International Journal of Environmental Research and Public Health

Editorial

3 pages, 245 KiB

Open AccessEditorial

Dental Public Health Landscape: Challenges, Technological Innovation and Opportunities in the 21st Century and COVID-19 Pandemic

by Marco Mascitti and Giuseppina Campisi

Int. J. Environ. Res. Public Health 2020, 17(10), 3636; https://doi.org/10.3390/ijerph17103636 - 21 May 2020

Cited by 16 | Viewed by 5982

Abstract

In response to the 2008 economic and financial crisis and to its effects on healthcare systems, dental care has become unaffordable for many people, and a huge number of patients worldwide are avoiding or skipping necessary dental treatments [...] Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

Research

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11 pages, 374 KiB

Open AccessArticle

Analysis and Evaluation of Dental Caries in a Mexican Population: A Descriptive Transversal Study

by Alejandro Moreno-Barrera, Pedro Morales-Ruiz, David Ribas Pérez, Javier Flores-Fraile and Antonio Castaño-Seiquer

Int. J. Environ. Res. Public Health 2023, 20(5), 3873; https://doi.org/10.3390/ijerph20053873 - 22 Feb 2023

Cited by 3 | Viewed by 2385

Abstract

Oral diseases are an important public health problem owing to their high prevalence and strong impact on people, particularly in disadvantaged populations. There is a strong relationship between the socioeconomic situation and the prevalence and severity of these diseases. Mexico is among the [...] Read more.

Oral diseases are an important public health problem owing to their high prevalence and strong impact on people, particularly in disadvantaged populations. There is a strong relationship between the socioeconomic situation and the prevalence and severity of these diseases. Mexico is among the countries with a higher frequency range in oral diseases, highlighting dental caries, which affect more than 90% of the Mexican population. Materials and method: A cross-sectional, descriptive, and observational study was carried out in 552 individuals who underwent a complete cariogenic clinical examination in different populations of the state of Yucatan. All individuals were evaluated after providing informed consent and with the consent of their legal guardians for those under legal age. We used the caries measurement methods described by the World Health Organization (WHO). Prevalence of caries, DMFT, and dft indexes were measured. Other aspects were also studied, such as oral habits and the use of public or private dental services. Results: The prevalence of caries in permanent dentition was 84%. Moreover, it was found to be statistically related to the following variables: place of residence, socioeconomic level, gender, and level of education (p < 0.05). For primary teeth, the prevalence was 64% and there was no statistical relation with any of the variables studied (p > 0.05). Regarding the other aspects studied, more than 50% of the sample used private dental services. Conclusions: There is a high need for dental treatment in the population studied. It is necessary to develop prevention and treatment strategies considering the particularities of each population, driving collaborative projects to promote better oral health conditions in disadvantaged populations. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

19 pages, 3218 KiB

Open AccessArticle

Implant Survival in Patients with Chronic Kidney Disease: A Case Report and Systematic Review of the Literature

by Iris Alla, Felice Lorusso, Sergio Alexandre Gehrke, Francesco Inchingolo, Maristella Di Carmine and Antonio Scarano

Int. J. Environ. Res. Public Health 2023, 20(3), 2401; https://doi.org/10.3390/ijerph20032401 - 29 Jan 2023

Cited by 2 | Viewed by 3256

Abstract

Background: The aim of this systematic review and case reports was to evaluate osseointegration and implant survival rate in patients with chronic kidney disease. Methods: The paper screening process was conducted on electronic databases in order to identify clinical studies concerning the study [...] Read more.

Background: The aim of this systematic review and case reports was to evaluate osseointegration and implant survival rate in patients with chronic kidney disease. Methods: The paper screening process was conducted on electronic databases in order to identify clinical studies concerning the study topic. The literature data were evaluated for eligibility and studies were included for the qualitative synthesis. The case report concerned a male subject affected by renal disorders, a candidate for full arch immediate loading procedure. Results: The article screening process reported a total of 54 manuscripts and one paper identified through the manual search. At the end of the review process, a total of 45 articles were excluded while nine manuscripts were included for the descriptive synthesis. No significant complications or events were present during the intraoperative/post-operative phases. The clinical course reported no significant inflammation or symptoms. At follow-up, the rehabilitation was found to be functionally and aesthetically integrated with no complications, probing, or bone resorption. Conclusions: The available evidence supports the clinical efficacy of the early implant placement protocol. Present findings indicate that the early implant placement protocol results in implant outcomes similar to immediate and delayed placement protocols and a superior stability of peri-implant hard tissue compared with immediate implant placement. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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13 pages, 2376 KiB

Open AccessArticle

Laser Er:YAG-Assisted Debonding May Be a Viable Alternative to the Conventional Method for Monocrystalline Ceramic Brackets

by Daliana-Emanuela Mocuta, Mariana I. Miron, Diana Lungeanu, Marius Mateas, Emilia Ogodescu and Carmen D. Todea

Int. J. Environ. Res. Public Health 2022, 19(21), 14564; https://doi.org/10.3390/ijerph192114564 - 6 Nov 2022

Cited by 6 | Viewed by 2833

Abstract

In orthodontic practice, due to the increased interest among patients in smile aesthetics, different types of brackets are now being used, with those most frequently applied being ones made of polycrystalline and monocrystalline ceramic. The aim of this study was to evaluate the [...] Read more.

In orthodontic practice, due to the increased interest among patients in smile aesthetics, different types of brackets are now being used, with those most frequently applied being ones made of polycrystalline and monocrystalline ceramic. The aim of this study was to evaluate the laser Er:YAG-assisted debonding technique compared to conventional methods for removing monocrystalline ceramic brackets from human teeth. The study sample included 60 vital teeth (frontals of the upper jaw) from 10 patients who had monocrystalline ceramic brackets and were in the final phase of orthodontic treatment. The debonding procedure was carried out following a split-mouth study design, using either the conventional technique or laser Er:YAG 2940 nm radiation. For each tooth, three variables were evaluated: the patient’s sujective tooth sensitivity associated with the debonding, the time required for debonding, and pulp blood flow microdynamics after the debonding. Three evaluation instruments were used to assess and quantify the treatment effects: (i) the Wong–Baker FACES Pain Rating Scale for pain assessment; (ii) a digital stopwatch/timer to measure the time required to remove the bracket; and (iii) laser Doppler flowmetry (LDF) for recording the pulp blood flow evolution. The statistical analysis of the recorded data showed a statistically significant difference between the two debonding methods regarding the tooth sensitivity during the debonding and the time required for the procedure. The subjective tooth sensitivity was reduced from a mean ± standard deviation of 3.07 ± 1.46 to 0.47 ± 0.86 on the Wong–Baker FACES scale (Wilcoxon signed rank, p < 0.001). The necessary time for debonding was reduced by 0.697 ± 0.703 s per tooth (paired t-test, p < 0.001). There was no difference in the blood microdynamics between the two debonding techniques. According to the results of this study, the laser Er:YAG-assisted debonding technique may be a viable alternative to the conventional method for monocrystalline ceramic brackets. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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15 pages, 616 KiB

Open AccessArticle

Are We Getting Any Better? A Critical Analysis of Selected Healthy People 2020 Oral Health Indicators in 1999–2004 and 2013–2016, USA

by Carolina Marques Borges and Meghna Krishnamurthy

Int. J. Environ. Res. Public Health 2022, 19(9), 5250; https://doi.org/10.3390/ijerph19095250 - 26 Apr 2022

Cited by 1 | Viewed by 2336

Abstract

Oral health disparities are prevalent in the American population and are influenced by various social determinants. This study aimed to analyze oral health disparities in the US between 1999–2004 and 2013–2016 according to sociodemographic characteristics. This analytic cross-sectional study analyzed five oral health [...] Read more.

Oral health disparities are prevalent in the American population and are influenced by various social determinants. This study aimed to analyze oral health disparities in the US between 1999–2004 and 2013–2016 according to sociodemographic characteristics. This analytic cross-sectional study analyzed five oral health indicators from Healthy People 2020. A binomial test was used to compare proportions between baseline and follow-up. Only the indicator for non-treated cavities among children reached its goal. White children had the greatest decrease (−15.4%; p = 0.0428) in dental caries. Higher income determined better outcomes for adolescents (−27.54%; p = 0.00032 dental caries) and adults (−15.96%; p = 0.0143 tooth extractions). However, adults 35–44 years with the highest income had a significant increase (40.74%, p = 0.0258) in decayed teeth. This study provides evidence to suggest that some progress has been made towards reducing oral health disparities in the US, primarily among children. However, trends for certain indicators remain disparate between different racial/ethnic and income groups. Applications for the findings of this study should address the intersectional nature of social determinants of health and should center on improving the equity of services offered by public oral healthcare. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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8 pages, 999 KiB

Open AccessArticle

Emergency Room Visits with a Non-Traumatic Dental-Related Diagnosis in Hawaii, 2016–2020

by Masako Matsunaga, John J. Chen, Patrick Donnelly, Carlotta Ching Ting Fok and Nancy S. Partika

Int. J. Environ. Res. Public Health 2022, 19(5), 3073; https://doi.org/10.3390/ijerph19053073 - 5 Mar 2022

Cited by 4 | Viewed by 1851

Abstract

The purpose of this study was to characterize the frequencies and patterns of emergency room (ER) visits with a non-traumatic dental-related diagnosis among adults (≥21 years old) in Hawaii, United States. This descriptive cross-sectional study used state-level inpatient and outpatient data recorded in [...] Read more.

