Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsinyG M Budaychiev, D R Akaeva, K A Alieva, P M Magomedova, Z G Mugadova, A M Kurbanov
The diseases of oral cavity belong to the most widespread non-communicable pathologies, significantly affecting quality of life and the economy. In Russia, the prevalence of dental caries and periodontal diseases remains high, especially in the rural population, where availability of stomatological care is limited. In the Republic of Dagestan, the situation is complicated by natural climatic, cultural and linguistic characteristics, that determine the necessity of local evaluation of factors of stomatological health.
Journal of human nutrition and dietetics : the official journal of the British Dietetic AssociationLauren Hallewell, Raul Bescos, Zoe Brookes, Robert Witton, Patricia Casas-Agustench
BACKGROUND: Diet is a modifiable risk factor linking oral and systemic health, contributing to dental caries and weight-related outcomes (including underweight, overweight and obesity) in the paediatric population. However, dietary advice provided by dental professionals in primary dental care is often brief and sugar-focused, representing a missed opportunity to address shared risk factors. Integrating dietitians into primary dental care may support more holistic paediatric preventative care. OBJECTIVE: To develop expert consensus on the components required to integrate dietitians into primary dental care to address diet as a common risk factor in paediatric oral health and weight-related outcomes. METHODS: A three-round online Delphi study was conducted with dietitians and dental professionals, followed by patient and public involvement (PPI) consultation with caregivers and children and young people. Round 1 open-text responses were thematically analysed and synthesised into 158 statements. In Rounds 2 and 3, experts rated statements using a 7-point Likert scale. Consensus agreement was defined a priori as ≥ 70% agreement (ratings of 6 or 7) and < 15% disagreement (ratings of 1 or 2) across the panel and within both professional groups. Results were summarised using descriptive statistics. RESULTS: Thirty-six, twenty-eight, and twenty-five experts completed Delphi Rounds 1, 2 and 3, respectively. Round 1 generated 158 statements, of which 90 achieved full consensus agreement by Round 3. Full consensus agreement was reached on safeguards for discussing weight-related outcomes sensitively, referral criteria for oral-health dietary support, training and skill development, organisational structures for collaboration, communication pathways and role clarification. No single approach to identifying weight-related outcomes met the predefined agreement threshold and remained exploratory. CONCLUSION: This study identified consensus-based components for integrating dietitians into primary dental care, providing a practical foundation to inform the design and piloting of integrated dietetic-dental care models with potential to improve oral health and broader child health outcomes.
Clinical and experimental dental researchSonja Henny Maria Derman, Laura de Boni, Edwin Mulder, Stefan Möstl, Julia Jagel, Teresa Kruse, Anna Greta Barbe
AIMS: To investigate longitudinal alterations in oral hygiene, gingival inflammation, and salivary secretion during a 60-day head-down tilt bed rest (HDTBR) protocol as a validated ground-based analog of microgravity. MATERIALS AND METHODS: Twenty-four healthy volunteers participated in a 60-day, 6° HDTBR study conducted under strictly controlled conditions. Oral health assessment safety measures were performed at baseline, mid-head-down tilt (HDT), end-HDT, and post-recovery. RESULTS: Plaque accumulation and gingival inflammation increased, with increases from baseline to end-HDT in the Quigley-Hein Plaque Index (1.8 ± 0.4 to 2.3 ± 0.4; p < 0.01), Gingival Index (0.8 ± 0.4 to 1.2 ± 0.2; p < 0.001), and bleeding on probing (BoP) (18.4 ± 11.6% to 35.1 ± 16.6%; p < 0.001). BoP partially recovered post-HDT, while QHI and GI remained elevated compared with baseline. Periodontal Screening Index scores shifted toward higher grades during HDT without evidence of destructive periodontal breakdown. The unstimulated salivary flow rate remained unchanged throughout. CONCLUSIONS: Prolonged gravitational unloading induces a plaque-driven deterioration of gingival health in systemically healthy individuals, likely related to impaired mechanical plaque control and microcirculatory changes rather than salivary dysfunction. Gingival tissues appear to be sensitive biomarkers of adaptation to unloading conditions, supporting the need for optimized oral hygiene and adjunctive preventive strategies during future long-duration space missions. TRIAL REGISTRATION: German Clinical Trial Registry (DRKS00033882, registration date 03-15-2024, https://www.drks.de/search/de/trial/DRKS00033882/details).
