Search Results (295)

Objective: This study evaluates the pre–post changes in dental knowledge, attitudes, skills, and behaviors following a community health worker (CHW)-led intervention. Methods: Adult caregivers from migrant worker families living near the United States–Mexico border participated in the five-week, in-person, CHW-led intervention program. The two-hour once/week interactive sessions were held in Spanish and included oral health education, skill-building, and goal-setting. Participants completed pre- and post-surveys about dental knowledge, attitudes, skills, and oral hygiene behaviors (N = 117). Participants self-reported frequency of brushing and flossing in the prior week, which was dichotomized to reflect meeting the American Dental Association (ADA) guidelines of brushing twice/day and flossing once/day. Mean group comparisons and paired t-tests were conducted to assess pre- and post-intervention differences. Intervention feedback was also evaluated. Results: Pre-intervention, most adults met hygiene guidelines, and in the overall sample, there were no significant differences post-intervention. However, there were meaningful behavior change differences observed among subgroups not meeting ADA guidelines at baseline. Among the 32% of adults who did not meet ADA brushing guidelines and the 61% that did not meet ADA flossing guidelines at baseline, there were significant improvements post-intervention and increased weekly frequency for brushing (p < 0.001) and flossing (p < 0.001). Pre-intervention, 30% reported not being taught to properly brush or floss; post-intervention, only 3% reported not being taught this skill (p < 0.001). Knowledge (p < 0.001) and some attitudes, including self-efficacy (p < 0.001), significantly increased post-intervention. Program feedback from participants and CHWs was positive, and 81% of participants shared materials. Conclusions: After the CHW-led intervention, there were increases in the adults’ self-reported dental knowledge, some attitudes, and hygiene skills. Toothbrushing and flossing frequency increased post-intervention among the subgroups of adults that were not already meeting ADA guidelines at baseline. Full article

Background: As a fundamental component of general health, oral health is of significant global concern, with the global burden of dental diseases continuing to rise. Dentists are expected not only to provide clinical care but also to model healthy behaviours and promote oral health through education and advocacy. The knowledge, attitudes and practices of dental students—which represent critical elements of their professional development—play a pivotal role in shaping their future clinical behaviour. However, the extant literature suggests considerable variability in these domains, thus indicating that dental students do not always demonstrate the exemplary oral health practices expected of them. Objectives: The objective of the preliminary study was to assess the oral health practices, utilisation of preventive care, and factors influencing the oral health status of dental students at the Medical University of Plovdiv. Methods: A cross-sectional study was conducted among 138 first- to fifth-year dental students. The study utilised a structured, validated, adapted WHO questionnaire and a clinical examination based on the WHO Basic Oral Health Survey criteria. A comprehensive data set was collected, encompassing sociodemographic characteristics, oral hygiene behaviours, lifestyle habits, and DMFT scores. Results: The utilisation of preventative dental care was found to be high, with 73.2% of the student population reporting a dental visit within the previous six months. This tendency was found to be particularly pronounced among female students, who exhibited a significantly higher frequency of such visits. The prevalence of smoking was found to be significant, with 45.3% of the population reporting current smoking habits. The mean DMFT score was 3.33 (SD 3.13), predominantly driven by filled teeth. The present study found residence to be a significant factor associated with DMFT (p = 0.010). Specifically, rural students exhibited higher scores compared to their urban counterparts. Despite the tendency of smokers and those who brush less frequently to exhibit higher DMFT values, no statistically significant associations were identified regarding toothbrushing frequency, smoking, alcohol consumption, or dental visit frequency. Conclusions: The present study demonstrates that, despite the high utilisation of preventive dental care among dental students, notable disparities in oral health outcomes persist. Residence was identified as the strongest associated factor, with students from rural areas exhibiting substantially higher DMFT scores. Overall, the findings underscore the need for stronger lifestyle-focused education and targeted interventions to better prepare future oral health professionals to promote effective preventive care. Full article