The purpose of this study was to characterize the frequencies and patterns of emergency room (ER) visits with a non-traumatic dental-related diagnosis among adults (≥21 years old) in Hawaii, United States. This descriptive cross-sectional study used state-level inpatient and outpatient data recorded in Hawaii from 2016 to 2020. We identified dental-related ER visits using the diagnosis codes for non-traumatic dental-related conditions and summarized the frequency, rates, and cumulative total charges of the ER visits. The results show that approximately 30 thousand ER visits between 2016 and 2020 had a dental-related diagnosis. Sixty-seven percent of them had it as a principal diagnosis, amounting to USD 38.7 million total charges over the five years. A high proportion of these visits was found among those aged 21–44 years old (62%), Medicaid beneficiaries (49%), and Native Hawaiians/Part Native Hawaiians (26%). Compared to the proportions of ER visits with a secondary diagnosis, these groups had a higher proportion of ER visits with a principal diagnosis (ps < 0.001). A higher visit rate was found for those aged 21–44 years old and from less-populated counties. These results suggest that oral health disparities in age, socioeconomic status, and race/ethnicity exist in Hawaii. Our findings could provide insight in developing a framework to reduce oral health disparities, particularly among Medicaid beneficiaries and Native Hawaiians. Dental coverage with effective education in multiple dimensions is necessary to reduce non-traumatic dental-related ER visits. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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11 pages, 9601 KiB

Open AccessArticle

Microbiology-Based Instruction during Prenatal Dental Visits Improves Perinatal Oral Health Literacy

by Joshua J. Thomson, Erin E. Relich, John R. Girdwood and Divesh Byrappagari

Int. J. Environ. Res. Public Health 2022, 19(5), 2633; https://doi.org/10.3390/ijerph19052633 - 24 Feb 2022

Cited by 2 | Viewed by 3033

Abstract

To improve oral hygiene education, we evaluated the perception and potential impact of microbiology-focused oral hygiene instructions (OHI) given to pregnant patients. Dental hygienists provided this supplemental education and administered Saliva-Check Mutans (SCM) tests to pregnant patients (n = 188) in Obstetrics [...] Read more.

To improve oral hygiene education, we evaluated the perception and potential impact of microbiology-focused oral hygiene instructions (OHI) given to pregnant patients. Dental hygienists provided this supplemental education and administered Saliva-Check Mutans (SCM) tests to pregnant patients (n = 188) in Obstetrics and Gynecology (OB/GYN) settings. Patients reported their self-perceived understanding of the relationship between oral bacteria and dental disease and returned postdelivery to receive a second SCM test and follow-up questionnaire (n = 47). Prior to the hygienist instruction, 84% of participants understood that bacteria caused tooth decay, while only 36% understood they could transfer these bacteria to their children. After instruction, patient understanding increased to 97% and 95%, respectively. Participants attributed these increases to the hygienist’s explanation and SCM test. In postdelivery participants, >80% reported adherence to routine oral hygiene practices, and a significant decrease in patients with high-risk levels of salivary Streptococcus mutans was determined by SCM test (p = 0.0253). Participants agreed that the SCM test (89%) and microbiology explanation (95%) should be provided to every pregnant patient. Evaluation of patient perception of this intervention highlights how focused instruction on the infectious nature of dental disease can increase perinatal oral health literacy. Microbiology-focused education should be given to pregnant patients to reduce oral health disparities. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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8 pages, 319 KiB

Open AccessArticle

Retention Ability of a Glass Carbomer Pit and Fissure Sealant

by Liana Beresescu, Monika Kovacs, Alexandru Vlasa, Alexandra Mihaela Stoica, Csilla Benedek, Mihai Pop, Denisa Bungardean and Daniela Eșian

Int. J. Environ. Res. Public Health 2022, 19(4), 1966; https://doi.org/10.3390/ijerph19041966 - 10 Feb 2022

Cited by 6 | Viewed by 2397

Abstract

Dental sealants are an excellent means to prevent pits and fissure decay. Currently, there are multiple commercially available sealant materials. The purpose of this study was to assess the retention of glass carbomer fissure sealant and the incidence of secondary caries over a [...] Read more.

Dental sealants are an excellent means to prevent pits and fissure decay. Currently, there are multiple commercially available sealant materials. The purpose of this study was to assess the retention of glass carbomer fissure sealant and the incidence of secondary caries over a period of 24 months in comparison with a resin-based sealant. Materials and Methods: We included 32 children in the study, with ages between six and eight years and an average age of 6.8 years old. For each child, we sealed four permanent molars (totaling 128 teeth). The study group was divided into sub-groups. Sub-group A was represented by 64 first permanent molars which underwent dental sealing procedures with composite resin-based fissure sealant, Helioseal F™, and sub-group B was represented by 64 first permanent molars which underwent dental sealing procedures with glass carbomer cement, GCP Glass Seal™. The sealants were assessed clinically at 6, 12, 18, and 24 months. Results: The 6-month follow-up evaluation showed no statistically significant differences between the two materials neither regarding sealant retention nor new carious lesions formation (p > 0.05). At the 12-month recall, 57 molars had good retention (89.06%) from sub-group A and 44 molars (68.75%) from sub-group B; there was a statistically significant difference (p = 0.0187) between the two treatment choices only regarding material retention. At the last recall after 2 years, sub-group A had a higher number of molars with perfect sealing (47–73.43%) and 8 molars (12.5%) with new caries lesions and sub-group B had 23 (35.93%) molars with perfect sealing and 15 molars (23.44%) with new caries lesions; there was a statistically significant difference (p < 0.0001) between the two treatment choices only regarding material retention. Conclusions: The glass carbomer retention is very inferior to the resin-based material. The glass carbomer sealant was effective in preventing new caries development, comparable with the conventional resin-based sealant. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

11 pages, 334 KiB

Open AccessArticle

Parents’ Willingness to Invest in Primary Oral Health Prevention for Their Preschool Children

by Peggy C.J.M. van Spreuwel, Katarina Jerković-Ćosić, Cor van Loveren and Geert J.M.G. van der Heijden

Int. J. Environ. Res. Public Health 2021, 18(21), 11437; https://doi.org/10.3390/ijerph182111437 - 30 Oct 2021

Cited by 6 | Viewed by 2831

Abstract

There is growing evidence for the beneficial effects of starting oral health prevention early in life. Preventing dental caries in very young children requires considerable investment from parents. Therefore, this cross-sectional study aimed to explore parents’ willingness to pay (WTP) and willingness to [...] Read more.

There is growing evidence for the beneficial effects of starting oral health prevention early in life. Preventing dental caries in very young children requires considerable investment from parents. Therefore, this cross-sectional study aimed to explore parents’ willingness to pay (WTP) and willingness to invest in time (WTIT) for primary oral health prevention in preschool children and describe whether these are related to the parents’ demographic, socio-economic and behavioural characteristics. In a convenience sample of parents of preschool children aged six months to four years (n = 142), data were collected with questionnaires. On average, parents were willing to pay EUR15.84 per month, invest time for 1.9 dental visits per year, and spend 2.4 min per day brushing their child’s teeth. A higher education level of the mother and having a child older than two were associated with a higher WTIT in brushing minutes per day (p = 0.03). In addition, parents who brushed their child’s teeth more frequently were also more willing to invest in brushing minutes (p < 0.01) and money (p < 0.01). Findings emphasise the importance of early oral health interventions and the need to increase awareness of primary prevention’s importance in maintaining healthy teeth and reducing possibly oral health inequalities. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

7 pages, 298 KiB

Open AccessArticle

Prevalence of Dental Caries and Periodontal Disease of High School Students Aged 15 to 18 Years in Taiwan

by Po-Sen Chang, Chun-Jui Huang, Chia-Lan Hsiang, Hongmin Lai and Aileen I. Tsai

Int. J. Environ. Res. Public Health 2021, 18(19), 9967; https://doi.org/10.3390/ijerph18199967 - 22 Sep 2021

Cited by 9 | Viewed by 3362

Abstract

The purpose of this study was to assess the prevalence and distribution of dental caries and periodontal disease in Taiwanese high school students aged 15–18. A total of 1069 Taiwanese students participated in a cross-sectional nationwide dental survey. By using a stratified method [...] Read more.

The purpose of this study was to assess the prevalence and distribution of dental caries and periodontal disease in Taiwanese high school students aged 15–18. A total of 1069 Taiwanese students participated in a cross-sectional nationwide dental survey. By using a stratified method based on the National Health Insurance administration regions, 24 high schools were randomly sampled in different areas of Taiwan. The participants were examined with dental mirrors and community periodontal index (CPI) probes without using radiographs, to measure dental caries and periodontal status. Demographic information and other relevant risk indicators for the two diseases were gathered via a self-report questionnaire. In this study population, the weighted mean decayed, missing and filled teeth (DMFT) scores for ages 15 to 18 were 5.2, 6.1, 6.1, and 5.7. The weighted mean decayed, missing and filled surfaces (DMFS) scores were 9.0, 12.0, 13.1, and 11.2 at ages 15, 16, 17, and 18, respectively. Additionally, 88.2% of the subjects had periodontal disease, with calculus as the most prevalent type. Moreover, 5.2% of these students showed loss of attachment. There was no significant association between dental caries and periodontal disease. Dental caries and periodontal disease were prevalent among Taiwanese high school students in this national dental survey. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

14 pages, 6427 KiB

Open AccessArticle

Evaluation of Preventive Treatment Protocols for Patients under Antiresorptive Therapy Undergoing Tooth Extraction at a Swiss University Clinic

by Ellen Pick, Nicolas Leuenberger, Irina Kuster, Nicole Selina Stutzmann, Bernd Stadlinger and Silvio Valdec

Int. J. Environ. Res. Public Health 2021, 18(18), 9924; https://doi.org/10.3390/ijerph18189924 - 21 Sep 2021

Cited by 4 | Viewed by 3510

Abstract

Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is a dreaded complication in patients with compromised bone metabolism. The purpose of the present study was to examine the occurrence of ARONJ and its related factors among patients with a history of antiresorptive therapy undergoing [...] Read more.

Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is a dreaded complication in patients with compromised bone metabolism. The purpose of the present study was to examine the occurrence of ARONJ and its related factors among patients with a history of antiresorptive therapy undergoing tooth extraction using preventive protocols at a Swiss university clinic. Data were retrospectively pooled from health records of patients having received a surgical tooth extraction between January 2015 and April 2020 in the Clinic of Cranio-Maxillofacial and Oral surgery, University of Zurich. A total of 970 patients received an extraction with flap elevation or wound closure during this period. A total of 104 patients could be included in the study. Furthermore, variables including age, gender, smoking, risk profile, choice, indication and duration of antiresorptive therapy, number of extractions, extraction site, surgical technique, choice and duration of antibiotics as well as the presence of postoperative inflammatory complications were assessed. Overall, 4 patients developed ARONJ (incidence of 3.8%) after tooth extraction at the same location, without previous signs of osteonecrosis. Preventive methods included predominantly primary wound closure using a full thickness mucoperiosteal flap and prolonged perioperative antibiotic prophylaxis. In accordance with current literature, the applied protocol showed a reliable outcome in preventing ARONJ when a tooth extraction is required. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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14 pages, 636 KiB

Open AccessArticle

Assessing the Quality of Life of Oral Submucous Fibrosis Patients: A Cross-Sectional Study Using the WHOQOL-BREF Tool

by Abdul Bari Memon, Aneela Atta Ur Rahman, Kashif Ali Channar, Muhammad Sohail Zafar and Naresh Kumar

Int. J. Environ. Res. Public Health 2021, 18(18), 9498; https://doi.org/10.3390/ijerph18189498 - 9 Sep 2021

Cited by 11 | Viewed by 3555

Abstract

The aim of the present study was to evaluate the quality of life (QoL) of oral submucous fibrosis (OSMF) patients using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. This cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery, [...] Read more.

