Search Results (579)

Background: Vaping has become one of the most prevalent risk behaviors among adolescents and young adults worldwide. Although electronic cigarettes (ECs) are often perceived as safer than conventional tobacco, concerns regarding their impact on oral health are increasing. This systematic review aimed to critically evaluate and synthesize the available evidence regarding the association between e-cigarette use and oral health outcomes in adolescents and young adults. Methods: A systematic search of PubMed/MEDLINE, EMBASE, Scopus, and EBSCOhost databases was conducted for observational studies published within the last ten years. Studies evaluating oral health outcomes among adolescents and young adults were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool for Analytical Cross-Sectional Studies, and certainty of evidence was graded using the GRADE approach. Results: Eight observational studies met the inclusion criteria and were included in the qualitative synthesis. E-cigarette use was associated with increased caries risk, higher prevalence of gingival inflammation, alterations in salivary flow and pH, changes in oral microbiota—including increased levels of Porphyromonas gingivalis—and elevated frequencies of micronuclei in oral mucosal cells. Four studies were rated as having low risk of bias and four as moderate risk. The overall certainty of evidence was low for all outcomes due to methodological limitations, heterogeneity in outcome assessment, and inadequate control of confounding factors, including dual use of combustible tobacco products. Conclusions: Current evidence may suggest a possible association between e-cigarette use and adverse oral health alterations in adolescents and young adults. However, given the low certainty of evidence, residual confounding, and the predominance of cross-sectional designs, causal relationships cannot be established. Well-designed longitudinal studies that clearly differentiate exclusive e-cigarette users from dual users and adequately adjust for behavioral confounders are required to clarify the independent impact of vaping on oral health in this vulnerable population. Full article

Background: Despite well-documented adverse impact on both systemic and oral health, tobacco smoking remains a persistent issue in military populations. It contributes to the global burden of tobacco use and is often perceived as a means of coping with stress in military settings. Purpose: This study aimed to assess the prevalence of tobacco use among military marines, its impact on oral health, and their level of knowledge regarding smoking, as well as to identify variables associated with their smoking habits. Thus, it provides a basis for implementing appropriate tobacco cessation and harm reduction strategies, particularly within the military. This study demonstrated a high prevalence of tobacco use among military marines, despite generally high levels of knowledge regarding tobacco smoking. A knowledge gap was still evident in relation to smoking behavior. The most frequently reported oral health impacts among smokers were tooth staining, halitosis, and taste impairment. Duration of military service and level of knowledge were significantly associated with smoking behavior. Materials and Methods: A validated and reliable online survey was administered to collect socio-demographic data, including age, education level, and length of military service. The survey also assessed smoking status, smoking behavior, its impact on oral health, and participants’ knowledge of smoking-related risks. Data were analyzed descriptively, and associated factors were examined using multivariate analysis. Results: A total of 475 military marines participated in the study. Of these, 44.8% were current smokers, 25.7% were former smokers, and 29.5% had never smoked. Overall, 71% of participants demonstrated good knowledge of smoking-related risks. The most commonly reported oral health impacts were halitosis, tooth staining, and impaired taste. Smoking status did not differ significantly by age (p = 0.095) or education level (p = 0.610), but differed significantly by length of military service (p < 0.05) and level of knowledge (p < 0.05). Multivariate analysis using multinomial logistic regression indicated that length of military service was a significant predictor of smoking behavior (p = 0.005; 95% CI: 0.282–0.800), with 1–5 years of service emerging as the most influential category. Based on the odds ratio, individuals with 11–15 years of service had a 1.8-fold higher likelihood of smoking. Conclusions: Despite a generally good level of knowledge regarding the health risks of smoking, the prevalence of tobacco use remains high among military marines. The most commonly reported oral health impacts were tooth staining, halitosis, and impaired taste. Length of military service and level of knowledge regarding smoking were identified as significant factors associated with smoking status. Full article

