Objetivo: Determinar la asociación entre la mala autopercepción de la salud bucodental y la última visita al odontólogo en una población de adultos estadounidenses entre los años 2015-2016. Materiales y métodos: Este estudio es de tipo observacional, analítico, retrospectivo, transversal. La muestra estuvo conformada por 4057 participantes (30-80 años), provenientes de la Encuesta Nacional de Examen de Salud y Nutrición (NHANES) 2015-2016. La mala autopercepción de la salud bucodental fue la variable dependiente y la última visita al odontólogo, la independiente. Como covaribales, se incluyeron variables sociodemográficas y de salud oral. Se realizó un análisis descriptivo y se utilizó la prueba de Chi cuadrado y t de Student para comparar la variable dependiente según las características generales de los participantes. Asimismo, la asociación se evaluó mediante la regresión de Poisson como estimador robusto de varianza y se reportaron razones de prevalencia en un modelo crudo (bivariado) y ajustado (multivarible). Resultados: El 9.9% reflejaron una mala autopercepción de la salud bucodental. Asimismo, se encontró una mayor asociación entre esta variable y los individuos con mayor edad, ingresos económicos bajos y que visitaron al odontólogo con fines recuperativos. En el modelo ajustado, se evidenció que quienes acuden al odontólogo en un tiempo de dos años a más, tienen mayor probabilidad de tener una mala autopercepción de la salud bucodental (RP 1.6, IC al 95% 1.1-2.4). Conclusiones: Existe una asociación entre la mala autopercepción de la salud bucodental y la última visita al odontólogo en la población estadounidense adulta entre los años 2015-2016. / Aim: The main purpose of this study was to determine the association between poor self-concept of oral health and the last visit to the dentist in a population of American adults between the years 2015-2016. Materials and methods: This study is observational, analytical, retrospective, cross-sectional. The sample consisted of 4,057 participants (30-80 years old), from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. Poor self-perception of oral health was the dependent variable and the last visit to the dentist, the independent one. Sociodemographic and oral health variables were included as covariates. A descriptive analysis was carried out and the Chi-square test and Student's t test were used to compare the dependent variable according to the general characteristics of the participants. Likewise, the association was evaluated by means of Poisson regression as a boundary estimator of variance and prevalence ratios were reported in a crude (bivariate) and adjusted (multivariate) model. Results: 9.9% reflected a poor self-perception of oral health. Likewise, a greater association was found between this variable and individuals who are older, have low income and who visited the dentist for recuperative purposes. In the adjusted model, it was evidenced that those who visit the dentist in a period of two years or more are more likely to have a poor self-perception of oral health (PR 1.6, 95% CI 1.1-2.4). Conclusions: There is an association between poor self-concept of oral health and the last visit to the dentist in the American adult population between the years 2015-2016. / Tesis

Magister Scientiae Dentium - MSc(Dent) / This study analyzed the dental surgical implant therapy in the past 5 years at Tygerberg Oral Health Centre, UWC Dental School, Cape Town, South Africa. The findings of this study serve as a guideline for the estimation of the prevalence in this dental hospital. The importance of this study was to aid in the establishment of the formalized electronic database for dental implant therapy. The data generated will form a foundational basis for future studies that may be conducted in the field of implantology.

