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1.
BackgroundThe number of cancer survivors in the general population is increasing. Oral and dental status affects patients' quality of life and oral function, which, in turn, may affect nutritional intake and general health. The authors review the importance of oral health and the role of the oral health care provider in supporting dietary intake and providing nutritional guidance.MethodsThe authors provide a brief review of oral complications of therapy and nutritional guidelines for patients with head and neck cancer.ResultsOral adverse effects of head and neck cancer treatment include salivary gland dysfunction, taste change, orofacial pain and mucosal sensitivity, oral infection, tissue defects and necrosis, trismus and fibrosis, progressive dental and periodontal disease, and problems with prosthesis function.ConclusionsManaging oral adverse effects of treatment may have an impact on dietary and nutritional intake, as well as on quality of life. Dietary modifications may be needed because of the patient's oral function and may include modification of food texture and flavor, as well as the use of dietary supplements.Clinical ImplicationsAs part of the patient's health care team, dental care professionals should be aware of the oral adverse effects of cancer therapy, as well as their role in recognizing and treating the resulting oral conditions. In addition, they should provide guidance to patients to support their oral dietary and nutritional intake.  相似文献   

2.
《Saudi Dental Journal》2022,34(6):431-444
AimIdentify the existing evidence base with regards to interventions that address high levels of dental caries. A discussion of the applicability of the evidence to possible replication in Saudi Arabia is presented, alongside recommendations to help reduce dental caries rates in children in Saudi Arabia.MethodsA comprehensive systematic review following PRISMA methods was conducted using three databases: MEDLINE via OVID; EMBASE via OVID and Cochrane Library. Studies were included according to inclusion criteria. AMSTAR2 was used to assess the quality of the included studies, while GRADE was used to assess the quality of evidence.ResultsTen studies were included in this review. The quality of these were ‘high’ (in two review), moderate (in two studies), low (in one study) and to ‘critically low’ (5 reviews). The quality of the evidence presented by the reviews ranged from ‘moderate’ to ‘very low’. The interventions methods included MI, one-to-one nutrition advice, educational interventions and dental screening. The applicability of the findings in relation to dental care in Saudi Arabia is discussed and summarized in a narrative.ConclusionNo strong evidence that supported interventions to improve the child oral health in Saudi Arabia was found. None of the included reviews included studies conducted in Saudi Arabia or evaluated interventions among the local community. As for different culture values, norms, beliefs and attitude to those demographics explored in the reviews, it is unclear if interventions with improve oral health among Saudi children. Further research is needed to explore the efficacy of these interventions in a Saudi context.  相似文献   

3.
BackgroundNutrient and caloric intake is critical during therapy for head and neck cancer.MethodsThe authors review the oral complications experienced by, and dietary and nutritional needs of, patients during therapy. They also present recommendations for oral care and calorie and nutrient intake.ConclusionsOral health care professionals can assist patients during treatment for cancer in maintaining oral, systemic and nutritional health, as well as in controlling oral symptoms. Recovery from the acute toxicities of therapy often requires diet modification, tube feeding or both to meet patients' energy and nutrient demands.Clinical ImplicationsEffective management of oral complications of therapy for cancer is necessary to facilitate oral intake throughout treatment. Oral health care professionals should be part of the multidisciplinary team helping meet the needs of patients during treatment.  相似文献   

4.
BackgroundImportant, but insufficient, gains have been achieved in access to and delivery of oral health care since the 2000 US surgeon general’s report on oral health in America. Access to care has increased for children and young adults, but considerable work remains to meet the oral health care needs of all people equitably. The National Institutes of Health report, Oral Health in America: Advances and Challenges, reviews the state of the US oral health care system, achievements made since 2000, and remaining challenges. In this article, the authors highlight key advances and continuing challenges regarding oral health status, access to care and the delivery system, integration of oral and systemic health, financing of oral health care, and the oral health workforce.ResultsPublic insurance coverage has increased since 2000 but remains limited for many low-income, minority, and older adult populations. The oral health care workforce has expanded to include new dental specialties and allied professional models, increasing access to health promotion and preventive services. Practice gains made by women and Asian Americans have not extended to other minority demographic groups. Oral health integration models are improving access to and delivery of patient-centered care for some vulnerable populations.Conclusions and Practical ImplicationsCoordinated policies and additional resources are needed to further improve access to care, develop dental insurance programs that reduce out-of-pocket costs to lower-income adults, and improve the integration of oral and medical health care delivery targeting a common set of patient-centered outcomes. Dental care professionals need to fully participate in meaningful and system-wide change to meet the needs of the population equitably.  相似文献   