BMC oral healthDina Attia, Mona K ElKashlan, Susan M Saleh, May M Adham
BACKGROUND: Sudanese refugees in Egypt face substantial barriers to oral healthcare access, resulting in high disease burden and poor oral health-related quality of life (OHRQoL). This study evaluated impact of gain- and loss-framed mobile text messages (mHealth) on oral health status, OHRQoL, and hygiene practices among this population. METHODS: A randomized controlled parallel trial was conducted between November 2024 and December 2025 among Sudanese refugees in Alexandria, Egypt, using snowball sampling. Eligible participants (≥ 18 years) were randomly allocated (1:1:1) into gain-framed SMS (emphasizing benefits), loss-framed SMS (emphasizing consequences), or control groups. Intervention groups received 24 SMS messages over 12 months. Outcomes were assessed at baseline, 6 months, and 12 months using clinical examinations (Plaque Index and Gingival Index), OHIP-5 questionnaire for OHRQoL, and a self-reported questionnaire for oral hygiene practices. Data were analyzed using ANOVA, repeated-measures ANOVA, Chi-square, McNemar-Bowker, and multivariable linear regression. RESULTS: Of 303 enrolled participants, 261 completed the study (dropout 13.9%). At 12 months, both gain- and loss-framed groups showed significantly lower PI scores compared to control (p-value = 0.012 and 0.03, respectively), with no difference between intervention groups. PI decreased by 28.46% (gain-framed) and 26.87% (loss-framed). Multivariable regression analysis confirmed gain-framed (B = - 0.429, p-value < 0.001) and loss-framed messaging (B = - 0.330, p-value < 0.001) as independent predictors of lower 12-month PI. GI and OHIP-5 scores showed no significant improvements in intervention groups; however, OHRQoL worsened in control group over time (p-value = 0.013, η2p = 0.12). Daily toothbrushing frequency was significantly higher in intervention groups at 12 months (p-value = 0.026), with no change in flossing. CONCLUSIONS: SMS-based oral health education improved plaque control and toothbrushing frequency among refugees, regardless of framing. However, SMS alone was insufficient to improve gingival health or OHRQoL, highlighting the need to combine mHealth with clinical care. TRIAL REGISTRATION: ClinicalTrials.gov, TRN: NCT06649760, Registration date:12 October 2024.
Oral health & preventive dentistryPoppy Andriany, Cut Fera Novita, Herwanda Herwanda, Munifah Abdat, Subhaini Jakfar, Basri A Gani
PURPOSE: The goal of this study was to look at the link between smoking, drinking coffee, and salivary oxidative stress biomarkers malondialdehyde (MDA) and superoxide dismutase (SOD) as signs of oral health risk among university students in Aceh, Indonesia, and to see if they could be used as non-invasive screening tools in a clinical setting. METHODS AND MATERIALS: There were three groups of students: active smokers, passive smokers, and non-smokers. We used validated questionnaires (Cronbach's alpha = 0.872) to gather behavioural data. We collected unstimulated saliva in a controlled manner and then used enzyme-linked immunosorbent assay (ELISA) to analyse it. We also looked at the physicochemical properties of saliva. We used ANOVA, the Kruskal-Wallis test, and receiver operating characteristic (ROC) curve analysis to analyse the data. RESULTS: Smokers had much higher MDA levels (4.1 ± 0.05 nmol/ml) and much lower SOD levels (0.72 ± 0.010 U/ml) than non-smokers (2.5 ± 0.01 nmol/ml; 1.20 ± 0.012 U/ml; P 0.001). Drinking coffee by itself didn't have a direct effect on oxidative stress, but when combined with smoking, it made the oxidative imbalance much worse. ROC analysis showed that the tests were very good at diagnosing (AUC = 0.88 for MDA; 0.84 for SOD). CONCLUSION: Salivary MDA and SOD are reliable, non-invasive markers that can detect early oxidative stress-related risk. It is a good idea to add saliva-based screening and culturally appropriate prevention strategies to campus health services. These results show that salivary biomarkers are useful in clinical settings for preventive dentistry.