The aim of the present study was to evaluate the quality of life (QoL) of oral submucous fibrosis (OSMF) patients using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. This cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro. We used the consecutive sampling technique to recruit patients who were clinically diagnosed with OSMF (n = 112). Data were collected using the WHOQOL-BREF questionnaire, which contains a total of 26 questions. The first two questions, related to overall QoL and overall health status, were evaluated separately. The remaining questions (3–26), which represented four domains—physical, psychological, social, and environmental health—were evaluated separately. Patients were asked questions in their native language (Urdu). The relationship between these four domains of life was evaluated with gender, age categories, functional staging, and habit duration using the independent t-test to determine statistical significance. Cronbach’s Alpha was used to assess the reliability of the WHOQOL-BREF domains. The overall QoL of the OSMF patients was considerably poor, and the majority of the patients were unsatisfied with their oral health status. The age variable significantly affected the scores of all domains except for social relationships, whereas habit duration and functional staging of OSMF did not significantly affect the scores of all domains. The domains of the WHOQOL-BREF questionnaire (translated into the Urdu language) showed good reliability, except for social relationships. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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10 pages, 1828 KiB

Open AccessArticle

Diagnostic Concordance between Optical Coherence Tomography and Histological Investigations for Immune-Mediated Desquamative Gingivitis: Observational Study

by Vera Panzarella, Alessia Bartolone, Rita Coniglio, Vito Rodolico, Laura Maniscalco, Giorgia Capocasale, Martina Iurato Carbone and Giuseppina Campisi

Int. J. Environ. Res. Public Health 2021, 18(17), 9095; https://doi.org/10.3390/ijerph18179095 - 28 Aug 2021

Cited by 9 | Viewed by 2313

Abstract

Desquamative gingivitis (DG) denotes a heterogeneous immune-mediated disease for which early diagnosis represents a great challenge. The main aim of this study is to validate diagnostic concordance between specific Optical Coherence Tomography (OTC) patterns for DG related to oral Lichen Planus (OLP), Pemphigus [...] Read more.

Desquamative gingivitis (DG) denotes a heterogeneous immune-mediated disease for which early diagnosis represents a great challenge. The main aim of this study is to validate diagnostic concordance between specific Optical Coherence Tomography (OTC) patterns for DG related to oral Lichen Planus (OLP), Pemphigus Vulgaris (PV), and Mucous Membrane Pemphigoid (MMP) and definitive histological diagnosis. Forty-three patients with suspected immune-mediated DGs, were progressively recruited. Before biopsy, an OCT preliminary evaluation was performed using specific pre-determined OCT diagnostic patterns (i.e., morphology and localization of blisters, status of the basal membrane, epithelial thickness, presence/absence of acantholytic cells into blister and/or inflammatory infiltrate) related to OLP, PV and MMP. After histological confirmation, OCT and histological diagnoses were compared. Using pre-determined patterns, OCT diagnoses of DGs were: 22 (51%) OLP, of which 11 (26%) were with the bullous variant, 4 (9%) PV and 6 (14%) MMP. The same diagnoses were found by histological investigations (with the main OCT discriminatory potential for the bullous variant of OLP). The concordance between the two diagnostic methods was confirmed by the Fisher exact test (p-value < 0.01). These specific OCT patterns show a diagnostic reliability in 100% of the cases investigated, suggesting their accuracy to support the complex diagnosis and management of immune-mediated DGs. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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12 pages, 1367 KiB

Open AccessArticle

Does Head Orientation Influence 3D Facial Imaging? A Study on Accuracy and Precision of Stereophotogrammetric Acquisition

by Giuditta Battistoni, Diana Cassi, Marisabel Magnifico, Giuseppe Pedrazzi, Marco Di Blasio, Benedetta Vaienti and Alberto Di Blasio

Int. J. Environ. Res. Public Health 2021, 18(8), 4276; https://doi.org/10.3390/ijerph18084276 - 17 Apr 2021

Cited by 11 | Viewed by 2718

Abstract

This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures [...] Read more.

This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures of a mannequin head were obtained with a stereophotogrammetric system (Face Shape 3D MaxiLine). Image acquisition was performed with no rotations and with various pitch, roll, and yaw angulations. On 3D images, 14 linear distances were measured. Various indices were used to quantify error magnitude, among them the acquisition error, the mean and the maximum intra- and inter-operator measurement error, repeatability and reproducibility error, the standard deviation, and the standard error of errors. Two one-sided tests (TOST) were performed to assess the equivalence between measurements recorded in different head angulations. The maximum intra-operator error was very low (0.336 mm), closely followed by the acquisition error (0.496 mm). The maximum inter-operator error was 0.532 mm, and the highest degree of error was found in reproducibility (0.890 mm). Anthropometric measurements from alternative acquisition conditions resulted in significantly equivalent TOST, with the exception of Zygion (l)–Tragion (l) and Cheek (l)–Tragion (l) distances measured with pitch angulation compared to no rotation position. Face Shape 3D Maxiline has sufficient accuracy for orthodontic and surgical use. Precision was not altered by head orientation, making the acquisition simpler and not constrained to a critical precision as in 2D photographs. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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16 pages, 1464 KiB

Open AccessArticle

Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial

by Biagio Rapone, Elisabetta Ferrara, Massimo Corsalini, Erda Qorri, Ilaria Converti, Felice Lorusso, Maurizio Delvecchio, Antonio Gnoni, Salvatore Scacco and Antonio Scarano

Int. J. Environ. Res. Public Health 2021, 18(6), 3018; https://doi.org/10.3390/ijerph18063018 - 15 Mar 2021

Cited by 56 | Viewed by 5294

Abstract

Background: Based on the holistic approach to prevention diabetic disease, the role of periodontal inflammation in type 2 diabetes mellitus (T2DM) is under intensive scrutiny. Data from clinical trials have shown benefit from a periodontal therapy in providing patients with type 2 diabetes [...] Read more.

Background: Based on the holistic approach to prevention diabetic disease, the role of periodontal inflammation in type 2 diabetes mellitus (T2DM) is under intensive scrutiny. Data from clinical trials have shown benefit from a periodontal therapy in providing patients with type 2 diabetes improvement despite relatively disappointing long-terms response rates. The aim of this study was to investigate the short-term glycemic control level and systemic inflammatory status after periodontal therapy. Methods: This was a randomized trial with a 6-months follow-up. Participants aged 56.4 ± 7.9 years with diagnosed type 2 diabetes and periodontitis were enrolled. Among the 187 type 2 diabetic patients, 93 were randomly assigned to receive non-surgical periodontal treatment immediately and 94 to receive the delayed treatment. Within and between groups comparison was done during the study period, and the differences between groups were assessed. Results: The difference between HbA1c values at baseline (Mdn = 7.7) and 6 months after non-surgical periodontal treatment (Mdn = 7.2) was statistically significant, U = 3174.5, p = 0.012, r = 0.187. However, although technically a positive correlation, the relationship between the glycated hemoglobin value and periodontal variables was weak. The differences between both the groups over 6 months were not statistically considerable, failing to reach statistical significance. At 6 months the difference between groups about the C-reactive protein (CRP) levels was statistically significant, U=1839.5, p = 0, r = 0.472, with a lower concentration for the intervention group. Furthermore, the intervention group showed a statistically significant difference between baseline and 6 months evaluation (U = 2606.5, p = 0, r = 0.308). Conclusions: The periodontal intervention potentially may allow individuals with type 2 diabetes to improve glycemic control and CRP concentrations, and diabetes alters the periodontal status. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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20 pages, 4921 KiB

Open AccessArticle

Musculoskeletal Disorders among Italian Dentists and Dental Hygienists

by Maria Giovanna Gandolfi, Fausto Zamparini, Andrea Spinelli, Alessandro Risi and Carlo Prati

Int. J. Environ. Res. Public Health 2021, 18(5), 2705; https://doi.org/10.3390/ijerph18052705 - 8 Mar 2021

Cited by 38 | Viewed by 6780

Abstract

Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian [...] Read more.

Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian dental professionals and the most affected body regions. A cross-sectional observational study was conducted between March 2019 and February 2020. The Nordic Musculoskeletal questionnaire (NMQ) was implemented with questions related to working habits (dental occupation, working hours per week and per days, years of work) and lifestyle (practiced physical activity, including frequency and duration, mobilization activities, and knowledge of ergonomic guidelines) was used. The-chi square test was carried out to detect any statistically significant difference (p < 0.05). Logistic regression was carried out to detect the most significant factors associated to WMSD occurrence. A total of 284 questionnaires have been used for the analysis. A high proportion of dental professionals (84.6%) were affected by WMSD in the last 12 months. A higher prevalence was found in females (87%) when compared to males (80%). The prevalence of WMSD was correlated to the working hours/day and hour/week, with a higher risk for operators working >5 h/day and >30 h/week. In addition, a high prevalence was found in operators working for 2–5 years after graduation. Most of the surveyed dental professionals practiced physical activity (70.1%) but only a few had satisfactorily knowledge of ergonomic guidelines (12.7%). Interestingly, participants who practiced yoga or stretching as physical activities demonstrated lower WMSD (77%) when compared to other physical activities (84%). We can highlight that generic physical activities have no functional effect on WMSD for dental professionals. The most affected body areas were neck (59.9%), shoulders (43.3%), lumbar region (52.1%), dorsal region (37.7%) and wrists (30.6%). Considering the magnitude of the problem, there is an urgent need to implement the education in ergonomics among dental professionals, that may be achieved by teaching biomechanics, posturology and integrative functional therapies (such as yoga) during the university education and by promoting holistic health of dental operators. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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10 pages, 443 KiB

Open AccessArticle

Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health

by Youngha Song and Junhewk Kim

Int. J. Environ. Res. Public Health 2021, 18(5), 2372; https://doi.org/10.3390/ijerph18052372 - 1 Mar 2021

Cited by 6 | Viewed by 4815

Abstract

Community water fluoridation (CWF), a long-established public health intervention, has been studied for scientific evidence from both of yea and nay standpoints. To justify CWF with scientific evidence inevitably leads to ethical justification, which raises the question of whether oral health is of [...] Read more.