5.
Treating the drug addicted dental patient is different than treating the non-addicted patient due to differences related to the emotional/behavioral/personality issues of the addict, the addict's often poor general health and poor nutrition, ongoing problems of oral hygiene and the effects of drugs on the oral mucosa, gingiva and dentitionBackgroundOral health care providers need to be aware of the emerging trends in substance abuse, able to recognize patient's addicted to drugs and to be knowledgeable about the effects of substance abuse to provide the most efficacious treatment to avoid the consequences of contraindicated dental procedures and therapy. This article defines the scope of the problem of drug abuse and provides an overview of commonly abused substances and their effects on health and oral health.MethodsA review of the literature combined with the authors' extensive experience in the substance abuse field explains parameters of oral health care treatment of the drug addicted individual for patient and provider safety.ConclusionsThe drug culture has evolved and the drug user is different. Oral health care providers need to realize that any patient may be an addict in order to identify them, provide appropriate oral care and direct them, if they desire, toward appropriate treatment.  相似文献   

6.
Abstract

Objective. Polypharmacy is a common cause of xerostomia. This study aimed to investigate whether xerostomia could be an adverse drug event of mouthwashes, when they are used for longer than 2 weeks by patients taking polypharmacy. Materials and methods. This cross-sectional observational study included 120 hospitalized patients (60 middle-aged and 60 elderly patients), taking polypharmacy (≥4 drugs daily) and at risk of drug-induced xerostomia. Xerostomia was assessed by questioning participants. Results. A total of 62.5% of patients complained of xerostomia. In the middle-aged group (mean age = 44.0 (8.7) years; 35.0% women) xerostomia seemed independently associated to mouthwashes, at the limit of significance (OR = 5.00, 95% CI = 0.99–25.3, p = 0.052). Active principles in mouthwashes were mainly quaternary ammonium compounds (91.9%). Mouthwashes may disturb the healthy balance of the biofilm moisturizing the oral mucosa. The biofilm contains mucins, salivary glycoproteins with oligosaccharides side chains able to sequester water and endogenous bacteria surrounded by a glycocalyx. Oral bacteria are fully susceptible to quaternary ammonium (chlorhexidine, hexetidine, cetylpyridinium chloride) and to other antiseptics used in mouthwashes, such as betain, resorcin, triclosan, essential oils and alcohol. However, caregivers currently recommend such dental plaque control products to patients suffering from xerostomia in order to reduce the risk of caries and periodontitis. Conclusion. This study is the first report that use of antiseptic mouthwashes for more than 2 weeks could worsen xerostomia in patients taking polypharmacy. Oral care protocols should avoid this iatrogenic practice, particularly when xerostomia alters the quality-of-life and worsens malnutrition.  相似文献   

7.
BackgroundWith the dramatic increase in the amount of scientific information available about oral health, an evidence-based approach to oral health care and the practice of dentistry is necessary. There is a need to summarize, critique and disseminate scientific evidence and to translate the evidence into a practical format that is used easily by dentists The evidence-based clinical recommendations in this report were developed by an expert panel established by the American Dental Association Council on Scientific Affairs that evaluated the collective body of scientific evidence on the effectiveness of professionally applied topical fluoride for caries prevention. The recommendations are intended to assist dentists in clinical decision making.Types of Studies ReviewedMEDLINE and the Cochrane Library were searched for systematic reviews and clinical studies of professionally applied topical fluoride—including gel, foam and varnish—through October 2005.ResultsPanelists were selected on the basis of their expertise in the relevant subject matter. The recommendations are stratified by age groups and caries risk and indicate that periodic fluoride treatments should be considered for both children and adults who are at moderate or high risk of developing caries. Included in the clinical recommendations is a summary table that can be used as a chairside resource.Clinical ImplicationsThe dentist, knowing the patient's health history and vulnerability to oral disease, is in the best position to make treatment decisions in the interest of each patient. These clinical recommendations must be balanced with the practitioner's professional expertise and the individual patient's preferences.  相似文献   