Orientador: Suzely Adas Saliba Moimaz / Resumo: O trauma buco maxilo facial (TBMF) relacionado à prática esportiva tem aumentado nos últimos anos, portanto é fundamental investigar os esportes de maior ocorrência, a saúde bucal dos atletas e a adoção de medidas preventivas. O objetivo neste estudo foi verificar a prevalência de trauma buco-maxilo-facial (BMF) em atletas; a relação com a modalidade esportiva praticada, bem como conhecimento e uso de protetores bucais, hábitos de higiene bucal, hábitos sociais e de hidratação. Trata-se de um estudo transversal, descritivo, envolvendo 647 atletas praticantes de diferentes esportes em um município do Brasil. Os participantes responderam a um questionário que abordava como desfecho primário a ocorrência de trauma na região da cabeça e pescoço durante atividades esportivas e o conhecimento e uso de protetores bucais. As seguintes variáveis também foram investigadas: esporte praticado, região afetada, escovação, uso do fio dental, consumo de refrigerantes, bebidas alcoólicas, tabagismo, hidratação e a respiração durante a prática esportiva. Do total, 148 atletas (22,87%) sofreram TBMF e os esportes de maior ocorrência foram o basquetebol e o futebol. Houve associação significativa entre ocorrência de TBMF e desconhecimento sobre protetores bucais (p=0,0042) e modalidade esportiva (p<0,0001). A boca foi o local mais acometido (30,40%), a cotovelada foi a principal causa (32,54%). O protetor bucal era conhecido por 538 atletas (83,15%), no entanto, apenas 169 (26,12%) utilizavam, s... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Buccomaxillofacial trauma (TBMF) related to sports practice has increased in recent years, so it is essential to investigate the sports with the highest occurrence of TBMF, the oral health of athletes and the adoption of preventive measures. The aim of this study was to verify the prevalence of buccomaxillofacial trauma (BMF) in athletes; the relationship with the sport practiced, as well as knowledge and use of mouthguards, oral hygiene habits, social habits and hydration. This is a cross-sectional, descriptive study, involving 647 athletes practicing different sports in a municipality in Brazil. Participants answered a questionnaire that addressed the occurrence of trauma in the head and neck during sports activities and the knowledge and use of mouthguards as the primary outcome. The following variables were also investigated: sport practiced, affected region, brushing, flossing, consumption of soft drinks, alcoholic beverages, smoking, hydration and breathing during sports practice. Of the total, 148 athletes (22.87%) suffered TBMF and the most frequent sports were basketball and football. There was a significant association between the occurrence of TBMF and lack of knowledge about mouthguards (p=0.0042) and sports (p <0.0001). The mouth was the most affected site (30.40%), the elbow was the main cause (32.54%). The mouthguard was known by 538 athletes (83.15%), however, only 169 (26.12%) used it, 13 (7.69%) of whom were personalized. It was found that 313 athletes (48.5... (Complete abstract click electronic access below) / Mestre

Background: Good oral health is fundamental to general health and well-being. Being in a dependent situation can result in lack of managing your own self-care which can lead to impaired oral health. Patients seem to be quite satisfied with their oral health but the assessment tool ROAG (Revised oral assessment guide) shows the opposite: that the oral standard is more inferior than the patients estimate. To ensure patients need of care, it is important to problematize and discuss oral health in the daily nursing care. Health personnel face dependent people in all kinds of health care. Registered nurses have the responsibility for nursing care and a role in leading the health personnel staff. Aim: The aim of this study is to describe health personnel's experience of working with oral health. Method: A literature-based study was performed with the analysis of seven qualitative articles. Results: The result consists of two main themes and six subthemes. The first main theme describes conditions to provide oral health. The second main theme describe barriers to provide oral health. The subthemes of the first main theme describe knowledge and earlier experiences. The subthemes of the second main theme describe the different barriers; insufficient knowledge, lack of time and resources, lack of support and routines, intrusion on someone's private sphere. These themes describe the health personnel's experience, working with oral health. Conclusion: The result shows that the health personnel need continuous education, clear routines and satisfactory resources. The oral cavity is seen as something private and it is easy to violate the patient's integrity.

BACKGROUND: Dental status has been implicated in several systemic inflammatory diseases and is a potential focus for systemic infections. Therefore, most lung-transplant centers have recommendations regarding pre-transplant dental care and follow-up, but there are no official clinical guidelines. To date there is little information on oral health status in lung transplant (LTx) recipients. The aim of this study was to systematically assess oral health status in LTx recipients. OBJECTIVES: The aim of this study was to assess oral health status, including periodontal disease, oral health behavior, and awareness of the need for good oral health after LTx. METHODS: LTx recipients were recruited during follow-up outpatient visits at a university clinic transplant unit. Oral health status was quantified using the count of Decayed, Missing, and Filled Teeth (DMF-T) and the grade of periodontal disease was measured by probing depth. Patients' oral health behavior was assessed using a questionnaire. RESULTS: Seventy-three patients were included at 5.8 ± 3.4 years after lung transplantation. The mean DMF-T was 21.9 ± 5.5. Patients with cystic fibrosis as the indication for transplantation had a significantly lower DMF-T than patients with chronic obstructive pulmonary disease as the transplant indication. Of the 66 patients with teeth, 97% had moderate or severe periodontal disease. The prevalence of moderate or severe periodontal disease was significantly higher in LTx recipients (mean age 55.9 years) compared with older individuals (age 65-74 years) from the German general population (P < .005). CONCLUSIONS: This single center study shows deficits in oral health and oral health behavior in patients after LTx. There is a strong need for interdisciplinary collaboration and clinical guidelines to foster better oral health education of the transplant recipient and better oral health.

