. A comprehensive search of the literature was conducted across PubMed, MEDLINE, and Embase. Studies involving PROMs in adults with tooth wear were included. Extracted data encompassed psychometric properties and domains assessed. PROMs such as the OHIP, OES, OIDP, and QMFQ have been frequently used, focusing on functional limitation, esthetic perception, and psychological distress. However, no single instrument comprehensively addresses all relevant domains of the Wilson and Cleary model. Moreover, variation in tools and constructs limits comparability across studies and clinical settings. Existing PROMs capture only partial aspects of the patient experience related to tooth wear. When mapping these instruments to a validated theoretical model, significant gaps become evident, especially in terms of general health perceptions and overall quality of life metrics. To improve the evaluation and management of tooth wear in clinical settings, it is essential to create a condition-specific PROM based on a solid conceptual framework. Full article

Objectives: This study aimed to evaluate the association between nutritional status and oral health-related quality of life (OHRQoL) in older adults from population-based studies of two cities in southern Brazil. Methods: A total of 569 community-dwelling individuals aged 60 years and older were included. Sociodemographic, dental, and behavioral data were collected. Nutritional status was evaluated using the Mini Nutritional Assessment (MNA). OHRQoL, the primary outcome, was measured using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Poisson regression with robust variance was applied in crude and adjusted analyses to evaluate the impact of nutritional status on OHIP-14 outcomes. Results: The prevalence of risk of malnutrition was 31.6%, while the mean OHIP-14 was 4.86 ± 7.55. Individuals with malnutrition risk (7.44 ± 9.95) showed overall OHIP-14 scores significantly higher than those with normal nutrition (3.65 ± 5.76) (p < 0.001). A similar trend in results was detected in all domains of OHIP-14 (p < 0.05). In the adjusted analysis, individuals at risk of malnutrition had a 66% higher prevalence ratio (PR) (95% confidence interval [95% CI]: 1.23–2.23) of having poorer OHRQoL. Associations were also observed for the severity (PR: 1.69; 95% CI: 1.31–2.19) and extent (PR: 2.33; 95% CI: 1.55–3.49) of OHIP-14. Conclusions: In conclusion, poorer nutritional status is significantly associated with a higher impact on OHRQoL in older adults. Full article

Background: The global rise in life expectancy and the resulting shift toward ageing populations pose significant public health and socioeconomic challenges. As healthy ageing becomes a priority, understanding the factors that support well-being in older age is essential. Oral health is increasingly recognised as a critical determinant of overall health and has been linked to chronic conditions. Objectives: To conduct a systematic review of longitudinal studies examining the relationship between oral health and healthy ageing. Materials and Methods: Two independent reviewers conducted searches in three databases (MEDLINE, EMBASE, and LILACS) up to April 2025, following a defined search strategy. Grey literature was explored using Open Grey and Google Scholar. The quality and the risk of bias of the included studies were evaluated using the Newcastle Ottawa Quality Assessment Scale (NOS) for longitudinal studies. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251029090). Results: Four longitudinal studies reporting the association between oral health and healthy ageing were recognised and included. All selected studies were considered of good quality according to the NOS. The studies varied in defining and measuring healthy ageing, the follow-up period, the sample size, and the measure of oral health; therefore, it was not possible to perform a meta-analysis. The studies included in the review demonstrated a positive relationship between the number of natural teeth and healthy ageing. Discussion: Despite variations in the definition of healthy ageing and the application of different oral health indicators, the review identified significant associations between the number of natural teeth and trajectories of healthy ageing. Conclusions: This review recognised significant longitudinal associations between oral health measures (number of teeth) and trajectories of healthy ageing. The findings emphasise the need to incorporate oral health into research and policy related to healthy ageing. Full article

