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The number of individuals 65 and older living in the United States is increasing substantially and becoming more racially and ethnically diverse. This shift will affect the demographics of the patient population seeking dental care. It will also impact the future treatment needs of older adults. In older adults, similar to the general adult population, oral health disparities continue to exist related to race, ethnicity, gender, and socioeconomic level. Dental practitioners must understand these changes in order to meet the challenges of providing oral health care to the increasing numbers of diverse, medically compromised, and cognitively impaired older adults.

Most oral health care providers encounter older adults in their practices and can play a critical role in supporting independence and quality of life for this aging cohort. Physiologic and structural oral cavity changes associated with normal aging may affect the presentation and oral health care of older adults. This article reviews the normative aging of dentition and oral structures and physiologic changes associated with normal aging, including cardiovascular, metabolic, and musculoskeletal changes, and how they may affect oral health. Oral health providers should be aware of normal aging processes when they plan care or schedule procedures for older adults.

BACKGROUND: Research into oral health care for older people has shown that dental care in general decreases with increasing age and frailty and, therefore, oral health care provision may be complex. The aim of this study is to identify the oral health care dentists provide to community-dwelling older people and which barriers they experience in doing this.METHODS: In this cross-sectional study, a representative sample of dentists in the Netherlands was asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to fill out a questionnaire. The relationship between experienced barriers in providing oral health care to older patients and characteristics of the dentists and the patients was studied by means univariate and multivariate logistic regression analysis.RESULTS: In total, 923 dentists were asked to participate in the study. Data were available for 39.4% dentist-patient pairs. In most cases (87.4%), oral health care was focussed on conservation of the dentition. In all, 14.0% of the dentists experienced barriers in providing oral health care for older people. Some patient factors increase the risk of experiencing barriers, eg, the more difficult behaviour of older patients and the greater disease burden.CONCLUSIONS: Oral health care was mostly focussed on conservation of the dentition, and dentists especially experience barriers in oral health provision to older patients if they are already frail.

OBJECTIVE This study aimed to investigate nurses’ perceptions of oral healthcare provision to inpatients in Japanese hospitals and the infection control measures taken by them after the coronavirus disease 2019 (COVID-19) lockdown, to promote collaborative oral healthcare in hospitals. METHOD The participants were 1,037 nurses working in inpatient wards at four hospitals in Fukuoka Prefecture, Japan. Data were collected through a questionnaire survey, approximately six months after the COVID-19 lockdown. RESULTS More than 90% of the 734 nurses participating in this study positively perceived the preventive effect of oral healthcare on aspiration pneumonia, ventilator-associated pneumonia, and viral infection. However, approximately half of them had negative perceptions about their knowledge and confidence regarding the control of COVID-19 with oral healthcare provision, and 84.7% expected to be provided with the necessary information by oral health professionals. Further, 537 nurses (73.2%) provided oral healthcare to their patients; nine nurses (1.7%) responded that those patients who received oral healthcare decreased after the lockdown; and 12 (2.4%) responded that they could no longer collaborate with oral health professionals because of the lockdown. Additionally, 41.7 % of them used neither protective glasses nor face shields even after the lockdown. CONCLUSIONS This study showed that almost all the nurses positively perceived the effect of oral healthcare on the prevention of viral infection and pneumonia. However, some nurses perceived that their oral healthcare provision and collaborative oral healthcare were negatively affected. It also showed that most nurses’ knowledge, confidence, and use of infection control measures were insufficient. This study proposes that oral health professionals should support nurses in providing oral healthcare by providing them with information on COVID-19 infection control measures to prevent infection transmission through oral healthcare.

Background: Antenatal care (ANC) providers are recommended to promote oral health care during pregnancy through the provision of oral health care practices, but studies have indicated that provider...

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

The growing demand for brilliant smile and tooth whitening has led to the increasing significance of tooth whitening methods. However, the development of tooth whitening materials with high efficiency and safety has been considered to be an urgent challenge. Here, we report a novel tooth whitening strategy, which overcomes the limitation of conventional methods, shows excellent tooth whitening efficiency and safety, and even exhibits outstanding antibacterial activity. Inspired by stomata and chloroplasts in green leaves, we have developed an integrated two-phase free radical hydrogel (TP-GEL), which integrates solid-phase and liquid-phase free radical functional components fabricated by cold plasma technology. TP-GEL demonstrated safe and ultrafast tooth-whitening effect with or without visible light, which can be more significant than that of 30% H2O2, the commonly whitening material in dental clinical practice. More importantly, we also avoid the damage to enamel, such as microhardness, roughness, surface morphology. Benefiting from free radicals, much higher antibacterial properties than commercial products (Chlorhexidine) was obtained. This research provides fundamental design criteria for the development of dual functional oral health care materials with advanced tooth whitening and antibacterial activity.

