Showing papers on "Oral hygiene published in 2016"

Oral inflammation and infection, and chronic medical diseases: implications for the elderly

Abstract: Oral diseases, such as caries and periodontitis, not only have local effects on the dentition and on tooth-supporting tissues but also may impact a number of systemic conditions. Emerging evidence suggests that poor oral health influences the initiation and/or progression of diseases such as atherosclerosis (with sequelae including myocardial infarction and stoke), diabetes mellitus and neurodegenerative diseases (such as Alzheimer's disease, rheumatoid arthritis and others). Aspiration of oropharyngeal (including periodontal) bacteria causes pneumonia, especially in hospitalized patients and the elderly, and may influence the course of chronic obstructive pulmonary disease. This article addresses several pertinent aspects related to the medical implications of periodontal disease in the elderly. There is moderate evidence that improved oral hygiene may help prevent aspiration pneumonia in high-risk patients. For other medical conditions, because of the absence of well-designed randomized clinical trials in elderly patients, no specific guidance can be provided regarding oral hygiene or periodontal interventions that enhance the medical management of older adults.

Fluoride: a review of use and effects on health.

Abstract: Introduction. Appropriate oral health care is fundamental for any individual’s health. Dental caries is still one of the major public health problems. The most effective way of caries prevention is the use of fluoride. Aim. The aim of our research was to review the literature about fluoride toxicity and to inform physicians, dentists and public health specialists whether fluoride use is expedient and safe. Methods. Data we used in our review were systematically searched and collected from web pages and documents published from different international institutions. Results. Fluoride occurs naturally in our environment but we consume it in small amounts. Exposure can occur through dietary intake, respiration and fluoride supplements. The most important factor for fluoride presence in alimentation is fluoridated water. Methods, which led to greater fluoride exposure and lowered caries prevalence, are considered to be one of the greatest accomplishments in the 20th century`s public dental health. During pregnancy, the placenta acts as a barrier. The fluoride, therefore, crosses the placenta in low concentrations. Fluoride can be transmitted through the plasma into the mother’s milk; however, the concentration is low. The most important action of fluoride is topical, when it is present in the saliva in the appropriate concentration. The most important effect of fluoride on caries incidence is through its role in the process of remineralization and demineralization of tooth enamel. Acute toxicity can occur after ingesting one or more doses of fluoride over a short time period which then leads to poisoning. Today, poisoning is mainly due to unsupervised ingestion of products for dental and oral hygiene and over-fluoridated water. Conclusion. Even though fluoride can be toxic in extremely high concentrations, it`s topical use is safe. The European Academy of Paediatric Dentistry (EAPD) recommends a preventive topical use of fluoride supplements because of their cariostatic effect.

Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients

Abstract: Objective: To evaluate the influence of an app-based approach in a protocol for domestic oral hygiene maintenance in a group of adolescent patients wearing fixed multibracket appliances. Materials and Methods: Eighty adolescent patients scheduled to start an orthodontic multibracket treatment were randomly divided into two groups of 40. Plaque index (PI), gingival index (GI), white spots (WS), and caries presence were recorded in all patients, and they were instructed regarding domestic oral hygiene maintenance on the day of braces application (t0) and every 3 months (t1, t2, t3, t4) during the first year of treatment. Study group (SG) patients were enrolled in a WhatsApp chat room–based competition and instructed to share monthly with the other participants two self-photographs (selfies) showing their oral hygiene status. Results: SG patient participation in the chat room was regular and active throughout the observation period. At t2, t3, and t4, SG patients had significantly lower values of...

The Role of Nutrition in Periodontal Health: An Update.

Abstract: Periodontal health is influenced by a number of factors such as oral hygiene, genetic and epigenetic factors, systemic health, and nutrition. Many studies have observed that a balanced diet has an essential role in maintaining periodontal health. Additionally, the influences of nutritional supplements and dietary components have been known to affect healing after periodontal surgery. Studies have attempted to find a correlation between tooth loss, periodontal health, and nutrition. Moreover, bone formation and periodontal regeneration are also affected by numerous vitamins, minerals, and trace elements. The aim of this review is to critically appraise the currently available data on diet and maintenance of periodontal health and periodontal healing. The effects of nutritional intervention studies to improve the quality of life and well-being of patients with periodontal disease have been discussed.