Community water fluoridation (CWF), a long-established public health intervention, has been studied for scientific evidence from both of yea and nay standpoints. To justify CWF with scientific evidence inevitably leads to ethical justification, which raises the question of whether oral health is of individual concern or social responsibility. As dental caries is a public health problem, public health ethics should be applied to the topic instead of generic clinical ethics. From both pro- and anti-fluoridationists’ perspectives, CWF is a public health policy requiring a significant level of intervention. Thus, there needs to take further considerations for justifying CWF beyond the simple aspect of utility. For further ethical considerations on CWF, three caveats were suggested: procedural justice, social contexts, and maintenance of trust. The process to justify CWF should also be justified, not simply by majority rule but participatory decision-making with transparency and pluralistic democracy. Social contexts are to be part of the process of resolving conflicting values in public health interventions. Public trust in the dental profession and the oral healthcare system should be maintained over the considerations. This article suggests accountability for reasonableness as a framework to consider infringement by CWF for public justification of its implementation. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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10 pages, 1309 KiB

Open AccessArticle

Protective Face Masks: Effect on the Oxygenation and Heart Rate Status of Oral Surgeons during Surgery

by Antonio Scarano, Francesco Inchingolo, Biagio Rapone, Felice Festa, Sergio Rexhep Tari and Felice Lorusso

Int. J. Environ. Res. Public Health 2021, 18(5), 2363; https://doi.org/10.3390/ijerph18052363 - 28 Feb 2021

Cited by 85 | Viewed by 6531

Abstract

Background: Safety in medical work requires eye protection, such as glasses, and protective facial masks (PFM) during clinical practice to prevent viral respiratory infections. The use of facial masks and other full personal protective equipment increases air flow resistance, facial skin temperature and [...] Read more.

Background: Safety in medical work requires eye protection, such as glasses, and protective facial masks (PFM) during clinical practice to prevent viral respiratory infections. The use of facial masks and other full personal protective equipment increases air flow resistance, facial skin temperature and physical discomfort. The aim of the present study was to measure surgeons’ oxygenation status and discomfort before and after their daily routine activities of oral interventions. Methods: 10 male voluntary dentists, specializing in oral surgery, and 10 male voluntary doctors in dentistry, participating in master’s courses in oral surgery in the Department of Oral Surgery of the University of Chieti, with mean age 29 ± 6 (27–35), were enrolled. This study was undertaken to investigate the effects of wearing a PFM on oxygenation status while the oral surgeons were actively working. Disposable sterile one-way surgical paper masks (Surgical Face Mask, Euronda, Italy) and FFP2 (Surgical Face Mask, Euronda, Italy) were used and the mask position covering the nose did not vary during the procedures. The FFP2 was covered by a surgical mask during surgical treatment. A pulse oximeter was used to measure the blood oximetry saturation during the study. Results: In all 20 surgeons wearing FFP2 covered by surgical masks, a reduction in arterial O₂ saturation from around 97.5% before surgery to 94% after surgery was recorded with increase of heart rates. A shortness of breath and light-headedness/headaches were also noted. Conclusions: In conclusion, wearing an FFP2 covered by a surgical mask induces a reduction in circulating O₂ concentrations without clinical relevance, while an increase of heart frequency and a sensation of shortness of breath, light-headedness/headaches were recorded. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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9 pages, 302 KiB

Open AccessArticle

The Effect of Proximal Cleaning Devices on Periodontal Status in Korean Adults between 2016 and 2018

by Eun-Jeong Kim and Su-Jin Han

Int. J. Environ. Res. Public Health 2021, 18(4), 2116; https://doi.org/10.3390/ijerph18042116 - 22 Feb 2021

Cited by 4 | Viewed by 3382

Abstract

Removal of the biofilm from the proximal space is essential for preventing periodontal disease. This study aimed to prove the association between the use of proximal cleaning devices, such as dental floss and interdental brushes, and periodontal health among nationally representative Korean adults. [...] Read more.

Removal of the biofilm from the proximal space is essential for preventing periodontal disease. This study aimed to prove the association between the use of proximal cleaning devices, such as dental floss and interdental brushes, and periodontal health among nationally representative Korean adults. Data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016–2018) were used for this purpose. A total of 11,359 participants aged 19 years or older who participated in KNHANES were reviewed. The response variable was the prevalence of high CPI (CPI of 3–4), and the explanatory variables were dental floss and interdental brush. A multivariable logistic regression analysis was performed to adjust for potential confounding factors and to analyze the association between periodontal disease and proximal cleaning devices. It was found that 63.1% of the participants did not use proximal cleaning devices at all, 17.5% used dental floss alone, 11.9% used an interdental brush, and 7.5% used both. Subjects who used both dental floss and interdental brush had a high CPI rate nearly half that of all the models for those who did not. In particular, for those using dental floss, the aOR of high CPI was 0.681 in Model 1, 0.714 in Model 2, and 0.737 in Model 3. Dental hygiene products for cleaning the proximal space, such as dental floss, are essential for removing the dental biofilm as a basic tool along with toothbrushes. Teaching and explaining the need to use these devices well are important for oral health care and maintenance. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

10 pages, 338 KiB

Open AccessArticle

More Teeth and Posterior Balanced Occlusion Are a Key Determinant for Cognitive Function in the Elderly

by Taejun Park, Yun-Sook Jung, Keunbada Son, Yong-Chul Bae, Keun-Bae Song, Atsuo Amano and Youn-Hee Choi

Int. J. Environ. Res. Public Health 2021, 18(4), 1996; https://doi.org/10.3390/ijerph18041996 - 19 Feb 2021

Cited by 7 | Viewed by 3527

Abstract

Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability [...] Read more.

Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability and cognitive function in the elderly. A total of 563 participants aged 65 years or over residing in urban and rural areas of South Korea were surveyed. The chewing ability was measured by objectively measurable indications such as the number of remaining teeth, denture status, color-changeable gum, and occlusal balance using T-Scan III^®. The cognitive function was measured by the Korean version of Mini-Mental State Examination-Dementia Screening (MMSE-DS) and a score of 24 or more (out of 30) indicates a normal cognition, below 23 indicates cognitive impairment. The association between socio-demographic factors, chewing ability factors, and cognitive function demonstrated statistically significant results. When comparing the denture status and chewing ability, the proportion of need denture group had fewer remaining teeth and anterior balanced occlusion. The average number of remaining teeth in anterior balanced occlusion with cognitive impairment was 11.2 compared to posterior balanced occlusion with the normal cognition 19.2. A multiple linear regression analysis declared a significant correlation between number of remaining teeth, denture status, occlusal balance, and cognitive function. Results of the present study revealed objectively measurable indications are suitable for chewing ability assessment and correlated with cognitive function. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

11 pages, 1461 KiB

Open AccessFeature PaperArticle

Analysis of the Efficacy of Two Treatment Protocols for Patients with Symptomatic Oral Lichen Planus: A Randomized Clinical Trial

by Simona Santonocito, Alessandro Polizzi, Rocco De Pasquale, Vincenzo Ronsivalle, Antonino Lo Giudice and Gaetano Isola

Int. J. Environ. Res. Public Health 2021, 18(1), 56; https://doi.org/10.3390/ijerph18010056 - 23 Dec 2020

Cited by 16 | Viewed by 4542

Abstract

Oral lichen planus (OLP) is a chronic, inflammatory, immune-mediated disease, which can alter the quality of life of patients. The aim of this randomized clinical trial was to compare the therapeutic efficacy of clobetasol oral gel 0.05% versus an anti-inflammatory in oral solution [...] Read more.

Oral lichen planus (OLP) is a chronic, inflammatory, immune-mediated disease, which can alter the quality of life of patients. The aim of this randomized clinical trial was to compare the therapeutic efficacy of clobetasol oral gel 0.05% versus an anti-inflammatory in oral solution (mouthwash) in the management of patients suffering from symptomatic OLP. The secondary objective was to analyze which one of the two treatments induced a greater risk of developing side effects. Forty patients were assigned (20 patients for group), through a randomized design, to receive clobetasol gel 0.05% or an anti-inflammatory mouthwash, which contains calcium hydroxide, hyaluronic acid, umbelliferone and oligomeric pro-anthocyanidins) for three months. At baseline (T0) and after 3 months (T1), patients underwent dental and dermatological examinations to assess their symptoms (Numerical Pain Scale (NRS) score) and signs (Thongprasom score). Data were calculated using T-test for the dependent variable, Wilcoxon test and Mann-Whitney u test. Both clobetasol and anti-inflammatory resulted in a statistically significant reduction of signs, (p < 0.001 and p = 0.02, respectively) and symptoms (p < 0.001 for clobetasol and p = 0.02 for anti-inflammatory). In conclusion, the results evidenced that, compared to clobetasol, the anti-inflammatory was less effective in determining the reduction of signs and symptom in OLP patients. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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11 pages, 22463 KiB

Open AccessArticle

by Antonia Marcianò, Gian Marco Guzzo, Matteo Peditto, Antonio Picone and Giacomo Oteri

Int. J. Environ. Res. Public Health 2020, 17(24), 9509; https://doi.org/10.3390/ijerph17249509 - 18 Dec 2020

Cited by 9 | Viewed by 3180

Abstract

The purpose of the present study was to estimate the prevalence of cyclin-dependent kinase (CDK) 4/6 inhibitors use among cancer patients from the medication-related osteonecrosis of the jaw (MRONJ) cohort of the University of Messina. We retrospectively reviewed the records of all patients [...] Read more.

