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Objectives: To determine whether treatment with tacrolimus plus sirolimus (Tac/Sir) as a prophylaxis for graft‐versus‐host disease worsens severe oral mucositis and delays healing compared to cyclosporine plus methotrexate (CsA/Mtx) following haematopoietic stem cell transplantation. Subjects and Methods: The study comprised 141 patients: 73 randomized to receive Tac/Sir and 68 to receive CsA/Mtx. The oral mucositis assessment scale and toxicity grading according to WHO were used to assess the severity, peak and duration of oral mucositis from the day −3 to day 24 post‐transplant. Results: Eighty‐seven patients developed oral mucositis in the first 24 days post‐transplant. No significant difference in oral mucositis severity between the Tac/Sir and CsA/Mtx groups was observed. The peak oral mucositis score occurred on day 10 in both groups. Although oral mucositis scores had returned to baseline in the CsA/Mtx group on day 24 post‐transplant, no significant difference compared with the Tac/Sir group was found. Conclusions: The introduction of tacrolimus/sirolimus as a graft‐versus‐host disease prophylaxis in haematopoietic stem cell transplantation increased neither the incidence nor severity of oral mucositis compared with cyclosporine/methotrexate. Furthermore, oral mucositis healing was not prolonged and followed the same time pattern as cyclosporine/methotrexate. [ABSTRACT FROM AUTHOR]

Background: Self‐perceived oral health (SPOH) is a summary of multiple determinants related to oral health and has been suggested for use in clinical practice as a health assessment tool. Aim: To analyse determinants of SPOH among adolescents. Design: In 2018, we selected 1742 participants from eight high schools in Olinda/PE, Brazil, using a multistage stratified cluster sample. The main survey item of SPOH was 'How would you rate your oral health'. Determinants of were queried with a questionnaire and a clinical examination: socio‐demographic variables, exposure to family violence, somatic symptoms, and orofacial and general health factors. Pearson's chi‐square test and logistic regressions evaluated associations between determinants and SPOH. Results: Very poor SPOH had a prevalence of 8.7%. Nearly half (43.5%) rated their oral health as 'fair'. Very poor SPOH was associated with poor self‐perceived general health (OR = 2.60), anterior open bite (OR = 2.24), not cohabiting with one or both parents (OR = 2.40), caries experience (OR = 1.93), dental pain (OR = 1.91), and temporomandibular disorders (OR = 1.77). Conclusion: Very poor self‐perceived oral health indicates life stress and associates with poor oral conditions. Assessments should be used to explore individual treatment needs and abilities to comply with recommendations. [ABSTRACT FROM AUTHOR]

Aim: To evaluate oral health outcomes and early oral health promotion of children in a Swedish, parental support programme conducted in a collaboration between Child Health Services and Social Services. Methods: The intervention offered first‐time parents six home visits from a paediatric nurse and a parental advisor with Social Services. On the fourth visit (infant age 6‐8 months), parents received a toothbrush and fluoride toothpaste from non‐dental staff. Twice, at child ages 18 and 36 months, a dentist used the International Caries Detection and Assessment System to record caries and conducted a structured interview with the parents on oral health habits. The intervention group (n = 72) was compared to a reference group (n = 100) from the standard child healthcare programme, which included one home visit. Results: Significantly, caries prevalence was lower and tooth brushing habits more consistent in the intervention group compared to the reference group in the standard child health programme. The difference was most pronounced at 18 months and had decreased at the 36‐month follow‐up. Conclusion: The extended postnatal home visiting programme had a positive impact on oral health. Early oral health promotion delivered by non‐dental professionals could be a beneficial approach to early caries prevention. [ABSTRACT FROM AUTHOR]

Background: No longitudinal study has evaluated the mutual relationship between dental fear and oral health in the same investigation. Aim: To evaluate the reciprocal longitudinal relationship between dental fear and oral health in schoolchildren. Design: This longitudinal study monitored 416 Brazilian children aged 5‐7 years of age at baseline for 2 years. The decayed, filled and missing teeth were clinically assessed for each child. Dental fear was evaluated by Dental Anxiety Question. Multilevel mixed‐effects linear and logistic regressions analysed the reciprocal relationship between dental fear and oral health. Results: Children with caries experience had 1.8 times higher odds of dental fear compared to children who were caries free. The presence of a carious tooth increased the odds of dental fear by 1.2 times. Children with dental fear had 0.46 additional carious tooth; an additional 0.22 tooth indicated for extraction; and a 0.67 higher caries experience score compared to children without dental fear. Conclusions: We observed a reciprocal relationship between dental fear and poor oral health. Both parents and dentists should provide realistic information for the children, discouraging biased negative expectations regarding dental treatment. Ultimately, the child would acquire positive perceptions of the dental environment, reducing their phobia and consequently improving oral health. [ABSTRACT FROM AUTHOR]

