Dental Treatment Improves Self-Rated Oral Health in Homeless Veterans – A Brief Communication

Objective: The aim of this study was to assess homeless veterans' perception of their oral health and the impact that oral disease and treatment have on self-assessed quality of life. Methods: Outcomes included measures of general and oral-specific quality of life and functional status. Single-item self-report of oral health and the General Oral Health Assessment Index were assessed at baseline and after treatment. Results: One hundred and twelve veterans completed the baseline questionnaire, and 48 completed the follow-up. Veterans who were eligible for ongoing dental care had improved General Oral Health Assessment scores, while patients who received only emergency dental care saw a decreased score (2.46 versus −2.12). General Oral Health Assessment improvement was significantly related to fewer teeth at baseline (18 versus 23), a lower baseline General Oral Health Assessment (23.6 versus 28.1), having a denture visit (22 versus 35 percent), and improvement in self-reported oral health (25 versus 42 percent). Conclusion: There was significant improvement in homeless veterans' perceived oral health after receiving dental care.     

Poor Oral Health and Coronary Artery Disease: A Case‐Control Study

Background: There is insufficient research on the relationship of oral health and coronary artery disease (CAD) from developing countries, such as Pakistan. This study observes the status of oral health in the CAD population. Methods: A case‐control study was conducted on 145 cases and 145 controls. Otherwise healthy patients with CAD (cases) and individuals free from previous/current history of CAD (controls), having ≥14 remaining teeth, were examined for oral health status through missing teeth, plaque index (PI), and community periodontal index (CPI). Student t test, χ² test, and multivariate regression analysis were applied at significance level of 95% (P ≤0.05) to compare study parameters between cases and controls. Results: A significant difference between cases and controls was observed in this study sample with respect to missing teeth (P = 0.027) and periodontal parameters of PI and CPI (P <0.001). Cases were observed with significantly higher scores of PI (2 and 3) and CPI (3 and 4) compared with controls. Prevalence of periodontal parameters was observed to be higher in cases than controls at subgroup‐level (sex and age group) analysis. A significant odds ratio (OR), unadjusted, between CAD and periodontal indicators of PI (mild to severe plaque/no plaque: OR = 5.04, 95% confidence interval [95% CI] = 2.24 to 11.36) and CPI (healthy/poor periodontal status: OR = 4.59, 95% CI = 1.81 to 11.61) scores was noted; cases were at odds of 1.20 (95% CI = 0.93 to 15.68, P = 0.017) for having poor oral health after adjusting age, sex, and education. Conclusion: Poor oral health was significantly associated with CAD in this study sample matched for sociodemographic characteristics.     

Oral Lichen Planus and Dental Implants – A Retrospective Study

Objectives: To examine whether oral lichen planus (OLP) affects the success rate of dental implants and if the manifestations of OLP are altered by implant‐borne prostheses. Materials and Methods: OLP patients, treated in the oral medicine department, with (the study group) and without (control group) dental implants were included. Pocket depth, mobility, bleeding on probing, erythema, pain and radiolucency around the implants, as well as clinical findings and OLP symptoms were recorded. Follow‐up ranged from 12–24 months. Ordinal variables and visual analog scale score were compared using the Mann–Whitney test. The significance of the trend within each of the groups was assed using the Friedman test. Categorical variables were compared using Pearson chi‐squared test and Fisher's exact test. Results: Fourteen patients in the study group with 1–15 implants per patient and 15 in the control group were included. No implant failures were recorded. Comparison between the clinical manifestations of OLP in both groups did not reveal any significant differences. Conclusions: Success of implant rehabilitation among treated OLP patients does not seem to be different from the success rate in the general population. Nor does implant placement influence the disease manifestations.     

Oral health‐related quality of life of 12‐ and 15‐year‐old Thai children: findings from a national survey

Abstract – Objective: To assess the prevalence and characteristics of oral impacts on daily life, and the relationship between certain dental conditions and impacts attributed to them, in a nationally representative population of Thai school children aged 12 and 15 years. Methods: A cross‐sectional study on a representative sample of children in Sixth Thailand National Oral Health Survey. Sample included half the children aged 12‐ and 15‐year‐old selected in Bangkok and all participants in 8 of 16 provinces included in national survey. Children were individually interviewed using the Child‐OIDP (12‐year‐old) and OIDP indices (15‐year‐old), and two questions for overall subjective assessments. Results: A total of 1066 12‐year‐olds and 815 15‐year‐olds were interviewed. Some 85.2% of 12‐year‐olds reported experiencing oral impacts during the past 3 months. Child‐OIDP scores ranged from 0 to 68.0 (mean = 7.83, SD = 7.8). Eating was the most commonly affected performance (64.4%), followed by cleaning teeth (51.7%) and maintaining emotional state (49.1%). Among 15‐year‐old children, 83.3% had oral impacts during the past 6 months. OIDP scores ranged from 0 to 39.5 (mean = 5.47, SD = 6.0). The three most commonly affected performances were eating (64.0%), cleaning teeth (55.3%) and maintaining emotional state (53.1%). Toothache and oral ulcers were the two most important perceived causes in 12‐year‐olds. Impacts from toothache were the most prevalent (39.2%) and had a condition‐specific (CS) Child‐OIDP score of 7.0, while oral ulcers affected 24.7% of children; mean CS‐score of 8.0. Among 15‐year‐olds, oral ulcers ranked first in terms of both prevalence (36.2%) and CS‐score (6.0), followed by toothache (prevalence 33.9% and CS‐score 5.0). For both age groups, problems with gums were of less concern. Conclusions: Oral impacts were common but not severe in Thai children and adolescents. For both age groups, impacts were mostly on eating performance; toothache and oral ulcers were the two important perceived causes reflecting needs for oral health promotion and treatment of dental caries and oral ulcers.     