Various factors were believed to play an important role and were closely related to the risk of Early Childhood Caries (ECC), including daily oral hygiene behavior. Oral hygiene of children under 2 years is very dependent on their parents, especially mothers or caregivers. This study revealed the prevalence of ECC and its related to children's oral hygiene behavior after 9 months of observation. A total of 60 caries-free children (deft= 0) under two y.o were observed for 9 months. Without prior dental education regarding oral health care, all subjects were observed for their oral hygiene behavior. The questionnaires were given at the beginning and at the end of the observation and recording the final deft score. After 9 months later, from 60 caries-free children, 19 (31.6%) study subjects were exposed to ECC with a deft average score of 2+2. Oral hygiene behavior related to ECC prevalence in this study (p0.05). In conclusion, the prevalence of ECC was related to poor oral hygiene behavior

BACKGROUND. Oral health has been connected to worse outcomes among hospitalized patients, but access to oral health care services in the hospital setting is limited. It is unknown how a hospital admission affects subsequent dental services use. METHODS. The authors conducted a retrospective analysis of insurance claims data from a national private insurer. Patients were included if they were admitted to the hospital and had visited a dentist at least once in the year before or after admission. Total number of dental visits, as well as Code on Dental Procedures and Nomenclature codes associated with these visits in the year before and after a hospital stay, patient demographic characteristics, hospital admission diagnosis, and length of stay were recorded. Differences in dental services use before and after the hospital stay were calculated. RESULTS. In total, 107,116 patients met inclusion criteria. There were fewer dental visits after admission (mean [standard deviation {SD}] 1.6 [1.7] than before admission (mean [SD] 1.9 [1.8]; P < .0001). Fewer procedures were recorded in the year after discharge (mean [SD] 7.0 [11.4] total Code on Dental Procedures and Nomenclature codes versus 8.5 [12.5] in the year before admission; P < .0001). The number of diagnostic and restorative services delivered was higher after admission, and the number of periodontic, endodontic, oral surgery, and prosthodontic services decreased (overall Pearson χ(2), P < .0001). CONCLUSIONS. Patients are less likely to visit a dentist after a hospital stay, although impact on oral health is unknown. PRACTICAL IMPLICATIONS. Hospitalization may contribute to already existing oral health disparities. Hospital teams and dentists should work together to enhance access to oral health care after hospital admission.

Background Pandemics have significantly modified our societal behaviour over the millennia, and the COVID-19 pandemic is no exception. Types of articles reviewed In this article, the authors review the history of pandemics, the probable reasons for their emergence, and the COVID-19 pandemic due to the severe acute respiratory syndrome virus 2 (SARS-CoV-2) and its variants, as well as its possible impact on dentistry during the postpandemic period. Results There are multiple reasons why catastrophic pandemics occur due to new infectious organisms that cross the species barrier from animals to humans. These include, population explosion, mass migration, and prolonged survival of debilitated and susceptible cohorts on various immunosuppressants. Coupled with global warming and the resultant loss of habitats, such vicissitudes of humans and nature lead to microbes evolving and mutating at an exponential pace, paving the way for pandemics. The contemporary epidemics and pandemics beginning with the HIV pandemic have modulated dentistry beyond recognition, now with assiduous and robust infection control measures in place. Conclusions and practical implications Because COVID-19 may become an endemic disease, particularly due to emerging SARS-CoV-2 variants the dental community should adopt modified infection control measures, teledentistry, and point-of-care diagnostics, among other measures. It is likely, that clinical ecosystems in future would be rendered even safer by predicting how pathogens evolve and priming the human immune system for the next wave of microbial combatants through vaccines produced using deep mutational scanning in which artificial intelligence and machine learning can predict the next variants even before their arrival.

OBJECTIVES: The aim of this research is to gain more insight in the methods and experiences of dental hygienists in the Netherlands regarding the treatment of patients with halitosis. MATERIAL AND METHODS: A total of 92 dental hygienists completed the questionnaire (consisting of 19 questions on personal and professional characteristics, clinical observation and treatment of halitosis, the referral of patients with halitosis, the presence and usefulness of a protocol). The questionnaire was distributed using a social media platform for dental professionals in oral health care from all over the Netherlands. RESULTS: 83.4% of 90 dental hygienists had paid attention to the patient's breath but only 37.8% of dental hygienists always informed the patient. Reasons for not informing patients were the fear of the patient's possible reaction or because other oral health problems were more important. Of the included dental hygienists 67.8% had never referred a patient for treatment of halitosis. 86.7% of the dental hygienists stated there was no protocol for diagnosis and treatment of patients with halitosis. However, 90.0% of the dental hygienists acknowledged a protocol would be useful. CONCLUSIONS: The majority of the dental hygienists in the Netherlands had paid attention to the patient's breath, but only a small group of dental hygienists informed their patients about halitosis. In dental practices halitosis is an underestimated problem. During the coronavirus pandemic people are more aware with the smell of their breath. Dental hygienists indicated scaling and root planning and/or providing information and instruction by patients with a bad breath.

The 17 sustainable development goals (SDGs) were established by the United Nations Agenda 2030 plan of action to achieve peace, prosperity, and well-being for all by 2030. SDG 3 aims to ensure healthy lives and promote well-being for all at all ages. However, oral health is not specifically mentioned and targeted in SDG 3. Numerous studies have demonstrated a connection between oral health and general health. Oral disease and the common non-communicable diseases have the co-existing modifying risk factors. In addition, oral health is associated with social, economic, cultural, and environmental problems. By the implementation of oral health care, oral health promotion, and universal health coverage, these could not only be good for oral health but also benefit for general health and well-being. Taken together, oral health is the first step to SDG 3.

