Journal of Oral Health and Oral Epidemiology
Volume:9 Issue: 3, Summer 2020

Recurrent aphthous stomatitis (RAS) is a lesion of the oral cavity with an unknown etiology. Several studies have been performed on the role of tumor necrosis factor-alpha (TNF-α) in RAS. The main purpose of this paper was to review TNF-α level and its gene polymorphism in patients with RAS, the factors influencing the production of TNF-α, and its role in RAS development.

In this review study, all articles containing English abstract were searched in the PubMed, Cochrane Library, and Scopus databases from January 2000 to December 2019. The searches were done using the Medical Subject Heading (MESH) terms and keywords of "recurrent aphthous stomatitis" or "recurrent aphthous ulcers" or "recurrent oral ulcers" and “tumor necrosis factor-alpha” or “TNF-α”. The data for gene polymorphism were analyzed using Comprehensive Meta-Analysis (CMA) software. Regarding the heterogeneity of studies, the random effects model was used. Cochran’s Q and I2 tests were used to evaluate statistical heterogeneity between the studies.

Amongst the 619 articles obtained in the first stage of our search of database, 21 articles which were fitted to our study based on the entry/exit criteria were selected in the review. According to this meta-analysis, recessive model of TNF-α -308 G/A had protective effects for RAS [odds ratio (OR) = 0.392, 95% confidence interval (CI) = 0.145-1.061, P = 0.045].

The results showed the important role of TNF-α in RAS development. There are numerous factors involved in producing this cytokine. Identifying TNF-α production pathway and its effects in RAS formation is significant in developing new prevention and treatment methods.

Various types of harmful wastes, which may or may not be contaminated with body fluids, result from health care services. When dental clinics are improperly managed, various environmentally hazardous wastes emerge. This study aims to determine and compare the knowledge levels of academic and dental health personnels and dentistry students and reveal the need for education.

The study was conducted face-to-face with 90 people, consisting of 4th and 5th-grade students studying at dentistry school, assistant professors, research assistants, nurses, and cleaning staff. The statistical significance level was set at 5% in calculations and SPSS statistical software was used for calculations.

No significant difference was found between the study participants when their waste knowledge levels were evaluated by gender and work experience. Significant differences were found between the study participants when their waste knowledge levels were evaluated by their education level and according to their roles (P < 0.05). Waste knowledge levels of individuals with an undergraduate or post-graduate degree were found to be higher than primary or high school graduates. The knowledge level of the cleaning staff was found to be significantly lower than all other groups.

The results reveal the need to update the medical waste knowledge of all health care occupations, especially the cleaning staff, at regular intervals, regardless of their work experience.

Periodontal disease is considered to be a remarkable factor affecting the quality of life and systemic and oral health by causing various symptoms for patients. The objective of this research was the evaluation of periodontal status and its related factors including age, gender, educational level, oral hygiene, and diabetes mellitus (DM) in people aged 35-70 years in cohort population of Rafsanjan, Iran.

In this cross-sectional study, 7855 patients aged 35-70 years who referred to Rafsanjan Cohort Center in 2019 were selected through systemic sampling and were examined according to their gingival health indices such as bleeding on probing (BOP), periodontal pocket depth, and clinical attachment loss (CAL). Data were then analyzed by SPSS software using chi-square test and independent t-test. P-value less than 0.05 was set as significant level.

All three gingival health indices were higher in people in older age category significantly (P = 0.0001). BOP index was significantly higher in women (P = 0.0001); the other two indices were also more in women, although insignificantly. By education level increase, BOP, pocket depth, and CAL decreased (P = 0.0001, P = 0.0650, and P = 0.0001, respectively). Moreover, brushing decreased all indices although this decline was just significant for BOP and pocket depth (P = 0.0380 and P = 0.0001, respectively). Concerning DM, no significant difference was observed between diabetics and non-diabetics in CAL (P = 08910) and pocket depth (P = 0.3240). However, people with DM had significantly higher BOP (P = 0.0001).

Periodontal diseases were more likely in women with older age and lower educational level who had poorer oral hygiene. People with DM had higher BOP but CAL and periodontal pocket were not different between diabetics and non-diabetics.

Teachers and healthcare providers play an essential role in raising the level of awareness and knowledge and serve as a model for different aspects of healthcare. Primary school healthcare providers with the necessary education could improve the oral health of the students. One of the methods for evaluating oral health is the assessment of periodontal indices. The Community Periodontal Index of Treatment Needs (CPITN) is one of the most common indices for the assessment of gingival status. This study aimed to evaluate gingival health and its relationship with the level and the type of education and activity of healthcare providers in elementary schoolchildren. This descriptive cross-sectional study was performed on 800 elementary schoolchildren in Tabriz, Iran, in 2017. Students’ gingival status was assessed with the CPITN. The healthcare teacher-associated factors, also, were determined through a checklist including age, sex, education, and activity. The data were analyzed with SPSS software. Independent t-test and chi-square test were done. P < 0.05 was considered significant. 63.2% of students had a CPITN score of 1, 31.5% of students had a CPITN score of 0, and 5.3% of students had a CPITN score of 2. Students of teachers with higher academic education (P = 0.029) and with health-related education (P = 0.013) received lower CPITN scores and had better periodontal health. There was no statistically significant relationship between age, sex, and activity of the teachers and CPITN of the students (P > 0.05). There was a significant relationship between the gingival and oral health of students and the level of education of healthcare teachers and their health-related university education. We strongly recommend the continuing education program for the healthcare providers in elementary schools.

