Search Results (1,796)

Background. Artificial intelligence (AI) is increasingly recognized as a transformative technology in healthcare, with growing interest in its applications within pediatric dentistry. Given the unique clinical, developmental, and behavioral characteristics of pediatric patients, AI-based systems may offer valuable support in improving diagnosis, prevention, and treatment planning. Methods. A narrative review was conducted to synthesize current evidence on AI applications in pediatric dentistry. A comprehensive search strategy, including predefined keywords and free terms, was applied across multiple databases (Embase, Scopus, PubMed, and Web of Science) up to 1 January 2026. Reviews addressing AI-based technologies in pediatric dental care were selected and analyzed. Results. The available literature indicates that AI is being progressively applied across multiple domains of pediatric dentistry, although with varying levels of evidence. More extensively investigated areas include diagnostic imaging, caries detection, orthodontic assessment, and growth evaluation, where AI systems—particularly those based on machine learning and deep learning—have demonstrated high accuracy and reproducibility. Other emerging fields, such as remote monitoring, behavioral management, preventive strategies, and patient education, show promising potential but remain less explored. Overall, AI-based tools appear to enhance diagnostic support, enable early detection of oral conditions, and contribute to more personalized and efficient clinical workflows. Conclusions. AI represents a rapidly evolving adjunct in pediatric dentistry with the potential to improve clinical decision-making, preventive care, and patient management. Despite encouraging results, further validation in real-world settings, along with careful consideration of ethical, legal, and data-related challenges, is required to support its responsible integration into routine clinical practice. Full article

An updated understanding of the U.S. oral health care system is essential for addressing the burden of oral disease, high dental expenditures, and persistent inequities in access. This narrative review synthesizes current evidence on the prevalence of major oral diseases, dental care delivery, financing, dental workforce, and public health initiatives, and highlights the challenges and future opportunities in the U.S. A comprehensive search of PubMed, Google Scholar, and reports from U.S. federal agencies and professional organizations was conducted between September 2025 and March 2026. Following the latest National Health and Nutrition Examination Survey, untreated caries remains widespread, affecting 11% of children (ages 2–5), 10% of adolescents (ages 12–19), 21% of adults (ages 35–49), and 12% of older adults (ages 65–74). Periodontal diseases are common, with 42% of adults aged 30 years or older having periodontitis. Oral cancer incidence stands at 11.5 per 100,000 and increases sharply with advancing age. Edentulism among older adults (ages 65–74) was approximately 11%. The U.S. dental workforce includes over 200,000 dentists, yet shortages affect rural and low-income areas, with 62 million Americans living in Dental Health Professional Shortage Areas. Dental care is primarily delivered through private practices, supplemented by community health centers. Financing relies mostly on private insurance and out-of-pocket payments, while the coverage of public programs like Medicaid varies across states, and Medicare generally excludes routine dental care for older adults. Water fluoridation remains widespread, yet ongoing debates highlight persistent challenges. School-based dental sealants and topical fluoride programs are widely recognized as cost-effective and scalable, offering substantial benefits at the population level. Nevertheless, community-based preventive measures are often hindered by resource constraints, inequitable access, and in some cases political conflicts. In summary, oral diseases remain prevalent in the U.S. Limited public coverage, workforce shortages in rural or underserved areas, and uneven access to dental care highlight the need for systemic reforms to improve oral health equity. These findings point to the importance of strengthening dental public health research and coordinated policy action to reduce structural barriers and expand access to dental care. Full article

