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.
British journal of community nursingKaren Harrison Dening
Oral health is recognised as an essential component of a person's overall wellbeing, increasingly so in people with dementia. As dementia progresses, a person diagnosed with the condition may become more dependent on the support of the family carer to meet their personal care needs. Similarly, community nurses may be one of the first health professionals that a family carer may call on when difficulties in maintaining good oral care become a concern. An understanding of some of the main concerns and resources available can be helpful for community nurses in helping their patients and their carers. This article discusses some of the common issues using case examples to illustrate possible rationales and considerations for further action.
Preventive oral health care and education are essential for soldiers' health and military readiness. This study investigated oral health behaviors, dental service utilization, oral health perceptions, and educational needs among enlisted South Korean Army soldiers during the coronavirus disease 2019 pandemic. A cross-sectional survey was conducted among 313 enlisted soldiers who visited military dental clinics in Gyeonggi-do, Republic of Korea, from March 24 to April 16, 2021. Descriptive statistics and Pearson's χ2 tests were performed. Overall, 60.4% of participants did not use oral care products, mainly because they did not perceive a need for them (62.9%). Furthermore, 71.9% had not undergone routine dental examinations, 63.6% had not received dental treatment after enlistment, and 91.4% had no oral health education experience during military service. Video-based education was the preferred method (40.6%), and halitosis prevention and management was the most preferred topic (20.4%). Preferred educational methods did not differ significantly according to age, military rank, educational level, or smoking status (all P > .05). Military rank was significantly associated with perceived adequacy of oral care time (P < .001) and the place of dental treatment (P = .048). Routine dental examinations, dental treatment experience, and oral health education experience showed no significant differences according to participants' general characteristics. Preventive oral health services and education were insufficient among enlisted South Korean Army soldiers. Tailored programs reflecting soldiers' needs and preferred learning methods should be developed and evaluated.
This study aimed to compare oral health status, oral-related behaviors, and caregivers' oral-health knowledge and beliefs between preschool children with autism spectrum disorder (ASD) and typically developing (TD) children. A cross-sectional study was conducted among 694 preschoolers (344 ASD, 350 TD) aged 3-6 in Changchun. Clinical oral examinations were conducted to record caries prevalence and the number of decayed, missing (due to caries), and filled teeth (dmft) index. Caregivers completed a three-part questionnaire covering demographic information, children's oral hygiene practices and dental history, as well as caregivers' oral-health knowledge and beliefs. Statistical analyses included univariate comparisons, multivariable logistic and negative binomial regression models adjusted for age, sex and residence. ASD children exhibited significantly lower caries prevalence and dmft values than TD children Significant intergroup differences were also observed in oral hygiene habits, snacking frequency, and dental attendance behaviors. Caregivers of TD children showed better oral health knowledge and attitudes, while parental educational level and household income were significantly lower in the ASD group. After adjusting for baseline confounding factors, ASD status remained independently associated with lower caries risk and lower dmft indices. Further sensitivity analyses excluding hospital-recruited TD children and adopting age- and sex-matched sampling confirmed the robustness of these findings. Although ASD children presented lower caries experience, they demonstrated suboptimal oral-hygiene-related behaviors and less frequent dental visits than TD children. Caregivers' knowledge and attitudes were critical factors associated with children's oral health. Considering baseline socioeconomic imbalances and partial hospital-based recruitment of TD controls in this cross-sectional study, these findings should be interpreted cautiously, and definitive causal relationships cannot be established.
Journal of developmental origins of health and diseaseSeema Lal-Kumar, Anand Marya, Bob Williams, Metua Bates, Abiola Adeniyi
The Developmental Origins of Health and Disease (DOHaD) paradigm has transformed our understanding of how early-life biological and social environments shape lifelong health trajectories. While DOHaD research across Oceania has focused primarily on metabolic, cardiovascular, and nutritional outcomes, oral health, particularly early childhood caries (ECC), remains largely absent from life course research and policy despite its early onset, shared risk factors with childhood obesity and other noncommunicable diseases (NCDs), and strong social and intergenerational patterning. This conceptual paper synthesises the DOHaD paradigm, First 1000 Days approaches, common risk factor theory, and Pacific relational worldviews to propose a Pacific-centred framework that explicitly integrates oral health. Using the Cook Islands as a regional exemplar, the paper demonstrates how oral health can be aligned with existing maternal and child health, nutrition, and NCD policy priorities. The proposed framework reframes ECC as both a biologically embedded developmental outcome and an early indicator of broader NCD risk trajectories. It highlights the interconnected influence of biological, family, community, health system, and policy environments on oral health across the life course. Integrating oral health within a Pacific centred DOHaD framework addresses an important gap in research and policy and provides a culturally grounded and policy relevant model to strengthen early-life prevention, improve health equity, and guide future research and implementation across Oceania.
Clinical and experimental dental researchGrace Wong, Sarah Glastras, Sarah Brennan, Marija Saponja, Anna Cheng, Jami Walk, Kyle Cheng, Wenpeng You
BACKGROUND: Periodontal disease is common among adults with diabetes, yet periodontal screening is rarely incorporated into routine outpatient diabetes care. The Oral Health Assessment Tool (OHAT) is a structured observational tool designed for non-dental healthcare professionals; however, its relationship with periodontal screening findings remains unclear. OBJECTIVES: To examine the association between OHAT findings and periodontal screening outcomes in adults attending diabetes outpatient clinics. METHODS: This cross-sectional study included adults with type 1 or type 2 diabetes at a tertiary hospital in Sydney, Australia. Periodontal screening was performed using the Periodontal Screening and Recording (PSR) system, and oral health was assessed using OHAT. Periodontal status was dichotomized as no/mild (PSR 0-2) versus moderate-to-severe (PSR ≥ 3). Logistic regression examined associations of OHAT domains and total OHAT burden with periodontal status. Covariate-adjusted models assessed robustness. Screening performance was evaluated using sensitivity, specificity, and predictive values. RESULTS: Among 120 participants (mean age 61.5 years, 64.2% with type 2 diabetes), 71.4% demonstrated moderate-to-severe periodontal findings. Mean OHAT score was 4.99 (SD 2.02). Change/unhealthy ratings for tongue (OR 3.23, 95% CI 1.30-8.02), gums and oral tissues (OR 4.59, 95% CI 1.78-11.85), and increasing categories of decayed teeth (OR 2.06, 95% CI 1.05-4.05) were associated with moderate-to-severe findings. Higher total OHAT score (> 5 vs. ≤ 5) was strongly associated with moderate-to-severe periodontal findings (OR 7.00, 95% CI 2.25-21.76), with consistent results. This threshold showed high specificity (87.5%) and positive predictive value (90.9%), but moderate sensitivity (50.0%). CONCLUSION: OHAT findings were associated with moderate-to-severe periodontal screening findings among adults with diabetes, supporting further evaluation of OHAT as a pragmatic screening and referral aid in settings where formal periodontal assessment is not routinely available. Its performance when administered by non-dental clinicians requires further investigation.
Journal of Indian Prosthodontic SocietyChaimongkon Peampring, Phatootip Henprasert
AIM: Conventional complete denture (CD) fabrication requires multiple appointments, posing barriers for remote elderly patients.This study compared oral health-related quality of life (OHRQoL) and patient satisfaction between digitally fabricated dentures (DD) and conventional methods within the Royal Mobile Dental Services in Thailand. SETTINGS AND DESIGNS: In this prospective randomized trial, 30 edentulous participants (aged 50-80 years) were allocated to CD ( n = 15) or DD ( n = 15) groups; 25 participants (CD: n = 15, DD: n = 10) completed the 1.5-month evaluation. MATERIALS AND METHODS: The CD protocol used a four-visit, heat-polymerized workflow. The DD protocol used a three-visit workflow with mucostatic intraoral scanning and three-dimensional (3D) printing dentures. Participants and outcome assessors were blinded. STATISTICAL ANALYSIS USED: Outcomes were assessed after the first meal, at 24 h, and at 1.5 months using a Visual Analog Scale (VAS) for satisfaction and the Oral Health Impact Profile-14 for OHRQoL. Data were analyzed using Mann-Whitney U -tests. RESULTS: Overall VAS satisfaction showed no significant intergroup differences ( P > 0.05). At 24 h, the DD group reported significantly higher negative impacts ( P < 0.05) on phonetics, taste perception, and food avoidance. By 1.5 months, most OHRQoL dimensions in the DD group normalized to match the CD group, but phonetic difficulties remained significantly higher ( P < 0.05). CONCLUSION: 3D-printed dentures offer satisfaction comparable to conventional methods while reducing clinical visits. Early functional limitations resolve rapidly, but persistent phonetic issues suggest that standardized computer-aided design protocols may benefit from patient-specific customization to optimize speech outcomes in mobile dental settings.