The purpose of the present study was to estimate the prevalence of cyclin-dependent kinase (CDK) 4/6 inhibitors use among cancer patients from the medication-related osteonecrosis of the jaw (MRONJ) cohort of the University of Messina. We retrospectively reviewed the records of all patients with either intravenous bisphosphonates or denosumab-related MRONJ reported in the electronic health records of the Unit of Oral Surgery, School of Dentistry, University of Messina between the first quarter of 2018 and the first quarter 2020 to identify eligible patients. We observed six cases of MRONJ associated with CDK4/6 inhibitors concomitantly with intravenous bisphosphonates and/or denosumab in breast cancer patients. The CDK4/6 inhibitors registered were palbociclib (n = 5) and abemaciclib (n = 1). Data of cancer patients diagnosed with MRONJ in the same period (n = 10) were extracted for comparison. The comparative assessment with this group of patients showed a similar distribution of MRONJ stage ranged and clinical course after treatment. The degree of risk for osteonecrosis in patients taking these new classes of drugs is uncertain but warrants awareness and close monitoring. The role of premedication dental evaluation as a prevention strategy has been acknowledged for cancer patients about to initiate intravenous bisphosphonates and/or denosumab for treatment of bone metastasis, but additional attention should be paid to whom are assuming CDK4/6 inhibitors because of their oral adverse events. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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11 pages, 3309 KiB

Open AccessArticle

Dental Challenges and the Needs of the Population during the Covid-19 Pandemic Period. Real-Time Surveillance Using Google Trends

by Magdalena Sycinska-Dziarnowska and Iwona Paradowska-Stankiewicz

Int. J. Environ. Res. Public Health 2020, 17(23), 8999; https://doi.org/10.3390/ijerph17238999 - 3 Dec 2020

Cited by 21 | Viewed by 5330

Abstract

Background: The outbreak of the COVID-19 pandemic may lead to changes in the dental needs of the population and new challenges concerning oral health care. Methods: The Google Trends tool was used to collect data on the Internet search interest. The investigated material [...] Read more.

Background: The outbreak of the COVID-19 pandemic may lead to changes in the dental needs of the population and new challenges concerning oral health care. Methods: The Google Trends tool was used to collect data on the Internet search interest. The investigated material was collected from 1 January 2020 to 23 August 2020. Search terms “toothache”, “dentist” and “stay at home” were retrieved for the whole world as well as for the US, the UK, Poland, Italy and Sweden. Results: During the lockdown, correlation analysis indicates the lowest public interest in the word “dentist” one week preceding the peak for “toothache”, followed by an increase in the word search for “dentist”. On 12 April, worldwide, the maximum of Google Trends Relative Search Volume (RSV) for “toothache” was observed. Conclusion: Decrease in “dentist” queries during lockdown followed by an increase in “toothache” search predicts greater dental needs in the post-pandemic period. The surveillance shows significant changes in queries for dental-related terms during the course of the COVID-19 pandemic. In order to prepare for future pandemic outbreaks teledentistry programs should be taken into consideration. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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12 pages, 2577 KiB

Open AccessArticle

Risks of Aerosol Contamination in Dental Procedures during the Second Wave of COVID-19—Experience and Proposals of Innovative IPC in Dental Practice

by Maria Giovanna Gandolfi, Fausto Zamparini, Andrea Spinelli, Vittorio Sambri and Carlo Prati

Int. J. Environ. Res. Public Health 2020, 17(23), 8954; https://doi.org/10.3390/ijerph17238954 - 1 Dec 2020

Cited by 31 | Viewed by 4982

Abstract

Dental-care workers operate very close to the patient’s mouth and are at high risk of contamination by SARS-CoV-2. Droplets may be contaminated by patient’s saliva and exhaled breath particles. All asymptomatic patients should be considered as Coronavirus positive. All dental procedures must be [...] Read more.

Dental-care workers operate very close to the patient’s mouth and are at high risk of contamination by SARS-CoV-2. Droplets may be contaminated by patient’s saliva and exhaled breath particles. All asymptomatic patients should be considered as Coronavirus positive. All dental procedures must be revised after positive identification of SARS-Cov-2. Novel recommendations as the use of novel suction cannula designed for fast spray/saliva aspiration, use of Tyvek suits and innovative sprayhoods designed for dental-care worker protections are proposed to prevent virus transmission. New tailored operative and clinical procedures are being currently developed by university dental clinics and hospitals in attempt to reduce risk for dental workers and patients. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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21 pages, 1701 KiB

Open AccessArticle

The Management of Dental Practices in the Post-COVID 19 Era: An Economic and Operational Perspective

by Giovanna Lo Nigro, Maria Eleonora Bizzoca, Lorenzo Lo Muzio and Giuseppina Campisi

Int. J. Environ. Res. Public Health 2020, 17(23), 8905; https://doi.org/10.3390/ijerph17238905 - 30 Nov 2020

Cited by 10 | Viewed by 3707

Abstract

Background: In order to protect dental teams and their patients during the COVID-19 pandemic, dentists have had to adopt several measures (operating and post-operating procedures) which may increase the total treatment time and costs relating to individual protective measures. This paper will propose [...] Read more.

Background: In order to protect dental teams and their patients during the COVID-19 pandemic, dentists have had to adopt several measures (operating and post-operating procedures) which may increase the total treatment time and costs relating to individual protective measures. This paper will propose a thorough analysis of operating dentistry procedures, comparing the economic performance of the activity in a dental surgery before and after the adoption of these protective measures, which are required to contain the risk of SARS-COV-2 infections. Methods: The economic analysis is articulated in three approaches. Firstly, it assesses a reduction in markup by maintaining current charges (A); alternatively, it suggests revised charges to adopt in order to maintain unvaried levels of markup (B). And the third Approach (C) examines available dental treatments, highlighting how to profitably combine treatment volumes to reduce markup loss or a restricted increase in dental charges. Results: Maintaining dental charges could cause a loss in markup, even rising to 200% (A); attempting to maintain unvaried levels of markup will result in an increase in dental charges, even at 100% (B); and varying the volumes of the single dental treatments on offer (increasing those which current research indicates as the most profitable) could mitigate the economic impact of the measures to prevent the transmission of SARS-COV-2 (C). Conclusions: The authors of this paper provide managerial insights which can assist the dentist-entrepreneur to become aware of the boundaries of the economic consequences of governmental measures in containing the virus infection. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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12 pages, 818 KiB

Open AccessArticle

Italian Response to Coronavirus Pandemic in Dental Care Access: The DeCADE Study

by Luca Aquilanti, Silvia Gallegati, Valerio Temperini, Luigi Ferrante, Edlira Skrami, Maurizio Procaccini and Giorgio Rappelli

Int. J. Environ. Res. Public Health 2020, 17(19), 6977; https://doi.org/10.3390/ijerph17196977 - 24 Sep 2020

Cited by 23 | Viewed by 3545

Abstract

The aim of the study was to evaluate the impact of the coronavirus pandemic on the willingness, anxiety and concerns of Italian people on undergoing dental appointments. An anonymous survey was posted online on social media on 11 May 2020 and was completed [...] Read more.

The aim of the study was to evaluate the impact of the coronavirus pandemic on the willingness, anxiety and concerns of Italian people on undergoing dental appointments. An anonymous survey was posted online on social media on 11 May 2020 and was completed by 1003 respondents in one week. Multiple correspondence analysis and multiple logistic regression were used to evaluate the association between socio-demographic characteristics, dental care access, contagion fear of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), trust in dentists regarding sanitization procedures and perception of the impact of the risk of contagion on dental care. Subjects with a high level of education, attending public dental offices and that are used to go to dental offices for urgent care would not feel comfortable in undergoing a dental appointment and would prefer to postpone or cancel dental visits, waiting for a decrease in the number of the contagions. Moreover, the risk of canceling or postponing the appointment at the dentist was 1.59 times greater in those who claimed to be strongly influenced by SARS-CoV-2. Fear of coronavirus disease (COVID-19), new cases decrease and the not urgent nature of dental visits influenced more than the lowered income household on upcoming or resuming dental appointments. In the next months, despite the forecasted economic crisis caused by coronavirus pandemic, fear and anxiety generated by the spread of the virus will impact more than the lowered familiar income with regards to access to dental care. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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12 pages, 629 KiB

Open AccessArticle

Perceived Job Insecurity and Depressive Symptoms among Italian Dentists: The Moderating Role of Fear of COVID-19

by Roberta Gasparro, Cristiano Scandurra, Nelson Mauro Maldonato, Pasquale Dolce, Vincenzo Bochicchio, Alessandra Valletta, Gilberto Sammartino, Pasquale Sammartino, Mauro Mariniello, Alessandro Espedito di Lauro and Gaetano Marenzi

Int. J. Environ. Res. Public Health 2020, 17(15), 5338; https://doi.org/10.3390/ijerph17155338 - 24 Jul 2020

Cited by 106 | Viewed by 8481

Abstract

Containment measures adopted to reduce the spread of coronavirus disease 2019 (COVID-19) have produced a general perception of job insecurity. Dentists have been highly affected by such measures, as they represent an easy source of contagion. As perceived job insecurity is associated with [...] Read more.

Containment measures adopted to reduce the spread of coronavirus disease 2019 (COVID-19) have produced a general perception of job insecurity. Dentists have been highly affected by such measures, as they represent an easy source of contagion. As perceived job insecurity is associated with psychological distress and Italian dentists have been highly affected by the COVID-19 outbreak in terms of potential financial loss and the risk of being infected, this study aimed at assessing whether the fear of COVID-19 moderated the effect of perceived job insecurity on depressive symptoms. This cross-sectional online study has included 735 Italian dentists recruited during the lockdown and ranging in age from 27 to 70 years old (495 men and 240 women). A quantile regression model with an inference based on the median and with an interaction term between the fear of COVID-19 and perceived job insecurity has been used to estimate the hypothesized associations. The results indicated that both perceived job insecurity and fear of COVID-19 were positively associated with depressive symptoms, and that the effect of perceived job insecurity on depressive symptoms was weaker among those with a low fear of COVID-19. The findings may inform public health policies for dentists in relation to reducing the risk of developing negative mental health outcomes. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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13 pages, 344 KiB

Open AccessArticle

Cross-Sectional Association between Behaviors Related to Sugar-Containing Foods and Dental Outcomes among Hispanic Immigrants

by Sonia Vega-López, Karla Armenta, George Eckert and Gerardo Maupomé

Int. J. Environ. Res. Public Health 2020, 17(14), 5095; https://doi.org/10.3390/ijerph17145095 - 15 Jul 2020

Cited by 5 | Viewed by 2423

Abstract

A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to [...] Read more.