Purpose: Oral squamous cell carcinoma (OSCC) carries a substantial burden in low- and middle-income countries as well as underserved subpopulations within high-income settings, where structural barriers contribute to worse outcomes. While evidence supports targeted screening of high-risk groups, practical guidance for designing organized, quality-assured programs remains limited. This review proposes a framework to translate contemporary cancer-screening principles into operational criteria for OSCC. Methods: A review following the Scale for the Assessment of Narrative Review Articles principles was conducted. Conceptual papers, international evaluations, implementation studies, and programmatic guidance were included. The evidence was synthesized narratively, with emphasis on contemporary cancer-screening principles, implementation frameworks, and their applicability to OSCC. Results: Clinical oral examination can improve the detection of OSCC in early stages and reduce mortality among high-risk groups when embedded in coordinated care pathways. Effective programs require governance structures, screening policies, risk-stratified approaches, and robust information systems capable of call-recall, referral tracking, and quality monitoring. Dental schools and academic clinics may serve as feasible regional hubs for programs within mixed health systems. Conclusions: Aligning core OSCC-screening principles with operational enablers offers a practical pathway to develop context-appropriate programs that strengthen capacity, promote equity, and generate evidence for responsible scale-up. Full article

Background: In pediatric dental care, antibiotics are routinely prescribed for both therapeutic and preventive purposes. Their use is primarily indicated for the management of widespread dental or oral infections, in conjunction with appropriate clinical treatment. Additionally, antibiotics are administered to prevent infective endocarditis (IE) in patients identified as being at increased risk. The present study aimed to evaluate the knowledge and prescribing practices of Italian dentists regarding antibiotic use in pediatric patients through an anonymous online questionnaire. Methods: A specifically designed questionnaire was electronically distributed to a group of Italian dentists. The questionnaire included three sections: demographic data, general knowledge on antibiotic prescribing, and IE prophylaxis in pediatric dentistry. Data were analyzed using appropriate statistical methods. Results: The study included 242 Italian dentists. Only a limited number of statistically significant differences were observed between specialists in pediatric dentistry and general dentists or those with other specializations, as well as between practitioners who mainly treat pediatric patients and those who predominantly treat adults. Regarding antibiotic prophylaxis for IE, most respondents identified amoxicillin as the first-line antibiotic for pediatric patients without penicillin allergy, whereas nearly 30% indicated clindamycin for patients with penicillin allergy. The knowledge about the dosage of assumption of the antibiotic of choice and the timing of administration of the antibiotic prophylaxis were considered as not sufficient. Conclusions: Important gaps remain in dentists’ knowledge of current guidelines for IE prophylaxis, particularly regarding drug dosage and administration. Increased awareness of updated recommendations and potential adverse effects of alternative antibiotics, such as clindamycin, is needed. Full article

The present study proposes a narrative synthesis with an original translational approach to analyze the consequence of the global increase in waterborne microbial diseases. The focal point of this research is the relevance of these diseases for infection prevention and control (IPC) in dental settings and for public health. In order to analyze the main issues, the text focuses on studies published between January 2021 and September 2025. Over the past fifteen years, a small number of outbreaks and cases have been reported in dental settings. Nevertheless, the water utilized for dental care is frequently heavily contaminated with microbes, primarily opportunistic ones, which have the potential to cause pandemics of pseudo-infections. These include mainly Legionella, Pseudomonas, and nontuberculous Mycobacterium (NTM), antibiotic-resistant species, and other opportunistic pathogens with relative abundance exceeding 1%. This study focuses on five areas of research: (a) iatrogenic outbreaks and cases, and causes of underestimated waterborne infections; (b) the prevalence, complexity, and relevance of the dental unit water line contamination; (c) factors influencing water contamination in dental settings, (d) issues relating to products used for dental unit water line (DUWL) treatment, (e) main guidelines on water quality and European Union (EU) legislative acts and issues related to water testing. The text highlights the urgent need for greater awareness and preparedness in dental settings, as well as updated guidelines and rules to ensure the safety of patients and healthcare workers. Full article