OBJECTIVES To assess community pharmacists' knowledge, attitude and practice towards oral health care in Asir region, Saudi Arabia. METHODS A prospective cross-sectional study was carried out using a self-administered structured questionnaire, targeting 254 community pharmacies across the Asir region. The questionnaire consisted of four domains: demographics, knowledge, attitudes and practice related to oral health care. Statistical analysis was performed using Social Sciences (SPSS) version 23.0. RESULTS Of the 254 pharmacists, 202 respondents completed the survey, yielding a response rate of 79.5%. Almost two-thirds (66%) of the community pharmacists exhibited good knowledge, 65% possessed a positive attitude, and 55% perceived a good practice towards oral health care. Pharmacists have shown a good understanding on dental care (p

Pregnancy marks a unique milestone in woman’s life cycle enriched with an array of physical, psychological, social and even spiritual needs. In this context, an optimal level of oral health status has become fundamental to overall health and well-being of a pregnant woman. This is evident more than ever before, for preventing exacerbation of poor oral health in pregnancy, possible control of adverse pregnancy outcomes whilst ensuring low risk for early childhood dental caries for the offspring. Nevertheless, pregnancy renders special oral health needs for a woman compounded by changes in dietary habits, oral hygiene practices and hormonal changes thereby increasing the risk of dental caries and periodontitis. The possible link between Periodontitis and adverse outcomes in pregnancy is well known. The pandemic caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compounded by emergence more virulent strains not only indelibly impacted on population, countries, economies and health systems across the globe but exposed vulnerable population groups to pervasive health catastrophes. There is accumulating concerns on periodontitis linking with severe complications of Covid-19 attributed to commonalities of exacerbated inflammatory responses. Moreover, adverse Covid-19 induced maternal and fetal outcomes has garnered attention of researchers based on the previous knowledge indicating adverse outcomes attributed to epidemics of human corona viruses. However, it is not known how maternal oral hygiene status and burden of periodontitis impact on Covid-19 induced adverse outcomes in pregnancy. However, it could be rational to argue that poor oral health of a pregnant woman could elevate her risks for adverse health outcomes. Oral health care in pregnancy has received recognition as an essential element of comprehensive antenatal health care provision. However, the persistent global public health emergency of Covid-19 has profoundly impacted on availability of and accessibility to routine oral health care services. Therefore, accessing routine oral health care services poses serious causes for concern among pregnant women. Against this backdrop, present opinion attempts to explore and expound the potential of preventive oral health care could offer to mitigate the potential risks of Covid-19 induced adverse maternal outcomes embracing the context of Sri Lanka: a developing lower middle-income country.

OBJECTIVES The aim of this study was to update the much-cited knowledge, published over half a century ago, of the age of eruption of the third molar in the Finnish population. METHODS The study followed a retrospective and cross-sectional protocol and included 710 digital panoramic radiographs of patients (49.3% men, 50.7% women) aged 15-23 years visiting the public oral health care services of the City of Helsinki in 2015. Age and sex of the subjects were recorded. The radiographs were examined for inclination of the third molars in both jaws and vertically located teeth were further classified into four stages of eruption: (A) in bone, (B) alveolar emergence, (C) gingival emergence, and (D) complete emergence. Statistics included chi-squared, Mann-Whitney U, and median tests. RESULTS Of altogether 2502 third molars, 53.0% (n = 1325) were in vertical position. The median age of gingival emergence (stage C) of the third molar varied between 19.8 and 20.8 years, and the median age of reaching the occlusal level (stage D) between 20.8 and 21.8 years depending on sex and the jaw. CONCLUSION The median ages for the third molar to pierce the gum were lower than reported over half a century ago.

The COVID-19 has spread throughout the world since December 2019 and brought the delivery of the oral health facilities to a standstill. Customization of oral health care guidelines during the COVID-19 pandemic at the dental division of a tertiary health care setup in India. Existing literature was searched regarding any available information regarding oral health care guidelines at the tertiary health care set up. Further, various health regulatory authorities' websites were searched for guidelines related to COVID-19 and patient management and infection control. Adhering to the health regulatory protocols for COVID-19, a total of 24548 patients were provided with dental consultations and various dental procedures, including teeth extraction, orthodontic interventions, teeth restoration, root canal treatment, and oral prophylaxis, major and minor oro-maxillofacial surgeries from April 1, 2020, to August 31, 2021. Emphasis was on providing a safe working environment to the oral health care team and the patient. None of the members of the dental health team became positive for COVID-19 during the study. On the basis of our experience, we highlight that it is very much possible to efficiently and effectively treat the patients which oral health care during and post-COVID-19 pandemic. Frequent change in the guidelines regarding COVID-19 infection by various authorities, so keeping an eye on the same is also advised because various aspects of COVID-19 infection are yet to be confirmed and brought to the light. In our setup, patient satisfaction was good among the treated patient, and they applauded the efforts put by our team.

This mixed methods study explored the oral health–related knowledge, attitudes, and practice patterns of nurse practitioners (NPs) in Canada. The survey was sent to all NPs across Canada (N = 4,540); 153 respondents (3.4% response rate) completed the online survey, and 4 respondents were subsequently selected to participate in qualitative, semistructured interviews. NPs believe that they have a role in oral health care and are motivated to include oral health into their practice. However, a lack of knowledge and skills, likely caused by gaps in education and training, is limiting their ability to do so with confidence.

Lymphomas are the second most common malignancy in the oral cavity after squamous cell carcinoma. Non-specific clinical presentation of lymphoma mimics the other common oral pathologies thereby; delaying its diagnosis, ensuing definitive treatment, and leading to a guarded prognosis. The present clinical review and accompanying case report highlights the clinical presentation, diagnostic challenges, progression, manifestations, and holistic management of a rare extra-nodal, nasal variant of Natural Killer T-cell lymphoma and underscores the importance of interdisciplinary coordination in the overall management of this aggressive tumor.

