Search Results (463)

Alcohol Use Disorder (AUD) is common among patients with maxillofacial trauma. Conventional perioperative care recommends complete abstinence. However, abrupt cessation can lead to Alcohol Withdrawal Syndrome (AWS), negatively impacting psychological well-being and compliance. This randomized controlled pilot study evaluated the effectiveness of Monitored Therapeutic Alcohol Administration (MTAA) in reducing perioperative stress and enhancing quality of life without impairing fracture healing. Twenty-four adult male patients with AUD and isolated facial fractures requiring surgery were enrolled. They were assigned to either an intervention group (n = 12) receiving MTAA—oral alcohol at 0.5 g/kg/day for two weeks—or a control group (n = 12) undergoing complete abstinence. Outcomes were assessed over six weeks, including stress (Zung Self-Rating Depression Scale), quality of life (Oral Health Impact Profile-14), soft tissue healing (Landry’s Index), and hard tissue healing (Moed’s Scale, serum osteocalcin). The MTAA group showed significantly reduced stress and improved quality of life (p < 0.001). Healing outcomes were comparable between groups, with no significant differences in soft tissue indices, osteocalcin levels, or radiographic scores. MTAA appears to be a safe and effective strategy to manage AWS-related distress and improve postoperative recovery, offering a practical alternative to strict abstinence in the surgical management of patients with AUD. Full article

Mucositis involving the gastrointestinal, vaginal, and nasal mucosa is one of the primary dose-limiting toxicities of hematopoietic stem cell transplantation (HSCT) and its conditioning regimen. The oropharyngeal mucosa is commonly affected, which can be detrimental to patient health and quality of life. Despite its significant prevalence and deleterious effects, we have an inadequate understanding of the risk factors and outcomes associated with oral mucositis (OM). We performed a literature search through PubMed and EBSCO (inception to 31 March 2024) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was extracted from eligible studies using a pre-specified data extraction form. Quality of the data was assessed using the Newcastle-Ottawa Scale for non-randomized, observational studies and the Cochrane Collaboration Tool for randomized controlled trials. Our initial search identified 1677 articles, 34 of which were included in our study. Of those 34, 30 were included in the qualitative assessment of clinical risk factors in the development of OM, and 4 were included in the meta-analysis assessing the relationship between OM and infectious complications following HSCT. Across both HSCT modalities and cancer cohorts, female sex and high-intensity conditioning were common risk factors in the development of OM. When stratified by allogeneic and autologous HSCT, methotrexate, younger age, and longer duration of neutropenia were associated with increased OM risk in allogeneic HSCT recipients, while renal dysfunction, HSV-1 reactivation, and longer neutrophil engraftment were associated with increased OM risk in autologous HSCT recipients. Longer neutrophil engraftment was a common risk factor across different cancer cohorts; however, renal dysfunction was a distinct risk factor for OM in multiple myeloma patients. Additionally, our meta-analysis revealed that patients with OM have an increased risk of developing infectious complications following HSCT compared to those without OM, with an odds ratio of 3.84 (95% CI: 2.51–5.86). The development of OM is related to various risk factors, and individuals with OM are at greater risk of infectious complications. Knowledge of these risk factors and outcomes will help clinicians identify high-risk individuals, prevent OM, and protect an immunocompromised population from subsequent life-threatening complications. Full article