Oral diseases remain highly prevalent worldwide and require early diagnosis and continuous monitoring to improve clinical outcomes. Conventional diagnostic methods are often invasive, time-consuming, and limited in their capacity for real-time assessment, which has driven the development of biosensor technologies for point-of-care applications. Among these, cell-based biosensors utilize living cells as sensing elements capable of responding to inflammatory mediators, bacterial toxins, metabolic products, and tumor-associated biomarkers. This narrative review summarizes the principles, cell types, detection mechanisms, and applications of cell-based biosensors in oral health. The literature was identified through a structured search of PubMed, Scopus, Web of Science, and Google Scholar using keywords related to cell-based biosensors, oral diagnostics, salivary biomarkers, periodontal disease, oral cancer, and lab-on-chip technologies. Due to the heterogeneity of biosensor designs and detection methods, the selected studies were analyzed qualitatively. Cell-based biosensors have demonstrated applications in periodontal disease detection, cariogenic biofilm monitoring, oral cancer diagnostics, cytotoxicity testing of dental materials, and salivary biomarker analysis. The integration of microfluidic and lab-on-chip systems enables real-time and multiplex detection, supporting the development of chairside diagnostic platforms in dentistry. However, challenges related to standardization, reproducibility, and clinical validation remain and must be addressed to facilitate broader implementation in routine practice. Full article

Background and Clinical Significance: Dyskeratosis congenita (DC) is a rare inherited disorder classified as a telomere biology disorder and characterized by multisystem involvement, including bone marrow failure and mucocutaneous abnormalities. Oral manifestations such as leukoplakia, increased susceptibility to infection, and abnormal dental development have been reported; however, detailed descriptions of long-term oral functional management in pediatric patients remain limited. This report aims to describe the longitudinal oral management and imaging-based assessment of dental development in a child with DC and to discuss the clinical implications in the context of existing literature. Case Presentation: A female patient diagnosed with dyskeratosis congenita due to a heterozygous TINF2 mutation was followed from early childhood. She underwent hematopoietic stem-cell transplantation at five years of age and later required lung and liver transplantation. Long-term oral management included regular professional oral care, preventive strategies, and periodic imaging evaluation. Panoramic radiographs obtained over several years demonstrated generalized delayed eruption and incomplete root formation relative to chronological age, with apparent early arrest of root elongation. Discussion: This case highlights the potential association between telomere dysfunction, intensive systemic therapy in early childhood, and arrested odontogenesis. These findings suggest a possible association between telomere dysfunction, early intensive systemic therapy, and impaired root formation. Despite severe systemic disease, continuous preventive oral care and imaging-based monitoring were effective in maintaining oral health and detecting mucosal changes. Conclusions: Long-term preventive oral management combined with noninvasive imaging assessment may play an important role in preserving oral function and monitoring dental development in pediatric patients with dyskeratosis congenita. This case adds to the limited literature on longitudinal oral outcomes in this rare disorder. Full article

Micro- and nanoplastics (MNPs) have now been detected in human blood, placenta, and arterial tissue, yet the oral cavity has received strikingly little mechanistic attention despite serving as a primary portal of environmental exposure and a local site of polymer generation from dental and oral-care materials. This narrative review addresses that gap from an environmental microbiology perspective, synthesizing recent literature on periodontal disease, chronic low-grade inflammation, oral biofilms, dental materials, microbial–plastic interactions, and systemic chronic disease risk. Unlike prior reviews, we apply an explicit three-tier evidentiary framework (established, plausible, unproven) that distinguishes what is directly demonstrated from what is biologically plausible but unproven, and we situate the periodontal environment specifically as a particle-retention and inflammatory-amplification niche. The strongest direct oral evidence shows that human dental calculus harbors at least 26 microplastic types, dominated by polyamide (41.4%), polyethylene (32.7%), and polyurethane (7.0%). Polyethylene isolated from calculus induces cytotoxicity, apoptosis, impaired migration, NF-κB activation, and upregulation of IL-1β and IL-6 in human gingival fibroblasts. From a microbiological standpoint, oral organisms actively degrade methacrylate dental polymers, and the degradation products of these polymers reciprocally modulate oral bacterial virulence gene expression. Across experimental systems, MNPs activate oxidative stress, inflammasome signaling, macrophage polarization, and barrier dysfunction, pathways that overlap extensively with periodontal pathobiology. Adjacent environmental microbiology demonstrates that plastic-associated biofilms enhance extracellular polymeric substance production, quorum sensing, pathogen persistence, and antibiotic resistance gene transfer, supporting a plausible but not yet validated oral plastisphere within plaque and calculus. We argue that periodontitis should be reconceptualized as a chronically inflamed particle-processing interface that may increase local MNP retention, cellular reactivity, and systemic inflammatory spillover, with implications for cardiovascular, metabolic, and other chronic disease risk pathways. Current evidence does not yet prove that environmental MNP exposure causes human periodontitis, and that evidentiary boundary is maintained throughout. A priority research agenda is proposed, centered on contamination-controlled subgingival biomonitoring stratified by periodontal status, spatially resolved multi-species biofilm models, polymer source attribution, and longitudinal clinical studies linking oral plastic burden to inflammatory and systemic outcomes. Full article