Background Older people are encouraged to remain community dwelling, even when they become care-dependent. Not every dental practice is prepared or able to provide care to community-dwelling frail older people, while their ability to maintain oral health and to visit a dentist is decreasing, amongst others due to multiple chronic diseases and/or mobility problems. The public oral health project ‘Don’t forget the mouth! (DFTM!) aimed to improve the oral health of this population, by means of early recognition of decreased oral health as well as by establishing interprofessional care. A process evaluation was designed to scientifically evaluate the implementation of this project. Methods The project was implemented in 14 towns in The Netherlands. In each town, health care professionals from a general practice, a dental practice, and a homecare organization participated. The process evaluation framework focused on fidelity, dose, adaptation, and reach. Each of the items were examined on levels of implementation: macro-level, meso-level, and micro-level. Mixed methods (i.e., quantitative and qualitative methods) were used for data collection. Results The experiences of 50 health care professionals were evaluated with questionnaires, 22 semi-structured interviews were conducted, and the oral health of 407 community-dwelling frail older people was assessed. On each level of implementation, oral health care was integrated in the daily routine. On macro-level, education was planned (dose, adaption), and dental practices organized home visits (adaption). On meso-level, health care professionals attended meetings of the project (fidelity), worked interprofessionally, and used a screening-referral tool of the project DFTM! in daily practice (dose, adaption, reach). On micro-level, the frail older people participated in the screening of oral health (fidelity, dose), had their daily oral hygiene care observed (adaption) and supported if necessary, and some had themselves referred to a dental practice (reach). The semi-structured interviews also showed that the project increased the oral health awareness amongst health care professionals. Conclusions The project DFTM! was, in general, implemented and delivered as planned. Factors that contributed positively to the implementation were identified. With large-scale implementation, attention is needed regarding the poor accessibility of the oral health care professional, financial issues, and increased work pressure. Trial registration The Netherlands Trial Register NTR6159, registration done on December 13th 2016. URL: https://www.trialregister.nl/trial/6028

Background: The aim of these two (pre COVID-19 pandemic) public health studies in Amsterdam were to promote the profession of the oral hygienist and to increase oral health care awareness among (pregnant) women and young mothers, who were visitors of public consumer’s exhibitions. Methods: Two cross-sectional studies were carried out. In 2018, during the first study, 1,765 visitors of the Household Fair completed a questionnaire. In 2020, during Study 2, 304 visitors of the Nine-Month Fair completed a semi-structured online questionnaire. At both fairs a team of ‘outspoken’ oral hygienists, i.e., members of the Foundation ‘Goed Gebekt’, provided the visitors with tailored advices about general health related to adults, mothers’, and their children’ oral health, using natural routine interviewing, that was based on their own professional daily practical experience. Results: In Study 1, just over half (53.5%) of a total of 1,742 visitors, (85.7% female) was younger than 45 years old. In Study 2, 210 visitors with a mean age of 30.7 years were included. Most women reported their self-perceived oral health as ‘good’ (mean=8.0, standard deviation=1.3; range 3∼10). Qualified (self) employed oral hygienists seem to be known among the visitors, but still only visited upon referral of the dentists. Up to the age of 18 reimbursements by the basic insurance is still unknown to the public. Conclusion: The Foundation ‘Goed Gebekt’ encourages other oral hygienists to make their own initiatives and experiences public and to share it. Public awareness is needed for oral health promotion and the development of optimally targeted interventions among (pregnant) women and young mothers by oral hygienists.

Patients affected with microcephaly have a head circumference below the average for sex and age, and in most cases it is associated with altered brain structure, developmental problems and dysmorphic facial features. Thus, the objective of this study was to describe the therapeutic approaches for dental care of patients with microcephaly. The selection of scientific articles for the study construction was carried out through the databases Scielo, Medline, Bireme and PubMed with a total selection of 16 scientific articles with years of cut-off between 2010 to 2019. Microcephaly affects not only the patient’s general health status, but also dental care, which is hampered by the small number of professionals qualified to care for special patients and the little knowledge of the craniofacial and dental characteristics of these individuals. In most cases, the dental surgeon is unprepared and insecure before these patients, which is hampered by the little knowledge they have of their main oral and craniofacial characteristics. Thus, the professional is unable to determine clinical procedures to be performed. Thus, it can be concluded that it is necessary for the dentist to have knowledge about microcephaly and provide instruction to the children’s parents and guardians in this condition, thus facilitating the dental procedures execution.Keywords: Disabled Persons. Dental Care for Disabled. Oral Pathology.ResumoOs pacientes acometidos com microcefalia possuem um perímetro cefálico inferior à média para o sexo e idade, e na maioria dos casos está associado à estrutura cerebral alterada, problemas de desenvolvimento e características faciais dismórficas. Sendo assim, o objetivo deste trabalho foi descrever as condutas terapêuticas para atendimento odontológico de pacientes com microcefalia. A seleção dos artigos científicos para construção do trabalho foi realizada por meio de bases de dados Scielo, Medline, Bireme e PubMed, com seleção total de 16 artigos científicos com anos de corte entre 2010 a 2019. A microcefalia afeta não apenas o estado de saúde geral do paciente, mas também o atendimento odontológico, que se torna dificultado devido ao pequeno número de profissionais habilitados para o atendimento a pacientes especiais e ao pouco conhecimento das características craniofaciais e dentárias desses indivíduos. Na maioria dos casos, o cirurgião-dentista encontra-se despreparado e inseguro diante desses pacientes, o que é dificultado pelo pouco conhecimento acerca das principais características bucais e craniofaciais. Com isso, o profissional fica impossibilitado na determinação de procedimentos clínicos a serem realizados. Desta forma pode-se concluir que é necessário ao cirurgião-dentista um conhecimento sobre a microcefalia e proporcionar instrução aos pais e responsáveis pelas crianças nesta condição, facilitando assim a execução dos procedimentos odontológicos. Palavras-chave: Pessoas com Deficiência. Assistência Odontológica para Pessoas com Deficiências. Patologia Bucal.