No Mental Health without Oral Health

Abstract: The poor physical health faced by people with mental illness has been the subject of growing attention, but there has been less focus on the issue of oral health even though it is an important part of physical health. This article discusses the two-way association between oral and mental health. In one direction, the prospect of dental treatment can lead to anxiety and phobia. In the other, many psychiatric disorders, such as severe mental illness, affective disorders, and eating disorders, are associated with dental disease: These include erosion, caries, and periodontitis. Left untreated, dental diseases can lead to teeth loss such that people with severe mental illness have 2.7 times the likelihood of losing all their teeth, compared with the general population. Possible interventions include oral health assessments using standard checklists that can be completed by nondental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral.

Oral Health-related Beliefs, Behaviors, and Outcomes through the Life Course.

Abstract: Complex associations exist among socioeconomic status (SES) in early life, beliefs about oral health care (held by individuals and their parents), and oral health-related behaviors. The pathways to poor adult oral health are difficult to model and describe, especially due to a lack of longitudinal data. The study aim was to explore possible pathways of oral health from birth to adulthood (age 38 y). We hypothesized that higher socioeconomic position in childhood would predict favorable oral health beliefs in adolescence and early adulthood, which in turn would predict favorable self-care and dental attendance behaviors; those would lead to lower dental caries experience and better self-reported oral health by age 38 y. A generalized structural equation modeling approach was used to investigate the relationship among oral health-related beliefs, behaviors in early adulthood, and dental health outcomes and quality of life in adulthood (age, 38 y), based on longitudinal data from a population-based birth cohort. The current investigation utilized prospectively collected data on early (up to 15 y) and adult (26 and 32 y) SES, oral health-related beliefs (15, 26, and 32 y), self-care behaviors (15, 28, and 32 y), oral health outcomes (e.g., number of carious and missing tooth surfaces), and oral health-related quality of life (38 y). Early SES and parental oral health-related beliefs were associated with the study members' oral health-related beliefs, which in turn predicted toothbrushing and dental service use. Toothbrushing and dental service use were associated with the number of untreated carious and missing tooth surfaces in adulthood. The number of untreated carious and missing tooth surfaces were associated with oral health-related quality of life. Oral health toward the end of the fourth decade of life is associated with intergenerational factors and various aspects of people's beliefs, SES, dental attendance, and self-care operating since the childhood years.

McDonald and Avery's Dentistry for the Child and Adolescent

Abstract: * Examination of the Mouth and Other Relevant Structures * Child Abuse and Neglect * Psychologic Management of Children's Behaviors * Development and Morphology of the Primary Teeth * Radiographic Techniques * Clinical Genetics for the Dental Practitioner * Acquired and Developmental Disturbances of the Teeth and Associated Oral Structures * Tumors of the Oral Soft Tissues and Cysts and Tumors of the Bone * Eruption of the Teeth: Local, Systemic, and Congenital Factors That Influence the Process * Dental Caries in the Child and Adolescent * Mechanical and Chemotherapeutic Home Oral Hygiene * Nutritional Considerations for the Pediatric Dental Patient * Local Anesthesia for the Child and Adolescent * Pharmacologic Management of Patient Behavior * Hospital Dental Services for Children and the Use of General Anesthesia * Dental Materials * Pit and Fissure Sealants * Restorative Dentistry * Treatment of Deep Caries, Vital Pulp Exposure, and Pulpless Teeth * Gingivitis and Periodontal Disease * Management of Trauma to the Teeth and Supporting Tissues * Prosthodontic Treatment of the Adolescent Patient * Dental Problems of Children with Disabilities * Management of the Medically Compromised Patient: Hematology, Oncology, Hepatitis, and AIDS * Growth of the Face and Dental Arches * Cephalometrics and Facial Esthetics: The Key to Complete Treatment Planning * Managing the Developing Occlusion * Multidisciplinary Team Approach to Cleft Lip and Palate Management * Practice Management * Community Oral Health * Pediatric Oral Surgery NEW!

