Background

Radiotherapy (RT) is associated with significant acute and long-termside effects that may impair oral health-related quality of life (OHRQoL). This systematic review aimed to synthesise the existing evidence on how RT affects OHRQoL in patients with head and neck cancer (HNC).

Methods

This review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (CRD42023448568). A systematic search was carried out in PubMed, Scopus,Web of Science, and EBSCO host using combinations of terms related to RT, HNC, andOHRQoL. Only observational studies involving adult patients treated with RT were included. Data extraction and quality assessment were performed independently by two reviewers.

Results

A total of 5100 records were identified, with 73 studies meeting the inclusion criteria. The results were categorised into impacts during RT, and shortterm (<6 months), and long-term (≥6 months), impacts after RT. During RT, OHRQoL was most affected by oral mucositis (OM), pain, xerostomia/dry mouth, and taste dysfunction (TD). Short-term after RT the most notable effect on OHRQoL was pain, xerostomia/dry mouth and sticky saliva, similar to outcomes during RT. In the longterm, xerostomia/dry mouth and TD remained the predominant issues, often persisting for years after treatment and contributing to sustained reductions in OHRQoL.

Conclusion

RT for HNC is associated with poorer OHRQoL. However, these findings should be interpreted with caution, as all included studies were observational and of moderate quality. Xerostomia/dry mouth and related oral complications were the most consistently reported contributors to reduced quality of life (QoL). These findings underscore the need for individualised, interprofessional care strategies that integrate clinical assessments with patient-reported outcomes (PROMs).

OBJECTIVES: To investigate the association between the individuals' level of sense of coherence (SOC) and periodontal disease severity.

METHODS: The study populations originated from two stratified cross-sectional random samples of residents in a medium-sized Swedish city in 2003 and 2013, respectively. The final samples constituted 491 individuals in 2003 and 538 individuals in 2013. The samples were classified into three groups according to the severity of periodontitis (no/minor, moderate and severe). The 13-item Swedish version of Antonovsky's "Orientation to life" questionnaire, measuring the individual's SOC, was filled out. Descriptive statistics were performed as well as multinomial logistic regression analysis. Dependent variable was the severity of periodontal disease and independent variables, age in years, presently smoking and education at university level.

RESULTS: In the multinomial regression analysis, smoking, age, and total SOC score were significantly associated with severe periodontitis at both examinations. The strongest predictor of severe periodontal disease was smoking. The total SOC score did not differ between the examinations, but there was a statistically significant difference in two of the SOC dimensions, manageability (lower), and comprehensibility (higher), over time.

CONCLUSIONS: Individuals with severe periodontitis had significantly lower SOC compared to subjects periodontally having no/minor periodontal disease. Smoking was the strongest overall predictor of having severe periodontitis.

Introduction: The World Dental Federation (FDI) has recently proposed a new definition and theoretical framework of oral health. The theoretical framework includes 4 main components and describes the relationships amongst them. In 2020, an international work group proposed the minimum Adult Oral Health Standard Set (AOHSS) of variables to measure oral health, which was mapped onto the FDI's theoretical framework. By using an empirical data set, the proposed variables in the AOHSS and the potential interactions amongst the components of the FDI's theoretical framework can be tested. The purpose of this research was to investigate structural relations of the components of the FDI's theoretical framework of oral health based on data from a general adult population.

Methods: Data from a previously conducted Swedish cross-sectional study focusing on oral health were utilised (N = 630; women, 55.2%; mean age, 49.7 years [SD, 19.2]). Variable selection was guided by the AOHSS. Structural equation modeling was used to analyse relationships amongst the components of the FDI's theoretical model (core elements of oral health, driving determinants, moderating factors, and overall health and well-being).

Results: The Oral Health Impact Profile (OHIP)-14, xerostomia, and aesthetic satisfaction had statistically significant direct effects on overall health and well-being (p < .05). Driving determinants and moderating factors had statistically significant direct effects on all core elements of oral health (p < .05) except aesthetic satisfaction (p = .616). The predictors explained 24.1% of the variance of the latent variable overall health and well-being. Based on several indices, the proposed model showed acceptable model fit.

Conclusions: The FDI's theoretical framework can be used to describe different components of oral health and the relationship amongst them in an adult general population. Further research based on the FDI's theoretical framework in other populations and settings is needed to explore complex interactions and possible relationships that form oral health and to investigate other or additional important social determinants.

AIM: This study aimed to identify the factors influencing the changes in the number of teeth present, and the number of healthy or filled surfaces between two time-points.