Background/Objectives: Neglect of children’s oral health is a major concern at international, national, and regional levels. Of all the health problems that can occur in childhood, dental ones are among the most common. Tooth decay, for example, is a chronic condition in children and can have long-term consequences, especially in otorhinolaryngology and pediatric diseases if not treated properly. Methods: The data collection method was questionnaire. Questionnaires were administered to parents regarding oral hygiene habits and access to dental services; data were collected in dental offices across Timiș County, encompassing urban, peri-urban, and rural settings. Children enrolled in the study underwent clinical dental examinations to assess their oral health status (dental caries, gingival diseases, developmental anomalies). Results: Parental education level was not significantly associated with the habit of annual dental check-ups (χ², p = 0.092); however, a directional trend was observed. Total monthly family income was significantly associated with the stated reason for not attending dental check-ups (one-way ANOVA, p = 0.043): families with lower incomes more frequently cited financial and logistical barriers, whereas higher-income families cited lack of time or perceived lack of necessity. Parental education level (p < 0.001) and family income (p < 0.001) were both significantly associated with daily tooth-brushing frequency. Conclusions: The efforts of specialists must be increased through coherent policies, adapted education, and real support for vulnerable groups. An informed child, with supported parents, is a child with a real chance at a healthy life. This is not just a professional opinion, but a collective responsibility. Full article

Background and Objectives: Halitosis is a common condition with substantial psychosocial impact, frequently driven by intra-oral biofilm, tongue coating, and reduced salivary clearance. This study compared the short-term effectiveness of standardized counseling alone, probiotic lozenges containing Streptococcus salivarius K12, and a zinc-containing mouthrinse in adults with persistent intra-oral halitosis. Materials and Methods: In this 4-week, parallel-group, randomized pragmatic trial, 117 adults with bothersome halitosis for at least 3 months and baseline organoleptic score ≥ 2 were allocated 1:1:1 to standard care, probiotic lozenges, or zinc mouthrinse. All participants received standardized counseling and tongue cleaning instructions. The primary endpoint was change in volatile sulfur compounds (VSCs) measured by portable sulfide monitoring. Secondary outcomes included organoleptic score, Halitosis Associated Life-Quality Test (HALT), Oral Health Impact Profile-14 (OHIP-14), tongue coating, plaque, and salivary Solobacterium moorei quantified by qPCR. Results: Baseline demographic, clinical, and biochemical characteristics were comparable across groups. All interventions improved outcomes over 4 weeks, but improvements followed a consistent gradient favoring zinc mouthrinse, followed by probiotic lozenges, then standard care. Mean VSC reduction was −12.7 ± 33.9 ppb with standard care, −47.3 ± 42.2 ppb with probiotics, and −78.5 ± 36.3 ppb with zinc mouthrinse (p < 0.001). Organoleptic scores improved by −0.2 ± 0.7, −0.8 ± 0.8, and −1.2 ± 0.8, respectively (p < 0.001). HALT and OHIP-14 scores showed parallel reductions, and moderate/severe halitosis at week 4 remained most frequent in the standard care group (58.9%) and least frequent in the zinc group (20.5%; p = 0.004). Conclusions: Both active adjunctive strategies improved intra-oral halitosis beyond standardized counseling alone, but the zinc-containing mouthrinse produced the greatest short-term benefits across objective, clinician-rated, and patient-reported outcomes. These findings support zinc-based rinses as a practical short-term adjunct for managing persistent intra-oral halitosis in outpatient dental care. Durability after discontinuation and potential relapse beyond 4 weeks were not assessed in this trial. Full article

