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Objectives: The Toddler Oral Health Intervention (TOHI) was launched in 2017 to promote oral health prevention at well‐baby clinics, with a focus on parents with children aged 6–48 months. This study aims to evaluate the integrity of motivational interviewing (MI) as one of the core intervention pillars in the TOHI study. Methods: The TOHI study was conducted at nine well‐baby clinics in the central and southern regions of the Netherlands, with 11 trained oral health coaches (OHCs) delivering a tailored individual counselling programme. Audio recordings of counselling sessions were uploaded by the OHCs into an online portal for feedback and integrity evaluation purposes. A trained independent assessor evaluated MI integrity using the MITI 4.2.1 coding scale. IBM SPSS Statistics was used to analyse the data, with ratings on technical and relational components and behavior counts computed by adding up the scores and categorizing them into six key MI skills. Descriptive statistics, including frequencies, percentages and median scores with interquartile ranges, were calculated. Results: The median ratings on the technical and relational components were 2.5 (IQR 2.0–3.5) and 3.5 (IQR 3.0–4.0) out of a maximum of 5, with 45% and 58% of recordings showing fair or good MI integrity, respectively. A median of 38% (IQR 25–55%) of complex reflections and a reflection‐to‐question ratio of 0.7 (IQR 0.4–1.0), with 47% and 24% of recordings showing fair or good MI integrity, respectively. Median counts of MI‐adherent and non‐adherent statements were 3.0 (IQR 2.0–5.0) and 0.0 (IQR 0.0–1.0), respectively. The duration of recordings and MI integrity varied among oral health coaches. Conclusion: Overall, this study revealed that, while intensive training was provided, not all OHCs in the TOHI study met fair thresholds for MI integrity. These findings emphasize the necessity of ongoing training, reflection and support to achieve and maintain a fair or good level of MI integrity in clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: Periodontitis (PD) patients frequently suffer from comorbidities, necessitating increased attention to disease management and monitoring. The aim of this study is to describe the prevalence and patterns of comorbidities among patients with PD in a private periodontal referral practice. Methods: This study involved 3171 adults with PD. Data on demographics, lifestyle, number of teeth, pockets of size ≥ 6 mm, bleeding on probing, periodontal inflammatory surface area, and comorbidities were extracted from electronic patient records. Descriptive and statistical analyses, including t-tests, chi-square tests, cluster analysis, binomial logistic regression analysis, and hypergraph network analysis, were performed. Results: Among this PD population, 47% had a comorbidity, and 20% had multimorbidity (≥2 diseases). Based on the disease patterns, two distinct clusters emerged: Cluster 1 was dominated by respiratory tract conditions (asthma, lung disease, and allergic rhinitis), allergies, and hypothyroidism, while Cluster 2 primarily included cardiometabolic diseases (angina pectoris, hypertension, diabetes mellitus (DM), and hyperthyroidism). The hypergraph network analysis for those with multimorbidity identified two main groups: (i) pulmonary conditions (lung disease, asthma, allergic rhinitis, and allergies) and (ii) cardiometabolic disorders (hypertension, myocardial infarction, cerebrovascular disease, and DM). Hypertension, allergies, and allergic rhinitis showed high centrality, serving as central nodes frequently co-occurring with other diseases. Conclusions: Nearly half of the PD patients in a private periodontal referral practice were found to have comorbidities, primarily clustering into cardiometabolic and respiratory tract diseases. These findings, based on real-world data, should encourage dental professionals to integrate systemic conditions into their care strategies. They could also guide policymakers and practitioners in developing evidence-based approaches to mitigate the reciprocal negative effects of PD and comorbidities. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess whether psychological distress mediates the association between financial strain and oral health and dental attendance in the Dutch adult population. Methods: The study followed a cross‐sectional design based on 2812 participants from the 2014 wave of the Dutch population‐based GLOBE study. Financial strain was considered the exposure, while psychological distress measured with the Mental Health Inventory‐5 (MHI‐5) was the mediator. The outcomes included self‐reported number of teeth, self‐rated oral health, and self‐reported dental attendance. Generalized regression analyses were used for the mediation analysis adjusted for several covariables. Results: Greater financial strain was significantly associated with poorer self‐rated oral health (total effect: 0.09, 95%CI: 0.05; 0.14) and restorative or no dental attendance (i.e. participants never visiting a dentist or only visiting a dentist for regular treatments or when they have complaints with their mouth, teeth, or prosthesis) (total effect: 0.05, 95%CI: 0.02; 0.09). Greater financial strain was not significantly associated with self‐reported number of teeth (total effect: −0.14, 95%CI: −0.91; 0.64). Psychological distress significantly mediated the association of financial strain with self‐rated oral health (average causal mediation effect [ACME]: 0.02, 95%CI: 0.01; 0.03) and self‐reported dental attendance (ACME: 0.01, 95%CI: 0.00; 0.02), respectively. However, it did not significantly mediate the association of financial strain with self‐reported number of teeth (ACME: −0.11, 95%CI: −0.25; 0.02). The estimated proportion of the total effect of financial strain on self‐rated oral health and self‐reported dental attendance that could be explained by psychological distress was respectively 24% (95%CI: 14%; 48%) and 19% (95%CI: 6%; 62%). Conclusions: Psychological distress partly explains the association of financial strain with self‐rated oral health and dental attendance, but not with self‐reported number of teeth. Future studies using longitudinal data are necessary to confirm the results. [ABSTRACT FROM AUTHOR]

Objectives: Although many studies have reported a higher risk of atherosclerotic cardiovascular diseases (ACVD) in people with periodontitis (PD), this has been tested in a few large‐scale population‐based studies with a longitudinal design. The aim of this study was to investigate whether people with PD status have an increased risk of a nonfatal ACVD event compared to people without PD status. Methods: A cohort of 1.2 million participants from a healthcare insurance claims database was studied longitudinally for a period of 8 years. PD status was derived from PD‐related insurance claims and ACVD status from ACVD‐related insurance claims. Person‐time at risk (PTAR) was calculated from the start of follow‐up (01 January 2007) for participants with and without PD status until ACVD or event‐free censoring (31 December 2014). Time‐dependent Cox proportional hazard models were used to calculate the hazard ratio (HR) and to adjust for shared risk factors (age, sex, socioeconomic position and diabetes mellitus). Results: The prevalence of PD was 20.1%, and the cumulative incidence of nonfatal ACVD events was 7.5%. The univariable and multivariable analyses revealed a limited risk of ACVD for participants with PD status (HR: 1.12; 95% CI 1.10–1.14, HR: 1.06; 95% CI 1.04–1.08, respectively). A subgroup analysis of participants ≤35 and > 35 years of age showed that those ≤35 years of age with PD status had a higher ACVD risk (univariable HR: 1.20; 95% CI 1.05–1.37, multivariable HR: 1.21; 95% CI 1.05–1.39). ACVD risk was not increased in participants >35 years of age with PD status (univariable HR: 0.92; 95% CI 0.91–0.94, multivariable HR: 0.96; 95% CI 0.94–0.98). Conclusions: This study based on a healthcare insurance cohort shows that PD can hardly be regarded as a risk factor for nonfatal ACVD. The increased risk is of minor size, and therefore, the proposed role of PD in the development of ACVD events should be reconsidered. Possibly PD plays a role as a risk factor in younger people due to overlapping genetic risk factors of ACVD and a more aggressive course of PD. [ABSTRACT FROM AUTHOR]

Keywords: Achilles tendon; rupture; treatment; complications 1688 Acute Achilles Tendon RuptureMinimally Invasive Surgery Versus Nonoperative Treatment With Immediate Full Weightbearing-A Randomized Controlled Trial SAGE Publications, Inc.200810.1177/0363546508319312 RoderickMetz MD Department of [...]