Background/Objectives: Gastrostomy tube (GT) placement plays a vital role in managing children with chronic illnesses who are unable to meet their nutritional needs orally. While its clinical benefits are well established, limited data exist on caregivers’ satisfaction with GT use in Jordan. This study aimed to assess caregivers’ satisfaction and identify factors that influence their experiences by using a validated satisfaction scoring system in which a score greater than 20 indicates a high level of satisfaction. Methods: A cross-sectional study was conducted at Jordan University Hospital, including children under 18 years of age who underwent endoscopic GT insertion between July 2017 and December 2024. Caregivers completed the Structured Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8), and demographic and clinical data were collected. Statistical analyses explored associations between satisfaction levels and patient-, caregiver-, and healthcare-related factors. Results: A total of 46 caregivers participated. The median satisfaction score was 26.1, surpassing the high satisfaction threshold of 20. Overall, 63% of caregivers expressed satisfaction or high satisfaction with GT feeding, and 82.6% were satisfied with the support provided by the healthcare team. Additionally, 69.5% and 65.2% of caregivers reported improvements in their child’s nutritional status and overall family well-being, respectively. Notably, 89.1% observed a reduction in feeding time, and 84.8% reported fewer respiratory infections following GT placement. Over half of the caregivers (58.7%) indicated that they would have agreed to earlier GT placement if they had been more aware of its benefits. Conclusions: Caregivers reported high satisfaction with GT use, with scores well above the validated threshold indicating high satisfaction. These findings highlight the positive impact of GT placement on children’s health outcomes and family quality of life. Enhancing caregiver education and providing robust healthcare support are crucial to improving the management of children who require GT feeding. Full article

Background\Objectives: Chronic kidney disease (CKD) is defined as a clinical syndrome secondary to a permanent change in kidney function or structure, making it irreversible. Most patients at the onset of the disease are asymptomatic or present nonspecific symptoms, including signs and symptoms at the oral level. These manifestations, such as hyposalivation, increased calculus index, enamel defects, or changes in saliva composition, contribute to the diagnosis of this pathology and can also significantly affect the patient’s quality of life. The aim is to systematically assess the presence and relevance of oral manifestations in patients with CKD, and to identify correlations between these symptoms and clinical parameters such as glomerular filtration rate or concomitant conditions of the patient. Materials and Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was carried out in the PubMed, Scopus, Scielo, and The Cochrane Library databases on 7 April 2025, using terms related to “chronic kidney disease” and “oral manifestations”. Inclusion criteria referred to observational studies published in the last ten years that reported oral symptoms in patients with CKD. The quality of cohort and case-control studies was assessed using the Newcastle–Ottawa Scale (NOS), while for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used. Results: A total of 27 studies met the inclusion criteria, primarily cross-sectional in design. The most frequently reported oral manifestations included hyposalivation, increased calculus and plaque indices, enamel defects, periodontal disease, and oral candidiasis. Significant associations were identified between the duration of dialysis and severity of periodontal disease, as well as between CKD stage and taste dysfunction. Findings varied by age group and CKD stage, with children showing distinct salivary profiles and adults presenting more pronounced periodontal and mucosal conditions. Conclusions: This review highlights a clear relationship between CKD and various oral health disturbances, although more studies are needed to better understand oral–systemic interactions in CKD. What is necessary is the establishment of multidisciplinary care approaches. Full article

Background/Objectives: Orthodontic camouflage is a treatment strategy designed to address mild to moderate skeletal discrepancies through dental compensation when growth modification or orthognathic surgery (OGS) is unsuitable or declined by the patient. This report highlights the treatment of a child with a skeletal Class II pattern, Class II division 1 malocclusion, a 10.8 mm overjet, traumatic overbite, and unilateral temporomandibular joint (TMJ) ankylosis on the left side. Methods: The treatment plan focused on correcting the proclination of the maxillary incisors and improving the facial profile. A non-extraction camouflage approach using pre-adjusted edgewise appliances was implemented following a gap arthroplasty procedure on the left TMJ. Results: The patient achieved a satisfactory treatment outcome, with an ideal static and functional occlusion and significant improvement in facial esthetics. The approach effectively managed the severe mandibular retrognathia and TMJ ankylosis without OGS, thereby minimizing the risk of progressive condylar resorption. Conclusions: This case underscores the importance of personalized treatment plans tailored to each patient’s dental, skeletal, and individual needs. It demonstrates that non-surgical camouflage treatments can be a viable alternative for addressing severe mandibular retrognathia with TMJ ankylosis, achieving favorable esthetic and functional outcomes. Full article