A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to examine the associations of behaviors related to added sugar-containing foods/beverages (overall intake and consumption before bed) with dental outcomes. Outcome measures involved dental outcomes, dental self-care practices, and added sugar intake. Estimated daily added sugar intake among all participants was 98 (SD = 99) g, with no difference in consumption among participants from different countries. The majority of added sugar (63 (SD = 74) g) was provided by sugar-sweetened beverages. Participants who reported consuming sugar-containing foods or beverages within an hour before bed were more likely to report having a fair/poor/very poor condition of teeth and gums and having felt dental pain (p < 0.05 for all). The amount of sugar intake was associated with being prescribed medication for oral or dental problems (p = 0.008) and dental pain (p = 0.003). Findings support the association between sugar containing food–related behaviors and dental problems among Hispanic immigrants to the U.S. Health promotion and preventive interventions for this population should consider these behaviors as modifiable contributors to adverse dental outcomes. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

12 pages, 349 KiB

Open AccessArticle

Geriatric Dentistry Curriculum in Six Continents

by Irina Xavier, Ronald L. Ettinger, Luís Proença, João Botelho, Vanessa Machado, João Rua, Ana S. Delgado and José J. Mendes

Int. J. Environ. Res. Public Health 2020, 17(13), 4682; https://doi.org/10.3390/ijerph17134682 - 29 Jun 2020

Cited by 14 | Viewed by 3979

Abstract

The purpose of this study was to examine the presence of geriatric dentistry (GD) in the curricula of worldwide dental schools, and to identify and compare their curriculum content. Eighty-three dental schools (16.4% response rate), from 24 countries, in six continents, completed a [...] Read more.

The purpose of this study was to examine the presence of geriatric dentistry (GD) in the curricula of worldwide dental schools, and to identify and compare their curriculum content. Eighty-three dental schools (16.4% response rate), from 24 countries, in six continents, completed a 25-item online questionnaire, to assess their GD curriculum, and were included in the study. GD was a mandatory course in 56 dental schools (67.5%), an independent subject in 14 schools (16.9%), and was taught as a series of lectures in 31 schools (37.4%). Clinically, 56 dental schools (67.5%) had some form of mandatory education in GD. The type of school, location and method of presentation were not associated with greater interest in expanding their curriculum in GD (p = 0.256, p = 0.276, and p = 0.919, respectively, using the Chi-square test). We found GD is a curriculum requirement in most of the surveyed dental schools and is becoming more common among dental school curricula. This survey is the first study to present data from dental schools from all continents, using a web-based survey which is a resourceful, less-expensive tool to gather data. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

8 pages, 922 KiB

Open AccessArticle

Efficacy of a U-Shaped Automatic Electric Toothbrush in Dental Plaque Removal: A Cross-Over Randomized Controlled Trial

by Michele Nieri, Veronica Giuntini, Umberto Pagliaro, Monica Giani, Lorenzo Franchi and Debora Franceschi

Int. J. Environ. Res. Public Health 2020, 17(13), 4649; https://doi.org/10.3390/ijerph17134649 - 28 Jun 2020

Cited by 17 | Viewed by 15737

Abstract

Background: The aim of this single-use, four-treatment, four-period (visit), cross-over, mono-centered, examiner-blind, cross-over randomized controlled trial (RCT) was to evaluate the efficacy in dental plaque removal of a U-shaped automatic electric toothbrush (U) compared to a conventional powered toothbrush (P), a habitual [...] Read more.

Background: The aim of this single-use, four-treatment, four-period (visit), cross-over, mono-centered, examiner-blind, cross-over randomized controlled trial (RCT) was to evaluate the efficacy in dental plaque removal of a U-shaped automatic electric toothbrush (U) compared to a conventional powered toothbrush (P), a habitual toothbrushing procedure (H), and no brushing (N). Methods: Eligible participants were volunteer students. Primary outcome measure was the reduction in full-mouth plaque score (FMPS) after brushing. The secondary outcome variable was a visual analogic scale (VAS) on subjective clean mouth sensation. Mixed models were performed for difference in FMPS and VAS. Results: Twenty-two participants were randomized to the treatments in the four periods of the study. The differences between treatments in FMPS reduction after brushing were statistically significant (p < 0.0001). The differences were statistically significant between the U and P groups (difference −48; 95% CI from −54 to −41) favoring the P group, and between the U and H groups (difference −45; 95% CI from −52 to −39) favoring the H group. On the contrary, the difference between the U and N groups was not significant (difference 5; 95% CI from −2 to 12) favoring the U group. The differences between treatments in clean mouth VAS was statistically significant (p < 0.0001) favoring the P and H groups. Conclusions: The U-shaped automatic electric toothbrush tested in this study proved to be not effective in removing dental plaque. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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9 pages, 1362 KiB

Open AccessArticle

Facial Skin Temperature and Discomfort When Wearing Protective Face Masks: Thermal Infrared Imaging Evaluation and Hands Moving the Mask

by Antonio Scarano, Francesco Inchingolo and Felice Lorusso

Int. J. Environ. Res. Public Health 2020, 17(13), 4624; https://doi.org/10.3390/ijerph17134624 - 27 Jun 2020

Cited by 180 | Viewed by 16120

Abstract

Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present [...] Read more.

Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present study was to compare the facial skin temperature and the heat flow when wearing medical surgical masks to the same factors when wearing N95 respirators. A total of 20 subjects were recruited and during the evaluation, each subject was invited to wear a surgical mask or respirator for 1 h. The next day in the morning at the same hour, the same subject wore a N95 mask for 1 h with the same protocol. Infrared thermal evaluation was performed to measure the facial temperature of the perioral region and the perception ratings related to the humidity, heat, breathing difficulty, and discomfort were recorded. A significant difference in heat flow and perioral region temperature was recorded between the surgical mask and the N95 respirator (p < 0.05). A statistically significant difference in humidity, heat, breathing difficulty, and discomfort was present between the groups. The study results suggest that N95 respirators are able to induce an increased facial skin temperature, greater discomfort and lower wearing adherence when compared to the medical surgical masks. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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8 pages, 313 KiB

Open AccessArticle

Career Prospects of Young Dentists in Switzerland

by Guglielmo Campus, Philippe Rusca, Christine Amrhein, Andreas Meier, Oliver Zeyer and Thomas Gerhard Wolf

Int. J. Environ. Res. Public Health 2020, 17(12), 4310; https://doi.org/10.3390/ijerph17124310 - 16 Jun 2020

Cited by 7 | Viewed by 2977

Abstract

The observational cross-sectional study was aimed to obtain information on the promotion and development of young professionals in Switzerland. An online survey with 20 questions was sent out. Data was collected on participants’ demographic data, including age, gender, level of qualification, place of [...] Read more.

The observational cross-sectional study was aimed to obtain information on the promotion and development of young professionals in Switzerland. An online survey with 20 questions was sent out. Data was collected on participants’ demographic data, including age, gender, level of qualification, place of work, information on employment, future perspectives, and career prospects. The survey was sent out to 1920 practitioners, of which 440 (22.9%) responded (37.1% males and 62.9% females). Of them, 76.6% were members of the Swiss Dental Association (SSO) 15.9% students, and 7.5% non-SSO members. Most participants had parents with a dental education (80.9%), and 19.8% did not. Young dentists in Switzerland most often saw their career prospects as neutral (39.8%) or rather positive (39.3%). Whereas significantly fewer dentists had a negative view of their professional future (16.8%), including more women than men, the fewest dentists of both sexes (4.1%) saw their career prospects as positive by far. The majority of young dentists were satisfied with their career prospects. Within the limitations of the current study, the reasons for this need further investigation. Despite good career prospects, there is a desire among young colleagues for cantonal practice assistance and mentoring programs, as well as support in finding a job and in taking the plunge into self-employment. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

11 pages, 335 KiB

Open AccessArticle

Functional Dentition and 12-Month Changes in Body Measurements among Thai Older Adults

by Piyada Gaewkhiew, Wael Sabbah and Eduardo Bernabé

Int. J. Environ. Res. Public Health 2020, 17(12), 4200; https://doi.org/10.3390/ijerph17124200 - 12 Jun 2020

Cited by 5 | Viewed by 2276

Abstract

This study evaluated the association of functional dentition with 12-month changes in body measurements and nutrient intake among older adults. Data from 651 community dwellers, aged 60 years and over, in Phetchaburi, Thailand, were analysed (retention rate: 83%). Data were collected via interviews [...] Read more.

This study evaluated the association of functional dentition with 12-month changes in body measurements and nutrient intake among older adults. Data from 651 community dwellers, aged 60 years and over, in Phetchaburi, Thailand, were analysed (retention rate: 83%). Data were collected via interviews (including a semi-structured food frequency questionnaire), anthropometric measurements and dental examinations. Associations were tested in linear regression models adjusted for baseline sociodemographic factors, behaviours, chronic conditions and medications. On average, participants experienced a significant increase in body mass index (BMI) and significant decreases in waist circumference (WC) and triceps skinfold thickness (TSF). A negative, albeit not significant, association between functional dentition and change in BMI was observed after adjusting for confounders. Whilst participants who had non-functional dentition without dentures experienced increases in BMI (predicted mean change: 0.25; 95% Confidence Interval: 0.09, 0.41), those who had non-functional dentition with dentures (0.21; 95%CI: −0.08, 0.50) and functional dentition (−0.07; 95%CI: −0.42, 0.28) remained stable. No similar trends were noted for WC or TSF. Functional dentition was not associated with changes in nutrient intake either. The findings provide little evidence on the association of functional dentition with short-term changes in nutrient intake or nutritional status. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

11 pages, 726 KiB

Open AccessArticle

Association of Work Patterns and Periodontitis Prevalence in Korean Adults Aged 50 Years or Older: A Nationwide Representative Study

by Young Jin Ra, Young Jin Tak, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Hye Rim Hwang, Seung Hun Lee, Eun Ju Park and Young In Lee

Int. J. Environ. Res. Public Health 2020, 17(11), 4006; https://doi.org/10.3390/ijerph17114006 - 4 Jun 2020

Cited by 4 | Viewed by 2808

Abstract

This study analyzed the relationship between the work pattern and the prevalence of periodontitis. We analyzed the data of 3320 adults (1779 men, 1543 women) aged 51–80 years from the Korean National Health and Nutrition Examination Survey (2013–2015). The work pattern was divided [...] Read more.