Background: Preparing patients for oncological therapy requires the elimination of foci of infection in accordance with Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) guidelines. Complications of dental caries, such as abscesses, can lead to sepsis. In Poland, the pre-oncologic dental treatment of patients with hematopoietic disorders does not yet meet MASCC/ISOO standards; however, an inventory of the current status of dental care for these patients is ongoing. The aim of this study was to investigate the frequency of dental caries and to define the local caries risk factors in adult patients prior to Hematopoietic Stem Cell Transplantation (HSCT) as a part of anticancer therapy. Additionally, the time available for dental treatment was assessed. Methods: A total of 302 patients were examined. Dental status was determined based on the number of decayed, missing and filled teeth and on treatment needs. Local caries risk factors, such as poor dietary habits, insufficient oral hygiene, and symptoms of reduced salivary flow, were examined. The diet was assessed using a questionnaire; tooth cleaning efficiency was assessed as a percentage of dental surfaces with biofilm. Symptoms of reduced salivary flow were determined by subjective and clinical signs of low salivary secretion. Results: Active (progressive) dental caries was diagnosed in 85.2% of patients. Insufficient oral hygiene had been found in 71.52% of those examined. Symptoms of hyposalivation were present in 85% of patients. In 31% of cases, time available for dental treatment prior to HSCT was too short. Conclusions: Tooth decay, the presence of caries risk factors, and insufficient time for oral treatment in patients submitted to HSCT represent a serious clinical problem. There is a clear need to establish comprehensive oral health protocols aimed at providing patients with appropriate, urgent dental care. Furthermore, coordination between oncologists and dentists in Poland must be improved. Currently patients are rarely referred to a dentist before starting anticancer therapy; those scheduled to hematopoietic stem cell transplantation, usually see a dentist too late. Full article

Objectives: Oral healthcare and regular dental follow-up are important during pregnancy, as maternal oral health may have important implications for both maternal and fetal well-being. However, dental attendance remains low. Therefore, this cross-sectional e-survey aimed to explore pregnant women’s dental pain management strategies, their perceptions of endodontic treatment, and avoidance of specific endodontic procedures during pregnancy. Methods: An 18-item online questionnaire was administered to 130 pregnant women. Data were collected on dental attendance, experiences of toothache, use of analgesics or antibiotics, and perceptions of the safety of dental anesthesia and radiographic procedures during pregnancy. Statistical analyses were conducted using Chi-square or Fisher’s exact tests and multivariate logistic regression (p < 0.05). Results: The mean age of participants was 32 years. Only 26.15% reported attending regular dental visits during pregnancy. Among participants who experienced toothache, 51.52% used analgesics and 1.54% used antibiotics. Although 92.31% believed dental infections should be treated during pregnancy, concerns regarding dental procedures were common; 76.92% considered dental radiography unsafe and only 50% considered local anesthesia safe. Multivariate analysis showed that the number of pregnancies was associated with dental visits during pregnancy (p = 0.048), age with analgesic use (p = 0.018), and education level with perception of dental radiography safety (p = 0.013). Conclusions: Despite awareness of the importance of treating dental infections, pregnant women may delay endodontic care during pregnancy, highlighting a need for improved patient education and clearer clinical guidance. Full article