Oral health inequalities between young Aboriginal and non‐Aboriginal children living in Ontario,Canada

Abstract – Objectives: To investigate (i) oral health inequalities between off‐reserve Aboriginal and non‐Aboriginal children entering junior kindergarten (JK) in the Thunder Bay District, Northwest Ontario, Canada, (ii) oral health inequalities between kindergarten‐aged (4 years old) Aboriginal children living on reserves in the Sioux Lookout Zone (SLZ), Northwest Ontario and those living off‐reserve in the Thunder Bay District and (iii) early childhood caries (ECC) trends among SLZ children between 2001 and 2005. Methods: Cross‐sectional oral health data (dmft/s Indices) for 416 (2003/2004), 687 (2004/2005) and 544 (2005/2006) 3‐ to 5‐year olds attending JK in the Thunder Bay District were collected by calibrated dental hygienists with the District’s Health Unit. Secondary analysis of oral health status data from two studies conducted in the SLZ between 2001 and 2005 provided the dmft of random samples of children younger than 6 years of age living in 16–20 First Nations communities. Results: When compared with non‐Aboriginal children aged 3–5 years attending the same schools in the Thunder Bay District between 2003 and 2006, off‐reserve Aboriginal children had 1.9 to 2.3 times the risk of having ECC (dmft > 0), 2.9 to 3.5 times the risk of a dmft > 3 and 1.8 to 2.5 times the risk of untreated decayed teeth after adjusting the prevalence ratios for child’s age and sex, school’s risk level and clustered‐correlated data. The mean dmft of on‐reserve Aboriginal 4‐year olds in 2005 was 11.2 and 5.9 for their off‐reserve Aboriginal counterparts. In 2001, the mean dmft scores (95% confidence interval) of 2‐, 3‐ and 4‐year‐old Aboriginal children in the SLZ were: 9.1 (8.3–9.9), 12.4 (11.8–13.1), 13.1 (12.1–14.2). In 2005, similarly aged SLZ children had a mean dmft of: 6.2 (5.2–7.1), 8.9 (8.2–9.6), 11.2 (10.5–11.9), representing significant reductions in caries severity (32%, 28% and 14.5%, respectively). Conclusions: Significant disparities in caries experience exist between off‐reserve Aboriginal and non‐Aboriginal children living in the same locales and between Aboriginal children living on‐ and off‐reserve in northwestern Ontario. The study showed decreased trends in the severity of ECC for children in the SLZ occurring over the 5‐year period. Despite this progress, the oral health of young Aboriginal children in Ontario continues to lag far behind that of non‐Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities.     

Oral health behaviors of preschool children with cerebral palsy: a case‐control community‐based study

To describe and compare the oral health behaviors of preschool children with and without cerebral palsy (CP), and to assess the oral health knowledge and attitudes of their primary caregivers (PCGs). Seventy‐two preschool children with CP were recruited from 23 Special Child Care Centers in Hong Kong. An age‐ (±3 months) and gender‐matched sample of children from mainstream preschools was recruited as a “control group.” Assessment of children's oral health behaviors and the PCGs' oral health knowledge and attitudes was conducted using questionnaires. Preschool children with CP were less likely to have ever attended a dentist (p < 0.05). Tooth brushing frequency was similar between the two groups (p > 0.05), but PCGs of children with CP more frequently reported provision of tooth brushing assistance to their children (p < 0.001). PCGs in both groups had similar oral health knowledge and attitudes (p > 0.05). Difference in oral health behaviors existed between preschool children with and without CP. PCGs of children with and without CP had similar oral health knowledge and attitudes.     

Influence of Periodontal Status and Periodontopathogens on Levels of Oral Human β‐Defensin‐2 in Saliva

Background: Expression patterns of human β‐defensin‐2 (HBD‐2) mRNA or HBD‐2 protein concentration and periodontal diseases have been a focus of scientific research. This study compares the salivary levels of HBD‐2 protein concentration of healthy patients and patients with gingivitis and chronic periodontitis (CP) and correlates these levels with the presence of periodontopathogens. Methods: A total of 89 patients were enrolled in this study: 31 periodontally healthy, 27 with gingivitis, and 31 with CP. Plaque and gingival indices, probing depth, and clinical attachment level were measured. The presence of Campylobacter rectus, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia was evaluated qualitatively by conventional polymerase chain reaction. HBD‐2 quantification in saliva was performed using an immune enzymatic assay. Frequency of periodontopathogens and HBD‐2 protein concentration was assessed. Association between HBD‐2 protein concentration (≥100 pg/mL) and the simultaneous presence of one to two, three to four, or five to six periodontopathogens was tested. Results: Although periodontally healthy individuals and patients with gingivitis showed similar HBD‐2 levels, the CP group displayed an increased level of HBD‐2. P. gingivalis, P. intermedia, T. forsythia, and T. denticola were more prevalent in CP; however, their mere presence was not related to the increased levels of HBD‐2 (Pearson correlation and multinomial logistic regression model). Conclusions: Salivary HBD‐2 protein concentration was higher in patients with CP compared with healthy individuals or patients with gingivitis. These different protein concentrations were not related to the frequency of periodontopathogens. Clinical inflammatory profile had a higher impact on salivary HBD‐2 levels than bacteria.