Aim: Asthma is a chronic condition with high prevalence in pediatric populations and may negatively influence oral health. The primary aim of this study was to evaluate the association between asthma and oral health-related quality of life (OHRQoL) in Portuguese children aged 6 to 8 years. Secondary aims included comparing caries experience, salivary parameters, and other clinical oral health indicators between asthmatic and non-asthmatic peers. Materials and Methods: A cross-sectional study was conducted with 89 child–parent pairs using a convenience sampling approach. Children with asthma were recruited from a hospital immunoallergology service, and healthy controls were recruited from a primary school. Data collection included parent-administered questionnaires on sociodemographic and behavioral factors, the Portuguese version of the SOHO-5 (child self-report and parent proxy forms), and standardized intraoral examinations assessing caries (WHO criteria, 5th edition), malocclusion, gingival bleeding, dental erosion, mucosal lesions, and molar–incisor hypomineralization. Stimulated salivary flow was measured. Bivariate statistical analyses and multivariable regression models were performed using SPSS (v.29), with a significance level set at p < 0.05. Results: Asthmatic children had significantly higher caries prevalence in both primary (52.6% vs. 27.5%, p = 0.027) and permanent dentition (32.4% vs. 0%, p < 0.001), as well as higher mean dmft scores (2.68 vs. 1.14, p = 0.026), reduced stimulated salivary flow (78.9% vs. 41.2% with low flow, p < 0.001), and worse child-reported SOHO-5 scores (mean 2.42 vs. 1.25, p = 0.004). After multivariable adjustment, asthma remained a significant independent predictor of low salivary flow (OR = 4.017, 95% CI: 1.443–11.178, p = 0.008), while the association with caries was attenuated and no longer significant (OR = 1.345, p = 0.590). Pain experience in the past year was the strongest predictor of OHRQoL across all multivariable models (SOHO-5 child: B = 1.583, p = 0.006; SOHO-5 total: B = 4.970, p < 0.001), indicating that children with pain history reported substantially worse OHRQoL. After adjustment, asthma did not reach statistical significance for either child-reported (B = 0.732, p = 0.090) or total OHRQoL scores (B = 0.693, p = 0.293). These findings should be interpreted cautiously given the limited number of covariates included in the models, constrained by the available sample size. Conclusions: Within the limitations of this cross-sectional study, including a small and non-probabilistic sample, asthmatic children presented a higher caries burden and a markedly higher prevalence of low stimulated salivary flow compared with non-asthmatic peers. Asthma remained a significant independent predictor of low salivary flow after multivariable adjustment, while the association with caries was attenuated, suggesting partial confounding by dietary habits. These findings highlight the importance of integrating oral health surveillance into the routine care of asthmatic children, with particular attention paid to salivary function and caries prevention. Full article

Background/Objectives: Curcuma longa is widely recognized for its antioxidant, antimicrobial, and wound-related biological effects. The present study aimed to compare two extracts prepared from organic turmeric powder (Curcuma longa), using distilled water (CUR-H₂O) and 96% ethanol (CUR-EtOH), in terms of extraction yield, phytochemical profile, antimicrobial activity, and in vitro biological behavior relevant to future oral-health-oriented applications. Methods: The extracts were prepared by maceration followed by ultrasound-assisted processing, concentration, and lyophilization. Their antioxidant potential (AOP) was evaluated by DPPH assay, total phenolic content (TPC) by the Folin–Ciocalteu method, and targeted polyphenolic profile by UHPLC-MS. Antimicrobial activity was assessed by broth microdilution against Streptococcus mutans, Streptococcus oralis, and Candida albicans. In vitro biological activity was investigated on HaCaT keratinocytes. Results: CUR-EtOH extract showed a higher extraction yield than CUR-H₂O (5.13% vs. 2.01%), higher AOP (69.54 ± 0.49% vs. 53.35 ± 0.30%), and a higher TPC (163.87 ± 0.32 vs. 78.05 ± 0.28 mg GAE/g dry extract). Consistent with these TPC results, UHPLC-MS revealed a richer targeted polyphenolic profile in CUR-EtOH extract, particularly in terms of p-coumaric and ferulic acid derivatives. CUR-EtOH extract was more active against the tested oral streptococci, especially S. mutans (MIC 10 µL vs. 60 µL for CUR-H₂O), whereas CUR-H₂O extract showed a slightly better antifungal effect against C. albicans (MIC 60 µL vs. 80 µL). In HaCaT cells, CUR-H₂O extract exhibited the more favorable compatibility profile, while CUR-EtOH extract showed stronger cytotoxicity, despite promoting faster wound-gap closure at 10 µg/mL. Conclusions: The extraction solvent strongly influenced both the chemical profile and biological behavior of the turmeric-powder-derived extracts. These findings suggest that solvent selection may be used to tailor the balance between antimicrobial efficacy and epithelial compatibility in future turmeric-powder-derived preparations intended for oral-health-oriented applications. Full article