Background/Objectives: Early childhood oral health is strongly influenced by parental and caregiver behaviors, yet evidence on the impact of sociodemographic factors remains limited in Eastern European settings. This study evaluated the association between parental and caregiver sociodemographic characteristics (age, educational level, and living environment) and oral health-related behaviors, dental attendance, and caries experience among preschool children in Romania. Methods: A cross-sectional study was conducted among parents or caregivers of children aged 0–6 years (n = 490). Data were collected between September and November 2025 using a structured online questionnaire (24 items). Statistical analyses included Fisher’s exact test, Mann–Whitney U test, Kruskal–Wallis test with post hoc analysis, and Spearman’s correlation (p < 0.05). Results: Higher parental education was consistently associated with favorable oral health behaviors, including earlier initiation of oral hygiene, parent-assisted toothbrushing, use of fluoridated toothpaste, and preventive dental visits (p < 0.01). Children of parents aged 21–30 years were more frequently caries-free (62.7%), whereas caries prevalence was higher among those with parents aged 41–50 years (60.5%) (p < 0.05). Urban residence was associated with twice-daily toothbrushing (49.4% vs. 36.2%) and earlier dental visits compared with rural residence (p < 0.05). Conclusions: Parental education, age, and living environment are significantly associated with early oral health behaviors and caries experience. Preventive programs should prioritize families with lower educational levels and those living in rural areas. Full article

Objectives: Combining mechanical plaque control, the physical removal of oral biofilm, with chemical plaque control, the use of agents to inhibit biofilm formation, is effective in preventing periodontal disease. Chlorogenic acid (CGA) found in coffee beans has medicinal effects, such as anti-inflammatory and antibacterial properties. Periodontal pathogens are difficult to reach in certain areas with traditional self-care tools, such as toothbrushes. Additionally, the viscous biofilm is difficult to remove using mechanical plaque control alone. Therefore, this study aimed to evaluate the efficacy of CGA in chemical plaque control. Methods: The mRNA and protein expression of inflammatory cytokines in lipopolysaccharide (LPS)-stimulated human gingival fibroblasts (HGFs) and human periodontal ligament fibroblasts (HPDLs) in the presence of CGA were analyzed using reverse transcription-qPCR and enzyme-linked immunosorbent assay. Additionally, the proliferation levels of oral bacteria in the presence of CGA were evaluated. Results: CGA suppressed mRNA and protein expression levels of the inflammatory cytokines, interleukin (IL)-1β and IL-8, in HGFs and HPDLs stimulated with Porphyromonas gingivalis LPS. Furthermore, CGA inhibited bacterial proliferation of Streptococcus mutans, Aggregatibacter actinomycetemcomitans, P. gingivalis, and Fusobacterium nucleatum. Conclusions: This study demonstrated that CGA exhibits anti-inflammatory effects on gingiva and periodontal ligaments, and antibacterial effects against oral bacteria. These results indicate the potential application of CGA in chemical plaque control and suggest its use in preventing periodontal disease progression. Full article

Background/Objectives: The consumption of ultra-processed foods (UPFs) has increased markedly in recent decades and has been associated with adverse health outcomes. In childhood, the family environment plays a central role in shaping dietary habits and oral health behaviors. This study investigated the association between UPF consumption by caregivers and children, its relationship with caregivers’ periodontal health-related quality of life, and described children’s dietary practices and oral hygiene habits. Methods: This cross-sectional study was conducted with caregivers of children participating in the Happy Smile Project in Birigui, São Paulo, Brazil. UPF consumption was assessed using a questionnaire based on the NOVA classification, and periodontal health-related quality of life was evaluated using the OHIP-14-PD. Results: A high frequency of UPF consumption was observed among both caregivers and children. Children whose caregivers had high UPF consumption were more likely to also present high consumption (OR = 9.96; 95% CI: 5.38–18.44; p < 0.001). Higher caregiver education was associated with lower odds of high UPF consumption among children. Children in the high-consumption group were older and showed higher consumption of sweetened milk beverages (p < 0.001). Risk behaviors for oral health, such as nighttime use of sweetened bottles and absence of toothbrushing afterward, were frequently reported. Regarding periodontal health-related quality of life, only the physical disability domain showed significantly higher scores among caregivers with high UPF consumption (p = 0.014). Conclusions: This study demonstrated that high consumption of ultra-processed foods by caregivers significantly increased the odds of children’s consumption and was associated with a greater negative impact on caregivers’ periodontal health-related quality of life, specifically in the physical disability domain. In addition, children exhibited a high frequency of oral health-damaging behaviors. These findings highlight the importance of family-centered strategies aimed at reducing the intake of ultra-processed foods and promoting healthier dietary and oral health behaviors. Full article