Knowledge and attitude of oral hygiene practice among dental students

Abstract: Aim: the aim of the present study is to evaluate oral self-care practices and knowledge among dental students. Objective: brushing methods, oral hygiene aids and use of dental floss by students will be evaluated.background: it is essential to practice good oral hygiene practices in order to maintain optimum oral health. Materials and methods:the cross-sectional survey was conducted among undergraduate students. A self-administered questionnaire that elicits information on demography, frequency of tooth brushing, type of tooth brush, use of dental floss and previous visit to the dentist was issued to the students and collected. A descriptive statistics was performed to evaluate the oral hygiene practice. Conclusion: this study will help us to assess the oral hygiene practice .if essential oral health education and promotive programmed need to be conducted to improve oral hygiene practices and health among young adults.

Effect of oral hygiene maintenance on HbA1c levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients: 2 years follow-up

Abstract: Objective The aim of the present 2-year follow-up study was to assess the effect of oral hygiene maintenance on hemoglobin Alc (HbA1c) levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients with varying glycemic levels. Material and methods Ninety-one individuals were divided into three groups. In group 1, 30 systemically healthy individuals were included (HbA1c < 6%). Patients in group 2 and 3, comprised of 30 patients with T2DM (HbA1c 6.1–8%); and 31 patients with T2DM (HbA1c 8.1–10%) respectively. In all groups, patients received immediately loaded bone level implants. All participants were enrolled in a 6 monthly periodontal/peri-implant maintenance program. Peri-implant bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL) were measured at 6, 12, and 24 months of follow-up. Results Mean preoperative HbA1c levels in patients in groups 1, 2, and 3 were 4.5%, 6.8%, and 8.7% respectively. In group-1, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in groups 2 and 3, there was a significant decrease in HbA1c levels at 24-months follow-up than 6-months follow-up. At 6 months follow-up, BOP, PD, and MBL were significantly higher among patients in group-3 than group-1. At 12 and 24 months follow-up, there was no significant difference in BOP, PD, and MBL in all groups. Conclusions Oral hygiene maintenance reduces hyperglycemia and peri-implant inflammatory parameters around immediately loaded dental implants placed in type 2 diabetic patients.

Post-treatment supportive care for the natural dentition and dental implants.

Abstract: Long-term successful treatment of chronic periodontitis requires placement of patients on post-treatment recall programs known as either periodontal maintenance therapy or supportive periodontal therapy. Selection of the recall intervals must be based on the specific needs of individual patients. A single recall interval (e.g. 6 months) is not suitable for all patients. The main purpose of these programs is to prevent the recurrence of periodontitis. The components of every periodontal maintenance therapy program include: review of medical/dental histories; complete oral examination with an emphasis on the detection of gingival inflammation; establishing whether the maintenance program is working by monitoring clinical attachment levels; evaluation of oral hygiene; and full-mouth supragingival and subgingival debridement (i.e. biofilm removal). Long-term post-insertion care for dental implants also requires a similar patient-specific recall program of supportive implant therapy. The main purposes of a supportive implant therapy program are to maintain a healthy peri-implant mucosa and thereby prevent the development of peri-implantitis. In cases in which plaque-induced peri-implant mucositis has occurred, a well-designed supportive implant therapy program can help return the mucosa to a healthy state. At the current time there is no consensus on the optimal interventions for the treatment of peri-implant mucositis. However, all effective supportive implant therapy programs emphasize meticulous oral hygiene practices, careful peri-implant examination, thoughtful analysis of risk factors and periodic removal of microbial deposits from the implants.

Dental neglect among children in Chennai.

Abstract: Background: Child dental neglect is the failure of a parent or guardian to meet the child's basic oral health needs such that the child enjoys adequate function and freedom from pain and infection, where reasonable resources are available to family or caregiver. Aim: The aim of the study is to evaluate the phenomenon of dental neglect among children in Chennai and to associate dental neglect with oral health status of children aged 3-12 years. Materials and Methods: This is a cross-sectional study involving 478 pairs of parents and children. Dental neglect scale and a questionnaire were used to assess the dental neglect score among parents of the children involved in the study. Oral health status of children was clinically assessed using oral hygiene index, decayed, extracted, filled teeth (def(t)), pulp, ulcers, fistula, abscess (pufa), decayed, missing, filled teeth (DMFT), PUFA as per the World Health Organization criteria and pufa/PUFA index. Student's t-test and one-way ANOVA were used appropriately for statistical analysis using SPSS software version 20.0. Results: A significant higher dental neglect score was reported among the parents who reside in the suburban location (P 3 years (P = 0.001). A significant higher DMFT (P = 0.003), deft (P = 0 < 0.001), pufa (P = 0.011), and debris index (P = 0.002) scores were seen in the higher dental neglect group. Conclusion: Child dental neglect is seen among the parents whose educational qualification was secondary, who reside in the suburban location, and who have not utilized the dental services for more than 3 years in Chennai. This dental neglect results in poorer oral health of children.