Objective: This retrospective study aims to assess the impact of bite-raising on patients’ quality of life and to compare the outcomes of anterior versus posterior build-ups. Materials and Methods: A total of 94 young adolescents treated with fixed orthodontic were selected and divided into two groups: the anterior bite raisers group (ABG) and the posterior bite raisers group (PBG). To enable comparison with untreated individuals, a control group (CG) of 50 subjects was also included. Pain intensity was assessed using a Visual Analog Scale (VAS), while oral health-related quality of life (OHRQoL) was measured through the OHIP-14 questionnaire (Italian validated version) before treatment and during each appointment for the first 3 months after build-ups placement. Results: Patients undergoing orthodontic treatment without bite raisers (CG) reported lower OHIP-14 scores compared to those with anterior (ABG) and posterior (PBG) bite raisers. In both ABG and PBG, the most commonly reported side effects included difficulty eating, oral pain, and feelings of embarrassment in social situations—similar to those reported by the control group. However, participants in the ABG also reported challenges in pronouncing certain words. Furthermore, the ABG experienced higher levels of physical pain, physical disability, and psychological discomfort compared to both the PBG and CG. Patients in the ABG reported more build-ups detachments or breakages than patients in PBG (ABG 32% vs. PBG 18%, p < 0.01). Build-ups were removed due to adequate overbite correction significantly before in the ABG (4.2 ± 0.9 months) than in the PBG (6.1 ± 1.4 months, p < 0.01). Conclusions: Anterior bite raisers have a significantly greater impact on patients’ quality of life compared to posterior bite raisers, leading to increased difficulties in eating and speech, higher levels of physical pain and disability, greater psychological discomfort, and more intense pain following build-ups placement. Full article

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article

Background and Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder that primarily affects young adults and is frequently accompanied by psychiatric comorbidities such as depression and anxiety, both of which significantly diminish patients’ quality of life (QoL). This study investigated the effect of two oral disease-modifying therapies (DMTs), fingolimod and cladribine, on mental health and QoL in patients with relapsing-remitting MS (RRMS). The aim of the study was to compare levels of depression, anxiety, and health-related quality of life (HRQoL) in RRMS patients treated with fingolimod or cladribine, and to evaluate their associations with clinical and radiological parameters. Materials and Methods: Eighty RRMS patients aged 18 to 50 years with Expanded Disability Status Scale (EDSS) scores of 3.0 or less, no recent disease relapse, and no history of antidepressant use were enrolled. Forty patients were treated with fingolimod and forty with cladribine. Depression and anxiety were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). QoL was evaluated using the Multiple Sclerosis QoL-54 (MSQOL-54) instrument. Additional clinical data, including MRI-based lesion burden, EDSS scores, age, disease duration, and occupational status, were collected. Results: No statistically significant differences were observed between the two groups regarding HDRS and HARS scores (p > 0.05). However, patients treated with fingolimod had significantly higher scores in the Energy/Fatigue subdomain (7.55 ± 2.02 vs. 6.56 ± 2.57, p = 0.046) and Composite Mental Health (CMH) score (64.73 ± 15.01 vs. 56.00 ± 18.93, p = 0.029) compared to those treated with cladribine. No significant differences were found in the independent items of the MSQOL-54. A negative correlation was identified between total lesion load and QoL scores. Conclusions: Although fingolimod and cladribine exert comparable effects on depression and anxiety levels, fingolimod may be associated with better mental health outcomes and reduced fatigue in RRMS patients. Furthermore, lesion burden and clinical parameters such as age and EDSS score may independently influence QoL, regardless of the DMT used. Full article

Students, particularly those in the medical field, are exposed to various stressors that can affect their health-related behaviors, including smoking habits, with implications for oral health and quality of life. Background and Objectives: to analyze the relationship between smoking, oral health, perceived stress level, and self-assessed quality of life in a sample of dental students. Materials and Methods: The cross-sectional study included 338 students, who completed validated questionnaires and were clinically examined. Lifestyle was assessed using a smoking behavior questionnaire, stress levels were measured with the Student Stress Inventory (SSI), and quality of life was evaluated using the EQ-5D-5L instrument. The DMFT index was calculated to determine oral health status. Results: Among the 338 participating students, 53.8% were smokers. The lifestyle analysis revealed slightly higher average scores among non-smokers across all domains—social (3.26 vs. 3.09), attitudinal (2.75 vs. 2.97), and behavioral (3.82 vs. 3.49), but without statistically significant differences (p > 0.25). The mean DMFT score was 12.48, with no significant differences between smokers and non-smokers (p = 0.554). The SSI total score averaged 83.15, indicating a moderate level of perceived stress, again with no statistically significant differences between the groups (p > 0.05). However, slightly higher average stress scores among smokers may suggest the use of smoking as a coping mechanism. In contrast, quality of life as measured by EQ-5D-5L showed significantly worse outcomes for smokers across all five dimensions, including mobility (78.6% vs. 95.5%, p = 0.000) and self-care (93.4% vs. 100%, p = 0.001). Multivariable logistic regression identified smoking (OR = 1.935; p = 0.047) and moderate stress levels (OR = 0.258; p < 0.001) as independent predictors of oral health status. Conclusions: The results obtained suggest that smoking may function as a stress management strategy among students, supporting the relevance of integrating specific psychobehavioral interventions that address stress reduction and oral health promotion among student populations. Full article