Background/Objectives: Head and neck squamous cell carcinoma (HNSCC) remains a global public health challenge with significant morbidity and mortality. Emerging epidemiological data indicate a rising global incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Serology for early HPV antigens has been highlighted as a relevant biomarker for HPV-associated OPSCC. This study aimed to determine the seroprevalence of HPV16 E6 antibodies in HNSCC patients in the state of Espírito Santo, Brazil. Methods: This is a prospective longitudinal cohort study in which 287 patients with HNSCC were enrolled, recruited from two oncology centers in Espírito Santo between 2011 and 2018, along with 68 cancer-free individuals. Serum samples were analyzed using the HPV16 E6 GST Capture ELISA assay. Statistical analysis was performed using SPSS. Binary logistic regression was employed to identify independent predictors of seropositivity. Results: The overall seroprevalence of HPV16 E6 antibodies was 7.3%. Seropositivity was observed in tumors of the oral cavity (6.2%) and oropharynx (13.3%). Patients with OPSCC demonstrated a significantly higher likelihood of seropositivity compared to those with tumors of the oral cavity, larynx, and hypopharynx (OR = 2.96, 95% CI: 1.21–7.28, p = 0.018). The highest frequency of HPV16 E6-positive cases occurred in tumors of the palatine tonsils (OR = 6.00; 95% CI: 1.58–22.89; p < 0.009). No seropositive cases were observed in hypopharyngeal or laryngeal tumors. Among patients with OPSCC and oral cavity squamous cell carcinoma (OCSCC), HPV16 E6 serostatus did not significantly correlate with sociodemographic, behavioral, or clinical tumor characteristics. Conclusions: Our findings reinforce the predilection of HPV-associated carcinogenesis for the oropharynx, more specifically in the palatine tonsils. In addition, this study highlights HPV16 E6 serology as a potential biomarker for HPV-driven OPSCC and underscores Brazil’s epidemiological heterogeneity, warranting standardized clinical validation. Full article

Objectives: This longitudinal study examined the association of parents’ dental anxiety during early pregnancy with the stability of brushing their own and their children’s teeth from the age of one to four years. Methods: The study used data from the FinnBrain Birth Cohort Study, which included 816 mothers and 379 fathers who completed questionnaires on dental anxiety at gestational week 14 and on toothbrushing frequency for themselves and their child at the ages of 1, 2, and 4 years. Dental anxiety was assessed using the Modified Dental Anxiety Scale. The stability of toothbrushing was categorized as stable good (twice daily or more at all time points), fluctuating, good at 4 years (fluctuates over time points, but good at age 4 years), fluctuating, poor (less than twice daily) at 4 years (fluctuates over time points, but poor at age 4 years), stable poor (poor at all time points). Unordered multinomial logit models regarding the association of parents’ dental anxiety on brushing their own and their children’s teeth were adjusted for education, and education and parents’ own toothbrushing, respectively. Results: Compared to the mothers who brushed their teeth twice daily throughout the study (“stable good”), those belonging to the “fluctuating, good at 4 years” group and those belonging to the “stable poor/poor at 4 years” group were more likely to have higher dental anxiety (OR = 1.07, 95% CI = 1.01–1.13 and OR = 1.04, 95% CI = 1.00–1.08, respectively). This association was not found among fathers. Parents’ dental anxiety was not associated with the brushing of their children’s teeth. Conclusions: Attending to the mother’s dental anxiety during pregnancy could improve her toothbrushing. Full article