Periodontal diseases as a source of halitosis: a review of the evidence and treatment approaches for dentists and dental hygienists.

Abstract: Bad breath (halitosis) is an important social complaint. In most cases (≥90%), the cause of halitosis can be found within the oral cavity. Under this circumstance, the term oral malodor applies. It affects both healthy and periodontally diseased individuals. Oral malodor is mainly caused by a microbial degradation of both sulfur-containing and nonsulfur-containing amino acids into volatile, bad-smelling gases. Anaerobic gram-negative bacteria, the same species that have been linked to periodontal diseases, are especially involved in this process, explaining why clinicians often associate oral malodor with periodontitis. Some volatile organic compounds render patients more susceptible to periodontitis and this supports the malodor-periodontitis link. This review investigates the interaction between oral malodor and periodontal diseases. Pro and con arguments regarding the mechanisms of halitosis and clinical implications will be presented. In general, however, the impact of tongue coatings has been found to be the dominant factor, besides gingivitis and periodontitis. The last part of this review discusses the treatment of bad breath, with different options.

Gender differences in oral health status and behavior of Greek dental students: A meta-analysis of 1981, 2000, and 2010 data.

Abstract: Background: The aim of this study was to investigate the oral health status and behavior of Greek dental students over time, and to meta-analyze these findings to test the widely documented hypothesis that women have better oral health behavior, oral hygiene, and periodontal status but higher dental caries rates than men. Materials and Methods: A total sample of 385 students was examined using identical indices to assess oral health and behavioral data initially in 1981 while the years 2000 and 2010 were selected due to significant changes that took place in the dental curriculum in the 1990s and 2000s. Data by gender concerning the outcome variables recorded in every one of the three surveys were analyzed using Mantel—Haenszel and continuous outcomes methods. Results: A significant improvement in the oral health status and behavior of students was observed over time. The meta-analysis of data by gender showed that females brushed their teeth significantly more often than males [summary odds ratio (OR): 1.95 and 95% confidence interval (CI): 1.08—3.54]. Males and females were found to have a similar risk of developing dental caries. Conclusion: The hypothesis that young women have better oral hygiene habits compared to men was confirmed. However, the hypothesis that women have better oral hygiene and periodontal status but exhibit higher dental caries experience than men was not supported by the findings of the study.

Combining self-management cues with incentives to promote interdental cleaning among Indian periodontal disease outpatients

Abstract: Periodontal disease is a significant public health issue worldwide. Motivational techniques in combination with financial incentives are shown to lead to effective behavior change. The current study sought to examine whether a brief oral health promotion program (self-management cues that were based on self-efficacy and self-regulatory skills) in combination with an incentive (free dental treatment) would make a difference in the adoption of regular dental flossing in a population of Indian periodontal disease outpatients.

Oral Health in Pregnancy

Abstract: Oral health is crucial to overall health. Because of normal physiologic changes, pregnancy is a time of particular vulnerability in terms of oral health. Pregnant women and their providers need more knowledge about the many changes that occur in the oral cavity during pregnancy. In this article we describe the importance of the recognition, prevention, and treatment of oral health problems in pregnant women. We offer educational strategies that integrate interprofessional oral health competencies.

Tooth loss as a predictor of shortened longevity: exploring the hypothesis

Abstract: Many factors contribute to human tooth loss, including oral hygiene practices, trauma, smoking, health status, socio-economic status and individual preferences. Loss of teeth impairs quality-of-life measures, including the eating of most foods that require full masticatory function. A recent study of centenarians found that at age 65–74 years, those who lived to be 100 had a lower rate of edentulism than did younger members of their birth cohort at ages 65–74 years. Oral health was consistent with compression of morbidity toward the end of life. This article explores the hypothesis that factors associated with oral disease and noncommunicable diseases may increase the risk of tooth loss and lead to diminished longevity as a result of multifactorial interactions. It specifically addresses two critical questions. The first is: ‘Can we conclude that the number of teeth in aging humans can affect longevity and life expectancy?’ The answer is yes. The second is: ‘Is tooth loss a predictor of shortened longevity?’ Again, the answer is yes. Edentulism and partial edentulism are discussed as a disability, and how the philosophy/belief systems of dental providers and patients toward retaining teeth influences the outcome of tooth loss is also examined. Osteoporosis and cognitive impairment provide examples of modifying risk factors.