8.
Objective The aim of the study was to investigate oral health-related knowledge, attitudes and habits and their relationship to perceived oral symptoms among 12-year-olds and differences between boys and girls. Material and methods The study population consisted of children (n?=?588) in 15 randomly selected elementary schools in Turku, Finland. Associations between oral health-related habits, knowledge and attitudes with perceived oral symptoms and gender differences were evaluated with χ2-test, Mann-Whitney U-test and logistic regression analysis. Results Oral health promoting habits but not knowledge or attitudes associated significantly with absence of oral symptoms. Girls reported a higher percentage of several health promotional habits than boys. Girls reported more frequently gingival bleeding and less frequently dental calculus than boys did. The most common oral symptom was gingival bleeding. Conclusions The present findings suggest some gender-related differences in oral health habits, attitudes, as well as perceived oral symptoms in 12-year-olds. There seems, however, not to be gender differences in relation to knowledge or the association of health habits with perceived oral symptoms. It is important to maintain health promotion at schools and additional efforts should be aimed at translating knowledge into action.  相似文献   

9.
BackgroundPeople who have recovered from the initial severe acute respiratory syndrome coronavirus 2 infection are at risk of developing long COVID, a prolonged suite of signs and symptoms that may interfere with daily life and the ability to undergo routine oral health care.MethodsThe available literature on long COVID was reviewed and compiled to produce a review of the syndrome as currently understood. Articles were evaluated with a focus on how long COVID may affect the provision of oral health care and on ways in which treatment may need to be modified to best care for this vulnerable patient population.ResultsLong COVID includes a wide variety of symptoms, such as fatigue, shortness of breath, chest pain, risk of developing thromboembolism, and neurologic and psychiatric complications. These symptoms may arise at various times and in a wide range of patients, and they may necessitate modification of routine oral health care interventions.ConclusionsRecommendations for the treatment of affected people in an oral health care setting are presented, including a thorough evaluation of the patient history and current status, understanding of how related symptoms may affect oral health care interventions, and which modifications to treatment are needed to provide safe and appropriate care.Practical ImplicationsOral health care professionals must be aware of long COVID, an increasingly prevalent condition with a widely variable presentation and impact. Oral health care professionals should be prepared to treat these patients safely in an outpatient oral health setting.  相似文献   

10.
BackgroundDespite evidence that community water fluoridation (CWF) protects oral health, improves health equity, is safe and cost-effective, and contributes to social well-being, little is known regarding which of these benefits should be highlighted to effectively influence support for CWF.MethodsThis within-participants study examines differences in CWF support in response to pro-CWF messages reflecting themes of oral health, health equity, CWF safety, cost-effectiveness, or social well-being among a sample of parents. Prior belief that CWF has health benefits, worry about potential health risks, and normative beliefs were also examined as independent predictors of support for each theme.ResultsOral health, health equity, and safety messages significantly increased support in comparison with social well-being messages (P < .05). Oral health messages also produced greater support than cost-savings messages. Belief that CWF has health benefits positively predicted support, as did normative beliefs that one’s family and physician approve of CWF. Worry about health risks and community and dentist norms were not significant predictors of support. There were no interaction effects of message themes and prior beliefs.ConclusionsMessaging focused on oral health, health equity, and the safety of CWF may be the most effective at influencing support for CWF. Preexisting personal beliefs about CWF benefits significantly predict support, but so do normative beliefs—family and physician norms in particular.Practical ImplicationsFindings suggest dental health educators should emphasize CWF's oral health benefits, such as preventing caries, over cost-saving and social well-being outcomes. They should also consider collaborating with family physicians to promote CWF and referencing other groups that may positively influence beliefs that CWF is beneficial.  相似文献   

11.
Objectives: To describe the oral health and oral health-related quality of life among social vulnerable adults enrolled in a special oral care program, and to evaluate the effect of oral care on their oral health-related quality of life.