This study aimed to assess mothers’ oral health-related knowledge and practices in immediate and late puerperium, and in the child’s first year of life. This study is a prospective cohort study, in which data were collected from 358 mothers of children born between 2013 and 2014, in immediate and late puerperium, and in children’s first year of life, by interviews with sociodemographic characterization and oral health questionnaires, and were analyzed by descriptive statistics and Chi-square test (α = 5%). Participants were mainly aged 20 to 29 years (53.9%), with 7 to 11 years of education (67.6%), from low social class (72.3%), unemployed (58.9%), married or in common-law marriage (84.1%), with more than one child (60.1%). Although 51.7% of them had received information about children’s oral health, only 0.8%, 32.4% and 13.7%, respectively, knew the concept, etiology and preventive attitudes regarding dental caries. Mothers aged under 20 and over 30 years, with lower education and from low social class presented significantly lower oral health-related knowledge. At children’s first year of life, although 78.7% of the children had already been taken to the dentist, half of them had already tasted sugary foods and drinks. It is highlighted the social determination and the need of an improvement of mothers’ oral health related knowledge and practices. Educational actions, especially in prenatal programs, are important to achieve this improvement and to decrease early childhood caries rates.Keywords: Dental Caries. Child. Health Knowledge Attitudes, Practice. Parents. Oral Health.ResumoAvaliar o conhecimento e as práticas de mães sobre a saúde bucal de seus filhos no puerpério imediato, tardio, e no primeiro ano de vida da criança. Trata-se de um estudo de coorte prospectiva, no qual os dados foram coletados de 358 mães de bebês nascidos entre 2013 e 2014, no puerpério imediato, tardio e um ano após o parto, por entrevistas com perguntas sobre dados sociodemográficos e sobre saúde bucal. Os dados foram analisados por estatísticas descritivas e pelo teste Qui-quadrado (α = 5%). As participantes apresentavam, majoritariamente, idades entre 20 a 29 anos (53,9%), com 7 a 11 anos de estudo (67,6%), eram de baixa classe social (72,3%), desempregadas (58,9%), casadas ou em união estável (84,1%), e tinham mais de um filho (60,1%). Apesar de 51.7% delas afirmarem ter recebido informações sobre saúde bucal infantil, apenas 0,8%, 32,4% e 13,7%, respectivamente, sabiam o conceito, etiologia e as atitudes preventivas à cárie. Mães com idades abaixo de 20 e acima de 29 anos apresentaram menor conhecimento sobre saúde bucal do que as demais. No primeiro ano de vida, apesar de 78,7% das crianças já terem ido ao dentista, metade delas já havia experimentado alimentos e bebidas açucarados. Destaca-se a determinação social e a necessidade de melhora no conhecimento e práticas das mães sobre saúde bucal. Ações educativas, especialmente em programas de atenção pré-natal, são importantes para atingir essa melhora e, consequentemente, diminuir as taxas da cárie na primeira infância. Palavras-chave: Cárie Dentária. Criança. Conhecimentos, Atitudes e Práticas em Saúde. Pais. Saúde Bucal.

Aim: The lack of knowledge and stress towards COVID-19 can lead to unfavorable dentist’s attitude towards the practice making them reluctant and fearful in dental operatory. The purpose of this cross-sectional study was to assess the knowledge, attitude and perceived stress among dental practitioners during current COVID-19 outbreak. Materials and Methods: In this study, a total of 459 dental practitioners involving both general practitioners and specialists from different types of practice completed a questionnaire for assessment of knowledge and attitude towards COVID-19 and stress perceived by them. The association of perceived stress for gender, age, designation and type of practice was analyzed using Chi-square tests with Statistical significance set at 5% level. Results: Total of 459 individuals participated in study with 51.0% males and 49.0% females, of them 54.7% were specialists and 45.31% general dental practitioners, working at different types of practices. More than 90% were aware of mode of transmission and were following current guidelines. Similar results were observed for attitude towards COVID-19. Majority of participants had total PSS scores in the study sample ranged from 0-38, with total mean scores of 17.08 (±7.8), Men demonstrated significantly lower values PSS scores when compared to females (p Conclusions: Covid-19 pandemic has led to increased level of stress among dental practitioner’s despite of possessing high level of knowledge and positive attitude. Keywords: COVID-19. Perceived stress. Knowledge. Dental Practitioners.

