Profile of orofacial dysfunction in Brazilian children using the Nordic Orofacial Test-Screening

Objective: The parameters of orofacial dysfunction (OFD) in children can guide clinicians and researchers in the monitoring of deviations from normality. The aim for this study was to evaluate manifestation patterns and the prevalence of OFD in children.

Materials and methods: A population-based cross-sectional study was conducted involving 531 schoolchildren (8–10 years old) in a small city in southern Brazil. OFD was evaluated using the Nordic Orofacial Test-Screening (NOT-S). Poisson multiple regression analysis with robust variance was used to estimate adjusted NOT-S rate ratios (ratio of arithmetic means) among the different categories of covariables and their respective 95% confidence interval (RR: 95%CI).

Results: The mean NOT-S score was 2.1 (SD 1.4, median: 2.0; range: 0–8). The majority of children (87.6%) had at least one domain of the scale affected. The most affected were Chewing and Swallowing (50.5%), Habits (41.4%) and Breathing (26.4%). NOT-S scores were lower among children from higher income families (RR?=?0.73; 95% CI: 0.61–0.87) and higher among those with difficulty regarding access to dental services (RR?=?1.14; 95% CI: 1.01–1.28), those with sleep bruxism (RR?=?1.18; 95% CI: 1.04–1.32) and those with open bite (RR?=?1.65; 95% CI: 1.42–1.93).

Conclusions: The prevalence of OFD was high and both socioeconomic and clinical factors exerted an influence on NOT-S scores.     

Association between subjective oral health and regularity of service use

The aim was to evaluate the predictive power of two different measures of subjective oral health in relation to regularity of use of oral health-care services. The nationally representative data were collected as part of the Health 2000 Survey on Finnish adults, 30+ yr of age (n=4926). Subjective oral health and regularity of using of oral health-care services were measured using single questions and oral health-related quality of life was measured using the 14-item Oral Health Impact Profile (OHIP-14) questionnaire. Those reporting poor oral health or higher impacts in the OHIP-14 were more likely to be irregular users of oral health-care services. Further research is needed to investigate more precisely the applicability of these measures in different settings of oral health-care provision.     

Effect of an impaired oral stage on swallowing in patients with Parkinson's disease

We investigated the swallowing function in patients with Parkinson's disease (PD) using deteriorated tongue control because patients with PD frequently exhibit an impaired oral stage of swallowing and the tongue movement affects oral and pharyngeal stage. In total, 201 patients with PD (106 men, 95 women; mean age 70·6 ± 8·0 years; median Hoehn‐Yahr Stage III) were studied. The patients swallowed 10 mL of liquid barium under videofluorography, and their oral transit time (OTT) was measured. Based on 20 healthy controls (mean age 70·3 ± 7·8 years) with an OTT + 2 standard deviation (0·89 + 2 × 0·46) of 1·81 s, the patients with PD were divided into 167 patients with an OTT < 1·81 s and 34 patients with an OTT ≥ 1·81 s. Swallowing function was compared between the groups and assessed using logistic regression analysis. The following factors were significantly associated with oral stage impairment in both groups: tongue‐to‐palate contact, tongue root‐to‐posterior pharyngeal wall contact, premature spillage into the pharynx, aspiration and onset of swallowing reflex. Logistic regression analysis showed that tongue root‐to‐posterior pharyngeal wall contact, onset of swallowing reflex and aspiration were independent factors. PD patients with prolonged OTT displayed poor lingual control and decreased range of motion of the tongue due to bradykinesia and rigidity. Such problems in the oral stage affected the subsequent pharyngeal stage of swallowing with aspiration. Lingual movement in the oral stage thus appears to play an important role in the sequential movement of swallowing in PD.     

Eating disorders and oral health: a review of the literature

This article is a review of the recent literature pertaining to the oral sequelae of eating disorders (EDs). Dentists are recognized as being some of the first health care professionals to whom a previously undiagnosed eating disorder patient (EDP) may present. However, despite the prevalence (up to 4 per cent) of such conditions in teenage girls and young adult females, there is relatively little published in the recent literature regarding the oral sequelae of EDs. This compares unfavourably with the attention given recently in the dental literature to conditions such as diabetes mellitus, which have a similar prevalence in the adult population. The incidence of EDs is increasing and it would be expected that dentists who treat patients in the affected age groups would encounter more individuals exhibiting EDs. Most of the reports in the literature concentrate on the obvious clinical features of dental destruction (perimolysis), parotid swelling and biochemical abnormalities particularly related to salivary and pancreatic amylase. However, there is no consistency in explanation of the oral phenomena and epiphenomena seen in EDs. Many EDPs are nutritionally challenged; there is a relative lack of information pertaining to non-dental, oral lesions associated with nutritional deficiencies.     