Method: Social workers identified social vulnerable persons in social centres and referred them to the program. Dental clinics were arranged including a well-motivated staff to be special responsive to these clients. The participants, (n?=?235, mean age 43.5 years) with drug abuse, being homeless, permanently unemployed, or with mental problems were offered low-cost treatment services. Data collection was made by clinical registration and questionnaires. Oral health-related quality of life was measured by means of the Oral Health Impact Profile-14 index (OHIP-14).

Results: 94% of the participants had actual decayed teeth (mean 9.5). Forty-four per cent had not visited a dentist within 5 years and less than one-third reported tooth brushing twice a day, 17% even less frequent. One hundred and forty-six completed the dental program within the program period. Mean OHIP-14 score was 28.6 at baseline. Among those who fulfilled the program, the OHIP-14 score was reduced to 9.9 (p?<?.001).

Conclusion: Oral health among the study population was very poor. However, oral problems in this group can be solved, and their oral health-related quality of life can be increased although it requires special arrangements and special clinical environment.  相似文献   

12.
The use of illicit and misuse of licit drugs is a global public health problem, with illicit drug use being responsible for 1.8% of the total disease burden in Australia in 2011. Oral adverse effects associated with illicit drug use are well‐established, with aggressive caries, periodontitis, bruxism, poor oral hygiene and general neglect documented. Other factors such as a high cariogenic diet and lifestyle, social and psychological factors compound the poorer oral health in illicit drug users. Literature has shown that the oral health‐related quality of life among injecting drug users is poorer compared with the Australian general population and the overall quality of life of addicted people correlates with caries experience. Thus, the role of the dentist is imperative in managing the oral health of these individuals. Given their widespread recreational use, it is likely that dental practitioners will encounter patients who are regular or past users of illicit drugs. The aim of this article is to describe the prevalence and mechanism of action of commonly used illicit drugs in Australia, including cannabis, methamphetamine, cocaine and heroin and to inform dentists about the common orofacial presentations of their side effects to help with patient management.  相似文献   

13.
Prevention and treatment of oral disease is required to maintain quality of life and to improve prognosis of patients infected with the human immunodeficiency virus (HIV). Management requires a team approach, and close collaboration with the appropriate responsible physicians and other health care workers is necessary. Oral infection is frequent and usually opportunistic, and management is based on certain principles. Infections may disseminate and can be persistent and severe; multiple concurrent or consecutive infections with different microorganisms are frequent; fungal, viral, and parasitic infections are rarely curable; and long-term antimicrobial therapy may be required. This article reviews the management of oral candidiasis, hairy leukoplakia, and infections with herpes simplex virus, varicella-zoster virus, and cytomegalovirus. The management of Kaposi's sarcoma, lymphomas, aphthous ulceration, gangrenous stomatitis, bleeding, xerostomia, and adverse drug reactions is also described. Treatment should avoid further immunosuppression and inducement of xerostomia or caries, and should be designed to avoid adverse drug reactions and possible drug interactions.  相似文献   

14.
International Journal of Paediatric Dentistry 2011; 21: 223–231 Background. Some of the basic dental health practices that are recommended to the public by professionals are not evidence based. Incorrect oral health messages may adversely affect children’s oral health behaviours. Aim. To identify and list the recommendations concerning children’s oral hygiene practices provided by dental and paediatric organisations, and to assess how these recommendations relate to the scientific evidence currently available. Design. Cross‐sectional. The authors contacted professional organisations in ten countries requesting items (brochures, leaflets or folders) containing messages on children’s oral hygiene practices. They then listed these recommendations and assessed how they related to scientific evidence obtained from systematic reviews available at PubMed and the Cochrane Library. Results. Fifty‐two of 59 (88%) organisations responded to our request and 24 dental health education materials were submitted to the authors. They mentioned recommendations on oral hygiene practices for children, such as toothbrushing frequency, supervision and technique; when to start and how long toothbrushing should last; toothbrush design and replacement; flossing; gums/teeth wiping; tongue cleaning; type and amount of toothpaste and advice on toothpaste ingestion. The search at PubMed and the Cochrane Library resulted in 11 systematic reviews addressing these topics. Conclusions. Several oral hygiene messages delivered by professional organisations showed inconsistencies and lacked scientific support.  相似文献   