Patient satisfaction and prosthetic aspects with mini-implants retained mandibular overdentures. A 5-year prospective study.

Abstract: PURPOSE This study aimed to evaluate patient satisfaction and prosthetic aspects during a 5-year prospective clinical study of mini dental implants (MDIs) retaining mandibular overdentures. MATERIALS AND METHODS This observational prospective clinical study was conducted on a group of completely edentulous patients (n = 28) with retention problems of conventional mandibular dentures. All patients received new maxillary and mandibular conventional dentures. A total of 112 MDIs (four per patient) were inserted using the flapless surgical approach and immediately loaded by the new mandibular dentures (overdentures). Patients indicated satisfaction with their prosthesis using a questionnaire and a visual analogue scale (VAS). Patient satisfaction and prosthetic complications were recorded 6 months (T6 m ), 1 (T1), 3 (T3), and 5 (T5) years after overdenture insertion. RESULTS The patient satisfaction with eating (hard/soft) food (P < 0.001), talking (P < 0.001), appearance (P = 0.001), comfort (P < 0.001), healing process (P = 0.013), socialization (P < 0.001), stability/retention of mandibular dentures (P = 0.001), ease of oral hygiene (P = 0.008), and ease of handling the dentures (P < 0.001) increased significantly with time. After 5 years, the most common complication was wear/damage of O/rings (n = 235), O/ring replacement (n = 125), maxillary denture relining times (n = 13), worn teeth (n = 10), overdentures relines (n = 10), detachment of the metal housings (n = 9), and fracture of mandibular overdentures (n = 8). Mucositis, soreness, and decubitis ulcer under overdenture occurred most often at T6 m and decreased significantly with time (P = 0.002, 0.005, and 0.024, respectively). CONCLUSION Within the limitations of this clinical study, patient satisfaction with mini-implant retained mandibular overdentures increased significantly with time. However, this treatment required a considerable amount of prosthetic maintenance and repair after 5 years of service.

Quantitative Molecular Detection of 19 Major Pathogens in the Interdental Biofilm of Periodontally Healthy Young Adults

Abstract: In oral health, the interdental spaces are a real ecological niche for which the body has few or no alternative defenses and where the traditional daily methods for control by disrupting biofilm are not adequate The interdental spaces are the source of many hypotheses regarding their potential associations with and/or causes of cardiovascular disease, diabetes, chronic kidney disease, degenerative disease, and depression This PCR study is the first to describe the interdental microbiota in healthy adults aged 18-35 yrs old with reference to the Socransky complexes The complexes tended to reflect microbial succession events in developing dental biofilms Early colonizers included members of the yellow, green and purple complexes The orange complex bacteria generally appear after the early colonizers and include many putative periodontal pathogens, such as F nucleatum The red complex (P gingivalis, T forsythia and T denticola) was considered the climax community and is on the list of putative periodontal pathogens The 19 major periodontal pathogens tested were expressed at various levels F nucleatum was the most abundant species, and the least abundant were A viscosus, P gingivalis and A actino a The genome counts for E corrodens, C concisus, C rectus, T denticola and T forsythensis increased significantly with subject age The study highlights the observation that bacteria from the yellow complex (Streptococcus spp, S mitis), the green complex (E corrodens, C gracilis, C ochracea, C sputigena, A actino a), the purple complex (V parvula, A ondotolitycus) and the blue complex (A viscosus) are correlated Concerning the orange complex, F nucleatum is the most abundant species in interdental biofilm The red complex, which is recognized as the most important pathogen in adult periodontal disease, represents 808% of the 19 bacteria analyzed P gingivalis was detected in 19% of healthy subjects and represents 002% of the interdental biofilm T forsythensis and T denticola (002% and 004% of the interdental biofilm) were detected in 93% and 49% of healthy subjects, respectively The effective presence of periodontal pathogens is a strong indicator of the need to develop new methods for disrupting interdental biofilm in daily oral hygiene