Acta odontologica ScandinavicaJuvenary John Rutabanzibwa, Andrew Ross
OBJECTIVE: To examine determinants of oral health knowledge, perceived oral health status, perceived dental needs, and clinically assessed tooth decay among adults attending Katutura Hospital, Namibia. MATERIAL AND METHODS: A cross-sectional hospital-based study was conducted among adults attending the dental clinic and general outpatient department. Of 660 invited participants, 639 were included in the final analysis (response rate 96.8%). Data were collected using structured questionnaires assessing socio-demographic characteristics, oral health knowledge, oral hygiene practices, perceived oral health status, and perceived dental needs. Clinical oral examinations were performed to assess tooth decay. Multivariable logistic regression analyses were conducted to identify factors independently associated with the outcomes. RESULTS: Most participants (89.7%) demonstrated good oral health knowledge. Tertiary education was the only independent predictor of good oral health knowledge (adjusted odds ratio [AOR] = 2.47; 95% confidence interval [CI]: 1.54-3.97) and was associated with lower odds of tooth decay (AOR = 0.39; 95% CI: 0.27-0.57). Brushing twice or more daily was significantly associated with good self-rated oral health (AOR = 2.03; 95% CI: 1.45-2.84). Employment status was inversely associated with perceived dental needs (AOR = 0.71; 95% CI: 0.51-0.99). CONCLUSIONS: Education was the principal determinant of oral health knowledge and clinical tooth decay, while oral hygiene practices influenced perceived oral health. Strengthening oral health promotion and improving access to preventive services may reduce inequalities and unmet dental needs in Namibia.
BMJ openAmani Alhazmi, Maha Ali, Manal Mohammed Hawash, Ali Mohieldin, Mahmoud Abdelwahab Khedr, Mona Metwally El-Sayed, Wagida Wafik, Hala Awad, Eman Mahmoud Mohammed…
OBJECTIVES: To describe socio-demographic and health-related characteristics, eating behaviours, food satisfaction and oral health-related quality of life (OHRQoL) among community-dwelling older adults in Abha, Saudi Arabia; to assess how eating behaviours, food satisfaction and OHRQoL vary across socio-demographic and health-related groups; and to examine how eating behaviours and food satisfaction are associated with OHRQoL, adjusting for socio-demographic and health-related characteristics. DESIGN: A descriptive cross-sectional study. SETTING: Primary healthcare centres (PHCCs) in the Abha district of the Asir region, Saudi Arabia. PARTICIPANTS: A total of 350 older adults aged 60+ were recruited from PHCCs in Abha, Asir Region, Saudi Arabia, using a non-probability convenience sampling. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was OHRQoL, assessed using the Geriatric Oral Health Assessment Index. Secondary outcome measures included food satisfaction, measured by the Satisfaction with Food-Related Life scale and eating behaviours, assessed using the Eating Behaviours Scale-Short Form. RESULTS: Most participants showed fair-to-good eating behaviours (86.6%), moderate-to-high food satisfaction (87.7%) and fair OHRQoL (69.7%). Bivariate analyses revealed that food satisfaction was significantly positively associated with OHRQoL (r=0.517, p<0.001) and weakly negatively associated with eating behaviours (r=-0.185, p<0.001). Multiple linear regression analysis identified food satisfaction as the factor most strongly associated with OHRQoL (β=0.496, p<0.001), followed by oral care practices (β=0.180, p<0.001) and eating behaviours (β=0.177, p=0.001). CONCLUSION: Food satisfaction showed a strong association with OHRQoL, highlighting the psychological dimension of dietary experiences in later life. Although many participants reported favourable eating behaviours and food satisfaction, OHRQoL remained moderate. These findings emphasise the need for integrated, culturally tailored interventions that incorporate nutritional counselling, oral-health promotion and chronic disease management to optimise healthy ageing in this population.
Revista brasileira de epidemiologia = Brazilian journal of epidemiologyDebora Lana Alves Monteiro, Juliana Pereira da Silva Faquim, Rênnis Oliveira da Silva, Edson Hilan Gomes de Lucena, Yuri Wanderley Cavalcanti
OBJECTIVE: To analyze factors associated with the time since the last dental visit among Brazilians aged 15-19, 35-44, and 65-74 years, according to Andersen's Behavioral Model. METHODS: This cross-sectional analytical study used microdata from a nationally representative oral health survey. Data from 21,385 individuals were analyzed. The outcome was the time since the last dental visit (≤1 year vs. >1 year). The independent variables were grouped into predisposing, facilitating, and perceived need factors according to Andersen's Behavioral Model. Analyses accounted for the complex sampling design and were performed using multilevel logistic regression with random intercepts at the municipality level, estimating odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Older adults (OR 1.436; 95%CI 1.242-1.660), Black (OR 1.161; 95%CI 1.011-1.334) and Brown individuals (OR 1.096; 95%CI 1.005-1.196) were more likely to report a dental visit more than one year prior. Higher education was strongly associated with lower odds of delayed visits (OR 0.383; 95%CI 0.318-0.461). Poor self-rated oral health (OR 2.486; 95%CI 2.041-3.028) increased the likelihood of delayed visits, whereas dental pain was associated with more recent use (OR 0.413; 95%CI 0.382-0.448). Use of private services was associated with lower odds of delayed visits (OR 0.820; 95%CI 0.732-0.919). Municipal coverage and the presence of specialized centers were not significantly associated. CONCLUSION: Sociodemographic characteristics and perceived need factors remain central determinants of recent dental service utilization patterns in Brazil.