Philosophiae Doctor - PhD / Rehabilitation of edentulous jaws without the option of osseointegrating implants will remain the only treatment option within reach of many older patients for the foreseeable future. Many routine prosthodontic procedures are based on dogmas, because no high-level scientific evidence exists to either accept or reject them, among these is the “neutral zone” (NZ) concept. In spite of paucity of evidence using approved patient-based outcome instruments, it is generally agreed that the NZ should be respected when constructing complete dentures. The purpose of this research project was to determine how shapes of conventional and NZ mandibular dentures differ, and if the two different types of dentures impact differently on oral health–related quality of life by using an accepted oral health-related quality of life instrument as a patient-based outcome. Thirty nine edentulous patients were selected for his prospective, randomised, cross-over, single-blinded clinical trial. Two sets of complete dentures were made for each patient. One denture set was made following conventional biometric guidelines for determining the position of the mandibular posterior denture teeth in relation to the ridge; another set was made following a functional impression of the potential denture space. Each set of dentures was worn for at least two months. A similar number of types of dentures were delivered first. Widths of residual ridges and mandibular denture arches were measured using digital measuring software. Position of denture teeth was related to the ridge. Denture dimensions were compared by means of analysis of variance using the mixed procedure. Using formula of parabola, arch-widths were compared using paired t-tests. Pre- and post-treatment patient feedback was obtained by means of the 20-item Oral Health Impact Profile (OHIP-20) and a preference score. Treatment effect size (ES) was established based on the OHIP-20 scores. Relevant associations among denture dimensions, OHIP-20 scores, preference, age, gender, marital status, education, income, period of edentulousness, and quality of denture-bearing tissue were done using the generalised linear model and correlation analysis. For all statistical analysis, level of significance was determined at p<0.05. The mean age of the sample was 62.3 years. Twenty four patients were female. Mean period of edentulousness was 31 years and mean number of denture sets worn prior to the trial was 2.5. Except for the canine region, NZ dentures were statistically wider than anatomic dentures. The difference in mean widths between the two types of dentures was larger for female patients. Older patients had smaller differences in denture dimensions. More unfavourable denture-bearing tissue was associated with a larger difference in the two types of dentures. Both types of mandibular dentures significantly improved the OHRQoL of patients. Both types of dentures had a high treatment ES. The OHIP-20 instrument could not distinguish a statistical difference in impact on OHRQoL between the two treatment options. There was a minute difference in treatment ES between the two types of treatment. The only domain representing a small clinical benefit between NZ and anatomic dentures was “physical pain”, with the NZ dentures scoring better. There was no correlation between pre- and post-treatment scores for both types of dentures. No significant associations were found between post-treatment OHIP- 20 scores on the one hand and tissue scores, gender, age, education, marital status, period of edentulousness and denture dimension differences on the other hand. Based on OHIP-20 scores, there was a significant association between denture preference and NZ dentures, but not for the other preferences. No significant associations were found between denture preferences on the one hand and tissue scores, gender, age, period of edentulousness and denture dimension differences on the other hand. Even though no significant relationship was found between preference and gender, the majority of female patients preferred the NZ denture and the majority of male patients did not express a preference.Providing new complete dentures improved OHRQoL of edentulous patients. The majority of female patients preferred the NZ compared over the ANA denture. The NZ technique appeared to have a higher positive impact on OHRQoL of female patients compared to male patients.