American journal of primatologyJonathan Y An, Johnny Hudson, Andrew Nordlie, Ryan O'Donnell, Josué E Negrón-Del Valle, Daniel Phillips, Nahiri Rivera, Angelina Ruiz Lambides, Noah Snyder-Mac…
Free-ranging rhesus macaques (Macaca mulatta) on Cayo Santiago provide a uniquely characterized translational model for periodontal disease, supported by decades of demographic and genetic data. To assess the feasibility of conducting comprehensive periodontal examinations, oral biospecimen collection, and portable intraoral radiography in free-ranging macaques during a 5-day pilot field campaign. Eighteen macaques (7 males, 11 females; ages 9-23 years) were evaluated under ketamine/xylazine anesthesia. Periodontal charting (probing depth, clinical attachment level, bleeding on probing), multimodal biospecimen collection (gingival crevicular fluid, tongue swabs, supragingival plaque, whole saliva), and portable intraoral radiography (KaVo NOMAD Pro 2) were performed within an existing multi-station sedation workflow. Full periodontal assessments were completed in 18/22 animals (82%). Mean probing depths were 2.0-2.2 mm, with significantly greater depths in aged animals (≥ 15 years; p < 0.05). GCF RNA and protein yields were inadequate for planned analyses. Tongue swabs from 15 animals yielded sufficient protein for 37-analyte multiplex profiling; 31 analytes met the minimum criterion for age-group comparisons. Exploratory analysis identified higher CD40L and IL-8/CXCL8 in aged animals and modest difference in TNF-α. Age-by-sex interactions were identified for IL-8/CXCL8 and IP-10/CXCL10. Radiographs showed age-related alveolar bone loss without caries. Comprehensive oral health assessment is feasible in this field setting. Earlier dental-station placement and improved GCF collection are needed. Tongue swabs offer a practical specimen for inflammatory profiling, supporting future longitudinal oral health phenotyping within the established Cayo Santiago infrastructure.
The Journal of school healthMary E Northridge, Lynn Gargano, Margaret K Mason
BACKGROUND: Given the importance of oral health to overall health, inclusive evidence-based interventions to improve health care access, quality of life, and learning and development through school-based delivery of oral health care are needed for all children, including those with special needs. CONTRIBUTIONS TO PRACTICE: Integrated delivery of school- and community-based health care holds the potential to improve the health and lives of children and adolescents. Team-based approaches are effective in ensuring continuity of care on-site in schools. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Greater attention to ensuring socioeconomically disadvantaged students gain access to school-based delivery of dental services and adolescent priorities (periodontal disease, dental erosion, and misalignment of the upper and lower teeth) may enhance oral health care for these underserved groups. Long-term tracking of oral health outcomes (caries-free rate, oral health-related quality of life) and educational success (attendance/graduation rates, grade point averages) would bolster the case for school-based delivery of integrated health care. CONCLUSIONS: School-based oral health programs provide comprehensive on-site care, including topical fluoride application and sealant placement to prevent dental caries. Involving parents and teachers in program activities emphasizes the importance of oral health to overall health both at home and in school.
Clinical oral investigationsJ P Woelber, N Wirth, A Dallmer-Zerbe, C Tennert
OBJECTIVE: The recommendation of free sugar reduction in dental practice is mostly given with regard to caries prevention but has also further health impacts. This umbrella review aimed to comprehensively display the shared health consequences of sugar consumption in both oral and general health. MATERIALS AND METHODS: Within an umbrella review, two independent reviewers identified and analysed systematic reviews examining free sugar consumption alone or as a part of dietary patterns and its association to described diseases in three databases (Epistemonikos, Pubmed, Cochrane Library). Electronic databases were searched up to March 2026, findings were synthesised narratively. Risk of bias was assessed using AMSTAR-2. RESULTS: The literature search identified 10,593 articles, of which 633 were further assessed for eligibility. Finally, 228 articles were included after full-text analysis. Results showed that sugar intake was consistently associated with increased risks of 18 generalised negative health outcomes. Strongest evidence was found for type 2 diabetes, obesity, cardiovascular and all-cause mortality, oral diseases, irritable bowel syndrome, and cognitive disorders. Furthermore, a positive association was found between excessive sugar consumption and cancer, non-alcoholic fatty liver disease, kidney disease, gout, asthma, poor sleep, reduced bone density, mood disorders, telomere shortening, and fertility impairments. AMSTAR-2 showed that most reviews had low or critically low methodological quality, while about one third demonstrated moderate to high confidence. Most studies (68%) investigated sugar in form of sugar-sweetened beverages. CONCLUSIONS: Within the limitations of this umbrella review, available evidence indicates that avoiding free sugar intake contributes to both reduced chronic disease burden and improved oral health. Against this background, avoiding free sugar, as recommended by dentists, is a key shared health factor that should be emphasized in the context of caries, periodontal disease, and in terms of general primary prevention. CLINICAL RELEVANCE: Dental advised and assisted sugar reduction is an important preventive measure not only for oral health but also for several general health outcomes. After synthesizing and evaluating the available systematic reviews, this study highlights the crucial need to reduce sugar consumption as an important factor in improving both systemic and oral health. SYSTEMATIC REVIEW REGISTRATION: The systematic review was registered in the international register for systematic reviews Prospero. Systematic review registration CRD42023380458.
Oral health & preventive dentistryXiaoyuan Pan, Shuwen Su, Jianli Li, Leyi Han, Xinyue Chen
BACKGROUND: China's aging population faces significant unmet oral health care needs, with delayed service utilisation exacerbating disease burden. Currently, there is a lack of empirical research applying composite health models and analysing pathway relationships among influencing factors in this population. METHODS: A cross-sectional study was conducted from July to September 2023 among 356 older adults in Foshan and Guangzhou using a theory-driven questionnaire. Group comparisons used independent t tests/analysis of variance for sociodemographic variables. Structural equation modelling (SEM) with maximum likelihood estimation was employed to validate pathways. RESULTS: Significant differences were observed: sex and age affected individual model variables; education, residence location, and economic status influenced multiple variables; and living arrangement showed no significant effects. Only 34.04% of older adults proactively sought oral health knowledge, while 65.03% did not receive regular dental checkups. Just 51.84% sought treatment (scaling, fillings, extractions, dentures, implants). When acute oral pain disrupted daily life, 25.15% still delayed medical care. SEM revealed that behavioural intention/control had the strongest total effect on utilisation behaviour (β = 0.593) followed by perceived benefits (β = 0.404), subjective norms exerted only indirect effects (β = 0.216), and both subjective norms (β = 0.365) and perceived benefits (β = 0.282) directly influenced behavioural intention and control. CONCLUSION: Oral health service utilisation among older adults remains passive. The present authors' model identifies three key modifiable factors: behavioural intention and control, perceived benefits, and subjective norms. Strategies to enhance service utilisation should focus on strengthening social support and modifying unrealistic health perceptions.