This study analyzed the relationship between the work pattern and the prevalence of periodontitis. We analyzed the data of 3320 adults (1779 men, 1543 women) aged 51–80 years from the Korean National Health and Nutrition Examination Survey (2013–2015). The work pattern was divided into two groups (regular and irregular). The periodontal status was assessed using the community periodontal index. We observed a statistically significant difference in the association between work patterns and prevalence of periodontitis in Korean women aged over 50 years. For female workers with irregular work patterns, the prevalence of periodontitis was lower than that in workers with regular work patterns by 10.3% (40.3% vs. 30.0%, p = 0.011). The annual health examination rate was significantly higher in the irregular group than in the regular group (for men 77.9% vs. 73.5%; p < 0.001, for women 76.4% vs. 75.9%; p < 0.001). In female workers with irregular work patterns, the annual dental examination rate was significantly higher than that in workers with a regular work pattern by 7.7% (34.3% vs. 26.6%, p = 0.043). In conclusion we found a statistically significant difference between the work patterns and prevalence of periodontitis in Korean women aged over 50 years. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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17 pages, 337 KiB

Open AccessArticle

Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia

by Ugo Consolo, Pierantonio Bellini, Davide Bencivenni, Cristina Iani and Vittorio Checchi

Int. J. Environ. Res. Public Health 2020, 17(10), 3459; https://doi.org/10.3390/ijerph17103459 - 15 May 2020

Cited by 193 | Viewed by 10527

Abstract

The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and [...] Read more.

The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and the second highest in Europe. An anonymous online survey composed of 40 questions has been sent to dentists practicing in the area of Modena and Reggio Emilia, one of the areas in Italy most affected by COVID-19. The survey was aimed at highlighting the practical and emotional consequences of COVID-19 emergence on daily clinical practice. Specifically, it assessed dentists’ behavioral responses, emotions and concerns following the Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20), as well as the dentists’ perception of infection likelihood for themselves and patients. Furthermore, the psychological impact of COVID-19 was assessed by means of the Generalized Anxiety Disorder-7 test (GAD-7), that measures the presence and severity of anxiety symptoms. Using local dental associations (ANDI-Associazione Nazionale Dentisti Italiani, CAO-Commissione Albo Odontoiatri) lists, the survey was sent by email to all dentists in the district of Modena and Reggio Emilia (874 practitioners) and was completed by 356 of them (40%). All dental practitioners closed or reduced their activity to urgent procedures, 38.2% prior to and 61.8% after the DM-10M20. All reported a routinely use of the most common protective personal equipment (PPE), but also admitted that the use of PPE had to be modified during COVID-19 pandemic. A high percentage of patients canceled their previous appointments after the DM-10M20. Almost 85% of the dentists reported being worried of contracting the infection during clinical activity. The results of the GAD-7 (General Anxiety Disorder-7) evaluation showed that 9% of respondents reported a severe anxiety. To conclude, the COVID-19 emergency is having a highly negative impact on the activity of dentists practicing in the area of Modena and Reggio Emilia. All respondents reported practice closure or strong activity reduction. The perception of this negative impact was accompanied by feelings of concern (70.2%), anxiety (46.4%) and fear (42.4%). The majority of them (89.6%) reported concerns about their professional future and the hope for economic measures to help dental practitioners. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

9 pages, 774 KiB

Open AccessArticle

Can Teledentistry Improve the Monitoring of Patients during the Covid-19 Dissemination? A Descriptive Pilot Study

by Amerigo Giudice, Selene Barone, Danila Muraca, Fiorella Averta, Federica Diodati, Alessandro Antonelli and Leonzio Fortunato

Int. J. Environ. Res. Public Health 2020, 17(10), 3399; https://doi.org/10.3390/ijerph17103399 - 13 May 2020

Cited by 118 | Viewed by 8964

Abstract

The aim of this pilot study was to describe the advantages of telemedicine (TM) in dental practice during the current national emergency condition due to the Covid-19 dissemination. At Department of Oral Surgery and Pathology—Magna Graecia University of Catanzaro, regional reference center for [...] Read more.

The aim of this pilot study was to describe the advantages of telemedicine (TM) in dental practice during the current national emergency condition due to the Covid-19 dissemination. At Department of Oral Surgery and Pathology—Magna Graecia University of Catanzaro, regional reference center for Covid-19—two groups of patients were determined: patients with urgent conditions (group U) and patients in follow-up (group F). Both groups were instructed to implement remote consultations using a messaging service (WhatsApp Messenger, WhatsApp Inc., Mountain View, California, USA) to send photos. A total of 418 photos were collected by 57 patients. Thirty-four photos were obtained by five patients in the U group after surgical procedures. All patients sent photos on the established evening, except for two patients who sent two photos outside the set days. In the F group, 384 photos were collected by 52 patients. None of them sent more photos than the number that was established by the protocol. Telemedicine allowed a monitoring of all patients, reducing costs and limiting human contact, decreasing the risk of Covid-19 dissemination. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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15 pages, 2275 KiB

Open AccessArticle

Dentistry during the COVID-19 Epidemic: An Italian Workflow for the Management of Dental Practice

by Matteo Peditto, Simone Scapellato, Antonia Marcianò, Paola Costa and Giacomo Oteri

Int. J. Environ. Res. Public Health 2020, 17(9), 3325; https://doi.org/10.3390/ijerph17093325 - 11 May 2020

Cited by 45 | Viewed by 14788

Abstract

The COVID-19 outbreak has raised concerns about infection control all over the world. Among health workers, dentists are particularly exposed to the COVID-19 infection risk. The aim of this paper is to present a workflow to manage dental procedures already in use at [...] Read more.

The COVID-19 outbreak has raised concerns about infection control all over the world. Among health workers, dentists are particularly exposed to the COVID-19 infection risk. The aim of this paper is to present a workflow to manage dental procedures already in use at the Dental Unit of the University Hospital of Messina. The proposed workflow accounts for the many aspects of dental practitioners’ risk in the COVID-19 era, and focuses on the assessment of patient risk level, a two-phase dental procedure management (remote and face-to-face), and the use of specific preventive measures. No cases of COVID-19 infection were detected among patients and staff of the dental unit in a two-month period of time while using this protocol. This workflow seems a promising and effective solution to manage dental procedures during the COVID-19 outbreak, and could be implemented in both public and private practices until the emergency is contained. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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Review

Jump to: Editorial, Research, Other

13 pages, 2014 KiB

Open AccessReview

Perioperative Management of Antithrombotic Therapy in Patients Who Undergo Dental Procedures: A Systematic Review of the Literature and Network Meta-Analysis

by Andrea Boccatonda, Alessio Frisone, Felice Lorusso, Calogero Bugea, Maristella Di Carmine, Cosima Schiavone, Giulio Cocco, Damiano D’Ardes, Antonio Scarano and Maria Teresa Guagnano

Int. J. Environ. Res. Public Health 2023, 20(7), 5293; https://doi.org/10.3390/ijerph20075293 - 28 Mar 2023

Cited by 8 | Viewed by 3344

Abstract

Background: The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was to investigate the clinical findings of dental surgery operative management of the patients under anticoagulants drugs protocol. Methods: [...] Read more.

Background: The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was to investigate the clinical findings of dental surgery operative management of the patients under anticoagulants drugs protocol. Methods: The literature screening was performed using Pubmed/Medline, EMBASE and Cochrane library, considering only randomized clinical trials (RCTs) papers. No limitations about the publication’s period, follow-up time or clinical parameters were considered. Results: A total of eight RCTs were included for the qualitative synthesis. No thromboembolic complications were reported in any studies. Several bleeding episodes associated with anticoagulant drugs in dental surgery were mild and generally happened on the first day after the treatment. Conclusions: The use of local haemostatic measures is generally effective for bleeding control with no further pharmacological drug management or suspension. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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23 pages, 1772 KiB

Open AccessReview

The Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Systematic Review with a Pooled Analysis of Only Surgery versus Combined Protocols

by Olga Di Fede, Federica Canepa, Vera Panzarella, Rodolfo Mauceri, Carmine Del Gaizo, Alberto Bedogni, Vittorio Fusco, Pietro Tozzo, Giuseppe Pizzo, Giuseppina Campisi and Antonio Galvano

Int. J. Environ. Res. Public Health 2021, 18(16), 8432; https://doi.org/10.3390/ijerph18168432 - 10 Aug 2021

Cited by 24 | Viewed by 4604

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents, and it is also a potentially painful and debilitating condition. To date, no specific studies have prospectively evaluated the efficacy of its treatment and no robust standard [...] Read more.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents, and it is also a potentially painful and debilitating condition. To date, no specific studies have prospectively evaluated the efficacy of its treatment and no robust standard of care has been established. Therefore, a systematic review (2007–2020) with a pooled analysis was performed in order to compare MRONJ surgical techniques (conservative or aggressive) versus combined surgical procedures (surgery plus a non-invasive procedure), where 1137 patients were included in the pooled analysis. A statistically significant difference in the 6-month improvement rate, comparing combined conservative surgery versus only aggressive (91% versus 72%, p = 0.05), was observed. No significant difference regarding any group with respect to the 6-month total resolution rate (82% versus 72%) was demonstrated. Of note, conservative surgery combined with various, adjuvant, non-invasive procedures (ozone, LLLT or blood component + Nd:YAG) was found to achieve partial or full healing in all stages, with improved results and the amelioration of many variables. In conclusion, specific adjuvant treatments associated with minimally conservative surgery can be considered effective and safe in the treatment of MRONJ, although well-controlled studies are a requisite in arriving at definitive statements Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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13 pages, 577 KiB

Open AccessReview

Dental Care Access and the Elderly: What Is the Role of Teledentistry? A Systematic Review

by Luca Aquilanti, Andrea Santarelli, Marco Mascitti, Maurizio Procaccini and Giorgio Rappelli

Int. J. Environ. Res. Public Health 2020, 17(23), 9053; https://doi.org/10.3390/ijerph17239053 - 4 Dec 2020

Cited by 51 | Viewed by 7505

Abstract

A high level of unmet oral health needs is very common among elderly people. In a society that is getting older and that has been hit so hard by the coronavirus pandemic, the development of new strategies aimed at enhancing general and oral [...] Read more.