Recent developments in all-ceramic restorative materials have enhanced the clinical applicability of lithium disilicate for aesthetic dental restorations. The current study explores the influence of sintering parameter modulation over the translucency and color change of Amber Mill and IPS e.max CAD ceramics at baseline and following simulated aging through thermocycling and simulated toothbrushing. Sixty discs of lithium disilicate were assigned to two groups according to material type (Amber Mill; E-max), then according to translucency level (HT: high translucency; LT: low translucency). All specimens were sintered, polished, and ultrasonically cleaned in accordance with manufacturer guidelines. Optical properties—including translucency parameter (TP), color difference (ΔE), and color coordinates (L*, a*, b*)—were measured using a spectrophotometer at baseline and after a five-year clinical simulation. Scanning electron microscope (SEM) analysis was performed. Amber Mill-HT demonstrated the highest initial translucency (15.48 ± 0.89), followed by Amber Mill-LT (12.52 ± 0.61). Aging increased TP values in Amber Mill groups, while a slight reduction was observed in E-max groups. Amber Mill-LT exhibited the lowest color change (ΔE = 0.80 ± 0.10), reflecting superior color stability, whereas E-max-LT showed the highest ΔE (1.43 ± 0.21). SEM analysis demonstrated distinct microstructural differences between materials and translucency levels. High-translucency ceramics exhibited finer, more uniform lithium disilicate crystals and continuous glassy matrices, whereas low-translucency groups showed larger crystals, increased heterogeneity, and greater surface irregularities after aging. Overall, Amber Mill-LT displayed the greatest color stability, whereas E-max groupsretained translucency more consistently. All evaluated ceramics showed optical alterations within clinically acceptable limits, confirming their suitability for aesthetic restorative applications. Full article

The long-term esthetic performance of indirect restorations is closely related to the color stability and surface integrity of the restorative materials used. With the increasing use of CAD/CAM technologies, a wide range of ceramic- and resin-based materials have been developed for indirect restorative applications. These include feldspathic ceramics (VITA Mark II, VITA Zahnfabrik), hybrid ceramics (VITA Enamic, VITA Zahnfabrik), resin nanoceramic CAD/CAM blocks (Lava Ultimate, 3M), and indirect microhybrid resin composites (GC Posterior, GC Corporation). However, these materials are continuously exposed to chemical and mechanical challenges in the oral environment, such as staining from beverages and daily toothbrushing, which may compromise their optical and surface properties over time. The purpose of this in vitro study was to evaluate and compare the color change (ΔE) and surface roughness (Ra) of these materials after repeated coffee immersion and simulated toothbrushing. A total of 240 disk-shaped specimens were fabricated and subjected to three aging cycles consisting of storage in coffee or distilled water, followed by simulated toothbrushing with or without toothpaste. The color parameters were measured using a spectrophotometer according to the CIE Lab* system, surface roughness was assessed using a contact profilometer, and surface topography was qualitatively analyzed by atomic force microscopy. The results demonstrated that coffee immersion significantly increased both color change and surface roughness for all tested materials, with more pronounced effects observed in resin-based materials. Ceramic-based CAD/CAM materials (VITA Mark II and VITA Enamic) showed greater resistance to discoloration and surface degradation, whereas the resin nanoceramic material (Lava Ultimate) and the microhybrid resin composite (GC Posterior) exhibited clinically perceptible color changes and higher roughness values, particularly after toothbrushing with toothpaste. Full article

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

Objectives: This cross-sectional study aimed to evaluate oral health knowledge, self-perceived oral status, hygiene behaviors, prevalence of dental injuries, and mouthguard use among Croatian basketball players and coaches. Materials and Methods: A total of 414 participants of both sexes, spanning various levels of basketball participation in Croatia, completed an anonymous online questionnaire assessing oral health knowledge, hygiene habits, trauma history, and preventive practices. Data was analyzed using descriptive statistics, Chi-square, Mann–Whitney, and Kruskal–Wallis tests. Results: Participants demonstrated generally poor oral health knowledge, with coaches scoring significantly higher than players (p < 0.05), and knowledge levels varying according to education and socioeconomic status (p ≤ 0.001). A majority reported no prior dental trauma (69.6%), and mouthguard use was notably low (20.8%). While regular toothbrushing was prevalent (87%), the use of dental floss was limited (39.9%). The most reported oral health problems included gingival bleeding (37.9%), dental calculus (35.0%), and tooth sensitivity (34.3%). Conclusions: Despite relatively good hygiene habits, Croatian basketball players demonstrated low oral health knowledge and insufficient preventive practices, particularly regarding mouthguard use. These findings indicate the need for targeted education and preventive strategies within the basketball community. Full article