BACKGROUND: Social disparities in oral health persist, disproportionately affecting Indigenous populations. OBJECTIVE: This study aims to compare oral health status, dental care access, treatment needs, and social determinants between Mapuche and non-Mapuche older adults in the La Araucanía Region of Chile, within a hybrid dental care model, and to explore whether ethnicity is associated with these outcomes, guided by the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) framework. METHODS: We conducted a cross-sectional exploratory analytic study using data from 480 adults aged 60 years or older who received dental care through a hybrid teledentistry and mobile clinic model (Geriatric Dental Specialties Tele-Platform [TEGO]) in 4 municipalities of La Araucanía. The analytic sample was restricted to community-dwelling, functionally independent older adults. Outcomes included oral health status (nonfunctional dentition, edentulism, cavitated caries, and periodontitis), dental care access (fixed prosthetic rehabilitation and unmet denture need), and dental treatment needs (restorative and prosthetic). Structural (sex, age, education, rurality, and ethnicity) and intermediary determinants (behavioral, biological, psychosocial, and health system access) were analyzed following the WHO-CSDH framework. Bivariate analyses compared outcomes between Mapuche and non-Mapuche participants. Multivariable logistic regression models examined associations between determinants and outcomes. RESULTS: A total of 471 older adults (mean age 72.8, SD 7.7 years) were included; 76.9% (362/471) had nonfunctional dentition, 18% (85/471) were edentulous, 25.6% (98/383) had cavitated caries, and 46% (154/335) had periodontitis. In bivariate analyses, Mapuche participants showed lower educational attainment, higher rural residence, poorer oral health, more behavioral risk factors (eg, infrequent toothbrushing and higher sugar intake), greater restorative needs, and reduced access to complex dental care compared with non-Indigenous peers. In multivariable analyses, female sex was associated with increased odds of edentulism but lower odds of periodontitis. Lower education was associated with nonfunctional dentition (odds ratio [OR] 4.28, 95% CI 2.34-7.88; P<.001) and edentulism (OR 3.04, 95% CI 1.52-6.09; P=.002). Mapuche ethnicity was associated with higher prevalence of cavitated caries (OR 2.40, 95% CI 1.25-4.63; P=.009) and periodontitis (OR 2.43, 95% CI 1.21-4.88; P=.01). Dental care access was associated with behavioral factors (brushing, interproximal hygiene, and sugar intake) and structural determinants (age, sex, and rurality), while restorative and prosthetic needs were linked to sugar consumption and tobacco use, respectively. CONCLUSIONS: Oral health inequalities among older adults in La Araucanía were associated with both structural and behavioral determinants. Although Mapuche participants exhibited poorer oral health, higher restorative needs, and reduced access to complex dental care in bivariate analyses, ethnicity remained associated only with cavitated caries and periodontitis in adjusted models. These findings underscore the importance of incorporating social determinants into oral health planning for underserved older adults and highlight the potential utility of data generated through digitally supported territorial care models for informing equity-oriented oral health strategies.
BMC oral healthAmira H Elwan, Rana Mahrous, Fadia Alawad, Aml Hatem, Rowan Elshahawy, Wafaa Essameldin Abdelaziz, Maha El Tantawi
BACKGROUND: The Big Five personality traits comprise five broad dimensions of personality namely openness, conscientiousness, extraversion, agreeableness, and neuroticism which may influence oral health. Examining these influences in underserved communities helps inform the design of tailored oral disease prevention strategies. This study assessed the association between personality traits on one hand and dental caries as well as oral health behaviors on the other hand, among underserved Egyptian adults. MATERIALS AND METHODS: A cross-sectional study was conducted in three governorates (Alexandria, Elbeheira and Matrouh) in Northwestern Egypt between November and December 2025. Data were collected, in community settings, from mentally healthy, adults, using a self-administered questionnaire assessing personality traits by the Big Five Inventory-2 Extra-short Form, as well as the Arabic translated WHO adult form for oral health behaviors (toothbrushing, dental visits, and sugar consumption). Dental caries experience was assessed using the DMFT index. The independent variables were personality traits, while the dependent variables were caries and the three oral health behaviors in four separate models. Potential confounders (age, gender, educational level, and residence) were controlled. Four regression models (linear and binary logistic) were fitted and regression coefficients (B), Adjusted odds ratio (AOR), 95% confidence intervals (CI), model fit statistics (R²/pseudo-R², as appropriate to model type)were calculated. RESULTS: A total of 820 adults were included (mean age = 36.5 ± 13.0 years), of whom 70.2% were females, 59.1% brushed once or more daily, 60.6% had visited a dentist in the previous year, the mean sugar consumption score was 3.85 ± 2.06 and the mean DMFT index was 5.16 ± 5.04. Agreeableness showed the highest mean score (11.53 ± 1.97), while openness had the lowest mean score (9.64 ± 2.27). Neuroticism was significantly associated with less toothbrushing (AOR = 0.90, p = 0.003). Openness was significantly associated with higher dental visits (AOR = 1.08, p = 0.03) and sugar consumption (B = 0.12, p < 0.001). Conscientiousness was significantly linked to reduced sugar intakes (B=-0.15, p < 0.001). CONCLUSION: Personality traits were significantly associated with the caries experience and oral health behaviors of underserved Egyptian adults, which may help targeting individuals for preventive interventions.
OBJECTIVES: Diet-related inflammatory processes have been implicated in the development of oral and periodontal diseases; however, data in pediatric populations remain limited. The Children's Dietary Inflammatory Index (C-DII) is a validated tool designed to assess the inflammatory potential of diet in children. This cross-sectional study aimed to evaluate the association between dietary inflammatory potential and oral-periodontal health parameters in children. MATERIALS AND METHODS: A total of 300 systemically healthy children aged 6-14 years were included. Sociodemographic characteristics and oral hygiene habits were recorded. Clinical examinations assessed DMFT/dmft, Plaque Index (PI), Gingival Index (GI), and Bleeding on Probing (BOP). Dietary intake was evaluated using three-day dietary records, and C-DII scores were calculated after energy standardization per 1000 kcal. Statistical analyses were performed using Jamovi (version 2.3.28), with significance set at p < 0.05. RESULTS: C-DII scores showed a significant negative correlation with DMFT (p = 0.035) and a positive correlation with PI (p = 0.030). Quartile comparisons demonstrated significant differences in PI (p = 0.007), GI (p = 0.02), and BOP (p = 0.034) among children aged 6-10 years. In the 11-14-year group, GI (p = 0.002) and BOP (p = 0.01) values differed significantly across C-DII quartiles. CONCLUSIONS: Higher dietary inflammatory potential was associated with less favorable periodontal parameters in children. These findings suggest that proinflammatory dietary patterns may be linked to early periodontal changes. CLINICAL RELEVANCE: Assessment of dietary inflammatory potential may help identify children at increased periodontal risk and support preventive nutritional strategies in pediatric dental care.
INTRODUCTION: Dental caries remains one of the most prevalent chronic diseases in childhood worldwide. In Brazil, untreated carious lesions continue to affect oral health and quality of life in school-aged children. Minimally invasive approaches for caries management have demonstrated feasibility in community settings and may expand access to preventive and restorative care in socially vulnerable populations. METHODS: This multicentre longitudinal intervention study will recruit 50 000 children aged 6-12 years from public schools in five Brazilian cities (Santos, Ponta Grossa, Brasília, Fortaleza and Belém). All participants will undergo clinical examination using the International Caries Detection and Assessment System (ICDAS) and will receive preventive and educational measures, including oral health counselling, supervised toothbrushing with fluoridated toothpaste (1100 ppm F), toothbrushes, toothpaste and application of Duraphat fluoride varnish to permanent molars and incisors. Among children with active carious lesions, 2500 will enter the longitudinal minimally invasive treatment phase according to lesion severity: fluoride varnish for ICDAS 1-2 lesions; fluoride varnish or atraumatic restorative treatment (ART) sealants for ICDAS 3 lesions; and ART with high-viscosity glass ionomer cement for ICDAS 4-6 lesions. Participants will be re-evaluated every 3 months for up to 24 months. EXPECTED OUTCOMES: The primary outcome will be control of caries activity assessed longitudinally using ICDAS criteria. Secondary outcomes include inactivation of white spot lesions, survival of restorations and sealants and adherence to preventive measures. The study is expected to generate evidence to support public oral health policies and minimally invasive strategies for school-based caries management in Brazil. ETHICS AND DISSEMINATION: This protocol has been approved by the human research ethics committee of Universidade Metropolitana de Santos-UNIMES (protocol number: 7.630.345. Approved on 10 June 2025). Results will be submitted to international peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER: NCT06999005 (registered on 14 May 2025).
British dental journalHabib Benzian, Sudeshni Naidoo
Global political declarations play a growing role in shaping health priorities, yet the diplomatic processes through which they are negotiated remain poorly understood across much of the health community. The 4th United Nations High-Level Meeting on non-communicable diseases (NCDs) and its political declaration provide a revealing illustration of how global health diplomacy operates under contemporary political constraint. Oral diseases entered the declaration through a negotiated process in which technical evidence, existing policy frameworks, and advocacy interacted with discretion, political feasibility, and geopolitical context. The failure to secure consensus on adoption in September 2025, followed by adoption by majority vote in December, underscores both the fragility of multilateral agreement and the willingness of Member States to defend negotiated commitments. Oral diseases have achieved durable political recognition within the global NCD agenda, yet this recognition has yet to be fully translated into corresponding responsibility for financing, delivery, or accountability. Political declarations function primarily as instruments of alignment that stabilise expectations and signal collective intent, while leaving the work of implementation to national health systems. Understanding these dynamics is critical for navigating the space between global commitment and practical change in oral health policy.