Revista brasileira de epidemiologia = Brazilian journal of epidemiologyWaneska Ferreira de Melo, Helene Soares Moura, Sandra Aparecida Marinho, Lívia Natália Sales Brito, Gustavo Gomes Agripino, Pierre Andrade Pereira de Oliveira
OBJECTIVE: To analyze the impact of oral health conditions on quality of life and daily activities among adolescents according to the Oral Impacts on Daily Performances (OIDP) and its domains. METHODS: This cross-sectional study was based on data from the Brazilian National Oral Health Survey (SB Brasil 2023) and included 8,054 adolescents aged 15 to 19 years from all regions of the country. The outcome was oral health-related quality of life assessed using the OIDP instrument. Associations between OIDP and its domains with the presence of untreated caries, tooth loss, odontalgia, need for prostheses, gingival bleeding, and dental calculus were analyzed. Statistical analyses were performed considering the complex sample design, using the Rao-Scott adjusted F-test and multiple logistic regression considering a 95% confidence interval (CI). RESULTS: A negative impact of oral health on quality of life was observed in 37.2% of adolescents, with a higher frequency among those with lower family income and education level. All oral health problems analyzed showed a significant association with an OIDP≥1. After adjusting for sociodemographic factors, dental pain in the last 6 months was the condition most strongly associated with a negative impact on quality of life (OR=9.06; 95%CI 6.32-13.0), followed by the need for a prosthesis (OR=3.86; 95%CI 2.31-6.43), untreated dental caries (OR=2.39; 95%CI 1.87-3.05), tooth loss (OR=1.56; 95%CI 1.07-2.26), gum bleeding (OR=1.62; 95%CI 1.14-2.29), and dental calculus (OR=1.33; 95%CI 1.03-1.71). CONCLUSION: Oral health problems represent a limiting factor in the quality of life and daily activities of Brazilian adolescents.
Revista brasileira de epidemiologia = Brazilian journal of epidemiologyRafaela Zazyki, Nathalia Ribeiro Jorge da Silva-Garcia, Sarah Arangurem Karam, Francine Dos Santos Costa
OBJECTIVE: To analyze socioeconomic inequalities in negative maternal perception of children's oral health in Brazil using data from the 2023 National Oral Health Survey (SB Brasil 2023). METHODS: This cross-sectional study included 6,970 five-year-old children. Our outcome was a negative maternal perception of child oral health. Inequalities were assessed by sex, race/skin color, maternal education, region of the country and wealth index. Complex measures of inequality, Slope Index of Inequality (SII) and Concentration Index (CIX) were estimated using ordered stratification. For interpretation, the estimates were multiplied by 100. RESULTS: The prevalence of a negative maternal perception of child oral health was 30.4% (95% confidence interval - 95%CI 27.1-33.9). It was higher among children whose mothers had ≤8 years of schooling (35.6%), were in the poorest wealth quintile (42.5%), and had caries experience (51.8%). The SII and CIX indicated marked inequalities for wealth quintiles (SII: -28.0; 95%CI -39.2; -16.7/ CIX: -10.3; 95%CI -17.4; -3.1) and maternal education (SII: -22.1; 95%CI -33.0; -11.2/ CIX: -7.9; 95%CI -14.5; -1.4). Higher prevalences were found in the North and Northeast regions and among Black and Brown children. CONCLUSION: Substantial socioeconomic inequalities persist in maternal perception of children's oral health in Brazil. The findings highlight the need for equity-oriented oral health policies and actions to address social and racial disparities.