Introduction and Aim: Toothpastes are the most common preventive means in oral health care. Many commercially available dentifrices claim to have antimicrobial properties, but little research has been conducted to investigate these claims. Therefore, this study was conducted to evaluate the efficacy of different toothpaste formulations in reducing the oral microbial load. Methodology: A total of six types of tooth pastes-4 herbal and 2 non-herbal- were assigned to a group of 20 subjects each, who used it for a period of six weeks. During the course of the study, at the end of 1st, 3rd and 6th week, subgingival plaque samples collected were subjected to microbial analysis. Results: Microbial analysis identified colonies of organisms such as S. mitis, S. mutans, S. salivarius, Peptostreptococcus species, Prevotella species and Lactobacillus species. Colony forming units (cfu) calculated indicated a reduction in microbial load from 1st to 6th week of use of different tooth paste formulations. However statistical analysis of the results did not show significant differences between the groups (p>0.005). Conclusion: The selected tooth paste formulations were effective in controlling the microbial load and therefore contributing to maintain good oral hygiene. However, practicing appropriate oral hygiene measures & brushing technique is of utmost importance in maintaining good oral health than the effectiveness of various ingredients in the toothpastes used.

Background Oral health care use remains low among adult Medicaid recipients, despite the Patient Protection and Affordable Care Act's expansion increasing access to care in many states. It remains unclear the extent to which low use reflects either low demand for care or barriers to accessing care. The authors aimed to examine factors associated with low oral health care use among adults enrolled in Medicaid. Methods The authors conducted a survey from May through September 2018 among able-bodied (n = 9,363) Medicaid recipients who were aged 19 through 65 years and nondisabled childless adults in Kentucky. The survey included questions on perceived oral health care use. Semistructured interviews were also conducted from May through November 2018 among a subset of participants (n = 127). Results More than one-third (37.8%) of respondents reported fair or poor oral health, compared with 26.2% who reported fair or poor physical health. Although 47.6% of respondents indicated needing oral health care in the past 6 months, only one-half of this group reported receiving all of the care they needed. Self-reported barriers included lack of coverage for needed services and lack of access to care (for example, low provider availability and transportation difficulties). Conclusions Low rates of oral health care use can be attributed to a subset of the study population having low demand and another subset facing barriers to accessing care. Although Medicaid-covered services might be adequate for beneficiaries with good oral health, those with advanced dental diseases and a history of irregular care might benefit from coverage for more extensive restorative services. Practical Implications These results can inform dentists and policy makers about how to design effective interventions and policies to improve oral health care use and oral health outcomes.

Objectives: Good oral heath not only promotes an individual to look and feel good, it also helps in preserving oral functions. The study was carried out to assess oral health knowledge and practices, attitudes as well as their oral hygiene habits among university students in the UAE. Method: A structured and revised questionnaire was distributed to 300 university students that were randomly sampled from the selected universities of the UAE. The questionnaires were answered anonymously by the students and paper consisted of questions to study and assess the prevalence of oral diseases amongst these students. The answers were then subjected to statistical analysis to determine if there is a significant correlation between oral health knowledge and attitude. Results: Data showed a positive correlation with a Pearson coefficient value of 0.4 given at a positive gradient when plotted as a linear graph. The students had good knowledge on the basic oral health measures but still students had poor oral health practices they brush their teeth once daily and brushed for less than the optimal time of two minutes. Lack of time and cost were reported to be the most common causes that prevented visiting the dental clinic. While some students reported no importance to visit the dentist if there is any pain as the second most common reason. Conclusion: Students had good knowledge on the basic oral health measures but efforts towards spreading proper dental education is very important to minimize and prevent the escalation of oral diseases that may develop due to lack of correct dental knowledge. Oral health education programs should be conducted with reinforcement to close the gap between knowledge and practice.

Infant oral health care is essential in a way where it provides a solid foundation on which a healthy oral environment is augmented. Dental caries is perhaps the most infectious and prevalent disease seen in the current scenario. Dental caries is 5 times more common than asthma and 7 times more common than hay fever in children. Rotten primary teeth can influence kids' development, lead to malocclusion, and result in huge torment and possibly perilous swelling. To forestall caries in youngsters, high-risk individuals should be distinguished at an early age (ideally high-risk moms during pre-birth care), and aggressive strategies ought to be received, such as anticipatory guidance, behaviour modifications (oral cleanliness and taking care of practices). On establishment of Dental Home, mothers should be told about preventive measures to take during teething of infants and how to administer oral care and proper cleaning of teeth.

Objective The objective of this study was to investigate the effect of an interprofessional oral hygiene support program for elderly inpatients and the perception of caregivers of the elderly towards oral health care. Materials and methods Participants comprised 37 elderly inpatients requiring nursing care (17 males, 20 females; mean age, 83.3 ± 4.9 years) and 29 registered nurses who participated in the interprofessional oral health care support program as a caregiver (4 males, 25 females; mean age, 45.2 ± 10.3 years). In this program, inpatients received daily oral cleaning by registered nurses based on each patient's oral health care plan. The number of microbes on the tongue surface of the inpatients was measured once a week for 12 weeks. Additionally, as an investigation of the perception of the caregivers towards oral health care, a questionnaire about the required frequency and duration for oral cleaning was conducted with registered nurses before and after the program to investigate the perception of the caregivers towards oral health care. Results Significant differences were observed in the number of microbes on the tongue surface between baseline and at every measurement after the beginning of this program, except for the first week. The mean required frequency and duration for oral cleaning by registered nurses at baseline were 1.5 ± 0.8 times and 3.8 ± 2.2 minutes, whereas those after the program were 2.7 ± 0.7 times and 5.8 ± 2.9 minutes, respectively. Conclusion Implementation of the program decreased the number of microbes on the tongue surface of the elderly inpatients and improved the perception of their caregivers towards oral health care.