Magister Scientiae Dentium - MSc(Dent) / Candida glabrata (C. glabrata/ Cg) is a pathogenic organism that is increasingly developing frank innate and acquired resistance to the most commonly used antifungal agents, namely, azole group of antifungals. Furthermore, C. glabrata-associated oropharyngeal infections affecting immunocompromised patients, are more difficult to treat and the development of resistance worsen the prognosis. Molecular studies related the emergence of resistance in C. glabrata to the upregulation of ATP-binding cassette (ABC) transporter genes, which work by reducing drug concentration within the cell via drug efflux mechanism, and among these genes, CgCDR1 is considered to play a major role in resistance development. Thus, in order to overcome this problem, several combinations of antifungal agents are being studied. Aim: To evaluate the effect of a combination therapy of fluconazole and amphotericin B on the growth and CDR1 gene expression of C. glabrata. Research design and methodology: This in-vitro study evaluated the effect of a combination therapy of fluconazole and amphotericin B on the growth of C. glabrata and related it to the expression of CgCDR1 resistance gene. C. glabrata was revived in brain heart infusion (BHI) broth and later inoculated onto agar plates. Following overnight incubation, 5 colonies were transferred using a sterile loop into 2 ml of phosphate buffered saline (PBS) solution to establish McFarland (Mcf) standard. Later, the solution was diluted by transferring 200 μL to 400 ml of yeast peptone dextrose (YPD) agar (flask 1). From (flask 1), 90 ml, 99 ml and 89 ml of inoculum were allocated into 3 separate flasks, into which 10 ml fluconazole, 1 ml amphotericin B and 11 ml combination (10 ml fluconazole + 1 ml amphotericin B) were added, respectively. The inoculums were left to settle for 20 minutes, then incubated at 37oC with serial dilutions carried after 30 minutes, 2, 4, 6 and 24 hours. From the 96-microtiter plate, 10 μL for each treatment arm and time interval were transferred from selected wells and onto 30 Casein-peptone Soymeal-peptone (CASO) agar plates, and incubated for 24 hours. After incubation, the number of colonies were counted using an automated colony counter, to establish colony forming unit (CFU)/ml. CgCDR1 gene expression was analyzed using real time polymerase chain reaction. After 6 hours of incubation, a sample was taken from each treatment arm, transferred into CASO agar plates and incubated for 24 hours at 37oC. After establishing Mcf, gene extraction and gene expression were carried out according to manufacturer’s instructions. Results and discussion: No significant difference between the effect of the combination and amphotericin B was evident regarding C. glabrata growth. However, the combination therapy was more effective against C. glabrata than fluconazole, with a marked decrease in candidal growth at 30 minutes and 6 hours. Furthermore, the expression of CgCDR1 gene at 6 hours contact time was more pronounced in the samples of C. glabrata treated with the combination therapy, compared to that of the monotherapy. Conclusion: The combination therapy had better effect on the growth of C. glabrata than fluconazole monotherapy. On the other hand, the expression of CgCDR1 was detected in the samples of C. glabrata treated with the combination therapy, suggesting the ability of the yeast to adapt and develop resistance in such environment.

Background: The South African National Defence Force (SANDF) like other Defence Forces of the world, conducts medical classification on their members. This medical classification has, as one of the components, an Oral Health Fitness (OHF) classification which is done according to North Atlantic Treaty Organisation (NATO) standards. The aim of the Oral Health Fitness classification is to standardize dental readiness, assess oral health, prioritize dental care, minimize the number of dental emergencies (DE), and emphasize the importance of good oral health to all active duty and reserve forces. Medical classification is conducted by the South African Military Health Services (SAMHS). Aim: The aim of the study was to evaluate the dental emergency outcomes of the Oral Health Fitness classification of the SAMHS in Area Military Health Unit Gauteng (AMHU GT), South Africa Objectives: To determine dental emergency rate for the SAMHS, analyse the dental emergencies and to make recommendations regarding dental emergencies to the SAMHS Methods: A cross-sectional retrospective record analyses of members of the SANDF that received an OHF classification of 1 and 2 in AMHU GT in 2009. The AMHU GT members were followed up for a year to determine if they developed dental emergencies. Data analysis included frequency tables, chi-square tests and logistic regression analysis. The level of significance was set at p<0.05. Results: The dental emergency rate for AMHU Gauteng was 307/1000 per year. The type of dental emergencies were: 58.5% dental restorations, 13% extractions and related complications, 4.3% crown and bridge, 3.9% emergency root canals, 9.9% recementations, 3.6% denture related problems while other emergencies were 6.8%. Patients were more likely to experience a dental emergency if they were white, female, of OHF 2 classification and older than fifty years of age. Conversely they were least likely to experience a dental emergency if they were black, male, of OHF 1 classification and in the age group 31-40. Conclusion: The dental emergency rate of 307/1000 per year for the SANDF is high compared to military health units from other countries and it was influenced by race, age and gender. The types of dental emergencies were mainly preventable. / Dissertation (MChD)--University of Pretoria, 2012. / Community Dentistry / Unrestricted