Revista brasileira de epidemiologia = Brazilian journal of epidemiologyMarcos Pascoal Pattussi, Adriana Vieira Macedo Brugnoli, Francine Lorencetti da Silva Campioni, Renato Canevari Dutra da Silva
OBJECTIVE: To investigate inequalities in oral health between beneficiaries and non-beneficiaries of the Bolsa Família Program (PBF) in Brazil. METHODS: This was a cross-sectional household study using data from the 2023 National Oral Health Survey (SB Brasil). Clinical indicators (caries, tooth loss, need for treatment and prosthesis) and subjective indicators (self-perception and dental pain) were evaluated. Associations between beneficiary status and outcomes were estimated using Poisson regression and multinomial logistic regression adjusted for sex, skin color, and dental visit in the last year. RESULTS: Beneficiaries reported worse self-perception of oral health (PR 1.87; 95%CI 1.19-2.94 to PR 2.30; 95%CI 1.48-2.28) and a higher prevalence of caries, pain, and need for treatment. 12-year-old children reported more dental pain (PR 1.47; 95%CI 1.10-1.95). In adolescents, the greatest inequities occurred in caries severity (PR 2.03; 95%CI 1.45-2.83), need for urgent care (PR 2.29; 95%CI 1.54-3.39), and partial dentures (PR 2.66; 95%CI 1.65-4.29). Among adults, the need for partial (OR 2.11; 95%CI 1.56-2.85) and total (OR 3.38; 95%CI 1.65-3.42) prostheses was more frequent, a pattern that was maintained in the elderly (OR 1.61; 95%CI 1.05-2.47 and OR 2.06; 95%CI 1.36-3.13). CONCLUSION: Significant inequalities in oral health are observed between beneficiaries and non-beneficiaries of the Bolsa Família Program. Overcoming these inequities requires integration between income transfer policies, primary care, and specialized dental services, guided by the principles of equity and social justice.
PloS oneJohn Rong Hao Tay, Gustavo G Nascimento, Jasmine Sio Hong Ho, Narayanan Ragavendran, Bryan Wei Ren Yeo, Hanimi Reddy Kallam, Sean Shao Wei Lam, Marco A Peres
This study describes the establishment of the National Dental Centre Singapore Oral Disease Registry (NDCS-ODR), a large-scale, electronic health records registry designed to capture real-world data on oral diseases. The NDCS-ODR was developed to standardize and integrate oral health data within Singapore Health Services, the country's largest healthcare cluster. Its development, governance, and data architecture are described, with an overview of individuals with oral diseases recorded in the registry. Data collection from 2013 to June 2025 has been completed. As of June 2025, the NDCS-ODR comprises 229,249 unique patients, with a mean (SD) age of 49.1 (19.5) years and an approximately equal sex distribution. Most were of Chinese ethnicity (77.6%), and Singapore citizens (92.5%). Clinical variables indicated substantial disease and treatment burden, with a mean of 7.9 (7.7) missing teeth, 4.8 (6.2) restored surfaces, and 2.8 (3.4) restored teeth per patient. Among 108,517 recorded periodontal diagnoses, Stage III periodontitis (2018 EFP/AAP Classification) and severe chronic periodontitis (1999 Classification of Periodontal Diseases and Conditions) were most common. The NDCS-ODR represents Singapore's first large-scale, real-world oral disease registry embedded within a national specialty center, demonstrating the feasibility of leveraging electronic health record data for research and service evaluation.
International journal of molecular sciencesJun Ohshima, Nobutake Tanaka, Masayoshi Morita, Shotaro Abe, Eriko Nakamura, Mikako Hayashi
Ectopic olfactory receptors (ORs) are G protein-coupled chemosensors expressed outside the olfactory epithelium, where they may couple local chemical inputs to cell-specific signaling. The oral cavity is continuously exposed to food-derived compounds, microbial metabolites, volatile organic compounds, and inflammation-associated metabolites, yet the molecular roles of oral ORs remain incompletely defined. This review critically synthesizes current evidence for OR expression and signaling in oral tissues and associated cell populations, with emphasis on ligand-receptor-signaling relationships and disease relevance. Functional OR signaling has been demonstrated in mammalian taste cells, while emerging transcriptomic studies in oral mucosa and transcriptomic/localization studies in the periodontal ligament indicate OR-related programs during tissue-specific or repair-associated states. Candidate metabolic axes, including short-chain fatty acids and lactate linked to OR51E1/OR51E2/Olfr78-related pathways in non-oral models, provide testable mechanistic hypotheses for microbiome-host communication in periodontitis and oral cancer; however, direct causal validation in oral disease models remains limited. We propose an evidence-tiered framework integrating spatial expression mapping, metabolomics-guided deorphanization, receptor perturbation, and longitudinal oral-fluid profiling. Oral ORs should currently be regarded as candidate molecular modulators and components of multimodal biomarker strategies rather than validated standalone diagnostic or therapeutic targets.