MATERIALS AND METHODS: Repeated cross-sectional data from population-based studies, i.e., the German Oral Health Studies (DMS-III vs DMS-V), the Studies of Health in Pomerania (SHIP-START-0 vs. SHIP-TREND-0), and the Jönköping study (2003 vs. 2013), were analysed. Oaxaca decomposition models were constructed for the outcomes (number of teeth, number of healthy surfaces and number of filled surfaces).

RESULTS: The number of teeth increased between examinations [DMS: +2.26 (adults), +4.92 (seniors), SHIP: +1.67, Jönköping: +0.96]. Improvements in education and dental awareness brought a positive change in all outcomes. An increase in powered toothbrushing and interdental cleaning showed a great impact in DMS (adults: +0.25 tooth, +0.78 healthy surface, +0.38 filled surface; seniors: +1.19 teeth, 5.79 healthy surfaces, +0.48 filled surface). Interdental cleaning decreased by 4% between SHIP-START-0 and SHIP-TREND-0, which negatively affected the outcomes.

CONCLUSION: From this study, it can be concluded that education may be the most important factor having a direct and indirect effect on the outcomes. However, for better oral health, powered toothbrushing and interdental cleaning should not be neglected.

Objectives

To investigate alveolar bone loss (ABL), which is an indicator of periodontitis, and to identify risk factors for ABL in an older population between 2008 and 2018.

Methods

This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions ten years apart to 273 individuals who were 65 years and 75 years in 2008.

Results

The mean number of teeth decreased significantly over the ten-year study period, while the proportion of individuals with calculus and moderate ABL visible on radiographs increased. For both ages, the number of teeth decreased by a mean of 2 teeth. The proportions of participants reporting poor general health, daily medication, xerostomia, living singly, visiting dental care irregularly and being in need of extra support in their homes all increased over the observation period.

Conclusions

Despite an increased progression of moderate alveolar bone loss, a fairly good dentition and chewing capacity was retained in this older population. However, the individual's age and fragility are important indicators that need to be considered when planning oral health care and the availability of dental care.

Objectives: To investigate the prevalence of dental caries and to identify risk factors for dental caries in an elderly population between 2008 and 2018.

Methods: This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions 10 years apart to 273 individuals who were 65 and 75 years of age in 2008. The variables included were prevalence of dental caries as well as socioeconomic and socio-behavioural factors.

Results: The number of teeth decreased in both age groups by a mean of 2 over the 10-year study period, but the prevalence of dental caries remained stable. Approximately, a quarter of the participants had caries lesions. Toothbrushing once a day or less was the factor most strongly correlated with dental caries lesions (OR: 3.82, 95% CI: 1.68–8.66, p = 0.001), followed by need for homecare (OR: 3.50, 95% CI: 1.55–7.93, p = 0.003) and interproximal cleaning less than once a day (OR: 2.65, 95% CI: 1.36–5.19, p = 0.004).

Conclusions: This longitudinal study revealed no increase in the prevalence of dental caries lesions, indicating that good oral health can be preserved among elderly people. The highest risk for dental caries lesions was among participants with inadequate oral hygiene routines (toothbrushing once a day or less and seldom using interproximal devices) and in need of help in daily living, emphasizing the importance of oral hygiene and collaboration between dental services and community-based health care.

Introduction

Oral health is part of general health, and oral diseases share risk factors with several non-communicable diseases. The World Dental Federation (FDI) has published a theoretical framework illustrating the complex interactions between the core elements of oral health (CEOHs): driving determinants, moderating factors, and general health and well-being. However, the framework does not specify which self-reported or clinical measurements to be included in the CEOHs.

Objectives

To explore oral health measurements relevant for a general adult population to be included in the CEOHs in the FDI's theoretical framework of oral health.

Materials and methods

A psychometric study was performed, using cross-sectional data from Sweden (N = 630, 54% women, mean age 49.7 years). The data set initially consisted of 186 self-reported and clinical measurements. To identify suitable measurements, the selection was discussed in different settings, including both experts and patients. Principal component analyses (PCAs) were performed to explore, reduce and evaluate measurements to be included in the three CEOHs. Internal consistency was estimated by Cronbach's Alpha.

Results

The validation process yielded 13 measurements (four clinical, nine self-reported) in concordance with the CEOHs. PCAs confirmed robust validity regarding the construction, predicting 60.85% of variance, representing psychosocial function (number of measurements = 5), disease and condition status (number of measurements = 4), and physiological function (number of measurements = 4). Cronbach's Alpha indicated good to sufficient internal consistency for each component in the constructs (a = 0.88, 0.68, 0.61, respectively).

Conclusion

In a Swedish general adult population, 13 self-reported and clinical measurements can be relevant to include to operationalise CEOHs in the FDI's theoretical framework.