A high level of unmet oral health needs is very common among elderly people. In a society that is getting older and that has been hit so hard by the coronavirus pandemic, the development of new strategies aimed at enhancing general and oral health status should be crucial in order to promote healthy aging. The aim of this systematic review is to assess the feasibility of Teledentistry in communities or in a domiciliary setting where elderly people live. A structured and systematic research was performed on the major electronic databases for studies published in English until 30 June 2020: the PubMed, Cochrane Library, Web of Science, Scopus, and CINAHL databases. A total of 13 articles were identified through database searching using combinations of keywords. Out of 13 papers, eight abstracts were reviewed to assess if they were coherent with the aim of the study, and full texts were retrieved. After abstract reviews, seven articles were selected for closer inspection. Of these, six were assessed for eligibility. Four papers were aimed at assessing patients and health practitioners experiences about Teledentistry, three studies reported a cost analysis and cost description of Teledentistry in residential aged care facilities, and two studies investigated the feasibility and accuracy of Teledentistry for diagnosis dental pathology. The implementation of Teledentistry in residential aged care facilities and in home-assistance programs could be a viable tool for the management of oral care in people who cannot access dental care. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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13 pages, 903 KiB

Open AccessReview

The Role of Matrix Metalloproteinases in Periodontal Disease

by Vittorio Checchi, Tatjana Maravic, Pierantonio Bellini, Luigi Generali, Ugo Consolo, Lorenzo Breschi and Annalisa Mazzoni

Int. J. Environ. Res. Public Health 2020, 17(14), 4923; https://doi.org/10.3390/ijerph17144923 - 8 Jul 2020

Cited by 102 | Viewed by 9062

Abstract

This review provides a detailed description of matrix metalloproteinases (MMPs), focusing on those that are known to have critical roles in bone and periodontal disease. Periodontal disease is an inflammatory process initiated by anaerobic bacteria, which promote the host immune response in the [...] Read more.

This review provides a detailed description of matrix metalloproteinases (MMPs), focusing on those that are known to have critical roles in bone and periodontal disease. Periodontal disease is an inflammatory process initiated by anaerobic bacteria, which promote the host immune response in the form of a complex network of molecular pathways involving proinflammatory mediators such as cytokines, growth factors, and MMPs. MMPs are a family of 23 endopeptidases, collectively capable of degrading virtually all extracellular matrix (ECM) components. This study critically discusses the available research concerning the involvement of the MMPs in periodontal disease development and progression and presents possible therapeutic strategies. MMPs participate in morphogenesis, physiological tissue turnover, and pathological tissue destruction. Alterations in the regulation of MMP activity are implicated in the manifestation of oral diseases, and MMPs comprise the most important pathway in tissue destruction associated with periodontal disease. MMPs can be considered a risk factor for periodontal disease, and measurements of MMP levels may be useful markers for early detection of periodontitis and as a tool to assess prognostic follow-ups. Detection and inhibition of MMPs could, therefore, be useful in periodontal disease prevention or be an essential part of periodontal disease therapy, which, considering the huge incidence of the disease, may greatly improve oral health globally. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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30 pages, 864 KiB

Open AccessFeature PaperReview

Covid-19 Pandemic: What Changes for Dentists and Oral Medicine Experts? A Narrative Review and Novel Approaches to Infection Containment

by Maria Eleonora Bizzoca, Giuseppina Campisi and Lorenzo Lo Muzio

Int. J. Environ. Res. Public Health 2020, 17(11), 3793; https://doi.org/10.3390/ijerph17113793 - 27 May 2020

Cited by 74 | Viewed by 14604

Abstract

The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of [...] Read more.

The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (pre- vs post-COVID19) for the most common dental procedures. The outcome is forecast to help dentists to individuate for a given procedure the differences in terms of safety protocols to avoid infectious contagion (by SARS-CoV-2 and others dangerous agents). An investigation was performed on the online databases Pubmed and Scopus using a combination of free words and Medical Subject Headings (MESH) terms: “dentist” OR “oral health” AND “COVID-19” OR “SARS-CoV-2” OR “coronavirus-19”. After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The authors have highlighted the importance of knowing exactly the risk of infections in the dental practice, and to modulate correctly the use of PPE, in order to invest adequate financial resources and to avoid exposing both the dental team and patients to preventable risks. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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10 pages, 737 KiB

Open AccessReview

COVID-19 Surface Persistence: A Recent Data Summary and Its Importance for Medical and Dental Settings

by Luca Fiorillo, Gabriele Cervino, Marco Matarese, Cesare D’Amico, Giovanni Surace, Valeria Paduano, Maria Teresa Fiorillo, Antonio Moschella, Alessia La Bruna, Giovanni Luca Romano, Riccardo Laudicella, Sergio Baldari and Marco Cicciù

Int. J. Environ. Res. Public Health 2020, 17(9), 3132; https://doi.org/10.3390/ijerph17093132 - 30 Apr 2020

Cited by 136 | Viewed by 17273

Abstract

Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not [...] Read more.

Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not to be underestimated at this stage of the pandemic. The purpose of this article is to highlight all the sources currently present in the literature concerning the persistence of the different coronaviruses in the environment as well as in medical and dental settings. As this was a current study, there are still not many sources in the literature, and scientific strategies are moving towards therapy and diagnosis, rather than knowing the characteristics of the virus. Such an article could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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Other

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8 pages, 652 KiB

Open AccessBrief Report

Oral Health Problems among Canadians Aged 45 to 85: Data from the Canadian Longitudinal Study on Aging Baseline Survey (2011–2015)

by Vanessa De Rubeis, Ying Jiang, Margaret de Groh, Lisette Dufour, Annie Bronsard, Howard Morrison, Fahad Butt and Carol Walker Bassim

Int. J. Environ. Res. Public Health 2023, 20(8), 5533; https://doi.org/10.3390/ijerph20085533 - 17 Apr 2023

Cited by 1 | Viewed by 1802

Abstract

Oral health is a critical component of overall health. The objective of this study was to describe oral health problems among 47,581 adults aged 45 to 85 in the Canadian Longitudinal Study on Aging (CLSA) among those who have at least one natural [...] Read more.

Oral health is a critical component of overall health. The objective of this study was to describe oral health problems among 47,581 adults aged 45 to 85 in the Canadian Longitudinal Study on Aging (CLSA) among those who have at least one natural tooth (92%) and those without natural teeth across various demographic categories. Among the 47,581 participants in the study, 92% reported having at least one natural tooth (dentate). Among those without teeth, 63% reported an income less than CAD 50,000 versus 39% among those with teeth. Whether they had teeth or not, over 30% of people reported two or more oral health problems. Older adults appear to be retaining their natural teeth (28.9%), but still report experiencing oral health problems. As the population ages, loss of all teeth may not be the most useful proxy for poor oral health, and a population-level understanding of oral health problems may help to better define poor oral health. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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15 pages, 686 KiB

Open AccessSystematic Review

A Systematic Review on Nerve-Related Adverse Effects following Mandibular Nerve Block Anesthesia

by Luca Aquilanti, Marco Mascitti, Lucrezia Togni, Maria Contaldo, Giorgio Rappelli and Andrea Santarelli

Int. J. Environ. Res. Public Health 2022, 19(3), 1627; https://doi.org/10.3390/ijerph19031627 - 31 Jan 2022

Cited by 18 | Viewed by 9213

Abstract

Inferior alveolar nerve (IAN) block injections are commonly used in clinical practice, but they are not free from complications. The aim of the present systematic review is to assess the nerve-related adverse effects of IAN block anesthesia. A structured and systematic search was [...] Read more.

Inferior alveolar nerve (IAN) block injections are commonly used in clinical practice, but they are not free from complications. The aim of the present systematic review is to assess the nerve-related adverse effects of IAN block anesthesia. A structured and systematic search was performed on the major electronic databases (PubMed, Cochrane Library, Web of Science, Scopus and CINAHL) for studies published in English until 30 September 2021. A total of 131 articles were identified through database searching using combinations of keywords. Fifteen papers were included and assessed for eligibility. Overall, nerve damage following an IAN block anesthesia injection is a rare occurrence, probably due to the direct nerve trauma of the needle, a neurotoxic effect of the used anesthetic solution and/or a combination of them. From a medico-legal point of view, a balanced discussion prior to nerve block anesthesia should be pursued in order to avoid patients’ reluctance to undergo necessary dental treatment due to the remote eventuality of nerve injury. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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19 pages, 626 KiB

Open AccessSystematic Review

Oral Manifestations of COVID-19 in Hospitalized Patients: A Systematic Review

by Giulia Orilisi, Marco Mascitti, Lucrezia Togni, Riccardo Monterubbianesi, Vincenzo Tosco, Flavia Vitiello, Andrea Santarelli, Angelo Putignano and Giovanna Orsini

Int. J. Environ. Res. Public Health 2021, 18(23), 12511; https://doi.org/10.3390/ijerph182312511 - 27 Nov 2021

Cited by 25 | Viewed by 4668

Abstract

Background: COVID-19 disease first appeared in 2019 and quickly spread worldwide, causing a global pandemic. The oral cavity represents a target of SARS-CoV-2, and oral lesions are observed in both non-hospitalized and hospitalized patients. This systematic review aims to investigate the frequency of [...] Read more.

Background: COVID-19 disease first appeared in 2019 and quickly spread worldwide, causing a global pandemic. The oral cavity represents a target of SARS-CoV-2, and oral lesions are observed in both non-hospitalized and hospitalized patients. This systematic review aims to investigate the frequency of oral manifestations in COVID-19 hospitalized patients. Methods: An electronic search was conducted in PubMed, Scopus, and Web of Science databases, including articles published up to September 2021. The review protocol was based on PRISMA-P. The risk of bias of the studies was assessed using the Joana Briggs Institute. The certainty of evidence was assessed using the GRADE instrument. Results: Fifty-nine articles were included: 19 case reports, 17 case series, 2 case-control studies, 13 cross-sectional studies, 4 observational studies, and 4 retrospective studies. Oral ulcers, cheilitis, and tongue lesions were more common in patients before hospitalization, while perioral pressure ulcers, macroglossia, blisters, and oral candidiasis were more recurrent in patients during hospitalization. The first could be related directly to COVID-19, while the latter could be caused by medical devices, treatments, prone position, and immunological impairment. Conclusions: An accurate oral examination during the hospital admission of all confirmed COVID-19 cases is encouraged to recognize oral early manifestations and to apply appropriate treatments. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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15 pages, 910 KiB

Open AccessConference Report

by Giuseppina Campisi, Rodolfo Mauceri, Francesco Bertoldo, Giordana Bettini, Matteo Biasotto, Giuseppe Colella, Ugo Consolo, Olga Di Fede, Gianfranco Favia, Vittorio Fusco, Mario Gabriele, Antonio Lo Casto, Lorenzo Lo Muzio, Antonia Marcianò, Marco Mascitti, Marco Meleti, Michele D. Mignogna, Giacomo Oteri, Vera Panzarella, Umberto Romeo, Andrea Santarelli, Paolo Vescovi, Claudio Marchetti and Alberto Bedogni Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2020, 17(16), 5998; https://doi.org/10.3390/ijerph17165998 - 18 Aug 2020

Cited by 110 | Viewed by 11211

Abstract

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons [...] Read more.

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended. Full article

(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)

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