Journal of the Indian Society of Pedodontics and Preventive DentistryBhavna Dave, Vaishnavi Patil, Seema Bargale, Anshula Deshpande, K S Poonacha, Pratik Kariya
BACKGROUND: Childhood intelligence is influenced by the caregiving environment and psychosocial factors, whereas oral health reflects overall care and health awareness. Evidence regarding the association between intelligence quotient (IQ) and oral health status across different caregiving settings remains limited. AIM: This study aimed to evaluate the association between IQ and oral health status among orphaned children and children of employed and unemployed mothers aged 8-11 years. SETTINGS AND DESIGN: A cross-sectional observational study was conducted among 75 children aged 8-11 years. MATERIALS AND METHODS: Participants were categorized into three groups: orphaned children (Group A), children of employed mothers (Group B), and children of unemployed mothers (Group C), with 25 participants in each group. IQ was assessed using Raven's Progressive Matrices, and oral health status was evaluated using decayed, missing, and filled teeth (DMFT), deft, and Gingival Index scores. STATISTICAL ANALYSIS: Data were analyzed using descriptive and inferential statistics. Intergroup comparisons were performed using one-way ANOVA, whereas associations between categorical variables were assessed using the Chi-square test. P < 0.05 was considered statistically significant. RESULTS: No significant association was found between IQ grading and DMFT, deft, or gingival Index scores. Oral health status also did not differ significantly across caregiver groups. However, caregiver status was significantly associated with IQ distribution ( χ2 = 16.941, P = 0.010), with orphaned children demonstrating comparatively lower IQ performance and no representation in the above-average IQ category. CONCLUSION: Caregiving environment appears to influence cognitive outcomes, with orphaned children exhibiting lower IQ scores. No significant association was found between IQ and oral health status.
Journal of the Indian Society of Pedodontics and Preventive DentistryKrupali Gadhvi, Virat Galhotra, Rhea Gandham, Abhiruchi Galhotra, Atul Jindal, Tundup Dolker, Mugilan Ravi, Joseph Lepcha, Maneesha Babu
BACKGROUND: Children with special healthcare needs (CSHCN) often face elevated risks for oral diseases and significant challenges in accessing timely dental care. This study was conducted because data on the oral health status of CSHCN in Raipur, Chhattisgarh, India, were unavailable. AIM: The aim of the study was to determine the oral health status and treatment needs of individuals with special healthcare needs aged 3-19 years attending special institutes in Raipur district, Chhattisgarh, India. DESIGN: A descriptive, institution-based cross-sectional study was conducted encompassing 684 CSHCN. Dental caries and oral hygiene status were recorded using the decayed, missing, and filled (DMFT)/dmft and OHI-S indices as per the World Health Organization Basic Methods criteria, employing a complete enumeration sampling technique. All examinations were performed on-site at the institutions, with findings for every participant captured on a purpose-built mobile application. RESULTS: Dental caries prevalence was 67.7%, with an overall mean DMFT/dmft of 2.55. Mean DMFT/dmft did not differ significantly with age or sex but differed significantly across disability type; it did not differ significantly across socioeconomic status (SES). Fair oral hygiene was seen in 51.5% and poor oral hygiene in 12.0%; poorer hygiene was significantly associated with older age, disability type, and lower SES. Overall, 93.4% of participants required dental treatment. Developmental enamel defects were present in 41.4%, traumatic dental injuries affected 10.2%, and 24.9% exhibited a deleterious oral habit. CONCLUSION: A substantial and multifactorial unmet oral health need persists among CSHCN in Raipur; the findings indicate barriers to accessing dental care and caregiver awareness in relation to unmet oral health needs. Targeted interventions and policy reforms are vital for improving their oral health status.
Journal of cross-cultural gerontologyYuri Freddy Curo-Valdivia, Andrés A Agudelo-Suárez
This study investigates the socioeconomic inequalities in the use of dental services among older Peruvian adults according to ethnicity. Oral health issues are prevalent among older populations, with a significant burden in Peru. The study uses data from the Peruvian Demographic and Family Health Survey from 2017 to 2023, focusing on adults aged 60 and older. The analysis reveals that older White/Mestizo individuals have higher dental service utilization compared to other ethnic groups, such as Quechua/Aymara and Afro-Peruvian populations. The research examines the impact of variables such as education, wealth, geographic location, and health insurance on access to dental care, employing statistical methods like the Rao-Scott chi-square test and the Concentration Index to assess inequalities. The results show socioeconomic inequalities in dental service utilization, with utilization concentrated among wealthier groups and lower levels of use observed in some ethnic groups, especially those from rural areas and with lower educational attainment. The findings underscore the need for targeted health policies and interventions to reduce these inequalities and ensure equitable access to dental care for all ethnic groups in Peru.
Frontiers in public healthJoana Pombo-Lopes, Paulo Mascarenhas, Jorge Fonseca, José Grillo-Evangelista
BACKGROUND: Oral health is a critical yet frequently overlooked component of global public health, with significant implications for overall health and healthcare costs. In countries like Portugal, where public dental coverage is limited, non-dental healthcare professionals are primarily responsible for monitoring oral health. This study aimed to adapt and validate the Nursing Dental Coping Belief Scale for Portuguese healthcare professionals (NDCBS-PT) and identify factors associated with their beliefs to develop effective interventions and ensure equitable care for dependent populations. METHODS: This cross-sectional psychometric study followed a five-stage international protocol. Structural validity was tested via confirmatory factor analysis (CFA) using the weighted least squares mean and variance (WLSMV) estimator. Internal consistency and temporal stability were evaluated using ordinal alpha, McDonald's omega total (ωt), and intraclass correlation coefficients (ICC). Multivariable associations were examined using robust linear models to identify factors independently associated with NDCBS-PT scores. RESULTS: A total of 304 healthcare professionals were included (82.6% female; mean age 44.5 years). The correlated four-factor model - internal locus of control (IL), external locus of control (EL), self-efficacy (SE) and oral healthcare beliefs (OHCB) - showed the best relative fit, although fit was marginal (CFI = 0.858). Despite pronounced floor effects, total-score reliability was acceptable to good (ordinal α and ωt = 0.81). The institutional sector was the most consistent independent determinant of global scores (p = 0.004). Some non-public sectors showed more favorable global scores than the public sector. The EL domain was the most sensitive to caregiver profiles showing exploratory associations with gender (p = 0.009), area of training (p = 0.043), and age-experience interaction (p = 0.007). Although men had more favorable beliefs, this requires caution as gender invariance was not established. Regarding SE, specific oral health training was the only significant predictor (p = 0.034). Item-level diagnostics identified items 3, 4, and 24 as weak. CONCLUSION: The NDCBS-PT demonstrated sufficient reliability and preliminary structural support for the four-factor model among Portuguese healthcare professionals, though requiring further refinement. Caregivers' beliefs appear to be influenced by organizational settings and professional backgrounds. Oral-health training was linked to better self-efficacy and merits prospective testing.
Clinical oral investigationsInês Lopes Cardoso, Maria Inês Guimarães, Elisa Le Cozic, Fernanda Leal
OBJECTIVES: Cystic fibrosis is an autosomal recessive disease caused by mutations in the CFTR gene, mainly affecting the respiratory and digestive systems. Advances in diagnosis and treatment have increased life expectancy, making cystic fibrosis a chronic condition requiring long-term multidisciplinary care. Consequently, oral health has gained importance, as disease manifestations and prolonged therapies may influence the oral cavity and dental management. This review aimed to analyse the available scientific evidence regarding the impact of cystic fibrosis on oral health and dental treatments. The guiding research question was: What is the impact of cystic fibrosis on the oral cavity and dental treatments? METHODOLOGY: A literature search was conducted in PubMed, Scopus, Web of Science and Cochrane Library using the keywords: cystic fibrosis, oral health, and dental treatment. After applying inclusion and exclusion criteria, 22 articles were selected. RESULTS: Although findings remain heterogeneous, the included studies suggest that cystic fibrosis is associated with specific oral changes. In children, a lower prevalence of dental caries was frequently reported, often linked to prolonged antibiotic use. In adults, studies indicated a higher prevalence of untreated caries and poorer oral health status. Developmental enamel defects and salivary alterations were also commonly observed. CONCLUSIONS: Cystic fibrosis may significantly affect oral health, highlighting the need for individualized dental care focused on prevention, regular monitoring, and adaptation to each patient's specific needs. CLINICAL RELEVANCE: Individualized preventive and therapeutic strategies, regular monitoring, and integration of dental professionals into multidisciplinary teams may improve oral health outcomes, treatment adherence, and quality of life.