This study examined whether short water rinsing after hydrofluoric acid (HF) etching achieves comparable total bond strength (TBS) to more advanced cleaning protocols. Ninety-six lithium disilicate specimens were etched with 5% HF and then assigned to one of six post-etch cleaning methods: a 15 s water spray, 60 s water spray, brushing with a toothbrush, an ultrasonic bath with distilled water, an ultrasonic bath with 99% isopropanol, or a 37% phosphoric acid followed by an ultrasonic bath. The specimens were then bonded to acrylic tubes filled with composite resin. Half of the specimens were stored in water at 37 °C for three days, and the other half were stored for 150 days with 37,500 thermal cycles (5 °C/55 °C). TBS testing, failure mode evaluation, and microleakage testing were performed. Two-way ANOVA and Tukey’s test were used for statistical evaluation. Aging for 150 days significantly reduced TBS in all groups. Cleaning with a 60 s water spray resulted in significantly higher TBS than phosphoric acid plus ultrasonic cleaning, regardless of storage time. No significant differences were found among the other cleaning methods. There was no change in microleakage among the different groups; the failure was predominantly cohesive. A 15 s water spray after HF etching was as effective as more complex cleaning protocols in terms of TBS and SEM-observed surface characteristics. Full article

Individuals with developmental disabilities often experience physical and mental chronic conditions from early childhood, which can negatively affect their education, employment, and social participation without appropriate interventions. These impairments frequently limit the acquisition of essential daily living skills, including personal hygiene skills. This study examined a multicomponent intervention package—comprising video prompting, step-by-step instruction based on task analysis, systematic error correction, and reinforcement—to support the acquisition of handwashing skills for two adolescents with developmental disabilities (Autism Spectrum Disorder and Intellectual Disability) and toothbrushing skills for one adolescent. A nonconcurrent multiple-baseline design across participants and skills was employed, including baseline, intervention, maintenance, and generalization phases. The intervention was conducted over eight weeks. The results indicated low and stable baseline performance for both participants, followed by a systematic increase in performance after the introduction of the intervention, reaching accuracy levels between 80% and 91%. Participants demonstrated meaningful improvements in hygiene skill performance following intervention. These gains were maintained over time and generalized to new settings, although a few task steps continued to require prompting. Furthermore, teachers and parents rated the intervention as highly feasible, practical, and useful for supporting hygiene skills, while students reported enjoyment, perceived improvement, and willingness to participate again. Overall, the findings suggest that structured, evidence-based instructional approaches may support increased functional participation in essential daily living skills, particularly when complete independence may not be attainable for all individuals. Full article

Background/Objectives: The novel wave electric toothbrush is considered potentially helpful in removing subgingival plaque to prevent the occurrence of periodontal diseases. This study aimed to assess the cleaning efficacy of a novel wave electric toothbrush on subgingival plaque and its safety profile for oral soft tissues. Methods: In vitro cleaning efficacy evaluations were conducted using oral dental models. The wave electric toothbrushes were divided into low-, medium-, and high-swing parameter groups, with manual brushing (Bass technique) as the control. Simulated plaque was applied to the buccal and gingival sulcus sites of the four first molars, and the plaque removal area and sulcus cleaning depth were measured. For safety evaluation, Sprague Dawley (SD) rats were brushed on their molars daily for 30 days, with bleeding incidents recorded. Oral soft tissues were analyzed through H&E staining and immunohistochemical analysis. Statistical analysis included ANOVA and Kruskal–Wallis (p < 0.05). Results: Medium- and high-swing groups demonstrated superior gingival sulcus cleaning efficacy, showing significant differences compared with the low-swing and control groups (p < 0.05). All swing parameters achieved complete plaque removal on buccal surfaces. No significant differences were observed between the low-swing and manual groups, or between the medium- and high-swing groups, regarding sulcus cleaning efficacy and maximum sulcus depth. During the 30-day in vivo experiment, medium- and high-swing groups showed low bleeding frequencies, primarily at the palatal gingiva and vestibule. Histological analyses indicated that higher swing parameters increased the likelihood of soft tissue injury. Conclusions: Wave electric toothbrushes enhance subgingival plaque removal, with higher swing parameters improving gingival sulcus cleaning. However, stronger parameters may increase the risk of soft tissue damage. Further clinical studies are required to establish optimal guidelines. Full article