Oral health & preventive dentistryAzhar Iqbal, Farooq Ahmad Chaudhary, Saeed Alqahtani, Hmoud Ali Algarni, Meshal Aber Alonazi, Yasir Alyahya, Bilal Arjumand, Yasir Dilshad Siddiqui, Kumar Chan…
PURPOSE: The effect of restorative dental treatment on oral health-related quality of life (OHRQoL) and general well-being in Saudi adults is not well-documented. This study therefore evaluated the sensitivity of the OHIP-14, OIDP, and WHOQOL-BREF instruments in capturing changes in OHRQoL and health-related quality of life (HRQoL) after restorative care for caries. MATERIALS AND METHODS: Between September 2024 and March 2025, a prospective longitudinal cohort of 269 adult patients with untreated caries was recruited from Jouf University Dental Clinics in Saudi Arabia. Standardized restorative protocols were followed for all treatments. The three validated Arabic version of OHIP-14, OIDP, and WHOQOL-BREF instruments were used to assess the quality of life at baseline and at a one-month follow-up. To examine discriminant validity, responsiveness of the instruments, and factors predicting therapeutic change, statistical analysis involved paired and independent t-tests, effect size calculation (Cohen's d), and multiple linear regression. RESULTS: Statistically significant post-treatment improvements were observed across all subdomians of the three instruments. Mean OHIP-14 and OIDP scores decreased markedly (20.64 to 6.81 and 7.17 to 0.27, respectively; p 0.001), while WHOQOL-BREF scores increased statistically significantly (32.53 to 43.03; p 0.001). The degree of improvement was linked to initial caries severity. Therefore, the participants having more advanced caries at the start of the study demonstrated greater responsiveness, particularly in their scores on the OHIP-14 and WHOQOL-BREF. CONCLUSION: The restorative dental treatment of dental caries statistically significantly improves the oral health-related and general quality of life of adult patients. The responsiveness of the OHIP-14, OIDP, and WHOQOL-BREF instruments, as demonstrated by the current study findings, supports their application as robust patient-reported outcome measures (PROMs) in clinical dentistry. It is recommended that these PROMs should be integrated into practice to advance a more holistic and patient-centered approach to the provision of oral healthcare.
Revista brasileira de epidemiologia = Brazilian journal of epidemiologyLívia Natália Sales Brito, Gustavo Gomes Agripino, Sandra Aparecida Marinho, Helene Soares Moura, Robeci Alves Macêdo Filho, Pierre Andrade Pereira de Oliveira
OBJECTIVE: To describe the distribution profile of untreated dental caries in Brazilian adolescents, using the PUFA index, and identify the main associated factors. METHODS: This is a cross-sectional study based on data from the 2023 National Survey of Oral Health. The sample consisted of 8,053 adolescents aged 15 to 19 years. The dependent variable was the presence of untreated caries, measured by the PUFA index. Independent variables included sociodemographic and oral health-related factors such as impacts on quality of life and access to dental services. Descriptive and bivariate analyses were performed using the Rao-Scott test and multiple logistic regression, considering a significance level of 5% (p<0.05). RESULTS: We verified that 12.5% of Brazilian adolescents had at least one tooth affected by some repercussion of untreated caries. There were statistically significant associations between PUFA≥1 and the adolescents' socioeconomic conditions, such as lower level of education, low family income, being beneficiary of government cash transfer programs, in addition to Black skin color/race. We observed a negative impact on the quality of life of 22.4% of adolescents with PUFA index ≥1, and 19.1% had never had a dental appointment. Low family income, presence of pain in the last six months, and self-perceived need for dental treatment were factors strongly associated with PUFA≥1. CONCLUSION: Social determinants influenced the progression of dental caries in adolescents. Therefore, social policies targeting Black adolescents and expanded access to dental services are essential to reduce oral health problems in this more vulnerable population.