Background/Objectives: Adolescence is a critical developmental stage during which lifestyle and dietary habits are established, influencing both general and oral health outcomes. Territorial disparities between rural and urban environments may contribute to nutritional inequalities and health vulnerabilities. The aim of this study was to analyze differences between rural and urban environments in terms of lifestyle behaviors, dietary patterns, and oral health outcomes among adolescents in Mallorca, Spain. Methods: A cross-sectional study was conducted among 463 adolescents corresponding to the WHO index ages (12 and 15 years). Data were collected through questionnaires assessing dietary habits, oral hygiene behaviors and lifestyle characteristics. Clinical oral examinations were performed following the World Health Organization Pathfinder methodology. Statistical analyses included descriptive statistics and comparative analyses between rural and urban populations. Results: Urban adolescents reported higher consumption of sugar-sweetened beverages and ultra-processed foods (p < 0.001), whereas rural adolescents showed higher weekly physical activity (4.45 ± 2.34 vs. 3.62 ± 2.41 h/week; p < 0.001). Caries prevalence was higher in rural students (45.0% vs. 28.6%; p < 0.001), who however demonstrated better periodontal indicators. Conclusions: Geographic environment is associated with differences in dietary patterns, physical activity levels, lifestyle behaviors, and oral health outcomes among adolescents. These findings highlight the importance of targeted public health interventions adapted to geographic context and support the role of broader social and environmental determinants in adolescent oral health. Full article

Background/Objectives: Diabetes is a prevalent chronic condition and a major contributor to morbidity, mortality, and healthcare costs in the U.S., particularly among older adults with comorbidities such as hypertension and dyslipidemia. Complex medication regimens increase the risk of nonadherence, which can worsen glycemic control, cardiovascular outcomes, and healthcare utilization. This study assessed longitudinal adherence patterns to oral antidiabetic medications among high-risk older adults and identified predictors using group-based trajectory modeling (GBTM). Methods: This retrospective cohort study used 2016–2017 Texas Medicare Advantage claims. Participants were older adults with diagnoses of diabetes, hypertension, and hyperlipidemia who had continuous plan coverage throughout the study period and at least one prescription fill for an oral antidiabetic, a statin, and a renin–angiotensin system (RAS) antagonist. Adherence was measured monthly over 12 months using the proportion of days covered (PDC). GBTM identified adherence trajectories, and multinomial logistic regression, based on the Andersen Behavioral Model, evaluated predictors using perfect adherence as the reference. Results: Among 7847 patients, three trajectories were observed: perfect adherence (59.50%), near-perfect adherence (29.21%), and rapid decline (11.29%). Female sex (OR, 1.38; 95% CI, 1.19–1.60) and absence of health plan subsidy (OR, 0.79; 95% CI, 0.68–0.92) were associated with rapid decline. Female sex (OR, 1.13; 95% CI, 1.02–1.25) and age ≥ 75 years (OR, 1.20; 95% CI, 1.00–1.43) were associated with near-perfect adherence. Conclusions: Older adults with diabetes and comorbidities exhibit distinct medication adherence patterns. Trajectory-based methods can identify those at risk for declining adherence and guide interventions to improve outcomes. Full article

Background/Objectives: Unhealthy dietary behaviors and suboptimal oral hygiene practices remain common among Italian children, potentially affecting both nutritional and oral health. Dental caries, a preventable yet highly prevalent condition in pediatric populations, has a multifactorial etiology in which lifestyle factors play a key role. This study aimed to assess the prevalence of dental caries, dietary habits, and oral hygiene behaviors in school-aged children in Lombardy, and to identify factors associated with prevalent caries status. Methods: A cross-sectional study was conducted on 307 schoolchildren aged 9–10 years from ten schools in Northern Italy. Oral health status was evaluated through the plaque index and the DMFT/dmft index during school-based dental examinations. Dietary habits, lifestyle, and oral hygiene practices were collected through structured questionnaires. A mixed-effects logistic regression model was developed to explore potential associations between variables and prevalent caries status. Results: The dietary patterns, weight status, oral hygiene behaviors, and oral health conditions were generally consistent with the national data. Higher plaque index, skipping breakfast, consuming mid-morning snacks, and parental reports of previous caries experiences were retained in the final model. Internal validation suggested reasonable discriminatory ability overall, whereas calibration shows heterogeneity across schools. Conclusions: The findings highlight suboptimal dietary and oral hygiene behaviors among Lombardy schoolchildren and confirm their association with dental caries. Lifestyle-related factors, particularly oral hygiene practices and eating patterns, showed a relevant association with prevalent caries status in the analyzed sample. These results underscore the need for targeted preventive strategies integrating nutritional education and oral health promotion in pediatric populations. Full article