Introduktion: Munhälsan har stor betydelse för den allmänna hälsan och påverkar livskvalitén. God munhälsa innebär att munnen är fri från sjukdomar såsom cancer. Tidigare studier visar på att cancerbehandlingar kan ge orala biverkningar som påverka munhälsan negativt, vilket leder till ett ökat lidande för patienterna och ger en ökad belastning på vården.  Syfte: Syftet är att beskriva patienters upplevelser av sin munhälsa under och efter en cancerbehandling oavsett diagnos och behandling.  Metod: Allmän litteraturstudie baserad på kvalitativa studier. Resultaten från studierna som uppfyllde syftet analyserades med hjälp av en artikel skriven av Popenoe, Langius-Eklöf, Stenwall och Jervaeus, som är en praktisk guide för att analysera allmänna litteraturstudier i tre steg. Sammanlagt analyserades 22 artiklar.  Resultat: Analysen resulterade i fyra kategorier och elva subkategorier. Kategorierna var: fysiska förändringar, psykosociala upplevelser, behov av information och stöd och copingstrategier. Studierna visar på att orala biverkningar från olika cancerbehandlingar har en stor påverkan på patienternas upplevda munhälsa.  Slutsats: Studiens resultat indikerar på att patienterna påverkas av de orala biverkningarna i olika omfattningar. Bristande information, bemötande och stöd från sjukvården gällande deras orala biverkningar bidrog till ett ökat lidande för patienterna. Studiens resultat anses vara av klinisk relevans för sjuksköterskor som arbetar med patienter med cancer, för att kunna förebygga vårdlidande och ge en individuellt anpassad vård. / Introduction: Oral health is important for general health and affects the quality of life. Good oral health means that the mouth is free from diseases such as cancer. Previous studies show that cancer treatments can cause oral side effects that affect oral health negatively, which leads to increased suffering for patients and an increased burden on care. Aim: The aim is to describe patients` experiences of their oral health during and after cancer treatment regardless of diagnosis and treatment. Method: General literature study based on qualitative studies. The results of the studies that fulfilled the purpose were analyzed using an article by Popenoe, Langius-Eklöf, Stenwall, and Jervaeus, which is a practical guide for analyzing general literature reviews in three steps. In total 22 articles were analyzed.  Result: The analysis resulted in four categories and eleven subcategories. The categories were: physical changes, psychosocial experiences, need for information, and support and coping strategies. Studies show that oral side effects from various cancer treatments have a major impact on patients' perceived oral health. Conclusions: The result of the study indicates that the patients are affected by the oral side effects to varying degrees. Lack of information, response, and support from health care regarding their oral side effects contributed to increased suffering for the patients. The result is considered to be of clinical relevance for nurses who work with cancer patients, to be able to prevent suffering from care and provide individually tailored care.

Magister Chirurgiae Dentium (MChD) / Objectives: Previous studies have indicated that most of the older adult population has poor oral health but only a few of them demand care for their problems. The reason for this discrepancy has never been explained adequately. The obj ectives of the study were, first, to assess the perceived oral health needs (with regards to social, functional and psychological impacts of oral diseases) of older adults aged 55 years and above, second, to assess the oral health status (periodontal disease, dental caries and oral mucosal lesions ) in an adult population aged 55 years and above.Third, compare the relationship between normative and perceived need. Methods: This was a quantitative cross-sectional, descriptive study and consisted of 100 older adults who were randomly selected from three areas in Guguletu. These areas included the home for the aged Ekumphumleni, NYl and NY2 clinics. Participants aged 55 years and above were interviewed using a structured questionnaire consisting of 32 questions and a clinical examination done. Frequency tables were computed and analysed. The relationship between variables like oral health status, perceived need and a variety of socio-demographic variables and measures of psycho-social impact of oral diseases were analysed by using the chi square test and odds ratio. Results: The ability to perceive that they had a problem and the recency of the last visit to the dentist was associated with perceived need for dental care. There was a significant relationship between the presence of symptoms which were painful and perceived need for dental care (mouth, p value=0.015; gums, pvalue=O.OOl; teeth, p value=0.0006) The positive attitude towards dental care and regular dental hygiene was an indicator of positive attitudes towards oral health care. In this study a substantial difference between perceived and normative need was also observed. 88% of the respondents perceived a need for dental care and 99% were assessed as needing treatment (normative need) but only 29% demanded the care. 63% were dissatisfied with their functional ability to chew and expressed a need for dentures. Conclusion: The aim of this study was to assess the oral health status and perceived oral health needs among older adults in Guguletu. The oral health status was poor in most of the participants and the demand for care was low even though perceived need was high. The study has shown that social, functional and psychological factors influence the demand for care in this adult population. The cost for dental care and access to these services are major barriers to the demand of care.Perceived oral health needs and the impact of oral diseases are important influences in the assessment of oral health needs in the elderly. The assessment of oral health needs as perceived by the elderly facilitates the planning and implementation of dental services with special consideration on the cost and accessibility of oral health care.