INTRODUCTION: Dental caries remains highly prevalent among children despite being preventable. Limited access to dental services, workforce shortages and low oral health literacy among informal caregivers contribute to its delayed detection and poor oral health outcomes for children. As informal caregivers play a vital role in children's daily oral health practices, innovative and scalable approaches are needed to support them. Artificial intelligence (AI)-based mobile health applications could potentially help engage these caregivers in education, early detection, and other preventive activities. However, the evidence is still limited. The objective of this review is to map and characterise the existing evidence on caregiver-centred AI-based applications supporting the management and prevention of childhood dental caries. METHODS AND ANALYSIS: The scoping review will adhere to the Joanna Briggs Institute (JBI) methodology guideline, using Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) for reporting structure and PRISMA-S (PRISMA Search Reporting Extension) for a comprehensive search strategy. The search strategy will be developed in collaboration with an expert librarian. An initial search will be conducted in Embase (Ovid) and adapted for other databases (MEDLINE (Ovid), PubMed and Scopus). Two reviewers will independently screen the titles, abstracts and full-text articles, with a third resolving any conflicts. The included studies will be selected according to the participants, concept and context (PCC) framework, in any setting and any country, that addresses AI-based applications facilitated by informal caregivers for caries prevention and management in children. Articles published in English and primary studies will be included, with no restrictions on publication date. Data will be charted and synthesised using descriptive statistics and qualitative thematic mapping. ETHICS AND DISSEMINATION: Ethics approval is not required for this review. These findings will be disseminated in a peer-reviewed publication and at academic conferences. TRIAL REGISTRATION DETAILS: (https://osf.io/7akw5).
This study aims to comprehensively examine the interrelationships among physical activity, stress, and oral health status in university students to provide empirical evidence for targeted oral health promotion strategies. A survey was conducted among current university students in mainland China. Physical activity was evaluated via the International Physical Activity Questionnaire Short Form, and stress was measured through the 14-item Perceived Stress Scale. Oral health status was evaluated through self-reported indicators, including gingival bleeding, toothache, and oral ulcer. Data were analyzed using multivariable logistic regression and structural equation modeling. A P value < .05 was considered statistically significant. A total of 1578 participants were included. Findings revealed that 47.7% of students had insufficient physical activity, while 38.7% reported high or excessive stress. Multivariable logistic regression showed that insufficient physical activity and elevated stress levels were associated with an increased risk of gingival bleeding and oral ulcers (P < .05). Structural equation modeling showed that physical activity was negatively associated with perceived stress (standardized coefficient = -0.360, P < .05), and perceived stress was positively associated with self‑reported oral symptoms (standardized coefficient = 0.411, P < .05). However, the direct association between physical activity and oral symptoms was not statistically significant (standardized coefficient = -0.009, P = .765). Physical activity, stress, and oral health are closely intertwined. Insufficient activity and high stress are critical determinants of poor oral health among university students. The observed association between physical activity and oral symptoms was mediated primarily through perceived stress rather than a direct effect. Universities should implement integrated interventions that encourage regular exercise and provide mental health support to enhance the holistic and oral well-being of the student population.
Brazilian oral researchMiguel Konradt Mascarenhas, Marina da Costa Rocha, Mariana Gonzalez Cademartori, Marcos Britto Correa, Francine Dos Santos Costa, Luiz Alexandre Chisini, Flávi…
This systematic review and meta-analysis investigated the potential links between clinically assessed oral health conditions and depressive symptoms in adults. Six databases were searched for observational studies examining dental caries, periodontal disease, or tooth loss through clinical examination, and depressive symptoms through validated instruments. Data extraction and quality assessment (JBI) were independently performed by two reviewers, and random-effects meta-analyses were conducted for compatible effect measures (OR), assessing heterogeneity. Out of 6.917 unique records, 20 studies were selected. The meta-analyses revealed increased odds of depression for patients who experienced tooth loss (pooled OR = 1.19, 95%CI: 1.09-1.30, I2 = 54.7%), supported by a dose-response gradient in subgroup analyses. Periodontal disease also increased the odds of depression (pooled OR = 1.59, 95%CI: 1.14-2.21, I2 = 0.0%). Conversely, depression as an exposure was associated with higher odds of dental caries (pooled OR = 1.20, 95%CI: 1.04-1.39, I2 = 0.0%), but not with periodontal disease. The relationship between oral and mental health seems to be condition-specific, with robust quantitative evidence indicating the importance of tooth loss in the development of depressive symptoms, which in turn increase the odds for dental caries, suggesting a possible feedback loop. Evidence for depression affecting periodontal status remains inconclusive.
Israel journal of health policy researchDara Schwartz, Hagit Domb Herman, Shiri Waingrod, Lena Natapov
BACKGROUND: Oral diseases are among the most prevalent non-communicable conditions worldwide, contributing to significant health burdens and disparities. In response, the World Health Organization established the Global Oral Health Action Plan 2023-2030, urging countries to integrate oral health into universal health coverage and adopt comprehensive prevention strategies. This article examines Israel's alignment with these objectives. MAIN BODY: Over the past 15 years, Israel has advanced oral health within Universal Health Coverage by integrating dental services into the National Health Insurance Law and progressively expanding public financing to children and the elderly, while maintaining coverage for special patient groups. Children and the elderly now account for over 40% of those eligible for publicly funded dental care. Prevention is central to policy. National school and mother-and-child health programs provide supervised toothbrushing, fluoride varnish applications, and oral health education, reaching nearly all children in recognized educational settings. Multidisciplinary primary care models link dental professionals with nurses and pediatric providers to deliver coordinated, life-course services, while strengthening the oral health workforce. Additional system measures include front-of-pack sugar warning labels, a national policy to phase down dental amalgam use, and ongoing efforts to establish a unified digital surveillance system for oral health. Together, expanded coverage, prevention-focused delivery, workforce development, and system strengthening position oral health as an integral component of Universal Health Coverage in Israel. CONCLUSION: Israel has made considerable progress in aligning with the Global Oral Health Action Plan, particularly by expanding coverage and preventive interventions for children and the elderly. However, continued efforts are needed to address remaining gaps in adult coverage, strengthen the capacity and distribution of the oral health workforce, and further integrate oral health care into innovative, multidisciplinary models. Systematic surveillance systems are also needed to accurately track disease burden and ensure equitable outcomes across all population groups.
Revista de saude publicaCristiane Maria da Costa Silva, Juliane Franco Martins, Gustavo Fernando Silva, Walbert de Andrade Vieira, Carlos José Soares, Luiz Renato Paranhos
OBJECTIVE: To analyze the time trend of dental extractions performed in primary health care and their association with human development indicators and oral health coverage in municipalities at the extremes of wealth distribution. METHODS: An ecological study using secondary data from August 2019 to July 2024, with Brazilian municipalities as the units of analysis. A total of 200 municipalities were selected, comprising the 100 with the lowest and the 100 with the highest gross domestic product per capita. The number of tooth extractions was obtained from national health information systems, and rates were calculated per 1,000 inhabitants. The temporal trend was estimated using generalized least squares regression with an autoregressive structure, and the annual percentage change was calculated. Comparisons between the groups were performed using a mixed-effects model with a negative binomial distribution, adjusted for indicators of oral health coverage, socioeconomic status, and demographics. A significance level of 5% was used. RESULTS: A total of 355,218 tooth extractions were recorded during the study period. The rates showed stationary trends in both groups, although municipalities with higher per capita gross domestic product exhibited a borderline trend towards an increase (p = 0.06). The Municipal Human Development Index was inversely associated with the outcome, while population coverage of primary patternsoral health care was positively associated with it. Per capita gross domestic product was not significantly associated with tooth extraction rates in the adjusted model. CONCLUSION: The stability of tooth extraction rates throughout the time series, regardless of municipal wealth, suggests that factors related to human development and the organization of services may be more relevant for understanding the distribution of this procedure within the Unified Health System.