Background/Objectives: Survival after pediatric intensive care unit (PICU) admission has improved, yet many children experience post-intensive care syndrome in pediatrics (PICS-p), including persistent feeding difficulties that impair growth and quality of life. An intensive feeding program (IFP), also known as intensive interdisciplinary behavioral treatment (IIBT), reduces tube dependence and improves oral intake; however, outcomes in PICU survivors remain understudied. This study aimed to evaluate feeding outcomes in children with prior PICU admission who completed IIBT. Methods: This study was a retrospective case series of children (0–18 years) admitted to the HDVCH, Corewell Health, Grand Rapids, Michigan, who subsequently completed IIBT (from 2007 to 2024). Variables included demographics, PICU course (admission indication, complications, length of stay, ventilation, and nutrition status) and IIBT outcomes (feeding modality, oral skills, and malnutrition status). Feeding outcomes were compared pre- and post-IIBT. Results: Sixteen patients were included (62.5% female; mean age 1.44 ± 1.21 years). Primary PICU admission causes were post-operative recovery (68.8%) and acute respiratory failure (25%). PICU complications included acute respiratory failure (43.8%) and the need for respiratory support beyond baseline (62.5%). At PICU discharge, 75% remained tube-fed and 18.8% were malnourished. The mean time from PICU discharge to IIBT initiation was 641 ± 385 days. At IIBT baseline, 75% were tube-fed and all were non-self-feeders. Following IIBT completion (mean length of stay 4.8 ± 0.9 weeks), 58% of tube-fed patients achieved tube removal eligibility; 44% transitioned to partial or full self-feeding; problematic mealtime behaviors decreased (45.7% → 9.9%); oral acceptance improved (62% → 95%); and mouth clearance improved (59% → 96%). Malnutrition prevalence decreased (20% → 12%). Conclusions: Children with prior PICU admission demonstrated substantial feeding and behavioral improvement during IIBT participation, with over half achieving tube-weaning eligibility. The time from referral to program start reflects barriers that delay intervention. Full article

Background/Objectives: Dental caries continues to represent a major oral health concern in children, particularly in uncooperative patients, where effective sealant placement is often compromised. This study evaluated the long-term clinical performance of hydrophilic (UltraSeal XT hydro) and hydrophobic (Helioseal-F) resin-based sealants in uncooperative children aged 6–9 years, assessing retention and caries incidence over 24 months. Methods: In a split-mouth, double-blinded randomized controlled trial, 34 children (104 first permanent molars) were enrolled, with 31 participants (98 teeth) completing the study. Sealants were randomly assigned to hydrophilic or hydrophobic group, with assessments at 3, 6, 12, 18, and 24 months. Results: Complete retention declined progressively in both groups, from 59.2% to 2.0% in the hydrophilic group and from 42.9% to 0% in the hydrophobic group at 24 months, with no significant intergroup differences (p = 0.719). Caries-free rates decreased from 81.6% to 49.0% in the hydrophilic group and from 75.5% to 40.8% in the hydrophobic group (p = 0.293). Children with definitely negative behavior showed significantly lower retention at 6 and 12 months (p = 0.006 and p < 0.001) compared to those with negative behavior, although differences were not significant at 24 months. Conclusions: Overall, both sealants demonstrated comparable retention and cariostatic performance, indicating that material properties alone do not determine long-term success. Further research should focus on long-term follow-up and comparative evaluation of hydrophilic sealants in cooperative and uncooperative populations to better understand how patient behavior affects sealant performance. Full article