Droplet microfluidics enables high-throughput, compartmentalized reactions using minimal reagent volumes, but most implementations rely on precision-fabricated chips and external pumping systems that limit portability and accessibility. Here, we present a handheld vibrational droplet generator that repurposes a consumer electric toothbrush and a modified disposable pipette tip to produce nearly monodisperse water-in-oil droplets without microfluidic channels or syringe pumps. The device is powered by the toothbrush’s built-in motor and controlled by a simple 3D-printed adapter and adjustable counterweight that tune the vibration amplitude transmitted to the pipette tip. By varying the aperture of the pipette tip, droplets with diameters from ~100–300 µm were generated at rates of ~100 droplets s⁻¹. Image analysis revealed narrow size distributions with coefficients of variation below 5% in typical operating conditions. We further demonstrate proof-of-concept applications in digital loop-mediated isothermal amplification (LAMP) and microbiological colony-forming unit (CFU) assays. A commercial feline parvovirus (FPV) kit manufactured by Beyotime Biotechnology Co., Ltd. (Shanghai, China), three template concentrations yielded emulsified reaction droplets that remained stable at 65 °C for 45 min and produced distinct fractions of fluorescent-positive droplets, allowing estimation of template concentration via a Poisson model. In a second set of experiments, the device was used as a droplet-based spreader to dispense diluted Escherichia coli suspensions onto LB agar plates, achieving uniform colony distributions across the plate at different dilution factors. The proposed handheld vibrational generator is inexpensive, easy to assemble from off-the-shelf components, and minimizes dead volume and cross-contamination because only the pipette tip contacts the sample. Although the current prototype still exhibits device-to-device variability and moving droplets in open containers complicate real-time imaging, these results indicate that toothbrush-based vibrational actuation can provide a practical and scalable route toward “lab-in-hand” droplet assays in resource-limited or educational settings. Full article

Background and Objectives: Current evidence remains insufficient to determine whether the impact of autism spectrum disorder (ASD) on dental health is primarily mediated through oral hygiene and dietary habits or through direct effects of the disorder itself. This study examined the theoretical pathways through which ASD severity and toothbrushing-related and dietary-choice-related factors influence dental health in autistic children and adolescents. Materials and Methods: A cross-sectional study was conducted with 399 mothers reporting on their autistic children (aged 2–18 years, mean = 7.8). The exclusion criterion was being older than 18 years. Data included parent-reported data about ASD severity, dental health status, willingness to brush teeth, and dietary quality (assessed using the Diet Quality Inventory). Structural Equation Modeling (SEM) was used to analyze the direct and indirect effects of ASD severity on dental health, with probit regression coefficients estimated using the WLSMV method. Results: Parent-reported variables of ASD severity, diet quality, and toothbrushing willingness together explained 37% of the variance in dental health. The direct effect of ASD severity on dental health was 0.199 (p = 0.039). The indirect effect via toothbrushing was 0.137 (p = 0.006), and via diet quality, it was 0.070 (p = 0.020). The total indirect effect of ASD on dental health was 0.207 (p = 0.026), which was approximately as strong as the direct effect. The associations among the studied variables were statistically equivalent across sex and age groups. Conclusions: Parent-reported ASD severity shows significant association with dental health outcomes, both directly and indirectly, with toothbrushing behavior emerging as the primary mediator. Interventions that promote regular brushing (and, to a lesser extent, healthier eating) may help to reduce the dental health disparities associated with autism. Full article

Introduction: Non-invasive methods to modulate orthodontic tooth movement have gained interest, particularly those targeting inflammatory mediators such as IL-1β and TNF-α, which regulate osteoclast and osteoblast activity. High-frequency vibrations (HFV), including those delivered by sonic toothbrushes, have been proposed to influence these biological responses. The aim of the study is to assess whether sonic vibrations affect IL-1β and TNF levels in patients undergoing clear aligner therapy. Materials and Methods: Twenty Invisalign^® patients were evaluated. For each patient, one tooth received HFV via a 285 Hz sonic toothbrush (experimental), while the contralateral served as a control. Gingival crevicular fluid was sampled at baseline (T0), after one week without HFV (T1), and after one week with HFV (T2). Cytokines were measured by ELISA. Because data were non-normally distributed, non-parametric tests were applied. Results: No significant differences across T0–T2 were found within the HFV group. At T2, IL-1β levels were significantly lower in the HFV group (mean: 23.04; SD: ± 20.18) than in controls (mean: 44.44; SD: ± 47.14), which showed an IL-1β increase with orthodontic force alone. TNF-α levels remained near the ELISA detection limit. Conclusions: Sonic vibrations combined with clear aligners appear to reduce IL-1β secretion and local inflammation without adverse effects. Sonic toothbrushes provide a simple HFV delivery method, though larger studies are needed to confirm these findings. Full article