Objective: Undocumented migrants in Europe face multiple barriers in access to oral health care. This study aimed to explore the accessibility of a voluntary dental network providing dental treatments to undocumented migrants in the Netherlands, from the perspectives of patients, dentists and staff members of nongovernmental organizations involved. Methods: This qualitative study used semi-structured interviews (n = 21) with undocumented migrants (n = 12), dentists (n = 7) and staff members of nongovernmental organizations (n = 2) during the implementation of a voluntary dental network. Interviews were analysed using a framework analysis method. Results: As a temporary answer to problems in access to oral health for undocumented migrants, the voluntary dental network targeted initial barriers to dental care. Main challenges within the network were conflicting expectations and perceived treatment outcomes by patients, dentist and NGO staff members, limited financial resources, logistic and communication barriers and an increasing administrative burden. Furthermore, feelings of compassion for and trust of the patient affected the ethics of the professional relationship and influenced treatment decisions of dentists. Conclusion: Through the implementation of a voluntary dental network, treatments could be provided to undocumented migrants as a temporary solution. However, the voluntary nature of dental care in the network resulted in a fragmented provision of oral health care among undocumented migrants. To reduce inequalities in oral health on the long term, systemic barriers in access to oral health care need to be addressed.

Infant oral health is one of the most overlooked aspects when it comes to the oral well -being of a child because many do not consider it to be of much significance. This is generally due to the misconception that children do not have teeth during this phase which leads to the conclusion that focus could be on other developmental aspects. There is also a deficit in the education of parents and family members. Knowledge of mothers is of extreme importance because they need to be well aware that a child's first dental visit should be between 6 - 12 months of age to maximize the preventive potential of fluorides, health literacy and dietary modifications. Oral health, when integrated into primary medical care, can result in improved outcomes for children. A simple message of fluoride adequacy, dietary control of bottle use and sweet intake, oral hygiene, and regular dental visits cross professional barriers. This literature review aims to give mothers and family members access to information so that we can optimise the oral health of the infant. KEY WORDS Infant Oral Health, Knowledge, Attitude and Practice of Mothers, Anticipatory Guidance, Early Childhood caries.

Background: Despite evidence-based guidelines advocating for the provision of oral health care throughout pregnancy, dentists remain hesitant to provide dental treatment for pregnant women. However, little is known about attitudes toward treating pregnant women among dental school faculty, who may transmit their attitudes and treatment preferences to their students. Methods: We collected cross-sectional survey data at the New York University College of Dentistry, which produces 10% of all US dentists and is the largest US dental school, to understand faculty attitudes and knowledge regarding providing dental treatment to pregnant women. This study was part of an educational effort to improve dental care access by pregnant women and to examine what factors influence willingness to treat pregnant patients among dental faculty members. Results: We found that concerns about professional liability outweighed inadequate knowledge regarding treatment of pregnant patients in determining dental faculty’s willingness to treat pregnant women. Conclusions: Educational interventions delivered to dental faculty regarding current dental treatment guidelines for pregnant women may not be sufficient to increase faculty’s provision of dental care to women during pregnancy. Future work to design effective interventions to increase dental treatment of pregnant women among dental faculty should address liability concerns. Knowledge Transfer Statement Interventions addressing dental clinician and faculty knowledge about dental treatment for pregnant women may be insufficient to increase dental treatment among pregnant women. Instead, policy makers should consider designing, implementing, and evaluating interventions addressing malpractice and liability concerns.

BACKGROUND: As part of a larger study, the Crossroads-II Dental sub-study determined the patterns of, and barriers to, oral health care service utilization in a rural area of Victoria. METHODS: In this cross-sectional sub-study predisposing, enabling, needs-related, and oral health variables were considered in association with patterns of oral health care utilization. A logistic regression was performed to explain the use of oral health care services. RESULTS: Overall, 574 adults participated, with 50.9% reporting having visited an oral health care service in the previous 12 months. Age, number of chronic health conditions and holding a health card; were associated with increased visit to a dentist (OR = 1.01; 95% CI: 1.00-1.03; OR = 1.08; 95% CI: 1.01-1.16; OR = 2.06; 95% CI: 1.26-3.36, respectively). Perceived barriers to care and number of missing teeth decreased the odds of using services (OR = 0.46; 95% CI: 0.36-0.58; OR = 0.95; 95% CI: 0.92-0.98, respectively). CONCLUSIONS: Results suggest that use of oral health care services is associated with a range of financial, educational, health and structural barriers. Increasing the use of oral health care services in rural populations requires additional efforts beyond the reduction of financial barriers.