Scientific reportsMartin Berger, Marta Rizk, Jaana-Sophia Kern, Ulrike Schulze-Späte, Sandra Hennecke, Maximilian Neuhaus, Florian Kahles, Julia Moellmann, Stefan Wolfart, Joach…
Observational studies suggest an association between impaired oral health and cardiovascular disease; however, the directionality and underlying mechanisms remain unclear. In particular, whether heart failure (HF) itself adversely affects oral and periodontal health has not been systematically investigated in large populations or experimental models.We examined the association between HF and self-reported oral health indicators in 502,387 participants of the UK Biobank, including 17,356 individuals with HF defined by ICD-9/10 codes. Multivariable logistic regression models adjusted for demographic factors, cardiovascular comorbidities, systemic inflammation, lifestyle, and socioeconomic status were applied. To explore causality and mechanisms, periodontal tissue remodeling and inflammation were assessed in a murine model of pressure overload-induced HF using transverse aortic constriction (TAC). Periodontal ligament (PDL) space and alveolar bone microarchitecture were quantified by micro-computed tomography, and gingival inflammatory gene expression was analyzed by RT-PCR.HF patients exhibited a significantly higher prevalence of oral health burden compared with controls (51% vs. 40%, p<0.001). HF was associated with a 1.6-fold increased risk of impaired oral health, which remained significant after full adjustment (adjusted OR 1.18, 95% CI 1.14-1.22; p<0.001). In mice, reduced left ventricular ejection fraction following TAC was strongly associated with expansion of the maxillary PDL space (R2 = 0.63, p = 0.009) and alterations in alveolar bone microarchitecture (trabecular thickness R2 = 0.41 p = 0.061, trabecular number R2 = 0.38 p = 0.07). These structural changes were accompanied by increased gingival expression of pro-inflammatory cytokines, including Il1b (SHAM vs. TAC: 1.44 ± 1.02 vs. 3.39 ± 1.53, p = 0.06) and TNF-α (SHAM vs. TAC: 1.37 ± 0.86 vs. 5.71 ± 1.23, p = 0.002 predominantly in the maxilla.HF is independently associated with impaired oral health in a large population cohort and induces site-specific periodontal inflammation and remodelling in experimental HF. These findings support HF as an upstream driver of compromised oral-periodontal health, challenging the prevailing concept that oral disease primarily contributes to cardiovascular pathology.
JMIR research protocolsRuihang Zhang, Rong Lin, Wenyan Huang, Sujuan Zeng, Jiao Wang, Si Meng, Lin Xu
BACKGROUND: Children with disabilities attending special education schools face significantly higher risks of oral diseases, particularly dental caries, due to physiological, cognitive, and environmental challenges. However, school-based oral health interventions targeting this population are limited in China. OBJECTIVE: This study aims to assess the effectiveness of fluoride varnish (FV) application, delivered alongside oral health education for parents and teachers, in improving the oral health of students in special education schools in Guangdong Province. METHODS: This is a stratified, cluster randomized controlled trial conducted in Guangdong Province, China. Schools will be stratified by regional economic development level and randomly assigned to either an intervention or control group. The intervention group will receive annual dental examinations, biannual FV applications, and oral health education. The control group will receive standard annual examinations and comparable oral health education. Participants will be students aged 5 to 22 years enrolled in selected special education schools. Baseline assessments and 12-month follow-ups will include oral examinations and questionnaires assessing oral health knowledge, attitudes, and behaviors. The primary outcome is the difference in caries prevalence between the intervention and control groups at follow-up. Secondary outcomes include changes in oral hygiene behaviors and caregiver knowledge. Data will be analyzed using multivariable regression models adjusting for potential confounders and clustering effects. RESULTS: This trial was funded by the Department of Education of Guangdong Province in 2025 (grant YCKJ-2025-30). As of June 2025, 12 special education schools across 3 cities had been enrolled (n=7, 58.3% intervention and n=5, 41.7% control schools), and more than 1100 students had been recruited. Baseline data collection and the first FV application are complete. Follow-up data collection is ongoing and is expected to conclude in June 2026. Data analysis has not yet started, and results are expected to be published in 2027. CONCLUSIONS: Biannual application of FV is expected to significantly reduce caries prevalence and improve oral hygiene behaviors among students in special education schools. This school-based intervention model aims to provide a scalable and evidence-based strategy to mitigate oral health inequities for children with disabilities in China.