15.
《Saudi Dental Journal》2022,34(3):249-258
ObjectivesDepression is highly prevalent across populations, yet studies on its contribution to oral health are lacking. Therefore, our goal is to examine the association of depression and oral health problems (preventative care, access to dental care, and oral condition in relation to quality of life) controlling for sociodemographic and chronic disease indicators (CDI).Methods5,992 respondents’ data 18+ years old were analyzed from the 2015–2016 National Health and Nutrition Examination Survey (NHANES). The independent variable of interest was depression symptoms status. Oral health outcomes were the dependent variables. We used the Patient Health Questionnaire-9 (PHQ-9) for depression and the Oral Health Questionnaire (OHQ) to measure oral health outcomes. Covariates included sociodemographics (age, education, sex, race/ethnicity, and income) and CDI included current smoking, diabetes, and body mass index. All data were weighted using 2 years sample weight.ResultsThe mean age of respondents was 47.22 years (45.97–48.46) and 46% were males. Participants with depression present 6.93%, and females 63.85% were higher than males 36.15%.Participants with depression have significantly low income 43.10% than others p value < 0.0001. After adjusting for sociodemographics and CDI, participants who have depression were more prone to report fair/poor oral condition [aOR = 1.91 (1.29–2.84)], oral pain [aOR = 2.66 (1.91–3.71)], and difficulty accessing needed dental care [aOR = 2.52 (1.96–3.24)] than others. Having depression was associated with poor oral health perceptions [aOR = 2.10 (1.41–3.13)], and having difficulty at job/school because of their oral health [aOR = 2.85 (1.90–4.26)].ConclusionBased on the empirical evidence provided by our study, there is an association between depression and oral health outcomes and oral health-related quality of life.  相似文献   

16.
Aim. To systemically collect and summarize the literature on case reports concerning adverse events associated with the oral use of a toothbrush. Materials and methods. Two electronic databases were searched for articles published up to October 2013 to identify appropriate studies using focused search terms and ‘case reports’ as a filter. Results. A comprehensive search identified 419 unique titles and abstracts. Ninety-four studies met the eligibility criteria. In total, 118 subjects (age range = 1–60 years) presented adverse events related to the oral use of a toothbrush. Events could be summarized in five categories, of which ingestion was the most reported problem among the individuals (50 cases). This was followed by impaction of a toothbrush (27 cases). Reports more frequently involved females and children were more likely to have injuries compared to males and adults. Most of the cases that presented with adverse events of the oral use of a toothbrush were referred for treatment to a physician. Conclusions. The combined evidence related to serious adverse events as presented in case reports showed that the oral use of a toothbrush can be associated with ingestion, impaction, instant trauma, gingival traumatic injury and seizures. Given the incidence of reporting, important recommendations are that a toothbrush should not be used to induce vomiting, nor should people walk or run with this device in their mouths, especially children.  相似文献   

17.
BackgroundOral health–related quality of life (OHRQoL) is a multidimensional, perception-based measure of how oral health affects social and physical functioning and self-image. OHRQoL is important for assessing women living with HIV (WLWH) who may have unmet dental needs and experience disparities that impact dental care accessibility.MethodsIn 2016, the authors conducted an assessment of OHRQoL among a national sample of 1,526 WLWH in the Women’s Interagency HIV Study using the Oral Health Impact Profile instrument, which assesses the frequency of 14 oral health impact items. OHRQoL was measured using multivariable linear regression with a negative binomial distribution to assess the association between report of a recent unmet dental need and OHRQoL.Results“Fair or poor” oral health condition was reported by 37.8% (n = 576) of WLWH. Multivariable linear regression showed that unmet dental needs had the strongest positive association with poor OHRQoL (difference in Oral Health Impact Profile mean, 2.675; P < .001) compared with not having unmet needs. The frequency of dental care utilization was not associated with higher OHRQoL. Older age, fair or poor dental condition, smoking, symptoms of anxiety and loneliness, and poor OHRQoL were also associated with worse OHRQoL.ConclusionSelf-perceived impact of oral health on social and physical function and self-image, as measured by OHRQoL, may be an easily assessable but underrecognized aspect of OHRQoL, particularly among women aging with HIV.Practical ImplicationsDentists should implement OHRQoL assessments in their management of the care of patients with HIV to identify those who do have significant oral health impacts.  相似文献   