AIM The aim of this study was to design, implement, and to evaluate the success of an oral health care programme specially designed for visually impaired children over a 12-month period. DESIGN A structured questionnaire collected information regarding oral health knowledge and practices of the study population. A specially designed oral health education programme was conducted for the children and their teachers and reinforced after 1, 3, 6, 9, and 12 months. The oral health status of the children was assessed and scored at baseline examination and after each follow-up visit. Independent t-test and paired t-test were used for comparison of scores. Spearman's correlation test was used to measure the correlation between knowledge and practices scores with oral hygiene status. RESULTS The study population (5-16 years) had good knowledge about oral health which, however, did not translate into everyday practices. The overall oral hygiene scores declined from 2.06 ± 1.20 at the preliminary examination to 1.24 ± 0.79 at the end of 12 months (p

Background/purpose Oral health care provision in long-term care settings is often limited by specific behaviors exhibited by residents, which may be interpreted as a refusal of care. Such behaviors can be attributed to oral tactile hypersensitivity (TH), which is characterized by aberrations in the perception of oral stimuli. TH is also associated with a decline in ingestion and swallowing function. The purpose of this study was to examine the effectiveness of a technique for mitigating TH (TMH) among institutionalized older persons. Materials and methods In this study, 18 institutionalized older persons (Mean age, 90.6 ± 4.5 years; 92.9% females) with TH were randomized to a control group or an intervention group. Pre- and post-intervention assessments were conducted for seven participants in each group. Routine oral care was provided by the facility's staff in both groups. TMH in the intervention group was performed by a dental hygienist over a 3-month period. Results In the intervention group, the number of areas with TH was significantly reduced (P = 0.027). No significant change was observed in the control group. Conclusion The results of this study suggest that TMH can effectively mitigate TH. Our findings provide clinicians with an additional treatment option for hypersensitivity in older patients. Additional long-term studies with larger sample sizes are required to confirm the effectiveness of this technique.

OBJECTIVES Institutions with a positive cultural climate make community members from all backgrounds valued and included, and treated equitably. Such an environment is optimally suited to prepare future dentists well for leading a diverse team of staff members and addressing the oral health care needs of increasingly more diverse patient populations. The objectives were to assess how many United States and Canadian dental schools had participated in a climate study at their parent institution and/or had conducted their own climate study, which topics these studies had addressed, how they collected their data, from whom they collected data, and how the findings affected these academic units. METHODS In January 2020, 54 of the 78 dental school deans in the United States and Canada responded to a web-based survey (response rate: 69%). RESULTS Forty-six parent institutions (85%) and 27 dental schools (50%) had conducted climate studies. Eighty-seven percent of parent institutions assessed the climate overall and the climate for specific groups (70%), such as for persons from underrepresented minority backgrounds (67%) or different religious backgrounds (59%). Most parent institution and dental school studies utilized surveys to collect data from faculty (parent institutions: 76%/dental schools: 96%), staff (74%/93%), administrators (72%/93%), and students (72%/89%). Overall, climate study results positively affected parent institutions' and dental schools' humanistic environment (61%/63%) and the recruitment of faculty (46%/50%), students (46%/46%), and staff (41%/43%). CONCLUSIONS Climate studies are a widely accepted practice at dental schools and their parent institutions. Their results can play a vital role in shaping the climate of these academic units by fostering efforts to increase diversity, equity, and inclusion.

Objective The aim was to investigate how leading dentists and their superiors view oral health care quality, as they are in key positions to pursue high-quality care. Materials and methods We interviewed five leading dentists and three of their superiors from Southern Finland via semi-structured telephone interviews including themes based on the Institute of Medicine's six quality dimensions. The material was analysed using theory-driven content analysis. Results Participants divided safety into occupational, instrumental and patient safety and considered timeliness as timing treatment clinically correctly. They also linked timeliness to patient-centeredness with wider opening-hours and quick access to care. Effective care was considered as a prerequisite for efficiency. Participants saw effectiveness as treating the illness, not the number of treatment measures. Leading dentists took survival time of fillings and cost per operation as a measurement of efficiency, and the superiors measured efficiency by the number of treated patients or visits. The leading dentists considered the equal treatment of patients, whereas the superiors took the amount of care provided with public resources and co-workers into consideration. Conclusions The participants shared similar views of oral health care quality which should enable cooperation. Observed minor differences relate to professional background and leading positions.

Background Tooth loss, systemic diseases and medications add to the complexity of the oral conditions in geriatric popuation, making this age group a special group in need of specific preventive and curative oral health care. Therefore, the dental teams need to be equipped with specific knowledge and skills to provide the appropriate dental care. This study was iaimed to assess the knowledge, attitude, practice and willingness of general dentists to provide dental care to geriatric patients. Methods This cross-sectional study was conducted on 231 dentists using a questionnaire including demographic characteristics, knowledge, attitude and practice sections. The availability of the facilities for providing services to the older people in the office was also evaluated. Data were fed into SPSS-22 and analysed using descriptive statistics, t-test, Chi-squared, ANOVA and correlation coefficient tests (α = 0.05). Results 62.8% of the participants were women and their mean age was 34. 4±8. 1 years. The knowledge mean score was 13.3± 2.9 (out of 30). 86. 5% of the participants had moderate knowledge, and 2.6% displayed good knowledge. The mean score related to the attitudes toward geriatric was 55.8 ± 6. 1 (out of 85), which was not significantly different based on gender. The mean score of practice was 21. 4± 4.3. There was a significantly positive correlation between knowledge and attitude. Dentists with a higher knowledge score had moderately a more positive attitude towards the older people (R = 0.33, p_ value P-value = 0.006). Nearly 30% of the dentists found their knowledge and experience insufficient in treating the older people with complex medical problems. 40% believed that the current dental education in dental schools did not provide adequate training in geriatric dental care. Conclusion Although the dentists in this study had average knowledge and capacity, they mostly displayed a positive attitude towards the old. A high percentage of them were unsatisfied with the sufficiency of geriatric dental education in dental schools.