Association between socioeconomic status and oral health behaviors: The 2008-2010 Korea national health and nutrition examination survey

Abstract: Socioeconomic status (SES) has been reported to be associated with oral health behavior. Therefore, the present study was conducted to assess the relationship between SES and oral health behaviors in a large sample of the Korean population. Data from the Korea National Health and Nutrition Examination Survey, which was conducted between 2008 and 2010 by the Division of Chronic Disease Surveillance under the Korea Centers for Disease Control and Prevention and the Korean Ministry of Health and Welfare, were used in the present study. Daily tooth brushing frequency and the use of secondary oral products according to demographic variables and anthropometric characteristics of the participants were assessed. Multivariate logistic regression analyses were used to analyze the associations between daily tooth brushing frequency and the use of secondary oral products, and SES, urban/rural residence, body mass index (BMI), alcohol intake and smoking. An association between SES and tooth brushing frequency and the use of secondary oral products was detected after adjustment. Following adjustment for age, gender, BMI, smoking, drinking, exercise, energy intake, fat intake, periodontal treatment needs and education or income, the adjusted odds ratios and 95% confidence intervals (CI) of tooth brushing ≥3 per day in the highest income group were 1.264 (95% CI, 1.094-1.460) and 2.686 (95% CI, 2.286-3.155) for highest education level group. The adjusted odds ratios for the use of secondary oral products in the highest income and highest education groups were 1.835 (95% CI, 1.559-2.161) and 5.736 (95% CI, 4.734-6.951), respectively, after adjustment for age, gender, smoking, BMI, exercise, calorie intake, periodontal treatment requirements or income. The present study demonstrated an association between SES and oral health behaviors in a large sample of the Korean population. Within the limits of the present study, income and education were suggested as potential risk indicators for oral health behaviors; therefore, patients with a low SES should be investigated further, in relation to oral health.

Oral care measures for preventing nursing home‐acquired pneumonia

Abstract: Pneumonia occurring in residents of long-term care facilities and nursing homes can be termed 'nursing home-acquired pneumonia' (NHAP) NHAP is the leading cause of mortality among residents NHAP may be caused by aspiration of oropharyngeal flora into the lung, and by failure of the individual's defence mechanisms to eliminate the aspirated bacteria Oral care measures to remove or disrupt oral plaque might be effective in reducing the risk of NHAP To assess effects of oral care measures for preventing nursing home-acquired pneumonia in residents of nursing homes and other long-term care facilities Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 November 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 10), MEDLINE Ovid (1946 to 15 November 2017), and Embase Ovid (1980 to 15 November 2017) and Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1937 to 15 November 2017) The US National Institutes of Health Trials Registry (ClinicalTrialsgov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials No restrictions were placed on the language or date of publication when searching the electronic databases We also searched the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, and the Sciencepaper Online to 20 November 2017 We included randomised controlled trials (RCTs) that evaluated the effects of oral care measures (brushing, swabbing, denture cleaning mouthrinse, or combination) in residents of any age in nursing homes and other long-term care facilities At least two review authors independently assessed search results, extracted data, and assessed risk of bias in the included studies We contacted study authors for additional information We pooled data from studies with similar interventions and outcomes We reported risk ratio (RR) for dichotomous outcomes, mean difference (MD) for continuous outcomes, and hazard ratio (HR) for time-to-event outcomes, using random-effects models We included four RCTs (3905 participants), all of which were at high risk of bias The studies all evaluated one comparison: professional oral care versus usual oral care We did not pool the results from one study (N = 834 participants), which was stopped at interim analysis due to lack of a clear difference between groupsWe were unable to determine whether professional oral care resulted in a lower incidence rate of NHAP compared with usual oral care over an 18-month period (hazard ratio 065, 95% CI 029 to 146; one study, 2513 participants analysed; low-quality evidence)We were also unable to determine whether professional oral care resulted in a lower number of first episodes of pneumonia compared with usual care over a 24-month period (RR 061, 95% CI 037 to 101; one study, 366 participants analysed; low-quality evidence)There was low-quality evidence from two studies that professional oral care may reduce the risk of pneumonia-associated mortality compared with usual oral care at 24-month follow-up (RR 041, 95% CI 024 to 072, 507 participants analysed)We were uncertain whether or not professional oral care may reduce all-cause mortality compared to usual care, when measured at 24-month follow-up (RR 055, 95% CI 027 to 115; one study, 141 participants analysed; very low-quality evidence)Only one study (834 participants randomised) measured adverse effects of the interventions The study identified no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental stainingNo studies evaluated oral care versus no oral care Although low-quality evidence suggests that professional oral care could reduce mortality due to pneumonia in nursing home residents when compared to usual care, this finding must be considered with caution Evidence for other outcomes is inconclusive We found no high-quality evidence to determine which oral care measures are most effective for reducing nursing home-acquired pneumonia Further trials are needed to draw reliable conclusions