PURPOSE: Obstructive sleep apnea (OSA) is associated with reproducible oral microbiome dysbiosis mediated by five simultaneous biological pathways: chronic intermittent hypoxia-driven immune dysregulation, obligate mouth breathing causing salivary desiccation, elevated salivary glucose promoting cariogenic biofilm proliferation, gastroesophageal reflux acid challenge, and hypothalamic-pituitary-adrenal axis activation suppressing mucosal immunity. The December 2024 FDA approval of tirzepatide for moderate-to-severe OSA and the emergence of retatrutide and orforglipron have placed GLP-1 receptor agonists (GLP-1RAs) at the center of OSA pharmacotherapy. This review examines the oral microbiome consequences of GLP-1RA therapy in OSA patients, characterizes the competing biological influences these agents introduce, and identifies the monitoring and research implications of the resulting uncertainty. METHODS: A narrative review of published literature examining OSA-related oral microbiome dysbiosis, GLP-1RA pharmacological mechanisms relevant to oral biology, salivary gland pharmacovigilance data, and gut microbiome restoration evidence. Sources included PubMed, Web of Science, and Scopus databases searched through June 2026. RESULTS: GLP-1RA therapy engages five restoration pathways that mechanistically counter each OSA-driven dysbiosis mechanism: direct AHI reduction, attenuating hypoxia-driven immune dysregulation; pharyngeal airway improvement, reducing obligate mouth breathing; glycemic normalization, reducing salivary fermentable substrate; gastric emptying delay and weight loss, attenuating GERD acid challenge; and sleep architecture restoration, reducing cortisol-mediated mucosal immune suppression. Pharmacovigilance data, however, indicate that semaglutide may impair salivary gland responsiveness through β-arrestin-mediated receptor desensitization-a competing oral risk that partially or fully counteracts the restoration benefits. Tirzepatide's biased agonism profile (preferential activation of cAMP signaling over β-arrestin internalization) may confer differential salivary gland safety, and orforglipron's daily oral dosing introduces direct oropharyngeal drug exposure with uncharacterized microbiological consequences. The net oral microbiome outcome in any treated patient is the product of these competing influences and has not been characterized prospectively. CONCLUSIONS: GLP-1RA pharmacotherapy in OSA creates a biologically complex oral microbiome environment whose clinical trajectory cannot be predicted from current evidence. Prospective studies are warranted, oral health monitoring beginning at treatment initiation is scientifically justified, and seven priority research questions are identified at the convergence of sleep medicine, endocrinology, and oral biology.
International journal of molecular sciencesMarziyeh Shafizadeh, Vikram Bhatia, Samah Ahmed, Britt Drögemöller, Chrysi Papadimitropoulos, Philip St John, Rajinder P Bhullar, Prashen Chelikani, Carol A Hi…
Bitter taste receptors (T2Rs) contribute to innate immune responses and taste preferences. Variants in T2R genes (TAS2Rs) may increase the risk of adverse oral health. This study investigated the association of single nucleotide polymorphisms (SNPs) in 25 TAS2R genes and 12 TAS2R pseudogenes with oral health symptoms within the Canadian Longitudinal Study on Aging (CLSA) cohort. Allele frequencies were calculated using PLINK and compared with the 1000 Genomes Project for individuals of European descent. Associations of oral health symptoms reported by 21,991 individuals (mean age 63 years, 50% female, 48% never smokers), with TAS2R SNPs (87 in TAS2R genes; 37 in TAS2R pseudogenes; minor allele frequency > 0.01) were tested by Chi-square with Bonferroni correction and by logistic regression correcting for sociodemographic variables and oral health habits. Fifteen SNPs in TAS2R8, 9, 13, 14, 20, and 50 showed modest suggestive associations with self-reported sore jaw muscles. These variants were associated with relatively small changes in the odds of reporting sore jaw muscles (6 positive; 9 negative). Nine of these SNPs were in TAS2R20 and highly correlated (r2 ≈ 1), likely representing a single locus-level genetic signal. However, none of the associations remained significant after Benjamini-Hochberg FDR correction across all 2604 SNP-phenotype tests, and these findings should therefore be considered exploratory. Structure-function analysis identified selected TAS2R20 residues near the predicted ligand-binding region, providing hypotheses for future functional investigation. These exploratory findings provide hypotheses for future genetic and functional investigation and require independent replication in clinically characterized cohorts.
British dental journalHabib Benzian, Sudeshni Naidoo
Oral health remains a soft voice in loud global health spaces. Other healthcare fields have secured coalitions, goals, governance, and entitlements; oral health often settles for symbolic inclusion and pilot projects. This paper uses 'meekness' as a metaphor for a structural posture of oral health advocacy marked by caution, deference, and lack of political leverage. Meekness is expressed across four domains: professional voice, institutional platforms, academic culture, and civic positioning. They create an architecture that privileges visibility over influence. Professional associations dominate public discourse but are closely tied to clinical and commercial interests. Weak civil society and groupspeak rhetoric reinforce cautious advocacy, while charity and awareness campaigns substitute for structural reform. Academic incentives discourage outward-facing scholarship and public intellectual leadership, muting analytic and civic pressure. Together, these factors sustain marginality in universal health coverage despite a large disease burden and strong evidence for prevention. The paper outlines what full recognition would entail: defined essential services, stable financing, primary healthcare-based delivery, diversified workforce models, and regulatory action on commercial determinants. Moving from meekness to power requires explicit demands for benefits, budgets, and rules, stronger civic alliances, and academic cultures that reward public reasoning as part of systemic change.
Clinical interventions in agingLinxin Jiang, Simin Li, Zhihao Liao, Daniel R Reissmann, Deborah Kreher, Gerhard Schmalz, Jianbo Li
PURPOSE: This study aims to identify distinct oral multimorbidity subtypes among Chinese older adults and to examine the structural and intermediary social determinants associated with subtype membership. PATIENTS AND METHODS: This cross-sectional study analyzed 423 adults aged 65-74 years recruited from 39 communities at 13 disease surveillance sites in Guangdong Province, China, within the 2021 key population oral health surveillance project. Oral health indicators, including caries, periodontal status, and tooth loss, were subjected to latent class analysis (LCA). The Bolck-Croon-Hagenaars (BCH) three-step approach was employed to examine associations between latent class membership and covariates organized within Solar and Irwin's social determinants of health framework (SDH). RESULTS: Three subtypes were identified: Class 1 (lower disease burden, 23.9%), preserved dentition with moderate periodontal involvement; Class 2 (periodontal-dominant subtype, 41.6%), severe periodontal destruction, substantial tooth loss, and high rates of unrestored missing teeth; and Class 3 (caries-tooth loss dominant subtype, 34.5%), elevated crown caries burden and tooth loss but relatively preserved periodontal status. Compared with Class 1, Class 2 was significantly associated with older age, smoking, and dental visit. Class 3 was significantly associated with older age, females, urban residence, and dental visit. CONCLUSION: Oral multimorbidity among Chinese older adults is heterogeneous. These findings may support the design of, subtype-specific rather than uniform oral health management strategies for older adults. Longitudinal validation and replication in other Chinese populations are required before wider generalization.
Health research policy and systemsMichael Lorenz, Ziade Sarroukh, Stefan Listl
BACKGROUND: The burden of oral diseases on society remains relevant as vulnerable groups lack accessibility to oral healthcare and it is expensive on a societal scale. While there is renewed political will from the UN to expand Universal Health Coverage to oral health, quality issues remain. Solving such complex systematic problems requires coherent efforts that span multiple stakeholders and sectors. The co-development of a definition of oral healthcare quality serves as a key enabler for quality improvement interventions as it facilitates collective understanding and normative directionality. METHODS: As part of the EU DELIVER project, a five-step co-development process was leveraged for consenting an actionable definition for quality of oral healthcare: (1) literature screening to identify relevant themes of quality of oral healthcare; (2) compilation of a starting list from these themes; (3) World Café sessions to deliberate about themes to define quality of oral healthcare; (4) thematic analysis of information from the World Café sessions; (5) final voting and completion of the definition. The definition provides a clear foundation and normative directionality for co-developing quality indicators and targeted interventions for quality improvement. The Consolidated criteria for reporting qualitative studies (COREQ-32) were used to report the study. RESULTS: Drawing from the breadth of the extant scientific literature and the depth of stakeholder insights from the World Café sessions, the following working definition was agreed upon: "Quality oral healthcare refers to the contribution of healthcare to optimal oral health. This entails that care alleviates oral health inequity, is comprehensive, empowers patients, mitigates harm and encourages learning systematically, improves well-being, minimizes waste of resources and is provided at the right time. To maximize quality, care should be equitable, accessible, patient-centered, safe, effective, efficient and timely." The definition forms the basis for the operationalization of targeted quality improvement interventions on the practice-, community- and health systems levels. CONCLUSIONS: The definition for quality of oral healthcare is the first that was co-developed together with providers, policy-makers, and patients from various European countries. This definition provides meaningful normative direction and is highly relevant to collective problem-solving aimed at optimizing the quality of oral healthcare.