Aging is a multifactorial process that affects various physiological functions, including masticatory performance, which is crucial for oral health and nutritional well-being. Impaired masticatory function, often due to factors such as tooth loss, reduced salivation, or muscle atrophy, can lead to significant nutritional challenges and compromise the overall health of elderly individuals. Recent research has illuminated the interconnectedness of masticatory function, oral microbiota, and gut health, suggesting that altered chewing ability may disrupt oral microbial communities, which in turn affect gastrointestinal health and systemic inflammation. This commentary review provides a comprehensive analysis of the role of masticatory function in aging, exploring its impact on the oral microbiota, gut health, and broader nutritional status. We discuss the potential consequences of impaired mastication, including malnutrition, dysbiosis, and gastrointestinal disorders, and explore possible strategies for improving masticatory function and maintaining a healthy gut microbiome through interventions like dietary modifications, oral care, and rehabilitation. We aim to underscore the importance of integrating masticatory function management into the broader context of aging-related healthcare, promoting holistic, multidisciplinary approaches to support nutritional needs and quality of life in older adults. Full article

Iron deficiency (ID) is the most prevalent micronutrient deficiency globally, affecting approximately one in four individuals, with a particularly high burden among children, women of reproductive age, and populations in low- and middle-income countries. It contributes significantly to the global burden of disease, with consequences ranging from impaired cognitive and motor development in children to increased risks during pregnancy, including low birth weight, preterm delivery, and maternal mortality, as well as reduced physical performance and quality of life in adults. ID often precedes iron deficiency anemia (IDA), though clinical and functional impairments—such as cognitive deficits, immune dysfunction, and fatigue—can occur even in the absence of anemia. Despite its widespread nature, challenges remain in precisely defining, diagnosing, and treating ID effectively. Advances in diagnostic tools allow for earlier detection, while novel therapeutic strategies, including updated oral dosing regimens and modern intravenous iron formulations, offer improved efficacy and tolerability. These approaches are particularly valuable in minimizing gastrointestinal side effects and enhancing patient adherence. This review is based on a comprehensive literature search conducted primarily through PubMed and Scopus, emphasizing studies published within the past 10–15 years. It is thematically structured to explore the epidemiology, health consequences, diagnostic complexities, and therapeutic developments related to ID. It highlights the multifactorial nature of ID and underscores the urgent need for early identification, targeted interventions, and updated clinical guidelines to reduce the long-term health and societal impacts of this preventable and treatable condition. Full article

Objectives: Burning mouth syndrome (BMS) is a chronic, painful, idiopathic condition of the oral cavity, characterized by the absence of visible pathological changes on the oral mucosa and normal laboratory findings. Recent evidence from the literature supports the classification of BMS as a neuropathic condition. It has been proposed that oxidative stress may contribute to neuropathic pain. N-acetylcysteine (NAC) is an antioxidant that exhibits neuroprotective properties. The aim of the study was to evaluate the efficacy of N-acetyl cysteine in the treatment of burning mouth syndrome (BMS). Methods: Eighty female patients with previously diagnosed BMS were randomly assigned to one out of two groups. One group received N-acetyl cysteine (600 mg/twice a day) and the other received placebo, for an eight-week period. The outcome was measured by the Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire and Numeric Pain Rating Scale, for burning and discomfort, both before and after completing the therapy. Results: Both groups experienced a significant reduction in burning and discomfort sensations, along with a significant improvement in oral health-related quality of life. However, the difference between the treatment and control group was not statistically significant. Conclusions: NAC does not significantly improve the oral health-related quality of life, burning sensations, and discomfort in BMS subjects compared to placebo. Full article