Oral health in children with physical (Cerebral Palsy) and intellectual (Down Syndrome) disabilities: Systematic review I

Abstract: Introduction: Traditionally, patients with physical and/or intellectual disabilities presented greater oral pathology, owing to their condition and to other external factors. Improved social and health conditions make it necessary to update knowledge on their oral and dental health. Material and Methods: For this purpose, a bibliographic review was done regarding the state of oral health of children with these two types of disability, in comparison with a control group. Some of the guidelines of the PRISMA statement were taken into account. The ranking of the articles found is based on the modified Newcastle-Ottawa Quality Assessment Scale. The final number of articles evaluated was 14. Parameters such as dental caries, oral hygiene, gingival health, dental traumas, malocclusion and habits were considered. Results: There is no consensus among authors regarding dental caries, oral hygiene and gingival health. The different results obtained are due in part to the fact that the methodologies used were not the same. However, it has been noted that, when studying other parameters and regardless of the methodology employed, the results obtained are similar. Conclusions: Children with physical and intellectual disabilities constitute a group that needs early and regular dental care in order to prevent and limit the severity of the pathologies observed.

A prospective cohort study on poor oral hygiene and pancreatic cancer risk

Abstract: Poor oral hygiene has been proposed to increase the risk for pancreatic cancer. We aim to assess this hypothesis, using number of teeth, dental plaque and oral mucosal lesions examined at baseline as a proxy for oral hygiene. During 1973-74 a population-based prevalence study of oral mucosal lesions was carried out in Uppsala County in central Sweden. We followed the study population through linkages with the Swedish Cancer and Total Population registers. A total of 19,924 participants were included, and 126 pancreatic cancer cases were identified during an average of 28.7 years of follow-up. Hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) for pancreatic cancer were estimated using Cox proportional hazards regression models. Overall, subjects with fewer teeth at baseline tended to have an increased risk for pancreatic cancer, although the estimates were not statistically significant. Among subjects with more than 10 teeth, those with unacceptable dental plaque had an HR of 2.1 (95% CI: 1.0, 4.7), compared with those without dental plaque after adjustment for potential confounding factors. Individuals with Candida-related or denture-related oral mucosal lesions, or tongue lesions, compared with those without any of the three studied lesions, had a 70, 30 and 80% excess risk of developing pancreatic cancer, respectively. Presence of more than one type of studied lesions further increased the risk for pancreatic cancer. In conclusion, our findings provide evidence to support the hypothesis that poor oral hygiene plays an important role in the development of pancreatic cancer.

Associations Between Periodontitis and Chronic Obstructive Pulmonary Disease: The 2010 to 2012 Korean National Health and Nutrition Examination Survey.

Abstract: Background: The aim of this study is to examine whether oral hygiene and self-care, particularly in periodontal health, are associated with chronic obstructive pulmonary disease (COPD) in the Korean population.Methods: Data from the Korean National Health and Nutrition Examination Survey from 2010 to 2012 were used to assess the community periodontal index (CPI) of 5,878 participants (normal lung function: n = 5,181; obstructive spirometric pattern: n = 697) aged ≥40 years, who underwent spirometry.Results: Participants with COPD brushed their teeth less frequently and used the following less frequently: 1) dental floss and/or interdental brush; 2) mouthwash; and 3) electric toothbrush (P <0.001). Prevalence of periodontitis in patients with COPD (58.1%) was significantly higher than in those without COPD (34.0%, P <0.001). Number of teeth was significantly lower in patients with COPD compared with controls. Decayed-missing-filled tooth index was significantly lower in patients with COPD. This study shows...