Background/Objectives: Online environment and social media platforms have become major sources of health information, influencing behaviors and decision-making related to oral health. The Aim of This Study was to culturally adapt and psychometrically validate the Romanian version of the Social Media Oral Health Literacy Questionnaire (SMOHLQ) and to assess oral health literacy levels among dental students. Material and Methods: An observational cross-sectional study was conducted among 304 fourth- and fifth-year dental students. The Romanian version of the SMOHLQ underwent cultural adaptation and psychometric evaluation using descriptive statistics, exploratory factor analysis (principal axis factoring with oblimin rotation), Cronbach’s alpha coefficient, intraclass correlation coefficient (ICC), Pearson correlations, and ANOVA analysis. Results: Exploratory factor analysis confirmed a three-dimensional structure consisting of access and understanding, critical appraisal, and behavioral impact domains. Internal consistency was high for the overall scale (Cronbach’s α = 0.856) and good across subscales (α = 0.744–0.836). Pearson correlations showed significant associations between dimensions (r = 0.162–0.603, p < 0.001). ICC values indicated good score stability. ANOVA analyses revealed significant differences across demographic subgroups (p < 0.05). Mean scores were higher for cognitive dimensions (MS = 4.20–4.54) compared with behavioral impact (MS = 2.87). Conclusions: The Romanian version of the SMOHLQ demonstrated satisfactory psychometric properties, supporting its reliability and construct validity as a tool for assessing digital oral health literacy in the context of social media use. Full article

Background: Persistent cervical human papillomavirus (Human papillomavirus) infection remains a significant public health concern, as it is the primary etiological factor in the development of cervical cancer and its precursor lesions. While prophylactic vaccination and standard screening programs are cornerstones of prevention, a substantial proportion of women with established infection are managed conservatively, often with prolonged follow-up and associated psychological burden. Interest has therefore grown in supportive interventions that may facilitate viral clearance during routine clinical management. Methods: This retrospective cohort study included 239 women with confirmed cervical Human papillomavirus infection followed at a tertiary referral center between February 2023 and August 2025. Participants were classified into a treatment group receiving oral Papivir/Pavirona^® twice daily for six months (n = 119) and a control group managed with routine clinical follow-up alone (n = 120). Human papillomavirus DNA testing and cervical cytology were evaluated at baseline and at 6 and 12 months. Results: Human papillomavirus clearance rates were significantly higher in the Papivir/Pavirona^® group compared with controls at both 6 and 12 months. Cytological regression was also more frequent in the treatment group at both time points. In multivariate logistic regression analysis, Papivir/Pavirona^® use emerged as the only independent predictor of both Human papillomavirus clearance and cytological regression, while demographic, reproductive, behavioral, and virological baseline characteristics were not significantly associated with outcomes. Conclusions: Papivir/Pavirona^® supplementation was associated with increased Human papillomavirus clearance and cytological regression rates in women with cervical Human papillomavirus infection, suggesting a potential supportive role alongside standard clinical follow-up. Full article

Objectives: Oral health-related quality of life (OHRQoL) reflects the functional and psychosocial impacts of oral conditions on daily life. In low-resource settings such as rural Tanzania, limited access to dental care and preventive services may increase the burden of oral disease. This study assessed the association between clinical oral health conditions and OHRQoL among schoolchildren in rural Tanzania. Methods: A cross-sectional study was conducted among 293 schoolchildren at Igelehezda Primary School, Ilembula, Tanzania. Clinical examinations assessed dental caries using the DMFT index and oral hygiene using the OHI-S index. OHRQoL was measured with the Child Oral Impact on Daily Performances (C-OIDP) questionnaire. Behavioral data included sugar intake, number of daily meals, and toothbrushing-related symptoms. Associations between clinical, behavioral factors and OHRQoL were analyzed using descriptive statistics, bivariate tests, and multiple linear regression (p < 0.05). Results: All 293 children completed the study (mean age 12.2 ± 1.2 years; 157 females, 136 males). Mean DMFT was 2.7 ± 4.1, with 80.5% free of untreated caries, and mean OHI-S indicated good oral hygiene (0.4 ± 0.6). Most participants were periodontally healthy (68.3%). Toothache, gum pain, or bleeding during brushing were reported by 26.0–31.6%. Eating was the most affected daily activity (42.7%). Missing teeth, toothbrushing-related symptoms, and consumption of high-sugar sweets were significantly associated with higher C-OIDP scores (p < 0.05), while a higher number of daily meals was associated with fewer impacts. Conclusions: Missing teeth, toothbrushing-related symptoms, and high sugar intake were associated with greater impairment in daily life, particularly affecting eating. These findings highlight the need for preventive and educational oral health interventions in rural, resource-limited settings. Full article