Background Dental professionals are required to report suspicions of child maltreatment to the social services. As yet, no studies assess the prevalence of these mandated reports from dental care services or their content. Aim This study investigates the prevalence and characteristics of mandated reports from dental professionals to the social services. Furthermore, it analyses associations between dental professionals reporting suspicions of maltreatment with such reports from other sources. Design The study collected dental mandatory reports from within one municipality of Sweden during 2008-2014. The material consisted of a total of 147 reports by dental professionals regarding 111 children. Results The total prevalence of reports from dental care services to the social services was 1.5 per 1000 children with a significant increase between 2008 and 2011 ( P < 0.001). The primary cause for a report concerned parental deficiencies in care ( n = 93) and secondly, a concern for dental neglect ( n = 52) ( P < 0.001). Among all reports, 86% involved children with prior contacts with the social services. Conclusion Reports to the social services from dental care services on suspicions of child maltreatment concern parental deficiencies (failure to attend appointments) and neglect (dental neglect). Mandated reports from dental care services often co-occur with other mandated reports. [ABSTRACT FROM AUTHOR]

Background: To compare the oral microflora in preschool children attending a fluoride varnish program with a reference group receiving a standard oral health program without fluoride varnish applications. A second aim was to relate the microbial composition to the caries prevalence. Methods: Five hundred seven 3-year-old children were enrolled from a cohort of 3403 preschool children taking part in a community based oral health project. Two hundred sixty-three of them had attended caries-preventive program with semi-annual applications of a fluoride varnish since the age of 1 year (test group) while 237 had received standard preventive care (reference group). Oral samples were collected with a sterile swab and analysed with checkerboard DNA-DNA hybridization using 12 pre-determined bacterial probes. Caries and background data were collected from clinical examinations and questionnaires. Results: Gram-positive streptococci (S. intermedius, S. salivarius, S. oralis) were most frequently detected and displayed the highest counts in both groups. There were no significant differences between the groups concerning prevalence of any of the selected bacterial strains except for S. oralis that occurred less frequently in the reference group. In children with caries, V. parvula were significantly more common (p < 0.05) while strains of Lactobacillus, Bifidobacterium and Neisseria were more prevalent among the caries-free children (p <0.05). Conclusions: A 2-year community program with semi-annual fluoride varnish applications did not seem to significantly influence the oral microflora in preschool children. Trial registration: www.controlled-trials.com (ISRCTN35086887) 20131216 'retrospectively registered'. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the relationship between body mass index (BMI kg/m2), the inflammatory mediator tumor necrosis factor alpha (TNFalpha), and interleukin-8 (-8) in gingival crevicular fluid (GCF) from 32 obese subjects aged between 13 and 24 years. Gingival inflammation (GBI %), pathological pocket depths, and alveolar bone loss diagnosed on radiographs were recorded. The GCF was collected from six sites per subject using periopaper, and the volume was determined using Peritron 8000. The levels of TNFalpha and IL-8 were determined using ELISA kits. Within the whole group, there was no significant relationship between BMI and the variables age, GBI %, number of periodontal pockets, smoking, and the levels of TNFalpha or IL-8. In subjects with BMI > or =40, however, there was a statistically significant correlation (r= 0.74, P< 0.01) between the level of TNFalpha in GCF and BMI. The correlation coefficient between BMI and TNFalpha in subjects with BMI > or =40 differed significantly (P< 0.05) compared to that between subjects with BMI <40. The level of TNFalpha in GCF was positively correlated (P< 0.05) with BMI in subjects with no periodontal pathological pocket. No significant correlation was found between the level of IL-8 and BMI. The results indicate that BMI positively correlates with TNFalpha in GCF in the group of young subjects with BMI > or =40 as well as in the subjects with no pathological periodontal pocket (> or =4 mm) and that TNFalpha in GCF may be affected by the obese condition through a systemic effect. [ABSTRACT FROM AUTHOR]

Background: Amelogenesis imperfecta (AI) is a rare, genetically determined defect in enamel mineralization associated with poor esthetics and dental sensitivity. Because the condition is associated with negative social outcomes, this study evaluated oral health-related quality of life (OHRQoL), dental fear, and dental beliefs before and after early prosthetic crown therapy for AI during adolescence.Methods: The study included 69 patients with AI, aged 6-25 yr: 33 males and 36 females (mean age 14.5 ± 4.3); healthy controls (n = 80), patients with cleft lip and palate (CLP; n = 30), and patients with molar incisor hypomineralization (MIH; n = 39). All matched in age and gender, and all but the CLP group insocioeconomic area. Patients completed three questionnaires measuring OHRQoL (OHIP-14), dental fear (CFSS-DS), and dental beliefs (DBS-R). Twenty-six patients with severe AI between ages 9 and 22 yr received crown therapy and completed the questionnaires twice: before and after therapy.Results: OHIP-14 scores were significantly higher among patients with AI (7.0 ± 6.7), MIH (6.8 ± 7.6) and CLP (13.6 ± 12.1) than healthy controls (1.4 ± 2.4) (p < 0.001). After crown therapy, quality of life problems in the 26 patients with severe AI decreased significantly, from 7.8 ± 6.1 to 3.0 ± 4.8 (p < 0.001). Early prosthetic therapy did not increase dental fear or negative attitudes toward dental treatment.Conclusions: OHRQoL increased after early crown therapy in patients with severe AI. Therapy did not increase dental fear or negative attitudes toward dental treatment. [ABSTRACT FROM AUTHOR]