Existence of developmental spaces during the primary dentition period is essential for the permanent dentition period and results in regular eruption of permanent teeth. The wide class of different occlusion and dental arch types during the primary dentition period, based on factors such as race, conducted to research the prevalence of these two occlusion factors in 3 to 5 years old children in Kerman-Iran. 520 caries-free children attending different kindergartens were selected to evaluate occlusion parameters in Kerman City, Iran, 2019. The oral examination of children was performed by a senior dental student using a tongue depressor and in a room with sufficient light. Collected data were analyzed by SPSS software using t-test, chi-squared, and analysis of variance (ANOVA) tests. The significant level less than 0.05 was considered. The children had predominantly open arch and prevalence of occlusion types was 73.4% for mesial step (MS), 10.5% for flush terminal plane (FTP), and 1.4% for distal step (DS), respectively. The statistical analysis explained a significant association between MS occlusion and open arch in the mandible (P = 0.013) and between dental arch types and sex in the maxilla (P = 0.028), so that the boys had a higher prevalence of open arch than the girls. The presence of developmental spaces in both jaws had a significant association with the upper mean age of the children (P = 0.001). The dental arches often had developmental spaces and molar relationship of MS during the primary dentition.

Molar incisor hypomineralization (MIH) is known as a developmental defect in enamel structure and shape seen in one to four permanent first molar teeth, usually affecting incisors. MIH can also influence children’s self-confidence and oral health-related quality of life (OHRQoL), as an index to assess the effect of oral and orofacial diseases on individuals’ health status, mood, and sense- quality; which are specifically measured in children and teenagers through the Child Perceptions Questionnaires (CPQ8-10 or CPQ11-14 ). Therefore, this study goaled to examine the prevalence of MIH and the effects of MIH on OHRQoL during mixed dentition period in Kerman, Iran. This descriptive-analytical cross-sectional study was performed on a total number of 2507 children aged 8-12 years in public schools selected using cluster random sampling method. Clinical examination was correspondingly done under day light with a dental probe and a disposable dental mirror by a calibrated dental student. The data were coded and imported into the IBM SPSS Statistics (version 20) wherein Chi-square test, independent t-test, and one-way analysis of variance (ANOVA) were employed for analyses. The significance level was also set at 0.05. A total of 129 (5.14%) students were diagnosed with MIH. The mean score of OHRQoL according to the standard CPQ8-10 or CPQ11-14 in children with MIH in this study was 19.9±15.1, ranged from 0 to 82. Moreover, girls suffering from MIH had lower OHRQoL compared with boys (p =0.006). It was concluded that MIH had a negative impact on OHRQoL in children.

Forensic odontology is a neglected field of dentistry despite its importance in profession. It must be considered as part of dental curriculum and undergraduate students must have insight into the subject. The objective of this study was to evaluate the awareness of dental graduates regarding forensic dentistry in Karachi, Pakistan.

A cross-sectional study was conducted from January to June 2019 among different dental colleges of Karachi. About 500 participants including house officers, postgraduate trainees, and dental teaching faculty were recruited through convenience sampling. Inclusion criteria were undergraduate and graduate dental students of recognized dental colleges who verbally consented for study. All quacks and non-registered practitioners were excluded. A predesigned questionnaire was used to collect data which consists of two sections, i.e., basic demographic data and knowledge of dental practitioners regarding forensic dentistry, respectively. Data collected were entered and analyzed on SPSS.

Women were major participants, i.e., 68.29% (n = 341). 55.80% (n = 279) of participants were postgraduate trainees. Approximately, 61.20% (n = 306) of people believed in significance of maintaining dental record. In 67.80% (n = 339) of cases, investigators could estimate age of victim while 49.20% (n = 246) could identify gender. 46.20% (n = 231) of participants agreed that forensic odontology helped in testification as an expert witness. The most accurate method for identification was an anthological examination, followed by fingerprints, serological, and visual identification. Whereas, 47.80% (n = 239) of participants knew the identification of a person with the help of bite mark, majority of participants (90.00%, n = 450) suggested that awareness programs must be initiated.

The awareness of dentists regarding forensic dentistry is judiciously sufficient and knowledge of maintaining dental records was satisfactory. Burly initiatives must be taken to develop the specialty in Karachi.

Oral verrucous carcinoma (OVC) is a rare malignant tumor with a complex etiology. This tumor is more prevalent in men and buccal mucosa is the most common site of OVC. Altogether, OVC has a relatively good prognosis.

In this case report, a rare case of a 64-year-old female with history of consuming opium and involvement of hard palate was reported. Because of the high recurrence rate, a more aggressive approach was considered for second surgery. After 18 months of follow up, the patient was in good health condition and no sign of recurrence was noted.

Precancerous lesions may develop into OVC; Differentiation of OVC from other oral lesions is challenging for oral pathologists due to different origins of the lesion. In case of immediate relapse or recurrence after surgery, surgeons are forced to use more aggressive approaches to eliminate the lesion.