BMC geriatricsSarah Porzelt, Alena Koenig, Maren Heyke, Anja Behrens-Potratz, Peter Stratmeyer, Petra Schmage, Claudia Konnopka, Stefanie Schellhammer, Martin Scherer, Alexa…
BACKGROUND: With the growing number of people requiring long-term care in Germany, not only is the prevalence of chronic diseases increasing, but oral health is also deteriorating. Many older adults with functional impairments who live at home can no longer maintain their oral hygiene independently and therefore rely on caregivers. Consequently, the quality of oral care often depends these caregivers. However, as oral health care in the outpatient setting involves multiple stakeholders - including dentists, dental assistants, general practitioners, professional and family caregivers- the fragmented German healthcare system, characterised by distinct responsibilities and reimbursement models, often results in poor coordination among those stakeholders. We aimed to explore the perspectives of key stakeholders, including family caregivers, professional caregivers, dentists, dental assistants, and general practitioners, to identify barriers, challenges, and facilitators related to both the delivery and utilisation of oral health care for older adults in need of home-based care. METHODS: As part of the 'Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP)' study, we conducted a descriptive qualitative study incorporating both homogeneous and heterogeneous stakeholder focus groups, complemented by individual interviews with professionals involved in oral health care for home-based care recipients in Hamburg, Germany. All interviews were digitally recorded, transcribed verbatim, and analysed using deductive-inductive qualitative content analysis following Kuckartz's framework. RESULTS: A total of 55 stakeholders participated in six homogeneous focus groups (n = 29), two heterogeneous focus groups (n = 9), and 17 individual interviews. Three main themes emerged: (1) Facilitators and Challenges in Oral health care, (2) Utilisation of Dental Care, and (3) Interprofessional Collaboration. CONCLUSIONS: Improving oral health care for older adults in need of home-based care requires greater awareness of its relevance to overall health and well-being. Our findings highlight the need for structured interprofessional collaboration, alongside reforms in reimbursement models, caregiver training, digitalisation, and coordination of care. Addressing these factors may contribute to improving oral health care services for older adults with reduced functional capabilities. TRIAL REGISTRATION: DRKS00027020. Date of Registration: 04/01/2022; https://drks.de/search/de/trial/DRKS00027020 .
BMC oral healthYang Liu, Liyi An, Lin Xie, Zining Zhang, Jing Sun
BACKGROUND: Oral health problems are common among patients with chronic kidney disease. Chronic kidney disease is associated with a broad range of oral manifestations, while poor oral health may accelerate chronic kidney disease progression, increase the risk of complications, and contribute to the overall disease burden. Despite their clinical importance, oral health problems often receive limited attention in routine nephrology care. This study aimed to develop and conduct a preliminary psychometric evaluation of the Chronic Kidney Disease Oral Health Questionnaire to assess nephrology healthcare professionals' knowledge, attitudes, and self-reported practices regarding oral health management in patients with chronic kidney disease. METHODS: The initial questionnaire was developed using a knowledge-attitude-practice framework, a literature review, and two rounds of expert consultation. In October 2025, the preliminary questionnaire was administered online to nephrology healthcare professionals in Hubei, Anhui, and Jiangsu provinces, China. Content and face validity, internal consistency, and test-retest reliability were evaluated. Exploratory factor analysis was conducted to examine the construct validity of the attitude and practice dimensions. RESULTS: The questionnaire comprised 25 items across three dimensions. A total of 169 valid responses were included. The scale-level content validity index was 0.95. Cronbach's α coefficients were 0.97 for the attitude dimension and 0.98 for the practice dimension, whereas the Kuder-Richardson Formula 20 coefficient for the knowledge dimension was 0.46. The intraclass correlation coefficient for the total questionnaire was 0.95. Exploratory factor analysis of the attitude and practice items identified two factors that explained 83.34% of the total variance. CONCLUSIONS: The questionnaire offers a preliminary structured approach to assessing nephrology healthcare professionals' knowledge, attitudes, and self-reported practices regarding oral health management in patients with chronic kidney disease. The findings provide initial evidence of its measurement properties while indicating the need for further refinement and validation in larger, more diverse, and independently recruited samples before wider application.
Frontiers in public healthSu-Kyung Park, Jung Yun Kang, Sun-Jung Shin, Sun-Mi Lee, Nam-Hee Kim
BACKGROUND: Community oral health practice increasingly requires dental hygienists to perform prevention-oriented, population-based, and interprofessional roles beyond traditional chairside clinical care. However, existing competency frameworks primarily emphasize clinical practice or general professional competencies, and an integrated competency framework specifically designed for community oral health practice remains unavailable. This study aimed to identify core competencies for community oral health practice among dental hygienists through a scoping review. METHODS: A scoping review was conducted in accordance with the JBI methodology and reported following the PRISMA-ScR guidelines. Literature published between 2005 and 2025 was identified through PubMed, Scopus, Google Scholar, and targeted searches of official organizational websites. Following predefined eligibility criteria, 38 sources were synthesized across three analytical layers: (1) seven cross-professional competency frameworks represented by 12 source documents, (2) five national or regional dental hygiene competency frameworks represented by nine source documents, and (3) 17 community oral health practice literature sources. Competency domains were identified through iterative qualitative coding and retained when supported by convergent evidence across at least two of the three analytical layers. RESULTS: Eight integrated competency domains were identified: Health Equity Practice (based on social determinants of health, SDOH); Population-Based Program Planning, Implementation & Evaluation; Professionalism & Social Responsibility; Policy & Health System Literacy; Community Problem-Solving; Interprofessional Collaboration & Leadership; Evidence-Based Practice & Data Literacy; and Cultural Competence & Public Communication. The resulting framework integrates competencies derived from international healthcare professional frameworks, national dental hygiene competency frameworks, and community oral health practice literature, reflecting the expanding public health role of dental hygienists. CONCLUSION: This study proposes an integrated competency framework for community oral health practice that may support competency-based curriculum development, workforce preparation, and professional development for dental hygienists. The framework provides a structured foundation for strengthening prevention-focused community oral health practice and may be adapted and validated across diverse educational, sociocultural, and healthcare settings.
Oral health & preventive dentistryLise Gentet, Lucile Barré, Alexia Marie-Cousin, Sylvie Jeanne, Sarah Dion, Solen Novello
PURPOSE: To investigate the sixth-year community pharmacy French students' perception of their oral health education and knowledge. METHODS AND MATERIALS: An analytical cross-sectional study was conducted using a questionnaire sent by e-mail to sixth-year community pharmacy students of 20 faculties of pharmacy. Data were collected online, and descriptive data analyses were conducted. RESULTS: A total of 318 students responded to the survey. The majority (n = 308) felt that courses in dentistry would be useful for their future practice. Two-thirds of students (n = 228) rated their perceived knowledge as 'insufficient' or 'non-existent'. More than half reported feeling uncomfortable when facing a patient presenting to the pharmacy with an oral health complaint or pathology. Overall, participants emphasised the importance of strengthening oral health training and improving communication between pharmacists and dentists. A collaboration between pharmacists and dentists could improve patient care, according to 298 students. CONCLUSION: The results showed that, although students reported some familiarity with oral health conditions, their perceived knowledge remained limited. Since the study assessed perceived knowledge rather than objectively measured competence, the findings should be interpreted with caution. These findings suggest that strengthening oral health education in pharmacy studies could help improve pharmacists' confidence in managing oral-health-related situations and appropriately referring patients when necessary.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in CancerFelipe Rodríguez-Oria, Valentina Vera-Díaz, Dominique Mengin-Trefny, Sofía Salazar-Arcos, Constanza Marín-Márquez
PURPOSE: Oral conditions are highly prevalent among patients receiving oncological palliative care and may be associated with poorer quality of life. However, evidence on the relationship between oral health-related quality of life (OHRQoL) and overall health-related quality of life (HRQoL) in this population remains limited, particularly in Latin America. This study aimed to describe oral conditions and assess the association between OHRQoL and HRQoL in patients receiving oncological palliative care. METHODS: A cross-sectional study was conducted in a palliative care unit in southern Chile. Adult cancer patients were consecutively recruited. Quality of life was assessed using the EORTC QLQ-C30 and QLQ-OH15, and xerostomia using the Xerostomia Inventory. Associations were analyzed using Spearman correlation, Mann-Whitney U tests, and multivariable linear regression adjusted for age, sex, number of medications, opioid use, and metastatic disease. RESULTS: Eighty-two patients were included (median age: 65 years; 65% women). Oral conditions were highly prevalent, including mucosal lesions (64%), denture use (62%), and xerostomia (73%). OHRQoL was positively correlated with multiple HRQoL domains. Patients with xerostomia had significantly lower functional scores and OHRQoL. In adjusted analyses, greater xerostomia severity was associated with poorer cognitive functioning (β = - 0.69; 95% CI: - 1.36 to - 0.01), social functioning (β = - 0.88; 95% CI: - 1.71 to - 0.05), and oral quality of life (β = - 0.87; 95% CI: - 1.29 to - 0.45). CONCLUSION: In this single-center exploratory study, OHRQoL was associated with overall health-related quality of life among patients receiving oncological palliative care. Greater xerostomia severity was independently associated with poorer cognitive functioning, social functioning, and oral quality of life. These findings support the importance of routine oral health assessment and xerostomia management in palliative care and warrant confirmation in larger multicenter studies.