Polycystic ovary syndrome (PCOS) is an endocrine disorder prevalent in women of reproductive age, often requiring complex pharmacological management. The heterogeneity of the syndrome and the use of on- and off-label therapeutic agents—ranging from insulin sensitizers and ovulation inducers to oral contraceptives and herbal supplements—pose significant challenges, including adverse effects, drug interactions, and poor adherence. This narrative review explores the role of pharmacists in identifying and mitigating drug-related problems (DRPs) associated with PCOS therapy. Through thematic synthesis of the current literature, the study highlights common DRPs such as suboptimal drug selection, inappropriate dosing, prolonged therapy duration, and treatment-related safety concerns. It underscores the value of pharmacists’ interventions in enhancing medication adherence, optimizing therapeutic regimens, providing patient education, and monitoring adverse events. A structured, patient-level pharmaceutical care model is proposed, emphasizing personalized assessment, interdisciplinary collaboration, and continuous follow-up. The integration of clinical pharmacists into PCOS care teams has the potential to improve treatment effectiveness, patient satisfaction, and long-term health outcomes. Pharmacists’ contributions are especially critical given the widespread use of off-label therapies and supplements with variable evidence of benefit. Tailored pharmaceutical care can thus bridge the existing gaps in PCOS management and enhance the quality of life for the affected individuals. Full article

Background: Cachexia worsens prognosis, quality of life and chemotherapy treatment compliance of patients with lung cancer. Chemotherapy-induced cachexia has also been implicated in lowered mortality. This study aimed to evaluate the frequency of cachexia-related measures and symptoms as outcomes in lung cancer chemotherapy trial protocols and to examine how key trial characteristics influence them. Method: We conducted a cross-sectional data analysis of randomised controlled chemotherapy trials of lung cancer registered in four public trial registries between 2012 and 2023. Trial outcome measures included overall survival, treatment toxicity/side effects and cachexia-related indicators such as physical activity, weight/body mass index (BMI), dietary limitations, caloric intake and lean muscle mass. Symptom-related outcomes, including appetite loss, diarrhoea, pain, fatigue/insomnia, constipation, nausea, vomiting, dysphagia, dyspnoea and oral mucositis, were also extracted. Additionally, the number and type of performance status and assessment tool were recorded. Data were summarised descriptively. Chi-square tests were used to examine associations between trial outcomes and characteristics including cancer type, trial location, lead investigator/funding source, assessment tools and trial commencement year. A p < 0.05 was considered statistically significance. Results: Of the 335 trial protocols (non-small cell (87.2%) and small cell (12.8%)), most were from Europe (50.4%). The trial lead investigator was from industry (56.7%) followed by academia (25.1%). Allied health professional involvement was minimal (0.6%). Trial protocols mostly recorded overall survival (96.4%) and toxicity (83.9%). However, physical activity, weight/BMI, dysphagia, dyspnoea and oral mucositis were recorded in <30%, with dietary limitations, caloric intake and lean muscle mass recorded in <3% of the trials. Measures and symptoms were not associated with cancer type. Trial location was associated with the measures toxicity, physical activity and caloric intake and all symptoms. Lead investigator was associated with the measures toxicity and weight/BMI and all symptoms except for dyspnoea. Performance status and assessment tools were mentioned in 93.4% and 41.8% of the trials, respectively, with significant associations between assessment tools and outcomes, except for weight/BMI, dietary limitations, lean muscle mass, dysphagia and oral mucositis. There was a significant trend with trial commencement year for the measures physical activity (p = 0.002) and weight/BMI (p = 0.000) and all symptoms, except for appetite loss (p = 0.115) and pain (p = 0.433). Conclusions: While the reporting of measures and outcomes was generally higher compared to gastrointestinal chemotherapy cancer trials, it still faced significant under-reporting. Assessment tools should include cachexia-specific symptoms to accurately assess the quality of life in patients with lung cancer undergoing chemotherapy clinical trials. Full article