18.
BackgroundThis objective of this umbrella review was to summarize the evidence on safety, efficacy, and effectiveness of human papillomavirus (HPV) vaccines in the general population.MethodsThe authors conducted a literature search and selected systematic reviews if they were published from January 2006 through November 2018, included randomized controlled trials or observational studies, related to the general population, and evaluated HPV vaccine–related clinical outcomes. The authors independently and in duplicate screened literature, extracted data, and appraised reviews using AMSTAR 2, a critical appraisal tool for systematic reviews.ResultsThe authors selected 30 systematic reviews that included male and female participants aged 9 through 76 years from multiple countries. Reviews evaluated postvaccine seroconversion, HPV infection rates, precancerous or benign lesions, and adverse events; none of the researchers reported on oral or oropharyngeal lesions. Results from the reviews showed that, compared with those who received a placebo or non–HPV-type vaccine, HPV-vaccinated participants had statistically significantly higher rates of seroconversion and local adverse events, statistically significantly lower rates of HPV infection and condylomata lesions, and decreased rates of HPV-related precancerous lesions, which did not always attain statistical significance.ConclusionsSystematic reviews have found evidence that the available HPV vaccines are safe, effective, and efficacious against vaccine-type HPV infection and HPV-associated cellular changes, including precancerous and benign lesions.Practical ImplicationsDentists may use this resource to better understand the literature on the potential harms and benefits of HPV vaccination.  相似文献   

19.
BackgroundHealth-related quality of life (HRQOL) is a multidimensional concept regarding quality of life (QOL) as it relates specifically to health and disease. The effect of ongoing hemodialysis on a person's oral health can be determined by clinical variables, but these do not reflect the person's perception of health versus illness. The authors conducted a study to determine the periodontal status, attitude toward oral health and self-perceived oral health in patients undergoing hemodialysis, as well as to evaluate the effect of oral health on QOL within this group.MethodsPatients undergoing hemodialysis were evaluated for socio-demographic and periodontal variables. The authors evaluated oral health–related quality of life (OHRQOL) by means of the short-form Oral Health Impact Profile (OHIP-14) and the General Oral Health Assessment Index (GOHAI). They measured perceived oral health by asking a single question.ResultsThe study involved 47 patients undergoing hemodialysis. Plaque index score, gingival index score, probing depth and bleeding-on-probing status were 2.21 ± 0.66, 1.24 ± 0.77, 2.17 millimeters ± 0.53 mm and 33.51 percent ± 24.58 percent, respectively. Participants reported being uncomfortable when eating or swallowing. Participants reported being sensitive to hot or cold (69.8 percent), having a worse sense of taste (90.8 percent) and having painful aching in the mouth (72.1 percent). The mean OHIP-14 and GOHAI scores were 19.40 ± 7.74 and 15.72 ± 8.68, respectively.ConclusionsThe self-perceived health of 72.7 percent of participants undergoing hemodialysis was fair or poor, and the impact of OHRQOL was moderate, which means that oral health was not a major concern. These results underscore the importance of using subjective and self-reported oral assessments to determine more convenient and satisfying treatment approaches for each patient.Clinical ImplicationsClinicians should use oral health assessment tools to determine individual treatment and approaches to promote the oral health of patients undergoing hemodialysis and improve their QOL.  相似文献   

20.
Teledentistry has the potential to address the oral care needs of those who have limited access to care. More research is needed to establish the evidence base to support teledentistry practice.Background and PurposeEnormous potential exists to improve oral health services throughout the world by using information and communication technologies, such as teledentistry to expand access to primary, secondary and tertiary care. Comparison of teledentistry procedures with standard clinical procedures can demonstrate the relative effectiveness and cost of each approach. However, due to insufficient evidence, it is unclear how these strategies compare for improving and maintaining oral health, quality of life, and reducing health care costs. This review discusses the merits of teledentistry for the delivery of oral care.MethodsThis article summarizes the available literature related to the efficacy and effectiveness of teledentistry and presents possible barriers to its broader adoption.ConclusionsTeledentistry seems to be a promising path for providing oral health services where there is a shortage of oral health care providers.  相似文献   

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