BMC cancerSandra Einarsson, Annica Almståhl, Hanna Gyllensten, Mats Sjöström, Lena Mårell, Ove Björ, Linda Marklund, Lovisa Farnebo, Göran Laurell, Ylva Tiblom Ehrsson
BACKGROUND: Head and neck cancer comprises a heterogeneous group of tumours affecting anatomical sites of the upper aerodigestive tract. Treatment often involves surgery and either radiotherapy or chemoradiotherapy. These treatments are associated with substantial morbidity and may have long-lasting adverse effects on oral health. Oral complications can negatively affect health-related quality of life, nutritional status, and social and work-related functioning. The aim is to evaluate an oral health care programme designed to prevent or mitigate late oral sequalae, and to assess its impact on health-related quality of life, oral health, work ability, nutritional status, healthcare-related economic costs, and psychological well-being. METHODS: This is a study protocol for a Swedish multicentre, two-armed, superiority randomised controlled trial that has been ethically approved by the Swedish Ethical Review Authority. Patient inclusion commenced in September 2025, with an intended sample of 300 participants. Adult patients (≥ 18 years) planned for curative-intent treatment for head and neck cancer (oral cavity, oropharynx, larynx stage III and IV, hypopharynx, nasopharynx, salivary gland, or unknown primary) are randomised (1:1) to either an oral health care programme (intervention) or standard of care. EXCLUSION CRITERIA: severe alcoholism, cognitive impairment, or inability to understand the Swedish language. Participants are followed before the start of cancer treatment and at 4 follow-ups: 6 months after completion of treatment, and 1, 2, and 3 years after the 6-month follow-up. The primary outcome measure is health-related quality of life. Secondary outcomes include quantitative oral health indicators, return to work, nutritional status, healthcare-related economic costs, and patient-reported outcome measures focusing on self-reported oral health and psychological well-being (depression, anxiety and stress), and self-efficacy. DISCUSSION: Oral health follow-up for head and neck cancer survivors often lacks consistency and uniformity. To date, few oral health care interventions for head and neck cancer survivors have been evaluated within the framework of a randomised controlled trial. The findings have the potential to inform clinical practice and contribute to the development of more integrated, evidence-based oral healthcare strategies within routine follow-up for head and neck cancer survivors, with the overarching goal of improving their oral health and long-term quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT07173270, date 15/9/2025.
PURPOSE: Inadequate oral hygiene and management affect oral health and are associated with systemic diseases. Although systemic disease history may relate to subjective oral status and oral health behaviours, these associations remain insufficiently examined. This study investigated the associations between systemic disease history, subjective oral status, and oral health behaviours among community-dwelling older adults. METHODS AND MATERIALS: We analysed data from 979 individuals aged 65-85 years, residing in Higashiura-cho, Aichi Prefecture, who participated in a 2018 group examination and completed a self-administered questionnaire. Multivariable logistic regression was used to evaluate associations between oral-related variables ('concerns about teeth and mouth condition', 'use of interdental brushes and dental floss', and 'experience of oral hygiene instruction') and histories of systemic diseases (cancer, myocardial infarction, stroke, hypertension, diabetes, liver disease, lung disease, mental illness, and bone disease). RESULTS: The mean age was 73.0 ± 5.2 years, and 52.4% were female. No significant associations were observed between 'concerns about teeth and mouth condition', 'use of interdental brushes and dental floss', and systemic disease history. However, participants who had received oral hygiene instruction had higher odds of a history of hypertension (odds ratio: 1.4; 95% confidence interval: 1.0-2.0). CONCLUSION: Among community-dwelling older adults, receiving oral hygiene instruction was positively associated with a history of hypertension. As the data were self-reported, findings should be interpreted with caution. Dental hygienists should consider patients' systemic health status, particularly hypertension, when providing oral hygiene instruction.
BACKGROUND: Dental and oral health activities that promote awareness of oral health are essential in children's nutrition education. We aimed to evaluate the effects of the Comprehensive Awareness Modification of Mouth, Chewing And Meal (CAMCAM) program for kids, in which participants gather monthly to learn about oral health and nutrition while consuming a textured meal at community children's cafeterias. METHODS: This single-group pre-post pilot intervention without a control group included 52 children and 32 parents/guardians who regularly attended two community children's cafeterias in Tokyo, Japan. They participated monthly in six sessions in which they were provided a "munchy" textured meal and a 10-minute lecture on chewing, oral health, and food and nutrition. Participants completed questionnaires assessing their awareness of the subject and food intake frequency, before and after the intervention. Changes in awareness and behaviors following participation in the program were analyzed. RESULTS: The median ages of the children and parents were 8.5 (6-16) and 43.0 (36-50) years, respectively. The frequency of self-observation of the oral cavity among children increased. Daily fluoride use frequency increased from 61.5% to 76.9% (p = 0.020). The number of children who reported not considering nutritional balance decreased from 63.5% to 38.5% (p = 0.022). The number of parents/guardians who actively practiced a nutritionally balanced diet non-significantly increased from 56.2% to 75.0%. Food intake frequencies for meat, dairy products, and tubers, among caregivers, and that for rice, tubers, and fruits among children increased post-intervention. The number of participants who did not consider the number of chewing cycles decreased. CONCLUSION: Participation in CAMCAM-P for kids was associated with favorable changes in oral health awareness and attitudes toward nutritional balance among children and parents/guardians. As a pilot study without a control group, these findings should be considered preliminary. Larger controlled studies are warranted to confirm effectiveness.
BACKGROUND: The global aging population has heightened the need for comprehensive oral care in older adults, yet evolving aspects such as preventive strategies, technological advancements, and interdisciplinary approaches remain underexplored. This systematic review and qualitative meta-synthesis aimed to synthesize qualitative evidence on perceptions, experiences, barriers, facilitators, and impacts of oral care in older adults, guided by the Socio-Ecological Model. METHODS: Following PRISMA and ENTREQ guidelines, a systematic search was conducted in MEDLINE (PubMed), Embase, CINAHL, PsycINFO, Scopus, and Web of Science for qualitative studies published from January 2000 to December 2025. Eligibility criteria were defined using the SPIDER framework, focusing on older adults (aged ≥ 60) and stakeholders. Two reviewers independently screened records, extracted data, and appraised quality using CASP. Thematic synthesis was performed using NVivo to generate higher-order themes. RESULTS: From 1,416 records, 49 studies were included, involving diverse participants from multiple countries. Four overarching themes emerged: [1] Meaning-Making and Beliefs Surrounding Oral Health (e.g., cognitive biases, links to general health, responsibility); [2] Barriers to Accessing and Maintaining Oral Care (e.g., financial, physical, systemic); [3] Facilitators, Strategies, and Ethical Considerations in Oral Care Delivery (e.g., interprofessional collaboration, education, autonomy); and [4] Oral Health as a Determinant of Quality of Life and Human Dignity (e.g., functional, psychosocial, broader implications). A conceptual model illustrated the cyclical evolution of oral care. CONCLUSIONS: Oral health in older adults is influenced by multifaceted perceptions and systemic factors, impacting well-being. Findings advocate for interprofessional models, policy reforms, and education to address gaps and promote equitable, holistic care. Future research should explore digital interventions and multilingual syntheses.