Background: Monitoring skeletal muscle mass (SMM) during radiotherapy (RT) is important, as SMM loss is associated with poorer clinical outcomes. Cone-beam CT (CBCT), acquired before each RT fraction, offers the potential to track the lumbar skeletal muscle index (LSMI) over time. However, CBCT has lower image quality than conventional CT. This study assessed the agreement between CT and CBCT and evaluated the reliability of LSMI measurements in patients with head and neck squamous cell carcinoma. Methods: Patients who underwent both CT and CBCT on the same day during RT were included. The cross-sectional muscle area at C3 was measured, converted to L3, and used to calculate the LSMI. Two researchers analyzed all scans, with one repeating the measurements. Agreement and reliability were quantified using intraclass correlation coefficients (ICCs) and visualized with Bland–Altman plots. Results: LSMI measurements showed excellent agreement between CBCT and CT (ICC: 0.97–0.99; 95% CI: 0.95–0.99). The intrarater (ICC: 0.99; 95% CI 0.98–0.99) and interrater reliability (ICC: 0.97; 95% CI: 0.66–0.99) were high. Bland–Altman plots, however, revealed wide limits of agreement. Conclusion: CBCT provides reliable LSMI measurements and agrees well with CT, but the observed variability suggests cautious interpretation. When both modalities are available, CT remains the preferred standard for SMM assessment. Full article

Background/Objectives: Japan, the world’s first super-aged society, has confronted rapid population aging and increasing healthcare demands earlier than any other country. In this context, dysphagia rehabilitation has become a critical issue affecting quality of life and survival. With nearly 30% of the population aged ≥65 years, Japan has developed a distinctive dysphagia rehabilitation model characterized by interprofessional collaboration and dental involvement. This narrative review describes its historical evolution and structural characteristics. Methods: This narrative review employed a structured literature search of PubMed and Ichushi-Web, supplemented by manual searches of policy documents and professional guidelines. Publications from 1980 to January 2026 were included if they addressed dysphagia rehabilitation systems or dental involvement in Japan. Both English- and Japanese-language sources were analyzed using thematic synthesis. Results: Japan’s dysphagia rehabilitation model evolved alongside population aging and is embedded within the universal health insurance and long-term care insurance systems. A prominent characteristic is the sustained involvement of dental professionals, who contributed to the foundational development of the field and remain actively involved across care settings, particularly within community- and home-based care. The system is further supported by certification frameworks, a triadic model integrating rehabilitation, nutrition, and oral health, and institutionalized interprofessional education. Conclusions: Previous studies have examined specific aspects of dysphagia care in Japan, but few have examined the overall structure of the system. This review maps the fundamental structure of Japan’s dysphagia rehabilitation model within its historical and policy context, offering insights relevant to dysphagia care in other aging societies. Full article

Introduction: Persons diagnosed with Autism Spectrum Disorder (ASD) require adaptations to dental care that many undergraduate programmes may not explicitly treat. This cross-sectional pilot study assessed the extent of ASD-related content in Australia and New Zealand (ANZ) dental and oral health curricula and explored Oral Health Therapy students’ knowledge and self-efficacy. Methods: Online surveys of academic staff across ANZ programmes and Bachelor of Oral Health Therapy students at the University of Newcastle were conducted. Quantitative data was summarised descriptively, and free text responses underwent thematic analysis. Results: Fifteen educator responses (8% of 178 invitees) suggest limited ASD-specific teaching and minimal use of simulation-based education. Among 38 student responses (from one institution), knowledge was generally foundational, but misconceptions persisted and no respondents reported high confidence in providing oral health care for Autistic patients. Interest in further training was high. Conclusions: Within the constraints of low response rates and a single institution student sample, these preliminary findings suggest opportunities to strengthen Autism-related teaching, particularly sensory adaptations, communication strategies, and experiential learning. Inferences should be considered exploratory and hypothesis generating. Limitations: Low educator responses and potential response bias due to limited external validity from a single student cohort. Full article