Tooth wear is a growing oral health concern with implications for function, esthetics, and psychological well-being, ultimately affecting oral health-related quality of life (OHRQoL). While clinical indices assess tooth wear severity, they fail to capture patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs). This narrative review aims to identify and synthesize the use of PROs and PROMs used in adults with tooth wear and to map their assessed domains against the Wilson and Cleary model of health outcomes, highlighting gaps and guiding the development of condition-specific instruments. A comprehensive search of the literature was conducted across PubMed, MEDLINE, and Embase. Studies involving PROMs in adults with tooth wear were included. Extracted data encompassed psychometric properties and domains assessed. PROMs such as the OHIP, OES, OIDP, and QMFQ have been frequently used, focusing on functional limitation, esthetic perception, and psychological distress. However, no single instrument comprehensively addresses all relevant domains of the Wilson and Cleary model. Moreover, variation in tools and constructs limits comparability across studies and clinical settings. Existing PROMs capture only partial aspects of the patient experience related to tooth wear. When mapping these instruments to a validated theoretical model, significant gaps become evident, especially in terms of general health perceptions and overall quality of life metrics. To improve the evaluation and management of tooth wear in clinical settings, it is essential to create a condition-specific PROM based on a solid conceptual framework. Full article

Objectives: This study aimed to evaluate the association between nutritional status and oral health-related quality of life (OHRQoL) in older adults from population-based studies of two cities in southern Brazil. Methods: A total of 569 community-dwelling individuals aged 60 years and older were included. Sociodemographic, dental, and behavioral data were collected. Nutritional status was evaluated using the Mini Nutritional Assessment (MNA). OHRQoL, the primary outcome, was measured using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Poisson regression with robust variance was applied in crude and adjusted analyses to evaluate the impact of nutritional status on OHIP-14 outcomes. Results: The prevalence of risk of malnutrition was 31.6%, while the mean OHIP-14 was 4.86 ± 7.55. Individuals with malnutrition risk (7.44 ± 9.95) showed overall OHIP-14 scores significantly higher than those with normal nutrition (3.65 ± 5.76) (p < 0.001). A similar trend in results was detected in all domains of OHIP-14 (p < 0.05). In the adjusted analysis, individuals at risk of malnutrition had a 66% higher prevalence ratio (PR) (95% confidence interval [95% CI]: 1.23–2.23) of having poorer OHRQoL. Associations were also observed for the severity (PR: 1.69; 95% CI: 1.31–2.19) and extent (PR: 2.33; 95% CI: 1.55–3.49) of OHIP-14. Conclusions: In conclusion, poorer nutritional status is significantly associated with a higher impact on OHRQoL in older adults. Full article

Background: The global rise in life expectancy and the resulting shift toward ageing populations pose significant public health and socioeconomic challenges. As healthy ageing becomes a priority, understanding the factors that support well-being in older age is essential. Oral health is increasingly recognised as a critical determinant of overall health and has been linked to chronic conditions. Objectives: To conduct a systematic review of longitudinal studies examining the relationship between oral health and healthy ageing. Materials and Methods: Two independent reviewers conducted searches in three databases (MEDLINE, EMBASE, and LILACS) up to April 2025, following a defined search strategy. Grey literature was explored using Open Grey and Google Scholar. The quality and the risk of bias of the included studies were evaluated using the Newcastle Ottawa Quality Assessment Scale (NOS) for longitudinal studies. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251029090). Results: Four longitudinal studies reporting the association between oral health and healthy ageing were recognised and included. All selected studies were considered of good quality according to the NOS. The studies varied in defining and measuring healthy ageing, the follow-up period, the sample size, and the measure of oral health; therefore, it was not possible to perform a meta-analysis. The studies included in the review demonstrated a positive relationship between the number of natural teeth and healthy ageing. Discussion: Despite variations in the definition of healthy ageing and the application of different oral health indicators, the review identified significant associations between the number of natural teeth and trajectories of healthy ageing. Conclusions: This review recognised significant longitudinal associations between oral health measures (number of teeth) and trajectories of healthy ageing. The findings emphasise the need to incorporate oral health into research and policy related to healthy ageing. Full article