INTRODUCTION: Orphaned children face heightened vulnerability due to the absence of parental care and limited access to preventive services. Evidence linking oral health knowledge, attitudes, and practice (KAP) with clinical outcomes in this population remains limited. This study aimed to assess oral health KAP among orphaned children in Karaj, Iran, and examine their associations with clinical indicators of dental caries, gingival status, and oral hygiene. METHODS: In this cross-sectional study, 72 children aged 6-12 years residing in four government-run quasi-family centers in Karaj were examined between October 2024 and January 2025 through a census sampling approach. Inclusion required age eligibility and informed consent, whereas children with systemic or developmental disorders or those receiving orthodontic treatment were excluded. Data were collected using a structured, validated questionnaire (α = 0.83) to assess KAP and demographic factors. Clinical examinations were performed by a calibrated examiner (ZJ) (Kappa = 87.68%) using the CAST, GI, and OHI-s indices. Logistic and linear regression models were used to examine predictor variables of KAP and oral health outcomes. RESULTS: The mean scores of knowledge, attitude, and practice were 3.16 ± 1.60 (out of 7), 33.52 ± 4.36 (out of 50), and 10.26 ± 2.72 (out of 20), respectively. Overall, 62.5% of children demonstrated fair oral hygiene (OHI-s = 1.75 ± 1.58) with mild gingival inflammation. CAST assessment indicated that fewer than one-third of primary molars were sound, while more than half of permanent first molars showed enamel caries. Regression analyses showed that frequent toothbrushing (p = 0.015, OR=0.52, 95% CI: 0.30-0.88) and more positive attitudes toward oral health (p = 0.013, OR=0.70, 95% CI: 0.53-0.93) were significant predictors of improved oral status, whereas knowledge and self-reported practice were not consistent predictors. CONCLUSIONS: Orphaned children in Karaj demonstrated moderate oral hygiene, a high prevalence of untreated dental caries, and limited awareness of oral health. Addressing these behavioral and systemic gaps through targeted, evidence-based interventions-particularly oral health education, caregiver involvement, and routine dental monitoring-may help improve oral health outcomes in this vulnerable population.
British journal of community nursingSwapnil Ghotane, Jennifer E Gallagher, Ben Bowers
Oral health is often neglected within palliative care where symptoms such as dry mouth, oral pain and swallowing difficulty undermine comfort, communication and nutrition. This reflection explores the challenges and opportunities for implementing oral health guidance in practice.
Journal of dentistryLuiz Alexandre Chisini, Luana Carla Salvi, Maximiliano Sergio Cenci, Tatiana Pereira-Cenci, Marcus Cristian Muniz Conde, Francine Dos Santos Costa, Flávio Fern…
OBJECTIVE: To evaluate the socioeconomic position (SEP) inequalities in dental pain prevalence in Brazil between 2010 and 2023. METHODS: Data from two Brazilian National Oral Health Surveys (2010, n = 37,519; 2023, n = 40,720) were analyzed. The outcome was self-reported dental pain in the last six months. SEP was modeled as a latent variable using household income, household goods, educational attainment, and housing density. Inequalities were measured using the Slope Index of Inequality (SII) and the Concentration Index of Inequality (CIX) across age groups (5y, 12y, 15-19y, 35-44y, 65-74y). Sensitivity analyses excluded edentulous individuals. RESULTS: The prevalence of dental pain was 23.3% (95%CI:21.3-25.4) in 2010 and 20.4% (95%CI:18.6-22.3) in 2023. Negative SII and CIX values confirmed persistent SEP inequalities concentrated among disadvantaged groups across most age groups in both surveys. A significant inequality reduction was observed among 5-year-olds, where absolute inequality decreased from -23.5 to -5.0 percentage points, becoming non-significant in 2023. This reduction was driven by a convergence across socioeconomic groups, with decreased pain among the poorest and increased pain among the wealthiest. Among older adults (65-74 years), no significant inequalities were detected in the main analysis, but sensitivity analysis excluding edentulous individuals revealed significant inequalities in 2023 (SII=-12.4; CIX=-11.4%). CONCLUSION: The prevalence of dental pain did not significantly change during the study period. SEP inequalities in dental pain remained largely stable and significant in Brazil from 2010 to 2023, except for a reduction among young children (5 years). CLINICAL SIGNIFICANCE: The consistent socioeconomic gap indicates that patients from lower socioeconomic backgrounds continue to bear a higher pain burden. Clinically, this implies that screening for pain should be prioritized in vulnerable populations, and policies aimed at reducing social disparities remain a needed path toward equitable oral health.