Variation in oral health parameters between older people with and without mental disorders

This study investigated the variation in the oral examination findings and the subjective oral complaints between older people with and without mental disorders. An interview and an oral investigation were performed in a group of older patients with mental disorders with a mean age of 71.9 years and in a group of older people without mental disease with a mean age of 70.2 years. The analysis did not reveal any statistically significant differences in the dental status of the participants and in the prevalence of oral ulcers and stomatitis. However xerostomia, burning mouth, dysgeusia, and oral malodor complaints were more frequent in patients with mental disorders, whereas general chewing complaints were less frequent. The multiple logistic regression analysis revealed that psychiatric illness was significantly associated with more complaints of dysgeusia and fewer chewing complaints. The increased prevalence of specific oral complaints in the older patients with mental disorders revealed the significant psychopathological compound of these symptoms.     

Effects of age and non‐oropharyngeal proprioceptive and exteroceptive sensation on the magnitude of anticipatory mouth opening during eating

To best prevent and treat eating/swallowing problems, it is essential to understand how components of oral physiology contribute to the preservation and/or degradation of eating/swallowing in healthy ageing. Anticipatory, pre‐swallow motor movements may be critical to safe and efficient eating/swallowing, particularly for older adults. However, the nature of these responses is relatively unknown. This study compared the magnitude of anticipatory mouth opening during eating in healthy older (aged 70–85) and younger (aged 18–30) adults under four eating conditions: typical self‐feeding, typical assisted feeding (being fed by a research assistant resulting in proprioceptive loss), sensory loss self‐feeding (wearing blindfold/headphones resulting in exteroceptive loss) and sensory loss assisted feeding (proprioceptive and exteroceptive loss). Older adults opened their mouths wider than younger adults in anticipation of food intake under both typical and most non‐oropharyngeal sensory loss conditions. Further, the loss of proprioceptive and exteroceptive cues resulted in decreased anticipatory mouth opening for all participants. Greater mouth opening in older adults may be a protective compensation, contributing to the preservation of function associated with healthy ageing. Our finding that the loss of non‐oropharyngeal sensory cues resulted in decreased anticipatory mouth opening highlights how important proprioception, vision, and hearing are in pre‐swallow behaviour. Age‐ and disease‐related changes in vision, hearing, and the ability to self‐feed may reduce the effectiveness of these pre‐swallow strategies.     

Association between oral conditions and functional limitations in childhood

The aim of this study was to evaluate the impact of oral conditions on functional limitations among preschoolers. A preschool‐based, cross‐sectional study was carried out with 843 preschoolers in Campina Grande, Brazil. Parents/caregivers answered a questionnaire addressing socio‐demographic characteristics and perceptions regarding the general/oral health of their children as well as the Brazilian version of the Early Childhood Oral Health Impact Scale. The nonparametric Kruskal–Wallis test followed by Mann–Whitney test (α = 5%) was used to compare mean children's quality‐of‐life scores for each independent variable. Poisson regression analysis was used to test associations between the independent and dependent variables (difficulties eating, drinking and speaking) (α = 5%). The multivariate regression model involved a hierarchical approach with four levels (distal to proximal determinants): (i) socio‐demographic aspects; (ii) health perceptions; (iii) oral conditions; and (iv) pain conditions. The prevalence of negative impact on function was 24·7% for eating/drinking and 8·0% for speaking. Significant associations were found between toothache and negative impact on eating/drinking (PR = 5·38; 95%CI: 3·20–9·02) as well as between high severity dental caries and negative impact on speaking (PR = 14·91; 95%CI: 1·98–112·32). Dental caries, traumatic dental injury and malocclusion were not significantly associated with a negative impact on eating or drinking. However, toothache was an indicator of negative impact on eating/drinking and dental caries severity was an indicator of negative impact on speaking.     

Interactions between sleep disorders and oral diseases

Dental sleep medicine is a rapidly growing field that is in close and direct interaction with sleep medicine and comprises many aspects of human health. As a result, dentists who encounter sleep health and sleep disorders may work with clinicians from many other disciplines and specialties. The main sleep and oral health issues that are covered in this review are obstructive sleep apnea, chronic mouth breathing, sleep‐related gastroesophageal reflux, and sleep bruxism. In addition, edentulism and its impact on sleep disorders are discussed. Improving sleep quality and sleep characteristics, oral health, and oral function involves both pathophysiology and disease management. The multiple interactions between oral health and sleep underscore the need for an interdisciplinary clinical team to manage oral health‐related sleep disorders that are commonly seen in dental practice.     

Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross‐sectional observational study

The total number of natural teeth was related to swallowing function among older adults; however, limited information is available regarding the impact of occluding pairs of teeth on swallowing function. This study aimed to examine the association between posterior teeth occlusion and dysphagia risk in older nursing home residents. This cross‐sectional study included 238 residents aged ≥60 years from eight nursing homes in Aso City, Japan. Swallowing function was evaluated using the modified water swallowing test (MWST); the primary outcome was dysphagia risk (MWST score ≤3). Posterior teeth occlusion was assessed using number of functional tooth units (FTUs), determined based on number and location of the remaining natural and artificial teeth on implant‐supported, fixed or removable prostheses. Univariate and multivariate logistic regression analyses were performed to examine the association between posterior teeth occlusion and dysphagia risk, adjusted for the covariates of number of natural teeth, demographic characteristics, comorbidities, physical function, body mass index and cognitive function. Of the 238 subjects, 44 (18·5%) were determined to be at risk of dysphagia based on the MWST scores. The odds ratio (OR) of dysphagia risk decreased in subjects with higher total FTUs [OR = 0·92, 95% confidence interval (CI) 0·87–0·98]. After adjusting for covariates, this association remained significant (OR = 0·90, 95% CI 0·84–0·97). Loss of posterior teeth occlusion was independently associated with dysphagia risk in older nursing home residents. Maintaining and restoring posterior teeth occlusion may be an effective measure to prevent dysphagia.     

Association between soft drink consumption,oral health and some lifestyle factors in Swedish adolescents

Objective. The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents. Materials and methods. A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13–14 years, n = 195; 18–19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression. Results. Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18–19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer. Conclusion. High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.     

人口老龄化及口腔健康对策

中国的老龄化进程发展迅速，老年人口占总人口的比例逐年增高，老年口腔疾病的发病率也有所提高。口腔健康作为全身健康的一部分，对老年人的生活质量有着重要的意义。本文就中国人口老龄化的现状、人口老龄化对口腔健康及卫生保健的影响以及相关对策的研究进展作一综述。     

Relationship between chronic trauma of the oral mucosa,oral potentially malignant disorders and oral cancer

J Oral Pathol Med (2010) 39 : 513–517 Background: Oral cancer represents 2%–5% of all cancers, being one of the 10 most frequent ones. Apart from oral cancer risk factors already described in literature, such as tobacco and alcohol consumption, others emerging risk factors have been proposed, such as chronic irritation from dental factors. The aim of this work was to assess the influence of chronic trauma of the oral mucosa (CTOM) in patients with oral potentially malignant disorders (OPMD) and cancer. Methods: A retrospective study of 406 patients (both sexes; aged between 18 and 80 years; with OPMD and cancer) who attended the Department of Clinical Stomatology A of the National University of Cordoba was performed by non‐probabilistic sampling. The association of variables and outcome variable diagnosis, with levels control, OPMD, oral cancer, was evaluated by multinomial regression model. Results: Population under study was represented by 72% of control patients, 16% patients with OPMD and 11% of patients with oral cancer. It was observed a significant association between diagnosis and CTOM (P = 0.000), after adjustment of confounding factors (smoking and drinking habits, sex, cancer inheritance and denture use). Conclusions: Our results suggest that CTOM is, together with other factors, an important risk factor in patients with oral cancer diagnosis, but not for patients with OPMD.     

Association between perceived oral and general health

Objectives

The aim of this study was to determine the magnitude of the association between perceived oral and general health-related quality of life (O/HRQoL) in the German general population and to compare it with the correlation of both constructs in dental patients.

Methods

OHRQoL was assessed using the OHIP-49 and HRQoL using the SF-36 in a sample (N = 811) representative of the adult general population of Germany (age: 18–99 years), and in a sample (N = 313) of consecutive adult dental patients at least 18 years of age seeking prosthodontic care or attending their annual checkup. Correlation between OHRQoL and HRQoL was computed using structural equation modelling-based confirmatory factor analysis and path analysis. Based on the correlation coefficients, the coefficients of determination (r²) were calculated.

Results

Correlation between OHRQoL and HRQoL after partialling out effects of age, gender and level of depression in general population subjects was rho = 0.28 resulting in an explanation of the variance of HRQoL by OHRQoL of 7.8%. In dental patients the correlation coefficient was somewhat lower (rho = 0.24) corresponding to an explanation of the variance of HRQoL by OHRQoL of 5.6%. Difference between correlation coefficients was not significant (p = 0.514).

Conclusion

Our findings provide evidence for the inseparable, intertwined relationship between perceived oral and general health.